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November: Ask Dr. Scott

Q: My husband and I have enjoyed the previous questions and answers about drugs and health. I wonder if you have any thoughts about the high cost of medications in the United States? 
A: In light of the Supreme Court’s recent deliberations on the strengths and drawbacks of the Obama healthcare plan designed to rescue an ailing American healthcare system, one fact remains indisputable: Healthcare costs as administered by conventional medicine are spiraling out of control with few signs of tapering.

The fact that drugs are not cures but often only take the edge off the pain needs to be emphasized. Besides avoiding the prospect of being doped out on opioids and thus being less than fully functional to society, it doesn’t take a CSU-P professor to imagine what would happen if PREVENTIVE MEASURES and/or ALTERNATIVE TREATMENTS (such as chiropractic, good nutrition and diet, yoga, exercise and life-style changes, Chinese medicine and more) were incorporated into the American health care approach instead.

For example Workers’ Compensation studies have shown that costs per claim for chiropractic care were $7,505 for chiropractors compared to $16,558 for non-chiropractors; the average number of days to maximum medical improvement was 160.6 for chiropractic care and 219.2 days for non-chiropractic care; and the average number of days to return to work was 76.6 for chiropractic care and 130.4 for non-chiropractic care. (Folsom & Holloway, 2002) Of 10,652 back-related injuries occurring while on the job, those who received chiropractic care compared to medical incurred (a) 51.3% shorter total disability durations, (b) lower treatment costs by 58.8% ($558 vs. $1,100 per case) and (c) lower hospitalization rates (20.3% vs. 52.2%). (Wolk, 1988)

This is merely a sampling of these studies, probably merely the tip of the iceberg as to what savings could be achieved with chiropractic care. Particularly worrisome is the cost of pharmaceuticals, having been recently identified in the Journal of the American Medical Association as the chief driver (188% increase, from $7.3 billion to $19.8 billion) of the 65% increase in costs for spinal pain relief in the United States from 1997-2005. (Martin et al., 2008)

Under these circumstances, one wonders whether unlimited access to pharmaceuticals in the treatment of pain without exploring more conservative alternatives will ever solve the cost crisis in American healthcare.

By 2015 America is expected to spend 20% of all it produces on health care!! (Health Affairs, 2006) (And once upon a time we thought that the smart money was in real estate, a fact lamented by all of us in Southern Colorado whose financial situation has been battered by falling real estate values over the past several years.) A study in the Journal of the American Pharmaceutical Association (2001) also showed that drug-related problems (overdoses, adverse reactions, etc.) cost the nation more than $177 billion for emergency room visits, nursing home care, hospital stays, and other expenses needed by people hurt or killed by prescription drugs.

Why do pharmaceutical companies have to spend 25% or more of their revenues on advertising? (Centers for Medicare & Medicaid Services, 2003) At least one reason is the drugs they market do not work for large numbers of people who take them. The majority of drugs — more than 90% — only work in 30 or 50 percent of the people. (Petersen, 2008) A literature review on the effectiveness of drugs prescribed for fourteen diseases found that the medicines worked in as few as 25% of patients who took them. (Trends in Molecular Medicine, 2001) 30 to 70% of patients get no benefit from taking statins, designed to reduce cholesterol. Drugs prescribed to strengthen bones worked in only 48% of patients taking them for osteoporosis. Pills swallowed to ease migraines succeeded only about 50% of the time. Medicines taken to stop incontinence were even less effective, easing bladder problems for only 40% of patients. As many as 50% of patients are not helped by antidepressants, either.

Prescription drugs can save lives. However they can cause severe, unpredictable and sometimes deadly side-effects even when used correctly (right situation, right amount, etc.) Some drugs can cost between $100,000 and $250,000 a year. Going broke might be acceptable to families if the medicines added years to their loved ones’ lives, but some of the superpriced drugs barely work at all. (Anand, Wall Street Journal, Nov. 16, 2005)

Unless causes of poor health in America are dealt with, drug treatments will fail in the long run – even when used as prescribed.

 

  • Dr. Scott Cuthbert is a chiropractor at Chiropractic Health Center in Pueblo, Colorado, as well as the author of two textbooks and multiple research articles. PuebloChiropracticCenter.com.

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