It’s in your best interest
Imagine a world in which automobile maintenance is available only from car dealerships and is exempt from consumer oversight and market pressures. In this world, the owners of the dealerships set the standards for service and they also warn the public of the dangers of working on cars themselves.
Each year, the dealerships add new high tech equipment for diagnosing problems in cars. But despite this, cars break down more often than ever. Automobile safety is so important, though, that no one notices this discrepancy.
Even if were noticed, the car owners wouldn't question the dealerships. They've been convinced by the dealerships that only the dealerships are knowledgeable enough to understand the care of cars. Whatever the dealerships tell them, the drivers comply with. The dealerships have convinced the drivers that terrible things will happen to their cars if they don't do what the dealerships advise.
This scenario is not some fantasy. It is happening in health care right here in the United States. In his book, Expecting Trouble: the Myth of Prenatal Care in America, Thomas H. Strong, Jr., M.D., a board-certified Obstetrician-Gynecologist, reveals that modern medicine has convinced the consumer that pregnancy should be treated like a disease. As a result, pregnant women now visit their doctors every couple of weeks for time-consuming, expensive, largely unnecessary testing -- all in the name of ensuring healthy babies.
This might be acceptable if modern prenatal care actually produced healthier babies, but the supposed benefits are belied by the facts. As prenatal care has increased over the past thirty years, the number of dangerously low birthweight babies, the ones most at risk for death or complications at birth, has also steadily increased. In addition, research reveals a direct correlation between this high tech monitoring of pregnancy and birth and the number of unnecessary, costly, and sometimes hazardous interventions.
Because no one wants to jeopardize the safety of babies by depriving mothers of the mythological benefits of prenatal care, these statistics are disregarded. In fact, prenatal care is thought to be so essential to fetal health that proponents of social equality want to provide this expensive high tech care to low-income women. This is despite the fact that low-income women, unlike their more privileged sisters, have had no increase in low birthweight babies over the past thirty years.
Statistics show that the more modern medicine involves itself in a pregnancy, the more chance there is that there will be problems. Why, then, does the medical profession persist in treating pregnancy like a disease? Evidently because it is in the doctors' best interest to be expensively involved in pregnancy, even if it is not in the best interest of the patients.
This information is relevant to all of us because similar trends exist in every area of health care. Dr. Strong points out that laws of supply and demand do not influence the cost of care from the medical profession. "Across the twentieth century, as the number of doctors has increased, their incomes have also increased. The only challenge that their burgeoning number posed was that of finding enough disease to keep everyone busy. For enterprising physicians, this hasn't been a problem: as the supply of doctors has expanded, the threshold for conditions that require medical supervision has fallen. In other words, doctors have gone looking for business."
Last week it was announced that the threshold was about to fall for medical treatment of high blood pressure. This week another threshold for treatment has fallen. In a study of the benefits of statins -- cholesterol-lowering drugs -- that was partially financed by Merck & Co., the maker of Zocor, the drug used in the study, it was concluded that taking statins reduces the risk of new heart attacks and strokes for anyone with heart disease, no matter how low their cholesterol level. At present about 25 million people worldwide take statins. It was estimated that the latest findings mean approximately 200 million worldwide would benefit from the drugs, about double the number for whom they are currently recommended.
Instead of protesting, people all over the world are probably phoning their doctors to demand prescriptions for statins. Patients who don't ask for a prescription will undoubtedly find it recommended. Because of the study, use of the drug seems wise. Are there side effects? Of course, but they haven't killed many people when you consider the number taking statins.
Because we've accepted the sales pitch that health is too complex for us to understand and manage on our own, we can be convinced of almost anything medical professionals choose to tell -- and sell -- us. They tell us it's best to spend increasing amounts of money on diagnosis, checkups, and drugs. They assure us we can trust their advice about these complex issues. They insist they have only our best interests in mind. Really they do. Just like the guy trying to sell you a car does.
Quantities of research that was not funded by drug companies reveal significant health benefits from low tech, low cost practices that positively influence the mind as well as the body. For example, studies of the effects of supportive female birth assistants on costs and outcomes during pregnancy and labor show a 25 percent reduction in length of labor, 50 percent reduction in cesarean rates, 60 percent reduction in requests for epidurals, and 40 percent reduction in forceps delivery.
Dr. Dean Ornish's book, Love and Survival: The Scientific Basis for the Healing Power of Intimacy, uses dozens of studies to underscore the fact that it's in our best interests to recognize the health benefits of mind-body factors like social ties and intimacy. Ornish says, "I am not aware of any other factor in medicine -- not diet, not smoking, not exercise, not stress, not genetics, not drugs, not surgery -- that has a greater impact on our quality of life, incidence of illness, and premature death from all causes."
It certainly is not in the best interest of the drug companies to fund research that reveals the health benefits of mind-body factors. Nor is it in the medical profession's best interest to inform you that the most effective ways to promote health cost little to nothing. At present only you, the health care consumer, will benefit from recognizing that you're being flimflammed by the guys who own the dealerships.
Information supporting this fact is not hidden, nor is it too complicated for a layperson to understand. From a purely economic perspective, it's a simple matter of noticing how much bang you get for your health buck. According to a World Health Report last year, the United States spends a whopping $3,724 per person on health each year. The Japanese, who spend just $1,759 per person annually, enjoy four more healthy years of life -- healthy longevity, not just existence in a hospital or nursing home -- than those in the U.S. The French, who spend $2,125, live three years longer in good health than a U.S. citizen. And, please, don't break out the red wine and tofu. It's not their diets that make this big difference. Analyzing a few statistics as we did in last week's newsletter shows that it's mind-body factors that protect health in these countries.
Of course, the question is not only how much health you get for your money. The question is whether health is something only money can buy. It is in your best interest to wake up to the reality behind the mythology of expensive, high tech health care. You've heard that the best things in life are free. It seems clear that despite what you hear at the doctor's office, the best ways to promote health are free, too.