Updated: Aug 27
Have You Heard This Claim?
"In ancient China one only paid the doctor when he was well; if you got sick you didn’t pay because the doctor had not done his job which was to keep you healthy. The doctor then treated you for free until you were well again."
And Do You Believe it?
Supposedly this is a historical fact. It is oft repeated and quoted in a thousand different articles, books and studies. Many people believe that adopting a system like this would fix what is "wrong" with our health care system. I don't buy it.
Here is the problem with this type of thinking. This implies that if you are sick it's the doctors fault, not your fault. And likewise if you are healthy the doctor gets the credit, not you. I don't believe that. And the idea that this system of remuneration for doctors would suddenly fix our health care system is just ignorant. Suddenly doctors would quit holding back, and they would make us healthy, so they could get a paycheck?
When you meet a healthy person, do you think: "Oh he must have a good doctor." Or do you think: "He obviously doesn't smoke, drinks little or not at all, exercises regularly and has a good diet, etc."
You know the answer to this. Just think about it. If you break all the rules: eat a horrible diet, get no exercise, smoke like a chimney, and have multiple anonymous sex partners, do you think a good doctor could make you healthy? Or keep you healthy? No, you will end up with the illness's that are the natural outcome of your choices.
After you have ruined your health, can good doctors do anything to help? Of course! When you do get COPD from your smoking, you may breathe a little easier with a prescribed inhaler. When you get lung cancer, the treatment might extend your life somewhat. When you get diabetes, high blood pressure and obesity, thanks to your sedentary lifestyle and poor diet a good doctor might minimize your symptoms. When you get HIV due to your promiscuous lifestyle, a good doctor might do a better job of managing your AIDS.
But in none of these cases can the doctor undo the effects of your poor choices and make you healthy!
Health has always been the result of your own choices, good genes and good luck and very little to do with the doctor. What does that mean?
There are hereditary illnesses you can get even if you make the best health choices.
And some people walk down the street and a piano falls on their head. Not their fault, but they will be spending some time in the hospital!
This will never change. Good health requires good choices, but good choices don't guarantee good health. Good choices, do however, tip the scales in your favor.
So the only way to be healthy, really, is to make good choices. Do all the things we all know we are supposed to do and you will probably end up healthy. Or make bad choices and be prepared to pay for lots of medical care to treat the symptoms of of the poor health caused by your bad choices. But you can take this to the bank: there is no long term health, without making good choices. The best doctor in the world can NOT change this formula, regardless of what some old Chinese myth says.
But many people, even Wise Government Planners, ignore the fact that good health is based on your own good choices. Here is an example. Rich people are always healthier than poor people, based on group averages. Compare 1,000 poor people to 1,000 rich people, and the rich group will always come out with better statistics. Less cancer, less diabetes, less heart disease, etc. There will always be individual exceptions. But on average, poor people are always less healthy than rich people.
Why are poor people less healthy? Many of these Wise Government Planners claim it is because poor people have less access to medical care. If poor people could just get into see doctors more often, and see the good doctors the rich people see, they would be as healthy as rich people, they claim. It is just a matter of "equity" they say. (When the word equity is used, they want more tax money to benefit a certain group, or some type of preferential treatment for somebody.) But we know that doctors CAN NOT make people healthy, so we know this is wrong thinking.
So Why are Poor People Less Healthy?
Poor people, as a group, do not exercise, or exercise very little according to a study in Preventive Medicine published in 2017, and many other sources.
Poor people eat less fruits and vegetables and far more sugar and processed foods according to a 2019 study in BMC Public Health.
Poor people smoke more according to the Truth Initiative. Poor people are at least twice as likely to smoke as more well to do people and 3 out of 4 smokers come from poor communities.
Poor people are more likely to contract HIV infection because they engage in higher-risk sexual behavior compared to wealthier people according to the Demographic and Health Surveys report in 2013.
Despite what the Chinese myth says, withholding a paycheck from poor peoples doctors will NOT make poor people healthy! Until poor people address these types of issues mentioned above, their health will suffer.
So why do Wise Government Planners promote the false narrative that lack of medical access makes poor people less healthy? I can only speculate. If we were to believe the Wise Government Planners, we would probably accept their solution, which is to vote for their politicians, pay more taxes and pay Wise Government Planners big salaries to fix things.
On the other hand, if the truth is known about personal choices, we can see the solution is for poor people to get off the couch, start exercising, quit smoking, eat better food and practice monogamy. (Which, BTW is the same thing ALL of us need to do.) Please note, poor people don't need the Governments help to do any of these things!
Addressing the Chinese health care myth of when doctors should get paid and whose fault it is if you're sick: With few exceptions if you are sick, you can put the blame at your own feet. No doctor owes you free treatment for the consequences of your lifestyle choices.
The Bottom Line?
Regardless of whether you are rich or poor, your good choices are the most important thing for your good health. Seek good medical care ONLY as a supplement to your wise choices. Don't get fooled into thinking good medical care can replace the need for you to make healthy choices! You can't buy good health! Not even from a good doctor.
Take care and BE HEALTHY!
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