Dean Ornish injects himself in the health reform debate

by Rahul Parikh, MD

It looks like The Huffington Post’s honorary Medical Editor, Dr. Dean Ornish, walked into the same trap that Whole Foods CEO John Mackey did.

Mackey got a lot of flack when he wrote an op-ed in the Wall Street Journal on health care reform, one in which he emphasized the need for personal responsibility for our health.

Ornish, in an effort to inject himself into the current debate, blogged, Don’t Tread on Me: Transcending the Left Wing/Right Wing Health Care Debate.

On the surface, the piece is quite reasonable – Ornish discusses his 14-year fight to get Medicare to pay for services that rewarded doctors for helping to prevent disease. But in doing so, he says:

I understand those who think that single-payer health care is the way to go. However, after needing 14 years to get Medicare to do something as obvious as paying for intensive lifestyle changes scientifically proven to reverse heart disease despite the strong personal support of those at the highest levels of government and the leading experts in the scientific community, I share the Republican concern about greatly expanding the power of the Centers for Medicare and Medicaid Services. I’m as deeply suspicious of big government as anyone. I’m strongly in favor of universal coverage but not single payer.

Ornish goes onto tell us how he is equally suspicious of insurance companies. Then he proposes OrnishCare:

There is a third alternative. The idea that changing our lifestyle can prevent and even reverse the most common, the most deadly, and most expensive diseases transcends the old left wing/right wing, red state/blue state divisions. These are profoundly human issues that we can all support, bringing together liberals and conservatives, labor and management.

OrnishCare must have reminded the HuffPo audience of MackeyCare, as he received a plethora of comments criticizing him as naive and elitist.

“Foolish academic BS from someone who has never been without access to healthcare,” wrote one reader.

From another: “The problem with your third line of reasoning – reasonabl­e as it is – was demonstrated to me today at Church where our wonderful Knights of Columbus put on a glorious gut-busting breakfast including eggs, ham, sausage, bacon, HFCS-loaded syrups, fruit treats, doughnuts, omelets, cheesey-potatoes, French toast, and pancakes, topped off with a celebration chocolate cake for the new pastor. This after a service listing all the folks in the parish being treated for cancer and heart disease”

These same kind of class-war comments led Whole Foods customers to boycott the store because of MackeyCare.

Probably the most insightful comments came from health care and economics writer Merrill Goozner:

I spent much of last year trying to shoehorn the Ornish philosophy into the health care debate. I agree we need to pay for cost-effective prevention options – including the Ornish approach to lifestyle intervention for people seriously at risk of heart disease.

But it’s a tough fit because that’s not going to end disease in America. And as long as people continue to get sick, they will face the problem of an inadequate insurance system and an out-of-control medical system. As one intelligent commentator pointed out, every one of us is eventually going to get sick, face a traumatic injury or an unexplained illness. Every one is going to die, and many will face agonizing end-of-life medical choices – no matter how healthful their lifestyles.

When any of that happens, they deserve a well-functioning and reasonably priced sick care system. The last thing a sick person needs is a lecture on how they ate wrong and failed to get enough exercise in the months and years leading up to the acute event.

I couldn’t have said it better myself. And, like Goozner said, eventually you, me, and Dean Ornish are going to need that well-functioning and reasonably priced sick care system.

Rahul Parikh, a pediatrician in California, is a contributor to the Los Angeles Times and blogs at sWell on Open Salon.

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5. Support for the patient centered medical home in the House health reform bill
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