18. June 2009 by admin.

 The Obama administration is proposing a major overhaul of the U.S. health care system, and the insurance industry is poised to play a major role in the process. Insurance firms, like most businesses, are driven by profit, and this fact compromises any health care plan that includes them.

    Why?, let’s reflect on it……..

    For those having any doubts that insurers place profit above health, consider their investments in tobacco. The U.S.- based Prudential Financial provides life insurance and long-term disability coverage and is also a major owner of tobacco stocks, with total tobacco holdings of $264.3 million. The U.K.- based Prudential offers life, health, disability, and long-term care insurance, with their stake in tobacco totaling $1.38 billion. Standard Life, which is also based in the United Kingdom and offers both life and health insurance, owns nearly $950 million of tobacco stock. Canada-based Sun Life, which offers life, health, disability, and long-term care insurance, owns just over $1 billion of tobacco stock. Northwestern Mutual and Massachusetts Mutual Life Insurance Company (MassMutual) both offer life, disability, and long-term care insurance. MassMutual owns more than $585 million of tobacco stock, and Northwestern Mutual’s stake exceeds $235 million. (These figures, from The New England Journal Of Medicine, are accurate as of March 26, 2009, but given the current economic climate, they are subject to change.)

    Although investing in tobacco while selling life or health insurance may seem self-defeating, insurance firms have figured out ways to profit from both. Insurers exclude smokers from coverage or, more commonly, charge them higher premiums. Insurers profit — and smokers lose — twice over.

    These data are a reminder of the true priority of the insurance industry, which is making money, not ensuring health and well-being. These data raise a red flag about the prospect of opening vast new markets for private insurers at public expense, as has happened in Massachusetts, whose recent health care reform is often cited as a model for national reform.

    Milton Friedman wrote, “Few trends could so thoroughly undermine the very foundations of our free society as the acceptance by corporate officials of a social responsibility other than to make as much money for their stockholders as possible.” Market incentives favor pursuit of profit over the public’s well-being. The insurance industry’s investments in tobacco reinforce Friedman’s message and mandate caution regarding insurance firms’ participation in care.

    It’s clear their top priority is making money, not safeguarding people’s well-being, for tobacco is considered the leading cause of lung cancer and a major risk factor for heart attack, stroke, pulmonary disease and cancer. According to the World Health Organization, it is a contributing factor in 5.4 million deaths a year..

    Yet, the debate rages on. Indeed, it has reached a fever pitch since President Barack Obama took office, with Americans either dreading or hoping for the dawn of a single-payer health care system. Opponents of such a system cite Canada as the best example of what not to do, while proponents laud that very same Canadian system as the answer to all of America’s health care problems. Frankly, both sides often get things wrong when trotting out Canada to further their respective arguments.

    As America comes to grips with the reality that changes are desperately needed within its health care infrastructure, it might prove useful to first debunk some myths about the Canadian system.

    Again, let’s reflect on this……..

    Myth: Taxes in Canada are extremely high, mostly because of national health care.

    In actuality, taxes are nearly equal on both sides of the border. Overall, Canada’s taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

    Myth: Canada’s health care system is a cumbersome bureaucracy.

    The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn’t when everybody is covered.

    Myth: The Canadian system is significantly more expensive than that of the U.S.

    Ten percent of Canada’s GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada’s. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

    What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

    Myth: Canada’s government decides who gets health care and when they get it.

    While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

    There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don’t get one no matter what your doctor thinks - unless, of course, you have the money to cover the cost.

    Myth: There are long waits for care, which compromise access to care.

   There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists’ care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

    Myth: Canadians are paying out of pocket to come to the U.S. for medical care.
    Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.

    Myth: Canada is a socialized health care system in which the government runs hospitals and where doctors work for the government.

    Princeton University health economist Uwe Reinhardt says single-payer systems are not “socialized medicine” but “social insurance” systems because doctors work in the private sector while their pay comes from a public source. Most physicians in Canada are self-employed. They are not employees of the government nor are they accountable to the government. Doctors are accountable to their patients only. More than 90 percent of physicians in Canada are paid on a fee-for-service basis. Claims are submitted to a single provincial health care plan for reimbursement, whereas in the U.S., claims are submitted to a multitude of insurance providers. Moreover, Canadian hospitals are controlled by private boards and/or regional health authorities rather than being part of or run by the government.

