Musing 37

It is no secret that the American healthcare system has many faults, some inherent to a system oriented around profit, not good outcomes, and some a by product of sin breaking the system.

I’ve worked in some form of healthcare for most of my 13 year career as a software engineer, mostly on some form of gov’t program. But combined with helping my wife navigate her chronic health conditions, I’ve seen pretty much every aspect of the healthcare system that people can interact with.

From these observations, I think there are a number of parts to the solution –

sin in the system

I think the easiest place to start is with the obvious - the sin in the system. As a Christian, this is where there are a lot of things to deal with.

While my right wing brothers would shudder at the thought, this is where gov’t intervention would be appropriate. Just to use the obvious example, there’s fraud everywhere. Whether it’s fraud at the provider level (whether you have quacks who shouldn’t be practicing in the first place, or billing for services that never happened, etc) or the insurance level (wrongly denying a claim in the hopes that it’s too much trouble for the average person to fight) or anywhere else in the system

As fraud is a sin, it is something the gov’t has an interest in punishing and making sure it stops. While yes, insurance companies often investigate fraud as well, it’s also an effectively vigilantic endeavor at the end of the day (and is often more aligned to reducing the cost to the company than actually ensuring you and I get the best care possible, no matter what they may say).

system working as designed

Another major aspect to the system being broken is that it’s oriented around a transactional view of health (outside those who work with chronic conditions). What I mean by a transactional view of health is that “you feel bad, you go to the doctor, you get meds or a treatment, you feel better”.

Which is great, but we are increasingly not dealing with conditions that are treatable purely with a pill. Sure, medication works (usually), but they are a bandaid over a deeper problem - we don’t want health, we want convenience, no matter the cost.

And there’s a heavy cost to living for convenience. We see increasing obesity and the many difficulties that brings. We see increasing isolation as people turn to devices instead of their neighbors and friends. (Though happily it feels like this latter point is changing)

And because our system is designed to generate profit, the system is all too happy to give us yet another pill to deal with the symptoms.

But this is also where we have to take control of ourselves too. We need to teach ourselves what good health looks like and the steps to get it. From nutrition to exercise to understanding our meds, there’s so much that we need to make sure we actually care about.

our role

One of the first pieces of advice I was given in my career was that “no one is as interested in your career as you are”. The same holds true for our health. As much as our doctors may care for us, they can only help us so much. And especially for those with chronic conditions that won’t go away this side of eternity, understanding our own health needs to be able to live life is most successful when we’re invested in it.

At minimum, I think everyone should be have some knowledge of nutrition, basic exercise (even if it’s just walking the dog!) and how to handle stress are the 3 things to focus on (with a 4th being “get enough sleep”). You take care of the basics, and its amazing how much things improve, and improve quickly.

This also becomes even more important when you need to take multiple medications. I’ve found that doctors are absolutely awful at detecting when symptoms might be a problem with existing meds, or are side effects in general. And if you don’t ask about something they usually won’t bring it up themselves.

And fundamentally, our role is to seek to honor God with our bodies. Being right with God spiritually brings rest to the body. We are embodied souls, and so any plan that doesn’t treat the soul isn’t a full treatment. We might heal physically, but the soul brings its own burdens and we too often forget our soul when trying to heal the body. Don’t let that happen.