SEATTLE--All of the government manipulations of the US health-care
system will have little impact on the more potent forces--demographic,
social, scientific, cultural, moral, and legal--that shape the
American way of health and fuel its cost, says former Secretary
of Health, Education, and Welfare Joseph A. Califano, Jr.
Mr. Califano, who is currently president of the Center on Addiction
and Substance Abuse (CASA) at Columbia University, is a strong
believer in "radical surgery" for the way we approach
health, life, and death in America.
This radical surgery cannot be accomplished through legislation,
he believes, but rather through changes in our basic thinking
about health and individual responsibility.
The Lesson of 1994
The lesson of 1994, when President Clinton's administration brought
forth its "preposterously bureaucratic" health care
plan, he said, is that no single law can revamp the entire health-care
system. Instead, he stressed, reform is a perpetual process, and
achieving universal coverage is a long-term proposition.
Speaking at the presidential symposium held during the American
Society of Hematology meeting, Mr. Califano described our current
system as providing "sick care" rather than "health
care," ie, programs that foster healthy lifestyles.
Although he praised the accomplishments of America's research
community, he looks with dismay on how new breakthroughs are sometimes
perceived by consumers.
"We see them not as palliatives to be used when we become
sick despite our best efforts to stay healthy but, rather, as
a means to allow further overindulgence, inactivity, and abuse
of mind and body," he said. "If Moses were an American
in the 1990s, the tablets he would bring down from the mountain
would be Prozac and aspirin, not a set of commandments to guide