Thinking And Eating For Two: The Science of Using Systems 1 and 2 Thinking to Nourish Self and Symbionts

By Greg Maguire

In his book of good news for how to maintain optimal health throughout a long life, including during the times of a viral Covid-19 outbreak. Prof. Dr. Greg Maguire explains in this illuminating book how to avoid being over diagnosed and over treated by our dangerous medical system and the illnesses that the system often causes. The book covers the many failures of our medical system and the scientific basis for eating a whole food plant-based diet that will prevent and even treat our chronic diseases. Because our exposome, including our diet, accounts for 70-90% of chronic diseases, nourishing ourselves with a whole plant based diet can drastically reduce our need for medical diagnosis and treatment. Eating plants nourishes the self (host) as well as the host’s microbiome (symbionts such as bacteria); hence we are always eating for two. Without a healthy microbiome, the self cannot be healthy. The book emphasizes the need to understand foods as a system, and not just understand food in a reductionist manner as simply how the single microcomponents of the food act in isolation, and in acting on one part of the body. Rather, the complex interaction of the nutrient components, working synergistically, and how these nutrients affect the whole body, is how we need to understand food. You’ll learn, for example, that a plant based diet can help reset your innate and adaptive immune systems to reduce chronic inflammation and help remediate autoimmune diseases, and even help to prevent and treat cancer. And those practicing a high fat keto diet will learn not to do so given the many negative effects and few positive effects of the fat laden diet that is poorly understood by many. This book is written for the scientifically-inclined lay public, and physicians and healthcare providers, and offers a new way of thinking about nutrition using critical analysis of relevant scientific and medical studies with their references. In order to understand health and practice a healthy lifestyle, two types of thinking are required, Systems 1 and 2 thinking; hence the “thinking for two.” Systems 1 thinking is reactionary, automatic thought and Systems 2 thinking is deep thought used to understand something. New ideas learned using Systems 2 thinking can be made into Systems 1 thinking so that the new things learned can become automatic. As such, when using Systems 1 and 2 thinking, this book is not simply a prescription for diet, lifestyle, and healthcare, rather this book is a prescription for how to think about and analyze diet, lifestyle, and healthcare, using our simian Systems 2 brains to think well, and to eat well like a plant consuming haplorhine (primates who lost the ability to make vitamin C) to nourish self and symbionts. This updated edition contains a special section on how to best prevent and mitigate a Covid-19 infection caused by the Coronavirus SARS-CoV-2.

• Language: English
• Publisher: Greg Maguire
• Release date: Jan 26, 2020
• ISBN: 9780463131176

Greg Maguire

Dr. Greg Maguire, Ph.D., FRSM, pursued his graduate training at the University of California, Berkeley, University of Houston, University of Texas, The Marine Biological Labs, Woods Hole, MA, and Cold Spring Harbor Laboratory, NY. He is a former professor of neuroscience and ophthalmology at the University of California, San Diego School of Medicine, a visiting associate professor of physiology at Keio University School of Medicine in Tokyo, Japan, visiting assistant professor of molecular neurobiology at the University of Washington, former faculty at the Bascom Palmer Eye Institute, and a visiting scientist at Massachusetts General Hospital (MGH), at Harvard University. Awarded a prestigious Fulbright-Fogarty Fellowship from the National Institutes of Health, Dr. Maguire managed his NIH funded laboratory at UCSD studying tissue degeneration and regeneration, and the role of stem cell released molecules (SRM) through paracrine and autocrine actions to maintain, repair, and regenerate human tissues. His NIH funded studies of systems biology and reverse engineering at the University of California, Berkeley and stem cell biology at UC San Diego led to the development of adult stem cell-based S2RM® technology for the development of therapeutics. Dr. Maguire is a Fellow of the Royal Society of Medicine and has over 100 publications, multiple patents, and his book, “Stem Cell Released Molecules: A Paradigm Shift to Systems Therapeutics” was published by Nova Scientific Publishers of NY in 2018.

Book preview

Thinking and Eating For Two:

The Science of Using Systems 1 and 2

Thinking to Nourish Self and Symbionts

Greg Maguire Ph.D.

Copyright 2020

Berkeley Free Speech Press, License Notes

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Table of Contents

Ackowledgements

Introduction

Systems Nutrition

Prebiotics, Probiotics, and Postbiotics

Fiber and Health

Instituting Homeostatic Renormalization

Nutrients

Exposome (Including Coronavrus Covid-19)

Vitamins and Minerals, Supplements and Drugs

Conditions: Improving Bodily Functions, Incuding the Brain

Skin Disease

Cannabis

Epilogue

References

Glossary

Acknowledgements

"Most physicians and other healthcare professionals are unaware of the pervasiveness of poor quality clinical evidence that contributes considerably to overuse, underuse, avoidable adverse events, missed opportunities for right care and wasted healthcare resources.

Prof. Dr. John Ioannidis, M.D., Physician scientist at Stanford University School of Medicine

Clearly, a serious problem with an exaggerated and misanthropic human trait, greed, challenges the medical profession to move to higher moral ground in the care of the sick.

Prof. Dr. Ralph Crawshaw, M.D., Professor and member of the Institute of Medicine

I can no other answer make but thanks. And thanks.

William Shakespeare, Twelfth Night

Story Tellers Rule the World

Plato

Practical men, who believe themselves to be quite exempt from any intellectual influences, are usually the slaves of some defunct economist

John Maynard Keynes

As the great Native American Kiowa thinker and writer, Prof. Dr. N. Scott Momaday, Ph.D., has said, the most important question you can ask is, who am I. We should all ask this question, think about it deeply, and answer it honestly. Often. The world would be a better place for it. The book I’ve written is partly an answer to my personal questioning, and reflects the many people who have given me so much and have helped me to develop and determine who I am. My journey has been humbling for having met and learned from so many brilliant people, and having been given so many chances. To all, my sincere thank you for leading and propelling me in the eventual writing of this book. Dr. Momaday often writes about the land, and the land is partly who we are. Destroy the land and we destroy ourselves. Damage the land, and we are damaged. My journey has led me to understand that there is deep damage in our lands, and in particular, that land in which I have the knowledge to address; there is an internecine fight between pseudoscience based physicians and science based physicians that is leaving the public, and indeed physicians themselves, in a bewildered, unhealthy state. The corruption rampant in the medical-industrial complex (Relman, 1980) would not be happening without colluding physicians who have brought upon this pseudoscience fueled by greed (Vox, 2010). Pseudoscience physicians come in a number of forms, including those who are shills for the pharma companies, and, at the other extreme, those who often shun pharmaceuticals and vaccines and instead offer supplements and fake medical procedures that do little other than to harm the patient, but make money for the physician. That vaccines are efficacious has overwhelming evidence (e.g. Mogensen et al, 2016; Spencer et al, 2017), yet many physicians have become antivaxxers (Khazan, 2017; Trotter, 2019), and to further confuse the issue have even been given voice by Donald Trump (Robbins, 2016). Physicians, such as Andrew Brandeis, N.D., say silly things such as, kids are supposed to get sick; they’re supposed to get childhood illnesses, it’s what builds the immune system (Trotter, 2017). Statements such as this by Mr. Brandeis reflect a poor knowledge of the science regarding the immune system. Little does he know for example, that certain infections degrade the immune system and other tissues, often killing the infected or leaving them maimed for years or even for the rest of their lives, and setting the infected person easily vulnerable to new infections.

