Our Healthcare System: Follow the Money

Part One of Two: The 20th century’s lost leader.

So why is there is so little care in healthcare? Many would say follow the money. Healthcare has become the focus of corporations and insurance carriers bent on making a profit. Health insurance for most of the 20th century was a lost leader.

Our healthcare system is really a system for treating illness because that’s where the money is. Prevention has always been given lip service, even before the 1980s. Today the U.S. spends more money on health care than any other country in the world, nearly twice as much per person. Yet, the U.S. ranks 34th in life expectancy, along with Colombia, Costa Rica, and Cuba.

Much of our care is controlled by the pharmaceutical industry. Major killers of our population, such as depression and anxiety, are a secondary focus of the present system. And the treatments we provide can make things worse. For example, in the treatment of chronic pain, our healthcare system over the past several years has emphasized the prescription of pain-relieving medications, such as oxycodone and OxyContin. Unfortunately, the over-prescription of this medication in the treatment of chronic pain has resulted in many, many people becoming addicted to the painkiller.

A local sheriff recently told me that most of the individuals the penal system comes in contact with are addicted to opioids and that their addiction began legally through a prescription from a licensed physician. Non-pharmaceutical interventions, such as behavioral approaches like cognitive behavioral therapy and acupuncture, have, in general, been ignored.

A British physician recently confided in me that if she prescribed opioids with the frequency and dosage levels of American physicians she would have risked losing her license in Great Britain. In England, chronic pain is usually treated with cognitive behavioral therapy first, acupuncture second, and the prescription of an opioid fourth or fifth on the protocol.

Some national organizations, such as the American Psychological Association, are supporting the development of a workforce of psychologists and other providers who are trained in non-pharmaceutical interventions as an alternative in the treatment of chronic pain and, thus, as a way of responding to the opioid crisis by preventing it.

So what can you do about it? A lot. We’ll talk about this in the next post.

This article was originally posted to Psychology Today, “In the Face of Adversity“, by Dr. Ron Breazeale, Ph.D. With his permission, we will share a series of posts on Chronic Pain and related issues as a prologue to introducing what Maine has to offer for treatment options.

Photo pf Ron Breazeale, Ph,D.
Ron Breazeale, Ph.D.