The Bucknuts Hot Spot

If by useless you mean beyond your comprehension, I suppose you may have a point.....

It's not really hard to quote you and disprove your claim that I am "putting words in your mouth" - but it does make me read them again and that can get a little nauseating.

So....you win. You never put attribute words or thoughts to liberals. You never said that unemployed people just need to work harder because the opportunties are there. You never opposed the individual mandate which reduces amount of people who don't pay for ER care. Even though you did all 3 in this thread alone, you didn't.

But I am just not sure I can keep up with your stupidity - I can barely agree with it as fast as you spew it out. Should hospitals sue individuals? Sure, but they don't have the money. So take it out of thier paychecks? Well if they have jobs, then hospitals can get in line behind thier other debts. And its easy to file for bankruptcy - and more Americans are doing so than ever, many of them driven by high healthcare costs. In fact, had you read the link I attached you would see that the plaintiff whose case is in front of the Supreme Court claiming the individual mandate is unconstitutional has GONE BANKRUPT and written off her medical debts. I wonder who is picking those costs up? Yep you and me Sparky.

I am glad you never have to worry about losing your insurance coverage or getting screwed by insurance companies who need to trim thier losses or employers who need to keep the executive bonus pools fat. Some people do and it sucks and it isn't because they were lazy. I don't expect you to care because until it happens to someone you love, you will continue to be a judgmental self-centered prick.

Obamacare is certainly Socialized medicine. At the very least, it is a huge step forward to Socialized medicine. You call it what you want, and I'll continue to tell the truth about it.

It depends on what u call "preventative care". If you think it's vaccines and mammograms, your right it doesn't save anything. From day one we need to educate kids on lifestyle choices, since 80% of all diseases came from our lifestyle choices. Your telling me we wouldn't save money if 80% of all diseases were reduced because as a society, we understand that it is up to US to make the right choices about eating, exercise, stress reduction & whether we choose healthy or bad habits? Big Pharma doesn't want healthy people because healthy people don't take prescription drugs. Emergency medicine is great, but M.D.s are clueless when it comes to prevention. It's all about intervention with drugs & surgery, which is their paradigm, which is controlled by Big Pharma.
Ask yourself one question, who pumps the most money in lobbying our trusty politicians???
Follow the money.

You can take "huge exception" all you want but look at their training. How many of hours of nutrition, exercise physiology> ZERO. Plus they (AMA) fought tooth & nail to eliminate other health care providers from the system(even found guilty of conspiring to eliminate the Chiropractic profession). Every major study about chiropractic care helping more than medicine or PT has been thrown under the bus, ancient systems like acupuncture are blown off as "nonscientific", yet killing & maiming with "FDA" approved drugs is all scientific. Antibiotic overuse is out of control & the MDs blame the patient for demanding them>>>>Who the hell is the doctor!!!! More people die each year of PROPERLY prescribed meds than by street drugs. Who the hell is prescribing these poisons?? We pay twice as much for health care(disease care) than any other country , yet rank near the bottom for longevity, infant mortality, etc???? If we are paying for it , it ought to get better results, but they are barking up the wrong tree...

Sorry, but your opinion is way out there, you obviously have had some sort of bad experience with a Doc at some point. or you are a chiroprator and are butt hurt at some snooty docs that look down on you, I dont, never went to one, but it is not my specialty so I dont pay it much attention, my wife is a PT and she hates them.

I know the training, lived it, and teach it today. and you are not even close as to what is in the curriculum, you may know of a single place that may or may not offer what you are asking, but I did receive that training and current residents at OSU receive that education. is it the same level of training as a dietician? no, but in a large percentage of programs it is offered.

So you are saying the AMA speaks for every Dr. across the Country? it is no different than the chamber of commerese or the local moose lodge, I cant stand the AMA, they certainly dont speak for me.

To you prescription drugs killing more people than illeagle drugs, what does that have to do with a Dr.? I am sure you are refering to the recent story out of FLa making this claim, if you bothered to read the story and the study by the States medical examiners, it is attributed to the illeagle prescription drug trade, which is one of the reasons Kasich pushed for more regulations and stricter laws. No where in that study was properly prescribed drugs implicated in the results, the same with the study recently done by the center of disease control, the attribute it to the street prescription drug scene especially among teens.

