Getting more for less in health care (National Post, 06 Oct 2009)

Esmail assumes that producing “health care” is analogous to producing widgets; the law of supply and demand applies to both. Not so. Demand for “health care”, really disease care, is infinite. Deluded inhabitants of developed societies believe that any money spent on doctors and hospitals will prolong their lives. But, there is no correlation between per capita expenditure on doctors and hospitals and any measure of health. The cost of disease care will continue to rise as long as demand is fueled by absurd expectations of a necessarily finite system, driven by the latest, doctor-self-aggrandizing story on some “life-saving” technology. The cost of disease care can only be contained if doctors are put on salaries and practice according to the Hippocratic Oath and the best evidence for effectiveness and safety of treatments. Only then will doctors have an incentive to do less. Unlike the present perverted fee-for-service system, there would be no incentive to administer profitable but superficially attractive and potentially lethal procedures or drugs for non-life threatening disease. Also, unlike the present system, there would be a primordial incentive, less work for the same money, to prevent the diseases of lifestyle that account for most of the cost of the disease care system and most of the premature deaths in our society.

---

Getting more for less in health care
NADEEM ESMAIL
National Post
06 Oct 2009

Thanks to poor fiscal management, the government of Ontario finds itself in a difficult fiscal situation. It must find a way to eliminate the significant deficits that are expected until at least 2015/16. Given that tax increases are certain to damage…read more…

Tech Tags: National Post newspaper ISSUES & IDEAS

WHAT YOU EAT MAKES YOU FAT

Great article, Joe. We appreciate there are those that are confused. But there are also large numbers who know what is healthy to eat, but easily blind themselves to reality; they are junk food addicts. That “food” they are piling on their plates is specifically formulated to appeal to addictions to sugar, salt and the mouth feel of fat. Extensive advertising of these high calorie density, low nutrient density foods, “junk food,” reinforces this desire, and gives legitimacy to guiltlessly indulge the addiction. That “food”  that the cruise passengers are piling on their plates is specifically formulated to appeal to addictions to sugar, salt and the mouth feel of fat. Unfortunately, treating junk food addiction is just as hard as treating addictions to tobacco, cocaine or heroin. Doctors are not trained to and not paid to treat addictions. They are paid to “treat” the symptoms of junk food addiction, like hypertension, Type 2 diabetes and “cholesterol” and do futile gastric bypasses. “Treatment” of these symptoms deceives the addict into believing that s/he can avoid the consequences of the addiction and makes the addiction worse. Americans are inundated with direct-to-consumer (DTC) drug advertising, claimed to be a First Amendment right by corporations with $billion ad budgets, promoting this deception and doctors are paid to prescribe those drugs.  Canada is catching up fast. Obesity rates are rising and there is pressure from the media to allow DTC in Canada, presumably guaranteed by the Bill of Rights.

The solution? Each individual has to balance the transient pleasure of addiction against the long term disastrous consequences of the addiction. In our society this is the hardest thing most people have to do 24/7/52 for a lifetime and doctors must avoid aggravating addictive behaviour.

---

WHAT YOU EAT MAKES YOU FAT
JOE SCHWARCZ
The Gazette
13 Sep 2009

Occasionally, I like to spy on people. Only for the sake of science, of course. And what better opportunity to do that than on a cruise ship? I like cruising. Besides outstanding entertainment, impeccable service, interesting ports, activities galore…read more…

Tech Tags: The Gazette newspaper Insight

FREE LUNCHES COME AT A PRICE

No professional should take any benefits from any industry for which s/he makes recommendations to clients. Medical licensing bodies should de-license any doctor who does so.

