Two Reforms Still Needed for an Effective US Health System

I wish to begin with a Groucho Marx joke: “Did I ever tell you how I shot a wild elephant in my pajamas? How he got into my pajamas I’ll never know.” In this country, health care system reform is getting more attention than Michael Jackson, Walter Cronkite, Lance Armstrong and that unhinged professor who protested too much, just because the police, in his living room, demanded he identify himself and be polite about it. What a nerve. All the fuss about health system legislation is a good thing, but it would be a much better thing if proposals took notice of the proverbial elephant in the room (but not anyone’s pajamas), which the experts and politicians alike seem determined to ignore. Except me. I will describe the elephant in just a moment. First, a few observations about the maddeningly myopic health reform debate.

A major assessment of the situation appeared in the New York Times. The author took the view that all ideas favored by Democrats or Republicans share a basic flaw. I agree with that statement, but I don’t think the writer identified the correct flaw. According to David Leonhardt (“Health Care Reform and the Unpopular T-Word,” Economic Scene, New York Times, July 29, 2009), the flaw in all plan proposals is that none would raise revenue as quickly as costs will surely rise. (During the last ten years, the economy grew 20 percent; medical costs rose 50 percent.)

Well, that sounds like a flaw to me, too, but it’s not as devastating as the flaw (or unacknowledged elephant) that will trample any and all reform attempts, even IF revenues somehow rise in concert with but not much greater than medical costs.

The debate to recast the legislation one way or the other addresses all manner of topics, but focuses on the insurance mandate, controlling costs via efficiencies, as well as boosting access to care and improving the quality of services. Hello? What about boosting the sorry health status of the people? Why is this upstream situation given so little attention? Yes, everyone needs access to quality medical care at affordable rates in a system the economy (and taxpayers) can sustain. However, we must at the same time create conditions wherein Americans are prodded, motivated and helped to live so as to remain healthier longer and thus needful of less medical attention.

There are, in fact, two elephants in the room, both of which are equally ignored. I know – how the hell can politicians ignore something so impressive, so big and so loud (not to mention so dangerous) as two bloody elephants? To me, it seems inconceivable that this is happening, but to me a lot of things seem inconceivable. (I still find it inconceivable that George W. Bush was president of this country for eight years and that Sarah Palin was a major party candidate for vice-president.) But, I digress. Back to the elephants.

No, I don’t think it is what Senator Lindsay Graham identified when he said, Well, the big elephant in the whole system is the baby boomer generation that marches through like a herd of elephants. And we begin to retire in 2008. Wrong elephant, Senator.

The largest elephant is the fact that Americans have sorry lifestyles. Two-thirds of us are undernourished, overfed, underfit and overfat. Or, put in a more positive light, most Americans have not realized their potentials for well-being. There is less reason, exuberance and liberty than there would be if more citizens pursued REAL wellness lifestyles. In addition to the four under and over factors I just mentioned, most of us are overstressed and undercalm, overmorose and underhappy, overbored and underexuberant and underskeptical and overly superstitious. (The under and over dichotomies could go on at length but enough, already. I’m sure you get the point.) We are a society that does not make choices favoring health and optimal functioning. That is the larger elephant in the room.

Let me tell you a bit about the smaller elephant, also a substantial problem. It is nearly unbelievable that this huge creature is not being specifically addressed in reform discussions at the highest levels. Even if the larger elephant (sorry lifesyles) were not around, this smaller beast can only be ignored at great peril at reform prospects. Ignore this creature and no reform element will make much difference. In fact, overlook this monster and any reforms could render a very bad situation much worse.

The smaller elephant is obesity. OK, maybe most people can’t sustain REAL wellness lifestyles even if they knew of such an option and were motivated to pursue such lifestyles (big “ifs”). However, the lesser elephant (but still HUGE) could be addressed in the context of health system reforms. The cost savings would be immense.

According to the lead article in a USA Today article by Nanci Hellmich entitled, Obesity Is A Key Link To Soaring Health Tab, (July 28, 2009, page one), those 30 or more pounds over healthy weight cost the country $147 billion in weight-related medical bills last year. Consider some of the consequences of obesity, as noted in a government-funded report by RTI International entitled, Weight of the Nation highlighted in the USA Today story.