To your last point, you are citing the study by the WHO, which has been debunked by both halth profesionals, govt officials from Canada, US, France, Germany, UK, Singapore, Sweeden, Finland etc etc, I posted numerous stories stating this. Not only is that study over 12 years old, the parameters it used are guess's more than factual data. Do you know how infants in the US are reported compared to the UK? France? each country reports medical information differenty making it impossible to rank halth care.

There are plenty of bad Docs out there, just like there are plenty of bad politicians, business managers etc, but to lump them all in to one group like you are doing is very narrow minded

Ok, sorry didnt know you have heard hundreds of stories to come to your conclusions, I wish you would have told me that up front and I would have just agreed with you since 100's of stories is proof of everything

I used 2 studies that were performed by the medical examiners of Fla and by the national center of disease control, the last time I checked both were funded by taxpayers not private funding, so not sure what your comment means, I did a quick google search on the subject and the first 12 articles all cite either the Fla study or the national disease study, all saying the same thing that scrip drugs bought off thestreet are the reasons. didnt see your multiple studies?

I would think since you are accusing Dr of killing people that there would be some huge uproar and govt investigation, but have not heard talk of that at OSU or on the news?

But like I said, I wish u would have told me you have heard hundreds of stories about tums and vitamins and other things, I would have just beleived your accusations without questioning your proof to back it up

The American Medical System
Is The Leading Cause Of Death And Injury In The United States
By Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD
A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good. The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million. (1) Dr. Richard Besser, of the CDC , in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics. (2, 2a)

The number of unnecessary medical and surgical procedures performed annually is 7.5 million. (3) The number of people exposed to unnecessary hospitalization annually is 8.9 million. (4) The total number of iatrogenic [induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures] deaths is 783,936.

The 2001 heart disease annual death rate is 699,697; the annual cancer death rate is 553,251. (5) It is evident that the American medical system is the leading cause of death and injury in the United States.

Introduction
Never before have the complete statistics on the multiple causes of iatrogenesis been combined in one paper. Medical science amasses tens of thousands of papers annually—each one a tiny fragment of the whole picture. To look at only one piece and try to understand the benefits and risks is to stand one inch away from an elephant and describe everything about it. You have to pull back to reveal the complete picture, such as we have done here. Each specialty, each division of medicine, keeps their own records and data on morbidity and mortality like pieces of a puzzle. But the numbers and statistics were always hiding in plain sight. We have now completed the painstaking work of reviewing thousands and thousands of studies. Finally putting the puzzle together we came up with some disturbing answers.

Is American Medicine Working?
At 14% of the Gross National Product, health care spending reached $1.6 trillion in 2003. (15) Considering this enormous expenditure, we should have the best medicine in the world. We should be reversing disease, preventing disease, and doing minimal harm. However, careful and objective review shows the opposite. Because of the extraordinary narrow context of medical technology through which contemporary medicine examines the human condition, we are completely missing the full picture.

Medicine is not taking into consideration the following monumentally important aspects of a healthy human organism:

(a) Stress and how it adversely affects the immune system and life processes
(b) Insufficient exercise
(c) Excessive caloric intake
(d) Highly processed and denatured foods grown in denatured and chemically damaged soil
(e) Exposure to tens of thousands of environmental toxins.
Instead of minimizing these disease-causing factors, we actually cause more illness through medical technology, diagnostic testing, overuse of medical and surgical procedures, and overuse of pharmaceutical drugs. The huge disservice of this therapeutic strategy is the result of little effort or money being appropriated for preventing disease.

Under-reporting of Iatrogenic Events
As few as 5% and only up to 20% of Iatrogenic acts are ever reported. (16, 24, 25, 33,34) This implies that if medical errors were completely and accurately reported, we would have a much higher annual Iatrogenic death rate than 783,936. Dr. Leape, in 1994, said his figure of 180,000 medical mistakes annually was equivalent to three jumbo-jet crashes every two days. (16) Our report shows that six jumbo jets are falling out of the sky each and every day.

Correcting a Compromised System
What we must deduce from this report is that medicine is in need of complete and total reform: from the curriculum in medical schools to protecting patients from excessive medical intervention. It is quite obvious that we can't change anything if we are not honest about what needs to be changed. This report simply shows the degree to which change is required.

