Monday, May 4, 2009

C R A P may explain rising health care costs?

This is just my take on this informative article at Junkfood Science. But could it actually be the nocebo effect that has millions of people thinking they are sick, running to the doctor, and demanding that doctors test and test and test to find/rule out every disease/risk of disease that's reported by mainstream media and that is raising the cost of health care across the board for everyone?
A financial publication isn’t a place you might expect to find an insightful article on health, but Financial Times proved the exception. Last weekend, Stuart Blackman explored how seemingly helpful educational health messages can be bad for our health. In fact, they can lead us to believe we are unhealthy and to actually feel quite unwell.

I've known people who, the minute they hear about a new disease/condition, start looking to see how many of the symptoms for that disease/condition they have. Then they run right out to their doctor and demand to be tested for it and then medicated for it, whether they actually have said disease/condition or not. They used to be called hypochondriacs.
His article, “Why health warnings can be bad,” began by describing the nocebo effect. That’s the powerful phenomenon of developing the most extraordinary physical symptoms when we believe or fear that something is bad for us. It’s the negative stepsister of the placebo effect and the full significance of both isn’t understood by many people. The nocebo effect is behind the confirmation for most food fears, for example. People who’ve been taught to believe certain foods are bad for them actually feel sick, experiencing such things as headaches, chest pain, nausea and indigestion, rashes, cough, congestion, weakness and fatigue, and even paralysis when they believe they’ve eaten them. It’s the stepsister of the placebo effect, at work when we feel healthier after eating foods or taking dietary supplements we believe are healthy.

How much of the blame here really lies with the patients and how much of it can be laid at the feet of the medical and pharmaceutical companies? After all, if researchers weren't out looking for more ways to use more drugs on more people to make more money, I would venture to say that most of the people who are diagnosed with this, that, or the other disease (in order to cover the doctor's ass in this litigious society of ours) would do perfectly fine without those drugs.
As Arthur Barsky, professor of psychiatry at Harvard Medical School, said, when “you induce negative expectations – whether it’s through a pill, a health warning or advertising by a drug company – you set in motion the same process of symptom reattribution, which then amplifies the symptom, which further solidifies the reattribution.”
According to John Adams, professor emeritus at University College London and Britain’s leading risk expert and author of Risk, a major contributor to our negative expectations is the popular trend among health professionals and health agencies to issue precautionary advice concerning health risks, even when there is no evidence for any credible risk to people’s health. He labeled it a “syndrome” he calls C.R.A.P.

Yeah, living is risky all right, everything we do on a daily basis has some element of risk to it. Hell, just getting in and out of the shower can cause severe injury and/or death if you slip and fall just right. You risk injury/death every day when you leave your house, get in your car, and drive to work/school. You risk injury/death every time you play sports, exercise, take the stairs, take the elevator, or even eat a meal (choking on a piece of food can be deadly if no one around you notices or knows how to do the Heimlich maneuver). Life is a risk, from the cradle to the grave, and none of us get out of it alive or in perfect health.
You really should go give this article a read. I'm not saying that there are people who don't have things like chronic fatigue/fibromyalgia/severe back pain/etc that they deal with on a daily basis and don't go away after a couple of days or a week. Those things do exist and do need diagnosing and treatment, and not blame. But because of this cover your ass mentality and unrealistic expectations of perfect health that everyone is supposed to have, medical costs are rising and it's not the created "obesity epipanic" that is causing those increases, but all of the media hype about all of the so-called "dangerous" foods/additives/diseases that are going to kill us if we don't do something about them soonest. Doesn't matter that we're living longer lives, and are able to do more in our "golden years" than ever before, or that more people are living to see those "golden years". In addition to all of that, no one must ever get sick from anything, never have any kind of physical problem with their bodies, and must maintain for the rest of their lives the optimum level of health that the ideal 18 year-old has. Talk about unrealistic expectations, especially in the face of researchers finding all kinds of genetic markers for diseases we may never get, but are at risk of getting (even if it's a snowball's chance in hell) and must be medicated for, just in case. Add to all of that the lowering of diagnostic standards for things like diabetes, high blood pressure, and high cholesterol, and you have a health care system running roughshod over you, demanding that you treat these diseases, even when you don't have any symptoms, demanding that you make lifestyle changes that may or may not do any good, demanding that you take medications that may or may not do any good (and whose side effects could be worse than the disease you're trying to treat that you might not even really have) and that sounds like a recipe for disaster. Are we there yet? If not, I think we're pretty damned close.


  1. Ugh, the nocebo effect is exactly why they release new diseases and flus and epidemics all the time. If it's not Bird Blue, it's SARS, or obesity, or more recently, the Swine Flu. The point is to get everyone afraid of other people, and constantly in fear of something or other.

    If only because fear distracts us from bigger picture things, like discrimination(of ANY kind) or governmental policies we normally wouldn't accept. If anything, fear makes us more quick to accept scapegoating, leading to discrimination or putting our heads in the sand.

  2. Sadly, I have to admit that I have fallen for the nocebo effect. I have a touch of anxiety disorder and used to get panic attacks a few times a year whenever I "overthought" things that I percieved were going on with me. Having mild asthma contributed greatly to that mindset as well.

    Suffice it to say, middle age has brought wisdom that can now usually
    talk me off the ledge, so to speak.

    My health insurance company keeps calling me to sign me up for "free" enrollment in their health maintenance program. Basically, they want me to receive my medications by mail order so that I can "save" a copay ($25). The bullshit of it all is that my doctor's have given the green light on reducing my medication so that I can ultimately go off them altogether if my lungs respond favorably. So if I enroll, I am stuck with months and months of medicines I won't need, just so my insurance company can pay for them from a cheaper supplier. Insurance companies truly are the antichrist.

    That being said, the fuck of it all with this article is that it won't get the media attention it deserves so that people can actually start wising up about the fearmongering that is perpetuated throughout all forms of media. I don't even watch the news anymore because the fear frenzy pushed way too many of my buttons. The reality is, medicine is mostly about labeling things. Sanitary living has done more for the health and longevity of individuals than most medicines out there. The fear hype is just to cover their asses in case the shit their peddling fails to work.

  3. I haven't been following you blog for the past few months (computer got stolen and never really caught up). but my mum has just started saying her doctors are pressuring her to have a gastric band fitted to cure her type 2 diabetes and I thought I remembered you writing about such things and I was wondering if you could reccommend anything for me to send her other than your links down the side? Sorry to jump on an unrelated post, but I really want to help my mum.

  4. pola-bear - Sandy at JFS has a post on WLS that, near the bottom, talks about WLS "curing" type 2 diabetes. You can see it here.
    I know I did a post on it too, but I can't remember exactly when it was. I'll look through my archives and see if I can find the post and I'll put the link to it in a comment here on this post.

  5. pola-bear, I found the post I did on WLS for type 2 diabetics, you can find it here. There's a link there to the one article I found referencing it.
    The problem I see with using WLS as a "cure" for type 2 diabetes is that it really doesn't cure the cause, which is the body's cells not being able to use the insulin produced to control blood glucose. Basically, all WLS does is lessen the total amount of food one can eat, which also lessens carbs, which would lower blood sugar. If that's all it takes, then all one should have to do in order to control blood sugars is quit eating most carb-containing foods, like Dr Bernstein recommends (less than 45 grams of carbs a day is his recommendation to keep BG low and minimize complications).


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