Obama's Health Plan: What Matters the Most is Missing

Want to know the real truth about healthcare in this country?

Even if President Obama and Congress get everything else right in healthcare reform, it won't matter...that is, unless we address the underlying causes of illness that drive both skyrocketing healthcare costs and the proliferation of chronic disease.

But we can't get there with our current model of medicine, and that's what nobody is currently talking about, not even President Obama.

However, there is a solution...

Thankfully, an innovative approach currently exists that can not only prevent but also more effectively treat chronic disease...more about that in a moment.

To effectively reform healthcare in the U.S., we must change not only the way we practice medicine, but also the type of medicine we practice.

We must improve financing and delivery of healthcare, as well as our fundamental scientific approach to chronic disease -- an epidemic that now affects 133 million Americans and accounts for 78 percent of healthcare costs.

Healthcare costs are now approaching 20 percent of the U.S. gross domestic product -- approximately $2.5 trillion, or $8,160 per person annually. This is more than what the federal government spends on national defense, homeland security, education, and welfare combined!

Unless real change is made we are facing an impending collapse of our economy as more of our resources are put toward caring for the chronically ill.

This is a national security issue that threatens our standing in the world. As President Obama has stated, "Healthcare reform is no longer just a moral imperative, it is a fiscal imperative."

Fortunately, there is a new model of medicine that offers the real change we need. This new medicine is personalized, preventive, predictive, participatory, and patient-centered.

It is proactive rather than reactive. And it addresses the causes of disease and optimizes biologic function in the body's core physiologic systems, rather than just treating symptoms.

This model exists today -- it is based on systems biology and is called functional medicine.

Why We Need to Change Healthcare Now

Our current model of medicine is unsustainable because it cannot stem the rising tide of chronic disease.

Relying only on reforms in coverage or access, financing, electronic records, malpractice, medical errors, coordination of care, and research on new drug therapies -- while retaining the conventional acute-care model -- will be untenable in the long run.

To be sure, such reforms are necessary, but not sufficient to avoid the collapse of our healthcare system, which may soon dwarf our current financial crisis if the Medicare trust fund runs out in 2016 as projected. According to the "Status of the Social Security and Medicare Programs" annual trustees report just published, the program is actually bankrupt right now - it has taken in less money than it has paid out two years running.

This is not being alarmist; this is simply facing reality.

Here's the problem: These reforms do not alter the fundamental approach to prevention and treatment.

If we focus on improving the way we practice the medicine of the past, we will still have the medicine of the past. If we improve the wrong type of care, then we will simply be doing the wrong things better.

Conventional acute-care medicine is disease-, drug-, and procedure-based and is designed for acute illness, trauma, and end-stage disease for which it is the best form of treatment in the world.

As a result, our current medical education focuses on sickness rather than health; journals publish about disease management not what causes disease.

However, disease-based, acute-care medicine is the wrong model to address chronic illness, because it doesn't address why people are sick or the underlying mechanisms and biologic causes of their illness.

This is why we spend more money than any other industrialized nation on healthcare yet are near the bottom of the list for all major health outcomes. This is why we are witnessing a decline in life expectancy for the first time in history.

The Right Solution for the Problem of Chronic Disease

Functional medicine, on the other hand, is a system of personalized care that directly addresses how our environment and lifestyle influence our genes to create imbalances in our core biologic systems that, over time, manifest as disease. It is this kind of medicine that is needed to create real success in 21st century medicine.

Functional medicine is not a new treatment, test, or procedure--it is a new "operating system" or method for problem solving and processing complex clinical information.

It is a fundamentally different way of thinking about the origins and mechanisms of illness. It encompasses all the tools of healing and medicine, both conventional and integrative. And it provides a common language, a map or GPS system for navigating through the puzzle of chronic illness.

Simply put, functional medicine identifies why our underlying biology is imbalanced and corrects those imbalances. Then our body's natural healing intelligence takes over and automatically fixes what's ailing us.

This is the future of medicine and it's available right now.

