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For some, the dichotomy between the conventional medical approach and Self-Managed CareTM seems clear; but in fact, informed Managed Care leaders are among the most pro-active advocates of Self-Managed CareTM. They want individuals to take more responsibility for their own health and well-being – to seek healthier lifestyles and to embrace effective alternatives to clinical health care. This approach, they know, is both more cost-effective and more likely to generate beneficial results for patients … and reduce costly demand on the system.
Managed Care systems evolved in response to out-of-control rises in the costs associated with medical and hospital care. Business and government, through insurance, were the ultimate "providers" of this care – but they were not in a strong position to moderate and mediate soaring prices. Managed Care organizations, by using volume-purchase and sound business negotiations, were able to mitigate the worst of the rising costs – but at a price. The price was individual freedom, individual choice, restricted and regulated through controlled access and capitation.
Managed Care has evolved into a system that controls cost by controlling access to care. Self-Managed CareTM is an approach that balances this approach by promising to control costs by reducing demand for costly and unnecessary services – by empowering the individual with knowledge needed to remain healthy, to manage illness when it occurs, and to promote recovery before expensive medical intervention is required. Of course, the greatest benefit is that individuals will feel better and have a higher quality of life. When that doesn't work, HealthWorld Online stands ready to assist individuals in finding the most qualified health professionals to match their needs, and effectively treat their illness or disease. Together, Managed Care and Self-Managed CareTM can work in PARTNERSHIP, helping individuals to achieve the highest level of health at the lowest practical price – and with the greatest personal freedom and choice.
Repositioning of Health Care
Earlier this century patients were treated in a humane manner. Today, due to the influence of technology and financial incentives, physicians have come to view patients in a more mechanistic manner. Even before the advent of Managed Care, the increasing "business" orientation of many physicians – an orientation they began learning in medical schools in the '60s and '70s – began putting a distance between what patients expected and physicians delivered. This trend only increased as the focus of healthcare shifted from personal care to cost control. As Managed Care has sometimes failed to meet the real and perceived expectations that they should promote improved health, preventive care and wellness, the managed care approach has lost its luster. The media, always a mirror on society, has recently shifted coverage away from managed care's effectiveness in controlling costs and toward managed care's seeming inability to provide for the real health needs of individuals. In their minds, the public has "positioned" managed care downward – to hold it in less esteem.
People yearn for the 'good old days' when doctors spent more time listening to their patients than ordering complicated tests and procedures.
At the same time, individuals in huge numbers have turned to alternatives or complementary approaches to Managed Care, with its emphasis on costs and its need to control access to care. These individuals have sought out natural, traditional alternatives – chiropractic, acupuncture, naturapathic, and many more – and in the process, they have repositioned this alternative care system upward.
According to the World Health Organization, 65% to 80% of the world's health care services can be classified as alternative -- although the preferred term outside the United States is 'traditional,' since most of these approaches derive from ancient practices.
By choosing these alternatives – and by paying themselves, when the insurance system failed to keep pace with their needs and demands – individuals have given natural, alternative health care a higher regard. As a society, we have become more open in the '90s to alternatives to conventional medicine than we ever were in any previous post-war decade. In fact, alternative healthcare services now account for 35-50% of all health services delivered in America.
In the end, we the citizens, or the payers of healthcare, are consumers who can learn to act in their own interests to control costs, and who ultimately constitute the strongest interest group. Moreover, the proposals and goals of wellness and prevention are not anti-medicine: rather, they are in the tradition of a profession devoted to improving health. Ultimately, a service profession must applaud this initiative – and many, if not most physicians already support this strategy.
New England Journal of Medicine, July 1993
As a set of disciplines, alternative health care practices (traditional health care practices from around the world) has taken advantage of Managed Care's failure to provide access to the information and answers individual consumers have demanded for themselves and their families. By creating an information vacuum, the conventional medical system has led people away from their temple, and toward the new paradigm.
Grass-Roots Response
Individuals reacted to this information vacuum, not by opting out of Managed Care systems, which do provide many valuable, even essential services – including acute and traumatic health care services – but by also opting into a parallel, alternative system that provides them a much broader range of services, information and options.
As a result, there were far more visits last year to "natural and alternative" health practitioners than to medical doctors. According to a study published in the Journal of the American Medical Association, more than 80 percent of visits to natural and alternative practitioners in 1990 were paid for out-of-pocket by patients who also participated in a Managed Care system that met some – but not all – of their healthcare needs. Clearly, the ground was being laid for a consumer-driven Self-Managed CareTM system. The movement has already started. But why?
The Issues Facing Health Care
Even with the stringent cost controls imposed by private and governmental Managed Care systems, the cost of conventional healthcare is astronomically high – and in spite of these controls, those costs are still growing at a rate 50% higher than inflation.
In this "disease management" system – what one former U.S. Surgeon General referred to as the "sick-care" system – it seems there are no more cures. Instead, doctors seek to "manage" health "conditions" and "disorders." The typical biomedical model views the patients as a passive, silent biological organism – an unfortunate outgrowth of the sound, scientific system of "double-blind" studies designed to reduce or eliminate all dependent variables – such as personal needs, wants, desires and choices. This unfortunate negative result of a well-intended focus on scientific medicine leaves individuals with unmet needs – and a pent-up demand for answers that conventional medicine is not prepared to give them.
