Sunday, January 9, 2011

Dr. Weil on Health Care in America

Here is part of an interview with Dr. Andrew Weil and his input on health care in America. I thought it was interesting and worth the read.

Kupfer: Where do you see the nation’s healthcare system going?

Weil: Unless we transform it, it’s going to steer us into bankruptcy. At the moment the debate is mostly about health insurance, but that’s not the root problem. The root is cost, and I don’t think we can look to politicians to bring costs down. Both Republicans and Democrats are so beholden to the big-insurance and pharmaceutical lobbies that they are not free to act. If Congress can stop the big insurers from disqualifying people on the basis of preexisting conditions, that’s great, but these are little steps. Real change is going to come only if people get aroused enough to start a movement that shifts the balance of political power.

Also, if we don’t get serious about our health, it’s going to bankrupt us as a society. We already have the worst healthcare outcomes of all the developed nations, and we spend more on healthcare than anybody else. We’re spending something like 17 percent of the gross domestic product on it, and it could soon be 20 percent. That is simply not sustainable. And this is before the baby boomers reach old age and become the heaviest consumers of healthcare. We want universal healthcare, but we cannot extend our present disease-management system to all of our citizens. No one could pay all those bills.

Kupfer: Specialized medicine is the most expensive. How did we end up with so many specialists and so few generalists in American medicine?

Weil: The reason is obvious: specialists get paid more and have more prestige. But research has shown that countries and states with more primary-care providers have healthier citizens. To balance the system we could try forgiving student loans for people who go into primary care, but we need political organizing to promote these ideas.

Kupfer: Do you think there’s an opportunity now to get holistic practices covered by national health insurance?

Weil: Yes, but the priorities of insurance reimbursement are completely backward. We happily pay for interventions, diagnostic tests, and drugs, but we don’t pay for doctors to sit down and teach patients how to eat or how to relax. We talk about prevention, but that’s not where the money is going. One way to change those priorities is to conduct outcomes-and-effectiveness studies. Let’s look at five or ten common ailments that now cost us huge sums of money, such as type 2 diabetes or chronic back pain. Because conventional medicine has no magic-bullet treatment for these conditions, people often try complementary and alternative therapies. We could compare conventional treatment with integrative treatment (which might make selective use of conventional medicine) and assess medical outcomes and costs. I’m quite certain that integrative approaches would produce better results at lower costs. If we could get the data and show it to the people who pay for the nation’s healthcare, then they might change their reimbursement policies and start to pay for preventive and integrative medicine.

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