Myth for the Cure: Essential for Disease Focus

Do no harm has lost its charm - when dollars are involved.

Do no harm is difficult when the focus is eliminating disease. Nearly all of the disease-focused treatments cause harm and some cause substantial harm to people, to groups, or to entire nations. Harm can be direct to patients or indirect within health care. At ever more spent on health care, disease focus can wreck and entire nation and impact the world. The United States has a way of impacting many others throughout the globe by its designs and the consequences of these designs.

Race for the Cure is the recent best example of disease focused health care. The Pinking of America, Million Hearts Campaigns, Four Diseases focus of global health care, and Radiology Screens that could cause more disease with little real hope for cure (but more tests and procedures) are just a few other examples.

There is no easy cure for diseases that remain prevalent. The easy cures were few and long ago. We now have spending and spending and spending with some gains and some losses.

The myth of finding a cure will continue. It is what is essential to funding efforts. All who experience death want to stamp out this particular cause of death. Those most likely to raise funding are those who experienced death from disease who still believe that they can save lives with their efforts. Actually they do little beyond just telling colleagues and contacts about their loved ones and their own situations – people contact matters as much more more than dollars sent somewhere else.

The myth of the cure is directly related to our myth that we will live forever. The myth of the cure is essential to disease-based fund raising. Busting this myth would spell disaster for those focused on disease  and what disease can generate in dollars for them – such as CEO paychecks of $400,000 or more for those at the top of the Komen pyramid built by countless efforts of tireless volunteers.

Disease impact is not a myth, but focusing on cures for the fewest and oldest can impair needed health for the most and the youngest.

Focusing Far Too Much Upon the Cure

Marketing campaigns have existed for centuries and will continue, but marketing slogans will not be truthful as we have found out for over a century. WWI was marketed as "the war to end all wars" and as "war to make the world safe for democracy." History teaches a different lesson for 100 years. So far this century we have constantly been in a state of war. The myth of war to end war continues as we fail to understand divisions between nations as well as divisions within nations.

Cure focus is a prestigious line of work with a long and glorious tradition. A number of novels trace the path of various fund raising organizations. The myth of the cure is the "essential element" of fundraising for disease based collection. You can understand "essential elements" by how much promotion is involved and how promoters fight to keep from being discovered.
  • Essential to credit card use is credit corporation prevention of awareness just how much and how long it will cost to pay off the card at minimum payment levels.
  • Essential for insurance companies is preventing understanding of how much insurance companies divert for their use.
  • Essential for Wall Street is prevention of the knowledge of how little gain goes to customers compared to Wall Street trading pockets.
  • Essential for drug companies is avoiding at all costs the government ability to negotiate drug cost. Not only did drug company lobbyists and insider Congressmen prevent this during Part D Medicare legislation, they actually passed legislation that prevented this ability by government. Worst of all is the obligation for trillions in debt due to future spending sent to drug companies and the drug distribution corporations.
Never forget Part D Medicare - the worst moment of Congress. Our children and grandchildren facing ever greater challenges will remember the crippling of an entire nation by previous legislation. When we spend more and more at the end of life, it is a guarantee that it will hurt those that cannot even vote, organize, or raise their voices because they have not been born yet or are too young.

Funders must use the myth of the cure to succeed in extracting funds for disease focus. Health institutions spread the myth of cure to generate funding and utilization, especially the important 30% of health spending in the last year of life. Related is a focus on the best care (best and brightest, most technology, disease approved) or duking it out with cancer as if cancer is a person (personification of disease). Poster children drive home the message best. Does anyone realize that advertising expenditures are a primary way to divert funding away from the delivery of health care? As if many had a choice at all...

The myth of the cure has become a primary destabilizing force with regard to our civilization. Lead metal used in plumbing may have ended intelligence in various past civilizations from plumbism, but we should not allow ignorance and distraction and distortion (too much disease focus) to kill off organized and civilized society.

Breast cancer is a good example of the complexity that society would need to address to actually result in a cure – cures promised by those who want your money.
  • There is no one breast cancer.
  • There is no single treatment for breast cancer.
  • There is no entirely correct treatment for each type of breast cancer.
  • There is no entirely correct way to prevent breast cancer.
  • There is no entirely correct way to decide when to stop treatment for breast cancer.
  • There are no unique single types of human beings in their body and genetic composition.
  • There are no unique single types of human beings in their socioeconomic status and demographic indicators.
  • There are no unique single types of humans by their place of residence.
  • There is no universal access to care and access to specialized care such as cancer is most limited.
  • The genes that might help in various treatments are owned by people, groups, and institutions that plan substantial profit. Others are owned by those who will use ownership to prevent cures as their products can be sold in place of an effective treatment that would compete with their product.
The one single best focus for helping to address breast cancers and various major causes of death is to increase public health, health educators, primary care, and primary care personnel of all types who blend in with the community and people so well that access to care is no longer limited by social determinants. For 50 years we have been integrating these interventions and to me they are limited mainly by the disease focus of our society. Every 20 years some new movement (lay nursing, parish nursing, COPC, community based, population based, self empowerment, personal prevention) rediscovers the power of getting inside people and groups of people to help them improve their health, only to see this washed away by an ocean of disease focus.

People Focus is Specific to Improvements in Health     Disease Focus is Not

Million Hearts Campaign that is one more step that compromises 160 million left behind as I noted in a 3 part blog. Family practice RN, MD, DO, NP, and PA workforce is the solution for 160 million left behind and this workforce is also the workforce that will best insure that prevention interventions do more good than harm. Prevention is important for all in family practice, but focusing attention on diseases is not a good plan to address the most pressing needs of patients cared for by those in family practice.Four diseases focus has pushed the United Nations toward disease focus and away from the health of the public. Weak disclaimers do not stop this movement toward disease and away from health. Good WHO and United Nations works on primary care, rural access, and other public health efforts will be marginalized when disease focus takes hold again rather than health focus. Even communicable disease loses out when nations focus on NCD or non-communicable diseases, especially when more believe that communicable diseases are "their own fault."

We must learn to focus prevention and workforce specific to top priority health needs. We must learn to ignore disease focus. We must gain awareness not of disease but of those who profit from disease focus and those who promote the myth of cure for complex diseases.

We must learn that health spending that matches up best to locations and populations in need of care is most needed for health access and is most needed for recovery of economics in locations and populations left behind.

We must oppose more spending for fewer spent in fewer locations at fewer ages and at older or oldest ages

As this will result in the most spending, the most workforce, the most disease focus, and the greatest ability to bend all of our spending their way and away from the basic needs of most Americans - by design.
 

Thanks to all 12,000 who have visited Basic Health Access in 2011.











Robert C. Bowman, M.D.        Basic Health Access Web    Basic Health Access Blog

Dr. Bowman is the North American Co-Editor of Rural and Remote Health and a Professor in Family Medicine at A T Still University School of Osteopathic Medicine. He was the founding chair of the Rural Medical Educators Group of the National Rural Health Association, he was the long term chair of the STFM Group on Rural Health, he is the founding director of Priority Infrastructure at http://www.infrastructureamerica.org/ and he is the author of the World of Rural Medical Education, and Physician Workforce Studies
SMART – Specific, Measurable, Achievable, Realistic, Timely


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