Sicko - Why Michael Moore is flat out wrong about healthcare...

[Guest guest]

REPOSTING FROM DR HYMAN

 

Hello Shan,

 

I just watched Michael Moore's new movie, " Sicko. " Today, I'd like to talk

about what I saw.

 

I want to help you understand what has to happen for meaningful change to occur

in our " sick " healthcare system.

 

And it is NOT what Michael Moore suggests.

 

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To see the quick, 5-minute video version of this, go to:

 

==> http://www.ultrawellness.com/blog

 

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Now back to the movie.

 

I must say I was disappointed. I was hoping for a novel look at the problem

of not only access to healthcare, but of the type of healthcare that is

practiced.

 

Don't get me wrong.

 

I'm all for more access to healthcare, better healthcare, and lower costs.

 

But I am not for getting more people access to a broken healthcare system

that creates more problems than it solves.

 

Consider this.

 

Our healthcare system itself is the leading cause of death overall, followed

by heart disease and cancer!

 

If our healthcare system is responsible for more than 700,000 deaths a year

from medical errors, hospital infections, bed sores, surgical errors, drug

reactions, and more, which lead to an extra $250 billion in costs, do we want

more

people to be exposed to this type of care?

 

I don't think so!

 

Moore's answer to all our healthcare woes is to have a single payer system,

like Canada.

 

I went to medical school and internship in Canada -- and I can tell you, the

picture is not as rosy as it seems. I worked with a poor family doctor who

had to see more than 50 patients a day just to earn a basic living.

 

And when the doctors went on strike because they were unhappy with the

system, the death rate actually went down.

 

If the Canadian healthcare system is so great, why have so many of my medical

school class migrated south of the border to the US?

 

Universal coverage may be part of the solution - - or not -- but Moore really

missed the whole point.

 

If we improve a broken system just by reorganizing how it is paid for, we

still have a broken system.

 

He didn't address that in any way.

 

In fact, Moore's movie is a distraction from the real problem.

 

The type of medicine we are practicing is antiquated, often dangerous, and

based on the wrong premises and outdated approaches.

 

Instead, it must be founded on the laws of biology that help us address the

true causes of disease, not just find better drugs or procedures to deal with

them once they occur.

 

Getting more people access to the wrong treatments does not help us in the

long term to create a sustainable model of health for society.

 

The thing Moore misses is a direct discussion and analysis of the lack of

QUALITY in our healthcare system.

 

And quality is defined as the health of our population, which is clearly

worse than almost every developed nation and worse than many third world

countries. We are 45th in life expectancy, coming after Bosnia and just ahead

of

Albania!

 

I do not dispute the inherent problems in healthcare, where the whole system

profits from reducing access to care, denying care, avoiding preventive care,

or shifting costs to employers.

 

When Starbucks pays more for the healthcare of its employees than it does for

coffee beans, then we know we are in trouble.

 

What Michael Moore ignores is that the entire ecosystem of business and

products and services related to the health of our population has its whole

orientation backwards.

 

You see, the healthcare industry and the food industry profit from us being

sick and fat. All the incentives are backwards.

 

Until it is PROFITABLE for everyone to help create health rather than

disease, we will not thrive as a society.

 

So we need to find a way to line up all the incentives for everyone involved

in healthcare:

 

* For the insurers (or government, which actually pays 60 percent of all

healthcare bills through Medicaid, Medicare, the VA, tax deductions, and other

incentives); * The pharmaceutical industry; * The hospital industry; * The food

industry, where the sale of products that support health would bring in more

profits than foods that destroy health; and * The doctors, who would be paid

more for creating health than doing procedures.

 

Marion Nestle, PhD, professor of Nutrition and Food Studies at New York

University says:

 

" It is difficult to think of any major industry that might benefit if people

ate less food; certainly not the agriculture, food product, grocery,

restaurant, diet, or drug industries. All flourish when people eat more, and all

employ

armies of lobbyists to discourage governments from doing anything to inhibit

overeating. " (1)

 

Clearly, something needs to change.

 

" Sicko " did have some interesting points.

 

The best part of the film was the part where a British doctor described how

he was paid more for helping people lose weight, stop smoking, improve their

blood sugar, and lower their cholesterol.

 

If an American doctor does that, he or she LOSES money. The British doctors

actually get a BONUS for keeping people healthy!

 

The American doctor gets paid thousands of dollars for doing angioplasties

and stent procedures and maybe 30 dollars for talking to someone about their

cholesterol.

 

Though doctors are generally well meaning, well- intentioned people, the

healthcare system appeals to their dark side.

 

Do more procedures, provide more invasive care, and get paid more -- EVEN if

it ultimately does not benefit the patient.

 

What is absolutely frightening is that the system of payment for care and the

system as a whole almost NEVER address the issue of VALUE of the care we get.

