One Skeptic to Another

One Skeptic to Another

Note: the following blog is in response to an article that appeared in my local newspapers

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Professor Pasachoff is a skeptic, as am I…to the extent that one of my guiding precepts is: ‘the quality of your life and your understanding of the world will be determined by the quality of the questions that you ask.’

I suspect that Professor Pasachoff and I would agree on many things, specifically that critical thinking seems to be underutilized, at best, and undermined, at worst, in our society.

But, he and I are at odds when he targets chiropractic in his skepticism. He crossed the line from skepticism/doubt into dogmatism with his label of pseudo-science. So, how do I, as a chiropractor and a skeptic, reconcile this? Quite simply, I welcome Professor Pasachoff’s skepticism, questions and scrutiny, as I do that of my patients. I would ask him what personal research he has done to make this broad denouncement? Or, in this instance, might he be wanting in critical thinking skills?

There is a plethora of scientific evidence supporting both the physiological effects and efficacy of chiropractic adjustments for the treatment of acute neck and low back pain of mechanical origin.

In fact, in 1989, the US government established the Agency for Health Care Policy and Research “to enhance the quality, appropriateness, and effectiveness of health care services and access to these services.” Because of the prevalence, the first guideline developed was for the treatment of acute low back pain. “This guideline was developed by an independent multidisciplinary panel of private-sector clinicians and other experts convened by the Agency for Health Care Policy and Research (AHCPR). The panel employed explicit, science-based methods and expert clinical judgment to develop specific statements on acute low back problems in adults.”

The panel concluded: “Surgery has been found to be helpful in only 1 in 100 cases of (all) low back problems. In some people, surgery can even cause more problems.” Furthermore, scientific, evidence-based research supported only three “Proven Treatments” for acute low back problems: NSAIDS (oral anti-inflammatories), the use of ice or heat and, remarkably…42 studies supported the use of (chiropractic) spinal manipulation of the low back.

Were these guidelines implemented? No! Why? Because citing the efficacy of conservative approaches and recommending non-surgical treatments for low back pain, drove back surgeons wild. They organized and lobbied congress and effectively stripped the AHCPR of its power, halting the development of all future guidelines. Incidentally, the number of spinal fusions continued to rise dramatically, over 127 percent between 1997 and 2004.

Perhaps Professor Pasachoff’s skepticism would be better directed at the machinations of the medical-pharmaceutical industrial complex. After all, in terms of risks verses benefits, the risks and deaths associated with medical/pharmaceutical care far exceed those of any he labeled as pseudo-science. Why aim so low?

It has been estimated that only 15% of what doctors do is backed by the type of hard scientific evidence Professor Pasachoff seeks: ie: that ‘there is little to no evidence that many widely used treatments and procedures actually work better than various cheaper alternatives.”

While there is significant evidence that corporate-backed science has infiltrated and undermined virtually all aspects of medical research for the purpose of marketing drugs.

In September of 2001 the editors of 12 of the world’s most prestigious medical journals issued an unprecedented and chilling alarm titled: Sponsorship, Authorship and Accountability. They wrote: “We are concerned that the current intellectual environment in which clinical research is conceived, study subjects are recruited and the data analyzed and reported (or, not reported) may threaten scientific objectivity…In light of that truth, the use of clinical trials primarily for marketing makes a mockery of clinical investigation and is a misuse of a powerful tool.”

In a world where medical journals have become an extension of pharmaceutical companys’ marketing strategies, skepticism, critical thinking and questioning are not only important, they can save your life.

No Stone Left Unturned

No Stone Left Unturned

One of the biggest indicators of how much we need health care reform is the extent and costs of the battle that the special interests of the medical-pharmaceutical-industrial complex are waging to kill it.

Theirs’ is a well financed, coordinated, no-holds-barred war, leaving no stone un-turned in their efforts to influence the minds, opinions and votes of politicians and the public.

The extent to which they will go, and the strategies which they employ, know no bounds and exceed the imagination of a trusting, misinformed and distracted public.

