I’m going to classify this under both Saturn (making the hard choices) in Virgo (dealing with day to day life in a body such as health, diet and routines), as well as Pluto (transformation) in Capricorn (the way our governmental structures operate). The fact is, we need a complete overhaul with the way we look at health and healthcare, and not just the way we insure our health. Offering a public option for health insurance is not enough.
The fact is that the health care in the United States makes us sicker than people in other countries. Despite the recent slam of the British healthcare system by the conservative press, a 2006 study in the
Journal of the American Medical Association showed that more Americans suffer from chronic diseases than their counterparts in England. According to this study, Americans spend $5274 per year per person on health care as opposed to $2164 in the UK, yet there are twice as many Americans with diabetes as Brits, and Americans have a higher rate of heart attacks, strokes, lung disease and cancer.
Last year a book was released by journalist
Shannon Brownlee called
Overtreated–why too much medicine is making us sicker and poorer. Ms. Brownlee draws from the work of
John Wennberg, who with his team from Dartmouth over the past forty years has proven that wealthier parts of the country spent more on health care, but were not any healthier. Wennberg’s colleague Elliot Fisher demonstrated in 2000 that people in areas that spent more on health care were dying at a higher rate. They were not getting more surgery; they were getting more tests, more pharmaceuticals and more unnecessary procedures. Fisher determined that the 2-6% increase in deaths was directly attributed to more time spent in the hospital.
In 2008 the
World Health Organization found that France, Japan and Australia rated the best and the US the worst in preventable deaths due to treatable conditions. These preventable deaths include bacterial infections and complications of surgical procedures, both the result of hospital visits. This study has been used as an argument for greater access to health care in poorer populations. But the Wennberg and Fisher studies demonstrate that more health care is not the answer.
Dr. Barbara Starfield‘s work is also interesting. Starfield pointed out that Americans do not lead a lifestyle that is more unhealthy than their peers in other nations. Fewer people smoke and drink alcohol, and the US had the lowest mean cholesterol. However, she reports, 12,000 people die each year in the US from unnecessary surgery. 7000 deaths occur each year from medication errors. 20,000 deaths occur from other hospital errors. 80,000 deaths occur each year from infections. 106,000 deaths occur each year from adverse effects of prescribed medication.
Drs Welch, Schwartz and Woloshin in 2007 proposed that Americans are sicker because too many of us are being diagnosed. Hospitals have lots of expensive equipment that needs to be utilized and provides more and more subtle defects that left untreated would probably be just fine. Fears of malpractice lawsuits drives this overtreatment and overdiagnosis as well. Children with behavior problems are being diagnosed as having disorders that require pharmacological treatment. Seniors are using five, ten, even fifteen different prescription drugs that may be causing more problems than they are treating.
My father-in-law was sent to the hospital with rectal bleeding. He and his wife had just talked to a realtor about listing their home of 47 years. He was probably under a lot of stress. The doctors couldn’t find anything wrong, so they were going to remove the whole colon. He said no, thankfully, and once the house was listed and sold he was fine.
The insurance companies through their conservative spokesmen seem to have instilled a desperation in the heartland over socialized medicine. The single-payer proponents on the left are calling for a public option that will insure all Americans. Obama is attempting to address the high cost of health care, but his caution over unnecessary procedures is being twisted into fears over death panels.
Until the overtreatment issue is addressed, there is no possibility for real healthcare reform.
posted August 19, 2009 at 6:35 pm
Excellent post, as always. I heard something on NPR recently about physicians being encouraged to “do” things (procedures) rather than spend time talking with patients about their concerns. Any moron could tell you that could lead to hasty and unnecessary surgery. Bravo to your father in law for “just saying no”.
posted August 20, 2009 at 3:24 am
August 22nd/ A Time of Radical Change And Renewal?
http://community.webtv.net/Babajani2/Ramadan2009/
posted August 20, 2009 at 7:58 am
Thanks!
posted August 20, 2009 at 9:25 am
Thanks Lynn! Excellent insight.
posted August 20, 2009 at 10:38 am
Thanks everyone, I am just so disappointed at the distractions regarding this debate. And that goes both ways. The left is fixed on the public option, which does not solve this inherent problem. And the right is skewing everything just to be crazy, or at least that’s how it seems from here. To me it’s a Pluto in Capricorn thing – the foundation of the structure must be repaired, even if the whole structure has to be demolished. Just like the financial system.
posted August 20, 2009 at 2:38 pm
A couple of my relatives who are nurses and a hospital nurse have recently told me some shocking things about the foundation of our health care system.
1 — it’s very difficult to get into nursing school. there just are not enough teachers, and that’s because they are paid about one third of what a newly graduated nurse can make. The same is true of public health nursing, which handles such a huge number of people. Because of the low pay the “best and brightest” nurses just don’t want to go into those jobs.
2 — OB/GYN specialists are cutting out the OB part of their job because their insurance costs are so high; reportedly $100,000 annually for an OB, $17,000 for a gynecologist, since the gynecologist is not in as much danger of being sued for malpractice.
I don’t think we are rushing the efforts toward reform, but we might be neglecting some of the basics. and we probably should be getting more input from health workers. It’s really not a job for politicians.
posted August 20, 2009 at 4:38 pm
Lynn,
Great post… you are right on the mark, and hopefully more people are coming to see things this way.
I’ve been watching the healthcare debate (such as it is) and it’s not making much sense to me. Government already runs healthcare programs (Medicare and VA are examples of this) and while these systems certainly have their faults, they’re not all bad. My retired parents (cancer patient and lung disease patient) get all the care they need. Those who I know who’ve used VA services are “astonished” at the level of care they can get.
What’s more, we already have rationing of healthcare in this country whether people realize it or not… doctors and medical staff make decisions like this every day. Patients who can’t be saved are made comfortable, resources are diverted to those with the best chance of survival. You might not like it, but it’s a fact.
Worst of all for those struggling to make ends meet… we’re already paying, in one way or another, for those who don’t have insurance… probably costing more for their urgent care than it would to take care of these poor souls in the first place. Law-abiding, hard-working, tax-paying citizens will always pay, it’s the way of things.
And, let’s not forget, we’re all overpaying for medications. But then with the insurance companies and big pharma holding Washington in thrall it’s no wonder we can’t have a clear, informed debate. Each side is too busy shouting at the other… holding up ridiculous pictures and refusing to consider any other option but their own.
Thought your ‘readers might like to see a few posts on a similar theme, and with some FANTASTIC points to make. Check it out here:
http://overfortyandlovingit.com/http:/overfortyandlovingit.com/health-careagain/
http://overfortyandlovingit.com/http:/overfortyandlovingit.com/rant-hang-pants/
and more at the over forty and loving it blog.
Maybe if enough regular people get informed and get involved we can have a sensible discussion and a realistic solution that works for everyone BUT lobbyists and bureaucrats.
Thanks for sharing your take,
Sue
posted August 22, 2009 at 7:21 pm
Great blog with great information. And I agree with you.
posted November 23, 2009 at 5:36 am
We need health insurance reform so no one ever is denied coverage because of a “pre-existing condition.” We need health insurance reform so no one is dropped by their insurance company simply because they are too expensive.