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John Abramson – Overdosed America

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The medical profession which John Abramson writes about in Overdosed America does not resemble a Norman Rockwell painting in any way. The current state of affairs is rather more dangerous and damaging – for both Americans’ health and their pocketbooks – than even your family doctor may realize. Overdosed America charts how this state of affairs came about, what the costs have been in both dollars and lives, and what Abramson, a practicing physician and teacher at Harvard, sees as the best case scenario to fix current problems and reform the system to meet current and future needs.

Where the book really shines is in Abramson’s detailed chapters exploring how the medical industry has, since World War Two, valued profits over lives when developing treatments for everything from menopause to heart disease. These chapters constitute the bulk of the book and have a tendency to feel long and dry, a problem for a book written for a lay audience. I fought the urge to skip ahead to the last three chapters, Abramson’s recommendations, mainly out of a perverse desire to see how often the drug companies have defrauded and deceived the public. The facts disclosed here are truly stunning, and worth reading for shock value alone. But they also go a long way toward creating a fuller picture of the crisis in American health care.

Time and again Abramson painstakingly details the triumph of commercial interests over scientific evidence. As familiar as this refrain is to anyone familiar with the Bush administration, Abramson traces the beginnings of this state of affairs to the Food and Drug Administration’s 1942 approval of Premarin (estrogen) “for the treatment of symptoms associated with menopause.” (159) Wyeth-Ayerst still holds the patent for processing “PREgnant MARe’s urine” into a drug effective at relief of symptoms felt by a minority of women, which “last no more than two to five years.” (ibid.) Marketed as part of a hormone replacement therapy (HRT) to protect all women against the ravages of old age, over 20 million American women bought into this therapy. Effects of HRT included: a “66% higher chance of getting breast cancer,” a 50% increase in the risk of developing Alzheimer’s disease, and a 15% chance of suffering at least one “adverse event” – heart attack, stroke, blood clots, dementia, breast cancer, and so on – after five years of therapy. (ibid.)

Abramson discusses many other cases, all with the same bottom line: American pocketbooks are more important to the medical industry than American lives. If this doesn’t sound like an urgent problem in need of an immediate solution, next time you’re over at your grandparent’s house, open up their Reader’s Digest. About 40% of the advertisements are for new and popular drugs.

Abramson discusses in Part Three of the book alternatives to biomedical (drug and surgery) therapies, supporting options such as lifestyle counseling and increased exercise regimens with study after scientific study proving their effectiveness. This is not to the detriment of biomedical therapies, which he is careful to note are valuable in situations “from emergency surgery… to the treatment of strep throat.” (204) However, when the U. S. Centers for Disease Control and Prevention report that “‘half of all deaths that occurred in the United States in 2000 could be attributed to… largely preventable behaviors and exposures,’” it may be time to look beyond the latest and greatest and most expensive pill, and return to a little common sense and conventional wisdom.

Of course, the difficulty, which both doctors and patients face here, Abramson states, is that non-biomedical therapies are often strongly reliant upon behavioral changes. These behaviors – lifestyle choices – are more difficult to prescribe and adhere to. Just ask anyone who has tried to quit smoking.

Further, the extent to which the big drug companies are able to influence medical opinion reminds one of the great investigative journalism of the American press. Abramson writes “experts with financial ties to the drug companies dominate the FDA’s Advisory Committees and the panels that write the clinical guidelines that define the standards of care for practicing doctors.” (250) As if it isn’t enough to control the testing and approval of new biomedical therapies, “the medical industry even funds the majority of doctors’ [required] continuing education.” (ibid.) This points toward a conflict of interest throughout the medical industry, but, as Abramson is right to point out, “the drug companies have no more responsibility to oversee the public’s health than the fast-food industry has to oversee the public’s diet.” (ibid.)

With that information, plus all of the other facts, figures, and recommendations that Abramson reports in Overdosed America, it will be obvious to any reader that America’s health care industry has become corrupt. Significant, long-term changes need to be made everywhere from medical school classrooms to drug company boardrooms. John Abramson’s report is an eye-opening look beyond that Norman Rockwell façade. The lesson he wants us to learn is that an apple a day is still the right dose.

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  • Bryce Eddings

    listed at Advance

  • Melisande

    glad to see more publically informative/industry critiques like this on the market. the drug cos are out of control, for sure. might grab a copy of this one myself. thanks for the info.

    m

  • Mark McConnell, MD

    I just finished reading John’s book…I have been practicing Internal Medicine for 18 years. About 10 years ago, I became aware of the increasing influence pharmaceutical companies seemed to have on (a) prescribing (b) “education” (c) the research agenda (that is, what gets studied) and (d) their impact on “guidelines”…the “rules” that advise doctors how to practice. I have become increasingly convinced of the validity of the truths John has so clearly articulated in his book and my personal belief is that if every physician and every nurse and every patient read his book we would see a dramatic reduction in the amount of medication used, the number of medical tests/treatments used and a subsequent reduction in the cost of healthcare; a cost more and more of us seem unable to afford. This book “rings true” to me in my experience as a physician. But I would caution activists: the medical community does not seem to receive this information well.

