Americans - even President Obama - getting "too much" care

Experts are suggesting that perhaps Americans are getting over-treated : "too much cancer screening, too many heart tests, too many cesarean sections." Recently a study found that angiograms are being overused, and even the President has gone through a battery of tests lately that some feel are unnecessary and extensive for no real reason.

I was excited, if for a brief shining moment, that the article mentioned "too many c-sections," and in one article I read the recent NIH conference on VBAC managed to register a blip on their radar screen. It gave me hope. But none of this is "news" to countless pregnant women who feel they've been tampered with, prodded and poked endlessly, often for no good reason.

Some tests, like cancer screenings, I'm all for, though, especially when you consider that Americans generally have a better prognosis and survival rate for certain cancers like prostate - because we generally treat it more aggressively than some of our European counterparts. Of course, I can't find the article I read several years ago in the Wall Street Journal, but it basically suggested that in some countries more males were dying of prostate cancer - a generally slow-spreading disease - than they were in the US, because of their less-aggressive approach to treating the illness.

Maybe this latest revelation is good news for pregnant women, but maybe not. It might bring to light that medicine in general is overwrought with waste and needless intervention across the board, and no where does it seem to be the case than in maternity care. If it can somehow change opinions that "it's best for the baby" when, in fact, it might not be, then we might be getting somewhere in educating others of our plight.

The most recent push for a national healthcare plan has had me wondering how all this is going to sort itself out for some Americans, or if it will make it worse. What does it mean for the pregnant woman? Generally speaking, we know that a more low-tech approach to prenatal care and labor can, in the low-risk woman, have better results, both in the short and long run. Fewer interventions means mom's labor can actually be shorter, less painful, and that she'll likely have a better recovery.

But how do you re-train doctors to this way of thinking? Will they revert to unsafe practices to avoid being punished by a government-run healthcare scheme for wasting too much money? I've often thought that some private insurance carriers should investigate OB's with a high rate of induction, episiotomy and c-section, as these are all procedures that cost the insurance company more money because it means more drugs and more care. When I compare the insurance bill I received after my VBAC delivery with no epidural and the one I received from just the anesthesiologist after my third was born, I realized the spinal block for my section alone cost almost as much as my entire vaginal birth.

If I were a pregnant woman using national healthcare, I'm not sure how I would feel being seen as a means to save the government money. But neither do I appreciate being seen as a cash cow by an OB. And if it means I could have a healthy, low-tech birth without you sticking your fingers in my vagina every 10 minutes, then I guess I'm all for it.

I wonder if, in a way to save money, the government would encourage OBs to avoid c-sections unless absolutely necessary. Would they again start teaching OBs how to deliver breech babies? Restrict the use and administration of Pitocin (which, according to manufacturer guidelines, they should be doing already)? Or does it mean doctors will continue to induce, but go back to using the less expensive Cytotec instead? Would the government condone its use because it's cheaper, ignoring the risks that Searle has outlined and put women at even more risk? From what I've read some OBs disagree with Searle's warning and are using it anyway, or are pissed off and think it's bunk.

My biggest fear is that OB's would be forced to return to a care model that they are, by and large, out of touch with. Does it mean that doctor who's been in practice for 30 years, in the last 15 of which he's never delivered a breech baby vaginally, is now suddenly being asked to deliver that baby? Maybe more women would choose midwives, who are usually more equipped to handle low-tech births, and then there would be even more midwife backlash from OBs than there is already. Maybe OBs would feel that their hands were tied, and as a result, just recommend to a government payor that cesareans are the safest way for every mother.

We know that some countries with national healthcare, like The Netherlands and Great Britain, have great success with low-tech, low intervention births. As a way to save the government money, they encourage home births and VBACs. But if you take a physician who does not practice this model of care, hasn't in years, and doesn't plan to in the future, what outcome can we expect for pregnant women?

The Dawn of a New Era: National Health Care?

The upcoming inauguration of President-Elect Obama has a lot of people excited, especially over his views on socialized medicine. Personally, I find the entire idea scary: to think, that our land of the Free and Home of the Brave could slowly be turning into an extension of another European nation?

Everyone's buzzing about "free healthcare," probably because ... it's free. At least on the surface. The idea of not having to pay for high medication costs and other procedures sounds alluring, I'm sure. But once you dig a little deeper, it becomes clear that the whole idea is a scary proposition. 

We've all read in the news in recent months and years about people hopping the border to the US to take advantage of better healthcare. To most US citizens, being put on a four-month waiting list to have a brain tumor looked at does not sound so appealing. I read not too long ago in the Wall Street Journal how death rates from prostate cancer, which is usually a relatively slow-spreading disease,  are apparently much higher than in the US, because patients don't even get to see a cancer specialist until they're in Stage Four cancer. Our rates of success and life expectancy are much higher here because we tend to treat cancer more aggressively. 

Hawaii became the first state to adopt universal healthcare for children, and it was a disaster, failing miserably after only seven months. Not only were budgetary problems a main concern, but the fact that people were dropping privatized care to opt for free coverage - which should be a warning flag to the kind of dishonesty and cheating that even this type of healthcare coverage is susceptible to. Multiply that on a national level, and it sounds like a surefire prescription for disaster. 

Nationalized healthcare looks good on paper - but let's examine some of the root causes for why so many people have high medical bills in the first place. We are considered, according to an article on Forbes.com, to be ranked the ninth-most obese country in the world, which should also not come as much of a surprise. 

Heart disease is the number one killer of men and women in this country. And most causes of heart disease are from poor diet and lack of exercise - which makes you ... obese. For the sake of argument, I won't include the killers of people that are usually beyond their control, like Alzheimer's Disease and accidents. The list includes:

• Heart disease

• Cancer

• Lung diseases

• Diabetes

Barring certain cancers like breast and lung cancer not caused by smoking, you can bet these types of illnesses are offshoots of a greater problem, most likely the explanation behind America's top ten spot in the above-mentioned poll. Obesity can cause a wide range of problems, from the obvious heart disease and diabetes, to high blood pressure, stroke, joint pain and depression. It's no wonder, then, that of the top 20 most commonly prescribed drugs as noted by Pharmacy Times, five drugs are used to treat high blood pressure or heart-related ailments. And smoking, another major factor, causes many of the same type of risk factors. 

Here, take this pill: it'll cure everything

At some point we have to ask ourselves, why should the government - and essentially the taxpayers - be responsible for footing the bill for a nation of people who can't take care of themselves? We know smoking is bad for us, but obviously we do it anyway. We know that excessive eating has led to a nationwide epidemic of overweight people, and not just adults - childhood obesity is on the rise as well. And yet, what are we doing about it? 

One can argue that you make the decision to overeat/smoke/drink or whatever and should be responsible for the outcome. But it seems that more and more Americans who cry foul over the rising costs of healthcare and how everything should be "free free free!" are ignoring the fact that they're part of the problem. 

As much as our system is flawed, it still could be much worse. Perhaps the high costs for healthcare are just another price we pay for the freedom to make choices, however bad they are.