The Killing Fields of American Health Care

Hell is empty.
And all the devils are here.
The Tempest (I.ii.)

American health care is being crushed under the iron heel of a cabal of ruthless and merciless robber barons. Indeed, this primitive and backward system continues to be a source of horrendous suffering, as the health insurance companies, hospital executives, and pharmaceutical companies repeatedly place their insatiable lust for profit over the lives of their fellow Americans. And the health care oligarchs should be proud of what they have achieved: For they have created a health care system that is unrivaled in the industrialized world for its degradation and barbarity.

As economic inequality grows in America, so too does inequality of health care. Writing for The Harvard Gazette, David Cecere points out that tens of thousands of Americans die each year due to a lack of health insurance. Unsurprisingly, life expectancy is directly proportional to income in the United States, as evidenced by the fact that Pine Ridge Reservation in South Dakota has a life expectancy of 47 for men and 52 for women. This inequality continues unabated as pharmaceutical CEOs rake in unprecedented profits.

According to a Johns Hopkins study, more than 250,000 Americans die each year due to medical errors. This is inextricably linked with the fact that hospitals prioritize profit-making over patient care. Consequently, administrators are forcing physicians, and residents in particular, to work extremely exploitative and unsafe hours. Obamacare, which should really be called the Unaffordable Care Act, caused premiums and deductibles to go up, and failed to address the problem of health care either being tied to one’s job or to a fluctuating salary if the patient is an independent contractor.

Two thirds of all bankruptcies filed in the United States are medical bankruptcies, and over half a million American families file for bankruptcy each year as a result of medical bills they cannot pay. Indeed, this vitally important institution is in thrall to the forces of privatization, and this has transformed what was once a healing profession into a machinery of oppression and mass murder.

Pharmaceutical Totalitarianism

While unnecessary drugs and medical procedures are sometimes prescribed so that a doctor can milk a good insurance plan, vitally important drugs and procedures are even more likely to be inaccessible should a patient’s insurance be inadequate. For example, the cost of insulin has become prohibitively expensive for a growing number of Americans, leading many diabetics to resort to rationing which has resulted in premature death. As Ralph Nader writes in “Big Pharma: Gouges, Casualties, and the Congressional Remedy:”

In 2017, the U.S. consumers spent $333.4 billion on prescription drugs.

There are no price controls on drugs in the U.S. as there are in most countries in the world. Senator Bernie Sanders just took a bus tour to a Canadian pharmacy where insulin cost patients one tenth of what it costs them in the U.S.

The price of an EpiPen, made by Mylan, has also skyrocketed, and EpiPens are indispensable in warding off severe allergic reactions that can lead to anaphylactic shock and death. In “Life-Saving Allergy Treatment is Becoming Too Expensive for Families to Afford,” published in 2016, Laurel Raymond points out that “Over the past nine years, since Mylan bought the rights to the EpiPen, the price for the easy-to-use injectors has quintupled — increasing about 450 percent, from around $50 for one injector to $600 for a pack of two.”

The growing unaffordability of the device has resulted in patients carrying around expired EpiPens and resorting to dangerous jerry-rigged alternatives. The prices for anti-epileptic drugs have likewise soared, also putting patients’ lives at risk.

Prior authorizations (PAs), where health insurance companies place significant obstacles in place to get a drug or procedure approved, have led to needless suffering and death. Discussing the results of a survey where 1,000 physicians were asked about their experience with PA, Andis Robeznieks writes in “1 in 4 Doctors Say Prior Authorization Has Led to a Serious Adverse Event:”

More than nine in 10 respondents said PA had a significant or somewhat negative clinical impact, with 28 percent reporting that prior authorization had led to a serious adverse event such as a death, hospitalization, disability or permanent bodily damage, or other life-threatening event for a patient in their care.

Few realize that the Food and Drug Administration (FDA) is not engaged in impartial third party testing of drugs, and that the pharmaceutical companies are simply supplying the FDA with their invariably fudged statistics. Incredibly, the FDA admits this on their own website, stating that the FDA’s Center for Drug Evaluation and Research (CDER) “doesn’t actually test drugs itself, although it does conduct limited research in the areas of drug quality, safety, and effectiveness standards.”

