I stumbled across an article today, http://hitconsultant.net/2016/08/16/xerox-research-consumer-health/.

The premise is just like it sounds.  Physicians believe only 6% of patients take responsibility for their health.  Patients believe 50% do, and I personally think the number is somewhere in the middle.

There are a multitude of problems, beginning with the fact that by their own admission fully 50% of patients do not take responsibility for their own health!!!!!

 

Is it any wonder that the news has been peppered with stories about the failure of Obamacare?  http://www.investors.com/politics/editorials/obamacare-is-failing-exactly-the-way-critics-said-it-would/

Insurance carriers across the country are leaving the exchanges, citing unsustainable costs.

Allow me to compare physical health to financial health, for the sake of illustration.

There are millions of Americans that are massively in debt, that have abysmal credit, but that from outward appearances, are normal or even successful!  (Check out the movie “The Joneses” for an only slightly exaggerated version of my point.)

But what happens when you don’t take care of your financial health for too long?  Like it or not, you pay the consequences.  Your privileges (NOT RIGHTS!!!!) are removed.  You are disallowed from making certain purchases.  Your housing options shrink.  No more credit.  Most people still don’t take responsibility and make the necessary changes, but at least they must live with the consequences!

What are the consequences of poor health?  Not poor health care, I think that America has probably the most able health care in the world, even if the management and delivery systems are almost fatally flawed.  Poor health does not have equivalent consequences.  Heart attack from poor diet?  No problem.  See you next week.  Diabetes because you drink four liters of soda a day?  No problem, we’ll deliver it.  Broke your head open riding a dirt bike?  No problem, the Emergency Room is open 24/7 and won’t do anything more than send you to collections if you don’t pay.

There are NO MEANINGFUL CONSEQUENCES FOR POOR HEALTH!  Clearly Americans don’t care enough about actual ill-health to change, and there is almost zero financial reason to change, when non-payment has no practical effects, so why on earth would we expect citizens to make any changes?

The Hippocratic Oath, here in it’s modern version as adopted by Johns Hopkins University, http://guides.library.jhu.edu/c.php?g=202502&p=1335759 is an honorable pledge, but nowhere in the pledge does it require that a care provider sacrifice their own health, well being, or self for the cause of another.  Nowhere does it indicate that a physician is obligated to financial ruin to care for another.  HEALTHCARE IS NOT A RIGHT!

Physicians in America today may have one of the least desirable jobs I can imagine.  Crushing debt, a decade or more of schooling, thankless patients, unending increase in the cost to do business, perceived fault for every unwanted outcome, entitled employees, regulation and compliance mazes impossible to navigate, it’s no wonder that  the number of healthcare workers that are foreign born is accelerating.  http://www.migrationpolicy.org/article/foreign-born-health-care-workers-united-states  American’s don’t want the job!

What will be the tipping point?

Are we headed for nationalized healthcare, like some European nations have?

Who will work in that system?  America is not Canada, not Switzerland, not Norway.  Capitalism is still king, and you can bet that droves of physicians would leave the national system and start boutique offices.

Can you afford to pay the tax increase AND pay your privatized specialists?

Or will we wake up?  Will we, as a majority of America, recognize that healthcare costs can only be driven down if we are actually HEALTHY?  Will we eat better?  Will we do something active?  I would bet that even an incremental change in behaviors would have a massive change in outcome.  This is an instance where the investment would pay off in spades.

I don’t think it will happen.  Who wants to move to Canada with me?