Articles by JCS

Guardians of a Monopoly

Thinking Outside the Little Black Bag

Guardians of a Monopoly

By

JCS

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]

If Obama and Americans are to “tackle” this healthcare dilemma, first we must realize the present healthcare crisis is not by accident since history will show it’s the net result of a policy begun over a century ago that can be laid at the doorstep of the AMA. Considering the medical profession has had an iron-fisted control of the American healthcare delivery system forever, this crisis can only lead to one conclusion: medicine has panned out.

In effect, this healthcare dilemma is not the result of cheats who made millions on Wall Street as Main Street lost its shirt, or bigwigs in Detroit who made gas hogs that people can’t afford to drive, but a powerful medical cartel consisting of the AMA and its allies, the HMOs, Big Pharma and Big Hospitals, that enjoy the present healthcare system making billions in profits at the expense of patients.

Obviously the medical profession must admit, just as Wall Street and Detroit must plead guilty, to the fact that under their auspices, their industry fell apart. 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.

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.

Meanwhile, other medical critics have sounded off. “Our health-care system is fraught with waste,” Gary Kaplan, chairman of Seattle’s cutting-edge Virginia Mason Medical Center.[2] As much as half of the $2.4 trillion spent today does nothing to improve health, he said.

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.[3]

The looming question is why is American health so poor considering we spend so much money and have supposedly the best high-tech healthcare, the best doctors, and the best hospitals in the world? It would be one thing if Americans spent the most and had the best health and healthcare system in the world, but we don’t.

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.[4]

Compounding the aggressive, expensive treatments of patients with health insurance are those Americans without insurance creating the modern “health tourists” who flee to foreign countries for these procedures at a fraction of the price or those uncovered who flood the ER or simply go without any treatment.

If anyone in this healthcare reform needs a bailout, it’s the patients who pay high prices for insurance that operates on the theme of “squeeze care to expand profits” as well as patients pay for medical services that obviously aren’t working well if these statistics are any clue.

Aside from the enormous prohibitive costs of the medical cartel that has become the second-leading cause of bankruptcy today, another basic problem is the technology of “medical” care is not the same as “health” care; in fact, medical health care is an oxymoron in that medical care is principally “disease” care. Medical, aka, “allopathic,” care at its best is crisis care as seen in emergency rooms, and at its worst, the management of chronic care exclusively by drugs, shots, and surgery.

When President Obama said at his press conference, “Let's invest in preventive care,” he drove a stake in the heart of the AMA which has a dark history of fighting the non-MDs whose philosophy of care mirrors Obama’s call for prevention.

“Prevention” also means different things to different doctors. For instance, MDs think an aspirin-a-day is prevention for systemic inflammation that may lead to heart disease, while CAM practitioners believe anti-inflammatory diet and supplements is better prevention. Some orthopedists believe pain pills are preventative for back pain while chiropractors believe spinal manipulation and exercise does a better job at prevention.

It’s time for a paradigm shift unlike anything ever seen in healthcare and be certain the medical cartel will fight any change to its dominance as we saw in the failed Clinton healthcare reform attempt in 1993.

 

Medical McCarthyism

Just as the deflated Republican Party has become the Party of No to everything President Obama suggests, the same can be said of the medical Profession of No that publicly has been strangely quiet about the impending healthcare reform, nor has it been forthcoming with any explanation about reform or solutions. This is quite a paradox that Obama’s administration must solve, but to do so he must appease the Profession of No—“No to reform, no to universal healthcare, and no to alternatives, thank you very much.”

Indeed, any bailout in this reform is not the need for more of the same drugs, shots or surgery since the present poor health stats show the limitations of that approach. Let’s face the obvious: the allopathic model has its successes, but it also has it limitations in that not all health problems can be solved with drugs, shots or surgery. If that were the case, no one in American should ever be sick considering America is the most over-medicated society in the history of the world yet we lead the world in every category of chronic illnesses like heart disease, diabetes, cancer and chronic back pain.

Compounding this cartel’s power is the fact that MDs are seen as cultural authorities who often go unchallenged despite the obvious shortcomings; in effect, their elitist image standing atop their sacrosanct pedestal is actually part of the problem because few feel qualified to question their diagnosis and treatments. After all, Marcus Welby, MD, was never wrong.

In fact, it hasn’t been that long ago when the AMA held stock in tobacco and promoted smoking in mass media advertisements. In other words, the AMA has been wrong on many things but the public had little idea at the time.

