What's Wrong With America's Health Care System?

This is an article I wrote for a recent course I took towards my degree in Nutritional Science. I would like to begin my blog with this article. Maybe we will all become a little bit healthier from this information in spite of the tremendous difficulties we face from both the American food and health care industries. I hope that this information can encourage us to be more careful with our health and develop additional ways for healing.

My paper is entitled "What's Wrong With America's Health Care System":


“Nearly 70 percent of uninsured adults who are in poor health, and nearly 50 percent of uninsured adults in fair health, report that when they needed care in the past year, they were unable to see a physician because of cost”
- Families USA - September 2007

From all accounts, one would think that the health care provisions in the United States were among the best in the world: state of the art facilities, innovative technological equipment and break-through medications have all propelled American health care to be the most expensive, and most advanced, health care in the world. But beneath this exalted veneer, a grim and unethical industry is being revealed. In view of the fact that 89 million Americans remain medically uninsured, and that upwards of 225,000 fatalities are the direct result of medical errors every year, and that overwhelming medical debt is the leading cause of bankruptcy in America, American health care is not only largely inaccessible for millions of people, it has become downright dangerous and a significant cause of injury and harm.

“Every year, the deaths of 18,000 people between the ages of 25 and 64 can be attributed to a lack of health insurance. This makes uninsurance the sixth leading cause of death, ahead of HIV/AIDS and diabetes.”

- Families USA - September 2007


Of the 89 million uninsured adults under age 65, the great majority (70%) simply avoids medical treatment due to an inability to pay. In a recent report from Families USA, millions of uninsured adults avoided attending to a medical concern due to cost, clearly increasing the chances of medical complications that often result in disability or death (Wrong Direction: One Out of Three Americans Are Uninsured: Bailey, K., Families USA Foundation 2007).

In a report from the Journal of American Medical Association (JAMA) “The uninsured are less likely to get any care at all, but among those that did get some care, they were much less likely to get recommended follow-up care,” (Becker, C. 2007). And according to the Citizen’s Health Care Working Group, “Not getting care when it’s needed can cause serious health consequences. A recent study found that, of people who get into car accidents, those who are uninsured receive 20 percent less treatment and are more likely to die from their injuries than people with health insurance coverage” (Health Report to the American People: Health Care That Works For All Americans)

Ever since its origin, health insurance in America has been work, or employer, based. Persons who have lost their jobs and families who have lost an employed parent or spouse due to death or divorce often lose their medical coverage. Nonetheless, millions of people work at jobs in America that do not offer medical benefits; jobs offering less than 40 hours per week are legally not liable for not providing medical insurance for their employees.

While the majority of medical insurance is obtained through full time employment, there are millions of people who work full time in jobs that do not provide medical insurance. According to Families USA, the majority (over 70%) of the 89 million medically uninsured worked full time during 2006 (Wrong Direction…) in jobs that did not provide medical insurance. An additional 8% worked part time. The majority of the uninsured are families, including over 9 million children.

Because most people are covered by Medicare by age 65, almost all of the uninsured are under 65. And while children from low-income families are more likely to be covered by Medicaid and other state and federal programs, parents do not qualify under the same income guidelines as their children. Because children’s eligibility income level is much higher, they can be entitled to Medicaid in the very same families where their parents are not. In addition to this, entire families, including children, are not eligible for Medicaid or any of the other government run health insurance programs if the income is above a certain level. Even at this higher level, most families cannot afford the exorbitant costs of private health insurance, and simply do without. A full 65-70% of all uninsured are in families where adults work full time at jobs that do not provide medical coverage. They cannot afford the price of health insurance on their own.

"The paradox is that the costliest health system in the world performs so poorly. We waste one-third of every health care dollar on insurance bureaucracy and profits while two million people go bankrupt annually and we leave 45 million uninsured” - Dr. Quentin Young, national coordinator of Physicians for a National Health Program.