Consider the shingles vaccine, something that receives little attention. During a shingles outbreak, the virus not only causes much pain, but also can infect arteries. The immune system reacts to clear the infection from the vessels inducing inflammation, and damaging artery walls. When this post-shingles complication, called varicella zoster virus vasculopathy, hits arteries in the brain, the risk of stroke rises. These problems can be prevented given that overall vaccine efficacy against herpes zoster was 97.2% using a vaccine in older people (Lal et al, 2015).

I thank science based physicians who believe in and use science based dietary and medical procedures, epidemiological methods, and drugs to treat their patients – surprisingly and sadly, few of these physicians exist. As the great physician and humanitarian Ralph Crawshaw, M.D. has written, The profession is aware that greed best describes how some of its members place profit before patient wellbeing (Crawshaw, 1993). Further, Dr. Crawshaw goes on to write, With an ethic of greed doctors [sic] cease to base their motivation on compassion and caring to become merchants selling medical services to the highest bidder. And as Prof. Dr. Richard Pearl, M.D. has written, Over the last two and a half years, I’ve focused on greedy doctors [sic], insurance executives and drug companies, but increasingly, I see the fundamental problem is the culture of medical practice (Pearl, 2017). Why is medical care ineffective and expensive in the USA? The reasons are many. One of many reasons is detailed by Prof. Dr. Robert C. Smith, M.D., Distinguished Professor at Michigan State University. Dr. Smith writes that, the U.S. health care system, represented by the medical industrial complex (MIC), is rigged for profit at the expense of care. And that medicine and the rest of the MIC have legitimated their interest in maximizing profit by continuing to believe they’re doing a good job and helping people (Smith, 2019). To the altruistic American physicians, like Dr. Smith, thank you for speaking up. Most Americans don’t realize the structural problems inherent in our healthcare system. For example, 75% of Americans erroneously believe that a new drug approved by the FDA means the drug will help most people who use it (Sullivan et al, 2019). And half of Americans may erroneously believe that TV ads by pharma are approved by the FDA. An uninformed American is just the way the medical industrial complex likes it. So called asymmetric knowledge, where the drug companies and physicians know more than you, especially knowing that their medical procedures and drugs mostly do harm with little or no efficacy, gives them a huge market advantage in our capitalistic healthcare system. Selling you ineffective procedures and drugs through a veil of authority and through TV ads with beautiful people and cute dogs doing fun things is meaningless and deceitful, but makes money. In his medical journal paper entitled, Sloppy, Greedy, or Overworked?" professor Joseph Albert, M.D. has for 5 years reviewed the work of cardiac surgeons who implanted cardioverter-defibrillators (ICDs) in the USA. I believe another word should have been inserted into the title: incompetent. Prof. Dr. Albert laments the consistent failure of the surgeons, and although the number of failures is not reported, the government eventually recovered 280 million dollars from the offending hospitals and cardiologists who performed substandard ICD surgeries during this 5 year period (Albert, 2018).

A big thank you goes to Prof. Dr. Peter Gøtzsche, M.D. who has exposed the pharmaceutical industry as one that is highly corrupt and committing many crimes (Gøtzsche, 2012). Dr. Gøtzsche was a founding member of the Cochrane Collaboration, a non-profit organization that was formed to scientifically review drugs and recommend whether those drugs should be used, and if so, how they should be used. Unfortunately, as the Cochrane Collaboration grew, it became more influenced by the drug companies and eventually had Peter Gøtzsche removed. As Robert Wolff, M.D., a member of Cochrane Germany has written about the Cochrane Collaboration, Currently, there appears to be a mismatch between two organizational models, a grassroots science-focused collaboration and a top-down more business-orientated structure. Generally speaking, a centralized, top-down model will benefit branding and business-related outcomes while a collaborative grassroots approach is more likely to encourage scientific endeavor. In 2012, Cochrane hired a bean-counter Mark Wilson to serve as its CEO. Wilson, who does not have a science or medical background, would become the driving force behind the organization’s abandonment of its early, idealistic principles (Kolitz, 2019). The tentacles of big pharma spread wide and deep, corrupting almost every organization they touch, and it is physicians like Drs. Gøtzsche and Wolf whom we can thank for the exposure of many problems in the medical-industrial complex. As Dr. Gøtzsche has said, I dig so deeply in my research that I find the skeletons people have buried down there. And when I put them up on the ground people yell and scream, and call me all sorts of names, because they didn’t think anybody would ever find the skeletons (Kolitz, 2019).

We can also thank Peter Wilmshurst, a physician colleague of Peter Gøtzsche. In 1986, Dr. Wilmshurst, a cardiologist then working at St. Thomas’ Hospital, London, approached The Guardian newspaper with a substantial dossier detailing alleged misconduct in the development of Amrinone, a cardiac drug manufactured by Sterling-Winthrop in the UK. The drug was supported by a study at Harvard Medical School and published in the New England Journal of Medicine, whose lead author was Eugene Braunwald, M.D., a leader, or shall we say one who accepts much money from pharma, in his field. One of Braunwald’s medical fellows, John Darsee, M.D., has had 30 of his medical paper retracted for reason of fraud (Relman, 1983), was involved in this research. Dr. Wilmshurst’s group performed a series of experiments on the promising new drug but found no effect on contractility of the heart, but found frequent life-threatening side effects. Wilmshurst reported these findings to Sterling-Winthrop, who asked him to suppress the data. He refused, and the company retaliated by threatening litigation. He continued the research and published his adverse findings in abstracts and conference presentations, until Sterling-Winthrop staff removed all stocks of the drug from hospital pharmacies. A review by the Netherlands Committee for the Evaluation of Medicine found substantial discrepancies between the record cards of Wilmshurst’s group and those submitted by Sterling-Winthrop. Dr. Wilmshurst showed that they had falsified the records, suppressing the adverse events he had reported. He then contacted the UK’s Committee for the Safety of Medicines and discovered that Sterling-Winthrop had also failed to report the adverse events to the UK. The company had also threatened the UK Government with closure of a large manufacturing plant in the UK. Sterling-Winthrop subsequently reported over 1,400 adverse events to the FDA, and terminated research and marketing in the US, while continuing to market the drug in developing countries. Finally, after a substantial feature in the UK’s Guardian newspaper, the company withdrew the oral drug entirely in 1986. In 2003, Dr. Wilmshurst was given the Health Watch Award for this work. Please note that while Dr. Wilmhurst sold his services to the pharma industry, he did not sell his soul. Physicians working with pharma in an honest effort to develop drugs that actually work are needed; dishonest physicians colluding with pharma are not. I thank Dr. Wilmhurst, and those physicians like him for working for the greater good.