“But the doctor said I must take these drugs and have the surgery…” is the angst of many patients who often don’t understand their diagnosis, why they need surgery, what side effects they may experience from medications, or what alternatives they have. This confusion is often aggravated by medical bias toward alternative healthcare providers. And a second opinion is merely another medical opinion rather than an opinion from a different school of healing; indeed, to the allopaths, there is no other school of thought.

Even today if a patient were to ask a neurosurgeon about seeing a chiropractor before back surgery as the guidelines from the American College of Physicians and the American Pain Society suggest spinal manipulation before spinal fusion, the typical response is classic medical McCarthyism—one of ridicule for asking a “stupid” question, intimidation of the patient for questioning the authority of the surgeon, and slander about chiropractors to scare the patient into surgery.

For example, a typical response I’ve heard many times from frightened patients who ask if they should see a chiropractor before having back surgery, “If you’re stupid enough to go to a chiropractor, don’t come crawling back to me after you’re paralyzed.”

Many in the public and media still believe this lie despite the evidence that chiropractic care is safer, faster, cheaper and longer-lasting than medical care for neck and low back pain and is considered a “proven treatment” for acute low back pain by the US Public Health Service.[5]

The century old smear campaign happens daily in thousands of medical offices across America, yet this lie has never been publicly confronted for what it is—medical McCarthyism. Although the AMA acted as the “guardians of health” protecting the public from quacks, in fact this action led to an antitrust case to monopolize the healthcare professions. Indeed, it was an ugly and dark chapter in medical history that few understand its significance in today’s healthcare crisis.

For those too young to remember McCarthyism, the roots of this political demagoguery stems back to the Red Scare of the 1940-50s. According to Wikipedia, “McCarthyism is the politically motivated practice of making accusations of disloyalty, subversion, or treason without proper regard for evidence. The term is also now used more generally to describe reckless, unsubstantiated accusations, as well as demagogic attacks on the character or patriotism of political adversaries.”

The misinformation about chiropractic stemming from the medical McCarthyism is clearly “reckless, unsubstantiated accusations, as well as demagogic attacks on the character…of political adversaries.” It led to an antitrust lawsuit that began in 1976 and ended in 1987, but nothing was explained to the public what the AMA was guilty of nor was any apology given by the AMA to either the public or the chiropractic profession. [6]

Indeed, the AMA monopolized healthcare, it character assassinated chiropractors to ruin their reputations with phony persecutions—15,000 in the first half of the 20th century—and marginalized them to “watch them wither on the vine,” yet after being convicted, no real punishment was given, no mea culpa or tabula rasa was offered, and basically the medical monopoly continued in its efforts to “contain and eliminate the chiropractic profession.,”

After decades claiming to be the “guardian of American health,” it turns out that the AMA is mainly the “guardian of a monopoly.” Now the general public feels what the chiropractic profession has long known: what it’s like to get screwed by the medical monopoly.

In effect, the healthcare crisis today is a function of this medical McCarthyism and demagoguery that has opposed and attack competition with unsubstantiated accusations, condemned CAM methods as quackery, and monopolized our healthcare system and public hospitals for its exclusive profit.

Think Outside the Little Black Bag

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 the solutions cannot be solved with what’s in the bag. 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 long practiced.

The medical cartel has also shunned the “ounces of cure”—the emerging low-tech “green” alternatives. A clear example is the rash of back surgeries in the era of evidence-based medicine that shows the high costs and low outcomes of spinal fusion, and the fact that conservative active rehab methods including spinal manipulation are recommended, yet patients are often railroaded into spine shots and surgeries.  Although many spine researchers now consider surgical spinal decompression as risky and experimental, the same insurance companies will pay for it but not for non-surgical spinal decompression.

Another good example of the medical cartel sabotaging emerging green technology in healthcare was the huge, $100 million federally-funded study known as ALLHAT that showed simple diuretics were the best blood pressure medicine to start with.[7] Unfortunately, the drug companies “ganged up and attacked, discredited the findings,” according to Curt Furberg, the early leader of the trial.[8]

Now recent medical research trials tell us that most back surgeries[9], heart procedures[10], and knee surgeries[11] 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.

Despite the medical cartel’s political efforts to strangle preventative care, as the AMA’s Committee on Quackery stated, “to watch chiropractic wither on the vine,” there are growing trends to alternatives in healthcare. David M. Eisenberg, MD, is the Director of the Osher Institute at Harvard Medical School who conducted two surveys showing that Americans made more office visits to non-MDs than they did to MDs.

