CHICAGO, IL (February 3, 2006) – Dr. G. Timothy Johnson closed the Midwinter Pastors Conference this morning by exhorting the attendees to work for health care reform, which he said “ultimately is a moral question.”
“Our health care system is an absolute mess,” Johnson said. “It’s a national tragedy. It is a national disgrace.”
The ABC News medical editor and ordained Evangelical Covenant Church minister, urged his colleagues to work for change so that all people could have access to good health care.
Johnson told the gathering that despite spending by far the most money per person on health care, the United States is the only Western industrialized nation not to offer some sort of universal health care coverage, suggesting the country receives a poor return on its investment.
Health care spending in the United States averages $5,500 per person each year, Johnson said. That is nearly double that of most other nations. Despite the massive spending, the country ranks poorly at both ends of the life spectrum, standing 37th in life expectancy and 41st in infant mortality.
At the heart of the issue is the high cost of overhead, Johnson said, explaining that 30 percent of the spending is on overhead costs, such as administration and advertising. By contrast, Medicare spends roughly five percent on overhead costs.
Medicare is the federally managed health insurance plan for seniors over 65 and some young people with disabilities. “Someday, out of sheer desperation, we are going to slowly expand the Medicare system,” predicted Johnson.
For much of his talk, Johnson focused on the latest thinking regarding a number of medical conditions.
Researchers have discovered that two-thirds of deadly heart attacks are caused by fatty deposits inside the walls of blood vessels that break open due to inflammation. A clot then forms. Until recently, physicians have been unable to detect these because their presence never showed up on standard diagnostics such as stress tests and angiograms, Johnson said. New techniques including ultrasound are being tested. Johnson said taking the cholesterol reducing statin medications such as Lipitor may be able to reduce the deposits inside the walls.
Researchers now suggest a new method of determining an individual’s healthy cholesterol level, Johnson said. Previously, doctors looked at the ratio between good (HDL) cholesterol and bad (LDL) cholesterol. Now, physicians are looking at just the LDL number and lowering what is an acceptable level. Once considered safe at 130, LDL levels should be down to 100 for most people and 70 for people who also have other risk factors for heart disease.
Speaking in the city (Chicago) most recently determined to be the most obese in the country, Johnson said fat in the mid section is “metabolically active” as to the more static fat elsewhere. Physicians now refer to the belly-butt ratio, Johnson said, joking, “You can all stand up at the end and examine each other.”
Researchers also are taking a new approach to stress, saying that calm-looking people could be more stressed than those who might seem outwardly stressed. The difference is whether the “external environment” matches or is different than the person’s “internal environment.”
Depression continues to be a major factor in heart disease, with those who go untreated running four times the risk of having a heart attack. He exhorted people to take medication, which he said works for most people.
Johnson told the gathering that “colon cancer should theoretically never kill anybody” because it takes 10 years to become cancer from its inception as a polyp. A colonoscopy is the only diagnostic test people should consider.
Men diagnosed with prostate cancer “face a breathless array of choices” in treatments, none of which is demonstrably better than the other, Johnson said. The skill of the physician doing the procedure is far more important than the procedure itself, he explained.
Women who have been treated with a lumpectomy, or local or radical mastectomy for breast cancer, are less likely to be treated systemically with chemotherapy if tests show no involvement in surrounding lymph nodes. Doctors are beginning to refrain from using the practice, which has been done to help prevent a reoccurrence. Johnson said the additional chemotherapy probably doesn’t help 70 percent of the women, but can cause other health risks.
Copyright © 2011 The Evangelical Covenant Church.