Millions of others work in jobs that, while offering medical insurance, offer insufficient medical benefits that require higher out-of-pocket costs for medical care. In a startling Harvard report, the study revealed that medical bills are the leading cause of bankruptcy, and “medical bankruptcies affect about 2 million Americans annually -- counting debtors and their dependents, including about 700,000 children” (Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds: ConsumerAffairs). These people had job-based medical insurance that proved insufficient for their illnesses or hospital stays. According to Dr. David Himmelstein, the lead author of the study and an Associate Professor of Medicine at Harvard, "Unless you're Bill Gates you're just one serious illness away from bankruptcy. Most of the medically bankrupt were average Americans who happened to get sick." (Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds…)

And while the uninsured and minimally insured struggle simply to obtain medical care, the medical care available in the United States has largely proven less than adequate even for those who can afford it. In a landmark report titled “Is US Health Really The Best In The World?” by Dr. Barbara Starfield (JAMA 2000, vol. 284, #4) findings of upwards of 225,000 deaths every year are attributed to medical errors within the health care system. Her report breaks down the fatalities into the following categories:

Death from medical errors (an estimated 39,000) is often the result of a lack of accurate communication involving any one or all of the following:

1. Patients being given the wrong medication due to inaudible or illegible prescriptions

2. Clinicians misreading the results of a test; urgent and critical symptoms that are misdiagnosed in the emergency room or by medical professionals elsewhere

3. Surgical errors resulting from miscommunication involving specific information about a surgery

An additional 80,000 deaths a year result from infections acquired in hospitals, and another 106,000 deaths a year result from accidental adverse effects of medications. More money is spent to treat medication-related problems than is spent on the cost of medications (Seniors At Risk, 2004).

The issue involving medication errors is so grim that the American Society of Consultant Pharmacists estimates that 1.5 million people a year either die or are permanently disabled due to medication errors and their adverse effects. These are statistics involving prescription medication specifically, and many of the victims are senior citizens. According to an epic report titled Seniors At Risk - Designing the system to protect America’s most vulnerable citizens from medication-related problems (American Society of Consultant Pharmacists, March 2004) “More than 200,000 people die and another 2.2 million are injured each year because of medication-related problems—and seniors are the most susceptible” (Ernst and Grizzle 2001; Lazarou, Pomeranz, and Corey 1998).

In addition to the human toll, the medical expense involved in medication-related problems has risen to $200 billion in the past five years. This is the result of the following (Seniors At Risk…)

■ In the community population, medication-related problems cost $177.4 billion a year, a 57% increase in only five years (Ernst and Grizzle 2001):

■ Hospital admissions cost $121.5 billion (69%)
■ Long-term care admissions cost $32.8 billion (18%)
■ Physician visits cost $13.8 billion (8%)
■ Emergency department visits cost $5.8 billion (3%)
■ Additional treatments cost $3.5 billion (2%)

■ An additional $24 billion is spent on medication-related problems in other settings:
■ $20 billion in acute care facilities, such as hospitals (Bates et al. 1997)
■ $4 billion in nursing homes (Bootman, Harrison, and Cox 1997)
The initial cost of outpatient prescription medication is $154 billion.

Given the dire consequences of this plethora of medications, there is still a significant reluctance within the health care industry to encourage more natural therapies. While diet and exercise is known to effectively reduce the risk of numerous medical conditions, reliance on pharmaceuticals and surgeries, even for the simplest ailment, has taken precedence over more natural therapies. Yet, overwhelming evidence in recent years points to specific foods and nutrients, as well as simple exercises, as being capable of significantly reducing the chances of disease, in addition to having the ability to reverse disease in many instances, as well. Many of these ‘natural’ therapies can restore health without the additional need for medications and surgeries, greatly reducing the risk of medication errors and medical mistakes.

