10 Tips to Optimize Your Healthcare Consumption
Healthcare is an industry just like any other. Doctors, hospitals, pharmaceutical drug makers, medical device manufacturers, and all the associated software and equipment companies are in business to make money. You are the consumer.
When you need a plumber or some house repairs you probably do some research, shop around for a good price, and maybe see if there is part of the job you can do yourself. If you’re particularly discerning, you’ll get a second opinion on what the problem is and how it could best be addressed. Shouldn’t we be doing that with our health?
Profits Come First
Health care spending in the United States was $4.5 trillion in 2022 which equates to over $13,493 per person according to the Centers for Medicare and Medicaid Services. Nearly 30 percent of this spending comes from private health insurers and 11 percent ($471 billion) is out-of-pocket costs paid by you, the consumer. While we can be lulled into thinking our doctors and the products they recommend are altruistic in nature—focused on making us well—health care is one of the most profitable industries in the world.
A 2020 study published in the Journal of the American Medical Association, compared the profitability of 35 large pharmaceutical companies with over 300 companies in the S&P 500 in other industries. It found the 35 pharmaceutical companies earned a gross profit of $8.6 trillion on revenue of $11.5 trillion, a margin of 76.5 percent, while the combined profit margin of the other companies was a more reasonable 37.4 percent. The companies that make the tests, testing equipment, and medical devices, or run the clinics and hospitals, also have shareholders that they report to and need to provide a return for. The outcome on your health is not at the top of their list.
Your Health Plan Is Part of the Problem
Health insurance was invented in the mid-20th century to help patients cover the cost of the new treatments and tests that were starting to emerge such as X-rays, insulin, and elective surgery. But in order to keep premiums affordable only certain procedures were covered—which started to influence how medicine was practiced. You are more likely to opt for the treatments that are covered by the insurance policy you have already paid for rather than independently assess what is best for your long-term health.
The optics of health insurance also propagate the myth that the more modern and costly tests and treatments must be superior to hundreds of years of common sense and wisdom. But this is often not the case.
Here are some examples of treatments promoted by your doctor or health plan that evidence shows can be equally or better handled yourself:
Your doctor puts you on a statin medication simply because a blood test indicates your LDL (low-density lipoprotein often incorrectly referred to as “bad cholesterol”) is higher than considered optimal. As outlined by Dr. Aseem Malhotra, a world-renowned cardiologist, in his book, “A Statin Free Life”, the benefits of statins for most people have been heavily exaggerated and their significant side effects downplayed.
You’ve been diagnosed with an autoimmune condition—maybe multiple sclerosis, rheumatoid arthritis, or Crohn’s disease—and your doctor prescribes a high-cost drug such as Humira (brand name for adalimumab) when the potentially serious side effects outweigh the benefits for most people.
You’ve had a general malaise, poor appetite, not sleeping well, not enjoying usual activities. Your doctor has diagnosed depression and put you on one of the popular antidepressants like Prozac. However, there are many potential root causes of your symptoms such as nutrient deficiencies, a thyroid condition, an impaired microbiome, and even an infection from mold or a parasite which are hard to detect with standard tests. Taking Prozac will only cover these up and lead to more problems.
You are considered diabetic or pre-diabetic and your doctor has put you on one of a range of drugs to better control your blood sugar—again exaggerating the benefits of such medications and downplaying the long-term side-effects and prognosis. You are unlikely to be told of the studies indicating the cheap supplement berberine may be just as effective as the pharmaceutical drug Metformin or how lifestyle changes can completely reverse diabetes.
The Efficacy of Diet and Supplements
The human body was perfectly designed to interact with the natural world.
When sunlight hits our bare skin we synthesize vitamin D which is involved in hundreds of functions in our body including immunity, strong bones and teeth, reducing inflammation, and regulating cell growth and repair.
The nutrients we take in from natural whole foods are critical to good health.
The microbes living in and on our body (known as our microbiome) are involved in the manufacture of hormones, regulating our metabolism, and optimizing neurological functioning. Pharmaceuticals can kill off our friendly microbes and can also induce a deficiency in certain nutrients throwing our bodies further out of balance. By contrast, improving the quality of the food we’re ingesting and supplementing with high-quality vitamins and minerals, can completely reverse disease.
Other lifestyle factors are important too, such as getting adequate sleep, moving our bodies regularly, and drinking plenty of clean water.
