Alternative Medicine and Traditional Medical Care

In case you have not seen it, this is a good review and comparison of alternative medicine and traditional medical care. No smoking, healthy diet and regular physical activity could trump at least half of today's medical problems. And a caring practitioner always helps.

Taxes and Subsidies

Mark Bittman makes some good points about getting people to stop eating "bad food" and start eating more "good food". Using the public health model for tobacco might work but everyone agrees that food is much more complex. Tax policy and subsidies have created plenty of problems for the U.S. and maybe they could get us out of some trouble. However, the trend for the future appears to be a more simple tax code and fewer subsidies. Reducing or eliminating subsidies for the agricultural commodities would help even if no subsidies were forthcoming for vegetables. Most of the taxing on unhealthy food and drinks is coming at the local and state level. Furthermore, the local (city) projects for health promotion mobilizes the powerful force of community support and peer pressure.

Can Washington Cure Disease?

Medical research and life science companies are successful with innovation and economic development. But finding cures for chronic diseases has not been a success story. The possibility of preventing much of the chronic disease is greater and more immediate than finding cures. If the objective of the government is innovation and economic development, then they should continue doing what they are doing. On the other hand, lifestyle modification and public health are more likely to result in a healthier population with a lower incidence of chronic diseases and less need for the cost of medical care. I wonder how that might effect the economy, especially long term.

Great Expectations and High Hopes

It is conceivable that modern medicine began in the 1960s with Medicare and Medicaid. The era started with great expectations and high hopes. The sudden and increasing flow of money created excesses and continues to generate the biggest financial bubble of all. Mere hints of discovery are a sensation. Researchers and professors become rock stars and start companies. The process has corrupted the academic world. Even a deliberate investigator can have their head turned by the commercial rush to judgement that comes with fame and money. Universities became big business and partners in the process with reluctance to stem the flow of resources, not to mention the desire for institutional fame. Politicians rant about the necessity to provide medical care for everyone. Medicine dominates the health field and the public no longer understands health except in terms of sickness and medical care. Who knows, the genome and its practical application might take us to optimum health status even if it is a long and expensive road. False starts are to be expected. They are factored into the cost.

The medical care bubble is the most severe risk to the country at this time. It is the major contributor to financial strain and it distracts from the basic and necessary understanding of health by the American public.

The Need For Medicaid

A study of one year duration in Oregon indicates people are better off with medicaid than no health insurance. Observations to date speak more to utilization of services and surveys of satisfaction than changes in health status. More medical care and secondary prevention can lead to improved health status at greater cost but this study does not yet support that conclusion. The important study would be to compare these results to primary prevention by means of lifestyle changes in a similar population. Interestingly, the desired outcome in the primary prevention study is improved health status with decrease in the need for medicaid.