13 posts shown.
If the courts have officially ruled on this, then I suppose those hefty damage payouts are definitely on the table.
AstraZeneca Pleads Guilty in Cancer Medicine Scheme
By MELODY PETERSEN
WILMINGTON, del., June 20 - AstraZeneca, the large pharmaceutical company, pleaded guilty today to a felony charge of health care fraud and agreed to pay $355 million to settle criminal and civil accusations that it engaged in a nationwide scheme to illegally market a prostate cancer drug.
The government said the company's employees had given illegal financial inducements to as many as 400 doctors across the country to persuade them to prescribe the drug, Zoladex. Those inducements included thousands of Free samples of Zoladex, worth hundreds of dollars each, which the physicians then billed to Medicare and other federal health Care programs, prosecutors
said. The company also gave doctors financial grants, paid them as
consultants and provided free travel and entertainment, the government said.
The $355 million that AstraZeneca, an American company, agreed to pay is among the largest settlements in a heath care fraud case. Of that amount, about $64 million is a criminal fine. The company will pay about $266 million to The federal government to settle most of The civil accusations. An additional $25 million will go to settle accusations that it defrauded the Medicaid programs, which are partly financed by the states.
The largest fin for health Care fraud came in a settlement in October 2001 by TAP Pharmaceutical Products. It agreed to pay $875 million to settle criminal and civil accusations that it had engaged in a scheme that largely mirrors the allegations made by prosecutors against AstraZeneca.
"We want doctors to prescribe what is best for their patients and not what is best for the doctor's bank account," Richard g. Andrews, first assistant United States attorney for The DISTRICT of Delaware, said at a news conference. He and other prosecutors said the government's action should send a message to all pharmaceutical companies that such conduct will not be tolerated.
......... (you can find the rest of the article over at the
CureZone forum, where the full post is available, or you can check out the
original on The New York Times website, though you'll need to register and the article costs about $3.)
Regarding the question of who provided the citations, everything is listed right above (along with the article) including all the references... so there’s really no need for anyone to go digging...
I honestly had to do some serious digging myself to track down this article. To be blunt, those primary statistics I highlighted—the ones everyone keeps talking about—were popping up all over various alternative medicine websites. Because I wanted to verify the actual highly-cited study, I spent quite a bit of time hunting for it. Once I finally tracked it down, I actually had to pay for access, since the Journal of the American Medical Association doesn't just give its articles away for free. I even had to hunt down a friend with a credit card just to finalize the purchase, and so on...
So, if anyone is truly interested in seeing who was cited, the names, references, book titles, specific page numbers, and so forth are all laid out above... exactly as you'd expect from a professional paper. K
(It honestly surprises me that some people here are reacting as if this were hearsay or some tabloid gossip; I've even seen comments calling this sensationalism! Look, Bro, what was written above was authored by Doctors, in THEIR own professional journal, by doctors and for doctors—not for the general public—citing other doctors and their professional, peer-reviewed research. The Journal of the American Medical Association, much like the New England Journal of Medicine, isn't The New York Times or the National Republican Party)
I’m right there with you on that one.
There is no denying that medicine has made massive strides in terms of what we can achieve today compared to what was once impossible. However, looking at the data, it’s clear that the field isn't quite as effective as the hype suggests—in fact, it can often be just as harmful as it is helpful.
Now, regarding the idea that "to err is human"... there is one specific factor driving the sheer volume of mistakes. It isn't stupidity, poor eyesight, or simple confusion. It is Greed.
Of course, this isn't a flaw exclusive to the medical profession; far from it. But since this is a health forum, that is precisely the issue we need to put on the table.
Just look at the statistics regarding victims of unnecessary surgeries. UNNECESSARY procedures? Where do unnecessary surgeries even come from? Why are they performed? There is really only one logical answer: money. Surgeries are expensive. Why would doctors recommend so many redundant operations if not for the paycheck? If there were 12,000 deaths resulting from them, it means the number of actual unnecessary surgeries must be many times higher.
