Real healthcare reform!

I just read a revolutionary article by David Goldhill in the September issue of The Atlantic, entitled “How American Health Care Killed My Father.”

In his appropriate indictment of mainstream, conventional healthcare (i.e., the healthcare business), Goldhill begins his call-to-action commentary by telling what happened to his 83-year-old father: from the time he entered a “well-regarded” New York City hospital with pneumonia, through his development of hospital-acquired sepsis 36 hours later, to his death five weeks later.

Nearly two years after his father’s death, Goldhill does not blame the doctors, or the nurses, nor any one person or institution. “There were no greedy pharmaceutical companies, evil health insurers, or other popular villains in his particular tragedy,” writes Goldhill.

Goldhill instead points to our “massively subsidized” healthcare system that is full of structural distortions and with incentives that “inexorably generate terrible and perverse results.” He notes that the biggest problem of all is the fact that consumers have been removed from their “irreplaceable role as the ultimate ensurer of value.”

In my July 2000 editorial in Better Nutrition magazine, “Escape From the E.R.,” I shared my own emergency room experience—-in my case not tragic, just demoralizing and disappointing—I talked about what I experienced as I made my way through two emergency rooms, triage, tests and waiting, a lot of waiting. I saw “victims of a world without a family doctor, statistics at the periphery of an HMO universe.”

I wrote, at the time, that my experience represented “the very worst and the very best of what's horribly wrong and allegedly right about mainstream medicine today. It's high-tech but ‘low-heart,’ the apex of empirical skill yet the nadir of compassionate medicine.”

As the healthcare reform debate looms and town hall forums ignite hope and conversation (and also some pessimism and shouting) across the land, what better time is there than now to take a look as some bills that were introduced in 2009 (in some cases re-introduced several years running) that warrant inclusion in the reform debate, pieces of legislation that have (in most cases) not attracted the level of Congressional interest or consumer awareness that they deserve:

H.R. 1869, title: “To require the President to call a White House Conference on Food and Nutrition”; introduced by Rep. James P. McGovern on April 2, 2009; cosponsors: 81. This conference’s goals would be to: end hunger; reduce food insecurity; coordinate government and community programs to improve nutrition; bring attention to the medical, developmental, educational, economic; and psychosocial impact of inadequate nutrition. See also related bill, H.R. 2297. Take away? This bill has real potential, provided (a) the focus is on optimal (best possible) nutrition and (b) the critical importance of supplements to maternal, infant, child and general nutrition is spotlighted.

H.R. 3263, title: “To amend the Internal Revenue Code of 1986 to provide that amounts paid for foods for special dietary uses, dietary supplements or medical foods shall be treated as medical expenses”; introduced by Rep. Dan Burton on July 20, 2009; cosponsors: 0. With the proposed name of “Tax Supplement Fairness Act,” this bill has the potential to do much good, especially in allowing tax deductions for dietary supplements, especially if the supplements serve a “special dietary use” or are considered “medical foods.” Take away: If this bill is broad or inclusive enough, many people will be helped. Concerns? If restricted to special dietary use or medically supervised diets, however, it could serve to medicalize food supplements and place the rationing of them under medical control.

H.R. 3406, title: “To amend the Internal Revenue Code of 1986 to exclude from gross income amounts reimbursed by an individual’s employer for certain dietary supplements and meal replacement products”; introduced by Rep. Earl Blumenauer on July 30, 2009; cosponsors: 1. This bill would exempt the purchases of health-claim-backed dietary supplements (for example, calcium, folic acid, omega-3s, selenium and vitamin D) from gross personal incomes via Flexible Spending Accounts (FSAs). Take away: This is a great start and a good bill. Concerns? Hopefully the consumer take-away would not be that only supplements for which there is a health claim are effective, science-based or legitimate.

Gormley Take-Away: While it appears that, among these bills, some version of Congressman McGovern’s H.R. 1869 stands the best chance of gaining sufficient support for passage, it will be vital for us to make sure that our Congresspeople and Senators know that we will continue to support these bills and other similar legislation in 2010. Because, legislation that emphasizes nutrition and optimal wellness (especially pro-supplement bills such as these) and keeps more money in our pockets is what I would truly call healthcare reform!