Medicine is big money. Some estimate that by 2020 prescription drug spending in the U.S. may reach $600 billion. The American Medical Association spends approximately $20 million a year lobbying politicians. The medical insurance industry collects about $1 trillion a year in premiums. With all that money running through the system, there is a lot of people working to keep things the same.
As you can imagine, when businesses get that big, they have a lot of power to control the marketplace. There’s something that then happens, most of the people involved in the industry have no concept of the fact that what they do has life or death consequences for people. Many company executives have no sense of why they are involved in healthcare, indeed, many couldn’t care less if they were in the auto industry, computers, or medicine. The only concern they have is in creating systems that generate profit. What this does is make the priorities of those companies drift away, from quality care for the patient, to doing what makes the most money.
It would be great if those two things went hand in hand at this time, but that isn’t always the case with healthcare. Sometimes what provides the best service to the individual isn’t what makes the most money for the companies involved. There are a lot of complex things that make this the case. Although I do believe that these companies have the right to profit from their services, I also feel like they have lost a sense of why they work in healthcare. For those of us at the patient care level, service to our fellow humans is often the reason for becoming involved in healthcare, whereas executives and business men may get involved because of the sheer amount of money running through the industry.
If service to others was the priority of everyone involved, then we might not find ourselves so often dissatisfied with healthcare. The fact of the matter is, the people that are primarily focused on profist make the biggest decisions that have the most impact on the most people.
This impact is felt in a lot of ways. The price of care is very high. The choices available are not what they could be. We often feel not in control of our care or the decisions about our care. People become wary and don’t trust the system, but need to engage with it if they want to maintain quality of life. Doctors and other providers become alienated with their profession and don’t feel like they are able to practice in a way that serves their patients best. The practice of medicine, and the practice of big business are not the best of partners.
The slow spiral downward continues along it’s path and now people look to government to fix the problem. Unfortunately, government cannot fix the problem. What healthcare needs is free markets and competition so that individuals are the ones in control and those providing services must listen to the needs of patients if they are to survive in the marketplace. “That’s what we have!”, you might say. Although that is partly true, when we look at American healthcare, the big changes in how care was delivered were induced by government regulating the industry in very specific ways that rewarded very specific behavior of only a few companies. For example, making it much more difficult for, so called, ‘alternative’ medicine to be available to patients even though the outcomes of some of these therapies far outperform those offered by the establishment.
Don’t worry, this isn’t a rant on government healthcare.
The point of this article is to wake you up, to not only where we are and how we got here, but more importantly, to start to frame the strategy for creating something much better. Creating a better healthcare system in the United States depends on empowering patients to take back control of their medical decisions. The fact of the matter is, healthcare providers of all kinds are paid consultants. Yes, they have an area of expertise, but that doesn’t mean they should be trusted blindly. Ultimately, you are the one that will live with the consequences of your decision to listen to that person, or to say no thank you. You don’t blindly trust a mechanic who tells you need $5,000 worth of repairs, so why would you trust a doctor in that way? Just because someone got a license to practice medicine doesn’t mean they are trustworthy.
With all that said, how do we go about using this understanding to take back control of our care? It’s all a matter of education and assertiveness. The internet provides an incredible resource for people to learn about what is available and how to use treatments effectively, and it makes it very easy to cross reference information and get second opinions. Granted, you’ll have to find people who you can trust, but that is something anyone can do. With so many problems we face throughout our lifetimes, many of them are ones that are not difficult to learn about and understand. When we do this we can have a conversation with our providers where we know enough going into the conversation to be sure that the doctor we are talking to is making sense and providing us with good service.
You are your own best advocate. With more resources available, you can take control of your health and get the service you need to reach your full health potential.
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