The National Scorecard on U.S. Health System Performance, 2011, updates a series of comprehensive assessments of U.S. population health and health care quality, access, efficiency, and equity. It finds substantial improvement on quality-of-care indicators that have been the focus of public reporting and collaborative initiatives. However, U.S. health system performance continues to fall far short of what is attainable, especially given the enormity of public and private resources devoted nationally to health. Across 42 performance indicators, the U.S. achieves a total score of 64 out of a possible 100, when comparing national rates with domestic and international benchmarks. Overall, the U.S. failed to improve relative to these benchmarks, which in many cases rose. Costs were up sharply, access to care deteriorated, health system efficiency remained low, disparities persisted, and health outcomes failed to keep pace with benchmarks.
How can you protect yourself and your family, given the dim outlook on access to care, rising (unattainable) insurance premiums, and rising health disparities?
I give you a hint. It will be Self-Care that is Central to Health Care!
The report highlights that access to care significantly declined in just 4 years. As of 2010 it is estimated that 81 million working-age adults (44% of those ages 19 to 64), were either uninsured or underinsured during the year. Compared to 2003, this number is up 20 million people (McCarthy, How, Fryer, Radley, & Schoen, 2011).
Lets look at improvements: (McCarthy et al., 2011)
- Information systems
- Care for chronic conditions, such as hypertension improved from 31% to 50%, but still falls short of the benchmark of 75%
- Effective hospital care
- Preventable hospitalizations
- Quality of postacute care and long-term care
- Cigarette smoking
- Preventable mortality: The rate of mortality amenable to health care—deaths that might have been prevented with timely and effective care, increased by 21% in the U.S. from ’97-98 and ’06-’07. But these rates improved on average by 32% in 15 other industrialized nations, putting the U.S. last with a 68% higher death rate than that of leading countries.
Lets look at some indicators with significant deterioration: (McCarthy et al., 2011)
- Insurance and access (mentioned above).
- Affordable care: As insurance premium rose significantly faster than wages, people living in a state where group health insurance premiums averaged less than 15% of household income dropped from 57% in 2003 to just 4% in 2009.
- Primary and preventative care: In 2008 44% of adults lacked a regular primary care provider with easy access to consult by phone or during office hours. Only half received a set of basic preventative services.
- Hospitalizations from nursing homes
- Infant mortality: While the U.S. improved slightly, we are still more than 35% higher that the rates of the best individual states. Even the rates in best performing states are about twice as high as those achieved by certain industrial countries.
- Childhood obesity: Almost 32% of children 10-17 were overweight or obese as of 2007.
- Safe care: In 2007, 18% to 36% of elderly patients were prescribed a drug that is potentially inappropriate for the elderly.
- Patient-centered, timely, coordinated care: In 2008, a mediocre 43% of U.S. adults in need of medical attention were able to rapidly secure an appointment with a physician. This is about half the rate than that of the best country.
- Disparities: Minorities and low-income or uninsured adults and children were unfortunately more likely to wait to see a physician when sick, compared to white, higher income or insured counterparts. Disparities also exist for uncontrolled chronic disease, avoidable hospitalization, and worse outcomes. Minorities were also less likely to receive preventative care or have and accessible source of primary care.
I know the situation seems pretty grim, but what is the take home message from all of this? I guess simply put… Don’t get sick!
But isn’t that an unattainable goal? Well, we all get sick form time to time, and that should not be a problem, if you don’t have health insurance or access to care. The problem arises when chronic disease sets in. What is the solution?
As you many of you know I am currently working on my Ph.D. in Mind-Body Medicine at Saybrook University. So it is only natural that what I am proposing centers on the individual, and the individual taking charge of his/her own healthcare. What do I mean by that?
If you look at the good, the bad and the ugly that is happening in the U.S. health care system it becomes obvious that the solution is to focus on a preventative, patient centered healthcare system, teaching individuals the very basics of taking care of themselves. Remember form above? Only half of all adults received a set of basic preventative services!
