THE CHINESE WORD FOR crisis is comprised of two separate words, “danger” and “opportunity” — and this describes the exact situation we face with the healthcare crisis in our country.
As a nation we are at the precipice of change for our healthcare system.
But if we make the wrong choices and simply provide universal coverage to an outdated 19th and 20th century model of medicine, this crisis will lead us into danger.
However, there are different choices we can make now that will lead to profound opportunity — one that may provide real solutions to our healthcare crisis.
Today, I will outline a 9-point plan for real healthcare reform. This plan takes into account all of the changes we need to make — including the fundamental shift in the type of medicine we practice — if we are going to truly resolve the health catastrophe in this country.
Hope for a Brighter Future in Medicine
Despite the looming dangers we face as we work to change medicine, I have hope.
I have been privileged to participate in events at the nexus of change that have all focused on fundamentally changing our disease-based healthcare system to one focused on creating health and wellness.
These ideas are not yet at the center of the healthcare debate, but they must be — and they can be.
In February of this year, the Institute of Medicine held a Summit on Integrative Medicine and the Health of the Public at the National Academy of Sciences. Six hundred key leaders and stakeholders in healthcare including educators, scientists, community leaders, practitioners, lawmakers, policy makers, and insurance leaders attended it.
It was a broad coalition that came together with a common purpose to change not only the way we practice medicine, but also the type of medicine we practice.
I believe the medicine at the core of healthcare reform must be founded on the clinical model and framework for practice developed by the Institute for Functional Medicine, a nonprofit organization of which I am a member. The Institute’s mission is to support the widespread adoption of functional medicine.
These policies and initiatives are necessary for healthcare reform that addresses the true causes of our chronic disease epidemic and exploding costs.
This new way of thinking about health and disease is the biggest secret in healthcare today, yet it is the most effective model to address the current drivers of cost and chronic disease. To spread the word, the Institute recently published a detailed white paper called “21st Century Medicine: A New Model for Medical Education and Practice.”
The same week the white paper was published, I testified on integrative and functional medicine before Senator Edward Kennedy’s Senate working group on healthcare reform, alongside other leaders in healthcare including Drs. Dean Ornish, Mehmet Oz, and Andrew Weil. The full testimony is available for the Committee on Health, Education, Labor, and Pensions, “Integrative Care: A Pathway to a Healthier Nation.”
I also met with key policy makers in the White House. and was heartened by their openness and willingness to find a way to true healthcare reform.
More recently, at a retreat center on the edge of a Minnesota pond, I was privileged to be part of a think tank sponsored by the National Institutes of Health on “whole systems research.”
It was an international gathering of systems biologists, mathematicians, physicists, geneticists, physiologists, psychologists, researchers, and doctors from a dozen countries and diverse backgrounds—Palestinians and Jews, Chinese and Iraqis, French and Germans — all exploring very important but neglected questions that hold the solution to our epidemic of chronic disease.
In this isolated place, the thinkers with their fingers on the pulse of the future all suddenly came to the same conclusion. The way we do research doesn’t help us understand how things really work as a whole, integrated system.
In other words, the current model of studying one drug, chemical pathway, or gene for one disease doesn’t give us useful answers to how we get sick and how we can get well.
What everyone at the conference understood at that moment is the same truth we need to come to as a nation …
The old, conventional model of medicine and scientific research is simply outdated. It must give way to a new way of thinking about health and illness and a new method for medical practice.
A 9-Point Plan for Real Healthcare Reform
I believe that real healthcare reform is now possible because of a perfect storm where alignment of economic, scientific, and moral imperatives provides us an opportunity to do well as a nation by doing good, through fundamentally changing the kind of medicine we practice.
But to achieve that goal will require the collective imagination, intention, focus, and action of healthcare providers, consumers, industry, and policy makers.
A coordinated effort across government agencies and industry sectors focusing on health and wellness, incorporating what we already know, is urgently needed. We also need leadership at the highest levels of the White House to successfully create a culture of health and wellness and transform our healthcare system.
The 9-point plan below, while not at the center of the healthcare debate, is essential to create real change and avert disaster.
Just as horse-and-buggy makers gave way to the automobile, and 8-track tape manufacturers gave way to the iPod so must conventional medicine give way to a new way of practice.
Yes, some industries will fade, as funds are allocated toward policies and initiatives that prevent and treat chronic disease through dietary, lifestyle, and community interventions instead of expensive drugs and medical technologies. But other industries that promote health and wellness will flourish in their place.
