Healthcare is a tapeworm on the economic system.
Warren Buffett
Healthcare needs to change, on that we all agree, or so it seems. The simple solutions are a shift from treatment to prevention and the avenues for doing that are Lifestyle Medicine and a Whole Foods, Plant-Based diet. It almost seems as if nobody is talking about the solutions, but the fact is a quiet revolution is developing. Most importantly, at this point it is both doctors and patients realizing that the system we have does not work and cannot work. Spending nearly 20% of GDP and ranking #37 in the world in terms of health outcomes with declining life expectancy is simply a joke, not to mention spending 86% of healthcare dollars on treating conditions that are caused by diet and will respond primarily to diet, with only a minimal support role for medical treatment. On top of that medical bills are the leading cause of personal bankruptcy. I have recently published and article about the paradigm shift that is in the air for medicine and healthcare as a whole.
Healthcare “reform” is a red herring argument
All the attention in this political season seems to be on something called healthcare reform, which is only about who gets access and how we pay for it and so, this process diverts the attention from the fact that healthcare as we know it does not work for either doctors or patients. Of course a single payer system is more efficient, but that does nothing for the quality of care.
According to Dr. Dean Ornish, a.o. in his book Undo It! and also in the ACLM Handbook of Lifestyle Medicine, 86% of our healthcare spending is on medical treatments for things that should not primarily be treated with medicine in he first place, but with diet. Specifically, essentially all non-communicable diseases, such as heart disease, diabetes, cancer, autoimmune diseases, and even ED and lower back pain and so on are the result of the Standard American Diet, that is high in fat, animal protein, and refined, processed foods. One by one the growing clinical practice in these various areas shows us that all of these conditions can be significantly improved and often completely reversed with a Whole Foods, Plant-Based diet.
The conclusion must be that the amount of medical intervention in this area can and should be reduced by 80-90% over time, by switching to Whole Foods, Plant-Based nutrition and appropriate lifestyle changes, including exercise, relaxation, meditation and sleep hygiene. Lifestyle Medicine should be the first stop, and provide triage – medical interventions should be reserved for acute cases or sometimes as a temporary support – eliminating most of that 86% which is now misspent on dysfunctional medical treatments.
The “Success” of Big Pharma Equals the Failure of our Medical System
America is (nearly) unique in allowing pharmaceutical marketing on television. We are marketing disease and the treatment of disease, and in the process we created a perverse incentive, for more treatment equals more money for the medical system and the pharmaceutical companies, but this has nothing to do with achieving better health. The only other country to allow pharma advertising on TV is New Zealand. It has been extremely successful, for Americans use more drugs than anywhere else. Americans use more prescription drugs than any other nation. Better marketing has everything to do with it, for in health outcomes we’re #37 in the world.
Lifestyle Medicine is the beginning of the way back to sanity and health, by prioritizing nutrition and lifestyle as the first line of defense. Simply put, ALL nutrients are better absorbed from whole foods than from pills (supplements). Dean Ornish’s uniform theory of disease brings it all together, by recognizing that most people die from non-contagious, chronic illnesses that are all diet related, so that diet (and lifestyle) is the single biggest thing we can all do for our health, and eventually, that should make 75% of current healthcare spending superfluous in the long run, for you were going to eat anyway, and arguably a plant-based diet is cheaper than a meat-based diet.
Nutrition is the Pi in Healthcare
Without Pi, we are stuck in a linear world, Pi closes the circle, and in medicine that symbolizes more of a systems view, instead of the traditional linear one symptom, one cause, one medicine model that was very helpful in the first half of the 20th century, but has now outlived its usefulness.
We know fairly well by now that cardiovascular disease (CVD) is reversible by diet alone, as long as it is not acute. If it is acute medical intervention is the way to overcome the crisis – a stent can restore blood flow etc. – but that still does not solve the problem. Diet is the cause and if that is not addressed the progression of the disease will not be reversed. When followed up with a change to a Whole Foods, Plant-Based diet, recovery is usually quite fast and within a year most of the damage could be gone and during that time many if not most patients could be free of medications.
Type 2 Diabetes (T2D) is much the same thing, it is usually reversible in 3 weeks to 3 months with a whole foods, plant-based diet.
