Page 11 - Boca Club News - November '22

Boca Club News, Page 11
Medical Matters:

The American Health Care System (Part 1)

By Richard Nagler, M.D., a member poorly prepared and vastly under-estimated the severity of infant mortality as compared to other industrialized nations.
of Broken Sound Club and retired this pandemic, but it rapidly descended into a political versus Although since the introduction of the Affordable Care Act
physician. After graduating from the science nightmare with misinformation, denial, confusion 70 million more Americans now have health insurance, there
University of Pennsylvania and New and delays that resulted in thousands of lives lost that could remain approximately 30 million Americans without it. The
York University’s School of Medicine, have been avoided. failure of repeated efforts to repeal and replace the Affordable
Dr. Nagler served his internship and Despite the miracle of having developed in record- Care Act fortunately portends that it will remain basically
residency at Baltimore City Hospital breaking time newly conceived mRNA effective vaccines, intact for the foreseeable future.
and Johns Hopkins. He followed that which significantly protect against hospitalization and death, However, there is much in the Affordable Care Act
with a Fellowship in Gastroenterology progress has been slowed by the large number of citizens that is in need of reforms. For example, premiums have
at Yale University School of Medicine, and was then Chief who continue to refuse vaccination and boosters. In addition, recently begun to rise considerably, threatening to become
of Gastroenterology at Fitzimmons General Army Hospital refusal to mitigate appropriately against the virus when cases unaffordable despite government subsidies. Several major
in Denver. He returned to the Yale Medical School for one spike with mask-wearing and social distancing—especially insurance carriers have opted out of the program leaving
year as an Assistant Professor of Medicine before opening indoors and in crowded conditions—which have been only one insurer in a number of states. Many doctors don’t
his own successful private practice in Internal Medicine advanced by irresponsible politically motivated Governors accept Medicaid as the remuneration is paltry. In addition,
and Gastroenterology. During that time, he also served for in many states has encouraged the development of more many private insurers have deductibles and co-pays that are
ten years as Chief of Medicine at Huntington Hospital in contagious resistant mutations. so high as to make it impossible for those who are insured
Huntington, N.Y. Despite the remarkable advances in technology and to seek medical attention except for catastrophic situations.
The finest and most advanced medical care in the world the plethora of extremely well-trained professionals, these Essential insurance reforms will only happen in the unlikely
exists in our country. Over the past two-plus years, it has achievements remain inaccessible for millions of our citizens. event that Democrats and Republicans are willing to work
been severely tested by the unprecedented once-in-a-lifetime This is reflected in our dismal record in longevity (27th together in a bipartisan manner for the common good.
COVID-19 pandemic and found wanting. Not only were we and falling now for men to age 76, down three years), and The cost of medical care is out of control, and this is a
major problem in our health care system. Rampant abuse
and overuse of medical technology abounds, which has
driven costs through the roof. For example, it is estimated
that 50% or more of angiograms, angioplasties and stents
are not necessary. There is no evidence to support the belief
that angioplasty and stents used to dilate narrowed Coronary
Arteries in asymptomatic patients will prevent a subsequent
heart attack or prolong life. On the other hand, for patients
with angina and those who have significant risk factors such
as high blood pressure, obesity, diabetes and possibly very
high calcium indexes, these are reasons to consider these
procedures.
CT Scanning centers are still vigorously promoting the
myth that whole body scans for asymptomatic individuals
can discover cancers very early, thereby affording the
greatest chance for survival. The reality is that most of
CARE
what is discovered is benign, but what follows are invasive

Medical Matters on page 12

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