HEALTH or SICK Care?

Dr. Sachin H. Jain wrote a good article in Forbes calling for Redesigning Health Care to Meet the Needs of Our Sickest Patients, and I’m publishing my response here, titling it “HEALTH or Sick Care.”

While I understand the need to improve care of our sickest and most frail elderly patients, my view conflicts with that of the medical industry, which we mistakenly call the “healthcare” industry. 

As Benjamin Franklin once said and Public Health officials have known for decades…

Unfortunately, the way our fee-for-service healthcare system has evolved has caused medical schools to focus almost entirely on diagnosing and treating illness and injury, not preventing it, because that would go against the business model of profiting from each patient’s visit, test, prescription and procedure, a model with the perverse incentive to do more and more, and charge more.

We are, however, starting to see a rise of complementary practices that do focus on wellness, such as Functional Medicine, but there still remains a severe lack of wellness training, and that’s a major hurdle to overcome. How do we change medical school curriculum to cover both geriatric needs for the aging population AND preventive medicine for us all?

Health or Sick Care? — The Resistance to Change

A potentially larger hurdle is the deeply entrenched medical industrial complex of insurers, hospitals, drug companies, testing companies, and equipment providers, which resists the sort of wellness changes I support.

While America spends twice as per capita on healthcare as other advanced nations and theoretically should be able to cut its $3T/year spending in half while still improving health and outcomes, that would mean losing $1.5 trillion in yearly revenue. To keep that from happening, the medical industry spends twice as much on political lobbying as the military industrial complex. Obviously, there’s more financial incentive to keep us chronically ill than well.

Overcoming that Resistance

To overcome such industry and political resistance, there must be a strong enough reason, with compelling benefits that are too massive for politicians to ignore. The marketing message must rally significant public support and an outcry from the consumers who’d benefit from better health, increased longevity, and lower costs. It must become political suicide to oppose that outcry, reminding politicians that yearly trillion-dollar savings from health reform can also help cut taxes, pay down the debt, and fund strategic investments in education, research and infrastructure. But the savings from a healthy and productive workforce shouldn’t stop with lower medical care costs.

The 3 Pillars of Health

Understanding that the pillars of health are good Nutrition, Exercise and Sleep, with sleep arguably the most important, I’m working with collogues at Intelligent Sleep to define and promote the concept of Population Sleep Wellness.

Given all the ways sleep impacts health, and the scary number of people who don’t get enough sleep, the CDC has labeled sleep deficiency “a public health epidemic.” Add the public safety impact when 20% of police-reported car accidents (>100,000/year) are a direct result of drowsy driving and cause over 1,500 deaths, 71,000 injuries, and $12.5B in monetary loss.

As much impact that sleep has on health and safety, I argue that the larger impact is on performance – in school and work. That’s because sleep affects alertness, attention, concentration, creativity, decision-making and much more. As such, sleep also has a huge impact on the lifetime earning capacity of individuals, on the profit of corporations, on the GDP of our nation, and on our global competitiveness and arguably national security. This is why I see population sleep wellness as a cornerstone of developing a healthy & productive workforce for the next century and true health reform.

Related Articles

• Healing America’s Health Care System, by Dr. Susan Blumenthal, Former U.S. Assistant Surgeon General
• A Disease-Creation Economy, by Dr. Mark Hyman
• Bitter Pill: Why Medical Bills are Killing Us, By Steven Brill for TIME
• What is Functional Medicine?, with two good videos
• The Future of Medicine is … Not Medicine, about Dr. Sebring’s Functional Medicine practice
• “Fed Up” with the Food Industry, featuring Katie Couric’s documentary
• Is American Health Care the Best?, with lots of good charts
• Doctored, about Physician Disillusionment, about Dr. Sandeep Jauhar’s book
• Fixing Health Care, by mHealthTalk Editor Wayne Caswell
• How can we make healthcare more productive?, by mHealthTalk Editor Wayne Caswell
• Chipping Away at Healthcare Special Interests Yet?, by mHealthTalk Editor Wayne Caswell

Related Videos

While the medical establishment may resist efforts to eventually replace much of what they do with algorithms, the pace of this trend is accelerating exponentially, as I wrote in Moore’s Law and the Future of Health Care. Google’s Verily initiative gives a glimpse into a their vision of Preventive & Predictive Healthcare, which teams chemists, engineers, doctors and behavioral scientists. In similar efforts, IBM has also focused its cognitive computing efforts on healthcare.

In Health Care Should be a Team Sport, we present several popular videos of Intel’s Eric Dishman, who now serves as National Director of All of Us. In that role, he’s been promoting precision medicine, shared research, and the idea that Health Care should be a Team Sport that includes the patient, the provider, and the researcher.