Health care change will have to come from the public

Most of us want to know how to fix this healthcare mess these days. We’re scared about the future and how we’re going to afford costs that never, ever seem to stop skyrocketing. We’re scared about the world our kids are going to inherit and the phenomenal debt they’ll be haunted by throughout their lives. We’re scared about living in a country that’s cowering under the hefty weight of fear and control perpetuated through incessant sound-bytes controlled by those who have against those who have not.

When leather-capped crusaders with bows and arrows of outrageous fortune steal from the poor to give to the rich, it’s called a Reverse-Robin Hood Phenomenon. We seem to be living in it today; especially in healthcare.

As a quick summary, health insurance companies make about $4 billion dollars per quarter, give or take. Drug companies make about $20–60 billion a year. The government wants to mandate you to pay for the uninsured while still trying to pay for your own health insurance without getting rid of for-profit incentives.

You (19–64 year olds) already pay for > 80% of $2.5 trillion dollars. As you get sicker and drop into the growing ranks of the uninsured, the poor slobs left over who are still struggling to pay for private health insurance and public programs will bear the brunt of the costs.

Private health insurance will go skipping into the sunset by separating the market into those who are healthy, scared and willing to pay, and those who are sick, poor and dying. The cost of both will still be carried by you and I, the 19–64 year olds who keep paying more and more without seeing any relief.

What’s wrong with this scenario?

Well, for starters, we’re wasting time talking about what’s wrong with this scenario. We’re holding our breath, scared to do anything about it. We keep waiting and waiting until someone like a government institution or a doctor’s group or some political junkie to figure this out and tell us what to do with our health and our lives.

We’re waiting for the capped crusaders to save us.

But that’s the problem. Those crusaders are going to hand us a sack that looks like it’s filled with gold. But there’s only a lump of coal inside. All the gold is still going to Wall Street.

So here’s a solution. It’s a scary thought, but waiting for something to happen is even scarier. Are you ready?

Change is going to have to come from the public.

Yes, that means you and I.

That also means no more waiting. That means if we want to find health, if we want to live a good life, a happy life and change the world for ourselves and our kids, invest in a failing country’s future, we are going to have to “be the change we wish to see in the world.”

The bottom line is there is no hope for America’s health until self-interest dies. The American dream is dead. It can’t afford its own health care.

So how do we kill self-interest in healthcare and resuscitate our dreams?

First, we all drop health insurance. Across the board, we do not accept private health insurance. Period.

Escalating premiums that outpace inflation, posting billions in profit during economic recessions, and creating underhanded, unethical, immoral tactics to profit from controlling your access to health is worse than Lex Luther trying to take over the world. It’s the Grim Reaper.

Second, we drop Medicare. Yes, we drop Medicare. It’s been sold to private companies who make profit. It’s not a healthy program anymore. The money Americans paid in forty years ago has been long gone, face the reality. It’s simply a horrible distraction away from the real issue of how do we find health and stop paying exclusively for disease.

Third, doctors join you. We work together, doctor and patient. And as paradoxical as it may seem, doctors should drop Medicare.

At the same time, they should all drop private insurance.

So when you need care and you come to the office, there’s nothing standing between you and your doctor. And the cost will be much, much, much cheaper than playing these insane games that both patient and doctors play for outside parties who control bureaucracy and nothing else.

Fourth, doctors have to drop their malpractice.

This cost has increased by 229% during 1990–2006. It’s not the doctor who pays for malpractice. No indeed. It’s you and the doctor – it’s all of us. And that cost is driving up your cost of health care via lawyers who need to perpetuate hatred and blame between you and your doctor.

It’s a terrible thing when the most healing and sacred of all relationships a human can have has been toxified like this. How can we expect to nurture health in the middle of hatred and blame between doctor and patient?

Fifth, you need to negotiate ALL your health care bills.

That’s what insurance companies do to all of us. Why can’t we do the same thing? Hospital bill too high? Start at 10% cash if you can afford it and stop at 15% of the bill. Tell them to screw it and take you to bankruptcy. You’re going there anyway, so they may as well get something as opposed to nothing.

What you don’t know is that hospitals bill you the same rate they bill health insurance companies. That’s a health insurance rule. Although they would like to offer you a ‘cash rate’ they can’t.

But believe me, they don’t want to keep begging for insurance to cut their bills by a third after 90 or more days. They’d rather cut the bill now (since it’s higher than what they expect anyway) and have the cash now.

It’s just business. Take away insurance and the government and we can do business together. Just like they do.

Finally, America has to decide what kind of country it wants to be.

What kind of country do you want to live in? Do you have the balls to stand up and fight for what you want?