As for what drives those various blunders and the fear-mongering campaigns run by Big Pharma? It’s profit.
It is a profit motive that doesn't care about the individual—profit for the sake of profit, a drive that tramples over thousands of people. That is the lifeblood of big business, whether you're talking about oil, the military-industrial complex, banking, or pharmaceuticals.
That article focuses on the healthcare system here in the USA. While we don't have identical datasets for our local context, the frequent occurrences of kickbacks and bribery suggest that that same Greed reigns supreme in our own medical landscape as well.
I certainly want to tip my hat to the many exceptions and the honorable individuals within the profession, but let's be honest: being a Doctor today is primarily extremely lucrative.
To be clear, I am not claiming that things are worse now than they used to be, nor that medicine has regressed... I am simply saying that in this specific regard, it is NOT better, despite how much people brag about its progress.
If this has always been the case, it is perhaps best captured by a supposed inscription found in an ancient Egyptian tomb:
"A man lives on one-quarter of what he eats—the other three-quarters go to his Doctor."
This is just as sensationalist as this whole anti-SARS campaign. It would actually be interesting to see what kind of data they used to come up with those specific figures.
An anti-SARS campaign? So, you're more in favor of a pro-SARS campaign? 😉
If anything regarding SARS is considered a
campaign, then we're talking about the media blitz we were bombarded with for two months straight (I'm not sure how things were in America, but overseas, the bombardment was INTENSE)
Every single new death "from SARS" made the headlines and dominated the nightly news.
However, what the "anti-SARS" campaigners—who don't have major media outlets at their disposal, just their own websites—point out (among other things) is, for example, the standard mortality rate from various types of pneumonia, which is
incomparably higher than the mortality rate of so-called SARS:
"In the US, it has been estimated that there are between 70,000 to 75,000 hospitalizations and 6,000 to 7,000 deaths attributed to pneumonia and influenza in an average year(14). The numbers could be multiplied several times in an epidemic year."
source:
CDC And who is the CDC? They are the government health body:
"The CDC is the federal agency responsible for helping the people of the US maintain and improve their health. In partnership with state and local governments, the CDC provides national leadership to develop health policy, enforce health regulations, promote disease prevention and enhance healthy living for all Americans."
It seems like people around here aren't big fans of quotes and links, but I don't post or link opinions, comments, or op-eds. I exclusively share verified data and articles from the most professional literature and official sources available (like the New England Journal of Medicine, Journal of the American Medical Association, the CDC, and so on).
It’s really about that tight loop between Big Pharma and the regulatory agencies. The issue runs much deeper than just one group.
Exactly. That was the core of my argument—it isn't just about doctors as individuals. It's the entire ecosystem of modern medicine: the pharmaceutical giants, the regulators, the physicians, and the hospital systems all working in tandem. And let's be honest, even the doctors aren't entirely blameless in this setup; you can see it in how some practitioners here handle kickbacks and unethical incentives.
As for whether modern medicine is actually doing more harm than good, I honestly wouldn't go that far.
That’s a shame, because that's precisely where the real debate lies.
Well, bravo.
If someone shoots someone else, we can certainly conclude that it wasn't the shooter who caused the death, but rather the bullet. Maybe the bullet should be the one sent to prison—after all, it’s the projectile that did the killing, right? Not the person holding the gun.
The term "iatrogenic cause of death" exists in the medical field for a reason. The author of this article—who, unlike you, IS a Doctor—knows exactly what she’s talking about when she labels something a cause of death. And I’m fairly certain the editors at The New York Times know what they’re doing by giving her a platform to publish this.
Think about it this way: if a shell hits a house during a war and someone inside dies, what is the actual cause of death? Is it the shell? Or did the shell just blow a hole in the wall, causing a piece of concrete to strike the person in the heart? So, was the piece of concrete the cause? But even that piece of concrete just caused massive blood loss. Was the bleeding the cause? Well, the bleeding just led to oxygen deprivation in the brain. Was the lack of oxygen the cause? But that just triggered cell death. At the end of the day, the ultimate cause of death is simply... death.
