By MERRILL GOOZNER
Ariana Huffington recently anointed diet-and-exercise guru Dean Ornish as her chief medical correspondent. With all the guff her site had taken from the science-based medicine crowd for giving free rein to anti-vaccinists, faith healers and the no-evidence-needed alternative medicine freaks, I thought it was a smart move — a tack toward the responsible center, if you will.But in a post this week, Ornish recounted his 14-year-battle to get Medicare to pay for a pilot project to test lifestyle intervention as a cure for heart disease (which wouldn’t save Medicare money, but would save more lives for the same money expended as, say, giving those people cholesterol-lowering medication). What he drew from his saga was that the government can’t be trusted to run health care, and that health care reformers needed to rise above the right-left divide and unite around reimbursing physicians for keeping people well.It was a classic case of crunchy granola versus the class warriors. The comments section was overwhelmed with hostile attacks on Ornish’s above-the-fray moralizing. The commentators defended single-payer, pointed out the indiscriminate nature of many diseases, articulated the special needs of the poor whose stress and multiple jobs make them especially prone to disease, etc. etc. What was striking was how thoughtful and well-reasoned many of the comments were, a far cry from conspiracy-minded rants of that usually dominate the comments space.
I spent much of last year trying to shoehorn the Ornish philosophy into the health care debate. I agree we need to pay for cost-effective prevention options — including the Ornish approach to lifestyle intervention for people seriously at risk of heart disease.But it’s a tough fit because that’s not going to end disease in America. And as long as people continue to get sick, they will face the problem of an inadequate insurance system and an out-of-control medical system. As one intelligent commentator pointed out, every one of us is eventually going to get sick, face a traumatic injury or an unexplained illness. Every one is going to die, and many will face agonizing end-of-life medical choices — no matter how healthful their lifestyles.When any of that happens, they deserve a well-functioning and reasonably priced sick care system. The last thing a sick person needs is a lecture on how they ate wrong and failed to get enough exercise in the months and years leading up to the acute event.
Merrill Goozner has been writing about economics and health care for many years. The former
chief economics correspondent for the Chicago Tribune, Merrill has
written for a long list of publications including the New York Times,
The American Prospect and The Washington Post. His most recent book, “The $800 Million Dollar Pill – The Truth Behind the Cost of New Drugs
” (University of California Press, 2004) has won acclaim from critics
for its treatment of the issues facing the health care system and the
pharmaceutical industry in particular. You can read more pieces by Merrill at Gooznews.com, where this post first appeared.
More by this author on THCB:
- E-Health: It All Depends on How It’s Used
- The Myth of the Cadillac Plan
- Should We Open the VA To All Comers?
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Glad I ran into this blog. Great stuff here. I will have to cite it on my own. I’m finishing my last of 4 posts on health policy reform.
Alternative health practitioners and advocates seem determined to torpedo healthcare reform and the reasons why shed a lot of light on their belief that cossetting the “worried well” is more important than providing healthcare for the poor.
Alternative health practitioners approach healthcare reform as would any special interest group. The most important question is: “What’s in it for me?” They are irritated by the answer: Of the millions of dollars that would be expended providing healthcare to the underserved, not much would go to them. To their dismay, the President and Congress appear to believe that providing access to care for people who already have diseases like cancer and heart disease is more important than lining the pockets of those who cater to the worried well.
In their zeal to mine healthcare reform for personal profit, advocates of alternative health come strikingly close to the insurance and pharmaceutical companies they claim to despise. They fail to acknowledge that their “prescription” for reform is just as transparently self-interested. They promote only what they can provide without regard to whether that is what is needed.
Ornish was gornished.
Prevention is fleeting in adults and as such ought be focused on the scourge of poverty on the health of babies and their mothers. People die from something. Ornish programs are difficult to follow and unproven in large populations. Insurance carriers will cover programs merely to shut him up.
A high dose of American manufactured computerization will prevent handwriting mistakes but cause others, an antiprevention if you will.