Articles by JCS

Chiropractors Blame AMA

 

Chiropractors Blame AMA 

for Healthcare Crisis

by

JC Smith, MA, DC

 

President Obama said during his March 24, 2009 press conference that solving the healthcare crisis is imperative to solving the financial crisis; “in fact, the biggest driver of long-term deficits are the huge health care costs that we've got out here that we're going to have to tackle …”[1]

An enraged Congress recently took Wall Street and Detroit executives to the woodshed to explain why their industries collapsed as they made millions, so now it’s time for the next shoe to drop for Congress to hold the reclusive AMA’s feet to the fire too.

If Obama and Americans are to “tackle” this healthcare dilemma, first we must realize the present healthcare crisis is not by accident but the design by a powerful medical cartel consisting of the American Medical Association and its allies, the HMOs, Big Pharma and Big Hospitals, all stakeholders in the present private healthcare system making billions in profits at the expense of sick patients forced into an expensive capitalistic medical system rated low by the WHO and denied alternative methods that are often cheaper, safer and more effective than drugs, shots, and surgeries.[2]

Ironically, medical cartel has been conspicuously absent during this discussion and must see no reason for reform or the need to explain the high costs, poor outcomes, and virtually no competition—the trademarks of any monopoly—that consume $2.4 trillion annually or nearly 20% of the GDP.

The AMA has been strangely quiet in this healthcare debate by avoiding the media and offering no explanations or solutions publicly, but we can be certain the AMA is twisting arms behind the scenes on Capitol Hill to keep the present system in tack; like the oil industry, it pays to be a monopoly. Obviously the medical profession must admit, just as Wall Street and Detroit must plead guilty, to the fact that under their control, the American capitalistic healthcare industry is in shambles.

If there is blame to be laid in this healthcare crisis, it is at the doorstep of the medical cartel whose demagoguery, monopolization, and illegal boycott of complimentary and alternative methods has led to this American health mess and the need for reform.

“Our health-care system is fraught with waste,” Gary Kaplan, chairman of Seattle’s cutting-edge Virginia Mason Medical Center.[3] As much as half of the $2.4 trillion spent today does nothing to improve health, he said.

The medical cartel by nature does not want reform from its monopolistic control nor does it want patients to have a freedom of choice in healthcare.  Neither does it want transparency or accountability on this healthcare crisis that it created, just as the Wall Street barons laid as low as they could before Congress unveiled them.

The chiropractic profession calls upon Congress to hold hearings on this healthcare crisis to demand explanations by the medical cartel why Americans are told that we have the best doctors, the best medical schools, and the best teaching hospitals in the world, but this begs the obvious question: why are we so sick?

According to the World Health Organization, in 2000 the USA ranked #1 in cost, #72nd in population health, #37th in healthcare delivery, and #24th for longevity or an average of 70.0 years of healthy life for babies born in 1999.[4] America also has nearly 48 million uninsured citizens.

In contrast, France ranked #4, #4, and #1, with only 1% uninsured.[5] Obviously the French are getting more bang for their francs than we’re getting for our dollars despite the fear-mongering in the media about socialized medicine.

Meanwhile, Americans lead the world in every category of chronic degenerative diseases due to its gluttonous lifestyle problems, not genetics, germs, poverty or war. Diseases of the circulatory system and cancer are the main killers, accounting for approximately two-thirds of all deaths. In contrast, these diseases account for only one-third of deaths in the less developed world. Overall, chronic and degenerative diseases predominate in the West, whereas the infectious and parasitic diseases (along with childbirth-related deaths) associated with much younger ages prevail in less developed countries.[6]

It would seem logical if Americans spend the most on healthcare that we would have the healthiest citizens and best healthcare system in the world, but we obviously don’t.[7] Without a doubt, America is the most over-medicated society in the history of the world yet we rank among the sickest in terms of chronic, degenerative diseases.[8] Obviously the American capitalized system is broken.

