A Culture Flaw

I’ve been scouring the news to understand the changes brought to us by health care reform. Some say the bill is the greatest congressional move since the civil rights movement, others say it is a decision more about party politics than about health care. I’ve read the information, and I’ve read the list of major changes that will come about: the government will cap premiums for health coverage so that families will not have to spend half of their income on insurance (as is quickly becoming the case). Companies with over 50 employees will be fined for not providing insurance to their employees. Insurance companies will not be allowed to deny coverage for pre-existing conditions. Medicaid coverage will expand to cover more of those who cannot afford coverage. The list goes on (for 2000 pages!), but those are some of the main points. Still, after reading the news and searching through editorials, I was not satisfied with the answers I was given. I was not fully convinced that these legislative changes could, in fact, be considered reformation of our system in place.

And then I listened to an episode of This American Life that tried to break down some of the reasons for rising health care costs. I love This American Life. When I didn’t understand the mortgage crisis, I turned to them to break it down for me. Listening to their story on health care killed an insanely quick hour at a gym, and I highly recommend a listen. So here’s the main point I think I learned from listening.

Our culture of health care is flawed. It’s not just that our insurance is flawed (which it is). It’s not just that our prescription costs are too high (which they are). The thing holding us back, the problem that has been growing and growing (just as the mortgage crisis grew and grew until it burst), is that we think that when it comes to medicine, a right answer exists. We have somehow decided to put so much faith in the medical technologies and treatments, that we fail to recognize that medical science does not always have the answer.

What Ira Glass (the host of This American Life) showed me was that doctors often perform medical procedures because they fear being out-competed—that another doctor will perform a procedure whether necessary or not, and claim a patient and all the fees that go along with it. According to the Dartmouth Atlas of Health, one third of medical spending goes to tests and treatments that are not necessary. One Third! Patients are guilty as well. Patients request procedures and tests in order to check for every possible ailment, to ensure complete accuracy.

I have been blaming insurance companies for a while. And I still blame insurance companies for many of the flaws in the health care system. But too, I have learned that patients are to blame. Doctors are to blame. And an entire culture that is fixated on treatment, on speed-of-light advancements, and a demand that someone must know the answer. Maybe that’s not so wrong. Maybe I undervalue the race for the cure to everything. But let’s face it, that much advancement is going to get pricey. The path to the fountain of eternal youth is long, and the fare is steep.