Can someone explain the health care 'crisis' to me?

[Dan.]

[ QUOTE ]

That was the WalMart the far left dem alderman fought against on the westside, no? Are you saying the democrat alderman would rather see people starve than allow Walmart into town?

[/ QUOTE ]

Seems that way, doesn't it? I don't really want to turn this into a discussion about Walmart, so I'll leave it with this: A job at Walmart is better than no job, but to say that a job at Walmart is ideal or can provide all that a person needs is silly, imo.

[TomCollins]

[ QUOTE ]
TomCollins -- America isn't all that much fatter or unhealthier than Europe. You really think that if all of the sudden we had France's medical system then Americans would be living much shorter lives? I really don't think that this is true.

[/ QUOTE ]

People would be living much different lives. You have no control group. People in different countries have different values and priorities. Certain countries have healthier diets or exercise more. Certain countries are more prone to having people walk a lot vs. drive. You are comparing apples to oranges.

[TomCollins]

[ QUOTE ]
[ QUOTE ]

That was the WalMart the far left dem alderman fought against on the westside, no? Are you saying the democrat alderman would rather see people starve than allow Walmart into town?

[/ QUOTE ]

Seems that way, doesn't it? I don't really want to turn this into a discussion about Walmart, so I'll leave it with this: A job at Walmart is better than no job, but to say that a job at Walmart is ideal or can provide all that a person needs is silly, imo.

[/ QUOTE ]

They don't pay you in ponies?????? Damn, I'll withdrawl my application.

[mjkidd]

[ QUOTE ]

This is a really, really bad argument. American doctors aren't treating the same things other countries doctors are treating, so its absurd to claim that it is their fault that American's aren't healthier. It may still be true (its not) but this is no way to demonstrate it.

[/ QUOTE ]

You're right, it's hard to quantitate. But countries like the UK, Norway, Sweden, and other European countries have similar rates of heart disease, autoimmune disease, cancer, and diabetes, but spend far less on healthcare. And they live just as long as we do.

What does American medicine do for heart disease? They'll give you Lipitor to lower your cholesterol, another medicine to lower your blood pressure, and tell you to eat less pork and beef and more chicken and fish. With this course of treatment, cardiovascular disease will continue to progress, and eventually you'll have crushing angina or a heart attack, and medicine will perscribe a risky 40k angioplasty or a risker 100k bypass surgery. Neither of these procedures will increase life expectency, but they will relieve the angina for those who don't die on the table. This whole approach is really just rearainging deck chairs on the Titanic. The heart disease will continue to progress.

There's actually a far more effective dietary approach to treating heart disease: cutting out all meat products and eating a low-fat, high carbohydrate diet. This has been shown to not only halt progression of the disease, but actually reverse it. Dean Ornish showed that after 1 year on such a diet, patients showed a 7% decrease in the diameter of arterial blockage. This is a huge result -- no conventional treatment can show such dramatic results; indeed, the goal of the cardiologist is to slow the progression of disease and ameliorate its symptoms, not reverse it.

If you go to a cardiologist with crushing angina today, there is a roughly 0 percent chance that he will tell you about the dietary approach. He will recommend angioplasty or bypass surgery instead. In my opinion it is not a coincidence that angioplasty costs 40k, bypass surgery up to 100k, and oatmeal is free. Now, it may be that your average American isn't willing to go on such a restrictive diet. But some will, and in my opinion it is the physician's duty to tell their patient all the treatement options, not just those that benefit their practice.

And what would you choose if your cardiologist gave you the following options:
1) Angioplasty: We're going to charge you 40k, and inflate a balloon in your heart/brain/whatever. There's a chance you'll die, but it's pretty low. This is a stopgap measure that will likely have only a transient benefit.
2) By-pass: We're going to charge you 100k, take a vein out of your leg, stop your heart, put you on a bypass machine, graft the veins onto your clogged blood vessels, restart the heart. You have about a 4% chance of dying and a high probablility of suffering minor brain damage from the bypass machine. This ought to clear up that angina for about a year or so, then it comes back. Sorry dude. Oh, and it doesn't significantly prolong your life.
3) Oatmeal: You can't eat any meat or dairy products. You'll have to eat alot of salad and fruits and vegetables and stop pouring salt on everything. You have the best chance of a good outcome with this course of treatment.