Studies have shown that a diet rich in colorful fruits and vegetables, whole grain breads and cereals, and foods raised without pesticides can greatly increase our chances for health and recovery from disease. Specific foods, food groups, and nutrients benefit the body like a natural medicine. Studies have discovered that modern diseases, such as diabetes and heart disease, are directly related to what we eat, and can be relieved by simple changes in diet.

On his website, world renowned Dr. Joel Fuhrman states, “The vast majority of my patients, who adopt my nutritional and exercise recommendations for diabetes, become thin and non-diabetic. They are able to gradually discontinue their insulin and eventually their other medications. They simply get well” (Reverse Disease Through Nutritional Excellence, Spotlight on Diabetes).

Dr. Fuhrman highlights specific steps one can take to reverse diseases, such as diabetes, using food choices alone. His recommendations for diabetes consist of a vegetable based diet, emphasizing liberal use of vegetables of every kind as the most important food. Complementing the vegetables, in lesser degree, are fruits, whole grains, seeds, nuts, and legumes. The effect on health is often dramatic, many times resulting in the patient actually being able to go off of diabetic medication, completely, as a result of returning to health.

Using specific foods and nutrients in healing disease is not limited to diabetes. Major illnesses and disabling conditions can be helped, across the board, by simple dietary changes. In particular, an inadequate diet is one of the major causes of heart disease, one of the nations most devastating health conditions. “Making significant dietary changes allows people who suffer with coronary heart disease, high cholesterol, overweight or obesity and/or high blood pressure to reduce and to eliminate their dependence on medications, avoiding major surgeries such as heart bypass and angioplasty.” (Fuhrman, J. MD. Reversing Heart Disease,)

Innovative medical professionals, such as Dr. Fuhrman and others like him, have proven that an emphasis on vegetables, fruits, legumes, seeds, nuts, and an avoidance of salt, can significantly improve chances of recovery from disease, with many patients restored to optimal health.

Similarly, a reliance on medication to reduce cholesterol underestimates the healing power of “plant sterols, which naturally occur in foods of plant origin” (Lars H. Ellegård, MD, PhD, Susan W. Andersson, PhD, A. Lena Normen, PhD, and Henrik A. Andersson, MD, PhD – 2007: Nutrition in Clinical Care: Dietary Plant Sterols and Cholesterol Metabolism) This study reveals that a liberal use of plant sterols from the use of plant-based foods (fruits, vegetables, and whole grains) can be instrumental in reducing both high cholesterol and heart disease.

Another threat to health are the chemicals and pesticides routinely used in conventional farming. Identifying and avoiding these toxins can be additionally instrumental in maintaining health (Food Additives, Center for Science in the Public Interest). Specific scientific findings have linked residues from pesticides, insecticides, and heavy metals, found to be present in modern foods, to a variety of chronic diseases. A passage from “Can Organic Foods Really Improve My Health?” reiterates this as follows:

“….Organically grown food is your best way of reducing exposure to toxins used in conventional agricultural practices. These toxins include not only pesticides, many of which have been federally classified as potential cancer-causing agents, but also heavy metals such as lead and mercury, and solvents like benzene and toluene. Minimizing exposure to these toxins is of major benefit to your health. Heavy metals damage nerve function, contributing to diseases such as multiple sclerosis and lowering IQ, and also block hemoglobin production, causing anemia. Solvents damage white cells, lowering the immune system's ability to resist infections. In addition… organically grown foods have been shown to contain substantially higher levels of nutrients such as protein, Vitamin C and many minerals.” (Can Organic Foods Really Improve My Health? The George Mateljan Foundation/Worlds Healthiest Foods).

Understanding various aspects of nutrition is essential in improving our health. An article titled “The Importance of Our Internal Environment” by Dominic Speirs emphasizes that by choosing alkaline foods and creating an alkaline environment in the body we can significantly prevent major disease (Speirs, Dominic. Positive Health, Dec 2007 Issue 142, p28-32, 5p).

