ANOTHER (Hundred) Billion Dollar Medical SCAM
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2017-11-04 07:00 by Karl Denninger
in Personal Health , 338 references Ignore this thread
ANOTHER (Hundred) Billion Dollar Medical SCAM
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Stents are little mesh things that are inserted into an artery that has become plugged to "expand" it and hold it open. They've never made sense to me on a basic physiological level unless they were utterly necessary; you are inserting a foreign material into the body, which will provoke an immune response.  Further, like so much of medicine, they treat symptoms rather than causes -- that is, they "force open" a clogged artery that got that way due to inflammation but do exactly nothing about the cause of the clog in the first place, which occurred due to inflammatory response.

This doesn't mean there aren't arguments for their use under very specific circumstance.  If you just had a heart attack, for example, and there's no good graft available to replace the bad arterial section from your body, then there's a decent argument for forcing open the artery that's already there -- since the alternative, if you do nothing, is death by myocardial infarction.

But that's not what the cardiac "doctors" have restricted these things to.  No, they will use them on anyone who complains of angina (heart pain) and shows evidence of narrowing of the cardiac arteries.

The argument for this rests on two pillars:

  • Forcing open the artery will likely prevent a heart attack (very good, if true)
    and
  • Improving circulation will reduce or eliminate angina (heart pain.)

Of course no surgery is without complication risk.  The risks of inserting these stents include creating blood clots which, if they break free, will cause a heart attack or stroke.  Second, there's a risk of hemorrhage (bleeding) that can be extremely serious if it occurs, since the bleeding would be into the chest cavity.  In some people the procedure kills them outright.

And finally, of course, there's another problem: These damn things are expensive, with the typical cost of having one put in you running from $10,000 to more than $40,000 each.

As time has gone on, however, there have been a number of studies that have shown no material decrease in risk of heart attack or stroke for someone who hasn't already had one.  That is, their value in prophylaxis (prevention) of heart attack or stroke appears to be either zero or negative.  This is probably because they cause some number of these events due to the complications and that balances out the events they prevent.

This leaves you with the alleviation of angina as the major indication for their use in those who have not had a heart attack.

Well, that just went poof like a fart in a church.

When the researchers tested the patients six weeks later, both groups said they had less chest pain, and they did better than before on treadmill tests.

But there was no real difference between the patients, the researchers found. Those who got the sham procedure did just as well as those who got stents.

This study was very well-designed.  The patients both underwent a procedure, but in the case of the ones who didn't get a stent the procedure was a sham.  In other words you went in the OR, they threaded in the catheter to place the stent but then didn't do it and withdraw the catheter without placing anything.  Of course the doctor placing the stent or not knew which was which but neither the researchers or the patients did.

There was no statistical difference in objective treadmill performance nor reported pain levels between the two groups.

So what we have here is a "procedure" that is done on lots of people who complain of chest pain and have a coronary scan that shows some obstruction, costs tens of thousands of dollars for each person involved and yet objectively the procedure is worth exactly zero.  In fact, it's worse than zero because it kills some percentage of the people who undergo it.

Those who argued for and got approved these "treatments", and who profited from same, without first demonstrating objective improvements need to have all of the revenue gained by same clawed back, returned to the patients and/or anyone else (including the government if Medicare or Medicaid was involved) who paid for them and then everyone involved must go to prison.  That includes the doctors, the hospitals and the device manufacturers.

Of course you know that won't happen, any more than it will happen to those who have argued repeatedly to eat lots of "fast carbs" and no saturated fats, which was known decades ago to be demonstrably bad advice yet it was pushed at the urging of both the food and medical industries.  Said "advice" has killed tens of millions of people in the United States alone and currently runs the government (through Medicare and Medicaid) roughly $400 billion a year, never mind the deaths and illness.

As information continues to come out the picture becomes more and more-clear, as I've been talking about now for nearly a decade in these pages.

The vast majority of our medical spending is a scam; it either results from price-fixing and other monopolist behavior that is specifically illegal under federal law or, far worse, it consists of useless and even harmful "treatments" that cost billions and take, rather than saving lives.

Were we to put a stop to this crap the entire federal budget deficit would instantly disappear and be replaced by a moderate surplus, which would immediately and permanently cause the purchasing power of your money to rise rather than fall as it does now.  Not only would everyone (other than the scammers in the medical field, of course) be richer you'd be healthier and less-likely to die at the hand of one of these jackasses at the same time.

