Dr Andrew Weil on Healthcare

As an American, you have a right to good health care that is effective, accessible, and affordable, that serves you from infancy through old age, that allows you to go to practitioners and facilities of your choosing, and that offers a broad range of therapeutic options.

We currently have an expensive system that is not making people well. While there has been tremendous debate over access and payment, there has been less focus on the content of health care. Without a change in that content, we will never have a sustainable system; all attempts at reform will be taken down by unmanageable costs. – Huffington Post Blog by Andrew Weil

In this video, Dr. Weil discusses health care, the pharmaceutical industry and his forthcoming book, Why Our Health Matters.

Vodpod videos no longer available.

In an interview by Larry King (September 2009), Weil elaborates…

“there is a real movement toward changing the medical curriculum, toward teaching doctors the things that they’re not currently getting about nutrition, about mind-body interactions, about low cost therapy other than pharmaceutical drugs…

…You can’t have the government telling us to eat more fruits and vegetables and at the same time, through its subsidy program, ensuring that fruits and vegetables are the most expensive things in grocery stores and all the unhealthy stuff is the cheapest…

…The kinds of interventions that we’re using to treat disease are way too expensive because they’re dependent on technology. I include pharmaceuticals in that…

…At the moment, all I hear the argument about is how we’re going to give more people access to the present system and how we’re going to pay for it. And to me, that’s not the issue. The present system doesn’t work and it’s going to take us down. We need a whole new kind of medicine.”


It’s great to welcome back to LARRY KING LIVE — too long a time between visits — Dr. Andrew Weil, M.D. The number one “New York Times” best-selling author. He wrote “Healthy Aging.” And now his new book, “Why Our Health Matters: A Vision of Medicine That Can Transform Our Future.” There you see its cover, published by Hudson Street Press.

Forgive me, Andrew, but the title sounds a little — isn’t it silly, why our health matters?

Why wouldn’t it matter?

DR. ANDREW WEIL: Well, it certainly matters to us individually, because when we lose it, life doesn’t become very worth living.

KING: No kidding.

WEIL: But it should surely matter to us as a nation.

KING: So you’re referring to this nationally?

WEIL: Absolutely. As you just heard, we spend more per capita on health care than any people in the world. And we have very little to show for it. Our health outcomes are dismal. We’ve been paying more and more and getting less and less for it. And if we don’t do something about this, it will sink us economically. We’ll be spending up to 20 percent on our gross domestic product on health care. And we can’t sustain that. It will make us bankrupt.

KING: Now, this is what the president said about his goals for health care reform.

Let’s watch a segment here.

(BEGIN VIDEO CLIP)

OBAMA: The plan I’m announcing tonight would meet three basic goals. It will provide more security and stability to those who had health insurance. It will provide insurance for those who don’t. And it will slow the growth of health care costs for our families, our businesses and our government.

(APPLAUSE)

OBAMA: It’s a plan that asks everyone to take responsibility for meeting those challenges — not just government, not just insurance companies, but everybody, including employers and individuals.

(END VIDEO CLIP)

KING: Before we get to some specifics, overall, Andrew, what did you think of the speech?

WEIL: Well, I think the — the trying for reform is laudable. But I think the speech and the plan barely scratched the surface and they miss the point.

The point is we have to get the cost of health care in this country down. And to do that, we have to shift our efforts toward prevention and we have to change the nature of medicine. And I hear nothing in the speech about that.

King: OK, if you — if you could make some changes, give us some that you would make right now. Be — be — be the king.

WEIL: OK. First of all, we don’t have a health care system in this country, we have a disease management system that’s horribly dysfunctional and getting worse by the day. And the vast majority of disease that we’re trying to manage is lifestyle related and, therefore, preventable.

So what we really need to do is to shift our energies away from disease management toward making people healthy and preventing them from getting sick. And that means that I think a society wide effort of — of everyone pulling in the same direction. You can’t have the government telling us to eat more fruits and vegetables and at the same time, through its subsidy program, ensuring that fruits and vegetables are the most expensive things in grocery stores and all the unhealthy stuff is the cheapest. You know, everything has to work together here.

Secondly, the kinds of interventions that we’re using to treat disease are way too expensive because they’re dependent on technology. I include pharmaceuticals in that. We need a new kind of medicine in which doctors know how and patients accept low tech, high touch approaches to the treatment of illness.

