Page 11 - Boca Club News - November '22
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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
                                                                                                              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
                                                                                                           what is discovered is benign, but what follows are invasive

                                                                                                           Medical Matters on page 12

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