Preventive health care, anyone?
When you are a PhilHealth member and meet certain requirements, you are assured of lifetime membership without paying dues anymore. There is just one big problem: in old age you need more maintenance medicines to take daily to cover a variety of illnesses like high blood pressure in my case. But unless you are hospitalized, taking medicines, even if prescribed by your doctor, is not covered by PhilHealth. This is not fair because taking maintenance medicines actually protects your health and thus makes hospitalization unnecessary. Another problem with PhilHealth is that in serious cases it covers only a fraction of the hospital bill.
To prevent paying a lot for hospitalization or buying prescribed medicines when out of hospital, we have to be careful with our health by doing things to prevent diseases like cancer. Are we doing enough for disease prevention?
Yesterday I read a New York Times article by David Agus titled “The 2,000-Year-Old Wonder Drug.” Agus talks of the rise in health care spending in the US but that the focus, whenever it is being talked about, is how to pay for that care, not on reducing the need for it. The exception, according to him, is Mayor Michael Bloomberg of New York, who is setting new standards that would do well if adopted nationally. What Bloomberg did was to change the city’s health code to mandate restrictions on sodas and trans fats — products that, when consumed over the long term, harm people.
The US is not the Philippines, but if I were correct in my readings, Philippine diseases, especially fatal cases like cancer, are already approximating that of US levels, thanks to the way we ape what our idols eat in the US.
Here comes the question Agus raised in his article: when does regulating a person’s habits in the name of good health become our moral and social duty? His answer is in two parts: first, when the scientific data clearly and overwhelmingly demonstrate that one behavior or another can substantially reduce — or, conversely, raise — a person’s risk of disease; and second, when all are stuck paying for one another’s medical bills like they do in the US by way of Medicare, Medicaid and other taxpayer-financed health care programs.
In such cases, Agus argued, encouraging healthy behavior, or discouraging an unhealthy one, ought to be a matter of public policy. In the US for instance, they insist on vaccinating children for measles, mumps, rubella and polio because they know these preventive strategies save lives. In some of these cases, we also do this in the Philippines as what is required for those covered under the government expanded 4-Ps, for example.
Finally, Agus raised this point: Under that rationale then (as in the above), why not make it public policy to encourage middle-aged people to use aspirin?
According to Agus, Aspirin, developed in 1897 by the German chemist Felix Hoffmann, has long proved its value as an analgesic and that two millenniums before that, Hippocrates, the father of modern medicine, used its active ingredient extracted from the bark and leaves of the willow tree to help alleviate pain and fevers.
Now we know, according to Agus, that many high-quality research studies have confirmed that the use of aspirin substantially reduces the risk of cardiovascular disease which prompted the US Preventive Services Task Force to strongly recommend that men ages 45 to 79, and women ages 55 to 79, take a low-dose aspirin pill daily, except for those who are already at higher risk for gastrointestinal bleeding or who have certain other health issues.
Now new reports also come about aspirin’s benefits in cancer prevention. In 2011, according to Agus, British researchers, analyzing data from some 25,000 patients in eight long-term studies, found that a small, 75-milligram dose of aspirin taken daily for at least five years reduced the risk of dying from common cancers by 21 percent.
Agus also mentioned something that two more papers published by The Lancet (that I also read few months back when I was researching how to help my cancer-stricken wife) which bolsters the case for this ancient drug.
The conclusion is that Aspirin, one of the oldest remedies on the planet, helps prevent heart disease through what is likely to be a variety of mechanisms, including keeping blood clots from forming. It also helps prevent cancer, in part, by dampening an immune response called inflammation.
So the question remains, given the evidence we have, why is it merely voluntary for physicians to inform their patients about a health care intervention that could not only help them, but also save untold billions in taxpayer dollars each year?
Agus warns that for some men over the age of 45 and women over 55, the risks of taking Aspirin outweigh any benefits — and patients should talk with their doctors before taking any medication, including something as familiar as aspirin.
But with such caveats in place, however, Agus said that it still ought to be possible to encourage Aspirin’s use in those for whom the potential benefits would be obvious and the risks minimal.
Just as we discourage smoking through advertising campaigns, for example, shouldn’t we suggest that middle-aged Americans speak to their doctors about Aspirin, Agus asked.
I agree.
