healthcare - Page 3

Will You be Left Without a Doctor?

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The New York Times looks at a critical problem growing in rural areas of our country. Will you be left without a doctor or specialist in the near future?

“The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.”

 

Read the rest of the article focusing on one of the nation’s critical zone, the Imperial Valley of Southern California, here.

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Health at the Nexus of Economics and Innovation

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Health innovation exists largely because of the promise of great profits. Whether it is new drugs, devices or even health insurance, the development of these products are firmly established capitalist endeavors. Health itself, however, like life, liberty or even the pursuit happiness exists on a different plane entirely, more closely aligning with the right of life than with a corollary product or commodity. Where it gets squishy is in determining who is responsible for paying for that right, especially when someone chooses to ignore the responsibility of good health, is genetically burdened with ill-health, faces poverty, or as is the case in modern industrial society, is sold ill-health by companies whose very existence depends upon products that cause illness.

Where do one’s right of life and presumably some quality of life or health end and the right to profits begin? Who shall pay for these rights? And are there innovation opportunities in defining or re-defining health as a right versus a product or a commodity?

Understanding Moral Hazard and Modern Health Care

In 2009, with the financial system in ruins, the phrase moral hazard burst into the daily lexicon. One could not listen to a news report without hearing how those responsible for the crisis pushed all of the risks of their highly profitable ventures on to everyone else – textbook moral hazard. And then, to make matters worse, we were being asked to bail out these giant institutions that crumbled our economy, while they continued to reap huge salaries and bonuses. The gall…

Many view health insurance and by association, healthcare, as an industry based upon moral hazard. Unlike the moral hazard of the current financial markets, however, where the chosen few distribute risk downward to the many, the moral hazard in health care presumes that the many distribute the risk back up to the few, those presumably responsible individuals, who are healthy. Indeed, the distribution of risk penalizes good health with the increased cost of bad health borne by all. “How dare we be asked to pay for our neighbor’s smoking or obesity?” The gall…

What is often missed in our moral outrage, is how being sick reduces the profitability for those at the top of the insurance industry. This is the crux of modern health care’s fatal flaw – a skewed version of moral hazard where health care is a commodity that few at the top of the food chain are willing to risk on those at the bottom.

Health Economics

Modern theories of health economics argue that the act of providing health care services to all and the distribution of those costs amongst everyone will reduce the total financial risks but also increase the need for care, and therefore reduce profits. The presumption is that when people are given low-cost health care will, they will choose to partake in more health care services in much the same way that lower prices encourage other product purchases.

Appendectomy anyone?

Despite the almost comical notion that people enjoy going to the doctor’s office and/or to the hospital in the same way they enjoy purchasing a new handbag, or that these services are like any other commodity driven purely by access and cost, this concept of moral hazard pervades the health care/insurance debate, with nary a question of its legitimacy or utility. What is more, this model likely reduces overall profitability of the industries that seek to reap the rewards from health while increasing the profits of those who benefit from illness or at least benefit from ignoring the illnesses their products cause.

Health Innovation

If health innovation (the products within the health care system, new drugs, devices, programs, vitamins etc.) are only developed on the promise of great profits, how does that square with the notion that individuals really don’t want to go to the doctors unless they have to? How do we reconcile the need for health innovation to maintain our economic and health vitality and the premise that health care isn’t a product in the traditional sense; that it isn’t needed or wanted until it is needed?

Marketing Health (or Illness)

The current healthcare business model answers that question with marketing. Make the consumer or the physician want or believe they need the products being sold. The pharmaceutical industry is quite successful marketing must-have medications and products and they do so by employing the same tactics and strategies used to market any other consumer product.

Indeed, the newer model products/drugs are akin to the designer versions of a handbag and yield the same ‘must-have’ response from the consumer (even the physician) who is willing to pay premium prices for the latest and greatest medication. Like the must-have handbags, newer drugs often have no more efficacy than older ones (sometimes are worse), often contain only single isomer changes  (meaning molecularly they are almost entirely the same drug as the earlier, cheaper version e.g. Lexapro and Celexa) and more often rest the perceived utility solely on re-branding. A brilliant model if it wasn’t health or life and death that was for sale.

