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Book Review of: The New Health Age
The Future of Health Care in America
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The New Health Age, by Author (Softcover, 2011)|
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This book immediately made a good impression on me, with the first sentence of the Introduction: "This book is about the future of health care and medicine in America." What's the big deal about that statement? See below this review for an explanation. Unfortunately, the authors didn't maintain the promise of this sentence. They made some other errors, too. See below this review for commentary on this book's errors.
While some of the errors involve such simple things as counting and thus don't really detract from the thrust of this book, some errors do. The reader needs to overlook those errors to understand and appreciate what the authors are saying. I think their message is important, and not because of any preconceived notions but because of the case they make for it.
This book consists of 17 chapters and a glossary, across 316 pages. It's organized into three Parts.
Part I: History and Context. I'm a huge fan of history. It enables you to understand current events and what drives them. It also helps you see what's coming. One reason why I appreciate history is my technical background; trending the history of electrical infrastructure and mechanical equipment (e.g., the test results, usage, measurements, etc.) is how you know when to repair or replace before failure. That's the foundation for cost-effective maintenance and operation of all manufacturing plants.
It's also the basis for cost-effective maintenance and operation of all governments, which is why, in our history-apathetic culture, we have a federal government that is not cost-effective.
So when you look at how to make medical care more cost-effective, you are on a fool's errand unless you work from a solid understanding of the history. The lack of doing that is why the Unaffordable Care Act is such a travesty.
Houle and Fleece aren't advocating the UCA or any other scheme. They didn't write this book as self-appointed experts who "know" exactly what the country needs. Instead, they began by analyzing (in Part I) how we got to where we are.
Part II, The Dynamics of the New Health Age, looks at how the medical care industry would do things if it joined the 1990s and beyond. I don't say that facetiously. In an age where paper-based processes have largedly been abandoned due to their high cost and dysfunctionality, the medical care industry still runs on paper-based processes. Not only that, the information silo (which, in the information technology world is akin to having a giant zit on your forehead) is so pervasive as to be the underlying model for how things are done.
The authors didn't have to work particularly hard or engage in fanciful dreams to lay out how medical practitioners would use today's tools. Nor did they try. What they envision is dead-on accurate. It's based 100% on reality, except for the fact that the medical industry does not have incentives to modernize (and they explained why that is so).
Part III, The Landscape of the New Health Age, looks not at the modernization of practices but at the change in the (presently awful) health score that Americans (in general) will have if current trends continue and proper decisions are made. In Part III, the authors do include actual health care in their discussion. Something they overlook is an idea I have for drastically slashing medical costs. Let me explain....
If you do an analysis of men being treated for prostate cancer, you will find that they aren't being treated for the cancer at all. They are being treated for their PSA, which experts say is like basing treatment protocol on the weather. Prostate cancer is a nutritional disease. It is caused by overeating. The number one risk factor is the amount of body fat a man carries. Every ten pounds raises his risk by an order of magnitude. A man with double digit body fat is not healthy, period. It's common to find men with prostate cancer at 50% body fat with no health care provided to get that down to 6 or 7%. The fat they accumulate is a cancer cell factory.
What the doctors do instead is, and this goes back to what I said about medicine working against health care, lower the man's testosterone. This hormone is what tells the body to burn fat and store calcium in the bones. So now the man gets fatter and he gets osteoporosis. He gets fatter because he isn't exercising the portion control required to lower his body fat and now his hormonal environment is skewed the wrong direction. So his cancer gets stronger and he gets weaker.
So what's my idea? Make active engagement in a health care plan a condition of receiving continued medical care.
I knew a man (now dead) who, after 11 years of prostate cancer "treatment" consumed two Personal Pan Pizzas at one sitting. That "meal" provided three days worth of calories. In one sitting. His body fat level was at 50%. Had he been engaged in health care, his prostate cancer would have been long gone. And, by the way, one month of his useless treatments ran $40,000. And people wonder why there's a medical care cost crisis?
