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With Health Care, the Profit Motive is Infectious

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Jonas Salk discovered a polio vaccine in 1955 and the world cheered. Polio deaths declined from 37,476 in 1954 to 910 cases in 1962. Salk refused to patent it. "Can you patent the sun?" he asked. Barry Marshall discovered a cause [helicobacter] and cure for stomach ulcers in 1984 and practically nobody heard about it for more than 10 years. What was the difference? Ulcer victims were being treated with two multibillion-dollar pharma palliatives, Tagamet and Zantac. These expensive drugs relieved the symptoms but didn't cure the disease. The bottom line was greed. The powerful industries making huge profits from ulcers were simply not interested in curing their patient-customers if it meant losing their profits.

America's medical industrial complex became so wedded to the heavily marketed pills that it was not until 1994, 10 years after [Marshall's discovery] that a government panel announced that ulcers should be treated with antibiotics. One year after that announcement only about 5% of ulcer patients were receiving antibiotics. And by 1997 the government had been forced to begin a public information campaign urging doctors to change their practices. The government pointed out that curing an ulcer with a 17 day course of antibiotics cost less than $1,000. This was less than 1/10 of the expense of using years of the expensive acid suppressing drugs. --Melody Petersen, Our Daily Meds, p.144-145

After Marshall and his collaborator J. Robin Warren were awarded the Nobel Prize for Medicine in 2005, Marshall said, "If the drug companies are truly into discovery they would've gone straight after the helicobacter...Had these drugs [Tagamet and Zantac] not existed, the drug companies would have jumped on our findings." ( Petersen, p.144 )

The fact that the medical industrial complex suppressed the cure for stomach ulcers for nearly 15 years raises crucial questions about trusting a system which demonstrably favors corporate profits over patient health. If a young scientist like Barry Marshall were to step outside the box of traditional thinking today and discover a cheap, relatively easy cure for cancer, could we be sure that the medical establishment, now making billions of dollars on cancer treatments, would rush to support such a breakthrough? Or would they hem and haw, procrastinate, find excuses, and sweep it under the rug, as they did for 15 years with the antibiotic treatment for ulcers?

In this critical time of medical reform, the ulcer story rings loud warning bells against sustaining a business controlled system whose first concerns are maximizing the bottom line rather maximizing public health. It is a powerful case example of the fundamental corruption underlying the very idea of a profit oriented health system. Legislators reexamining and revising our health system need to dissect this travesty and put it under a powerful microscope to see how doctors and Pharma conspired to suppress a basically simple discovery of a cure for a widespread disease. This story shows the need for building in powerful public interest safeguards into any reformed system to prevent such a travesty from occurring in the future. The ulcer story is strong evidence why the influence of profit-making interests need to be treated like malignant cancer cells and carefully excised from any reformed medical system so that doctors judgments are always and incontrovertibly made in the best interests of their patients, not pharma or the insurance corporations, nor their own fees.

You don't have to be a "communist" or "socialist" to realize that there is an inherent contradiction between the profit motive and the health motive. All you have to be is a caring person with a loved one mistreated by the current failed health care system. When people are able to find health though simple or cheap regimes, the current profit-oriented medical system has no motive to encourage those methods or systems to develop or be widely known. The "alternative medicine"movements spawned by the Sixties cultural revolution have clearly been responding to the issues raised by a pharma driven health culture.

Besides the ulcer story, another damning example against bottom line medicine is Celiac disease and its sibling gluten intolerance. Celiac disease afflicts an estimated 2 million Americans, yet only five percent of the people afflicted by it are aware of the nature [and cure] of their illness. Many people suffering from it are misdiagnosed as having "irritable bowel syndrome" or another chronic digestive disease, or when their symptoms are anemia and fatigue, they are liable to being misdiagnosed as having chronic fatigue syndrome, depression, or other fatigue-causing disorders.

Why is there such confusion? Again the crucial factor is that Celiac disease is inexpensive to cure. There is no medicine, no surgery, all there is, is dietary change-removing foods containing gluten [wheat, rye, barley] from the diet. Unfortunately, dietary cures are of little or no interest to our profit oriented medical system. When nobody but the patient profits from a cure based upon dietary change, American medicine has little motivation for diagnosing and spreading the word that something as universal as "the staff of life" might be making you or your loved ones sick. As Celiac disease is not immediately life threatening, undiagnosed people with gluten intolerance are treated symptomatically with palliatives with little or no attention paid to the cause and cure to the problem. The fact that there is a genetic tie-in to Celiac disease makes the failure of the medical system to identify it and treat it even more egregious. The customary medical history that patients fill out could ask about a family history of Celiac disease or its defining, often confused, symptoms, to alert doctors of the possibility of the presence of Celiac through a genetic relationship.