Ever wonder why our healthcare system is so expensive, and yet those with true and expensive healthcare needs go unserved. The following story comes from Kaiser Health News, a great source of investigative journalism in the healthcare arena. Alexa Kasdan had a cold and a sore throat. The 40-year-old public policy consultant from Brooklyn, N.Y., was worried her upcoming vacation trip might be ruined by strep throat. Because the soreness had persisted for more than a week, she decided to have it checked out. Kasdan visited her primary care physician, Roya Fathollahi, at Manhattan Specialty Care just off Park Avenue South. The visit was quick. Kasdan had her throat swabbed, gave a tube of blood and was sent out the door with a prescription for antibiotics. She soon felt better and her trip was enjoyable. Then she returned home and the bill arrived: $28,395.50 for an out-of-network throat swab. Her insurer issued a check for $25,865.24. The actual bill was $28,395.50, but the physician’s office said it would waive her portion of the bill: $2,530.26. Such a strategy of waiving the patient’s portion of a fraudulent bill usually works to relieve the patient’s anxiety about out of pocket expenses and let the large, surprising medical bill go unchallenged. But Kasden was troubled, I couldn’t fathom in what universe I would go to a doctor [sic] for a strep throat culture and some antibiotics and I would end up with a $25,000 bill. How could a throat swab possibly cost that much? Three possible reasons are obvious. First, the physicians sent Kasdan’s throat swab for a sophisticated smorgasbord of DNA tests looking for viruses and bacteria that might explain Kasdan’s cold symptoms. Dr. Ranit Mishori, a professor of family medicine at the Georgetown University School of Medicine, said such scrutiny was entirely unnecessary. There are cheap rapid tests for strep and influenza. In my 20 years of being a doctor[sic], I’ve never ordered any of these tests, let alone seen any of my colleagues, students and other physicians, order anything like that in the outpatient setting, she said. I have no idea why they were ordered. The tests might conceivably make sense for a patient in the intensive care unit, or with a difficult case of pneumonia, Mishori said. The portion of the tests for influenza are potentially useful, since there are medicines that can help (marginally though), but there’s a cheap rapid test that could have been used instead. There are about 250 viruses that cause the symptoms for the common cold, and even if you did know that there was virus A versus virus B, it would make no difference because there’s no treatment anyway, she said. (Kasdan’s lab results didn’t reveal the particular virus that was to blame for the cold. The results were all negative.) The second reason behind the high price is that the physicians sent the throat swab to an out-of-network lab for analysis. In-network labs settle on contract rates with insurers. But out-of-network labs can set their own prices for tests, and in this case the lab settled on list prices that are 20 times higher than average for other labs in the same ZIP code. The third reason. Physicians are often in collusion with out of network labs and providers so that the profit from the exorbitant bill is shared with the colluding physician. Kasdan’s bill shows that the lab service was provided by Manhattan Gastroenterology, which has the same phone number and locations as her physician’s office (Harris, 2019). Collusion here is obvious, and we have a concerned patient and journalists at KHN to thank for illuminating this scheme. Unfortunately, nothing will happen to the physician, and she’ll likely continue to bilk the insurance system. This is one of many reasons why our healthcare system is out of control, because physicians are cheating – all of the time. You’ll learn more about all of the reasons as the book proceeds thanks to organizations such as Kaiser Health News (KHN).

Should one ask these greedy physicians about such a predicament in our healthcare system, they may essentially quote Richard the III by saying, You may very well say so, but of course I couldn’t possibly comment. Most don’t. More insidiously, tribal members often protect their tribe, even if the tribe is perverse, so long as money is made. The tribe will setup organizations to protect and do battle for the tribe, such as setting up the AMA. In order to protect the revenue stream of itself and that of it member physicians, the AMA would, for example, do battle with President Harry Truman and his attempt to institute a single payer system of national health care back in the 1940s. The AMA would use all means available to protect their financial turf, including using the McCarthyism red scare tactics to call single payer socialized medicine, and saying that Truman was following the Moscow Party Line. That rubric continues to this day. Now, less than one-fourth of physicians belong to the AMA, but the AMA remains powerful because of its many revenue streams and control of many medical journals. They set the tone, largely through funding from pharma companies, that if you’re sick, or if you don’t want to become sick, just take a pill (I remember back to Mark Blankfield who starred as a drug addled pharmacist in a regular TV show Fridays sketch on ABC, known as The Pharmacist, in which he would often yell take a pill to his customers).