  • http://www.mothering.com/discussions/forumdisplay.php?f=47 Brenda Kaiser

    I just bought the book today. But this is not a new subject to me. We discuss comparable topics on MDC (see my URL).

    Our dialogue goes beyond what John’s book covers… we discuss the most offensive and widespread insult to the immune system – vaccines.

    Anyone who is interested in learning more, come and lurk a while or join us.

  • geerish pandiya

    Drug Industry has reduced most doctors to the status of glorified drug salespersons instead of what they should be–providing treatment and cure for the sick and the infirm people.And the tragedy is that they-the drug companies- are spreading this insidious practice to the rest of the world with the blessings of the Government

  • http://desertjazzman richard kopasek

    I have been healthcare for 34 years. The advent of the forprofit model. with large healthcare management companies such as Tenet,HCA,etc.Large insurance companies and health maintance companies and HMO’s. It’s all about big business,the bottom line,shareholders. Did you hear anything in there about patients! NO! Because that is not what healthcare is about today. We put all our money and resouces into the back end of life. It’s a fact that we use our intensive care units and acute care hospitals today to keep the dead and dying alive,in there last 30 days to a year.On lifesupport,tons of medications. But this is the american way. Keeping muliorgan failure patients alive on life support or a end stage lung disease patient alive to smoke again. Costing this country billion of dollars and just a huge amount of resources. Again it is sad the richest country in the world can not provide basic healthcare for its children. Teaching them good health and making them responsible for there choices that they make in how they live there life.
    We as Americans do not die with dignity with grace. I don’t know if Dr. Abramsons book states this fact but healthcare is somewhere between 15% and 18% of ourGNP. This is disgraceful. And we have almost 48 million americans unisured in this country. ABC did a program on 12/15/05 it was Peter Jennings last documentary that he filmed before he himself was diagnosed with lung cancer. The program was called Breakdown: America’s Health Insurance Crisis! It was excellant. Peter did a great job with the alotted time limit of one hour. For such a huge problem in this country. You can order the program at abcnewsstore.com. Anoter book which is helpful is Kevin Trudeaus Book Natural Cures. And John Robbins books Diet for a New America and a May All Be Fed-Diet For A New World. Peace!

  • Jason Paras

    When has the last cure for a major disease? found?And why has not there been more in 50 yrs. or so?

  • http://mybenefitsplus.com/tpishdad Cynthia Watkins

    OT – I agree with Richard Kopasek, Mr. Peter Jennings did great job documenting the health insurance crisis in America today.

    I believe Mr. Jennings’ intent for this first of several documentaries, was to voice the need for Americans to WAKE UP!!!

    I do not believe that socialized health care or national health plans are viable solutions to this crisis. In my view, that would be like putting a band aid on an abscess. The solution is changing how we receive health care benefits in America today. As was mentioned in the Peter Jennings Report, Consumer Driven Health Care — where the health decisions are put back in the hands of the patient and doctor thus eliminating decisions by disinterested people (insurance companies) is a sound solution many businesses are now turning to. I’d have to watch the report again, but I believe the segment on “Whole Foods Market” was where this was discussed. My parent company has been a leading advocate of this form of health care since 1992. We offer an affordably priced, non insurance package that has evolved to include medical, dental, vision, prescription drug and chiropractic benefits. We believe a discount fee-for-service package partnered with the use of a Health Savings Account and a High Deductible, or Catastrophic, Health Plan is the future. That’s why I’m excited about telling people about our benefits so that they can get the care they need without “Big Brother” or anyone else, saying “yea” or “nay”, or the overpriced cost. Our parent company was founded by people with a health insurance background who noticed that traditional health insurance wasn’t working for a huge segment of our society. They were determined to come up with a product that would — and they did. If $59.95 per month for an entire household sounds too good to be true, all I ask is for you to do your due diligence and get more information from my website. [Deleted]

  • dennis j. cleary

    I don’t trust doctors except in emergencies. I always search for second opinions or read info on the Internet than make a decision of belief. I know doctors, who are acquaintances, who get money, checks, trips, and other perks from drug companies on a regular basis. It’s like a don’t tell, don’t show policy, but everyone knows what’s going on.

    The other real issue related to Abramsom’s book is the issue of death. If drug companies are killing people by withholding information from the public who use their products isn’t it first or second degree murder?

    Just watch television from 5-7PM every night and watch the drug ads targeted to retired people using fear and cached language. Most people I know take 4-5 drugs from sleep disorders to giggly legs to heartburn all based on fear or else.

    Then there’s the FDA, the handmaiden-consort to the drug industry where researchers suddenly retire or quit the FDA and get big jobs with the drug companies. Isn’t this a type of fraud or deception of the American people? Why aren’t researchers who participate in these false studies and the executives of the FDA who formulate and approve the final drug study results being arrested for their abuse and even death of Americans? Apparently the White House has no interest, but where are the public interest lawyers and the Attorney Genereals of teh federal and state levels?

    Enough is enough. I have little respect for many doctors and their Oath of Hypocrisy!

  • anne

    Overdosed Amercia is the most important books out there….everybody read it and pass it on to everyone around you!!!! corrupt drug companies!