A growing coalition of practitioners, educators, and scientists is dedicated to advancing this model. I am part of that coalition.

We at the Institute for Functional Medicine have introduced 20,000 physicians and healthcare providers to functional medicine since 1991, and we wrote the Textbook of Functional Medicine in 2005 to describe both the underlying science and the practical clinical strategies and tools that comprise this new model.

This is not just an elegant theory - it works in practice ... something that I am very familiar with since I have been practicing functional medicine for over 10 years.

Let me illustrate how this works with real patients I have treated in my practice.

A Woman with Multiple Chronic Diseases

Deborah, a 46-year-old woman, having seen a dozen doctors over a dozen years, came to me with 29 different diagnoses, including depression, hypertension, obesity, polycystic ovarian syndrome, migraines, heavy menstrual bleeding, asthma, sinusitis, irritable bowel syndrome, reflux, fibromyalgia, osteoarthritis, and psoriasis.

Each disease was treated with the best available conventional treatment. But she was still sick, despite 9 medications.

Of course, she didn't have 29 separate diseases. She had imbalances in a few of her core underlying biologic systems --digestive, immunologic, and hormonal--that gave rise to all her symptoms.

The underlying cause of all her "diseases" was an autoimmune response to gluten, leading to autoimmune thyroid disease and severe vitamin D deficiency because of low absorption of nutrients from the foods she consumed.

Six weeks after eliminating gluten from her diet (wheat, barley, rye, etc.), improving her diet, and replacing thyroid hormone and vitamin D, her 29 diseases were completely gone--along with 21 pounds...not a bad side effect!

A Boy with Attention Deficit Disorder and Asthma and Allergies

Clayton was a 12-year-old boy who had been diagnosed with severe attention deficit hyperactivity disorder (ADHD) and behavior problems and had poor school performance who was on Ritalin for years. He also had illegible handwriting, or dysgraphia.

He also had apparently "unrelated" problems of asthma, allergies, hives, stomachaches, headaches, insomnia, muscle cramps, and anxiety and a history frequent infections and antibiotic use.

He had seen 5 specialists (lung, gastroenterologist, allergist, psychiatrist, and neurologist) and was on 7 medications for allergies, asthma, pain, and ADHD. No one asked how everything was connected, or how his diet of junk food and sugar made him sick.

His immune system was activated, his digestion not working, and he was nutritionally deficient in zinc, omega-3 fats, magnesium, and vitamin B6.

We simply normalized his biologic function by removing impediments to health (junk food diet, food sensitivities, overgrowth of yeast, and lead) and providing the ingredients necessary for optimal biologic function--a whole-foods diet, additional nutrients including vitamin B6, magnesium, zinc, omega-3 fats, and probiotics.

In two months he returned without any physical or psychiatric symptoms and was off all his medication. His mother brought a sample of his handwriting, which had gone from illegible to normal, simply by getting his brain working again by getting his body in balance.

A Once in a Lifetime Opportunity for Real Reform...

This model of care is the basis for the type of medicine that must be at the center of healthcare reform. I live in the trenches as a practicing doctor, treating real people who are suffering from real problems.

These problems have real solutions, which are being overlooked -- solutions that hold the key to saving our healthcare system from self-destruction.

Functional or systems medicine needs to be the "Intel inside" that drives the type of medicine that is practiced as we create a new healthcare system.

Real healthcare reform is now possible in a perfect storm where the alignment of economic, scientific, and moral imperatives provides an opportunity for us as a nation to do well by doing good through fundamentally changing the type of medicine we practice.

It will require the collective imagination, intention, focus, and action by healthcare providers, consumers, industry, and policy makers. But we can do it, and we must do it now.

In the words of the ancient sage, Rabbi Hillel, "If I am not for myself, then who will be for me? And if I am only for myself, then what am I? And if not now, when?"

Now I'd like to hear from you...

What steps do you think will be necessary for successful healthcare reform?

How do you think healthcare reform will be achieved?

What do you think is the biggest obstacle we will face in reforming healthcare?

