The cost of health care in America is obscene. Only the super rich and indigent are covered by adequate health insurance. For the 47 million Americans with no health insurance, health catastrophes have become a primary reason for bankruptcy and divorce. If you are on Welfare, Social Security, or other government doles, then you have some security against health problems. Border states from California to Florida spend many billions annually treating illegal aliens and providing full neonatal care for their newborns, who then become “anchor” babies, allowing the parents to become legal citizens. Yet millions of tax paying American-born citizens have no health care.
And if you really want full medical, dental, and psychiatric coverage for free, then commit a crime. I am not kidding. In 1976, the U.S. Supreme Court ruled that prisoners are entitled to full medical, dental, vision, psychiatric, and pharmaceutical benefits. California is on the ragged edge of bankruptcy and thus must release 55,000 prisoners because their prison care is considered inadequate. In March of 2009, a court appointed receiver ordered the state of California to spend $8 billion to upgrade prison medical facilities in spite of the $42 billion deficit the state faces.
America spent $2.4 trillion in 2007 on disease maintenance, which was 17% of our gross national product–twice the expense per capita of any other health care system on earth. Notice that I said “disease maintenance”, because we certainly do not support health care in America, and “health insurance” is neither related to health nor solid actuarial insurance. Health care for the indigent is the primary expense in many state budgets. The United States spends 6 times more per capita on the administration of our health care system than its peer Western European nations.
A SILVER LINING? Before we dive into the gloomy statistics on the American health care system, let’s touch on the good news. Life expectancy for Americans has increased from 50 years in 1900 to 78 years in 2009. Microsurgery on eyes (Lasik) and joints (arthroscopic) would have dazzled the famous futurist, Jules Verne. Pain management and emergency medical procedures can allow catastrophic injuries a chance at healing. Yet, in spite of the exotic arsenal of drugs, diagnostic tools, and procedures available to modern medicine, the most significant improvement in the health of modern humans, according to the first heart transplant surgeon, Christiaan Barnard, MD, was the invention of the indoor flushing toilet in England in the 18th century, thus ending many plagues from fecal contamination.
Like the auto industry in Detroit, our American health care system is in dire need of reform. All the more reason to take care of your health and that of your family. Prevention is a key to avoiding this health care nightmare that reigns in America. And eating whole foods is an irreplaceable link in your wellness program. You need to take charge of your own health, because the government or your health insurance provider (if you have one) may not be able to do so.
NATION OF DRUG ADDICTS
No one with a headache is suffering from a deficiency of aspirin. No one with elevated cholesterol has a deficiency of statin drugs. No one with depression has a deficiency of Prozac. While drugs can provide short term valuable relief in health problems, drugs are usually not recommended for long term care, which is what happens in millions of Americans.
Nancy Reagan offered a catchy phrase during her term as the first lady of the White House “just say no to drugs”. To be sure, America has a problem with illicit drugs. But we have an equal or greater problem with prescription drugs. They are overused, expensive, dangerous, and often unnecessary. While America comprises 5% of the world’s population, we consume 40% of the world’s prescription medication. Every winter, nearly one million “snow bird” seniors gather along the Mexican border in their RVs in California and Arizona to have access to cheaper (by 30-50%) but identical prescription drugs found in Mexico. A professor at Harvard Medical School, John Abramson, MD, has written a brilliant and well documented book, OVERDOSED AMERICA, showing that lifestyle changes (diet, exercise, stop smoking, stress reduction) can offer cheaper, safer, and more effective healing from illness than prescription drugs.
Of the worldwide $600 billion pharmaceutical industry, $250 billion is in the United States. Drug companies underwrite 90% of continuing medication education, giving them inordinate control over physician awareness of drug strengths and limitations. Although Americans were issued 3.4 billion prescriptions in 2003 (12 per man, woman, and child) we rank 29th in life expectancy in the world.
Maybe the costs of these drugs would be more acceptable if they actually cured or relieved more symptoms than they created. In the past 6 years over 65,000 lawsuits have been filed against American drug makers. According to an article in the Journal of the American Medical Association, the proper use of prescription drugs is the 4th leading cause of death in America, killing somewhere between 100,000 and 140,000 Americans annually.[i] According to a review of the literature by a physician and naturopath, Carolyn Dean, MD, ND, in her book, DEATH BY MODERN MEDICINE, more like 780,000 Americans die each year from modern medicine.
Prescription drugs are approved based upon clinical trials published in peer reviewed scientific literature. Now we find out that many of these researchers are fabricating data or “bending” the study to suit the needs of the drug manufacturer. The former Editor in Chief, Marcia Angell, MD, of the blue chip medical journal the New England Journal of Medicine, has written a scathing expose, THE TRUTH ABOUT THE DRUG COMPANIES, stating that many medical reports are nothing more than unvarnished marketing reports from the drug manufacturers.
