HIJACKED: US HEALTHCARE Care in Crisis, Physicians at the Center
By Ronald Stallings, MD.
A Babe in the Woods
My patients that night, a group of young accident victims with head and neck fractures, had made my 24 hour ER shift especially exhausting. The early morning drive east along the Columbia River from the Oregon coast was lulling me to sleep. It is a beautiful drive, but the beauty is repetitive, and that morning it was blurring in and out of focus. My eyelids lifted and fell like lead.
The endless forms that I’d had to fill out that night on each of the patients had taken their toll, too. The forms are designed to facilitate patient evaluation, but I think they are really designed to squeeze the maximum billing out of each patient visit.
As I drove along, the next choice I made changed my life forever. I decided to fight off sleep by listening to a medical education tape series that I subscribe to. Barely able to focus, I snapped the tape into the player. The voice said,
“The former editor of the New England Journal of Medicine states that it is no longer possible to believe most of clinical research published, or rely upon the judgment of trusted physicians or authoritative medical guidelines. The FDA, as of twelve years ago, is entirely funded by the pharmaceutical companies.”
My eyes popped wide open. The speaker had my full attention. I suddenly knew that what he was telling me was the real reason behind my sabbatical leave the year before. And I thought about my present work place. The one and only meeting that I was ever asked to attend at that hospital was a marketing session. How could this be? How could the field of medicine I had dedicated 25 years of my life to have taken such a drastic wrong turn? How had the forces of self interest turned a once ethical institution into an establishment that places profits over people? Like a raging flood down the Columbia River, I felt a rush of memories—the irritants, the contradictions, the corruption I’d seen first-hand–it all poured over me.
That day I also wondered if the medical use of marijuana, which I had been ambivalent about, could possibly be part of the solution for medical care in the U.S. And, I wondered if it also might save me from the guilt and outrage I was feeling.
Two years have passed since that pivotal day. I have read books and articles, talked with people here and in other countries. In the U.S., it seems that the hijacking is just about complete. It will take persistent hard work over a long period of time to turn this situation around and I want to begin by telling you about what I have learned.
Not Your Parents’ History Lesson: A Short History of Drugs and Supplements
Many of the wonder drugs that transformed human health during the last hundred years are natural substances that have been in use for centuries. Penicillin, for example, was used by South American indigenous physicians some 800 years ago. Greenwald, Blackman, Dowell, Pascual, and Woodbury in their 1998 Time article, “Herbal Healing,” reviewed some history:
“Ephedra, the main ingredient of some over-the-counter asthma treatments, has relieved breathing problems in China for 5,000 years. An estimated 25% of all modern pharmaceutical drugs are derived from herbs, including aspirin (from white willow bark), the heart medication digitalis (foxglove), and the cancer treatment Taxol (Pacific yew tree). There might have been no sexual revolution without the birth-control pill, derived from a Mexican yam. Studies have shown that wine, which has been available to many cultures throughout the centuries, is a major factor in the reduction of cardiovascular disease and longevity. U.S. Doctors more commonly prescribed medicinal herbs before World War II and before the advent of wonder drugs like penicillin (Greenwald, et. al., 1998).
Also, less parochial minded individuals are turning to cannabis, which has been shown to be scientifically effective and has been used for thousands of years for a myriad of illnesses
All of the alternative medications are popular, in part, because they are usually cheaper than prescription medications (Yan, 2009).
Linda Marsa, in her book Prescription for Profits notes that most of the reasons for the improved health of the world, in developed countries where infections had not been a major factor in morbidity and mortality, can be attributed to better sanitation of water and food as well as improved safety conditions at work and elsewhere.
It is, she says, “…impossible to overstate the importance of the discovery of penicillin…Common potentially deadly illnesses, after penicillin came on the scene, became relatively minor ailments. And the unprecedented collaboration between government and industry to mass-produce penicillin was a spectacular demonstration of what a well-financed, cooperative research effort could accomplish.” (Marsa, 1997, p. 22)
Bacterial and parasitic diseases are the second leading cause of death worldwide. According to a report on antibiotic research released in 2009 by the London School of Economics and Political Science, 175,000 deaths are attributed to hospital-acquired infections each year in Europe alone (Harrell, 2009).
Despite the importance of effective antibiotics, the number of different antibiotics available to treat infections when they do occur is dwindling because pharmaceutical companies have neglected to invest in the development of new types of drugs (Harrell, 2009).
It is true in general that the development of any new drugs is declining sharply because the big money is to be made in lifestyle drugs and making small changes in existing drugs to seek approval to market them for treatment of other conditions.
My own trips to Central and South America have helped me understand the reasons that microbes have mutated and why we are losing the battle against them, with little help from the pharmaceutical industry. In many countries a person does not need a physician’s prescription to buy an antibiotic. Patients who are experiencing flu-like symptoms will, at the encouragement of their pharmacist, self-medicate for a viral or other illness for which antibiotics are completely ineffective. This, of course, ruins the effectiveness of an antibiotic when it is needed to treat an infection. I contend that doctors and pharmacists, almost single handedly, are responsible for an infection epidemic that is sweeping the nation: MRSA [Methicillin-resistant Staphylococcus aureus]. MRSA is a potentially lethal disease caused by an over prescription of antibiotics, usually for viral illnesses for which there is no cure.
Laura Blue, in an October 17, 2008 Time Magazine article discussing MRSA, noted that, “The last two decades of the 20th century saw nearly zero progress, and in those years several disease-causing bacteria evolved resistance to commonly used drugs. Researchers at the Centers for Disease Control and Prevention found that more than 40% of staph infections in the U.S in 2006 were MRSA– a bug that now kills more Americans a year than AIDS.”
There are several reasons why it’s not cost-effective for pharmaceutical companies to invest in antibiotic research, according to a London School of Economics report cited by Eben Harrell’s 2009 article in Time, “The Desperate Need for New Antibiotics.” Here are the reasons.
“The course of antibiotic treatment is typically short because the drug helps patients get better quickly.
“Doctors tend to write fewer prescriptions for an effective antibiotic so that their patients will be less likely to develop resistance to the drug.
“And then, when resistance to a certain antibiotic inevitably develops, the drug becomes obsolete.”
And, as we know, if it is not profitable, industry won’t invest research dollars.
Underlying the criticisms is the understanding that products like Clarinex, Crestor, and Botox waste resources, keep drug spending high, and distract the industry from doing really important work….all the brainpower that is devoted to tweaking Claritin (to keep the patent going) or developing Botox and other “Lifestyle drugs” could have been used to cure cancer (and AIDS) (Hawthorne, 2005, p. 277).
Or, of course, developing new antibiotics.
How did we get to a point where drug companies are manipulating our healthcare system for their own profits? How did we get to a point where government agencies support the interests of Wall Street and Big Pharma and leave the rest of us with the world’s most costly (2.3 trillion dollar a year) sick-care system that rewards us with a of life expectancy that ranks 42nd in the world and is, by all accounts, broken?
In the next issue, I will relay to you what I have found.
© Copyright 2010. Dr. Ronald Stallings. Reprinted by permission. Originally appearing in Treating Yourself magazine in 2010. Dr Ronald Stallings, MD, Board Cert. Emergency Medicine, Director Research and Developement, Emerald Leaf Institute, Read the entire article (after the last installment) at www.EmeraldLeafInstitute.com.