    Myth: There aren’t enough doctors in Canada.

    From a purely statistical standpoint, there are enough physicians in Canada to meet the health care needs of its people. But most doctors practice in large urban areas, leaving rural areas with bona fide shortages. This situation is no different than that being experienced in the U.S. Simply training and employing more doctors is not likely to have any significant impact on this specific problem. Whatever issues there are with having an adequate number of doctors in any one geographical area, they have nothing to do with the single-payer system.

    And these are just some of the myths about the Canadian health care system. While emulating the Canadian system will likely not fix U.S. health care, it probably isn’t the big bad “socialist” bogeyman it has been made out to be.

    It is not a perfect system, but it has its merits. For people like “Aunt Betty”, who has been, let’s say, waiting for 14 months for knee-replacement surgery due to a long history of arthritis, it is the superior system. Her $35,000-plus surgery is finally scheduled for next month. She has been in pain, and her quality of life has been compromised. However, there is a light at the end of the tunnel. “Aunt Betty” - who lives on a fixed income and could never afford private health insurance, much less the cost of the surgery and requisite follow-up care - will soon sport a new, high-tech knee. Waiting 14 months for the procedure is easy when the alternative is living in pain for the rest of your life.

     If you don’t think health care is not rationed in this country — far more than it is in, say, Canada, you haven’t talked to the millions of underinsured, or uninsured. America’s illness profit industry rations health care more than any other industrialized nation in the world. 
 
    Democrats overwhelmingly support increased government influence over their health-care coverage in return for lower costs and greater coverage for more Americans. Six out of 10 independents feel the same way, but only one in four Republicans agrees.

    Opposition to President Barack Obama’s health-care plan is ideological. It comes from Republicans and conservatives. You are not hearing a lot of opposition right now from the business community and the health care industry.

    In fact a lot of businesses and insurance companies are working with the Obama administration on serious health-care reform. They don’t want to pay the costs any more. They’re willing to promote the health of young children, before five years of age, thereby saving society up to $65 billion in future health care costs, according to an examination of childhood health conducted by researchers at the Johns Hopkins Bloomberg School of Public Health.

    Reflecting on this, for instance……..

    Smoking impacts young children through prenatal exposure and environmental tobacco smoke. In the U.S., an estimated 25 percent of children are exposed to environmental tobacco smoke by household members, and 500,000 babies are born annually to mothers who smoke during pregnancy, according to tobacco prevention studies. Environmental tobacco smoke programs specifically aimed at reducing exposure to children within the first five years of life would produce an estimated cost savings of $500 million.

    And health insurance is not a guarantee that illness won’t bankrupt you. Lots of health insurance comes with big co-payments, deductibles and uncovered services. So you can be insured and still end up with big bills. At the same time, even if you have good insurance through your employer, you can lose it if you get sick and can’t work.

    Sick, did somebody say sick? Why would that be? Most people who filed medical-related bankruptcies were solidly middle class before financial disaster hit. Two-thirds were homeowners, and most had gone to college.

    Perhaps it has a lot to do with the use of the powerful antibiotic streptomycin as a growth-promoting agent in healthy livestock. The U.S. agribusiness pumps more than 20 million pounds of antibiotics into healthy livestock each year, constituting more than 70 percent of all antibiotics used in the United States.

    As serious questions arise about U.S. food safety nearly monthly, and with antibiotic abuse rampant and with antibacterial-resistant “super bugs” reaching epidemic proportions, maybe it’s time to rethink the practice of industrial-scale animal production.

    Scientists at Johns Hopkins Bloomberg School of Public Health in Baltimore and the Pew Charitable Trusts are calling for a phase-out and eventual ban of antibacterial agents for nontherapeutic use in livestock. They have taken their cause to Washington this month with ads in the Metro subway system and elsewhere.

    The food factory industry argues that its practices have made food more affordable and that reducing antibiotic use will lead to more outbreaks of E. coli, salmonella and the like. The former is true at the cost of animal abuse and meat quality. The latter is perhaps true only because of the stressed, cramped conditions that breed bacteria.

