Literary Review of Overdo$ed America
Overdo$ed America written by Dr. Abramson describes how the pharmaceutical companies had created a monopoly through compromising medical journal articles, promoting newer and more expensive dangerous medications, and affecting the doctor patient relationship negatively through false advertisements (seen in Claritin). Dr. Abramson's book is a great work on medical ethics. The book details how it is possible to be ethical in medicine despite the corruption and deceit that has increased since the 1980s and 1990s. With pharmaceutical companies and health insurance companies attempting to take autonomy from primary care physicians since the 1980s, Dr. Abramson describes how it is still possible to remain ethical and moral by choosing to not be a part of corruption and deceit.
We learn that there is always a choice to remain ethical and practice integrity. There is the choice to persevere with morality despite the temporary lies of the snake that says, "Everyone sins. Why not sin and be like everyone else?" We can choose to avoid the lies of the snake knowing that there are individuals that are good and practice integrity. We do not need to believe the temporary lies of the snake that envies when individuals worship GOD Almighty. We choose to remain ethical and speak out against corruption especially when it attempts to promote faulty "medications" and "vaccines". We can choose to avoid adverse experimental "vaccines" and expose corruption.
Exposing Deceit and Choosing Integrity
"The ideals and personal goals that had brought me to medicine and then to family practice now called me to investigate, full-time, just how the fundamental mission of American medicine was being undermined-and how we might begin to fix it."- (page 71)
Dr. Abramson described how he had left medical practice in order to describe how the medical field was being affected negatively by the pharmaceutical monopoly (socialism). Dr. Abramson described how he decided to leave a busy medical practice in order to research and expose the corruption and lies of medical journal articles, questionable medical treatments and medications based on deceitful medical journal articles, and how the pharmaceutical companies had essentially attempted to usurp power from researchers and physicians in the 2000s. Dr. Abramson left a busy practice where he had practiced primary care for many decades in order to understand just how bad the state of the medical system was in the 2000s.
Dr. Abramson discovered that medicine had been corrupted by pharmaceutical companies. He probably left practice after seeing how patients were actually demanding newer, more expensive, and brand name medication because of commercials. Despite the newer medications not being better than generics in some cases (i.e. Vioxx, Celebrex, Actonel, Fosamax, Quinoglute, and Norpace), individuals demanded newer medications instead of listening to Dr. Abramson's medical counseling. Dr. Abramson discovered that commercials for medications were using deception to make it seem that medications were the solution to disease when there are other solutions including exercise, diet counseling, inexpensive generic medications, and preventative care that are actually more effective at improving health or reducing disease. Apparently pharmaceutical companies had used commercials, ads, medical journal articles, continuing medical education classes, and marketing firms in order to sell more newer, brand name, prescribed medications. Dr. Abramson decided to write Overdo$ed America to describe the reality of primary care medicine in the 2000s. The book is impressive because it describes how the truth can allow individuals to not believe the lies of deception. Pharmaceutical companies wanted to sell newer medications that were not better than generics and could have even caused worse disease. Dr. Abramson decided to fight corruption instead of being a part of corruption. Overdo$ed America describes how there are individuals that choose integrity and genuine empathy over corruption and deceit.
Medical Advancements in the Early and Mid 1900s and Decreased Medical Care Quality in the 1980s
Dr. Abramson described how there have been substantial medical advances in the US since the 1900s. There have been great medications and treatments created since the beginning of the 20th century. Dr. Abramson offers constructive criticism concerning how medicine has been commercialized since the 1980s and resulted in the decreased quality of medical care. This is interesting because science is a tool that can be used to help individuals and patients instead of leading to poor health outcomes including heart attacks, strokes, osteoporosis, and falls. There have been great innovations in medicine such as the Polio vaccine that was created in the 1950s by the healthy competition of Dr. Salks and Dr. Sabin that resulted in the decrease of polio cases and lower limb paralysis. The cardiopulmonary bypass machine has helped with surgery in the 1950s. Coronary artery bypass graft surgeries also were successful in the 1960s to remove blocked arteries.
Dialysis machines created in the 1960s have helped individuals with chronic kidney disease. Hip and knee replacement surgeries allow for increased mobility for patients. There have been medical innovations such as Dr. Debackey's heart surgery inventions that have helped patients survive heart surgery. Izoniazid and streptomycin were antibiotic treatments that helped against bacterial infections. Tagamet was created in 1977 and helped against ulcers. Zantac was later created and approved because it caused less side effects than Tagamet. Prilosec OTC was later approved being better, cheaper, and without the need of a prescription compared to Zantac. Medical innovations and inventions have helped patients. Despite great innovations, medical care quality has decreased since the 1980s due to socialism's attempts to corrupt medical research, the medical supplies industry, and medicine. Socialism has attempted to decrease the quality of medical innovations seen most obviously with the covid experimental "vaccine" in 2019, yet even newer, expensive medications approved in the 1980s (including statins) can cause adverse health effects. Surveys and statistics have described how the quality of medical care in the US has decreased. It is most likely because of corruption and socialism (monopoly "capitalism") The quality of health care has decreased due to the decreased autonomy of physicians since the 1980s seen in how insurance companies have tried to usurp authority, and socialists have fought against H.M.O. plans that were actually suppressing the cost of medical care. H.M.O. plans were actually cost effective in the 1980s and also gave physicians autonomy to practice. Because H.M.O.s were cost effect and not allowing medical costs to balloon to double digits, socialists slandered and lied about cost saving H.M.O.s with great physicians who were preventing a rising cost of medical care while providing great medical care quality in primary care.
"Then I saw an article in the Journal of the American Medical Association, in July 2000, claiming that 'the U.S. population does not have anywhere near the best health in the world.'"- (page 44-45)
"The low ranking of Americans' health reported in this article was so disparate from what I had believed that I started to look for other sources of comparitive data to see if this was right. An extensive comparison of the health of the citizens of industrialized countries done by the Organization for Economic Co-Operation and Development (OECD) confirmed the conclusions presented in Dr. Starfield's article. The United States again ranked poorly, with 18 industrialized countries having greater life expectancy."- (page 45)
"Children born in the United States today can expect to live the equivalent of about 69.3 healthy years of life, while children born in the other 22 industrialized countries can expect an average of 2.5 additional years of healthy life."- (page 46)
Corruption in Medicine in the 1940s
"Estrogen was approved by the FDA in 1942 for the treatment of symptoms associated with menopause." -(page 59)
"Clearly, restricting the use of Estrogen to women with troublesome menopausal symptoms limited its potential market greatly. If more drugs were to be sold, new reasons to take estrogen would have to be found."- (page 60)
"Estrogen became the most frequently prescribed drug in the United States in 1966. It remained one of the most frequently prescribed drugs through 1975."- (page 62)
It is difficult to pinpoint when medicine began to be corrupted. In the 1940s, there was a case of corruption when a corrupt physician, Dr. Wilson, decided to publish a book and an article in a medical journal about how estrogen replacement therapy helped women with menopause and also prevented "breast and gential cancer" in 1962. Combined estrogen therapy was marketed as supposedly helping decrease cervical cancer (1979), heart attacks (1985), strokes, and improved overall health.
