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Imagine There's No Healthcare
Imagine there's no healthcare, it's easy if you try. Now, imagine there's no pill to take. That might be more of a stretch of the imagination. According to a recent MSNBC article, it is estimated that 130 million Americans consume about 3.5 billion prescription drugs annually.
Seems like that could be a huge part of our healthcare crisis. Especially since a large portion of those drugs - and other related healthcare expenses - are for the treatment of conditions that are not only 100% preventable, but brought on entirely by our own behavior. I can't help but wonder, if we are choosing to make ourselves sick, why should we expect anyone else to make us healthy?
I ask that as an honest question.
David Martin, Senior Medical Producer at CNN, tells a very eye-opening story:
"An orthopedic surgeon told me the story recently about a 300-plus pound man whose feet gradually failed under his immense weight - until he walked on the inside of his ankles. He required complicated surgery on each foot and ankle - 3 ½ hours in the OR, a night in the hospital and months of rehab each time. The bill ran into the tens of thousands of dollars for a problem largely attributable to his weight."
He goes on to point out that in the US, medical spending for obesity related conditions - including diabetes, cancer and heart disease - was $147 billion in 2008. Not altogether shocking, given that about 32 % of Americans are medically obese.
Smoking, not surprisingly, accounts for nearly $100 billion in medical spending - with about 20% of the population addicted to cigarettes, which we ALL KNOW PERFECTLY WELL will probably kill you and make you horribly sick on your way to death's door.
You have some decisions to make now. There is no healthcare, no doctor to see, and no pill to make you better. What will you change? If you knew that what you were doing would make you sick, leave you in chronic pain and limit both your life and your lifestyle and that there would be NOTHING you can take to make it better, would you still do it?
With freedom comes huge responsibility. We have the freedom to choose how to live our lives, but we also have the responsibility to deal with the consequences of our actions.
It's not just smoking and obesity, just to be clear. We are seeking pills and intervention so that we can all achieve some very idealized vision of "health and happiness." We want to be perfect people with perfect lives, and we expect our doctors and pills to make us that way.
A lot of things need to change, and if you think about a world with no medical intervention whatsoever, it's much easier to look at our crazy ideas as, well, a little crazy.
- There were 56 million prescriptions written for sleeping pills in 2008. If there were no pill to take, would you drink less caffeine? Exercise more? Take up meditation? Yoga? Deal with it?
- Adult use of antidepressants has tripled since 1988. My personal experience with depression leaves me believing that it is very real and very genetic, but what would we do if we couldn't take a pill? Accept that not everyone is "happy" in the same way or to the same degree? Work harder on diet and exercise? Learn new ways to interact with each other? Stop expecting ourselves to be happy all the time and embrace our own range of emotions as legitimate?
- Alzheimers Disease, another one that I have painful experience with, has doubled since 1980 and affects 4.5 million people. If we couldn't slow the disease, would we be more able to let people "go," gracefully? Care for them in our homes since there would be no fancy - and expensive - institutions to send them away to die in?
- What of people who are born with disabilities like blindness or deafness? If there was nothing to be done about it, would we learn to love and appreciate them for exactly who they are? Would we find a place for them in our world, rather than changing them to meet our needs?
- What if there was a bad accident, and an otherwise healthy person lost a limb, and there was nothing to be done about it? Needed a transplant, but there was no such thing? What would we do differently? If we didn't expect miracles, how would we handle it?
And in all of those cases, who would we blame? Who would we sue?
There is little doubt that medical "miracles" offer great promise. But what has that promise delivered? A world of increasingly elaborate interventions to achieve ideals rather than basic human health? A world in which we have lost responsibility for our own bodies and take pills instead? A world in which we have superhuman expectations of doctors and surgeons, and then sue them when they turn out to simply be human after all?
Somewhere, there has to be a balance. People get sick. Some people are born sick. Some people live long lives while others live short lives. The only person who is, in fact, responsible for your health is you. Perhaps we ought to spend less time fighting to live longer and more time fighting to live healthier and happier?
I fully believe that all people need basic healthcare coverage. We should not be dying from things like the flu, lack of nutrition, or anything else that is simple and easy to treat in this day and age. That is embarrassing and we should be ashamed of ourselves. Even most cancers can and should be combatted with everything we've got. But I also believe that we cover a lot of things that are far from basic - like the repair and rehab of feet destroyed by carrying around 200 extra pounds.
I am incredibly glad that I don't have to deal with the muddy waters of what is "basic" and what isn't. I am fairly certain that we are funding more than a few unrealistic expectations that amount to a shifting of responsibility and denial of reality.
And one thing that remains clear to me is that if you - or I - are doing something that is causing a chronic and expensive medical condition, it is not anyone else's responsibility to fix it.
No politician is going to suggest that, it would be political suicide. But I'll suggest it. Healthcare reform starts at home. It starts with all of us getting healthy and getting a grip - and not by taking pills.
The best thing that we can do to solve the healthcare crisis is to lose weight and stop smoking. NOW. And start taking responsibiity for the rest of your health and well being too. Any change you would make out of necessity, you can make out of responsibility. Live as if this were the last day of your healthcare.
As David Martin points out, the Obama proposed healthcare plan would cost an estimated $239 billion over ten years. The cost of obesity and smoking - our own behavior - will cost $2.4 trillion over the same ten years. At that rate, there will be no healthcare. What will you do to solve that problem? Because there is no pill to fix it. And there won't be a bill that can fix it either.
Photo by Striatic, who has lots of great shots in his Flickr Stream.