Health Care: It’s Complicated (or Is It?) —by Jinny Batterson
It is sometimes easy these days to grow disenchanted with the various attempts to improve the U.S.’s ailing health care system. As Congress grapples with ways to improve/replace the Affordable Care Act and to shore up existing government health care subsidy programs such as Medicare and Medicaid, let’s take a broader look at what we mean by health care.
A generation ago, a non-partisan grass roots political group I belong to, the League of Women Voters, studied the health care issue in order to make some informed recommendations at multiple levels of government. (A summary of the U.S. League’s position on health care is available at http://lwv.org/content/health-care.) Some of the conditions we discovered during our initial study in the early 1990’s have changed, but other basic trends have remained, even accelerated. As a population, we Americans are getting older, fatter, and more likely to suffer from various addictions—drugs, alcohol, nicotine, sweeteners, fats. Access to health care is skewed toward those who already have a disproportionate share of economic resources.
We’ve all likely heard the various statistics—overall, health care costs for Americans account for nearly 18% of U.S. economic activity, compared to a global average of about 10%. Is it any wonder that many people’s health care insurance premiums are going up?
Part of the increase in medical costs comes from advances in medical practice and tools. If my grandmother suffered from arthritis, she had few options other than aspirin. My mother’s options were broader, but not nearly as broad as mine. Now it’s possible to have most joints replaced. Medicines and/or surgery are available to deal with many of the chronic illnesses that either killed or debilitated Americans in previous generations. Yet dissatisfaction with the state of our health and our health care continues. Some have more medical coverage than they need, while others have little or none. Medical providers are exhorted to improve “patient satisfaction,” yet some studies show no correlation at all between patient satisfaction and one important measure of medical efficacy—mortality. So what are we to do?
One non-traditional approach comes from “clown doctor” Patch Adams, his staff and colleagues at the “Gesundheit Institute.” I’d read Patch’s book Gesundheit when it first came out in 1993, and watched the 1998 movie partially based on it, but hadn’t really thought much recently about this approach to medicine. Patch and crew subscribe seriously to the notion that “laughter is the best medicine.”
This spring, as I was preparing to visit a young doctor friend in China, I emailed Ruby to see whether there was anything I could fit into my luggage that she’d like me to bring her from America. What she asked for were copies of some of Patch’s books. By jettisoning an extra shirt and pair of slacks, I fit in one copy each of Gesundheit and House Calls. Like any conscientious donor, I reread the first book and skimmed the second during trip preparations. Lots of what it said about healthy habits and healthy communities made sense to me.
As luck would have it, my visit with Ruby coincided with the opening of a newly built hospital in her home town. It also fell on the weekend when she’d arranged a monthly “clown doctoring” session at the hospital children’s ward. For several years previously, Ruby had spent extra time and effort to incorporate a clowning component into the medical practices at her hospital. She’d developed a corps of about twenty doctors, nurses, and volunteers. Prior to our ward visits, she spent over an hour preparing us, individually and as a group, for our interactions with each other and with patients. Ruby especially emphasized the importance of not invading the children’s or their families’ space without permission. Once our visits were over, she did a thorough debriefing. I don’t know if any measurement would have detected an impact on the health of these children and their families. I do know that among the children who wanted to interact with us, we got lots of smiles, some chuckles, and even a few outright guffaws.
My visit with Ruby and my reintroduction to Patch Adams’ work reminded me that health care is about more than preventing or curing active illness. It is also about more than preventing death at all costs. Health involves caring for each other. It is vibrant. It includes the capacity to be silly and to laugh with each other, to make fun of ourselves and of some of life’s absurdities. Put that way, it doesn’t seem all that complicated.