register |  login
› GOLDEN
Loading Ad
Visit Other Hubs:
ADVERTISEMENT
Loading Tower
RECENT STORIES

Our medical system is unsustainable

Contributed by: Francis Miller on 5/24/2006

Several years ago, I read this fascinating book by Dr. Thomas McKeowan, titled "The Role of Medicine." In it he questioned whether the health care system was responsible for our improved life expectancy or whether it came from improved sanitary conditions, water and sewer.

Now comes an article in the May 29 issue of Business Week, "Medical Guesswork." by John Carey that is along those lines and must reading, if you ever plan on getting sick and seeing a doctor.

High tech health care in the U.S. is $2 trillion a year industry and we outspend our mother country Britain by 1-1/2 times, yet we are not as healthy as it or at least a dozen other countries in the World. What is worse, according to Carey, is that there is "no evidence that many widely used treatments and procedures actually work better than cheaper alternatives". In the 1980s, Dr. David Eddy, of Stanford and, later, Duke, was a voice in the wilderness when he stated that only 15% of what doctors do is backed by hard evidence. Now, 20 years later, there is common consensus amongst the medical decision making elite, that only 20% to 25% is proven effective, the rest is done by tradition.

Consider a few of the diseases that might someday afflict you or your loved ones:

Diabetes--The conventional treatment approach does not prevent strokes and heart attacks, but a simple regimen of aspirin and generic statin and ACE inhibitor drugs, which lowers blood pressure and cholesterol, can send rates plummeting.

Tonsilectomies and Ear Tubes-- In the 1950s, I, and most of my childhood friends had our tonsils yanked, yet now we know it produces no benefits to most children. There are 300,000 ear tube operations a year done at a cost of $2,000 to $4,000 a pop, yet we are now coming to the conclusion that such operations can hamper hearing and slow language development.

Spinal Surgery--The 325,000 spinal fusions in the US every year cost an average of $50,000, equivalent to the price of a luxury SUV, but there is increasing evidence that exercise, physical therapy, and time itself can also work. Not to mention the pain clinics full of people who had surgery who are now worse off.

Prostrate Cancer--There is no evidence that the PSA test you routinely get at the talking head health fair improves survival. There are four kinds of surgery, various kinds of radioactive seeds and several radiation treatment possibilities to pick from. See a surgeon and you'll likely get surgery but go down the road to a radiologist and you'll likely get radiation. The conventional wisdom that aggressive surgery is the gold standard but it lacks evidence and according to Dr. Erick Klein, head of urologic oncology at the Cleveland Clinic, "there really isn't good evidence to suggest that one treatment is better than another".

Heart Bypass Surgery--There are 400,000 heart bypasses a year at $20,000 to $50,000 each. Yet, for the 97% of the people who do not really have severe heart disease, it is believed drug treatment is as good to extend life and prevent heart attacks. That's not to mention another 1 million angioplasties done every year of which 400,000 are believed unnecessary. According to Dr. Roger J. Laham, of the Harvard Medical School, "there is no evidence that opening up chronically narrowed arteries reduces the risk of heart attack" And, don't forget: by-pass surgery carries a big risk of inducing mental declines.

Mastectomy versus Lumpectomy--There are 50,000 mastectomies a year at $12,000 to $14,000 each; a source of unmeasureable stress for women. Yet, "there is no evidence that a mastecomy has a better 20-year outcome than a lumpectomy, provided the tissue around the lump is clear of cancer.

Now, if you are like me, you think--aren't these guys studying this all the time with our tax dollars. Well, according to the Journal of the American Medical Association, JAMA, one third of all clinical studies are later overturned. And, a no less credible source than the RAND Corporation says, "the disturbing truth is treatments that are proven to work reach only half of Americans who need them".

For 150 years it has been known that unwashed hands pass infections from patient-to-patient and thousands of people die every year at a cost of billions of dollars. Concentrated efforts in select hospitals have proven 80% of hospital acquired infections could be eliminated if doctors and nurses would only wash their hands.

I encourage everyone to go to the Library and read John Carey's article in Business Week. Even better, make a copy and send it to your doctor or forward e-mail this posting. And send a letter to your legislator demanding that Colorado hospitals be required to report their infection rates and the number of unnecessary or questionable procedures they perform where evidence is not supportable.

State-after-state is considering mandating that we all buy health insurance as a solution to the health care cost crisis. But, as I have previously reported, the average cost of an employee family policy nationwide is over $8,000 a year and will be $16,000 per family policy in another five years based on past trends. The Colorado insurance commissioner website shows the monthly cost for a Kaiser family policy is over $1,300 a month and for someone who needs to pick their doctor, an Aetna indemnity policy is over $2,300 a month.

This situation is clearly unsustainable and cannot be solved by forcing health insurance on the have-nots. You can't have PERA employees retiring at 70% of their salary at 55 and large corporation employees working at U.S. West and Public Service with cradle-to-grave benefits, all the while with the chiropractors and other providers constantly lobbying for mandated benefits.

My prediction is that we are merely biding our time, waiting for the big event that pushes the system over the edge. Maybe it will be a pandemic, terrorism, or a series of hurricanes and earthquakes in populous centers. Or, perhaps it will be a depression that causes a rise in unemployment and an inability of government to raise taxes. It is a system just waiting for the bubble to burst. That will purge the excess out of the system when surgeons are happy to accept a chicken as payment for their services. Until then, the band on the Titanic is taking your request.

Francis M. Miller is a practicing management consultant and the past vice chairman of the Colorado Health Data Commission and past president of the Colorado Business Coalition for Health. He is currently involved in setting up a website and technical assistance center for trade associations, chambers of commerce, cooperatives and franchise networks who want to sponsor health plans for their membership. The website can be viewed at www.healthfuturesexchange.com



SUBMIT COMMENT

Rate the above story



Current Rating
Based on 1 user ratings.

Talk Back : submit comments to the story

*Note: you need to log-in to add a comment or rating.

CONTRIBUTOR INFORMATION

Francis Miller

Parker , CO

Francis Miller has posted 699 stories and 9 comments since joining on 11/17/2005. Francis Miller's average story rating is 4.2.
SAVE AND SHARE THIS STORY
STORY RSS FEEDS
WANT TO WRITE FOR YOURHUB.COM?
Want to see the stories you write and the photos you shoot featured in the YourHub.com Thursday print section available all over the Front Range and with home subscriptions of the Rocky Mountain News and The Denver Post? All you have to do is register, then post a story or column, start a blog or tell everyone what events are happening in town. We will print the best stories, columns, event listings, photos and blog entries in our print sections.

ADVERTISEMENT
Loading Ad

Loading Ad
ADVERTISEMENT
Loading Ad

This YourHub.com community is produced by The Denver Newspaper Agency
Web Development and Channel Analytics provided by Indigio

terms of use //  privacy policy
the staff //  advertise //  help & faq
buy photos