His shocking surveys revealed Baby Boomers made 427 million office visits to non-MDs in 1990 compared to 388 million visits to MDs, then his 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 billiona trend that obviously indicates a growing disenchantment with the present medical system. [12]

In a 2007 study by the Centers for Disease Control (CDC), 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.[13]

As Dr. Eisenberg concluded, “Maybe ‘alternative’ isn’t so alternative anymore,” and be sure the Profession of No hates it when he talks like that.

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.[14]

Medical mistakes are pale in comparison to 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. [15] 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.

“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. [16]  

And 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. Although quiet publicly, the medical cartel is certainly pulling strings and twisting arms behind the scenes on Capitol Hill to keep this train moving full steam ahead.

Dr. Benjamin Rush, Founding Father, Signer of the Declaration of Independence, and the Father of American Psychiatry, supposedly warned of the rise of a medical monopoly:

 “Unless we put medical freedoms into the Constitution, the time will come when medicine will organize into an undercover dictatorship. . . . All such laws are un-American and despotic and have no place in a republic. . . . The Constitution of this republic should make special privilege for medical freedom as well as religious freedom.”

 

How this medical cartel developed into a monolithic power is a chapter of medical history that few textbooks will explore, and its net effect of an impaired healthcare system is a testament to the depths of its dubious history to monopolize healthcare in America.

The Institute of Medicine indicated that entirely new patterns of thinking will be necessary to escape this dilemma. "Our present efforts," suggested Mark Chassin, MD, to the IOM panel, "resemble a team of engineers trying to break the sound barrier by tinkering with a Model-T Ford. We need a new vehicle, or perhaps many new vehicles. The only unacceptable alternative is not to change."[17]

To be certain, the American healthcare system has been sick for a long time so it won’t change easily as the Profession of No fights to maintain control even as Americans are suffering in a broken system.

 Indeed, the medical cartel has failed terribly as leaders in the war on disease, but like the CEOs on Wall Street, they’ve profited dearly. The real solution is a complete overhaul of philosophy of healthcare as well as the incorporation of CAM treatments the AMA has fought long to destroy.

In fact, it hasn’t been that long ago since 1988 when the AMA held stock in tobacco and promoted smoking in mass media advertisements.

Medical McCarthyism

Until recently, most MDs typically chided patients who took vitamins as a waste of money with their “golden flow” down the toilet, and chiropractors, homeopaths, naturopaths, and even the original osteopaths were branded as quacks by the AMA.

The AMA drove homeopaths out of existence then stole their treatment of vaccines, they drove the osteopaths to capitulation, which explains why DOs are the same as MDs today, and they waged an unholy war against the chiropractors who refused to cave in to the medical boycott “to contain and to eliminate the chiropractic profession” that led to a guilty verdict in a federal antitrust trial.[18]

If truth be told, the AMA’s blitzkrieg against non-MDs left a wake of maligned methods that would have helped offset today’s malady if given a fair chance on a level playing field in a free market unobstructed by illegal tactics by the medical cartel and marginalized to the fringe of the mainstream.

 Long before the “official” illegal boycott of chiropractic began in 1963, the AMA initially persecuted chiropractors through the local state courts by claiming DCs were “practicing medicine without a license” despite the fact that chiropractors never practice with drugs or surgery. In fact, chiropractors were jailed over 15,000 times in the first half of the 20th century alone for practicing health care without drugs or surgery.[19]

 Most historians will trace the call for reform in healthcare legislation back to President Truman, but his call came long after others had already engaged the medical profession in the unholy healthcare war.

Of course, among the original healthcare reformists were chiropractors, the victims of 113 years of medical persecution. Indeed, they foresaw that the road to good health was not laden with more drugs and surgery; instead they preached non-drug, non-surgical, and other non-allopathic concepts of healthcare and were immediately attacked by the AMA’s Department of Investigation created in 1906, and lasting until 1976, (only stopped when an antitrust suit was filed by four chiropractors) whose mission was to eliminate those “quacks” who professed any method of healing that did not advocate drugs and surgery.

