Tuesday, October 1, 2013

Our "Health Care" System is Upside Down and Backwards

sick care system, Health Care system, Paradigms, disease management system
An essay for my community and an appeal for common sense

– By Dr. Larry S. Arbeitman, D.C.

I believe that in 500 years human beings will look back on this period of time and say, “What were they doing to themselves?”

A recent article in The New York Times revealed that 11% of school-aged boys are diagnosed and treated for ADD/ADHD1. This number is astonishing! When did it become normal for millions of children to require medication for the simple operations of their daily lives? These drugs are stimulants. Stimulants can be dangerous. Dr. Jennifer Ashton, the CBS News Medical Correspondent, reports that the use of these drugs increases the chance of sudden death by 600-700%2. This reality forces us to ask another important question: how could a medicine that is deadly for one child, be healthy for another?

We’ve got it wrong. Our culture’s view of health and lifestyle is upside-down and backwards. As I refer to “health care” throughout the essay, keep in mind the term is grossly misused in our society. We improperly utilize the term “health care” to describe our “sick care” system. Most “heath care” spending in our country goes towards the treatment and management of chronic conditions. Managing illness and getting people well are two different approaches.

According to the Institute of Health, 30% of “health care” spending (about $750 billion annually) is wasted on services that do not improve health outcomes.3 The Journal of the American Medical Association states the aggregate benefits the current American “heath care” system provides may not outweigh the aggregate harm it imparts.4

Although the U.S. health care system shines in crisis and trauma management, studies show that U.S. health care ranks as low as 50th in the world in key health statistics; including lifespan.5

“According to the World Health Organization (WHO), the United States spent more on health care per capita ($7,146), and more on health care as percentage of its Gross Domestic Product (GDP) (15.2%), than any other nation in 2008. Likewise, The Commonwealth Fund ranked the United States last in the quality of health care among similar countries, and notes U.S. care costs the most.”6
What are we getting in return for this soaring investment?

Of 17 high-income countries studied by the National Institutes of Health in 2013, the United States was at or close to the bottom in infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, homicides, and disability rates. The report placed the U.S. dead last for life expectancy. The average U.S. male will live about four years less than those in the top-ranked country.7

If drugs were the solution, shouldn’t we be the healthiest country in the world? We spend and consume more of them than any other country in the world. In the United States, spending for prescription drugs was $234.1 billion in 2008 – more than double what we spent in 1999.8 According to the WHO, the global pharmaceutical market totals $300 Billion.9 The United States consumes more medication than the rest of the world, but the amount spent doesn’t translate into better health outcomes. We’re worse.

We do not have a health care system. We live in a disease management system that profits most when people remain in it. Doctors and companies do not have financial incentives to prevent disease, or to cure them. Doctors and hospitals are reimbursed for procedures, not outcomes. Lifetime disease management will always yield the most financial gains. A cardiac catheterization that only takes a few minutes yields $1,500. A 45-minute lifestyle discussion with a diabetic patient pays $15.

I do not blame the doctors. Doctors do the best they can with the training and tools provided. It’s the system itself that is broken and our fellow citizens who are getting hurt…badly.

The Institute of Medicine reports in the Journal of the American Medical Association10 that medical errors and hospital acquired infections account for more than 187,000-225,000 deaths annually. Iatrogenic disease (caused by medicine) is the third leading cause of death in the United States, only behind heart disease and cancer.

It is projected that treating obesity will cost the U.S. over one trillion dollars per year, and account for 1/5th of healthcare spending.11 Even more alarming, 1 in 3 children and adults are pre-diabetic or diabetic.12 The average diabetic accumulates $150,000-$250,000 in healthcare expenditures. Again, despite this spending, estimates report that diabetics have a shorter lifespan of up to eight years.13

How did we get so sick?

One source is our diet. Much of our country is malnourished. We eat too many calories that are void of any nutritional value. Our health is directly proportional to the nutrient content within each calorie that we consume. Most processed foods and sweetened beverages carry very little, if any, nutrient content per calorie. This is the reason that many processed foods, including orange juice and bread have been “fortified” with added nutrients; since any nutrient content was eliminated in the processing of the food.

The government’s current agricultural policy and subsidies for corn and wheat has enabled bad food to be cheap, and healthy food expensive – so much so that many people on a fixed income have to choose between paying for their medications or buying food that can improve their health. Too often these people must resort to eating the less expensive, processed and fast foods that cause their illness to begin with. They feed this food to their family, perpetuating multiple generations in this cycle. Diseases do not run in families. Lifestyles do.