It’s not that we don’t have enough doctors, in fact, we may have too many aggressive MDs who over-prescribe drugs, shots, and surgeries in America, evident by the fact that the US does 5 times more back surgeries per capita than the UK and Scotland combined.[9]

The chiropractic profession believes America's healthcare crisis is the direct result of the medical cartel that has monopolized mainstream healthcare to the exclusion of all other alternative treatments. The allopathic ideology of treating symptoms rather than correcting the underlying causes of disease has created a society of gluttons more comfortable popping pills than walking around the block for exercise.

Compounding this gluttonous lifestyle with a medical demagoguery touting instant cures, Americans have a mindset that the only legitimate treatments are drugs, shots, and surgeries that have proven ineffective and expensive, but that’s what the public has come to expect rather than a Rx of lifestyle changes, hands-on treatments, smoking cessation, and a healthy attitude of self-reliance habits.

Indeed, Americans are convinced a wonder drug is so much easier to swallow than simply avoiding junk foods. Until this pathetic and unhealthy attitude is changed, nothing will improve the dwindling health statistics in America, which explains why President Obama now calls for "preventative" health care to lower costs. He acknowledged that such proposals would “cost money on the front end,” but he maintains that they offer “the prospect of reduced costs on the back end.”

This comes as music to the ears of chiropractors who historically have been the leaders in preventative health care, not medical doctors who have ridiculed such methods in the past. Although the medical model has focused on crisis care in emergency rooms and has done an admirable job, the medical society has ignored wellness care that chiropractors and other natural healthcare providers have long championed.

 Despite the obvious wisdom of a preventative approach, ironically the so-called Health Maintenance Organizations (HMOs) refuse to pay for maintenance spinal care, for example, although research shows the positive effects of preventive chiropractic treatment in maintaining functional capacities and reducing the number and intensity of pain episodes after an acute phase of treatment.[10] 

  In other words, the present American healthcare system emphasizes the “pound of cure” rather than the “ounce of prevention” that complementary and alternative medicine (CAM) healthcare professions have always practiced and now are growing in popularity among the public, indicating a growing disenchantment with the present medical system.

Baby Boomers made 427 million office visits to non-MDs in 1990 compared to 388 million visits to MDs; the follow-up survey in 1997 revealed that the numbers to non-MDs rose to 629 million while the numbers to MDs went down to 386. Expenditures for CAM services increased by 45 percent to $21 billion, much of this are out-of-pocket expenses since the HMOs refuse to pay for prevention or maintenance care. [11]

A 2007 study by the Centers for Disease Control (CDC) confirmed this trend to CAM: approximately 38% of adults in the United States aged 18 years and over and nearly 12% of U.S. children aged 17 years and under use some form of CAM, according to this nationwide government survey.[12]

Maybe alternative’ isn’t so alternative anymore, and be sure the medical cartel hates to hear that, just as the oil cartel flinches when T. Boone Pickens touts the benefits of green technology in the energy crisis.

Not only is the allopathic model resistive in terms of prevention, it also has proven to be dangerous and slow to change. Clinical iatrogenic deaths (doctor-caused) constitute 225,000 deaths per year, which is the third-leading cause of death in the United States after deaths from heart disease and cancer.[13]

Medical mistakes also reveal a medical system based on outdated concepts and the lack of innovation. Medical experts now admit it takes 17 years for a new treatment to become mainstream and 44 years for an ineffective treatment to be purged. [14] Indeed, if the electronics industry were as slow as medicine, it would still be in the vacuum tube era and, if it killed as many, it would be outlawed, and if Microsoft monopolized the market as the AMA does, it would be broken up.

Obviously medical practice today is a function of intransigence, profit, bias, and tradition rather than incorporating new technology and encouraging competition on a level playing field to spur innovation with a better mousetrap—the very basis of the American free marketplace. Instead, we are riddled with monopolistic constraints that explain why American healthcare is so ineffective, outdated, and expensive. Indeed, just where is there room for innovation?

“More people are interested in getting on the gravy train than on stopping the gravy train,” said Dr. Richard A. Deyo, a medical professor and researcher at Oregon Health and Science University. [15] 

Recent medical research trials tell us that most back surgeries[16], heart procedures[17], and knee surgeries[18] are no better in the long run than non-invasive conservative care, but the AMA and its cohorts in the media have been slow to inform patients of these revelations that could drive down costs and improve outcomes.