And following that logic, none of this has anything to do with
whoever fired that shell. They could walk free because neither they, nor their commanding officer, nor the shell itself technically caused the death. In war, nobody actually kills anyone; it's just bullets, bombs, and knives doing the work. If we follow that line of reasoning, I don't see why war is even considered a problem or why people bother with trials and punishments.
A medical error isn't the cause of death.
A wrongly prescribed medication isn't the cause of death.
An unnecessary surgery isn't the cause of death.
The cause of death is the condition that directly resulted in death.
If you had actually read the article instead of just skimming it—or better yet, if you had actually thought about what you skimmed—you would realize this isn't some deep philosophical debate about the definition of causality. It’s about whether modern medicine and pharmaceuticals are becoming more beneficial or more harmful. To claim that a misprescribed drug (or the side effects of a correctly prescribed one) isn't the cause of death is to suggest we can just keep going down this path, handing out pure toxins to people because, technically, they aren't the "cause"—that role belongs to some other link further down the logical chain.
Go wash your face, you look like you need sleep; then come back to the discussion. You wouldn't want to get an unexcused 😉absence
.
I don't know, maybe the answer lies in bridging the gap between alternative and Western medicine.
That’s very likely.
In fact, I'm certain of it.
Just as we shouldn't discard thousands of years of natural wisdom, we shouldn't dismiss centuries of scientific progress (in the modern sense) either.
Think of it this way: we should extract the wisdom and practical benefits from traditional medicine while stripping away the superstition. Similarly, we need to pull the genuine, useful insights about the human body from modern science, while tossing out the hype, the purely chemical reductionism, and anything driven solely by corporate profit.
But for that to actually happen, we’re going to have to roll up our sleeves and work for it, because alternative approaches are
already under fire.
If I had to summarize my current take on global trends in this area (and I do quite a bit of reading), I'd put it like this:
Christianity was originally like any religion that sought to be more advanced than the ancient faiths it inherited. It stayed true to its spirit—the Christ spirit—as long as it remained an "alternative." But once it became the official state religion (the Mother Church), it began to calcify, losing touch with its core mission. When the Church eventually turned into a hub for money and power, it morphed into an outright tyrant. Slavery to Rome simply turned into slavery to the Church.
It wasn't until the Renaissance that people truly started breaking free from the dictatorship of Church dogma. The Enlightenment and the rise of natural science undoubtedly helped humanity progress and dismantle that dogmatic tyranny. Throughout the 20th century, Science effectively replaced religion as the "official truth." Now, however, Science itself has become a massive source of wealth and influence. We might just be entering a new era of the "Church of Science" and the return of dogmatic tyranny.
Or, to borrow from the words of those old rural prophets, Mitar Tarabic:
"There will be many different sages who, through their books, will believe they know everything and can do everything. They will stand as massive obstacles to reaching the true knowledge. Only when that knowledge is finally discovered and realized will people see how deeply they were misled by listening to these self-proclaimed wise men."
Mitar Tarabic (1829-1899)
I truly hope I'm wrong.
But you know that old joke: after a shipwreck, an optimist and a pessimist are both drifting in a lifeboat in the middle of the ocean. Both of them drown. 😉
By the way, does anyone know what that message icon with the little black dot in the middle actually means? You know, the one appearing on this forum's thread list.
It isn't listed in the legend at the bottom of the page where all the other icons are explained, and strangely enough, only my two posts seem to have it...
Unfortunately, the US is heading down that same path too.
Exactly. In fact, that’s really the whole reason I’m posting this on a local forum (since I’m not currently living in the States)
When I look at the US in general, it feels like there is this desperate push to align ourselves perfectly with certain Western interests—interests that seem to dictate everything from labor laws to the gradual stripping away of social safety nets. It strikes me that the pharmaceutical industry, much like the oil and defense sectors, is one of the primary drivers behind this aggressive, almost inhuman version of "globalization" being forced upon the world, including America.
