• Kosta Shilev

Free Healthcare Reform We Really Need


You may have heard of recent healthcare reform in the US. Underestimation implied. You may also have heard dissent from the general public to this reform. Underestimation heavily inferred. Honestly, as a passionate advocate of many things, I do my best to avoid political debate if at all possible... but when it comes to healthcare I have some thoughts. Beyond these thoughts, I have a reform policy of my own and I’m going grassroots with it (I’m still waiting for the White House to return my call). It’s a 4-point plan, it applies to nearly everyone in some way and the main thing... it’s FREE for all. No deductible to meet, no co-pay or co-insurance collected and open to every single individual willing. Sounds too good to be true, right? Well frankly, it is... because it’s a reform most of us have turned our back to for decades. So at the risk of being a zealous extremist, I offer the reform the US really needs to decrease healthcare cost and implement true change.

1) Exercise – For the eye-rollers out there, I’m not suggesting we all train for a marathon in the spirit of improved fitness. I’m talking 30 minutes of continuous “movement” everyday... did it sound easier when I removed the word “exercise” from the sentence? Honestly, the sedentary nature of our culture has gotten a little ridiculous. Sitting is the new smoking, right? We sit at work, in the car, at home; then we sleep and recover to prop ourselves back up into the same position again the next day. Movement is exercise if done at even moderate intensity and continuously for 30 minutes per day. Gyms are awesome, but exercise is free. Take advantage.

Suggested reform – Minimum 20-30 minutes of continuous movement 5-6 days/week with increased duration as able.

2) Sleep – OK, I realize I just told you all to get moving, but sleep is as important as any other component of health. I’m talking immune system, musculoskeletal system, cognitive function and emotional health. Vitamin Zzz shouldn’t be overlooked... plus, guess what? It's free folks!

Suggested reform – 7-9 hours of sleep per night depending on age and activity/stress level.

3) Water – It’s one of the substances vital to our function and the majority of us are running on a ¼ tank. Our bodies are over half water. Hydration is paramount for cardiovascular regulation, brain function, joint/muscle utility and overall health. Here’s a suggestion... replace a 12-ounce cup or bottle of water for that soda. Then repeat five times per day. You’re actually saving money and!

Suggested reform – Eight 12-ounce servings of water, ideally replacing sugared beverages.

4) Posture – If I sound like your mother telling you to sit up straight, good! With the “sitting epidemic” I alluded to earlier, posture has to be among the top musculoskeletal deficiencies on a consistent basis that we can improve. Again, kind of like smoking being the main preventable death. Maybe poor posture isn’t the straw that herniated the camel’s disc, but guaranteed it is the main contributing factor. Meaning, you’ll blame that box you lifted for “throwing your back out”, but it was the years of sitting at your desk that predisposed you to it. With spinal injuries, imaging and their medical management accounting for a significant percentage of our injuries, this tip just saved billions of dollars annually. You’re welcome, Obama.

Suggested reform – Take a moment to assess you posture at your workstation (or slouched over your laptop reading this at home) and adjust accordingly. If you need help re-training your posture to avoid that more serious injury, it’d be worth getting in with a PT for a session. Otherwise, put a sticky note on your desk or monitor that says “Posture” or “you can do it, put your back in to it”, etc... and whenever you see that note, let it be a cue to reassess and correct your posture.

There you have it! If America just followed my 4-point plan to healthcare reform (presidential candor implied), the products both practical and financial could be immense. With all obvious adages aside, our nation needs to take a serious survey of ourpreventative healthcare. The strategies I mentioned won’t eliminate injury or disease, but reduce them.

And when healthcare management is necessary, emphasis ought to be placed on more cost-effective treatment strategies (PT soapbox saved for future date). That means reduction of unnecessary medical imaging, medication prescription and surgery. These treatments most certainly have their place, but I don’t necessarily believe it should be the first line-of-defense for most patients. It’s kind of like putting out a match with a firehose. Opposition will say “... what if the match is a raging inferno?” With the rejoinder being that it is the role of direct access clinicians (PTs) to identify the severity of diagnosis and direct care appropriately. Meaning not all flames need a firehose. If the analogy is too difficult to follow, I’m saying physician care is not necessary for many (most?) diagnoses, more specifically musculoskeletal diagnosis. Physical Therapists educated as direct access practitioners are able to differentiate whether a patient’s condition requires physician referral or extensive medical work-up and reducing our reliance on physicians as gatekeepers to the healthcare system will decrease both spending and strain on physician utilization. Which are good things.

Not that I expect this reform to sweep the nation in months or years, but “share” if you believe taking slightly more accountability for our own health could go a long way in the scheme of things. And as always, I’d love to hear your thoughts, reaction and discussion!

Thanks for reading!

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