"In a 1962 article published in JAMA, Dr. Wilson, a gynecologist, reported the results of a study in which 304 women had been treated with estrogen. Though 18 cancers were predicted over the time that the women had been taking estrogen, none developed."- (page 60)
"Perhaps Wilson's own tongue had been sharpened by the support his foundation was receiving from several drug companies, including the manufacturer of estrogen. In 1965 the Wilson Research Foundation received $34,000 (the equivalent of about $175,000 in 2004 dollars) in contributions from drug companies, enough to cover Wilson's expenses while he was writing his book. In total, Wilson's foundation received $1.3 million from drug companies."- (page 60)
Dr. Wilson had financial ties with pharmaceutical companies (Wyeth-Ayerst) who paid him to promote estrogen replacement therapy. It was noted in the 2000s that estrogen replacement therapy increases cancer incidence in women 8% for every year that they take estrogen. Dr. Wilson did not describe the risk of cancer in the 1940s despite there probably being cases.
It was not until 2003 and 2004 that new studies described that taking estrogen replacement therapy causes cancer, stroke, Alzheimer's disease, and heart attacks. It is possible that estrogen replacement therapy was marketed as an amazing treatment by pharmaceutical companies since the 1940s as population control. Socialists hate that the population size keeps growing and probably falsely marketed estrogen replacement therapy as a good treatment in the 1940s without real scientific evidence. A lying journal article and a lying book were used to promote cancer causing medication to women in the 1940s. It took 60 years to find out that estrogen replacement therapy actually caused adverse health effects. (Covid experimental "vaccines" may not be good vaccinations either despite lies from socialist propaganda.)
It seems that because American industriousness and ethics allowed for innovations in medicine since the 1900s, socialists wanted to prevent such great medical care and advancements starting in 1942 with false lying information published about estrogen replacement therapy. Initially, it was stated that estrogen replacement therapy prevented cancer while actually causing different types of cancer, strokes, osteoporosis, and Alzheimer's disease. Researchers published medical journal articles in 1975 that described that estrogen replacement therapy caused cancer. Taking estrogen replacement therapy increased the risk of cancer 14 times after seven years of treatment. Yet another lying article stated that adding progestin hormone to estrogen therapy prevented cancer. This was probably to protect sales of estrogen replacement therapy in 1979.
"In December 1975, two articles published in NEJM showed that estrogen therapy increased the risk of cancer of the lining of the uterus (endometrial cancer), up to 14-fold after seven years of treatment. This fear was quashed when, four years later, in 1979, an article published in the Lancet showed that adding another hormone, progestin, for about 10 days each month to estrogen therapy prevented the changes in the lining of the uterus that predisposed to cancer. Several other studies soon confirmed that progestin protected women on estrogen therapy from developing endometrial cancer. Still, HRT had been linked with cancer in the public's mind, and sales plummeted. Only half as many prescriptions for Estrogen were filled in 1980 as had been filled in 1975."-(page 62)
"An aggressive drug rehabilitation program was needed. 'Marketing a disease is the best way to market a drug.'"- (page 62) [Osteoporosis was marketed as a disease that could be improved with estrogen replacement therapy in 1986.]
Since individuals were realizing that estrogen may have caused cancer in 1975, the socialists decided to rehabilitate the medication by marketing osteoporosis as another disease that can be treated with estrogen. Before 1985, few people had heard about osteoporosis being a deadly disease. Osteoporosis was marketed heavily in the 1980s as a dangerous disease for women that could lead to falls and fractures in order to sell estrogen since sales had plummeted in the 1970s. It is possible that the disease was heavily marketed to increase sales of estrogen.
"And osteoporosis or thinning of the bones was a perfect disease to market: there are no symptoms until you develop fractures, so no postmenopausal woman could be sure she was safe. And the criteria were set so that one quarter of all women over 65, and more than half over 75, would be diagnosed with the disease if they had bone density tests. There was, however, a lot of work to be done to turn osteoporosis from part of the normal spectrum of skeletal aging into a feared disease."- (page 62)
Osteoporosis may have been marketed in advertising by pharmaceutical companies in medical journal ads, funded medical meetings, and lectures about osteoporosis to make osteoporosis a feared disease and cause estrogen sales to increase again. The pharmaceutical industry did not care about the health of women, and instead chose to market a non-existent disease (osteoporosis is actually normal in the aging process and improves with exercise and nutrition) that caused the prescribing of estrogen therapy. This may have led to numerous cases of heart attacks, strokes, cancers, and Alzheimer's disease to women. This was while it was known in 1975 that estrogen therapy caused cancer. The pharmaceutical companies marketed a drug that was known to cause cancer in 1975.
"The next step was to 'educate' the public. In 1985, only 23 percent of women had heard of osteoporosis. But, according to US News and World Report, that changed quickly as the result of the efforts of Burson-Marsteller, the public relations firm hired by Wyeth-Ayerst. The campaign was successful at increasing public concern (some would say unnecessary fear), generating many articles in women's magazines and culminating in National Osteoporosis Week. The National Osteoporosis Foundation was started with drug company support in 1986. Doctors and patients came to fear that undiagnosed osteoporosis would lead to hip bones' suddenly snapping with minimal trauma, though in more than 20 years as a busy family doctor I never saw such a thing."
The pharmaceutical companies caused for estrogen to be seen as a good treatment to osteoporosis by helping create disinformation in ads, National Osteoporosis Week, and even the National Osteoporosis Foundation to educate women on the need to take estrogen. The pharmaceutical companies followed the disinformation about osteoporosis with additional lies that estrogen replacement therapy prevented heart attacks while actually causing heart attacks. The prescribing of estrogen increased to its 1975 high prescription levels in 1992 through lies and deceit and may be responsible for adverse health outcomes further described in randomized controlled studies in 2004.
"Coinciding with the public's "education" about osteoporosis was a 1985 report in NEJM about the positive effect of estrogen on the risk of heart disease. More than 30,000 postmenopausal women participating in the Nurse's Health Study, which followed the women for more than three years, showed that nurses who were currently using estrogen had 70 percent less risk of developing coronary heart disease than women who had not used hormones-a dramatic finding."- (page 63) [Another lying article published in a medical journal about estrogen therapy decreasing heart attack risk after sales had decreased.]
