Health Care Reform: Paying for Prevention, not Procedures

With health care reform in the news every day, it's so hard to sort all the hype and lobbying spin from the real issues. It's a giant blame game, tinged with a threat of socialism, that has the media and the public all distracted and confused. If we peel all that confusion away, what is really at the root of the health care problem in the United States? (And it is a problem -- the most expensive and least effective in the world.)

The problem is that we (the public, the government, and insurance companies) pay doctors -- thus rewarding them and incentivising them financially -- for doing procedures, not for preventing disease in the first place. Hospitals and insurance companies make their money from CT scans and MRIs, not yoga classes or massage sessions. Doctors make their money from ordering tests, not from teaching people how to exercise and eat right. Prevention is an afterthought that's considered a little bit hokey, rather than the thing that keeps you out of the hospital or doctor's office to begin with.

It's an old story, one that goes back to the 1950s, when my grandfather launched Prevention magazine. But at least now there are thousands of studies that show preventing diseases works best, and tons of financial evidence to support the fact that preventing disease is financially more effective than treating it. And the people who make fun of prevention are in the minority now, not in the majority, as they were in my grandfather's day.

It's a bold move to try and figure out how to turn an intricate and entitled financial-reward system upside down, and make money from keeping people healthy rather than fixing them once they are sick. But somehow, we have to figure that out.

We will always need doctors and hospitals. People will always get sick and injured, and women will always have children (we hope). I am personally grateful that doctors and hospitals got me through three difficult childbirths and once saved my daughter's life. But I also see how my mother has had a better quality of life and is living longer than expected by not going through aggressive treatments for cancer.

Rethinking the reward system takes a whole different mindset. But it's a mindset we need to find, and learn to live in, if we want to live longer, healthier, happier, and more affordable lives.

For more from Maria Rodale, go to http://www.mariasfarmcountrykitchen.com.

Comments

[sunnybunny]

I think people have different ideas about what constitutes good care and what prevention means. To me, prevention means staying healthy eating right exercising and addressing any problems I might have with lifestyle changes or simple changes like diet or exercise routines before they become something major that requires medical intervention.It does not mean undergoing painful, invasive, possibly damaging tests and procedures to rule out problems, or taking a drug to prevent something that I have no symptoms of. Good care would be addressing health issues with the most conservative minimal treatment that can be the most effective and only using more drastic procedures as a last resort. Others concern is they want to be extremely thorough and the want their doctor to "fix them". It depends on the individual and I believe that our needs are really different depending on our perception.

[Alison Rose Levy - Huffpost Blogger]

Well, Maria, your grandfather founded Prevention magazine and my grandfather read it and practiced it, so in my family we were given that approach. Growing up with that as a foundation is one reason why I became a health journalist, health coach, and writer.

Your comments remind me of things I've heard from f Dr. Andrew Weil, whose upcoming book-- a real tour de force on what we need to make the change you are talking about -- I look forward to blogging on when it appears this coming September.

I'm currently developing a book concept to help Americans face this issue, shift their mindset, act proactively for their personal health and take action in our society to make the necessary changes.

Get the free Health Outlook ezine at www.health-journalist.com

[RMankovitz]

Wow! A great post.

One comment I have is regarding uncomplicated births and the need for doctors and hospitals. I have trouble viewing birthing as an illness, unless there are complications, in which case, as you pointed out, they can be lifesaving to mother and child. Otherwise, I am a great fan of midwives and doulas.

Roy Mankovitz, Director
http://www.MontecitoWellness.com