    The Pew Charitable Trusts reported serious obstacles to its study. Industry representatives were openly hostile, the report said, and threatened authors that they would withhold research funding at their universities. So it’s unlikely the Pew commission can make an impact.

    According to a survey, to be published soon in the American Journal of Medicine, about 78% of bankruptcy filers burdened by healthcare expenses were insured. Wonder why they were sick.

    As Dwight Eisenhower warned about the dangers of the military-industrial complex, we are faced with an agro-industrial complex — an alliance of agriculture commodity groups, scientists at academic institutions who are paid by the industry, and their friends on Capitol Hill.

    That’s just plain sick.

    JA
 
 

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11. June 2009 by admin.

    Contrary to the TV sitcom where the wife experiencing strong labor pains screams at her husband to stay away from her, women rarely give birth alone. There are typically doctors, nurses and husbands in hospital delivery rooms, and sometimes even other relatives and friends. Midwives often are called on to help with births at home.

    According to many paleoanthropologists, assisted birth has likely been around for millennia, possibly dating as far back as 5 million years ago when our ancestors first began walking upright, and accordingly, that social assistance during childbirth is just one aspect of our evolutionary heritage that makes us distinctive as humans.

    Humans need helpers in childbirth because it is difficult and potentially dangerous. While it’s not so risky today — maternal mortality is low — as recently as two generations ago, it was not uncommon to hear of women dying in childbirth.

    Through fossil records and comparisons of humans with other primates, anthropologists can now show how the uniquely human traits of bipedalism, large brains, infant helplessness and social assistance all came together, resulting in the challenging and somewhat dangerous manner in which humans give birth.

    When our ancestors evolved to begin walking on two legs, this upright posture created a wide but short opening in the pelvis in which the baby must travel, requiring a new form of birth so that the baby could find its way through a now tight birth canal.

    Anthropologists say the average pelvic opening in women today is 13 centimeters at its largest diameter and 10 centimeters at its smallest. The average infant head is 10 centimeters from front to back, and the shoulders are 12 centimeters across. And today the birth canal is a twisty tunnel subjecting the infant to a series of complex twists and turns on its way out.

    There has been a sexism in the study of evolution until recently. Researchers have mainly focused on men and the tools they used in hunting, and these things were more difficult to connect to reproductive success and hence to natural selection.

    With childbirth, as well as many of the other things that happen to women — pregnancy, nursing, menopause — it’s really easy to see how natural selection works.

    Childbirth is just one of a series of examples throughout a woman’s life cycle, in which enlisting the help of other women significantly improves reproductive outcomes.

    Women take up the slack for other women when they are pregnant and nursing so that they have the energy to devote to their infants. Cooperative childcare is something in which women help each other out. Often, but not always, these helpers are post-reproductive women who have fewer of those responsibilities of their own, but may be helping out their daughters. All of this puts a great selective premium on a kind of social intelligence that many scientists think partly accounts for the increase in brain size that happened over the last two million years.

    How will women and childbirth continue to evolve? Will the birth canal grow narrower, or wider? Will childbirth become more painful, or easier? Will more helpers be needed in future births? It’s really anybody’s guess.

    Evolution doesn’t have a direction. Knowing where we’ve been doesn’t give us any help in where we’re going. But it does help us understand what makes us human, as well as how we’re connected to the natural world.

     And a new study finds that largely owing to obesity and arthritis, which take root during early and middle age, old age can be miserable for many women — even when comparing men and women of the same age.  A 2005 study that found that women suffer more pain than men, in part because of perceptions of pain related to differing hormone levels. But the new study flat-out finds that a higher percentage of women suffer painful conditions.

    Higher rates of obesity and arthritis among these women explained up to 48 percent of the gender gap in disability — above all other common chronic health conditions, researchers announced recently.  Among 5,888 people over 65, women suffered up to 2.5 times more disabilities than men of the same age.

    While women tend to live longer than men, the Duke University Medical Center study shows that they are at greater risk of living with disability and much of the excess disability is attributable to higher rates of obesity and arthritis. This is important because it suggests that women’s tendency to pack on extra pounds in their child-bearing and peri-menopausal years translates into loss of independence in their old age.

