7 ms·

"Doctors are largely in the pill dispensing business." You do realize that doctors don't make any more money based on medications they prescribe. "Problem is,

by arn 18y ago

"Doctors are largely in the pill dispensing business." You do realize that doctors don't make any more money based on medications they prescribe. "Problem is, the pills don't work. ..... and the treatments are empirically known to do nothing." I don't really want to get into a big discussion about it because I know I won't be able to convince you. But this is just wrong. Many pills do work. Modern medicine is based on the scientific method and millions on dollars are spent on studies to prove that therapies work. Strnagely enough, insurance companies are part of the gatekeepers for this, since they don't want to pay out of their pockets to provide expensive care for things that don't work. On the other hand, much of "natural" medicine and homeopathic medicine are based in anectodal evidence and not on any large scale scientific evidence.

kingkongrevenge 18y ago
> Modern medicine is based on the scientific method and millions on dollars are spent on studies to prove that therapies work. Sure. Take Ambien, for example. The studies show it works! People who take it fall asleep a whole 15 minutes sooner than placebo! For thousands of dollars and unquantified long term consequences you can have something pathetically less effective than lifestyle changes or some cognitive therapy sessions, so ask your doctor about Ambien. Same for the cholesterol statins. They work! They really do lower serum cholesterol, just as advertised. However, they have absolutely no affect on mortality rates in the typically prescribed case, and are implicated in serious neurological disease... This kind of nonsense is pervasive in the medical industrial complex. Doctors, for the most part, dispense treatments pushed on them. But the stuff is largely a waste of money. With a whole lot of these cancer therapies you statistically buy an extra year of life. But the person who took the therapies felt like shit for four years and blew all their savings. The person who just let it be died a year earlier but spent a lot more time feeling ok and saved a lot of money. You can just go on and on with stuff like this. The medical industrial complex is deeply dysfunctional, and at the end of the day there are way too many doctors and they do too much. This is why health care spending and number of doctors per capita is uncorrelated to lifespan and health across regions of the US.
- arn 18y ago
  "[statins] have absolutely no affect on mortality rates in the typically prescribed case" http://www.ncbi.nlm.nih.gov/pubmed/12114036 http://www.ncbi.nlm.nih.gov/pubmed/12114036 The Heart Protection Study (HPS) randomly assigned 20,536 subjects to simvastatin (40 mg/day) or placebo After an average follow-up of 5.5 years, the following significant benefits with simvastatin were observed: - A 13 percent reduction in all-cause mortality (12.9 versus 14.7 percent for placebo). - An 18 percent reduction in deaths from heart disease or related blood vessel disease (5.7 versus 6.9 percent). - A 24 percent reduction in major cardiovascular events (19.8 versus 25.2 percent) - A 25 percent reduction in the first event rate for stroke (4.3 versus 5.7 percent) reflecting a 28 percent decrease in ischemic strokes and no reduction in hemorrhagic strokes - Among 3982 diabetics without prior cardiovascular disease, a 28 percent reduction in the incidence of MI and stroke (14 versus 18.7 percent).
  - kingkongrevenge 18y ago
    This study supports my position. 12.9 vs 14.7. From taking my statins I get a measly 1.8% lower chance of dying over a five year period, and that's a shaky assertion. It costs a fortune, I'm impotent, and my short term memory is screwed up, but hey, the doc says to take it for that 1.8%. And I suspect the 1.8% is misleading. The profile of the people who died in both groups was probably distinctly identifiable, so in effect the vast majority probably got no benefit. And I think I've seen this methodologically refuted elsewhere. Some studies have definitely got the opposite result.
    - iamelgringo 18y ago
      Dude, I've worked as an ER/Critical care nurse for years. I push a drug, a person's heart rate changes. I tweak a drug on an IV pump, a person's blood pressure comes out of shock and normalizes. The idea that pharmacology doesn't help people is quite simply wrong. Sure, the protocol for Advanced Cardiac Life support changes every 2 years, because some therapies that we use to thing were very effective, are proven to be less effective than new ones. But, there is a strong self-corrective factor in Medicine. The ideal isn't to do what the pharma companies push the doctors to do. The ideal is to do whatever the best science says increases lifespan, quality of life and decreases morbidity and mortality. At times, studies are funded by pharma companies, and the research is tainted. Current best practices are a moving target, because the science changes. But, over all, good medical practice is a big plus. Sure there are drugs that have great promise, are pushed through FDA approval and then are found to have bad side effects and/or not as effective as once thought... (e.g. Vioxx, Celebrex... both recalled several years after approval). But, for every drug that isn't effective, or has bad complications, there are dozens that do work. And, many more are found to have other beneficial uses. For example, mucomyst is a drug that was developed to help break up mucous plugs in people's lungs. Then, is was found to work as the antidote for one of the most common and toxic poisonings: tylenol. It's also used to protect people's kidney's during IV contrast injections. I'm sorry but the anti-pharma, anti-vaccination stuff that flies around the internet is one of the clearest examples of FUD I've seen, and it's very harmful. I've seen a number of people die because they didn't trust medicine and they didn't trust doctors. Please, check what you are saying before someone gets permanently hurt by your ideas.
dividendium 18y ago
"Strnagely enough, insurance companies are part of the gatekeepers for this, since they don't want to pay out of their pockets to provide expensive care for things that don't work." Consider the economics here. If something is not expensive, you don't need insurance. So it's in the insurance companies' interests to inflate the prices so more people will need health insurance and can't pay for procedures out of pocket. The insurance companies just have to raise their premiums to compensate, and the larger the amounts of money passing through their hands, the easier it is for them to keep some of it. I'm not attacking insurance companies, just pointing out that it's not entirely logical to assume that their interests are aligned with yours.
- arn 18y ago
  I'm not saying they are the only gatekeeper. But point is, pharmaceudical companies can't just create a medication and claim it "does xyz" and expect that people will pay for it. These medications are reviewed before being "covered" by insurance companies or medicare (goverenment), so it's not a free for all, as implied in the original poster's comment.