We are fully aware that what stands in the way of change are powerful pharmaceutical companies, medical technology companies, and special interest groups with enormous vested interests in the business of medicine. They fund medical research, support medical schools and hospitals, and advertise in medical journals. With deep pockets they entice scientists and academics to support their efforts. Such funding can sway the balance of opinion from professional caution to uncritical acceptance of a new therapy or drug.

You only have to look at the number of invested people on hospital, medical, and government health advisory boards to see conflict of interest. The public is mostly unaware of these interlocking interests. For example, a 2003 study found that nearly half of medical school faculty, who serve on Institutional Review Boards (IRB) to advise on clinical trial research, also serve as consultants to the pharmaceutical industry. (17) The authors were concerned that such representation could cause potential conflicts of interest.

A news release by Dr. Erik Campbell, the lead author, said, "Our previous research with faculty has shown us that ties to industry can affect scientific behavior, leading to such things as trade secrecy and delays in publishing research. It's possible that similar relationships with companies could affect IRB members' activities and attitudes." (18)

Medical Ethics and Conflict of Interest in Scientific Medicine
Jonathan Quick, director of Essential Drugs and Medicines Policy for the World Health Organization (WHO) wrote in a recent WHO Bulletin:

"If clinical trials become a commercial venture in which self-interest overrules public interest and desire overrules science, then the social contract which allows research on human subjects in return for medical advances is broken." (19)
Former editor of the New England Journal of Medicine (NEJM), Dr. Marcia Angell, struggled to bring the attention of the world to the problem of commercializing scientific research in her outgoing editorial titled "Is Academic Medicine for Sale?" (20) Angell called for stronger restrictions on pharmaceutical stock ownership and other financial incentives for researchers. She said that growing conflicts of interest are tainting science.

She warned that, "When the boundaries between industry and academic medicine become as blurred as they are now, the business goals of industry influence the mission of medical schools in multiple ways." She did not discount the benefits of research but said a Faustian bargain now existed between medical schools and the pharmaceutical industry.

Angell left the NEMJ in June 2000. Two years later, in June 2002, the NEJM announced that it would now accept biased journalists (those who accept money from drug companies) because it is too difficult to find ones who have no ties. Another former editor of the journal, Dr. Jerome Kassirer, said that was just not the case, that there are plenty of researchers who don't work for drug companies. (21) The ABC report said that one measurable tie between pharmaceutical companies and doctors amounts to over $2 billion a year spent for over 314,000 events that doctors attend.

The ABC report also noted that a survey of clinical trials revealed that when a drug company funds a study, there is a 90% chance that the drug will be perceived as effective whereas a non-drug company-funded study will show favorable results 50% of the time.

It appears that money can't buy you love but it can buy you any "scientific" result you want.

The only safeguard to reporting these studies was if the journal writers remained unbiased. That is no longer the case.

Cynthia Crossen, writer for the Wall Street Journal in 1996, published "Tainted Truth: The Manipulation of Fact in America," a book about the widespread practice of lying with statistics. (22) Commenting on the state of scientific research she said that:

"The road to hell was paved with the flood of corporate research dollars that eagerly filled gaps left by slashed government research funding."
Her data on financial involvement showed that in l981 the drug industry "gave" $292 million to colleges and universities for research. In l991 it "gave" $2.1 billion.

The First Iatrogenic Study
Dr. Lucian L. Leape opened medicine's Pandora's box in his 1994 JAMA paper, "Error in Medicine." (16) He began the paper by reminiscing about Florence Nightingale's maxim—"first do no harm." But he found evidence of the opposite happening in medicine. He found that Schimmel reported in 1964 that 20% of hospital patients suffered Iatrogenic injury, with a 20% fatality rate. Steel in 1981 reported that 36% of hospitalized patients experienced iatrogenesis with a 25% fatality rate and adverse drug reactions were involved in 50% of the injuries. Bedell in 1991 reported that 64% of acute heart attacks in one hospital were preventable and were mostly due to adverse drug reactions.

