Going at It From a Different Angle

Healthcare has been approached in America as a means of treating a multiplicity of diseases that apparently have no common link in diagnosis or treatment. It has been the accepted standard of care for clinicians to treat a disease through multi-subspecialties. Managed care has promted this through the development of multiple codes that consists of a variety of attached prices fixed to a certain disease. Cosde match deisgnated diagnosis and therapies to the costs . This approach has seen the soaring cosst of medical treatment , devices , diagnostics , administrative waste and duplicity. It may have contributed to over-diagnosis, misdiagnosis , phanthom diagnosis as well as the defensive legal reflex of clinicians called CYA (cover your rear) in response to medial liability sanctions. But, what if the major medical diseases were all related to a key central disease that exists at epidemic proportions, not only that, but what if this central disease was treated or addressed as a first line of defense against a long list of diseases. This might vastly reduce the cost and waste in the current system . This primary approach would also improve the health outcome of both the quality and utilization of the system. What economic impact would it have to put this one key underlying disease as the primary diagnosis for the twenty plus diseases it causes. It just might reduce adminstrative costs and duplicity. This scenaria may be the real case of disease diagnosred in ou healthcare system today where 75 % of our population is either obese or overweight. There is a clinical diagnosis for this condition known as the Cardio-Metabolic syndrome. We simply know it as the Lifestyle Syndrome . Obesity is the core of all major diseases that costs the most and is the primary disease related to the development of most major diseases that cost the healthcare systme the most. But, the current healthcare system separates obesity as a single cause instead the underlying culprit of the majority of diseases that it causes. This is a mistake and snowballs the effect of skyrocketing prices. The language and the coding of medical diagnosis itself needs to be changed to enlighten diagnosticians in properlyy treating the primary disease, obesity. The list of problems that obesity causes: Heart disease and related cardio-vascular diseases such as heart attacks, stroke, high blood pressure, vascular disease in the periphery, high cholesterol, high triglycerides and embolism. It is related or causes Type 2 diabetes and imbalances in testosterone as well as estrogen. Obesity causes liver disease along with fatty liver and gall bladder disease such as gallstones. Obesity is associated with cancer of the colon, breast, ovaries, uterus, prostate and throat. It also is associated with both obstructive lung disease such as asthma and restrictive lung disease creating difficulty in breathing. Sleep Apnea , another pulmonary problem is very well-known to be related to obesity. The obstruction in the throat and restrictiveness central obesity causes is harsh snoaring with episodes where carbon dioxide build up causes cessation of breathing. Arthritic diseases such as osteoarthritis and gout are both related to obeisty as well. There also numerous psychological, and emotional problems associated with obesity such as body dysmorphia, depression, eating disorders, anorexia-bulimia and night time eating disorder associated with insomnia. It is also believed that obesity is associated with a depressed immune system noted with a lowered white blood cell function leading to infectious disease. THE REAL QUESTION: If obesity/overweight syndrome is so prevalent in our society and is the primary underlying cause of the major diseases costing our system the most; why aren't we approaching the health of the nation from that angle. That is one of spearheading a campaign on obesity as a first line of defense and prevention? Instead, we treat ltiple diseases from a non-wholistic view that only sees different aspects of the same disease. It stands to reason that the wholistic-preventive approach would save the American tax payer billions of dollars by preventing the disease through lifestyle and behavioral approaches that require none to very little medical intervention in life. One might imagine what effects obliterating obesity early in life might have on the 18 % of GDP used for healthcare currently. What if grocery stores, fast food restaurnats, schools and the workplace had built-in prevention approaches with coincided with the affordability of healthcare? What would daily lifestyle approaches consist of? Regular exercise activity, nutritional support, behavioral modification to sustain healthy habits, and prevention education. This approach costs much less than our reflexively "treat only by acute and chronic care" approaches that costs us trillions of dollars. . This type of prevention approach actually allows for healthcare to pay for itself. It is also affordable. Other aspects this permits incentives to promote and sustain prevention through wellness and worksite health promotions programs at places of work, schools and the community. Unless the healthcare system doesn't put the brakes on spending, we are destined to crash. ABOUT THE AUTHOR Dr. Wells is a previous N.I.H fellow at the National Heart, Lung, & Blood Institute. He has worked in the U.S. Health and Human Services, U.S. Public Health Service and holds a Master's in Public Health from Emory University.