Foreword

What follows is the result of my unexpected 22 year journey through the American healthcare system. The various roles I've held as a physician have yielded a surprising discovery: modern medicine causes more harm than societies realize. Why is modern medicine so harmful? Very simply, modern medicine lacks the accountability and incentives for producing the best health outcomes possible. Poor accountability and incentives have allowed the development of three major forces which worsen health.

     Now, you may say, "Modern Medicine is Killing You? Isn't that a bit of an exaggeration?" One statistic will make this idea more real. The Japanese experience a life expectancy of 82 years, which is 4 years greater than the life expectancy in the United States. To understand the significance of this seemingly small difference we must multiply the 4 years by the number of people in the United States, which is approximately 300 million. Relatively speaking, the Americans are losing 1.2 billion life-years compared to the Japanese!

     But what does this figure mean? We can break it down simply. For example, part of the 1.2 billion life-years shortfall could be explained by 5 million children who lost their lives before the age of 5 instead of reaching their potential of 85 years. This would account for 400 million life-years lost, calculated by multiplying the 80 years of life lost by each of the 5 million kids. Another 10 million adults might have died at 50 years of age instead of 90 and thus account for another 400 million life-years lost. Finally, 20 million 70-year-olds might have died when they could have reached 90 years of age, accounting for another 400 million life-years lost.

     Why were these years of life lost? Either society didn't do a good job of preventing the loss of life, the healthcare system failed to treat ailing patients appropriately, or the healthcare system actually worsened the patient's situation. This book explains how society and the healthcare system are failing you by not being held accountable for truly excellent outcomes. If you are an American, do not make the mistake of thinking this is only a problem for the uninsured. Regardless of your socioeconomic status, you have the possibility of being harmed by ineffective systems and incomplete awareness of the keys to health and healing. We're all in this together in more ways than you may realize.

     My medical roles have included: training as a medical resident, learning how to perform medical research, designing and conducting medical trials as a clinical scientist, leading a medical department, helping to build medical departments with different types of healthcare providers, and participating in various healthcare reform movements. I've been inside the healthcare system and can provide powerful examples of its most fundamental failures.

     The ideas in this book have been presented hundreds of times to a range of audiences, including consumers, medical students, medical residents, physicians, and even healthcare CEOs. This experience has allowed us to distill the ideas down to key concepts in plain language that will unlock the healthcare system puzzle for you.

     The average person without a medical background may be overwhelmed with the amount of available healthcare information. Many people are intimidated by medical decision-making and the healthcare system in general. Healthcare has seemingly become so complex. This book will provide you the tools and confidence to see through the fog and make intelligent decisions about your own healthcare as well as the healthcare reform debate.

     You only need a few key ideas or thinking tools to take control of your healthcare finances, healthcare planning, and the healthcare system itself. You will be surprised at how quickly you can become an intelligent partner in healthcare decision-making as opposed to simply accepting what your healthcare providers hand you. Your healthcare providers are flying more blindly than you realize! We are confident that you can be a powerful advocate for a revolution in the way the medical community delivers healthcare as well as a revolution in the development of your own healthcare plan.

     The current American healthcare reform debate is misguided because it ignores the stunningly poor performance of the American healthcare system. The debate also ignores the more fundamental causes of this poor performance. This book presents solutions for a broken American healthcare system that are derived from extensive evidence. We recommend nothing short of a restructuring of the American healthcare payment system as well as the implementation of powerful healthcare science and accountability infrastructures.

     Let's look at an analogy to understand how misguided modern medicine is. Imagine you are using a ladder to climb a wall as the paradise of wonderful health and healing is on the other side. How frustrating would it be to discover that your ladder is broken. Worse, someone keeps trying to knock you off the ladder as you climb it. Horror of horrors, you then discover that after all your effort to climb the ladder, the ladder was placed against the wrong wall! Instead of the paradise of health and healing, you are greeted by the desert of chronic disease! Such is the current state of modern and especially American medicine. In their current form, these systems are literally killing you either directly, or indirectly through inadequate care.

     A couple quick notes of clarification: We intentionally do not footnote the references within the text. The reason is to encourage you to study the other references in addition to the articles pertaining to a specific point. You will hopefully realize how much evidence lies behind our concepts. Additionally, this book will often to refer to "we", meaning the authors. Though I am the primary author, there are many who have helped with this work over the past decade, whether by listening to me or suggesting clearer ways to express the ideas. At this point, this is a collective work. Please refer to the Acknowledgments to meet some of my family and friends who have taken this journey with me. Hopefully by the end of this book, you will want to join us!

©2017 Life Ecology Org, LLC. ~ All material is the property of the Life Ecology Org, LLC. and may only be used with permission.