When All You Have is a Hammer...

Well no doubt that all this talk about health care reform has brought some long overdue can-o-worm opening. Take, for instance, unnecessary surgeries: a medical nuisance of the worst magnitude, and common practice for decades. A recent report discloses that riskier surgeries for low back pain have risen in number and in cost, yet many are unwarranted. Well n-o-o-o chit! You know what they say, "When all you have is a hammer, everything looks like a nail."

Data on more than 32,000 Medicare patients with low back pain stemming from spinal stenosis (a narrowing of the spinal canal causing a squeezing low back pressure) showed that costlier, more complex spinal fusion surgeries were recommended and performed over a six year period. Less expensive decompression surgeries, costing roughly $20K, were often bypassed for $60-90K spinal fusions, despite the more expensive surgeries having greater complications and even leading to death.

Worse yet, many a spinal fusion was lacking in evidence for appropriateness of care. You don't say? Our doctors doing the unnecessary? Nah, not McReamy. You bet your assets they are. And I love it, because we chiropractors have known about it for years, and we haven't been quiet about it, either. We have tried to sway the public toward more natural and highly effective treatment options, but noooo, stay away from them chiropractors, they can hurt you.

Yeah? Listen to these number:

• Risk of stroke in a $20K spinal decompression (part of vertebrae hacked out to take pressure off nerve): 1 in 50
• Risk of stroke in a $80K complex spinal fusion (vertebrae connected and joint removed): 1 in 20
• Risk of stroke in a $3K round of chiropractic care: 1 in 5.85 million

Frickin' duh!

According to the study, more than half the patients who had complex fusions had a simple stenosis, which usually calls for decompression alone. Rates of complex fusions in Medicare patients rose 15-fold from 2002-2007, while decompressions declined, and hospital charges grew 40 percent. There have been allegations of kickbacks to spine surgeons for using products of a particular hardware manufacturer. Hey Izzy, them screws you got in ya back sent me and the missus to Reno...

Listen, I don't really think there's some big conspiracy here: It ain't rocket science. The medicos are admittedly deficient in their training in treating musculoskeletal issues. Surgery is also notoriously ineffective at relieving low back pain for any significant stretch of time. So why are drugs (equally ineffective) and surgery still the treatments of choice by the cultural health authority? Simple. When all you have is a hammer...

Cancer Cut by Intense Exercise

Put this in your socialized health care pipe and smoke it--men who do heart-pounding exercises regularly are less likely to develop cancer. Yeah, you got it: more exercise, less cancer; less cancer, less cost. Quick, call your congressman--get health club memberships subsidized. Uh...dream on.

Nobody yet is pushing real health care reform, one where actual health enhancement finds its place in a national bill. Why not, you may ask? Because it's a political and money game being sold to the public as concern for the greater good. Sure it's about people...suuuuurrre!!! That's why all the big money players are positioning themselves like never before. Insurance companies, pharmaceutical companies, AMA--all former opponents to universal health care are now on board hoping to get it all into place. Think there's some money to be made?

I wouldn't be against this whole sham if I didn't know that it isn't going to change a thing that's worthwhile. Same old medicine, same old s@$#. Findings like the one in the title of this post get a quick mention and then back to, "how can we sell more drugs, surgeries, procedures, politics, bull turds...?"

Here's how: The latest findings came from a study out of Finland that looked at more than 2,500 men and their exercise habits for one full year. They followed up with the same men sixteen years later. They found that the men who exercised the most--not sissy exercising, either; intense exercise, stuff that made them sweat--were half as likely to develop cancer than the men that exercised the least. The researchers attributed the lower cancer rates to an increase in oxygen consumption. The cancers most reduced were of the stomach or intestines, lungs, prostate and brain.

I find this study very exciting. To me it makes real sense as to where our focus should be. But guess what: I'M ALONE! Nobody, and I mean nobody (OK, besides former Health and Human Services Secretarial Nominee, Tom Daschle) is looking at this information and realizing where health care needs to go to become "affordable". The big sham is thinking that if we all pick up the tab for those who choose to not exercise, not lose weight, not get off heavy duty drugs (both pharmaceutical and recreational), not moderate their alcohol intake, not eat well, not get chiropractic care, not fix their relatively minor physical problems before they become major ones, and so forth, then everything will be alright--and cheaper in the long run. What a frickin' joke.

Hospitals Oppose Reform

Here we go. Hospitals, medical technicians and a medical imaging access coalition all oppose President Barack Obama's latest health care reform proposal to reduce Medicare and Medicaid spending. These organizations believe that the proposed cuts will impair access to medical care to many who need it.

The president suggested yesterday that $200 billion could be saved over the next ten years by trimming federal payments to hospitals. He justified this change by noting broader insurance coverage, so in other words, they'll make it up in volume. Many hospitals, especially those with large numbers of poor patients say these cuts will be unfair and will only hurt the poor, sick and elderly.

