by Bill Sardi
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A couple of PhD analysts write about what's wrong with American healthcare in a recent edition of The New England Journal of Medicine. Their report, entitled "What Business Are We In?"
They analogously lead off their article by pointing to the Eastman Kodak Company that saw itself in the film business rather than the imaging business and after 131 years in business, filed for bankruptcy in January of 2012.
So they write: "The analogous situation in health care is that whereas doctors and hospitals focus on producing health care, what people really want is health. Health care is just a means to that end — and an increasingly expensive one. If we could get better health some other way, just as we can now produce images without film….., then maybe we wouldn’t have to rely so much on health care."
With this revelation, that modern healthcare needs to rethink what business it is in, comes the concession that maybe modern medicine doesn't deserve all of the accolades it receives. The PhD-analysts say it best: "the evidence does suggest that health care as conventionally delivered explains only a small amount — perhaps 10% — of premature deaths as compared with other factors, including social context, environmental influences, and personal behavior."
But do we really see the end of doctoring? The American people have fallen sucker for the sales pitch, that America has the best healthcare in the world, and they want more of it, regardless of whether it works or not. Many Americans feel they paid into a system (Medicare) and they want what they paid for. They want the miracle drugs, the CAT-scans, the robotic surgery, all of it, as long as it doesn't have to be paid out of their own pocket. They can't imagine that that healthcare system cannot possibly deliver on its promises to provide more and more high-technology medicine to a growing population of aging Americans. There will be a default, call it rationing, but from a different quarter, as I will explain momentarily.
But then these PhDs get side tracked. They somehow believe better monitoring (snooping) will produce better health. A major aspect of the type of healthcare reform being thrust upon doctors is electronic medical records. Just how does electronic charting improve health? It doesn't, but it allows overseers to see if a doctor is prescribing according to establish guidelines, guidelines often written by Big Pharma. We already have an over-medicated society. This is just another evidence of growing fascism in medicine.
The PhDs ask: "What do we need to move from a product-oriented industry to a customer-oriented one?" No, they didn't get their own message. Modern medicine is the problem, not the solution. Modern medicine is not going to take money out of its own hands. The solutions are going to come from an entirely different quarter. Neither did Kodak see the handwriting on the wall. The only way to reform medicine and bring down its obscene costs is to create alternatives, just like Kodak succumbed to digital cameras. The problem is, alternative medicine has not fared much better. It still is mired in Ouija-board medicine (alkaline diets, "muscle testing," and a variety of still unproven nostrums). While alternative medicine now garners about a third of healthcare dollars, all it has done is add more costs as confused patients now partake of both conventional and alternative medicine. They take Lipitor, Metformin and Xanax along with fish oil, vitamin C and whatever the latest herbal craze is.
The PhDs do point in the right direction when they say: "One signal is that while much of recent U.S. medical practice proceeds as if health and disease were entirely biologic, our understanding of health’s social determinants has become deeper and more convincing. An enormous body of literature supports the view that differences in health are determined as much by the social circumstances that underlie them as by the biologic processes that mediate them." They point to British civil servants whose health status increases with their civil-service grade.
In a prior column about healthcare reform I wrote that American wages have stagnated. Pay raises were traded for increased health insurance premiums paid by employers.
Income predicts health. People with extra dollars can purchase better quality food, vitamins, and tend to be more literate and therefore savvy about producing health at home. The irony here is that the people who can least afford modern medicine tend to be its best customers, while wealthier and better educated tend to seek alternative treatments (think of Steve Jobs in his battle with pancreatic cancer).
But contrast this with the recent revelation that 46% of American retirees solely rely on a Social Security check. Over-priced American healthcare stole their pay raises and left them penniless in their retirement! (The PhDs missed this point.) There is no freedom to choose. Most retirees have to take what Medicare pays for, and it certainly doesn't pay for vitamin supplements or healthy food. Herded like cattle, retirees take more and more problematic and ineffective medicines without recognizing these pharmacological elixirs are causing more problems than their diseases.
There may be no way out of this mess short of altering the food chain, eliminating cheap sugars (high fructose corn syrup), taste enhancers (MSG), hormonized meat, hydrogenated fats, iron-fortified breakfast cereals, and cheap food that is centered on carbohydrates (pasta, rice, bread, beans). Greater advances in health status will come from improving the American food chain than in any doctoring. But don't bet on Kraft or Archer Daniels Midland leading the way either. All the promotion of healthy foods is completely undone by TV advertising for snack foods. Pringles are not going to disappear.
One of the more startling reports I have read is the recent revelation that the diabesity epidemic that America has spawned appears to emanate from the earliest days of life when infants are programmed to be obese.
Liberated American women are not given to the inconvenience of breast feeding. While an estimated 74% start out with good intentions, only 33% of moms exclusively breast feed at three months of age and only 14% exclusively breast feed at six months. The selection of an alternative to breast milk may doom a child's future health. A recent study reveals that cow's milk infant formulas provide an excessive amount of leucine, an amino acid that genetically re-programs a child towards obesity. Cow's milk is intended to build a newborn calf into a 1000-pound cow.
As researchers at Temple University have said: "Obesity, Type 2 diabetes, asthma, autism spectrum disorder and attention deficit hyperactivity disorder have increased at rates that cannot be due to changes in the genetic structure of the population, and are difficult to ascribe to changes in diagnostic criteria or ascertainment." What they have discovered is that modern environmental factors, in particular foods but also other chemicals in baby bottles (bisphenol A), teething rings, even toys, are genetically reprogramming a generation of diseased children outside of their own control.
How will modern medicine respond to this sad discovery? Will pediatricians warn mothers away from cow's milk formulas? Don't bet on it. Modern medicine will revel in the fact there is more disease to treat and collect more insurance money.
Fortunately, genes are not static. The discovery that genes can be re-programmed suggests many of these genetic tendencies can be undone. The French found a way. Their traditional fattier diet and dark aged red wine reprograms the human body way from abdominal obesity. The heart healthy diets and empty-calorie diets proposed by modern medicine are not effective. A study of why people living in 32 towns in Spain were far healthier (half as much obesity, far lower mortality from heart disease) among 1822 Spanish towns surveyed found that high fish intake and wine consumption were strongly related to this healthy pattern. (The lesson here is study health, not disease.) And there is evidence that small molecules known as polyphenols, found in grapes, wine, tea, coffee and cocoa help to genetically program the body towards health and less disease.
To conclude, modern medicine is not going to recommend anything where it is shoved out of the picture. But that is exactly what needs to be done. Less doctoring, not more. If you want to remain healthy you need to learn how to skirt around the present healthcare system. Humans can be re-programmed to be healthy by their foods and dietary supplements, not doctor-prescribed drugs.
Will this happen? The Western disease-promoting diet can be changed. But don't bet on social change. Yet it is a fact that the mortality rate for coronary heart disease has declined in America from 240 per 100,000 in the 1990s to less than 200 per 100,000 today at the same time wine consumption has risen dramatically. Is it just a coincidence that the unhealthiest metro areas of the U.S. just happen to be the areas of the lowest consumption of wine? Should this ever be fully realized, wine will rival gold as an item of value.