The evidence that our healthcare system is the most expensive and the least effective among developed nations keeps piling up to an extent that is irrefutable! Fixing this dire problem could relieve the pressure on family and governmental budgets. It should be a leading national priority.
I attended an annual dinner of a medical organization, which operates clinics. I basically did not eat, for I fast after 6 PM. So only water for me, and a few leaves of lettuce in this case. But I watched with mounting disgust at the dishes that were served. And I asked my contact, how can you have an annual dinner for this organization like this and serve the kind of foods that GIVE people heart attacks? I mean what is wrong with us, is we are in an unwell system and a codependent system. We need to go back to Freud and understand secondary gain - the perverse gain from the victim position. https://www.academia.edu/88292557/Wilful_Ignorance_of_Secondary_Gain The assumption that people want to be well, is a faulty assumption that drives healthcare costs to infinity.
The only good news I see in medicine, is that we have better and better tools to support taking responsibility. One area is with a cardiometabolic test that provides near 90-100% accuracy of diagnosis and prognosis, with the emphasis on the latter. It can also provide valuable feedback for making lifestyle changes. I have literally seen cases that start out looking like when do we need to put in a stent, to a complete return to health, with the patient adding decades to their life expectancy. https://hippocratessays.com/restarting-wfpb-jumpstarts/
In short, the options are growing, but the fix is not primarily the healthcare system, it is the doctor-patient relationship, and the patient's willingness and interest to take care of their own health. We have lost that to the pharmaceutical industry, who have trained us carefully to always look for drugs first, which generally speaking suppresses symptoms, and allows chronic diseases to fester, and then when you retire, the bills come due, just when you have to learn to live on a fixed income. All unnecessary, but patients are unwilling to do dangerous things like healthy nutrition, healthy sleep, exercise, relaxation, meditation and prayer and so on. Lifestyle changes. We resist them exactly because we are often our own worst enemies, and until we are willing to step up to the plate and begin to want to work on healing that inner conflict and our self-destructive tendencies, nothing will ever change.
Thanks Roger. You bring up an important point and I hope other readers make their views known. I worked as an internist in direct patient care for decades. My honest assessment after all that contact is that very few people want to be fat or sick. I was fat (307) pounds and sick and I hated every minute of it. Now I have lost 70 pounds. Two thirds of my patients lost weight. Four lost over 100 pounds. I tried to help patients understand that eating, drinking, and smoking are aspects of our lifestyle that put everything else at risk. There are many people in this country who are interested in a longer healthier life. I write regularly to help them find a path. Americans are bombarded daily with messages that promote unhealthy lifestyle choices and expensive medical products to fix them. Many Americans are indeed victims of predatory forces that put profits above all else.
The food served at your event is a perfect example. Our health system is dominated by huge health systems that proper by maximizing "heads in beds", expensive procedures and tests, and specialty visits. Supporting people in being healthier longer costs them money and that is literally "the bottom line." There are many people, including me, who want to have a longer, healthier life, and they want to retain as much function as they can as long as they can. Those are the people I write for. I do hope others will participate in this discussion.
One more thing. Other developed countries are thinner and they live longer for half the impact on gross domestic product. Japan, New Zealand, and Singapore live longer for 1/4 the impact. I know that Japan fosters a health culture and Singapore puts a lot of emphasis on best practices. I don't think Americans want to be fat or sick anymore than we do. It seems to me that we admire wealth over all else. I think individual Americans can be as responsible as anyone else. We have a cultural problem and a leadership problem. Those things can change and I want to be part of pushing that. I will put up a post about fixing our system Friday.
Thanks, there are two manifestations of the inner conflict, and mostly only one of them is addressed. It's what Doug Lisle and Alan Goldhamer call The Pleasure Trap - it is about our disastrous addiction to feeding. But that is behavioral. The other dimension is to understand the issue of secondary gain, of wanting to be sick.
I understood that early, for I had a sister who was a bit more sickly than I ever was, nothing serious, but she wanted attention, very, very obviously, for she was always on my case about not attending to her when she was sick. On the other hand if I ever felt sick as a kid, I wanted no visitors. I'll get back to you when I'm feeling better, but don't bother me. Then when I studied Freud's theory of secondary gain, it all started to make sense.
How very true: "Everyone in healthcare talks about patient-centered care but it is a bad joke. Patient-centered care is virtually non-existent. Our care system is designed to meet the needs of large hospitals systems, drug companies, device companies, and provider groups."
Successive governments in the UK have been pushing the American model of healthcare as the one to follow for decades. As a result our National Health Service is in line to be privatised. Sadly, we live in a world where money is more important than people.
That is terrible news. People in the UK live longer for half the impact on gross domestic product. They are way ahead of us. If you look at the UK guidelines for patients with stable heart artery disease, primary care manages the disease using optmimal medical therapy and they have been doing that over ten years. The American model is the least effective and the most expensive. It is the last model you should copy. Here is the information copies directly from their guideline.
"Offer people optimal drug treatment for the initial management of stable angina. Optimal drug treatment consists of one or two anti-anginal drugs as necessary plus drugs for secondary prevention of cardiovascular disease.
Consider revascularisation (coronary artery bypass graft [CABG] or percutaneous coronary intervention [PCI]) for people with stable angina whose symptoms are not satisfactorily controlled with optimal medical treatment."
Optimal medical therapy is the way they do buiness in the UK. You cannot get it anywher in the US. That's the difference.
Encourage those you know to vote out politicians who want to take you down this path.