Case in point:

Health Insurers Caught Paying Facebook Gamers Virtual Currency To Oppose Reform Bill

(click the above link and then their link to gethealthreformright.org)

As the article says: in a process called ‘astro-turfing,’ or in this instance more appropriately called ‘virtual astro-turfing’, corporations like the insurance industry, or organizations like ‘think-tanks,’ etc., create FAKE (virtual) grassroots movements by paying people to act like political supporters. In this case, it isn’t even real money. It is ‘virtual currency!’

Could it get any more insidious or cynical? If this doesn’t exemplify the extent and depths to which they will go…and doesn’t frighten you…I don’t know what will. What else are they doing below the radar of the public at large?

And, could the public knee-jerk response to virtual crumbs (for an inane computer game, of all things) in exchange for their vote (contrary to their own best interests) be any more pathetic?

If you are not ACTIVELY working to enact health care reform (or reform in other major areas: financial, environmental, etc), you should be.

Once again, it reminds me of Hillel’s aphorism: (on personal responsibility)

IF NOT ME, THEN WHO?

IF NOT NOW, THEN WHEN?

Sow the seeds of civil disobedience now!

Health Care Is A Sick Business

Health care is a sick business

Imagine an entity that is both amoral and soulless; its guiding precept is profit and growth. This is the foundation of the modern American conglomerate; including those of the health care, pharmaceutical and insurance industries.

Witness:

“Health insurance giant Aetna is planning to force up to 650,000 clients to drop their coverage next year as it seeks to raise additional revenue to meet profit expectations.

In a third-quarter earnings conference call in late October, officials at Aetna announced that in an effort to improve on a less-than-anticipated profit margin in 2009, they would be raising prices on their consumers in 2010…Aetna actually made a profit in 2009 but not at levels that it anticipated.”

This is consistent with other insurers as well. In May of 2008, “Wellpoint (one of the nation’s largest private pay health plans) reported less-than-expected profits from the first three months of the year” Angela Braly, President and CEO reported, “We will not sacrifice profitability for membership."

Cutting their rolls, increasing premiums and lowering physician re-imbursement to enhance profit margins…could it be any more obvious that the only insurance business they are in is ensuring profit?

Cutting their rolls and raising premiums will increase the numbers of uninsured, typically the sick and elderly, who in turn, will be added to government-run Medicare and Medicaid programs. If that isn’t socialized medicine, what is?

Witness:

“Even as drug makers promise to support Washington’s health care overhaul by shaving $8 billion a year off the nation’s drug costs after the legislation takes effect, the industry has been raising its prices at the fastest rate in years.

In the last year, the industry has raised the wholesale prices of brand-name prescription drugs by about 9 percent, according to industry analysts. That will add more than $10 billion to the nation’s drug bill, which is on track to exceed $300 billion this year. By at least one analysis, it is the highest annual rate of inflation for drug prices since 1992.”

Wow, what a concession: raising prices by more than $10 billion, conceding $8 billion, on their way to $300 billion annually, and growing!

In addition, David Brennan, head of pharma giant AstraZeneca, when asked if he would oppose reform said: "We said there were principles we didn't want to see violated. And if those principles -- price controls, Medicare rebates, moving dual eligibles back from Medicare and back into the Medicaid discount program -- if those things happen, I can't see how we could be supportive of the program."

In short, if health care reform does not guarantee increasing profit margins and growth, BigPharma will oppose it.

By 2017, health care costs are projected to reach $4.3 trillion dollars; an astounding $138,890 per second!! Don’t forget; what you and I call health care costs, the medical-pharmaceutical-insurance industrial complex call profit, projected growth and earnings.

It is precisely this profit oriented approach to health care that has created and drives both, the disease crisis and its subsequent disease-care financial crisis in America.

“At the current rate of increase, the cost of family insurance will reach twenty-seven thousand dollars or more in a decade, taking more than a fifth of every dollar that people earn. Businesses will see their health-coverage expenses rise from ten per cent of total labor costs to seventeen per cent. Health-care spending will essentially devour all our future wage increases and economic growth. State budget costs for health care will more than double, and Medicare will run out of money in just eight years. The cost problem, people have come to realize, threatens not just our prosperity but our solvency.”

Without reform the only thing that will alter this course is its obvious and anticipated collapse, as happened on Wall Street.

Does anyone really still believe we don’t need reform? If so, what have you got to offer that can save us?

The Dark Side of Science

The Dark Side of $cience

Science: knowledge, as of facts or principles, gained by systematic study.