Another Way

What would happen if health was re-conceptualized as a right? If it were considered a right, then there would be a duty to protect it, legally. The current practice approving drugs and devices would look very different than it is today. From a market standpoint, the backlash from those who profit from illness would be swift and intense, but the potential for innovation and profits from other sectors could be equally strong, if the opportunity is recognized.

As it stands, we have big pharma, big agriculture (pesticide and herbicide use), big coal, big tobacco and other industries profiting wildly from their products, while distributing the health and economic risks downward to the masses in the classic model of moral hazard. These industries bear little to no responsibility for the true health costs of their products. Those risks are dispersed over time and over millions of people.

On the other side, we have the health care industry, straddled with the burden of caring for an ever less healthy populous while simultaneously having to answer to shareholders demand for profits. Their model of moral hazard proscribes increased profits for the top, increased cost for the healthy, and reduced services for everyone else. The health care industry pushes back on the individual, dis-enrolling, reducing access, but pays little attention to the purveyors of bad health. They buy hook-line-and-sinker the notion that the individual is solely responsible for his/her health. And while that is true in many cases, in today’s cesspool of environmental carcinogens, dangerous and eventually recalled (although not before the damage is done), pharmaceuticals and devices, endocrine disruptors, and generally unhealthy food supply, no individual alone can avoid all contact with the garbage that is in our environment and ultimately causes illness. And they shouldn’t have to. If the industries that currently lose money from illness (insurance, hospitals, employers), would step in and push back against those that profit from illness, we would see a radical change in disease rates, an enormous reduction in health care costs and an incredible increase in innovation.

If health were a right akin to the right of life, then products that affect health would be judged not just on the perceived profit margin, but on the actual cost/benefit ratio to health. The economics of health would switch from how do we distribute the cost of ill-health among the masses to how do we reduce ill-health of the masses. If a product causes more ill health and costs more than it benefits, perhaps it shouldn’t be on the market. Right now the debate is over how not to break the bank by including sick people on the insurance rolls or providing access to care for the poor, perhaps the math would work better if we looked how to prevent illness in the first place.

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The Slippery Slope of Regulating Perceptions: Stand your Ground

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As I write this post, there are two, seemingly mutually exclusive, events rocking the nation and a third about to re-ignite; the Trayvon Martin tragedy, the battle over women’s health rights and the Supreme Court hearing on healthcare. I can’t help but thinking somewhere in the depths of these events there is an important point missing from the conversation.

On the one hand, a child was shot and killed as he walked home from the store. His killer remains free and protected by a poorly written law giving the shooter justification by self-defense. The killer believed  the child was a threat to him and that is all that was needed under the NRA supported Stand Your Ground Law, recently enacted in Florida and other states.

“The Stand Your Ground Law acts as an immunity to both criminal and civil liability once it is successfully raised at or before trial by somebody who has been accused of using deadly force.  See Peterson v. State, 983 So.2d 27, 29 (App. Ct. 2008) (holding that “[t]he [Florida] Legislature finds that it is proper for law-abiding people to protect themselves, their families, and others from intruders and attackers without fear of prosecution or civil action for acting in defense of themselves and others.”).  Once a person raises this self-defense, “the trial court must determine whether the defendant has shown by a preponderance of the evidence1 that the immunity attaches.”  Id.  Once the immunity attaches, it is then the prosecution’s burden to prove beyond a reasonable doubt2 that the self-defense should not apply and that the person is guilty of the crime. Montijo v. State, 61 So.3d 424, 427 (App. Ct. 2011).” (The Urban Politico)

On the other hand, we have a series of laws, proposed and enacted, that give a physician the right to withhold medically relevant information to a woman, if that information can be perceived as leading to an abortion. Furthermore, should the withheld information cause injury or death to the mother or child, which is inevitable, additional laws have been enacted protecting the physician from medical malpractice in these ‘wrongful birth’ cases.

In both cases, the fundamental questions of guilt or innocence, and the personal responsibility for the life or death of another human being need not be based upon the actual facts of the case. Rather, these laws allow defendants protection based upon what they believe or feel about the circumstances. The aggressor has legal justification to act if he/she believes a threat exists or a possible future action might occur. Feelings and beliefs are trumping facts and reality. This is a slippery slope.