Then we start discussing the decadent markup on prescription drugs. While discount stores, like WalMart, might typically markup an item by 10%, and vitamins typically have a 200-400% markup. Markup from drugs goes up to 569,000%, or 5,690 times cost.
WHAT PRESCRIPTION DRUGS REALLY COST
PRICE $/100 CAPS
COST $GENERIC ACTIVE INGREDIENT
Source: Life Extension Magazine, Mar.2005, p.11
IS IT SAFE?
“Today we are faced with what may be the single greatest drug safety catastrophe in the history of this country or the history of the world… In my opinion, the FDA has let the American people down, and sadly, betrayed a public trust.” David Graham, MD, MPH, Associate Director of Drug Safety, Food and Drug Administration, Nov.2004
The Food and Drug Administration (FDA) began its authoritarian rule of the American drug and supplement industry after the drug Thalidomide caused major birth deformities in 10,000 babies in Europe and Africa between 1956-62. No doubt that we need some form of policing to insure that our foods are safe and our drugs are safe and effective if used as directed. Our current government watch dog groups are incapable of doing this job. For example, Vioxx, a drug to reduce pain and inflammation, was associated with 100,000 unnecessary deaths during its use in 20 million people between 1999 and 2004. Since the FDA is primarily funded by fees paid by the pharmaceutical industry, conflicts of interest abound.
“Beware the military industrial complex” Dwight Eisenhower, 34th president of USA.
And all of this cost and risk might be acceptable if Americans were healthier than other countries. We are not. In a detailed survey comparing the health care systems of America, United Kingdom, Australia, Canada, Germany, and New Zealand; America came in dead last, in spite of having the most expensive health care system. Australia came in first place. The World Health Organization (WHO), in 2000, ranked the U.S. health care system as the most expensive in the world, yet 37th in overall performance, and 72nd by overall level of health among the 191 nations included in the study.
According to medical journalist, Shannon Brownlee, we spend roughly 1/3 or $700 billion annually for ineffective medical care, another $700 billion annually for dangerous counterproductive medical care, the remaining $700 billion for appropriate medical care.
General Motors, once the largest corporation in the world, is now bankrupt. GM insured 1.1 million employees and their dependents at a cost of $5.2 billion per year. On each car sold, $1400 went to health insurance for employees, which is more than they spent on steel for their cars. GM had $77 billion in future health care commitments with only $20 billion set aside for this purpose. Game over.
CANCER TREATMENT NEEDS REFORM
When Richard Nixon launched the “war on cancer” in December of 1971, he confidently proclaimed that we would have a cure for a major cancer within 5 years. Now, 38 years later, over $90 billion in public research funds spent at the National Cancer Institute, and over $1 trillion spent in therapy for cancer patients, we don’t have any unqualified cures for any cancers. Five year survival rates for advanced breast and lung cancer are unchanged. In 1900 only 3% of deaths in America were caused by cancer. Today it’s 24%. As of 2004, cancer is the number one cause of death in America.
The five year survival rate in 22 different cancers has been increased by 2.1% using chemotherapy, according to a review in the journal Clinical Oncology. That is not much of a benefit given the horrendous side effects, costs, and toxicities of chemo. Another study from the Buck Institute for Age Research found that chemo may promote the development of cancer later in life. “Chemotherapy is brutal…” according to the study’s chair, Dr. Judith Campisi. In a 2008 study published in the Archives of Internal Medicine following 110,000 Norwegian women, researchers found that women who DID NOT get mammograms had 22% fewer breast cancers. Essentially, many breast lumps will spontaneously disappear and need not have dramatic invasive toxic oncology care. “Uncertainty about the value of mammography continues.” wrote the editorial.
Of all drugs evaluated by Dr. Brian Spear in the scientific journal Trends in Molecular Medicine, cancer drugs were the least effective, being effective only 25% of the time, with pain medication (analgesics) the most effective at 80%. John Bailar, MD, PhD, former editor of the New England Journal of Medicine, called the war on cancer “a qualified failure”. Yet, chemo, radiation and surgery are the only reimbursable therapies offered to most American cancer patients, who have to go to Germany or Mexico to find treatment options.
WHY WOULD ANYONE INSURE A BURNING BUILDING?
Many Americans are “arsonists” with their destructive lifestyle creating health problems that are treated in the most expensive and dangerous way possible, with prescription drugs to relieve the symptoms, rather than using lifestyle to change the underlying cause of the disease. Smoking quadruples the risk for lung cancer, emphysema, and pulmonary disease. Obesity quadruples the risk for type 2 diabetes and hypertension. United Kingdom is beginning to deny medical therapies for patients who make poor lifestyle choices.
Nearly all of the 20 million diabetics in America have a self-induced lifestyle component to their disease. 80% of heart disease risk is lifestyle induced. A Mediterranean diet can reduce the risk of heart attack by 70%, while the $14 billion we spend annually on cholesterol lowering drugs only cuts the risk by half that much.
