By Dr. Sherri Tenpenny, DO, AOBNMM, ABIHM
Dear Mr. President,
In Part 1 of my Open Letter to you, I suggested three priorities I believe could immediately transform the current healthcare crisis very quickly: Stop the $77 billion lost from Medicare and Medicaid through fraud, theft and incompetence; overhaul the insurance industry, and remove the pharmaceutical industry from the government money trough. Then give line-item discretion to the new Secretary of HHS, Dr. Tom Price, to eliminate billions in waste on the HHS annual budget.
But even with those efforts, at some point, we must stop tinkering with an old, broken system. We need to stop tweaking a system, stop offering more of the same. We’re doing nothing more than moving the deck chairs around on the Titanic. Isn’t the definition of insanity, Mr. President, doing the same things over and over and expecting a different outcome?
The only parties who will benefit – again – with a Repeal and Replace of Obamacare are the drug and insurance companies. Congress is reallocating funds within a broken system, a sick care system that will soon consume more than 32% of our total GDP. They seem to be obsessed with finding ways to give everyone ‘access’ to care. But what are these millions of uninsured or underinsured Americans getting ‘access’ to?
“Access” is an appointment with a physician who orders blood tests and x-rays, and then takes out a pad to write a prescription. While sometimes a medication, such as an antibiotic, is necessary, more often than not the pill merely provides temporary relief or obliterates a symptom. The underlying cause of that symptom is never identified and eliminated – so the dis-ease will continue. Over time, a second, third or even fourth medication is prescribed. Insuring this “access” comes with exorbitant costs to the people and is breaking the back of the American economy.
We have been conditioned to believe that symptom-free in the presence of a pharmaceutical product is “health” and people need “access” to these drugs.
Spoiler alert. This is NOT health. It is a temporary fix, at best. Prescription medications have no long-term solutions.
Mr. President, without restoring health, Congress and you – or the next president – will be discussing yet another health insurance crunch in only a few more years. The sooner we embrace the fact that the existing system is irreparably broken and do the hard work of creating a new paradigm around health instead of treating illness, the sooner Americans can be made Healthy – again.
Let’s start the innovations:
1. Invite those who actually work in the medical industry to participate in the creation of a new paradigm in American Health.
The following is a breakdown of members in the 115th Congress (2017-19) who had previous careers in healthcare:
- Senate: 3 physicians – Tom Coburn (obstetrics), Rand Paul (ophthalmology) and John Barrasso (orthopedics), and 1 optometrist
- House: 11 physicians, 4 dentists, 3 psychologists, 2 nurses and 1 pharmacist.
- Federal Government: Tom Price, MD, a former representative from Georgia, has been confirmed as the head of HHS.
The rest of the members represent a wide range of occupations including various roles in education (101), insurance agents or executives (21), ranchers/farmers (26), real estate representatives (36), the construction industry (14), car dealership owners (6) and more.
Putting that in perspective, there are 535 members in Congress. Of those, 167 members of the House and 55 senators – 41% – hold law degrees with only 25, a mere 5%, hold degrees in medicine or healthcare.
Let that sink in: Only 5% of those in Congress have any concept of what the practice of medicine is all about.
What if a group of physicians were sitting in a room, and arguing over a trillion dollar package to reform the legal system? Would they be qualified experts if they had gone through a divorce, experienced a lawsuit, participated in Jury Duty, or dealt with a parking ticket? Of course not. It would be laughable to think that doctors could reform legal processes in this country.
We are expecting a bunch of lawyers and non-medical types to create a massive new law that will somehow improve the most complex system in this country and literally impacts every citizen? Mr. President, this is not laughable. It is actually dangerous. Can you see the disaster looming with this scenario?
2. Appoint a Medical Commission on Making America Healthy Again
Mr. President, you have met with leaders of large and small companies across diverse industries including manufacturing, technology, airlines and gas/oil. And you recently met with mainstream health physicians. This is a good start, but those discussions will contribute more of the same – more drugs, more tests, more vaccines. You need to meet with a broader scope of professionals, those in Integrative Medicine and Holistic Health, to create a new paradigm.
Those of us who are practice Integrative Medicine know the frustrations our patients are experiencing. We have first-hand knowledge about layers of waste and unnecessary regulations that inhibit our ability to get patients well. We know that health restoration methods, technologies, and laboratory assessments are not paid for any third party carrier. Our patients struggle and pinch pennies to find ways to recover and eliminate the cost prescription medications from their lives, from their family budgets.
The unfortunate truth is that the money is in the medicine, not in the cure.
