The Role of Mindfulness in Healthcare Reform:
A Policy Paper
By Kelley McCabe Ruff, MBA and Elizabeth R. Mackenzie, PhD
THE URGENCY OF HEALTHCARE REFORM By now it is clear to everyone— economists, lawmakers, health professionals, and the public—that healthcare reform is an urgent need, a national emergency that requires immediate and focused attention.
Costs continue to spiral out of control, large numbers of Americans are uninsured (medical bills are a leading cause of bankruptcy), and the aging of the so-called baby boomer generation threatens to burdenMedicare beyond its capacity. The United States spends over $2 trillion annually on healthcare, yet some key national health indicators lag significantly behind other developed nations (eg, infant mortality rates in the United States rank 23rd globally, on par with Poland and Slovakia). As a percentage of gross domestic product, healthcare spending exceeds 16% and is projected to reach 17.7% by 2012.
Clearly, our healthcare system is unsustainable both in terms of its financial and human costs. However, despite a nearly unanimous call for reform, there remains a lack of consensus about what form the changes should take, and different stakeholders have put forth a variety of approaches. At this stage, one of the most important questions we can ask is, “What is driving healthcare costs?”
It is reasonable to assume that if we can identify the underlying problem, we will increase our chances of arriving at an effective solution. Like most commodities, healthcare is subject to the rule of supply and demand. Right now, we have a high demand for healthcare procedures characterized by sophisticated and expensive medical technology. The evidence suggests that advances in medical technology are the single biggest factor driving up healthcare costs over the last 50 years or so, eclipsing all the other factors such as aging population, costs of health insurance, rising incomes, defensive medicine, administrative costs, lower productivity, end-of-life care, and the like.
However, since advances in medical technology have also tended to produce better health outcomes for certain conditions,3 we do not want to thwart technological progress. The problem is that the nation, regardless of who pays for healthcare, can no longer afford to keep supplying the ever-increasing demand. One solution is to put limits on the supply—to engage in healthcare rationing. There are many serious objections to this approach, chief among them the moral issue of denying potentially life-saving procedures to human beings.
Fortunately, there is another more humane and sensible solution: reducing the demand by leveraging preventive medicine.