They Are Still Practicing Bad Medicine -- on Medicine (and Therefore on Us).

Imagine that your doctor says the following. What should you do?

You tell me you have trouble breathing, chest pain and swollen ankles. I will do expensive tests but I already know what is causing this. The root cause is a "broken" heart muscle - you need a new heart. That is too radical a treatment for me to do. I will treat you to take away the chest pain and pills to make you pee. You will feel and look better tomorrow. This will be temporary. Please pay the cashier on the way out.

Hopefully you would stop seeing such a doctor and find someone who would practice good medicine on you: evidence-based, and by doing what you need rather than what is best for the doctor.

Now suppose that your name is M. Healthcare. Your doctor says you are critically ill and will not survive without treatment (reform). Your doctor goes on to say the following. What should you do?

You tell me about uninsured millions, unsupportable costs, shortages of providers, and avoidable deaths. I will do no tests to determine why you have these symptoms. The system itself is broken but I am not going to do anything about that. I know you need system replacement but I cannot do that. I will treat your symptoms and say I am fixing (reforming) you. You will feel better temporarily but you will not BE better. Over time your symptoms will get worse. I will print more money to pay for what I am doing. Don't worry about the bill. Your children will pay it.

Do I overstate? Is this not fairly close to what is happening right now with ObamaCare?

Some who are opposed to ObamaCare - like me - are opposed not because of party affiliation or partisanship and not because I oppose reform. I want real reform - that actually makes things better - instead of the appearance of doing something.

Given a fundamentally flawed, unsupportable health care system, we need a new one rather than changing where some dollars flow and adding new dollars that we don't have in the first place.

My friend and colleague Dr. Bill Wiese had the audacity to speak the truth. "We already have enough money in the system. It is just distributed wrong." Throwing more money into health care or moving the dollars around will solve nothing.

To have a system that works for us, one that we can actually afford, we need to create a new system instead of tinkering with the old one. Everyone is afraid of such radical change. Sometimes the medicine you need tastes awful.

Follow Deane Waldman on Twitter: www.twitter.com/systemmd

Comments

[Conk]

Let's start with getting Big Pharma fake science out of the equation! Maybe revamp the FDA and get rid of the collusion with drug companies and giant agri-business. And duh, maybe teach people how to take care of themselves and not get sick in the first place.

[johnashman]

Dear Dr Waldman,

Here is your radical reform right here, with all the incentives in exactly the right places -

http://64.203.97.61/SolutionsLab/Solution.aspx?Guid=2d50363e-00be-44e8-9251-9a6589ba820d

I'd appreciate your comments or questions.

[AOGutierrez]

Imagine you're going down a hill on a skateboard really fast and realize that the skateboard is rickety and you could definitely use new one. You have a couple of options: 1)Try to switch boards in mid plummet, 2) step off the old one and hope you survive the tumble then get a new one or 3) slowly turn the old one back uphill till you can execute one of the other options.

Which is a kind of cutesy way of pointing out that calls for radical change, beside being opposed by well funded and entrenched interests, seem to disregard the current state of affairs and somehow require forcing an almost magical change on an entire system whole cloth. Incremental change is necessary but the ultimate goal must be kept in clear view.