Some immediate things. I would immediately ban direct to consumer advertising of pharmaceutical drugs. That’s been a disaster for patients and doctors and a great boon to the drug companies. No other company — no other country in the world allows that except New Zealand. Stop that right away.

Secondly, I’d set up an office of health education in the Department of Education with adequate funds to get serious about K through 12 health education, starting with teaching kids about what health is and what lifestyle choices promote it. I think education is something that we could really be serious about.

You know, I heard the president last night talk about prevention very briefly. And he talked about mammograms and colonoscopies. To me, that is such a superficial aspect of prevention. You know, the meat of prevention is about teaching people how to make the right choices about food, how to keep your body physically active, how to deal with stress.

KING: Yes, but — but — I understand that. But that’s changing a whole philosophy.

What do you do about 300 million people…

WEIL: We have to change a whole philosophy…

KING: …many of whom need that colonoscopy tomorrow…

WEIL: Larry, we have to…

KING: …to find out if they have colon cancer?

WEIL: We have to — of course we do that. That’s part of prevention. But that’s an insignificant part. At the moment, insurance companies happily pay for drugs, for procedures, for expensive diagnostic tests. There’s no reimbursement for doctors to sit with patients and give them advice about proper lifestyle choices.

Our priorities of reimbursement are completely backward. We don’t pay for preventive strategies. We pay for intervention.

KING: Does any country do what you want?

WEIL: No, I don’t think so. And I think we, in a way, have the best chance of doing things differently, because there is a stronger movement here toward reforming medicine. You know, there is a real movement toward changing the medical curriculum, toward teaching doctors the things that they’re not currently getting about nutrition, about mind-body interactions, about low cost therapy other than pharmaceutical drugs.

So I think we have a very good chance of doing this here — better than any other country. Maybe China — you know, China has a great tradition of integrating Eastern and Western care. For instance, the average cancer patient in China gets integrative treatment. They get chemotherapy, surgery, radiation and, also, very sophisticated herbal therapy to minimize the toxicity of those treatments and increase the efficacy.

Here that cancer patient is very lucky if they can get that kind of treatment.

KING: So you are not optimistic?

WEIL: Well, I’m…

(LAUGHTER)

WEIL: I guess I’m — it’s the best of times and it’s the worst of times. I think that as the economic crisis in health care deepens, which it certainly will, it’s going to force this deeper kind of change. At the moment, all I hear the argument about is how we’re going to give more people access to the present system and how we’re going to pay for it. And to me, that’s not the issue. The present system doesn’t work and it’s going to take us down. We need a whole new kind of medicine. We need a — we really need to work at making people healthy. I heard nothing in the plan that’s going to make us a healthier nation. That can only be done through (INAUDIBLE)…

KING: We’re going to find it…

WEIL: Yes.

KING: (INAUDIBLE) obviously, through education.

But how do you start that?

(COMMERCIAL BREAK) KING: Before we move back into the heart of the book and some other ideas — brilliant ideas that Dr. Andrew Weil has, the book, “Why Our Health Matters” — let’s talk about swine flu.

First, do you fear a major pandemic in this country?

WEIL: Well, I think, that’s a possibility. My daughter, who is a freshman at the University of Colorado, had the swine flu a couple of weeks ago. She got over it in five days. She was moderately sick, had a little cough afterwards.

You know, fortunately, that’s the way this disease is looking at the moment. And the dire predictions of it turning into something much more serious, so far, haven’t come true.

If they don’t come true, I think we can all take a deep breath and be thankful and look at this as good practice, because, inevitably, at some point, a serious strain of flu is going to come around.

So for the moment I think…

KING: There will be?

WEIL: There will be a lot of cases, but it doesn’t look as if it’s that serious.

KING: There will be two shots, the standard flu shot, which you can get now. A lot of places have it.

WEIL: Yes.

KING: Then the 1st of October the Swine Flu shot. Do you expect it to be effective?

WEIL: I think there’s a good chance it will be effective. I don’t know that I would want to be first in line to get it. I would rather wait and see and just be sure that it’s safe, and that the reactions to it are OK.

KING: Do you agree that everyone, if they can afford it, should have Tamiflu handy?

WEIL: No, I’m not so sure of that.

KING: No?

WEIL: First of all, indiscriminate use of Tamiflu has already resulted in increasing resistance of the Swine Flu to it. I think that should be held in reserve for cases of people who really need it. I think we should know how to get it or have a plan for how to get it, if you need it. You have 72 hours or so in which to take it. But I wouldn’t put all my eggs in that basket.