Perhaps, even more insipid is the underlying assumption that it is OK, even justified, to harm another individual, a woman, a child, if doing so accords with one’s religious, political, economic or racial beliefs; that those organizational ideologies somehow supersede the basic human ethic and make the harming or even killing of another individual, whether by force or by bad policy, OK so long as I/my group believe it to be OK.

Enter this week’s Supreme Court hearings on the individual mandate aspect of the Affordable Healthcare Act. Although unconnected on the surface, this too has the air of succession of belief over reality. Only in this case, the courts will decide the value of human life versus the value of economic gains or loss, under the auspices of state’s rights and individual liberties versus federal power. Admittedly, legal scholars frame this decision differently and the pundits on both sides of the aisle have their opinions, but at its core, this decision will determine whether basic access to health care is a right determined by the presupposition that human life has value above economic or political gains worth protecting at the federal level or whether it is simply a commodity in a very screwed up political economy.

The facts of this case are that the American healthcare system is inefficient, has poor outcomes compared to other industrialized nations and is way too expensive. To boot, 30 million Americans do not have the insurance that provides them access. Every one of these 30 million Americans will become ill at some point and many will die without access to care. Do we as a nation think this is acceptable? Apparently, many do. And the fact that many people are suffering or dying doesn’t appear to have bearing when compared against the perceived economic gains or losses of certain industries or the political power many seek to retain. What some feel they will lose, should the healthcare act survive, has primacy over reality and facts. Indeed, if facts and reality mattered, there would have been a host of other solutions to presented, that address the actual costs to a nation that doesn’t provide its citizens healthcare. As we all know, this was not the case.

Yes, there will be economic consequences if healthcare is provided to all (perhaps some positive). And maybe the individual mandate is not the solution, but the arguments before the courts are not about whether the mandate is the right solution. These hearings are about whether facts trump feelings and whether the value of human health trumps state power and the economic gain of a few. Let’s hope the collective wisdom and ethics of the Supreme Court is greater than what has been observed in local legislatures and courts across the nation.

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Why Citizens United, Feckless Politicians and Misogynist Radio Hosts are good for Women’s Rights

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Yes, you read that correctly. The current diatribes and debates about women’s health and our rights to health care are a good thing. We are seeing, perhaps for the first time in a very long while, what many individuals and organizations really think about women’s rights. For this we have the Supreme Court and Citizens United to thank.

Citizens United, the infamous Supreme Court decision that decreed corporate personhood, cemented a long brewing trend in American political conscience favoring the rights and goals of corporations and institutions over those of individuals. More than simply allowing organizations or the super-rich to buy politicians of their choosing and do so entirely unencumbered by messy citizen-based fundraising or even approval, Citizen’s United capped, like an exclamation point, the corporate and institutional priorities of the last half of the 20th century.

Unhindered by legality, or even the good sense to mask a blatant trampling of the rights of human citizens, organizational power, under the corporate personhood decision, can now progress to its logical absurdity, which it is doing with astonishing alacrity. And women’s rights are in the cross-hairs.

Nothing but the pure hubris that comes with the unbridled power of corporate sponsored politicians can explain the all-male congressional hearings on women’s health, the Blunt Amendment or the continued political capitulation to the vile diatribes of a male radio host who debases women with every breath. Did they really think these events would go unnoticed by the female population? Obviously, they did. How else does one explain such a huge strategic error in political engineering? Even a neophyte political operative, if asked, would have suggested at least giving the appearance of inclusion of women or paying lip-service to those with differing opinions, if only to manage the optics.

With corporate personhood and corporate sponsored politicians, many politicians, it appears, believe that managing the optics is no longer necessary. Forget about working for the citizenry that the politician was elected to represent (that was lost long ago) it is much more expedient to manage the ‘corporate persons’ that sponsor one’s political longevity.  In many ways, politicians in this post-Citizen’s United world are freer to behave in accordance with their actual beliefs. This includes favoring the prerogatives of the corporation or large organization over those of individuals; and as we’ve seen in recent weeks, throwing women’s health under the bus.

I would argue, however, that this is dire mistake, because despite the apparent victory that Citizen’s United granted corporations and other large organizations, it was rooted in 20th century trends (and even earlier ideological foundations). Romney’s ill-fated “corporations are people” bespoke a critical truth, too quickly ignored. A corporation is not a unified entity, with a monolithic point-of-view, no matter how much money those at the top decide to throw at their chosen politician or desired political goals.