* About 34% of adults – more than 72 million – in the USA were obese in 2006, up from 23% in 1994, according to government data. Two-thirds of people in this country are overweight or obese.

* Obesity accounts for 9.1% of all medical spending, up from 6.5% in 1998.

* An obese patient has annual medical bills of $4,871 compared with $3,442 for a patient at a healthy weight.

* Obese patients on Medicare spent about $600 a year more in prescription medications than patients at a healthy weight.

* The average American is 23 pounds overweight and collectively, we are 4.6 billion pounds overweight. (Statement attributed to CDC Director Thomas Frieden.)

* Taxpayers picked up about half the $147 billion tab in 2008 through Medicare and Medicaid.

* Obesity increases the risk of heart disease, diabetes, several types of cancer and other diseases.

* As important, obesity and simple overweight costs in other ways, such as lower prospects for a dynamic life wherein one can experience more joy and happiness, success in life and other psychological advantages. Obesity is, according to the report cited, the single biggest reason for the increase in health care costs. The lead author put it this way: If you really want to rein in health care dollars, you have to get people dieting, exercising and living a healthier lifestyle.

As William Dietz, director of the CDC’s Division of Nutrition, Physical Activity and Obesity observed, Obesity is not a problem that is going to respond to a silver bullet or single solution. Comprehensive policy and environmental changes are needed.

The president could regain support for his own health plan reform concepts by including incentives for healthy lifestyles. This could entail benefit elements that promote wise lifestyle choices generally and specific features that would combat obesity specifically, particularly exercise, nutrition and related benefit subsidies conducive to appropriate body weight.

The president would, with this single addition, regain the high ground by putting something positive into play, namely, a message that Americans can do much better in looking after their own best interests. Initially, given the widespread nature of the obesity problem, he would be offering the overweight a little help from their government, given the stake all taxpayers have in citizen health status. This seems good for the president at this time, as support for his reforms (focused on access and cost) has fallen dramatically in recent weeks. (See Laura Meckler, Support Slips for Health Plan – Obama Push Faces Growing Doubts in Poll; Overhaul Advances in House, Senate, Wall Street Journal, July 30, 2009.) Mr. Obama’s new emphasis is consumer protection. He should add to that consumer enhancement of life quality.

In putting forward a legislative program that addresses the need for healthy lifestyles, provides support for healthy lifestyles and creates conditions conducive to healthy lifestyles, Mr. Obama would be calling attention to the elephants in the health system reform room. More important, a reform plan that assists all citizens to make better choices will lower costs and thus fund expanded access to care for everyone.

The great wit Steven Wright once remarked, “My roommate got a pet elephant. Then it got lost. It’s in the apartment somewhere.”

It’s not hard to find either of the elephants in the health system reform debate dominating the air and other media waves at this time. Just look around.

Women and Depression or Beauty and The Beast

Is the fight to reach the top bringing women to their knees? Has the fairer sex really become the weaker sex? Are we depressed or are we just experiencing what men have always known concerning pressure, but because we are women we are a push over for analysis ultimately ending in medication that calms “what ails us”? We must remember that we are still living in a predominately male operated society. Men have the natural instinct to want to “fix it” when anything they perceive as a problem arises. If our reaction to a problem is not to handle it in the strict male fashion, we must be falling apart and need to be fixed by medication, counseling, or both. You are by now asking what do men and their view of our reactions to problems have to do with us being depressed. Well, I’ll tell you.

Women are not men. No matter how short you cut your hair, Madam President, (sarcasm intended) or the fact that you wear pants will ever make you a man. But every day we are told that having the feelings and reactions associated with women is wrong. There are some popular theories going around that say women are making men gay by expecting them to have emotions that are prevalent to women, but these same men will deny that telling women to subdue their emotions, or natural reactions, will have any mental effect on them.

Women are trying to fit into a society built and operated by men. We have certain attitudes about how things should be. For too long we have been told we are wrong and to do something about it. So what do we do? We put it in its place. Somewhere deep in our minds where we don’t dare go. Not knowing what to do with this unnatural act, our hearts and minds are bogged down. There’s no where for it to go. It has no outlet. This is labeled depression.

