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EditorialEditorials

The Price of False Beliefs: Unrealistic Expectations as a Contributor to the Health Care Crisis

Steven H. Woolf
The Annals of Family Medicine November 2012, 10 (6) 491-494; DOI: https://doi.org/10.1370/afm.1452
Steven H. Woolf
Department of Family Medicine, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
MD, MPH
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  • Re:Health Care Reform
    Charles Weber
    Published on: 26 January 2013
  • The Price of False Beliefs: the importance of the denominator
    Carol P Herbert
    Published on: 18 November 2012
  • Health Care Reform
    Valerie Bengal
    Published on: 15 November 2012
  • Published on: (26 January 2013)
    Page navigation anchor for Re:Health Care Reform
    Re:Health Care Reform
    • Charles Weber, retired

    I feel a sales tax should be levied on any food that has known poisons added such as aluminum, aspartame, fluoride (see http://charles_w.tripod.com/fluoride.html ), sulfite, chili pepper (see http://charles_w.tripod.com/diabetes.html )and etc. or essential nutrients subtracted. It should be effective even at the municipality level and certainly the state. I am certain this would cause a great improvement in our country's...

    Show More

    I feel a sales tax should be levied on any food that has known poisons added such as aluminum, aspartame, fluoride (see http://charles_w.tripod.com/fluoride.html ), sulfite, chili pepper (see http://charles_w.tripod.com/diabetes.html )and etc. or essential nutrients subtracted. It should be effective even at the municipality level and certainly the state. I am certain this would cause a great improvement in our country's health when processors corrected the situation or, if not, when less of it was purchased. If a tax were placed on food that has had essential nutrients removed the improvement in health would be dramatic. A fringe benefit would be to enable the heavy Medicare tax (USA) to be reduced or eliminated. If everyone is getting good food most diseases would disappear and we could then devote our research to the few remaining. Perhaps you can use your influence to get such a law passed. See this site http://www.citizensadvisory.org/news/Advisories/TaxingBadFood- Environment.html for a further discussion.

    We talk endlessly about better health insurance. Insurance is a marvelous invention, but there is no excellent substitute for not getting sick in the first place. In any case, if everyone is healthy, the insurance premiums will go a way down as a side effect no matter how they are instituted. With the extra money we could then start to pay down that miserable national debt and with the extra time, enjoy ourselves (say with a shorter work day).

    We would not need a national health insurance. Indigents could be cured at government expense in the form of a loan, which loan could be paid back by an escalation of their income taxes. They would thus have a life time to pay back, and usually no burden on their countrymen. Also this would prevent a degradation of our freedom. It can not be assumed that your society will remain robust automatically. http://www.sjsugeology.org/ It could just as well decline miserably as have other societies.

    Sincerely, Charles Weber

    Competing interests:   None declared

    Show Less
    Competing Interests: None declared.
  • Published on: (18 November 2012)
    Page navigation anchor for The Price of False Beliefs: the importance of the denominator
    The Price of False Beliefs: the importance of the denominator
    • Carol P Herbert, Professor, Department of Family Medicine

    Dr. Woolf's excellent editorial should be required reading for medical students, residents in all disciplines, and practicing physicians. In our zeal to 'do something', we may do harm to our patients. If we wish to practice patient-centred medicine, we need to take the time to provide critical analysis of the available evidence for diagnostic tests and therapeutics so that patients can make informed choices. Similarly,...

    Show More

    Dr. Woolf's excellent editorial should be required reading for medical students, residents in all disciplines, and practicing physicians. In our zeal to 'do something', we may do harm to our patients. If we wish to practice patient-centred medicine, we need to take the time to provide critical analysis of the available evidence for diagnostic tests and therapeutics so that patients can make informed choices. Similarly, family physicians need to be confident and brave enough to withstand both well-intentioned advice from other specialist colleagues and marketing tactics from industry. We need to consider 'the denominator' of our primary care populations, as well as the numerator.

    Nowhere is this more evident than in the management of patients with chronic illness. Guidelines for treatment and both primary and secondary prevention must be reviewed with an eye to numbers needed to treat (NNT) and numbers needed to harm (NNH).

    Competing interests:   None declared

    Show Less
    Competing Interests: None declared.
  • Published on: (15 November 2012)
    Page navigation anchor for Health Care Reform
    Health Care Reform
    • Valerie Bengal, Physician

    Thank you for the excellent essay. Reforming health care will require many fundamental changes in how we use evidence-based and time-honored practices, and how we learn from other societies which have better health outcomes than we do. A single payer system of health care financing is the best option for the United States for many reasons: everyone, being equal under law, will be in the same financial and risk pool, it wil...

    Show More

    Thank you for the excellent essay. Reforming health care will require many fundamental changes in how we use evidence-based and time-honored practices, and how we learn from other societies which have better health outcomes than we do. A single payer system of health care financing is the best option for the United States for many reasons: everyone, being equal under law, will be in the same financial and risk pool, it will be possible to save money through global budgeting and cutting administrative waste, health coverage will not depend on employment (business owners will not have to struggle with providing expensive health care benefits for their employees), research and health policy will be more objective, etc. But as the article points out, no system can succeed if patients and physicians together cannot pursue high quality and rational medical practices. The increasing interest in palliative care and in preventive medicine demonstrate that a shift in consciousness is in process which will help with personal awareness and responsibility. I hope this discussion continues, so we can diminish the harm to the population due to lack of access to care, inappropriate interventions, adverse effects of medications and procedures, and basic misconceptions regarding health.

    Competing interests:   None declared

    Show Less
    Competing Interests: None declared.
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The Annals of Family Medicine: 10 (6)
The Annals of Family Medicine: 10 (6)
Vol. 10, Issue 6
November/December 2012
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The Price of False Beliefs: Unrealistic Expectations as a Contributor to the Health Care Crisis
Steven H. Woolf
The Annals of Family Medicine Nov 2012, 10 (6) 491-494; DOI: 10.1370/afm.1452

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The Price of False Beliefs: Unrealistic Expectations as a Contributor to the Health Care Crisis
Steven H. Woolf
The Annals of Family Medicine Nov 2012, 10 (6) 491-494; DOI: 10.1370/afm.1452
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