Liberally including a wide range of colorful fruits and vegetables is also known to increase our chances of avoiding disease. In an article titled “Colorful Choices Make Good Choices” written by the University of Iowa Health Sciences Department, “The more reds, oranges, greens, yellows, and blues you eat, the more health-promoting properties you get from your diet.” (University of Iowa, 2004). Each natural color represents a different essential nutrient, crucial for optimum health.

Understanding how nutrition affects our children can reduce the need for dangerous medications that are routinely given for hyperactivity and behavioral problems, as well. As concern about the nutritional impact of the American diet on children and adolescence has risen in recent years, studies have shown a direct correlation between what our children eat and their performance, both academically and behaviorally. How processed foods (also known as fast food) and foods lacking essential nutrients affect our youth is the focus of a monumental undertaking by an organization called Focus Adolescent Services, which maintains a clearinghouse of information, resources, and support for teens and their families.

On the Focus Adolescent Services website there are direct references to nutritious and organic foods as a primary source of both academic and behavioral health for teens and their families. As those who work with teens at risk seek ways to solve the difficulties these young people and their families face, nutrition has surfaced as a major area of concern. There is ample evidence that many of the academic and emotional problems faced by young adults might, inadvertently, be the result of faulty nutrition.

While medication is the norm for mental illness, studies have proven that nutritional support can clearly reduce, and even replace, the need for prescription drugs. Research obtained by A Perfect Healing, Inc., a nutritional advocacy group that encourages nutrition in healing disease, has discovered that the B Complex vitamins play a major role in emotional health. As revealed in their website, in the chapter on mental illness, the late world renowned nutritionist and author Adelle Davis illustrates in her book ‘Let’s Get Well’ how a lack of these essential nutrients can severely effect emotional health:

“…in dozens of experiments men and women volunteers remained on diets lacking one or another of the B vitamins…... individuals undersupplied with vitamin B1 quickly became fatigued, depressed, forgetful, irritable, quarrelsome, apathetic, confused, restless, anxious, and uncooperative; they neglected their work and appearance, became intolerant of details and noise, and suffered from insomnia, nervousness, paranoid tendencies, and hypochondriasis, all of which were relieved soon after the vitamin was given…..A lack of the B vitamin niacin amide results in such confusion, disorientation, clouding of consciousness, and hallucinations that it can cause total mental breakdown…..mild deficiencies, associated with irritability, suspiciousness, imaginary unfairness, and mental depression, usually described as “the blues,” are common.… Induced pantothenic-acid deficiencies have caused persons to become irritable, depressed, quarrelsome, hot-tempered, easily upset over trivialities, and to want to be left alone. Similarly, volunteers lacking vitamin B6, not only became highly nervous, tense, irritable, depressed, and mentally confused, but developed halitosis and hemorrhoids…..Fatigue, confusion, irritability, and mental depression have also occurred when deficiencies of folic acid or biotin have been produced….”(‘Let’s Get Well’ Signet Books, 1965, p. 274).

Additional work with the mineral magnesium has revealed amazing results. Adelle Davis, in her book “Let’s Eat Right To Keep Fit’ goes on to state that persons only slightly deficient in magnesium will show the following symptoms:

“…Persons only slightly deficient in magnesium become irritable, high-strung, sensitive to noise, hyperexcitable, apprehensive, and belligerent. If the deficiency is more severe, or prolonged, they may develop twitching tremors, irregular pulse, insomnia, muscle weakness, jerkiness, and leg and foot cramps: their hands may shake so badly that their writing becomes illegible. Electroencephalograms, electrocardiograms, and electromyograms, or the records of electrical waves in the brain, heart, and muscles, all become abnormal. If magnesium is severely deficient, the brain is particularly affected. ….Clouded thinking, confusion, disorientation, marked depression, and even the terrifying hallucinations of delirium tremens are largely brought on by a lack of this nutrient and remedied when magnesium is given…. (Adelle Davis, Signet Books, 1970)

Considered the pioneer and ‘grand lady’ of the nutritional movement in the 1960’s, the late and great nutritionist Adelle Davis revealed powerful elements in nutrients, particularly B complex and magnesium, that were actually found capable of curing disease, particularly heart disease, diabetes, kidney and liver diseases, and much mental illness. Her studies revealed factual evidence that nutritional deficiencies, or dependencies, is the real culprit in disease, including mental illness, and that there can be no success in combating these illnesses until their nutritional components are responsibly addressed.

