Tuskegee 2
In 1932, the U.S. Public Health Service chose 399 black men with syphilis and 201 black men without syphilis and decided to study them---without their consent---to see what the natural history of the untreated disease would be. The discovery of the efficacy of penicillin against the disease in the 1940s did not slow the researchers down---they resorted to tricks and subterfuge to keep the study participants from getting penicillin and any other treatment. The "study" continued until 1972. Many participants died of their treatable disease. Many spouses and children were infected.
When a whistleblower, Peter Buxton took the story to the press, the response was huge. The backlash changed the way that medical research is conducted in this country. However, we are still conducting another form of denial of treatment study, one that is much larger in its scope. It is called the U.S. Health Care System. In this on going study, based upon a roll of the dice, you either get state of the art treatment for all your ills, or you can get no health care at all until you develop the inevitable often fatal consequences of years of medical neglect.
There are too many treatable problems for me to describe them all, so I will focus on one that has a huge potential impact on your health and which is almost impossible to treat without insurance---obstructive sleep apnea. If you have no insurance and you snore and stop breathing at night, you may be hard pressed to come up with the thousands of dollars out of pocket that you will need to pay for your own sleep study and the thousands more than you will need to pay for your own CPAP titration and your own follow up. You will definitely not be able to pay for an operation to open up your airway--surgery is expensive. Since OSA is seldom an emergency---except in extreme cases in which the morbidly obese may go into a coma---you can not get care for it in the emergency room (the GOP's Universal Health Care of choice) where you can get care for your heart attack or your pneumonia and even your acute leukemia. You can't just "lose weight". Sleep deprivation has been shown to increase the body's craving for fatty, sugary foods. And you can't just tell yourself "Stop snoring." The apnea only happens when you are unconscious. If you have an untreated case of sleep apnea, it will remain untreated until one of three things happens.
1) You win the lottery of life and get a job with insurance. Not as easy to do as it sounds. If you have an untreated sleep disorder, you have memory issues, you are grumpy, you often oversleep, you make mistakes on the job. That makes it difficult to get one of the "good" jobs.
2) You reach age 65 and get Medicare.
3) You develop one of the complications of your untreated sleep disorder such as renal failure (dialysis patients get Medicare automatically) or heart failure or a stroke, at which point Medicare will pay for your sleep study. A little late for your heart and kidneys and brain. How does untreated sleep apnea destroy your kidneys? It raises your blood pressure and makes it difficult to control even with 4 or 5 medications. It increases pain and makes it more likely that you will take lots of NSAIDs which damage kidneys. How does it hurt your heart? It causes heart attacks and raises the blood pressures. How does it cause a stroke? It raises your blood pressure and damages your arteries.
Around 10% of American men over 40 have obstructive sleep apnea. Double that number if you are of African or Asian descent. So, if you are an uninsured African-American man---like the folks in Macon County, Alabama who were enrolled in Tuskegee---you may be taking part in a prospective study of the effects of untreated sleep apnea without even knowing it. A study that no one knows about yet, but when we look back in the future, your contribution will be invaluable. So, thank you in advance for giving your kidneys, your heart, your brain, your life for medical science.
What? You don't want to sacrifice your kidneys for medical science? Then sign up for the ACA and go see a doctor about your snoring.
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