{"id":1778,"date":"2011-05-26T14:58:47","date_gmt":"2011-05-26T19:58:47","guid":{"rendered":"http:\/\/urbanthoreau.com\/blog\/?p=1778"},"modified":"2011-06-02T13:50:15","modified_gmt":"2011-06-02T18:50:15","slug":"irresponsible-medicine","status":"publish","type":"post","link":"https:\/\/www.urbanthoreau.com\/blog\/irresponsible-medicine\/","title":{"rendered":"Irresponsible Medicine"},"content":{"rendered":"

Are they insane?<\/a> Have our elected leaders never<\/em> heard of evidence-based medicine? What kills me is that our congresswoman, Tammy Baldwin<\/a>, makes universal health care her signature issue, but we never, ever hear her resolving to create a medical system that emphasizes health<\/em>. It is always about more medicine at all costs. Let’s face it folks, more medicine is bad. Less medicine is good. What we need is a federal spending paradigm that emphasizes health over health care. That starts with creating healthy, active, community environments and continues with a medical system that is less hubristic and positively non-heroic.<\/p>\n

Universality of medical coverage is certainly a necessity, but it must be done right.<\/p>\n

In the first instance, active community environments, doing it right means winding down spending on unhealthy infrastructure such as paving and power plants, and instead focusing on creating healthy, people & community oriented places<\/a>. Less pavement, more green. Less distance, more convivial interactivity. In short: healthy communities, not sprawl. (Unfortunately, on this front, all we got with the “recovery” money — when Democrats were fully in control — was just more money for more sprawl-inducing highways; crumbs for anything healthy.)<\/p>\n

In the second instance, it means looking at health systems which de-emphasize medicine and emphasize healthy living. It also means judiciously applying medicine only where the evidence merits the application of medicine. The fee-for-service model is harmful, at best; deadly in all too many instances<\/a>. Gawande’s thesis rings true for my spouse who has practiced in for-profit, non-profit and government medical systems; the amount of waste that goes into uncoordinated wheel-spinning on the for-profit side is unconscionable. In a fully-accountable medical system (typically government-run), you have much more of a focus on the patient, with positive outcomes. Profit should not have an overriding role in medicine. Or at a minimum, profit should only derive from population-wide improvements in outcomes.<\/p>\n

If US senatorial candidate Rep. Baldwin wishes to impress her constituents in this district & state — a leader in the most cost-effective health care delivery in the country (examples of excellent health care at reasonable costs exist right here in Wisconsin; see p. 7 of the Gawande article above) and active community environments (Madison routinely ranks high on every measure of biking & walking) — she should make patient-centered, evidence-based medical delivery and active community environments the center-piece of her campaign. She could begin a Ryan-style campaign that delivers both cost savings and <\/em>quality improvement\u00a0to Medicare & Medicaid now. <\/em>It is time to call the Republicans on their savage cost-cutting. The thing is, if Democrats were in the least bit savvy, they could show that better health can be delivered at lower costs. So far, I haven’t seen that.<\/p>\n

Unfortunately, in the world of Democratic politicians, an ounce of prevention means less government spending — anathema to them, even when less is more.<\/a><\/p>\n

Update 1: Death Panels & Rationing & Bears! Oh My! <\/strong>Here is a very, very powerful series of views<\/a> on how we could “cut” Medicare\/aid while improving health. There are over a trillion (with a ‘T’) $$ in savings from very low-hanging medical fruit here. Easy fixes. No deathpanels required. Heck, no exercise, no diet change even! And none of it is new. I’ve heard some variation of virtually all of these solutions from several friends\/family members who are involved in the medical system in one fashion or another over the course of decades<\/em>. And still, our good liberal politicians resist good sense. That the troglodyte right blocks out the truth doesn’t even need to be stated. But when the people who claim to be smart liberals block out good information, we are in trouble…..From January 2008 to January 2011 they had it all….And squandered it.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Are they insane? Have our elected leaders never heard of evidence-based medicine? What kills me is that our congresswoman, Tammy Baldwin, makes universal health care her signature issue, but we never, ever hear her resolving to create a medical system that emphasizes health. It is always about more medicine at all costs. Let’s face it […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"footnotes":""},"categories":[760,5,56,13,1],"tags":[986,988,998,994,1002,992,997,996,990,995,1001,1004,1000,993,999,1003,625,991,362,989,1005,987],"class_list":["post-1778","post","type-post","status-publish","format-standard","hentry","category-economics","category-environment","category-health","category-politics","category-uncategorized","tag-accountable-medical-organization","tag-atul-gawande","tag-carole-levine","tag-cheryl-woodson","tag-david-himmelstein","tag-david-leonhardt","tag-grace-marie-turner","tag-jane-gross","tag-jonathan-s-skinner","tag-kevin-pho","tag-liam-yore","tag-maggie-mahar","tag-rick-mayes","tag-rita-f-redberg","tag-robin-hanson","tag-steffi-woolhandler","tag-tammy-baldwin","tag-the-dartmouth-atlas-of-health-care","tag-the-new-york-times","tag-the-new-yorker","tag-troglodyte-right","tag-universal-coverage"],"_links":{"self":[{"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/posts\/1778","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/comments?post=1778"}],"version-history":[{"count":15,"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/posts\/1778\/revisions"}],"predecessor-version":[{"id":1790,"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/posts\/1778\/revisions\/1790"}],"wp:attachment":[{"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/media?parent=1778"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/categories?post=1778"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.urbanthoreau.com\/blog\/wp-json\/wp\/v2\/tags?post=1778"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}