There are growing conflicts of interests, where MDs that sit on FDA panels receive monetary payments from the companies that make the very drugs they are charged with evaluating. The payments are doled out after the drugs are approved, allowing the officials to get away with not disclosing conflicts of interest before the drug is placed under review.

Acknowledging the disastrous consequences that have ensued due to the absence of a responsible regulatory body, Donald W. Light writes in Risky Drugs: Why The FDA Cannot be Trusted, published with Harvard’s Edmond J. Safra Center for Ethics:

Every week, about 53,000 excess hospitalizations and about 2400 excess deaths occur in the United States among people taking properly prescribed drugs to be healthier. One in every five drugs approved ends up causing serious harm, while one in ten provide substantial benefit compared to existing, established drugs. This is the opposite of what people want or expect from the FDA.

Prescription drugs are the 4th leading cause of death.

Physicians are increasingly being fed manipulated data, and duped into believing that new drugs always do what their manufacturers claim that they do. This degradation of regulatory constraints imposed on industry is rooted in the fact that the firefighter has become a pyromaniac.

This corruption has had a deleterious impact on the doctor-patient relationship. In “Institutional Corruption of Pharmaceuticals and the Myth of Safe and Effective Drugs,” published with The Journal of Law, Medicine & Ethics, the authors caution that “industry has commercialized the role of physicians and undermined their position as independent, trusted advisers to patients.” The pharmaceutical companies are also frequently testing new drugs against placebos, which is unethical as it leaves clinicians with no meaningful benchmarks.

There is competition between the different drug companies to be the first to get their drugs to market, and the FDA is expected to dutifully rubber-stamp new drugs of which very little is known. Commenting on the FDA’s new role as a poodle for the pharmaceutical companies, Caroline Chen writes in “FDA Repays Industry by Rushing Risky Drugs to Market:”

The FDA is increasingly green-lighting expensive drugs despite dangerous or little-known side effects and inconclusive evidence that they curb or cure disease. Once widely assailed for moving slowly, today the FDA reviews and approves drugs faster than any other regulatory agency in the world.

Clinicians have also been bribed into prescribing drugs which they might otherwise not have prescribed, as transpired with Nuplazid, manufactured by Acadia Pharmaceuticals. Chen writes, “The top five prescribers of Nuplazid in Medicare, the government’s health program for the elderly, all received payments from Acadia.” Nuplazid, a drug designed to treat Parkinson’s, has been associated with thousands of adverse side effects and over eight hundred deaths.

Vioxx is a particularly chilling example of the horrors that can unfold amidst the growing collusion between the FDA and the pharmaceutical industry. Whistleblower David Graham, MD, who is a senior researcher within the FDA’s Office of Drug Safety, has confirmed that Merck knew that Vioxx posed a significant risk of heart disease. Testifying before the US Senate Committee on Finance on November 18, 2004, he said:

Prior to approval of Vioxx, a study was performed by Merck named 090. This study found nearly a 7-fold increase in heart attack risk with low dose Vioxx. The labeling at approval said nothing about heart attack risks.

In an article published with The New England Journal of Medicine, Eric Topol, MD, of the Cleveland Clinic posits that 160,000 heart attacks and strokes were caused by Vioxx. Internal Merck memos reveal that the company sought to conceal these dangers from physicians. Vioxx led to the deaths of around 55,000 Americans and netted $11 billion for Merck, which spent over a hundred million a year marketing the drug. Interviewed on PBS, Dr. Graham said that “FDA is an institution that has become a factory for the approval of new drugs and safety is not a consideration.”

The New Opium Wars

Along with suicides, a significant factor contributing to the decline of American life expectancy has been the opioid crisis, and it is likely that the history of opioid addiction was deliberately withheld from medical students and trainees, thereby making them malleable to the machinations of industry. Many have forgotten that there was a terrible opioid epidemic that ravaged the US in the later part of the 19th century, and which began with the Civil War, as doctors had little knowledge of how to treat pain aside from opioids and amputation, and the military technologies of the day far surpassed 19th century medical knowledge. Yet even before the birth of Christ, there were physicians that understood the dangers of opium-based drugs. Diagoras of Cyprus (3rd century BC) and the Greek physician Erasistratus (304 BC-250 BC) both understood that opium use was fraught with danger. According to the Centers for Disease Control and Prevention (CDC), “On average, 130 Americans die every day from an opioid overdose.”

