Articles by JCS

Ounce of Prevention

Ounce of Prevention

By

JCS

If this reform accomplishes anything, hopefully it will end the stranglehold on healthcare by the medical profession. For too long the present American healthcare system emphasizes the “pound of cure” rather than the “ounce of prevention” or even the “ounce of cure” 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.

President Obama mentioned the need of preventative care to offset the development of chronic disorders:

The second step that we can all agree on is to invest more in preventive care so that we can avoid illness and disease in the first place.” [1]

He is reiterating what many in the public have already known. According to the National Cancer Institute:

“Scientists estimate that as many as 50–75 percent of cancer deaths in the United States are caused by human behaviors such as smoking, physical inactivity, and poor dietary choices.”[2]

This may come as a surprise to people who think they catch cancer or inherit it, but the majority of cancer victims develop their cancer from unhealthy habits, especially smoking that will kill 169,000 according to the American Cancer Society.[3]

Dean Ornish, MD, founder and President of Preventive Medicine Research Institute wrote of this challenge for Americans to embrace a healthier lifestyle rather than relying upon crisis medical care.[4]

“Meaningful health reform needs to provide incentives for physicians and other health professionals to teach their patients healthy ways of living rather than reimbursing primarily drugs and surgical interventions. If lifestyle interventions proven to reverse as well as prevent many chronic diseases are reimbursed along with other strategies for improving cost-effectiveness across the U.S. healthcare system, then it may be possible to provide universal coverage at significantly lower cost without making painful choices, and the only side-effects are good ones.”

Heart disease, diabetes, prostate/breast cancer, and obesity account for up to 75% of these health care costs, and yet these are largely preventable and even reversible by changing diet and lifestyle.

According to Dr. Ornish, large-scale studies have shown that changing lifestyle could prevent at least 90-95% of all heart disease.[5] Thus, the disease that accounts for more premature deaths and costs Americans more than any other illness is almost completely preventable, and even reversible, simply by changing lifestyle.

Many people were surprised to learn that bypass surgery and angioplasty don't work very well; a major randomized controlled trial found that angioplasties and stents do not significantly prolong life or even prevent heart attacks in stable patients.[6] Many people still don’t know that these procedures are questionable, especially when they’re given a life-or-death diagnosis that scares them into a surgery.

In 2006, according to the American Heart Association, 1.3 million angioplasties and stents were performed at an average cost of $48,399 each, or more than $60 billion. [7] In addition, 448,000 coronary bypass operations were performed at a cost of $99,743 each, or more than $44 billion—more than $100 billion for these two operations.

Indeed, if 90% of heart disease is preventable, this would be a savings of nearly $90 billion, but you don’t see these people running to the health food stores or their local gyms. Sitting in front of a TV or computer screen eating junk phoods while popping meds for hypertension are a lot easier to do than changing lifestyles.

Research by Dr. Ornish et al. have shown that lifestyle changes also may beneficially affect gene expression in only three months, turning on genes that prevent disease and turning off genes that promote heart disease, prostate cancer, breast cancer, and other illnesses.[8]

“Often, people say, ‘Oh, it's all in my genes, there's not much I can do about it,’” but this is not true, according to Ornish.

“For many people, it captures their imagination to know that changing lifestyle changes their genes for the better.

“Last year, my colleagues and I published the first study showing that these intensive lifestyle changes significantly increase telomerase, and thus telomere length, in only three months. Telomeres are the ends of your chromosomes that help control aging -- as your telomeres get longer, your life gets longer.” [9]

Although many Americans ignore this advice, more and more Americans are listening and acting on this information.

Two studies by Dr. David Eisenberg at Harvard’s Osher Institute stunned the medical world when he revealed Americans were seeking non-drug, non-surgical solutions when they made more visits to CAM providers than MDs. 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.[10]

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.[11]

Considering this trend to CAM, it still remains a small part of total health care costs. At $33.9 billion, CAM accounts for approximately 1.5% of total health care expenditures and 11.2% of total out-of-pocket expenditures on health care in the United States.[12]

The $14.8 billion spent on non-vitamin, non-mineral, natural products is equivalent to approximately one-third of total out-of-pocket spending on prescription drugs ($47.6 billion), and the $11.9 billion spent on CAM practitioner visits is equivalent to approximately one-quarter of total out-of-pocket spending on physician visits ($49.6 billion).  

