It’s a shame. Michael Jackson did not have to die.
At least not if our politicians had their way. Most of the major national health reform initiatives being shopped on Capitol Hill include two ingredients which might have prevented the King of Pop from accessing the deadly combination of prescription drugs that contributed and most likely caused his death last week. Interestingly enough, though not without controversy, these concepts (or at least much of the rationale behind them) enjoy fairly widespread support throughout the health insurance industry and on both sides of the political debate.
The first is the concept of a “medical home”, an idea that rose to prominence in recent years led by the American Association of Family Practitioners and The Future of Family Medicine Project published in 2004. The basic idea is that every patient has a “home” doctor-a Primary Care or General Practice physician-who serves as the focal point in directing the team of specialists and other providers utilized by the patient, and coaching the patient through the myriad of medical decisions they encounter throughout their treatment.
How could the medical home have saved The King of Pop? From the article “The Future of Family Medicine: A Collaborative Project of the Family Medicine Community” published in the Annals of Family Medicine (March/April 2004):
Through their medical home, patients can be assured of care that is not only accessible but also accountable, comprehensive, integrated, patient-centered, safe, scientifically valid, and satisfying to both patients and their physicians. (p.S14)
According to published reports, Jackson’s daily intake of drugs included Demerol, Dilaudid, Zoloft, Vicodin, Soma, Paxil, Xanax, and Prilosec.
Satisfying maybe, but accountable, safe, scientifically valid? Hardly.
The second element, strongly favored by President Obama and backed by $1.1 billion in Stimulus funding, is the more controversial “Comparative Effectiveness Research”. CER is based on the theory that, for many conditions, there are proven best practices that doctors should follow to achieve optimal health outcomes. While insurers and larger employers have long called for improved medical quality through the use of evidence based medicine, these guidelines are often cited by critics of government run healthcare as the hammer to ration care and dictate how doctors need to treat patients.
Think about how these guidelines, either enforced by a government run plan or put into elective use by his doctors, might have saved the King. Really, could there be any evidence that the most effective treatment for Jacko’s condition was a combination of Demerol, Dilaudid, Zoloft, Vicodin, Soma, Paxil, Xanax, and Prilosec???
He was a drug addict, no doubt. And can you help someone who doesn’t want to be helped? Well, that would depend on many factors, not the least of which is who controls the payments and what is the role of the government in overseeing (or dictating!) healthcare in the U.S. Both are subjects for another day, and let’s face it: do they truly matter anyway? After all, nothing can change the fact that the King of Pop is still dead.
But his dance moves live on forever. A link to some of MJ’s best dance moves.
Do what you will with the healthcare system – the MJ’s of the world will go outside of the US and get what they want. Those who can’t afford to leave will be left with what you carve out for us. Doctors did not kill MJ – poor decisions (Michael’s) killed him. Michael was a talented person who certainly would have known that those types of drugs are not to be taken lightly. He chose to continue on and take them. Our “national healthcare” won’t apply to those who have money – they will get the care that they want. It will however, add additional financial stress – how can we absorb the cost of healthcare without additional taxes? And many businesses are running too lean to afford any further taxation – and I think that would be where Obama would look for the money. (Which guess what: means more businesses will go under and more people will be unemployeed) He doesn’t seem as interested in requiring personal responsibility and buying the insurance that you need rather than the big screen TV or the jacked up car. Another thought – every thing that is nationalized stinks – why? no competitive or capitalist reason to improve or maintain a level of service. So – our car makers are most certainly not going to do a better job. I don’t want to “bail” out any more industries. So let’s leave MJs story where it belongs – in People Magazine or MTV or some other entertainment mag – another celebrity that burned out too quickly. Don’t try to make this a political piece.
BTW – I loved his music and am sad to see him go – much like I was sad when Elvis died.
You’re right Maggie, and don’t get me wrong-I am in no way in favor of a single government system. But it was PILLS-PILLS-and more PILLS that did him in. And I do favor a system with a single Physician paid and incented to review and coordinate his scripts and his overall care-his “medical home”. I doubt it would have had any impact in MJ’s case-where you have a will, a way and the wherewithall. But at least he would have have been forced outside of the system (i.e. the street) to feed his habit.