---

FREE LUNCHES COME AT A PRICE
ALEX ROSLIN SPECIAL TO THE GAZETTE
The Gazette
12 Sep 2009

Adam Hofmann is used to getting teased about his lunch. It’s not because his mom gave him something uncool to eat. It’s because he paid for it. Hofmann is a doctor and fifth-year medical resident at McGill University. Lunchtime is often when residents…read more…

Tech Tags: The Gazette newspaper Taking Their Medicine Part 2

MY FAITH IN SWEET SCIENCE IS DOUBLE-BLIND

Those chiropractors certainly look like willfully ignorant charlatans but some medical doctors are also guilty of the same unwillingness to perform or abide by the results of randomized trials. For example angioplasty of coronary arteries for “treating” stable angina (chest pain caused by inadequate blood flow to the heart during exercise) has been shown in multiple randomized trials to cause more heart attacks than treating with drugs only. But these procedures are still done at great expense to our medical system. As an example of unwillingness to perform randomized trials, consider “bariatric” surgery. Even our Minister of Health and Social Services, Yves Bolduc, a neurosurgeon, believes various forms of gastric surgery is a cure for obesity but there has never been a single randomized, sham-operated controlled study showing surgery is any better than treatment for junk-food addiction alone without the operation. Bariatric surgeons refuse to do a randomized trial and are not compelled to. And yet $billions are being spent on these operations. Like the chiropractors, if you ask these doctors why they are ignoring or not doing randomized trials they will answer that they know what is right for the patient, no need to do trials.

---

MY FAITH IN SWEET SCIENCE IS DOUBLE-BLIND
SCHWARCZ
The Gazette
16 Aug 2009

“Awhite crystalline substance is known to be either glucose or fructose. How would you identify it?” That’s been a standard question asked on organic chemistry exams for over a hundred years. Glucose and fructose are both simple sugars with exactly…read more…

Tech Tags: The Gazette newspaper Insight

Advice from the Government of Canada – Put more pork on your fork

Here is another great example of the Canadian Government’s concern about the health of the population and the environment. Industrial production of high-fat content, nutritionally unnecessary pork is one of the most environmentally destructive of agricultural activities. So when the pig feeders scream about H1N1, the high cost of corn and protectionism in the US does the government dare say that it takes about 6 pounds of corn to produce one pound of pork, so eat the corn instead, which is healthier too. That would be political suicide; hundred of porkers would block highways with their tractors. No Gerry Ritz, Minister of Agriculture says we should ruin our health and the environment by eating MORE pork. That keeps the porkers happy and keeps him in his job and encourages even more people, with limited entrepreneurial creativity, to take up pig feeding.

Of course, if all domestic swine were eliminated world-wide, there would be no more reservoir to generate nasty influenza viruses which have killed millions of people in the past and will probably do so in the near future. Billions of people with dietary rules forbidding pork manage to live quite normally without any pork. The rest of the world would be better off without any domestic swine, too.

—————————————

Ottawa considers culling hogs

H1N1, feed prices add to industry’s decline

PATRICK WHITE

Globe and Mail

Saturday, July 18 2009

The federal government is poised to trim the fat out of Canada’s hog industry and is considering culling the entire sector by up to 20 per cent to do it.

The move would respond to pleas from a struggling pork industry that has found itself overextended in recent years as flagging demand and high feed prices have sheared profits down to nothing.

‘We can’t continue on like this,’ said Jurgen Preugschas, an Alberta hog farmer and president of the Canadian Pork Council. ‘I can’t pay my bills right now. That’s why we need the government to step in and assist producers so that the industry can stay in the game. Otherwise, a meltdown would jeopardize about 42,000 jobs.’

In past years, the council has urged the federal government to assist tapped-out hog producers with loans and advances that would keep their operations afloat until favourable markets returned.

But the lobby group now seems resigned to the prospect that the high times are gone for good.

In its recently released Strategic Transition Plan, the pork council calls on the federal government to buy out the worst-off producers at $500 per sow, plus the market value of the animal. By 2014, the plan foresees an 18-per-cent drop in Canadian pork production, from 31 million pigs in 2008, down to 25.5 million. That would follow on a 13-per-cent contraction over the past three years, according to Statistics Canada figures. ‘We are having day-to-day discussions with Canadian Pork Council,’ Agriculture Minister Gerry Ritz said yesterday, ‘reviewing their proposal, and working together to find a solution that will help hog producers in this difficult economic climate.’