In the past century the miracles and wonders of science have helped us understand our world and tap into, channel and use its natural forces and resources. In every field, from physics to chemistry to medicine, etc., scientific discovery has contributed to benefit and advance humankind. It is no wonder that we look at science with awe and respect bordering on reverence.

However, as the saying goes, ‘power corrupts’ and, science is not exempt.

As I wrote in my last entry, Science Fiction, in today's world $cience is abused to manipulate the masses for corporate profits. Just referencing ‘science' enhances our beliefs and primes our acceptance. Combine that with knee-jerk responses to fear triggers (ie: high cholesterol, osteoporosis, swine flu,etc.), and a general respect and desire for an authoritative voice, and you have a marketing bonanza creating obscene profits.

The corruption of science comes in two basic forms: either the science itself (e.g.; the construct and bias of studies) has been corrupted, or the use of the science (e.g.; the intentional misuse of information) is corrupt. Both abound in medicine. The rigging of medical studies and misrepresentation of research results have become routine and the accepted norm.

Due to the conflict of interests that exist in the prevailing medical-pharmaceutical industrial complex, science and medical knowledge have been appropriated and are being ‘sold’ to an unsuspecting, trusting and increasingly unhealthy public.

But, to what extent?

In September of 2001 the editors of 12 of the world’s most prestigious medical journals issued an unprecedented and chilling alarm. In an article titled: Sponsorship, Authorship and Accountability, they wrote:

“We are concerned that the current intellectual environment in which clinical research is conceived, study subjects are recruited and the data analyzed and reported (or, not reported) may threaten (scientific) objectivity….In light of that truth, the use of clinical trials primarily for marketing makes a mockery of clinical investigation and is a misuse of a powerful tool.”

In no uncertain terms they are saying that the science has been corrupted to the extent that it is no longer reliable. And, even worse, it undermines all they do while putting all of us at tremendous risk: i.e: if the doctors cannot trust the science, the basis for all they do, then how can they (or we, as patients) trust the treatments based on that science?

This begs the question:

How come the editors continue to print commercially sponsored studies?

Answer:

The pharmaceutical companies that sponsor the research also sponsor the journals. They are their largest advertisers. But, more insidiously, to the tune of millions of dollars, they ‘buy back’ reprints of the published studies and use them as scientific evidence of efficacy to market their drugs to doctors and the public.

How are we to know the truth?

The truth, most often, is quite simple, and as such is often too difficult for people to believe.

The truth is: your body is genetically programmed for health. Health is your set-point, your body's most basic survival mechanism. If that was not true, we would have died out, as a species, long ago.

The truth is: we need to reform our health. We need to change our focus away from the failed scientific, never-ending, profit-generating fight against disease to a model of personal responsibility that nurtures our own natural health.

It is often wiser to trust the wisdom of the body and let good sense prevail over corporate science.

Follow the Money

Things are getting seriously ugly as the health care reform debate moves forward. That’s because we have a President who is determined to actually DO something. What it is that he actually CAN do, remains to be seen.

Conservative and GOP-backed think-tanks along with the medical-pharmaceutical-insurance industrial complex’s media, advertising arms and hired guns/lobbyists have ratcheted up their spare-no-expense, no-holds barred, all-out-to-win, fear-mongering campaigns of misinformation and outright lies. Not to mention their wholesale buying of votes, as campaign contributions, from senators and congressmen.

In short, they have nothing positive to offer because they don’t see any problem. According to them, there is no health care crisis. Our health care and insurance systems are fine as they are. Any attempt at reform is a slippery slope to socialism (which, of course, leads to communism), that will lead to the rationing of care (as if we don’t already have it), the end of medical innovation, euthanasia of our elderly (I couldn’t make this up) and, God forbid (or, GOP forbid), higher taxes!

Visit msnbc.com for Breaking News, World News, and News about the Economy

None of this is surprising or new. But sadly, these tactics work.

Fear is a great motivator. Throughout history, governments have used it and, more recently, multi-conglomerate global corporations use fear and lies to motivate the masses to act contrary to their own best interests. We just don’t want to believe that United States’ politicians or agencies (FDA, EPA, etc), or American corporations would knowingly do anything to hurt us.

