Saturday, July 11, 2015

Are health care and medical care the same? (Part I)

This is in two parts and kinda long.  Sorry.

So-called pundits, thought leaders and politicians have confused medical care with medical insurance so often and for so long, one almost wearies of calling them out.  I think there's another confusion of terms that may seem innocuous, but which is equally careless, mistaken and damaging to analysis: that health care and medical care are the same

I think it’s useful to point out the obvious - that despite popular usage, health care and medical care are not the same.  I think this insight enables clearer understanding of our medical cost problems.  For one thing, you'll notice that health care is free, it’s medical care that’s expensive. But there are many more, some less-obvious, things to notice.  Important things

For example, people who aren’t careful about their health tend to have higher medical expenses. Second, despite our medical ability to treat far more effectively, American public health has been deteriorating for decades.  Part of the reason is that we Americans are failing to be careful about our own health. Deteriorating public health has become a huge driver of medical costs. Third and most important, when we fail to understand – or choose to ignore - that health care and medical care are not the same, I think we make it harder to diagnose our problems and set ourselves up to miss significant opportunities to improve the public health and at the same time save overall medical costs.

When pundits, thought leaders and politicians use health care and medical care interchangeably, it’s natural for people to believe that e.g., a physical exam delivered by a medical professional is health care.  But is it?  It’s also common thinking that an exam delivered to a “well person” is not medical care.  But is that true? In what way exactly is an exam health "care"?  Besides, it’s not logical to believe that the way to care for our health is to visit an office someplace and get an exam “delivered” by a licensed professional.  I don’t know how much you may have read about the effectiveness of regular physical exams in the early detection of disease; the marketing pieces are rosy but the peer-reviewed literature is not so encouraging. 

Sure, medical professional may advise you about healthy behaviors.  But here is the key distinction: those behaviors are UP TO YOU.  Health care is fundamentally what you do to take care of your own health.  In other words, you are responsible for your diet; your sleep habits; your exercise; whether you smoke; whether you abuse alcohol or other drugs; whether you drive carelessly or recklessly, whether you follow your doctor’s advice, etc, etc.  Your health care is fundamentally not some service you must pay for, provided to you by someone else.  That’s nearly a definition of medical care.  Instead, your health care is mainly the sum of your own behaviors that bear on your own health.  And unlike a medical professional’s services, health care - your own behavior - is free.  You don’t get a bill for quitting smoking; for avoiding junk food; for getting plenty of exercise and so forth.  Your behavior is free.

[Click here for Part 2]
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