While an entire nation waits patiently for a change, America’s health care system continues to exclude millions of people; rely exclusively on often ineffective and dangerous pharmaceuticals in treating disease; kill and injure millions with medical and medication errors; and is the leading cause of financial ruin. State of the art medical facilities, and groundbreaking medical and surgical achievements, pale in comparison to its inefficiency and lack of success. For all its hype and exorbitant costs, modern American health care remains largely inaccessible, ineffective, and seriously dangerous for millions of people.

While little else is available to take its place, we must realize the importance of self-help in all of this. Adopting a colorful-plant based diet and an easy exercise routine is a great place to start. By not smoking, and by learning what foods, nutrients, and exercises can help us avoid the need for medication, we can considerably reduce our chances of medication injury and medical error, and naturally increase our chances of recovery from disease.



References

Bailey, K. 2007: Wrong Direction: One Out of Three Americans Are Uninsured: Families USA Foundation 2007, on the web at: http://familiesusa.org/assets/pdfs/wrong-direction.pdf

Becker, C. Access varies with income: JAMA. Study shows many patients squeezed on paying for care (Modern Healthcare) 2007 Mar 19; Vol. 37 (12), pp. 14

Yager, J. (Sept. 2007) Study: 89 million uninsured. Retrieved from the Blue Cross/Blue Shield website (http://www.bcbs.com/news/national/study-89-million-uninsured.html)

Healthlink: Medical College of Wisconsin: Medical Mistakes: Where Do We Go from Here? Retrieved from website: http://healthlink.mcw.edu/article/1031002765.html

Citizens’ Health Care Working Group: Health Report to the American People: Health Care That Works For All Americans: retrieved from the website at:
http://www.citizenshealthcare.gov/recommendations/healthreport3.pdf

Lars H. Ellegård, MD, PhD, Susan W. Andersson, PhD, A. Lena Norme´n, PhD, and Henrik A. Andersson, MD, PhD – 2007: Nutrition in Clinical Care: Dietary Plant Sterols and Cholesterol Metabolism.

Importance of Our Internal Environment. By: Speirs, Dominic. Positive Health, Dec2007 Issue 142, p28-32, 5p; Abstract

ConsumerAffairs.com: 2005: Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds: retrieved from web at: http://www.consumeraffairs.com/news04/2005/bankruptcy_study.html
JAMA, 2000: Starfield, B., MD, MPH: Commentary: Is US Health Really The Best In The World: retrieved from web at: http://silver.neep.wisc.edu/~lakes/iatrogenic.pdf

“Colorful Choices Make Good Choices”, University of Iowa Health Sciences Department, (University of Iowa, 2004) http://www.uihealthcare.com/topics/medicaldepartments/foodandnutrition/colorfulfoods/index.html

The George Mateljan Foundation, http://whfoods.org/organics.php

Dr. Joel Fuhrman, http://www.drfuhrman.com/disease/default.aspx

Center for Science in the Public Interest, http://www.cspinet.org/reports/chemcuisine.htm

Focus Adolescent Services, http://www.focusas.com/Nutrition.htm

A Perfect Healing, Inc., http://aperfecthealing.org/

‘Let’s Get Well’, Adelle Davis, Signet Books, 1965, p. 274

“Let’s Eat Right To Keep Fit’, Adelle Davis, Signet Books, 1970