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by Donald B. Ardell, Ph. D.
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Wellness in the Headlines
(Don's Report to the World)

Visitor Feedback on Recent Essay Entitled "Blacks Inadvertent Beneficiaries Of Racial Discrimination!"

Friday September 9, 2005

A few weeks ago, I described studies that indicate black Americans receive "far fewer operations, tests, medications and other ... treatments than whites." I wrote that while on the face of it this sounds like a bad thing, given that all sensible folks oppose such inequalities, in fact most of the victims in this case might be better off as a consequence of such neglect! Then I described the studies and noted that whites and blacks need something more valuable to their health than a cornucopia of medical operations, tests, medications and treatments. That, of course, would be healthier lifestyles. Unfortunately, doctors, drug companies, hospitals and the rest can't make the kind of money in promoting wellness than is available from high risk surgeries, drugs and so on. I advised that America needs a far better medical system than exists today, one that would give blacks, whites and everyone ample opportunities to learn about and sustain wellness lifestyles.

Well, I got a lot of feedback on that essay. Here is a sampling of letters. All feedback is appreciated, so always know that comments on any essay are read, welcomed and sometimes published for others to consider, as well. 

• Hi Don -- Well, this was an interesting slant on inequalities in health care.  I bet (hope) you get some feedback on it! The topic is a good one for a debate.

Lenore Howe

• Don - I think you found an effective way to address some critical issues in health care ("more medical care is not always synonymous with better medical care or best health outcome").  I like the suggestion that researchers focus their efforts on learning which medical treatments are cost effective and truly benefit our quality of life.
   
  From the standpoint of balance, you might concede that blacks may be disproportionately deprived of necessary medical treatments and surgeries. While you might be able to show that overall (on average) medical treatments don't help that much and often do a lot of harm, averages are no consolation to many blacks and other poor people who receive substandard or no medical care when they need it. For many people who suffer from grave medical conditions, good medical treatment is their only option.
   
  I have recently had more than a routine encounter with health care providers. I discovered that the prescribed medications I need are very expensive. Even less effective OTC medications are expensive. As far as I can tell, my condition has nothing to do with lifestyle choices. Refraining from some foods and beverages may help a little, but medication or surgery may be the only effective treatments for my problems.
   
  I received excellent care from all medical personnel involved. My doctor spent an hour (!) discussing my treatment options with me and then gave me about a thousand dollars worth of the prescription medication, promising more when I run out. Probably helps that he's a bike racer. Do you think a poorly educated, low-income black person would have received such good care? I feel somewhat guilty about the free medication samples; I was tempted to suggest he give them to someone more deserving, but at $160 a month, I decided to think it over. For sure I wouldn't want to be coping with this condition without access to medical care.
   
  I wonder how many people out there are living with pre-cancerous esophagi with little or no hope of receiving appropriate medical treatment. Luckily for me, my Medicare and Medicare supplement covered all the costs of the test. My drug costs will be mainly out of pocket, which is one reason I'm going to revisit the surgery option after my esophagus heals. Who wants to spend $160 a month for the remainder of his life? I'll know in 18-24 months.
   
  Anyway, for all its flaws and inefficiencies, I wouldn't want to revert to life without modern medicine. You are right, though--our health-care system is a mess. And your other points are very well taken. I started to say you don't want to create the impression that medical tests, medications, and treatments are worthless, but then I realized you didn't say that. What you didn't say is that frequently they are the only option.

Bob Ludlow

• Hi. I know the point that you are trying to make (i.e., over-medicalization) and agree about too many treatments lacking proven indications (i.e., evidence-based medicine). But I don't think that you bring sympathy to your position by using an example of clear racial discrimination, even with the irony injected into your prose. The under-treatment of blacks is just part of the continuing 400 year history of same in this country. Best wishes,

Steve Jonas 

• Don -- Actually, Asians also receive significantly less medical services. In their case, it is attributed to their healthier lifestyles and being less dependent upon Western-style medicine. For African Americans, the issues are how medical services are distributed, the availability of needed (appropriate) care and preventative care -- versus all the other stuff we do. For too many people living in poverty, the primary source of care is the ER and 911 calls.
   
  Steve McDermott, Alamo, CA

That's just a sampling. All the best. Be well. Always look on the bright side of life.

Domain: mental
Subdomain: factual knowledge

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