The Starfield lightning bolt: medical killers

From time to time, I reprint my interview with Dr. Barbara Starfield. Each time I try to write a new introduction.

On July 26, 2000, the Journal of the American Medical Association published Starfield’s review, “Is US health really the best in the world?”

In it, Starfield, who was a respected public health expert working at the Johns Hopkins School of Public Health, stated that:

The US medical system kills 225,000 Americans a year.
106,000 deaths per year from FDA-approved medical drugs.
119,000 deaths per year from error-ridden treatment in hospitals.

I’m aware that independent research puts those death figures much higher, but I focus on Dr. Starfield’s work because no mainstream reporter or government official could challenge her credentials or the credentials of the journal that published her findings.

And yes, there were stories in the press at the time, in 2000. But the coverage wasn’t aggressive, and it faded out quickly.

And none of the mainstream coverage did the obvious extrapolations. For example, we are talking about 2.25 MILLION deaths per decade. And over a MILLION deaths from medicines the FDA has approved as safe and effective.

Based on my long knowledge of mainstream reporters, I would make these estimates. 70% of them weren’t even aware of the significance of Starfield’s findings. That is, they were oblivious. The human toll didn’t register in their minds.

25% were aware Dr. Starfield had discovered shocking facts, but they didn’t believe the story had “legs.” They assumed it wouldn’t make a big splash.

5% saw how huge the story could become, if it were assigned as an ongoing investigation, like Watergate. But they knew their editors wouldn’t permit that, because among other reasons, their newspapers and television outlets were heavily dependent on pharmaceutical advertising dollars.

So the story died.

Several reporters I contacted came back with this reply: the US government must not be aware of the Starfield report. As if that matters.

But, in fact, the US government is aware. You can search for an FDA page titled, “Why Learn About Adverse Drug Reactions (ADRs)?” As of an hour ago, the page is available.

It states: “Over 2 MILLION serious ADRs yearly.” And “100,000 DEATHS yearly.” (The capital letters are the FDA’s, not mine.)

The FDA, of course, is the single federal agency responsible for certifying all medical drugs both safe and effective before they are released for public use. They readily admit the human death and maiming devastation…but take no responsibility for it.

On December 6-7, 2009, I interviewed Dr. Starfield by email. Here are excerpts from that interview.

What has been the level and tenor of the response to your findings, since 2000?

The American public appears to have been hoodwinked into believing that more interventions lead to better health, and most people that I meet are completely unaware that the US does not have the ‘best health in the world’.

In the medical research community, have your medically-caused mortality statistics been debated, or have these figures been accepted, albeit with some degree of shame?

The findings have been accepted by those who study them. There has been only one detractor, a former medical school dean, who has received a lot of attention for claiming that the US health system is the best there is and we need more of it. He has a vested interest in medical schools and teaching hospitals (they are his constituency).

Have health agencies of the federal government consulted with you on ways to mitigate the [devastating] effects of the US medical system?

NO.

Since the FDA approves every medical drug given to the American people, and certifies it as safe and effective, how can that agency remain calm about the fact that these medicines are causing 106,000 deaths per year?

Even though there will always be adverse events that cannot be anticipated, the fact is that more and more unsafe drugs are being approved for use. Many people attribute that to the fact that the pharmaceutical industry is (for the past ten years or so) required to pay the FDA for reviews [of its new drugs]—which puts the FDA into an untenable position of working for the industry it is regulating. There is a large literature on this.

Aren’t your 2000 findings a severe indictment of the FDA and its standard practices?

They are an indictment of the US health care industry: insurance companies, specialty and disease-oriented medical academia, the pharmaceutical and device manufacturing industries, all of which contribute heavily to re-election campaigns of members of Congress. The problem is that we do not have a government that is free of influence of vested interests. Alas, [it] is a general problem of our society—which clearly unbalances democracy.

Can you offer an opinion about how the FDA can be so mortally wrong about so many drugs?

Yes, it cannot divest itself from vested interests. (Again, [there is] a large literature about this, mostly unrecognized by the people because the industry-supported media give it no attention.)

Would it be correct to say that, when your JAMA study was published in 2000, it caused a momentary stir and was thereafter ignored by the medical community and by pharmaceutical companies?

Are you sure it was a momentary stir? I still get at least one email a day asking for a reprint—ten years later! The problem is that its message is obscured by those that do not want any change in the US health care system.

Are you aware of any systematic efforts, since your 2000 JAMA study was published, to remedy the main categories of medically caused deaths in the US?

No systematic efforts; however, there have been a lot of studies. Most of them indicate higher rates [of death] than I calculated.

What was your personal reaction when you reached the conclusion that the US medical system was the third leading cause of death in the US?

I had previously done studies on international comparisons and knew that there were serious deficits in the US health care system, most notably in lack of universal coverage and a very poor primary care infrastructure. So I wasn’t surprised.

Did your 2000 JAMA study sail through peer review, or was there some opposition to publishing it?

It was rejected by the first journal that I sent it to, on the grounds that ‘it would not be interesting to readers’!

Do the 106,000 deaths from medical drugs only involve drugs prescribed to patients in hospitals, or does this statistic also cover people prescribed drugs who are not in-patients in hospitals?

I tried to include everything in my estimates. Since the commentary was written, many more dangerous drugs have been added to the marketplace.

Jon Rappoport is the author of two explosive collections, The Matrix Revealed and Exit From the Matrix, Jon was a candidate for a US Congressional seat in the 29th District of California. Nominated for a Pulitzer Prize, he has worked as an investigative reporter for 30 years, writing articles on politics, medicine, and health for CBS Healthwatch, LA Weekly, Spin Magazine, Stern, and other newspapers and magazines in the US and Europe. Jon has delivered lectures and seminars on global politics, health, logic, and creative power to audiences around the world. You can sign up for his free emails at www.nomorefakenews.com