"By 1992, estrogen sales were topping their 1975 peak."
"One out of five postmenopausal women in the United States was taking hormones. The prestigious American College of Physicians issued guidelines to practicing physicians recommending that 'all women... should consider preventive hormone therapy,' and that 10 to 20 years of therapy were recommended for 'maximum benefit'. The American College of Obstetrics and Gynecology also recommended that all postmenopausal women, barring a medical contraindication like breast cancer, should take HRT for life. Bolstered by the recommendations of these professional organizations, estrogen use increased another 40 percent over the next three years. In 1995 estrogen once again became the most frequently prescribed brand-name drug in the United States. Perhaps the strongest evidence supporting routing HRT was presented in a 1997 article published in NEJM showing that 'mortality among women who use postmenopausal hormones is lower than among nonusers,' again overriding continuing concerns about the link to breast cancer."- (page 64)
After promoting estrogen as a treatment for osteoporosis and prevention of heart attacks, sales of estrogen increased. In 1992, one out of five women were taking estrogen replacement therapy even after studies in 1975 described that estrogen replacement therapy caused cancer. This was due to the advertisements placed in medical journals and lying medical journal articles published in 1979 and 1985. Not only the pharmaceutical companies created the Osteoporosis Foundation to promote estrogen as a treatment for osteoporosis, but they also told the American College of Physicians and the American College of Obstetrics and Gynecology to promote estrogen replacement therapy. In 1997, another lying article was published in the NEJM stating that women who took estrogen replacement therapy had lower mortality rates. It was not until the year 2000 that truthful journal articles described the risk of increased cancer incidence of women who took estrogen replacement therapy. Instead of helping women be healthier, estrogen replacement therapy caused increased mortality rates in postmenopausal women.
"It is amazing that before 1998, not one of the claims supporting the benefits of HRT had been substantiated by large randomized control trials."- (page 66)
"The Nurses' Health Study was the source of the data for the 1997 NEJM article showing a lower mortality rate among women taking HRT. This benefit of HRT lasted for up to five years after woman stopped taking the therapy, but after five years they had a 16 percent increase in their death rate compared with women who had never taken hormones. These contradictory findings deserved a lot more attention that they got at the time. Why did the nurses experience a lower death rate while they were taking hormones, and for five years after they stopped? And why did they go on to experience a significantly higher death rate than women who had never been on HRT?" -(page 66) [1997 NEJM article describing that estrogen replacement therapy lowered mortality rate for five years then increased mortality rate after five years.]
The reasoning to why some women had decreased mortality rates while taking estrogen replacement therapy was that the warning label of estrogen therapy described that women with heart disease, high blood pressure, and diabetes were not supposed to take estrogen therapy. This could mean that women who were healthier and had not started estrogen replacement therapy did not have chronic disease such as heart disease, high blood pressure, and diabetes.
"Dr. Elizabeth Barrett-Connor, a professor at the University of California, San Diego, points out that while the observational studies of HRT were going on, doctors across the country knew, from estrogen product labeling (included in the Physicians' Desk Reference), that woman with a history of heart disease, high blood pressure, or diabetes should not be treated with estrogen. This would contribute to the spurious findings in the observational studies that women who took hormones had less heart disease. Of course they did: Not only were they the type of women who were going to be healthier; the women taking hormones had already been screened to exclude those with heart disease, high blood pressure, and diabetes. The observational studies that found that estrogen decreased the risk of heart disease had not, according to Dr. Barrett-Connor, adequately adjusted for this." -(page 67)
After they stopped taking estrogen replacement therapy (after five years), they began to develop chronic disease and an increase incidence of mortality rates. This means that estrogen replacement therapy actually caused increased adverse health effects in healthy post-menopausal women taking estrogen replacement therapy for multiple years. However, these findings were not considered significant and estrogen kept being prescribed and sold in pharmacies in the 1990s. Also the studies were observational and not randomized controlled studies. (Observational studies are not the best type of studies because they can have significant bias compared to randomized controlled trials.) The observational studies may have been biased to make it appear that estrogen replacement therapy was beneficial to women (the women did not have chronic disease and were healthier), while not explaining the increased mortality rate after women stopped taking estrogen for multiple years (healthy women then had heart attacks and adverse heart disease).
In the 1990s, the pharmaceutical company Wyeth-Ayerst requested the FDA to approve estrogen for the prevention of heart disease in postmenopausal women. This was when there were only biased observational studies and no randomized controlled trials. The FDA did not approve estrogen treatment for the prevention of heart disease in postmenopausal women in the 1990s. This was because there were no randomized controlled trials demonstrating that estrogen therapy was effective at preventing heart disease. Pharmaceutical companies probably wanted to increase drug sales while disregarding the health risks such medication caused. Estrogen had not been completely studied and researched since the 1940s when the medication was approved for postmenopausal symptoms in postmenopausal women. (There is the need to be skeptical of untested and unresearched medication and "vaccines".)
"In 1998 the results of the first randomized controlled clinical trial of HRT were published. This manufacturer-sponsored study showed that despite significantly lowering LDL (bad) cholesterol and raising HDL (good) cholesterol, HRT increased women's risk of heart disease by 50 percent in the first year. And over the four years of the study, treatment with hormones provided no reduction in the risk of developing cardiovascular disease. In fact, this study showed that the overall death rate was not lower in the women who took hormones; it was slightly higher."
It was noted in 1998 and in the 2000s in medical journal articles that combined estrogen and progestin hormone replacement therapy caused worsening health effects such as heart attacks and strokes. It is questionable how estrogen therapy could have been promoted on medical journals, books, magazines, and commercials for so long while actually leading to cancer, heart attacks, strokes, and even dementia. Even in 2000 when a journal article published in JAMA showed an 8 percent increase in breast cancer in women every year that combined estrogen replacement therapy was taken, doctors continued to prescribe combined hormone replacement therapy. In 2001, despite a new journal article describing that combined estrogen replacement therapy causes cancer, estrogen was the third most prescribed medication in the US. That was after journal articles published in 1975, 1998, and 2000 showed significant adverse health effects in postmenopausal women taking combined estrogen replacement therapy. It was not until 2004 that estrogen and combined estrogen replacement therapy was repudiated as a treatment due to multiple scientific studies with randomized control trials. (There is the need for healthy skepticism with new medications and "vaccines".)
