False profits and silent partners in health care

Abstract

Traditional health care services have focused more on treatment of signs and symptoms of cardiovascular disease rather than on prevention of primary causal factors. This bias created a nation with increasing numbers of older people paying for increasing treatment costs. Treatment-oriented clinicians, drug companies and hospitals take a major proportion of ever-increasing health care dollars. Without prevention, American families gain little long-term relief from the highest health care treatment costs in the world. A lack of public accountability for valid surrogate endpoints continues to drain funds for treatments that do not remove underlying primary causes. It seems unethical and uneconomical to withhold community-wide primary prevention advice and only attend to people with clinical signs of disease. Also, treatments that remove a sign or symptom without removing the primary cause unethically set a sense of improved health while leaving unchanged the cause to continue harming future generations. A good alternative would be long-term primary prevention that removes primary causal factors and prevents the onset of signs and symptoms of disease. Health insurance companies could be effective partners with corporate and individual subscribers by diverting resources toward preventing proved primary causes of disease. A chain of molecular events that causally connects modifiable food choices to many health disorders has a measurable mediator: the proportions of omega-3 and omega-6 in tissue highly unsaturated fatty acids (HUFA). Health risk assessment can monitor the diet-based proportions of tissue HUFA which influence hundreds of vital physiologic events. Many financial losses will likely be decreased by primary prevention advice to choose foods that increase intakes of omega-3 fats, decrease intakes of omega-6 fats and include fewer calories per meal.