Although congress will sculpt the new laws, the president has influence. Obama has urged the congress to resist powerful lobbies trying to maintain their clout and profits. Like those greedy hospitals, medical technicians and imaging centers (X-rays, MRIs, CT scans), I presume. All in all, the president wants to cut $313 billion in both federal programs over the next decade.

All I can say is, "Wow!" Already being one of the worst reimbursing insurances in the country, Medicare under Obama's proposal would pay even less? Does anybody have any idea of what the consequences will be? Why don't we ask The Access to Medical Imaging Coalition, a trade group representing diagnostic imaging centers and their patients,

It would "impair access to diagnostic imaging services and result in patients' delaying or forgoing life- and cost-savings imaging procedures."

The group also said Obama's efficiency estimates were based on a flawed survey. You don't say...

What else? Some believe that providers--doctors, hospitals, imaging centers--will have to ration services due to the cuts. No kidding--what else do you think will happen? Do you think that doctors will pay for a patient's lab tests themselves? C'mon! If you have been reading this blog lately, then you know I've been saying it repeatedly--health care reform, as proposed by our current government, will do little to improve health care and a lot to diminish its quality. Unfortunate, since quality is the one thing American health care has got going for itself.

Where's the "Reform" in Universal Health Care

Here's a question: What medical treatment improves health? Chemotherapy? Heart bypass? Prozac? What? Feel free to answer below--all comments welcome. I really want to know, because if improving health is a goal of health care reform--and it certainly should be--then shouldn't we define which aspect of today's health care system is improving health?

Former Health and Human Services Secretary appointee, Tom Daschle had it right when he spoke of the importance of making "wellness cool". But wellness comes from lifestyle behaviors, not medical procedures. If you've read my book, The Six Keys to Optimal Health, then you know where I place medical care on the health care spectrum--it's for saving lives. And in saving lives, nothing beats American medicine.

But health giving? Yeah, what? One gentleman told me about his doctors visit where they found his thyroid to be under-functioning. "And that is medical prevention or wellness," he said.

"What was prevented," I asked.

"My thyroid becoming a problem."

"But it's already hypothyroid--that doesn't change. The medicine or treatment prevents you from becoming lethargic. It's saved your life--at least the quality, that is."

I know that's a tough point for people to accept, but it's true. Antibiotics don't kill bacteria; they simply poke holes in the cell walls of bacteria or stop their growth, and so they leave the bacteria susceptible to attack from the white blood cells of the immune system. Chemotherapy doesn't bring the body back to health--it kills all the cells in the body, and the body must build itself back up through its own faculties.

Here's the point: Nothing heals the body but the body itself. It can be helped along through medical procedures, but ultimately it must self-heal and self-regulate. The only way to nurture the body's innate healing ability is through practicing healthy lifestyle habits.

With this in mind, how is providing universal health coverage going to "improve" the health of Americans? The only real way to improve the health of the masses is by teaching, encouraging and rewarding healthy behaviors. This doesn't mean punishing business that provide junk--it's everybody's responsibility to know what's healthy and what's not. Instead, why doesn't the government provide tax breaks for gym or yoga studio memberships? How about covering chiropractic and massage therapy in every health plan? Twelve a year--how 'bout it Obama? How about really making wellness cool. Or do we just have to hear the rhetoric, and see another law passed that helps the rich (insurance industry).

If what the President says is true, that a universal health plan should "place the American people's interests above the special interests," then shouldn't it do more than just provide us with life-saving coverage. Shouldn't we take the cool wellness concept to heart? It's really the only way to bring health care costs down.

Insurance Companies Push for Universal Health

I wrote in my last blog post that insurance companies have a vested interest in universal health care. This might be a surprise to some, since it might not be obvious how private insurers will profit from health care reform. A Los Angeles Times piece hot off the press explains just how--through mandated individual coverage.

"Individual mandate" is the provision private insurers are hoping for; without it, they might as well pack it in, because reforms are sure to destroy the industry. Why else would insurance companies back a plan to restructure the health care system that they've fought to block for sixty years plus? The individual mandate would require everyone to buy medical insurance, which insurers hope will be sweetened by taxpayer-funded subsidies for customers who can't afford it, and enforced with fines.

If the individual mandate provision goes through, then insurers stand to gain millions of customers over night; and it will probably save the sinking ship as the insurance industry has been hurting for some time now. Since 2000, business has waned for private insurers as rising premiums pushed scores of people out of the market. The current recession has only heightened the problem. As baby boomers age, things will get worse: 79 million boomers will turn 65 in 2011 and move away from private insurance coverage to Medicare. And an estimated 170 million people will be making that shift over the next two decades. So, basically, health insurers need this mandate.

The scenario which the private health sector can least afford would be the one where the single-payer plan is adopted. In this scheme the government pays all bills, rendering private insurance obsolete. Clearly, for the health insurance industry, this can't happen.