Not only does the medical cartel reject CAM, it has also shunned the “ounce of cure”—the cheaper alternatives like chiropractic care instead of spine surgery. If patients had freedom of choice and undeterred access to chiropractors, the present $100+ billion bill for spinal treatments alone could be cut in half as researchers now suggest.[19]

Aside from chiropractic’s ability to reduce costs for spine problems, another good example of the medical cartel sabotaging emerging green technology in healthcare was evident from the huge, $100 million federally-funded study known as ALLHAT that showed simple diuretics were the best blood pressure medicine to start with.[20] Unfortunately, the drug companies “ganged up and attacked, discredited the findings,” according to Curt Furberg, the early leader of the trial.[21]

This tactic sounds painfully similar to the US Public Health Service’s Agency for Health Care Policy and Research (AHCPR) study of over 4000 articles on acute low back pain in 1994 that recommended spinal manipulation as a “proven treatment” before drugs, shots or surgery, but the medical society sued the researchers to block the study’s release, politicked Congress to gut the AHCPR funding, and ignored this landmark study, too.[22]

Be certain the medical cartel has no interest in slowing down this gravy train whether it’s due to CAM practitioners like chiropractors or medical critics like Dr. Deyo or the call for reform by President Obama. This gravy train is too valuable to be side-tracked by critics, competitors or even the president. And be sure the medical cartel is pulling strings on Capitol Hill to keep this train moving full steam ahead, just as it killed the Clinton Health Care Reform Act in 1993.

Without a doubt, the road to lower costs and healthier patients does not rest with more drugs and surgery, but with better diets, more exercise, smoking cessation, and a strong backbone--all issues promoted by chiropractors but ridiculed by the AMA; as recently as 1988 the AMA still held stock in tobacco companies and its illegal persecution of its main competitor, chiropractors, was well documented in a 1987 federal antitrust court case, but never revealed in the media to the public for fear of embarrassing its medical cohorts.[23]

The Wilk et al. v. the AMA et al. antitrust case illustrated how the medical cartel controlled public hospitals to the exclusion of all other healthcare providers and was ruled illegal by a federal judge in 1987, but the discrimination against chiropractors continues to this day, thus denying patients a “proven treatment” for acute and chronic low back pain provided by chiropractors. [24]

The medical media also refused to inform to the public that the soiled image of chiropractors was the direct result of medical McCarthyism created by Morris Fishbein, executive director of the AMA and editor of the JAMA from 1924-1949, as the trial evidence revealed. The damage to chiropractors’ reputations has never been repaired, nor has the AMA ever publicly apologized for its unethical and illegal persecution and character assassination. Indeed, just where do we chiropractors go to get our reputations back?

It’s past time for the American people to think outside the box or, in this case, to think outside the doctor’s little black bag since this crisis cannot be solved with what’s in the bag; more drugs and more surgeries are not the answers.

America’s been there, done that, didn’t work, which explains why we have a healthcare crisis today, a tough admission for a government that has enabled the medical monopoly, a ruthless trade association, to manage the nation’s healthcare delivery system by its own design and for its own profit.

Congress must also decide if capitalism and health care even mix, which explains why many nationalized systems in Europe and Canada do better and cost less according to the WHO report.[25] Instead of a commodity to buy, these countries have decided health care, like public education, is a right for all and not solely a privilege for the wealthy or a profit motive for the medical cartel to exploit.

The real solution includes not only universal coverage, but a complete overhaul of the philosophy of our healthcare delivery system, the breakup of the stranglehold by the  medical cartel, as well as the incorporation of CAM treatments the AMA has fought long to destroy.

The real battle will not be changing the public’s mind about a new paradigm in healthcare since the trend to CAM is growing and the evidence away from drugs, shots, and surgeries of all sorts is mounting, but the real battle will come from the opposition by the medical cartel that has no interest in any reformation. There’s just too much money at stake to cooperate or to apologize.

It’s time for transparency and accountability by the medical cartel. Until all Americans understand these gross deficiencies, and the consequences from the lack of competition and the lack of freedom of choice in healthcare, nothing will change to improve our nation’s health.