Just as the WTO destroys small-scale producers in favor of massive corporations under the guise of "free trade," or how the World Bank and the IMF dismantle the economies of smaller nations while claiming to offer aid
*, we recently saw a similar dynamic with the so-called SARS outbreak
**. We got a front-row seat to how the WHO flexes its muscles in places like China and Canada, acting as a pillar of "global authority" capable of dictating policy and destabilizing entire economies.
* For anyone interested in digging deeper, I highly recommend reading Dr. Joseph Stiglitz's book, *Globalization and Its Discontents*. Stiglitz is a Nobel laureate, served as the chief economic advisor to Clinton, and was formerly the
chief economist at the World Bank. He’s a true insider who actually realized what his organization was doing, resigned, and ended up on the other side of the barricades at anti-globalization protests. He wrote an incredibly insightful book on how the IMF and the WB impact the very economies they claim to be "helping."
Check out this Greg Palast interview with Stiglitz It’s wild when you stop to think that our own government
honors officials from the IMF... 🙂
** At the end of the day, how many people actually died from SARS worldwide? 100? 200? 500? I doubt it hit 500, but even if it were 1,000: did you know that in Canada alone, between 6,000 and 7,000 people die
annually from various types of pneumonia (there are about 70 different kinds)? That's just in Canada. So why all this massive hysteria over this "newest" type of pneumonia? Why is it that in Australia, for instance, the police can arrest someone just on the suspicion they have SARS? Why the intense airport screenings? The symptoms of SARS are virtually identical to the flu, a common cold, or "standard" pneumonia. I fear this has very little to do with public health and far more to do with state and political control, especially with the war in Iraq winding down. This might belong in a different forum rather than the Health section, but it's happening right here... 🙂
BTW, if anyone wants more material regarding this
so-called SARS, let me know; I have some links...
Hey Quote: Solaris, thanks for the correction 🙂
And honestly, look, I have zero ambition to go around preaching to the masses...
My goal is simply to plant a seed of doubt in the minds of those who are actually ready to hear it, rather than confronting someone who hasn't even encountered the idea yet. 🙂
Regarding simplicity—I tried to lay out the core concept at the beginning in plain English. Then, I follow up with the full article or a link just to show this isn't some wild fantasy. It’s documented in black and white within the most prestigious publications of the medical profession.
Lately, as I keep up with current global events and the history leading up to them, I’m increasingly struck by the feeling that medicine is losing its way. It seems to be drifting further from nature, from the human element, and from true health, pivoting instead toward chemicals, profit margins, and propaganda.
When I read in JAMA that iatrogenic death is the third (!) leading cause of death in the USA, or see in BMJ reports suggesting the pharmaceutical industry invents illnesses purely for profit, I realize this isn't just a gut feeling.
I probably won't be hanging around this forum for very long; I just wanted to drop in. While I truly value the exchange of health experiences and advice here, I’ve noticed that "health" is often used interchangeably with "medications" and "doctors." I wanted to remind people that those things aren't necessarily one and the same. But, like I said, it’s a matter of whether you're willing to listen. From my own experience—watching my parents and many others—so many people lack that perspective because they are dependent on drugs. To them, doctors are infallible archangels who know everything, and prescriptions are treated like sacred scripture. (Though, even they might admit that doctors used to suggest lifestyle changes, teas, and physical activities; nowadays, it feels like one visit equals one prescription.)
If a person couldn't survive and remain healthy without all these powerful pizdamicins 😉, humanity wouldn't have made it through the last few million years. Of course, anyone will argue that we've conquered many diseases and that humans are generally healthier and living longer than ever before. But once you realize that this brand of medicine kills more people than almost any other disease (aside from two), you have to ask yourself if that's really progress, and what the actual cost is.
REFERENCES
1. Schuster M., McGlynn E., Brook R. How good is the quality of health care in the United States? Milbank Q. 1998;76:517-563. CrossRef | ISI | MEDLINE
2. Kohn L, ed, Corrigan J., ed, Donaldson M., ed. To Err Is Human: Building a Safer Health System. Washington, D.C.: National Academies Press; 1999.
