June 06, 2020

Insurance as it was meant to be

Maine, and the nation as a whole, is in a serious health-care crisis. Before long, if circumstances continue as they are, health care will bankrupt our nation.

Let me explain. When my oldest brother was born in Fort Kent in 1962, my mother distinctly remembers her entire medical cost for his delivery and four days in the hospital – $150. Today, the average childbirth is well over $5000, and much more if there are any complications.

That’s a 50 times increase in just one medical service. If our incomes had risen in the same manner, we would all be millionaires by now. But the economy has not risen at nearly the same rate as medical care. Here is another example: In 1973 the average per-capita expense on medical care was $250. That included hospital care, insurance costs and doctor visits. Today, the average yearly medical expenses per capita is $4500. Let us extrapolate to the year 2025. At this rate of increase, each person will have health-care expenses in excess of $80,000 per year. This is why the health-care system needs to be changed – drastically. If not, it is sure to bankrupt our nation.

So how do we fix the health-care system? Most approaches discussed appear to be Band-Aid solutions that will only slow down the rate of increase in health-care expenditures. What is needed is a complete restructuring of health care delivery – and that begins with philosophical change regarding what is true health care. We need to return to the fundamentals of health care through health promotion rather than disease intervention.

Everyone knows the fundamentals of health care but few people, including doctors or lawmakers, talk about them. The fundamental change that needs to take place in health care is to devise strategies that promote health through exercise and nutrition rather than through drugs and surgery. In other words, health is not found in a bottle or a doctor’s office. The best health care is found through proper lifestyle.

The problem with this idealistic approach is that doctors don’t get paid much for this type of health promotion service. And patients are not typically receptive to lifestyle change – it requires effort. People would rather eat junk food than real food. People would rather sit down to rest than exercise. Some people choose to drink and smoke daily. And unfortunately, people would rather pop pills than change their lifestyle.

Doctors, on the other hand, should be promoting proper lifestyle – insisting that patients make substantial change regarding nutrition and exercise. However, most doctors just touch on this.

Standard protocol is to order expensive tests, prescribe expensive drugs or treatment, or refer for expensive surgery. This is what is considered “crisis-oriented medicine,” waiting for illness to arrive before any action is taken. It is the wrong approach and it is costing our nation 14 percent of the gross domestic product.

Maine’s Blue Ribbon Commission on Health Care issued its final report in November. This 63-page report was thorough and complete in pointing out health-care issues and making suggestions to improve health-care costs in our state. However, the report gave no strong suggestions on how to do it. Rather, it suggested that the only way out was to wait until a national policy was in place.

Folks, a national policy of providing health care to all in need is the right thing to do. But not in the same manner as health care is delivered today. Everyone should have access to emergency medical care: accidental injuries, infections, fractured bones, cancer, or any life threatening illness.

However, universal health coverage for everyone for everything will bankrupt our society. There would be no incentives for people to take care of themselves. People would become sicker and require more health care. And taxpayers would be required to pay for it. Essentially, those who decide to take care of themselves would be paying for those who decide not to.

I propose a new paradigm regarding health insurance. As an example, let us take car insurance. Do you buy car insurance so that each time you go to the gas station your insurance will pay for it? Do you also take your car to the mechanic and expect the insurance to pay for it, less a $10 copay? How about home insurance. Do we have home insurance so that once we have a home the home insurance can pay for the furnishings or the food or your clothing? No. So why do we expect health insurance to pay for all ailments, all doctor visits, all test procedures, and especially, all drugs?

Instead, health insurance should be for catastrophic illness or accident only, particularly for unpredictable conditions. Beyond that, sound and proven preventive services should be covered yearly to assess one’s health status, comparable to normative data. In other words, a patient should know where he or she stands regarding his or her health status compared with other people the same age and gender and compared to healthy people the same age and gender. If one falls out of a healthy range, proper measures could be taken to make a change. These proper measures, of course, would likely be exercise, nutrition, and stress management.

The idea is to have health care as it was meant to be – to preserve one’s health, not to wait until one became so ill that she or he needed drugs, expensive testing or treatment, or surgery. And the idea is to have health insurance in case an unpredictable accident or illness has befallen that person.

I realize that the ideas expressed above are radical and quite unlikely to happen. But how long is our society going to allow health care to dictate an ever-increasing percentage of our Gross National Product? How long before employers opt out of providing health insurance as a benefit to their employees? How long before an ever-increasing percentage of our people have no coverage at all for basic health care?

The bubble of this ever-increasing health care system will burst eventually producing serious chaos. Proactive measures need to be taken now before it is too late.

Kevin Chasse, D.C. has been practicing chiropractic in Dover-Foxcroft since 1991. He is a certified chiropractic sports practitioner and was certified as a diplomate by the American Chiropractic Board of Occupational Health in 1999.

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