Archive for August, 2013

Transforming Health Care

Saturday, August 3rd, 2013

By Don McCormick

The underlying causes of bad health care and its high cost will not be fixed in the United States by adjustments to the current system. It will also not be fixed in other countries in which quality of care is higher and the cost of care is lower. Converting the system in the United States to a universal single payer plan, as has been done in many other countries, appears to control costs relative to the our system, but it does not assure the quality of care that is possible at the current level of knowledge in medicine and surgery. In saying that, I assume the depth of knowledge in Science and Medicine is less than it will be and far less than is needed to overcome most diseases and injuries. When we look back at famous physicians in the United States, such as Benjamin Rush, we know that his understanding of the way the body worked and the medicines it needed were without merit and mostly harmful. Hubris and fame in that ”Age of Enlightenment” made what Rush thought he had done the opposite of what he had intended. What we are doing today, driven by those same vices, will, in hindsight, be no less disappointing. This is compounded by economic systems that are nonsensical and socially structured science that is exclusionary. Too many negative factors dominate and exert their forces on the practice and use of medicine to allow adjustments and course corrections to work in fixing the problems. We must begin with humility, with positive acts, and with clear thoughts to bring our power to bear on activities that heal and cure our sicknesses and injuries. That power is always there in knowledge and truth to be taught from the bottom up by those having a higher level of awareness sharing and helping to raise the awareness of every person with whom they live and work.

Thus, we begin with cooperation between patients and physicians in places where they can interact easily and peacefully. While the present condition of the medical care system is in a crisis based on deaths and injuries caused by medical and hospital care, we cannot proceed as if we were in a disaster syndrome. Patients and physicians cannot continue to interact as though the theater were not on fire and they were only spectators doing their own things in their own ways. There is in the “universal conscience” a plan of peaceful engagement in which cooperation in selected communities can begin.

The people in each community are to be enlisted into a cooperative, the physicians that serve them are to be recruited, and the facilities in which care will be delivered are to be made safe and accessible. The economic structure that will support the cooperative is that of mutual support in a private club that has more abundant services and resources and is in a place where care is comprehensive. Patient education will underpin the cooperative to the extent that the knowledge and expertise of the physicians and nurses spreads to the medical assistants and community health workers and patients. The understanding of the people will grow enough so that preventive care and chronic care can be done by the patients and their families.
Insurance, whether it is called Platinum, Gold, Silver, or Bronze does not necessarily result in access to good health care. It just makes the people who deliver health care, regardless of quality or need, able to earn a living wage and much more. It may also help the patient avoid loss of savings and income, but it will not heal anyone and it will not teach anyone and it will not stem mortality and morbidity rates that are caused by attempted medical care.

Suppose that you and the people around you just walked away from the current system. How many people would be needed to assure that the group had access to people with sufficient knowledge and skill to be healthier than in their present conditions? Assuming it were a competition and the knowledge and skills were the same as represented in all of the classes of medical training. Further, suppose that you had to pay these people so that their social status was not lessened by your group. The number of patients needed as members would be large. You would have to support about fifty physicians, a hundred nurses, and two hundred other kinds of medical workers. Support at that level would require about ten thousand families who were at peace, who were willing to help each other, and who could see value in education and cooperation and who were not trapped in a system of patronage and dependency. This can’t be organized in a war zone and it can’t be done by force.

Oddly, we may not need all of the many different kind of skills represented in the medical care industry. The better educated the patients become the fewer advisors they need. So, as the system progresses the demand for physicians lessens and their capacity to treat patients increases. This is unlikely to transform society and even be noticed by the establishment, but it will transform health care for its participants and it will be less expensive and it will extend and save lives.