Sunday, October 08, 2006

National Health

We are in a bit of a state about health.

As a society we are still happy with our bliss of ignorance. Not for that much longer.

The health systems we have established are dysfunctional. At least they don't function as we intend them to because they have no design. The are no architects of the system and the people who have been appointed to improve things can not articulate the problem from a useful perspective so it can not be 'fixed'.

The dysfunction:

A practitioner of the present system of health will struggle to define health. If you cant define health, you cant be practicing it in any useful way.

This is obviously true by inspection. We have a system that is visibly not working. Over the last 100 years problems like the rate of cancer and more recently diabetes and obesity have continually increased. One of the top five killers of people is the health system itself, with 'medical error'.

So we have built a colossal medical system of 'health' but we cant define it so no wonder it doesn't work, no one can define what 'works' means. There is no way of measuring success.

This is why governments tasked with fixing the issue will keep changing the way we measure success. Its the only way to pretend in the short term that they have improved something. But in reality they have no hope of actually improving 'health' unless it can be defined.

This is where we need to start.

There is only one useful definition of health i can think of and that is how little you need another to be OK. For example if you need a machine and a team of technicians around you 24/7 to survive i would say you are not healthy.

In this respect health is a measure of your independence from external services.

This simply leads to measuring success of a health system by how little one needs it, which is obviously the right answer. If hospitals helped you stay out of hospital and off drugs they would be better hospitals.

In reality we don't get this result because we have setup the system backward. We have setup a national sickness system rather than a national health system.

Here is how, and it all comes from the way we pay the money. In the system we have, the more people are sick, the more we pay the money to the system. The more drugs people take the more money the drug company gets. This naturally leads to companies supplying services that increase revenue which in turn will be the services that require the most dependence.

So its easy to fix.

Just start measuring the level of independence of people from the system and pay the system by how much it promotes this independence.

That could then be called a national health system.

"The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease."

~ Thomas Edison

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