3. Starfield B. Primary Care: Balancing Health Needs, Services, and Technology. New York City, NY: Oxford University Press; 1998.
4. World Health Report 2000. Available at:
http://www.who.int/whr/2000/en/report.htm. Accessed June 28, 2000.
5. Kunst A. Cross-national Comparisons of Socioeconomic Differences in Mortality. New York City, Netherlands: Erasmus University; 1997.
6. Law M., Wald N. Why Heart Disease mortality is Low in France: The time lag explanation. BMJ. 1999;313:1471-1480.
7. Starfield B. Evaluating the State Children's Health Insurance Program: critical considerations. Annu Rev Public Health. 2000;21:569-585. ABSTRACT/FULL TEXT
8. Leape L. Unnecessary surgery. Annu Rev Public Health. 1992;13:363-383. CrossRef | ISI | MEDLINE
9. Phillips D., Christenfeld N., Glynn. Increase in USA medication-error deaths between 1983 and 1993. Lancet. 1998;351:643-644. CrossRef | ISI | MEDLINE
10. Lazarou J., Pomeranz B., Corey P. Incidence of adverse drug reactions in hospitalized patients. JAMA. 1998;279:1200-1205. ABSTRACT/FULL TEXT
11. Weingart SN, Wilson RM, Gibberd RW, Harrison B. Epidemiology and medical error. BMJ. 2000;320:774-777. FULL TEXT
12. Wilkinson R. Unhealthy Societies: The Afflictions of Inequality. New York City, United States: Routledge; 1996.
13. Evans R., Roos N. What is right about the Canadian health system? Milbank Q. 1999;77:393-399. ISI | MEDLINE
14. Guyer B., Hoyert D., Martin J., Ventura S., MacDorman M., Strobino D. Annual summary of vital statistics—1998. Pediatrics. 1999;104:1229-1246. ABSTRACT/FULL TEXT
15. Harrold LR, Field TS, Gurwitz JH. Knowledge, patterns of care, and outcomes of care for generalists and specialists. J Gen Intern Med. 1999;14:499-511. CrossRef | ISI | MEDLINE
16. Donahoe MT. Comparing generalist and specialty care: discrepancies, deficiencies, and excesses. Arch Intern med. 1998;158:1596-1607. ABSTRACT/FULL TEXT
17. Anderson G., Poullier J-P. Health Spending, Access, and Outcomes: Trends in Industrialized Countries. New York City, NY: The Commonwealth Fund; 1999.
18. Mold J., Stein H. The Casci Effect in the clinical care of patients. New England Journal of Medicine. 1986;314:512-514. ISI | MEDLINE
19. Shi L., Starfield B. Income inequality, primary care, and health indicators. J Fam Pract. 1999;48:275-284. ISI | MEDLINE
One analysis overcomes som of Thes limitations by estimating adverse effects in outpatient Care and including adverse effects other Than death.11 This study found that somewhere between 4% and 18% of sequential patients deal with adverse outcomes during outpatient visits. We are talking about a massive ripple effect: 116 million extra trips to the Physician, 77 million unnecessary prescriptions, 17 million ER visits, 8 million hospital stays, 3 million long-term admissions, 199,000 preventable deaths, and a staggering $77 billion in wasted spending—which, interestingly, is roughly what it costs to manage all diabetic patients combined.11
It is also worth noting that United States on health indicators is The high degree of income inequality in this country. Think of it like a race where some people start miles behind the starting line; an extensive literatura documents The enduring adverse effects of Low socioeconomic position on health ; a newer and accumulating literatura suggests The adverse effects not only of Low social position but , especially , Low relative social position in industrialized countries . 12 When looking at the 13 nations in the international study mentioned earlier, the US lands at 11th place regarding income inequality—effectively the third-worst performer. Compare that to Sweden, which leads the pack in income equality (once you factor in taxes and social safety nets) and sees that reflected in its top-tier health metrics. While the link between wealth gaps and health isn't always a perfect one-to-one match, the USA stands out as a unique case: it is the only nation that performs poorly in both categories simultaneously (B.S., unpublished data, 2000).
