The New York Times had this to say today, first from an editorial:
Eight years and seven million patients later, we still don’t know whether the diabetes drug, Avandia, is safe or effective. This is largely because the manufacturer, GlaxoSmithKline, failed to vigorously pursue questions about cardiac safety and the Food and Drug Administration acquiesced in its feeble efforts. Both either ignored or tried to silence scientists who raised the alarm.
( Link: Misdirected Studies on Avandia )
Then there was this from an article on chemotherapy:
In general, oncologists make money by providing chemotherapy, even when it has little chance of success. Oncologists naturally dislike telling cancer patients that they have exhausted all available treatments. Ending chemotherapy, after all, means acknowledging that a patient’s disease has become terminal…
…Because the profits on different drugs varied enormously, doctors had an incentive to prescribe medications with the highest margins… The profits helped drive a vast increase in the amounts doctors billed Medicare for injectable drugs, which soared to $10.9 billion by 2004 from $2.9 billion in 1997.
These two quotations, although addressing entirely different issues, tell us about the brave new world of government in medicine. Those involved in the health care system and those in government who funnel billions of dollars to them have developed a mutually-supportive and self-sustaining relationship. This all exists under the heading of “science,” which seeks to present you, the consumer, with a seamless, uniform image of a health care system that is the best money can buy.
Nevertheless, hardly a day goes by when the New York Times does not publish an article where large, ugly cracks form in this beautiful fantasy.
This situation produces my bipolar reaction to the possibility of a single-payer system run by the government. One morning I wake up gung-ho on the idea of eliminating the billions of dollars of profit to the opportunistic paper-pushing businesses in our health care system. The next morning I wake up horrified at the prospect of a tighter relationship between government and medicine, because it is a disaster. I go to great lengths to make sure neither I nor my patients fall into this system.
What is a least common denominator medicine? It is a medicine, which, instead of producing excellence, produces a system that maximizes profits and then publishes scientific studies—funded by the system--to convince you that the decisions for your care are impartial and objective.
Least common denominator medicine corrals you into some category and treats those corralled in the same uniform way. Easy for the bureaucrats. Good for streamlining profits. Bad for you.
Least common denominator medicine puts a number on you—the diagnostic code—and thereby starts a multi-billion dollar industry humming. Doctors become technicians that tag you with the code, enabling all the industries attached to that code to make profits.
I am not against profits in medicine, because, not to throw out the baby with the bathwater, this is the reality of the time in which we live. I am against a system radically out of touch with the human, and that is what we now have. Medical science studies the human as if we were machines, often ridiculing any viewpoint that suggests otherwise. Any medicine must be grounded in a realistic view of who we are, how we get ill, and how we truly heal. Medical science's view of illness and healing is astonishingly narrow, and the result is a medicine that is equally narrow. We are multi-dimensional beings faced with a uni-dimensional, monolithic system.