Why I Am A Conservative On Health Care Reform

I appeared on Larry King Live Wednesday night to discuss health care reform with a panel of respected, high-profile physicians. I sounded the themes I wrote about in The Wrong Diagnosis: that Americans must change the content of health care, not just access to it, or we'll remain among the unhealthiest people in the developed world, and the costs will sink us.

Bill Frist, a physician and former Senate Republican majority leader from Tennessee, responded with what has become the conservative line: that "we do have the best health care" and what Americans principally need is "insurance reform" rather than improved health care practices. Later in the program were video clips of what host Wolf Blitzer termed "conservatives" disrupting town hall meetings on health care reform. Clearly, the prospect of change in health care is highly emotional and disturbs many people.

But here's my question: Since when is it conservative to embrace new, overpriced, corrupt systems, like the health-destroying and ruinously expensive protocols of much of modern medicine? "Conservative" has several meanings, but two central ones are "favoring traditional views and values," and "avoiding excess."

I hold that nothing could be more wild, unconstrained, and downright liberal than the path medicine has taken in just the last 20 years -- an unprecedented bacchanalia of excess and contempt for traditional American values.

Pharmaceuticals, once just one of many therapeutic modalities, are now synonymous with medical care; more than half of all insured Americans are taking prescription medicines for chronic health problems. Medical journals, formerly bastions of objectivity, are today often ghostwritten shills for moneyed interests. And physicians, once free to make healing their only goal, must now obey the dictates of lawyers and stockholders by ordering endless tests and dangerous, dubious surgeries for even minor conditions.

While billions of dollars are shunted into very few pockets via such abuses, insurance premiums skyrocket, leaving 47 million Americans with no coverage. The result of medicine's libertine spree? The relief agency Remote Area Medical, established to bring health care to rural parts of third-world nations, now sends 60 percent of its missions to U.S. cities such as Los Angeles, California and Knoxville, Tennessee.

By contrast, integrative medicine (IM), the system we teach at the Arizona Center for Integrative Medicine at the University of Arizona in Tucson (and that is taught at more than 40 other medical schools nationwide including Harvard, Yale, Johns Hopkins and the Mayo Clinic) is profoundly conservative in at least three ways:

1. It is philosophically conservative in that it aims to restore core values of medicine that were strong in the past, such as a reverence for the healing power of nature and the importance of the therapist-patient relationship.

2. It is medically conservative in stressing prevention and advocating lesser rather than greater intervention -- the least invasive, least harmful, least expensive treatments that the circumstances of illness demand. IM practitioners always observe the Hippocratic precept of "First, do no harm," relying in simpler interventions whenever possible and turning to more drastic ones only when the former fail to produce desired outcomes.

3. It is fiscally conservative in its willingness to look beyond the blinders of high-tech medicine to identify inexpensive therapies that may be useful and in its insistence that they be held to the same standard for clinical- and cost-effectiveness in well-designed outcomes trials.

I urge Senator Frist and all Americans to join me and thousands of physicians and patients in demanding a return to sensible, sustainable, conservative values in medicine. The liberals have had their day.

Andrew Weil, MD, is the founder and director of the Arizona Center for Integrative Medicine and the editorial director of www.DrWeil.com. Follow Dr. Weil on Twitter. Become a fan on Facebook.

Comments

[Mark4Boston]

Partly from need (I drove a cab for years and could not afford health insurance), partly from interest in things Asian, I discovered acupresure. It has helped me deal with minor health concerns for decades.

However, it will not help me if I have the BRCA gene, or if I have trauma from accident, or live a really bad lifestyle. For those things you need GOOD medical care, or you die. Should we allow fat people or junkies to have medical care? Yes, and more importantly we need them to have mental health care.

We should have a national single payer plan, whether socialized medicine (MD's are gov't employees) or health insurance for all, where cost is paid by employers, or funded on a pro rata basis.

The rich pay less tax now than 25 years ago. Don't believe me? Ask Bill Gates or Warren Buffet. It's time the rich stopped having their bills paid by the poor, and kicked in their share. It's long overdue.

[Artemis34]

Frist, Scott and others should be in jail

http://piratenews.org/billfrist.html

Of course they love the sick system as it is. They've been able to suck billions of bucks out of it right into their pockets!

[Artemis34]

When we have health care for people NOT for profit, then we can talk about getting the most EFFECTIVE care not the most PROFITABLE care.

[mediacrazed]

The word liberal continues to be mischaracterized, and the rhetorical flourishes in this article needlessly weaken its power by dissing many potentially stalwart allies in this debate.

