The Problems with Illness Care
The practice of medicine in the world today is often labeled health care." Actually, it should be described as "illness care." It is built upon the diagnosis of disease, the repair of injury, and the treatment of symptoms - all of which are necessary and valuable services. Sometimes, it delivers just what we ask for. Oftentimes, however, we get more than we bargained for.
We've asked our medical professionals to take care of us, to be responsible for our lives. The demands come in a variety of questions and prayers:
"What's wrong, Doc?"
"Will you fix me up?"
"Just tell me I'm going to be all right!"
"I want relief now!"
"Please Doc, just let me live!"
At the same time, we've become dissatisfied with the doctor's inability to play God, threatening lawsuit or censure should treatment prove inadequate. This system also operates at an ever-increasing financial cost to the consumer and is running wildly out of control. Each of us now spends on the average $3,000 per year for such services.
Our resistance to footing such an expensive bill might not be so great if we were getting only what we've paid for. The fact is we're getting more than we can handle. The term for these unasked-for benefits is iatrogenesis. It means a condition created by the doctor's treatment. Prescription drugs, for example, have become one of the leading causes of death. In the United States, drug-related deaths rank number five on the list of killers.* In 1999, the Institute of Medicine's Committee on the Quality of Health Care issued its landmark report "To Err Is Human," which concluded that medical errors killed between 44,000 and 98,000 American hospital patients each year. The majority were medication errors, and given the underreporting of such errors, the number is suspected to be even larger. Moreover, the misuse and overuse of antibiotics have contributed to the development of treatment-resistant bacteria, which kill 90,000 Americans every year.
The illness-care system, moreover, is often overrated. If you were to examine the list of the ten most frequent causes of death among the U.S. population in the early 1900s, you would see that we have made great strides in controlling the infectious killers: tuberculosis, diphtheria, and influenza. But in their place today we find cancer, heart disease, and stroke. We have merely substituted one set of killers for another.
As hard as it is to believe, medical science has done little to increase the potential life span of the American adult. Figures quoted about average life expectancy show an increase often attributed to the introduction of antibiotics in the 1940s and other technological breakthroughs, but this supposed increase is due mainly to a lower infant and childhood mortality rate, mostly from improved sanitation and other public health measures. More children now live out a normal life span instead of dying young; this radically affects the average statistics. Overall, we are really not living any longer than did people sixty years ago. In fact, it may be that our potential life span is being shortened by increased stresses and by poisons in the environment.
Much of the illness-care system de-emphasizes the role played by lifestyle in determining your state of health. Most illness results from choices about lifestyle, not from lack of access to health services. The excessive strains of sedentary work can encourage obesity and cigarette smoking, for example. Such work can foster depression and anxiety - conditions common among the white-collar middle class in the United States. And the mortality rates of this group during mid-life (forty-five to sixty-four) are substantially higher than those of the population at large - particularly from such conditions as cancer, heart disease, and stroke.
* DrugIntel, "Adverse Drug Reactions, Adverse Drug Events, and
Medication Errors Are a Leading Cause of Preventable Death in USA,"
U.S. Food and Drug
Administration, "Battle of the Bugs: Fighting Antibiotic Resistance,"