What can cure our ailing health care system?


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The future of health care in America depends on the economic eyesight of our business leaders. At present, our near-sighted strategy of trading health for profits is costing Americans trillions of dollars annually. It is decreasing productivity and lowering profits for non-health-related businesses. That doesn’t factor in the cost of a human life or the value of feeling well.

At nearly 20 percent of the gross national product and rising, our health care system isn’t just driving the economy, it’s devouring it. Even if the business moguls controlling America’s economy place little value on a human life, the system they’re running is unsustainable and will self-destruct, taking the rest of us with it.

How many of our economic leaders are willing to take the far-sighted approach to health care by investing in a system that actually manages health and promotes health care?

Such a shift would require the unthinkable: moving from a health system based on profits to a system based on actual science that incentivizes results like longer life spans, fewer sick days and a culture that promotes exercise and a healthy diet.

To make that happen, we need to change the goal of our health care system on a national scale. When the major goal of the health care system is profiteering, then the various players – doctors, hospitals, pharmacies and the pharmaceutical and health insurance industries – benefit from the public pouring more money into the system. Therefore, health care becomes ever more expensive.

If the goal of our health care system was better health, the players in the system would refocus accordingly. The conversation of health care would change from a debate over Obamacare to a discussion about how to deliver health care more efficiently and cost-effectively.

If that sounds fanciful, then take a look at other health care models throughout the industrialized world. Those nations have a far more effective and comprehensive health care system at a fraction of the cost we’re paying, and they don’t have the supply of physicians and equipment we already have in place.

Each country has its own unique health care delivery system, but they all share a few basic characteristics.

Other countries have succeeded by uniting the various components of their health system – aka single payer system. Their taxpayers – backed by their government – set the rate of health care cost as low as possible. They determine the “size of the pie,” if you will. In turn, the various elements of the health delivery system adjust their rates to meet the cost margins set by the taxpayer/government.

If any section gets too greedy, then there isn’t enough money available for the other sections to work. The government can step in, but their systems are almost self-policing, as each player in the system makes sure he gets his fair share.

Such a system is the polar opposite of outsourcing, a common practice here in the U.S. Since no one entity is responsible for the overall cost of the system, costs quickly get out of hand and the system becomes more expensive.

Realigning the goal of our health care system is neither a communist nor socialist policy. Nearly all of the businesses profiting from a disease-oriented health care system can also profit from a health-oriented system.

The food industry can shift from a carbohydrate-centered system to one based on proteins and healthy fats. The pharmaceutical industry can still benefit from disease treatment, but with more emphasis on cancer care and communicable diseases such as AIDS, Ebola and influenza. Hospitals would still treat the critically ill, but they would adjust to become more like health centers rather than disease centers.

All businesses would see a decrease in overhead as the cost of health care drops. Fewer sick days would mean more productivity and lower the cost of hiring temps or training new workers.

A healthy population creates a more robust economy. There would be fewer bankruptcies (currently, health care costs account for well over 50 percent of bankruptcies in the U.S.) and more dollars available for buying the goods and services those businesses offer. But the most important point is that an economy based on attaining and maintaining a physically healthy America is both stable and sustainable.

Whether America’s business oligarchs can adjust their vision and transform America’s system of health care into a system based on delivering and maintaining health remains to be seen. Time is of the essence for, unlike the financial institutions of 2007 and 2008, America’s health care system won’t grow too big to fail; it will grow too big to succeed.

Dr. James Fieseher is a family-practice physician in Dover. The first part of this article appeared in the Dec. 26-Jan. 8 NHBR.

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