Dr. Irving Kent Loh
On the first day of the new year, we humans tend to reflect solemnly on past events and contemplate with apprehension and hope what may happen in the coming year. In healthcare, there are indeed too many topics to cover in one column, but I will write about many of them in future columns. But this column is my personal reflection on the state of health care and the forces that may affect its forward trajectory.
As in the past three years, any conversation about the state of healthcare needs to start with COVID. Unsurprisingly, but disappointingly, the SARS-CoV-2 virus is behaving as predicted in my first column on COVID in January 2020. It has mutated to increase its ability to spread, and its lethality has changed only by chance. The idea that COVID has become less virulent over the course of evolution may be the result of mass vaccination and an immune milieu created by previous infections that lessened its innate severity. If anyone has any doubts about this, just look at what happened after China canceled its failed zero-COVID strategy and COVID started to ravage a large number of unvaccinated and uninfected people.
Any source other than the tightly controlled state media would be telling a horrific story, were it not for the tireless efforts of basic scientists, experimenters, clinicians, public-private collaborators, public health and epidemiologists, and a host of Medical support workers, who we are, are just as ignorant of this new coronavirus as we were at the start of the pandemic. However, due to the human toll it has taken, it is sad and at the same time concerning as new variants may emerge from these new pools of victims. Science must remain vigilant.
Social media companies are double-edged swords that can spread accurate and inaccurate data. We have to be skeptical of companies run like fiefdoms by petty financial tyrants who yell about free speech but shut down those who do them no favors. Removing restrictions on COVID misinformation and outright lies will make it harder to spread accurate COVID information. We have had experiences with thin-skinned politicians who have tried to use the levers of government to intimidate and control doubters and push approved messages based only on hope and whim rather than science. Other social media moguls want us to enter a virtual world where the rules are theirs and you “exist” as an avatar. You might as well be on Mars or Pandora. Anyway, let’s go while the rest of us work to make the world a better place for our children and future generations.
I will be writing about healthcare technologies and drugs in cardiovascular, obesity, addiction, and cancer treatment that have the potential to revolutionize care and, most importantly, improve outcomes. The overall impact of COVID has shortened the average American life expectancy, reversing decades of extension. The innovation and translation of basic science at the bedside is extraordinary, and it has been a privilege and honor for me as a clinical trial investigator for almost 50 years, with many of my patients being able to participate in many of these projects that benefit many of you. I hope to be able to write soon about a new endeavor that will enable many of my colleagues and their patients to contribute as well…see this space.
As I’ve written before, the U.S. Supreme Court has played a big role in healthcare this year. Whether it’s good or bad depends on where you are on the political spectrum, but there’s no doubt it has an impact, and it’s good or bad depending on one’s political stance. But what’s clear is that Dobbs’ decision has implications for women’s health and lives that will last a generation.
Like most of you, I watched the run-up to the November election cautiously, not knowing what to expect. What happened was relatively normal. America’s great and great experiment is enduring, so when one reads what is reported in major newspapers and media outlets around the world (except Russia, China and Iran), it proves it to the world.
Extremists on both ends of our political spectrum remain outspoken. The political forces of the far right tell us what is wrong in America and who is to blame instead of identifying the root causes of poverty and intolerance and offering real solutions. They demonize the entire human class and apparently think they’re getting political points by taking t-shirt-wearing immigrants out into the cold, which doesn’t conflict with their so-called Christian values. I don’t think Jesus would approve. The threat of a government shutdown is expected to resurface in the House of Representatives by midyear. The specter of withholding government services like Social Security, Medicaid, and Medicare will hold ordinary Americans hostage to ordinary Americans who just want to live their lives. They did it in protest of government debt, largely caused by the massive tax cuts they backed for the super rich. Why are some of them not even paying any federal income tax at all.
Of course, the far left, which is progressives, prefers to throw money at problems without the accountability necessary to ensure that problems are actually being solved, not just on paper. Like the famous fable, most of us believe that it is better to give a man a fish than to give him a fish.
That’s probably why most of us are in the middle, and while we tend to lean a little to the left or right, overall we’re usually balanced. The extremes between the two sides make the most noise, and therefore attract the most media attention. We in the middle of the political spectrum have a voice when we vote, despite a concerted effort by some to suppress that voting power for their political advantage.
I state at the outset that these are my personal thoughts. Based on my experience writing these columns over the past 22 years, some of you may disagree with me on these topics. That’s why this column has long been called “Second Opinion.” Instead of complaining to me as usual, write your thoughts down and send them to this news outlet for publication. Please sign your name and provide your email as I always do. All readers should have the opportunity to weigh your views against the open discussion. I’ve been doing this for over 20 years; now it’s your turn.
I wish you all a Happy New Year.
Irving Kent Loh, MD, is a preventive cardiologist and director of the Ventura Heart Institute in Thousand Oaks. Email him at firstname.lastname@example.org.