Yet state and federal authorities rigorously patrol medical offices for any signs of deviating from “standard of care”, meaning non-traditional therapies. James Carter, MD, DPH, has written a disturbing book, RACKETEERING IN MEDICINE, detailing the “witch hunt” to eliminate any medical practice that uses protocols outside of prescription medication and surgery.
FINANCIAL MELTDOWN OF MODERN MEDICINE
“No good deed goes unpunished.” Anonymous
In the dark days of World War II, America was struggling to climb out of the decade of financial depression while fighting a war on two continents. Most able-bodied young men went to war. Women, like my grandmother, worked in the factories to provide supplies to the war movement. In order to prevent inflation, the federal government mandated wage freezes. Yet manufacturers had contracts with the government to produce airplanes, ships, and all the other needs of war. So employers started offering “free health care” as an incentive to bring capable workers to their factories. Seemed like an innocent idea at the time, but it has become a Pandora’s box.
Once the war was over, the concept of free health care as a “perk” (perquisite) grew in popularity, especially among union jobs. Once Mom and Dad had free healthcare, the next step was getting free health care for Grandma and Grandpa, which began with the passage of the Medicare Act in 1965. We need to take care of our senior citizens. Yet America has lost the concept of “personal accountability” that founded this country and put us at the top of the world’s caste system.
Medicare and Medicaid comprise a “debt that we cannot pay” or unsecured liability of around $62 trillion. We currently spend a billion dollars a day on Medicare, of which 60% goes to treat patients in their last 6 months of life, with questionable results in either quality or quantity of life. A Dartmouth study found that 30% of Medicare spending is wasted.
Health care costs have made America far less competitive in the global economy, resulting in millions of jobs “outsourced” overseas. Social Security and Medicare are already the largest expenses in the federal budget. The aging of the 75 million baby boomers threatens a “perfect financial storm”, since people under 65 years of age use $2761 per year in medical services while those over 65 use $12,271, which is a 440% increase in medical use by the aged.
FREE MARKET SOLUTIONS?
Some experts say that the “free market” system could fix our problems. Let capitalism do its work in lowering costs and improving quality through free market competition. The plastic surgery field has led the way. Since plastic surgery is usually not insurance reimbursable, the industry had to compete for customers like any other segment of capitalism. The result over the past decade is a tripling of consumer use and an 84% drop in costs, all due to free market competition. Let the consumer pick and choose health care providers and therapies. Expand our options for treatment. Let “outcomes data” show us the most clinically effective and cost effective therapies. Costs will be controlled when the consumer has a vested interest in the game. Let the insurance actuarial use real risk calculation to assess health insurance. Let the government act as the “referee” in this business, making sure the “game” is played fairly.
If not free market, then let the government take over health care with a single payer system–nationalized health care. The Veteran’s Health Administration, run by the government for veterans, has become a model of efficiency, treating patients for half the cost of other health care institutions, with a prescription accuracy rate of 99.9% and lower hospital infection rate. What we have now is some Frankenstein hybrid of health care that limits the free market considerably with a myriad of unnecessary governmental regulations and bureaucracies. Free market or government run. Take your pick. We could not do any worse than what we have right now.
WHOLE FOODS AND LIFESTYLE AS THE SOLUTION
This chapter was meant to open your eyes to our ineffective health care system. You are encouraged to work with your doctor and continue on your medication while changing your diet and lifestyle so that, hopefully, you do not need the medication.
Whole foods offer us a treasure chest of known nutrients and more obscure “conditionally essential” nutrients that may be able to dramatically bolster your body’s ability to heal itself. And that is the best medicine of all.
PATIENT PROFILE: Benito Martinez Abrogan died in 2006 at the age of 120, leaving the oldest living human title to someone else. Mr.Abrogan was part of one of the poorest countries on earth, Cuba, which spends an average of $251 per person per year with free health care for all, compared to the $7900 per person in the United States providing patchy elitist coverage with dramatic invasive medicine as the prize. Cuba has so many centenarians (people who live to be 100) that they have a club. Mr. Abrogan lived a simple peasant’s life: hard work daily, walked everywhere, only ate what he could raise which was a plant-food dominated diet. There are many books, including BLUE ZONES by Dan Buettner, which try to bring reason to the elusive subject of longevity. In general, the oldest people in the world work hard, live in the country away from city stress and pollution, eat a plant based organically grown diet, take naps, are respected for their age, no vaccinations, all breast fed as infants, have a sense of community in living with family and around friends, drink clean water that is high in minerals, and do not use medical services. Maybe our health care meltdown or metamorphosis will bring us a more sane, humane, scientific, and effective health care system.
[i] . Lazarou J, Pomeranz BH, Corey PN: “Incidence of adverse drug reactions in hospitalized patients.” JAMA 1998;279:1200.
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Last edited by Dr. Patrick Quillin, PhD,RD,CNS on October 22, 2018 at 7:43 pm
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