The recent estimates from the National Health Interview Survey, January to June 2011 on the Financial Burden of Medical Care show that about 33% of all Americans were in a family experiencing the financial burden of medical care. The worse news is that children were the ones who were three times as likely to be in a family that was struggling to pay medical bills.

It’s our kids who we’re killing.

So are you strong enough to fight for your kids?

When we continue to block real solutions to care and leave families bereft of hope, health and life by blocking bills to real solutions just because we want to block bills to real solutions, we all stand to lose. Big.

Political and financial self-interest at the level of unrest it is today is killing us, literally. It is time to collapse what we have.

From its ashes will be born something new; a system that functions on a different paradigm – one that worships health instead of death, dying and disease.

It boils down to the question we don’t want to ask.

“Is health care all about me, or am I willing to sacrifice for the good of my country since we’ve gone so far?”

Our personal health and the future of our country are at stake in this tale of merry-men. Every one of us should care about healthcare – doctor, patient, CEO, uninsured, mother, father, child and you. Especially you.

Not just because it’s the right thing to do, but because it’s going to cost you a lot more than money if you don’t.

Natasha Deonarain is the founder of The Health Conscious Movement. She is the author of the  upcoming book, The 7 Principles of Health and can be reached on Twitter @HealthMovement.

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  • Valarie Murphy

    Certainly, a system of HSAs and high-deductible insurance would bring costs down IF people paid their bills on the spot and didn’t have to wait until the insurance company tells them how much to pay. First dollar processing by insurance companies is horribly expensive. HSAs should be portable unused portions should be saved for future medical needs. In fact, if everyone had an HSA beginning at age 30, Medicare could be phased out for all but those to ill to have built an HSA nest egg.

    An added bonus: If people paid the first $10,000 of medical expenses before the insurance company got involved, those in power would have a terrible time creating that national medical dossier on each of us. The database was authorized at $19.1 billion in the Stimulus bill.

  • Margalit Gur-Arie

    How does the person bagging your groceries at the supermarket pay for a quadruple bypass? Is this where the “sacrifice for the good of my country” comes in?

    • Kathleen Summers

      Read The Spectrum by Dean Ornish, MD, University of California at San Francisco. You can reverse heart disease without stents and surgery.

      • Margalit Gur-Arie

        I will, thank you. Is there a book about reversing everything else that costs hundreds of thousands of dollars to treat?

    • Natasha Deonarain, MD, MBA

      It is the individual that must change in order to change this Country’s health system. In this now, there is no crisis. He is just simply bagging groceries. As long as he keeps thinking in this now about the FEAR of a quadruple bypass and he keeps thinking this, he will require a quadruple bypass. But if he practices health right now, bagging groceries, and releases the toxic effects of anxiety and worry your body, mind and spirit he will begin to change into health. And this is the journey we must follow.

      • sFord48

        While many people need healthcare because of lifestyle choices, there are those of us who resent being thrown under the bus. I don’t make a lot of money and your solution for my health care needs is to practice health. What on earth would I need a doctor for?

        • Natasha Deonarain, MD, MBA

          Exactly!! You do not need a doctor for health. We are the disease experts. You only need a doctor for disease. Here’s a joke I heard recently: “There are four things you will die from today; diabetes, heart disease, cancer and doctors.”

          • sFord48

            I am fast and fit. I don’t need a doctor to tell me how to live. I can’t afford a doctor for disease…are you suggesting I die instead?

          • Natasha Deonarain, MD, MBA

            If you’re fast and fit…why are you so worried about dying? Live now! The healthcare system needs us to be afraid. It makes money that way. If we weren’t so afraid of dying while we are fast and fit…would we be willing to pay billions upon trillions for this that we have??!!

      • Margalit Gur-Arie

        I’m sorry, Dr. Deonarain, I don’t quite understand what you are proposing, so here is a very simple question. What does my grocery bagging person do if he is hit by a bus or falls off a ladder, or if he is diagnosed with lymphoma or appendicitis, or has a new baby born with a congenital defect? Are you saying that none of these things will happen to him if he “practices health”? If not, how is he going to pay for medical services? Or perhaps you think he shouldn’t get any medical services beyond his grocery bagging means?