Long before the “official” boycott of chiropractic began in 1963, the AMA initially persecuted chiropractors through the local state courts by claiming DCs were “practicing medicine without a license” despite the fact that chiropractors never practice with drugs or surgery. In fact, chiropractors were jailed over 15,000 times in the first half of the 20th century alone for practicing health care without drugs or surgery.[20]

Before scope laws protecting chiropractors, merely touching anyone with the intention to help was considered practicing medicine. Ironically, the real offense by chiropractors was getting patients well without drugs or surgery.

According to the Court:

“The anti-competitive effects of the AMA boycott were established by defendant's witnesses: The activities of the AMA undoubtedly have injured the reputation of chiropractors generally…In my judgment, this injury continues to the present time and likely continues to adversely affect the plaintiffs. The AMA has never made any attempt to publicly repair the damage the boycott did to chiropractors' reputations.” (Opinion pp. 10).

 The district court held that the AMA was guilty of engaging in a nationwide illegal boycott in violation of the Sherman Act and imposed a nationwide injunction that is still in force but much of the damage done is unenforceable, such as the lingering slander and libel toward chiropractors.[21]

Undoubtedly the foremost reason why some Americans remain skeptical of chiropractors stems from this “lengthy, systematic, successful and unlawful boycott” [22] designed to eliminate the profession of chiropractic as a competitor in the United States health care system—its Final Solution to the chiropractic holocaust.

Despite the court ruling in favor of the chiropractor-plaintiffs, the damage was done—their main rivals were defamed, the market was cornered by the AMA, and the medical cartel now controls exclusively this $100+ billion dollar industry of healthcare. The mere slap on its hand by a federal judge was a small price to pay for an antitrust victory by its wounded rivals.

If you were to examine the aversion toward chiropractors, you will see that the negative public opinion of chiropractors never came from their patients, 90% of whom were satisfied with their chiropractic care according to Gallup.[23] Neither did it come from the state boards or governing agencies that regulate chiropractors. Nor does it come from malpractice insurance companies since chiropractors are the lowest of all spine practitioners in terms of malpractice costs.

But the public remains unaware of these positive revelations about chiropractors. A public survey taken in 1984 in Oklahoma revealed the effects of this medical McCarthyism as well as the dilemma many people face about their mixed attitudes toward chiropractors. [24] This is an ugly chapter in medical history that has gone untold but has influenced millions of Americans’ attitudes of health care as well as the negative attitude toward chiropractors.

  “The fact that chiropractors are an acceptable part of the health care scene is the number one attitude which is agreed with in a list of eleven offered to respondents. Number two is the fact that most people do not have a good opinion of chiropractic. 71% feel chiropractors probably suffer under a stigma which may not be deserved…to many respondents, chiropractors are seen as being fine for many people in the community, but ‘I wouldn’t want my daughter to marry one.’

 

“The third most agreed with factor is the opinion that chiropractors are highly underestimated regarding their benefit to the community and their patients. 60% hold or agree with this opinion to one extent or another.”

 

So, where does this duality of opinion stem from? On one hand people believe chiropractors are “an acceptable part of the health care scene” and “highly underestimated” suffering “under a stigma which may not be deserved,” but then admit, “I wouldn’t want my daughter to marry one.”

This skepticism came directly and solely from a multi-faceted, multi-year, multi-million dollar campaign by the American Medical Association “to contain and to eliminate the chiropractic profession” with dirty tricks, public propaganda, legislative obstruction, and coercive tactics toward their own members never seen before or since in American healthcare.

This medical opposition was led by Morris Fishbein, MD, who was executive secretary of the American Medical Association and editor of the Journal of the AMA from 1924 to 1949. In its professional publication Fishbein called chiropractors “rabid dogs” and referred to them as “playful and cute…but killers.” He has been referred to as the “Medical Mussolini” who openly attacked all alternative and complementary healthcare methods to eliminate competition.

He portrayed chiropractors as “members of an unscientific cult, caring about nothing but taking their patients’ money” (perhaps a Freudian slip?). His propaganda was so well believed by the mainstream press that he was honored in 1937 on the cover of Time magazine, which may be faint praise. Lest we forget that Time also honored in 1938 Adolph Hitler as Man of the Year and in 1939 Joseph Stalin received this award too—appropriate company for Fishbein during a time of worldwide fascism.