Thus we need a Manifesto for a New Medicine!
Fortunately, we don’t have to look very far, because Dr. James Gordon has already penned such a manifesto for us. He also happens to be the Dean of the College of Mind-Body Medicine at Saybrook. Here are just a few quick points, the “Seven Pillars of the New Medicine.”
- Pillar 1: Uniqueness– The new medicine respects the radical uniqueness of each human being.
- Pillar 2: Holism– Holism regards health as a state of harmony and wellness in body, mind, and spirit.
- Pillar 3: Healing Partnerships– The new medicine rests on the healing partnership between healer and patient, which is a collaborative one in which the patient participates fully and actively in her own movement towards wellness.
- Pillar 4: Self Care– Individuals learning to care for their own health and wellness lie at the core of the new medicine. Our current model has drugs and surgery at the core, with psychosocial and mind-body therapies being in the periphery. In the new model of medicine, this changes with psychosocial and mind-body therapies taking the core.
“Many of the factors leading to ill health and physical symptoms lie within the person and his or her behavior; the healing process must begin with the patient learning to change these behavioral pathways to disease. Self care means that each patient must become more aware of the powerful role of mind and emotion on the human body and its functions” (Gordon & Moss, 2003, p. 9).
- Pillar 5: Other Healing Systems– The western biomedical system is not the only system on this planet. We must strive to learn from older systems of medicine, and integrate the best of both worlds.
- Pillar 6: Group Support– The new medicine draws from the power of small groups to bring forth healing and personal change.
“Many of the most successful studies showing the power of CAM therapies and mind-body methods in restoring health have imparted these healing strategies with- in a small cohesive therapeutic group. The group provides emotional support, encouragement, and connectedness for the sufferer, and may be a hidden source of the therapeutic outcomes in these research studies” (Gordon & Moss, 2003, p. 10).
- Pillar 7: Spirituality and Transformationn- Part of the new medicine is the respect for the integral role that spirituality takes in healing and transformation. In 1977 Mahler wrote “Indigenous healers, native healers, traditional healers, and similar practitioners manage the healthcare needs of roughly 70 percent of the world’s population” (Moss, McGrady, Davies, & Wickramasekera, 2003, p. 192).
Where Am I getting with all of this? Well, I am going to help shape this “new medicine” by teaching people how to take care of themselves, and actively pursuing research in the field of Mind-Body Medicine (I am in the research track) to find out what type of Mind-Body interventions improve quality of life and possibly increase survival in cancer patients. My graduate education at Saybrook prepares me for the challenges ahead.
How can you benefit from this right now?
Starting in November I am going to start facilitating Mind-Body Skills Groups to teach cancer patients and their caretakers/loved ones about the 7 Pillars of the New Medicine! If you live in West-Michigan. Click here to register. Space is limited to 10 participants for each group.
Remember it is never too late to start a journey towards better health and wellness…
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APA: W Absenger. (year, month, day). Title of Blog Post [Web log post]. Retrieved from PASTE PERMALINK
MLA: Absenger, Werner. “TiTLE of BLOG POST.” The Alternative Medicine Blog. The Alternative Medicine Blog., DAY MONTH. Year. Web. Insert your date of access here.
Gordon, J. S., & Moss, D. (2003). Manifesto for a New Medicine. Biofeedback, Fall 2003, 8-19.
McCarthy, D., How, S. K., Fryer, A. K., Radley, D. C., & Schoen, C. (2011). Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011. The Commonwealth Fund Commission on a High Performance Health System. Retrieved from http://www.commonwealthfund.org/Publications/Fund-Reports/2011/Oct/Why-Not-the-Best-2011.aspx?page=all
Moss, Donald, McGrady, A., Davies, T. C., & Wickramasekera, I. (Eds.). (2003). Handbook of mind-body medicine for primary care. Thousand Oaks, CA: Sage Publications.