The Healthcare Illusion

Healthcare

Healthcare. It’s something most of us believe we need. Many of us are convinced we need to go to the doctor for everything that has to do with our health, no matter how trivial the problem.

Certainly, this makes sense for accidents and other traumas, with modern medicine having developed some of the most amazing life-saving care. But emergency medicine is only part of the bigger healthcare picture.

The question is, on the whole, is modern medicine – what many call healthcare – really the miraculous system that most of us believe it is?

Life Expectancy

Let’s look at one of the best measures of the health of a society. Life expectancy. Life expectancy is the average life span of an individual in a group or basically at what age you’re likely to die on average.

In 1900, life expectancy in the United States was 47.3 years, reaching 69.7 years by 1960, a positive increase of 22.4 years, an impressive 47% rise over those 60 years. From 1960 over the next 60 years, life expectancy reached 78.8 years in 2019, a much smaller positive change of 9.1 years or a 13% increase.

Unfortunately, from 2009 until 2019, peaking in 2014, progress in life expectancy has essentially flatlined at 78.7 years, with virtually no real gain over those 11 years.

Cost

How much does this massive medical system cost?

The Gross Domestic Product, or GDP for short, is a monetary measure of the market value of all the final goods and services produced in a specific period by a country.

In 1900 the United States national health expenditure was 2.5% of GDP, doubling to 5% by 1960. After 1960 national health expenditure began to rapidly climb, reaching 17.6% by 2019, a staggering 252% increase, with no end in sight to the ceaseless growth in health care costs.

Since 1960, over the last 60 years, the health care bill has amounted to $66.7 trillion, with just about half that amount ($33.7 trillion) spent during those 11 years of zero gain in life expectancy.

Medicine and Life Expectancy

The medical system is extremely costly and growing, with little to no impact on life expectancy in recent years. What may be surprising is that any gains in life expectancy over the last 120+ years are not primarily because of modern medicine.

A 1970s paper by McKinlay found that medical measures and services only accounted for at most 3.5% of the decline in mortality from 1900 to 1973.¹ Furthermore, according to a 2001 report by John Bunker in the International Journal of Epidemiology,

“All told, clinical services, composed of preventative services as well as therapeutic intervention, we credited with 5 or 5½ years of the 30 years increase in life expectancy since 1900 [to 2000]... I estimate there is a loss of life expectancy of 6 months or possibly as many as 12 months as a result of iatrogenic [medically caused] death.”²

According to Bunker, taking into account his estimate of medically caused death, we are left that the medical system can be credited with 4 to 5 years of the total improvement in life expectancy. However, the Bunker study assumed a lower end of medical error (75,000 to 150,000) that resulted in death. But, according to a 2016 article in the British Medical Journal, medical error contributes to 251,000 deaths and is the third leading cause of death.³

This brings that medicine-caused disease loss to perhaps 1.5 years, which changes the possible life expectancy gain attributed to medicine to 3.5 to 4.0 years, or about 11% to 14% of the total improved life expectancy over the 20th century.

Whatever the exact percentage that medical measures have increased life expectancy, the vast amount had to do with other non-medical factors. Yet, “the public attributes 80% of the improvement to modern medicine and only 20% to all other factors.”⁴

Piped water, sewage treatment, garbage collection, food transportation and storage, electricity, better housing, labor and child labor laws, economic prosperity, education, pollution controls, improved nutrition, exercise, and so forth were actually the main factors in improved life expectancy. Not modern medicine.

Lifestyle

Is there a better way to live a full and long life?

A study in 2018 in the journal Circulation looked at the impact of five lifestyle factors of never smoking, a normal body mass index (or BMI), 30+ minutes/day of moderate to vigorous physical activity, moderate alcohol intake, and a high diet quality score on life expectancy. They found,

“We estimated that adherence to five low-risk lifestyle-related factors could prolong life expectancy at age 50 by 14.0 and 12.2 years for female and male US adults, compared to individuals who adopted zero low-risk lifestyle factor.”⁵

A 2020 study in PLoS Medicine examined the life expectancy of healthy versus unhealthy people based on four lifestyle factors of leisure-time physical activity, smoking, diet, and alcohol consumption. They found,

“Our results indicate that in participants with the healthiest lifestyle score, at 45 years the average life expectancy was about 7.6 years longer in men and 6.5 years longer in women compared to those reporting the lowest lifestyle score.”⁶

These and other studies show that a healthier lifestyle is associated with an average gain of 10 years in life expectancy, with every reason to believe this number could be even much higher. This means that lifestyle modification far exceeds the benefits of modern medicine in improving longevity and, no doubt, a tiny fraction of the cost of trillions of dollars currently being spent.

The focus on prevention at the personal level far exceeds attempting to remedy problems after the fact with costly and frequently dangerous, and deadly medical interventions. Prevention should be a top priority for national health policy, with positive lifestyle education and preventive care as the primary part of a genuine health care system.