Indeed, this is a cultural challenge, not merely a matter of producing more fuel efficient cars as Detroit is challenged to do. Americans not only have to realize good health does not come from pills, potions, or surgeries as much as lifestyle changes; plus they must realize the medical cartel is not their friends as much as the enemy within this call for healthcare reform.

Actually, what America needs is a healthcare Revolution, not merely a reform. Simply rearranging the deck chairs will not stop this medical Titanic from sinking. We need a new captain at the helm and a new course of direction if America is to improve its dire situation in healthcare. How much longer can we spend so much for so little?

 

 



[1] President Obama’s News Conference, NY Times, March 25, 2009.

[2] World Health Organization, The World Health Report 2000: Health Systems—Improving Performance, 2000.

[3] Victoria E. Knight, Half of U.S. Spending on Health Care May Be Wasted, Washington Post, December 2, 2008.

[4] World Health Organization, The World Health Report 2000: Health Systems—Improving Performance, 2000.

[5] Victor G. Rodwin, PhD, MPH The Health Care System Under French National Health Insurance: Lessons for Health Reform in the United States, Am J Public Health. 2003 January; 93(1): 31–37.

[6] Gee, Ellen M., Causes of Death, Macmillan Encyclopedia of Death and Dying,  2003.

[7] World Health Organization, The World Health Report 2000: Health Systems—Improving Performance, 2000.

[8] Richard J. DeGrandpre, The cult of pharmacology: how America became the world's most troubled drug culture, Published by Duke University Press, 2006.

[9] Cherkin, DC et al., “International comparison of back surgery rates,”  Spine 19 (11): 1201-1206 (1994).

[10] Efficacy Of Preventive Spinal Manipulation For Chronic Low-Back Pain And Related Disabilities: A Preliminary Study Martin Descarreaux,a Jean-Se´bastien Blouin, Marc Drolet, Stanislas Papadimitriou and Normand Teasdalea, Journal of Manipulative and Physiological Therapeutics, October 2004.

[11] Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional  medicine in the United States -- prevalence, costs, and patterns of use. N Engl J Med 1993;328:246-252.

[12] Barnes PM, Bloom B, Nahin R. CDC National Health Statistics Report #12. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. December 10, 2008.

[13] Ronald Grisanti D.C., D.A.B.C.O.,M.S. Iatrogenic Disease: The 3rd Most Fatal Disease in the USA, http://www.yourmedicaldetective.com/public/335.cfm.

[14] Refuting Ineffective Treatments Takes Years, The BackLetter® 101 Volume 23, Number 9, 2008.

[15] Reed Abelson, Financial Ties Are Cited as Issue in Spine Study, NY Times, January 30, 2008.

[16] Weinstein JN et al., Surgical vs. non-operative treatment for lumbar disk herniation: The Spine Patient Outcomes Research Trial (SPORT) observational cohort, JAMA, 2006; 296:2451–9.

[17] William E. Boden, M.D., et al., Optimal Medical Therapy with or without PCI for Stable Coronary Disease, NEJM, No. 15, vol. 356:1503-1516, April 12, 2007.

[18] Alexandra Kirkley, MD, et al.,  A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee, NEJM, Volume 359:1097-1107, Number 11, Sept. 11, 2008.

[19] Legorreta, A.P. Treating Back Pain Less Costly With Chiropractic Care , Archives of Internal Medicine, Oct. 11, 2004; vol 164: pp 1985-1992.

[20] The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) December 18, 2002, JAMA.

[21] Goldestein, J. “Study found cheap blood pressure meds are best. No one cared.” Nov. 28, 2008, New York Times.

[22] Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No. 14. AHCPR Publ. No 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services, December 1994, pp. 90.

[23] Wilk et al  v AMA et al. US District Court Northern District of Illinois, No. 76C3777, Getzendanner J, Judgment dated August 27, 1987

[24] Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No. 14. AHCPR Publ. No 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services, December 1994, pp. 90.

[25] World Health Organization, The World Health Report 2000: Health Systems—Improving Performance, 2000.

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