Your health has become a product you cannot afford. Or even understand. It has been taken out of your hands and placed in the hands of the health industry. In a perfect expression of capitalism your health has been productised, commercialised, and then sold back to you at a cost you cannot sustain. In countries where health care costs are heavily subsidised by government tax revenues, the whole system is now under enormous financial pressure. So whether you pay as you go, or suffer the huge costs of medical insurance, or whether you pay via the taxation system, health care is a significant financial burden.
The guts of the problem is that health is an industry. The result is an embedded conflict of interest between profit and care. As health is a business, profit must be made. Doctors, specialists, hospitals, clinics, pharmaceutical companies, equipment and technology suppliers, complementary health practitioners, fitness and weightloss businesses – everyone involved is looking for their cut, and in many cases a very big cut. And one way or another, you pay to support the system and industry profits, even when you are not sick.
If you want to understand the scale of the problem this conflict of interest makes, just imagine for a moment that there are no sick people. The system that supports sick people is so vast, so complex and so profoundly embedded in modern life it is almost impossible to imagine a world without it. But then imagine what else could be done with all the resources currently dedicated to health – the funding, education, science, human ingenuity, infrastructure, bureaucracy and effort. Public health absorbs massive resources. And a very significant percentage of those resources are absorbed by the health industry itself.
Any industry, and any business within that industry, requires customers. In this case customers are either sick people or people who believe they are sick. It is at least interesting to note that the health industry has enjoyed a great deal of success in increasing its customer base. In the ultimate irony, the health industry needs more people to be sick and it has been succeeding. They aren’t just finding new ways to help more people be less sick, they are finding new ways to define them as sick. Lowering the recommended cholesterol levels for example. Will you have Lipitor with that?
What is imperative to the existence of health businesses is that sickness and disease are not prevented, but rather ‘treated’. By treated I don’t mean cured, because then they would lose customers. The best customers are the ones that continue to need products and services.
Another of the ironies in this story is that the more science, drugs and technology we have, the more sick people we have. Keeping sick people alive is not the same as making them healthy. There are now fewer people dying of heart disease as a percentage of population than at any time in history – but there are actually more people with heart disease than ever before.
Which raises the subject of life expectancy. In Australia this has increased by approximately twelve years however only the first four of those years are regarded as being quality of life. So the health industry has successfully added 8 years of misery to your life expectancy – not dead, not healthy, and probably forgetting everyone you know. But very profitable!
Industry spin would have you think we are advancing in disease treatment, that there are significant advances in medicine that enshrine a future that is disease free. But the reality is that the opposite is happening. This is because lifestyle and dietary factors are the principle causes of disease and they are contributing significantly to the declining health status of our societies. People are getting sicker, not healthier, whatever the treatments that are becoming available.
For example there has been significant increase in pharmacological treatments for Type 2 diabetes. However Type 2 diabetes is a lifestyle disease that is the end product of inactivity and poor nutrition choices. No pharmaceutical drug can compensate for inactivity and poor diet. They can only serve to mitigate some symptoms. This is a perfect scenario for profit – a person who is sick due to poor lifestyle choices is given symptom mitigating drugs for the rest of their life, while their overall health continues to decline, requiring yet more expensive drugs – all the while ignoring the real causes of the illness – poor lifestyle choices.
I would get a strong argument from within the industry that Type 2 diabetes can be cured. The investment in science by industry skews the argument in their favour. However I have taken Type 2 diabetic clients from a position of being heavily medicated and with “no chance of a cure”, to good health and no need for medication – all with exercise and nutrition, and in just a few months. And no, I don’t have mystical abilities – exercise and whole food works extremely well.
Prevention is a much less expensive than intervention and also improves quality of life. But the health industry doesn’t want to know about prevention because that would diminish its customer base. This demonstrates just how massive the conflict of interest is – the health industry is, by default, heavily invested in not preventing disease.
General practitioners are now rarely more than a delivery mechanism for pharmaceutical companies, or a directory for other specialist services that apply expensive medical technologies as well as more expensive drugs. Doctors in Australia do not study exercise at all, and study nutrition for just a few weeks. Given that exercise and nutrition are the key mechanisms in the prevention of disease, this is pretty remarkable. It means that they can only apply what they actually do study – the responses of the body and disease to pharmacological drugs or surgery. The entire medical establishment is therefore trapped, by default, in interventionist practices.
For sure, the corporate players in health industry are okay with that. But if you are in the health industry after perhaps many years of study, do you want to lose your job and your income? This is the big question: to what extent are you personally invested in this system?
Australia’s number one employment sector is the health industry. It’s a simple case of following the money. But how are these sick people going to pay for all of this? Especially when a huge component of the demographic of truly sick people is the elderly – people who aren’t earning. The bottom line is that the situation as it stands is utterly unsustainable. And equally unnecessary.
The bottom line is that there is an inescapable conflict of interest because health is very big business. This conflict is entrenched in government policy because the premise of public health policy is interventionist.
Add to this some pretty astonishing facts: our food is managed by the Department of Industry (not the Department of Health as you would probably expect), and food politics is an intense, high stakes game that the food industry is winning – thus the universal confusion about good nutrition. The National Dietary Guidelines here are adopted from the US – where they are produced by the US Department of Agriculture. Exercise is owned by the weight loss industry, which is very unfortunate because exercise is fundamental to health and reducing it to weight loss is the reason most people don’t exercise.
At the end of the day there is no other option than to engage meaningfully in preventative health. It is going to take a great deal of collaboration from those of us who are in the health industry but recognise the reality that is coming our way – too many sick people and not enough resources to help them.
The only way to turn the situation around is to adopt a preventative approach to public health at the highest levels of health management. Given that the vast majority of causes of disease are primarily lifestyle, a preventative approach to public health would save a huge amount of resources as well as improve the quality of life for our whole society. This is a great sell to government and the public. But don’t expect any form of cooperation from the Health Industry itself.