Healthcare Reform? Blow it up, and Start from Scratch!

June 20th, 2009 by Nick Jacobs Leave a reply »

Healthcare Reform? The premise and the incentives are wrong.  We treat sickness (which can be a good thing), however, we do it to the almost total exclusion of encouraging and incenting wellness. While in the Netherlands a few years ago, I asked a very comfortably-situated business person why she and her entire family all rode bikes. She smiled and explained that the millions of bikes in the Netherlands are a way of life because they keep people healthy.  Of course, we don’t have to ride bikes, but why not?  “It is much less costly.  It gets us where we want to go, and it is so much better for our bodies,” she said.

Photo credit: Amsterdamize
Photo credit: Amsterdamize

After going to doctor after doctor in my early thirties and then again in my early forties for a recurring and seriously painful back problem, someone suggested a Chicago-trained chiropractor.  After a very quick, one time manipulation, he said, “Follow me, please.”  When we descended the stars of his office, in front of me was literally an entire homemade work out facility.  This particular center seemed to emphasize strength training.   The Doc walked me over to a row of three machines and said, “If you use these three machine or their equivalent, just the way I show you, you will never have to come back here again.”  Then he said, “Oh, and if you drop fifteen pounds, you may be able to get off those blood pressure pills, stop taking that stomach medicine, and feel better about yourself in the process.”

The Dr. Dean Ornish Coronary Artery Disease Reversal Program is completely about health and prevention.  It is about wellness; treating yourself with the love and respect that you deserve, being kind to yourself, yet being disciplined enough to get you where you need to be in order to enjoy a healthy, pain free life.

We spend only 4% of our health care dollars on prevention.  That may sound like a lot to some of you, but do the math.  Take 4% and multiple it times $2.2 trillion …or possibly soon $3 or $4.0 trillion.  Every physician should endorse a workout facility and work to send you there, and every physician should receive bonuses for having you use it.  A primary care physician in Britain can make about $320K a year, which includes incentives directed toward encouraging healthy living for their patients.  Our primary care docs make, what, $130,000, $150,000, $180,00 in comparison?   Would you really care if your physician could make almost twice as much if you were living a wonderful, healthful, reduced stress life?

There is absolutely NO DOUBT in my mind that the reason I’m typing this here today and not deceased at age 58, like my father, is because of the work of people like Drs. Ornish, Benson, Jonas, and Weil.   It is not because of my old donut shop, the nachos and cheese, the automobiles, my Lazy Boy, or the grueling work habits that we Americans think of as normal.

And what about death?  I have to tell you that death happens to all of us.  (Sorry.)  When it happens may depend a great deal upon our recognition of that fact, but it is not avoidable.  So, why is it that we, as a society, reject death as evil, and ignore its possible existence?  How could we cut billions and billions of wasted healthcare dollars?  Hospice is the answer.  Don’t commission oncologists for drug use when there is absolutely no hope that the patient will live.  Don’t pay radiologists for radiation treatments that will not work in preventing death.  Don’t reward hospitals financially for readmission after readmission for people who should have been told to mark  their DNR’s months earlier.  Face death as part of life.


Finally, look at the food and restaurant industry.   For every restaurant or food company that pulls a killer food and replaces it with the reasonable alternatives, reward them through the $3 or $4 trillion health budget.  You can buy veggie hot dogs on the streets of Toronto.  (Try Morning Star Farms brand veggie hot dogs.  They rock.)

In closing; diet, exercise, stress management, balanced lives, less capitalistic rewarding of killer diets, higher reimbursements in healthcare for the “right stuff,” and acknowledgement that this will eventually end, can make it all work so much better, so much cheaper, so much easier.  Did you have your pneumonia shot yet?  Well, actually, you may not need one if you start taking care of yourself.  I’m going downstairs to workout now.

Next time?  Tort reform.



  1. Immigrant says:

    Bikes are a way of life in the Netherlands because they keep people healthy? What a load of crap, maybe someday she’ll actually convince herself of it, too. Most Dutch ride bicycles because they can’t afford everything it takes to drive a car.

    Driving lessons: 50E per hour (minimum 20 hours)
    Tax on car purchase: 19%
    Petrol: 6-8E per gallon
    Monthly tax on car ownership: 50-100E
    Insurance: 50-100E

    Telling yourself you ride a bike because it’s healthy: priceless

  2. Immigrant says:

    One more thing about just how healthy the Dutch are. You can’t legally begin to get a drivers license until you’re 18. But you can get your beer at 16. That’s uber healthy.

  3. Nick Jacobs says:

    Hey, Immigrant, one question. Is it healthier to ride a bike or sit in a car?

    I’m sure you’re correct on everything else, but my point is that we are “Couch Potatoes.” Money is NOT always good for your health.

    Oh, and beer consumption beginning at 21? How do you spell binge drinking because everyone is tryiing to make up for lost time?

  4. memory foam says:

    The British system of including incentives in doctors pay based on their toward encouraging healthy living for their patients is something that needs to be adopted quickly in the US. It has two very significant benefits … it would increase preventative health education by doctors, which has been neglected (to the detriment of control of health care costs), and by providing higher pay for primary care doctors would alleviate the growing shortage of these.

  5. GvG says:

    While the argument about money might be true for students, it’s not valid for most adults.

    Most Dutch ride bikes because it’s the fastest way from point A to point B in lots of places.

  6. I would think both arguments are valid. Whilst some may wake up in the morning and think, I’m saving the environment today, there may be many who would just as soon as drive if they could afford the car.

    I do think that more people over here in the UK should cycle though as many journeys are very short.

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