Tuesday, February 24, 2009

Healthcare Crisis

There is a big crisis in the health care system (some would like to call it sick care system). The prices are going up by 10-15% every year, and correspondingly the insurance premiums. There is a tuberculosis epidemic that is threatening to breakout anytime, even in the developed countries. The chronic diseases, such as cancer, diabetes, hypertension continue to plague us with no solution in sight. The pharmaceutical companies and the medical community have managed to find palliative measures that keep a patient alive for a long time, but there is no true cure for many health problems. Every new drug invented, every new procedure developed is costlier than the one before, but with few exceptions, most of them do not cure the patient. Instead they keep him or her dependent on the system for a long time, with attendant expenses and unwanted side effects. Even antibiotics which saved so many lives in the 20th century have become ineffective against increasingly virulent and resistant bugs.

Every spoke in the wheel of health has had its own role to play in creating the mess we find ourselves today. Let's start with the health care professionals. General physicians seldom get to spend enough time to understand an individual patient, his or her lifestyle or diet. More than 50% feel they are overworked. More often than not, it is a quick enumeration of symptoms and some lab tests and a prescription. Physicians are happy to prescribe antibiotics and other strong medications even when they are not strictly called for. The pediatricians are the worst offenders of overprescribing antibiotics. Majority of the cases do not even need them because the infections are viral. This not only creates super bugs, but also weakens the immunity of a child. My reasoning is simple – if you give a crutch to the body, the body stops making an effort to heal itself and comes to rely on the crutch. See this article on antibiotics. Specialists such as dentists and orthopedics doctors are even more culpable. Often they tend to treat individuals like mechanics treat your cars – the more repairs the better – for them. This is not to say that there are no ethical, sincere and loving doctors around. But often they become unwitting part of an establishment that is too hard to navigate and change.

Next come the insurance companies. They show no interest in ensuring that an individual gets proper health care. For them every medical expense is another expense and it is their stated goal to reduce this expense. For example, most insurance policies do not cover preventive measures such as multi vitamins or supplementation. Most policies won't cover the membership of a health club or give discounts if you are an active member. Most often they are not interested because the employers who provide the biggest chunk of insurance policies, keep changing the insurance companies frequently. Thus insurance companies have zero incentive in keeping an individual healthy.

Then come the pharmaceutical companies. While they have done some wonderful work in the past in developing life saving drugs, now they are in a rat race. Their credibility lies in tatters due to recent scandals. Peddling drugs that are of dubious efficacy, suppressing research that shows negative aspects of their drugs, bribing doctors to prescribe more medicines, encourage doctors to use the drugs off label, you name a perversion, they have indulged in it. The scandal goes on and on and with no end in sight. What is worse, there is hardly any liability for the individuals who consciously swindle the society. At the most they get a slap on their wrists.

This brings us to the fourth spoke – the regulator – FDA in America. For all practical purposes they do the bidding of the pharma companies. It is a revolving door at the FDA, often professors and researchers with deep connections to pharma industry head the FDA. While there is a process to certify and monitor drugs, FDA uses its big stick to beat back any attempt by alternative medicines to address a market need. In the States, no supplement or food producer can make a claim that his ware can cure anything. There are many such instances where a traditional (really traditional like an Ayurvedic preparation) can and does alleviate a certain condition, but they are not allowed by FDA to make that claim or at least FDA won't certify them. According to FDA, something is a drug only if it has gone through certified clinical study. No matter that these clinical studies are conducted by the interested parties, and that the traditional medicines have gone through millennia long trials. A lot of the funding for FDA comes from the pharma industry itself.

The final spoke is the consumer. This is where the biggest blame lies in the whole system. People tend to believe that a doctor knows everything. We are ultimately responsible for our own health – failure to recognize this simple truth often results in fatal consequences. People go to doctors with their mundane problems and accept prescriptions which are often not necessary. Doctors have become very defensive because of the ever hanging threat of malpractice lawsuits. So they will choose the strongest measure even when a wait and watch method will work just as well. We are too lazy to choose a careful diet that's suitable for our lifestyle, genes and body. We do not exercise enough. We eat and drink a lot of junk food. In the end is it any surprise that we are at the mercy of harsh chemicals and - at best - indifferent professionals?

In the second part of this article I will write about some of the methods we have adapted to ensure a healthy lifestyle.

Sunday, February 1, 2009

A limitation of the scientific method

Scientific method

"Scientific method refers to bodies of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering observable, empirical and measurable evidence subject to specific principles of reasoning. A scientific method consists of the collection of data through observation and experimentation, and the formulation and testing of hypotheses."

I often hear from scientists and wanna-be scientists (like me) that the scientific method is the only way possible forward in understanding the universe. Logical reasoning and the scientific method have their place in the scheme of things. But to say that they are primarily responsible for all progress is putting the cart before the horse. In the definition above, formulation of a hypothesis is taken as a part of the scientific method. However, this formulation is often mysterious, and no one can really explain how a "productive" hypothesis is arrived at. Most of the times logic and reasoning have nothing to do with it.

The anonymous Indian genius that conceived zero, Kepler, Newton, Kekulé, Marie Curie and Einstein all have one thing in common: they created a paradigm shift in our understanding of nature. The paradigm shift was not in the proof they offered but the hypothesis itself. While proof is important, it is secondary to the hypothesis. I doubt if anyone of these giants have explained how they came up with the hypotheses. Given a "productive" and viable hypothesis, someone can and will come up with a proof eventually just as Fermat's last theorem demonstrated.

The modern scientists spend their lifetimes perfecting the scientific method. But they probably do not spend enough time understanding how the hypotheses are made. It is assumed that a good scientist "knows" how to arrive at one. There is no process, no class (that I know of) and no "formal" guidelines to come up with a good hypothesis. No good hypothesis no significant progress. That's a limitation of the scientific method.

The ancient Indian sages approached the process in a different manner. Many of them were true yogis and attained samadhi by meditation. The claim is that when one attains samadhi, the knowledge about the true nature of the universe arises spontaneously. Perhaps this is the source of all hypotheses. They made seemingly amazing leaps in understanding the nature. Often they didn't explain how they arrived at that knowledge, but only stated it with authority. Frequently one hears the phrase "self evident" with such statements. It is left for the later commentators to comment on that statement and expound it. Some commentaries on Patanjali's Yoga Sutras say this: if all the books are burnt and all knowledge is lost save the Yoga Sutras, then rest of the knowledge can still be developed by accomplished yogis.

I know that there will be some scientist types on DC who will grill me on this one (where is Commonsense?), but I will make this claim: scientists will do much better in their disciplines if they include meditation in their curriculum. Have you noticed how often multiple scientists come up with the same new idea that miraculously solves a difficult problem that mankind has grappled with for ages? In my opinion this phenomenon is not magic or coincidence, but it can be explained by our spiritual nature. We are all connected by an underlying thread and that manifests itself in these mysterious ways. In fact someone even conducted a maze running experiment on rats that showed that once a particular maze is solved by one rat, other rats find it easy to solve.