In 1949 the AMA removed Fishbein but continued its anti-chiropractic campaign. In 1971, H. Doyle Taylor, the Director of the AMA Department of Investigation, and Secretary of its Committee on Quackery (COQ), submitted a memo to the AMA Board of Trustees stating:

“Since the AMA Board of Trustees decision, at its meeting on November 2-3, 1963, to establish a Committee on Quackery, your Committee has considered its prime mission to be, first, the containment of chiropractic and, ultimately, the elimination of chiropractic…to see it wither on the vine” and “die a natural but somewhat undramatic death.”

Evidence in Wilk also indicated that one of the early and continuing goals of the AMA was to: “Oppose chiropractic inroads in health insurance” and “workmen’s compensation.”[25] This policy continues to this day with severe limitations on the number of visits available to chiropractors compared to PTs or MDs although evidence at trial showed chiropractors were better educated and skilled in musculoskeletal disorders compared to MDs. Despite this expertise, chiropractors are also paid less than PTs or MDs for the same services.

 The following is an excerpt from the COQ’s first annual report to the Board of the AMA:

“We hope and believe that, with continued aggressive AMA activity, chiropractic can and will be contained at the national level and that steps are being taken to stop or eliminate the licenser of chiropractic at the state level.”

In 1967 the COQ released its anti chiropractic Final Solution campaign goals:

“Basically, the Committee’s short-range objectives for containing the cult of chiropractic and any additional recognition it might achieve revolves about four points:

1. Doing everything within our power to see that chiropractic coverage under title 18 of the Medicare Law is not obtained.

(In 1967, Congress asked the then Department of Health, Education and Welfare (“HEW”) to conduct an unbiased study to determine the need for including coverage for chiropractic services under the Medicare program. The actual study that was conducted was a “sham” engineered by the AMA and complicit medical physician staff members of HEW’s Public Health Service. The study’s conclusion was determined five full months before the study even began. The AMA’s leaders had secretly met with the medical physicians, helped select and “coached” members of the study panel. As a result of the fixed negative report of the study panel, Congress delayed including chiropractic care in Medicare for five more years. The AMA’s involvement in the study was fraudulently concealed from Congress by Dr. Cashman, even after Congress questioned HEW about the AMA’s involvement in the study.[26] Finally, due to extensive public demand, and despite the AMA’s objections and efforts of dissuasion, Congress passed the Social Security Amendments of 1972 that, among other things, modified the Social Security Act to include chiropractic services as a covered service under Medicare (42 U.S.C.§ 1395x(r)(5), albeit in a very limited role.)

2. Doing everything within our power to see that the recognition or listing by the U.S. Office of Education of a chiropractic accrediting agency is not achieved.

(The U. S. Commissioner on Education, Department of Health, Education and Welfare, granted continued recognition to the Council on Chiropractic Education Commission on Accreditation on June 21, 1979.)

3. To encourage contained separation of the two national chiropractic associations.

(Although the American Chiropractic Association has the largest membership of chiropractors and remains the voice of chiropractic on Capitol Hill, the International Chiropractors Association still exists although it now represents a minority of chiropractors since its previous leadership was found to have conflicts of interest with shady vendors.)

4. To encourage state medical societies to take the initiative in their state legislatures in regard to legislation that might affect the practice of chiropractic.” (This medical opposition remains in tack although chiropractic is now licensed in all 50 states.)

The AMA through its Committee on Quackery broadened its war against chiropractic by distributing propaganda to the nation’s teachers and guidance counselors, eliminating the inclusion of chiropractic from the U.S Department of Labor’s Health Careers Guidebook, and establishing specific educational guidelines for medical schools regarding the “hazards to individuals from the unscientific cult of chiropractic.”

It also punished colleges that offered pre-chiropractic programs and vowed to de-license any MD that referred to or accepted referrals from chiropractors, encouraged hospital staffs to bar chiropractors, and discouraged radiologists from accepting requests from chiropractors to x-ray their patients.

Indeed, the AMA did everything it could to blackball chiropractors from destroying their public image to boycotting their presence in hospitals and in the mainstream healthcare delivery system like workers’ compensation programs, Medicare, the VA, and military health programs.

An example of the AMA's propaganda campaign against chiropractors included the clout of popular syndicated newspaper columnist Ann Landers, who ridicule chiropractors in exchange for favors from the AMA, including a paid vacation to China. In a court deposition, Landers acknowledged she had been a paid delegate by the AMA to write “goofus feather” articles where Landers referred to the profession as such, supporting the AMA's condemnation of chiropractic as an “unscientific cult.” When confronted by intelligent rebuttals to her columns, she often recruited the help of the AMA to write responses under her byline.