Corporations are comprised of millions of actual citizens (>50% are women) who are technologically connected and capable of launching powerful movements for or against their corporate or political leaders. Indeed, corporations and politicians are far more dependent upon the goodwill the citizenry than most realize. Consider the social media onslaught that befell proponents of the heavy-handed, industry-sponsored legislation to curtail online piracy (SOPA/PIPA) or the more recent attempt to block public access to tax-payer funded scientific research (HR3699/RWA). Both bills were blocked by internet activism. And these were relatively arcane bills. Imagine the power of millions of angry, connected women?  Talk about a countervailing force to Citizen’s United, corporate shenanigans and feckless politicians; yes, this war on women is a good thing. It is awakening a sleeping giant. What this giant will do is anyone’s guess, but I’d hate to be the wrong side.

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Redefining Healthcare for Women

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As the dust settles on the Komen Foundation decisions of last week, I am reminded once again how compartmentalized and politicized the notion of women’s health has become.  Boobs and wombs seem to represent the sum total of interest in women’s health.  And if the Komen fiasco is any indication, one can’t care about both, because where one stands or one’s employer stands on reproductive issues is now becoming the litmus test that permits or denies access to care. If you are a woman, that is. No such criteria exist in men’s health.

Women’s health is inherently political. We carry the responsibility of continuing the species. With that responsibility inevitably comes intrusion (no pun intended). We seem to forget, however, that women have cancer (not just breast), heart disease, diabetes, immune diseases and the whole host of illnesses that are unrelated to whether or not we bear children. Certainly, whether we have born children impacts these diseases, more so than many are willing to admit, but what we think about birth has nothing to do with our health and should have nothing do with our access to healthcare.

As a private organization, Komen has every right to change its mission. It has every right to fund only those organizations that align with their political or religious views. If it believes strongly in those views, then it should change its mission and hold to it.  However, Komen should be prepared for mass defunding from those who don’t share the same ideology. Early signs of this were evident last week.

There is no delicate or politically adroit way around this issue for Komen and other organizations who believe that views on reproductive rights trump a woman’s access to healthcare or an agency’s access to research funding. If that is the litmus test, however, then say so. Take the stand and own the results. Tell the world that your organization provides preventative healthcare, supports breast cancer research and other activities only for some women and only for organizations that share your views.

Then let the rest of us get on with the business of providing healthcare and research for all women.

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The Match Game Of Healthcare That Works (Part II)

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“What is the sign of a healthy person? Such a person is happy anywhere. He or she is relaxed everywhere – always at ease and in peace, within and without. Even in hell, such a person will be at ease. A healthy person hates no one, dislikes nothing. Total love, universal love emanates from within. There is no tension anywhere, no stress or friction. These are the signs of real health.”

Swami Satchidananda

Make healthcare truly about you – your personal definition of “health”

From Part I of this Match Game series you have a sense of how a payment system (health insurance) has been setting the playing field determining what constitutes health and well-being for millions of Americans.

To experience healthcare that works for you, we have to change the nature of the game – “reset” our current paradigm.  This reset starts with your personal worldview of health and the relationship, or lack of relationship, between the physical, mental and emotional bodies (see related article).  This worldview will naturally integrate with your definition of health and well-being.

Crafting your personal worldview of health likely resulted in one of two primary worldviews:
• Newtonian – from the namesake of Isaac Newton.  Very simply, in this worldview the world is seen as a mechanical machine.  The physical body is like a machine, divided into parts to be worked on like a machine.   Mind and emotions have little, if any, impact on the physical being.  Healing is rarely considered.  Practitioners treat illness or disease in separate parts of the physical body.
• Quantum – from understanding the world through the lens of quantum physics.  Very simply, at a quantum level everything is interconnected.  Physical, emotional and mental aspects of our being influence each other.  Our outer world and inner world are also connected.  Consciousness matters.  This worldview encompasses healing.  Practitioners treat the person, not the disease.

You may have a blended worldview, or a different lens for different circumstances.  Whatever your result, keep this in mind as you explore the nature of “health.”

What is health?  What is well-being?  And, where does healing fit in?

