We’ve lost the “health” in healthcare; can we get it back?

• Is your health not where you want it to be?
• Are you getting less healthy as you get older?
• Is the cost of health insurance taking a bigger bite out of your paycheck?

If you answered “Yes” to any of these questions, this blog is for you.

Americans are less and less healthy while spending more and more

Fact: Americans continue to get less healthy despite paying more and more to their “health” insurance company.

Proof: The 2016 Commonwealth Fund report: the shortcomings of the U.S. healthcare system have not improved over the past 15 years: we continue to pay far more for our medical care when compared to the 10 other richest nations of the world.

“In comparison to adults in the other 10 richest countries, adults in the United States are sicker.”

Further proof: March 2018 report in JAMA (Journal of the American Medical Association) compared U.S. health statistics with those of the highest income countries of the world and found the American healthcare system fares quite poorly.

The U.S. spends far more per capita on healthcare when compared to other countries, but has less in healthcare outcomes to show for it.

What is health? How is it defined?

The World Health Organization’s definition of health moves away from older definitions citing health as merely the absence of disease, and toward a dynamic model:

Health is: “The extent to which an individual is able to realize aspirations, satisfy needs and change or cope with the environment.”

The attainment of health is not about the suppression or masking of symptoms, but instead, the restoration of optimal function such that you are able to achieve your goals, desires, and aspirations.

• Are you ideally healthy?
• Does your body have effortless energy and mental clarity, all day, every day?

If you are like most people in America, the answer to at least one of these questions is “No”.  You are not alone; in fact, you represent the majority of Americans.

Of course, this shouldn’t be the case if our healthcare system was designed to bring about the result of ideal health.

Is your optimal health the intention of your health insurance company?

What is the purpose of health insurance?

According to Health Insurance Basics (2007), the purpose of health insurance is:

1. to facilitate access to health care, and
2. protect you and your family from catastrophic health expenses.

If we put the definition of health together with the purpose of health insurance, it would result in health insurance companies facilitating your access to doctors and services that reverse disease.

I think you’d agree, your insurance company doesn’t do this. They should facilitate access to doctors and healthcare that achieves true health as we have defined it above. Instead, they only allow you to receive the type of healthcare that increases their profit.

A real-life example

You’re a 47-year-old overweight woman with type 2 diabetes. Your health insurance company will pay for you to see a doctor that provides you insulin, a drug that increases inflammation, ramps up your risk of developing heart disease, and will contribute to weight gain, exactly what you don’t need when trying to fight diabetes.

The drug therapy will attempt to “manage” your symptoms but they will worsen over time, as will your overall health.

Your insurance company will pay for the doctor giving you dangerous drugs. Does that make it the right thing to do since they’re paying for it?

Insurance companies work against doctors that reverse disease naturally

Your insurance company adamantly opposes and will not pay (much of anything) to the doctor that can naturally reverse your type 2 diabetes. If you’re compliant with the natural approach, within a matter of a few weeks you can have reversed your type 2 diabetes with no drugs.

This has been proven repeatedly by research.

Your insurance company won’t pay the doctor naturally reversing your disease. Does that make seeing that doctor the wrong thing to do?

Our “sick-care” model isn’t working

Did the above scenario sound ridiculous? Unfortunately, it is exactly the “healthcare” (more like “sick-care”) model we are stuck with.

Your insurance company is NOT facilitating your access to the healthcare practitioners who actually reverse disease.

As Americans, we assume that our insurance company knows what’s best for us. We believe they have our best interests at heart. If they approve a treatment that must mean it is the correct and safe thing to do.

If they disapprove of a treatment, that must mean it doesn’t work or is somehow dangerous.

Insurance doesn’t support programs that reverse degenerative disease

Research studies that have proven time and time again that type 2 diabetes and heart disease is reversible with a natural program of diet and nutrition, has made no impact on your insurance company supporting such programs.

Why doesn’t your insurance company support doctors who can naturally reverse degenerative disease?

Why?

You know the answer, don’t you?

Raise your hand if you thought it was for financial gain.

You’re right.

As I’ve been researching insurance companies in the past few months, I’ve asked many patients and lecture attendees about this very question. Most appear to know that financial motivation drives your insurance company, not your optimal health and well-being.

If a treatment doesn’t require drugs or expensive medical procedures, your insurance company will definitely not support it. They will instead rally against it. This statement may sound harsh but I prove the truth of it in this blog, “5 Ways Insurance Keeps you in Poor Health While You Pay More”.

We have never been a part of any insurance network

Here at Root Cause Medical Clinic, we’ve never been a part of any insurance network. We didn’t want to be in a contractual relationship where your insurance company could dictate how much care you could receive.

We want to correct your problem, not just put a temporary band-aid on it.

You may not realize this, but an in-network doctor does not have the freedom to deliver to you what you actually need. If your insurance company cuts you off, that’s the end of it. Even if you wanted to pay for care yourself, your doctor is not legally able to accept any payments once your insurance company has deemed care unnecessary.

Being out of network, care can still be deemed unnecessary, but it’s not illegal for us to continue to treat the patient if they want care.

We realized last year with Cigna that no matter what was wrong with a patient, Cigna had the same cut-off point for visits. Complex cases doing well under care were denied further coverage despite their improvement and obvious need for more assistance.

Family of a cancer patient isn’t allowed to pay for their mother’s care – it’s illegal, their doctor explains

A friend of mine’s mother was recently diagnosed with cancer. She has insurance and her doctor recommended 3 rounds of a certain medication. After much cajoling, the insurance approved 2 rounds. The doctor told my friend, “that should be okay”.

My friend persisted, however, reminding the doctor that he originally recommended 3 rounds. He reluctantly admitted that he did want 3, but the insurance wouldn’t allow it. My friend volunteered to pay for the third round herself but was informed she couldn’t – “that’s illegal”, the doctor said.

Hopefully, it now makes sense why we’ve never chosen to be an in-network clinic.

Insurance is for crisis care, NOT health care

We need to adjust our thinking: Health insurance is predominantly for crisis care. Utilizing the services they pay for is not going to make you healthy.

You’re going to have to do that on your own.

When it comes to the degenerative diseases killing most Americans your health insurance company is not going to steer you in the right direction. In fact, they are banking on your ill health to continue to feed their profit margin. If that sounds like an exaggeration, read this blog where I prove it: “Is Your Insurance Company Making You Healthier or Keeping You Sick?”

Do you want to reverse the chronic disease or just manage it?

Which one would you like?

• Drugs will manage your symptoms while the underlying cause worsens.
• Root Cause Medicine can reverse chronic disease.

Your health insurance doesn’t want you to reverse your disease, therefore they won’t pay (much) for Root Cause Medicine. 

Read my earlier blogs in this series here and here for the proof.

We need to “get past” the notion that if your insurance company doesn’t pay for something that means you shouldn’t do it. Just the opposite is true.

Root Cause Medicine – true health care that reverses disease

Do you want to get truly healthy? Find a practitioner who can get the job done whom you trust.

If you want the best care, be ready to pay for it. Your insurance company won’t.

Would you agree that nothing is more important than your health?