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Answer: I wrote Why Our Health Matters because I care very much about health, about my profession, and about my country. I would like to see people become informed, and upset and angry with the facts about health care in America. I want them to understand how much we are paying and how little we are getting. I want to show them all the things that have to change.
Q: Can you talk about the three myths of American health care and the realities? A: I think many people buy into three myths about American health care that really deaden us to the realities.
The first is that because American health care is the most expensive in the world, it must be the best. The reality is that although we spend more per capita on health care than any people in the world by a long shot, our health outcomes are at or near the bottom compared to those of other developed countries. The World Health Organization recently ranked America thirty-seventh in a survey of countries in terms of health-care outcomes. That puts us on a par with Serbia. And that’s any way you look at it, whether it’s in terms of infant mortality, longevity, or rates of chronic disease.
The second myth is that having the most elaborate and expensive medical technology in the world must translate into medical excellence. The reality is that medical technology has helped us in certain areas like the management of trauma and critical conditions. It has, however, served us very poorly in terms of creating cost-effective health care. In fact, one of the main reasons American health care is so expensive is that our interventions are based in expensive technology—including pharmaceutical drugs. There are many low-tech methods of intervening in disease that our doctors simply don’t learn. Also, our entire health-care system is geared toward intervention in established disease, yet the vast majority of that disease is lifestyle related and therefore preventable.
The third myth is that we have the best medical schools and research institutions in the world and that they are producing the best physicians and the best research in the world. The fact is that we have a great medical infrastructure, in terms of bricks and mortar and very highly trained faculty. But the curriculum of medical school—and this is also true of nursing and pharmacy schools—omits very large areas that are extremely relevant to health and healing. For example, our health professionals know next to nothing about nutrition. They don’t learn about botanical medicine. They don’t learn about mind/body interactions. We conduct a great deal of research, but the fraction of it that is relevant to health and healing and to developing cost-effective treatment strategies is very low.
A: I think our efforts at prevention are feeble because we work from a model of prevention that is not very robust. The cornerstone of prevention should be lifestyle medicine. That means teaching people how to make better choices about how they eat, how they exercise, how they rest, how they neutralize stress. This is primarily something that needs to be done in terms of education, but the whole society has to pull in the same direction. The government and corporations both have to work to make the right lifestyle choices affordable and easy. You can’t have the federal government telling people to eat more fruits and vegetables while at the same time making unhealthy foods cheap and healthy foods expensive through its patterns of crop subsidies. Also, a lot of our preventive efforts are very limited in that they have a lopsided preference for pharmaceutical drugs, like statins to prevent heart attacks or bone-building drugs to prevent osteoporosis. This is not the most cost-effective way to prevent disease. We need to think about prevention in new and better ways.
Q: What is health and who is responsible for it?A: To me health is an inner state of balance and resilience that allows you to move through life and not get hurt by all the things out there that have the potential to hurt you. An image that I like to use to illustrate that is a child’s knock-down toy with a weighted bottom. You can knock it over; it bounces back up to the center. You can hold it down; it will stay down for as long as you hold it, but if you let go, it bounces back to center. If you have that kind of inner springiness or resilience you can interact with germs and not get infections. You can interact with allergens and not have allergic responses. You can interact with toxins and not be harmed. That’s a quality that we’re all born with. This quality is innate, but it’s up to us to learn how to protect and enhance that quality as we go through life. So I think, ultimately, that health is an individual responsibility. But it’s also the responsibility of society to help us in that effort.
Read the entire interview [PDF]
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Most Helpful Customer Reviews
41 of 42 people found the following review helpful:
5.0 out of 5 stars
"Without a transformation of the fundamental content of medicine, any attempt at health-care reform is doomed.",
By
This review is from: Why Our Health Matters: A Vision of Medicine That Can Transform Our Future (Hardcover)
Dr. Andrew Weil doesn't mince words; he joins the health care reform fray with a "radical" point of view: "Most commentators assume that the root problems are (a) how to give more people access to the present system and (b) how to pay for it. I strongly disagree." In recent weeks Weil has appeared on CNN, written articles (Google for them), and, now, released a new book, Why Our Health Matters: A Vision of Medicine That Can Transform Our Future, urging a fundamental shift from "high-tech" to "high-touch." He makes the persuasive case that our accelerating reliance on expensive medical technology and medicine have contributed greatly to ballooning health care costs: on page 70 of the book, he lists 1950 costs of U.S. care at $8 billion, 1980 costs at $212 billion, and 2009 costs at $2.5 trillion (with a T). He also estimates future costs in 2015 at $4 trillion. Even adjusting for general economic inflation and related factors, these are staggering increases that amount to one-sixth of earnings presently (p. 123). Weil insists that for this reason, "high-tech disease intervention...is obsolete." He wants less reliance on expensive pharmaceuticals, scans, surgeries, specialist ,hospital stays; and more emphasis on integrative medicine which treats patients not just for isolated symptoms but as whole persons. He wants the general practitioner to make a comeback. He wants doctors who will take personally take lengthy histories, listen carefully, recommend dietary modifications, offer exercises for stress relief, refer to practitioners of Chinese or chiropractic medicine if appropriate, etc. He says, frankly and convincingly, that continuing high-tech is simply unsustainable.