The members of the physician tribe often march, salute, bobble their heads, and kiss the ring of the authority figures so long as prestige is maintained and their pockets are lined. But in our democracy, we have the means to change our system to one of true healthcare, if only we realize the problem and then act. In this book, I tell you about many of the problems in healthcare, and offer a couple of ways, of the many needed means, to deal with the problem and yield a beneficial end – effective healthcare and better health. This can only be done because of the many scientists, physicians, politicians, journalists, professors, and many others who have been diligent and altruistic in their efforts to bring light to the many dark corners of our healthcare system. To all of you, and many of you are referenced in this book, I thank you for your hard work and for having educated me. For those others who have been altruistic and whom I haven’t referenced: YKWYA. As Plato taught us, story tellers rule the world. Unfortunately story tellers who lie, offering an easy to present false narrative, have captured many aspects of our world, particularly as they misinform a part of our populace who are, for many reasons, prey to their lies as the liars empty the pockets of those whom have been lied to. On the other hand, fact based, well informed stories are often complicated and difficult to tell, and often not so approachable to those who are easily preyed upon. For example, the medical zeitgeist will incessantly tell you that many more physicians are needed, and clinics and hospitals too, as described in just one example of many, according to a study by the marketing firm IHS Markit and promulgated by the Association of American Medical Colleges (April 23, 2019). That false narrative is echoed in many places. But dig beyond the veneer of this false narrative, and the very opposite often emerges. How many have heard, as an example, that the U.S. has more than double the number of congenital heart surgery centers that it needs, and about 40 of those centers in the USA aren’t cooperating with authorities to report their medical statistics – and, those non-cooperating centers have unexpectedly high mortality rates, according to Dr. Carl Backer, MD presenting at the 2019 Annual Meeting of the American Heart Association in Philadelphia, PA. In 2014, the Institute of Medicine released their analysis on graduate medical education, arguing there was no shortage of physicians, and that we have no need to invest more in increasing the number of new physicians who are trained annually (IOM, July 29, 2014). The narrative then should be instead, that we have too many physicians in search of customers, who should also often be described not as patients, but as victims of a greedy profit scheme. The reality, the true narrative, is that we have too many physicians in those areas of the country that are desirable, whereas we have too few physicians in those areas of the country that are undesirable; often rural areas. Each of the two situations provides ripe opportunity for medical rip-offs; I’ll describe this as the book proceeds. An example, Kaiser Health News reported on the case of Drew Calver, an Austin, Texas, man whose heart attack resulted in a bill of $164,941 from St David’s Medical Center in Austin, which the billing experts at WellRithms told the reporter should have only cost around $26,985. No wonder that a study by scientists and physicians at Johns Hopkins University found that 48% of all spending by the U.S. federal government now goes to healthcare in all its hidden forms (Bai et al, 2019). No one is stopping this greed and incompetence, especially in unregulated Texas because the pro-business mentality has reached its zenith here where physicians and healthcare businesses make big bucks, despite not delivering true healthcare. Or as they say in Dallas, TX, hospitals in Dallas are Profits-R-Us (Schnurman, 2019). However, when Kaiser Health News reporters stepped in and effectively blew the whistle on St. David’s, Mr. Calver’s bill was lowered to $332. St. David was the one who denounced Pelagianism, the belief that man didn’t need divine assistance to do well. Here in Austin, TX, St. David’s was in need of divine intervention just as St. David said – sadly it was Kaiser Health News (KHN) in faraway San Francisco, CA who would provide divine assistance that had somehow escaped St. David’s namesake in Austin, TX. Without the intrepid reporters at KHN, many of these stories would go undiscovered and therefore never told. In a country where the U.S. government invests $15 billion each year in the training of physicians, or $150,000 per year on each and every resident physician, where no other profession enjoys this level of public support - 31 percent of physicians nationwide are not willing to accept new Medicaid patients. The rate was even higher for orthopedic surgeons and dermatologists, two of the highest-paying specialties in medicine. To the physicians who are ingrates, greedy, corrupt, and incompetent, I give you your story in black and white. You may be the ones who bilk the system on a small scale, ’Dermatologist Removes a Simple Growth and Bills for Multiple Growths’ (Crawshaw, 1994), or perform unnecessary surgery on your patient-victim, Why do surgeons continue to perform unnecessary surgery? (Stahel et al, 2017). One recent study found that, referring to medical tests and procedures in the US, almost half the care examined was wasteful (Washington Health Alliance, 2018). Unnecessary tests and procedures harm your health, and leave the monies in the healthcare system depleted when needed for the truly sick to be given proper treatment.

To those story tellers working hard to bring us evidence based, rational narrative – thank you sincerely. You have taught me well, and the world is a better place because of you. I wish the narrative in this book could have been simpler and easier, but in order to introduce the ideas of greed and incompetence in our medical system, the gory (literally) details had to be listed and referenced to be believed. Had I not, my narrative could have been easily dismissed given the current zeitgeist – the beneficiaries and apologists for medicine as it currently exists in a profit-driven, greedy system. As Prof. Dr. Craig Schindler, Ph.D., professor of Environmental Sciences at the Univ. of California, Santa Cruz and author of The Great Turning: Personal Peace, Global Victory, says, choose hope, not as a feeling, but as a choice of knowing that you matter. This leads to action. I thank those who have given me hope, and this book is meant to pay that hope forward. The hope and resultant action is the relative ease with which you can become healthy by eating a whole food plant based diet and controlling you exposome. As the four times Pulitzer Prize awardee, NY Times senior writer and investigative journalist, and UC Berkeley professor, David Barstow, teaches us: I have tried to back up my assertions with facts and their original sources, and to have included all of the necessary facts in order to provide the correct context. Any story can give facts, and be completely wrong, if all of the relevant facts haven’t been included in order to provide the proper context (https://www.youtube.com/watch?v=0RGugYm9Be0). To David Barstow, thank you for all the work you have done, and the experiments you are now performing in investigative journalism at Berkeley. I also want to thank Prof. Dr. Shoshana Zuboff, Ph.D., whom I will introduce later in the book for her work on surveillance capitalism (Zuboff, 2019). For now, I thank Prof. Dr. Zuboff, Ph.D. for helping me give the proper voice to this book in order to express my profound indignation regarding the corruption of our healthcare system for the cause of greater greed by companies, physicians, non-profits, and a host of other players you will see identified later in this book. I was reminded by Dr. Zuboff of the great German- American philosopher, Prof. Dr. Hannah Arendt Bluecher, Ph.D., best known by many of us for her book, The Origins of Totalitarianism (Bluecher, 1951, English edition), something many of us were introduced to in our social psychology classes. Dr. Bluecher had been criticized by an academic colleague for her tone of indignation in speaking about her theories of totalitarianism in a scholarly setting and book; for allowing her personal indignation to infect her scholarly work. Her response inspires me, as it has Dr. Zuboff. She says, and I paraphrase, If I describe these conditions without permitting my indignation to interfere, then I have lifted this particular phenomenon out of its context in human society and have thereby robbed it of part of its nature, and deprived it of one of its most important inherent qualities. Thank you Drs. Bluecher and Zuboff for persuading me not to rob myself of voice, as I describe those who rob us of our health.

INTRODUCTION

"I’d have said the right thing but I must have used the wrong line." Dr. John, Musician

I’m not a journalist, I’m a talk show host. Sean Hannity, Fox News, College Dropout

Were American healthcare a patient, we would diagnose it as suffering from multiorgan failure and put it in the ICU for further testing. Very few of the test results would be normal. Robert Pearl, M.D., CEO of The Permanente Medical Group.