        • Natasha Deonarain, MD, MBA

          Margalit – if I may, tell me – does the Earth revolve around the Sun or does the Sun revolve around the Earth? The geocentrists firmly believed that the Earth was the center of our solar system until 1837 or so, despite evidence to the contrary by learned scientists. We have set up a paradigm in medicine that has engrained in our thinking that we must begin with the disease first, work backwards by splitting things into their parts and their molecules of parts and enzymatic reactions and electrons and peptides and receptor sites and so on. We think we can put the human back together again after we’ve taken it apart, and then expect to ‘fix’ the genetic defect or disease or problem with one very highly specific thing. But we are finding out, the more we treat that one thing, the more disease we seem to be causing. And the sicker we become. So if we try with a new way of thinking, for example, forget the genetics, forget the disease, forget the drug (put them on hold for a moment) and then say this, “You know what? I’m perfect right here, right now, just as I am. And now, I’m hungry. I’m going to nourish my body with the right choice.” If we do this in every moment consciously of every day (yes, we are human, we will slip up) but we keep going every day for the rest of our life, suddenly, those diseases – well, they correct themselves. Suddenly, the genetics just isn’t that important. Suddenly, we are healthy and we live for life, not our disease. Would you consider Lance Armstrong a sickling sort of guy? He’s got a label of cancer, doesn’t he? Would you consider Steven Hawking, today’s most brilliant scientist, a sub-standard human being because he can’t talk let alone walk or dance. He’s got a disease label. You as the individual determines what you will become – not me as a doctor. You as the individual determines how healthy you will be – not me as the doctor. Doctor in latin means “to teach” not to preach. I’m tired of preaching anymore!! It’s time that we doctors learned this and showed you the way to find light and happiness, not death, dying and disease. My dear – I hope that helps :) Please, check out chapter 1 on the website. Listen to the downloads when the staff upload, and give it go for yourself. I will share with you this secret – I am sick by every definition of today’s medical standards. I have 10 disease labels! Yes, you heard right – ten! So please, see through my eyes that the Earth revolves around the Sun, and that the doctor of today is no longer the center of your health. You are ;)!! And if we all think this way, we all see this perspective – suddenly, we become healthier as a population. Suddenly, we don’t need to spin, spin, spin in escalating cost and be afraid of disease. Suddenly….we can now afford to take care of those in our midst who really need care….These are my dreams. Will they be realized in my lifetime?

  • Kathleen Summers

    I am a physician and a patient, and I walk this talk.

    Well said. Let’s take it back. We have the power.

  • Jack Cain

    Dr. Deonarain ignores the realities of human nature. Only the extreme minority cares about anyone but themselves and “us vs. them” is built into our genes. Describing a way to solve a problem that encourages everyone to work together is great, but saying that patients should “negotiate” by threatening bankruptcy if the hospital doesn’t settle doesn’t sound like working together to me.
    There is no doubt that the existing system is broken – I have 21 year old receptionists making health decisions for me now – but when I bring in a printout of my complaint, allergies, insurance, meds and current medical professionals treating me it gets tossed on the counter and ignored. The person who rooms me can’t imagine a system where the size of the blood pressure cuff affects the result – but of course the machine taking my blood pressure couldn’t possibly be wrong now, could it. I haven’t seen an actual medical doctor for three years and the PA-C who is my primary care provider is called “doctor” by everyone.
    Our twitterized society can’t hold a thought longer than 30 printed characters, so until Dr. Deonaraincan squeeze her solution into that size, we are doomed.

    • Natasha Deonarain, MD, MBA

      Dear Jack,
      Thank you for your response. You are absolutely right, our society is distracted beyond relief-and this is the cause of our suffering. No Doctor or anyone else for that matter can make you change. Change can only come from the desire you have within yourself. On a personal level, I hope that your outlook of doom begins to change into hope. And this is how the future of our society will change. Helen Keller said, “Alone, we can do so little, but together we can do so much.” My hope still stands strong for this world, regardless.

  • Michael Mank

    For a direct payment model to work, there needs to be more transparency in set prices for services. Ideally, these services should be, in a sense, advertised as to their costs. This would allow the patients, or consumers, to shop around- What pcp do they want to see based on cost, location, and perceived quality of physician? What diagnostic centers do they want to go to for lab work, imaging, etc.? What hospital they want to use for elective procedures, etc? ER prices should probably remain standard as the choice of ER depends on location and breadth of services (stroke center, etc.). This would drive costs down as providers are competing with each other and would increase access as people would have more control over the services they seek. It may also increase accountability as people would see how much services actually cost. Currently, most providers and patients DO NOT know what services cost! Furthermore, there should be a voucher provided based on income, etc. Couple this with catastrophic and/or high deductible insurance, and this may be a recipe for greater patient control and lower healthcare costs overall… or at least I would hope…

    • Natasha Deonarain, MD, MBA

      I completely agree. The only caveat is for-profit stake holders MUST be eliminated. There is no future in reducing cost when profit is involved. This includes health insurance companies, drug companies, a government that is bought out by health and drug companies, and lawyers who make a profit by encouraging injury and illness claims.

