We have missed the boat by only one letter in attempting to solve our health care crisis: It's not WHO that should fix it (the HMO's, PPO's, the State, and the Feds) but WHY it fundamentally needs fixing. What is actually broken is the upside-down way we have been looking at this problem. We are trying to fix a costly "reactive" health care system rather than create a cost-saving "proactive" program.
We need to immediately initiate a massive preventative health care program in order to truly stop the bleeding of now over a trillion dollars in health care costs. We must utilize our best technology, peer into our individual futures with the newly mapped human genome, and for the first time easily identify those at risk for known chronic, debilitating, and expensive diseases. We'll then be able to maneuver around them with personalized preventative care plans, based on targeted education, medications, and life-style adjustments. And most importantly, incentivize everyone for good behaviors (what if your insurance company actually paid you for losing weight, joining a gym, or cutting your calories in half?).
Every one of us, starting at birth, would have access to state of the art diagnostics like endoscopies, heart scans, genetic testing, and exposing biomarkers found in our blood and known to be associated with specific diseases. We can already identify who is at risk for diabetes, Alzheimer's, heart disease, addiction, cancers, and mental illness. Take addiction as an example of what should be done. Less than ½ of 1% of all doctors treat addiction, yet it's the most menacing of health problems, especially in adolescents. In a recent survey of senior medical students, 65 % admitted they felt incapable of treating alcoholism. So the first thing we should do is increase the training of physicians and other health care professionals about this disease. We must educate those at high risk (genetics and environmental cues have been clearly identified to select out those that are vulnerable), address their individual neurochemistry that could potentially drive their addictive behavior, fix that, and monitor their progress until they enter adulthood. The judgment part of the brain (the prefrontal cortex) is not fully developed until we are in our early twenties, making adolescence a vulnerable period in anyone's life for making mistakes and creating behaviors that have long-lasting health implications. Identifying adolescents at risk and intervening early is good insurance for a healthier adult, in any chronic disease.
All of this comes at a time when those my age will sit heavily on the health care burden we will all share over the next ten years. Let us pray that someone in the government will vow to "stand on their head" to solve this problem, and finally be able to see the solution from the right direction.