Op/Ed: Money Can’t Buy You Health

AddThis Social Bookmark Button

"Healthcare" is supposed to be a big election issue: politicians promise universal and equal "healthcare," or prevent it from being taken away. Everyone wants to be healthy, and a $3 trillion industry wants to keep the money flowing.

So, I have a confession to make as a doctor: I don't think I have ever kept anybody healthy. If someone comes to me asking for "health maintenance," I don't have a shot of "health" to give, or a prescription for "health" to be filled at your neighborhood Walgreens, CVS, or Rite-Aid.

And as a patient, I can't recall any ways in which doctors kept me healthy, although they did save my life by taking out my appendix, and they treated some illnesses and injuries. I am very grateful to them, and whatever I paid them seemed reasonable and well worth it.


Beltway Insider: Trump/Queen Toast, Brits Protest, D-Day Anniversary, PM Hopefuls Implode, Manafort Headed to Rikers, Dr. John

To my mind, a healthy person is one who does not have to see a "healthcare provider" regularly or take medicine every day, and who can go to work, take care of family, and generally lead an active life.

We hear endless complaints about how we spend too much money treating sickness instead of preventing it. If only we had the government take all the money, plus trillions more, and "invest" it in health, we wouldn't have to spend so much, and everyone would be healthier—so they say.

This was the rationale for the National Health Service in Britain. Once the NHS took care of the backlog of untreated illnesses, much of the need for it would melt away. This did not happen. Expenditures kept rising and were never enough. The backlogs and waiting lists grew. Ambulances circle emergency departments, and patients are crammed into hallways and storage rooms.

Suppose you go for your government-funded, "value-based" health maintenance visit. Details of your once-private life will be entered into a very expensive electronic health record. (For most people, it will be their own data, but occasionally someone else's will be cut-and-pasted in, causing endless trouble.)

You will be checked for diabetes or pre-diabetes, hypertension or pre-hypertension, tobacco use, cholesterol, in many cases gun ownership, body mass index, and other government-mandated items. You will get educated about the evils of tobacco (in case you have been on Mars and hadn't heard). You'll be lectured about obesity if your BMI is too high. You'll very likely get a prescription to lower your blood pressure or cholesterol, and you may get vaccinated for something.


World News: Benny Gantz Cosmetically Shifts Center-Right in attempt to 'Trump Netanyahu's Ace'

Your provider will likely get a bonus for checking all the right boxes and for "keeping you healthy," and will get penalized if your "numbers" don't improve or you get sick. Since I don't think others are any better than I am at creating health, there is a huge incentive to "manage the case mix" to discourage unhealthy or noncompliant patients from joining the practice.

People on drugs for blood pressure or cholesterol may feel worse rather than better but are supposed to be less likely to have a heart attack or stroke decades later. Studies with huge numbers of patients, who may be very different from you, have shown a decrease in such events with treatment. So far, a decrease in expenditures has not been shown, in view of the cost of all the drugs and side effects.

Of course, as an internist I treat high blood pressure and diabetes, but I consider this to be disease management. Would better diet prevent these things? Possibly, but what diet? I recommended low-fat diets for years. This government-approved advice is now questioned.


World News: Emmanuel Macron and .... the Others

So how would government-funded primary care have prevented the diseases my patients have had? Heart failure? (Statin drugs probably make it worse.)

Heart attacks? (When the patient has one, it is too late to prevent it.)

Stroke? (Preventive aspirin is now criticized because of the bleeding it may cause.)

Osteoarthritis? (We have great joint replacements but are much better at blocking access to surgery than at curing the arthritis.)

Gall bladder disease, cancer, pneumonia, blood clots, thyroid disease, cataracts, arrhythmias such as atrial fibrillation, herniated disks, asthma, endocarditis from drug abuse, on and on. If we put all the doctors to work pretending to keep people healthy, who would treat disease and injury?

Healing the sick is what medicine is about. The politicians who promise to "fix healthcare" can only destroy medicine—while bankrupting the country.

 

 

Bio:Jane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital.

She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989. She is currently president of Doctors for Disaster Preparedness. She is the author of YOUR Doctor Is Not In: Healthy Skepticism about National Healthcare, and the second through fifth editions of Sapira's Art and Science of Bedside Diagnosis published by Wolters Kluwer.

She authored books for schoolchildren, Professor Klugimkopf's Old-Fashioned English Grammar and Professor Klugimkopf's Spelling Method, published by Robinson Books, and coauthored two novels published as Kindle books, Neomorts and Moonshine. More than 100 of her papers have been published in the scientific and popular literature on a variety of subjects including risk assessment, natural and technological hazards and nonhazards, and medical economics and ethics. She is the editor of AAPS News, the Doctors for Disaster Preparedness Newsletter, and Civil Defense Perspectives, and is the managing editor of the Journal of American Physicians and Surgeons.