Please appoint a commission of physicians, nurses, physical therapists, hospital administrators and others in the field of medicine and healthcare, such a chiropractors, naturopathic physicians and nutritionists, to find a long term solution to a HEALTHY AMERICA. Invite physicians from across the country – from cities to rural clinics; from multidiscipline clinics to solo practitioners. We have something important to contribute. We can share our vision of what A New Model for Health the 21st Century should look.
Let’s not to discuss a new form of insurance and access to an old paradigm. Let’s discuss Health – and how to achieve it.
3. Address the two largest medical issues facing America today: Opioid addiction and Obesity.
Solving the opiate addiction crisis
Most people are acutely aware of the opiate and drug addition problem in America. And many know that it is connected to abuse of pain medications such as Oxycontin and Vicodin. We also know that more than 100 million Americans – nearly 1/3 of our population – suffer from chronic pain. The conventional medical system has limited tools to address these conditions, In fact, physicians have greatly contributed to the addiction of Americans through writing prescriptions, their primary tool for mitigating pain.
Many non-pharmaceutical solutions exist. We need to embrace them and provide insurance coverage for real solutions.
One example is acupuncture, a treatment that has been accepted worldwide for addressing a long list of clinical conditions. The positive effects of acupuncture on opiate addiction have been investigated in many clinical trials with a moderate degree of success. This treatment is simple, inexpensive and relatively non-invasive. It can even be administered in a group setting. Acupuncture should be primary tool in the treatment of both chronic pain and drug addiction.
Conventional medical doctors routinely disparage chiropractic, a therapy they really know little about. There is a large body of science that concludes chiropractic treatment can improve health and eliminate pain. When insurance companies and Worker’s Comp limit the number of visits to 10 per year, patients who still have pain have nowhere to turn but to legal pain medication and illicit street drugs.
These are only two of many low-cost treatments that need to be maximized. What if these two modalities were only 30% effective? That would mean 30 million Americans – a staggering number! – have found relief and can return to a productive life and away from harmful, addictive opiates. Would that not be worth it?
Solving the obesity crisis
Obesity is one of the biggest drivers of chronic illness and healthcare costs in our country. According to StateofObesity,org, obesity issues can cost the country from $147 billion to nearly $210 billion per year. In addition, obesity is associated with job absenteeism and lowered productivity, costing employers at least $506 per obese worker per year. Obesity contributes to hypertension, heart disease, diabetes, and chronic pain in the knees, hips and back, as well a long list of secondary conditions that cost billions.
The math speaks for itself:
“A 2008 study by the Urban Institute, The New York Academy of Medicine and TFAH found that an investment of $10 per person in proven community-based programs to increase physical activity, improve nutrition and prevent smoking and other tobacco use could save the country more than $16 billion annually within five years. That’s a return of $5.60 for every $1 invested. Out of the $16 billion, Medicare could save more than $5 billion and Medicaid could save more than $1.9 billion.”
And that was in 2008 – imagine the human and financial costs today, a decade later.
Here are some simple solutions to incentivize weight loss and lead to a healthier America and a healthier work force:
- Give a tax or HSA credit for providing proof of walking 10,000 steps per day (all FitBit and similar technologies can print a report).
- Give a tax or HSA credit for certifying to be within 10 pounds or 10% of one’s ideal bodyweight at the time of filing taxes.
- Give a tax or HSA credit for proof of use of a gym membership.
- Allow a tax deduction for home exercise equipment.
- Allow a tax deduction for fees paid to a personal trainer.
- Allow a tax deduction for a lifestyle and/or nutrition coach. Most people today do not know how to transition from a junk food diet to one of healthy fruits and vegetables. With personal education, personal transformation can occur.
- And while we’re focusing on important health issues, give a tax or HSA health credit for sustained smoking cessation, which can be verified by a urine test.
By rewarding health and solving these two issues with health credits and tax deductions, we could go a long way towards Making America Healthy Again.
Mr. President, we need a drug-free, healthy American work force. We have been coerced, manipulated, and saturated with advertisements to make us believe that symptom-free in the presence of drugs is health. We have been badgered into believing that vaccine-free should be a crime. What if we created a system where American workers and families were robust, productive and active without taking a handful of daily pharmaceuticals? What if, over the next four years, we collapse the lion-share of the existing system and build a new model that would restore health and truly Making America Healthy Again?
If you want Repeal and Replace, why not change it all?
Stop trying to “fix” a broken system. Mule-kick the old model off the cliff. Let it fall apart. Let it implode. Then pick up the pieces that have real value and rebuild it from the ground up. You would do that in real estate; why not do it in healthcare?
You’re a brave, visionary man, Mr. President. There’s another side to this story that needs to be told. Connect with your base. Hear what restoring health should be all about.
Let’s Make America Great – and Healthy – Again.