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Comrader
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a few years ago my mother-in-law was in fairly decent health at 82. after a physical she was sent for a stress test at the local hospital where it was decided that she needed a stent put in that day, nothing serious we were told outpatient, couple of hours she will be fine. just like you said she had a blood clot go to the brain and caused a stroke. she never went home after that,spent the next year and a half in nursing homes unable to walk and communicate till she died. she was diabetic and followed the carb laden low fat diet that her doctor recommended. one of the many reasons that i stay as far away from doctors as possible
Lunatic_fringe
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Good article. We do many, many procedures simply because they make sense. Tests for detecting cancer early also fall into this category. People die at the same rate of cancer if it's detected early or later. Medicine claims that early detection provides benefits due to some statistical shenanigans:

The first is that the "survivor rate" is based upon lasting a certain period of time, generally 5 years. Your odds of surviving those 5 years go up if your cancer is caught earlier and you're considered a "survivor" even if you last 5 years and 1 day but succumb to your cancer.

The second is that often times something unusual is caught early and is considered cancer but may not have developed into actual cancer. An example of this is DCIS (Ductile Carcinoma in Situ), when an exam will find abnormal cells that may or may not turn into cancer yet the patient is often advised to go through cancer treatment that could include radiation, surgery and chemo. Several studies have shown that DCIS patients develop breast cancer at the same rate as the rest of women so there's no benefit to treatment or early detection, in fact there's only harm over the general population.

This is modern medicine - you are looked upon as a cash cow to be milked. Buyer beware.
Jfms99
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I have had skepticism about stents for a long time. A few years back there were the lawsuits and studies on coated and uncoated stents. While there may have been some people who benefited from them I always had questions on the Immune response to a foreign piece of matter inserted in one's body.

My own father at age 80 had heart bypass and valve replacement. It bought him another 13 years but in his late 80's he had to have two stents put in, so for him it was a great help. At the end he had heart failure but he had those extra 13 years and it was great.

I agree with you Karl that overall the stent debate needs to be fully aired.
Flyanddive
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Is it possible to get rid of CAD once you have it? I always thought it was a genetic thing, and the drugs were a scam, i.e. Lipitor.

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Analog
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while i don't doubt there are some unnecessary stent installations

Mine in May gave immediate and marked improvement. I had it done in Denver because my local doc feared to tread where the blockages were and told me to find a "High Risk Interventionist".
So i did, and he did his magic with me on only a 'happy happy joy joy' shot.
We chatted the whole time and i watched it on the giant screen . Took five stents to open up LAD (80% blocked) and Circumflex(90%) .
Next afternoon i walked a mile to the grocery store , didn't even breathe hard and mind you this was at Denver altitude.

So they can provide at least temporary relief.

My carb intake isn't zero but it's down 90% from two years ago . A sandwich with bread about once a week, pizza less than once a month. No pasta for a year now.. But an apple a day.

I'm told i have " an inordinate amount of CAD" - so i'll know in a couple more years if it's reversible by diet and exercise.

a.

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Johnnyb
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A great book that all here would enjoy is "Overdiagnosed" by Gilbert Welch.

I once had a doctor suggest I needed a stent after a stress test. I politely declined. That was over a decade ago. I've never had problems.
Bobbyk
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I'm 62, 148#, been on a LCHF lifestyle for 3 years and one Sunday last year I started getting angina on my daily bike ride. Monday called a recommended GP, got in Tuesday as a new patient, saw a cardiologist Thursday for an evaluation, had the latest drug eluting stent put in Saturday after he found a single 95% block in my proximal LAD (the widow maker) and after a night in a private ICU room was home Sunday and have been pain-free doing vigorous exercize ever since. Total cost 8k cash. I live in Thailand.
Tickerguy
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Despite writing articles for 10+ years here, and pointing out repeatedly that the plural of anecdote is not "data", every time something like this comes up that's the exact argument a huge percentage of commenting parties make.

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Analog
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Sorry KD , i forgot to finish the post.

Mine was billed somewhere north of 90 K, Medicare adjustments cut it to about 10% of that and they paid it. Supplemental paid all but my $20 co-pays.

Former employer's insurance allowed typically 50% , paid 40% leaving me responsible for 10%, which is about all it should have cost to begin with ! .

So it's a fact , as you say, for working folks it's overbilled tenfold and settled four or fivefold. Insurance/medical complex split that overpayment which is drawn from the 'protection money' we all pay.

Medicare pays providers less but pays them quickly. I suppose that's why it's still widely accepted.

a.

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Tickerguy
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Quote:
Medicare pays providers less but pays them quickly. I suppose that's why it's still widely accepted.

Note that any facility or provider can CLAIM that Medicare's payment is under cost, because the law requires their payment schedule not be. But, if they do so they'll get audited.

