Are we over-medicalized?

Those of you who have seen the film "Moneyball," or have read the book by Michael Lewis, will be familiar with the story of Billy Beane. Billy was supposed to be a tremendous ballplayer; all the scouts told him so. They told his parents that they predicted that he was going to be a star.

But what actually happened when he signed the contract — and by the way, he didn't want to sign that contract, he wanted to go to
college — which is what my mother, who actually does
love me, said that I should do too, and I did — well, he didn't do very well. He struggled
mightily. He got traded a couple of times, he ended up in the Minors for most of his career, and he actually ended up in management. He ended up as a General Manager of the Oakland A's.

Now for many of you in this room, ending up in management, which is also what I've done, is seen as a success. I can assure you that for a kid trying to make it in the Bigs, going into management ain't no success story. It's a failure.

And what I want to talk to you about today, and share with you, is that our healthcare system, our medical system, is
just as bad at predicting what happens to people in it — patients,
others — as those scouts were at predicting what would happen to Billy Beane. And yet, every day thousands of people in this country are diagnosed with preconditions.

We hear about pre-hypertension, we hear about pre-dementia, we hear about pre-anxiety, and I'm pretty sure that I diagnosed myself with that in the green room.

We also refer to subclinical conditions. There's subclinical atherosclerosis, subclinical hardening of the arteries, obviously linked to heart attacks, potentially. One of my favorites is called
subclinical acne. If you look up subclinical acne, you may find a website, which I did, which says that this is the easiest type of acne to treat. You don't have the pustules or the redness and inflammation. Maybe that's because you don't actually
have acne.

I have a name for all of these conditions, it's another precondition: I call them preposterous. In baseball, the game follows the pre-game. Season follows the pre-season. But with a lot of these conditions, that actually isn't the case, or at least it isn't the case all the time. It's as if there's a rain delay, every single time in many cases.

We have pre-cancerous lesions, which often don't turn into cancer. And yet, if you take, for example, subclinical
osteoporosis, a bone thinning disease, the precondition, otherwise known as osteopenia, you would have to treat 270
women for three years in order to prevent one broken bone. That's an awful lot of women when you multiply by the number of women
who were diagnosed with this osteopenia.

And so is it any wonder, given all of the costs and the side effects of the drugs that we're using to treat these preconditions, that every year we're spending more than two trillion dollars on healthcare and yet 100,000 people a year — and that's a conservative estimate — are dying not because of the conditions they have, but because of the treatments that we're giving them and the complications of those treatments?

We've medicalized everything in this country. Women in the audience, I have
some pretty bad news that you already know, and that's that every aspect of your
life

has been medicalized. Strike one is when you hit puberty. You now have something that happens to you once a month that has been medicalized. It's a condition; it has to be treated. Strike two is if you get pregnant. That's been medicalized as