Aug 06, 2007
Rethinking Healthcare
“We will never solve our problems using the same kind of thinking
that caused them in the first place.” —Albert Einstein
The healthcare debate of the past few years must have Einstein nodding sagely from the grave. For all the volumes that have been written, for all the legislative starts and stops, for all the heated discussions of experts and pundits, little has been said about the medical thinking that underlies our current healthcare crisis. We have fixated on the secondary concerns of administrative bureaucracies and payment systems, when we should be exploring long-overdue changes in societal attitudes, lifestyles, and healing practices.
American medicine grew out of and remains mired in the Industrial Age. The “kind of thinking” that characterizes an industrializing society is reflected throughout our current healthcare system:
- the turning of “healthcare” into a mass-produced consumer item; the imbalanced relationship between so many doctors and their patients;
- the overuse and abuse of invasive drugs and surgeries;
- the shifting of power and prestige from general practitioners to overpaid specialists;
- the discounting of mental, emotional, and nutritional causes of illness;
- the over-medicalizing of the should-be sacred events of birth and death;
- the granting of ultimate authority to distant, profit-driven bureaucrats;
- the fundamental dis-ease of the modern hospital;
- and the continuing failure to see polluted air, water, and soil as vital public health issues
These are all symptoms of a medical-industrial-complex that has become as dangerously outmoded as the smokestack factories of a hundred years ago.Yet, contrary to the prevailing mythology of constant medical progress, America’s healthcare problems will not be remedied with “new and improved” technologies, drugs, or bureaucracies. This is just more of the same kind of thinking. What is needed now is a genuine revolution in the ways that we think about our bodies, about the nature of illness, and about the role of healers within the community.
Allopathic Medicine — Hardcare
Until the middle of the 19th century, most people died of traumatic injury and/or infectious disease. Infant mortality was very high, and the median age of death was in the thirties. Two key developments changed all that, ushering in the modern era of miracle medicine and ever-extending lifespans.
First, and most important, came major improvements in public sanitation. As sewage and water systems were established, especially in urban areas, much of the underlying cause of
Infectious disease was eliminated. To this day, access to decent food, clean water, and good sewage is a far better predictor of a nation’s overall health than its medical system. (For example, the high infant mortality rate in America is not a failure of medicine, but a consequence of the malnutrition and environmental toxicity that afflicts its poorest citizens).
Second, came the scientific discovery and understanding of infectious microbes. This began a medical revolution as countless microbes were identified and medicines were developed to kill or neutralize such microbes. This in turn allowed for the advancement of surgical techniques, as it finally became possible to operate on people without infecting them (though, here again, a key innovation was the attention given to sanitizing the surgical environment).
The approach to healing that has since evolved, called allopathic medicine, or, “hardcare,” is characterized by a reliance on drugs and surgery. Illness is viewed as coming from beyond the individual’s control — an invading microbe or a traumatic injury (or, these days, a faulty gene). The doctor intervenes on the patient’s behalf, working to defeat the invader and/or fix the ill effects of the injury.
For most of the 20th century, hardcare has performed one life-enhancing wonder after another. Diseases that plagued humankind for millennia can now be eliminated with a single injection or a handful of pills. The most horribly injured trauma victims can be saved, mended and returned to the living with nary a trace of their injuries. The blind can be restored to sight, the lame can walk again, failing organs can be replaced. It has all been truly miraculous and any future healthcare system will certainly make use of some elements of allopathic medicine.
Still, such harcare derives from a kind of thinking that is now causing more problems than it heals.
The Limits of Allopathy
As people were saved from the ravages of infectious disease and traumatic injury, individual lifespans increased, and a new set of illnesses began to inflict men and women. Chronic, degenerative diseases — such as heart disease, cancer and arthritis — became the major challenges to medicine. Cancer, for instance, became such a frightening threat that an all-out war was declared against it. Hundreds of billions of dollars were channeled through an enormous medical-industrial apparatus, regularly sustained by the promise that a cure for cancer was just around the corner. It never happened.
Hardcare has proven to be mostly futile, if not recklessly dangerous, against most modern illnesses. While the surgeries have grown ever more heroic (dangerous and expensive), and the drugs ever more powerful (dangerous and expensive), the human suffering caused by chronic, degenerative illnesses has steadily increased (including among children).
At the same time, the suffering caused by medical practices (such as when too much chemotherapy destroys a patient’s immune system, or when a surgical patient dies from secondary complications) has also increased, as hardcare treatments have grown ever more
invasive.
Even some of the greatest miracles of hardcare are reaching their limits. Antibiotics are proving to be less and less effective against each new generation of invading microbes. Moreover, it is becoming apparent that our overuse of antibiotics, vaccinations, and immunizations has undermined the integrity and innate healing powers of the human immune system. Ultimately, we failed to understand that all drugs have side-effects; after a century of relying on ever more powerful medications, we are now experiencing a plague of medicine-induced illness.
Likewise, many common surgical practices — such as caesarian sections, hysterectomies, and heart by-pass surgery — have been carelessly overused. As with antibiotics, an over-reliance on surgery seriously undermines the body’s own healing mechanisms. Surgery delivers a quick-fix of symptoms while ignoring, and often exacerbating, the underlying causes of an illness.
Finally, it must be said that hardcare is inevitably expensive. Both drugs and surgery demand large cash infusions at every stage of their development and use. The vast research facilities, the long and intensive training of practitioners, the high-tech tools and hospitals, the complex administrative systems, the steep malpractice payments and the high profit margins at every step of the way: To the extent that America remains committed to hardcare, we will never get healthcare costs under control, nor can we hope to create a fair and equitable system for all of our citizens.
Reclaiming Responsibility
The most serious failing of harcare is its shifting of primary healthcare responsibilities away from the individual. Just as illness is thought to be caused not by the person, but by a nasty germ, a traumatic injury, or a faulty gene, healing is thought to be caused not by the person, but by the doctor, the drugs, the technology, the insurance company. The net effect of such thinking is a nation of people desperately searching for health in all the wrong places.
This is an unfortunate but logical result of allopathic medicine’s great strengths.
After so many years of miracle drugs and surgical heroics, it’s reasonable that people see themselves as being healed by others (and that those others — the doctors — attain a god-like status). As I’ve said, there will always be a place for such medicine; in the course of a lifetime, we may all occasionally find ourselves acutely ill and unable to heal without the outside help of powerful drugs and/or invasive surgery. For such times, harcare may long be a blessing.
But hardcare becomes a curse when it institutionalizes the notion that sickness and healing come from outside of ourselves. That is precisely the kind of thinking which must change if we are to bring about a genuine healthcare revolution.
Because harcare has shifted responsibility away from the individual, it has also largely ignored (or argued against) the major causes of modern illness and health: our thoughts and beliefs, our emotions, our dietary habits, our bodily practices (ie, posture, movement, breath, sleep, exercise and sex), our use and/or abuse of intoxicants, the relative health of our environment, the nature of our relationships, and our personal experience of spirituality. Any vital and effective healthcare system must address all of these factors first, teaching healthcare as a lifestyle which must be vigorously practiced every day of one’s life.