There have been multiple attempts to make that sort of claim, ESPECIALLY with lab work -- and gee, Medicare's pay schedule doesn't seem to go up all that much. I wonder who wins those audits? smiley

You hear this crap all the time in the media from various medical providers, but the fact is that it's a lie -- and one that, since it's used to try to get more money, ought to be directly prosecuted by State AG offices (never mind federal) as an act of criminal fraud.

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Analog
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And as you and i have both said

The symbiotic paperwork empires in medical billing and insurance industries are like those 'Alien' larvae that eat you from the inside..

https://www.ncbi.nlm.nih.gov/pmc/article....
Quote:
BIR (Billing and Insurance Related) costs in the U.S. health care system totaled approximately $471 ($330 $597) billion in 2012.

"Hundred billion here and hundred billion there , soon you're talking real money."

Ever been to a healthcare billing industry trade show ? They're an eye opener. My reaction was "We're supporting all this ? "

https://www.hbma.org/meeting_calendar/

a.

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Analog
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Quote:
...the law requires their(Medicares's) payment schedule not be. (less than cost)
??

Thanks KD i didn't know that.

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Spazzoidal
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Flyanddive,

CAD is from eating carbage. Stop eating it, exercise, and look up taking vitamin K2.

I believe it is reversible over time if you are diligent.

Truthseeker
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Spazzoidal,

That is not only incorrect, it is precisely the opposite of true. Cabbage, and all of the vegetables in the cruciferous family are foods directly related to artery health and the reversal of CAD.

Sulphorafane, a natural substance found in all cabbage-family vegetables, activates the protein Nrf2, the body's protective mechanism against CAD.

So, Flyanddive, eat your cabbage (and bok choy, arugula, kale, broccoli, brussel sprouts, cauliflower, and collard greens) EVERY DAY. They all go great with a nice, juicy steak. (And don't bother trimming the fat.)

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"...But people better realize that the worst-case scenario could actually happen.9/11 happened. This can happen. An economic 9/11, the likes of which we've never seen." Gerald Celente
Tickerguy
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I think he meant "garbage", not "carbage" smiley

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Truthseeker
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Excellent.

A more complete cruciferous list:
Arugula
Bok choi
Broccoli
Broccoli rabe
Broccoli romanesco
Brussels sprout
Cabbage
Cauliflower
Chinese broccoli
Chinese cabbage
Collard greens
Daikon
Garden cress
Horseradish
Kale
Kohlrabi
Komatsuna
Land cress
Mizuna
Mustard seeds and leaves
Pak choi
Radish
Rutabaga
Tatsoi
Turnips root and greens
Wasabi
Watercress

Some weeds are really good for you!


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"...But people better realize that the worst-case scenario could actually happen.9/11 happened. This can happen. An economic 9/11, the likes of which we've never seen." Gerald Celente
Ckaminski
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No, I'm pretty sure he meant carbage...

Pizza, pasta, rice, potato...

:-)
Tickerguy
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Those are the same word

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Oculust
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Karl pointed out an article some years back noting that arterial blockages start on the *outside* of blood vessels, as an immune reaction to inflammation.

Well, now they seem to have found a culprit:


Quote:

"Bacterial fats, not dietary ones, may deserve the blame for heart disease:
Research could explain why gum disease is associated with atherosclerosis"
https://www.sciencedaily.com/releases/20....

"For a very long time, doctors and researchers assumed that the lipids came from eating fatty, cholesterol-rich food. But the research hasn't borne this out; some people who eat large amounts of the foods we thought were the sources of the fat, such as eggs, butter, fatty fish, and meat, don't necessarily develop heart disease.

UConn researchers believe they may have solved part of the puzzle. Using careful chemical analysis of atheromas collected from patients by a colleague at Hartford Hospital, they found lipids with a chemical signature unlike those from animals at all. Instead, these strange lipids come from a specific family of bacteria."
...
"The marked chemical differences between Bacteroidetes lipids and the human body's native lipids may be the reason they cause disease, suggests Nichols. The immune cells that initially stick to the blood vessel walls and collect the lipids recognize them as foreign. These immune cells react to the lipids and set off alarm bells.

Nichols and Yao's team also showed that despite being non-native lipids, the Bacteroidetes lipids could be broken down by an enzyme in the body that processes lipids into the starting material to make inflammation-enhancing molecules. So the Bacteroidetes lipids have a double whammy on the blood vessels: the immune system sees them as a signal of bacterial invasion, and then enzymes break them down and super-charge the inflammation."

http://www.jlr.org/content/58/10/1999


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