Health Care Deficiencies

There has been a sharp increase in patient visits to alternative care practitioners in the United States. More and more patients are seeking preventive therapies such as chiropractic manipulation and nutritional counseling. I have copied the following article which came to me from an insurance company. I think it's vital to everyone's good health to be aware of the state of standard medical health care in this country. In my opinion, the quality of American medicine is being diminished even further by managed care. As you will see we aren't anywhere close to being Number 1 in health care delivery in the world. Those of you who start taking a more active approach to your health by seeking out preventive health care --- especially through nutrition evalutation and counseling--- will reap great rewards and can avoid becoming one of the statistics mentioned in the article below


In the July 26, 2000 issue of JAMA (Vol. 284, No. 4) Barbara Starfield, MD, MPH of the Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, talks about the deficiencies of U.S. medical care. Among her notes and comments are:

  • More than 40 million people have no health insurance.
  • Evidence from a few studies indicates that 20 percent to 30 percent of patients receive contraindicated care.
  • An estimated 44,000 to 98,000 die each year as a result of medical errors.
  • "The U.S. population does not have anywhere near the best health care in the world. Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom for 16 available health indicators)."
  • The U.S. ranks behind Japan, Sweden, Canada, France, Australia, Spain, Finland, The Netherlands, The United Kingdom, Denmark, and Belgium.
  • The United States ranks:
    • 13th (last) for low-birth weight percentages
    • 13th for neonatal mortality and infant mortality overall
    • 11th for postnatal mortality
    • 13th for years of potential life lost (excluding external causes)
    • 11th for life expectancy at 1 year for females, 12th for males
    • 10th for life expectancy at 15 years for females, 12th for males
    • 10th for life expectancy at 40 years for females and 9th for males
    • 7th for life expectancy at 65 years for females and 7th for males
    • 10th for age adjusted-adjusted mortality
  • The poor performance of the United States was recently confirmed by the World Health Organization, which used different indicators, and ranked the United States as 15th among 25 industrialized countries
  • "Thus, the figures regarding the poor position of the United States in health worldwide are robust and not dependent on the particular measures used."
  • Explanations for this poor performance do not implicate the health system, but rather implies it is the result of smoking, drinking, and violence. However, this is not supported by the data.
  • The proportion of females who smoke ranges from 14 percent in Japan to 41 percent in Denmark. In the United States it is 24 percent (fifth best).
  • The proportion of males who smoke ranges from 26 percent in Sweden to 61 percent in Japan. In the United States it is 28 percent (third best).
  • The data for alcoholic beverage consumption are similar: the United States ranks fifth best.
  • "Thus, although tobacco use and alcohol use in excess are clearly harmful to health, they do not account for the relatively poor position of the United States on these health indicators."
  • The United States has relatively low consumption of animal fats (fifth lowest in men aged 55-64 years in 20 industrialized countries) and the third lowest mean cholesterol concentrations among men aged 50-70 years among 13 industrialized countries.
  • "The health care system also may contribute to poor health through its adverse effects." For example:
    • 12,000 deaths/year from unnecessary surgery
    • 7,000 deaths/year from medication errors in hospitals
    • 20,000 deaths/year from other errors in hospitals
    • 80,000 deaths/year from nosocomial infections in hospitals
    • 106,000 deaths/year from non-error, adverse effects of medications
      "These total to 225,000 deaths per year from iatrogenic causes."
  • "These estimates are for deaths only and do not include adverse effects that are associated with disability or discomfort."
  • If other estimates are used, the deaths due to iatrogenic ( doctor induced ) causes would range from 230,000 to 284,000.
  • "In any case, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer."
  • An estimate of adverse effects in outpatient care and including adverse effects other than death concluded that between 4 percent and 18 percent of consecutive patients experience adverse effects in outpatient settings, resulting in 116 million extra physician visits, 77 million extra prescriptions, 17 million emergency department visits, 8 million hospitalizations, 3 million long-term admissions, 199,000 additional deaths, and $77 billion in extra costs.
    The author notes that there is a "relationship between iatrogenic effects (including both error and non-error adverse events) and type of care received." Specifically, there is a high availability of medical technology in the United States; i.e., the availability of MRI and CT in the U.S. is second only to Japan. However, Japan ranks highest on health, whereas the United States ranks among the lowest. Dr. Starfield explains this by noting that the results of such diagnostic procedures often result in the patient being hospitalized, causing a "cascade effect" that leads to an adverse iatrogenic event, while in Japan, such diagnostic procedures result in "the common practice of having family members rather than hospital staff provide the amenities of hospital care."
  • "Recognition of the harmful effects of health care interventions, and the likely possibility that they account for a substantial proportion of the excess deaths in the United States compared with other comparably industrialized nations, sheds new light on imperatives for research and health policy."

The preventive/nutritional evaluation program we've developed in my office is second to none. We can also guide you through the current maze of media mis-information and multi level marketing. If you are interested in optimal health for the new year, or you just want a tune up---we look forward to seeing you soon and developing a well-rounded health program that's right for you.

Toward excellent health,
Ron Saltman DC