"The truth about HRT came out very slowly and was difficult for most doctors to accept. Even after the article appeared in JAMA in 2000 showing the 8 percent per year increase in the risk of breast cancer in women taking combined hormone therapy, most experts continued to recommend, and most doctors continued to prescribe, routine hormone replacement for postmenopausal women. In 2001, estrogen was still the third most frequently prescribed drug in the United States."- (page 68)
"[Article in July 2002] The study found a statistically significant increase (15 percent) in the overall frequency of adverse events in the women taking HRT compared with the women who took a placebo. This translated into about one adverse event for every 100 women who took hormones for five years. The data and safety monitoring board of the study determined that the increased frequency of complications in women who had taken HRT instead of a placebo had 'crossed the designated boundary... of a finding of overall harm,' and that it was no longer ethical to continue the study knowing that the women taking HRT were going to be harmed more than helped." -(page 69)
"The newspapers were full of articles about the government-sponsored Women's Health Initiative study, which had been specifically designed to determine whether routine HRT was beneficial for postmenopausal women. The 16,000 women in the study had been randomly assigned to take either (estrogen and progestin) HRT or placebo. The study had been scheduled to run through 2005, but the women received letters instructing them to stop taking the study medication because the risk (increase in breast cancer, heart attack, stroke, and blood clots) associated with combined HRT had been found to be significantly greater than the benefit (decrease in hip fractures and colon cancers). The study found a statistically significant increase (15 percent) in the overall frequency of adverse events in the women taking HRT compared with the women who took a placebo." -(page 69)
"In May 2003 more results from the Women's Health Initiative were published showing that combined HRT not only did not prevent Alzheimer's disease, but actually doubled the risk of developing dementia (primarily Alzheimer's disease) in women aged 65 and older, causing about 1 additional case of dementia for every 100 women treated with HRT for five years."
"[Another study with sample size of 1 million described increased cancer in the women taking combined estrogen replacement therapy.] The results showed that women who were currently taking hormones had a 66 percent higher chance of getting breast cancer (30 percent for those taking only estrogen, and 100 percent for those taking both estrogen and progestin) than the women who were not taking hormones. The women taking hormones were also significantly more likely to die of breast cancer than the women not taking hormones. To put the risk into perspective, the researchers calculated that there had been about 20,000 extra cases of breast cancer caused by HRT in the United Kingdom over the previous 10 years. Based on the difference of population size alone, even at the same rate of hormone use, there would have been an extra 94,000 cases of breast cancer in the United States in the previous 10 years as a result of women taking HRT. The total number of American women who developed breast cancer because of taking HRT was likely to be much higher than this, though, because women in the United States were about four times more likely to take HRT than women in the United Kingdom."- (page 70)
It was concluded through multiple research articles published in medical journals in the 2000s that women who took HRT for more than five years developed significant adverse health effects. Such adverse health effects included breast cancer, heart attack, strokes, dementia and Alzheimer's disease, blood clots, and possibly even other health complications including cardiac problems. It is stated that probably 94,000 women in the US were affected in ten years yet estrogen replacement therapy had been approved and prescribed since the 1940s. It is possible that a lot more women were affected due to the use of estrogen replacement therapy and combined replacement therapy. This describes how the pharmaceutical companies did not fully research the effects of estrogen therapy for postmenopausal women in 1940. It took 60 years later to prove that the increase of cancer cases in women was due to estrogen replacement therapy. There is the need to be skeptical of new medications and "vaccines".
"...Starting in the early 1980s, progestins where added to estrogen to reduce the risk of uterine cancer in women who had not had a hysterectomy. The risk of uterine cancer was reduced to near zero, but nobody evaluated the overall effect of adding progestin to routine HRT. The Million Women Study confirmed that taking estrogen without progestin caused 10 extra uterine cancers and 5 extra breast cancers, a total of 15 extra cancers per 1000 women over 10 years. Adding progestin did, in fact, eliminate the risk of uterine cancer but caused an extra 19 breast cancers per 1000 women over 10 years. In other words, the problem of uterine cancer was 'solved' by adding a drug that increased a woman's risk of getting other types of cancer."- (page 70)
Dr. Abramson described how progestin was added to estrogen replacement therapy in order to prevent uterine cancer in postmenopausal women. The treatment was approved yet was not completely researched. It was not until the 2000s that randomized controlled trials described that progestin did not in fact prevent cancer. Progestin prevented uterine cancer yet resulted in additional types of cancer. The pharmaceutical industry advertised combined estrogen therapy as a good treatment against cancer while actually causing different types of cancer. A study conducted in the 2000s described how progestin prevented 15 cases of uterine cancer while adding 19 cases of other types of cancer. This describes that estrogen and progestin combined hormone replacement therapy caused more cancers than estrogen therapy alone. This was after combined estrogen replacement therapy with progestin was approved in 1980. Ethical researchers told participants of the study to stop taking combined estrogen and progestin hormone replacement therapy because it caused cancer and other adverse health effects. It was not until the 2000s that the truth about estrogen and progestin replacement therapy was told and estrogen therapy was no longer favored as a treatment for menopausal symptoms.
"The estrogen-only part of the Women's Health Initiative Study was ended prematurely, in February 2004. Researchers concluded that after almost seven years, the women taking estrogen had more strokes and fewer broken hips than the women taking placebos. The most important finding was that there was no overall benefit to taking estrogen and that, therefore, it 'should not be recommended for chronic disease prevention in postmenopausal women.'"- (page 70)
The Women's Health Initiative Study was ended prematurely in February 2004 because the findings noted that estrogen therapy caused strokes to postmenopausal women. The researchers published their findings and allowed for the truth on estrogen replacement therapy to be known. The most interesting and significant finding was that taking estrogen replacement therapy showed no overall benefit and that it should not be recommended for chronic disease prevention in postmenopausal women. This was when estrogen replacement therapy was said to prevent postmenopausal symptoms in the 1940s without having significant adverse health effects. Estrogen was touted as helping combat osteoporosis and heart disease in the 1980s without randomized controlled trials. The treatment showed no overall benefit to health after randomized controlled trials were done in the 2000s. This describes the need to see science as a tool and not as a religion. Science can be used for good, yet can also be misutilized by unethical scientists. We should keep healthy skepticism against pseudo-science, lies, deceit, and bad medicine. The estrogen replacement therapy treatment was approved since the 1940s without knowing how the medication actually affected individuals until the 2000s.
"Twenty million American women have taken HRT not only to relieve symptoms such as hot flashes... but also believing that hormones would protect their hearts, decrease Alzheimer's and Parkinson's disease, prevent tooth loss and diabetes, strengthen their bones... improve the quality of their lives, and increase their longevity... Despite this, they unwittingly exposed themselves to increased risks of breast cancer, heart attack, stroke, Alzheimer's disease, and blood clots."
