Michael Pollan
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 Much lip service is paid to the importance of prevention, but the health care industry, being an industry, stands to profit more handsomely from new drugs and procedures to treat chronic diseases than it does from a wholesale change in the way people eat. Cynical? Perhaps. You could argue that the medical community's willingness to treat the broad contours of the Western diet as a given is a reflection of its realism rather than its greed. |
Shannon Brownlee
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 Fewer than 1 o percent of hospitals in the country have instituted electronic medical records, and the health care industry as a whole spends less than 3 percent of its revenue on information technology, far less than the 10 percent that other information-intensive industries, like the airlines, spend. Some hospitals have put in systems only to pull the plug when doctors rebelled. Cedars-Sinai Medical Center, in Los Angeles, installed a thirty-four-million-dollar computerized physician ordering system to streamline drug prescriptions and reduce error rates. |
Mike Adams, the Health Ranger
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 Sure, there are lots of so-called "reform" schemes being tossed around, but if you examine them closely, you'll find they're all just financial shell games that pass the buck on who pays for a diseased population. Our health care industry, you see, is really a disease management industry, and it's based on maximizing profits while keeping the American people in a state of chronic degenerative disease while pushing drugs, surgery and other treatments that do nothing to address the causes of poor health in the first place. Nobody is teaching disease prevention. |
Mike Adams, the Health Ranger
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 Lawmakers are on the food chain too, addicted to health care industry money for their reelection campaigns. The corporations in power today are allied against any switch to universal health care because it would take the profit out of the system and deliver quality health care services on the cheap.
Think about it: Americans pay the most, by far, for health care. We pay monopoly prices for pharmaceuticals. It's a great scam if you're cashing in as a drug company or corrupt FDA official. But the People just get the shaft. |
Michael Pollan
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| So we turn for salvation to the health care industry. Medicine is learning how to keep alive the people whom the Western diet is making sick. Doctors have gotten really good at keeping people with heart disease alive, and now they're hard at work on obesity and diabetes. Much more so than the human body, capitalism is marvelously adaptive, able to turn the problems it creates into new business opportunities: diet pills, heart bypass operations, insulin pumps, bariatric surgery. |
Shannon Brownlee
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| Growth industry
Medicine itself was also setting out on a new course, one that would lead to the dramatic expansion of the health care industry, to more cases like Orabilex, and to many of the problems that would reach crisis proportions by the turn of the next century. In 1965, Congress passed the Medicare Act, which for the first time provided the elderly with free hospital insurance and coverage for physicians' fees. |
Michael Pollan
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| The mainstream media is full of advertisements for new gadgets and drugs for diabetics, and the health care industry is gearing up to meet the surging demand for heart bypass operations (80 percent of diabetics will suffer from heart disease), dialysis, and kidney transplantation. At the supermarket checkout you can thumb copies of a new lifestyle magazine, Diabetic Living. Diabetes is well on its way to becoming normalized in the West—recognized as a whole new demographic and so a major marketing opportunity. |
Stacy Malkan
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 Besides knowing her own body burden load of the chemicals — three different types of phthalates were in her body at the time of her biomonitoring test — she had been following the science on phthalates for years in her job as executive director of Health Care Without Harm, an international coalition that works on reducing the environmental impact of the health care industry.
The group was founded in 1996 after the US Environmental Protection Agency named medical waste incinerators as the leading source of dioxin, one of the most potent carcinogens. |
Craig Pepin-Donat
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 The health care industry's solution to ADHD is to prescribe antidepressant drugs that have a history of causing "suicidal attempts and other self-injurious destructive behaviors." It is shameful.
Studies and real-world examples in schools show that eliminating these harmful additives from children's diets results in clearer focus, higher test scores and fewer classroom disruptions. So the next time your "hyperactive" kid starts to get out of control, don't reach for the Ritalin, look at his or her food intake. |
| My issue is with those companies in the health care industry whose shareholders demand higher and higher profits regardless of how they are attained. This creates extraordinary pressure — and a conflict of interest — for companies who profess to have the public good in mind, but are really beholden to the stockholders.