Weil also is a staunch supporter of universal health care with single payer. He believes the federal government should take a very active role in many aspects of health care. For instance, he proposes a federal mandate requiring doctors to have, at minimum, a one-hour initial consultation with a new patient. He also desires that government create several more health agencies, and he supports a "national system of electronic medical records" with privacy guarantees (although he makes no mention of how privacy would be achieved). He wants a legislative ban on "direct-to-consumer advertising of prescription drugs." In fact, Weil says, "It is imperative that the pharmaceutical drug industry be drastically reformed by increased governmental oversight" and other pressure. He says malpractice reform could save "as much as 10%." He is also insistent that for-profit health insurance companies and hospitals need to be phased out: hospitals ought to be non-profit, and private insurance companies shouldn't exist. In general, the blueprint Weil details in WHY OUR HEALTH CARE MATTERS is focused and visionary, both qualities very valuable to the current, heated health care debate in our country. At times though, Weil adopts seemingly contradictory views. He, for example, strongly lauds individual responsibility for personal health and reminds us that Americans used to pay most medical costs out of pocket instead of relying on Medicare, Medicaid, private insurance, etc. His point, in part, is that when we only pay a co-pay for a doctor's visit, we may go more than if we had to pay it all directly ourselves. Yet, as mentioned, he also advocates universal health care with everyone being insured, basically, by the government, and he wants to expand the health services which would be covered. Such a universal system could invite less individual responsibility regarding costs of procedures and services. In a sense, these contradictions are simply an indicator of the sheer complexity of health care issues. Even when a knowledgeable, experienced M.D. seeks to lay out a comprehensive reform plan, not everything fits together. This can help remind us all that there are no easy answers, and we should all question everything anyone says about health care reform. One does not have to agree with all of the proposals in WHY OUR HEALTH CARE MATTERS to find this an instructive and important contribution to the debate. Weil arguably places too much trust in the abilities and powers of government, and not enough in the ability of private enterprise to be flexible under changing conditions. And one can argue that his aims are too utopian (or just too overreaching). But his clarion call that "we must stop paying for failure" in our health care system is advice best heard. His new book is one every American ought to read and then contact their legislators about implementing those portions of it with which they do agree. (4.5 stars)
29 of 34 people found the following review helpful:
5.0 out of 5 stars
Compelling and credible vision for the transformation of health care,
By Alison www.health-journalist.com (New York, NY USA) - See all my reviews
This review is from: Why Our Health Matters: A Vision of Medicine That Can Transform Our Future (Hardcover)
This is the most timely and essential book you will ever read.
Andrew Weil has the right diagnosis and the right cure for what ails America-- he helps you understand why so many people have health problems and crippling health costs, despite the myth that America is number one in health. (Hint-- our real rank in health status is way down the list with the Serbians!) This book answers every single question about why the health of US citizens is worse (and more costly) than that of folks in all other developed nations. In a clear, thoughtful, readable and no-nonsense way, Weil assesses what works and what doesn't work in US health care, and proposes the major changes we need to get health care right in this country. For health information and action, get the free ezine the Health Outlook at [...]
11 of 11 people found the following review helpful:
5.0 out of 5 stars
A much needed wake up call for Americans,
This review is from: Why Our Health Matters: A Vision of Medicine That Can Transform Our Future (Hardcover)
The hard truth, a truth that Dr. Weil communicates expertly, is that America is NOT #1 when it comes to health care. We may spend the most, but as the book states, if any other industry performed as poorly and cost this much, we would have stopped throwing money at it years ago. It is difficult for free enterprise to function properly when the product being offered may mean life or death. This is where the system breaks down.
I am not going to quote the whole book, I'm note even going to rattle off some of the very disturbing statistics of just how horrible a shape we're in. I am going to say that Dr. Weil makes a fair and informed argument for his idea of change, praising the areas where we excel and pointing out the areas of grave failure. While everyone is arguing about how to give more people access to the system, Dr. Weil draws attention to the root of the problem, the system itself. His ideas are not so radical. They are old ideas, applied to a new era of medicine. We've lost a lot of what made our doctors great, what made them proud of their jobs and their roles in our communities. The trillion dollar industries of health insurance, pharmaceuticals, and medical technologies have distorted our views of what is beneficial, appropriate, and necessary when it comes to our health. High-tech health care has its place, but we also need to take responsibility for our lifestyles and not rely on a pill or surgery to fix the problems we created by our own choices. They don't always work. Awareness must come first, before the solutions. Reading this book certainly helped me realize that our health care crisis is going to go from bad to worse in short order if this country doesn't make a major course correction. It starts with me, my health, my choices, and whether or not you agree with Dr. Weil's plan for America, my hope is that it makes you examine your own life and decide that your health DOES matter.
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