Must Healing and Profit Be Linked?
2001; Mary Ann Liebert, Inc.; Volume: 7; Issue: 6 Linguagem: Inglês
10.1089/10762800152709660
ISSN1557-9085
Autores Tópico(s)Complementary and Alternative Medicine Studies
ResumoI have been following the debates regarding managed care, fee-for-service, and nationalized health care with avid interest for many years. My interest is personal and professional. I have two family members who are on brand medications that they must have in order to prevent lifethreatening seizures. And I write columns, from time to time, about the inclusion of alternative and complementary medicine (ACM) in managed care. Health care in the United States is a well-known “crazy quilt” of fee-for-service; managed care of several varieties, including health maintenance organizations that use practitioners within a certain loop and preferred provider organizations that allow patients to go outside the loop on a fee-for-service basis; and some free coverage for extremely poor and/or severely disabled people. Why is this a matter of concern for the ACM community? The most obvious answer is that this crazy quilt is not meeting the needs of patients. Despite increasingly high-technology advances that profit the very wealthy or those few individuals who receive treatments for free on an experimental basis, modern medicine is failing most people. It does not answer the need for health at a price that is reasonable and affordable. And, many of the treatments, even if they are somehow paid for, do not do the job. Patients are still sick and, oftentimes, suffer from deleterious side-effects of treatments or medications. Enter ACM with its promises for more natural, less-expensive healing and the virtual “gold rush” began. This is good for those of us who believe that ACM has much to offer. It forces open doors that have been formerly closed to ACM with mainstream, peer-reviewed journals accepting papers about ACM and more trend-sensitive insurers covering ACM modalities. But, the rush to ACM does not really solve the entire problem, which was so aptly stated by Adriano Borgna, M.D. (Italy), L.Ac., in this issue: Ethics and profit are still working at cross-purposes and patients still lack essential care. In fact, some practitioners say that illne s s is somehow the “fau l t ” o f the patient—she or he did not follow instructions, failed to seek help at the right time, or did not live a proper lifestyle. This judgmental idea is held by some conventional physicians and ACM proponents. Conventional physicians may feel that patients should be “compliant” to get well. This stems from the hierarchical slant of conventional medicine. ACM practitioners may feel that patients who are sick do not “want” to get well. Insurance companies worry about the costs. Patients still get sick and are blamed for their conditions. The truth is that we do not even know enough to attribute causes to many conditions despite decades of research. Is cancer caused by a virus? What fault in brain development is responsible for depression? What is the placebo effect? How can we blame patients for what practitioners and researchers do not know? If we had the answers, the medical profession would be out of business. Until then, there is the very real problem of people getting sick and needing care and not being able to afford it. No herb, no supplement, no exercise, no diet, no meditation, no modality can solve this problem until we undergo a complete paradigm shift about the meaning of medicine. Until we refuse to allow even one single patient to “fall between the cracks” of the system, we have failed in our goal to heal. Until we give up the profit motive in our society and consider survival and service as our raisons d’etre, we shall never be able to cure the worst thing that ails our society: Guilt for allowing others to suffer while we enjoy prosperity. What is the solution? One can argue, quite rightly that medical practitioners invest much in their studies and are entitled to be recompensed. How can we demand that they serve us for no profit? These are germane questions. The answer lies in disentangling the profit earned from the modalities, treatments, and activities that practitioners have to offer. That leaves one option— nationalizing the health care system. Every civilized country in the world has known this from get-go. Only the United States has failed to acknowledge this. We can only truly have the right to “life, liberty, and the pursuit of happiness,”1 if our medical needs are met. This means covering all medical modalities. This means no formularies and no rejections of types of medicines that have been proven to work (“proven” can be debated). It means letting practitioners practice their art and letting patients become partners in their own care. And it means that our society as a whole grants good remuneration for the venerable art of healing with full respect for its ability to save lives and relieve suffering. In these ways, we shall value patients and the practitioners who treat them to benefit all sectors of society. For there is not one person who shall not need the services of a healer at some point in her or his life. n
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