The brunt of those difficulties comes from a dismal bit of math: producers need more than $150 per pig to break even, but they’re only getting around $120.

‘Usually the summer brings a rise to about $170,’ said Mr. Preugschas. ‘But we just haven’t seen the increase this year.’

A battery of events have contributed to the shortfall. The H1N1 outbreak, also called swine flu, closed off a number of international markets and weakened North American demand. The recession has also severely cut down protein consumption in all forms. And new Country of Origin Labelling requirements in the United States have severely interrupted cross-border shipments.

‘Before the COOL laws, the business model between Canada and the U.S. worked very well,’ said Mr. Preugschas. ‘The U.S. government wrecked a very good business model.’

But the biggest hit of all has come in the from of skyrocketing feed prices. Corn that once went for $2 a bushel now hovers around $3 – with no drop in sight.

‘I think that this shift in prices is set for the long term,’ said Derek Brewin, agricultural economics professor at the University of Manitoba. ‘The ethanol programs in the U.S. have pushed corn higher, and that will likely remain that way.’

The Department of Agriculture will be announcing some manner of assistance package in the coming weeks. So far, Mr. Ritz is only offering a verbal boost to the industry: ‘Canadians can help tremendously by putting more pork on their fork and their barbecues this summer.’

Drug costs have ballooned in Quebec

Why am I not surprised? In Quebec, doctors are paid by drug dealers to prescribe drugs.

---

Drug costs have ballooned in Quebec
AARON DERFEL GAZETTE HEALTH REPORTER
The Gazette
17 Apr 2009

Quebec spends far more on prescription drugs than any other province or territory in Canada – a factor that’s to blame for spiralling healthcare costs, a new study reveals. More disturbing, Quebec has gone from spending the least of any province on…read more…

Tech Tags: The Gazette newspaper Montreal

AstraZeneca pays medical students

So it has finally come to this. It is not enough that drug dealers fund medical school faculties, now they are paying medical students. Anyone who thinks this donation to a bursary fund by one of the most aggressive drug marketers is not going to give them a lot of influence over drug policy in New Brunswick is very naive. Insidiously, the entire medical profession is becoming a marketing branch of drug dealers.

——————————————————————————————

Bursary program launched for med students

Cindy Wilson/Telegraph-Journal

Published Friday April 3rd, 2009

SAINT JOHN – The first donation Thursday to a new trust fund will allow two medical students to receive four years of free education at the Saint John medical school.

Mark Jones, president and CEO of AstraZeneca, said he hopes his company’s $500,000 donation will help kick-start the New Brunswick Medical Education Trust.

The aim is to raise enough money to pay for the education of 10 students per year. In return, the students will have to promise to stay and work in the province.

The New Brunswick Medical Education Trust was established Thursday afternoon when AstraZeneca Canada Inc., a pharmaceutical company, donated the first $500,000 toward the bursary program.

“The hardest donation to get is the first one,” said Mark Jones, president and CEO of AstraZeneca.

“Once you have somebody, it’s easier to bring others in. We just hope this donation will help kick-start this program.”

Dr. Donald Craig, chairman of the Medical Staff Organization of Zone 2, Regional Health Authority B, said the $500,000 was the first step in raising $15 million for a sustainable bursary program.

Craig said the money will be invested and the return on investment will pay the tuition for 10 medical students each year to study in the province

“We will pay the tuition for four years of medical school. We will probably find them summer work. If they are married, we will try to find their spouses jobs and in return we are asking for a service contract,” Craig said.

Craig said it has not been determined how long the bursary students will be required to live and work in the province.

He said the return on investment for the $500,000 donation received Thursday will pay for the tuition for two medical students who will study in New Brunswick when the medical program opens in September 2010.

Craig said business, governments and citizens will be asked to contribute to the trust and eventually enough money will be raised to fund 10 students per year.

