We do not have a health care system

I do not provide health care. What we physicians do is practice medicine, and what we do for patients is called medical care.

No one says, “I want some health care.” What they think is, “I don’t feel well. I want to see a doctor.”

People get sick and they get hurt. It’s true that many these conditions occur as a result of things they do (smoke, eat junk food, drink too much alcohol, go skiing) or don’t do (use seat belts in the car or helmets when riding motorcycles, exercise regularly). But even if everyone in the whole country made perfect choices all the time, they would still need medical care for illnesses and accidents from time to time.

One of the wonderful things we can do these days is keep people from getting sick. This is called preventive medicine. We have primary prevention, such as vaccines to prevent certain infectious diseases, and secondary prevention, such as taking aspirin and statins after a heart attack to prevent you from having another one.

We can also find some diseases before the patient has any symptoms of it. Sometimes (not always!) we can treat it then, preventing symptoms in the future and possibly (possibly!) prolonging life.  This is called screening. It is still a form of medical care.

Health care is a made up term. It was invented by administrators, bureaucrats, and politicians (people who do not provide medical care) to insinuate themselves into the process between people who are either sick or hurt, or who feel well and wish to avoid becoming sick or hurt, if possible, and the people whose care they seek. Their sole purpose is to siphon off as much of that revenue stream as they possibly can, leaving an ever shrinking pool of funds to pay the doctors and hospitals (meaning nurses, technicians, and housekeepers) who actually take care of people who are sick or hurt.

Sadly, they’ve done an awesome job of it. One of their strategies is recruiting doctors who are tired of fighting them to come join them … not coincidentally by greatly enriching them in the process. But every doctor seduced away from taking care of patients (our word for “people who are sick or hurt”) means one fewer available to make a real difference in the lives of real people.

What would I do to reform the “health care” system? Begin by abandoning the words health care and going back to calling is what it is: medicine.

Lucy Hornstein is a family physician who blogs at Musings of a Dinosaur, and is the author of Declarations of a Dinosaur: 10 Laws I’ve Learned as a Family Doctor.

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