The Illusion

As a society, we are deeply invested in the myth that medicine has drastically increased the human lifespan and will continue to do so. The medical industry heavily markets its importance and aggressively pushes treating illness over preventing it with lifestyle modification. The industry relies on the notion that humans are lazy, preferring to take pills rather than exercise, eat properly, and other positive disease prevention measures.

The media plays a significant role in causing this misperception. Television programs dramatize and glamorize the world of modern medicine and portray healthcare as having extraordinary powers to restore health. Television dramas seldom communicate to viewers that environmental factors, poverty, housing, food insecurity, education or social welfare, diet, and exercise are powerful predictors of health.

A 2022 opinion piece in the British Medical Journal states that we live with an illusion of evidence-based medicine. The authors declare that the pharmaceutical industry’s responsibility is to its shareholders, which means that priority must be given to their hierarchical power structures, product loyalty, and public relations propaganda over scientific integrity. Their focus is not on your health.

“The release into the public domain of previously confidential pharmaceutical industry documents has given the medical community valuable insight into the degree to which industry sponsored clinical trials are misrepresented. Until this problem is corrected, evidence based medicine will remain an illusion.

A science of real integrity would be one in which practitioners are careful not to cling to cherished hypotheses and take seriously the outcome of the most stringent experiments. This ideal is, however, threatened by corporations, in which financial interests trump the common good.

Medicine is largely dominated by a small number of very large pharmaceutical companies that compete for market share, but are effectively united in their efforts to expanding that market. Scientific progress is thwarted by the ownership of data and knowledge because industry suppresses negative trial results, fails to report adverse events, and does not share raw data with the academic research community.Patients die because of the adverse impact of commercial interests on the research agenda, universities, and regulators.”⁷

Corruption

Constitutional Attorney Jonathan Emord,

What concerns me is that a significant minority… significant minority of drugs that have been approved by FDA have been approved over the FDA’s own medical reviewers’ objections on safety grounds. And the FDA’s whole system of drug review is bogus. It’s designed to protect and advance the interests of the drug industry. A lot of people don’t realize this, but FDA never tests the drugs it approves. FDA does no independent testing at all. It relies entirely on the testing done by the drug advocate, the proponent of the drug application that has a self-interest and a conflict of interest. That party is looked to for all the drug testing. They do their own testing. There have been multiple instances of corruption in this process where false information or negative information has been kept away from the FDA so the FDA will approve the drug.

In fact, Sanofi-aventis, with its drug KETEK, relied principally on a clinical trial that FDA’s medical reviewers, that were sharp on the case discovered, didn’t even happen. They said a clinical trial that they presented that provided support for the claims for KETEK – which is a super antibiotic – was a principal justification for the application – the medical reviewers looked at it and found it never happened. They MADE IT UP! And there were FBI investigations and prosecutions. But what did the FDA do? The medical reviewers said to the commissioner, “Gee, they relied on a fraud for this application. We should deny it. But the FDA commissioner granted it! He put KETEK into the market. And many of the indications for KETEK came out of the clinical trial that was bogus.

So you see, it’s that degree of influence and corruption that makes it impossible for the American people to be protected.⁸

From Russell Brand, September 19, 2021,

The FDA is increasingly green-lighting expensive drugs despite dangerous or little-known side effects and inconclusive evidence that they curb or cure disease.

As patients (or their insurers) shell out tens or hundreds of thousands of dollars for unproven drugs, manufacturers reap a windfall. For them, expedited approval can mean not only sped-up sales but also — if the drug is intended to treat a rare disease or serve a neglected population — FDA incentives worth hundreds of millions of dollars.

“Instead of a regulator and a regulated industry, we now have a partnership,” said Dr. Michael Carome, director of the health research group for the nonprofit advocacy organization Public Citizen. “That relationship has tilted the agency away from a public health perspective to an industry friendly perspective.”

The FDA also increasingly allows drugmakers to claim success in trials based on proxy measurements — such as shrunken tumors — instead of clinical outcomes like survival rates or cures, which take more time to evaluate. In return for accelerated approval, drug companies commit to researching how well their drugs work after going on the market. But these post-marketing studies can take 10 years or longer to complete, leaving patients and doctors with lingering questions about safety and benefit.

Industry also sways the FDA through a less direct financial route. Many of the physicians, caregivers, and other witnesses before FDA advisory panels that evaluate drugs receive consulting fees, expense payments, or other remuneration from pharma companies.

What might be called pay-later conflicts of interest, which have gone largely unnoticed—and entirely unpoliced.  In examining compensation records from drug companies to physicians who advised FDA, Science found widespread after-the-fact payments or research support to panel members.

Among the investigation’s key findings: Over a nearly 4-year period, of 107 physician advisers who voted on the committees, Science examined, 40 received more than $10,000 in post hoc earnings or research support from the makers of drugs that the panels voted to approve or from competing firms; 26 of those gained more than $100,000, and six more than $1 million.⁹

Suffering and Death

According to ColdFusion about the Sackler Family,

...A company which reportedly earned $35 billion in revenue from Oxycontin and further fueled an epidemic which has killed over 200,000 people since 1997.¹⁰

KPIX CBS SF Bay Area, November 17, 2021,

New data shows that more than 100,000 drug overdose deaths in the US from April 2020 to April of 2021, a 28.5%  increase from the year before. Overdose deaths from opioids climbed passed 75,000.¹¹

On the Joe Rogan show with John Abramson:

Abramson: Between 20 and 25 million Americans had taken Vioxx. And between 40,000 and 60,000 Americans had died from the cardiovascular consequences of Vioxx. In the same ballpark as the number of Americans who died in Vietnam.