What I find truly fascinating in this dataset is how the rankings shift depending on how old you are. American children face a disproportionately steep uphill battle, while the elderly aren't hit quite as hard. Judging fra The dati on Life expectancy AT different ages, the disadvantage faced by Americans actually seems to diminish as they get older, though even the relatively stable position of our seniors is starting to slide. In fact, the USA held a stronger relative position for life expectancy in the oldest age brackets during the 1980s compared to the 1990s.13 Additionally, the chronic issue of the USA having poor rankings in infant mortality14 remains deeply troubling. Crucially, this isn't just a reflection of higher infant mortality or low birth weight rates within the Black community; if you look strictly at the White population, the international standing barely moves.
While we haven't pinned down a single "smoking gun" to explain why the USA lags behind, there are enough breadcrumbs to point us toward several overlooked issues:
(1) How the healthcare system actually functions. Unlike many other developed nations, the USA hasn't really looked at how much of a difference it makes whether a patient sees a primary care Physician versus a specialist when it comes to long-term survival and wellness. While available dati indicate that specialty Care is Associated with Better quality of Care for specific conditions in The purview of The specialist,15 the broader data on general medical care tells a different story.16 Most national surveys fall short because they don't track whether the care provided actually meets the standards of true primary care. Without that, we can't effectively connect community health trends to the specific types of care being delivered.
(2) The link between iatrogenic effects—basically, medical issues caused by the care itself, whether through mistakes or just over-treatment—and the type of care provided. Global surveys highlight just how much tech is packed into the USA. Out of 29 countries studied, the USA is second only to Japan in terms of MRI and CT scanner availability per million people.17 Here’s the kicker: Japan sits at the top of the health rankings, while the USA is near the bottom. It’s highly probable that Japan uses its tech primarily for diagnosis without triggering excessive treatment, whereas in the USA, heavy diagnostic use might trigger a "cascade effect"18 leading to endless follow-up procedures. You can see evidence for this in staffing: the USA has the highest number of employees per hospital bed among the countries studied, whereas those numbers are incredibly low in Japan17—so low that it can't simply be explained by families helping out with bedside care.
The way we currently code causes of death and outpatient diagnoses really misses the mark when it comes to seeing just how much medical interventions themselves contribute to poor health. If we were more consistent with using "E" codes—those used for external injuries and poisonings—we’d have a much better shot at identifying them, mainly because those ICD codes allow us to link a specific cause to "Drugs, Medicinal, and Biological Substances Causing Adverse Effects in Therapeutic Use." We might also see the true scale of complications from surgical and medical care if we consistently utilized the specific ICD codes (960-979 and 996-999) designed for that purpose. As it stands, most deaths stemming from these issues are probably just being filed under the immediate cause, like organ failure, which hides the bigger picture. Even if the IOM’s suggestions regarding mandatory reporting help fix things within hospitals, I don't think it will do much to solve the problem of underreporting in outpatient or non-institutional settings. Ultimately, unless we overhaul our record-keeping to document every single intervention alongside the patient's subsequent symptoms and signs, we won't truly grasp the full spectrum of both the good and bad effects of healthcare.
(3) There is a complex web connecting income inequality, social disadvantage, and the way our health systems are structured—specifically the balance between primary care and specialty care. Recent research looking at physician-to-population ratios (since we lack direct data on exactly how people access different types of care) shows a clear trend: states with a higher ratio of primary care physicians tend to see much better overall health outcomes.19 We haven't fully dug into how the density of specialists or the ratio of specialists to primary care doctors affects things, but early, surface-level looks suggest the opposite might actually be true. Interestingly, even when you factor in income inequality, the positive impact of having strong primary care remains. It’s also worth noting that states with more equitable income distribution often have better access to primary care resources. This really makes you wonder about the deep-seated links between social policy and health policy that dictate how resources are distributed in the first place.