They wouldn’t, right?

This is a betrayal of the public trust of the highest order, for profit over the public good. And, for that matter, profit over the viability of life on the planet.

We, the People, have the power to direct the national health care debate to achieve the outcome that benefits us most. First, we must learn and understand the facts of the issues and then get involved and take action.

We will be the victims of whatever level of ignorance, apathy and inaction we accept.

As the Nobel Laureate, Economist Paul Krugman, writes:

“It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved (Medicare, Medicaid and the VA/Veteran's Administration), even in private insurance.

And that government involvement is the only reason our system works at all… the bottom line: if you currently have decent health insurance, thank the government”

Indeed, surveys consistently show more patient satisfaction in the government run, single payer, systems of Medicare and the VA than with private sector or employer provided insurance.

And, don’t you find it more than ironic and cynical that the most outspoken critics against the public option for health care are Senators and Congressmen with government sponsored health care? Follow the money!

The role of government is to protect the basic rights of its' citizens from the government itself, and from businesses, corporate and other special interests.

In the case of the health care debate the case for the citizens is clear: access to affordable, ethical health care. Secretly negotiating and brokering deals with the medical, insurance and industrial special interests is clearly more about protecting their incomes than it is about protecting the welfare of Americans.

The 'single payer' sytems of Medicare and the VA, in particular, are excellent examples of government's success in protecting and providing for the basic right of health care to the elderly, the disabled and our veterans.

Perhaps, the area in which the government has proven the most incompetent and dysfunctional is in the Congress itself. That is where reform is needed most; campaign finance reform must happen to reclaim our political system and restore the government to the people.

Health Care Deform

Health Care Deformed

Just how powerful are the medical-pharmaceutical-insurance special interests that oppose health care reform? More powerful than ever, and their power grows daily.

During the Clinton administration these special interests were able to squash attempts at health care reform as if the President and First Lady were as insignificant and powerless as gnats. Their power grew.

Under the corrupt leadership of George Bush, the special interests crafted health care reform legislation that expressly prohibited Medicare from negotiating drug prices with the pharmaceutical companies. This, according to the US House of Representatives, Committee on Government Reform, caused pharmaceutical industry profits to soar by over $8 billion in the six months after January 1, 2006, when the Medicare drug program went into effect.

Recently, President Obama called “health care reform the single most important thing we can do for America's long-term fiscal health. That is a fact.”

And now, in spite of that fact, he is backing away from the single payer option, the ONLY possible solution to this fiscal meltdown.

Senator Dick Durbin (D-Ill) recently said of the banks…"these are still the most powerful lobbies on Capitol Hill. And frankly, they own the place.” The same can be said of the lobbies for the medical-pharmaceutical-industrial complex. That is how powerful these special interests are.

Is it becoming clear to me that the only thing, I repeat: THE ONLY THING, that will get Americans the health care reform we need to prevent, not only individuals and families, but small and large businesses, municipalities, cities, states and the US government from going bust is the kind of mass public demonstrations of the Anti-war and Civil Rights Movements and those that are happening in Iran as we speak.

Nothing short of that will get our corporate-owned politicians to do the work of the people over the interests of the medical-insurance-pharmaceutical industrial complex.

To believe anything else flies in the face of the 100 year history of health care reform and is to live in a fantasy.

Is Health Care Too Big To Fix?

Is Health Care Too Big To Fix?

We have a democratic president, elected by a landslide vote, and a democratic majority in the House and Senate, proposing a single payer solution for health care reform that is widely supported by a vast majority of Americans, Democrats and Republicans. Yet that reform legislation faces an uphill battle and is unlikely to pass in any significant, game-changing, way.

What’s wrong with that picture? Power and influence as exercised by vested interests (the medical-pharmaceutical-insurance industrial complex), their money, and their lobbyists.

These vested interesting have successfully blocked all attempts at health care reform for over 70 years, and are working hard to do so now. But, in today’s world, there are additional, complicating factors that make me wonder if health care is too big to fix.

Health care represents the largest sector of the American economy. That is, that it generates more money and employs more people than manufacturing, or any other sector of the economy. “Health care accounts for $1 in every $6 spent in the United States -- and costs are climbing at twice the rate of inflation.” Our biggest business is taking care of our sick and, for obvious reasons, is one of the only business sectors with projected growth.

