That “our healthcare system is broken” is a ubiquitous reality acknowledged across the political spectrum. Healthcare reform has been a hot political issue, especially with the right-wing resistance to Obamacare. What began as an earnest attempt to fix a system that leaves millions of Americans without access to healthcare has been turned, rhetorically, into a left-wing conspiracy to turn America into a socialist utopia. The healthcare reform debacle has been frustrating to watch, especially since this is an issue that affects each and every one of us. What is more troublesome is the way the entire healthcare “problem” has been framed, especially as evidenced by our discourse around obesity.
The healthcare system is broken because doctors are only treating symptoms, and often overlook related symptoms to put the pieces of the puzzle together and uncover the greater problem at hand. I find the current solutions offered for the solving of the obesity epidemic ironic. Obesity is considered one of the biggest health problems in our country, yet our healthcare industry and society at large have failed to look broadly at possible solutions. In narrowing their focus to the energy balance model––if you eat too much and don’t expend enough, you get fat––these groups have constricted ways of thinking about the problem, and limited discussions of possible solutions. When you begin to investigate the roots of the obesity epidemic, you uncover alarming realities of environmental toxins, issues with class and race, and fundamental issues with our food system and economic system at large. Yet a healthcare system could never address these deeper problems, only mitigate symptoms.
The ineffectiveness of healthcare reform stems from this issue of limited understanding of health, broadly conceived. We must rethink what it means for a doctor to “care” by envisioning care in a more holistic way in which doctors not only investigate and treat the symptoms, but work to address the root cause. A more holistic version of care would see the person as more than just a sum of its parts: body, mind, environment and personal history combined into one. Only then can a doctor truly have insight into the complexity of individual health issues. But doctors do not have enough time to treat each patient this way, nor do they have support from the current system in which pharmaceutical and insurance industries exert pressure to act as drug or service salesmen.
Healthcare reform must originate in the way doctors view their patients, and must consider immediate physical illness not an isolated event, but rather a signal of a dysfunction of the entire body. In this sense, health is much more than absence of illness, but rather optimal mental, physical, spiritual and social aspects of our daily lives. Treatment for any illness, then, would go far beyond addressing a particular symptom, and take into account the lifestyles and environmental and social circumstances of individual patients. Ultimately, in order to have a more healthful and effective healthcare system, we must realize that health is a highly individual concept, and means a variety of different things to many different people. The blanket, one-size-fits-all system that we are trying to construct simply won’t work for everyone.
I believe that the quality of care stems in part from the strength of the relationship between patient and doctor, but within our current system––which forces doctors to identify and treat only bodily symptoms and to see patients as quickly and efficiently as possible––is irresponsible and works against realizing a truly healthful society. Yes, this kind of holistic, individualized care is expensive and time-consuming. But it is a care that is paramount to our society’s well-being. I urge decision makers––and the public at large––to shift the way they think about healthcare away from a budget-based discourse and towards a more prevention-based, individualized and holistic understanding of health.