I attended an annual dinner of a medical organization, which operates clinics. I basically did not eat, for I fast after 6 PM. So only water for me, and a few leaves of lettuce in this case. But I watched with mounting disgust at the dishes that were served. And I asked my contact, how can you have an annual dinner for this organization like this and serve the kind of foods that GIVE people heart attacks? I mean what is wrong with us, is we are in an unwell system and a codependent system. We need to go back to Freud and understand secondary gain - the perverse gain from the victim position. https://www.academia.edu/88292557/Wilful_Ignorance_of_Secondary_Gain The assumption that people want to be well, is a faulty assumption that drives healthcare costs to infinity.
The only good news I see in medicine, is that we have better and better tools to support taking responsibility. One area is with a cardiometabolic test that provides near 90-100% accuracy of diagnosis and prognosis, with the emphasis on the latter. It can also provide valuable feedback for making lifestyle changes. I have literally seen cases that start out looking like when do we need to put in a stent, to a complete return to health, with the patient adding decades to their life expectancy. https://hippocratessays.com/restarting-wfpb-jumpstarts/
In short, the options are growing, but the fix is not primarily the healthcare system, it is the doctor-patient relationship, and the patient's willingness and interest to take care of their own health. We have lost that to the pharmaceutical industry, who have trained us carefully to always look for drugs first, which generally speaking suppresses symptoms, and allows chronic diseases to fester, and then when you retire, the bills come due, just when you have to learn to live on a fixed income. All unnecessary, but patients are unwilling to do dangerous things like healthy nutrition, healthy sleep, exercise, relaxation, meditation and prayer and so on. Lifestyle changes. We resist them exactly because we are often our own worst enemies, and until we are willing to step up to the plate and begin to want to work on healing that inner conflict and our self-destructive tendencies, nothing will ever change.
Thanks Roger. You bring up an important point and I hope other readers make their views known. I worked as an internist in direct patient care for decades. My honest assessment after all that contact is that very few people want to be fat or sick. I was fat (307) pounds and sick and I hated every minute of it. Now I have lost 70 pounds. Two thirds of my patients lost weight. Four lost over 100 pounds. I tried to help patients understand that eating, drinking, and smoking are aspects of our lifestyle that put everything else at risk. There are many people in this country who are interested in a longer healthier life. I write regularly to help them find a path. Americans are bombarded daily with messages that promote unhealthy lifestyle choices and expensive medical products to fix them. Many Americans are indeed victims of predatory forces that put profits above all else.
The food served at your event is a perfect example. Our health system is dominated by huge health systems that proper by maximizing "heads in beds", expensive procedures and tests, and specialty visits. Supporting people in being healthier longer costs them money and that is literally "the bottom line." There are many people, including me, who want to have a longer, healthier life, and they want to retain as much function as they can as long as they can. Those are the people I write for. I do hope others will participate in this discussion.
One more thing. Other developed countries are thinner and they live longer for half the impact on gross domestic product. Japan, New Zealand, and Singapore live longer for 1/4 the impact. I know that Japan fosters a health culture and Singapore puts a lot of emphasis on best practices. I don't think Americans want to be fat or sick anymore than we do. It seems to me that we admire wealth over all else. I think individual Americans can be as responsible as anyone else. We have a cultural problem and a leadership problem. Those things can change and I want to be part of pushing that. I will put up a post about fixing our system Friday.
Thanks, there are two manifestations of the inner conflict, and mostly only one of them is addressed. It's what Doug Lisle and Alan Goldhamer call The Pleasure Trap - it is about our disastrous addiction to feeding. But that is behavioral. The other dimension is to understand the issue of secondary gain, of wanting to be sick.
I understood that early, for I had a sister who was a bit more sickly than I ever was, nothing serious, but she wanted attention, very, very obviously, for she was always on my case about not attending to her when she was sick. On the other hand if I ever felt sick as a kid, I wanted no visitors. I'll get back to you when I'm feeling better, but don't bother me. Then when I studied Freud's theory of secondary gain, it all started to make sense.
BTW the recent video of Dr. Alan Goldhamer with T. Colin Campbell, is priceless: https://youtu.be/eJ5srBZOkPI?si=ARA_V0XIpNqKgD5S
How very true: "Everyone in healthcare talks about patient-centered care but it is a bad joke. Patient-centered care is virtually non-existent. Our care system is designed to meet the needs of large hospitals systems, drug companies, device companies, and provider groups."
Thanks for that affirmation, Janice. It means a lot to me
Successive governments in the UK have been pushing the American model of healthcare as the one to follow for decades. As a result our National Health Service is in line to be privatised. Sadly, we live in a world where money is more important than people.
That is terrible news. People in the UK live longer for half the impact on gross domestic product. They are way ahead of us. If you look at the UK guidelines for patients with stable heart artery disease, primary care manages the disease using optmimal medical therapy and they have been doing that over ten years. The American model is the least effective and the most expensive. It is the last model you should copy. Here is the information copies directly from their guideline.
"Offer people optimal drug treatment for the initial management of stable angina. Optimal drug treatment consists of one or two anti-anginal drugs as necessary plus drugs for secondary prevention of cardiovascular disease.
Consider revascularisation (coronary artery bypass graft [CABG] or percutaneous coronary intervention [PCI]) for people with stable angina whose symptoms are not satisfactorily controlled with optimal medical treatment."
Optimal medical therapy is the way they do buiness in the UK. You cannot get it anywher in the US. That's the difference.
Encourage those you know to vote out politicians who want to take you down this path.
https://www.nice.org.uk/guidance/cg126/chapter/Key-priorities-for-implementation
I do care but this is exactly the truth.
Great to hear from you
Total agreement. I'm glad I had parents who were into being open to alternative approaches - chiro's, etc.