There is also a connection between the overprescribing of opioids, illicit opioid use, and heroin, as four out of five heroin users used prescription opioids prior to starting heroin. Under the spell of the pharmaceutical companies, American doctors wrote over 240 million opioid prescriptions each year from 2009 to 2014. Even in 2017, after the carnage was obvious to all but the most insouciant, American physicians still wrote over 190 million opioid prescriptions.

Health insurance companies have also contributed to the crisis. As Linda Girgis, MD, points out in “Calling Responsible Parties to Task for their Role in the Opioid Epidemic,” insurance companies often refuse to cover alternative treatments for pain, such as massage, acupuncture, chiropractics and Lidoderm patches.

The breakdown in checks and balances has been total and absolute, and the regulator and the regulated are now intertwined like two knavish devils waltzing in hell. Dr. Curtis Wright, the FDA official that oversaw the testing of OxyContin, a drug manufactured by Purdue Pharma and which played a significant role in the opioid crisis, later went on to work for that very company.

Taking absurdity to new heights, drug companies are even permitted to fund continuing medical education courses that teach doctors how to prescribe opioids. Indeed, this is emblematic of how the American oligarchy has developed a hostility, not only to the humanities, but also towards science.

The complete degradation of credibility within the FDA has its roots in the Prescription Drug User Fee Act (PDUFA), which was passed in 1992, and authorized the FDA to collect fees directly from pharmaceutical companies for the purpose of financing the review process for new drugs. Cognizant of the fact that there is presently no impartial political body that can curb their unscrupulous designs, drug companies have vigorously lobbied Congress to protect their interests. Groups such as the Pain Care Forum receive funding and support from pharmaceutical companies, and spend millions of dollars lobbying congress to keep opioid regulatory measures lax.

So corrupt has the FDA become, that the FDA approved the Sanofi-Aventis drug Ketek, even when the FDA was aware of the fact that the data supplied by Sanofi-Aventis was fraudulent and based on a study that never even happened. The FDA was later forced to remove the drug after four cases of death due to Ketek-induced liver failure. Accutane, Rezulin, Selacryn, Diethylstilbestrol (DES), and Meridia are some of the other “wonder drugs” that the FDA has shamelessly unleashed on an unsuspecting public, and which later had to be recalled after inflicting grievous bodily harm and death.

Psychiatry and the War on Thoughtcrime

Another source of obscene profits for the pharmaceutical industry has been psychotropic drugs, and the complicity of the FDA and mainstream psychiatry with the push to enslave Americans to these dangerous and highly addictive substances is irrefutable. This is yet another example of how science is being degraded by the quackery of the drug companies and their paid “experts.”

The fondness of mainstream psychiatry for pseudoscience is matched only by its hostility towards informed consent, and this has resulted in a forging of alliances with deeply reactionary and anti-democratic forces. Speaking at the annual meeting of the National Council for Mental Hygiene on June 18th, 1940, British military psychiatrist J. R. Rees openly espoused totalitarian tactics, and called for psychiatrists to infiltrate every aspect of society. Undoubtedly, he would be pleased with the reign of terror unleashed by psychotropic drugs on Americans today, and the particularly devastating toll these drugs have taken on children, soldiers and veterans.

In “Psychiatric Drugs are False Prophets with Big Profits: Psychiatry Has Been Hijacked,” by psychiatrist Robert Berezin, the author bemoans the demise of ethics in his profession:

The real source of human suffering is not, nor ever has been, the brain. The issues are in the person, the human being, in the context of damage to the play of consciousness, created by deprivation and abuse in the formation of our character. My life’s work has taught me that the art, the science, the discipline, and the wisdom of psychotherapy attends to this damage. There are no miracles and no shortcuts, as drugs, like the other somatic therapies, always promise. Never mind the harm done. We have repeated the same mistakes over and over again, and we are doing so today. It doesn’t seem to matter that the chemical imbalance theory has been discredited. It doesn’t seem to matter that the multibillion dollar pharmaceutical industry and its influence peddling in academic psychiatry has been exposed as financially and scientifically corrupted and manipulated. The drug companies have engaged in study suppression, falsification, strategic marketing, and financial incentives.

