Skepticism about science and medicine

In search of disinterested science

Modern medicine: danger to public health and public purse?

Posted by Henry Bauer on 2017/02/23

Healthcare costs in the USA are now unmanageable, as illustrated by the common bankruptcies of people without good insurance and, just now, by the realization that the Republican promise to “repeal and replace Obamacare” is unworkable if many Americans are not to lose the insurance help they currently have.

One way to reduce costs that is not talked about, and that is unlikely to gain much traction until the crisis becomes catastrophic, would be to call a halt to medical  treatments that do harm rather than good. It comes as a surprise to learn, for example, that prescription drugs, used as prescribed, are the 3rd or 4th leading cause of death in developed nations (Gøtzsche, Peter C. Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare. Oxford & New York: Radcliffe, 2013
Healy, David. Pharmageddon. University of California Press, 2012).

A recent article at ProPublica and in  The Atlantic has much information  about unnecessary, often harmful practices that continue in routine medical practice:

When Evidence Says No, But Doctors Say Yes
Years after research contradicts common practices, patients continue to demand them and doctors continue to deliver. The result is an epidemic of unnecessary and unhelpful treatment.
David Epstein, ProPublica    February 22, 2017
This story was co-published with The Atlantic.”

The interests vested in present ways of doing things are many and powerful — clinics, hospitals, professional guilds, but chiefly the pharmaceutical industry. So it will not be easy to change the system, despite the fact that dozens of books and articles over the last few decades have described in documented detail what’s wrong with modern medicine.


2 Responses to “Modern medicine: danger to public health and public purse?”

  1. Dan Kegel said

    It’s true, the practice of medicine needs to be based more on science and cost-effectiveness than it currently is.
    A lot has been written on this, and some progress has been made;
    looks at why doctors order unneeded tests, and mentions that some progress has been made in reducing
    unneeded prostate cancer tests.

    Take any routine procedure — like pelvic exams for healthy patients — and you’ll find somebody asking whether
    the evidence supports it. Often the answer is no, e.g.
    Lots of work to be done here.


    • Henry Bauer said

      Dan K:
      Thanks for the additional links.

      Worth mentioning also is that over-testing and over-treatment are characteristic more of American practice than European, which helps explain why our national health-care costs are so much higher while outcomes (e.g. mortality) are generally worse. A comparison of national practices was published by Lynn Payer: Medicine and Culture (Henry Holt, 1996), still very much worth reading.


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