Do Americans Really Need More Medical Care?

Friday, June 6

As the Presidential campaign revs up, no doubt a big issue will be access to medical care for all Americans. It's a terrible tragedy that tens of millions of Americans have no health insurance and forego important health care measures like checkups and routine exams. This point was underscored for me one night this week on Health Talk when I talked to a man in his 60's with diabetes and hypertension, not yet eligible for Medicare, who was complaining of chest pain (angina).

The caller asked me what natural things he could take to alleviate his chest discomfort. My response was geared less to supplements he might use, but rather on the need for immediate medical attention. While "no insurance" often means foregoing optimal preventive medical care, clinics at city hospitals and at university medical centers are good places to go to enroll in low cost clinics if health problems become critical. But the system still needs a lot of fixing.

On the other hand, would access to unlimited medical care and prescription drugs improve the lot of Americans? It's simplistic to think so. Underscoring this is a recent Dartmouth University study that examines the care rendered to 4.7 million Medicare patients in their last two years of life. It turns that less is more when it comes to care of chronic illness.

Hospitals that treated patients more intensively and spent more Medicare dollars did not get better results. Aggressive care was not better care. More tests, more medications, and more doctors actually worsened the prognosis of many patients and accentuated their suffering at astronomical costs to the system. At this rate, Medicare will become unsustainable in a few years, much less universal care.

A similar study just out showed, counter-intuitively, that more intensive drug therapy to normalize blood sugar did NOT extend the lives of diabetics.

What an impressive rationale for examining low-tech, low-cost, gentle, natural health care interventions to save our medical system. What presidential candidate will have the guts to buck the medical-pharmaceutical complex and entitlement junkies to propose that we change the way we do medicine in this country? Or, as in the energy sector, will we have to wait for the medical equivalent of $10 per gallon gas before we challenge the current paradigm?