These policies and initiatives are necessary for healthcare reform that addresses the true causes of our chronic disease epidemic and exploding costs. These are the changes that must be made if we are going to fix our broken healthcare system:
- 1. Change reimbursement to include payment for healthcare teams focused on lifestyle treatments for chronic disease and the use of functional medicine, not just for expensive (and often unproven) procedures.
- 2. Improve research by comparing existing drug- and procedure-based medicine to changes in lifestyle, diet, and other functional and integrative approaches.
- 3. Transform medical education by including nutrition, lifestyle, and environmental factors as core components of the education of health professionals and physicians.
- 4. Establish an Institute for Functional Medicine at the federal level that would develop the educational curriculum for medical schools, residencies, postgraduate education, and other health professionals.
- 5. Improve food policy, agriculture policy, and school and community environments to encourage health by prohibiting food that is known to promote obesity and disease and providing whole, real, fresh foods for our children. Obese teenagers have the same risk of premature death as heavy smokers. We wouldn’t feed our dogs cola, burgers, and fries — so why do we feed them to our children?
- 6. Conduct projects in community health centers that demonstrate how offering inexpensive, nutritious meals (including takeout), recreational facilities, lifestyle counseling/education (like cooking classes), and healthcare based on functional medicine at one location can dramatically improve health outcomes.
- 7. Impose limits on pharmaceutical and unhealthful food advertising. More than $30 billion is spent on marketing junk and fast food to consumers, including $13 billion targeted at children, and more than $30 billion is spent by the pharmaceutical industry on marketing drugs to physicians (about $30,000 annually per physician). Direct-to-consumer drug advertising also drives prescribing practices based on preferences induced by commercials rather than science.
- 8. Develop a system of electronic medical records that facilitates 21st-century, systems-based, functional medicine. We shouldn’t simply transfer 19th- and 20th-century medical records-keeping systems to an electronic format.
- 9. Create a White House Office on Wellness, Health Promotion, and Integrative Health as a way to develop an ongoing vehicle for coordination of strategy and policy. It should focus specifically on coordinating and developing policies and programs for lifestyle-based chronic disease prevention and management, integrative health care practices, and health promotion.
These changes won’t take place overnight, and they won’t be easy. But they can happen.
However, the only way they will happen is if the average person—that means you—gets involved and votes for change every day with your fork, with your feet, and with your voice.
We are facing a watershed moment in the history of medicine, one where changing the very way we understand and treat disease is finally possible.
But we all must work together to effect such a tremendous change in our medical system.
As Margaret Mead said, “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.”
We now have all the information we need to cure or dramatically improve chronic problems that are poorly addressed by conventional medicine and to discover vital, vibrant, good health at any age.
And we can finally transform our “sick care” system into a healthcare system that promises vibrant health and vitality to every man, woman, and child in this country.
The answer lies in functional medicine –- the future of medicine, available now.
Now I’d like to hear from you …
What do you think of my 9 point plan?
Do you have any other suggestions?
How do you think functional medicine can help improve healthcare?
Please share your thoughts by leaving a comment below.
To your good health,
Mark Hyman, MD
I agree with much of what Dr. Hyman suggests/his opinions. I do wish he could get HIMSELF and his ego out of the picture……….not everyone has diabetes. I am in a community of aging people – scripts are the “answer” I get from EVERY dr., and at 79 yrs I have some serious health problems for the first time in my life. HBP has been my downfall, genes take a role, but I have bad reactions to so many of the drugs prescribed, but what is my alternative? Drugs DO same lives, but Big Pharma has NEVER considered anything but their PROFITS as really important………how much of their profit goes to research??? It is a terrible example of how things can go wrong in our country where greed seems to take precedence over EVERYTHING……….I am very disturbed at the world we are leaving to our grandchildren – doesn’t say much for the my generation……….
I have seen your show on Ch.8 and was impressed by the content. Your communication skills, not so much. Ch. 8 promotion was way too long and infused with commecials, a distraction. Similar comments apply to your book and your emails. You need to find ways to get rid of superflous material and self promotion [Ego]. See Michael Polan’s writing from which you draw so much. You have medical qualifications and Polan is a distinguished journalist. His presentations are brief, “Eat food, not so much, mostly vegitables”. When he elaborates, as in “In Defense of Food”, it is his style that compels attention. I suggest you read John Brogan’s ” CLEAR TECHNICAL WRITING” [McGraw-Hill, Inc.1973]. It is clear, concise and direct. It focuses on how to get rid of redundancies. I have to fast read through 90% of your writing to get to the point. Good luck with all your valuable efforts.
