Amid all the health-care hoopla this week, a few hearings took place that went unnoticed. These hearings also had quite a bit to do with health care, but nobody paid much attention, preferring to watch what one Democrat called the "dog-and-pony" show going on at the Blair House.
One hearing this week was conducted by the House Veterans Affairs committee and looked into the relationship between medication and veteran suicide. Chairman Bob Filner, D-Calif., said that with Post-Traumatic Stress Disorder, or PTSD, and Traumatic Brain Injuries, or TBI, being the signature wounds of the current war in Iraq and Afghanistan, mental health issues have "taken center stage."
The hearing focused on the two different viewpoints on psychiatric medications and suicide. Indeed, there have been articles in the popular press this week dealing with just that topic, but they're unrelated to the hearings taking place in Congress. The Veterans Administration said Rep. Harry Mitchell, R-Ariz., has been proactive with veterans and overturned its self-imposed ban on television advertising as a method to encourage vets to get to help. Rep. Mitchell said that what began as a small Washington, D.C., area pilot program has been expanded nationally. They now have a hotline for veterans that received nearly 225,000 calls, and Mitchell credits this hotline with saving 7,000 lives.
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There was testimony during the hearing on both the pro and con sides on the issue of antidepressants. One psychologist testified that treatment consisting of both psychotherapy and medication far outweighs the observed risk for suicidal thoughts and behaviors. He said that for high-risk suicidal individuals, medications can be very effective in managing symptom severity such as sleep disturbance, agitation and anxiety even during periods of imminent risk. He believes that with medication and crisis management and with a concerted effort to engage at risk lives of veterans can be saved.
Biostatistics professor Andrew Leon suggested that depression increases the risk of suicide, and to reduce suicidal risk clinicians must carefully monitor veterans with depression, whether they are treated or untreated. He said that a cause-and-effect relationship has not been established between antidepressants and suicide. Donald Farber, retired attorney for the U.S. Navy, said antidepressants did cause suicide and that manufacturers would not secretly settle wrongful death suits for large sums it did not have a cause and effect. He was concerned that the VA needed more structured monitoring of antidepressants. He said he believed the VA and the Department of Defense would be doing members a disservice if risky drugs are administered without safeguards patients in private practice receive at the recommendation of the FDA. He believes
the VA should have independent monitoring of the risk of suicide for veterans taking antidepressants.
Another hearing that went unnoticed this week took place at the House Committee on Energy and Environment. The title of the hearing was "Endocrine Disrupting Chemicals in Drinking Water: Risks to Human Health and Environment." Briefly stated, the problem is that although naturally occurring substances can be endocrine disrupters, too much of what goes into our water table has long-term effects. They have shown that even a low-dose exposure of BPA can effect brain development structure and function in rats and mice. The potential health effects can be linked to non-cancer abnormalities of the reproductive system, precocious puberty and disorders of fertility. In addition, they believe diabetes, obesity and cardiovascular disease can also be influenced. Chairman James Moran, D-Va., said this problem of disorders of the human endocrine system is seriously undermining the health of our nation. He said disorders such as autism, attention deficit disorder, obesity and diabetes began to noticeably increase in the 1970s when the first generation exposed in the womb to post-World War II synthetic chemicals reached maturity.
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What does all this bad news mean? It means that all the back-and-forth arguing we saw at the health summit was a ridiculous waste of time. We can spend and spend and spend on health care, but unless we do the basic science, it is pouring money down the drain. That drain may be filled with toxic chemicals. My dear friend, Jim Pinkerton, one of the smartest people I've ever met, came up with an idea for what he calls "serious medicine." His view is that our health-care money should not go to making sure people can get a sprained ankle fixed in the ER but to more serious issues that will have a great impact at reducing disease. He believes that we need to take a look at the very serious problems that are occurring in health care and find a way to solve them. Pinkerton says polio and antibiotics were all the result of serious medicine. I disagree with Jim that we don't need universal health care. However, he's right that we can have all the universal health care in the world, but it will be for naught if we don't solve the serious medicine problems and get to the root cause of major health-care issues. It's a shame these two hearings were overlooked this week because it really points to the larger, more serious problem for which we need initiatives such as Jim Pinkerton's "serious medicine."