For over twelve years and with the full knowledge and support of their executive officers, the AMA under the leadership of Fishbein’s successor, H. Doyle Taylor, paid the salaries and expenses for a team of more than a dozen medical doctors, lawyers, and support staff for the expressed purpose of conspiring with others in medicine “to first contain, and eventually, destroy the profession of chiropractic” in the United States and elsewhere.

While TV programs show us the upside of medicine, it rarely speaks the whole truth about the downside of a healthcare system built solely on drugs, shots, and surgery, similar to dentistry that ignores brushing, toothpaste, and flossing.

The only honest thing to be said about this AMA boycott of chiropractors was that it is effective.

 Obama’s hope to emphasize prevention in the mainstream healthcare comes into conflict with the basic nature of allopathic medicine.

Although medicine dominates the healthcare system by monopolizing public hospitals and insurance programs, few people realize the allopathic concept consisting of drugs and surgery is not the only healthcare philosophy albeit the last one standing after its political blitzkrieg over the last century to eliminate all competition.

While allopathic crisis care is necessary for emergency room care, these disease care methods cannot create a state of wellness nor do they prevent illness. At best, they give patients time to change their lifestyles—which is the real Rx for better health—to improve their vim, vigor and vitality, concepts espoused by non-MDs like chiropractors, naturopaths, homeopaths, and nutritionists—all the foes persecuted by the medical cartel.

Not only does Obama’s wish to see more preventative care fly in the face of traditional allopathic medicine, but the HMOs and insurance companies have a long-standing policy not to pay for maintenance care, especially done by chiropractors, although research shows that preventative care reduces spinal relapse. It also 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.[27] 

    

 Imagine the irony and the anger of patients who buy HMO coverage only to learn later that HMOs do not pay for health maintenance care; this epitomizes the lack of focus on real health care rather than allopathic crisis care.

 

WHO Issues New Healthy Life Expectancy Rankings

Japan Number One in New ‘Healthy Life’ System

Japanese have the longest healthy life expectancy of 74.5 years among 191 countries, versus less than 26 years for the lowest-ranking country of Sierra Leone, based on a new way to calculate healthy life expectancy developed by the World Health Organization (WHO).

Previously, life expectancy estimates were based on the overall length of life based on mortality data only.

For the first time, the WHO has calculated healthy life expectancy for babies born in 1999 based upon an indicator developed by WHO scientists, Disability Adjusted Life Expectancy (DALE). DALE summarizes the expected number of years to be lived in what might be termed the equivalent of "full health." To calculate DALE, the years of ill-health are weighted according to severity and subtracted from the expected overall life expectancy to give the equivalent years of healthy life.

The WHO rankings show that years lost to disability are substantially higher in poorer countries because some limitations -- injury, blindness, paralysis and the debilitating effects of several tropical diseases such as malaria -- strike children and young adults. People in the healthiest regions lose some 9 percent of their lives to disability, versus 14 percent in the worst-off countries.

In terms of DALE, the rest of the top 10 nations are Australia, 73.2 years; France, 73.1; Sweden, 73.0; Spain, 72.8; Italy, 72.7; Greece, 72.5; Switzerland, 72.5; Monaco, 72.4; and Andorra, 72.3.

DALE is estimated to equal or exceed 70 years in 24 countries, and 60 years in over half the Member States of WHO. At the other extreme are 32 countries where disability-adjusted life expectancy is estimated to be less than 40 years. Many of these are countries with major epidemics of HIV/AIDS, among other causes.

Obama said he would push proposals to fund new technologies in medical care, advance preventive care and monitor cost controls, signaling that the administration may seek to change the system under which the government reimburses health care providers under Medicaid and Medicare to emphasize “improved quality instead of the number of patients they treat.”

He acknowledged that such proposals would “cost money on the front end,” but he maintained that they offered “the prospect of reduced costs on the back end.”

President Obama said at his March 25, 2009 press conference that, “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 and …we are cutting out wasteful spending in areas like Medicare,

How are we going to reduce health care costs? Because the problem is not just in government-run programs. The problem is in the private sector, as well. It's experienced by families. It's experienced by businesses.

And so what we've said is, look, let's invest in health information technologies. Let's invest in preventive care. Let's invest in mechanisms that look at who's doing a better job controlling costs while producing good quality outcomes in various states and let's reimburse on the basis of improved quality, as opposed to simply how many procedures you're doing. Let's do a whole host of things, some of which cost money on the front end, but offer the prospect of reducing costs on the back end.