I’ve read all Dr. Hyman’s books and I read his articles. I find him to extremely clear in providing the information I need to foster my wellbeing. Pithy aphorisms are not sufficient to guide one in healthy living unless you have no problems to address. Michael Pollan can provide a bit of inspiration, but Dr. Hyman tells you how to figure out . what YOU, the specific individual, can do to determine your needs and improve your health. If you’re serious about changing your life, that “superfluous” material you claim is unnecessary is actually crucial. Dr. Hyman has real scientific knowledge, and it is Michael Pollan who draws from him and other experts, not the other way around. Keep it up, Dr. Hyman, and don’t dumb down or narrow your message. Many people don’t have access to a functional doctor and rely on the depth of your writing to navigate our way toward health.
What you are proposing, Dr. Hyman, requires a paradigm shift. To convert government, established medical practice and Big Pharma to this kind of thinking within the same generation would requirement mega-changes in the way those establishments come to their perception of their professional reality.
In my discipline — anthropology — this happened in the early 1960s, In California back then, reading Ludwig Bertalanfy was required even at the 101 level. But learning about the world as a systems thinker made for a treacherous journey through graduate school. Atomistic thinkers rebelled against these ideas. They were threatened, I guess and fought back with extra assignments to teach me how to think the right way.
I don’t know what the secret is, but I know there will be a clash of reality-perceptions at the fundamental level. I remember some systems thinkers who simply accepted the fact that this is not something people can learn except through a new generation of training unindoctrinated students.
Thank you Dr. Hyman for such a profound and timely article. Michelle Obama’s efforts to change America’s students’ choices to healthy ones is certainly a major step in the right direction. My grandaughter became diagnosed with diabetes a few years ago at age 13. She is very grateful for the new healthy choices in her high school’s menus. If they ever form a White House Office on Wellness, Health Promotion, and Integrative Health, as you suggested, you should be a top candidate for this position!
Dear Dr Hyman,
Until big business, pharmaceutical companies, the FDA and government are more interested in health margins than profit margins AKA greed, we will not be able to move this dial. In preparing for a “Sugar Lecture” I gave last month, I purchased the beverage size cups from MacDonald’s to demonstrate the sugar content these drinks contained and that are so popular with our younger generation. When I went to pay for them, all 3 sizes were only $1.00 for the summer!!!! What size do you think young people will choose…the small ( which used to be the large size when I was a child) with 10 packets of sugar contained in it, or the large size, with over 21 packets of sugar in them???
McDonald’s even has a question on the back of one of the cups…”How are we doing”??? They’re probably doing fine if you look at profits but how many youngsters will trip the scales into juvenile diabetics this summer or continue to gain
weight?
The Healthcare System needs a major overhaul in this country but unless we have clear thinking individuals with a passion for helping to keep people healthy and creating a TRUE reformed healthcare system, we will continue to be left at the mercy and cloudy thinking of government bureaucrats, the FDA or new boards of whatever, thinking about their back pockets. Functional medicine has a part to play but so does portion sizes, the FDA’s approval of HFCS, the Farm Bill that subsidizes processed foods, the GMO industry, the toxins we are allowed to spread through our food chain…etc.
I think I’ll start by calling McDonald’s
I think Dr. Hyman has some good ideas, but in terms of policy I am skeptical of the usefulness of any new federal department or agency. I am also wary of the suggestion of capping Big Pharma and the junk food industry’s ability to advertise. This has serious 1st Amendment implications. Thus, I think any suggestions that are based on voluntary changes will be the most effective; any proposals based on the initiation of force have the potential to be captured by special interests and used to make people less healthy.
While I always appreciate your information, and yes, I do agree somewhat that your writing could be more concise, I am not in agreement with bringing the government into this.
You and others do a lot to educate people, even the previous commentator who used McDonald’s cups to demonstrate her point, and this needs to continue and even expand. When I see overweight children, I wonder if the parents take responsibility for feeding their children properly. In a way I doubt it – in my area there are several commercials on TV about the various charities that are feeding children during the summer now that school is out. I know many people are out of work, but the number of people on food stamps is higher than ever. Those commercials never mention parents – where are they?? Do they use food stamps?? Why can’t they feed their children. Are only the children being fed, and the parents going hungry??
