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Fixin' Healthcare

Friday, August 31, 2007

The Dog Ate My Homework

The American Cancer Society might provide better service if their money was devoted to learning more about human behavior. What motivates people in their decisions about lifestyle and health? How can people be motivated to make decisions that benefit their health? Mindset is a major issue in health and the US spends vast sums of money tiptoeing around the problem. It is not that people don't deserve quality affordable health care with transparent costs, but let us not fool ourselves about what that health care should be. Take a tip from the ladies and see what people are capable of doing. And, no excuses.

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Thursday, August 30, 2007

A Journey Without End

What is the meaning of a "journey without end"?

It means the journey is a destination and the activities of the journey create conditions and outcomes. If the journey is delayed, changes course or stops, the conditions and outcomes change or cease. The journey is a lifestyle and it is a lifetime.

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Wednesday, August 29, 2007

Health Is the Journey Without End

Health care in the US is medical care. The last thing any sane person should want is universal insurance that provides access for everyone to the medical care system. That decision would surely increase the cost of care and lower the health status of the nation. Medical care serves those who are sick, ill and suffer with disease. It is appropriate for the medical care system to direct its attention and efforts to sickness, illness and disease. However, it is a disaster when the public comes to believe that medical care is health care.

To reform medical care is an exercise in futility if the goal is to decrease cost and improve health status of the population. Every effort should be made to increase the effectiveness and efficiency of medical care but the real challenge is to limit medical care to those who suffer with illness and disease. This can be best accomplished by the creation of a health care system to promote health and prevent illness and disease.

I do hope and pray that improving health status is what we are committed to. Our actions should make progress toward that goal and currently they do not. Let's get busy. There is a lot to do and many essential things we do not know.

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Tuesday, August 28, 2007

True, True and Unrelated

Does anyone believe the health status of the US population is determined by the 16% that have no health insurance? Eighty-four percent of the population have health insurance and the US ranks behind 41 other nations in life expectancy.

Does anyone believe that health insurance for everyone will decrease the cost of medical care? There are 6.8 deaths for every 1,000 live births in a country where insurance pays for a high incidence of C-sections and neonatal intensive care units.

Should the goal be to improve health status of the population? If so, expanding medical care is not the best way to get there. Medical care treats sickness, illness and disease. The need is to increase the effectiveness (and efficiency) of health promotion and disease prevention.

Health insurance (true) - medical care (true) - improved health status (unrelated).

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Sunday, August 19, 2007

Get A Grip

Is exercise at the center, and forms the core, of good health?

Well, when we finally arrive and look behind the curtain, there is the Wizard of Oz walking rapidly at an incline on the treadmill. He smiles and says that he has to do more than casual walking for a few minutes each day to stay in control of his life.

There is question whether "30 minutes of gentile exercise might not be just a bit too gentile." But, does one have to be a runner and a weight lifter to be in good health and manage body weight? Evidence indicates the truth lies somewhere in the middle.

It is a matter of common sense. Almost everyone is aware of physical conditioning. Start slow and low, and build up the speed and the intensity. Another principle of conditioning is that as conditioning is achieved the improvement levels off.

Try to walk as a dedicated activity at least 30 minutes each day. Don't let it drive you crazy if walking 30 minutes is impossible for that day but be realistic about impossibility. Increase the time to one hour whenever possible and be realistic about possibility. Three days weekly gradually increase the thirty minutes to involve walking briskly uphill or a treadmill at incline or hiking in the mountains. In other words, "break a sweat." Those three days should include some sessions of weight training to maintain muscle tone, strength and balance. As with everything of value in life, the challenge is focus and discipline.

Scientific data shows that brains can regenerate themselves and do not have to decline with age. Evidence is showing that the "human brain is not only capable of renewing itself but that (aerobic) exercise speeds the process."

It won't be easy but it is necessary. And, you will feel better.

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Wednesday, August 15, 2007

Prevention Where They Live

Build prevention into the community and get it out of the medical setting wherever possible. Certainly, convenience and culture are important considerations. Patience, persistence and knowing the lay of the land count for a lot. Keep smiling and never give up. Prevention is a different ball game than diagnosis and treatment.

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Monday, August 13, 2007

What's Your Sickness?

The Medicalization of Society by Peter Conrad.

Building the future one diagnosis at a time.

Now, that's something to anticipate, if it is not here already.

If you can't run, walk fast to get away while you are still able.

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Sunday, August 12, 2007

Medical Care Is Not Health Care

The "political season" generates pressure to propose innovative solutions to problems that rank high for public attention. This season health is on that list. If the goal is improved health status at lower cost, then health promotion, preventive health care, early detection of disease and more consistent care for chronic health problems are good ideas.

The concept of preventing health problems has been around for a long time. The greater part of improved health and increased life span that occurred during the 19th and 20th centuries is directly or indirectly due to public health and prevention. Think of sanitation, housing, safe drinking water, adequate nutrition, refrigeration, personal hygiene and immunizations. To say the least, improved health status is a broad, complex area that requires active participation of individuals and populations with social and government institutions. If it is to be done at a lower cost, the implementation cannot be within the medical care system.

During the 20th century, America redefined health care as medical care and, then, equated medical care with medical insurance. It has been a lethal and costly mind-set. When health promotion and preventive health care are defined in terms of medical care, the costs become prohibitive and the effectiveness is lost.

The politicians have a good idea. Now, they have to rethink how to implement it. I suggest they define and refine medical care to study and treat serious illnesses and diseases. Stop equating medical insurance with improving health status and recognize it as an economic risk tool to protect against financial ruin. Create a health care program for all citizens and implement it through the public health and educational systems at the community level.

I believe the Director of the National Center for Disease Control and Prevention suggested something similar. Are you listening?

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