Problem 1: Colossal Hubris of the Individual
Problem 1: Colossal Hubris of the Individual
In August 2006, the National Association of Health Underwriters issued a white paper listing key current and future healthcare cost drivers:
- Aging Population
- Pharmaceutical Costs
- New Technologies
- Behavioral and Lifestyle Choices
- System Inefficiencies
- Medical Malpractice
- Cost-Shifting
- Increases Utilization
Such factors dominate the discussion about cost in healthcare. However, all of these are either ancillary to, or predicated upon, the more fundamental motive driving demand for healthcare.
In pursuit of health, we often wax Quixotic, driven toward an illusory goal. Health, after all, cannot be acquired or possessed. In fact, health cannot even be measured, except as an absence of some symbol of vitality; a decrement in the performance of a life function or activity. So, when we ‘pursue health’, what are we actually pursuing? It turns out, we are pursuing autonomy, the ability to perform our life activities, as we wish. (See Gadamer )
And so, our arrogance blossoms. Conflating the Western doctrines of Reductionism and Rugged Individualism, we make a god of Capitalistic Science. Slowly, we the people, reduce our existence to discrete functions, to be managed or outsourced to a caretaker. As a society we have agreed to fund our desire to live unimpaired through a social insurance schema, essentially underwritten by those possessing more tempered ambitions. Yet, our quest often ends in disappointment, as we find that many of our caretakers also exact a hefty toll upon our self-determination. Such lack of objectivity is characteristic of a state of denial. And, denial is at the very root of our healthcare cost explosion.
An aging population that demands more care and new cures…we hear this song echoed throughout history. The symbols of the problem are all around us, from the pyramids of Giza to the promises of Cialis. Our vision no longer extends beyond our present experience. We’ve lost sight of our history and recoil from our future. Much of our healthcare system serves as life support to the “vital lie”. Ernest Becker won the Pulitzer Prize in 1974 for his eloquent and brilliant examination of the lengths we go, to reduce our lives to an equation we can solve. As it goes for life, in general, so it goes for healthcare, in particular. Our underlying problem is not the denial of access to primary care, or to the latest technology or drugs. Our problem is denial of death.
Solution to Problem 1:
Life is terminal. Drop an anchor in eternity and deal with it!
1 year ago