Last week I shared news from the Pharma front, specifically the latest on questionable business practices and undisclosed alliances that continue to dog the industry’s public image. Pharma, however, isn’t the only part of the health field cast in doubt these days. What would you say to a person who claimed that some 90% of medical studies were false – flawed in their parameters, riddled with basic error, skewed by presumption and bias? (No, it’s not me sayin’….) I’m talking about an insider: a highly esteemed, widely acclaimed, much admired, often cited medical researcher who has to turn down speaking engagements left and right. He’s a professional with a flair for statistics and penchant for credibility. His initial groundbreaking research (meta-research, actually) hit the medical scene years ago, but he’s still going strong and in more public headlines these days as the focus of an in-depth Atlantic Magazine feature.
There’s been a lot of news from the Pharma realm these last few weeks. As you all know, I make a point of passing this kind of thing along…. Given the massive role pharmaceutical drugs play in our society’s conventional health care, I like to keep on top of the developments. Speaking of “massive,” first there’s news from the National Center for Health Statistics, which released a report measuring trends in prescription drug use and cost in the last decade. Between 1999 and 2008, prescription drug use rose in all age categories, as did the number of people taking multiple prescriptions. Approximately 88% of people over the age of 60 take one or more prescription medications on a regular basis. A whopping 66% use five or more prescriptions. Not surprisingly, cholesterol-lowering medications topped the list for this age group. In those 20-59, the most popular prescription was antidepressants. In children, 22% take a prescription drug, most commonly asthma medication. In the teenage category, the number jumps to 30%, with ADD/ADHD related meds first on the list. Not surprisingly, what we shelled out for Pharma products soared as well. Already taking inflation into account, Americans in 2008 spent more than twice ($234 billion) what they did in 1999 ($106.4 billion). Against this backdrop, we also learned that two popular prescription drugs were shown to actually cause the very problems they prescribed to prevent. Telling stories and statistics, I’d say. What’s more sobering, however, are a number of recent publications that illuminate the cultural and financial underbelly of the pharmaceutical industry as a whole. I think you’ll find it thought-provoking.
While preexisting conditions and required coverage have taken the main stage on the health care reform bill, many of the smaller changes hold just as much weight in the future of America’s health. These changes and additions have been largely ignored by mainstream media despite several billion dollars allocated to new preventative care initiatives.
Additionally, the bill includes some surprising fine print regulations. Most regulations won’t take effect immediately, but the sum of so many new laws and restrictions could cause major repercussions on our system over the next several years.
Finally, while the bill is certainly heavy on spending, there are several programs included to reduce overall health care costs, but such programs appear highly unorthodox on a first reading. The Worker Bees and I have combed through thousands of pages of minutiae to find nine lesser known stipulations, clauses, regulations, and programs in the new bill.
Yesterday I challenged you to estimate my body fat percentage by looking at a recent picture. To be scientific about this little exercise I chose to reference as the correct answer the results of the “gold standard” hydrostatic weighing I had subjected myself to at the Malibu gym (it was actually a specialized truck that shows up once a year and performs the intricate and expensive underwater weighing tests for $60 each). 317 of you took a stab at guessing from the photo of me. It’s clear to me that many of you are quite good at estimating actual body fat levels (the average guess was 6.7%), but Gwen, anticipating the tenor of today’s post, took the prize with the closest guess at 12.5%… Ironically, that was also the highest guess of all and yet it was still a full 4 percentage points lower than what the actual “gold standard” test demonstrated. That’s right, my test score showed that I am 16.9% body fat. That’s 28 pounds of pure fat – if you believe the lab values. Even my wife Carrie tested lower at 13%. Am I really that fat? Probably not, but I went through this exercise to illustrate a point about which I will write today: that quite often, these so-called “gold standard” lab values are of little actual predictive value. Sometimes these tests are just plain wrong. And sometimes they can create far more problems than they solve. And if they are that far off when something is largely visible, what happens when they are dealing with more intricate hidden body chemistry? In this case, my jeans still fit loosely, so I really don’t care what the lab value was. I know the reality. But if I lived only by the lab values, I’d be inclined to start cutting calories immediately to lose weight.
When Winston Churchill, in the 1932 essay “Fifty Years Hence,” mused that “we shall escape the absurdity of growing a whole chicken in order to eat the breast or wing by growing these parts separately under a suitable medium,” he may have been more prescient than credited. Alexis Carrel had already been keeping a cultured chunk of chicken heart “alive” in a Pyrex flask for the past twenty years by feeding it nutrients (though Carrel was only interested in whether cell death was inevitable, not whether meat could be grown in a lab for human consumption). Sci-fi author Frederik Pohl was one man who took the idea of in vitro meat seriously enough to write about it – in the novel The Space Merchants, where cultured meat is the primary source of protein. That was science fiction, sure, but most good sci-fi is borne of the author’s honest opinion of what the future might hold and it’s usually inspired by the scientific advancements of the day. And sometimes, science fiction comes true. Like this time.
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