To that extent, what city or town would shun new jobs created by any of the players in the medical-pharmaceutical-insurance industrial complex? Or, perhaps even harder to imagine, what city or town would be willing to lose jobs, in our current economy, due to potential down-sizing of any aspect of the health care sector? And, hardest to imagine at all, what politician would ever make that pitch in his/her district?

The driving force of health care is how sick so many of us are. Our disease-focused culture and lifestyles have resulted in misguided and erroneous beliefs about, and expectations of, the capabilities of our health care to both provide for all of us and miraculously cure us at a cost we can all afford. We created a for profit health care delivery system that feeds on sickness to produce profits, pay dividends and project constant growth.

We are addicted to both our unhealthy lifestyles and the disease care, yet we are surprised by our diseases and the costs of care.

It is really a pretty straightforward and simple equation: increasing numbers of sick people with increased access to a for-profit, growth driven health care delivery system will continue to drive up costs, no matter who pays.

Any effective reform will have to be both dramatic and quick; not unlike the introduction of Medicare, which was efficiently instituted nationwide in less than a year, before there were computers.

In order to succeed, reform will have to include drastic changes in both the delivery systems and the way we pay for it, in addition to, drastic changes in our lifestyles and culture to promote health and wellness.

It is a complex and dangerous web we have woven. Ultimately, we are lead to believe that the Banks and Wall Street and are too big to fail and health care is too big to fix.

Waiting for Health Care Reform

Waiting for Health Care Reform

"We're waiting for the day when getting sick doesn't mean going broke. We're waiting for emergency rooms that aren't overcrowded. We're waiting for our policymakers to take action and fix the problem. We're waiting for the nation to have the best health care system. We are waiting for health care reform!"

On May 11^th, representatives from the insurance industry, the pharmaceutical industry, the hospital industry, the medical device manufacturer’s industry, doctors and the medical establishment (AMA) met with President Obama and agreed to slow growth in health care by 1.5%, thus shaving $2 trillion in savings over the next 10 years.

Three days later, they rescinded that promise.

Everything about this scenario highlights the principle flaws and failures of all attempts at so-called health care reform, to date.

I recently read that:

“Public policy is like sausage: you do not want to see how it is made, and the end product is not good for your health.”

All of the parties who met with the White House are representatives of the medical-pharmaceutical-insurance industrial complex. There was nobody there representing us, the people/consumers. It is clear that we, the people, do not have a seat at the table, let alone a voice, and that enormous profound decisions will be made relative to our health, health care and related expenses without our input.

That is dangerous and does not bode well for us. The reason: what you and I call health care expenses, they call profit.

The medical-pharmaceutical-insurance industrial complex is, above all else, a commercial, for-profit industry. As long as the business incentives of profit and growth dominate, the costs of care will continue to spiral higher. That is the essence and nature of business.

This point could not have been driven home more poignantly when the parties reneged on their promise. After all, their promise had nothing to do with killing profits, just with slowing growth by 1.5%; more precisely, slowing the annual rate of growth from the current 6.2%, to a rate of 4.7%. This, according to them, would be 2 trillion dollars less profit over 10 years ($200 billion dollars per year). That sounds like a lot, but this is an industry that generated $2.4 trillion in 2006, with anticipated revenues of $4.3 trillion by 2017.

Ultimately, they couldn’t even agree to curtailing profits by about 8%!

From our perspective as consumers, the system has failed us. The for-profit system continues to drive up costs, stressing the viability of businesses, government and individuals, excluding more and more people, at the same time providing inefficient and inconsistent quality of care. Yet, this for-profit health system refuses to reform. And, with each passing year, as their power and influence grows, the reform we need becomes more difficult to achieve.

The entire system needs drastic overhaul and reform, way beyond the mere creation of a unified payer, which has virtually nothing to do with controlling costs. Piecemeal attempts at reform evoke false hopes, much like CPR, which fails almost 100% of the time “because of the largely overlooked fact that it is being performed on the already dead.”

Ultimately, as David Mechanic says in his book The Truth About Health Care:

“At some point we as a nation will have to decide whether we wish to design our health system primarily to satisfy those who profit from it, or to protect the health and welfare of all Americans.”