 

 

Value is the benefit and improved outcome of care, divided by the cost of the

care. (VALUE = OUTCOME/COSTS).

 

Think of it this way.

 

If you paid for a fancy new car but it had no engine or no tires or didn't

run when you put the key in the ignition, the car company would go out of

business.

 

But in medicine in America today, we have a shiny new system that just

doesn't run very well despite paying 40 percent more for healthcare than any

other

nation in the world.

 

That's almost $7,000 per person, or close to $2 trillion total (one-third of

which is for administration costs).

 

In American healthcare, the outcome of that care is mostly ignored -- namely,

the health of the patient!

 

In a landmark 2001 report from the Institute of Medicine called " Crossing the

Quality Chasm: A New Health System for the 21st Century, " the authors said:

 

" Between the healthcare we that we have now and the healthcare that we could

have lies not just a gap, but a chasm. "

 

So what is the real solution?

 

Even though I know where we need to end up, I don't have all the answers.

 

But I do know this.

 

We have to change the competing needs in the healthcare industry and related

industries.

 

Promoting and treating sickness should not generate more profit. Creating

health should.

 

So how can we, as a society, line up all the needs and interests of all

stakeholders in our " sick " healthcare system?

 

If we follow the trail through our healthcare forest, it will be clear that

an alignment of values, needs, and interests must occur if there is to be

meaningful change.

 

It will also be clear that no one component can be separated from any other

and that if we create change in one area of the system, often negative forces

will fill in the blank space.

 

Let's follow the trail of a simple soda and French fries, for example.

 

The government subsidizes farmers to grow corn and soy crops with $30 billion

a year, which fuels the fast and junk food industry with high- fructose corn

syrup and trans fatty acids, which are used to produce energy-dense,

poor-quality, disease-creating foods such as soda and French fries. (2)

 

At the same time, funds for local schools are limited. So they cannot

provide students with quality food choices and physical education.

 

Then the food industry steps in, encouraging children to subsist on

nutrient-poor, energy- dense foods from vending machines for their breakfasts

and

lunches.

 

The marketing for these products exceeds $30 billion a year (more than $13

billion of which is aimed at children), increasing demand.

 

These are tax-deductible expenses to corporations, which are in effect

further subsidies by our government.

 

These children, then, become obese and diabetic in their 20s and require care

for heart disease and amputations before they are 30, for which the

government in part must pay.

 

So what is the answer?

 

I know that with the creative intelligence and ingenuity of this country, we

can find a solution. I don't know exactly what it is, but I do know this.

 

As long as the any one party has to lose for another to win, we are doomed to

failure. In order for things to work, everyone has to win!

 

We have to make it profitable to improve the quality of our food supply, to

encourage physical activity and to reduce stress in our lives.

 

When a hospital diabetes prevention program is so successful in helping

patients improve their health and reduce amputations and complications of

diabetes

that it has to be shut down because the hospital LOSES money by charging only

$60 for a nutrition consult instead of getting $6,000 for a toe amputation --

then we know something is seriously wrong with our incentives.

 

We have to make it profitable to help patients get healthy, and have business

MAKE money by providing preventive care and lifestyle programs that create

health.

 

The politics of food, agriculture, environment, and education cannot be

divorced from the traditional healthcare stakeholders: patients, providers,

insurers, employers, payers, and government.

 

We have to address the roots of the problems and create a system where

everyone involved thrives.

 

And despite Michael Moore's laser focus on a single payer system as the

answer to all our healthcare problems, we need a much broader and bigger change

in

healthcare.

 

What should those changes involve? I think this topic is so important that

I'll be discussing it in next week's blog, too. Stay tuned!

 

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

 

Have you seen " Sicko " yet?

 

What did you think?

 

What parts of the healthcare system do think need fixing most?

 

What ideas do you have for fixing the healthcare system?

 

Just look for the post at the top titled:

 

" Sicko - Why Michael Moore is flat out wrong about healthcare... "

 

To your good health,

 

Mark Hyman, M.D.

 

(1) Nestle, M. Food Politics: How the Food Industry Influences Nutrition and

Health

(California Studies in Food and Culture, 3). Berkeley, Calif: University of

California Press; 2003.

 

(2) Bitton A, Kahn JG. MSJAMA: Government share of healthcare expenditures.

JAMA.

2003;289(9):1165.

 

UltraWellness LLC

 

45 Walker Street Lenox, MA

01240 US

 

 

 

 

 

 

 

[Guest guest]

Moderator's Note: Like the pyramid structure of ancient Egypt, the power is at

the top of the pyramid but the top can't keep it's form if the base shifts.

-----------

But can this creative intelligence compete with Big Pharm's Big Bucks? It

has become a way of life/death - not easy to turn things around when the

culprit is running the show.

 

Jane

 

>I know that with the creative intelligence and ingenuity of this country,

>we

can find a solution. I don't know exactly what it is, but I do know this. <