Rogan: And what was the punishment for Merck?

Abramson: Nobody went to jail.

Rogan: So a small profit of a billion dollars?

Abramson: Maybe they made a billion.

Rogan: Isn’t that wild? You can make a billion dollars from lying.

Abramson: Merck’s chief scientist saw the data from that first study with the 3 heart attacks were omitted. There’s an email that the Wall Street Journal published from March 9, 2000, when they opened up the data on that. And the email, I’m paraphrasing, but the email said something like – it’s a shame, but the cardiovascular effect is there, but the drug will do well, and we will do well.

Rogan: Oh God.¹²

“Is fatal medical error a leading cause of death?” PBS NewsHour, May 4, 2016,

Host: For the better part of 2 decades, there has been a growing recognition that medical errors kill too many patients in the US. While exact numbers are elusive, a new analysis and estimate portrays an even grimmer picture. The new paper finds that as many as 250,000 people die each year from errors in hospitals and other healthcare facilities. That would make it the third leading cause of death in the US, ahead of respiratory disease, accidents, and even stroke. Dr. Martin Makary, a professor of surgery at the John Hopkins University School of Medicine who led the research, joins me now. So how did we get to this number? What did your research find?

Host: Well, we took the best available studies, the data from the medical literature, and we basically came up with a meta-analysis point estimate. And then asked where that fall if medical error were counted as a disease? It turns out we learned that the CDC does not consider medical error to be a cause of death in listing our national health statistics each year, even though the point estimate comes right in between number two and number three on the list, which means medical error is the number 3 cause of death in the United States, we’re just not measuring it.¹³

“Prescription Drug Dispensing Errors Kill 100,000 People Per Year In US,” CBSDFW, May 14, 2018,

Texas pharmacists are overworked, tired, and under the stress of staying open 24 hours. They stock 5,000 drugs, dispense 300 prescriptions daily, and make 2 to 4 mistakes every day.

Nationwide he says it results in 100,000 patients dying every year because of dispensing errors.  The I-Team found pharmacists making mistakes at just about every well-known pharmacy you can think of. And Dr. Shepperd says the reported cases do not begin to represent reality.

Host: This doesn’t begin to represent the number of problems.

Doctor: No. No. Because they’re underreported.¹⁴

1. John B. McKinlay and Sonja M. McKinlay, “The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century,” The Milbank Memorial Fund Quarterly, Health and Society, vol. 55, no. 3, summer 1977

2. John P. Bunker, “The role of medical care in contributing to health improvements within societies,” International Journal of Epidemiology, vol. 30, Issue 6, December 2001, https://academic.oup.com/ije/article/30/6/1260/651763

3. Martin A Makary, et al., “Medical error—the third leading cause of death in the US,” BMJ, May 2016, https://www.bmj.com/content/353/bmj.i2139

4. Gordon B Lindsay, et al., “The Contribution of Public Health and Improved Social Conditions to Increased Life Expectancy: An Analysis of Public Awareness,” Journal of Community Medicine & Health Education, 2014, vol. 4, issue 5, https://www.omicsonline.org/open-access/the-contribution-of-public-health-and-improved-social-conditions-to-increased-life-expectancy-an-analysis-of-public-awareness-2161-0711-4-311.php?aid=35861

5. Yanping Li, PhD, et al., “The Impact of Healthy Lifestyle Factors on Life Expectancies in the US population,” Circulation, July 24, 2019, pp. 345-355, doi: 10.1161/CIRCULATIONAHA.117.032047

6. Yogini V. Chudasama, et al., “Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study,” PLos Med, September 2020, doi: 10.1371/journal.pmed.1003332

7. Jon Jureidini and Leemon B. McHenry, “The illusion of evidence based medicine,” BMJ, March 16, 2022, http://dx.doi.org/10.1136/bmj.o702

8. “Jonathan Emord talks about corruption within the FDA,” September 23, 2014,

9. “THIS Is Why You Can’t Trust Big Pharma,” Russell Brand, September 19, 2021,

10. “The Sackler Family – A Secretive Billion Dollar Opioid Empire,” ColdFusion, July 27, 2019,

11. “Opioid Overdose Deaths Soar Nationwide,” KPIX CBS SF Bay Area, November 17, 2021,

12. “The Troubling Story of Vioxx,” PowerfulJRE, December 30, 2021,

13. “Is fatal medical error a leading cause of death?” PBS NewsHour, May 4, 2016,

14. “Prescription Drug Dispensing Errors Kill 100,000 People Per Year In US,” CBSDFW, May 14, 2018,