Our foods have been genetically modified to maximize profits, but they have become harmful as well. The most significant genetic modification of the past 20 years is the modern dwarf version of wheat. The “new wheat” has been created to maximize yield and profit in the shortest amount of time. However, the research is mounting that we are more sensitive and intolerant to the modern version of wheat. Modern wheat has been connected with diabetes, irritable bowel, gastrointestinal cancer, lymphoma, autoimmune disease, neurological disorders, skin disorders, and chronic inflammation.13 The dietary advice we are often provided is harmful. For instance, the recommendation that diabetics and heart disease patients should consume “heart-healthy” whole grains increases insulin resistance, which will accelerate the diseases.

Our lifestyle choices and food gets us sick and the medical system keeps us sick. Interestingly, both our food and drugs are regulated by the same federal agency, the FDA. Many higher-ups in the FDA have had past connections to “Big-Pharma” and the food industry giants. I am not claiming a conspiracy but pointing attention to the backgrounds of the many who influence public policy that impacts your family’s health.

Our environment is toxic. Scientists have determined that humans and animals can only tolerate certain levels of chemical exposure to their bodies. The CDC’s (Center for Disease Control) 4th annual report on human exposure to environmental chemicals tested 212 chemicals and found ALL to be in the blood and urine of most Americans! Scientists have found toxic chemicals throughout the world’s environments; even as far as the arctic people and animals.14

As a practicing chiropractor, I am trained to practice outside of the Medico-Pharma-Food machine. I have been screaming, “Shark! Everyone get out of the water!” Of course, my voice is but a grain of sand compared to the media onslaught and government policy that perpetuates poor lifestyle choices, and accentuates preventable disease and suffering in our families and neighbors. I advise my patients, “Look at what everyone is doing around you, then go the other way”.

So what’s the solution to our country’s health and economic challenges? Certainly it will not be answered in this short essay. However, I do know that we should not throw more money at this problem. We do not need more drugs and surgery. We need more people, less sick. We do not need more fear mongering, or scaring people into a learned helplessness/victim condition. We need a system that empowers the patient to take responsibility for their health. The doctor and the patient both have to believe this is possible.

Often, physicians will take a family history and then inform us that a particular disease runs in our genes. We are lead to believe that these genes will somehow determine our fate with not much that we can do. To the contrary, research from Yale University shows that genes contribute only 25% to the longevity of life.15 The emergence of the field of epigenetics proves that we have the ability to positively or negatively alter our genetic health expression through our lifestyle and environment. We are no longer a prisoner to our “genes and heredity”. A study by Dean Ornish, MD, demonstrated that after three months of lifestyle change men showed a change in activity in about 500 genes, including 48 that were turned on, and 453 genes that were turned off. “In just three months, I can change hundreds of my genes simply by changing what I eat and how I live? That’s pretty exciting,” Dr. Ornish said.”16

Those who want to enslave you have perpetuated limiting beliefs that support the notion we cannot alter our health destiny. You are in control of your future! Learn more! Become health literate! Question what you are being told! Free yourself and your family from the bondage of this system! All of the information is readily available to you via the Internet from professional sources and communities of like-minded individuals.

One of the problems with the current system is that the doctor often looks at their patient as fundamentally flawed. They use a chemical to artificially push the patient’s physiology in one direction or another to meet an arbitrary blood-work guideline. These “one-size fits all” guidelines have been altered several times over the past 20 years to include more and more people. One recent study in the Annals of Internal Medicine discusses how modern medicine has become the management of lab values in otherwise asymptomatic adults. Often, these patients end up taking multiple medications to offset the side effects of other medications that they are taking. They referred to this approach polypharamacy. The study demonstrated that over 50% of adults over the age of 50 to be on 5 drugs or more.17 I must ask… Are our bodies designed so poorly that we need so many medications by the age of 50? Are we that sick? Are all these drugs medically necessary?

Insanity has been described as doing the same thing over and over and expecting a different result. Einstein stated, and I paraphrase, we will not solve today’s problems with the same level of thinking that created them.

Turning the tides will not be an easy task. There are strong economic and cultural influences at work. In 2002, the combined profits for the 10 drug companies in the Fortune 500 ($35.9 billion) were more than the profits for all the other 490 businesses put together ($33.7 billion).18 Our current “sick-care” system pays doctors for procedures. It does not pay for counseling or advice that can help inform and educate the patient. As a result there are more procedures and little-to-no counseling or education of the patient. Our medical doctors are rarely trained on non-pharmaceutical interventions for creating and promoting health.

When was the last time your doctor provided you with a health workshop, wellness counseling or even a certified health coach? I have found these strategies to be an integral part of my practice in order to facilitate change in the lives of the patients that I serve.

A person close to me with a cancer diagnosis was recently told by a leading specialist not to waste his time taking vitamins since vitamins would not change his cancer prognosis. He was also instructed not to lose too much weight even though he is obese because it will affect the amount of drug needed for his treatment. It seems as if the doctor was trained to only recommend treatment that directly affects cancer. Lifestyle modifications that support this patient’s underlying physiology and health were seen as a waste of effort and time since they have not been shown to treat this particular type of cancer.

