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Dr. Jon LaPook

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Do Health Care Advances Make Us Healthier?

Posted: 02/25/10 03:00 PM ET

Last week's CDC report, "Health, United States, 2009" confirms that Americans are increasingly turning to medications, scans, and procedures to improve their health. Exercising, eating right, and weight loss: not so much.

Don't get me wrong. I love technology as much as the next guy. Maybe more. I'm writing this on a laptop while jetting from California to New York. My iPhone, Blackberry, and Kindle are all within ten feet of me. But my inner Luddite is starting to stir.

Here is the good news and bad news about three major findings of the CDC report:

1) The use of imaging studies like CT and MRI scans has tripled in the past ten years.

The good news
These tests can be truly lifesaving. They can diagnose conditions like appendicitis and cancer much earlier than in the past.

The bad news
They're expensive and carry risks. The annual price tag for all these scans is about 100 billion dollars and about 35 to 40 percent are estimated to be unnecessary. Experts are concerned that radiation exposure from tests like CT scans might increase the risk of cancer. And false positives often lead to further testing.

2) The percentage of Americans taking at least one prescription drug increased from 38 percent in 1988-1994 to 47 percent in 2003-2006. Those taking three or more drugs increased from 11 percent to 21 percent.

The good news
Medications clearly help control many medical problems -- for example, hypertension, high cholesterol, and diabetes.

The bad news
The more pills you take -- including vitamins, minerals, and herbs -- the greater the risk of an adverse interaction. Just three months ago, the FDA warned that commonly-used medications such as Prilosec and Nexium can make the anti-clotting drug Plavix less effective.

And medications can give patients a false sense of security. No matter how much Lipitor you take, you're not safe from heart disease if you eat a lousy diet, never exercise, and are obese.

3) Procedures such as angioplasty (opening up a blocked artery supplying the heart) and joint replacements are skyrocketing.

The good news
Used wisely, procedures are a tremendous boon. Emergency angioplasty performed during a heart attack saves lives. Knee and hip replacements can keep people active who otherwise would become immobile.

The bad news
About 30 percent of elective procedures are unnecessary according to experts like Dr. Elliott Fisher, director of population health and policy at the Dartmouth Institute for Health Policy and Clinical Practice. Dr. Fisher advises, "If I were a patient, I'd ask two questions: help me understand the risks and benefits of these procedures, and by the way doctor, do you have a financial interest in ordering this test?"


To try to put the CDC report in perspective, I spoke to Dr. Linda Fried, Dean of the Mailman School of Public Health at Columbia University. She explained that despite advances in many areas over the past decade, we are falling way short in providing adequate health care to Americans. A big reason: we lack a public health system that emphasizes prevention.

She told me, "In our fast paced society, which goes for silver bullets, quick fixes, high return on investment on quarterly reports, prevention is not part of that scenario because prevention's for all of our lives, for our whole lives. And if we're successful in prevention, we don't see anything different and that is a mindset change which we need to learn to live with." She added, "Eighty percent of health is created through prevention and public health. Three percent of our (health care) dollars go into that. We need to find a better balance."

Click here to see more of my interview with Dr. Fried.


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wayoutleft
my nano-bio coded in a period: .
04:04 PM on 03/01/2010
when its more widely understood that health care makes you fatter, the dems will be in even more trouble.
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HUFFPOST SUPER USER
Nomccain
03:44 PM on 02/26/2010
As I've often said, and it's true, what in the Hell is the good in having the best health care system in the world (as many alledge) if you can't afford it????????? This is a question that it seems like many people want to avoid answering as well as a slew of Politicians!!!!!!!!!!!!!!! We are the only so called civilized nation on earth remaining that considers health care a luxery and bases it upon PROFIT!!!! I happen to believe that this is a moral issue that should be taken out of the hands of captialists and share holders and provided for the American people just like it's done in more progressive and compassionate countries. Until it is, we will continue to let people die and lose their retirement plans and savings just because they can't afford to pay greedy pharma companies, doctors and health insurance companies. Where is the outrage people?
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
05:11 PM on 02/26/2010
Indeed. It's very sad. I frankly believe I wouldn't have any health problems if I had lived somewhere else. My problems all stem from only being given 2-3 weeks of an antibiotic when it should have been 4-6 weeks. I have tremendous neurological issues which I believe started from Lyme Disease that either returned or only went dormant for a few years. Now I have trouble walking and have double-vision.
12:42 PM on 02/26/2010
Our health care system, as it is, is not dedicated to promotion of good health for the people but rather promotion of wealth for all providers of health care, especially for the various medically-related industries. That is because we want the health care system to be under the free market system which
means profit is everything. But, in health care, people do not have a choice. When we get sick, we
need immediate treatment or we may die. It is " our money or our life " !
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BluestateGuyInTX
A Connecticut yankee in Emperor Bush's Town.
03:03 PM on 02/26/2010
Exactly! We Americans have got to realize this fundamental truth and treat our insurance and medical industries accordingly. Not everything works best as a profit driven enterprise.
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MrBadExample
Friends call me ‘exampleicious’
11:37 AM on 02/26/2010
The advances in the medical-industrial complex don't make us healthier--we know that long work hours and economic unease contribute to diseases like hypertension and diabetes. The 'advances' are quick-fix solutions for the employers (who pay for most healthcare anyway) to keep their minions working 45 hours a week. Just take another pill, kid. You can get it all done!