This brings us to the drug approval process. |
| Rather than create a viable model that actually benefits all Americans, our politicians, operating under the narcotic influence of health care industry lobbyists armed with tons of cash, have allowed the creation of the costliest health care system in the world. Despite the high cost, the World Health Organization ranked the U.S. 37th out of 191 countries. We are not getting what we paid for, or we are paying for the wrong things. It is enough to give one a migraine. |
Andreas Moritz
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 Although direct contact with sunlight has prevented cancer and many other diseases for thousands of years, it is discouraged and even warned against by today's health care industry.
As is so often the case, the purely symptom-oriented medical theories fall short in explaining the causes of disease. In fact, they are likely to make you ill. Beware of any advice given to you by any doctor, company, or organization who wants to protect you against a supposed threat while at the same time trying to sell you something else, such as sunscreen lotions.
Pittas—Watch Out! |
Shannon Brownlee
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| And nobody would want to put thousands of people who are currently employed by the health care industry out of a job, unless it was absolutely necessary But it is necessary, because the alternative to rightsizing health care is worse. Some economists, notably Harvard's David Cutler, claim that we should stop worrying so much about rising costs, that we can afford to spend 20 percent of the gross domestic product on health care, because there's so much "good stuff," as he puts it, to be gained from medicine. Besides, says Cutler, it's too hard to get rid of the bad stuff. |
| Maybe that's because talking about costs means talking about overtreatment, and bringing up overtreatment means facing the fact that reducing unnecessary, wasteful care would lead inevitably to a smaller health care industry. The seven hundred billion dollars we currently spend on unnecessary care doesn't just go down the drain—it goes toward paying for drugs and medical devices, which are manufactured by American workers. It helps pay the salaries of doctors, hospital administrators, nurses, orderlies, and pharmacists. |
Michael Pollan
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| But though fast food may be good business for the health care industry, the cost to society—an estimated $250 billion a year in diet-related health care costs and rising rapidly—cannot be sustained indefinitely. An American born in 2000 has a 1 in 3 chance of developing diabetes in his lifetime; the risk is even greater for a Hispanic American or African American. A diagnosis of diabetes subtracts roughly twelve years from one's life and living with the condition incurs medical costs of $13,000 a year (compared with $2,500 for someone without diabetes). |
John E. Sarno, M.D.
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 Finally, the health care industry plays a big role in validating and perpetuating psychosomatic disorders. As I mentioned earlier, medical school training and, therefore, medical practice does not understand or acknowledge psychosomatic disorders. Thus, physicians can only explain pain based on the structural model. This has several important implications. First, treatment strategies can only be derived from this model. Second, validating one's psychosomatic pain disorder as a structural problem reinforces the reason the pain is there in the first place, to distract one's unconscious emotions. |
Mike Adams, the Health Ranger
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 Too many journalists pretend to be health experts but are, in fact, largely illiterate when it comes to nutrition, human physiology or the truth about the health care industry.
Psychiatrists: This sorry group of professional sickos pretends to help children with their mental health "disorders" by drugging them up with powerful amphetamines like Ritalin and calling it treatment. Having sold its soul to the pharmaceutical companies, psychiatry is now little more than a drug-dealing front group engaged in chemical atrocities committed against children and adults alike. Their best skill? |
Mike Adams, the Health Ranger
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 Many workers in the health care industry are basically getting paid to shuffle paper around. The health insurance companies are paid to deny health claims and the government workers at Medicare and Medicaid offices are paid to find new ways to deny payments to doctors and hospitals for services rendered. Thus, doctors' offices and hospitals have to employ entire armies of people to sit around and reclassify procedures in ways that can get paid by insurance companies, Medicare and Medicaid. It's a massive waste of time, money and effort.