In “10 Reasons Why Psychiatry Lives On—Obvious, Dark, and Darkest,” psychologist Bruce Levine writes that the demonic power of psychiatry continues to grow despite the fact that “numerous studies have found that so-called ‘antipsychotics’—especially in the long-term—are essentially pro-psychotics; and that so-called ‘antidepressants’—especially in the long-term—are essentially pro-depressants.” Levine also warns that psychiatry has become a tool which can be used to suppress dissent:

Psychiatry maintains the societal status quo by its attributions that emotional suffering is caused by defects in individual biochemistry and genetics rather than by trauma and societal defects created by the ruling elite. Psychiatry covers up the reality that the root of much of what is commonly labeled as “mental illness” is a dehumanizing society—one orchestrated to meet only the needs of the wealthy and powerful and not designed to meet the needs of everybody else for autonomy, meaningfulness, and genuine community.

While the mass media has been unable to conceal the fact that hundreds of thousands of Americans have died from the opioid epidemic, they are less enthusiastic about covering psychosis, homicidal ideation, and suicidality triggered by Prozac, Paxil, and other selective serotonin reuptake inhibitors (SSRIs). Indeed, dozens of school shootings have been carried out by young people, either on, or suffering withdrawal from, psychiatric drugs.

Ominously, the virus of privatized health care is spreading to Europe, and in 2018 English doctors wrote over 70 million prescriptions for antidepressants. Andreas Lubitz, the German pilot who on March 24, 2015, intentionally crashed his airplane en route from Barcelona to Düsseldorf into the Alps killing everyone on board, was taking mirtazapine along with a number of other psychotropic drugs. Geert Michels, the driver of the vehicle in the Sierre bus tragedy, who drove his bus into a wall in a tunnel in Switzerland killing 28 people, 22 of whom were children, had traces of Paxil in his system.

Pharmaceutical chemist and whistleblower Shane Ellison, who has worked for Eli Lilly, has acknowledged that psychiatrists are inventing diseases so as to expand the clientele of the drug companies. In a 1993 letter to the editor of the New York Times, distinguished psychiatrist Peter Breggin wrote, “Since most antidepressants are highly toxic and frequently used in successful suicide attempts, their widespread availability probably increases the overall suicide rate, much as the availability of guns increases the murder rate.” According to the Citizens Commission on Human Rights (CCHR), there are over seven million American children (from toddler to the age of 17) on psychiatric drugs.

There used to be a time when we gave American youth literature, history, math, science, music, art and a sense of community. Now we tell our sons and daughters that they have “learning disabilities” and get them addicted to drugs that can cause brain damage. Every child’s mind is sacred. It is our duty to protect the liberty, sanctity, and inviolability of their souls.

There is a distinct possibility that the most intelligent and creative children are frequently the ones being medicated. As the brightest students are often the ones who shout out the answer before raising their hand, there is a real danger that these students will be diagnosed with ADD, ADHD, or any number of imaginary diseases and placed on mind-altering drugs. Many of these vulnerable patients, betrayed by their doctors in the cruelest possible manner, go on to take their own lives.

Even dermatologists, who delight in arm-twisting patients with inferior insurance into being medical models without their consent, are still engaged in the legitimate science of studying and treating skin cancers. What would possess a physician to abandon, not only science, but all traces of human morality and ethics? As Voltaire once wrote in Questions sur les miracles: “Those who can make you believe absurdities, can make you commit atrocities.”

Once a child has been labeled as “mentally ill” it is difficult to escape the crosshairs of the inquisitors. Indeed, it is not unusual for such a youth to be seized by Child Protective Services should their parents resist having their son or daughter placed on psychotropic drugs. This underscores the authoritarianism that is inseparable from the cult of psychiatry. Moreover, the technology now exists through the use of a digital pill for psychiatrists to easily coerce patients to take their “medication.”