We are in danger of destroying ourselves by our greed and stupidity. We cannot remain looking inwards at ourselves on a small and increasingly polluted and overcrowded planet. Stephen Hawking, Ph.D., Cambridge University

Walk with the dreamers, the believers, the courageous, the cheerful, the planners, the doers, the successful people with their heads in the clouds and their feet on the ground. Let their spirit ignite a fire within you to leave this world better than when you found it... Wilfred Peterson

If you’re an older American with a blood pressure of 150 and taking blood pressure medications, you’ll learn why you’ve been duped by your physician (Wright et al, 2015). If you’re a BRCA breast cancer patient and considering radical mastectomy, don’t become one of many American women who have been needlessly and harmfully mutilated by American surgeons (Golshon et al, 2020). I’ll discuss this more as we proceed and illuminate that the earth’s shell is literally and figuratively cracked and man is adrift on the floating pieces. Drifting along on the fragile North American Plate, the US is adrift in other ways too, and many other countries are in a similar state, albeit for some of the others the drift is less severe. Our drift is problematic, and the problem is structural and your health, indeed your life, is at stake. Our healthcare system doesn’t follow scientific, rational, evidence based policies and procedures (Kumar and Nash, 2011). Instead, corruption, greed, and ineptitude abound in the companies and people, including physicians, who are a part of the medical drift. Between 2000 and 2012, the proportion of adults in the U.S. who were taking five or more medications nearly doubled, from 8.2 percent to 15 percent. To achieve these remarkable capitalistic goals, drug companies don’t so much sell drugs as they sell lies about drugs. As the academic physician Peter Gøtzsche, M.D., teaches us, most of their drugs don’t work and most pharma business expenses are in marketing, not R&D (Gøtzsche, 2019). Although some argue that Pharma spends slightly more on R&D than on marketing, $29.6 billion spent on R&D in 2004 as compared to $27.7 billion for marketing, big pharma companies do sometimes spend more on marketing than R&D (Gagnon and Lexchin, 2008). While the drug companies are mainly engaged in lying as their business (Gøtzsche, 2013), not all of those involved in selling the drugs to patients are liars. The physicians who are hired guns for the companies, knowing nothing about the drug they are hawking, used to promote the drugs, are often liars. In his book, Code Blue, the physician Mike Magee, M.D. laments his serving as a corporate shill for Pfizer, hawking Viagra across the planet, including to the Pope (Magee, 2019). Seriously? Selling Viagra to the Pope. Magee writes that, I was right in there, helping give moral cover and scientific legitimacy to world’s largest drugmaker. Oh, how we fool ourselves by rationalizing our behaviors. Systems 1 Thinking at work (Kahneman, 2013). Magee neither acted morally nor provided anything scientific by acting as a shill for big pharma. Magee is neither a scientist nor does he represent science. He was a businessman pretending to be a physician, and pretending that he was living up to his Hippocratic Oath. The physician, Dr. Jason Fung, M.D., calls these people, as do businessman in the drug industry, physician whores or drug whores (Fung, 2016). However, I will thank Dr. Magee for coming clean and now exposing corruption by physicians and physician organizations. Dr. Magee has a wealth of insider knowledge, and his book Code Blue is very informative. For instance, he exposes the AMA not only for its active collusion with Perdue Pharma and with the American Academy of Pain Medicine for creating the false narrative that pain is undertreated and should be treated with opioids, but also for funneling data about physicians so that Perdue could sell more opioids to overprescribing physicians. The AMA has literally been killing people. OxyContin, widely known as hillbilly heroin because of its abuse in Appalachian communities (Borger, 2001) and in communities where industrial plants have shuttered (McGreal, 2015), has emerged as a major crime problem in the US. Armed robberies of pharmacies have occurred in places such as Oklahoma where the robber demanded only OxyContin, not cash (Vivian, 2009). In Tennessee, they’ve set a new world record for the number of prescription painkillers used per person, killing and maiming people at record rates (Fletcher, 2015). Yes, that’s right, physicians and the AMA are killing people, making people sick, and are partially responsible for armed robberies because of their collusion with pharma to knowingly help cause the opioid epidemic. Is the nonprofit name and URL, American Massacre Association (AMA), already taken?

However the venial pharmaceutical sales reps selling the drugs to practicing physicians often, but not always, lack the knowledge to know the drugs they sell are only doing harm (Gøtzsche, 2013). Yet these know-nothing pharma reps often are the teachers of the physicians (Ziegler et al, 1995; Othman et al, 2010; Lieb and Scheurich, 2014). As we shall see, the medical drift has been with us time immemorial, and only strong governmental rules, regulations, and referees can stabilize healthcare. Common in the United States is the use of the Caduceus, a symbol of commerce with its two snakes and wings, used erroneously as a symbol of medicine instead of the Rod of Asclepius, the true symbol of medicine with only a single snake. Like confusion of the Asclepius with the Caduceus, common in the United States too is the conflation of commerce with medicine. The commerce of the medical-industrial complex owes part of its success to the $567,753,091 spent in 2018 to lobby Congress – about 4 times as much as that spent by the defense industry, and the AMA is second only to the US Chamber of Commerce in monies spent lobbying (available on the website, opensecrets.org). Money trumps democracy every time, just ask the conservative Supreme Court who gave you Citizens United, where the Justices declared unconstitutional the government restriction on independent political spending by corporations, and determined the an anti-Clinton broadcast by the Koch Brothers should have been allowed. Those corporations include, of course, pharma and other industries trying to make money in healthcare. As a result, your health suffers. Thanks to the droning of big pharma advertisements, selling sickness and its cure with a pill, every day, 750 older people age 65 or older living in the United States are hospitalized due to serious side effects from one or more medications. Direct-to-consumer (DTC) advertising by pharma companies was $9.6 billion in 2016 (Schwartz and Woloshin, 2016). Over the last decade, older people sought medical treatment more than 35 million times for adverse drug events, and there were more than 2 million hospital admissions because of adverse events caused by drugs (according to the Lown Institute, April, 2019). Further, according to the Lown Institute, medication overload will contribute to the premature deaths of 150,000 older Americans over the next decade and reduce the quality of life for millions more. Focusing on reducing inappropriate or unnecessary medications could save as much as $62 billion over the next decade in unnecessary hospitalization for older adults alone. Moreover, physicians lack critical information and skills they need to appraise the evidence and make informed decisions regarding medications, and there is a pervasive lack of communication between a patient’s various providers. Often, more prescriptions are written to treat what appears to be a new condition, when in reality physicians are treating a side effect of another drug. This prescribing cascade can lead to a cycle of debilitation and even death (Lown Institute, April, 2019). Taking warfarin (a blood thinner) and simvastatin (a cholesterol drug) can increase the risks of bleeding problems. Yet there are many drug combinations that haven’t been studied and when you’re on three or four or five medications, there’s 100 percent drug interaction, and you have your own personal experiment with unknown consequences.

Spending billions of dollars on other ways to have people take drugs works too. In the medicalization of America for example, the American Heart Association and American College of Cardiology revealed new guidelines for managing hypertension in adults, changing the target for systolic blood pressure to less than 130, when the previous target was 140, and 150 for those age 60 and older. In making these recommendations to lower blood pressure targets, the absolute reduction in cardiovascular events was only 2%, moving from 8% in the group with less aggressive treatment to 6% in the group with more aggressive treatment (Wright et al, 2015). Further, because of the fantastical way these antihypertensive drugs are presented to the patient by the pharma company and the medics, the patient often stops healthy behaviors such as exercise in favor of just taking a pill as a cure all (Korhonen et al, 2020, JAHA, 9:e014168). The whole marketing scheme seems to be; do what you want, eat garbage and don’t exercise, and then just take a pill. Prescribing drugs with numerous negative side-effects and very little benefit is stupid. Don’t do it! Remember this instead, exercise has many benefits, including that 12 weeks of exercise training reduced craving for high-fat foods and trait markers of overeating in individuals with overweight/obesity compared to non-exercising control subjects (Beaulieu et al, 2019).