Please let me know your thoughts by posting a comment below.

To your good health,
Mark Hyman, MD

Mark Hyman, M.D. practicing physician and founder of The UltraWellness Center is the author of The UltraMind Solution. Dr. Hyman is now sharing the 7 ways to tap into your body's natural ability to heal itself. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on Youtube and become a fan on Facebook.

*Follow HuffPostLiving on Twitter and become a fan of Huffington Post Living on Facebook*

Follow Mark Hyman, MD on Twitter: www.twitter.com/markhymanmd

Comments

[leia3652]

This is the stuff that should be common sense! It amazes me when I see people giving their kids all kinds of drugs for all their health problems then take them to McDonalds 4 times a week. Schools need to do a better job of educating kids about the importance of their diets. Parents and adults really all need to take a step back and look at what we're putting into our bodies. We're eating things that aren't even food! It's just processed junk and preservatives. It doesn't help that there are a million commercials advertising drugs for everything under the sun. People can disagree with me and call me insensitive, but I think obese people should be just as shunned as smokers. And should have to pay higher health care costs. I'm sorry, but there is NO excuse for someone to be 400lbs or 500lbs. You should have checked out that "thyroid problem" 150lbs ago. I have absolutely no sympathy for obese people that want to whine about their plight and drive around the store on a scooter. Get off your fat ass and walk, and get some carrots. If I do drugs and ruin my health well, that's my problem and shame on me. But if I eat myself into a coma well, poor me don't say anything harsh that may hurt my feelings.
Who hasn't heard this: I just don't know why he's so overweight, his father's not overweight.(hands kid a burger and coke)

[annis]

HOW can we get this article read by everyone.

I'm going to talk about it, email it, copy it and distribute it.

[kissMYfish]

The individual have to be the one to change their lifestyle. Personally, we can not change behavior. The foods that we eat will kill us, first. The pesticides are at their worst. By the way, there are cures for some of the diseases. But, who makes money off of cures. People are going to remain ill for the love of Science so that they may continue with their Research. Drugs companies, make a killing off of people remaining the same but stable from their drugs. Doctors would prefer to give you presciptions for 15 drugs than take the time to find out what is wrong.

In a Nutshell, quite attacking the HealthCare Reform. I've been working in this field for more years than you probably been on earth. We need Health Care for everyone. We need Health Care that people can afford. We do not need all these profiteering Insurance Companies and their so called Preventive Care.

[jmpurser]

We desperately need Universal Single Payer Health Insurance run by the Government. Until we get that the rest will be relatively meaningless.

[shylove2]

Whose life is it when IT is a biosphere...we may not agree with eastern treatments but wholistic is the only istic in town. The yin-yang symbol of a unitive system if a whole and it's parts.
It could well be that all life on Earth, this tiny jewel in space, basking in the rays of our only begotten Sun, is related, interconnected, shares genetic characteristics!
And as such poisoning one tends toward poisoning everyone in a rather suicidal way!
Employing chemical warfare against life, even weeds we dislike, is an example of the futility of war to solve problems when there is so much collateral damage to the rest of life in general.
Cancer also is life...what are we to do destroy ourselves to save ourselves?? That is kind of like Mutual Assured Destruction theory or is it just the the toxic nuclear family values approach?

The above was a comment to an alternet article on the connection between parkinsons and pesticides but in this case the issue is using the paradigm of war in the medical system. Way too much trust is put in the logic of war and the idea that there can be a side that wins and a side that loses.

[juliaschopick]

In my recently posted comment, I included a link to my article, “Four Lifesaving Medical Treatments: Not So ‘Anecdotal,’ After All!" I just tried the link, and it doesn’t seem to work. I hope this one works better.

http://www.honestmedicine.com/2008/05/four-lifesaving.html .

I am sorry for any inconvenience.

Thanks very much!
Julia Schopick
HonestMedicine.com

[juliaschopick]

Dr. Hyman:

I believe that changing the medicine we do with relation to chronic diseases can come in many forms. Functional medicine is one. I like this approach; in fact, my own doctor practices this way.

