Monty Python Defined Health – As a Modern Day Cashectomy
We’ve welcomed in a New Year, but not much else has changed. Health needs more money spent on it: here, there and pretty much everywhere. A mere £100 billion budget is not enough for the Brits, while £260 million is not enough to spend for Manx folks. What if, heretics on guard – the model was wrong and the wrong behaviours were rewarded? What if, just as we have Peak Oil, we also have Peak Health? A Peak Health model, but one now crying out to move beyond the ‘scalpel or pill’ option.
Monty Python of course, had it sussed 47 years ago: ‘we’ve every facility here for dealing with people who are rich. We can deal with a blocked purse, we can drain private accounts and in the worst cases we can perform a total cashectomy, which is the total removal of all money from the patient’.
Models Getting Fatter – surely not, Twiggy?
If Monty and his pals were right, we may need to look outside the current ‘gold fish bowl’ model of health. A model that says “upwards only health inflation together with ever more spending on sickness”. Maybe we can assume that those who got us into the sick treatment model may not be the best ones to get us out of it and into a Wellness model. The current mantras, clinical pathways and protocols assume that each patient is like every other – best fixed by a National Cashectomy. But delivering not so much fixed or healed patients, but regularly treated ones. Currently, a patient can be on ‘ten meds’ or more as a ‘standard protocol’ despite each medication having many side effects and each patient being unwell in a quite unique and personal way. In the end, the pages of side effects read like War and Peace: which also had different endings – some good, some bad.
Some Sterling Clues
We have enough ‘sick’ clues along the way that despite record spending everywhere we now have:
Breast screening never having been shown to save lives (see BMJ, 2016)
Prostate over-screening with false positive harms
An Alzheimer’s epidemic
Allergies epidemics among the millennial generation
Falling life and Wellspan in the West
With the US spending 20x more per patient than Cuba (but with worse outcomes at every age) money is not the issue – while lifestyle, environment and treatment habits are.
From Petri Dish to Giant Field
What if we are over screened, over diagnosed, over chemo’d, over-probed and over-fed. But woefully undernourished due to being: under-vitamined, under mineraled and under-sunned. What if we went back to the future and adopted the words of Hippocrates “let food be thy medicine and medicine be thy food”. What if the cashectomy model moved from Pharma to Farmer, increasingly realigning our natural biology again to the soil and the seasons? As good live food ensures we build good live bodies, food is the best medicine to avoid a Doctoral visit – where you so often seek a short term solution to a long term problem.
Part of Your Five A Day, Polly
Perhaps we need to stew and vegetate, to define how we best reward Wellness habits, to institutionalise those healthy behaviours which societies can afford. Ideally and to match our healthy ‘five a day’ food habit – might we mandate by Law, only ‘five med’s a day max’ by 2020. That way we focus on the key issues – those major patient illnesses, while eliminating the diminishing returns (and costs) of polypharmacy. Sticking to our ‘five and five’ can likely delay shuffling off our perch – nailed Norwegian Blue, or not.