Health does not mean the same thing to all people.  Reflect on the nature of health described in the opening quote of this article.   It is basically about one’s “being-ness.”  No mention of disease or of physical vitality.

Healthcare physicians, practitioners, all have a different view of what constitutes health, which has been influenced by their field study and experience.  Physicians can only engage with you from their framework of knowledge and understanding.  As a result, for example, you can now see that talking about well-being from a quantum lens with a physician with a Newtonian framework is a mismatch on many levels.  It’s likely both of you will be frustrated.  Having a mismatched partnership is not a good foundation for well-being and healing.

You deserve health and care that fits YOUR unique being, your worldview.   These are very personal decisions.  To find people for your healthcare team requires matching healthcare providers concepts of health to your beliefs and principles.  The starting point is not a list provided by an insurance company.  The starting point is your worldview of well-being and your personal definition of health.

Every medical science, from ancient sciences to current sciences, has a definition or a guiding principle of what “health” means.   Just like worldviews, these generally fall into two categories.

Newtonian health science

The current dictionary definition of health is “freedom from disease.” This is the view followed by most allopathic doctors (M.D.s).  This is the mechanical worldview.  The physical body is a machine made up of parts.   Think about that list of practitioners found in health insurance paperwork – it’s a list that divides the body into parts.   This health science focuses on disease management.  Osteopathic medicine (D.O.s) uses the same tools, treatments and technologies of medicine as M.D.s, so for these very general purposes, they fall in the Newtonian field.

If your worldview is generally Newtonian, you will likely be satisfied with allopathic specialists.  For each symptom you may need to seek a new “mechanic” to address different parts of your body.  You may be the one coordinating care between the various pieces.

Quantum health sciences

While quantum physics is considered a new science, the ancient medical sciences viewed “health” through a quantum lens ‒ systems of health in which everything is connected.  Side effects don’t exist in these older sciences.  There are only “effects” because these sciences have studied well-being and the impact of all their treatments and medicines on the entire mind/body/spirit system for hundreds and thousands of years.  These health sciences focus on healing, eliminating the root causes of suffering, and balance.

Ancient sciences include:

• Ayurveda is the traditional medicine from India, the sister science of yoga.  You may be familiar with this from Deepak Chopra.  Ayurveda is the science of life, with a very precise definition of health. “Health is the state where the Tridosha, digestive fire, body tissues and components, and physiological processes are in perfect unison; and the soul and the sense organs and mind are in a state of total satisfaction and content.”  While this seems to be a complex definition filled with Sanskrit words, the point is for 5,000 years this science has focused on what a healthy mind/body system is, and how to measure, attain and maintain health.
• Traditional Chinese Medicine (TCM) is derived from Ayurveda, and so there are similarities.  Like Ayurveda, it is based on the notion of harmony and balance.  Health is viewed as a means to a good life – when an individual lives in harmony with her community and her physical and spiritual environment.  Many people are familiar with acupuncture, a primary TCM treatment to create overall balance.

Mid-millennium sciences include:

• Homeopathy, which is about 200 years old, believes one has a state of health when you experience freedom and creativity.  It’s interesting to consider how this seemingly simple definition effortlessly integrates physical, emotional, mental and spiritual aspects of well-being.  Disease is considered a breakdown of vital forces and can only be known according to symptoms – so all “symptoms” are of equal importance in treating the whole person.
• Naturopathy evolved from homeopathy.  Naturopathic medical schools include curriculum a range of medical sciences including TMC, homeopathy and herbal medicines.

If your worldview in primarily quantum, you will likely enjoy a positive relationship with doctors practicing these sciences to experience the essence of health you desire.  You may still need (or want) a team approach.  You’ll generally find physicians in the quantum sciences understand something about other quantum sciences, so you can actually achieve complementary care (meaning practitioners, treatments and medicines work well together, not in opposition to each other).

Your definition of health is what equips and empowers you to live your best life

Declaring “I want to be well;” or “I just want to not feel bad and get back to my life;” may seem like simple statements to make when requesting that a medical professional be your partner in well-being.  As we see from the viewpoints above, it’s not so simple.

