I ran into an old friend at the grocery store a couple days ago. We greeted each other warmly, after not seeing each other for several years. Matt is a medical doctor, specifically a radiologist, who was one of few medical professionals in our small rural California town to accept my efforts practicing Chinese medicine fifteen years ago. At that time, we bonded over our deep concern for the well-being of patients and our scornful opinions concerning the practice of medicine.
Yet, Matt and I were going in different directions. He was pretty cynical about many of his local colleagues, and how they used (and mis-used!) the very expensive technology at the core of his specialty. I learned a lot from him about both the strengths and limitations of medical imaging as part of my specialized training in “acupuncture orthopedics,” and I was searching for an entirely different conceptual framework for practicing health care. We drifted apart as the stresses of our respective lives consumed our attention, even though our souls knew we were “brothers” in our quest to improve American health care.
The focus of Matt’s rapier wit has shifted from local to global. He now believes there are severe systemic flaws in American health care, and declares that only a complete transformation of financial incentives can repair the system. Matt shared his perception that:
The current fee-for-service health care system renders patients into fodder to generate fees (and hence INCOME) for providers
Matt strongly expressed his conviction that our health care system can only be repaired by adopting a national program like the one in Great Britain. His twenty-five years practicing medicine has convinced him that the health care system must be designed with patient welfare at its center! I heartily agree with that perception.
While I may identify different specifics and remedies, Matt and I agree on many aspects of our societal challenges with health. I concur that our health care system suffers because of some very warped incentives, and believe lasting effective remedies must address them. Twenty years ago the “money people” devised “managed care,” which was supposed to squeeze the inefficiencies out of our health care system. Yet, that industry now soaks up more than 17% of GNP, and our health outcomes are poor relative to other industrialized nations, especially when measuring health span. Maybe we can start with several principles:
- We must find ways to put patients back at the center of health care, especially identifying specific life changes they can cultivate to promote healing
- We must line up incentives throughout the entire economy to support health
- Modern (western) medicine doesn’t have a monopoly on wisdom about health — a free marketplace of ideas will optimize our solutions
We can find solutions for our health care crisis!
I told Matt about my blogging concerning health care policy; he shared his small website to spread his philosophy. I suppose he got disheartened or busy with other things, because he hasn’t continued writing new pieces for that site. Matt seemed inspired by the idea of blogging, and I hope he gets invigorated to share his experience and insights about our profound societal health care challenges. While our voices and messages are rather different, I believe that a mélange of caring and concerned health care practitioners will identify the important principles for resolving our health care challenges.
Sometimes, the darnedest things happen at the supermarket!