Thursday, February 7, 2013

Over-Prescription and No Common Sense

Pills by Sylvar/Flickr
One thing when watching American television that really bothers me is the barrage of drug ads: not only do they show people suffering from all kinds of ailments- such as depression, lack of sleep, or high cholesterol - who suddenly after taking their magical pills start smiling, are happy hanging out with a group of fellow sufferers, wake up rested, and run energetically through a forest -, but they are also indicative of a health care system that is fundamentally unhealthy. The U.S. is among only two countries (i.e. the other is tiny New Zealand) that allow direct to consumer drug ads. 

As the World Health Organization stated:

" Direct-to-consumer advertising of drugs has been legal in the USA since 1985, but only really took off in 1997 when the Food and Drug Administration (FDA) eased up on a rule obliging companies to offer a detailed list of side-effects in their infomercials (long format television commercials). Since then the industry has poured money into this form of promotion, spending just under US$5 billion in 2008 alone." 

Does this increased spending on direct drug advertising mean that American consumers are healthier than others, or just that pharmaceutical companies are making more profits from their brand-name drugs?

Gary Burtless , economist at Washington-based the Brookings Institution explains this clearly in his article With Health Care Costs, the U.S. is a Huge Outlier  :

"...The United States spent about $7,500 per capita on health care compared to an average of $3,300 in other rich countries. If the nation obtained better-than-average health outcomes in exchange for its much-higher-than-average health spending, we would have little reason to complain. However, there is almost no evidence U.S. health outcomes are better than those in other rich countries. A variety of statistics on mortality and morbidity suggest outcomes may be worse in this country than they are elsewhere."

A visual explanation of the healthcare costs in the U.S. vs. Europe is presented in below video from the Khanacademy

My eye caught recently an article Pills-a-poppin': Our medication nation from best-selling author Mitch Albom, in the Detroit Free Press,where he describes his elderly's father experiences in a hospital:

"At the hospital, my father was asked this question: "How many pills do you take?"His answer: aspirin and Zocor. "That's it?" came the reply. Days later, after he'd been prescribed a daily blood thinner, a blood pressure drug and a stronger cholesterol drug, a therapist asked, "How many pills do you take?" He answered with the three new medications."Wow," he was told. "You're doing great for your age." 

Both responses are telling. We live in the Age of Prescription, when anything and everything has a pill assigned to it. If you're not swallowing something, doctors are surprised. Did you know the average American fills 12 prescriptions a year? Our medicine cabinets are stocked with small brown bottles. From heartburn to heartache, there is a pill you can pop.And that's how the drug companies want it." 

Does this experience sound familiar to you? This legalized drug pushing offers a clear example of rather than offering a response on how to ensure that people lead healthy, fit and productive lives,  we're coming up with the wrong answers resulting in having to endure annoying drug ads - which in the end someone needs to pay -, increased costs from over-prescribing of multiple drugs, and this all resulting in more people not being healthier. Does that make sense?

Another example of offering the wrong answer to a medical problem is what I saw earlier this week on the popular medical CBS TV show, The Doctors. A black dancer came on the show asking how to keep her bones strong and healthy, as she was lactose intolerant, and couldn't digest dairy products and therefore calcium.  Two doctors discussed this and suggested to start out with trying smaller amounts of dairy or low-fat yoghurts. Maybe this would work for her, but neither of the doctors expressed any doubt about the supposed need for dairy as a source of calcium. There is substantial evidence that calcium can be absorbed by other means than dairy, for example in vegetables, beans and fruits. Dr. Joel Fuhrman, a doctor specialized in nutritional medicine says this on his website:

" About 10 million Americans already have osteoporosis, and 34 million are at risk. Contrary to popular belief however, low intake of calcium is not the primary cause of osteoporosis. While Americans have the highest calcium intake in the world, we also have one of the highest hip fracture rates in the world. The standard American diet causes much of the consumed calcium to be lost in the urine. Excess salt, caffeine, sugar, and animal products leach calcium out of bones and promote urinary calcium loss. The Nurses' Health Study followed 72,337 women for over 18 years and found that dairy intake did not reduce the risk of osteoporosis-related hip fractures.

In contrast, vegetables, beans, fruits, nuts, and seeds are rich sources of calcium and other important minerals, and do not promote the urinary excretion of calcium. A three cup serving of raw, chopped greens – like kale, bok choy, or collards - provides the same amount of calcium (or more) as one cup of whole milk. Only 32% of the calcium in the cup of cow’s milk can be absorbed by the human body compared to about 50% for many green vegetables."

The two doctors on The Doctors  did not question whether dairy products are healthy at all. Behind the mainstream media scenes - which are often sponsored by ads from the dairy and food industry -, there are many experts who are critical about the health impact of dairy. Obviously, there are vegans and others who abstain from dairy,  based on how badly animals are treated, or on the toxicity of milk filled with anti-biotics and hormones. It's telling that in Europe and Canada, American milk is banned due to its use of BGH (i.e. Bovine Growth Hormone.)

So a more complete and scientifically honest answer to the dancer would have been along the lines that she doesn't need milk to support her calcium intake. Depending on the rest of her diet, she could increase her intake of vegetables and fruits. And if she insists on having dairy she should be aware of its toxicity and to look for dairy that is labeled "no BGH." Now that would be a responsible approach, offering enduring health.

It's time that more doctors, more patients and consumers, and, hopefully more politicians, start following the common sense approach and solve the problems at hand rather than offering the wrong answers and increasing problems. If American consumers would have better information about nutrition and medication, if pharmaceutical companies would not treat their products like smarties, and if the government would actually support the welfare of the people and not mainly of the corporations, then people would be healthier, would need less medication and treatments, would lower the costs of healthcare and strengthen the economy and society at large. Common sense would dictate this, so what are we waiting for?

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