"In the end, the 26 percent increase in the risk of breast cancer caused by HRT found in the Women's Health Initiative study was deemed by the National Institutes of Health 'too high a price to pay, even if there was a heart benefit.' The risk had been known a decade earlier, when the American College of Physicians made its recommendation that all women without unusual risk should consider taking HRT, but was not of enough concern at the time to invoke the principle 'First do no harm.' Far more than 100,000 unnecessary cases of breast cancer resulted."- (page 71)
"The important lessons from this chapter of American medical history will be lost if we simply attribute the debacle of routine HRT for healthy postmenopausal women to the vagaries of medical progess. Failure to understand how this mistake occurred commits us (doctors and patients alike) to being naïvely swept up by each new cycle of exaggerated claims about the effectiveness and safety of ever more expensive medical therapies- that is, until even newer 'medical knowledge' is produced that supports even costlier drugs. The fundamental lesson to be learned from the HRT debacle is that therapeutic decisions must be based on solid and unbiased scientific evidence. The trend, however, is going in exactly the opposite direction.'"- (page 71)
Dr. Abramson describes that there is a lesson to learn from the prescription of HRT since the 1940s that caused cancer, strokes, heart attacks, falls, and severe disease to women. We can learn that there is the need for healthy skepticism against newer "medication" and "vaccines" that may have been created in haste and attempted to lead to adverse health conditions. There is the need to study the effects of new "vaccines" and "medications" prior to deciding to take said newer "vaccinations" and "medications". There is the need to be skeptical of newer "medical knowledge" that may be false and written with the intention to lead to the taking of bad "medication" and "vaccines". We can persevere without covid "vaccines".
Increased Corruption in the 1980s in Medicine
It seems that the 1980s was when medicine began to be increasingly corrupted by financial ties with big pharma and researchers from medical journal articles (newer statins). Cost saving H.M.O.'s and great primary care physicians were under attack from the socialist media for preventing the rising cost of medical care while also preventing chronic disease in patients.
Great primary care and cost saving insurance H.M.O.'s were preventing medical costs from increasing substantially. Socialists despised that Americans were getting affordable quality care and began to state lies about how doctor visits were being rushed and that cost saving H.M.O.'s were not good. This led to increased medical costs with inflation of prices in the double digits. Quality of care also decreased because counseling the patient on preventative medicine was not remunerated economically while patient visit times were decreased. While lifestyle changes such as exercise, nutrition counseling, and smoking cessation have led to healthier lives without the need of newer, expensive, and brand name medication, patient counseling was not looked upon favorably by socialists (prevention of chronic diseases). This would describe why the patient doctor visit times were significantly decreased from an hour or thirty minutes prior to 1980s to fifteen minutes. (There was a psychiatrist that was let go for spending more than fifteen minutes per visit with her patients while being an amazing psychiatrist in the 2010s).
H.M.O. Plans and Managed Care Plans Caused Medical Costs to Decrease While Providing Great Medical Care
"The period of the late 1980s and early 1990s was the golden era of HMOs and managed care plans. They appeared to have solved the problem of rising health insurance costs..."-(page 78)
"Health care spending budgets that would have been unacceptable coming from the government were created by competing independent health plans, which employers choosing which to offer and employees usually (but not always) given a choice of several from which to choose... This market-based approach successfully tamed the double-digit percentage increases in health insurance premiums of the late 1980s and early 1990s, bringing the annual rate of increase down from a peak of 18 percent in 1989 to less than 2 percent by 1996."
Dr. Abramson described how competing HMO plans in the 1980s allowed for decreased medical costs and great quality of care. HMO insurance plans worked with employers to provide inexpensive health insurance plans while also providing great medical quality working with primary care physicians. Dr. Abramsondescribed how his work with HMO plans helped patients. Dr. Abramson described how preventative care allowed for better health outcomes, decreased hospitalizations and emergency room visits, and inexpensive routine check ups and vaccination visits that improved the health of communities in many cities in the United States. It is probable that because the insurance companies had to compete with other insurance companies through real capitalism, socialists were envious.
True competition allows for the better insurance companies to get more patients while expensive and ineffective insurance companies do not get customers. Because individuals were getting great healthcare at reduced costs in the 1980s, socialists began to slander and speak lies about great HMOs. A statistic stated that the annual rate of increase of health insurance premiums fell from 18 percent in 1989 to less than 2 percent in 1996. The cost of health insurance premiums fell 16 percent which may have caused envy from socialists. Since medical care costs had decreased signicantly with improved outcomes for patients and less hospitalizations with chronic disease, socialists attacked HMO cost saving plans. Socialists did not want healthier individuals and a decreased cost to great medical care. HMO plans began to be the major health care plans in the 1980s and 1990s until socialists slandered and lied about rushed doctor visits in the television (medical journal studies described how patient visits from HMO plans were not rushed and actually within average patient visit times. This is while socialists actually have caused for patient doctor visit times to decrease significantly from the early 1980s from an hour or half an hour to fifteen minutes.) Dr. Abramson described how it was probable that the pharmaceutical monopoly, medical equipment industries, and hospital industries may have had decreased financial revenues that led to negative coverage of HMO plans. Socialists probably did not care about improved health outcomes and actually cared about financial revenues. HMO plans were attacked and slandered because they prevented medical costs from increasing significantly each year.
Dr. Abramson Described How H.M.O. Plans Were Beneficial and Cost Effective
"Almost all of my patients welcomed the new plans. The broader insurance coverage meant that they no longer had to pay for their office visits or go through a lot of paperwork to collect from their indemnity insurance. And because family doctors take care of a broader range of problems than other primary care physicians, most of my patients already expected to discuss most of their medical problems with me before going to a specialist anyway. Besides the additional administrative burden of processing referrals to specialists, the added responsibility of functioning as the medical gatekeeper had little impact on my practice. Despite the discounted fees, I preferred taking care of my patients on the new insurance plans. I could provide better care because patients were willing to come in for routine exams and follow-up visits. Money was removed as an impediment to the doctor-patient relation. True, the low co-pay for office visits contributed to some nonessential patient-generated visits, but most of these served to increase the patients' trust and enhanced my ability to provide good care."- (page 79)
Dr. Abramson described that while being a family practice physician, he saw that H.M.O. plans were good. The H.M.O. plans helped individuals obtain cost effective medical treatment that was inexpensive and of great quality. H.M.O. plans along with Medicare were the two medical plans most seen in the 1980s. Dr. Abramson described that he saw that the health management plans were actually decreasing the cost of medical care while providing good health outcomes for patients and communities. It was noted that preventative medicine prevented individuals from getting chronic disease, being hospitalized, and from visiting the emergency department. Because all of that caused decreased medical costs, socialists probably envied H.M.O. plans.