Cancer is a harder nut to crack but there is growing anecdotal evidence of reversals and going back to the research of Dr. T. Colin Campbell, it is clear that it is nutrition that is key to growing cancer, not genetics or “carcinogens.” Campbell currently has a new book in the pipeline on cancer and nutrition and it should kick the doors wide open to more work in this area. Here is a two-piece interview that is very important about his thinking, and as a reflection on his own development.
A key point Campbell hits in these conversations is that it obviously all starts with a decision in the mind that eating meat was OK. This notion is the logical corollary to the observation in plant-based circles that you are in control of what is at the end of your fork… It turns out this is the key issue. Compare also the interesting personal testimonial from Dr. Joe Bath – he comes to the conclusion that cold turkey is the best method for making the transition to #WFPB. That has been my experience also. The first time I tried it, I was half-assed. The second time, I went full bore right away.
The big question remains, why are some people so resistant to the idea of taking responsibility for their health, whereas others feel highly empowered by it? I can only relate this to the idea that the basic ego-psychology is to always blame outside things or people for everything – our gut response to anything is to look for a cause outside ourselves. That defense mechanism is threatened by any notion that I am responsible for my own stuff, including health. We prefer to have something or somebody outside ourselves to blame for our situation. This fact alone perfectly explains why cancer research is so interested in genetic causes of cancer, and identifying supposed carcinogens, but in reality nutrition is the most decisive factor of them all, for it takes decades for cancer to develop, and a whole foods, plant-based diet is rich in nutrition, including copious anti-oxidants, all of which tend to inhibit if not shut down tumor growth. We would indeed rather spend billions on non-existent causes outside ourselves than accept responsibility for our own health and well-being.
Observational bias: the streetlight effect
The story of the drunk looking for his keys under the streetlight, because there is light there, is an old one, it has been ascribed to various sources, including Mullah Nasruddin, but it’s real origin is uncertain. The bottom line is that the germ theory of disease was the basis of modern medicine and made the rise of the pharmaceutical industry possible because of it’s focus on a single, proximate cause of the disease. So, we are looking under the streetlight, and ignoring the rest – the cause of the disease. Even with infectious disease, the question always comes up as to why some people get it and others don’t. People used to have an immune system! Again, another reason why a whole foods, plant-based diet is the first line of defense. Today however infectious disease is effectively “under control,” and the attention must shift to the non-communicable diseases from which people in the industrialized world now die, and which are “incurable” to medicine, and the best it can do is palliative care, typically with medicines you’ll have to take “for the rest of your life.”
Doctors, meanwhile are suffering burnout at unprecedented levels, for there is no satisfaction in being a legal drug pusher. I saw this professional dissatisfaction first hand at our dinner table in the doctor’s home I grew up in, for it was a frequent topic of discussion among my MD father and his colleagues, even then, back in the 1960’s. It has now come full circle, and very few give better voice to it than ZDoggMD, here:
The central theme is the restoration of the doctor-patient relationship to a partnership of equals where the doctor simply acts as the subject matter expert to support the patient in achieving health. The locus of the healing is the mind of the patient. If distrust enters the relationship, everything is pretty much futile.
Most physicians and other medical practitioners who get certified in Lifestyle Medicine and Plant-Based nutrition tend to say they are doing so because to them it is a way to practice medicine as it was meant to be, i.e. to focus on the health of the patients, and to support the healing. Unfortunately, our healthcare system has a powerful economic incentive that more treatment equates to more money for the doctors and the medical/industrial complex as a whole. This needs to change.
On the organizational front there is an important initiative already making the rounds, from a company called HealthRosetta, founded by one visionary, Dave Chase. I highly recommend Dave’s two books, The CEO’s Guide to Restoring the American Dream, and his book The Opioid Crisis Wakeup Call. This organization supports the development of more sensible health plans, with lower cost and better care. Eventually, I am sure, they would have to integrate Lifestyle Medicine into their program and achieve even stronger results.
Conclusion
The solutions to our healthcare crisis are in a lot of ways much simpler than people realize. The major change is for people to learn to relish the empowerment that comes from the realization that health begins with what’s at the end of your fork. The resistance to change is both patients who would rather have somebody or something else to blame, so they do not take responsibility and continue to think that the doctor will just give them a pill. Very likely then, the choice for Lifestyle Medicine is an individual one, but as better health plans come along, revolving around Lifestyle Medicine, we should see healthcare costs go down faster for people who follow Lifestyle Medicine and practice Whole Foods, Plant-Based nutrition as their first line of defense.