Wednesday, November 28, 2012 -Posted by Fadi Bejjani
Prevention Takes a Bite out of Life but Responsibility is the Teeth
Healthcare can be "consumed" thus fitting the profile described above, but NOT prevention. The latter advocates anti-consumption: How to stay well and fit so as not to have to consume medications or healthcare services. Nonetheless prevention can be squeezed into a consumer's mode american-style via a plethora of supplements, vitamins, and nutraceuticals and a litany of exercise modalities: aerobics, yoga, pilates, spinning, bar method, etc. Those industries are booming now because, albeit preventive in nature, they finally found their path to the american consumer.
Germain to this concept is to have those consumers PAY for their own preventive products and services, thus demonstrating a level of responsibility that is essential for the prevention seed to grow. If those were covered by insurance, personal responsibility would be gone and with it prevention. Carriers will not pay for it because there is no know code for Prevention in the CPT code book, and it is just as well I think.
This equation is quite simple yet it is often adulterated by ill-conceived regulations and legal processes. Examples abound: Take the tobacco issue for example, just as we were making headway in legally eliminating the threat, recently many states are legalizing marijuana which is six times more toxic. Of course little if any of the tobacco settlement money awarded made it into management, prevention and care of tobacco-related health ailments. Taxes increased significantly on tobacco and I doubt that any of that money is being used for treatment and prevention of these ailments.
Tobacco, Asbestos and others like 9/11, Sandy, Irene, Katrina became great causes célèbres for huge class action suits and even huger settlements, but most of the money collected rarely reaches target and very little if any goes to PREVENTION.
Prevention without responsibility WILL NOT work: If Mayor Bloombeg bans the 16 oz soda bottles, the consumer will buy two instead, and so on and so forth. Another less publicized example is Infection prevention. Enormous focus is placed on hospitals and surgical centers for infection control with interminable regulations but the truth is hospitals still have the worst infection rates (MRSA, mutant bacterias, etc.). With regard to ambulatory surgical centers (ASCs), the patients spend very little time there (a couple of hours on average) so logically the odds of on-site contamination should be minimal. Infections do occur after ASC surgeries sometimes 1-2 weeks later but I submit to you that they are caused by and large by the patient's poor habitus and nutrition, lacking hygiene and unsanitary environment and care-takers, so what if anything is being done for THAT prevention? Nothing really. ALL the emphasis is placed on the very short time patients spend in the ASC, a couple of hours versus the days they are at home or elsewhere in post-op. Why? because it is a lot more feasible, albeit futile, to regulate a licensed medical practice/ASC than a patient's home environment and habitus. Unfortunately the regulatory bodies CANNOT regulate personal responsibility; that is why they usually fail at prevention.
That does frustrate them so they come out with more regulations which is the only thing they can do. Still burying the providers with regulations will NOT breed patient personal responsibility. The lack thereof is pervasive amongst patients and the regulators cannot do anything about it: no show for follow-up care, not taking prescribed medications, not following post-op instructions, lying about their medical history, about their meds, and so on and so forth. Then a complication may happen and it certainly will be somebody else's fault, i.e. the provider of course: "my lawyer said so!"
The American consumer society is duly focused on finding out who is responsible and IT MOST CERTAINLY CANNOT BE ME! Nevermind fixing the problem let us just find out who to sue instead (usually Mr Deepest Pockets). Isn't it the American way?
Prevention is becoming more and more consumable (Wellness will soon be a trillion dollar industry) so it may have a flying chance in the USA after all, especially in these days of increased longevity, costly and troubled healthcare system and poor economy. Give it a good dose of personal responsibility and you got it made.
When it comes to your health, Defense is surely the best Offense!