KING: Then do you have any grave concerns about it?

WEIL: I think we’ll have to wait and see. You know, the CDC is putting out updated bulletins on the Swine Flu very regularly. You can access these on the Internet. I think we should pay attention to what’s happening. For the moment, I’m cautiously optimistic that it’s not going to be that terrible.

KING: Is this a classic example of a government responsibility?

WEIL: Absolutely. And this is where, you know, public health is one of the areas that the government is responsible for, has a very good track record on. And I think that this will give us the kind of practice exercise for how we mobilize ourselves if a more serious disease does come around.

KING: Do we — are there good preventive measures?

WEIL: Well, we all know about the value of washing hands. I don’t know that this has to be done with alcohol. I think using hot water and soap is just fine. There are some interesting strategies. There is a Chinese herbal product called Astragulus (ph). It’s a root. It’s easily available in health food stores, completely safe. It has anti-viral effects and immune boosting effects. I often recommend this to people. You can take it regularly through the flu season. I think I will start taking that if I’m traveling and the incidence of —

KING: Is it a pill?

WEIL: Yes, it’s a capsule, and perfectly safe. No side effects.

KING: What is it called?

WEIL: Astragalus. There’s also a number of Asian mushrooms you can buy in various products, in liquid or capsule form, that have similar effects, that help your body defend itself against viruses.

KING: You are Harvard educated. A lot of times, though, when you mention these things, they seem far out.

WEIL: Well, I don’t think they should anymore. First of all, there is good research on many of these. At the University of Arizona, Center of Integrated Medicine, which I founded and direct, we regularly train physicians, nurse practitioners, pharmacists, medical students, and residents in the use of this. And these are examples of what I mean by low tech, cheaper approaches to disease intervention and treatment.

And, you know, there are so many things out there, from dietary change, use of exercise, the various mind-body techniques. None of these being taught in medical school today. This is medicine of the future. I call it integrative medicine. It has the great potential to lower health care costs by bringing lower cost treatments into the mainstream, that can produce outcomes as good or better than those of conventional medicine.

KING: Are you generally an opponent of the pharmaceutical industry?

WEIL: Well, you know, I’m no friend of the pharmaceutical industry. I think there is a higher mark-up on pharmaceuticals than any other commodity in the American market. The drug lobby has immense power over our representatives, both Republicans and Democrats.

Consider this, Larry: it’s just astounding to me that over all these years the pharmaceutical lobby has blocked any legislation that would allow our federal government to buy drugs from Medicare at a discount. I mean, that’s outrageous. How do we stand for that?

But I will say I think the pharmaceutical drugs — the pharmaceutical lobby, these companies are just capitalizing on a mindset that has taken hold of both doctors and patients in this country, that the only legitimate way to treat disease is by giving drugs. If you told a doctor not to give a drug as part of a medical encounter, he or she wouldn’t know what to do. If a patient doesn’t get a prescription, they would think it’s not a legitimate medical transaction.

How did we come to believe that the only way to treat disease is by giving drugs?

<snip>

KING: All right. Question Tweeted via Kings Thing, that’s our Tweet site. “How do we make parents accountable for the garbage they’re feeding our kids?”

WEIL: I think this is a matter of education. You know, I have seen kids often be very effective change agents for parents and for families. If we get the information to kids in the ways that they can understand, maybe they’ll demand better food of their parents.

But, you know, Larry, people are going to eat what’s cheap and what’s available. We made the unhealthiest food cheap and available. And some of that is because we subsidize unhealthy ingredients that are everywhere out there and are cheap.

And I think we also cannot let the food corporations do whatever they want. Maybe we have to experiment with a sin tax on soda and junk food. This is a strategy that has worked for cigarettes. It’s one of the only strategies that has worked. Raising taxes, to a certain point, deters young people from buying them.

KING: We have an email question from Danny in Shanghai. “Do you think sodas and other unhealthy foods should be heavily taxed to discourage their consumption?”

WEIL: I think we should experiment with that as a method and see whether it works.

KING: What do you make of stem cells?

WEIL: I think the potential for stem cell research is enormous. I think there is — this is a frontier of high-tech medicine that is very exciting. The possibility of regenerating portions of heart muscle that are damaged by heart attack, of severed spinal cord, of damaged organs — this country has been set back horribly in stem cell research because of the years in which the religious right was allowed to dictate scientific policy. Fortunately, that’s changed.