However, Leape focused on his and Brennan's "Harvard Medical Practice Study" published in 1991. (16a) They found that in 1984, in New York State, there was a 4% Iatrogenic injury rate for patients with a 14% fatality rate. From the 98,609 patients injured and the 14% fatality rate, he estimated that in the whole of the United States 180,000 people die each year, partly as a result of Iatrogenic injury. Leape compared these deaths to the equivalent of three jumbo-jet crashes every two days.

Why Leape chose to use the much lower figure of 4% injury for his analysis remains in question. Perhaps he wanted to tread lightly. If Leape had, instead, calculated the average rate among the three studies he cites (36%, 20%, and 4%), he would have come up with a 20% medical error rate. The number of fatalities that he could have presented, using an average rate of injury and his 14% fatality, is an annual 1,189,576 Iatrogenic deaths, or over ten jumbo jets crashing every day.

Leape acknowledged that the literature on medical error is sparse and we are only seeing the tip of the iceberg. He said that when errors are specifically sought out, reported rates are "distressingly high." He cited several autopsy studies with rates as high as 35% to 40% of missed diagnoses causing death. He also commented that an intensive care unit reported an average of 1.7 errors per day per patient, and 29% of those errors were potentially serious or fatal.

We wonder: what is the effect on someone who daily gets the wrong medication, the wrong dose, the wrong procedure; how do we measure the accumulated burden of injury; and when the patient finally succumbs after the tenth error that week, what is entered on the death certificate?

Leape calculated the rate of error in the intensive care unit. First, he found that each patient had an average of 178 "activities" (staff/procedure/medical interactions) a day, of which 1.7 were errors, which means a 1% failure rate. To some this may not seem like much, but putting this into perspective, Leape cited industry standards where in aviation a 0.1% failure rate would mean:

• Two unsafe plane landings per day at O'Hare airport
• In the U.S. mail, 16,000 pieces of lost mail every hour
• In banking, 32,000 bank checks deducted from the wrong bank account every hour
Analyzing why there is so much medical error Leape acknowledged the lack of reporting. Unlike a jumbo-jet crash, which gets instant media coverage, hospital errors are spread out over the country in thousands of different locations. They are also perceived as isolated and unusual events. However, the most important reason that medical error is unrecognized and growing, according to Leape, was, and still is, that doctors and nurses are unequipped to deal with human error, due to the culture of medical training and practice.

Doctors are taught that mistakes are unacceptable. Medical mistakes are therefore viewed as a failure of character and any error equals negligence. We can see how a great deal of sweeping under the rug takes place since nobody is taught what to do when medical error does occur. Leape cited McIntyre and Popper who said the "infallibility model" of medicine leads to intellectual dishonesty with a need to cover up mistakes rather than admit them. There are no Grand Rounds on medical errors, no sharing of failures among doctors and no one to support them emotionally when their error harms a patient. Leape hoped his paper would encourage medicine "to fundamentally change the way they think about errors and why they occur." It's been almost a decade since this groundbreaking work, but the mistakes continue to soar.

One year later, in 1995, a report in JAMA said that:

"Over a million patients are injured in U.S. hospitals each year, and approximately 280,000 die annually as a result of these injuries. Therefore, the Iatrogenic death rate dwarfs the annual automobile accident mortality rate of 45,000 and accounts for more deaths than all other accidents combined." (23)
At a press conference in 1997 Dr. Leape released a nationwide poll on patient iatrogenesis conducted by the National Patient Safety Foundation (NPSF), which is sponsored by the American Medical Association. The survey found that more than 100 million Americans have been impacted directly and indirectly by a medical mistake. 42% were directly affected and a total of 84% personally knew of someone who had experienced a medical mistake.(14) Dr. Leape is a founding member of the NPSF.

Dr. Leape at this press conference also updated his 1994 statistics saying that medical errors in inpatient hospital settings nationwide, as of 1997, could be as high as 3 million and could cost as much as $200 billion. Leape used a 14% fatality rate to determine a medical error death rate of 180,000 in 1994. (16) In 1997, using Leape's base number of 3 million errors, the annual deaths could be as much as 420,000 for inpatients alone. This does not include nursing home deaths, or people in the outpatient community dying of drug side effects or as the result of medical procedures.

