What if the solution to healthcare was simple? I believe it is; but it is not easy. Think about the average 10-year-old child you might see on the soccer field or swim team, vibrant, silly, happy, flexible, and strong, with bursts of focused concentration and thoughtful insight helping them to make good choices. This is what health looks like. The body, mind, and spirit are all optimally functioning and balanced; this is sometimes called "homeostasis". The body is always striving to achieve this is homeostasis or equilibrium, and has a tremendous ability for self-repair; the mind and soul have an infinite ability for resilience.
As a society we are fortunate to be rich in examples of health for both children and adults. I tell you this to help you see "health" and that when the body falls out of these descriptors and cannot self-correct, we refer to it as dis -ease. The body, mind, and spirit are no longer flowing with ease, but rather are on a path to disease, injury, or illness. It is often only during these times, that Americans routinely seek healthcare. This in and of itself make healthcare an acute care/reaction-based system, where the stakes are higher because we now have a problem requiring a solution.
There is an old medical joke where the patient says, "Hey doc, it hurts when I touch here"; and the doc says, "Then don't touch there". Similarly, the solution to the healthcare dilemma is simple-stay healthy. If we use the health care system to maintain health and prevent disease, we would keep more people healthy for longer periods of time. This is why all people should be able to receive prevention/wellness-based health services.
But not all people start off healthy and even with the best prevention methods, there will be disease, injury, or illness. This is where the plot thickens, and the "not easy" piece comes into focus. When the body has a bad infection and it spreads everywhere we call this type of illness "systemic"; because the infection is everywhere it can wreak havoc on our individual organs, as well as make us feel generally unable to move, due to severe fatigue and weakness.
It is systemic illness that drives us as medical providers, to treat many things at one time. We may prescribe several antibiotics at once and call in several specialists to prescribe organ specific therapies for solving the problems caused by the infection. It can be confusing from the outside; patients and families are under stress, and it can all look very mysterious. But in truth, medical care is prescribed in very methodical and orderly ways.
Similarly the healthcare system suffers from a systemic disorder. The fact is healthcare, is not only an infrastructure that provides us all with the services we need to gain and maintain health, it is a self-sustaining industry dependent on us becoming and remaining ill.
The only way to truly fix this disorder is to come at it from many different angles just like medical professional would for an infected body. This would also require a massive cultural shift in focus; from a disease mindset, to health mindset. And honestly, we know from years of behavioral research this is unlikely to happen without some type of catastrophic impetus.
So, in my opinion, we must focus on solutions that meet us where we are currently. Federally, the decisions being made by politicians with little background in healthcare will cause people to only use health services when they must. This is equally true of our state representatives. Even on the face of it, will be more expensive care, because problems are bigger and it is more expensive to use a hospital emergency department then it is to go to a clinic for regular checkups. Because of this, more people will die unnecessarily, and more people will be on a trajectory of premature death due to a lack of preventative care.
Thus, prevention-based care is one part of the solution and it is a big one. But how do we pay for this?
The writers of the Affordable Care Act (ACA) thought that the program would be financially viable and ultimately sustainable because they assumed that there would be widespread, across the board, program participation in 'healthcare exchanges'. But this never happened, and perhaps one of the major reasons it never happened was because it was so difficult to understand what the healthcare exchange was, and what it wasn't. Unfortunately, the Obama administration did not effectively roll out the idea, and therefore it was set up from the beginning to have problems.
Stay tuned tomorrow for answers to your health exchange questions and for my take on solutions for our healthcare system.
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