Our EC trading partners understand this and they've taken steps to keep work hours down. A 35 hour work-week doesn't carry the risks for hypertension and diabetes that a 45 hour week carries. The employer gladly pays the freight; but a single-payer system has mandates to keep people healthy, not just working longer.

The 'advances' cited here are the same as the kind of medicine practiced in the NFL. No interest in the longterm health of the patient; the goal is to keep that QB or lineman healthy enough to finish out the season.
11:15 AM on 02/26/2010
Do health care advances make you healthier? Only if you can afford them.
11:07 AM on 02/26/2010
CBS News with Katie Couric, is better than FOX, but not much. No wonder this article kind'a looses sight of the fact that so many Americans don't have ANY health care and that the poor never have had the resources to practice healthy lifestyles. That's why poverty sucks. That's why we need government.
10:17 AM on 02/26/2010
It is good news that we have more procedures and medications available for diagnosis and treatment. The bad news is that millions of people do not have access to these because of lack in insurance coverage. While over-treatment certainly is a concern for people who can afford it; under-treatment is an even bigger problem for people who cannot afford medical care. An Urban Institute study estimated that 22,000 people die every year because of lack of insurance coverage.
10:53 AM on 02/26/2010
Exactly. I'm really tired of people who talk as if the poor, which is most of us, don't exist.
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10:05 AM on 02/26/2010
Good, simple pesticide free, non-genetically modified food.
Moderate exercise.
Adequate Sleep.
Love your friends and family.
Do some things you really like to do.
Blow up your TV
Get a dog.

You'll live forever!
10:58 AM on 02/26/2010
I've done all these things, all my life, and am still one step ahead of the grim reaper. However you left out picking healthy parents and a good doctor. A blood pressure cuff, a mammogram and appropriate medical intervention has allowed me to live outlive all my ancestors. If I had been uninsured I would have been dead at 35.
08:39 AM on 02/26/2010
Technology does not necessarily rule. If it did, explain the logic behind the CIA World Factbook listing Cuba as having a better infant mortality rate than the United States. My son who works in a highly technical field of health care often reveals his ethical dilemma in providing invasive and painful treatments to the terminally ill for no reason other than pure profit.
11:03 AM on 02/26/2010
Your son should be blowing the whistle.
Cuba has good health care for everyone because they have the highest number of doctors per capita than anywhere in the world. Their education is free. They also don't allow personal profit at the expense of public health. They don't have the US Senate.
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MrBadExample
Friends call me ‘exampleicious’
11:39 AM on 02/26/2010
Cuba gets hurricanes, we get the Senate.
Cuba must have gotten first pick.
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NorthSide
04:50 PM on 02/26/2010
So, is Cuba's great health system why people still ride rafts to escape to Florida, instead of vice versa?
05:27 AM on 03/13/2010
Umm... Cuba also claims that its people are free to leave at any time.

