Nocebo – the Art of Witch Doctors Practised By Medical Doctors

A week ago, the novelist Iain Banks announced he had terminal cancer and was not expected to live beyond a year. The doctors are the experts and this is their expert opinion.  Mr Banks has no doubt it is true and has accepted his fate …. And so it is very likely he will fulfill these expectations.

It’s called a nocebo. It’s where the witchdoctor tells the patient they will die in three days, and they go ahead and die in three days. It’s the power of the curse. Iain Banks has been told he will be dead within the year. And he has decided his doctors’ prediction is the truth. He cannot escape his fate. He

My wife, Bernadette, was told she had three months to live. She was told this on January 17th of that year. She died on April 16th. That was a very accurate forecast. Or was it a curse?

My friend Pauline was diagnosed with cancer a few years ago. She died slowly over a period of about 18 months. The interesting thing for me was that she absolutely resisted any attempt on my part to make suggestions. She knew I had been through this experience with Bernadette, that I had done years of research, that I had written books. She knew all that. But this knowledge was out-weighed in the balance against the doctor’s opinion that her case was terminal. She had, quite simply, taken on the narrative of death ….

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Study: Hospitals ‘Profit Handsomely’ From Surgical Errors

Hospitals nearly triple their profits when they make surgical errors, compared to how much they make when patients don’t suffer harm, according to a new study published in the Journal of the American Medical Association (JAMA).

On average, the hospitals studied reaped an extra $30,500 in profits when a patient developed one or more potentially preventable surgical complications because insurance plans pay more for longer stays and extra care, the study found.

Some surgical mishaps boosted profits by up to $44,000 per patient, reported researchers from the Boston Consulting Group, Harvard, and Texas Health Resources, a large nonprofit hospital system.

“It’s shocking, crazy and perverse that hospitals are being financially rewarded for harming patients, while the prize for hospitals that are working hard to improve patient safety and reduce surgical errors is losing money,” says Barry Rosenberg, MD, a coauthor of the study and a partner in the Boston Consulting Group.

Lethal Hospital Mistakes on the Rise

In 1999, the Institute of Medicine published a report saying that hospital errors killed nearly 100,000 Americans a year—a rate of lethal medical harm comparable to four jumbo jets crashing each week.

Overall, an estimated 15 million Americans (out of 37 million who are admitted) suffer medical harm in hospitals annually, according to the Institute for Healthcare Improvement. Along with the human toll, hospital errors cost the healthcare system $17.1 billion a year, another recent study reported.

A System That Rewards Substandard Care

Widow Billed for Care That Killed Her Husband

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Cancer Doctors Protest ‘Astronomical’ Drug Costs

Charging high prices for drugs cancer patients need to survive is like “profiteering” from a natural disaster by jacking up prices for food and other necessities, leading cancer doctors and researchers from around the world contend in a new paper published in Blood, the journal of the American Society of Hematology.

Of 12 new cancer drugs that received FDA approval last year, 11 of them cost in excess of $100,000 a year—prices that the specialists attack as “astronomical,” “unsustainable,” and maybe even immoral. What’s more, only three of these drugs were found to improve patient survival rates and of these, two only increased it by less than two months, according to the Washington Post.

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Making cancer drugs less expensive

By Hagop Kantarjian, Tito Fojo and Leonard Zwelling,February 22, 2013

Of the 12 new cancer drugs approved by the Food and Drug Administration last year, 11 were priced above $100,000 annually. Yet only three were found to improve patient survival rates and, of these, two increased survival by less than two months.

All this shows little or no correlation between drug efficacy and “just price.” Medical bills have become the major cause of personal bankruptcy in the United States, which is not surprising, given the amounts that even well- insured patients have to pay for drugs. Those that cost more than $100,000 can command a quarter to a third of some households’ annual income.

Once a cancer drug is approved by the FDA, the pharmaceutical company that made it determines its price. This is based on research and development costs and the expense incurred in creating drugs that were not successfully developed, as well as regulatory, education and advertisement costs. To outsiders, these prices can seem arbitrary. Often, the price is set above that of a similar drug on the market.