And for others who abuse within the system who don’t have the $$$, it would be more difficult to find their fix and might prevent a similar unfortunate demise.
Judy-
You raise a huge issue here regarding coverage for non-traditional holistic/naturopathic medicine. I have been in the health insurance business for 20+ years, and I cannot tell you how often the subject comes up and about how rarely coverage is provided. Frankly, I have no idea how/if any of the proposals being floated account for treatment and coverage-I’ll need to research a little myself.
As for the basis for CER, here is the link to the page with the draft definitions:
http://www.hhs.gov/recovery/programs/cer/draftdefinition.html
It really is about sharing data and following peer reviewed acadamic research on best practices for specific conditions. Here is a draft list of the conditions being suggested by the Institues of Mediucine (IOM)–go to page 80 for the listing:
http://books.nap.edu/openbook.php?record_id=12648&page=80
Based on the scope outlined so far, it is hard to imagine they will be promoting natural remedies anytime soon…
If you have the money and you surround yourself by “Yes” people, you’ll get anything you want.
The system is flawed but a perfect system won’t stop those that can afford to bypass it from abusing it or dying.
Maggie, I respect your love for Michael with your comment but frankly an unhappy childhood and media spotlighting doesn’t “kill” someone. The bottom line is he was a drug addict and yes the healthcare system could have prevented this by restricting his prescription drug intake. To Bill’s point, the system is flawed because it allowed him to have many doctors therefore gaining access to all their “prescription power”. If Michael had an established “medical home”, he would have been treated as NECESSARY. Big Robby, you’re right it’s not an isolated case but something tells me you and I couldn’t go to our family doctor and get scripts for Demerol, Dilaudid, Zoloft, Vicodin, Soma, Paxil, Xanax, and Prilosec. Regardless, he will always be the KING!
Does “evidence-based medicine” include alternative and complementary methodologies based on a tradition of observation and citation? Or does it only include science that tends to be biased toward financial reward? If we maintain the current medical model, evolving as it is away from the expertise of trained physicians(as limited as it is to diagnosing symptoms and prescribing pharmaceuticals or surgery)to the “expertise” of science in prescribing the same, we are perpetuating a system that has proven not only unsustainably expensive, but ineffective at best and deadly in alarmingly increasing statistics. If I am forced, as I understand I may be, to buy medical insurance, be sure that it allows me to visit a chiropractor, an acupuncturist, and others who contribute to my high level of health at the same deductibles as for physicians who, by their very training and propensity, must wait until my health is threatened by disease before they can begin to either understand or act. And be sure that any medical system that we move to recognizes the dangers of forcing democratic citizens from medical practices they deem dangerous or unacceptable.
It wasn’t our healthcare system that killed MJ…it was MJ himself, along with his abusive father, his unhappy childhood, the intense media spotlight, mental illness, and the power of money. Federal mandated healthcare would have done NOTHING to prevent this.
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I think that man has been on a path of destruction for a long time. If it wasn’t the pills, it would have been something. Some people seem like they were born to live fast and die young. The US healthcare system kills thousands of people every year, I don’t think MJ is an isolated case.
Hi Kate-
You’re right-it seems he was “Off the Wall” and practicing what he preached, but just couldn’t Stop til he got enough…I guess in his compromised mental state he couldn’t decipher when that was…
It does seem like the mental health/illness issue always gets relegated in the debate- we’ve heard for years about the role that mental health plays in a persons relative physical health, like John Grohol’s take here: http://psychcentral.com/blog/archives/2009/02/25/the-connection-between-mental-physical-health/
Given his obvious addictions and the fact that he weighed less than 120 lbs, it seems unbelievable that his Doctor couldn’t intervene in time. But he’s not the first, and won’t be the last…that’s Hollywood!!
Bill- As Michael would have eloquently sang,”one bad apple don’t spoil the whole bunch!!!!” It is obvious to this healthcare practitioner that his doctor aka “quack” should have had his license to practice pulled years ago… Then again it is America, and if you can afford it, you can buy it!! It is a tragic end to a man, and frankly his demise came as no real surprise to me… Until the insurance companies truly focus on coverage for psychiatric/addictive illnesses, we as a nation will never overcome these issues!!