We were told from the start that health care reform would be tough. On one side stands the public, with its tangled needs for medical care. What would be best for them? President Obama's town meetings have outlined the basics: lower costs, universal coverage, and a public plan to compete with private insurers. Among advanced countries, only the U.S. lacks those things. On the other side stand vested interests -- doctors, insurance companies, hospitals, and pharmaceutical giants -- who have their own needs. It goes without question that money is the first, overriding almost everything else. Doctors speak out for high quality of care, but what they really mean is maintaining the current backbreaking level of surgeries and new drugs.
I'm not arguing that physicians don't want reform. The AMA has endorsed it. But I don't hear doctors promoting what the public actually needs. A story this week announced a study from Columbia University in which older patients reduced the risk of Alzheimer's by more than half if they exercised and ate a diet rich in fruits and vegetables instead of red meat. If you didn't peruse the health section of the New York Times, you probably didn't read the story. You were far more likely to read about "death panels," government committees that President Obama wants to empower to decide who lives and dies by rationing out expensive procedures and last-minute attempts at resuscitation.
The hitch is that the story is a lie, a fabrication out of whole cloth, and its circulation is by the intractable right (Sarah Palin, Sen. Charles Grassley of Iowa, etc.), who seem addicted to the basest of political ploys. The "birthers" movement that denies Obama's American citizenship would be a ridiculous example, but it's not so ridiculous when we hear that health-care reform is a "government takeover" or that bureaucrats will soon be telling you which doctor you can see and what procedures you can have. We aren't hearing the great vested interests deny those rumors, either. So the enormous difficulty of health care reform is compounded with dishonesty. Obama has become Daniel in the liars' den.
The truth is that hardly anyone who already has health insurance is given unlimited access to any doctor and any procedure. HMOs make exclusions every day. The danger of a "government takeover" echoes the Republican campaign against Medicare in the Sixties -- none of them voted for it, either. But those who keep lies alive know what they want, which is to induce fear in the public mind. With enough discord in the public sector, people will forget their true needs, and then the parts of health care that vested interests hate, such as the public option and drastic cost-cutting, can be yanked out of the bill. (Notice how Nancy Pelosi, who staunchly stood up for the public option, is being vilified as a socialist.)
As adults, we are each responsible for sorting out the truth, but millions of informed citizens may not be enough to fight the system as it stands. The back-and-forth of politics will produce half measures and compromises to suit powerful lobbyists. That's why I keep thinking about the road less traveled: taking responsibility for your own wellness. That's the ultimate way to cut costs for individuals and families. Doctors will still waste hundreds of billions of dollars in unnecessary tests, perform surgeries known not to increase life expectancy (such as heart bypass and angioplasty), and grossly over-prescribe drugs with harmful side effects. Such is the American way of medicine. But there is an immense counter-trend toward alternative health. If you sincerely investigate what diet, exercise, meditation, stress reduction, and natural treatments are all about, you will beat the liars at their own game, even if Congress barely stands a chance to win a draw.
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