Michael L. Millenson, adjunct associate professor of medicine has written, Most patients would be very surprised to learn that more than half of all medical treatments, and perhaps as many as 85 percent, have never been validated by clinical trials. Even if a clinical trial has been performed, often the physicians overseeing the trial fake the results for reasons of profit and ego. Esther Crawley of Bristol University is one such physician. Crawley has published data on treating chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), CFS/ME, and ME/CFS, among other names, where the clinical trials have been corrupted. Crawley was also directed earlier this year to correct the ethics statements in eleven other of her published papers (Tuller, 2019). Meanwhile, if you are harmed in one of these clinical trials, understand that most insurance plans won’t cover the cost of treating your injury induced during the trial (Saey, 2019). Be clear, many people’s insurance policies do not cover experimental procedures, yet, deceptively, some informed consent forms required for participating in clinical trials contain clauses claiming that a subject’s insurance will cover side effects. Physicians running these trials add the insurance clause hoping to fool the subjects, sometimes they hope that, by putting that [clause] in there, it will release them from some burden (Saey, 2019).

Even if the drug has been found to be safe and effective in clinical trials, profit motive means the drug will be manufactured at the lowest possible cost. Beginning in 2018, numerous lots of generic angiotensin receptor blocker (ARBs), used to treat high blood pressure, namely valsartan, losartan, and irbesartan, have been recalled for containing the probable carcinogenic impurities N-nitrosodimethylamine (NDMA) and N-nitrosodimethylamine (NDEA). Now that the FDA knows some of the root causes of the nitrosamine impurity problem, they’re using those findings to evaluate medicines other than ARBs that use similar manufacturing processes. Once the FDA started this process, patients and health care professionals were alerted of NDMA found in samples of the antacid drug ranitidine (Zantac). Starting in late September 2019, lots of prescription and over-the-counter ranitidine underwent voluntary recall because of NDMA contamination. Affected products include those from GlaxoSmithKline, Novartis, Sandoz, Apotex, Perrigo Company, Novitium Pharma, Lannett Company, Aurobindo, Amneal, Glenmark Pharmaceuticals, Dr. Reddy’s Laboratories, and Sanofi. Then in December 2019, the Singapore government recalled three metformin drugs due to NDMA found above the acceptable level. Manufacturers of the drug are overseas, poorly regulated, and often skip important steps in synthesizing the drugs leading to the production of unwanted, dangerous molecules in the drug. About 80% of the main constituent in our drugs, called the active pharmaceutical ingredient (API), are made in India and China – places where they cheat and knowingly deliver dangerous drugs to the US. There’s a reason you don’t see Made in India, or Made in China on the label of your drug bottles. Often to find out where a drug is made, you have to make a public records request under the Freedom of Information to find out where your drug is made.

To further complicate the problem, an independent lab in Alameda, California, named Emery Pharma, has found that the NDMA contamination increases while the drug is in storage. One of the scientists at Emery Pharma said, Manufacturers should have a strong warning on the label that if the product has been heated above a certain temperature, they shouldn’t use it. Or else you may be exposing yourself to large quantities of this cancer-causing agent (Cortez, 2020). This, of course, could be a bigger problem for many drugs on the market; i.e. as the drug sits in storage the chemical composition may change. So called stability studies are required by the FDA in an attempt to obviate these problems, but as you can see, these stability studies are often faked or incomplete (Johnston and Holt, 2014). For example, The Food and Drug Administration said in two 2010 inspections, an internal company investigation and a third-party audit uncovered significant instances of misconduct and violations at a Cetero facility in Houston, TX (Reuters, July 26, 2011). Cetero performs stability studies for drug manufacturers. Surprisingly, about half of the clinical trials that were performed on the drugs we use today have never published their results. In one infamous example, a heart medication called Lorcainide was tested in clinical trials in the US and UK in the 1980s. While clinical trial results found that patients given the medication were far more likely to die during the trial than those not given the drug, those results were published more than ten years after the drug went to market. During the period Lorcainide was on the market, more than 100,000 people died from taking the failed drug (Goldacre, 2013).

Meanwhile, even when there is scientific evidence about what works best, large numbers of physicians don’t apply those findings to actual patient care (Millenson, 1997). About 70 years ago, the world learned that DES (a synthetic form of estrogen), a hormone brought to you by corporations in a highly unregulated market and used by millions of pregnant women to prevent miscarriages and premature deliveries, didn’t actually work. But physicians kept prescribing it for another two decades, right up until the drug was linked to cases of cancer (Bamigboye and Morris, 2003). Many physicians have banded together to fight other, competing groups whose actions can benefit health and limit physician corruption. In 1921 women reformers, using their advantage of the new power gained from the suffrage movement, persuaded Congress to pass the Sheppard-Towner Act, legislation that provided matching funds to the states for prenatal and child health centers. These centers were staffed mainly by public health nurses and women physicians, and sought to reduce rates of maternal and infant mortality by giving pregnant woman advice on personal hygiene and infant care. As the historian Sheila Rothman wrote, Advances in health care were to come not from the construction of hospitals, medical research, or the training of medical specialists–or even from new cures for disease. Rather, educated women were to instill in other women a broad knowledge of the rules of bodily hygiene and in this way prevent the onset of disease. But private practice physicians disliked the competition for their income, and in 1927 the AMA lobbied and was able to persuade Congress to discontinue the program (Starr, 1984). Later, in the 1980s, as leading members of the Reagan administration had their way, medicine would become corporatized and more deregulated, and profits would rule the roost (Starr, 1984). The development of medical corporations that hire or fire physicians depending on how healthy their bottom-lines, rather than how healthy theirpatients are, would become the norm in the Reagan Revolution (Fiore, 2019). Republicans during this time would foolishly fetishize deregulation, corporatization, and a free market, even though there is no such thing as a free market (Phillips, 2015), and most physicians would fall into place, voting for Republicans. Physicians truly interested in healthcare and not just money would vote against their own interest. The Stockholm Syndrome is in play, where hostages are in alliance with their captors, or as Erich Fromm has written in Escape From Freedom" (Fromm, 1941), authority figures can be appealing to an insecure group, such as physicians brought up in an abusive medical environment (Wible, 2017) such that they, the physicians, need some sense of pride and certainty.