I gained first hand experience with the degradations of the profit motive upon public health when I worked three illuminating years as a New York City health inspector. (New York Magazine cover story "Corruption in the Kitchen," Oct. 17, 1988.) Doing health inspections, it became obvious that most exterminator companies were not committed to doing their job completely. If they did, it might put them out of business. Over time I learned that the use of certain exterminator companies strongly correlated with the presence of vermin, while others, a distinct minority, correlated with cleanliness. Dominance of the palliative mind set keeps exterminators and drug companies in business. Customers always need more treatment. The bugs go into hiding, but are not exterminated and the bugs' hosts need to keep coming back and paying for more treatment whether it be for mice, roaches, or ulcers.

Ideally a medical system effectively working to maximize health would not only treat illness with the most effective treatments, it would also focus upon preventative medicine by working to raise public awareness of the threats of customary addictive substances like nicotine and alcohol. Upgrading the U.S. to a socially advanced medical system that the nation could be proud of would start with deprogramming America's hidden cradle-to-grave advertising persuaders that addict the masses to tobacco, alcohol, and unhealthy food and drinks. Mary Louise Hartman gets it in a letter published in the New York Times [9/21/09]:

I recently toured the Coca Cola center in Atlanta. The marketing glitz was beyond belief. It's no wonder that half the world is now addicted to sugary beverages. If this same marketing genius was used to promote healthier foods and beverages, we wouldn't have to deal with the current obesity epidemic and its ensuing health care demands.

A progressive new approach to advancing public health might begin with levying taxes on the promotion of unhealthy products like alcohol, tobacco, fatty foods and, of course, sugary Coca Cola-and its competitors, and channel the revenues into a national public health fund. If we had pro-active taxes on the advertising of cigarettes, alcoholic beverages, sugar drinks, and fatty foods, the culturally conditioned abuse of these products might decline and revenue from their would be used pay to treat the deleterious effects of their consumption. This would lead producers to create healthier products, as has recently been seen in the mainstreaming of the grass roots organic food and alternative health care movements that arose from the Sixties.

Those politicians with direct personal experience with the failings of our medical system have the best motivation for bringing change in our healing institutions. President Obama's indelible experience with his mother's cancer and the late Senator Kennedy's family's cancer experiences led them to put their exceptional powers of persuasion to work making the health care system work better. And even conservative legislators like Barry Imhof [Oklahoma] and Ben Nelson [Nebraska] appear to have some personal connections to Celiac disease, and have taken baby political steps to raise awareness of gluten intolerance in the form of a Senate resolution. [Sept 13, 2006]

I, too, know personally of what I speak. This blogger watched his wife turn pale and balloon to frightening dimensions in the hospital after eating a piece of toast two days following an appendectomy. She then suffered through a week's worth of horrific testing trying unsuccessfully to diagnose the problem. When she was gingerly recovering at home a week later, [still undiagnosed and released against the head surgeon's advice] she asked to change her breakfast menu from oatmeal to Cream of Wheat for variety's sake, and took a radical turn for the worse. In a fortuitous post-op visit with her surgeon, she was pale again and could hardly stand. Fortunately her doctor's old college roommate was a leading food allergist and he asked what she had been eating. When we listed the change to Cream of Wheat, he asked if anyone in the family was gluten intolerant. My wife's aunt was. Bingo!

Considering gluten intolerance in the U.S., we are talking about an estimated 2 million undiagnosed or wrongly diagnosed people. For those who are finally diagnosed, it is estimated that it takes 11 years of suffering to find the source of their illness. In perhaps the most famous case of Celiac disease, Elisabeth Hasselbeck's self diagnosis and recovery had to come from a cultural trip back into the pseudo-primitive world of reality TV. As a contestant on the Survivor reality show, Hasselbeck voluntarily took up a pre-agricultural [pre wheat] "primitive" diet, and to her surprise discovered that her chronic stomach distress disappeared -- only to return again when she came back to "civilized life" and gluten foods.

When we come face to face with the illness and disease of people we deeply care for, the obscenity of roadblocks created by criteria of profit and loss or artificial lines of political philosophy becomes crystal clear. Would John McCain, whose wife Cindy has a terrible migraine headache condition, want to see a cure for migraines suppressed the way the cure for ulcers was? When it comes to sickness and health, politics or profits should be the last concern. As Kennedy and Obama have so eloquently put it, doing what is right about universal health care is a matter of our national character. Human beings, someone's child, someone's parent, someone's mate, someone's employee should have access to the best known knowledge, analyses, and cures. This great country needs to construct a health system that puts the causes and cures of the sick and suffering first and foremost, whether they be cheap or expensive. The decisions defining the causes and cures of illness should not, cannot, be left in the hands of people and corporate powers whose primary concerns are the bottom line. We cannot patent the sun and we cannot patent good health, nor should we.

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