The Welfare Industry: A Money Maker, Says the Ethicist

This article has been edited for clarity.

Hello. I’m Art Caplan. I am in the Department of Clinical Ethics at NYU Grossman School of Medicine in New York City.

We have a lot of controversy and controversy swirling around Medicare’s out-of-control spending. Many people argue that we must reduce and reduce it, and many people realize that we cannot continue with that kind of consumption.

People are looking to save money. Of course, we cannot continue with the prices we are paying. No system can. We will make money if we don’t lower prices.

There’s another area that’s raising costs where, even though Medicare doesn’t pay, we can take resources and hopefully put them back into things like Medicare or other effective insurance. That area is the health industry.

I looked at the number recently, and I was surprised to see that worldwide, $ 1.8 trillion is spent on health, including billions in the US. Again, Medicare doesn’t cover that. It’s money coming out of people’s pockets that we could hopefully focus on paying for things we know work, not seeing the money come from covering bunk, nonsense, and charlatanism.

Do any or most of these things work? Do anything? Help who? No. We spend money on scammers and quacks. The US Food and Drug Administration (FDA), which you might think is the agency that could step in and start putting an end to this madness, is simply too overwhelmed with trying to track drugs, devices and vaccines to pay attention. a lot. health industry.

What exactly am I talking about? I’m talking about everything from intestinal probiotics sold in sodas to probiotic face creams and Gwyneth Paltrow’s Goop industry, where you have people buying things like wellness mats or ovaries that should maintain women’s health.

We’re talking about things like PEMF, or pulse electronic magnetic fields, where you buy a machine and expose yourself to magnetic fields. I went online to look them up, and the machines cost $5000-$50,000 to buy. There is no evidence that it works. In fact, machines are not only sold for pain relief and many other things for humans, but they are also sold for pets.

That industry is completely out of control. Health programs, whether transcranial magnetism or all kinds of supplements sold in health food stores, time and time again, we see a world where health is promoted but no data is presented to show that one of them helps, works or works. it does anyone good.

It may not be harmful, but it is definitely financial poison for many people who end up spending a lot of money using these things. I think doctors need to ask patients if they use any of these things, especially if they have chronic conditions. Perhaps, many of them, may be lured by internet advertising to get involved in these things because they prevent or will help treat other conditions they have.

The industry is out of control. We try to find a way to spend money on things that we know work in medicine, yet we continue to tolerate bunk, nonsense, quackery, and charlatanism, letting it grow and grow and grow. expenses.

That’s money that can go elsewhere. It is money that is being taken out of patients’ pockets. They do things that may delay medical treatment, that will not help them, and they do things that may interfere with medical care that is actually known to be good.

I think it’s time to push for more money for the FDA to regulate the health side. I think it’s time for the Federal Trade Commission to crack down on ads that promise health benefits. I think it’s time to have an honest conversation with patients: What are you using? What are you doing? Tell me about it, and here’s why I think you could probably put your money to good use.

I’m Art Caplan, Department of Clinical Ethics at NYU School of Medicine. Thanks for watching.