 

In the developed countries, 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. Infectious and parasitic diseaseswhich often attack young peopleare the major killers in the third world, making up 43 percent of deaths. Deaths associated with childbirth (to both infants and mothers) make up 10 percent of deaths in less developed countries but only 1 percent in more developed countries. Overall, it can be seen that the 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.[28]

In the developed countries, 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. Infectious and parasitic diseaseswhich often attack young peopleare the major killers in the third world, making up 43 percent of deaths. Deaths associated with childbirth (to both infants and mothers) make up 10 percent of deaths in less developed countries but only 1 percent in more developed countries. Overall, it can be seen that the 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.[29]

Former President George Dubya Bush added to this mess when he “deregulated” healthcare in 2000 so the HMOs could take over. After his election, the White House informed all the healthcare lobbyists not to come touting Healthcare Reform or the Patients’ Bill of Rights as the Clinton administration had done. Instead, the Republican administration enabled the HMOs to take control, which led to double-digit inflation over his eight years as patient services and provider fees tumbled under their mission to “squeeze care to expand profits.”

This was another nail in the coffin of healthcare in America, as was Bush’s insistence to include drug coverage under Medicare Part D Prescription Drug Benefit when he abolished the importation of less costly medications from Canada in order to give Big Pharma a captive audience and total monopoly too.

In the US, generic drugs now have a 3,000 to 5,000% markup, so is it any wonder why Big Pharma wants no change in the current healthcare system? The Bush administration’s task force alleged that the safety of widespread drug importations was the main reason for their new stance against importation of medications that were, incidentally, made in the USA initially.

Senator John Kerry said President Bush had personally “stood in the way” of importing drugs from Canada, which advocates say would significantly reduce costs.[30]

“George Bush stood right there and said, ‘Nope, we’re not going to help people to have lower cost drugs in America, we’re going to help the big drug companies get a great big windfall,’ ” Mr. Kerry said.

He said of the president’s opposition to legislation to re-import American-made drugs from Canada: “I thought these were the people who believed in the marketplace, in fair competition. This isn’t fair competition, it’s a monopoly, and it’s been put in place by George Bush and his friends, and it’s costing you a whole bunch of extra money, and it’s wrong, it’s fundamentally wrong.”

The next nail in the healthcare coffin came from the huge hospital chains represented well by Republican Senate Majority leader, Sen. Bill Frist, MD, (R-TN). Few knew he had amassed a fortune in millions of dollars, most of it the result of his ownership of stock in Hospital Corporation of America, the huge for-profit hospital chain founded by his brother and father. Nor did the public know HCA paid over $1.7-billion in criminal penalties for Medicare fraud.[31] Frist's 2005 financial disclosure form lists blind trusts valued between $15 million and $45 million. This was the last nail in the coffin of healthcare reform by the medical cartel.

For Obama’s hope of change in healthcare, he must overcome these powerful members of the medical cartel as well as the inertia of the medical bureaucracy in government that controls Medicare, the VA, and the military health services as well as the private insurance industry.

Actually, other large source of iatrogenic disease and deaths stem from “social” iatrogenesis where the basic healthcare delivery system causes ill health and premature deaths. When 48 million Americans don’t have access to healthcare, obviously it’s a big source of illness not to be treated at all. When Americans are subjected solely to drugs, shots, and surgery, the lack of choice in alternative treatments and the lack of informed consent are huge problems.

Even if every American had access to allopathic care, the tide wouldn’t change due to “cultural” iatrogenesis where attitudes and lifestyles are causing illness. Do you think for one moment people would give up their cigarettes, liquor, and junk phood to be well? Okay, stop laughing.

Another source of iatrogenesis is the emphasis on the pound of medical cure instead of ounces of prevention leads to illness. The belief fostered by the medical cartel that only allopathic medicine is legitimate and all other alternatives aren’t is an attitude leading to increase disease. The medical bias toward non-MDs is also a “political” source of iatrogensis where political agendas lead to disease.

Sadly, Americans suffer from all four forms of iatrogenesis in this medical cartel of capitalistic healthcare. Until these four problems are addressed, no real reform will happen and we now know that superficial makeovers will not suffice.