Only a Fraction of Medical Errors are Reported
Leape, in 1994, said that he was well aware that medical errors were not being reported. (16) According to a study in two obstetrical units in the U.K., only about one quarter of the adverse incidents on the units are ever reported for reasons of protecting staff or preserving reputations, or fear of reprisals, including law suits. (24) An analysis by Wald and Shojania found that only 1.5% of all adverse events result in an incident report, and only 6% of adverse drug events are identified properly.

The authors learned that the American College of Surgeons gives a very broad guess that surgical incident reports routinely capture only 5% to 30% of adverse events. In one surgical study only 20% of surgical complications resulted in discussion at Morbidity and Mortality Rounds.25 From these studies it appears that all the statistics that are gathered may be substantially underestimating the number of adverse drug and medical therapy incidents. It also underscores the fact that our mortality statistics are actually conservative figures.

An article in Psychiatric Times outlines the stakes involved with reporting medical errors. (26) They found that the public is fearful of suffering a fatal medical error, and doctors are afraid they will be sued if they report an error. This brings up the obvious question: who is reporting medical errors? Usually it is the patient or the patient's surviving family. If no one notices the error, it is never reported. Janet Heinrich, an associate director at the U.S. General Accounting Office responsible for health financing and public health issues, testifying before a House subcommittee about medical errors, said that: "The full magnitude of their threat to the American public is unknown." She added, "Gathering valid and useful information about adverse events is extremely difficult."

She acknowledged that the fear of being blamed, and the potential for legal liability, played key roles in the under-reporting of errors. The Psychiatric Times noted that the American Medical Association is strongly opposed to mandatory reporting of medical errors. (26) If doctors aren't reporting, what about nurses? In a survey of nurses, they also did not report medical mistakes for fear of retaliation. (27)

Standard medical pharmacology texts admit that relatively few doctors ever report adverse drug reactions to the FDA. (28) The reasons range from not knowing such a reporting system exists to fear of being sued because they prescribed a drug that caused harm. (29)However, it is this tremendously flawed system of voluntary reporting from doctors that we depend on to know whether a drug or a medical intervention is harmful.

Pharmacology texts will also tell doctors how hard it is to separate drug side effects from disease symptoms. Treatment failure is most often attributed to the disease and not the drug or the doctor. Doctors are warned, "Probably nowhere else in professional life are mistakes so easily hidden, even from ourselves." (30) It may be hard to accept, but not difficult to understand, why only one in twenty side effects is reported to either hospital administrators or the FDA. (31,31a)

If hospitals admitted to the actual number of errors and mistakes, which is about 20 times what is reported, they would come under intense scrutiny. (32) Jerry Phillips, associate director of the Office of Post Marketing Drug Risk Assessment at the FDA, confirms this number. "In the broader area of adverse drug reaction data, the 250,000 reports received annually probably represent only 5% of the actual reactions that occur." (33) Dr. Jay Cohen, who has extensively researched adverse drug reactions, comments that because only 5% of adverse drug reactions are being reported, there are, in reality, 5 million medication reactions each year.(34)

It remains that whatever figure you choose to believe about the side effects from drugs, all the experts agree that you have to multiply that by 20 to get a more accurate estimate of what is really occurring in the burgeoning "field" of Iatrogenic medicine.

A 2003 survey is all the more distressing because there seems to be no improvement in error reporting even with all the attention on this topic. Dr. Dorothea Wild surveyed medical residents at a community hospital in Connecticut. She found that only half of the residents were aware that the hospital had a medical error-reporting system, and the vast majority didn't use it at all. Dr. Wild says this does not bode well for the future. If doctors don't learn error reporting in their training, they will never use it. And she adds that error reporting is the first step in finding out where the gaps in the medical system are and fixing them. That first baby step has not even begun. (35)

Public Suggestions on Iatrogenesis
In a telephone survey, 1,207 adults were asked to indicate how effective they thought the following would be in reducing preventable medical errors that resulted in serious harm: (36)
• Giving doctors more time to spend with patients: very effective 78%
• Requiring hospitals to develop systems to avoid medical errors: very effective 74%
• Better training of health professionals: very effective 73%
• Using only doctors specially trained in intensive care medicine on intensive care units: very effective 73%
• Requiring hospitals to report all serious medical errors to a state agency: very effective 71%
• Increasing the number of hospital nurses: very effective 69%
• Reducing the work hours of doctors-in-training to avoid fatigue: very effective 66%
• Encouraging hospitals to voluntarily report serious medical errors to a state agency: very effective 62%

Get the picture??????????????????????????????????????????

