Last week, I was invited to attend a gathering of “community leaders” hosted by a regional health system that is looking to “re-imaging” the way healthcare is provided to the community. It was the second such session to which I had been invited–and I left even more frustrated by what I heard than I was after the first one. And the reason is simple, no one wants to address the real reason why our medical system is overwhelmed: People continue to act in ways that negatively impact their health….and they don’t care.
Let’s back up to the first “community leaders” gathering. At that event, we sat at assigned tables and heard health system officials blame insurance companies, Big Pharma, and the government for creating the financial situations that drive up costs, limit access to treatment, and tie the hands of doctors. Not once in the presentation was information provided to us on increasing rates of obesity, declining rates of physical activity, an explosion of “screen time” among youths, the rise in vaping, or the usage rates of illicit drugs. It was like we were supposed to adopt former President Barack Obama’s favorite phrase “it is through no fault of their own”, that there are so many people demanding healthcare services today.
So when it came time for us to engage in an “activity” meant to “inspire discussion”, I listened patiently to my fellow tablemates talk about proposing legislation, putting restrictions on insurance companies, enacting price controls on prescription drugs, and even going to single-payer, government funded healthcare to “guarantee access to everyone”. When it appeared that everyone else had finished with their generalities, I unloaded on the health care representative assigned to our group.
“You need to tell people to learn to live with discomfort,” I told him. “You need to educate people that there is a big difference between discomfort and disease–and that the medical system should be used almost exclusively for the treatment of disease and serious injury–not things like toenail fungus, ‘my back hurts when I do certain things’, or hair loss.”
And then I mentioned my grandmother’s feet. When I was a kid, I was kinda horrified by my grandma’s feet. She had overlapping toes, corns, bunions, and blisters all the time. The conditions were likely caused by growing up wearing bad shoes during the 1920’s, 30’s, and 40’s. To treat those problems, she wore those little donut pads around the corns, put Dr Scholl’s inserts in her shoes, and would soak her feet in hot water and epsom salts. Today, someone with feet like that would have gone to see a podiatrist or some other specialist, had corrective surgery, undergone physical therapy and rehab, worn special shoes designed specifically for her feet at a cost of several hundred dollars, and likely had prescriptions for painkillers and anti-inflammatory drugs–a process involving dozens of people at several different clinics, hospitals, and pharmacies.
But even if she was alive today, I doubt my grandmother would do that. And that is due in large part to her being part of a generation that grew up before the pharmaceutical age that promised a pill to fix all of our problems, that had to pay cash out of pocket for medical expenses (not having an insurance company pick up much of the tab), and that was raised with an ethic that you are going to experience some pain and discomfort in your life–and you are expected to just grin and bear it. Plus, you wouldn’t dare waste a doctor’s time with something that was neither life-threatening, nor serious enough to keep you from working.
And that is the attitude that I have adopted as well. When a new accountant did my taxes this year, she was shocked by the balance in my Health Savings Account. I told her it got to that point because the only time I ever use it is to cover any expenses tied to my one trip to the doctor for my annual physical, any expenses related to my two trips to the dentist for teeth cleaning and x-rays, and replacement parts for my CPAP machine. Her reply was “I wish I could do that, but I have so many things wrong with me.”
And as far as blaming “Big Pharma” for high drug prices or the “opioid crisis”–I say: They are only giving us what we want. It’s hard to tell someone to “just live with” the minor conditions I noted before that physicians are increasingly asked to “treat” when those patients see on the television and on internet pop-up ads that there is a new pill that can “cure” it (if you take the pills the rest of your life).
So back to that initial gathering. After I had offered my suggestions, the health care rep got a sheepish look on his face and admitted that yes, we are demanding too much from our healthcare system–but that is “not what we are here to discuss today”. I left that event extremely frustrated and quite honestly angry that my time had been wasted like that.
Now skip ahead to last week’s event. Now we were asked to “imagine what an inclusive and accessible health care system would be like” and how we can “help people live their best, unique life”. Again, my tablemates tossed out banalities like “we need to meet people where they are in life”, “doctors need to communicate on the level of their patients”, and “we need to make people feel ‘included’ in the healthcare decision making process”. Another table hit the modern word salad grand slam by suggesting “community groups need to collaborate to achieve synergies and ensure diverse, equitable, and inclusive processes that hear all voices and make everyone feel welcome”. I very nearly needed medical attention at that moment, as I thought I had rolled my eyes so hard that I might have strained an ocular muscle.
Again, after everyone else had expressed their generic platitudes, I “spoke my truth”. “You have to hold people accountable for the actions that lead directly to their own health issues.” I acknowledge that I have put on weight over the past ten years. Some of that is from more aggressive weight training in the gym–but most is from continuing to eat like I still have the metabolism of an 18-year old. Yet, not once have I been told to lose weight or change my diet during my annual physical exam–even though being overweight and obese is a leading cause of a multitude of physical ailments and diseases. Our healthcare professionals are going in the opposite direction, adopting the “body positivity” approach–where it’s more important that a patient “feel good about themselves” than it is to actually be physically healthy.
Then I noted that I had a “beef” (pun intended) with their catchphrase “live their own unique, best life”. I asked, what if someone’s definition of a “unique, best life” is the antithesis of healthy living? My definition of my “best life” is playing golf all day and eating steak, brisket, ribs and pasta every meal. Is that a recipe for never having to see the doctor? For my 12-year old nephew, his best life would probably be not having to go to school, playing video games all day, and eating nothing but pizza and chicken strips. Is that the lifestyle we really want to promote?
The morning of last week’s gathering, I went to the Heart of the Valley YMCA for one of my three weekly workout days. There were 8 people in the fitness center. Eight. That place should have been packed–and it should have been filled with many of the people that were being asked to be “leaders in improving the health of our community” at that meeting. If you want me to actually lead positive change, it’s going to include meeting me at the gym at 7:00 Monday, Wednesday, and Fridays–not listening to me just talk about how important it is to “feel good about yourself”.
