By: Dr. Rosabel Young, M.D.
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For the first time in US history, the Life Expectancy of our children will be shorter than our own. We started seeing the decline from the longest at 79 years of age in 2014, to 76 in 2021.
Meanwhile, the incidence of type 2 diabetes in children has skyrocketed. Before 1990, type 2 diabetes was rare in children, by 2002 incidence was 9 per 100,000, and by 2020 it jumped to 32 per 100,000.
We are no longer the leading world nation in medicine and health. What happened?
Did changes just sneak up on us because we were afraid to say something when things started going wrong, or was it simply because we weren’t paying attention?
In retrospect, I’m guilty of both.
The Food & Drug Administration no longer protects consumers
From the mid-1980’s until 1992 I was on an FDA drug study review committee, consisting of 12 doctors, all in academics or government full-time. Our job was to review new drug applications from drug companies to make sure they met safety and efficacy requirements before approving them for public use. Then one day, one of our committee members was offered a job at a pharmaceutical company with a big salary, and we were asked to vote on whether to allow him to stay on the committee, considering the potential conflict of interest. I didn’t do much talking because I was the youngest one in the group, and ended up voting along with the majority, so he stayed on.
Over the next few years, others on the committee accepted drug company jobs, and suddenly, there were 11 drug company members and 1 academic (me). When a new drug came up for a vote, I was often the dissenter – voting against approval when I saw dangerous side effects in the preliminary trials. Feeling like the Odd Man Out, always out-voted, I soon dropped out of the committee. I left quietly to avoid making waves. It was early in my career, and I needed good letters of recommendation.
The new drug review committee allowed changes in FDA conflict of interest rules, and even lobbied Congress to pass laws that rushed the drug approval process with streamlined testing. Drug companies dictated how the testing should be done, and this led to more adverse drug events and deaths. The FDA became just a rubber stamp for the drug companies, no longer protecting the consumer from dangerous drugs.
Corruption, Corruption, Corruption
Through an arrangement between California and Hawaii, I was able to get a contract to do Workers Comp examinations in both states. My job was to examine injured workers, mostly native Hawaiians and other minorities, and then I would submit my report to the insurance companies. The contractor paid for everything, my flight, four-day hotel stay and all expenses, even if I only worked one day, and he would invite the 4 or 5 of us – the insurance company, the contractor, and 1 or 2 others, to the nicest restaurants in town, exclusive golf resorts, front row tickets to events, etc. At that time, I didn’t ask questions – It was “just part of my job.”
But one day, after one of those nice weekends, I decided to ask the contractor,
“Who was that other guy who joined us for dinner and golf at that luxury resort yesterday? He laughed, “Ha-Ha, that was the Judge!”
I cringed and could have screamed in shock. I knew that was wrong, but I was a coward. Again, I walked away silently, reluctant to say or do anything about the injustice and corruption I had witnessed and participated in.
Since the 1990s, our Workers Compensation system has continued to deteriorate, inundated in fraud and bureaucracy, with little regard for the patient’s health or outcomes of treatment.
And it’s not just Workers Comp, the Personal Injury medical legal system is also in a shambles. People with minimal injuries get huge million-dollar settlements, while many with serious injuries get nothing to cover even basic medical costs. Even the Medicare programs they should be entitled to from their years of work and tax contributions as US citizens are now barely sufficient to provide basic medically necessary care.
Privatized health care is also interfering with our military defense
I stayed on with my favorite contracts that I had for many years – Department of Defense, Federal law enforcement officers, foreign service, and active duty military. For almost 20 years, I dealt directly with the Government agencies – no middle men, no contractors, no special interest groups.
For Military Entrance Processing, for example, I would get calls from the Army, Navy, or Air Force CMO on base to examine young men and women applying to enter the service. I would see them the same day I got the call, and those who passed were sent right to Boot Camp within 1 or 2 days, then were deployed overseas based on need as determined by the Chief of Staff for their Branch.
Corrupt contractors can’t touch these guys, they protect our freedoms, our safety, our national security, I thought.
But that also changed.
About 10 years ago, MEPS and other government medical operations were taken over by private insurance companies, like LHI and QTC. This meant that the military branch CMO could no longer call me directly to schedule the military processing examinations. Instead, they were set up like an HMO system, requiring that the CMO request authorization from the private contractors before I would see their military applicants and injured personnel.
The military personnel I dealt with were very concerned about these changes, but told me there was nothing they could do.
Then LHI was taken over by Optum, which is owned by United Health Group, an even bigger corporation. With each corporate merger and takeover, the bigger the corporation, the bigger the delays. Now it can take months from scheduling, to Boot Camp, to deployment.
The new corporate-run system has undermined our military readiness – and none of us want that uncertainty in our future.
Imagine our President having to ask our enemies, “Hold your fire, we’re waiting for HMO authorization before we can deploy our troops.”
Pro-industry Law Increased Drug Addiction and Abuse in California
In the late 1990s, AB 487 was drafted by legislators in response to the pharmaceutical industry’s need to “educate” physicians on narcotic drug prescribing. In contrast to our other 49 states, California’s law enacted disciplinary action against physicians accused of “undertreatment, undermedication,” and defined the denial of narcotic and opioid medications as “unprofessional conduct.” I lobbied against that law, along with many physicians and pharmacists, but we failed, and the law passed in 2001. Two of my UCLA residents were charged with violation of this new law and had their licenses placed on “probation” because they prescribed non-narcotic pain medications, including Naprosyn, chondroitin-glucosamine, and vitamin D. One was an elderly woman who had respiratory illness and would have been at risk for death in her sleep if prescribed narcotics. The other was a young man who did not have physical pain, and was at risk for addiction. My UCLA residents acted ethically, as the Hippocratic Oath dictates, “First do no harm.” But they were punished for doing the right thing.
Instead of continuing to fight and inform the public about the dangers of AB 487, I kept quiet, afraid that I would be next.
Until July of 2010, when my uncle, a university professor and scientist, was killed because a hospital nurse administered Dilaudid “per protocol” and he died of respiratory arrest. The nurse YELLED at me, saying “Dilaudid is not a narcotic” and I discovered that the drug was not properly stored under lock and key as narcotics were in the past, before AB 487. I risked my license and fought the State of California to restore old rules requiring that Dilaudid and other narcotics must be stored under lock and key in all hospital nursing areas. This earned me the hatred of several hospitals and state legislators, but the drug companies and irresponsible legislators were never held accountable.
Why did these changes happen right under our noses?
… because we allow our political leaders to make decisions that don’t represent our best interests.
Laws are written by lobbyists as “white papers” so that their authors remain anonymous, and easily avoid scrutiny. I know, I was one of them.
This is why so many laws sound like what private corporations want, not what the people want, … and not what’s good for our country.
How much longer are we going to sit back assuming that our lawmakers are “doing the right thing?”
How many young people are there in our country today, who, like myself years ago, are seeing our health care system in continuous decline, but choose to do nothing, and say nothing, … afraid for their jobs, their reputation, their image.
Yes, Mr. Mangione, I am one of many who are at fault for the current sad state of our health care system. I am guilty of not speaking up and of being afraid to raise my voice when I saw it coming.
Shoot me, Mr. Mangione, it was my fault.
DISCLAIMER: This blog is not meant to condone murder, nor is it in direct support of Mr. Mangione’s “manifesto” statements. It is an apology to young Americans for the errors of my generation of medical professionals who passively allowed our current health care system to deteriorate; but with the hope that future generations can fix it without violence.
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