KING: Do you think fetal stem cell might be even more remarkable than embryonic?

WEIL: It’s possible. There’s also an interesting line of research on adult stem cells, which avoid the whole question of dealing with embryos or fetuses. The whole world of stem cell research is exciting, promising. Let’s see where it leads us.

KING: How embryonic?

WEIL: How embryonic?

KING: How far along are we?

WEIL: As I said, I think we are behind other countries because we had a big setback. I think we’re getting close to this. We’re very close to being able to treat juvenile diabetes by using stem cells to regenerate Insulin producing cells in the Pancreas. I think these are right on the horizon.

KING: Does watermelon juice help with weight loss? That’s not a question. Hold it, Doc. We’ll ask it in 60 seconds.

(COMMERCIAL BREAK)

KING: By the way, the subtitle of “Why Our Health Matters” is “A Vision of Medicine That Can Transform Our Future.” Things like stop making corporations rich, stop making our society poor, start each of us on the road to optimum health. A myth or fact about watermelon juice?

WEIL: All fruit juice is concentrated sugar. If people want to lose weight, the easiest thing to do is to cut down and stop eating products made with flour and sugar. So, no, I don’t think watermelon juice is going to help you to lose weight, especially in you add it on to what you are already eating. Many schools —

(CROSS TALK)

WEIL: I said, in many schools that got soda machines out of schools, these are replaced with fruit juice vending machines. That’s not that different. These are still beverages that are concentrated sugar.

KING: So what happened to fruits and vegetables as the healthiest means to live?

WEIL: Well, there’s a big difference between fruits and fruit juice. Fruits are fine, but, again, in moderation. I think vegetables, you really want to go for, because they are full of protective compounds that help us defend against cancer and all sorts of degenerative diseases.

KING: Is Cantaloupe good for you?

WEIL: Sure. It’s a good fruit. It’s good for you.

KING: I like it. Got to feel it outside, though. Ottawa, Canada, called. Hello. Ottawa, hello.

CALLER: How are you some.

KING: Fine. Go ahead.

CALLER: Hello, doctor. I have always admired you very much. But I have to disagree with you on fighting the reform of health care in this country. I feel, because I go down there every winter — and I think that most of the doctors there are dictated by your insurance companies. It’s not good health care.

WEIL: I couldn’t agree with you more.

CALLER: They’re afraid.

KING: Ma’am, where do you disagree with him?

CALLER: Because when they have to check with their insurance companies whether they can proceed with any diseases.

WEIL: This is a big problem that —

KING: Is that different in Canada? Hold it, doc. Is that different in Canada, ma’am?

CALLER: Of course, it is, because our doctors do not depend — have to wait for an insurance company to say whether they can proceed or not.

KING: So I don’t think you disagree with him.

WEIL: Absolutely not. In fact, one of the problems here is that American medicine has become totally reimbursement driven. It’s not evidence driven. What’s done in medicine is what’s paid for. And the priorities of reimbursement are completely skewed. As I said, we happily pay for intervention. We don’t pay for prevention.

KING: Back with more of Dr. Andrew Weil after this.

(COMMERCIAL BREAK)

(NEWS BREAK)

KING: Back to Dr. Andrew Weil, author of “Why Our Health Matters.” Is the whole problem, as you see it, doctor, in the concept of the system? And that even though there may be various types of answers to reform, Democrats and Republicans are both locked into the idea of the insurance company and the benefits therein?

WEIL: I think the arguments are at a level that doesn’t even begin to touch the deep problems. And there are things we can do now, Larry. One of the big problems in this country is that we have far too many specialists, far too few generalists. We need many more generalists, meaning general practitioners, family medicine doctors, general internists. Country that’s have more generalists have better health better health outcomes. We don’t have people going into general medicine because it doesn’t pay as well. It doesn’t have the prestige. So the federal government should subsidize the education of doctors who go into those fields. That’s a change we could make immediately.

And by the way, I have a call to action, with seven steps that people can take right now, that demand meaningful changes in health care. You can access this on my website, DrWeil.com. And this is above this kind of nasty politics. It’s like creating an Office of Health Education in the Department of Education, banning direct to consumer pharmaceutical ads, demanding that insurance cover preventative strategies, mandating that integrative medical education be taught in medical residency programs and medical schools.

