I appeared on Larry King Live Wednesday night to discuss health care reform with a panel of respected, high-profile physicians. I sounded the themes I wrote about in The Wrong Diagnosis: that Americans must change the content of health care, not just access to it, or we’ll remain among the unhealthiest people in the developed world, and the costs will sink us.
Bill Frist, a physician and former Senate Republican majority leader from Tennessee, responded with what has become the conservative line: that “we do have the best health care” and what Americans principally need is “insurance reform” rather than improved health care practices. Later in the program were video clips of what host Wolf Blitzer termed “conservatives” disrupting town hall meetings on health care reform. Clearly, the prospect of change in health care is highly emotional and disturbs many people.
But here’s my question: Since when is it conservative to embrace new, overpriced, corrupt systems, like the health-destroying and ruinously expensive protocols of much of modern medicine? “Conservative” has several meanings, but two central ones are “favoring traditional views and values,” and “avoiding excess.”
I hold that nothing could be more wild, unconstrained, and downright liberal than the path medicine has taken in just the last 20 years — an unprecedented bacchanalia of excess and contempt for traditional American values.
Pharmaceuticals, once just one of many therapeutic modalities, are now synonymous with medical care; more than half of all insured Americans are taking prescription medicines for chronic health problems. Medical journals, formerly bastions of objectivity, are today often ghostwritten shills for moneyed interests. And physicians, once free to make healing their only goal, must now obey the dictates of lawyers and stockholders by ordering endless tests and dangerous, dubious surgeries for even minor conditions.
While billions of dollars are shunted into very few pockets via such abuses, insurance premiums skyrocket, leaving 47 million Americans with no coverage. The result of medicine’s libertine spree? The relief agency Remote Area Medical, established to bring health care to rural parts of third-world nations, now sends 60 percent of its missions to U.S. cities such as Los Angeles, California and Knoxville, Tennessee.
By contrast, integrative medicine (IM), the system we teach at the Arizona Center for Integrative Medicine at the University of Arizona in Tucson (and that is taught at more than 40 other medical schools nationwide including Harvard, Yale, Johns Hopkins and the Mayo Clinic) is profoundly conservative in at least three ways:
1. It is philosophically conservative in that it aims to restore core values of medicine that were strong in the past, such as a reverence for the healing power of nature and the importance of the therapist-patient relationship.
2. It is medically conservative in stressing prevention and advocating lesser rather than greater intervention — the least invasive, least harmful, least expensive treatments that the circumstances of illness demand. IM practitioners always observe the Hippocratic precept of “First, do no harm,” relying in simpler interventions whenever possible and turning to more drastic ones only when the former fail to produce desired outcomes.
3. It is fiscally conservative in its willingness to look beyond the blinders of high-tech medicine to identify inexpensive therapies that may be useful and in its insistence that they be held to the same standard for clinical- and cost-effectiveness in well-designed outcomes trials.
I urge Senator Frist and all Americans to join me and thousands of physicians and patients in demanding a return to sensible, sustainable, conservative values in medicine. The liberals have had their day.