One of the most frustrating things about working in healthcare, for me, is the assumption of conspiracy. The idea that because I wear scrubs and hand out bandaids, I'm in on some grand scheme that entraps people into unnecessary/harmful treatment, (or purposefully denies them necessary treatment) is a recurring theme among patients and the public. It's incredibly frustrating.

Part of the reason it's incredibly frustrating is that I too get the gut feeling that there are bad actors in the healthcare system. Hell, it's not even a gut feeling, it's frequently proven to be true (Looking at you, Purdue, Mylan and Kaleo).

But because the average person's contact point with the healthcare industry is a primary care doc, ER staff or EMS personnel, and not insurance or pharma execs, us grunts get tarred with the same brush. And let me tell you, we didn't go into these jobs because we have a sadistic interest in hurting you for cash. There are more lucrative jobs that are easier, require less training, and involve much less poop.

To get around to my point: Please don't treat the American College of Cardiology and a thuggish life insurance company as the same entity. Believe me, those of us on the other side of the stethoscope think insurance companies suck too. The cardiologists who worked on these revisions have doubtlessly each had countless conversations with patients trying to convince them that cutting some salt and going for a run once in a while will literally extend their lifespan, and have seen most of those conversations go nowhere. So now they're trying harder.

“We're recognizing that blood pressures that we in the past thought were normal or so-called pre-hypertensive actually placed the patient at significant risk for heart disease and death and disability,” said Robert M. Carey, co-chairman of the group that produced the new report. “The risk hasn't changed. What's changed is our recognition of the risk.”

The intent here pretty clearly appears to be to try and get Americans to pull their heads out of the sand a bit and realize that we treat our bodies horribly. Hell, taking lower levels of hypertension seriously might even lead to stopping serious cases before they start, possibly reducing the number of new prescriptions!

Will insurance companies find a way to profit off of this? Probably yes, because they're run by scum. Is your average practitioner happily skipping hand-in-hand with them as they do so? No. And as mentioned:

The four main classes of drugs for blood pressure have generic versions and can be as cheap as a few dollars a month.

Probably not gonna be an oxycontin-style surge of scummy marketing for these drugs any time soon. And if the sudden surge in prescriptions you posit does come to pass, and some Shkreli type buys them and jacks the price, you can believe that among the first groups to yell about it will be docs and nurses.

It's not as simple as "Oh, hey, let's make more people hypertensive and write more scripts so that our buddies at Cigna can buy another boat". It's easy to play the cynic here and to plaster over the truth in the nuance, but sometimes healthcare providers do things because they care about people's health.