You know, this is all stuff we could do immediately. And if people begin to demand these changes, we can see, I think, the start of real changes in the system.

KING: Where do we go wrong or have we always been wrong?

WEIL: I think we went wrong somewhere in the middle of the 20th century, when medicine started getting mixed up with big money. Medicine was never meant to exist in a for profit system. The interest of those who run for profit medical care are fundamentally at odds with those of doctors and patients.

As dysfunctional as this system is, it’s generating rivers of money that are going into relatively few pockets. And those pockets belong to people who don’t want to see the system change. Medicine — I mean it’s so sad that health care is now routinely called an industry. You know, it was always thought of as an art, as a profession, as a caring profession. Never an industry primarily concerned with making money. That has distorted everything in this country.

KING: Do you favor some sort of public system?

WEIL: Well, you know, I favor including everyone. I think it is — it’s — it’s a given to me that a free Democratic society should guarantee basic health care to all of its citizens. I mean that’s just as it guarantees basic security. But how we do that, whether that’s publicly, privately, a mixture of the two, I don’t know. I’m not a policy expert.

What I do know is if we try to do that now, given the kind of medicine that we’re now practicing, it’s unsustainable. It’s a recipe for bankruptcy.

KING: We do not — then it’s a myth that we have the best medicine in the world?

WEIL: Absolutely. You know, the World Health Organization recently ranked our health outcomes on par with Serbia. Now the reason for that is we have so many uninsured people who don’t have access to good medical care. But, you know, even in some of our biggest cities and our best hospitals, the quality of care is deteriorating. Rates of hospital infections are up. Shortage of nurses are acute. Medicine has gotten sloppy. I think these are all consequences of the profit-driven kind of medicine that we have today.

The system is just breaking down. The bottom line is you can’t afford to get sick today. And the amount of money that we pay for health care and what we have to show for it, this is a national disgrace.

KING: What about the shortage of doctors?

WEIL: You know, doctors are as frustrated and unhappy about the system as patients are. They have lost their autonomy. They are tired of practicing defensive medicine out of fear of lawsuits. They resent being dictated to by insurance companies. They can’t use their own medical judgment.

As we change all this, I think the medical profession will attract more, more, and more people who genuinely want to help people and are able to do that. It’s all one big knotted mess. As we begin to change the philosophy of the system, to shift our energies in the direction of prevention and health promotion, to break our dependence on these expensive, high-tech solutions to everything, I think that shortage will naturally disappear.

KING: What is your biggest complaint about the health insurance industry?

WEIL: It’s motives are profit. Its motives are profit.

KING: Do we live in a capitalist society?

WEIL: Sure. You’re allowed to make a reasonable amount of money. But when you look at the salaries of the CEOs of these big insurers, it’s the same situation you have with Wall Street. This is not justifiable. Something has to be done about this. There can’t be that amount of profit made when American health care and the lives of Americans are suffering so much.

KING: Don’t you think President Obama is aware of that?

WEIL: He said it at the opening of his speech. I think that, you know, he’s — he very clearly stated the problem and all of the hardship that it is causing. I think that was terrific. The fixes he proposes are just so short of what’s need. They don’t really touch the deeper problems.

Again, let me just repeat, the root of our troubles is that health care in America is so expensive. We have to get those costs down. The only way we can do that is by shifting this enterprise toward preventing disease and making our citizens healthy, and by changing the nature of medicine to break it dependence on high-tech, expensive solutions to everything.

The bottom line is, if we don’t change the content of health care, any attempt at reform will be taken down by unmanageable costs.

KING: What country has the best health system in the world?

WEIL: Well, you know, I think — I don’t know that anyone has the best. I think Germany, which has a mixture of private and public, does pretty good. Australia, which also has a mixture of private and public, I think does well. Citizens in Norway are certainly happy with their health care. So I think we can look around and see countries where things are better than here.

But everywhere the same problems are going to develop. What has happened here is developing everywhere for the same reasons, that the costs of health care going up because of the nature of medicine. That has to change.

KING: Always a pleasure having with you us, Andrew. Thanks so much.

WEIL: I enjoyed it. Good night.

KING: Dr. Andrew Weil, “Why Our Health Matters.” Before we go, want to recommend a terrific new book written by Robin Meade, the anchor at HLN’s “Morning Express.” It is called “Morning Sunshine.” It will inspire you. Check it out.

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