by Loraine Holden • July 26, 2007
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.
by Loraine Holden • July 18, 2007
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.
by Loraine Holden • July 5, 2007
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.
by Loraine Holden • May 27, 2007
Diet drugs always get attention. Too many people have tried everything to lose weight. I want to analyze the information about Alli and Hoodia.
Alli is being promoted by Smith, Kline Glaxo. The write-up is very honest, saying that their pill is not magic and only in addition to exercise and a healthy diet. They say subjects who took Alli lost 2-3 pounds more than the 5 pounds lost by control subjects during the same time. If this is a healthy 5 lbs. a month, will another 2 pounds really make you want to use the pill? It works by causing 25% of the fat in your diet not to be absorbed. However the side effect of loose stools can be troublesome.
The write-up about Alli says nothing about possible non-absorption of desirable oil-soluble vitamins A, D, and E or if it interferes with omega 3 fish oils or flax oil. I’m reminded of a product touted in the 1950s that would keep your body from absorbing sodium so you could keep your blood pressure normal. The product was a synthetic resin. Capsules would be too big, so they advised mixing it with your mashed potatoes. It was unacceptable by the public so marketing ceased. People said why not just use less salt? Similarly, because of the potentially embarrassing side effects, wouldn’t you rather just use 25% less fat?
Hoodia has a different mode of action. It is derived from a cactus-like plant, used by natives of the Kalahari Desert to keep from feeling hungry or thirsty when crossing the desert. Pfizer has spent millions trying to discover the active ingredient. However, Hoodia Plus advertises their version of hoodia on the web. They say it is safe and has no side effects because it is natural. This is misleading. Many natural plant substances do have side effects, depending on the person. Take coffee or tea that has been used by millions, of whom some suffer side effects. Many drugs derived from plants or the parts of plants used by herbalists can have side effects.
Another problem I have is their marketing on-line. Even when you click “Contact Us”, you don’t get an address and phone number you would expect from a reputable company, but only a chance to send them an e-mail after you fill out a form with your name, address and phone number.
Hoodia may well take your appetite away. Remember South American Indians chewed coca leaves for centuries for this effect. Many people world wide have suppressed their appetites by using tobacco. We now know that coca and tobacco products do have side effects even though both are natural.
The reason many diets don’t work and people on them always feel hungry might be because they are eating too few calories and often no fats. If you eat a healthy amount of fat, this will suppress your appetite for hours. I eat a couple slabs of a good quality whole milk cheddar cheese and don’t feel hungry for the next 5 or 6 hours. It’s the low-fat idea that has led to both intractable obesity and more type two diabetes as people think that eating complex carbohydrates is better for you than fats. I explain more in my posting on Body Fat and Exercise.
by Loraine Holden • May 27, 2007
Many people think that runners are healthy because of low body fat. Â This is NOT true for some female runners. Without enough body fat they can’t make enough estrogen. Some no longer have menstrual periods. Others get bones as thin as those of an old crone because of low estrogen. Some don’t eat enough protein which is necessary to form the web-like matrix of bone cells on which calcium salts are deposited. Whereas moderate exercise helps calcium to be deposited in bone, excessive exercise has the opposite effect.
Other women complain that no matter how much they exercise, they can’t lose weight. I say they can’t use body fat because they aren’t eating enough fat. In order to lose body fat, you need enough of the intrcellular enzymes that burn fat. Otherwise you go into “starvation mode” where every calorie not used for immediate energy is turned into body fat. In one study with mice that got no dietary fat, the enzymes that produce body fat from carbohydrates increased 26-fold(2600%). Conversely, if you eat enough fat, you increase fat-burning enzymes and then start to lose body fat. Moreover, dietary fat keeps you from feeling hungry because it slows down the emptying time of the stomach. You feel full longer also because fat causes the production of a satiety hormone in the brain. A high carbohydrate makes you hungry every 2 hours as your insulin goes up and down.
Men runners can let their body fat decrease but this gives them less reserves for long distance running. Too many think that carbohydrates are the only source of energy for muscle movement, so try to keep the glycogen (animal starch) stores in liver and muscle high, then use sugars during a race. Don’t they know that fat is a better source of energy for muscle movement? The heart, which beats continually prefers fat. In my book I calculate that a man with 10% body fat has over 15 pounds of available fat that could produce 61,000 calories of energy, while glycogen stores can furnish between 1400 and 1800 calories. Instead of carbo-loading, racers should have a moderately high fat meal the night before a strenuous run and then replace lost body fat after the race along with enough protein to repair micro-tears in muscles.
One new friend demonstrates the value of body fat for long distance running. He is short and stocky, with a thin layer of fat evenly distributed over his muscular body. He set a record on a 50 mile race, passing tall thin runners who constantly needed more sugar. He had enough fat reserves that kept him going to win the race.
A typical runners’ diet of 80% carbohydrate and only 10 percent each of protein and fat is not healthy for the long term. Both fat and protein are necessary for the immune system. Other authors say that runners have more colds than people who exercise more moderately since they don’t get the extra protein and fat they need to make constituents of the immune system.
No one should be afraid of eating fat. Thirty percent of your calories as healthy fat will keep you healthy along with moderate exercise.
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