 Certainly these stats are not much bang for the $2.4 trillion buck we’re spending, but what caused this remains unclear to the public, nor have the fundamental questions been asked by the press. All the public knows is their healthcare insurance premiums, deductibles and co-pays increase annually, we experience crowded, sub-standard and expensive hospital care, we take medications with serious side-effects, few realize most surgeries are now considered unnecessary, and 48 million remain uncovered as the HMOs squeeze care to expand profits. Considering medical bills are now the second-leading cause of bankruptcy in America, it’s painfully obvious something’s amok in American healthcare.

The real problem rests with the philosophy of the medical management to healthcare that relies mainly on drugs, shots, and surgery to the exclusion of all else. Not only are these methods risky, but they don’t change the underlying causes of degenerative disorders that have more to do with altered body chemistry, spinal instability causing neurological dysfunction, toxicity from junk foods and tobacco, and the complete lack of exercise.

Here are the realities that should guide health care transformation:[32]

Doctors and hospitals are paid by the quantity of services they deliver, not the results of those services — that is, providers are paid more the sicker you get.

Americans have only a 50 percent chance of receiving appropriate care when they go to the doctor — the result of a payment system that dictates assembly-line medicine.

Because they are paid for volume, doctors and hospitals provide enough unnecessary services to fund the uninsured 7 times over. At least one-third of health care spending is waste.

Ten percent of people account for 70 percent of health care spending; they have chronic illnesses such as heart disease, cancer and lung failure.

• The average Medicare patient sees seven doctors who can have no idea what the others are doing, leading to poor outcomes and high cost.

Here are the realities that should guide health care transformation:[33]

Doctors and hospitals are paid by the quantity of services they deliver, not the results of those services — that is, providers are paid more the sicker you get.

Americans have only a 50 percent chance of receiving appropriate care when they go to the doctor — the result of a payment system that dictates assembly-line medicine.

Because they are paid for volume, doctors and hospitals provide enough unnecessary services to fund the uninsured 7 times over. At least one-third of health care spending is waste.

Ten percent of people account for 70 percent of health care spending; they have chronic illnesses such as heart disease, cancer and lung failure.

• The average Medicare patient sees seven doctors who can have no idea what the others are doing, leading to poor outcomes and high cost.



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

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

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

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

[5] Bigos S. et al. US Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 14: Acute Low Back Problems in Adults AHCPR Publication No. 95-0642, December 1994.

[6] Wilk v. American Medical Assoc.,671 F. Supp. 1465, 1473 (N.D. Ill. 1987), aff’d, 895 F.2d 352 (7th Cir. 1990), cert. denied, 498 U.S. 982, 111 S. Ct. 513 (1990).

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

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

[9] 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.

[10] 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.

[11] 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.

[12] 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.

[13] 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.

[14] 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.

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

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

[17] Mark R. Chassin, MD, MPP, MPH; Robert W. Galvin; and the National Roundtable on Health Care Quality, The Urgent Need to Improve Health Care Quality Institute of Medicine National Roundtable on Health Care Quality,  JAMA.  1998;280:1000-1005.

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

[19]Gibbons, R. Go to jail for chiro. J Chiropr. Humanities 1994; 4:1.

[20]Gibbons, R. Go to jail for chiro. J Chiropr. Humanities 1994; 4:1.

[21] Id. The Seventh Circuit affirmed the verdict in 1990. Wilk v. American Medical Association, 895 F.2d 352, 371 (7th Cir. 1990), cert. denied, 498 U.S. 982, 111 S. Ct. 513 (1990).

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

[23] The Gallup Organization. Demographic Characteristics of Users of Chiropractic Services (Princeton, NJH: The Gallup Organization, 1991).

[24] “Attitudes toward chiropractic health care in Oklahoma” Welling & Company and Oklahoma Chiropractic Research Foundation in cooperation with the Chiropractic Association of Oklahoma, 1984.

 

[25]A554-62, Wilk evidence

[26] A824-25 Wilk evidence

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

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

 

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

 

[30] Jodi Wilgoren, Kerry Faults Bush Over Opposition to Drugs From Canada, NY Times, August 12, 2004.

[31]HCA To Pay $840M for Fraud Claim, New York Times, December 15, 2000.

[32] Guy L. Clifton, M.D, Managing costs is key to overhauling health system, Houston Chronicle, March 29, 2009,

 

[33] Guy L. Clifton, M.D, Managing costs is key to overhauling health system, Houston Chronicle, March 29, 2009.

 

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