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Universal Health Care

The high cost of health care is being debated in California and elsewhere in the U.S. The best suggestion comes from Dr. Arnold Relman.  He was a respected professor and one-time editor of the New England Journal of Medicine. His book “Second Opinion” explains how health care can’t be treated as just another business. Even in the 1970s a noted economist says it doesn’t correspond to economic principles.

However since that time insurance companies have taken over medical decisions. Doctors must spend more time treating their practice like a business instead of being concerned with healing.

He suggests a single payer, the government, to get the lowest administrative costs. Doctors could join together with both specialists and general practitioners in voluntary non-profit groups. Patients could decide which group they wanted and could change if necessary. Doctors would be paid a salary and not by the “piece-work” formula that is driving up costs and not benefiting patients.

You have heard elsewhere that there are 47 million uninsured Americans. Most are the working poor or small business owners who just can’t afford the coverage.

Dr. Relman states that as a country we are spending twice what other advanced countries do per person and are ranked among poorer countries in some criteria like infant death rate.

He says one of the reasons doctors have lost their vocations as healers is because of a Supreme Court decision saying that legal and medical associations could not be exempt from fair trade rules. This has led away from internal regulation of their members and a wide open use of advertising and other business practices. In order to compete, even the most conscientious doctors or non-profit HMOs (Health Maintenance Organizations) have had to consider their practice like a business and cut corners in the name of profits.

Persons who say they don’t want some government bureaucrat standing between them and their doctor seem to forget the many layers of employees in insurance companies or for-profit-HMOs. There are expensive lawyers, statisticians, claims adjusters, middle managers and secretarial staff, all dedicated to increasing profits. Stock holders also expect a profit on their investment and the CEO (Chief Executive Officer) thinks he deserves a salary of several million dollars just like a rock star or professional athlete.

Medicine should once more be a healing profession.

In California Governor Schwartzenegger says everyone should be required to buy health insurance. The government would subsidize the poorer people. To me, this is like saying that everyone should buy bottled water instead of communities providing pure water for everyone. Mandating health insurance would drive up costs even more.

It would be like the boondoggle of the drug benefits of Medicare.  The law was written for the benefit of the drug companies and if not changed will drive up the cost of Medicare and the taxes that support it.

Instead of making insurance companies and pharmaceutical giants even richer, we should change our attitude as suggested by Dr. Relman.  More medical students are women.  (I was only one of five in a class of 70.) Women as well as many men want to be doctors in order to care for their patients not become businessmen.

If you’re in California you may have the chance to vote for Senator Sheila Kuehl’s bill of a single payer plan that some call “Medicare for all ages.”  Like social security it would have a much lower administrative cost than that of for-profit HMOs or insurance companies. If vetoed by the governor, it could be one of the propositions put on the ballot next year.

Of course insurance companies will spend millions to keep their lucrative practices. If the government pays part of their bills for poorer people, they will make even more.

We need health care for all not health insurance for all.

Breast Cancer Survivor’s Diets

An article of July 18, Chicago AP describes the results of a study published in the Journal of the American Medical Association. It said a low fat diet loaded with many fruits and vegetables was not better than a standard healthy diet for breast cancer survivors.

First, it did not mention if the women used sugars. Dr. Bob Arnot tells his patients in his book , “Breast Cancer Prevention Diet” not to use sugar. Rapidly growing cells like new cancer cells are stimulated by sugar.

Now, most manufactured foods use high-fructose corn syrup instead of table sugar. This artificial product has been shown to increase blood fats and LDL-cholesterol. More experiments should be done on this before anyone should use it in any form. The biggest use is in soft drinks and many fruit flavored beverages.

Fat has gotten a bad name in the last thirty years. Finally, doctors and others realize that trans-fats from hydrogenated vegetable oils are harmful.  However, they still say to avoid natural saturated fats.  Studies showing a relation of animal fats to any type of cancer do not consider what these fats might contain. Unless the animal is raised on an organic farm, it will have insecticides and other toxins in its meat and milk.  These are foreign to our genetic background and could well promote cancer.

Dr. Bob Arnot also tells his patients not to use most bottled vegetable oils.  These contain too much omega-6 fatty acids.

Again, animals raised organically can contain the healthful omega-3 fatty acids as do wild salmon and other cold water fish.  Excess omega-6 fatty acids are changed into too much arachidonic acid which is bad for your immune system.

I would like to see a study using adequate fat, including organic saturated fats and oils with omega-3 fatty acids. These with no sugar to very, very low sugars plus adequate fruits and vegetables should improve breast cancer survival.

Exercise 2 hours after a fatty meal is healthy

July 5 article on Netscape that says fatty meal effects can be counteracted by exercise after 2 hours is not surprising.  It would take about that long for the sausage, eggs, and hash brown potatoes to be digested.  Remember fat slows down the stomach’s emptying time but by 2 hours the fat globules enter the lacteals in the villi of the small intestine and via the lymphatic ducts enter a vein that goes directly to the heart, bypassing the liver. This is efficient since active muscles, both that of the heart and the body’s skeletal muscles burn fat in preference to carbohydrate as a much more efficient source of energy.  This soon clears out the fat globules in the plasma.

Meanwhile, if other subjects had juice, cereal, milk and toast of the same 945 calories, I would expect their insulin to rise to allow all cells to accept the extra blood glucose from that meal. Glucose that isn’t needed by the brain easily enters the cells of their body fat, sooner than 2 hours after eating.

A breakfast that can damage the heart and blood vessels would be one that has margarine instead of butter and a sweet roll or syrup or jelly that contained high-fructose corn syrup.

The liver transforms high-fructose corn syrup into LDL-cholesterol and tri-glycerides (blood fats) that can clog arteries whose walls have been made stiffer by the long term use of trans-fats in margarine.

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