The multi-headed beast of modern medicine won’t be tamed easily

The American healthcare system is broken. That’s not hyperbole — it’s a conclusion backed by dismal outcomes, as per Dr. Meryl Nass, a physician and whistleblower. She describes it as “a multi-headed beast; hopefully, we can change some of the heads.” But for that to happen, the system needs an overhaul of its ethical foundations and a reckoning with its structural flaws.

Nass traces the erosion of trust in medicine to several key failures. First, she points to the corporatization of healthcare. What was once a personal relationship between doctor and patient has become a commodity. Doctors are increasingly employees of sprawling healthcare conglomerates. “Doctors used to control their practices. Now they are employees in a system they cannot influence,” Nass explains. This shift has robbed doctors of autonomy and patients of personalized care. The results? Spiraling costs, worsening outcomes, and declining satisfaction. “We have the most expensive healthcare system in the world,” she notes, “but we rank 40th or 50th in life expectancy.”

Pain as the Fifth Vital Sign: A Complex Crisis

One of the most glaring examples of systemic failure is the opioid epidemic. Nass describes how the medical establishment’s adoption of “pain as the fifth vital sign” paved the way for disaster. “Doctors were told to treat pain as a vital sign, and they were trained to prescribe narcotics for even moderate discomfort,” she says. This initiative, heavily pushed by pharmaceutical companies like Purdue Pharma, unleashed a wave of overprescription.

While Nass characterizes Purdue as central to this crisis, I argued in my article Empowered by the State, Condemned by the Crisis: The Purdue Paradox that they were not the unique villain. Purdue exploited a flawed system, but they didn’t create it. Policies mandating universal pain treatment, supported by state-sanctioned guidelines, laid the groundwork for misuse. “Purdue Pharma exploited pain treatment for profit,” Nass concedes, “but they weren’t alone in their greed.” The broader issue was the system’s embrace of chronic narcotic use, ignoring the reality that “pain is part of life.”

Regulatory Capture and Betrayal of Trust

Beyond the opioid crisis, Nass critiques the broader regulatory environment. “Captured agencies regulate for corporations, not people. They make their own laws and dodge accountability,” she asserts. She highlights how the FDA, CDC, and even global entities like the WHO have become tools of the powerful interests funding them.

This dynamic came into sharp focus during COVID-19. Nass’s vocal criticism of pandemic policies, particularly the suppression of treatments like ivermectin, led to the revocation of her medical license. “The governor wanted me gone,” Nass says, noting the lack of any patient complaints. “All agencies are political tools. The systems meant to protect patients now protect power.”

The WHO and Global Health Failures

Nass is particularly critical of the World Health Organization (WHO). “The WHO is controlled by wealthy donors; it cannot lead global health without bias,” she says. The COVID-19 pandemic exposed its limitations. Nass argues that the WHO’s attempts to dictate global health policies worsened outcomes rather than improving them. “It has no history, no experience, no experts,” she asserts. Her solution? The U.S. should leave the WHO. “There are better ways to perform the limited charitable work the WHO does without entrusting global health to such a compromised organization.”

While her critiques resonate, I see the WHO’s failure as emblematic of a broader issue: the centralization of power in systems ill-equipped for accountability. Just as Purdue leveraged regulatory blind spots to profit, the WHO operates within a structure that prioritizes donors over outcomes.

Ethics at a Crossroads

Nass argues that systemic issues in healthcare reflect a broader ethical decline in society. “We’ve replaced ethics in education with lessons on identity, but no one is taught right and wrong anymore,” she laments. The cultural emphasis on wealth and power, she says, has eroded trust in institutions and individuals alike.

This loss of ethics manifests in every layer of healthcare. From the push to overprescribe opioids to the misuse of medical boards for political ends, the system prioritizes profit and control over patient care. “Pain is part of life, but the betrayal of public trust doesn’t have to be,” she says.

Toward a Better Future

Despite her critiques, Nass remains cautiously optimistic.

She sees potential in reforming agencies, decentralizing power, and rebuilding ethical standards. “We can’t fix medicine without addressing the broader societal values that underpin it,” she insists.

But real change requires nuance. As I have written, villains like Purdue Pharma exist, but they are symptoms of a system that incentivizes exploitation. Nass’s call to dismantle captured agencies and abandon global institutions like the WHO underscores the need for accountability at every level.

The multi-headed beast of modern medicine won’t be tamed easily. But Nass and I agree on one thing: the fight is worth it. After all, as she says, “Doctors used to heal. It’s time to remember that mission.”

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