  • Kristy Sokoloski

    If health insurance is dropped by more people, then how are they going to be able to pay for the medical bills that occur such as like from going to their Primary Care Physician, hospitalization for complications that can occur from medical problems like Diabetes? Even with negotiating the prices there are still some people that can’t pay the bills because they don’t have jobs to get the money to pay them. The episode of Frontline the other night did a story about the state of dental care in this country. There are many people that can’t afford to go to the dentist for regular check-ups but yet they are needed. Some of the people that can’t go can’t make use of charity help either. Talk about frustrating.

    • Natasha Deonarain, MD, MBA

      The secret lies in the way we think. Albert Einstein said, “We cannot solve our problems by using the same thinking we used when we created them.” We are all still trying to the use the same thinking to solve all this mess. If you’re familiar with Steven Covey, The 7 Habits of Highly Effective People, he talks about a new paradigm. He uses the “old lady / young lady” picture at the beginning of the book. We currently believe in disease. We focus all our thoughts, comments, mind-set, actions and lives consumed in this thought of disease. We stuff our minds so full of the worry of disease and how to fix them, that we don’t have time for health – we lose our consciousness and awareness of how to practice health instead of worry about our medical system and why it’s not going to take care of us. We squander this moment thinking of disease. We are paying now under legislation for today’s disease. We are squandering our money now to continue to focus on someone else’s disease instead of using it to practice health and thereby prevent a future of disease. This has an effect on our body. All that cortisol from all that worry stresses our entire system. Continue this chronic stress and worry over many years, and what do we have? Epidemics of modern disease based on the chronicity of stress, anxiety, worry, fear, blame, guilt and victimization. We want someone else out there to fix us, take care of us, promise us that we won’t get sick and die. We have bought into these false promises. But what we’ve done by alleviating the responsibility of health practice now and disease focus, is seriously erode our health, bank accounts and happiness as a collective society. As long as America continues to believe as individuals that this system needs to be ‘fixed’ none of us will ever find our way back to health. Because the system itself is founded on the philosophy of disease. But believe me, no mattter how much you may want, the government, health insurance, drugs, doctors, lawyers, big business and the like to prevent and fix disease, they will never be able to unless we begin with a different paradigm and build a foundation of health from the ground up. This is something America has never done in hundreds of years. A foundation of health practice and health focus IS brutally slow. It takes a lot of daily discipline, something which Americans are not used to, especially coming off the quick fix medical mentality in healthcare today. Most people don’t want to hear what I’ve just said. Most just want this nightmare to go away. But no matter what your station in life, what your income, health status, cancer or not – we as Americans have put ourselves in this place we are experiencing. And so we will have to dig ourselves out. The infrastructure of a healthy, coordinated, cost effective system as in Canada, Switzerland, New Zealand, Australia and every other developed country except ours takes years to implement. It takes a different way of thinking – not all about me, me, me, but about us and what WE want. We have not invested in this system and yet we want something like this. So the transition WILL be very, very painful. But, in the end, if we can each turn our mind-set to health and not disease, we can change. We will change. And we will change those around us – one by one by one. That’s the only way it can work. Gary Null (Power Aging) says, and I paraphrase (apologies), “In the absence of disease-thinking, in the focus and practice of health, disease corrects itself.” I hate to tell you this, but I’m going to die one day ;)!! I will likely die sooner than you because I have lots of diseases. But I’m still going to drop my health insurance. Yup indeed. So, maybe ask Kevin to post my blog on how I came to that conclusion and you might see that “The problem is the way we see things that’s the problem…” (Steven Covey)

  • euonymous

    One thing that gives me hope for universal healthcare is that municipalities across the US are staggering under the cost of health insurance promised to current employees and retirees. It adds up to billions of dollars that are not set aside (yet) but will need to be paid for that insurance. Are we going to watch our government(s) go bankrupt en masse or are we going to enact a simple solution which will solve so many other problems along the way? The toxic combination of American politics and American capitalism is killing us, our children, and our future.

    The purpose of government is to protect the people who have agreed to that government. The purpose of society to enable people to pursue their self definition and happiness. Government is not society. American government is out of control. What you are saying is that society, and the many social groups that compose our society, must regain control of this country. Yup.

  • civisisus

    Kevin’s been on a downward spiral for a while, but this bilge has to be the bottom. Has to.

    Dr. Deonarain is clearly impassioned, and as clearly deranged. Chasing around with a fistful of slogans wrenched out of some nightmarish misinterpretation of the already cartoonishly sophomoric Ayn Rand oeuvre is a complete waste of energy. Please don’t do it.

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