When we start acknowledging that medical interventions can have harmful side effects—and that these might account for a huge chunk of why the USA sees higher excess death rates than other highly developed nations—it changes everything. It forces us to look at health policy and research through a completely different lens. We need to dive deep into these alternative explanations; they deserve nothing less than intense investigation.
AUTHOR INFORMATION
Corresponding Author and Reprints: Barbara Starfield, MD, MPH, Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, 624 N Broadway, Room 452, Baltimore, MD 21205-1996 (e-mail:
bstarfie@jhsph.edu).
Author Affiliation: Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, Md.
(I don't expect anyone to pay attention to this, just like my last post about the New England Journal of Medicine. It's fine. But if you've got an ear for the truth, listen in..)
Does anyone actually know what the term "iatrogenic" means?
Essentially, it means "caused by a physician." For all the doctors-worshipers out there, here is a statistic—and this time, it isn't coming from a fancy British journal, but from an American one.
Did you realize that physicians and hospitals are the third leading cause of death in the USA?
The Journal of the American Medical Association (JAMA) is a publication of the American Medical Association (AMA). The core of this article (you can read the full piece below) highlights this specific statistic:
"the combined effect of errors and adverse effects that occur because of iatrogenic damage not associated with recognizable error include:
* 12,000 deaths/year from unnecessary surgery
* 7,000 deaths/year from medication errors in hospitals
* 20,000 deaths/year from other errors in hospitals
* 80,000 deaths/year from nosocomial infections in hospitals
* 106,000 deaths/year from nonerror, adverse effects of medications*
(these) 225,000 deaths per year constitutes the third leading cause of death in the USA, after deaths from heart disease and cancer."
Or, to put it simply:
"the combined consequences of mistakes and counter-indicated reactions occurring due to iatrogenic harm include:
* 12,000 annual deaths due to unnecessary surgeries
* 7,000 annual deaths from hospital medication errors
* 20,000 annual deaths from other hospital errors
* 80,000 annual deaths from hospital-acquired infections
* 106,000 annual deaths from the side effects of correctly prescribed medications*
(these) 225,000 deaths every year make up the third leading cause of death in the USA, following heart disease and cancer."
That is 225,000 victims of "medicine" every single year, right here in the USA. And let's not forget, this number only counts those who died; it doesn't account for the survivors—who are surely much more numerous—left struggling with permanent disabilities...
When two people die from something like SARS in Hong Kong or one person dies in Canada, the news cycles go crazy with headlines about a "mysterious plague" or a "global epidemic." Yet, when thousands die daily due to the fallout of modern "medicine," it doesn't even make the news, does it?
* Regarding that final figure: this doesn't refer to victims of wrongly prescribed drugs (for those, only 7,000 die in hospitals, which is the other number on the list). No, this refers to 160,000 victims of correctly prescribed medications—the lesser-known side effects of the chemicals currently sold under the label of "medicine"...
Anyway, here is the article. Enjoy:
===============================
Is US health Really The Best in The World?
Barbara Starfield, MD, MPH
JAMA. 2000;284:483-485.
Information concerning The deficiencies of US Medical Care Has been accumulating. The fact that more Than 40 million People have no health insurance is well known. The high cost of The health Care system is considered to be a deficit, but seems to be tolerated under the assumption that better health results from more expensive care, despite evidence from a few studies indicating that as many as 20% to 30% of patients receive contraindicated care.1 In addition, with the release of the Institute of Medicine (IOM) report "To Err Is Human,"2 millions of Americans learned, for the first time, that an estimated 44,000 to 98,000 among them die each year as a result of medical errors.