“I hope the donation encourages other pharmaceutical companies. I hope it encourages communities in the province and governments provincially and federally, big industry, big business. We are going to be looking at all those aspects for help,” Craig said.

The trust was established by the Saint John Regional Hospital Foundation and the Medical Staff Organization as a way to attract and retain doctors in the province.

On Thursday, Jones presented the cheque to the trust at an event held at the Regional Hospital.

When he was approached about the project, he said, the story of the challenges New Brunswick has faced in setting up the medical school and recruiting doctors was compelling and he wanted to be part of the effort toward change.

Health Minister Mike Murphy was on hand for the announcement and said there will be more announcements to come.

Murphy said Nova Scotia receives $150 million in research each year while New Brunswick gets $9 million for clinical trials. He said, in time, he believes the province can “outstrip and out rival Nova Scotia.”

“You will hear from the government and myself in several weeks with some exciting news about an initiative the government wants to put together,” Murphy said. “There is a necessity to have an infrastructure base and to have researchers here in Saint John, because as we know those who are going to teach in medicine will want to teach, practise and research. We are working very hard on that.”

OBSTAT-Doctors being paid to push drug study

“Dr. LeLorier reports having served as a paid speaker or consultant for the following manufacturers of statins: Merck Frosst Canada, Pfizer Canada, AstraZeneca, and Bristol-Myers Squibb.” Why would anyone take any advice on statins from him?

---

Doctors being paid to push drug study
BY TOM BLACKWELL
National Post
03 Apr 2009

Quebec doctors are being offered $100 for every new patient they put on cholesterollowering statin drugs as part of a major, federally subsidized study that is raising questions about the influence of the pharmaceutical industry on health…read more…

Tech Tags: National Post newspaper Canada

OBSTAT: Doctors bribed to prescribe statins in Quebec

Here is a classic example of drug marketing a disguised as a “research study” funded by two drug dealers, Pfizer and Astra-Zeneca, with $1.2 million to give $100 to any doctor who starts a statin in ANY patient for no reason in particular. The goal is to find out why the patients STOP taking their expensive drugs, not why they really NEED them in the first place. With 4500 enrolled “patients” $450,000 will be spent by drug dealers on direct bribes to doctors. If each statin pill conservatively costs $2 per day, in just one year, they will have sold $3.3 million worth of drugs, an almost 400% yearly return on the investment including payments to the doctors. Over three years of the “study” the drug dealers will  have sold about $10 million worth of drugs to people, the vast majority of whom will never have had a heart attack or stroke and in whom, “statins have not been shown to provide an overall health benefit.” And the cost of this study will likely be classified as  “research”  by the drug dealers, not a marketing expense. All perfectly legal. Isn’t the drug business wonderful?

Needless to say, the lead “investigator” in OBSTAT, Jacques LeLorier, has a long history of personal payments from multiple manufacturers of statins. Here is a list from a publication in 2004. “Dr. LeLorier reports having served as a paid speaker or consultant for the following manufacturers of statins: Merck Frosst Canada, Pfizer Canada, AstraZeneca, and Bristol-Myers Squibb.” Is it any wonder he wants to keep any- and everyone on a statin for life?

All you unemployed Canadians will be thrilled to learn that this drug marketing is being supported by $584,250 from your income taxes via the Canadian Institutes of Health Research, if and when you get a job.

If you think it is unethical and unacceptable for doctors in Quebec or anywhere to accept money from drug dealers contact the Collège des Médecins du Québec. The licensing bodies will only take action if the public complains.

Here is the justification of OBSTAT for which Lelorier et al have received $584,000 of taxpayer money at a time of large cutbacks in funding to basic research. I will translate the most interesting part of the description.

” The premature cessation of this medication [statins] that most of patients must take for life can have disastrous consequences.”

There is no reason anyone has to take a statin for life. Atherosclerosis is NOT caused by a deficiency of a statin. A non-atherogenic lifestyle is much more efficacious that statins in preventing and treating atherosclerosis. The only disastrous consequence of stopping statins is to the profits of the drug dealers.