Conveyor-Belt Heathcare

Oliver DeMille has likened public education to a conveyor-belt education. Public school education he offers “is set up like a factory: everyone in the class gets the same education at the same age from the same textbooks, and they are tested the same and graded based upon the same scale regardless of their individual talents, goals, interests, personal mission. Conformity is the name of the game in public education.”

High-school teacher Erica Jacobs explains conveyor-belt education this way:

You remember the conveyor belt in school: You arrived early, appeared at the first “station” and underwent a modification as facts were stuffed into your brain. You then proceeded to the second, third, fourth, fifth and final stations. At each stop there was a worker who was in charge of too many products being generated at too fast a pace, but you were altered in some way at each step, making you feel like an assembly line product.

We have long been heading towards a conveyor-belt healthcare system, and further government involvement will only accelerate the trend.

Here is my caricature of conveyor-belt healthcare: Patients have almost no knowledge of, or interest in, what they can do to keep their bodies healthy. Their food intake is driven by convenience and what tastes good. They claim to be too busy to exercise or to take time to spiritually nourish themselves. When an alarming symptom arises, they have no alternative but to go to a doctor. They wait in overcrowded waiting rooms and are first seen by a physician’s assistant. When finally a doctor arrives, he or she first reads the notes of the assistant, asks a few questions, and carries out a physical exam. A doctor’s involvement in the visit may last 5 to 15 minutes and, on the basis of that brief time, the patient receives a diagnosis. Doctors may order tests; or moving directly into what is usually the treatment phase, doctors render illegible prescriptions. Patients take their prescriptions and feel a certain sense of satisfaction in having been given their diagnoses. Patients begin to define themselves by their diagnoses. They have reduced their identity to their symptoms, and doctors are only too happy to go along with the conveyor-belt medical fiction that a given drug fits all patients with certain symptoms. Patients have their prescriptions filled without any sense that they should be inquiring about potential side effects of the drug or considering alternative treatments. This allopathic model now puts patients and physicians on a slippery slope of further prescriptions to treat further symptoms and then surgery if the prescriptions don’t work.

Of course, this is a caricature; there are exceptions. Just as there are high achieving students and committed teachers in public schools, there are many caring physicians and patients who accept responsibility.

Consider the recent medical stories that I have come across. On March 19th the Food and Drug Administration (FDA) issued a warning about the statin drug Zocor. Here is their press release:

The U.S. Food and Drug Administration today warned patients and healthcare providers about the potential for increased risk of muscle injury from the cholesterol-lowering medication Zocor (simvastatin) 80 mg. Although muscle injury (called myopathy) is a known side effect with all statins, today’s warning highlights the greater risk of developing muscle injury, including rhabdomyolysis, for patients when they are prescribed and use higher doses of this drug. Rhabdomyolysis is the most serious form of myopathy and can lead to severe kidney damage, kidney failure, and sometimes death.

The statin drug market is huge and about to get bigger. The FDA has approved the statin drug Crestor—despite its risk of causing type 2 diabetes—as a preventive measure for millions of people who do not have cholesterol problems. Preventive measure? Isn’t proper diet and exercise the cheaper and better alternative? No wonder the big pharmaceutical companies are all for socialization of medicine.

And when diet and exercise aren’t enough, there are still low cost alternatives. A “study published in the New England Journal of Medicine which showed that niacin (a low-cost B vitamin) out-performs Merck’s drug Zetia for preventing the build-up of arterial plaque, a symptom of cardiovascular disease.

My children were homeschooled until last year. They are now freshmen in high school They often tell us stories in astonishment of students who make no effort to succeed, students who seemingly don’t care about what they are learning, and students who do not consider the consequences of poor grades. Their stories are sad because so much human potential is being wasted.

Clearly there is a link between conveyor-belt education and consumers who are willing to consume conveyor-belt healthcare. Both are not ready for the responsibilities that accompany freedom. Both are not ready for the responsibilities of self-care as the first step in healthcare even though it is the least costly and the most responsive form of care.

In his wonderful book on creativity, The War of Art, Steven Pressfield writes:

It may be that the human race is not ready for freedom. The air of liberty may be too rarified for us to breathe. Certainly I wouldn’t be writing this book, on this subject, if living with freedom were easy. The paradox seems to be, as Socrates demonstrated long ago, that the truly free individual is free only to the extent of his own self-mastery. While those who will not govern themselves are condemned to find masters to govern over them.

Read Pressfield’s last line again. Americans are not victims of a President and Congress intent on taking away their freedoms in healthcare. Instead, we are accomplices, playing the part of innocent victims. Obamacare is a reflection of a decision that we collectively made. We forfeited our freedoms because long ago we decided not to take responsibility for understanding how to nourish our body and our spirit.

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2 Responses to Conveyor-Belt Heathcare

  1. moslof says:

    “playing the part of innocent victims” The word “sheep” has often been used. I have been fortunate to be able to go to a graduate of Dr Weils school of integrative medicine. He told me to take an inexpensive beta sisterol supplement for my cholesterol before anyone I know had ever heard of it. After it went down to 175 he ordered me a blood test by Berkely Heart Lab that revealed my apoe 3/4 genotype. He recommend dietary changes and I feel like I am on the path to optimum health. You can’t get care like this from a regular doctor.

  2. Jim D. says:

    This post hits on a number of topics. Perhaps the end of the post should have come first, as it provides the framework for understanding the failures mentioned in the beginning. I would disagree with your last point only in that we are not “accomplices”, we are the perpetrators. Our refusal to accept responsibility leads us to seek out and earnestly believe the politicians who lie to us and tell us they can take care of us, and vote them into office. No matter how egregious their own indifferences to real problems, no matter how awful their track record at keeping their promises, no matter how badly their misguided efforts create new problems while not solving the old ones, we vote them into office.
    I’ve iterated it before in previous posts, but the recipe for generally good health hasn’t changed in 100 years: eat right, exercise regularly, drink in moderation, don’t smoke. If we refuse to accept personal responsibility for following those 4 basic principles, no system of health care will be capable of taking care of our ills.
    We can leave the ills of defensive medicine and our fear of inevitable death, 2 other major problems in healthcare, for other posts.

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