Dr. Abramson described that patients actually benefitted from the insurance plans and were grateful for the insurance plans. Patients were able to have inexpensive insurance that decreased medical costs and also resulted in a healthier lifestyle. Dr. Abramson described that the insurance plans allowed patients to discuss and speak about their medical concerns with ease since medical costs were decreased and the medical care received was of great quality and affordable. Socialists probably hated H.M.O. plans and slandered the insurance plans causing an increase of medical spending similar to Medicare in the 1960s. Apparently, socialists are stingy and also envied that Americans could have great inexpensive medical care quality in the 1980s and 1990s. This was after increasing the costs of medical care in Medicare in the 1960s. That is why socialism and monopoly "capitalism" need to be repudiated.
"The stage could not have been set more perfectly for prescription drug advertising to become a major force in American medicine. And so it did. In 1991 the drug companies spent a paltry $55 million on advertising drugs directly to consumers. Over the next 11 years, this increased to more than 50-fold to over $3 billion in 2003. The ads appeal to viewers as independent decision makers-capable of forming their own opinions about which drugs they need- and resonate with the growing concerns that HMOs and managed care plans tend to withhold the best care to save money."- (page 80)
Pharmaceutical companies spent on ads to get consumers to buy newer, expensive, brand name medication and also speak negatively on HMOs and managed care plans (lying about cost saving insurance). The ads were marketed to convince consumers to request brand name medications (that may not have been better than generics and even caused worse disease.) We can learn that we should not believe lies of commercials and ads that speak deception. Necessary items are never on commercials and ads.
"Largely freed of concerns about out-of-pocket costs, enticed by advertisement and media coverage of developments in medicine, and emboldened by a sense of autonomy, patients began requesting, and then demanding, specific tests, drugs, and procedures. Indeed, it became nearly impossible to convince many patients that more medical care was not necessarily better."- (page 80
Dr. Abramson described how advertisements on television were deceptive and leading patients to request and demand newer, brand name medication that may have caused serious adverse health effects. Dr. Abramson did not prescribe more expensive medication that could have led to adverse health outcomes. Because patients saw advertisements, they began to demand specific newer medication. Dr. Abramson may have left practice because he preferred to not prescribe bad medication that may cause adverse health effects. Advertisements from pharmaceutical companies attempted to promote brand name medications, speak negativity about HMO plans, disrupt the doctor patient relationship by telling patients to request "better" medication, and spoke lies. Dr. Abramson described how some patients believed the lying ads and began demanding medications like Vioxx and Celebrex which actually cause strokes and adverse health outcomes. Dr. Abramson decided to not be a part of corruption and left family practice to write Overdo$ed America.
Pharmaceutical Companies Paid For Lying Advertisement to Strain the Doctor-Patient Relationship
"Indeed, it became nearly impossible to convince my patients that more medical care was not necessarily better. Rather than adopting lifestyle changes that could prevent illnesses, many people began to believe that the latest "medical breakthroughs" were all that was needed to keep them healthy. Ethicist Daniel Callahan in his book False Hopes sums this up beautifully: "The market sells dreams and hopes as well as things."- (page 80)
The pharmaceutical companies paid to make lying advertisements about how newer, expensive, brand name medications were better than generics when they caused severe healh problems. Dr. Abramson described how even after counseling patients on the truth of false advertisements by the pharmaceutical companies, there were patients that still demanded faulty medications to be prescribed. The pharmaceutical companies were actively trying to strain the doctor-patient relationship through false advertisement. The false advertisements were made with the intention to lead patients to request and then demand medication that may have been harmful to their health. Instead a healthy lifestyle with adequate nutrition and exercise is better than brand name expensive medication that can cause adverse health effects.
Dr. Abramson described how pharmaceutical companies were trying to get patients to get doctors to prescribe expensive medication based on lies, deception, and falsehoods. The commercials were false and attempted to make it seem that brand name medications would solve their medical problems when nutrition and exercise were better options. Dr. Abramson describes how false advertisement sells unneeded products based on lies and deceit. We should skip the false advertisements and have healthy skepticism. (I have never seen commercials for generic medications. Also never seen commercials for vitamins and minerals during the covid "pandemic", but there were multiple commercials for experimental covid "vaccines".)
Dr. Abramson Described How the Pharmaceutical Company Used False Advertisements to Cause Conflict Between the Doctor-Patient Relationship
"To exactly the same extent that a person is seduced by the false hopes and dreams offered by the medical industry's marketing efforts, the ability to trust his or her doctor, especially a primary care doctor, is eroded."- (page 80)
Dr. Abramson described how false advertisement led to the straining of the doctor patient relationship in the 1990s and 2000s. The pharmaceutical companies were probably looking to cause conflict between patients and physicians. Socialists do not like harmony and cooperation between patients and doctors. Socialists tried to decrease the amount of time of doctor visits since the 1980s for primary care doctor visits. Then advertisements tried to tell patients to tell their doctors to prescribe the medications on the advertisements. This was when some medications were not good and caused adverse health effects.
Dr. Abramson tried to reason and counsel patients on not believing the deceit of false advertisement especially with bad medications (Vioxx and Celebrex). Patients began demanding the medications on advertisement when they may have caused adverse health effects. Dr. Abramson decided to not prescribe such medications. Dr. Abramson described how false advertisement from pharmaceutical companies may have also contributed to the doctor patient relationship being affected in a negative manner. There were patients who were angry when their med requests were not granted and even demanded faulty medications. Dr. Abramson decided against prescribing bad medication and left practice in the 2000s.
HMO's and Managed Care Plans Were Attacked By the Media When They Were Suppressing Price Inflation in the 1990s
"It wasn't long, however, before the enthusiasm about HMOs and managed care plans started to wane. News stories about HMOs unreasonably withholding care became a dominant theme, and by 1997, critical stories were outnumbering positive ones by a seven-to-one margin. The health insurance industry added grist to the mill by imposing one-day obstetric hospitalizations for normal deliveries, selectively contracting with doctors so that long-standing doctor-patient relationships were disrupted, and trying to save money by avoiding high-cost patients like those with HIV/AIDS. Patients' rights legislation emerged as a major political issue as the public focused on restricted access to care. The public's esteem for managed care companies plummeted. In 1997, 51 percent of those surveyed said that managed care companies were serving patients well; that figure was down to 29 percent just four years later."- (page 81)
Dr. Abramson described how the media began to speak negativity about HMO plans and managed care plans that were preventing price inflation in medical care. Because HMOs were cost effective and provided great care, socialists disdained that medical care costs were not increasing. Socialists had already increased the price of medical care in the 1960s by increasing the fees of hospitals and doctors since Medicare was paying for elderly patient's medical care. Socialists envied that the government was paying for the medical care of the elderly and made hospitals and doctors raise their fees while at the same time blaming Medicare for the rising costs of medical care. In the 1990s, HMOs were decreasing the cost of medical care and prevented price inflation. HMOs were good insurances, yet socialists envied that medical prices were not increasing each year.
