Is the U.S. Healthcare system the best?

The simple answer is no. The U.S. healthcare delivery system can be separated into two areas to further clarify this answer: acute care and prevention.

The first: In the arena of trauma, acute onset of illness, and other unexpected or unanticipated emergent situations, our healthcare system can be very efficient and effective. We excel at moderating mechanical, chemical, structural, and functional acute dysfunctions such as 3^rd degree burns, drug overdoses, and fractures as just a few examples. There are very complex strategies designed to address large-scale events such mass injuries (think freeway pile-up), terrorist attacks, and natural disasters (CDC, 2012). 

The second, prevention: That is another story. The answer is complex and convoluted due to the great array of involved parties, opinions, and perspectives. What we do know is allopathic medicine does not generally consider optimizing naturally occurring biologic homeostatic mechanisms to moderate the vast myriad of physiological dysfunctions.

What appears to be happening with America’s collective health problems that are associated with complex symptoms such as obesity, heart disease, and cancer is a comorbidity co-occurring with accepted standard treatment modalities. Pathways commonly used in allopathic treatment may precipitate the problem. They shortsightedly target clinical manifestations of underlying condition(s). This type of symptom response does not address etiological factors and the treatment may cascade dysregulation to other systems.

Two examples: depression and heart disease. Antidepression medication and statins are two of the most commonly prescribed drugs in the U.S. (DeNoon, 2011). The overall data concerning efficacy of anti-depression medication is only 50% (Moncrieff, 2005). That means that 50% of people taking antidepressants are receiving no clinical benefit. Circadian rhythms, diet and environment all play important roles in depression and rarely are part of the treatment process when a 25-dollar copay will suffice. They also play important roles for statins.

Speaking of statins: A closer look at this preventive measure elucidates no reduction in mortality rates for healthy people of any age that have what is currently determined to be high cholesterol by allopathic standards (Ifti, Jackson, Ramsay & Wallis, 2001). Moreover, in this large meta-analysis mortality rates increased by 1% over a ten year period compared to placebo. The PROSPER trial demonstrated that statin use does not increase survival rates in the elderly population (Blauw et Al., 2002) which is a particularly vulnerable population that may be placed at higher risk for physical complications due to the known alterations of statins on cognitive function, muscle degeneration (MasterJohn, 2005), and mood disorders (Kaplan, 2010)

So no, we have a long way to go when it comes to prevention. Perhaps we need to look to our past, our bodies, and our environment for answers to health questions.

References

Blauw, G., Bollen, E., Buckley, B. Cobbe, S., Ford, I., Gaw, A., Hyland, M., Jukema, J., Shepherd J, Kamper, A., Macfarlane, P., Menders, A., Norrie, J., Pakcard, C., Perry, I., Stott, D., Sweeney, B., Twomey, C., and Westondorp, R. (2002). Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. [Abstract]. Lancet. 23;360(9346):1623-30. Retrieved April 21, 2012 from www.ncbi.nlm.nih.gov/pubmed/12457784?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus

CDC, (2012). Emergency Preparedness and Response. Centers for Disease Control and Prevention. Retrieved April 21, 2012 from//www.bt.cdc.gov/disasters/

DeNoon, (2011). The 10 Most Prescribed Drugs: Most-Prescribed Drug List Differs From List of Drugs With Biggest Market Share WebMD. Better Information. Better Health. Retrieved April 21, 2012 from www.webmd.com/news/20110420/the-10-most-prescribed-drugs

Ifti, U., Jackson, P., Ramsay, L., and Wallis, E. (2001). Statins for primary prevention: at what coronary risk is safety assured? [Abstract]. British Journal of Clinical Pharmacology. 52(4):439–446. doi: 10.1046/j.0306-5251.2001.01478.x Retrieved April 21, 2012 from www.ncbi.nlm.nih.gov/pmc/articles/PMC2014585/

Kaplan, A. (2010). Statins, Cholesterol Depletion—and Mood Disorders: What’s the Link? Psychiatric Times. 27(11). Retrieved April 21, 2012 from www.psychiatrictimes.com/mood-disorders/content/article/10168/1743257

MasterJohn, C. (2005). Statins Fry Your Brain and Scramble Your Memory Like an Egg A Review of Statin Drugs Side Effects and the Misguided War on Cholesterol by Dr. Duane Graveline, M.D. Self-Published, April 2005. Cholesterol-and-health.com. Retrieved April 21, 2012 from www.cholesterol-and-health.com/Statin-Drugs-Side-Effects.html

Moncrieff, J., (2005). Efficacy of antidepressants in adults. [Abstract]. British Medical Journal. 331(7509): 155–157. doi:  10.1136/bmj.331.7509.155