The effects of deregulation can be seen in unregulated countries such as India where 80% of physicians may accept bribes, an issue made easier by both a lack of regulation and a failure by professional societies to promote ethics (Silverman, 2019). When surgeons in the USA weren’t making enough money to support their lavish lifestyles, they used a plethora of means to bilk healthcare plans. According to SmartMoneyMD.com, in the article, How To Become A Rich Doctor – Ride The Wave, the days of doctors [sic] opening up a practice and expecting millions of dollars rolling into your bank are over. New methods however will suffice. For example, the idea of having an assistant in the O.R. has become an opportunity to make up for surgical fees that have been slashed, said Dr. Abeel A. Mangi, a professor of cardiac surgery at Yale, who said the practice had become commonplace. There’s now a whole cadre of people out there who do not have meaningful appointments as attending surgeons, so they do assistant work (Rosenthal, 2014). In other words, bring in another surgeon, who is out of network, for the surgery, and the out of network surgeon-brigand, operating in a deep, dark forest of arcane regulations, can charge what he wants. While the in-network physician is constrained, the out of network has no such constraints. The two surgeons then share the loot taken from the patient-victim. These guys are part of the medical clan that will do anything for money, including the Texas physician who will knowingly give you chemotherapy when you don’t need it (Brantley, 2018). Yes, he was knowingly making his patient-victims sick for the sake of profit. These out of network physicians, otherwise known as drive by physicians love this scheme so much that in Texas after years of outcry about this greedy behavior, the Texas Medical Board drafted the rules for implementation of a law against excessive out of network charges. But the outcry would not thwart their greed. The Board, made up mostly of physicians, tried to introduce a blanket exception to the law for virtually all nonemergency cases, meaning the drive by physicians would go largely unchecked. Instead, after a concerted outcry from advocates and media coverage by KUT, NPR and Kaiser Health News, the medical board decided to relinquish its rule-making authority. The Texas Department of Insurance instead took over writing the rules that health care providers will have to follow. The Agency released a set of rules that advocates say are good for patients (Lopez, 2019). Let’s hope physicians don’t find another loophole that they can use to bilk their patients. These bills largely arise because hospital-based physicians, who are mostly employed by private equity-owned staffing firms, decline to join insurers’ provider networks. These physicians double dip by being paid by insurers and then collecting a balance from patients. These physicians also use their ability to bill out of network to negotiate higher fees when they do sign contracts. Efforts to correct these problems in Congress have stalled given Republicans control the Senate and they are beholden to business as usual.

One of the tricks that devious physicians will use on you is to bill using in the ER two of the highest-reimbursed severity levels, 99285 and 99284 when they’re not warranted. These two CPT codes are intended for lengthy or complex procedures. These codes grew by 38% and 16% respectively, supplanting billing at lower-severity, and therefore lower cost, codes (Hargaves and Kennedy, 2018). Any bill for one of these codes has at least a 1 in 6 chance of being an overcharge that should trigger a requirement verifying its accuracy (Williams, 2020). As the article by Williams (2020) points out, in a collection lawsuit over a surprise medical bill, a provider (the plaintiff in these suits) must prove that a service was delivered to the patient and also demonstrate the value of that service (quantum meruit in legal terms). The provider’s attorney generally cannot simply go to court and drop a bill on the judge’s bench: a witness must attest that the service was delivered and billed at its market value. Providers haven’t had to do this because such suits are historically uncontested, resulting in default judgments for providers. To trigger these requirements, though, a patient (the defendant) need only file a pleading in response to the lawsuit, known as an answer. Once an answer denies a material fact in the case, such as the reasonableness of the bill, the provider’s attorney must line up witnesses to testify at trial. Specific denials, particularly those related to the complexity of the billed services, could trigger the need for physicians themselves to testify, which would blow up hospital scheduling and, with it, the economics of balance billing; meaning the pool of contracted physicians at the hospital would be upset and higher cost physicians may need to be used that would decrease the profit or income of the hospital.

Without proper constraint and oversight, the system is more like a fetid sewer of rotting bodies that have been fed the scouring’s of once wholesome food and then poked and prodded with innumerable tests and procedures and medications, most of which will only foment the rot. For example, surgeons have an inherent conflict of interest in our healthcare system because they make more money doing surgery than they do if they otherwise manage the problem. That’s because they are paid approximately ten times more money to perform surgery than to manage your problem conservatively, according to James Rickert, MD, an orthopedic surgeon in Indiana (Crouch, 2019). Those scouring’s of food, funded by dark money (Jacobs, 2019), that most are eating can lead to conditions such as heart failure for many reasons, including lack of micronutrients that support heart function (Lennie et al, 2018). Land in the hospital because of heart failure (HF) and guess what - Medications that can worsen heart failure are often continued or even initiated during heart failure hospitalizations. Although clinical trials using adult stem cells to regenerate damaged heart tissue continue to this day despite ongoing questions of efficacy and a lack of mechanistic understanding of the underlying biologic effect, these studies do give clues as to how we can heal tissues, including the heart. Key here is that the functional benefit of cardiac stem cell therapy is because of an acute inflammatory-based wound healing response that rejuvenates the mechanical properties of the infarcted area of the heart (Vagnozzi et al, 2019). And inflammation and wound healing can be greatly controlled by what we eat (Hever and Cronise, 2017).

Exemplifying how bad is medical care in the US, fully 49% of patients hospitalized for HF were prescribed HF-exacerbating medications at some point prior to discharge, and for 12% the number of such drugs increased during the hospitalization (Goyal et al, 2019). Those using the American healthcare system will find themselves in a sordid system that is at once stunningly corrupt, unhealthy, and ineluctable. While the basic science, not clinical science, underlying healthcare has grown enormously, the ends to which all of this science is used has been to mostly make money, and not improve healthcare. Unfortunately, in our capitalistic system with few controls, the improved science has actually led to overdiagnosis and overtreatment – and therefore diminished our health status. According to the Institute of Medicine, Indeed, the evidence base on the effectiveness of most health services is sparse. Well-designed, well-conducted studies of the effectiveness of most health care services are the exception, and the available research evidence falls far short of answering many questions that are important to patients and providers (Institute of Medicine, 2008). Instead, the system is driven by profit and economics, and populated with many healthcare providers who are poorly educated, corrupt, and incapable of deep thought. Physicians are mostly incented by money to do procedures, and preventative medicine is rarely rewarded. As a result, most medical treatments don’t work, but may cause harm. Estimates vary about what fraction of medical treatments provided to patients is supported by adequate evidence, but a number of reviews place the figure at well under one-half (for example, McGinnis et al, 2007). One study identified 800 medical procedures that are useless (Garner, 2011). In another study, Classen et al (2011) found that adverse events occurred in one-third of hospital admissions. This proportion is similar to findings from a 2010 study by the Department of Health and Human Services’ Office of Inspector General (OIG) finding that Medicare patients experienced injuries because of their healthcare in 27 percent of hospital admissions (Levinson, 2010). Overall, the cost of needless medical overtreatment in the US added between $158 billion and $226 billion in wasteful spending in 2011, according to Berwick and Hackbarth (2012). So crazy is our healthcare system that if there are too many physicians of a given specialty in one geographical area, then there will be substantial overtreatment of conditions served by that specialty (Brownlee, 2007). Why? Physicians need to make money by performing procedures, and if there are too many physicians to serve the patient need, then the physicians create the need and overtreat results. In one study of patients having a simple cataract surgery, unneeded ECGs were performed that then led to 16% of these fee-for-service Medicare beneficiaries experiencing a potential cascade event, i.e. unneeded, additional medical procedures (Ganguli et al, 2019). This simply isn’t healthcare; it is just the opposite and is done for the sake of profit. The authors found that for every 100 patients who received the ECG, up to 11 extra tests, treatments, office visits, new diagnoses, or even hospitalizations were made in the three months following the ECG. The physician-authors of the study say that most of the additional procedures were most likely unwarranted, while some may have been beneficial.

