by Jessica Fraser
America was rudely awakened to a new kind of danger on September 11, 2001: Terrorism. The attacks that day left 2,996 people dead, including the passengers on the four commercial airliners that were used as weapons. Many feel it was the most tragic day in U.S. history.
Four commercial jets crashed that day. But what if six jumbo jets crashed every day in the United States, claiming the lives of 783,936 people every year? That would certainly qualify as a massive tragedy, wouldn't it?
Well, forget "what if." The tragedy is happening right now. Over 750,000 people actually do die in the United States every year, although not from plane crashes. They die from something far more common and rarely perceived by the public as dangerous: modern medicine.
According to the groundbreaking 2003 medical report Death by Medicine, by Drs. Gary Null, Carolyn Dean, Martin Feldman, Debora Rasio and Dorothy Smith, 783,936 people in the United States die every year from conventional medicine mistakes. That's the equivalent of six jumbo jet crashes a day for an entire year. But where is the media attention for this tragedy? Where is the government support for stopping these medical mistakes before they happen?
After 9/11, the White House gave rise to the Department of Homeland Security, designed to prevent terrorist attacks on U.S. soil. Since its inception, billions of dollars have been poured into it. The 2006 budget allots $34.2 billion to the DHS, a number that has come down slightly from the $37.7 billion budget of 2003.
According to the study led by Null, which involved a painstaking review of thousands of medical records, the United States spends $282 billion annually on deaths due to medical mistakes, or iatrogenic deaths. And that's a conservative estimate; only a fraction of medical errors are reported, according to the study. Actual medical mistakes are likely to be 20 times higher than the reported number because doctors fear retaliation for those mistakes. The American public heads to the doctor's office or the hospital time and again, oblivious of the alarming danger they're heading into. The public knows that medical errors occur, but they assume that errors are unusual, isolated events. Unfortunately, by accepting conventional medicine, patients voluntarily continue to walk into the leading cause of death in America.
According to a 1995 U.S. iatrogenic report, "Over a million patients are injured in U.S. hospitals each year, and approximately 280,000 die annually as a result of these injuries. Therefore, the iatrogenic death rate dwarfs the annual automobile accident mortality rate of 45,000 and accounts for more deaths than all other accidents combined." This report was issued 10 years ago, when America had 34 million fewer citizens and drug company scandals like the Vioxx recall were yet to occur. Today, health care comprises 15.5 percent of the United States' gross national product, with spending reaching $1.4 trillion in 2004.
Since Americans spend so much money on health care, they should be getting a high quality of care, right? Unfortunately, that's not the case. Of the 783,936 annual deaths due to conventional medical mistakes, about 106,000 are from prescription drugs, according to Death by Medicine. That also is a conservative number. Some experts estimate it should be more like 200,000 because of underreported cases of adverse drug reactions.
Americans today are used to fixing problems the quick way – even when it comes to their health. Thus, they rely heavily on prescription drugs to fix their diseases. For every conceivable ailment – real or not – chances are there's a pricey prescription drug to "treat" it. Chances are even better that their drug of choice comes chock full of side effects.
The problem is, prescription drugs don't treat diseases; they merely cover the symptoms. U.S. physicians provide allopathic health care – that is, they care for disease, not health. So, the over-prescription of drugs and medications is designed to treat disease instead of preventing it. And because there are so many drugs available, unforeseen adverse drug reactions are all too common, which leads to the highly conservative annual prescription drug death rate of 106,000. Keep in mind that these numbers came before the Vioxx scandal, and Cox-2 inhibitor drugs could ultimately end up killing tens of thousands more.
American medical patients are getting the short end of a rather raw deal when it comes to prescription drugs. Medicine is a high-dollar, highly competitive business. But it shouldn't be. Null's report cites the five most important aspects of health that modern medicine ignores in favor of the almighty dollar: Stress, lack of exercise, high calorie intake, highly processed foods and environmental toxin exposure. All these things are putting Americans in such poor health that they run to the doctor for treatment. But instead of doctors treating the causes of their poor health, such as putting them on a strict diet and exercise regimen, they stuff them full of prescription drugs to cover their symptoms. Using this inherently faulty system of medical treatment, it's no wonder so many Americans die from prescription drugs. They're not getting better; they're just popping drugs to make their symptoms temporarily go away.
But not all doctors subscribe to this method of "treatment." In fact, many doctors are just as angry as the public should be, charging that scientific medicine is "for sale" to the highest bidder – which, more often than not, end up being pharmaceutical companies. The pharmaceutical industry is a multi-trillion dollar business. Companies spend billions on advertising and promotions for prescription drugs. Who can remember the last time they watched television and weren't bombarded with ads for pills treating everything from erectile dysfunction to sleeplessness? And who has ever been to a doctor's office or hospital and not seen every pen, notepad and post-it bearing the logo of some prescription drug?
