In this election time, there is lots of talk about the high cost of government-funded health care- for medicare (for the elderly), and medicaid (for children). Democrats and Republicans argue about the burden these programs place on government. However, its not the President, or Democrats, or Republicans, or even Congress as a whole, who is at fault. The high price of these programs, the high cost of health care itself, is our own fault. It’s because of you and me, patients and doctors, that health care is so expensive for us and our children.
It is our consumerism that is helping drive up the cost of health care. Our yearning for the newest car, the newest smart phone for our kids in time for Christmas, has spilled over into how we “consume” health care. We often think of health care the same way we think about other goods and services- more is better, faster is better, more expensive is better. Have chest pain? Don’t bother with going to your regular doctor, head to the cardiologist. Your kid has back pain? Demand the MRI- that will find the problem, right? Can’t get seen right away- go the Emergency Department, you don’t need an appointment!
Thus we spend more than we should. Specialists are much more expensive to see than your regular doctor, and often don’t tell you much more about what’s wrong. Tests are much more expensive than your doctor doing a thorough history and physical; and again are not nearly as good for figuring out your medical problem. Finally, the Emergency Department is a very expensive place that is designed to take care of a very expensive problem- emergencies. It is not a good place to go for your back pain, or your kid’s two-week-long cough. Here is the real kicker: not only are these options more expensive, but their overuse actually makes for worse overall health for us and our kids.
The United States spends more per person on health care than any other advanced country in the world. Yet, we americans and our kids are not nearly as healthy as our foreign brothers and sisters. Part of our poor health is because of our other consumer passion-eating too much. However, another big part of our health problem is spending all those health care dollars in the wrong way. We spend on the expensive stuff, instead of on the stuff that really works- basic prevention and basic medical care.
Too much expensive and specialized medicine not only does not help most problems, it can even hurt. When we see a specialist, the specialist is inclined to do painful and risky tests to look for their particular kind of problem. When we demand an antibiotic for a cough, the antibiotic can cause side effects. Too many antibiotics also increase the chance of developing antibiotic-resistant strains of bacteria in our bodies and thus worse infections down the line.
Instead of demanding the most expensive test, insisting on seeing the specialist, or speeding right to the Emergency Department, we need to regain our faith in our general practitioners- the internists, family practitioners, and pediatricians in their offices. The vast majority of our medical problems can be easily diagnosed and treated by these unsung heroes of the medical profession. A doctor who listens carefully to you or your kid’s problem is way better at diagnosing trouble than any test, and is usually a much better listener than the Emergency doctor, who is ready to rush away from your bedside when a real emergency rolls in.
It is time for us to go back to a more “old-fashioned” way of “consuming” health care. We need to go to our regular doctors for health care prevention, as well as for sick care. We need to listen to their advice about healthy living, and taking care of ourselves when we are sick. We need to be patient with our illnesses, give them their time to get better, stick with and trust our office practitioners. This chicken-soup medicine is actually better for us, and already works better for people in other parts of the world.