When your surgery goes wrong, hospitals profit

For a patient, a surgical complication can be a painful, even deadly. For a hospital, a surgical complication can be incredibly profitable.

A surgical complication increases a procedure’s average contribution margin by 330 percent for the privately insured and 190 percent for Medicare patients, according to a study published this week in the Journal of the American Medical Association.

The study underscores how ludicrous the incentives are in the American health care system, generally paying doctors for each medical service they provide, even if some of that care is the result of a surgery gone wrong.

“If you personalize this and a relative is having heart surgery, which gets complicated by pneumonia, I don’t think we would want a hospital’s profit to go up as a result of that pneumonia,” said study co-author Barry Rosenberg, a partner in Boston Consulting Group’s health care practice.

When a surgical complication occurred, the profit margin jumped from $16,936 to $55,953. For Medicare patients, profits grew from $1,880 to $3,269.

Under that model, better results do translate into higher payments—the exact opposite of the system we have right now.

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The Cures (for Cancer)

I find myself unnerved by this seeming epidemic of cancer that surrounds me.  Intimates of mine seem to be getting it like a flu. These people aren’t chain smoking, drinking effluent or pursuing unhealthy lifestyles. They’re young and old, often in apparently perfect health.

I spoke to Salvatore (brain cancer), I spoke to Xeni (breast cancer) , and I also spoke to Magda Bandera, another friend of mine, an activist and journalist from Spain who went public with her cancer. They chose honesty, they valued openness, they took the responsibility for their dark state. And they have survived, to the extent that any of us mortals survive.

One can choose otherwise — like, for instance, Steve Jobs. The worst is to be kept in the obscure ignorance, where your body becomes the object, the victim, the target of an obscure menace. Disease may take your life but superstition and obscure protocols is where you lose your dignity, strength and social power.

When cancer knocks on our body, we become refugees within our own selves. Forces stronger then we can control seem to guide our being toward death. But there is a lucid moment when we realize that these forces can be understood: You cannot FIGHT cancer, win wars on cancer, battle cancer as a mystical otherness or just alien part of your body, because then you become part of that evil scheme.

Cancers are part of US, aspects of our metabolism gone astray, and parts of the human body, an entity that should be treated with love and care.  One can’t fight cancer with panic, fear, silence and hatred, any more than one makes peace during war by doubling the demonized resentment. Wisdom, science, politics of free information and activism is the path to survival: The Internet is a new presence in the ancient house of pain.

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The costly war on cancer

New cancer drugs are technically impressive. But must they cost so much?

CANCER is not one disease. It is many. Yet oncologists have long used the same blunt weapons to fight different types of cancer: cut the tumour out, zap it with radiation or blast it with chemotherapy that kills good cells as well as bad ones.

These new drugs sell well. Last year Gleevec grossed $4.3 billion. Roche’s Herceptin (the HER2 drug) and Avastin did even better: $6 billion and $7.4 billion respectively.

The snag, from society’s point of view, is that all these drugs are horribly expensive.

Not all these new drugs work. In December the FDA said that Avastin’s side effects outweighed its meagre impact on breast cancer. (Genentech will argue otherwise in a hearing in June.) More generally, some people reckon that new cancer drugs offer small benefits at an exorbitant price. Provenge costs $93,000 for a course of treatment and extends life by an average of four months. Yervoy costs $120,000 for three-and-a-half months. Some patients live much longer, which fuels demand for the drugs. But others spend a lot and get little. Otis Brawley, chief medical officer for the American Cancer Society, calls the new treatments “the next frontier”, but adds: “We are not buying a lot of life prolongation with these drugs.”

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Sausages, ham, bacon and other processed meats leads to early death / cancer / heart disease?

People who eat a lot of processed meat such as ham, bacon, sausages and burgers run a greater risk of premature death and developing conditions such as cancer and heart disease, research shows.

It concluded diets high in processed meats were linked to cardiovascular disease, cancer and early deaths.

The researchers, writing in the journal BMC Medicine, said salt and chemicals used to preserve the meat may damage health.

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