The $35 Billion Boondoggle
Reviewed by Irene Alleger

At a time when health care costs are threatening to bankrupt the nation, too little attention has been paid to procedures and treatments that have failed to show benefits, and not surprisingly, are some of the costliest medical interventions around. There is so much talk about unproven treatments and quackery, aimed at the alternative medical practices, that few people ever stop to question or investigate the efficacy or even safety, of high-tech medical procedures.

Even research that shows that over 80% of bypasses and angiogram being recommended are not necessary, has failed to change the lucrative methodology of cardiologists. Since heart disease accounts for a major portion of our health care dollars, it is a perfect example of how vested interests manipulate the public and bury any criticism of the methodology, in the name of profit. In Heart Frauds, Dr. Charles McGee documents the statistics, studies, and hidden failures surrounding the treatment of heart disease, particularly angiograms and bypass surgery.

Although one-third of the population now prefers some alternative medical care, when it comes to heart attacks, the scare tactics used to sell these procedures are almost fool-proof. Doctors tell the frightened heart attack patients they have a “widow maker,” referring to a blocked artery, or that they are living with a “time bomb.” Coronary bypass surgery and angioplasty are said to be absolutely necessary to get them through the next few days alive.

Few people in this situation (usually drugged, as well) can mount an intelligent argument against these “specialists.” If alternatives are discussed at all, such as the recent publicized results of diet and lifestyle changes, they are shrugged off by the cardiologist as too time-consuming, difficult to comply with, and haven’t really been proven to work. Specialists, particularly, have made medicine into business, and in business, as any American can tell you, it’s only the bottom line that counts.

Dr. McGee uses satire and humor in his presentation of an appallingly unethical use of balloon angioplasty as “the invasive cardiologist’s claim to a lifestyle of the rich and famous.” Ironically, the bypass surgeons saw the cardiologists using angioplasty as enemies initially (to their bank account) but soon learned that there was a big enough pie for all to share. As more angioplasties were performed, the number of Coronary Artery Bypass Grafts (CABG), referred to routinely and affectionately as cabbage, also increased. “Surgical procedures on the heart resembled a bottomless pit . . . if more physicians begin to divide up a medical pie, doctors can increase the size of the pie simply by recommending more procedures.” In 1990 cardiologists performed about 285,000 balloon angioplasties and cardiac surgeons cracked 380,000 chests.

“It is not unusual to see patients who have had 3 or 4 balloon procedures followed by a ‘cabbage,’ all within 4 or 5 months and all failing to help.” Dr. McGee cites the studies done on these procedures in detail, and it is clear that the public has been kept ion the dark; in three major controlled studies, bypass surgery was shown not to extend survival rates past 11 years, and that “early surgery is unlikely to increase the prospect of survival.” In an editorial that accompanied one study, Eugene Braunwald, professor of medicine at Harvard Medical School pointed out that an increasing number of patients were being operated upon, not because of the presence of intractable angina, but because of the hope, “largely without objective supporting evidence at present, that coronary bypass surgery prolongs life.” He further stated that “this rapidly growing enterprise is developing a momentum and constituency of its own, and as time passes, it will be progressively more difficult and costly to curtail it materially ...” He wrote “I believe that this operation should and increasingly will be restricted to patients in whom intensive medical therapy has failed, or in whom improved survival after surgery has been unambiguously demonstrated, rather than as a panacea for coronary artery disease.”

These remarks were made in 1977 and his fears that this “enterprise” would become more difficult to curtail were fully realized in the decade following. Although angiography and bypass surgery are the most high-profile and costly abuses in the treatment of heart disease, Dr. McGee shoots down the cholesterol theory, too, as another failed approach to treating heart disease. The pharmaceutical drugs to “treat” high cholesterol have not only failed to show efficacy, but are known to be dangerous as well. Perhaps the worse consequence of these hyped treatments is that patients do not get better, as they might on the diet and lifestyle change programs.

The first half of Heart Frauds is a careful examination of the rationale and results of this “standard of Care,” and Dr. McGee has no problem documenting the failure of these treatments to benefit heart patients. Although it may take some time to dislodge the “enterprise,” in the second half of the book, ample evidence is given of the alternative, non-invasive (and inexpensive) treatments that have shown efficacy in the treatment of heart disease. The diet and nutritional approach to treating coronary artery disease is documented by many recent studies, especially Dr. Dean Ornish’s program, and Dr. McGee brings them all together, showing the consistent success of this approach. Interesting studies are cited showing the long-term effects of the introduction of refined carbohydrates into our diet, for instance, EDTA chelation therapy is given top billing as well, for its documented ability to reverse artery disease.

An important aspect of these approaches is that they prove that coronary heart disease can be reversed, and that the body will heal itself if we will do just two things: remove the things that make us sick, and augment the things our bodies are lacking. Nutrients are examined in detail, citing studies that show the anti-oxidants, in particular, to be greatly preventive of heart disease, and some of the more widely studies nutrients associated with heart disease. Other risk factors such as lack of exercise, and chlorinated water, are explored as well. Dr. McGee speculates that the cholesterol theory is so well established now (as part of the “enterprise”) that it will take time for the oxidative theory of the development of atherosclerosis to replace it, despite the plethora of new studies on anti-oxidants.

However, as you may have noticed, change is the watchword of the day; old institutions and old ideas are changing rapidly at the end of this century and especially in the area of nutrition and lifestyle. Heart Frauds is a well-documented expose’ of the waste of approximately $35 billion a year in the standard treatment of heart disease, wasted because these approaches to treating heart disease are not shown to be beneficial, yet take a huge chunk out of the health care dollars. Dr. McGee acknowledges that the basic problem is politics and commercial interests - putting profit ahead of the welfare of the patient. Becoming informed with the help of books like this one, is the first step towards changing the standard of care, both for patients and doctors alike.

Reprint, Townsend Letter for Doctors, April, 1994 Heart Frauds:The Misapplication of High Technology in Heart Diseaseby: Charles T. McGee, MDMedipress, 1717 Lincoln Way, #108, Coeur d’Alene ID 838141993.