How can someone possibly get healthy in a disease management system that places little value on behavior modification and absolute power on treatment?

I contend that people cannot get healthy in the U.S. “disease-care” system. They can only become “not sick”, at best. That is also assuming they get out unharmed by the myriad of side effects and complications notoriously associated with medicine.

I look at my patients’ bodies as a biologist would look at a sick species of animals. If fish were dying in a lake, the first thing that would be done would be to clean up the lake and food supply. The strategy would not be to give the fish medication and surgery without accounting for the fish’s environment and diet. I am a doctor focused on the structure and function of my patients’ bodies. Subsequently, I recommend anything and everything that will enhance their physiology regardless of the “diagnosis”. It is irrelevant if the patient has cancer, asthma, back pain, migraines or no condition at all. All human beings, despite the presence or absence of a diagnosis, require good clean water, positive thoughts, good nutrition, adequate rest, and proper nerve flow to allow their body to function well and heal. If any of the aforementioned habits are absent for a substantial amount of time, the person’s ability to be well and heal will significantly diminish.

I never see a patient as a flawed individual who is lacking a chemical to be healthier. Headaches are never caused by an aspirin deficiency. Instead, I see the people I care for as having an incredible ability to heal and recuperate once we discover what is interfering with the “normal” healing process.

There are only two things that can be interfering with the healing process: deficiency and toxicity. Sometimes the person is deficient in good nutrition, vitamins and minerals, or deficient in movement and physical activity, deficient in proper alignment, deficient in energy, deficient in a clean and supporting environment or deficient in positive and empowering thoughts and beliefs.

Most often, people who are not healing also have toxicities, not just deficiencies. I define toxicity as having too much of something that does not enhance but decreases our physiology or function. Toxicity accumulates in our body in many forms: chemicals, thoughts, or improper physical activity. Toxicity can appear as negative thoughts (fear, guilt, worry), not enough movement or the wrong movements, and chronic exposure to chemicals in our foods, environments, and medicines (both prescription and over the counter). The list of possible deficiencies and toxicities are much longer than the simple examples I have noted.

In the nearly 80,000 visits that have come through my upper cervical chiropractic office, one of the most devastating causes to a person not experiencing high levels of health is related to the deficiency of proper alignment. Most people have structural changes to their bodies as a result of birth trauma, multiple falls, past accidents or injuries, and sedentary lifestyles. Structural changes to the body will always alter the function of the central nervous system, immune system, and endocrine system. The nervous system, immune system, and endocrine system are in constant communication with one another.

Simply stated, when the position of the skull, 24 spinal bones and pelvis are out of their proper alignment they put pressure on the spinal cord and nerves. Since the brain and spinal cord control every organ, cell and tissue of the body, structural pressure on the nervous system will interfere with the body’s function. Nerve interference eventually leads to dis-ease and a loss of the body’s ability to self-regulate and heal.

Altered alignment also affects the nerve pathways that allow the body to perceive itself and relate to the environment. This can effect the way relate emotionally to our outside world.

A misaligned body will slowly lose its ability to adapt to stress. As the body loses the ability to adapt, many measures of physiology go outside the “normal range” as well. Patients under prolonged stress develop higher levels of cortisol (a stress hormone), higher blood pressure, cholesterol, triglycerides and blood sugar. Digestive issues, sexual dysfunction, inability to concentrate or remember details, and chronic inflammation have been connected to chronic unrelenting stress. The Center for Disease Control (CDC) claims that upwards of 75-90% of chronic health conditions is related to chronic stress.

Upper cervical chiropractic care is one of the safest and most cost-effective ways to mitigate the effects of chronic stress. It has been shown that patient’s under long-term chiropractic care can improve their heart rate variability; a measure of autonomic nervous system function and the body’s stress response. Another study demonstrates that long-term chiropractic patients have a higher level of serum thiols, a DNA repair enzyme that has been shown to correlate with lifespan and aging.19

As you can see, upper cervical chiropractic is not just a natural treatment for neck and back pain. Instead, it is a system of health care that can optimize quality of life and the body’s ability to keep itself well.

Correcting (Adjusting) spinal misalignment (Subluxation) restores structural and neurological integrity to the body, better helping it to adapt to modern stress. An “adaptive” nervous system is an integral part of being well in the 21st century.

Upper cervical chiropractic adjustments do not treat any disease or condition. Recall that the disease/symptom treatment approach is the current model that is failing our society. Utilizing the upper cervical chiropractic adjustment as a form of “natural medicine” is perpetuating the faulty notion that treating symptoms reactively will somehow help one obtain good health. I encourage you to look at your health strategy from a different perspective. Rather than simply responding to symptoms and blood work, take a proactive approach towards your health care. After all, it’s easier to hold onto a champagne glass than it is to put one back together after it falls to the floor and shatters into thousands of pieces.