by arn 18y ago

kingkongrevenge 18y ago

> Modern medicine is based on the scientific method and millions on dollars are spent on studies to prove that therapies work. Sure. Take Ambien, for example. The studies show it works! People who take it fall asleep a whole 15 minutes sooner than placebo! For thousands of dollars and unquantified long term consequences you can have something pathetically less effective than lifestyle changes or some cognitive therapy sessions, so ask your doctor about Ambien. Same for the cholesterol statins. They work! They really do lower serum cholesterol, just as advertised. However, they have absolutely no affect on mortality rates in the typically prescribed case, and are implicated in serious neurological disease... This kind of nonsense is pervasive in the medical industrial complex. Doctors, for the most part, dispense treatments pushed on them. But the stuff is largely a waste of money. With a whole lot of these cancer therapies you statistically buy an extra year of life. But the person who took the therapies felt like shit for four years and blew all their savings. The person who just let it be died a year earlier but spent a lot more time feeling ok and saved a lot of money. You can just go on and on with stuff like this. The medical industrial complex is deeply dysfunctional, and at the end of the day there are way too many doctors and they do too much. This is why health care spending and number of doctors per capita is uncorrelated to lifespan and health across regions of the US.

arn 18y ago
"[statins] have absolutely no affect on mortality rates in the typically prescribed case" http://www.ncbi.nlm.nih.gov/pubmed/12114036 http://www.ncbi.nlm.nih.gov/pubmed/12114036 The Heart Protection Study (HPS) randomly assigned 20,536 subjects to simvastatin (40 mg/day) or placebo After an average follow-up of 5.5 years, the following significant benefits with simvastatin were observed: - A 13 percent reduction in all-cause mortality (12.9 versus 14.7 percent for placebo). - An 18 percent reduction in deaths from heart disease or related blood vessel disease (5.7 versus 6.9 percent). - A 24 percent reduction in major cardiovascular events (19.8 versus 25.2 percent) - A 25 percent reduction in the first event rate for stroke (4.3 versus 5.7 percent) reflecting a 28 percent decrease in ischemic strokes and no reduction in hemorrhagic strokes - Among 3982 diabetics without prior cardiovascular disease, a 28 percent reduction in the incidence of MI and stroke (14 versus 18.7 percent).
- kingkongrevenge 18y ago
  This study supports my position. 12.9 vs 14.7. From taking my statins I get a measly 1.8% lower chance of dying over a five year period, and that's a shaky assertion. It costs a fortune, I'm impotent, and my short term memory is screwed up, but hey, the doc says to take it for that 1.8%. And I suspect the 1.8% is misleading. The profile of the people who died in both groups was probably distinctly identifiable, so in effect the vast majority probably got no benefit. And I think I've seen this methodologically refuted elsewhere. Some studies have definitely got the opposite result.
  - iamelgringo 18y ago
    Dude, I've worked as an ER/Critical care nurse for years. I push a drug, a person's heart rate changes. I tweak a drug on an IV pump, a person's blood pressure comes out of shock and normalizes. The idea that pharmacology doesn't help people is quite simply wrong. Sure, the protocol for Advanced Cardiac Life support changes every 2 years, because some therapies that we use to thing were very effective, are proven to be less effective than new ones. But, there is a strong self-corrective factor in Medicine. The ideal isn't to do what the pharma companies push the doctors to do. The ideal is to do whatever the best science says increases lifespan, quality of life and decreases morbidity and mortality. At times, studies are funded by pharma companies, and the research is tainted. Current best practices are a moving target, because the science changes. But, over all, good medical practice is a big plus. Sure there are drugs that have great promise, are pushed through FDA approval and then are found to have bad side effects and/or not as effective as once thought... (e.g. Vioxx, Celebrex... both recalled several years after approval). But, for every drug that isn't effective, or has bad complications, there are dozens that do work. And, many more are found to have other beneficial uses. For example, mucomyst is a drug that was developed to help break up mucous plugs in people's lungs. Then, is was found to work as the antidote for one of the most common and toxic poisonings: tylenol. It's also used to protect people's kidney's during IV contrast injections. I'm sorry but the anti-pharma, anti-vaccination stuff that flies around the internet is one of the clearest examples of FUD I've seen, and it's very harmful. I've seen a number of people die because they didn't trust medicine and they didn't trust doctors. Please, check what you are saying before someone gets permanently hurt by your ideas.

dividendium 18y ago

"Strnagely enough, insurance companies are part of the gatekeepers for this, since they don't want to pay out of their pockets to provide expensive care for things that don't work." Consider the economics here. If something is not expensive, you don't need insurance. So it's in the insurance companies' interests to inflate the prices so more people will need health insurance and can't pay for procedures out of pocket. The insurance companies just have to raise their premiums to compensate, and the larger the amounts of money passing through their hands, the easier it is for them to keep some of it. I'm not attacking insurance companies, just pointing out that it's not entirely logical to assume that their interests are aligned with yours.

arn 18y ago
I'm not saying they are the only gatekeeper. But point is, pharmaceudical companies can't just create a medication and claim it "does xyz" and expect that people will pay for it. These medications are reviewed before being "covered" by insurance companies or medicare (goverenment), so it's not a free for all, as implied in the original poster's comment.