At A Time When 47 Million People Have No Health Coverage, A Story About Being Insured To Death.

You might think that a dedicated liberal such as myself would be spending his time writing about those people in our country with no health insurance, perhaps exploding the myth that the uninsured really do get the care they need. Well you know what? You'd be wrong. Today I'm just a little tired of hearing poor people whine about losing a leg to diabetes while the real victims of our health care system suffer silently. I ask you, who is looking out for the golf-course set? Not the people who walk around while playing golf mind you, but those who ride around in the little electric carts to get their exercise? Who will right the injustice piled upon those who feel no need to yell out "FORE!" to warn others of their errant balls, secure in the knowledge that should their inconsideration result in someone kicking their ass, the resulting medical bills will not be the slightest inconvenience?

The drugmonkey, that's who.

Today I share a tale of anemia, overtreatment, and death. Anemia, a condition characterized by a lower than normal number of red blood cells circulating in a person's blood, left untreated can make a person so lethargic they are practically unable to move or think. Based on this, I think 98% of my customers may have anemia. The condition has been treated since 1989 with a drug called epoetin, sold under the brand names Epogen and Procrit. Proper treatment with the med can make a big difference in people's lives, and does for nearly a million people in the US every year. Yay.

Thing is, according to the New York Times, "The amount of epoetin received by the typical American dialysis patient has nearly tripled since the early 90's." Obviously there must be a good reason for that you must be thinking. Maybe like there's lots of data to show that higher doses lead to better outcomes. You would be wrong. There was no data to support these doses for over 10 years, and when someone finally did decide to see what their effect was they found people receiving higher doses of epoetin were 34 percent more likely to die or suffer heart problems then people receiving a lower dose.

This "dose inflation" by and large did not happen in Europe, where around 15 percent of kidney dialysis patients die every year, compared to 22 percent here. USA!... USA! ...USA!

So why on earth would doses of epoetin go higher and higher with no evidence that it's actually helping anyone? The drugmonkey has two possible explanations.

1) A healthy adult man has about 14 grams per deciliter of hemoglobin (red blood cell stuff) in their blood, and even though 10 to 12 grams is sufficient for dialysis patients, doctors have decided over time that matching the lab results for the average man should be better for patients.

OR

2) From the Times article:

...patients may be receiving too much epoetin, in part because dialysis clinics make bigger profits for providing larger doses. Studies show that the clinics make little, if any, profit on the actual dialysis services they provide for Medicare patients, who are the vast majority of patients.

I'll let you decide which is more likely. While you're pondering it over, ask yourself what would have happened if dialysis clinics made less money by giving higher doses.

So on one hand, we have an estimate that lack of health insurance is the third leading cause of death among this country's near elderly. On the other, we have kidney patients being pumped full of meds at doses higher than they need, doses that could very well be harming them, in order to support our for-profit health care system. And for some reason, you are supposed to be afraid of the words "socialized medicine." You are literally being scared to death America. Wake up.

Read more here and here.