The media then attacked HMOs with negative news stories about how HMOs were withholding care, the quality of care worsening under HMOs, patient visits were being rushed, and physicians denying patient requests for referrals and specialists. Dr. Abramson described how there were seven negative stories for every one positive story of HMOs in the media in 1997. This was probably done with the intention to lead individuals to believe that HMOs were bad. The reason for the negative coverage was because HMOs were offering great medical care and preventing price inflation. The negative media coverage caused insurances to make medical decisions that increased the price of medicine leading to price inflation and arbitrariness. Insurances added a one day hospitalization stay to normal deliveries in addition to disrupting patient doctor relationships. High risk patients such as HIV and AIDS patients were dropped to save costs paying for high cost anti retrovirals. (Even idolatrous socialists hate LGBT homosexuals despite socialists being LGBT homosexuals. We hate sin and not the individual.) This was blamed on the insurances when it was the socialists who were attempting to prevent cost saving by leading to price inflation. Socialists wanted the prices of medical care to inflate every year since that leads to profits for socialists. HMOs were an obstacle to price inflation and were slandered and attacked on the media. Insurance companies increased costs and price inflation from 2 percent in 1996 to 13.9 percent in 2003 every year. Idolatrous socialists envied elderly patients in 1965 for obtaining Medicare, patients with physical discapacities in 1965 for obtaining Medicaid, and patients with HMO insurance in the 1990s for saving costs on great medical care. There is bad and then there is socialism. Socialists are greedy, stingy, envious, covetous, bitter, fake, and still want to appear as if they "help the working class and patients". The increase of medical care prices in the United States is all due to socialism and greedy, stingy socialists. We should avoid the lies of the socialists and lying media.
Stingy and Greedy Socialists Disdained Competition Between Insurance Companies That Kept Medical Costs Down
"Initial cost savings had come fairly easily. Doctors, hospitals, and other health care providers had little choice but to accept discounted fees in order to be included in the newly formed networks of healthcare providers; otherwise they risked losing access to their patients. These so called volume discounts controlled prices during the transition to managed care, but the apparent solution was short lived. Once the discounts had been factored in, this apparently exquisite solution to controlling costs- local health budgets set by the marketplace instead of the government- became the problem."- (page 81)
Dr. Abramson described that the villification of the media against cost saving HMO insurances may have been due to the prevention of health care cost inflation. Socialists saw that HMO insurances decreased medical costs and gave great medical care. Socialists were envious of cost inflation prevention and slandered competitive insurance companies. The insurance companies were efficient, ethical, and cost effective while decreasing costs. This was because Bastiat capitalism was used instead of monopoly "capitalism". Socialists hate true capitalism styled after Frederic Bastiat and attempt to oppose true competition. HMO and managed care insurances in the 1990s under an impressive Democrat economy, allowed for cost savings and great medical care to be given to patients. Insurance companies competed in the marketplace and caused for medical costs to decrease. Insurance companies had to give good medical care in order to gain patients while bad medical care from bad insurance companies caused patients to choose the better insurance. In a competitive capitalist marketplace, patients obtain cheaper insurance and medical care while receiving great medical care. Socialists hate and envy true competition and also great medical care because it is based on merit. Socialism disdains great medical care and also low prices for insurances and medical care. This actually occurred in the 1990s. Because patients were being benefitted and profits to socialists were decreased based on preventing price inflation, socialists attacked and lied about great insurance companies on the media with negative news stories that outnumbered positive news stories.
The real problem to socialists was cost controls on medical care based on local health care budgets set by the market place and not by the government. Socialists envied that great insurance companies had more patients based on merit and also that the cost of medicine had decreased significantly while price inflation was held down. Socialists then caused price inflation to rise each year starting in 2003 leading to expensive and also not so great medicine (this is concerning primary care since bad medication from big pharma was being prescribed that caused strokes, heart attacks, GI bleeds, and falls, office visit times were decreased, and litigation was causing the doctor patient relationship to be adversarial instead of cooperative). This led to increased prices and decreased quality of care. All of this because socialists disdained cheap, inexpensive, competitive, and amazing insurances. The problem was socialism and socialists who hate the utilization of resources with responsibility and effectiveness. Socialists hated that the government paid for Medicare and Medicaid in 1965 and attempted to slander and lie about how Medicare caused price inflation in medical care when it was socialists who caused price increases. Almost forty years later, and the same socialists or monopoly "capitalists" decided to increase medical prices by slandering and lying about HMOs and managed care plans. This describes why medical costs in the United States have increased significantly. Socialists hate true competition, cost saving, thriftness, and responsibility. We can avoid socialism and fake "capitalism" styled after non compete and prefer Bastiat capitalism. We should avoid socialists who make everything worse for everyone seeing how socialists caused cheap and inexpensive medical care in the 1990s to become expensive in the 2000s. In the 2020s, socialists are responsible for the experimental covid "vaccines" that caused strokes and blood clots.
Socialists Slandered HMOs and Managed Care Plans Because of Cost Savings
"When there were no more cost savings to be squeezed out of the fees paid to health care providers, HMOs and managed care companies had only one avenue open: they had to start to really 'manage' care, that is, control costs by eliminating unnecessary or wasteful care. (Of course, cutting down on advertising, executive salaries, and profits would have helped, too.)"- (page 81)
Dr. Abramson described how the insurance companies had lowered the cost of medical care and also allowed for the management of price inflation. This led to unnecessary and wasteful care to be eliminated. This meant that insurance companies and providers in primary care were helping contain costs of medical care. Medical care inflation was at 2% in the 1990s each year yet grew to almost 14% in 2003 each year once the slander and lies occurred against price saving insurance companies. Socialists saw that great insurance companies and great physicians were reducing the cost of medicine.
Because medical costs were decreased, socialists wanted more revenues and did not like that health care was inexpensive and effective. Since medicine was being practiced efficiently and effectively and reducing costs, socialists turned to lying and slander. Socialists instead of lowering executive salaries or decreasing advertisements decided to lie about insurance companies not being good for patients. 59% of people expressed negative feelings about HMOs and managed care in general after lying propaganda, yet 69% actually were satisfied by the medical care they were receiving by HMOs and managed care plans. It is probable that marxist socialists disdained great, low cost medical care.