Medical experts claim that patients' requests for certain drugs have no effect on the number of prescriptions written for that drug. Pharmaceutical companies claim their drug ads are "educational" to the public. The public believes the FDA reviews all the ads and only allows the safest and most effective drug ads to reach the public. It's a clever system: Pharmaceutical companies influence the public to ask for prescription drugs, the public asks their physicians to prescribe them certain drugs, and doctors acquiesce to their patients' requests. Everyone's happy, right? Not quite, since the prescription drug death toll continues to rise.
The public seems to genuinely believe that drugs advertised on TV are safe, in spite of the plethora of side effects listed by the commercial's narrator, ranging from diarrhea to death. Patients feel justified in asking their physicians to prescribe them a particular drug they've seen on TV, since it surely must be safe or it wouldn't have been advertised. Remember all those TV ads heralding the wonders of Vioxx? One might wonder how many lives could have been spared if patients didn't see the ad on TV and request a prescription from their doctors.
But advertising isn't the only tool the pharmaceutical industry uses to influence medicine. Null's study cites an ABC report that said pharmaceutical companies spend over $2 billion sending doctors to more than 314,000 events every year. While doctors are riding the dollar of pharmaceutical companies, enjoying all the many perks of these "events," how likely are they to question the validity of drug companies or their products?
Admittedly, not all doctors reside in the pockets of the pharmaceutical companies. Some are downright angry at the situation, and angry on behalf of an unaware public. Major conflicts of interest exist between the American public, the medical community and the pharmaceutical industry. And although the public suffers the most from this conflict, it is the least informed. The public gets the short end of the stick and they don't even know it. That is why the pharmaceutical industry remains a multi-trillion dollar business.
Prescription drugs are only a part of the U.S. healthcare system's miserable failings. In fact, outpatient deaths, bedsore deaths and malnutrition deaths each account for higher death rates than adverse drug reactions. The problems run deep and cannot be remedied without drastic, widespread change in the system's money and ethics.
The first issue – money – is the main reason the medical industry cannot seem to change. Prescribing more drugs and recommending more surgeries means more profits. Getting more drugs approved by the FDA, regardless of their safety, means more money for the pharmaceutical industry. As the healthcare system stands today, physicians and drug companies can't seem to pass up earning loads of money, even if a few hundred thousand people lose their lives in the process. Even in drastic cases of deadly drugs, everyone involved has a scapegoat: Drug companies can blame the FDA for approving their product and the doctors for over-prescribing it, and doctors can blame the patients for wanting it and not properly weighing the risks.
What ultimately arises is a question of ethics. In layman's terms, ethics are the rules or moral guidelines that govern the conduct of people or professions. Some ethics are ingrained from childhood, but some are specifically set forth. For example, nearly all medical schools have their new doctors take a modern form of the Hippocratic Oath. While few versions are identical, none include setting aside proper medical care in favor of money-making practices.
On the research side of the issue, "Death by Medicine" cites an ABC report that says clinical trials funded by pharmaceutical companies show a 90 percent chance that a drug will be perceived as effective, whereas clinical trials not funded by drug companies show only a 50 percent chance that a drug will be perceived as effective. "It appears that money can’t buy you love, but it can buy you any 'scientific' result you want," writes Null and his team of researchers.
The government spends upwards of $30 billion a year on homeland security. Such spending seems important. Since 2001, 2,996 people in the United States have died from terrorism – all as a result of the 9/11 attacks. In that same period of time, 490,000 people have died from prescription drugs, not counting the Vioxx scandal. That means that prescription drugs in this country are at least 16,400 percent deadlier than terrorism. Again, those are the conservative numbers. A more realistic number, which would include deaths from over-the-counter drugs, makes drug consumption 32,000 percent deadlier than terrorism. But the scope of "Death by Medicine" is even wider. Conventional medicine, including unnecessary surgeries, bedsores and medical errors, is 104,700 percent deadlier than terrorism. Yet, our government's attention and money is not put into reforming health care.
Couldn't a little chunk of the homeland security money be better spent on overhauling the corrupt U.S. healthcare system, the leading cause of death in America? Couldn't we forfeit the color-coded threat system in favor of stricter guidelines on medical research and prescription drugs? No one is attempting to say that terrorism in the world is not a problem, especially for a high-profile country like the United States. No one is saying that the people who died on 9/11 didn't matter or weren't horribly wronged by the terrorists that day. But there are more dangerous things in the United States being falsely represented as safe and healthy, when, in reality, they are deadly. The corruption in the pharmaceutical industry and in America's healthcare system poses a far greater threat to the health, safety and welfare of Americans today than terrorism.
If the Bush Administration really wants to save lives — a lot of lives — it needs look no further than the chemical war has been declared on Americans by Big Pharma.