Life expectancies in the United States are drifting downwards, and the cost of medical care is rocketing upwards. A major nightmare for any American is a chronic or catastrophic illness or injury. As a Presidential election approaches, most Americans are concerned about the economy and look to the candidates to improve their financial situations. They hope to hear how healthcare will be made more affordable, but little is being discussed by either major party.
As the gap between what a few wealthy Americans earn and what the other ninety-nine percent earn widens, middle and low income citizens hope the government will act to lessen the disparity. Much of the rhetoric heard from both major party candidates assures us that the cost of healthcare will be addressed by programs, imaginary or real, that rely heavily on borrowed funds, rather than on contributions from the wealthiest. As the feasibility of these hypothetical programs becomes increasingly improbable, supporters of both candidates are spending great sums on advertising to convince voters that the government can actually do what either candidate suggests without going bankrupt.
Since the Citizens United decision by the Supreme Court in 2010, the money invested by the very wealthy in the campaigns of politicians they trust or control has exploded. Not surprisingly, the ‘gifts’ provided to accommodating members of the high court have also grown in value and frequency. Despite this veritable blizzard of money directed at the candidates who must draft the promised legislation and the courts that must decide if the legislation is ‘constitutional,’ there is no evidence that programs that reduce the ever-increasing burden of American healthcare will be enacted.
What has not kept up with the largesse showered on our elected and appointed officials is the median income of the average American. John [and Jane] Q. Public have listened to the soundbites and the infomercials and have chosen to support candidates who seem the most earnest or the least threatening. In a move that defies logic but proves the value of misinformation, many, if not a majority, of our fellow citizens have placed their trust in the billionaires who have spent decades accumulating unimaginable wealth at the expense of their supporters.
Political power-brokers are promising to support health expenditures they actually oppose. In vitro fertilization [IVF] is just one of many examples of this ‘bait and switch’ tactic. IVF allows women who have fertility problems to ‘make babies.’ Since abortion has been depicted as a mortal sin and consequently banned in more than twenty states, the support for IVF is depicted as “prolife.” Unfortunately, IVF involves the fertilization of several human eggs which results in the production of several human embryos. Only a few of these embryos are implanted in the hopeful mother’s womb, and the rest of these ‘potential babies’ are discarded or otherwise dealt with in a manner that precludes their ever developing into actual babies. In effect, IVF may produce a baby, but it will inevitably result in the termination of numerous ‘potential babies.’ With in vitro fertilization comes ‘in vitro abortion.’
The notion that the government that opposes all forms of abortion or modalities that interfere with baby development [such as intrauterine devices, morning after pills, etc.] will pay for IVF is nonsense. If the government paradoxically covers the cost of IVF for the tens of thousands of citizens pursuing this option, the outlay will force the government to borrow trillions more than it is already committed to borrow to pay for military and infrastructure upgrades.
Even before the United States declared itself a nation, healthcare costs had been substantial and often unwarranted. Bloodletting, emetics, enemas, poisons [such as mercury and arsenic] and other such ‘therapeutic’ measures were widely adopted by the wealthy prior to the Nineteenth Century but were, fortunately, too costly for most citizens.
One medical procedure that was vigorously promoted by the government [and the military] in the Eighteenth Century and available to rich and poor alike was “inoculation” against smallpox. Inoculation involved the introduction of material, such as a scab or pus, from an individual with smallpox into the skin of an otherwise healthy individual. This occasionally produced smallpox in the ‘inoculated’ individual, but it reduced the mortality rate from smallpox from 30 % to about 3 %.
When Thomas Jefferson brought the enslaved, fourteen year old Sally Hemings to France [as his chamber maid and concubine], one of his top priorities was to get her inoculated against smallpox. It cost him the equivalent of more than $1,000 in 2024 funds to protect her angelic features from the disfiguring effects of smallpox. The irony in this expenditure was that Sally had been enslaved at Jefferson’s Monticello estate and would have certainly been expected to milk cows as one of her chores. Cows frequently had a virus, vaccinia, that caused a disease called cowpox that provided immunity against smallpox without causing the scarring or illness associated with smallpox. Jefferson, who was perennially in debt, could have saved his money without risking Sally’s life or beauty, but who knew?
America spends enormous sums on medical programs and interventions of questionable value. Billions have been spent on the ‘war on drugs’ with no identifiable benefit accruing from the effort. Drug and medical device companies are gorging themselves on inflated fees for drugs and devices while their agents in Congress run interference to protect indefensible profit margins for these companies. Cost controls are long overdue, but obscene profits are being defended by legislators paid by us but not working for us.
Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan. He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the U.S., as well as in England, Germany, and France.
