Saturday, February 09, 2013

Why Our Health Matters

src="" >The United States healthcare system is broken. Insurance companies rake in the money for simply abstracting the cost from the doctor-patient relationship. If you could buy futures on the cost of healthcare, you could easily rake in a fortune. Yet, by some measures, American healthcare ranks far below that of other industrialized nations. Why is that?

In Why our health matters, Dr. Weil argues that there is a lot of blame to go around, though big pharma is perhaps the single greatest factor. The drug companies spend huge amounts marketing their new wonder-drugs. Thus, the role of the doctor becomes primarily that of a drug subscriber participating in "disease management". The system is further hampered by a focus on "evidence-based medicine" that focuses on individual symptoms rather than the root cause. His solution is to advance "integrated medicine" in which doctors and patients have deep, long term relationships. Traditional medicine could still be used to treat acute symptoms, while lifestyle changes and alternative medicine may have a role in improving long-term health. Other policies must also be put in order. (Why is junk food so much cheaper than healthy food?)

The content and message of this book are extremely positive and well thought-out. However, finding somebody that fully carries them out is a challenge. Even Dr. Weil moonlights as a vitamin salesman. (Is there a real difference between taking a pill that his been determined to help a condition and a vitamin that has also used to help improve a condition?)

I see doctors as being a lot like the QA team in software development. They analyze the current state and make suggestions for improvement. However, it goes back to the actual software developers to implement the fixes. They do both "unit" tests of isolated bits of functionality and "system tests" of the entire software products. Developers are also supposed to run their software through unit tests before delivering to QA, though there are often items that slip. QA also runs through all previous test cases before certifying a new release to ensure that no "regression" bugs have appeared.

Our medical system is one in which doctors perform a standard set of unit tests on all human "software" and then prescribe the appropriate "bug fixes". The drugs are typically targeted towards a single symptom. As long as they don't have a strong negative impact on other areas when tested, they are deemed ok, regardless of the potential long term impact. Alas, this often disregards the entire function of human body. It also ends up assigning a one-size fits all system to everyone. It would be as if there were a few "software test" laboratories throughout the world. They may find a great test case and a potential solution for it. Local QA teams would run the standard "test suite". If they found a problem, they would ask the developers to implement the fix. It wouldn't matter if they were developing video games and the "fix" involved font sizes in Microsoft Word. It would still be a similar fix.

Alas, that is our medical system. We get more and more specialists working on specific obscure systems and conditions, but not enough focusing on improving health to make sure we don't reach those conditions. The tax program provides tax incentives for treating acute conditions, but not for preventing that condition from occurring in the first place. And then we have the health care "reform" which merely entrenches the current broken system. Crony capitalism at its best.

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