“An
ounce of prevention is worth a pound of cure,” Benjamin Franklin once
said addressing fire safety. In the nearly three centuries since, his
quote has become synonymous with a philosophical battle being waged in
modern healthcare: preventing vs. treating sickness. Though little
disagreement exists in the statement that “keeping a well person healthy
is easier than getting a sick person well,” the clear winner in the
on-going debate, at least in terms of which dominates our current
system, is the treatment camp. Of the $2.2 trillion spent on healthcare
in the United States each year, $1.6 trillion is spent treating
consistent examples of poor health; and treatment as the focal point of
healthcare has been a catastrophe, as reflected by poor outcomes despite
irrational spending.
One
of the primary efforts at fire prevention implemented in the 20th
century aimed to install a smoke detector in every house, offering
homeowners a warning sign; the strategy has proven incredibly
effective. During that same period, the population has been conditioned
to ignore the equivalent warning signs in their bodies, treating the
symptoms of fire-like circumstances while remaining largely unaware of
the underlying, slow-burning ruin. “When you hear the smoke detector
going off, find it, knock it off the ceiling, and move on with your
day,” a hypothetical fire prevention seminar sponsored by modern
American healthcare might teach. Clearly, healthcare should be
following the lead of fire safety, not the other way around.
Our
current “health” system has its priorities backwards. The number one
reason why people eat well in the United States is to lose weight and
the leading prompt for restoring previously lost structural balance is
chronic pain; being overweight and in chronic pain are effects of
becoming unhealthy, like fires, and proper nutrition and structural
realignment – items on the list of things we fundamentally need in order
to maintain good health – are presently used as treatments to put them out. That has to change.
It
is unlikely to change anytime soon, though. Nearly all manners of
forward-thinking in healthcare are directed toward innovations in
treatment, with one particularly noteworthy exception. Among the latest
and greatest treatments in the 21st century is stem-cell therapy, which
is an intriguing concept that has rapidly expanded its footprint and
repute. Stem-cells are like blank tiles in Scrabble, capable of
becoming any cell type that our bodies need them to be, and they are a
key facet in the constant and automatic natural regeneration that takes
place inside our bodies all the time; stem-cell therapy, then, aims to
extract stem-cells and place them where damage has accumulated most on
account of injury or breakdown. Plenty of controversy surrounds the
concept, from the source of the stem-cells to the long-term safety of
manipulating something as delicate as a living cell; the therapy also
falls beyond the orthodox bubble, threatening to disrupt the disease
management system status quo and thus generally costing, for a series of
treatments, what the average household in America spends on healthcare
all year. Nevertheless, stem-cell treatments are quietly developing a
solid reputation for their benefits, and even an opponent of the therapy
would have to admit that it makes far more sense to try and channel the
body’s innate capacity to repair itself than to stick with the tired
idea of chemical introduction to disrupt biochemistry, the hallmark
premise of conventional pharmaceutics.
Still,
even if the proliferation of the above becomes a pillar for healthcare
modernization in the coming decade or beyond, that it will
simultaneously serve to push us collectively further down the
rabbit-hole of operating healthcare out of the reactive realm, focusing
attention not on the efficacy of preventing disease and breakdown, but
on what to do once already broken down and in a diseased state, is
concerning.
It
is in our nature to want to understand and to want to solve problems,
but perhaps the best understanding we could ever reach is that most
health problems are caused by losing a game of percentages; more stress
than stress management skills, consistent interference within the body’s
internal communication network (like putting a dimmer switch on innate
functional capacity) minus the tools to eliminate the distortion, and a
lifestyle described as sedentary instead of physically active exemplify
how abnormal begins to overtake normal, making poor health an
inevitability, the end result primarily of a long-term process of
degradation rather than the by-product of bad luck or otherwise. To win
the game of percentages, we have to put in the necessary effort; and
victory is but a drastic mindset shift away.
Health
is not something that can be manufactured; like wealth, it must be
earned and continually maintained. Prevention of sickness alludes to
well-being, the maintenance of which – in accordance with a broader
definition of health inclusive of the various aforementioned
foundational pieces (function, structural balance, nutrition, stress
management, and exercise) – signifies a state of wellness strong enough
to dramatically reduce the need for treatment protocols.
In
order to adopt a more preventative approach, we would need to put the
responsibility for health back in the hands of the people, whose own
roles have been preposterously marginalized; part of the process to
achieve that cultural shift would involve teaching people that they can
and should trust that their bodies will adapt and react as designed if
given the support required to do so optimally. When a baby is born, the
phrase “it’s a miracle” is often expressed – and it is indeed
miraculous – but the miracle of life continues until we expire and we
have far more control over our health during the time in between the
beginning and end than has been let on during the medicalization of
healthcare over the past forty some odd years.
Interesting,
is it not, that the gold standard for contemporary preventative care
mirrors a process that routinely takes place every single day of our
lives, that being exposure to traces of microscopic foreign invaders
that engage our immune systems into action, building immunity to a
plethora of bacteria and viruses. Basic sciences, biology and
physiology specifically, teach that the strength of the immune system, a
reflection of health, determines both the degree of exposure and the
ability to eradicate invaders. However, generations of people now
believe that laboratory science is more important to immunity than the
very immune system that, by comparative ratio of elephant to ant,
constantly eliminates disease without artificial assistance.
By
no means, though, does advocating for a preventative model to take the
reins of healthcare suggest that treatments are not necessary or that
innovations like stem-cell therapy should not still be a major part of
the system at large, but the pendulum has currently swung about as far
toward the treatment-based model as it can and nothing is likely to
change about the state of American healthcare until the pendulum swings
significantly in the direction of prevention.
If
we took Franklin’s quote literally – if an ounce of prevention was
worth exactly a pound of cure – then we would stand to save over $20
trillion were we to dramatically revamp our healthcare system and focus
it on prevention. So, with that in mind, let the debate resume...
Thinking good things for you, as always,
-Dr. Chad
No comments:
Post a Comment