The answers no longer rest in technology – they rest in lifestyle. Today, 70% of diseases and medical conditions are lifestyle-related. If people seriously want a higher level of health, they have to first look within – then seek answers in nutrition, fitness and spiritual health – areas in which conventional physicians are singularly ill-prepared by training and philosophy to deal.
Those who feel – rightly or wrongly – that they have to challenge the system just to receive the care they need, want and believe they deserve – are understandably anxious to find a better way – a way that leaves them in control of their own health and destiny.
Health - What People Want
People do not want more "medicine." They want health and a higher quality of life. Over the past decade, medicine – like so many other icons of the middle decades of this century – has lost its luster. People want HEALTH – they are making the transition, individually, from sick-care to well-care; in doing so, they have created the demand for information and integration that makes HealthWorld Online both inevitable and essential. People want the knowledge, the information – the Power – to know how to proceed, and when to seek out natural cures and healing, ways to enjoy a higher quality of life by living the "wellness lifestyle" that prevents illness – or, when appropriate, qualified orthodox medical professionals.
Self-Managed CareTM
A sensible system of Self-Managed CareTM – one that focuses on achieving and sustaining health, rather than on managing disorders – is a viable and supportive adjunct to the evolving Managed Care system. Managed Care is resource-driven – and therefore inherently focused on restricting access. Individuals receive care only when others decide they need it badly enough.
Self-Managed CareTM, however, is demand-driven and access-friendly. When individuals need or want health information or services, they seek out the most effective alternatives available. If – and only if – those alternatives prove ineffective, they can then seek out conventional medical authorities.
Self-Managed CareTM is:
- Primary – not Secondary or Tertiary – Care
- Information-Friendly
- Demand-Driven
- Non-Invasive
- Non-drug oriented
- The First Choice
- The Individual is #1
- The Individual is not a Patient, but a Consumer
Self-Managed CareTM has been validated by hundreds of years of personal practice, supported by an increasing body of clinical research. Today, for instance, one of the fastest-growing segments of the Pharmaceutical field involves researching and validating native and folk cures – then synthesizing the bio-active agents in natural cures and bringing them to market.
Conventional medicine doesn't usually recognize the value of the "placebo effect" in improving an individual's health. Instead, that system validates measurable, reproducible results, and in doing so, misses the benefits offered by the individual's self-healing abilities. Self-Managed CareTM, however, embraces the placebo as a necessary and natural part of healing. If a person's knowledge or belief that a treatment really works actually accelerates the healing process – which is all the placebo effect is – most individuals welcome this synergistic benefit.
Given the opportunity and the resources, our bodies will, in fact, heal themselves of many diseases or injuries – as if inside each one of us is an "internal physician." Much of conventional medicine – and almost all of natural and alternative health care – is actually focused on achieving an inner balance that will permit self-healing. For individuals, improved health and greater sense of well-being – not clinical measurements – are what really matters.
The focus of Managed Care is to achieve a level of stability – to mitigate a condition that in many cases cannot be cured by conventional means. The goal of Self-Managed CareTM is to enhance the quality of life, to achieve wellness rather than just alleviating illness.
Because improving health often requires behavioral changes, and peer pressure can be a powerful force for health. Peer pressure has a major impact in encouraging the kinds of changes that are part of Self-Managed CareTM. Just as peer pressure has, in the last decade, made public smoking and public drunkenness – especially drunk driving – unacceptable, so too can peer pressure in a Self-Managed CareTM system work to reduce or eliminate many of the lifestyle-threatening practices that lead to disease – and death.
Integrating Conventional And Natural Health
This is an uniquely American problem. The United States is the only country in which "conventional" Western medicine holds a recognized, dominant position over more traditional, natural alternatives. In Europe and elsewhere in the developed world, homeopathy, herbal therapy and other natural forms of care are honored – and integrated into the holistic approach to healing practiced by MDs and other practitioners, without competition or over-regulation.
Hippocrates, the father of Western medicine, certainly knew that there is more than five millennia of healing knowledge and experience behind many of these natural traditions – the lessons of those years are overlooked only by those too focused on the technological future to learn from the past.
One problem in integrating conventional medicine with the more traditional natural healing disciplines is that natural health practitioners tend to be mavericks and entrepreneurs – by having been forced to buck the medical establishment, they have become naturally reluctant to come together into a unified, multi-disciplinary group. Until now, that has limited the ability of those who want to create synergy by integrating the various disciplines. However, the Internet – and more specifically, HealthWorld Online – offers the means of bringing together a multitude of views, disciplines and traditions under one "roof."
Under HealthWorld Online's synergistic umbrella, these diverse groups can collaborate – sharing information and integrating various disciplines. Together, on the information-sharing platform that HealthWorld Online has created, these natural disciplines stand as a Self-Managed CareTM partner, shoulder-to-shoulder as an equal partner with the conventional Managed Care medical establishment.
HealthWorld Online: The Key To Self-Managed CareTM
HealthWorld Online is as essential to a functioning system of Self Managed Care as a hospital is to a functioning Managed Care System. HealthWorld Online is the place that people come to find the integrated, accessible information that will empower them to make the personal choices that will aid them in achieving real health.
This electronic collaboration is only possible through an online service like HealthWorld Online, which brings Self-Managed CareTMTM right into individuals' homes, through their personal computers. On HealthWorld, individuals can compare various disciplines – seeing different answers to the same problem or opportunity – then make the choices that most nearly fit the lifestyle they wish to embrace. Along the way, by not limiting themselves to a singular approach – no matter how effective the approach may be – they move toward real health, real healing. Real personal power can begin to change their lives – and their health.
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