Healthcare or Health Harm?

Photo courtesy Deutsches Bundesarchiv, Wikimedia Commons

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A commentary by two doctors in the current Journal of the American Medical Association suggests that it’s time to differentiate between healthcare and health harm. Although the data are imprecise, the authors suggest the benefits delivered by US healthcare may not outweigh the aggregate harm imparted.

In other words, you can never have too much health. Yet your health can be harmed by the overuse of medicine or by the costs of funding healthcare.

How does that work? First there’s direct harm from healthcare, including adverse physical and emotional effects from all the usual stuff associated with everything from excessive use to misdiagnoses to conflicting treatments.

Second, the authors suggest, there’s indirect harm. This comes from the fact that healthcare costs increasingly divert resources from education, jobs, and environmental quality—all important determinants of your health.

Healthcare’s objective should be to improve health, they say. Yet its primary emphasis has been on producing services. And fee-for-service payments tend to encourage the use of more treatments, new technologies, and extra testing. These additional services and their costs can actually harm health.

The fix? To begin with, study health harm to improve healthcare. Specifically, we need to understand the tradeoffs involved in healthcare interventions and expenditures in order to guide healthcare reform efforts. While more people need access to healthcare, that’s not enough. Healthcare reform needs to improve how medicine is practiced: centering it on patients, organizing it around primary care, and curbing health harm, including excessive healthcare use and spending.

How about this Rx: Fewer drugs, cleaner water, better air, healthful food, more exercise, education, jobs… 
 

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THE BIG PICTURE

You expect the big picture, and it's our job at Mother Jones to give it to you. And right now, so many of the troubles we face are the making not of a virus, but of the quest for profit, political or economic (and not just from the man in the White House who could have offered leadership and comfort but instead gave us bleach).

In "News Is Just Like Waste Management," we unpack what the coronavirus crisis has meant for journalism, including Mother Jones’, and how we can rise to the challenge. If you're able to, this is a critical moment to support our nonprofit journalism with a donation: We've scoured our budget and made the cuts we can without impairing our mission, and we hope to raise $400,000 from our community of online readers to help keep our big reporting projects going because this extraordinary pandemic-plus-election year is no time to pull back.

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