The U.S. government's annual bill for healthcare spending – $3,925 per person – significantly exceeds that of all other nations. Despite this, our current health care system is increasingly failing both patients and medical practitioners. Of 13 nations, the U.S. is last for neonatal and infant mortality, last for years of potential life lost, 10th for age-adjusted mortality, 11th and 12th for female and male life expectancy respectively. Chronic degenerative diseases – heart disease, cancer, arthritis, obesity, etc. – are at epidemic levels and create the ideal long-term customers to grow the medical industry.
Looking for a culprit? Consider that pharmaceutical company profits are so large they outstrip every other American industry by far. Americans spend over $500 billion on drugs. The drug companies claim that they need large earnings ($124,835,595,000 in 1999, for example) to conduct their research, but just one of every five dollars the drug industry collects actually goes to drug research. Some drug companies spend twice as much annually for marketing and advertising. From the years 1996 to 2001, pharmaceutical companies spent $3 billion on consumer advertising. Many of the advertised pharmaceuticals are not (contrary to popular belief) FDA-approved, and the information contained in the advertisements is often misleading and not entirely accurate. Now there is even a new wave of drugs being marketed to alleviate the side effects of other drugs being marketed (e.g. NexiumTM to relieve digestive problems created by pain killers).
Pharmaceutical companies have enormous influence on physicians through the billions of dollars of marketing resources. Drug companies in the U.S. spend, on average, $10,000 each year per physician to influence their behavior through subsidizing studies in major journals, aggressive marketing by drug reps (in some instances trained exactly how long to shake a doctor’s hand), advertisements and sponsorship of medical education programs for doctors and medical residents. (Such support of education and science subtly brainwashes physicians into thinking symptom-based medicine is sound knowledge and science as well.) Is it any surprise that two thirds of visits to doctors' offices result in a drug being prescribed? Some patients may be on numerous medications prescribed by various specialists while not one of them knows, or could even predict, the health consequences of the interactions. (I recently discovered that my elderly mother, suffering from a variety of ailments, including dementia, was on 17 different medications. Not only did she not know what she was taking or when she did, neither did any of her physicians.) Little wonder pharmaceutical toxicity is one of the major factors contributing to medical care being the leading cause of death in the U.S. (Why Modern Medicine is the Greatest Threat to Health, [http://www.wysong.net/health/post_77_061902.shtml])
Aside from profiteering and marketing, the most fundamental flaw in the system is philosophical. Doctors and pharmaceutical companies think about names of diseases and removal of symptoms, not cure or prevention. They chase, but the race is rigged so they never catch.
Enabling such a system to prosper and flourish is a public that also has a flawed philosophy. They want to live life as they choose, carpe diem, thinking only of momentary relief, pleasure and convenience. When something goes wrong with their health they don’t want instruction on how to change lifestyle, but rather want to use the power of money (preferably the government’s) to buy their way out with a silver drug bullet that immediately takes the problem away. We spend much for dying, little for living.
American health will continue to slip and our economy will continue to be drained by a failing healthcare system until the underlying flawed philosophies are changed. Medicine must change from naming diseases and treating symptoms to prevention and cure. Yes, that means the medical care system should be trying to put itself out of business, not create a growth industry of illness.
On the other hand, people must change by taking the responsibility for controlling their own health destiny. As it stands, the public has become a pawn of commercial medical interests.
Ultimately health is something we do to ourselves, not something others do to us. When that fact is faced, the medical-pharmaceutical complex will shrivel to a cottage industry and the public will be the better for it.
(Br Med J, 2003; 326:416 http://bmj.bmjjournals.com/cgi/content/full/326/7386/416/b. N Engl J Med, 2002; 346:498-505, 524-531 http://content.nejm.org/content/vol346/issue7/index.shtml.)