But there are several lifesaving treatments I"ve been researching and writing about that may not fall within the functional medicine paradigm. I fear they won't be included in the new healthcare model, either.

Some of these treatments are pharma-based; others, nutrition-based. ALL are effective, non-toxic, and less expensive than the "standard" treatments. But none are widely prescribed by doctors -- probably because they don't have costly randomized double-blind clinical trials to back them up. Why not? Because only Pharma can afford to pay that freight.

I’ve written about some of these treatments­--includin­g intravenous alpha lipoic acid for terminal liver disease; low dose naltrexone for MS, and other autoimmune diseases; and the Ketogenic Diet for pediatric epilepsy--at www.honestmedicine.com/2008/05/four-lifesaving.html. I’m now writing a book about these so-called "anecdotal" treatments.

I doubt that these more innovative, less expensive treatments will be included in the Obama healthcare mix. A similar worry was expressed by you and Sen. Harkin during Senate Hearings in late February. You both expressed concern that Comparative Effectiveness Research (CER), which will help doctors choose which treatments to prescribe, will only include treatments that are, to quote you, "within the allopathic model." Alas.

Julia Schopick
HonestMedicine.com

[PlaceboStudman]

I have a question. Just what DID humanity do before the FDA? It seems to me, and I admit this is only speculation, but the biggest problems with our health have come SINCE the creation of the FDA. Granted, there are many many chronic illness, such as some congenital birth defects, that do not have a food or drug related cause. But, the majority of issues come directly or indirectly from interactions between the body's natural regulatory systems, and the products we ingest. It is more than just over eating...although that is a cause as well. Our entire environment is flooded with synthetic chemicals which we have NO idea what are their long term effects.

I just find it curious, and frankly sickening some times when I realize that the same government agency that is regulating our food is regulating our drugs too. Doesn't this kind of set up a situation where they can make them dependant on each other? Lord only knows what kind of chemicals and synthetic byproducts are allowed into our foods.

Essentially we need to dismantle the FDA COMPLETELY, and sever their conjoined twin relationship with BigPharma. We need to go back to a time as was in practice before the FDA where people were eating things straight from the ground and right to the plate.

This is, of course, just the first step. There are many other aspects of care related to more severe issue, but no one wants to talk about those

[lovbug]

you are right on!

[Key]

Welcome, Dr. Hyman! Your post is spot on.

[orangepetal]

The question is how to integrate it, or is it already integrated into regular health services?

[TheBurdicks]

Dr. Hyman claims, “Conventional acute-care medicine is … the best form of treatment in the world.”
Not true. Conventional U.S. acute-care medicine is the most profitable form of treatment, but among the worst in quality. Obsession with profit prioritizes interventions by price rather than by science. More expensive interventions generate more profits for hospitals, big pharma, medical suppliers, doctors, and insurance companies, which can charge higher premiums with greater profits. Quality is not a concern. The proof is in abysmal health statistics from our conventional acute care medicine.

His hidden commercial message promoting “Functional Medicine”, another ploy for profit by some in the medical community, is objectionable. Hidden under a cloak of preventive medicine is expensive treatment of chronic disease through laboratory testing and dietary supplements, promoted by anecdotes, and not supported by rigorous scientific evaluation.
Preventive medicine is really just health promotion; simple education focused on a triad of easy, healthy choices.

Moderation in a varied and reasonably balanced diet emphasizing fresh fruits, vegetables and grains, with caloric restriction to maintain healthy weight. No tobacco and (maybe?) a little red wine. Special diets and supplements are generally unnecessary.

Regular physical activity and exercise, aerobic and anaerobic, with stretching and strengthening.

Stress reduction, through meditation, religion, socialization, family, pets, reading, and/or others, along with diet and exercise.

Specialized testing, expensive supplements, and fees for “Functional Medicine” add costs and produce neither health quality nor savings approaching simple attention to diet, exercise and stress reduction.