Haute Tease

  • Dems Win House Put Brakes on Trump Reign; Senate Remains Red

    AddThis Social Bookmark Button

    Americans flocked to the polls yesterday, taking decisive action in the historic mid-term elections and put the brakes on President Trump’s steamrolling agenda winning back the House of Representative for the first time in eight years.

     
  • Hey, You're That Guy: Actor Paul Willson Talks Improv and an Actor's Life

    AddThis Social Bookmark Button

    Hollywood has launched a thousand careers, and among them are the many extremely talented character actors and comedians we’ve watched for years, whose nuanced performances knock us on our asses every time we see them.

     
  • Kobe & Cabernet Club Review - Membership Has its Privileges

    AddThis Social Bookmark Button

    When it comes to food-and-wine pairings, American Kobe (Wagyu) beef matched with an intensely flavored Cabernet Sauvignon is nothing short of impeccable.  The combination of a full bodied Cabernet with deep, concentrated flavor in combination with a fine-cut grade of this succulent, buttery beef is an exquisite epicurean experience like none other.

     
  • Celebrity Interview: Talking with Dennis Quaid on the Making of I Can Only Imagine

    AddThis Social Bookmark Button

    Dennis Quaid stars in the faith based I Can Only Imagine, which opens this weekend with the power behind the belief that faith can transform, and captivates from the opening scenes giving a tour de force performance.

     
  • Beltway Insider: ISIS Attacks Iraq; Syria Escalation; Election 2016; Ohio Execution Funerals; Jeffrey Katzenberg

    AddThis Social Bookmark Button

    The White House was placed under lockdown twice the past week as two separate confrontations arose causing Secret Service to secure the president inside and respond to intruders breaching the fence, both incidents were deemed non-active threats.

     
  • HL London: Kensington Whole Foods Review – A Delicious Intersection of Organic, Natural, Healthy and Fresh

    AddThis Social Bookmark Button

    I was feeling slightly uneasy when I moved back to London from California, where a healthy diet and looking beautiful are absolute musts. My life was taking another turn and I was leaving a love that had captured me from wheels down.

     
  • Celebrity Interviews & Review: The Signal – A Trip Worth Taking

    AddThis Social Bookmark Button

    "The Signal," from Focus Features and Low Spark Films, brings to the screen an unassuming sci-fi fantasy flick with fresh, genuine, dialogue and sharp visuals that twists into a layered, hidden, unusual and unexpected fast action thrill ride.

     
  • Money News: Dow Caught in Bear Trap; World Markets Split 80/20

    AddThis Social Bookmark Button

    The DOW Jones Industrial Average fell to the bear over the past week with limited collateral damage across global markets as the world markets bounced back from the devastating free-fall of the past week. 

     
  • Kon-Tiki Review – Visually Stunning, Inspirational, An Epic Tale

    AddThis Social Bookmark Button

    “Kon-Tiki,” from The Weinstein Company and Anchor Bay Entertainment, brings to the screen an epic tale that feeds the explorer spirit, pitting man against nature, in this real life high seas action adventure.

     
  • UK Celebrities Team Up For 'Christmas Number 1'

    AddThis Social Bookmark Button

    For the UK the Christmas single is as traditional as a turkey roast and we've got two very different ones competing.  From ex-boxer/rugby player Shinny who brought along his celebrity friends for a charity single and the classic sound of Diane O.   

  • Awe-Inspiring Groom’s Gifts From the William Henry ‘Embrace’ Collection

    AddThis Social Bookmark Button

    When considering what to get a budding bride, the options are seemingly endless. However, buying a memorable and meaningful gift for the would-be groom—and also the wedding party of the male persuasion—can prove far more challenging.

     
  • Beltway Insider:ObamaCare Deadline Approaches; November Job Numbers; Congress Delays UI Benefits; Black Friday Jitters

    AddThis Social Bookmark Button

    President Barack Obama kicked off a twenty-one day Affordable Care Act sign up campaign urging Americans, through Marketplace success stories, to initiate the mandated medical insurance coverage process immediately.

     
  • V Theater Las Vegas Review - Entertainment Aplenty

    AddThis Social Bookmark Button

    No matter how many times you’ve visited Vegas, no trip would be complete without taking in a show or two amidst the time you spend eating, gaming, clubbing, sunning and otherwise funing in Sin City.

     
  • Whitney Review - Beautiful, Sentimental and Heartbreakingly Honest

    AddThis Social Bookmark Button

    Whitney, from Miramax and Roadside Attractions, presents a beautiful tribute to the woman, the star, the voice that became the sound of a generation, her life, loves, and the slow decline that ended on February 11, 2012.

     
  • Beltway Insider: Obama/Dems in Philly; DNC Chair Out; PM Slows Brexit; Munich/Kabul; IOC/Russia; Garry Marshall

    AddThis Social Bookmark Button

    President Obama and the stars of the Democratic Party head to Philadelphia to outline the platform for the nation during the three-day convention that concludes with the official awarding of the delegates nominating Hillary Rodham Clinton as the Democratic Presidential Candidate.