So that's why you are now hearing insurance companies getting into the universal health care act. Playing their cards right can lead to huge profits; but playing the wrong hand can lead to a bust. Just pointing it all out so you understand the economics and politics behind this movement. I'm not against it, as long as the powers that be (or as it will probably turn out, the new powers that be) don't start messing around with fee schedules. If it prevents waste and crookery and medical mistakes without making hard-working health professionals go belly under, then wonderful; erect the statues today. But I can't see how all this is going to be funded without taxing the lot of us (bye-bye, small businesses), or slapping health care with mandated lower reimbursements. If it is the latter, expect the quality of health care to suffer big time.

Uninsured Raise Health Care Costs for All - Really?

What our federal government wants to do is reform the health care system--that is, make sure medical care is available to everybody. Universal health care, the belief goes, will lower costs and make people healthier (I'm guessing, because I don't really get the ultimate goal of all this reform stuff).

Healthier? Really. And lower costs? Hmm. A recent report from the sham organization, Families USA, has suggested that uninsured people increase health cost for everybody. They claim that as medical bills go unpaid, the costs are shifted to the insured through higher premiums. Unfortunately, but not surprisingly, Families USA provides no rational argument--no facts, whatsoever. I've read their sorry report, and it's obvious to me that it is just fodder for the politicos trying to push the health reform agenda. Most people, especially those that favor reform without question, won't bother to read the report; and many more won't understand it. In fact many doctors won't understand it because they don't do the billing in their office. But every billing manager in health care will know my words ring true. Listen.

Families USA claims that doctors and hospitals charge more for their services when uninsured patients don't pay their bills; they claim that providers primarily pass these increases on to insurance companies. Nonsense! That's illegal. All medical procedures have reasonable and customary (R & C) rates that are determined by discipline (medical doctor, chiropractor, physical therapist, etc.), procedure (examination, office visit, debridement, x-ray, etc.), and zip code (Beverly Hills, Bakersfield, Omaha, etc.). Charging more than this R & C rate 1) won't get paid by the insurer and 2) is illegal. A provider also can't raise the bill to insurers by upcoding either--that is, charging for a higher level of service to pad the bill. Illegal!

So the claims by Families USA are pure BS, plain and simple. And to the undiscerning reader it may seem like cold, hard facts; a good reason to support universal health care. But it's a lie. Understand this, universal health care is being embraced by political groups, ideologues, and insurance companies alike. That's right, insurance companies*. Because they smell the money-making opportunity in this horse turd. More insured means more premiums for the insurance companies--believe that. And they love it! They have a vested interest in perpetuating the complete falsity of passing costs onto the insured. Bull! Insurance companies raise premiums for one reason and one reason only; the same reason they withhold reimbursing health care providers for as long as they can--PROFITS. And profit from this political mumbo jumbo they will.

*"Reasonable and customary charges" are the allowable charges that Aetna will pay for medical services by contract with providers in its network. Rates are consistent with those normally charged by the provider for the same services or supplies and within the general range of rates charged by other providers in the same area for the same services or supplies. When you use a network provider, you pay only the coinsurance on the allowable charges. When you use an out-of-network provider, Aetna pays the allowable charges it would pay a network provider, and you pay the difference. You decide.

Wake Up and Smell the Mirror

There's a phenomenon happening in Asian medical care that mirrors our own practices, yet we seem too blind to see it. According to recent reports, doctors in Asian countries from Hong Kong to Indonesia are overprescribing drugs to patients that often don't need them. And this overmedicating is driven by profits, experts say. You don't say. Could that be the dirty little reflection staring "too expensive" American medical care back in the face?

"Polypharmacy (overmedication) is very popular [in Asia], it means they use a lot of medicines which are unnecessary, like giving you many types of antibiotics for a cold," said William Chui, honorary associate professor at the Clinical Trials Center attached to the University of Hong Kong.

Well Dr. Chui, let me wake you up to a harsh reality: It's not just profits that drive this practice--it's a faulty paradigm. Health care based on primarily treating illness, while merely paying lip service to healthy behaviors, and shutting out these same practices from insurance reimbursements, maintains this polypharmacy madness. Think about it: Health insurers, which includes the federal government's Medicare and Medicaid plans, only pay for symptomatic care. This perpetuates the myth that health comes from fighting illnesses.

No doubt, disease care is important; however, it is merely one aspect of human health. Denying all the rest--physical fitness, proper nutrition, regular bodywork, mental health services outside of psychiatry, and so forth--simply says, "It's not necessary." Do you think people get confused by this message?

The politicos talk a big game when it comes to health care reform. Wake up and smell the BS, America! Focusing on more of the same "health care", just subsidized, is insane. Look at Asia if you can't look at yourself. Put the finger back in its holster, American health care, or point the other four back at yourself; you wrote the book on medical over-consumption. But it's a heck of a lot easier imagining you see Asia through a window, than recognizing it's just a reflection in the mirror, now isn't it?