Who needs health care--the well or the sick?

doi:10.1136/bmj.330.7497.954

BMJ 2005;330:954-956 (23 April), doi:10.1136/bmj.330.7497.954

Education and debate

Current controversies

Who needs health care—the well or the sick?

Iona Heath, general practitioner¹

¹ Caversham Group Practice, London NW5 2UP iona.heath@dsl.pipex.com

Shifting drug spending from the worried well in developed countriesto those with treatable disease in poorer nations will benefitthe health of everyone

The first 150 words of the full text of this article appear below.

Introduction

Investment in health care, especially when it is driven by theinterests of pharmaceutical companies, seems to produce a Jcurve. For most of the curve, the more money spent, the betterthe health outcomes, but after a certain point, the more spendingand the more emphasis on health at the expense of other areasof human activity and achievement, the worse overall healthbecomes. Many poorer countries are trapped high on the longarm of the curve while richer countries seem intent on exploringthe upper end of the short arm through the excessive self confidenceof preventive medicine.¹ The emphasis on preventive care damagespatients in rich countries by tipping them towards misery. Thisprocess is built on a foundation of fear and is fanned by economicand political pressures.

A fraction of the spending on preventive medicine in rich countries could make a huge difference to the . . . [Full text of this article]

Health and wealth

Prolonging life

Medicalising healthy populations

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Rapid Responses:

Read all Rapid Responses

The well and insured: Diyanath S Samarasinghe
bmj.com, 22 Apr 2005 [Full text]
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Prevention article makes me miserable: Brian Neeson
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