Adjustments are part of a comprehensive lifestyle strategy focused on strengthening the body’s adaptive capacity. It is true that tens of thousands of people with a host of different conditions have gotten well while under upper cervical chiropractic care. However, they did not get well because upper cervical care “treated” their condition.” Rather, upper cervical care improved their body’s nervous system so the body can do simply just what it was intended to do; heal itself. Yes, your body can actually heal itself. Unfortunately, many people do not heal because their body has not been given the raw materials to facilitate healing. Imagine putting soda into the engine of a Ferrari and then blaming the Ferrari for not driving as fast as it was designed.

The concept is simple but the procedures and healing mechanisms involved are so complex that our greatest minds are still trying to better understand them.

Most families have a primary care doctor who is trained in disease management, illness and pathology. Nowadays, it is even more necessary to also hire a primary care provider/team that have a wellness orientation towards your family’s health. This is a requirement for any family to be well in modern America. It is also necessary to question and research any and all recommendations, conventional or alternative.

I believe in the fabric of America and the power of the consumer. In a free market economy you get to vote by choosing how, where, and when to spend your money. Choose organic, non-GMO, local grown produce. Invest in recreational activities that your family enjoys. Take trips that will teach your children to enjoy being outdoors. Hire health care providers that support your family’s value system.

Those who can afford organic and fresh foods but pass on them because of “price” need to remember how expensive the cheap food becomes once your family is sick. If you want to create wealth, invest in your family’s health now.

Other recommendations include regular meditation or prayer, do not watch the news; especially before bed, unplug from the technology as a family at dinner, eat dinners together, become part of a supportive community, get adequate sleep, purchase a great mattress and pillow, read empowering books, get a whole house water filtration unit, clean with non-toxic chemicals, make health the core value of your family.

B.J. Palmer, the developer of chiropractic, once said, “You never know how far reaching something you think, say or do today, will affect the lives of millions tomorrow.” I now urge you to do your part become informed, take small actions, be an example for others, and together we can promote health and turn things right side up again.

References:

1) More Diagnoses of A.D.H.D. Causing Concern, Alan Schwarz and Sarah Cohen, New York Times, March 31, 2013
2) Sudden Death and Use of Stimulant Medications in Youths Madelyn S. Gould, Ph.D., M.P.H.; B. Timothy Walsh, M.D.; Jimmie Lou Munfakh, B.A.; Marjorie Kleinman, M.S.; Naihua Duan, Ph.D.; Mark Olfson, M.D., M.P.H.; Laurence Greenhill, M.D.; Thomas Cooper, M.A.
Am J Psychiatry 2009;166:992-1001.
3) http://www.kaiserhealthnews.org/Daily-Reports/2012/September/07/iom-report.aspx
4) Kilo CM, Larson EB: JAMA 2009;302(1):89.
5) 2010 United States Census statistics
6) https://en.wikipedia.org/wiki/Health_care_in_the_United_States#cite_note-nihbph-1
7) ^ a b U.S. Health in International Perspective: Shorter Lives, Poorer Health” (2013) National Institutes of Health Committee on Population, Board on Population Health and Public Health Practice
8) Centers for Medicare & Medicaid Services. National Health Expenditure Accounts,
Historical. Available from: http://www.cms.hhs.gov/NationalHealthExpendData/.
9) http://www.who.int/trade/glossary/story073/en/
10) Journal American Medical Association July 26, 2000;284(4):483-5 J Bus Psychol. 2010 June; 25(2): 239–245. Published online 2010 March 7. doi: 10.1007/s10869-010-9166-5
11) Barkin, L. Shari. Millennials and the World of Work: The Impact of Obesity on Health and Productivity
12) http://www.bloomberg.com/news/2011-01-26/more-than-1-in-3-americans-found-to-have-pre-diabetes.html
13) Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health: William Davis M.D.; Rodale, 2011
14) http://news.nationalgeographic.com/news/2004/08/0827_040827_tvarctic_toxins.html
15) Intellihealth 10/19/06
16) Ornish D, et al: Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention . Proceedings of the National Academy of Sciences. June 16, 2008.
17) 16. Hunt LM, Kreiner M, Brody H: The Changing Face of Chronic Illness
Management in Primary Care: A Qualitative Study of Underlying Influences and
Unintended Outcomes. Annals of Family Medicine 2012;10(5):452.
18.) Summary below from New York Review of Books Volume 51, Number 12 · July 15, 2004
http://www.nybooks.com/articles/17244 The Truth About the Drug Companies
19) Clayton J. Campbell, Christopher Kent, Arthur Banne, Amir, Amiri and Ronals W. Pero; JVSR, February 18, 2005. Pp 1-5.
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