Wasteful Healthcare Spending

A number of years ago, during one of my morning walks, a man came up to me and asked if he could tell me about a product he was selling.  I courteously told him I didn’t have the time as I was doing my morning exercise but said I would be glad to read his marketing literature.  Good thing I didn’t know what he was selling as we would have had quite a heated discussion!

The man was selling a water deionizer for home use.  The machine’s manufacturer claimed that deionized water would lead to better health including curing bad breath, reducing weight, creating higher levels of energy, correcting acne conditions, curing stomach ulcers, lowering cholesterol, and reducing high blood pressure.  In fairness, some of the claims have a basis in fact.  When you drink a lot of water you’ll feel full and might lose weight, which would help with lowering cholesterol and reducing high blood pressure and would even make you feel more energetic.  But that would have nothing to do with the amount of ions in the water you drink.  You don’t need to buy a costly deionization machine to get those results: all you need to do is turn on your faucet.

Many Americans have legitimate concerns about the health safety of the water they drink.  Because we have not as a nation invested in infrastructure, including replacing old water lines, the risk exists that your water has mineral contaminants.  This is more likely in cities where old, lead pipes are still in use.  However, where Americans get their water from a municipal source, the water is treated to kill bacterial and viral pathogens, so unless the waterlines are badly degraded, most water is potable, i.e. safe to drink, bathe in, and cook with.  Deionization would not add to your water’s potability and, as I will describe below, might actually have negative health effects.

By the late 1800s, scientists understood that many diseases were caused by bacteria that resided in water, so they began to treat the water to kill the bacteria.  Today, a disease such as cholera, which kills tens of thousands of people worldwide each year, is essentially nonexistent in the U.S.  Although people in the U.S. still get dysentery and typhoid fever, also caused by water and food borne bacteria, few cases come from drinking tap water (for example, you can get it from drinking contaminated well water).  Combined with improved sanitation and sewage treatment, not only are these diseases rare, but these public health measures have also significantly contributed to lowering mortality in the U.S. over the past century.

There are many ways to treat water to make it potable, including filtering it and adding chemicals.  Distilling water takes outs mineral contaminants, as do water softening machines.  When mineral contaminants do appear in municipal drinking water, it is more likely to be absorbed from old pipes after the water leaves the water treatment plant.  Deionized water will also remove mineral contaminants, but it will not kill bacteria; consequently, while it is touted as having health benefits, making it safe from water borne diseases is not one of them.

In fact, deionization is not considered a recommended practice for treating drinking water.  Instead, it is preferred for scientific and manufacturing processes, such as adding water to a car battery, preparing chemical mixtures in a laboratory, diluting antifreeze, rinsing printed circuit boards, and diluting solutions such as perfumes and detergents.  At home, deionized or distilled water is recommended when adding water to a steam iron so that mineral deposits don’t accumulate.  Amazon even sells a deionization unit to attach to your garden hose to provide water that doesn’t streak when you wash your car.[1]  However, deionized water is not recommended for consumption.

As noted earlier, rather than being healthy for you, deionized water may actually be harmful.  Based on a study funded by the World Health Organization the following risks were associated with using deionized water as your primary source of drinking water:

Aside from its unpleasant taste and sensation in your mouth, there are good reasons to avoid drinking deionized water:

  1. Deionized water lacks minerals normally found in water which provide beneficial health effects. Calcium and magnesium, in particular, are desirable minerals in the water.
  2. Deionized water aggressively attacks pipes and storage container materials, leaching metals and other chemicals into the water.
  3. Drinking DI may lead to increased risk of metal toxicity, both because deionized water leaches metals from pipes and containers and because hard or mineral water protects against absorption of other metals by the body.
  4. Use of DI for cooking can lead to loss of minerals in food into the cooking water.
  5. At least one study found ingestion of deionized water directly damaged the intestinal mucosae. Other studies did not observe this effect.
  6. There is substantial evidence drinking DI disrupts mineral homeostasis. Long-term use of deionized water as drinking water may cause organ damage, even if additional minerals are present elsewhere in the diet.
  7. There is evidence that distilled and DI water are less likely to quench thirst.
  8. Deionized water may contain contamination in the form of bits of ion exchange resin.
  9. While deionized water made from distilled or reverse osmosis purified water may be pure, deionizing nonpotable water will not make it safe to drink.[2]

Given the health risks versus health benefits why was the man trying to sell me a water deionization machine?  First, of course, are profits.  Because there are legitimate, nonconsumption uses for deionized water, such equipment is not regulated by the Food and Drug Administration.  Consequently, there are no guidelines regulating nontraditional marketing and use of these machines.  Depending on the source and what you include in your definition of what constitutes complementary and alternative medicine, Americans spend about $250 billion on these interventions, i.e. procedures, medications, and devices which have not been approved by the F.D.A. and which lack vigorous testing and validation as to effectiveness.  Nonetheless, they are financially lucrative alternatives to traditional medicine, albeit often unproven and coming with some risk.

Second, Americans all too often are uninformed or misinformed, and as a result, many do not trust traditional Western medical practices.  For example, some people opt out of chemotherapy and/or radiation therapy for cancer and instead follow alternative approaches such as making changes in diet and taking alternative unproven medications which ultimately do more harm than good.  Another example of a nonconventional approach is using magnets to relieve joint pain.  So far, no study has demonstrated this works, but it hasn’t stopped millions of Americans from buying magnetic medical devices.

Third, medical science does not always provide concrete, black and white answers to all medical issues.  When I was working on my dissertation, I interviewed a gastroenterologist, who told me even with the best diagnostic equipment, a hard and fast diagnosis is not always possible, i.e., a physician’s response to a medical problem may be tentative, which is not what someone who is sick wants to hear.  Similarly, the scientific community’s understanding of the COVID19 virus has been incremental, which has been confusing to the general public because prevention guidelines have changed as new information emerged.

Even if you are a savvy consumer, it is sometimes difficult to obtain good, fact-based information about nontraditional therapies.  I recently saw an advertisement for an electronic pain relief device that used the electrical current produced by the body’s nervous system to power it.  The effectiveness of transcutaneous electrical nerve stimulation (TENS) is inclusive – some studies suggest it works better than placebo and some studies indicate that it is no better than placebo.  But everyone agrees that the body’s nervous system cannot produce enough electricity to power the device – they have to be battery powered.  Nonetheless, I found several websites touting the effectiveness of the appliance; these websites were apparently created by the sellers of the sham medical device to provide false, positive results to potential consumers.

COVID19 vaccine hesitancy has demonstrated just how uninformed and misinformed Americans are about health care and medical practice.  This helps explain why so many Americans either don’t believe in the effectiveness of traditional Western medicine and why so many turn to alternative treatments.  Deionized water, magnet therapy, and TENS are just a few examples of the many ways people are deceived – out of their money and unfortunately also out of good health.

[1] Understanding the Benefits and Risks of Deionized (DI) Water (theberkey.com)

[2] Is It Safe to Drink Deionized Water? (thoughtco.com)

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