We need a national health care plan, for sure. And using it must be a condition of obtaining medical care for chronic disease.
Overall, the authors did a great job with this book. It helps fill a gap in the current non "debate" about "health" (medical) care. It does fall short in some ways, and I will explain those after telling you why that first sentence made such a good impression.
The big deal about the first sentence
In America, health care is actively rejected by the vast majority of the population (which is one reason that over 90% of Americans have too much body fat for their own health). Medicine (which is akin to the firefighters showing up after the blaze is going) is very different from health care (sticking to a program of fire prevention).
In America, medical care providers actively work against health care practices and health care providers. This, despite the fact that health care practiced along with medicine makes medicine enormously more effective.
And in America, where it's presumably illegal to poison people with death, disablement, and disfigurement as the likely outcomes, the government subsidizes Big Agra to produce high fructose corn syrup. And while hydrogenated oil is a cause of, and not merely a risk factor for, colon cancer "food" manufacturers routinely poison Americans who, for some reason, buy this stuff and actually feed it to their kids.
When Obama talked about "national health care," he wasn't talking at all about health care. He was talking about medical care payments. A national health care plan would enforce existing laws against the indiscriminate mass poisoning that is so prevalent and that drives so much demand for medical care.
The authors really nail the underlying concept here, on page 154. They do a well-reasoned riff on the adage, "An ounce of prevention is worth a pound of cure."
The reality is that, not only is the ounce of prevention missing from the typical American's personal program, it's been replaced with a pound of cause!
This book is worth reading, and I recommend it to anyone concerned about keeping the low costs of health care low and bringing down the high costs of medical care. It does, as I mentioned, have errors. Those are detailed below.
This book's errors
First, note that I am a real pain in the butt regarding errors. I look for them. This book has errors, but not any that undermine its wonderful, badly needed message.
On page 85, the authors correctly state that 2010 and 2011 are the 10th and 11th year of this millennium. When we in the Western world count things, we count the first item with the number 1, the second with the number 2, and so on. The tenth object is denoted by a 10. Everything from our checks to our calendars follow this numbering convention.
I remember back in the year 2000 when the counting-challenged kept on (like nails on a chalkboard) insisting that was the first year of the new millennium instead of the last year of the 20th century. How they came up with this, I could never figure out. There is no basis for their miscounting.
On page 89, the authors suddenly digressed to pre-Kindergarten counting ability. And they maintained that mistake, repeating it throughout the remainder of the book. They keep referring to the eleven years of 2010 - 2020 as a "decade," but by definition a decade is 10 years and in our counting system we count decades using the number 1 for the first year. So the decade they probably meant was 2011 - 2020. I can understand how people might be confused, if they merely subtract the start from the end. That does produce 9. But that's the wrong mathematical operation, because the first year is included. If you laid out ten coins and counted them 2011, 2012, and so on, the tenth coin would be 2020.
Another problem of the nails on chalkboard variety was the persistent and frequent misuse of the word "impact." This misuse began in business seminars and quickly spread (along with "at the end of the day") as people parroted without stopping to think about actually communicating. If you mean to say "affect" then say "affect." Impact is not a synonym for this word. Word misuse defeats clarity, which is a hallmark of good writing.
On page 130, the authors hugely confuse health care and medical care. These concepts, which are starkly different and often at odds in practice, are not synonymous. As changing our disease-behavior culture into a health-behavior culture is the key to conquering runaway medical costs and delivery problems, it's vital to keep this distinction.
If anyone doubts that our culture is pro-disease and anti-health, just start reading ingredients labels at the supermarket (today's health tip: if it even has an ingredients label on it, it's probably not safe to eat). Then, listen to how people talk. For example, the use of "health nut." There is no such thing as a health nut. There is health-sane. What's nutty (as in crazy) is not following good health practices. But in our culture, we turn this completely around bassackwards as if working at being sick is virtuous. These disease-behavior embracing attitudes need to be replacing with sane attitudes.