In the U.S. |
Donald L. Barlett and James B. Steele
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 Don DeMoro, executive director of the Institute for Health & Socio-Economic Policy, in Orinda, California, who has been studying the health care industry's transformation for years, says that all the restructuring has been justified for one misguided reason alone: "All this was built around a business school belief in the market. The market says this. The market says that. There is this overriding belief that the market determines everything, as though human beings have no say. Don't interfere with it. Leave it alone. It will do the right thing. |
| More telling is how much the health care industry spends on lobbying. It invests more than any other industry except one, according to the nonpartisan Center for Responsive Politics. From 1997 to 2000, the most recent year for which complete data is available, the industry spent $734 million lobbying Congress and the executive branch. Only the finance, insurance, and real estate lobby exceeded that amount in the same period, with a total of $823 million. In contrast, the defense industry spent $211 million—less than one-third of the health care expenditure. |
| Look no further than the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which might more aptly be called the Pharmaceutical Company and health care industry Welfare Act. In the fall of that year, when Congress enacted a Medicare prescription drug benefit for the first time, the White House point man on the half-trillion-dollar-plus taxpayer-funded program was Thomas A. Scully, administrator for the federal Centers for Medicare and Medicaid Services (CMS). |
| But lawmakers would need to get it by Senate Majority Leader Bill Frist, the Tennessee Republican who played a pivotal role in pushing the Medicare bill through in the first place. The health care industry has no more ardent supporter in Washington than Frist, a heart surgeon and staunch advocate of free-market medicine. His father, Thomas F. Frist Sr., and his brother, Thomas F. Frist Jr., founded what has become HCA Inc., the nation's largest hospital chain with nearly 200 hospitals and revenue of $21.8 billion in 2003. |
| Like so many investors mesmerized by the mountain of cash available for tapping in the health care industry, Dr. Elkins, a Harvard-educated psychiatrist by trade, spotted an opening in the system. Many hospital patients needed ongoing care, but it was the kind of care and rehabilitation that could be provided in a much cheaper setting. That's when Integrated, based in Hunt Valley, Maryland, just north of Baltimore, turned a nursing-home wing into a subacute facility. More followed. |
Bob LeBow, M.D., M.P.H.
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 But they have been set up by the health care industry (insurers, drug companies, medical establishment) to have high expectations and to create a demand for expensive goods and services. As for the people who can't afford the expensive services, they don't matter. There are no profits to be made from the poor, unless they can qualify for a government program that will pay their bills.
The Search for a Comprehensive Solution
An interest in universal coverage once again seems to be growing, though it appears to be morphing into a less ambitious goal of "reducing the number" of the uninsured. |
J.D. Kleinke
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 The consensus among the health care industry's leading pundits, most of whom have never actually worked in a hospital, is that the problem stems from poor leadership. Classic Twaddle Echo Factor. In criticizing hospital leaders for failing to lead, the pundits are doing exactly what W. Edwards Deming warned us never to do when trying to diagnose an industry's woes: blame individuals for systemic failures (Deming, 1982). |
Donald L. Barlett and James B. Steele
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| The seed money came from none other than Tenet. As of May 31, 2002, Tenet "owned 67.3 percent of Broadlane." In turn, Broadlane provided services to Tenet hospitals and other health care companies. Barbakow and other Tenet executives and employees owned stock in the company.
One of Fetter's first major acts was to start selling hospitals. |
John D. Lantos, M.D.
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 This phenomenon may explain part of the extraordinary growth of the health care industry over the past few decades but probably doesn't explain much. Most new health care innovations are not hard to sell. In many cases, demand is induced not by marketing gimmicks but by discovering treatments or cures that are neither self-serving nor unnecessary. We allow the blind to see. We stop the congenitally abnormal heart, correct its deformities, and restart it. We take half of a mother's liver from her body and give it to her child. As Paul Simon says, "These are the days of miracle and wonder. . . . |
Bob LeBow, M.D., M.P.H.
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| Evil Empire" of the health care industry) have created the myth that America cannot, and will not, accept Medicare for All, or the equivalent. Who controls the media? Who has the ear of politicians? Who has the money to drop a few million dollars on an advertising campaign to derail an effort at universal coverage or to sink a proposal to put meaningful pharmaceutical benefits into Medicare?
Even the executive director at my community health center, though an advocate for universal coverage, frequently expresses his skepticism. "Do you really think we'll have universal coverage anytime soon? |
| We should be looking at health care from the perspective of the nation as a whole, not just from the point of view of the health care industry. We need to consider breaking the perverse link between employment and health insurance, a link which is not only an accident and unique to America but is also actually hurting U.S. industry by making it less competitive in a world market. The question of how much of our country's GDP we should be spending on health care will be discussed more fully in Chapter 11. |
| Americans, like our health care industry, think short-term. The new technologies are at times amazing and, of course, usually very expensive. But, after all, if it were available, who wouldn't want the "very best" treatment, especially if it were covered by insurance? If your child were ill, wouldn't you want the treatment with the highest chance of success, even if it cost a bundle?
Pharmaceutical industry dollars and the media attention given to medical and technological advances have changed the culture of how Americans look at health care. Americans have come to "expect the world. |
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