The fact is that the US population does not have anywhere near the best health in the world. Of 13 countries in a recent comparison,3 the USA ranks an average of 12th (second from the bottom) for 16 available health indicators. Countries in order of their average ranking on the health indicators (with the first being the best) are Japan, Sweden, Canada, France, Australia, Spain, Finland, the Netherlands, the United Kingdom, Denmark, Belgium, the USA, and Germany. Rankings of the USA on the separate indicators3 are:
Ranked 13th for low birth weight percentages
Ranked 13th for both neonatal and overall infant mortality rates
Ranked 11th for postneonatal mortality
Ranked 13th for years of potential life lost, excluding external factors
Ranked 11th for one-year life expectancy in women, and 12th for men
Ranked 10th for fifteen-year life expectancy in women, and 12th for men
Ranked 10th for forty-year life expectancy in women, and 9th for men
Ranked 7th for sixty-five-year life expectancy in women, and 7th for men
Ranked 3rd for eighty-year life expectancy in women, and 3rd for men
Ranked 10th for age-adjusted mortality
The lackluster performance of the USA was recently backed up by the World Health Organization using a different set of metrics. By looking at things like disability-adjusted life expectancy, survival rates for children up to age five, actual patient experiences within the medical system, social disparities in healthcare access, and how much families have to pay out-of-pocket regardless of their needs, this report placed the USA at 15th out of 25 industrialized nations.4 Essentially, the data showing the USA's weak standing globally is solid and doesn't just shift based on which yardstick you use. People often try to explain away this poor performance without pointing the finger at the healthcare system itself. The common narrative is that Americans simply "live poorly"—smoking too much, drinking too much, or being too violent. However, the data tells a different story, at least when compared to others. For instance, female smoking rates vary wildly, from 14% in Japan to 41% in Denmark; in the USA, it sits at 24%, which actually puts us fifth best. For men, the range goes from 26% in Sweden to 61% in Japan, while the USA comes in at 28%, making us third best.
Alcohol consumption follows a similar pattern: the USA ranks fifth. So, while heavy smoking and drinking are obviously bad for you, they aren't the reason the USA lags behind on these specific health markers. Even when you strip away deaths caused by external factors like car accidents or violence, our stats for years of potential life lost remain the worst among the 13 countries studied.3 We know diet plays a massive role in mortality rates across different nations,5 but the USA actually has relatively low animal fat consumption (ranking fifth lowest for men aged 55-64 among 20 industrialized nations) and the third lowest average cholesterol levels for men aged 50 to 70 among 13 industrialized countries.6
The true reason for the relatively poor health outcomes in the USA is almost certainly a complicated, multi-layered issue. Looking strictly at the healthcare system, it’s very possible that our historical failure to build a robust primary care foundation has played a part. There is a mountain of evidence3 highlighting the benefits provided by strong primary care. Interestingly, of the seven countries at the top of the global health rankings, five possess strong primary care infrastructures. While many argue that better access—specifically universal insurance—is the silver bullet, evidence suggests that access only really pays off when it actually leads to receiving primary care.3, 7 Furthermore, the healthcare system itself might be hurting people through unintended consequences. For example, US estimates8-10 regarding the cumulative impact of medical errors and adverse effects—those resulting from iatrogenic harm that isn't necessarily tied to a blatant mistake—include:
12,000 deaths annually from unnecessary surgeries
7,000 deaths annually from hospital medication errors
20,000 deaths annually from various other hospital errors
80,000 deaths annually from hospital-acquired infections
106,000 deaths annually from non-error-related adverse drug reactions
Altogether, this accounts for 225,000 deaths every year due to iatrogenic causes. There are three important things to keep in mind here. First, most of this information comes from studies focused on hospitalized patients. Second, these numbers represent deaths alone and don't count all the adverse effects involving long-term disability or general suffering. Third, these figures are actually more conservative than what was found in the IOM report.1 If we look at the higher estimates, deaths from iatrogenic causes could be anywhere between 230,000 and 284,000. Regardless, 225,000 deaths a year makes this the third leading cause of death in the USA, trailing only heart disease and cancer. Even if these numbers are a bit high, there is still a significant gap between this figure and the next major cause of death, cerebrovascular disease.
(continued in the next post, or rather, in response to this one)