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Our health care system, a contentious issue for many years, is much more accurately labeled a sick care system since the vast expenditure by individuals, states and the United States government goes directly to treating diseases, not preventing them.
The promise of Obamacare, however well intended, did not reduce the cost of health care. Since its passage costs have exploded far higher than inflation and will continue to do so. With the aging of our population and medical advances, the costs will continue to spiral out of control and devour more and more of family and government budgets.
Complicating this economic challenge of sick care is the current debate surrounding what represents adequate and effective health care.
American medical care from the standpoint of science, economics and availability have polarized society to such extents any solution to this quandary has become impossible.
A dysfunctional political class, special interest groups albeit the pharmaceutical industry, the medical device lobby, the legal profession driving up the cost of malpractice insurance, defensive medicine and the corporate minions running our health care have created an unsustainable paradox.
In addition, the internet, the proselytizingabout the dangers of vaccines and even the concept of preventive public health have made meaningful improvements in the effectiveness of our health care system ever more challenging.
Before I get into the body of this blog, I would recommend strongly a book called Nexus: A Brief History of Information Networks from the Stone Age to AI by Yuval Noah Harari. The text explores the history of information from the very beginning of civilization to AI.
Unfortunately, opinions and information do not readily translate into fact. I hope the questions I ask will stimulate meaningful input from the readers.
Why, after decades of success with vaccinations preventing a myriad of diseases from polio to the measles, are we now questioning the safety and validity of vaccinations?
Why, after decades of fluoridation reducing dental decay safely throughout the western world, are our states and federal government questioning its value and removing it from the water supply?
Why is medical education completely consumed by diagnosing and treatment of diseases rather than how to prevent illness?
Why do medical students get such a meager education regarding lifestyle and nutrition?
Why is dental education committed to learning how to repair and replace teeth instead of how to preserve the human dentition for a lifetime?
Why are there advertisements for teeth in a day rather than for teeth for a lifetime?
Along those lines, why is the tuition at Tufts University, where I received my dental education, now 50 times greater than I paid as a student?
Why does the pharmaceutical industry spend 25% of their budget advertising on television while providing very little information about the side effects of the medications they are promoting?
Why do the states and federal government collect nearly 50% of the revenue from cigarettes? These very cigarettes kill 480,000 Americans a year due to tobacco related diseases, as we spend 200 billion dollars a year to treat them.
Why do we spend two to three times more per American for health care compared to Canada and our European allies?
Why, despite spending all of this money, do we have a shorter life span than the Canadians or the Europeans?
Why is obesity two to three times higher in America than western countries? Why are there so few malpractice suits in Canada compared to the United States?
Why does a pediatrician who I recently met share with me that the corporate entity that she was asked to join would require her to see one patient every seven minutes?
Why are 30,000 people a year becoming HIV positive when the disease is preventable by lifestyle choices?
Why does lifestyle, albeit smoking, alcohol, obesity, lack of exercise and poor nutrition result in 60%-70% of our health care costs yet not get addressed by the medical community?
Why do 47,000 Americans die a year from gun violence?
Why is it so difficult to have a conversation about the unfettered availability of weapons?
Why is the maternal death rate in the United States three times higher than Canada and six time higher than Europe?
Why did the government not examine the enormous increase in the use of opioids by physicians in the 1990’s and the distribution by companies of millions of opioid pills to small communities throughout America where they were being sold and used for addiction?
Why have lawsuits against drug companies escalated in 1960 for settlements totaling $10-$15 million where now settlements result in the billions?
Why are the Mayo Clinic and the Cleveland Clinic considered the crème de la crème of medical care in the United States? All of their physicians are on salary, encouraging prevention.
Why does an insurance company pay so much for surgeries but so little for preventive medicine?
Why are young children not provided with a vaccine for the papilloma virus which is the leading cause of sexually transmitted cancer?
Why can the Veterans’ Administration negotiate drug prices but insurance companies and Medicare cannot?
Why did a patient of mine who recently left a large medical center and began working for the VA share with me that the veterans get much better care and much more time from her than she could provide in the traditional corporate medical setting?
Why are not all patients who have a history of smoking getting low dose CAT scans recommended by their physicians for the early diagnosis of lung cancer before it becomes life threatening?
Why aren’t virtual angiograms, which are nearly as effective as a medical angiogram, recommended for all patients who are at risk for heart disease?
These are the many questions that need to be asked. However, depending upon what political party you belong to, and which cable network you watch, they will either be avoided or discussed at length.
Much of the information we receive is not factual. When politics challenges science and when health care is adversely impacted by interest groups and the internet, the health of Americans and the economics of our country will continue to be challenged.
As always, I appreciate your feedback.
Yours truly,
Victor M. Sternberg, D.M.D.
By Westchester Center for Periodontal & Implant Excellence
December 31, 2023