I guess this sounds like a “let’s get men” attack, but it really isn’t meant to have a negative connotation to it. It is just the natural order of things. Women are smart humans and will learn to adapt in this harsher world in order to survive and one day to thrive again. I am not saying that we will not bring our own form of problem solving to this dilemma, eventually. But for now we must find a way of coping. Fortunately society has given us a way out by giving the monster a name, depression. And because it has a socially acceptable name, it’s okay to have this reaction called depression. I don’t think so!

Women must start to realize that just because we may not be able to have it all right now (emphasis on the may) does not make us any less “of a man” then our hairy counterparts. The female sector must never stop fighting for what is rightfully theirs in equal pay and other rights. But at the same time, we must stop beating ourselves up over the fact that we haven’t arrived yet in the eyes of a society that doesn’t know any better (at least for the moment) then to react in the status quo fashion.

Females have always been overachievers. You know our labels: perfect wife, great cook, and super mom. And now, let us place the added burden of breadwinner to our long list of “must dos”. Unfortunately being an overachiever means that we have to “out do” to be called successful. And we will “out do”, won’t we? What will we get if we aren’t at the top? We get to face that beast that goes by the name of depression. I am the world’s worst for this one. In everything I do I must be the award winner, the highest paid, the fastest runner, whatever. Talk about major self-appointed stresses! But seriously, does this not sound familiar to you?

But we need to find a way to shrug off some of the anxiety and self-appointed stress. Slay the beast by means other than anger or mood altering antidepressants. Why must I now add anger to our problems of emotional out cries? Now more than ever, women are venting their frustration through the use of anger. Road rage by women! Ever seen that one? Ever been on the receiving end of one of those fingers? I am not even coming close to suggesting that women own this one exclusively or even as a higher degree than men. But ask your mom how many times she was cut off, cussed out, and all those other glamorous actions we have come to see all too often, being initiated by a female when she was young. Perhaps you would use the explanation of more female drivers. Could be, but doubt it. We are programming ourselves to push, push, and push to get ahead. Our natural instinct is to react emotionally and unfortunately this is coming out as anger in a lot of situations.

The women I talked with stated they truly believed that women are angrier than they were in the past. The media has put so much pressure on us to be thinner, always look our best, and many times with unreasonable expectations to what is called excepted. Anorexia is at an all time high among women. Health issues are not at the heart of the attack, (no pun intended) on women to be skinny. You are unattractive and not appropriate for a career, marrying, or any other number of outside the home social activities. If you have any excess weight on you, you had better do something about it. But when you can’t reach, for one reason or another, these unreasonable goals, you become depressed.

Career goals, physical appearance, and respect are but a few of the reasons women become depressed. My main concern is for women to find a healthier, more positive way to handle these socially inflicted stresses then becoming depressed, angry, and ultimately becoming addicted to antidepressants. We know that historically men have used alcohol as a means to cope. We see how that faired, don’t we? Let’s not follow their lead but learn from their mistakes. I’ll let you in on a little secret if you don’t tell men. We are actually stronger than they are, as a whole. Men may find this funny and hard to prove, but I am 51 and have seen my share of tragedy. I have watched a lot of men go down the tubes when life smacks them down once or twice but at the same time have seen many women still standing after life has punched them in the stomach many times. Don’t let them tell you that because they are willing to go to war and die for a great cause makes them the stronger sex, either. There ain’t no such thing as a good war as a reason to die. Yes, I know that men start these wars, but you can’t use that against them. Crazy men are the ones starting wars. I just don’t think they should use their patriotic duty as a cause to say they are stronger, but if you ask them why they think they are stronger this seems to be their answer. That’s all I’m saying.

I was on antidepressants for 5 years and I smoke 1 ½ packs of cigarettes a day. I can say I was on them because I, not my doctors, took myself off them. I want to handle life through my own thoughts and strengths. As for the cigarettes, I have currently cut out ½ pack with the hope of quitting. Neither one of these actions has been easy. I will still “slap you into tomorrow” if I am aggravated enough, so I started my own home based business to keep me calmer during my transition. Whatever it takes. But my point is that I have become aware that I am stronger then this and want to be me, just me, and all the good or bad that comes with it.

