More Health For the Care

The body politic and the medical care industry are not without honor but they cannot achieve optimum health status or cost containment by manipulating health insurance or reforming medical care. It is a matter of priorities. Health must be emphasized above sickness. Even what is considered successful treatment of a disease does not yield the health status prior to the disease. Furthermore, illness, disease, injury and disability will always be costly. It is best to avoid them, if at all possible.

More health for the care can be achieved by placing emphasis upon primary prevention integrated into all aspects of community life. Every institution and organization is involved and responsible. A public health care system will monitor and address health status in the community. Primary care medicine that is oriented to individual and community health will be the first responders to sickness. Linking and coordinating these activities depends upon educating the public and providers alike. Everyone needs health care, medical care is for those who need it.

High Expectations

Public support of biomedical sciences, medical research and medical care comes with high expectations which frequently bear no relation to the nature and status of those endeavors. The public is interested in cures and they are conditioned to expect what they want to be true, which is misunderstood and overstated. From the laboratory to the clinical setting to everyday life data are gathered, analyzed, interpreted and organized to reach conclusions that shape medical care. The conclusions are derived in a context of biological variability, biological adaptability and behavioral uncertainty. Every step is subject to error, bias and ignorance. The unknown vastly exceeds the known and the boundary between the two moves slowly and erratically revealing contingent truths. It is at all times a work in progress and whether or not it is oversold, it is overbought.

A Fish Out of Water

Pricing and resource allocation are crucial functions of an economy. Value systems determine how this is accomplished and conversely the process contributes to defining a society and molding the character of its citizens. It is a process fraught with hazard. Small miscalculations and delayed consequences build over time to generate substantial impact. The pursuit of short-term objectives without consideration of broader and longer-term goals increases the danger of demand exceeding capability. Impatience to generate increasing quarterly profits to support greater allocation of discretionary resources fuels the consumer economy with emphasis upon choice and competition. Medical care developed within this framework and it became a consumer business. Many think medical care is broken but more likely it is a fish out of water.