Imagine the cost savings if more people used CAM preventative measures as religiously as they brush their teeth. The Eisenberg surveys showed Americans made more visits to CAM providers, yet the out-of-pocket costs were only a fraction of the costs associated with medical care. Indeed, it does appear an ounce of prevention is worth a pound of cure to many proactive Americans.

At last we have leadership with a vision and one who isn’t afraid to confront the medical cartel. Perhaps the table has finally turned on the medical boycott of chiropractic and CAM methods in general when the president of the USA calls for preventative methods in mainstream healthcare.

If the insurance industry would cover CAM providers as well as it covers MDs, a health reformation is possible. But if the reformists think all we need is more drugs and surgery, improvement won’t happen. Indeed, if all it takes to get well is taking more drugs and having more surgeries, then no one should ever be sick, but they are taking more drugs and only getting sicker.

The fallacy of this reform is to think our health statistics will improve by simply providing insurance coverage for all. What is needed is a serious paradigm shift about our cultural attitudes about healthy lifestyles and until we do, a real healthcare reform is impossible—it would be equivalent to dentistry without toothpaste.

Indeed, Americans are convinced a wonder drug is so much easier to swallow than simply avoiding junk foods. Until this dismal 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.”

 “It also means cutting down on all the junk food that is fueling an epidemic of obesity, putting far too many Americans, young and old, at greater risk of costly, chronic conditions. [13] That’s a lesson Michelle and I have tried to instill in our daughters with the White House vegetable garden that Michelle planted. And that’s a lesson that we should work with local school districts to incorporate into their school lunch programs.

“Building a health care system that promotes prevention rather than just managing diseases will require all of us to do our part.” [14]

These preventative measures have been left in the hands of the alternative group of doctors such as chiropractors, naturopaths, and homeopaths. If it weren’t for the medical genocide against these professions, these programs of prevention would certainly be far advanced than they are today.

It’s refreshing to hear our new president speak of preventative care:

“Our federal government also has to step up its efforts to advance the cause of healthy living. Five of the costliest illnesses and conditions - cancer, cardiovascular disease, diabetes, lung disease, and strokes - can be prevented. And yet only a fraction of every health care dollar goes to prevention or public health.” [15]

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.[16] 

 



[1] Text of President Obama’s health-care speech, Jun 15, 2009, by MarketWatch

[2] Cancer Trends Research Report: 2007 Update. http://progressreport.cancer.gov/doc.asp?pid=1&did=2007&mid=vcol&chid=71

[3] Cancer Facts and Figures: 2009. http://www.cancer.org/downloads/STT/500809web.pdf

[4] Dean Ornish, Medical Editor, Resuscitating Health Care Reform, The Huffington Post, August 10, 2009.

[5] Yusuf S, Hawken S, Ôunpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study). Lancet. 2004; 364: 937-52.

[6]Boden WE, O'Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356:1-14

[7] Lloyd-Jones D, Adams R, Carnethon M, et al. Heart disease and stroke statistics 2009 update. A report from the American Heart Association statistics committee and stroke statistics committee. Circulation. 2009;119:e1-e161.

[8]Ornish D, Magbanua MJ, Weidner G, et al. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proc Nat Acad Sci USA 2008;105:8369-8374.  

[9] Ornish D, Lin J, Daubenmier J, et al. Increased telomerase activity and comprehensive lifestyle changes: a pilot study. Lancet Oncol 2008;9:1048-1057.  

[10] 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.

[11] 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.

[12] National Health Expenditure Data for 2007. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services Web site. Accessed on June 25, 2009.

[13] Text of President Obama’s health-care speech, Jun 15, 2009, by MarketWatch

[14] Text of President Obama’s health-care speech, Jun 15, 2009, by MarketWatch

[15] Text of President Obama’s health-care speech, Jun 15, 2009, by MarketWatch

[16] 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.

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