Mindfulness meditation offers low-cost way to boost health

Returning this week from a 10-day mindfulness meditation retreat in the jungles of Thailand, I feel deeply rested and profoundly rejuvenated. This ancient art of mindfulness meditation has made substantial inroads into modern health care and costs next to nothing to learn and practice. Because it offers little potential to turn a profit for pharmaceutical and biotech titans, drug reps are not canvassing physicians’ offices with glossy brochures illustrating its benefits.

Yet, while the U.S. Senate considers a bill to repeal the Affordable Care Act, reduce Medicaid spending by 35 percent and drop health care insurance for 22 million Americans, mindfulness meditation offers an effective low-tech, low-cost option to prevent and manage illness. Today, mindfulness meditation warrants a closer look.

Practiced for centuries throughout Southeast Asia, mindfulness or insight mediation involves sitting, standing, lying or slowly walking while one draws attention to the breath by observing the movement of the abdomen or chest with each inhalation and exhalation. The practice involves bringing one’s awareness into the present and observing with curiosity the thoughts that might arise and to watch them as they pass away.

Almost 40 years ago Jon Kabat-Zinn, a renal physiologist at the University of Massachusetts, Amherst, began conducting research on the benefit of mindfulness-based stress reduction (MSBR) for patients with chronic disease who were not responding well to conventional treatments. Since then numerous academic studies on mindfulness-based interventions have demonstrated benefits to physical and mental health.

Some years ago Manakai o Malama Integrative Healthcare Group and Rehabilitation Center was asked by one of Hawaii’s largest insurers to conduct a three-year pilot study employing integrative medicine for its most costly patients with chronic pain. These patients received a 12-week intervention that included mindfulness-based treatment together with acupuncture, therapeutic movement, group psychotherapy and other services.

The results of Manakai’s study were published in the Hawaii Journal of Medicine and Public Health. Outcomes demonstrated a reduced utilization of health care resources, improved quality of life and a substantial return to gainful activity.

Mindfulness exercises assisted patients in better understanding their pain and to separate the actual pain from fear, uncertainty and old memories. It also helped participants make better lifestyle choices and assess appropriate activity levels, food intake and how much medication they actually needed.

Much of the demonstrated improvement among pain patients in resource utilization was based on a substantial reduction in opiate use, which remains another major challenge in health care today. In fact, the current Senate bill to repeal Obamacare is considering a $45 billion fund for dedicated opiate treatment to compensate for the proposed 35 percent reduction in Medicaid. Mindfulness-based interventions would be of benefit if covered under this fund.

The U.S. continues to pay just under 20 percent of its GDP for health care, far more than any other modern country, and has little to show for it. Without question, the advances in biomedical technology are profound. Progress in individualized cancer treatment is transformative. Yet, between the cost of research and development, our profit-driven model, social ills and market inefficiencies, the U.S. health care system remains sicker than the patients who come to it for care. Still, Obamacare remains the conscionable thing to do for the people of this country, but it must be refined.

One important way to refine U.S. health care is to refine ourselves. Whether we are patients, providers or administrators, health care happens one person at a time, one moment at a time. Mindfulness is about being aware of what is happening in each dynamic moment without judgment. It is about enjoying a pleasant atmosphere without fixation and accepting unpleasantness without jumping to conclusions.

Mindfulness is about embracing change that is inevitable. Being mindful is healthy.

Ira “Kawika” Zunin, M.D., M.P.H., M.B.A., is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. His column appears the first Saturday of every month. Please submit your questions to info@manakaiomalama.com.