Most doctors aren’t taught the efficacy of these modalities in medical school and aren’t likely to recommend a solution that doesn’t require their ongoing services. You may prefer to take a pill rather than make lifestyle changes, but at least make that decision with all the available information.
10 Tips to Becoming a More Discerning Consumer of Healthcare
Choose the Right Doctor. Your health plan will encourage you to pick a general practitioner to oversee your care and direct you to other resources. Use filters such as “integrative” or “functional” in your health plan network database to ensure your doctor is qualified beyond prescribing pharmaceuticals. The Institute for Functional Medicine is also a good resource.
Act on Early Warning Signs. It is much easier to reverse a condition when caught early. Monitor your own health regularly including blood tests once a year. You don’t always have to go through your doctor or health plan. Grassroots Labs is just one example of low-cost blood tests that anyone can order.
Optimize Your Use of More Advanced Testing. Government guidelines based on age are over-generalized and influenced by industry motives. Use the Choosing Wisely organization's resources to understand what tests make sense for you and which do not. There are safer and better alternatives to mammograms and colonoscopies for example.
Research Any Formal Diagnosis. If you are diagnosed with a condition, do not take your doctor’s word for it or their proposed solution at face value. Do some research: PubMed, The Epoch Times, or GreenMedInfo are great independent sources. Google is not! Get a second opinion where possible. Particularly from a different type of doctor—see point number one.
Know Your Drugs. If you are on a prescription drug, research its side effects thoroughly at PubMed—especially what nutrient deficiencies it may induce. Investigate natural therapies that may be just as effective—if not more so.
Surgery Is Never Routine. The human body has an amazing ability to heal itself when given the right support. If surgery is recommended, ask plenty of questions including, “What happens if I wait a couple of months?” Get a second opinion if necessary. If you are rigorous in your lifestyle changes you just might avoid surgery altogether. Cutting into your body and subjecting it to the range of chemical drugs that would be involved in the procedure and recovery, is a major insult to your health and wallet.
Explore What Your Employer Offers. If you work for a company, make sure to investigate the health and wellness options available. Many employers now offer alternative solutions beyond the basic health plan with subsidized programs to reverse diabetes, address musculoskeletal problems without surgery, get at the root cause of autoimmune conditions, and more.
Allocate Your Healthcare Budget Prudently. If you have the option of various health plans, it’s often more cost-effective to select a high-deductible plan or emergency-only coverage to give you more freedom to use solutions deemed “alternative.” You can also improve your diet and lifestyle to reverse current disease and keep you healthy long into old age. Remember the saying “It’s better to pay the farmer than the pharmacy.”
Re-think Preventive Care. Prevention is always the best approach to limit your need for healthcare services. This does not mean flu shots and statins. It means focusing on putting wholesome food in your mouth that will nourish your body, including a supplement routine to meet any nutrient deficiencies, drinking plenty of clean water, incorporating exercise or regular movement into your day, and maintaining a positive mindset boosted by healthy human interactions.
Take Responsibility for Your Health. You know more about your own body than anyone wearing a white coat or with any number of professional degrees.
Putting these tips into action can drastically change your relationship with the healthcare industry. No longer will a new symptom cause you to expect an expensive solution which often leads to procrastination—you may put off going to the doctor or getting an assessment of the problem. However, the earlier you intervene, the simpler the remedy is likely to be, and the quicker you can get back to good health.
Viewing yourself as a consumer of healthcare services that are optional puts you in the driving seat to better health.
If you’re in a car accident or having a heart attack then there is no substitute for emergency healthcare. But any condition that is not immediately life-threatening can be addressed in a myriad of ways.
It’s important to adjust any view of the professional in the white coat knowing more about your body than you do. They are simply human beings who have undergone a particular mode of study, usually focused on pharmaceuticals and surgery. Their recommendations are suggestions based on their assessment of the situation with the tools at their disposal.
To be better consumers we need to take ownership of our health—which might involve a bit more work than popping a pill—but is likely to have a far greater outcome on our overall health, longevity, and quality of life.
This article first appeared in The Epoch Times but is now public on Substack so feel free to share it.
About the author: Emma Tekstra is a Fellow of the Institute of Actuaries, an independent health researcher, and author of “How to Be a Healthy Human; What Your Doctor Doesn’t Know About Health and Longevity.” With a 30-year background in employee benefits and corporate health and wellbeing, she consults with employers looking for real solutions to runaway healthcare costs, and to startup companies bringing health solutions to market. Read more at About page.
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Thanks. I've saved the article for the next time I might think I need a doctor.