This article by Malcolm Gladwell in the New Yorker magazine discusses where health care reform in our country has gone wrong. It gives an overview of how the health care system in the United States was influenced by institutions and vested interests and discusses the need for not just focusing on our problems, but on solutions. This is a discussion we urgently need to have, but the conversation needs to be broadened. Recent figures point to 70% of our deaths and 75% of our health care costs being due to chronic disease. The role of chronic diseases impacting the state of our health care can be seen when reviewing the data from the CDC:
*As of 2012, about half of all adults—117 million people—have one or more chronic health conditions. One of four adults has two or more chronic health conditions (Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among US adults: a 2012 update. Prev Chronic Dis. 2014;11:130389.
DOI: http://dx.doi.org/10.5888
DOI: http://dx.doi.org/10.5888
*Seven of the top 10 causes of death in 2010 were chronic diseases. Two of these chronic diseases—heart disease and cancer—together accounted for nearly 48% of all deaths (Centers for Disease Control and Prevention. Death and Mortality. NCHS FastStats Web site.http://www.cdc.gov/nchs/fastats/deaths.htm
*Eighty-four percent of all health care spending in 2006 was for the 50% of the population who have one or more chronic medical conditions (Robert Wood Johnson Foundation. Chronic Care: Making the Case for Ongoing Care. Princeton, NJ: Robert Wood Johnson Foundation; 2010:16.
http://www.rwjf.org/…/d…/farm/reports/reports/2010/rwjf54583
http://www.rwjf.org/…/d…/farm/reports/reports/2010/rwjf54583
If diseases like Lyme disease, Alzheimer's disease and autism are on the rise, contributing to both suffering and an increased burden of health care costs for chronic disease, why are we not allocating more of our precious health care resources to address these growing problems? Lorraine Johnson did a recent blog on Lymedisease.org where she notes the inequity with funding for Lyme disease compared to other diseases. She found that "the annual incidence of Lyme disease is now 1.5 times more than the estimated number of cases of breast cancer and six times higher than the annual incidence of HIV/AIDS. However, federal funding of Lyme disease has been meager...While Lyme disease occurs six times more often annually than HIV/AIDS, it receives less than 1% of the funding allotted to HIV/AIDS by the National Institutes of Health.(http://report.nih.gov/categorical_spending.aspx).
We already have diseases like CFS/M.E. which have been estimated to affect up to 2.5% of the non-elderly adult population, costing billions of dollars every year (http://www.ncbi.nlm.nih.gov/pubmed/21251294). According to the National Pain and Fibromyalgia Association, more than 100 million Americans are in pain every year with an annual price tag of more than 65 billion dollars (http://www.fmcpaware.org/fibromyalgia/economic-burden.html).
Why are so many patients in pain? Could it be that Lyme disease and co-infections as well as environmental toxins are contributing to a significant number of these cases of fatigue, cognitive issues and pain syndromes? See my blog in Psychology today regarding the scientific data on whether some of these diseases may in fact be preventable:
(http://www.psychologytoday.com/…/are-adhd-and-dementia-prev…)
Why are so many patients in pain? Could it be that Lyme disease and co-infections as well as environmental toxins are contributing to a significant number of these cases of fatigue, cognitive issues and pain syndromes? See my blog in Psychology today regarding the scientific data on whether some of these diseases may in fact be preventable:
(http://www.psychologytoday.com/…/are-adhd-and-dementia-prev…)
Why are we not looking into the etiology of these diseases, and focusing more on prevention, instead of spending billions of health care dollars just treating symptoms? The MSIDS model discussed in detail in my book leads us to the next essential paradigm shift in health care. We must go from the "one cause, one disease" model taught in medical school (Pasteur's postulate), to a patient centered model where prevention and getting to multi factorial sources of a problem is addressed. This model (with a reference to my book) was recently discussed in an excellent scientific review article on Lyme disease published in the International Journal of Family medicine: (http://www.hindawi.com/journals/ijfm/2014/138016/).
Lets have a discussion about health care in our country, but lets look at the bigger picture regarding the multi factorial etiologies of chronic disease and get to the source of the problem. That is a discussion worth having if we are to move health care reform in the right direction.
http://www.newyorker.com/magazine/2015/01/12/bill-6
http://www.newyorker.com/magazine/2015/01/12/bill-6
In a new book, Steven Brill argues that health care needed major surgery but got a Band-Aid instead. Malcolm Gladwell reviews “America’s Bitter Pill.”
NEWYORKER.COM