Which one would you choose?

[TomCollins]

With this Oatmeal solves all problems diet, you sure can put a lot of heart surgeons out of business. Too bad its complete bs once the problems exist.

[Bill Haywood]

[ QUOTE ]
With this Oatmeal solves all problems diet, you sure can put a lot of heart surgeons out of business. Too bad its complete bs once the problems exist.

[/ QUOTE ]

You did not read closely.

[vhawk01]

[ QUOTE ]
[ QUOTE ]

This is a really, really bad argument. American doctors aren't treating the same things other countries doctors are treating, so its absurd to claim that it is their fault that American's aren't healthier. It may still be true (its not) but this is no way to demonstrate it.

[/ QUOTE ]

You're right, it's hard to quantitate. But countries like the UK, Norway, Sweden, and other European countries have similar rates of heart disease, autoimmune disease, cancer, and diabetes, but spend far less on healthcare. And they live just as long as we do.

What does American medicine do for heart disease? They'll give you Lipitor to lower your cholesterol, another medicine to lower your blood pressure, and tell you to eat less pork and beef and more chicken and fish. With this course of treatment, cardiovascular disease will continue to progress, and eventually you'll have crushing angina or a heart attack, and medicine will perscribe a risky 40k angioplasty or a risker 100k bypass surgery. Neither of these procedures will increase life expectency, but they will relieve the angina for those who don't die on the table. This whole approach is really just rearainging deck chairs on the Titanic. The heart disease will continue to progress.

There's actually a far more effective dietary approach to treating heart disease: cutting out all meat products and eating a low-fat, high carbohydrate diet. This has been shown to not only halt progression of the disease, but actually reverse it. Dean Ornish showed that after 1 year on such a diet, patients showed a 7% decrease in the diameter of arterial blockage. This is a huge result -- no conventional treatment can show such dramatic results; indeed, the goal of the cardiologist is to slow the progression of disease and ameliorate its symptoms, not reverse it.

If you go to a cardiologist with crushing angina today, there is a roughly 0 percent chance that he will tell you about the dietary approach. He will recommend angioplasty or bypass surgery instead. In my opinion it is not a coincidence that angioplasty costs 40k, bypass surgery up to 100k, and oatmeal is free. Now, it may be that your average American isn't willing to go on such a restrictive diet. But some will, and in my opinion it is the physician's duty to tell their patient all the treatement options, not just those that benefit their practice.

And what would you choose if your cardiologist gave you the following options:
1) Angioplasty: We're going to charge you 40k, and inflate a balloon in your heart/brain/whatever. There's a chance you'll die, but it's pretty low. This is a stopgap measure that will likely have only a transient benefit.
2) By-pass: We're going to charge you 100k, take a vein out of your leg, stop your heart, put you on a bypass machine, graft the veins onto your clogged blood vessels, restart the heart. You have about a 4% chance of dying and a high probablility of suffering minor brain damage from the bypass machine. This ought to clear up that angina for about a year or so, then it comes back. Sorry dude. Oh, and it doesn't significantly prolong your life.
3) Oatmeal: You can't eat any meat or dairy products. You'll have to eat alot of salad and fruits and vegetables and stop pouring salt on everything. You have the best chance of a good outcome with this course of treatment.

Which one would you choose?

