The G20 met on the weekend. As usual the topic of sustainability of health systems gets discussed. It is a problem facing all countries. The demographics of aging populations coupled with increasingly expensive healthcare makes for a government economist’s nightmare.
But it does not have to be. As Albert Einstein said “We cannot solve problems with the same thinking that created them”. There is another way, which is never considered.
Before considering this it is worth quickly revisiting the current situation. Essentially we have disease systems not health systems.
When you get sick you enter the system and the meter starts running. Our current disease systems though are based on a disease pattern of over 100 years ago. This was a time when most illness was acute and there was little that could be done.
You either died or recovered from trauma or infection – which were the main causes of sickness.
Today some 75% of the disease burden in western countries is chronic diseases. Things like diabetes, arthritis, heart disease and even some forms of cancer. Compared to the past you can live with these, without getting better or dying for many years.
And of course there are many tests that can be done, as well as medications prescribed. Which is where the big costs come in. The USA whilst accounting for 4% of the world’s population accounts for 35% of the global spend on pharmaceuticals. The problem is there is not much return on investment.
To quote physician blogger Luis Collar “…the number of diseases pharmaceutical drugs can actually cure is still exceedingly small. No pill can reverse all of the effects of unhealthy lifestyles or harsh socioeconomic realities”.
Yet the standard discussions are about how we can pay for more “disease care”. How can we pay for more hospital beds, tests and medications? The related question is who will pay? Little effort goes into asking whether spending more money has much effect. Nobody asks whether there might be a whole different approach.
The better question is what can we do to not get sick? Sounds obvious but nobody in government or in medical authority asks this basic question. This is notwithstanding that people are living longer.
The other interesting fact that nobody in officialdom seems to notice is that rates of conditions like Alzheimer’s are actually decreasing. And because of over-diagnosis we are devoting much resource to treating people who don’t need treatment and get no benefit from it.
When we look at ways of reducing the incidences of cancer, diabetes, heart disease, arthritis and even depression, something interesting occurs. That is the same things reduce the incidence of all these conditions.
If we probe further we find that the cost base of this prevention is not great. We also find that what is needed is neither difficult or beyond the reach of the vast majority of people. We also find that it does not need government action or expensive technology
All the information is freely available and does not come from “nutters”. It is all validated in long-term clinical trials.
So what is this radical way of reducing disease?
It is looking after your body at least as well as you look after your car. It means doing regular exercise or activity. It is getting adequate sleep and relaxation. It is drinking water instead of soft drinks. It is about eating mainly real rather than manufactured food. It is about having good relationships and having some fun and purpose in life.
None of this is difficult, expensive or beyond us. Yet it makes a massive and I mean massive difference.
If the focus from on high was more about supporting people seeking to be healthy rather than trying to figure out how to fix people when they are not – the system would become sustainable. There would be adequate resources to deal with those who need treatment.
I don’t expect any great flashes of insight from the G20. The disease industry has the ear of governments and treating disease is highly profitable and they will not want to lose that profit.
So don’t wait for the government to help you. Don’t wait for the disease industry to help you. Apply the basic eight pillars of health in your daily life.
The best way not to be sick is to be healthy.