Bob Duggan frequently refers to "our national disease-care system" when he talks about his new book, employing a term he has used across his 40-plus years as a healing-arts clinician and educator.
As co-founder and former president of Tai Sophia Institute, a North Laurel graduate school of complementary medicine, wellness-based education and research, he believes that labeling our current system "health care" is a gigantic misnomer — and a point of national disgrace.
In "Breaking the Iron Triangle: Reducing Health-Care Costs in Corporate America," Duggan offers a vision of a sustainable, wellness-based future in which corporations and entrepreneurs are able to slash rising health-care costs by investing in programs that focus on wellness instead of disease.
"We are spending fortunes and still not giving quality health care, and 40 million people have no access [to care] at all," he said. "There would be no
To bolster that argument, he quotes estimates that $1.2 trillion of the country's annual health-care expenditures could be avoided if individuals made common-sense lifestyle changes.
The Owen Brown resident retired from Tai Sophia two years ago in part, he said, because he had turned 70, and "new blood is a good thing."
Now 73, he works as a consultant at Wisdom Well, an
But his other priority in switching professional gears was gaining more time to write on a topic he's been confronting and contemplating for so long.
Imagine a health-care triangle with the values of cost, access and quality assigned to its three corners. What makes dealing with the triangle a conundrum is three-fold: Cutting costs means rationing access or reducing quality; increasing access to the uninsured means increasing costs or reducing quality; and increasing quality means adding costs or rationing access, he writes.
On the opening page of the 222-page hardcover edition published in July by Wisdom Well Press, Duggan brands all these scenarios "impossible."
"What is possible for us as a nation?" he asks, offering up observations in his book, which focuses on how the United States can avoid financial bankruptcy from uncontrolled medical expenditures.
"Life expectancy in the United States is ranked 50th in the world, below most developed nations and some developing nations," he said, attributing his statement to data published on the CIA World Factbook website.
Yet in 2009, U.S. federal, state and local governments, corporations and individuals together spent $2.5 trillion, or $8,047 per person, on health care, he writes, quoting National Health Expenditures 2009 Highlights.
"We must turn the medical conversation away from a war on disease and fear of our bodies, and expand our focus on learning and understanding ways of living well," he writes.
Duggan has his share of followers in Howard County, among them Peter Beilenson, who stepped down in October after nearly six years as the county's health officer.
Beilenson calls Duggan "a visionary fellow who is often ahead of his time."
"Bob has been talking to me about integrative medicine since I was a young health officer," said Beilenson, who helped create Healthy Howard, a program that helps county residents gain access to affordable, quality health care.
He resigned his county post to become CEO of Evergreen Health Cooperative, a fledgling nonprofit health insurance provider that will be offered statewide in October.
"Integrative medicine is still a little bit 'out there,' but not like it was 15 or 20 years ago," Beilenson said. "Clearly, [an emphasis on wellness] is the way health care is going, and that's long overdue."
Duggan said the concept of wellness coaches, which is part of the Healthy Howard plan, can keep people from the using the hospital inappropriately.
He is quick to point out, though, that "there obviously are appropriate uses for modern medicine," such as the time he injured his knee years ago and saw a surgeon, or when a person with
"Most of us assume we can live the way we want, and a doctor will fix us," he said.
But that's not always the case. Duggan tells the story of a successful female CFO who came to him with "a scary set of debilitating symptoms." She had spent $100,000 on medical testing and had been told her symptoms might be a precursor to
"I was both intrigued and intimidated [by her case] and read four medical reports" on her before their meeting, he said.
He posed simple lifestyle questions to the woman that exposed such regular, unhealthy habits as grabbing fast-food dinners at 11 p.m., sleeping six hours or less a night, and getting almost no exercise.
"She wanted to fix things without changing her behavior," he said. "But she was smart. She knew what she had to do."
Most people, like that CFO, don't belong in the "disease-care system," he said.
"We need to teach people to drive their bodies properly," Duggan said. "Most people have five minor symptoms that come and go. If you learn to manage them, you won't need a doctor."
Howard Ross, chief learning officer at Cook Ross Inc., a Silver Spring-based consulting and training firm that represents 46 health-care organizations as well as other clients, recommends Duggan's book.
"Bob Duggan hasn't only written a fascinating book, filled with wisdom about what good health really is, he has also created a powerful inquiry into what our society needs to do to address our health care needs for the future," Ross wrote in an email.
Duggan believes it's time to place a priority on managing ballooning health-care costs by examining the issues through a different lens.