People who consider themselves liberals— whether social or political— are frequently every bit as committed to non-pharmaceutical, non-surgical health modalities, if not more so, than many who consider themselves true conservatives.

Many liberal-minded people who cannot afford the luxury of expensive insurance policies or drug remedies work very hard— every single day— at maintaining or repairing their own health, using exactly the types of alternative modalities mentioned in this article.

Just for fun, here are some classic dictionary definitions of liberal: open to new behavior or opinions, favorable or respectful of individual rights and freedoms. Some dictionary synonyms for liberal: tolerant, unprejudiced, unbigoted, broad-minded, open-minded, enlightened.

These are not bad characteristics to bring to an important public debate like this.

[PlanetThoughts]

A number of my friends and I live in harmony with Dr Weil's philosophy. That is, we rarely need to see a doctor. Speaking of myself, I practice Tai Chi Chuan, I eat all natural and mostly (but not all) organic foods. I keep good relationships with those around me but also speak up for my principles. These are elements for good health.

At 56, I feel healthy, my weight is at a good level, and my heart rate is under 60. And you know, I still visit my MD when I have a pain come up, to be sure all is OK. But we need a system that rewards preventive health care and that rewards discussion time. Currently procedures (lab tests etc) are rewarded well but doctor/patient discussion is not. For-profit insurance companies, based on my actual experience, are often fraudulent. I strongly hope we can take the step of establishing a public option.

The government is full of qualified people for healthcare. Will profit-centered insurance companies take better care of the public than the government? My answer is that government is better than private industry for the public well-being. This does not necessarily mean to eliminate private opportunities, but they must be kept in check. When balance is restored, we can make needed adjustments to get the best possible healthcare system for the USA. But the first step is to break the stranglehold of the insurance industry on healthcare.

[WAY2MCCOOL]

Dr. Weil, it looks like we are obviously on the fringe of knowing what it means to be truly, wholly well, and healthy. Such a small percentage of us and such a large majority of truly lost and gullible peons, for lack of a better word. It's so difficult to get a wellness message across, when all they want is to eat cheetos, and red meat from factory farms, smoke, drink, and then want "heath care" to go to a doctor to "fix" them with drugs and surgery? It's so asinine and ridiculous in logic. I wish I could understand the thinking there, but now I see why they're so easily manipulated by the government, commercials and ads, Big Pharma, and insurance companies and of course the multi-national "food" industry. Frustrating, but when you have 92% of oncologists saying they'd refuse chemo and radiation if they had cancer, but of course they sell them to their patients because that's how they make a living, you know you have a very sick system. Bill Maher said it best on Real Time about health care reform,.. "Quit eating JUNK Americans!" I concur.

[americanalien]

The great thing about America is this: whenever she is faced with the choice of accepting the status quo or embracing major change, she almost always relents to the side of progress.

At various points throughout her history, the country has experienced periods of social upheavals, just like we are seeing today. Whether it was the fight to abolish slavery in the 1800s; the push for greater womens rights at the turn of the 20th century; the civil rights movement of the 1960s; or even the most recent choice whether to break the shackles of tradition and elect her first African-American President -- more often than not, America has always chosen progressive change over an entrenched status-quo.

That is why I've always held that the detractors of Health Care Reform are fighting a loosing battle. It is true that people are nervous. It is true that some are confused. However, one should never underestimate the ability of this country to embrace change.

[Cheryl Layos]

.....if only it didn't take her forever and a day, after being dragged kicking and screaming to the inevitable end....usually with a lot of unnecessary loss of life in the process.

[Yves Papa]

New agey doctors such as Mr. Weil or Ornish exist, i think, in the US only.

If we were to have universal public health care, Mr Weil would get out of business. A efficient, user friendly, free (tax based) health care system would remove every incentives to anyone to use his `specialized` services.

Dr Weil has every reason for not wanting a strong public system to work.

[WAY2MCCOOL]

I don't understand a lot of the posters on here, and their obsession with going to an allopathic doctor to get drugs and cut up on the operating table. It sounds like Christmas to a lot of these people. Dr. Weil presents a very clear understanding of the situation, and is correct, we need reform but not just by giving everyone a card so they can go see a doctor. What is it that a doctor is going to do for you?
Going to give you health and wellness information? Um, no. Going to tell you how you can live a nutritionally sound lifestyle, and give you options.. Um no. They just will write you a Rx so they get a kickback from the Pharma companies for being a good drug pusher. That's about it. It's SO frustrating trying to get this message across to you who are just obsessed about getting a Doctor card. It's like you can't see the light with your blinders on. Health Care reform is so much more then having higher taxes so you can all go see a doctor.. There's so much more. Even Today, Obama said it's just a sliver of the pie.