[JSDKoeln]

But that does not fit everybody. Not everybody jumping on a healthy diet and exercise routine is going to respond... there is something to be said about running some tests and seeing what is out of balance. Everything costs up front, but it's the length of time until one is healthy and healed is what I am concerned with. I think that was his point.

One size most definitely does not fit all.

[JuliaRain]

Thank you for posting. And I agree. And that message was glaringly obvious to me too.

[LemonMeringue]

Here's a fact about our health care system that is seldom mentioned:

Pharmaceutical companies prefer to develop medicine to treat chronic conditions than to develop cures. It's more profitable.

How twisted is that.

[lovbug]

i agree. Our health care system should not be profit driven. For profit has thrown a money wrench into the health care system that's getting worst. Preventive care has been lost a long time ago. It's all about drugs, now. The money is too good so the pharmaceutical companies, so they prefer to continue to development 100 types of medication for high blood pressure instead of finding a cure or natural remedies. So sad.

[LemonMeringue]

Corporations have ruined our food.

Monsanto has forced almost all farmers to use their genetically engineered, Roundup Ready corn and soy. Roundup residue causes Hodgkins Lymphoma which is skyrocketing. Farmers cannot save their own seed, they have to buy it from Monsanto, and if they try to grow different corn, they get sued by Monsanto because some Monsanto corn mysteriously appears in their field. The settlement, necessary because Monsanto would put the farmer out of business, always includes a gag on the farmer.

Watch The Future of Food, a video you can see on the internet. It's all in there.

If you grow your own food - even a tomato plant in a pot - you are taking some control of your health and life back from corporations.

[jeanneyogini]

Thank you for educating us on the dangers of genetically engineered foods. I agree that eating safe food is the first step in reducing health care costs. We support Monsanto every time we buy food that is not organic and has GMO ingredients. Some people complain that organic food is too expensive. What they don't realize is that they are paying for the cost to clean up of our environment due to the damaging effects of modern agricultural practices. They are paying higher insurance premiums due to the rising cost of disease care. Let's vote with our dollars. Don't buy non-organic and GMO food. Read the ingredients on the label.

[mommamia526]

Some medications cause problems and doctors appear to be unaware of those problems, or they wave them off. When I first went on diuretics for hypertension after a stroke I noticed immediate weight gain. I am not the only patient. I met others who had the same problem. For a few years I have been taking Toprol XL. Suddenly I experienced substantial weightgain over a short period of time. My doctor kept insisting that I was overeating. I was not, but I decreased my food intake. Weight kept going up. Then I googled Toprol and lo and behold, there it was, the medication may cause weightgain. What had changed for me that an ace inhibitor which I also take was exchanged for another medication. The combination is not a good one for remaining svelte and slim! It also increases my potential for developing diabetes type II and it is not helpful for keeping the blood pressure down either; it has gone up some.

[mommamia526]

Dr. Hyman, I think you are on the right track! Good for you. I am one of those patients with multiple chronic diseases, and I am not getting better. Funny enough, I had the same diseases, just not so many of them, when I lived elsewhere, in Europe. MY doctor there, the late Dr. Levy Van Vinninghe, concocted a small pill for me which I took daily. It consisted mainly of vitamins B6 and B12, a very small throid dosage, Folic Acid!!, and one or two more. I had no problems, whatsoever. It also cured my recurring and baffling anemias. In the U.S. I am on a battery of pills, for heart failure, hypertension, osteoarthritis, you name it. I felt better, was doing better, had insurance, and full employment overseas. The problem is that it appears to be impossible to get a doctor to listen to you. I would recommend a few things. First, if patients come here from another country as legal immigrants they should bring their health records with them and doctors should actually read them. Second, some groups, such as Ashkenazi jews, have higher percentages of certain chronic illnesses. Genetic testing should be part of diagnoses for those persons. We should have treaties on healthcare with a number of nations, just as we have now on Social Security. Everyone reads English, sothat streamlining forms, questionnaires, etc. will be easy to do, with first station computerized sorting.