This is why it’s really important to know at a very deep level what you’re seeking.  Be as clear with yourself as possible.   Research the essence of health, well-being, vitality, healing.  This article just provides some basic guidance to get you started.  Take your time.  And also be willing to evolve or change over time.  What starts as a quest for pain relief in a very allopathic sense of suppressing symptoms in a particular location may evolve to wanting to experience peace and freedom, regardless of physical challenges.

Being clear on what health and well-being mean to you puts you in the driver’s seat of this healthcare match game.   You have now declared your personal “reset” of the vast and complex healthcare system.  You can now confidently:

• Identify practitioners who actually fit your needs.
• Know when you have a mismatch and feel comfortable firing medical professionals who don’t resonate with your needs.
• Communicate effectively with your chosen professionals and develop strong partnerships with them.
• Know when to shift approaches if a particular physician or medicine/treatment isn’t working to support your journey to well-being.
• Spend your time, money and energy wisely, in a way that lets you experience your best life.
• Analyze what payment system (insurance) will work for your health, and make decisions based on what care fits your needs.  For example, if TCM or homeopathic is a fit for you, seek a payment system that pays for the care you use.  Alternatively, be confident that it’s okay to pay for care rather than contributing to an insurance corporation’s profit for “benefits” that don’t fit your needs and therefore you don’t use.  .

Resources you may enjoy to explore this further:
–The Quantum Doctor by Amit Goswami, PhD
–The Biology of Belief by Bruce Lipton
–Other inspiring people who offer a range of views for your exploration:  Deepak Chopra, MD; Larry Dossey, MD; Greg Brayden and Stephen Schwartz

Note:  This is part an ongoing series to equip you with a process, a path, to identify and experience healthcare that works for you.
— Foundation:  The heart of healthcare that works:  know your personal worldview of health:  https://hormonesmatter.com/the-heart-of-healthcare-that-works-know-your-personal-worldview-of-health/
— The match Game of healthcare that works series ‒ Part I: Understand the landscape set by insurance companies: https://hormonesmatter.com/the-match-game-of-health-care-that-works-part-1/
— The match Game of healthcare that works series ‒ Part II:  (current article)

Deb is co-owner of Experience In Motion, which equips organizations with tools to curate meaningful experiences for customers and employees.  Deb’s personal journey from decay to wellbeing inspired an emphasis in improving healthcare experiences for patients and practitioners by focusing on experiences that heal, and self-caring as a way of organizational being.  www.experienceinmotion.net.

 

 

 

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Pondering Cancer: the Hubris of Innovation

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This week begins breast cancer awareness month, a movement started 25 years ago largely by women and family members affected by cancer. The efforts of these men and women have been extraordinarily successful. Who doesn’t associate the pink ribbons with breast cancer? To boot, the public awareness catalyzed the need for research. The War on Cancer was born and a staggering amount of federal and private dollars research dollars have poured into cancer research. Federal breast cancer research dollars totaled $763 million in 2010.

And yet, except for the years between 1999-2005, which saw a 2% decline in new diagnoses (NCHS, SEER), largely attributed to the post-WHI decline in HRT use, breast cancer rates have increased steadily over the last two decades. The incidence of breast cancer is now 1 in 8 women (SEER). It seems the war on breast cancer has not been won.

I am not a cancer researcher and so my thoughts on cancer are offered with some trepidation. Sure, I did the requisite pharmacology papers and presentations in graduate school and even taught the basics in some of my undergraduate courses, but I don’t really know cancer, not like I know other disease processes. And so, as I pondered the state of cancer and reviewed the statistics, looking for an angle into this post, somewhere I could add to the conversation and not just regurgitate existing pablum, what became clear was a nagging sense of intellectual unease. Despite the billions spent on cancer research and the bevy of new treatments, more women are getting cancer than ever before. Perhaps better diagnostics explain the ever increasing incidence of breast cancer. Perhaps not.

Like so many modern diseases, cancer sits at the nexus between high and low science, between medicine and marketing. It is one of those diseases that at once benefits from 20th-21st century science and technology, and suffers immensely from the hubris of those same innovations.

A case and point: a report by the Personalized Medicine Coalition published three years ago and discussed last year in Bloomberg BusinessWeek indicates that of the $292 billion dollars spent on prescription medications in 2008 almost 50% went to medications that didn’t work. That means in one year, we spent $145 billion on medications that didn’t work. The report goes on to suggest that billions more were spent treating the side effects and adverse reactions.