[Dustee]

I don't understand that when a blogger admits to being a 'conservative' all of a sudden the tR0//ers say he is 'clear' and 'correct' in his assessment. Everything else you just said can be applied to Democrats as well as republicans. You guys are not goody two shoes, you know.

Also about the 'sliver of the pie' that you quoted from Obama was not said today or Tuesday. You've got to keep up with what going on and stop watching Fox. Fox make you sound like a ph00L.

[BoshSpong]

Some of the bloggers seem to have only read the title to his column. There are in fact many doctors who share Mr. Weil´s ideas of wellness and sickness prevention in many parts of the world where medicine is socialized.

His point is that the current medical system in the U.S. in not at all conservative but radical, the current system does not protect families, our society, nor foments stability wich are all - so called - conservative values.

It would behoove anyone who wishes to make a comment on a piece to read the whole thing beyond the headline, this is just plain ol´ common sense.

[RobinWhiteAZ]

Mr. Papa's comments underscore the danger in the now debated healthcare reform package: loss of choice and freedom. If he were our new Health Czar, we would all be taxed (hardly "FREE") to provide his brand of health care to all. We ALL have every reason to avoid this outcome.

Dr. Weil's viewpoint, while decidedly apolitical, does make it clear how skewed the current system has become toward certain favored interests who profit heavily at everyone's expense by government policies that limit competition. The answer is not less freedom of choice but much more. Here are some modest proposals in that direction:

1)Eliminate all licensing requirements for medical schools, hospitals, pharmacies, and medical doctors and other health-care personnel.

2)Eliminate all government restrictions on the production and sale of pharmaceutical products and medical devices.

3)Deregulate the health-insurance industry.

4)Eliminate all subsidies to the sick or unhealthy. Subsidies create more of whatever is being subsidized. Subsidies for the ill and diseased promote carelessness, indigence, and dependency.

Imagine a free marketplace of limitless, user friendly health choices, paid for by the patient (or private charity), with options affordable to all.

[y4real]

Great diagnosis, well camouflaged. That is precisely why we need reform.

If you support reform, check out this site for arguments in favor of meaningful reform (with a way to pay for it!) Matter of fact, spread the word if you can.

http://docs.google.com/View?id=d946wsj_63gngn8zcj

[DonCosenza]

As long as care providers (doctors, hospitals, etc.) are paid fee-for-service, there is no financial incentive for them to use holistic, or as Dr. Weil calls it, integrative medicine.

Also, there is little financial incentive for private insurance companies to cover preventative care, because the payoff is so far down the road that the individuals are likely to be with a different company by the time the prevention really reaps rewards.

[Eric8]

Conservation is not the same thing as conservative. His article is intellectual obtuse. You can't equate less with a political ideology and re-constitute meaning that grossly miscalculates the true problem. Conservatives are everything thats wrong with America. Scary to think there are doctors out there that openly speak of rationing care.

[Eric8]

Semantics. Its inaccurate and irresponsible to drudge up the idea that the "true" conservative lies in a forgotten past of traditional values and lesser intervention (whether medically or governmentally). Hello? The conservatives are Big Business and the Insurance Industries regular clients (some liberals are also very corporate but not everyone). This is a reoccurring fantasy of Alternative Health Practioners- that utopia lies somewhere in the past, in some forgotten way of life, that if we would return to would solve all the problems. Isn't this what Adolph suggested as the solution for Germany, to return to its Austrian roots of country living and simpleness? I agree with prevention as a means to a better quality of life, but too say that liberal means going on a spending spree or bankrupting the country, hello? Bush, a conservative, piled on the national debt. To me, Conservative means, un-limited spending on defense and security; free handouts to Corporations; relaxed environmental laws that promote the increase of toxins we inhabit and consume; and it means financially irresponsible. To be conservative is to be a war monger, a budget buster. To be liberal is to spend less, make better informed decisions. Last time I checked all the liberals were the ones running marathons and going vegetarian; its the conservatives who are racking up the health care costs with their unhealthy lifestyles.

[SpaceManJoe]

This is a healthcare crisis. There are many poor people in this country who need to get basic yearly checkups. In terms of preventive medicine, Weil's argument is irresponsible. We can start arguing about which treatments are best once people have some basic care.

[annshirley]

Give me a break. Corruption thy name is Frist .

[Booblius]

Well, I guess everybody's got a dog in the race now; so why not the touchy, feely, holistic, magic hug crowd?

[pmipIP]

Dr. J and Dr. Doolittle have upcoming posts.