The high cost of the health care system is considered to be a deficit, but it seems to be tolerated under the assumption that better health results from more expensive care.

However, evidence from a few studies indicates that as many as 20% to 30% of patients receive inappropriate care.

An estimated 44,000 to 98,000 among these patients die each year as a result of medical errors.

This might be tolerable if it resulted in better health, but does it?

Out of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom) for 16 available health indicators.

More specifically, the ranking of the U.S. on several indicators was:

13th (last) for low-birth-weight percentages
13th for neonatal mortality and infant mortality overall
11th for post-neonatal mortality
13th for years of potential life lost (excluding external causes)
11th for life expectancy, at 1 year for females, 12th for males
10th for life expectancy, at 15 years for females, 12th for males
10th for life expectancy, at 40 years for females, 9th for males
7th for life expectancy, at 65 years for females, 7th for males
3rd for life expectancy, at 80 years for females, 3rd for males
The poor performance of the U.S. was recently confirmed by a World Health Organization study which used different data and ranked the United States as 15th among 25 industrialized countries.

Wouldn't want you to throw bricks in your pretty glass house.... I said hundreds? I meant thousands....

You do realize that the exchanges the States are setting up are only for individuals without employer sponsored healthcare and for small business that employee less than 100 people. These exchanges cannot compete across state lines the same as for profit insurance cannot compete across state lines.

These exchanges will not put for profit out of business unless companies choose to drop employer sponsored health care as part of employee beni's, of course if that happens, the cost for govt will dramatically increase since the Govt is going to subsidize these exchanges which than creates a huge increase in defecit spending.

And honestly, if the state chooses to run the exchanges themselves which some are going to do, have you ever heard of a govt agency that has low overhead and efficient operations?

You keep talking about eliminating executive pay as part of your cost reduction in health care, do you know what percentage of a insurance companies overall operating budget is executive pay? keep in mind traditionally they only have 3 to 5% profit margins which is miniscule comapred to big pharma, med tech companies and large hosp corps.

First of all, try reading. The data above is from multiple souces. If anything the data about iatrogenic causes of death is UNDERREPORTED. That means that if anything, the reports are worse than stated. I never said the new health care laws were a fix, if anything they will make things worse because you will have doctors overburdened and making more mistakes. Again, I don't blame the individual physicians, I blame the SYSTEM. Our paradigm of "health care" has to change as a nation. You stated "All sides say the WHO report is flawed", don't you mean the people that are in the wallets of Big Pharma? How can you even defend the fact that so many drugs are approved by the FDA and knowingly cause problems, only to be taken off the market after enough people raise a stink about it? The CDC buries facts about immunization issues with mercury & autism maiming children!
It doesn't look like I will change your mind on these issues, I just ask you to investigate it from an objective point of view.
I never said all Physicians are bad, most have good intentions and rely on their training (& unfortunately pharma reps) for using meds. The problem is the dogma of outside - in cures. To my point that many the majority of MDs aren't trained in preventative health care. Early detection of disease in NOT prevention... We have to change the paradigm, keep what is good about emergency medicine to save lives & limbs, but integrate health awareness models that teach the people>BTW doctor in greek means teacher (I'm sure you know that).
Peace...

So because chemo is expensive it should be free?

OK - this is either the mother of all sarcastic tongue-in-cheek replies or you are someone who should be kept indoors and not allowed contact with actual thinking human beings.

Which is it?

You are putting words in his mouth. He didn't infer chemo should be free. He was merely illustrating the cost compared to food and how comparing the two is silly.

Please realize the issue is health insurance. Not health care. Not food. Not anything else.

Health insurance costs are lower when profit is removed from the equation. Overhead costs also shrink when there are fewer health insurance providers. These lower costs lead to more money being spent on health care.

Explain why someone should profit from health insurance. And don't start by saying the free market health insurance will bring down health insurance costs or improve quality of care because that is simply untrue.

Making profit from health insurance raises costs and/or cuts the amount of money spent on care. Quality of care goes up when more money is spent on actual patients rather than shareholders.

Be honest about the situation and the answer is clear.