If the healthcare is really so good in cuba - why don't more people go there to get it? The truth is that the cubam leaders get their healthcare in Western Europe - while the cuban people get next to nothing at all.
07:39 AM on 02/26/2010
Price of the rat race: poor health. The cure : medicine. Do we re-create the crappy system called capitalism where by governments print a bunch of money and then the populace fights over who can get the most or do we continue to live under the greatest system ever invented, the wonder of the world, the machine of growth yada yada yada yada. NOOOOOOOOOO we'll buy the refs. We'll buy the courts. We'll buy the government. We can make a crappy system SUPER CRAPPY. Feed the populace drugs. Give them facials till we're burying 90 year old with 40 year old faces. This is NOT an episode of Twighlight Zone. THIS IS YOUR LIFE!!!!!!!!!!!
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eddiestardust
07:17 AM on 02/26/2010
What about the STRESS caused by THE RISING COST OF HEALTHCARE?
05:06 AM on 02/26/2010
I don't want to wait until I have a problem like my brother or dad or friends or Ted Kennedy or Bill Clinton and then undergo expensive treatments that probably won’t cure me.

Ted Kennedy would be alive today if he had gotten an MRI/MRA scan 5 years ago. Doctors probably would have found he had beginning stages of brain cancer and could have treated it successfully before it got out of hand and at a much lower cost.

This country's heath care system is a very expensive reactive one. What we need is a proactive one that will catch problems before things get out of control. This is the way we can lower costs along with doing away with the tobacco industry and encouraging the fast food industry to provide healthier alternatives to fat and sodium and excess carbohydrates.

It is my life and my body. I'm in charge of my ship. My doctor is simply a consultant.
12:22 AM on 02/28/2010
Regretably this strategy is flawed from a cost to effectiveness standpoint. If you go out to your local mall and grab every male the age of Ted Kennedy and scan them you'll spend a ton of money and probably not find anything that is significant.
05:02 AM on 02/26/2010
President Clinton's recent health crisis is one reason why I'm arguing with Kaiser Permanente HMO about letting me pay 100% costs for a series of MRI and MRA scans to establish a "baseline" for my body as I grow older than 65. So far, I'm healthy because I eat a healthy diet, swim 5 days a week, don't smoke, etc, but it would be nice to know if I have beginning stages of Alzheimer’s, prostate cancer, clogging of the arteries, an aneurysm, evidence of pancreatic cancer, etc.

Dr. McCoy of the Star Ship Enterprise uses his medical Tricorder to scan patients. The “V” on the new sci-fi TV remake of the 1970’s series use a scanner that can extrapolate a person’s likely health over time.

MRI/MRA scans are the safest and best proactive preventive maintenance approach available. Such scans are not harmful like CT scans.

Kaiser claims that I can’t pay for these scans because it is a non-profit organization and because of some Medicare issue. Kaiser is telling me to have them done at a for profit private scanning facility and then give Kaiser the results.

Health care reform should require hospitals to allow patients to make the choice of paying the 100 % out of pocket costs for such scans.

Some folks are spending $200,000 just for a 2.5 hour ride into space next year.

I’d rather spend money closer to home on my own health, and Kaiser won’t let me do so.
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DrP
09:57 PM on 02/25/2010
I disagree with LaPook's comment that medications are a good thing for hypertension and diabetes treatment. Proper diet and exercise in most cases would manage both conditions and render medication unnecessary. Medications often only treat symptoms, and not underlying causes. Hypertension and "diabetes" are symptoms and just treating the symptoms with medications is counter-productive.
My partner is 68 and I am 57. Neither one of us takes a single prescription drug. We exercise and eat properly, don't smoke, and rarely drink.
He is a retired physician, by the way. We also rarely go see doctors! I guess we don't need to.
Finally... our diets are very high in fat (eggs, bacon, rib-eye steaks, butter, olive oil, cream, etc.) and very low in sugar, grains, and starches. We credit "getting it" about the fat fallacy for our excellent health.
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MrBadExample
Friends call me ‘exampleicious’
11:42 AM on 02/26/2010
ITA. None of the prescription drugs are complication-free. The diabetes drugs can't head off the other damage from the disease, and cause their own symptomatic problems (including weight gain).

We've got a generation of medical consumers who believe there's a pill to solve everything.
09:51 PM on 02/25/2010
Prevention is great but education is better. Think about what we teach in American schools. We spend a lot of energy teaching things that we never use in life but how many students come out of school who are literate in health and personal finance? And what are the two areas where America is failing miserably? How embarassed would you be if you couldn't read but when it comes to a basic understanding of health and personal finance we are illiterate.
09:15 AM on 02/26/2010
"How embarassed would you be if you couldn't read but when it comes to a basic understanding of health and personal finance we are illiterate."

well put!