But What's the Solution?

The other night we were guests of a self-made multi-millionaire octogenarian on his new 120 foot power yacht where we sat in the lap of Republican power. I was on my best behaviour so side-stepped many conversations until dinner when it became much more difficult.

One of the guests runs a major medical clinic and was very factual and somewhat severe as the discussion turned to "Obamacare". He and I had discussed this in private many times previously and although he recited the same statistics that a distinguished friend of mine has concerning the extreme concentration of health spending in the final stages of our lives-85% of our total outlay comes in the last 6months-they had very different solutions.

The former focuses on the fact that Americans are lethargic and either overweight or outright obese, and that they are crushing our medical infrastructure with their ill-health. His focus was on getting the public to recognise that they are literally eating themselves to death and the sooner they address this fact and stop "protecting" the individuals "right to be fat" the sooner we can reverse the crippling growth in the cost of health care.

The latter, a leading voice in the Hospice end of our medical infrastructure is much more focused on having the public come to terms with the fact that death is a natural event and that we will all die despite all the medical intervention money can buy. He would maintain that the interpretation of the Hippocratic oath will have to be and is being addressed under Obamacare and that this will allow/force doctors to stop making invasive procedures that only serve to prolong the inevitable and to discuss the alternatives.

Both of these individuals are passionate in their work and in their desire to see health care transformed into a sustainable format capable of delivering care to all.

Yet their focus is completely different.

I believe both are on the right track. The U.S. has to address the nation's obsession with food, and has to come to embrace a different approach to end-of-life care.

I fear like much in this country that despite the common cause and even common ground, they will find it very difficult to find a compromise.