[/ QUOTE ]

I'm not sure what to say, exactly, except that I think you are very, very wrong if you think doctors refuse to inform patients about their options, including, but not limited to, dietary modification, alternative medicine, and so on. You might have a point if you were saying something like "Doctors are so jaded at the fat, lazy patients who refuse to take any long-term, proactive action to protect their health that they mention these things only in passing, because they know they will just be ignored, and their patient will just want the quick, fast, expensive bariatric-surgery-equivalent." But if your actual position is that a large percentage of doctors are just shysters who are keeping their patients willfully in the dark about far superior treatments for the sole purpose of fattening their wallets...I just can't agree. It is entirely opposed to all of my experience in the health care field. I know thats not a very convincing argument to you, and you most certainly don't have to take my word for it. I just don't know of any better way to convince you. I don't think a survey asking doctors "How scummy are you, 1-10?" would show much. I'm aware there are a few books out recently about doctors running scams like this, where one sends his patients to another for completely unnecessary procedures. I just think it is ludicrous to consider these types of doctors to make up any significant part of the field.

We might just have to agree to disagree on this, since I'm not sure there is anything more I can do to convince you. I do appreciate your persepective, and I think its unfortunate that your experience with the health care field has been so negative. I know there are lots (LOTS!) of problems with the U.S. healthcare system, and I know doctors are far from perfect. I hope I've given you at least a little insight into the way a soon-to-be physician feels about some of these issues.

[mjkidd]

[ QUOTE ]
With this Oatmeal solves all problems diet, you sure can put a lot of heart surgeons out of business. Too bad its complete bs once the problems exist.

[/ QUOTE ]

ORLY?

From The Lancet, Jul 21, 1990 336, 129-33

In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care control group. 195 coronary artery lesions were analysed by quantitative coronary angiography. The average percentage diameter stenosis regressed from 40·0 (SD 16·9)% to 37·8 (16·5)% in the experimental group yet progressed from 42·7 (15·5)% to 46·1 (18·5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61·1 (8·8)% to 55·8 (11·0)% in the experimental group and progressed from 61·7 (9·5)% to 64·4 (16·3)% in the control group. Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.

And Caldwell Esselystyn's study, published in Preventive Cardiology (2001) 4, 171-177 (with pretty pictures):
http://www.heartattackproof.com/resolving_cade.htm

[vhawk01]

Oh, and real quick, "prolonging life" is a really bad metric, IMO. It is definitely the traditional one, and I think that is a significant failing and hurdle for the advancement of medical treatment. I, for one, am completely uninterested in prolonging anyones life. What I am interested in is alleviating suffering and improving quality of life, AS DEFINED BY THE PATIENT. A lot of times, this means living longer, but ALL the times, this means living better.

[mjkidd]

[ QUOTE ]


I'm not sure what to say, exactly, except that I think you are very, very wrong if you think doctors refuse to inform patients about their options, including, but not limited to, dietary modification, alternative medicine, and so on. You might have a point if you were saying something like "Doctors are so jaded at the fat, lazy patients who refuse to take any long-term, proactive action to protect their health that they mention these things only in passing, because they know they will just be ignored, and their patient will just want the quick, fast, expensive bariatric-surgery-equivalent." But if your actual position is that a large percentage of doctors are just shysters who are keeping their patients willfully in the dark about far superior treatments for the sole purpose of fattening their wallets...I just can't agree. It is entirely opposed to all of my experience in the health care field. I know thats not a very convincing argument to you, and you most certainly don't have to take my word for it. I just don't know of any better way to convince you. I don't think a survey asking doctors "How scummy are you, 1-10?" would show much. I'm aware there are a few books out recently about doctors running scams like this, where one sends his patients to another for completely unnecessary procedures. I just think it is ludicrous to consider these types of doctors to make up any significant part of the field.

We might just have to agree to disagree on this, since I'm not sure there is anything more I can do to convince you. I do appreciate your persepective, and I think its unfortunate that your experience with the health care field has been so negative. I know there are lots (LOTS!) of problems with the U.S. healthcare system, and I know doctors are far from perfect. I hope I've given you at least a little insight into the way a soon-to-be physician feels about some of these issues.

[/ QUOTE ]

Do you really think that most cardiologists talk about/advocate drastic dietary modifications with their patients? I'd be surprised if many cardiologists even know how effective dietary intervention can be. Is is common knowledge among physicians that heart disease is reversible through diet?