FrankRep
08-29-2009, 09:19 PM
Dr. Dean Ornish: Don't Tread on Me: Transcending the Left Wing/Right Wing Health Care Debate
Huffington Post
August 28, 2009
Recently, I found myself in the middle of a contentious debate on Larry King Live sandwiched between President Obama's longtime personal physician, Dr. David Scheiner, and Dr. Ron Paul, the libertarian Republican member of Congress from Texas.
Dr. Scheiner described his disappointment with President Obama for not supporting single payer health insurance as part of health reform, saying "Continuing private health insurance is crazy." On the other end of the spectrum, Congressman Paul wants to drastically limit the size and scope of the Federal government (a few days ago, he was the featured speaker at a John Birch Society luncheon in Houston).
These are false choices, a microcosm of the health reform debate between the traditional left wing policies of big government as the big teat taking care of everyone and the right wing policies of small government and survival of the fittest. We can transcend our divisions if we think more multidimensionally.
I want to focus here on an example of how my colleagues and I were able to bring together some of the most conservative Republicans and liberal Democrats across the political spectrum at the highest levels to work together to change Medicare coverage, how we're doing it again, and the lessons we learned that can enable health reform to be truly bipartisan.
For the past 32 years, I have directed a series of research studies showing that changes in diet and lifestyle can make such a powerful difference in our health & well-being, how quickly these changes may occur, and how dynamic these mechanisms can be.
We used high-tech, state-of-the-art measures to prove the power of simple, low-tech, and low-cost interventions. We showed that comprehensive lifestyle changes may stop or even reverse the progression of coronary heart disease, prostate cancer, diabetes, hypertension, obesity, hypercholesterolemia, and other chronic conditions that account for at least 75% of the $2.1 trillion in health care costs.
I thought that when we published our findings in the leading medical journals that this would change medical practice. In retrospect, that was a little naïve; good science is important but not sufficient to change medical practice. Despite the talk about evidence-based medicine, we really live in an era of what I call "reimbursement-based medicine"--it's all about the Benjamins.
I realized that it wasn't enough to have good science; we also needed to change reimbursement. We doctors do what we get paid to do and we get trained to do what we get paid to do. Therefore, if we could change reimbursement, then we would improve both medical practice and medical education.
Thus began my 14-year epic journey to persuade Medicare to cover intensive lifestyle changes for reversing heart disease. This culminated in achieving some coverage last year in the "Medicare Improvements for Patients and Providers Act of 2008" (Public Law 110-275).
Beginning in 1994, I was able to enlist the strong personal support of both Bill Clinton when he was President of the United States and Newt Gingrich when he was Speaker of the House for the idea that Medicare should cover programs of intensive lifestyle changes for reversing heart disease, not just preventing it. This was at a time when relations between Clinton and Gingrich were highly acrimonious during the midterm elections.
We also had the strong personal support of both liberal Democrat Rep. Charles Rangel (D-NY) and arch-conservative Dan Burton (R-IN), who joked at a press conference at the Capitol ten years ago that this was the only issue that they both agreed on. They even co-hosted a bipartisan Congressional retreat in 1999 in which all members of Congress were invited to learn how to improve their diet and lifestyle. We also had the support of many other members of the Senate and House on both sides of the aisle, along with the president of the AARP, the Chief of Medicine and the Chief of Preventive Medicine at Harvard Medical School, the head of the American Board of Internal Medicine, and many others.
And it still took us 14 years. As Secretary of State Hillary Rodham Clinton said in a recent interview with Fareed Zakaria on CNN:
...
Full Story:
http://www.huffingtonpost.com/dr-dean-ornish/dont-tread-on-me-transcen_b_271111.html
Huffington Post
August 28, 2009
Recently, I found myself in the middle of a contentious debate on Larry King Live sandwiched between President Obama's longtime personal physician, Dr. David Scheiner, and Dr. Ron Paul, the libertarian Republican member of Congress from Texas.
Dr. Scheiner described his disappointment with President Obama for not supporting single payer health insurance as part of health reform, saying "Continuing private health insurance is crazy." On the other end of the spectrum, Congressman Paul wants to drastically limit the size and scope of the Federal government (a few days ago, he was the featured speaker at a John Birch Society luncheon in Houston).
These are false choices, a microcosm of the health reform debate between the traditional left wing policies of big government as the big teat taking care of everyone and the right wing policies of small government and survival of the fittest. We can transcend our divisions if we think more multidimensionally.
I want to focus here on an example of how my colleagues and I were able to bring together some of the most conservative Republicans and liberal Democrats across the political spectrum at the highest levels to work together to change Medicare coverage, how we're doing it again, and the lessons we learned that can enable health reform to be truly bipartisan.
For the past 32 years, I have directed a series of research studies showing that changes in diet and lifestyle can make such a powerful difference in our health & well-being, how quickly these changes may occur, and how dynamic these mechanisms can be.
We used high-tech, state-of-the-art measures to prove the power of simple, low-tech, and low-cost interventions. We showed that comprehensive lifestyle changes may stop or even reverse the progression of coronary heart disease, prostate cancer, diabetes, hypertension, obesity, hypercholesterolemia, and other chronic conditions that account for at least 75% of the $2.1 trillion in health care costs.
I thought that when we published our findings in the leading medical journals that this would change medical practice. In retrospect, that was a little naïve; good science is important but not sufficient to change medical practice. Despite the talk about evidence-based medicine, we really live in an era of what I call "reimbursement-based medicine"--it's all about the Benjamins.
I realized that it wasn't enough to have good science; we also needed to change reimbursement. We doctors do what we get paid to do and we get trained to do what we get paid to do. Therefore, if we could change reimbursement, then we would improve both medical practice and medical education.
Thus began my 14-year epic journey to persuade Medicare to cover intensive lifestyle changes for reversing heart disease. This culminated in achieving some coverage last year in the "Medicare Improvements for Patients and Providers Act of 2008" (Public Law 110-275).
Beginning in 1994, I was able to enlist the strong personal support of both Bill Clinton when he was President of the United States and Newt Gingrich when he was Speaker of the House for the idea that Medicare should cover programs of intensive lifestyle changes for reversing heart disease, not just preventing it. This was at a time when relations between Clinton and Gingrich were highly acrimonious during the midterm elections.
We also had the strong personal support of both liberal Democrat Rep. Charles Rangel (D-NY) and arch-conservative Dan Burton (R-IN), who joked at a press conference at the Capitol ten years ago that this was the only issue that they both agreed on. They even co-hosted a bipartisan Congressional retreat in 1999 in which all members of Congress were invited to learn how to improve their diet and lifestyle. We also had the support of many other members of the Senate and House on both sides of the aisle, along with the president of the AARP, the Chief of Medicine and the Chief of Preventive Medicine at Harvard Medical School, the head of the American Board of Internal Medicine, and many others.
And it still took us 14 years. As Secretary of State Hillary Rodham Clinton said in a recent interview with Fareed Zakaria on CNN:
...
Full Story:
http://www.huffingtonpost.com/dr-dean-ornish/dont-tread-on-me-transcen_b_271111.html