Taking Care

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The issue discussed here is a simple one — but one which has far reaching implications with regard to good health and medical costs.

Take care of yourself.

We hear much talk about preventive care but nobody has really defined it well. Tamzin Rosenwasser, M.D., past president of the Association of American Physicians and Surgeons (AAPS), deduces that what the health bureaucrats actually refer to would be better characterized as “early detection.” Early detection is what occurs when a physician finds a disease in its early stages that might have been prevented by earlier measures.

But who can take those earlier measures? Only the patent is living his life. The doctor cannot live life for him.

Prevention lies entirely in the patient’s realm as the physician can only advise. Not even the most conscientious patient can prevent all disease and injury. The physician can do nothing to forcibly prevent medical problems unless the patient is reduced to the equivalent of a ward of the state.

Physicians do warn of problems that may arise if the patient does not take action to avert them. Dr. Rosenwasser observes that very few patients – who are counseled about the risks of smoking, excess alcohol, sun and tanning beds, sedentary lifestyle, unhealthy diets, and harmful drug use — follow the physician’s advice. Some patients openly state that they will not do so, while others are observed not to do so.

When government usurps that responsibility, patients are more likely to abdicate theirs. That has happened with Medicare and Medicaid. The taxpayers are stuck with paying for the medical care of strangers. People who don’t have to worry about the bills may be more willing to take the risk of getting skin cancer on the golf course, or hepatitis C from IV drug abuse, or lung cancer from smoking — instead of using sunscreen and clothing, not abusing drugs, or quitting all smoking. They are comfortable with spending someone else’s money to care for problems they could have prevented with their own efforts.

This dependency is part of the unconcern with preventive care that takes any personal effort by the patient. Much of life is maintenance, including maintenance of one’s own health. Should the physician, and strangers, care more about someone than he is willing to care about himself? Where would this burden ultimately end?

The founders of our nation constructed a Constitution, which is permanent because it takes into account an unchanging verity: human nature is immutable.

The moral corruption that accompanies allowing one person to sponge off another is mirrored in biology. If a person is treated long enough with high enough doses of prednisone his adrenal glands will stop making the equivalent steroid. If the prednisone is stopped suddenly the patient may die of adrenal crisis because the adrenal glands will not start working again quickly enough.

No society can be healthy when citizens refuse to take the steps necessary to keep themselves healthy. Physicians are doing what they can to detect disease early, but they cannot do the patients’ job of preventing the problems that arise from behavior such as smoking, excess drinking, dangerous drug use, violence, carelessness, sedentary lifestyle, poor diet, sexual promiscuity, and ultraviolet exposure.

If patients refuse to do the job of prevention should we let them suffer the consequences by themselves? Or should we force the entire society to pay the bill and suffer the consequences of the total loss of liberty at the hands of a dictatorial government.

That is a price we should not be willing to pay.

Michael Arnold Glueck, M.D., of Newport Beach writes on medical-legal issues locally and nationally.

 

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