Wednesday, September 27, 2006

Such low expectations....

I participated in a health insurance forum yesterday. Former Oregon Governor Kitzhaber is leading a project called the Archimedes Movement. It's focus is to confront the reality that the current health insurance system is failing us and must be redesigned to meet the needs of the 21st century.

At one point in the process, we broke up into small groups with the 'assignment' to design a health insurance system for Oregon. What would we want?--universal access?, means testing? prevention, public health education?--. In the 20 minutes allotted, we brainstormed lots of different ideas. In the course of the conversation, I threw out that with universal access there should also be some level of responsibility/commitment by members to maintain a healthy lifestyle. I said this based on the fact that, 80% of the illnesses that we'll be dealing with are "lifestyle" illnesses. The top four areas where we spend health care funds--heart disease, diabetes, some cancers and obesity--all have a major component in how we live our lives--so prevention was as necessary as any medical intervention.

Instantly, all the doctors in the group jumped on this and said "We shouldn't penalize patients for not meeting a health criteria--many patients simply can not due to poverty, mental health issues and 'diseases' like obesity (?), be held responsible for what is outside their control."

And you know, I know these doctors think they're well-meaning, but in truth, they've just trapped their patients in the 0-5 level of health care that has resulted in our terribly dysfunctional, fix it after its broke, reactive health care system--the very one we need to change.

One doctor expressed that many of her patients have drug problems, dual diagnosed mental illnesses and multiple generational/family health issues--along with poverty. She was essentially saying...This population can't function on a 6-10 level--they simply can not learn to be proactive, know themselves as whole human beings, take responsibility--they are victims and that's all they'll ever be.

We didn't have time to discuss this further....but I would argue to her that I've worked with this population--women coming out of prison with everything she said--drugs, mental illness, dysfunctional family.....and when I introduced the Life Puzzle model to them--their response was, "Wow, how come I've never seen this before?" They proved once again that most of us live on the 0-5 side of the Choosing Continuum-simply because that is what we see all around us and we rarely see the 6-10 side. My experience showed that when you share the 6-10 side of the Choosing Continuum, people will gravitate towards it.

Unfortunately, as these doctors made clear in this meeting, we have accepted such low expectations--0-5, reactive, unconscious, victim to the world around us. The medical/health system is perpetuating the 0-5 and the outcome results in very poor health. Despite throwing more money in our health care systems than anyone else in the world, we rank only #37 in world wide health quality. I don't know why we're surprised--a 0-5 health system could never lead to great health!

What does that mean to you? Choosing to build your own Life Puzzle is the option you'll have--but you'll have to choose it. Our medical system isn't ready for it yet!

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