The First Step Toward Rationed Care?

February 24, 2009
Category: Uncategorized

Columnist George Will first sounded the alarm on January 28. As he reported, the stimulus legislation now approved by Congress and signed into law by President Obama “create(s) a council for Comparative Effectiveness Research. This is about medicine but not about healing the economy. The CER would identify (this is language from the draft report on the legislation) medical ‘items, procedures, and interventions’ that it deems insufficiently effective or excessively expensive. They ‘will no longer be prescribed’ by federal health programs.”

According to The New York Times, “The program responds to a growing concern that doctors have little or no solid evidence on the value of many treatments.” And a Wall Street Journal article, “Drug Makers Fight Stimulus Provision,” states, “Officially drug and device makers don’t object to that sentiment [that government programs direct their dollars to treatments that are worth the money]. But they warn of a slippery slope where the government ends up axing useful treatments just because they cost too much. They have lined up patient groups that get industry funding to lobby Capitol Hill.”

Let’s examine this scenario using the example of type II diabetes, whose treatment using medications designed to simply “treat the blood sugar number” has been questioned recently in the medical literature. In the United States, nearly 13 percent of adults age 20 and older have diabetes, according to epidemiologists from the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), whose study includes newly available data from an Oral Glucose Tolerance Test (OGTT). Nearly one-third of Americans age 65 and older have the disease. An additional 30 percent of adults have pre-diabetes, according to the February 2009 issue of Diabetes Care.

The current medical model uses blood sugar-controlling medications as well as medications to treat the symptoms that often accompany type II diabetes, high blood pressure, obesity, and high blood fat levels. Safety concerns over the diabetic drug Avandia helped the public realize that while diabetes drugs help control blood sugar levels, it is not tackling the root causes of diabetes. According to an article in Natural News, “Aggressive use of drugs to radically lower blood sugar in hospitalized diabetics is no longer widely recommended as it was just a few years ago, with more and more researchers arguing that such treatments may actually end up killing more people than they save.”

In 2007, diabetes cost the US $218 billion in direct medical care and indirect costs, according to researchers at the Lewin Group—that’s about 10% of all healthcare spending in 2006, according to the Centers for Medicare and Medicaid.
A different approach to the treatment of type II diabetes is advocated by integrative physicians—an approach that is 90% effective, according to published studies from Dr. Walter Willett and his colleagues at Harvard. The “prescription” involves:
• eating as many fruits and vegetables as possible;
• eating no “bad” fats;
• eating some “good” fats each day;
• if grains are eaten, eating only whole grains;
• getting daily physical activity; and
• and supplementing with multivitamin and minerals daily.
A central Florida integrative physician has had such success treating diabetes with this approach, without the use of medications (based in Nobel prize-winning science), that certain insurance companies now laud “the money he saves them each year.” In addition, some specific supplements may also provide considerable help for diabetes.
How will government-funded healthcare justify the pharmaceutical treatment of type II diabetes? According to former Comptroller General of the GAO David Walker, the single biggest problem in government funded health care is waste. Not only are we are wasting money, but human lives as well: lives lost through side effects of dangerous prescription drugs, and through improperly or inadequately controlled diabetes and its accompanying ravages on vision, kidney function, wound healing, heart health, and cognitive function. The New York Times said it bluntly in their article “Disruptive Innovation, Applied to Health Care”: “There is no financial incentive to keep patients healthy.”

It is in response to this sad state of affairs that former NIH NCCAM director Wayne Jonas, MD, has launched a “Wellness Initiative for the Nation,” an initiative that echoes AAHF’s efforts to get a Wellness Resolution passed. Stand with Dr. Jonas and with AAHF—for wellness and personal responsibility, for health freedom and innovative integrative physicians. Say no government-driven healthcare.

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