One of the largest healthcare scams in U.S. history involved 24 physicians and chief executives across seven states who defrauded the government of $1.2 billion. Leading the alleged scheme were medical equipment companies who paid kickbacks to physicians for referring elderly patients to fraudulent telemedicine companies that would then promise free or low-cost braces for back and shoulder pain (Kaplan et al, 2019). And I’m only writing about the few who are caught. Like many of the other physician fraudsters, Harry Persaud, a cardiologist from Westlake, Ohio, a suburb of Cleveland, was a respected and trusted physician. Mr. Persaud was charged in federal court with cheating the Medicare program and private insurers by ordering diagnostic tests his patients did not need, performing heart catheterizations on the basis of fake test results and inserting cardiac stents in patients after falsely claiming that they had blockages in their coronary arteries. He was convicted after a four week trial. He is also being sued for medical malpractice by some of his patients who claim that his unnecessary procedures have harmed them. No medical tests are without some risk to the patient but the ones Mr. Persaud ordered are more harmful than most. This physician was injecting radioactive dye into the arteries of his victims so that any narrowing’s or blockages in the coronary arteries would appear on x-ray. In addition to the risks associated with the use of radioactive substances in the body, these procedures involve many more risks, including bleeding, heart attack, puncturing a blood vessel, infection, allergic reaction and stroke. After performing these dangerous diagnostics, Persaud falsely told some of his patients that they had blockages that required placement of a stent to re-expand the coronary artery and keep the blood flowing to the heart muscle. Stent placement presents all of the same risks as coronary catheterization plus a few more. Stenting is not something an ethical physician does unless the patient needs it for severe forms of heart disease. Apparently, Persaud went beyond a normal level of cheating and greed that is unnoticed by regulators when his patient base began to shrink and he needed to take special steps to keep the money flowing. According to federal investigators, his total take from Medicare and private insurers was over $7,000,000 during a six year period. He was convicted of fraud, falsifying documents and money laundering, and sentenced to 20 years in a federal prison (Cleveland.com, Dec. 15, 2015). In Michigan alone, data shows one Michigan physician goes to prison every month for health care fraud (Baldas, 2019). Persaud is only one of many physicians ruining your health, something I’ll explain as the book proceeds.

As Danny Goldberg (2017) teaches us in his book, In Search of the Lost Chord, seemingly small moments can make huge differences to the course of society. In the year 1960, John F. Kennedy, one month after having begun his presidency, created the space for a more creative and questioning period in American culture. How was this accomplished? Kennedy simply crossed an American Legion picket line to see the film Spartacus, written by formerly blacklisted screenwriter Dalton Thumbo – this effectively ended the Far-right wing, dishonest conspiracy period known as the McCarthy Era. Working in the framework of openness, we can mitigate our problems if we’re honest, think rationally, and rid our system of greed and corruption. As an example, in 2018, California’s version of Medicaid, Medi-Cal, introduced a three-year pilot study that’s already showing what progressive experts in the health care field have seen anecdotally; tailored nutrition can improve health and lower medical costs for chronically ill patients. The pilot includes specially formulated meals, containing more vegetables and fiber, and in-home visits for patients who suffer from heart disease, which has caused some of the highest rates of hospital readmissions. Studies in Massachusetts have provided data that these programs can work to make patients healthier when considering overall health (Berkowitz et al, 2019).

Meg Reeves, 60, believes much of her treatment for early breast cancer in 2009 was unnecessary. Looking back, Meg feels as if she was treated with a sledgehammer. At the time, Reeves lived in a small town in Wisconsin and had to travel 30 miles each way for radiation therapy. After she completed her course of radiation treatment, physicians monitored her for eight years with a battery of annual blood tests and MRIs. The blood tests include screenings for tumor markers that would detect relapses before they cause symptoms. Clinicians miss about 20% of all breast cancer cases, while half of U.S. women having annual mammograms are, over a given decade, told they may have breast cancer when they don’t have the disease (see American Cancer Society website, Limitations of Mammograms).

For survivors of early breast cancer who had no signs of symptoms of relapse these tests aren’t helpful and may cause harm. When asked to comment, Reeves’ primary physician declined to comment. In 2012, the American Society for Clinical Oncology, the leading medical group for cancer specialists, explicitly told physicians not to order the tumor marker tests and advanced imaging, such as CT, PET and bone scans, for survivors of early-stage breast cancer. Yet these tests remain common. Thirty-seven percent of breast cancer survivors underwent screening for tumor markers between 2007 and 2015, according to a study presented in June 2019 at the American Society of Clinical Oncology’s annual meeting and published in the society’s journal online. Sixteen percent of these survivors underwent advanced imaging. None of these women had symptoms of a recurrence, such as a breast lump. Beyond wasted time and worry for women, these scans also expose them to unnecessary radiation, a known carcinogen. A National Cancer Institute study estimated that 2 percent of all cancers in the United States could be caused by medical imaging (Szabo, 2017). Some physicians love money, and will do almost anything for it – including killing you.

Most Americans are angry about the high and unsustainable price of cancer drugs, many of which cost more than $100,000 per year of therapy. In the fraudulent world of prescription drug pricing, generic drugs can cost more than branded ones, old drugs can be relaunched at astronomical prices, and low-cost option drugs are shut out of the market by colluding companies (Feldman, 2019). As Prof. Dr. Feldman teaches us in her book, Drugs, Money, and Secret Handshakes: The Unstoppable Growth of Prescription Drug Prices, at the center of this collusion are the highly secretive middle players, pharmacy benefit managers (PBMs) who establish coverage levels for patients and negotiate with drug companies. By offering lucrative payments to these