Health Care – Managing Disease For Profit

A press release recently announced the findings of a study on the projected future cost of caring for diabetics in America. The headline is a real shocker: “Diabetes Population to Double, Diabetes Costs to Nearly Triple in 25 Years, New Study Shows.”"Finding ways to reduce the number of people who develop diabetes is both a national public health priority and a fiscal imperative,” said Dr. Elbert Huang, the lead author of the paper and an assistant professor of medicine in the Department of Medicine at the University of Chicago. “The best way to stem the dramatic rise in diabetes is to implement proven preventive care programs on a national level.”This study was published in the December issue of the Journal of the American Diabetes Association, “Diabetes Care.”The study’s findings are shocking, as they are intended to be — and I believe they are generally accurate — but there is a hidden agenda here that tells a curious story about how the medical profession defines “preventive care programs.”Key Point #1: The study was commissioned by Novo Nordisk, a Danish drug manufacturer specializing in diabetes medicines and devices for treating diabetes.Key Point #2: The general gist of the study results are intended to drive Congressional legislation for allocating more funding for diabetes “preventive treatments,” and agency coordination of services for the diabetic and pre-diabetic population, intended to reduce the crushing costs of managing the fullblown complications of diabetes, including amputation, kidney disease, and blindness.Key Point #3: Nowhere is it mentioned that diabetes may be prevented and even reversed by persuading the public to adopt better diet and exercise habits, essentially for free. (Dr. Neal Barnard, Dr. Ray Strand and Dr. John McDougall all proclaim this message in their books.)It would not serve the interests of the drug maker which funded the study to point out a simpler and nobler approach to making the public aware of the dangers of the excesses of the “Standard American Diet” of sugar-frosted cereals, processed meats, and Cheez Doodles, with a diet soda chaser. The whole study, and the press release with its shocking title are about finding more funds in the federal budget for making an “investment” in managing the projected increase in diabetes, due to the growing numbers of the obese population.Managing Disease in this Context Is All About Money, Not HealthThis press release, the academic study, and the supporting National Changing Diabetes Program, dedicated to “driving federal policy change” and “raising diabetes on the national agenda” really don’t get to the heart of the matter. At its heart is a clear picture of how corporations create urgency in the minds of the taxpayers and legislators so that more money is available from the federal trough to pay for their particular drugs and services.Most of Congress amiably goes along with this charade because they recognize the pharmaceutical companies as “good citizens” and allies in milking more tax money out of the U.S. public. Milking the public and passing out favors to wealthy industry groups are what Congress does best.This Is One More Reason Why American Health Care Is So ExpensiveCloaked in the dense verbage of policy wonks is one of the keys to understanding why American health care costs are going through the roof: “The best way to stem the dramatic rise in diabetes is to implement proven preventive care programs on a national level.”But what exactly are “preventive care programs”? I’d be willing to bet they involve drugs and services, just like the ones that Novo Nordisk sells. And the doctor who said it leaves it unclear. I suspect the language is purposefully hazy so that we may think it means what we’d like it to mean. (I visited Novo Nordisk’s Web site and found nothing I would call preventive care programs, only lots of drugs. No mention of using exercise and diet changes to make drugs unnecessary. But then, what did I expect?)There is an unspoken assumption that the American public cannot be expected to make intelligent changes in their diet and exercise habits. This assumption becomes a self-fulfilling prophecy if physicians don’t observe the “first steps care” protocol — as many doctors don’t — of informing the patient of changes in diet and exercise regimens that would make drugs unnecessary — and be healthier for the patient in the long run.It is a well-documented fact that diabetes, Type 2, can be prevented and even reversed by changes in the patients’ diet and level of exercise. Without the counseling and insistence by their physician, many patients wouldn’t know where to look for this information of if they could trust the source. [See Dr. Neal Barnard's Program for Reversing Diabetes ]Dr. Barnard’s book also reveals the fallacy in Dr. Huang’s statement about preventive care programs(no doubt involving drugs). According to Dr. Barnard, drug treatments for diabetes do not stop the progression of the disease and thus, could not lower costs, but would just start the “meter running” earlier. (But when a pharmaceutical company funds a study, do you think it would ever see the light of day if it didn’t recommend a need for more drug-based therapy?)Only informed and motivated patients can change their habits which have brought on the disease. Drugs cannot do so by themselves.Starting a national educational campaign to alert the public to the dangers of their unhealthy diet would cause great distress among the “farm vote” and the Processed Foods Industry, which would put their lobbying muscle and election funding contributions to work to prevent any program from revealing the true source of our obesity epidemic.Expecting Public Health Education From Those Who Sell Drugs — About Ways To Achieve Health Without Drugs — is UnrealisticIt is interesting how obesity has been turned into a disease that requires drugs and surgical interventions to manage it, so it won’t cost the public even more in the long run.To sum it all up: Intelligent personal strategies that prevent diseases like diabetes are not likely to gain traction because there are too many agencies, foundations, fundraisers, and industry groups that are feeding off the sick-but-not-terminal American public. There is little push to prevent diabetes, cancer, heart disease, etc., because there is no money in it for the key players…unless we define prevention to mean starting drug therapies sooner.Our health care system is all about keeping us sick. There is no incentive to cure us, because then the cashflow for doctors, hospitals, and pharmaceuticals would dry up. The money is in keeping us alive and somehow able to pay their bills. (This is where Congress can help.)Health care, (which should be called sickness care) is dedicated to extracting more money from the public to fund more studies, to pay more lobbyists to make sure our most feared disease is high on the agenda of Congress, who will declare a National Diabetes Awareness Day and try to find more tax money to support more round-about medical/pharmaceutical interventions to protect us from overindulging on the products of other fine campaign contributors — say, those in the Processed Foods Industry.But tell us how to cure our disease? No, that’s not on their business agenda. Doctors, for the most part, are simply doing what they were taught in medical schools largely funded by the pharmaceutical industry: how to prescribe drugs for various conditions, order tests, and refer patients for surgery.Smart Americans will need to find their own answers to preventing diabetes. There is only token funding for showing the public how they can solve their obesity problem for free — the Center for Disease Control puts out some fairly accurate pamphlets encouraging better eating habits and more exercise, for example. That’s step in the right direction, but that’s not where the real money is going.Follow the money trail to find out the real agenda of the medical/pharmaceutical complex. The big money is in keeping us sick and collecting payments for managing our disease, not curing or preventing it. Read between the lines of doublespeak to find the truth why our approach to health care is so expensive.=========================================================================