    Chronic pain can shrink the brain and besets about 75 million U.S. residents. Scientists still don’t full understand how pain works. But health experts say exercise is one of the best ways to battle chronic pain, and it can also help sharpen the mind and even reduce the risk of cancer.

    The researchers said the study is the first to isolate the impact of specific chronic health conditions on the difference in disability rates between older men and women. Women have a natural tendency to gain more weight than men over the lifespan, but may be more motivated to maintain a healthy weight if they realize that those extra pounds make it more likely that they will be disabled in later years – potentially becoming a burden to their children or requiring a nursing home.

    The findings of the study are more troubling when you consider the increasing rates of obesity among women and the higher rates of other conditions that are currently over-represented among men.

    In addition to obesity and arthritis, the study found the women were more likely than men to experience fractures, vision problems and bronchitis. Men were more likely to have emphysema, coronary heart disease, congestive heart failure, stroke, diabetes and hearing problems.

    JA

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1. June 2009 by admin.

    Our bottled water habit has a huge environmental impact, including the amount of energy it takes to make the plastic bottles, fill them and ship them to thirsty consumers worldwide.

    Pacific Institute, a nonpartisan research institute located in the USA, recently realized that no one had done a comprehensive survey of the energy use involved in the complete production cycle of bottled water, so they took on the task. Their study breaks down just how much energy is used at each step of the process.

    An estimated total of the equivalent of 32 million to 54 million barrels of oil was required to generate the energy to produce the amount of bottled water consumed in the USA in 2007, according to the study, detailed in the January-March issue of the journal Environmental Research Letters. Of course, this is but a third of a percent of the energy that the United States consumes as a whole in a year.

    In 2007, the last year for which global statistics were available, more than 200 billion liters of bottled water were sold around the world, mostly in North America and Europe. The total amount sold in the USA alone that year (33 billion liters) averages out to about 110 liters (almost 30 gallons) of water per person, according to the Beverage Marketing Corporation.

    Since 2001, bottled water sales have increased by 70 percent in the United States, far surpassing those of milk and beer. Only sodas have larger sales.

    The energy required to produce bottled water is particularly of interest now, at a time when many nations are looking for ways to reduce their energy use and associated climate impacts.

    The energy use breaks down into roughly four parts of the production cycle: that used to make the plastic and turn it into bottles, to treat the water, to fill and cap the bottles, and finally to transport them.

    Most plastic bottles are made of polyethylene terephthalate (PET). Little pellets of PET are melted and fused together to make the bottle mold. Pacific Institute estimated that about 1 million tons of PET were used to make plastic bottles in the United States in 2007, with 3 million tons used globally; the energy used to produce that global amount of PET and the bottles it was turned into was equivalent to about 50 billion barrels of oil.

    (Some companies have been shifting toward using lighter-weight plastics for their bottles, which reduces the amount of PET produced by about 30 percent and would therefore lower the amount of energy required to make them. The transition to less energy-intensive plastic is slow though, and not all companies use them.)

    The energy required to treat water is substantially less and depends on how many treatments are used on the water and doesn’t account for the bulk of the energy spent in production. Likewise, the energy used to clean, fill, seal and label the bottles is only about 0.34 percent of the energy built into the bottle itself.

    The energy used to transport the bottled water depends mainly on how far it is shipped and what transportation method is used. Air cargo is the costliest energy method, followed by truck, cargo ship and rail shipping, in that order. A different study on the carbon footprint of wine also found this breakdown of energy use for transportation methods.

    In their study, Pacific Institute used the examples of different types of water shipped to Los Angeles: water produced locally and shipped by truck involved the least amount of energy, followed by water sent by cargo ship from Fiji, with water produced in France and shipped by cargo ship and rail having the highest energy costs.

    The final tally of 32 million to 54 million barrels of oil may be only about a third of a percent of the total U.S.A. energy consumption, but it could be considered an unnecessary use of energy. The amount is 2,000 times more than is required to make tap water, and we live in a country where we have very good tap water.

    The purpose of the study was not to propose that bottled water be banned, but to help consumers understand the implications of their choices. With correct information on energy impacts, that also sheds light on the greenhouse gases that energy emits, we have choices to do the things as individuals that make a difference.

    JA

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