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Saputo and Belitsos: D.C. Needs to Catch Up to Public

Although we support the “public option— as a possible gateway to universal single-payer insurance, the current debate that has grown up around this discussion often misses much of the point. That’s because more advanced reform of the way medicine and health care are practiced is needed; without it, no form of health insurance will tame the beast of rising costs.

The core problem, as we argue in our new book, “A Return to Healing: Radical Health Care Reform and the Future of Medicine,— is that America’s health care system fights the wrong war — it engages in after-the-fact warfare. We devote vastly more resources to treating ill health than to prevention — at least 25 times more. Essentially, America is not focused on the true causes of our health problems. And our dreadful lack of attention to prevention and health promotion is getting costly in the extreme.

The bottom line is this: Our corporatized health care system is not really health care — it’s “disease care.— And if we are indeed fighting the wrong war with our disease care system, if we are wantonly allowing our population to develop diseases before we act, do we really want to pool the health care insurance premiums of our population so as to better finance this system while leaving its other assumptions unchallenged — especially if these assumptions drive up costs beyond reason and don’t deliver wellness, prevention and healing? And by the same token, do we really want to “automate— disease care with billions of government dollars now being targeted for information technology, when the very foundations of the industry itself need reconfiguring first?

To prevent our health care system from bankrupting the country, America’s health care needs reform that is both paradigmatic and institutional, not just a reform of its financing mechanisms or computer tweaks in the flow of medical information. Toward this end, we believe the nation needs radical health care reform based on what we call the integral-health medicine model —that is, the cutting edge of integrative medicine that arose from the earlier movement of complementary and alternative medicine. Aside from being informed by an integral or holistic worldview, this emergent health care model is dominated by a philosophy of prevention and wellness and is informed by an understanding of the role of consciousness in healing and the body’s innate self-healing capacity. Its treatment methodology involves four stages.

• Lifestyle strategies such as diet, exercise, adequate sleep, stress reduction, weight control and avoidance of toxic exposures are the first line of defense.

• Noninvasive complementary and alternative services such as acupuncture, herbal medicine, chiropractic, bodywork, homeopathy and energy medicine are the next line of defense.

• Natural medicine approaches based on the latest advances in orthomolecular medicine, functional medicine and bioenergetic research — including the more advanced forms of testing — are a further line of defense.

• Very careful and sparing use of pharmaceutical drugs, surgery and other invasive strategies are the last line of defense.

Integral-health medicine, if translated into a renewed delivery system, permits maximum freedom to choose one’s therapeutic approach according to personal preferences and the sacred bond between patient and physician. It incorporates integrative or holistic approaches at every juncture, especially for reasons of cost-effectiveness. And it robustly funds truly objective, comparative and broad-ranging scientific research — in all cases using public money.

Taking health care seriously, according to this worldview, would require far more funding than now designated in President Barack Obama’s budget for Comparative Effectiveness Research, including an expansion of CER’s scope, plus a reconfiguration of the National Institutes of Health’s budget in the direction of the new healing modalities of complementary and alternative medicine that now make up an embarrassing 1 percent of its budget.

At the level of leadership, the Samueli Institute’s recommendations contained in its Wellness Initiative for the Nation are right on target, including its recommendation that the White House or Congress create an executive office or national health board operating at the highest level, overarching numerous government agencies and focused on developing aggressive lifestyle-based wellness and prevention programs.

But current awareness of such ideas and principles on Capitol Hill is far behind. By all accounts, the public is driving the paradigm shift to this new medicine and the trend to healthy lifestyles; Congress is at least a decade behind public sentiment. This macrotrend is evidenced by the way more educated Americans spend their dollars — almost all of them out-of-pocket — on preventive measures in daily life, on integrative clinics and spas, on scores of alternative and natural treatments, on organic and fresh foods, on food supplements, and on other products and services of the burgeoning wellness market.

It is far past time for Washington, D.C., and the health policy establishment to catch up with this huge and growing mass of pioneers — as much as 40 percent of the population — who are mapping the future of health care and who are often their most affluent and thoughtful constituents.

But because prevention, healthy lifestyle, and the new healing modalities are usually not covered by insurance under our disease care system, the less affluent or less educated don’t get access, and these Americans are among that population that is driving up health care costs. These and many other measures for legislative change are listed at our Web site, where you can find a short document titled “Recommendations for Legislators.—

Adapted with permission from “A Return to Healing: Radical Health Care Reform and the Future of Medicine— (Origin Press, 2009) by Len Saputo, M.D., with Byron Belitsos. Saputo is the founder and director of the Health Medicine Forum in Walnut Creek, Calif. Belitsos is an author and editor.

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