Stanley Feld M.D.,FACP,MACE
Many feel the healthcare system is so complex and dysfunctional that it is going to be impossible to repair. I have faith in the American system and the American people. I believe people are going to stand up soon and say enough is enough. We are going to force the government to help us help ourselves.
I also believe American public is getting close to the point of demanding our elected officials make the correct rules to let us help ourselves.
Freedom of speech and freedom of the press has helped us solve many problems we have encountered in the history of America. The freedom to be creative and innovative drives us forward despite the complexity of any issue.
In healthcare we have all the technology and infrastructure necessary to do it right. I believe the internet and social networking will create the infrastructure for creating a competitive environment among the various secondary stakeholders.
Stakeholder vested interests naturally try to protect their products and services often to the determent of the general good. I am not criticizing the pursuit of a stakeholders’ vested interest. .
However, I am criticizing our elected officials’ resistance to make rules that will align everyone’s vested interest.
If a product or service is out of touch with the needs of the people it must not be permitted to survive. Obsolete companies have remade themselves with new products in order to survive. Companies not adjusting to the changing consumer demand simply must be permitted to disappear.
The healthcare system has many challenges. Eighteen percent of our gross national product (GNP) is spent in healthcare. Each year this percentage increases. Despite the increase in healthcare expenditures, access to physicians’ services is decreasing. Physician reimbursement is also decreasing.
Where is all of the money going if not to the physicians? Why do patients feel they are not receiving timely and appropriate care? Why is there an ever increasing shortage of primary care physicians while medical schools are producing more physicians yearly?
I have covered the answers to these questions previously. However, the politicians and the stakeholders in the healthcare system have not made any progress toward an answer to these questions or a solution to the problems. The problems of increasing cost, decreased access, affordable care, and avoidance of the complications of chronic disease have not been addressed in any logical way by any of our presidential candidates or candidates running for other offices.
Why? The solution to the Repair of the Healthcare System for each stakeholder varies with the differences in each stakeholder’s vested interest.
The primary stakeholders (patients and physicians) should be in control of the healthcare system. Patients should be responsible for their own care and their own healthcare dollar. Consumers should be subsided if they qualify for subsidy. The criteria for qualifying for subsidy must be clear and realistic.
Consumers with “adequate” healthcare insurance are not motivated to change behavior. Obesity, alcohol intake, and lack of exercise are increasing daily. Obesity is a major risk factor in precipitating chronic disease. The complications of chronic diseases are responsible for the expenditures of 90% of the healthcare dollars spent. This culture must be changed to make progress.
America food industries in pursuit of their vested interest do little to help fight the obesity epidemic. (See War on Obesity Part 1-7) The Fast food industry has not done anything to decrease the incidence of obesity. They have offered not so low calorie “salads” as a loss leader in order to look good in the eyes of the consumer. Cheap fast food containing an abundance of salt and fat contribute to the obesity epidemic and the high incidence of hypertension and diabetes mellitus.
Restaurants at all level serve large high calorie portions in order to raise prices while giving customers their money worth. When a company (TGI Fridays) tries to reduce the size of the portion while decreasing the price their volume of sales decreases.
The media has no interest in a public service campaign to discourage obesity. In having a successful public serviced campaign the media would lose a large share of their advertising revenue. The “open 24 hours” campaigns and the 99 cent meals are large revenue generators for the media. Two for the price of one fast food offers by all companies is endless.
The Supermarket industry is not interested in my War on Obesity because the “taste” of fatty food loaded with salt and sugar “taste” better than the non fat non salt non sugar food. Next time in the Supermarket notice the shelf space for cookies, soda pop, prepared foods and other fattening items.
The prepared foods in Supermarkets are not as healthy as advertised. They are convenient by loaded with fat and calories.
As a society, we have fallen for the organic food hype. The food costs a little more but it is healthy for you. Who said? Much organic food is loaded with calories and salt and promotes obesity.
National physicians’ organizations ( AMA,AAFP,ACP ect) have not helped its physician members’ help their patients stay healthy. Organized medicine has a terrific opportunity to step up and promote good health, fitness, and healthy habits community to community in a serious way. I’ll bet organized medicine could get physician volunteers from every community with a well organized and integrated public relations program. It would have to be sustained and awareness would have to be created at the political level, the social level, the educational level, and the corporate level to create the cultural change needed in society.
The environmental organizations are doing it and are becoming successful. Much of Corporate America wants to be known as a “Green Company” today in order to win the favor of the consumer.
Why hasn’t organized medicine stepped up to the plate? I know it could cite initiatives but how many have been transformational? Physicians want to keep their patients healthy. Organized medicine should help physicians with public service campaigns incorporating the grass roots physicians in order to change the culture of America’s health habits and health.
It would be a wonderful service for patients and physicians. It would also go a long way to reducing the costs of the healthcare system by reducing the incidence of chronic diseases and its complications.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.