On page 134, the authors make a false claim. They claim that healthier employees reduce company "health" (medical) care insurance premiums. I would like to see the data showing insurance companies reward companies with rate reductions based on the cost of claims filed. As far as I know, it's a flat rate structure based on your location, industry, etc., but not on your claims history. Yes, they may raise your rates or drop your coverage if your claims become an extreme burden.
The reward to companies whose employees are health-sane is they can work the salaried employees longer unpaid hours before those employees get burned out. There may be other incidental rewards, but let's not delude ourselves that cubicle farms are full of people who would be noticeably more productive if they didn't suck down sodas all day and overeat their way into obesity. I think the demoralizing atmosphere of these cubicle farms are why people palliate with these misbehaviors. The solution is to give workers some dignity and respect; that will motivate higher productivity and reduce the self-medicating with toxins and calorie splurging.
In certain areas, there would be an output increase. But in others, a decrease. Take sales, for example. In the typical sales relationship, the sales person calls on accounts and then engages in anti-health practices (wining and dining) with the customer. Only when these misbehaviors are not expected will sales people be able to avoid those behaviors without financial penalty.
Beginning around page 140, the authors talk about the self-poisoning that passes for "diet" here in the USA. An issue here is it costs more to buy human-compatible food than it does to buy the crap peddled by so many restaurants. The problem that must be addressed here is the illegal grain subsidies. In addition to putting 30 million Mexican farmers out of work, this transfer of wealth to Monsanto, et al, has resulted in a price structure that hides the real cost of poor food choices. That high fructose syrup-contaminated bread and nutrition-void lunch contaminated with hydrogenated oil might seem less expensive than the tasty and nutritious bounty in the produce aisle, but in reality we all pay a hidden medical care tax for this stuff. It's almost as if Big Agra and Big Pharma held a meeting on how to vastly increase each other's revenues and this arrangement resulted.
Rather than nag health-deaf people to make sane food choices, the government should simply stop subsidzing the mass poisoning operations. That would reduce the huge price skewing and then people would be more inclined to buy food that actually tastes good (the taste for HFCS and HO are acquired tastes; real food inherently tastes good) and that helps them instead of making them sick.
On page 245, the authors appear to have never heard of urban sprawl, oil shortages, automobile dependency, and the other ills that we "gained" from the interstate highway system. That system was a mistake, not a blessing.
On page 246, the authors are engaging in some kind of reader head petting or "brown nosing" with statements that don't belong in a serious work. And some are just flatly false. For example, they say, "Americans have never accepted anything that weakens us as a country." Look at the quality metrics for industrialized nations. The USA is at or near the bottom on all of these. As a nation, we too willingly accept that which weakens us. It's our major problem as a people. Perhaps exhibit one is the massive federal debt (mostly due to spending that is expressly forbidden by law, see the 10th Amendment) we now have. It exceeds the GDP of all nations combined, not once but three times over. That debt has weakened our nation immensely, yet Americans continue to accept our single-party fraudulent, ballot-controlled "elections" for federal offices.
On page 290, the authors say, "Many Americans worry that the country is losing its competitive greatness." First of all, it's imprecise to say "many" do anything. How many? 100? 1,000? The language here implies the authors are just stating their own view. And it's wrong. The country isn't losing its competitive greatness. That milestone was reached many years ago.
On page 292, the authors begin a list of 10 positions. But these are so poorly articulated, I find them meaningless.
On page 302, the authors recommend creating a special tax on unhealthy foods. This is wrong-headed. First of all, those "foods" are subsidized. So rather than creating a tax, just stop paying out taxpayer money to the criminals who peddle this stuff. Did I say criminals? Yes. It is already illegal to poison people. High fructose corn syrup is a poison. It's illegal to sell it. The issue of HFCS is not an FDA problem, it's an FBI problem. It's not that HFCS "might" contribute to health problems. It is an endocrine modifier that has immediate effects. And its chronic effects from sustained use are devastating. Only a psychopath would be involved in producing and distributing this substance. We need some arrests.