Dr. Irving Kent Loh
On this first day of a new year, we humans solemnly tend to reflect on events past and, with trepidation and hope, on what may occur in the coming year. In healthcare, there truly are too many topics to cover in one column, but I will write on many of them in future columns. But this column is my personal reflection on the state of healthcare and the forces that may affect its trajectory moving forward.
As it has for the last three years, any conversation about the state of healthcare needs to begin with COVID. Not surprisingly but disappointingly, the SARS-CoV-2 virus has behaved as I predicted in my first column on COVID in January 2020. It has mutated for enhanced transmissibility with only incidental changes in its lethality. The idea that COVID has become less lethal as it has evolved is likely the result from mass vaccinations and prior infections producing an immunologic environment that mitigated its innate seriousness. If one has any doubt about that, just look at what’s happening in China after its failed zero-COVID strategy was lifted and COVID began running amok in a hugely under-vaccinated and infection naïve population.
Any of the sources other than their tightly controlled state media are telling a horrific story that were it not for the tireless efforts of the basic scientists, trialists, clinicians, public-private collaborators, public health and epidemiologists, and the vast number of healthcare support personnel, it would have been us, just like it was at the beginning of this pandemic before we knew anything about this new coronavirus. Yet it is sad because of the human toll and it is also worrisome since new variants will likely emerge from these new reservoirs of victims. Science must remain vigilant.
Social media companies are double-edged swords that can spread both accurate and inaccurate data. We must look askance at companies that are managed like fiefdoms by petty financial tyrants who rant about free speech but shut down those who are negative to them. Taking off the restrictions of COVID misinformation and outright lies will make getting accurate COVID information disseminated that much more difficult. We had an experience with thin-skinned politicians who tried the same with the levers of government to intimidate and control doubters and push only the approved messaging based on hope and whim, not on science. Other social media moguls want us to move to a virtual world where the rules are theirs and you “exist” as an avatar. You might as well be on Mars or Pandora. By all means, please go while the rest of us try to make this world better for our children and future generations.
I will write on healthcare technology and medications in cardiovascular, obesity, addiction, and cancer therapies that may revolutionize care and most importantly improve outcomes. The totality of COVID has created a shortening of the average American’s lifespan, reversing decades of prolongation. The innovation and translation of basic science to the bedside has been remarkable, and my being a clinical trialist for almost 50 years has been a privilege and honor, and many of my patients have been able to participate in many of these programs that have benefitted many of you. And I hope to be able to write shortly on a new endeavor that will make it possible for many of my colleagues and their patients to contribute as well … watch this space.
The U.S. Supreme Court played a major role in healthcare this year as I wrote about previously. Whether it was good or bad depends on where you sit on the political spectrum, but no doubt it was impactful, again good or bad depends on where one’s politics are. But what is clear is that the Dobbs decision was hugely meaningful on women’s health and lives and will remain so for a generation.
Like most of you, I warily watched the run-up to the November elections, not knowing exactly what to expect. What happened was relative normalcy. America’s greatness and grand experiment endure and was thus demonstrated to the world when one read what was reported in the leading newspapers and media outlets around the world (outside of Russia, China and Iran).
The extremes on both ends of our political spectrum remain vocal. The far-right political forces tell us what’s wrong with America and who to blame for it, rather than identifying root causes such as poverty and intolerance and offering real solutions. They demonize whole classes of humans and apparently see no conflict in their purported Christian values by bussing T-shirt-clad migrants to freezing environments to score political points. I don’t think Jesus would have approved. Expect threats of government shutdowns to appear again mid-year from the House of Representatives. The specter of withholding government services, like Social Security, Medicaid, Medicare, will hold hostage average Americans who are just trying to live their lives. They will do this to protest government debt mostly created by huge tax cuts they endorsed for the über-wealthy. Why some of them didn’t even pay any federal income tax at all.
Of course, the far left, aka progressives, prefers to throw money at problems and not have the required accountability to make sure problems are truly being solved and not just papered over. Like the well-known parable, most of us believe it’s always better to teach someone to fish rather than give him a fish.
That’s probably why most of us are in the middle, and though we tend to lean a bit left or right, overall we usually balance out. The extremes on both sides make the most noise and thus get the most media attention. We in the middlin’ part of the political spectrum make our noise when we vote, despite the concerted efforts of some to suppress that right to vote for their political advantage.
I stated at the outset that these are my personal reflections. Based on my past experience of writing these columns for over the last 22 years, there are those of you who disagree with my thoughts on those subjects. Which is why this column has always been called Second Opinion. Rather than just complain to me as you are wont to do, please write down your thoughts and send them to this news media for publication. And please sign your name and provide your email, as I have always done. All readers should have the opportunity to weigh in on your opinions in the light of open discourse. I’ve been doing this for over 20 years; now it is your turn.
Wishing you all a Happy New Year.
Irving Kent Loh, M.D., is a preventive cardiologist and the director of the Ventura Heart Institute in Thousand Oaks. Email him at drloh@venturaheart.com.