Let those who have the responsibility, take it on. Leave the government and bureaucracy out of it. The last thing I ever want in my life is some government worker telling me what I should have for lunch. I can make those decisions myself, and if other people can’t. teach them how. Leave us to ourselves – we don’t need government control on our food choices, or any other facet of our personal lives, for that matter.
BRAVO Tate !!! Teach people how to eat healthier and leave the government out of it. I know it’s easier said than done but better for everyone.
Unfortunately sickness is the biggest business this country has and the govt isn’t likely to do anything to change that any time soon. Sheeple are stupid enough to buy into every commercial for drugs on TV. I think allowing drugs to be advertised was a huge mistake. People need to take responsibility for their own health, but personal responsibility is not big in this country. Advertising has a lot to do with the mass brainwashing of stupid people. They think they are doing something healthy when they drink a diet coke. We’ve been inundated with trasfats, HFCS, MSG, GMO’s, margarine, artificial sweeteners, just to name a few of the horrible choices that have been shoved down our throats. It’s hard to aviod these things as they are hidden in almost everything. Now, thanks to GMO’s, you can’t even trust vegetables anymore. The sickness in this country is manmade and it is intentional!
I too think that Dr. Hyman is right on target with what needs to happen. I really do think that we need to zero in on completely outlawing the marketing of drugs on tv. I’m not sure when this all came about and how it was allowed but all of us need to zero in on making our voices heard regarding this issue.
Dr. Hyman thank you for all your work. The changes will be made by those in the medical field. It is your industry that must change and pressure Congress and the insurance companies.
Please consider creating a program by which medical practices can “accredit” itself with a training program from your practice. Then once a physician or practice accredits itself you can post their contact information on your site. The physicians/practice will need to meet certain criteria to keep their accreditation with you. This way instead of books and supplements, we (people all over the nation) will actually have a person-person interaction with a physician/practice that can carry out your program for health and proper nutrition.
Please consider this. Thank you in advance.
No, no, NO, NO, NO!!!!
A white house Office on Wellness? Just what we need. Another 250 billion a year arm of government to make more do nothing regulations.
Improve food policy? Please.
Improve research? It’s not about research, it’s about research to maximize profits. They chase the buck.
You want to fix the system?
1) Give seniors vouchers for care. What doesn’t get spent, they get to keep. You’d be surprised how frugal the elderly can get.
2) Get rid of employer provided insurance. Provide vouchers for employees as well. Insurance is a scam and a pox on the public. It gives the profession every opportunity to overcharge for services because we don’t know what it costs. We don’t care what it costs. If there was no insurance, and people were paying out of pocket, or borrowing, and were personally responsible for the costs of their care, health care prices would plummet.
Health care is one if not the only service we pay for that we do not know what it costs when we go in. Only when you put the payment controls BACK in the hand of the consumer will you upend this system of fraud and corruption.
Dr. Hyman,
I have been in awe of you and your program to change the future of medicine ever since I heard your audio addressing a class at The Institute of Integrative Nutrition from where I graduated this past December. I am now a certified health coach of bio-individuality, and a raw food chef/teacher. I really love your program and I’m currently follwoing it to benefit my obesity and other issues. If I can show my family, friends and self that these changes really do work, then I will go out and seek clients who want to hear this message (because not everyone does). I am looking into a functional medicine doctor in my area to assist me, as well.
Thank you for all you are doing for the betterment of Americans who are sick and don’t even know they are! If I can do more for the cause, I certainly will.
Namaste, Dorothy
Thank you Dr. Hyman for initiating such vibrate and interesting commentary and discussions from all respondents. Certaintly and sadly, our present health health care system is really a medical care system based on the certainty that most individuals will one day get sick, develop a chronic illness or fatal disease. It sadens me that the most powerful country in the world limits access to health care based on whether or not a citizen can offord health care insurance. I believe in order for our system to serve our citzentry better and thus create a healthier socitey we must provide health coverage from cradle to grave with preventative services along the way. One way and pehaps the only way to improve health outcomes for all is to eliminate insurance companies who disguises as medical clinicians and create a single payor symtem which would remove a lot of the greed that is practice in our present system.
In direct response to Dr. Hyman’s nine-point plan, we need to first build on what is already at hand, the Affordable Care Act that will give millions of others access to health care, and next make sure that those who call the ACA the biggest health care tax in history do not repeal it. Putting a price tag on a human life is just plan unamerican and ungodly. After securing ACA, then lets get down to buisness improving it so that all US citizens may have a chance at the presuit of a healthier and happier life span.