Allied with a gang of zealots who are more than happy to peddle their poisons, the pharmaceutical companies have long since abandoned all considerations except that of profit-making. Harriet Fraad writes in The Guardian that “Every major company selling anti-psychotics – Bristol Meyers Squibb, Eli Lilly, Pfizer, Johnson and Johnson and AstraZeneca – has either settled investigations for healthcare fraud or is currently being investigated for it.” Should a patient attempt to stop their psychoactive drugs and suffer terrible withdrawal symptoms, Iago, now armed with a white coat and a stethoscope, will simply whisper in their victim’s ear that this is because their disease has returned.

In addition to fomenting totalitarianization, the psychiatrization of the culture is inextricably linked with the hysteria of liberal fundamentalists who believe that their ideological adversaries are not only “racist,” “homophobic,” and “sexist” – but also mentally ill. Hence, a dubious love triangle has formed between avaricious drug companies, whose lust for profit is insatiable; psychiatrists, who have autocratic tendencies and are hostile to both due process and habeas corpus; and liberals, who believe that we are living in a utopia, and who take offense with those that do not share this worldview.

In a passage that could have been taken from a government edict issued by the totalitarian regime in Orwell’s 1984, the Australian mental health organization, WayAhead, states on their website that “It is not uncommon for a person with a mental illness to deny they are ill or that they need help.” We are also informed that someone may have a serious mental illness if they “have thoughts which are not in tune with reality.” And whose reality would that be?

As the late Thomas Szasz, who authored over thirty books on psychiatry, wrote in the introduction to Psychiatry: The Science of Lies:

Because there are no objective methods for detecting the presence or establishing the absence of mental diseases, and because psychiatric diagnoses are stigmatizing labels with the potential for causing far-reaching personal injury to the stigmatized person, the “mental patient’s” inability to prove his “psychiatric innocence” makes psychiatry one of the greatest dangers to liberty and responsibility in the modern world.

Prescribing medicines that aren’t real medicines, to treat diseases which aren’t real diseases, the thought police thrive precisely in this environment of lawlessness and unaccountable government that has emerged following the attacks of September 11th. Indeed, the Patriot Act, the Military Commissions Act, the National Defense Authorization Act, the revival of the Espionage Act, and the RESPONSE Act all serve to empower the cult of psychiatry.

Gog and Magog: Barbarism Abroad and Barbarism at Home

As a child I used to think of drug dealers as vampires that would strike suddenly, waylaying innocent passersby in the dead of night. It is no small irony that the most diabolical drug dealers would turn out to be psychiatrists that prescribe psychotropic drugs and physicians that overprescribe opioids. This scourge of amorality is tied to the dismantling of the humanities, without which medical ethics cannot survive.

Overspecialization, a military-style hierarchy, and subjecting residents to such exploitative working conditions that they frequently suffer from sleep deprivation over prolonged periods of time, also contribute to inculcating these impressionable young minds with blind obedience. In this way are sentient human beings transformed into mindless unthinking automatons.

Like its cousin, the military industrial complex, the medical industrial complex has repeatedly demonstrated a total disregard for human life, and makes tens of billions of dollars off of death, misery and suffering. This slow motion coup d’état which has been unfolding inexorably since the 1980s, and which has resulted in the health care oligarchs being able to acquire a stranglehold over our health care system, has transformed a once respectable profession into a cruel and brutal machine that repeatedly harms instead of heals. As American health care has degenerated into a depraved and wicked business, it would seem that primum non nocere has been usurped by caveat emptor.

David Penner has taught English and ESL within the City University of New York and at Fordham. His articles on politics and health care have appeared in CounterPunch, Dissident Voice, Dr. Linda and KevinMD; while his poetry has been published with Dissident Voice. Also a photographer, he is the author of three books: Faces of Manhattan Island, Faces of The New Economy, and Manhattan Pairs. He can be reached at: 321davidadam@gmail. Read other articles by David.