California is in the midst of grappling with escalating health care costs. Early rumblings suggest that the California legislature is coming precipitously close to taking a path that is unsustainable and will serve to make the problem worse.
Here’s my radical proposal. And I use the word radical in its truest meaning: getting to the root cause.
Before there can be an intelligent conversation about health care costs and its increasing burden on California taxpayers, you must define your terms to effectively frame the debate. If the chiropractic profession’s contribution were merely to bring clarity to the language, this alone would be a Herculean accomplishment and advance its interests!
The most important distinction that must be made is between the terms “health care” and “sick care.” Simply put, unless this distinction is repeatedly made, any new initiative is doomed from the start.
Treating diabetes is not health care. That’s sick care.
Treating cancer is not health care. That’s sick care.
Back surgery is not health care. That’s sick care.
Prescribing medications to artificially lower blood pressure or even cholesterol is not health care. It’s sick care.
Using psychotropic drugs to make it easier to control children is not health care. It’s sick care.
Need I go on?
Yet, seeing a chiropractor for back pain relief is sick care too. As is consulting a chiropractor to relieve a nagging headache. And 99% of virtually all other visits to a chiropractor. So, sick care isn’t necessarily bad, it’s reactive rather than proactive. It treats the symptoms, not the cause.
Why does this matter? Because without striking at the root of the problem that creates the bulk of today’s expensive and largely lifestyle-induced diseases, the aging baby boom generation is poised to bankrupt California or virtually any other entity foolish enough to assume the risk.
So the question comes down to this: Is the California legislature actually interested in advancing true health, life and well-being, or is it merely interested in ways of spreading the cost of disease treatment in such a way that the many will pay for the few? Is it inclined to look for ways to raise the personal responsibility of each Californian, or is it looking for clever ways to steal that responsibility and facilitate the continued abuse of their constituent’s health, sabotage their longevity and burden other Californians with their poor choices?
Rather than simply rearranging the deck chairs on the Titanic; that is, focusing on how to manage end-stage treatment costs, it would be far wiser to prevent the problems in the first place, as so beautifully articulated in the poem entitled, A Fence or an Ambulance, written over a century ago by Joseph Malins:
'Twas a dangerous cliff, as they freely confessed,
Though to walk near its crest was so pleasant;
But over its terrible edge there had slipped
A duke and full many a peasant.
So the people said something would have to be done,
But their projects did not at all tally;
Some said, "Put a fence 'round the edge of the cliff,"
Some, "An ambulance down in the valley."
Then an old sage remarked: "It's a marvel to me
That people give far more attention
To repairing results than to stopping the cause,
When they'd much better aim at prevention.
Let us stop at its source all this mischief," cried he,
"Come, neighbors and friends, let us rally;
If the cliff we will fence, we might almost dispense
With the ambulance down in the valley."
Better guide well the young than reclaim them when old,
For the voice of true wisdom is calling.
"To rescue the fallen is good, but 'tis best
To prevent other people from falling."
Better close up the source of temptation and crime
Than deliver from dungeon or galley;
Better put a strong fence 'round the top of the cliff
Than an ambulance down in the valley.
If the motive of the legislature is to truly reform health care while enhancing the overall health and well-being of Californians, it will be essential to trumpet what health is, but also how it is lost and how it can be regained. Much of what we euphemistically call health care is the result of millions of poor lifestyle choices. Whether the state should be making it easier for taxpayers to make these poor choices, sending the bill to other taxpayers, is ripe for political debate. But let’s admit that at the root of this problem is a lack of education and the poor choices people make that often take decades to manifest before becoming a demand on what is the “health care” infrastructure.
Making the necessary changes will take at least a generation to achieve. Even the ban on indoor smoking pioneered in California will take years to show up as lowered cancer rates. There can be some quick wins. But changing attitudes and behaviors take time.
The legislature has the power and influence to...
Ban the promotion and raise the tax on unhealthy foods
Provide incentives for businesses to institute employee wellness plans
Direct grade school educational programs that teach the nature of health
Restrict the influence of the medical pharmaceutical industrial complex
Implement public education program about the cause of disease
Reward behaviors and lifestyle choices that advance better health
Commit to a 10-year goal of becoming the healthiest jurisdiction in the world
I hope the California legislature has the courage and the discipline to look beyond the financial interests that have actually helped serve to create the current crisis and get to the root cause of the problem. California is at a crucial crossroad. Will they take the easy path? Will they simply throw more money at doctors and drug makers? Or will they commit to the less popular choice that promotes prevention, self-responsibility and true health and well-being?
The entire world is watching.