Health care or disease care?

October 4th, 2012

With the presidential election in the very near future, the topic of health care has been put through the ringer on both political sides, each claiming it is the other’s fault that our system has become so faulty. Not to step on any politically charged toes, but let’s attempt to look at the issue in a less biased way. A documentary titled “Escape Fire: The Fight to Rescue American Health Care,” attempts to reveal the true underpinnings of the United States health care industry and the radical steps that need to be taken to make a real change. The movie explains the steps that need to be taken, or else we will continue to put Band-Aids on wounds that will never heal.

Here’s a number: $2.7 trillion. No, it is not the national debt. It is the annual amount of money that the United States spends on health care. This not only affects each of us by deepening the ever-growing hole in people’s wallets; it also affects something much more valuable – lives. With so much money being shoveled into the health care system, the United States is not even in the top 20 countries with the longest life expectancy (we are actually number 50). Clearly, somewhere down the line, there is a large disconnect. But let’s be honest – this is already known.

How many times have you been channel surfing and found commercial after commercial touting the newest miracle drug that will help with any medical condition, from depression to diabetes? Society is based off of efficiency, which results in the United States spending $300 million on pharmaceuticals per year (as much as the rest of the world combined). Drugs are the quickest answer to any health problem, but it is only a temporary fix. The real solution is addressing the root cause of the problem – lifestyle choices that dictate health. This is difficult to do, however, when doctors have little time to spend with each patient. Their hands are tied; if they want to pay their bills, they must meet the mandated number of patients a day. The blame should not be placed on health care professionals who are doing their job correctly; rather the blame should be placed on how the jobs are defined. If the way our society looks at health care is turned on its head, the focus on prevention could be easier to achieve.

Do you remember those Allstate commercials that used to offer you a discount for being a safe driver? The documentary proposes a similar idea as a means to force people to take their health into their own hands. A person can receive a discount in their health insurance plan if they do not smoke, have a low enough BMI (body mass index), etc. This empowers patients to take their health into their own hands, and also reminds them that they have a responsibility to themselves. Secondly, doctors should get paid for outcomes of their patients. The shift from quantity to quality adds humanity back into health care, which makes the industry patient-driven rather than profit-driven, just as it should be.

There is no silver bullet to fix all of the problems with the current health care system, but if we take a step back to look at the topic in a different light, we might just find the reason that we are struggling to find the right answer is because we are not asking the right questions. This documentary attempts to redefine the root problems in our health care system and offers suggestions not heard in the current political debate.

The Carroll News: Why do you think medicine directly correlates to shareholders on Wall Street?

Matthew Heineman: When pharmaceutical companies became publicly traded – it wasn’t until that happened that large insurance and pharmaceutical companies grew exponentially and had to start answering to Wall Street.

CN: After Enron, businesses became much stricter on records and facts. How is it possible that the FDA fast-tracked a similar illusion with Avandia in such recent history on a much more serious level?

MH: It’s really complicated; we are a profit-driven system and a for-profit system. And it says in our film that when medicine became a big business, we lost our moral compass, and we landed in trouble because of that; and that statement couldn’t be more true. When you are forced to make quarterly earnings and to meet the bottom line, sometimes you are forced to do things that aren’t best for the patient. I would like to think that when health care and money become intertwined that there are major moral lines being crossed every day. People don’t go into medicine hoping to hurt their patients, it just comes with the territory.

CN: Where do you see our disease care system in 20 years if people try to outrun this wildfire?

MH: I think we all recognize that our system is broken; we are paying $2.7 trillion a year, and twice as much [other people] in the world. But what is unclear is how we get out of this mess. What we tried to do with “Escape Fire” is not only show that the system is broken and that we are at a tipping point, but not only for the vitality of our economy. But we need to shift away from the costly high-tech acute orientation of medicine and get into prevention and low-tech interventions in order to be a more sustainable system for the future. There is overtreatment in society, and we really need to curve that as consumers and policy makers (one third of the price doesn’t go to health care).