America’s Broken Health Care: Diagnosis and Prescription

I developed a serious cardiac arrhythmia, ventricular tachycardia, seven years ago. It worsened over the past summer and early fall, and over the past six weeks I’ve had several ambulance rides and hospitalizations. And my experience through this illustrates the good side as well as the bad side of medicine today.

On the good side, I was fortunate to have the attention of two world-class doctors who spent six hours, one going inside my heart, the other coming through my chest wall to the outside of my heart, to map electrically the aberrant signals in my heart and to ablate them. Since then, I’ve not had a problem.

On the bad side, two days after the procedure, I was in the intensive care unit when a cardiologist came by on rounds. He advocates a wider use of cholesterol-lowering statin medications than I do, and he started to cite the literature about why I should be taking more cholesterol-lowering medicine than I already was. I asked him if he had read the studies underlying that literature, and of course he had. I then asked him if he understood that the endpoint of many of those studies wasn’t really appropriate to determine the benefit of statins, and he acknowledged there was some debate about that. Finally, I asked if he was aware that when peer-reviewed articles are published in medical journals—even the most reputable medical journals—the peer reviewers don’t have access to the actual data from the clinical trials being reviewed. And he answered, somewhat meekly, that yes, he was aware of that.

In other words, he was aware that his recommendation that I increase my use of statin drugs was based entirely on incompletely vetted commercially-sponsored and largely commercially-influenced medical journal articles. This gets to the heart of the problem of the commercial takeover of the medical knowledge that doctors believe in and implement.

But before continuing that thought, let me step back and explain why I begin from the assumption that U.S. health care is on the wrong track.

#HillsdaleCollege #Imprimis #Healthcare #BigPharma

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