In my role Horizon Scanning for the National Health Service (NHS) here in the UK I work at the leading edge of health. New services, new technologies, new inventions, exciting as they be in their potential to improve health, they still fundamentally feed one entity; the big healthcare machine that dominates the western world. The objective of many healthcare companies is understandably profit and shareholder dividends, but this is increasingly falling at odds with the objective of better health for our nation.
And because much of our healthcare here in the UK is driven by that same, principally US orientated healthcare machine, we exhibit the same symptoms as the US healthcare system. Aside from our ageing population we suffer similar spiralling costs from obesity (£11bn pa), smoking (£6bn pa) and alcohol related illnesses(£2.5bn pa). Just these constitute 20% of the entire UK spend.
I asked the speaker at a recent British Medical Association conference, who, from the platform, was pleading for extra funding to support his novel invention that might reverse the effects of cirrosis of the liver. From the audience I asked whether the funds might be more effectively used trying to reduce irresponsible drinking; there was stunned silence. It appeared heresy that I might suggest we better address the causes of that illness not the cure. 'Possibly the cure may be cheaper than we think, but who profits by that?' could have been the response.
We all know that neither the UK nor the US have healthcare, we have illness care. Illness is good business so why try to prevent it? If Barack Obama is correct in 'Audacity of Hope' and the cost of healthcare to ordinary US families has quadrupled over the last decade then it has done much the same in the UK. We know we cannot afford it much longer. But what can we change?
Focus on wellness. Accept that, as the Framilngham Report shows, obesity actually operates in much the same way as a disease, and hence can maybe prevented if we only looked for ways. In Finland they managed to drastically reduce obesity and related cardiac disease in just a generation by a public campaign that made them unacceptable. Every Finnish company canteen I have visited had some of the best balanced nutritious food you could find. Study closer and you see there are key geographical and demographic reasons why it worked well there, but no reason to suspect it could not make a big difference elsewhere. Here the Scottish Parliament attempted a price hike on alcohol to combat excessive drinking but were howled down in protest. But where did those cries come from? The families of those affected or the drinks companies and media?
But meanwhile the dominance of US driven health devices and pharmaceuticals is equally affecting UK and the rest of Europe as much as it does the US. Whilst its focus remains on shareholder profits before our national healthiness then can there be much future other than increasing millions falling outside any form of healthcare in the US, and some type of imposed rationing or partially privatised health in the UK and elsewhere?
What I suggest therefore is for the US under Barack Obama to change some underlying principles of healthcare and focus on efforts to maintain wellness, not rectify illness. It could markedly reduce healthcare costs whilst improving worker productivity through fewer lost days. And once the 'illness care' companies see the potential of this business-to-customer market, as opposed to their current business-to-business approach they may become more enthusiastic.
I have championed such ideas for over ten years in the UK and whilst top levels of government seem to appreciate the potential, nothing changes. Yet if the US administration chose to work together with some of their larger, non-US, markets it could be far easier to bring about change that benefits us all. Now that is a Brown-Obama summit meeting I would like to sit in on!
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