A Systemic Problem in Our Healthcare System

Those of you who are old enough to remember the Australian bush nurse Sister Kenny (1880-1952), will no doubt recall the brouhaha she caused within the medical establishment of her time. Elizabeth Kenny had devised a treatment for polio that was universally castigated by doctors of the day. In fact her methods proved time and again to be efficacious and became the forerunner for the practice of physical therapy as we know it today.

The reason Sister Kenny, and her struggles with the established order of medicine, is brought to mind is that licensed medical doctors all too often behave like members of a closed-shop union. In such an environment, no one is allowed to do work that is perceived as encroaching on their specialty, without consequent castigation and sanction. And, they vigorously lobby for laws to protect them from perceived interlopers.

In Sister Kenny's case, she struggled for years to get her therapeutic methods accepted, even in the face of observable success, and admiring testimonials from patients. The medical profession cast aspersions on her methods and her person, largely because she wasn't an accredited practitioner (only a nurse), and her methods contradicted generally accepted treatment standards.

In today's contentious health care environment, alternative treatments are greatly frowned upon, and their practitioners ridiculed. Ask licensed doctors what they think of acupuncture, chiropractic, aroma or muscle activation therapy, and they will almost always turn up their noses. In fact, they have convinced the insurance industry that these methods are nothing more than palliatives bordering on quackery. Thus, patients are channeled into much more expensive surgical and drug treatments that often times provide no relief.

This is not to say that there aren't quacks hovering around the practice of alternative medicine, just as there are quacks who are licensed to practice the approved variety. It is also not claimed that there alternative methods for all sicknesses or diseases. But it is also true that in most professions, wherever there is a buck to be made, a surfeit of willing hands will extend to accommodate. We see desperately sick people try all sorts of last gasp treatments, especially after traditional medicine has given up on them. And these alternative methods seldom work.

However, in the less well defined areas of pain management, due to a variety of causes, modern medicine has proven to be quite fallible. Countless thousands of people suffer through painful days of agony with only the promise of relief provided by dangerous drugs. Doctors prescribe many unproven medications because their pharmaceutical rep told them this was the cutting edge drug du jour for pain management. Big Pharma and the medical profession work hand and glove to push their latest (and expensive) drug on suffering patients. And since only licensed doctors can dispense them, this conduit is exploited by both parties. Why there might even be a financial incentive for the prescribing doctor. Heavens!

Because of the built-in aversion to examining or even testing alternative therapies, the healthcare system is saddled with more expensive, "accredited" treatments that push the insured patients in that direction.

Even though back surgery has been shown to be less than 50% effective, and much less costly alternative therapies have proven efficacious, they are ignored. Worse, just as in Sister Kenny's case, they are scoffed at by the establishment. Such are the ironic side-effects of our costly for-profit health care system.

As another example of padding the bottom line is a practice that is becoming more common. Doctors are increasingly insisting on patients coming in for an office visit just to renew a prescription. Admittedly for some drugs it is necessary to monitor side effects (another indication of how dangerous some of them are), but in many cases it is totally unnecessary. As cuts in Medicare go into effect (which will increase, rather than cut costs), doctors will seek more ways to supplement their income. Once a professional is used to a certain level of earnings (no matter the discipline), it's hard to accept less. Doctors are no exception.

So, the bottom line is that there just might be ways to improve both the costs of health care and the patients' welfare by researching and approving alternative therapies. Sadly, that's not even on the table for discussion.

Raff is an author who took early retirement from a career in the computer industry to pursue a writing career. He has two non-fiction books in print. Information about him and his work may be found at http://www.raffellis.com

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States Proceed With Health Insurance Exchanges

California, Connecticut, Hawaii, Iowa, Maryland, Nevada, New York, and Vermont have received new grants from the federal government to help support the establishment of Affordable Insurance Exchanges, provided by the Patient Protection and Affordable Care Act. Starting in 2014, consumers and small businesses will have access to high-quality, affordable health insurance through an Exchange—an online marketplace where consumers can choose a private health insurance plan that, it is hoped, will fit their health needs and, maybe, budgets.


According to the U.S. Department of Health and Human Services (HHS), Exchanges will level the health insurance playing field, so that small businesses will have a better choice of plans and insurers at a lower cost, the way larger employers do now. These competitive health insurance marketplaces will make purchasing health insurance easier and more understandable and offer consumers and small businesses increased competition and choice, HHS said.

In addition, small employers will be eligible to receive tax credits for coverage purchased for employees through the Exchange. And, consumers will be able to learn if they are eligible for tax credits and cost-sharing reductions, or other health care programs like the Children’s Health Insurance Program.

This latest round of awards will give states additional resources and flexibility to establish an Exchange. On August 23, California, Hawaii, Iowa, and New York were awarded Level One Exchange Establishment grants, which provide one year of funding to states that have begun the process of building their Exchange. Connecticut, Maryland, Nevada, and Vermont were awarded Level Two Establishment grants, which are provided to states that are further along in building their Exchange and offers funding over multiple years.

Previously, 49 states, the District of Columbia and four territories received grants to begin planning their Exchanges. With the new grants, 34 states and the District of Columbia also have received Establishment grants to begin building their Exchanges.

In June 2012, HHS announced an initiative to provide states with ten additional opportunities to apply for funding to establish a state-based Exchange, state Partnership Exchange, or to prepare state systems for a Federally-facilitated Exchange. States can apply for Exchange grants through the end of 2014, and may use funds during the initial start-up year. This schedule ensures that states have the support and time necessary to build an Exchange that best fits the needs of their residents.