Reform of the Health Care System: Does Government Know What the Problem Really Is?
As a "pit" physician, meaning I do family and emergency medicine full time, I have grave doubts that any bureaucracy, no matter how well meaning, can direct the kind of health care that we need-which is prevention. In this society in and above traumatic and serious mental health issues, the real problems are chronic diseases and their exacerbations. We are talking about obesity, hypertension, heart disease, strokes, peripheral vascular disease, cognitive decline, diabetes, retina problems, and "solid" cancers like lung, prostate, breast, and colon. The Metabolic Syndrome groups obesity, diabetes, and hypertension into one category because of insulin resistance.
Interestingly, all these diseases and states share a common denominator: oxidation or "rusting" within the inner walls of arteries, like a browning apple slice. We call this oxidative-inflammation, all silent and painless within the small arteries of our body that feed the heart, retina, brain, lung, kidneys, and so forth.
This oxidative process translates into what every body calls "the cholesterol problem," but in fact, cholesterol is a symptom and a patch for this inflammation, not its cause. Only when a soft plaque of cholesterol gets so large or ruptures does it cause a problem, like a sudden heart attack or stroke. The good news is that if the inflammation-oxidation is squelched then other strategies can reverse the cholesterol "patch."
Backing up a little, it is useful to remember that this chronic inflammation plays a role in some of the solid cancers as mentioned above. Heart disease and cancer prevention go hand in hand.
Chronic inflammation comes mostly from our lifestyle and lifestyle-contribution to genetic predispositions. Lifestyle has to do with the kinds of fats we eat, the kinds of sugars we eat, and our fitness (or lack thereof). Additionally, heavy metals from food or dental fillings play a role, as well as tobacco smoke whether primary or secondary. If we have a bad family history, poor lifestyle basically is pulling the trigger on a genetically loaded gun.
But, most of all, one can argue that the greatest contributors to chronic inflammation are the stresses we "dump" on our body that chronically raise hormones that were designed for a brief "flight or fight" response to a saber tooth tiger. Today, however, our "tigers" are constantly inside us with work worries, relationship stresses, isolation, personality struggles, and all that goes into a modern and hectic society.
In other words, chronic anxiety, fear, depression, and exhaustion contribute to oxidative damage to the walls of small arteries. And these issues are tied into our "comfort foods," our smoking addictions, and all the rest, making all this most complicated.
Inflammation and disease are like an iceberg. Picture an iceberg that plunges 1000 feet into the ocean with just 50 feet floating above the surface. The part we see (symptoms of a disease) is only a tiny part of the whole iceberg.
Since we have thousands of miles of blood vessels in every one of us, chronic oxidative inflammation is the iceberg below the surface with the diseases just the tip. To fix the problem we must spend less money on expensive treatments to the tip of the iceberg and focus more on the root cause below, which is more in the hands of the person and far less expensive (and painful).
I have designed a system where people can spend real time with a preventive physician and staff, have constant access, and address all these issues with an appropriate anti-oxidative program including stress management. But the government and big pharmacy are not in a position to support or even encourage all this.
Health is personal. A good physician plays a role if you can find one with the time to work with you. But, for all the money we all pay into the bureaucracy and big corporate players, prevention and prevention-minded docs get very little. The poor doc has to see more and more people to make a living, and this is where the 4-6 minute visit comes from.
As a founder of Wellness.com, I invite our readers-- including docs-- to organize with us. Let us develop a community of consumers and physicians who really want to make health care personal again and focus on good vascular health. There is an integrative solution that can bypass the inefficiencies and work directly with consumers with their doctor.
Do you want to hear it?
Need your ideas. Need to have you "sign up" to be on our electronic mailing list for Preventive Vascular Health. Need to have you recruit those doctors who are like minded. Maybe on Wellness.com we can self organize and make a difference?
After all, we are now leaving the era of failed PPO's and HMO's and entering the era of consumer directed health care. It is the time for the wellness community to take charge.
Donald L. McGee, MD, PhD
Wellness.com