Socialists Caused Public Disgruntlements To Prevent Great Insurance Companies From Reducing Medical Price Inflation
"Each of the constituencies of this complex system felt threatened by the limitation of medical expenditures. Though I have no proof, I strongly suspect that the parties that had the most to lose financially-the drug, medical equipment, and hospital industries; and the specialty care doctors-played the biggest role in fanning the flames of public disgruntlement. When public opinion turned so strongly against the measures to control health care costs, the insurance companies had no choice but to loosen their management of care. Yearly increases in health insurance premiums once again started to balloon out of control, rising steadily from a low 2 percent annual increase in 1996 to 13.9 percent in 2003."
The HMOs and managed care companies were being opposed by socialists because of price inflation controlled by cheap prices and great medical care created through competition between the private market. Socialists hate healthy competition in the economy that results in inexpensive and great medical care. Socialists actually prefer bureaucracy and red tape that is monopoly "capitalism". This form of socialism leads to increased prices and not the best healthcare. Socialists in the pharmaceutical monopolies probably opposed great inexpensive insurance companies since price inflation was being prevented.
The pharmaceutical industry probably got the hospital industry, medical equipment industry, and specialist doctors to foment negativity against great insurance companies so that insurance companies would stop containing price inflation and allow increases in medical care prices. This actually occurred and price inflation in 2003 led to expensive medical care that decreased in quality due to socialism and non-compete. Great insurance companies were made to manage medical care in a less efficient manner that allowed prices to keep increasing significantly each year. The socialists hated price containment and wanted price inflation to benefit the pharmaceutical industry profits for bad medication (Vioxx and Celebrex) and also cause negative outcomes for patients while misutilizing Medicare prescription coverage in the 2000s. Socialists caused medicine to be less inexpensive and not so good seeing the types of meds that were being produced (Actonel and Fosamax), advertised on medical journals, and then recalled by the pharmaceutical companies once bad medications were causing adverse health effects. This explains part of why medicine had changed negatively in the 2000s. The pharmaceutical monopoly probably did not want individuals to get great medical care at cheap prices and attacked insurance companies with lies. This describes how the pharmaceutical companies had attempted to change medicine from an ethical field into a monopoly industry in the 2000s. This was to negatively affect the great economy that was existing in the 1990s because of the Democrats who were classical liberals and not marxists. Socialists wanted to prevent a great economy in the 2000s, increase the price of medical care through non-compete socialism, advertise, approve, and prescribe bad medication, and increase profits for the pharmaceutical monopoly that created covid experimental "vaccines".
Why Medical Care Quality in the US Has Decreased Despite Higher Costs?
Dr. Abramson described that since 2004 the cost of medical care in the United States has increased significantly while the quality has not improved. It has been noted that the quality of care in the US has decreased because of big pharma's influence on primary care, changes in the doctor-patient relationship (decrease of time in doctor visits), and also because of the commercialization of medicine (despite no universal healthcare). On the measure of performance on the level of health, the US was number 72 in the world.
"Despite the poor performance of the American health care system, our healthcare costs are simply staggering. In 2004, health expenditures in the United States are projected to exceed $6,100 for every man, woman, and child. How does this compare with other countries? The United States spends more than twice as much per person on health care as the other industrialized nations. Even taking into account our higher per person gross domestic product, the United States spends 42 percent more on healthcare per person than would be expected, given spending in healthcare in the other OECD nations. The excess spending on health care in the United States is like a yearly tax of more than $1,800 on every American citizen. (And still the United States is the only industrialized country that does not provide universal health insurance, leaving more than 43 million Americans uninsured.)"- (page 46)
The United States has increased spending in health care, yet the quality of the medical care has decreased according to surveys and statistics. Most of this is due to many factors dealing with envy and socialism. It is known that primary care medicine is vital and indispensible for a nation's good health. Nations with good and excellent health care have multiple primary care physicians. Almost 50% of physicians in countries with excellent healthcare are primary care physicians and not specialists (compared to less than 30% in the US). In the United States, there are more specialists than primary care doctors since socialist medical mentality has disdained primary care for its long hours, decreased pay, and the manner that primary care actually allows for preventative medicine to be practiced. Preventative medicine prevents chronic disease from becoming worse disease. (Specialists are still needed in countries with good healthcare, yet primary care physicians are actually given importance, respect, and are seen with admiration for preventing chronic disease through the patient-doctor visit.) The socialists in the US since the 1980s have attempted to portray primary care as "insignificant", low paying, too much work, and inane while giving positive support of other specialties. Younger doctors since the 1980s were discouraged from being primary care physicians while being led to high paying specialties creating a limited amount of primary care physicians. Less primary care physicians means less preventative care. Less preventative care means more chronic diseases. More chronic diseases means more spending on health care.) Do socialists prefer instructing preventative care or allowing for less preventative care and more chronic disease? Socialists prefer chronic disease and disdain preventative care. That is why primary care has been disdained by socialists in the US since the 1980s.
There is also the manner that medicine is a practice that has increased litigation also since the 1980s. This is because socialists want patients and doctors to be hostile to each other instead of being partners in the improvement of health. Socialists wanted patients and doctors to be in conflict instead of working together. This has been seen in how litigation increased in the medical field causing doctors to order unnecessary testing based on patient requests or in order to prevent a negative patient visit to prevent litigation (this makes sense of why unnecessary tests and treatments have caused for medicine to increase in costs. Can not blame the physicians for this and rather can blame socialism (monopoly "capitalism"). The socialists probably caused for litigation to be seen in medicine after causing the decreased patient visit times from 30 minute to an hour visits prior to 1980 to 15 minutes.) Instead of only ordering needed tests and treatment, doctors had to order unnecessary tests in order to prevent litigation rather than not order tests. Litigation in medicine is from socialism. (Yet at the same time in 2019, pharmaceutical companies did not want individuals to litigate against pharmacutical companies and faulty covid experimental "vaccines".)
Another cause of increased spending in medicine while causing decreased quality of care has been the manner that pharmaceutical medications have been seen as the solution to everything. Instead, preventative care is more important to preventing disease. Expensive, newer, and brand name medication has caused increased costs in medical care. Part of the high cost of medicine is due to expensive medication that is not better than generics. Medicare also helped pharmaceutical companies prescribe newer and more expensive medication instead of generics in the 2000s. Dr. Abramson described how some of the dangerous medications (Pravachol, Lipitor, Vioxx, Celebrex, Actonel, and Fosamax) were among the most prescribed to medicare recipients instead of generic medication. Even tax payers had to pitch in to pay for expensive bad meds in the 2000s. The newer and more expensive bad medications may have also caused strokes, heart attacks, osteoporosis, and falls that also increased medical costs while not increasing quality of care. This describes why medical care has decreased in quality while increasing in cost.
This is also with the understanding that there is no universal healthcare in the US. Instead there are faulty covid experimental "vaccines". Not the best of times.