Aside from the ridiculous amount of money spent on medications that don’t work and the billions more spent mitigating the potentially serious side-effects of these medications, both of which threaten our national economy in a very tangible manner; aside from the economics, the point that may be lost in this conversation, is that we are ingesting these medications and trusting them to work or at least not make us worse.

What happens when medications originally intended for one use are marketed for another? What happens when the need for blockbuster drug sales overshadows the actual benefits of a medication or worse yet, hides the dangers (DES, HRT, Vioxx, Yaz/Yasmin)? What happens when we disregard basic genetics, basic science and common sense when prescribing a medication? What happens when we use the one-size-fits-all or the one pill-cures-all approach?

Are we creating the very cancers we are trying to treat?

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Perspective is Everything in Women’s Health

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As the economy and political situation continue to spiral with the frenetic, manic-depressive, mood swings of a toddler in the cereal aisle, the rest of us are left wondering what the…

Don’t they get it? Don’t they see what we see? Maybe not. With $174,000-$223,000 annual salaries and guaranteed health insurance that includes private personal physicians who provide routine medical care at no, or minimal charge, it is difficult if not impossible for Congress to feel the pain and uncertainty that the $38,000 per year teacher feels or that the unemployed construction worker must feel. It’s a matter of perspective and perception, neither of which seem focused on what matters most.

As the women’s healthcare debate heats up again, one can’t help but wonder if the difference in perspective is what propels statements like those from Senator Kyl earlier this year: “I don’t need maternity care. And so requiring it to be in my insurance policy is something that I don’t need and that will make the policy more expensive.” From his perspective, that of an older, male Senator, buffeted by a great salary and irrevocable health insurance, he is correct. He does not need a maternity rider on his policy.

Likewise, as a 40 something woman, I don’t, nor will I ever have, erectile dysfunction or a need for prostate cancer coverage, so why should I pay for those items in my policy? For that matter, why should my tax or insurance dollars, go towards anything that I don’t personally need or want?

I didn’t intend this blog to be a political or economic commentary, but the disconnect between the on-going political folly and reality are strikingly analogous to what many women experience when faced with a chronic, hormone-related condition. So many women among us live for years with pain, are often misdiagnosed repeatedly, sometimes even told,‘this is normal’ or ‘it’s just your hormones’ as if to say, it’s not important enough to merit consideration. Like with Senator Kyl, there is a disconnect between what is needed and what is perceived as needed.

How do we bridge that gap? It’s obvious to any woman who has experienced a chronic hormone or menstrual-related health condition that more research is needed. It is unconscionable that endometriosis, for example, which affects >10% of the female population, takes 5-10 years to diagnose (Arruda et al. 2003; Hsu, Khachikyan & Stratton 2010, Pugsley & Ballard, 2006). It is even more troubling that the first line of treatment is oral contraceptives, as it is for many women’s health conditions. Oral contraceptives are fabulous for birth control, but do they really work for all gynecological conditions? Are the hormonal indices for endometriosis the same as those for PCOS or for PMS? Are we all so similar that one pill will fix everything?

In light of the current discourse on women’s health, which includes such brain twisters as whether pregnancy is a pre-existing condition and men ought to be responsible for contributing to maternity care to ‘do women deserve preventative healthcare’ (thankfully, the IOM says yes) and my favorite, the whole pap smears at Walgreens suggestion, it’s not difficult to see why gaps in women’s health research still exist. It is also clear that the tenor and content of public discourse, and as a consequence, the direction of research and public policy, are important and must be brought back to stuff that matters. For many women, and the men who love them, women’s healthcare and research are important.

Even though I personally will not ever need prostate cancer treatment or research, the men in my life may, and so I don’t begrudge the dollars spent for those endeavors. I think many men feel the same about women’s healthcare and research. Help us bring the conversation back to what matters. Help us prove that hormones are important in women’s health research and care.

Stand up and tell your story.

Related posts:

gallbladder hormonesThe Gallbladder: An Essential Organ Influenced by Hormones PCOS, HA and Intense ExerciseIntense Exercise, PCOS, and Hypothalamic Amenorrhea women deserve betterDeconstructing Modern Illness: Idiopathic or Iatrogenic? birth control infertilityCan Birth Control Lead to Infertility?

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