06 November 2015

"There's no money in health..."

Suzanne Beachy talks to Dr Peter Breggin about the loss of her son 'due to psychiatry's failure to offer beneficial, caring human services, and indeed due to psychiatry's opposition to them.':
There's no money in health; there's only money in managing illness. Suzanne Beachy, Dr Peter Breggin Hour, 4 November
Ms Beachy is relating her experiences in the US, but the same applies to most western countries. The concept of 'health' is not one that can be readily addressed by our existing institutions. It suffers because it results from a huge number of influences, and because our institutions have grown up during times when that number of influences was much smaller. So these institutions and the systems they embrace aren't as good a fit in today's complex society's as they used to be. Curing short-term illnesses is a relatively visible and quantifiable activity. Treating or managing poor health can also be reduced to a series of procedures that can be performed by our current health care providers. Sure, clinical trials are performed, pills and equipment sold, and a whole array of indicators is measured and targeted. But much about the clinical trials - who performs them, how they're performed and which ones are quietly ignored - is questionable, and many of the targeted indicators are Mickey Mouse at best. They have evolved to measure highly specific rates of activity, rather than outcomes that are meaningful to ordinary people, healthy or sick. The result is exactly what Suzanne Beachy experienced: a system that motivates people and institutions to manage illness rather than optimise health. 

Here's another approach: measure the broad health of society, and target that for improvement. Society is so complex, and our knowledge about society and science is growing so rapidly that no government, however altruistic, generous, or far-sighted, can know how best to maximise our physical and mental well-being. But what a government can do is put in place a system that gives people incentives to find the most efficient ways to maximise society's health continuously. In short, government  can apply the Social Policy Bond principle to society's physical and mental well-being and issue Health Bonds.

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