Come on ladies, do a self-inventory. Are your reactions to situations over the top or are you coping in a positive manner? Pay attention to how you react and don’t excuse it if it’s not exactly lady like. It is not good for your health or your own self-image. When you screamed and yelled at that driver, did it do you any good? Bet not. Bet your blood pressure went through the roof. Why do you think more women are dying from heart attack and stroke then men are now? As we always have in the past, we must come up with a constructive way to stop “the madness”. Our society is mean to each other. You see it and you know it’s true. We are on a path to self-destruction. Take a deep breath, exercise more, try some natural products, become more spiritually involved, or go slower in your climb to the top, whatever it takes. Slow down and smell the roses! You can do it if you will just put a little effort into it. We are overachievers but we are also over comers, go for it with all that makes you a woman!

(Just a little P.S.) If we are depressed, medicated, angry, and fighting amongst ourselves, who is minding the store and winning the race? (And that ain’t no B.S.)

Good Food Good Health – Fighting Colds

Hi everyone

If you read my last article on those beastly little cold viruses that plague us all, you will know that your best line of defence is keeping your immune system in tip top condition. Not just for fighting colds but for any infection or illness that our body encounters.

Colds are one of the most common reasons we have time off work through the winter period and hospital beds are tied up with cold and flu cases. Colds and flu viruses are the biggest single killer of the elderly over winter.

I really cannot stress how everybody should take our motto ‘good food good health’ of eating a nutritionally balanced diet to give your body the best fighting chance at beating off viruses and illness.

Although diet is the main factor in keeping your immune system up to scratch, other factors are equally important, I believe sleep is also so very important and that we should all look at our sleep patterns and make sure we get a good seven hours sleep a night. A good nights sleep increases the release of immune stimulating hormones.

Stress is another strong factor, as this puts our body under untold pressure. People who have busy lives are generally under great amounts of stress and although all of us actually perform better when under a small amount of pressure, constant high stress levels are most certainly not good for us.

A lot of people are actually highly stressed because they cannot sleep, and therefore it is a vicious circle for many, this greatly weakens their immune system making it easier for them to be the victim of colds and other ailments, always feeling lethargic and rundown.

Our immune system is a highly specialised network of cells and organs working together, protecting us from bacterial and viral infections.

Obviously during the winter period our bodies are much more susceptible to viruses especially colds and flu, so to help maintain a healthy immune system we need to make sure we are eating a nutritionally balanced diet rich in minerals and vitamins that are vital for this.

So ‘good food good health’ really is the key. I know that during the winter months our diets alter but we still really do need to eat the five portions of different fruit and vegetables a day.

There are plenty of cheap vegetables at this time of the year and dried fruit counts just the same as fresh, also frozen fruit and veg is equally good, even some tinned fruit and vegetables count as well, as does a serving of fruit juice. There are also some very good vegetable drinks available now.

Another steadfast recipe of my dear old Nan is chicken soup or broth. Home made is best of course but even tinned is excellent and it is a proven fact that it helps to combat colds, flu and chills.

Eating a healthy diet does not have to be expensive if you try to use seasonal fruit and vegetables, and farm shops and markets give excellent value for money.

Relaxation is important to keep stress levels under control, and laughing is known to reduce stress hormones and increase the immune systems activity. So taking a little time out of your busy schedule will only benefit you, even if it is only putting your feet up for half an hour and watching a good comedy, chasing the children around the garden or park, anything that makes you feel good.

Exercise carried out in moderation regularly is beneficial for the immune system, reducing the risk of common infections and also help protect us from serious diseases too such as type 2 diabetes, cardiovascular disease and some types of cancer.

30 minutes a day of moderate intensity five days a week is thought to be the recommended exercise regime, and the 30 minutes does not have to be carried out all at the same time, it can be broken down into smaller periods to work into your schedule.

Wrapping up warm may help to keep colds at bay even though colds are caused by viruses and not by chilly weather. But being chilly makes blood vessels constrict, especially in the nose inhibiting immune response and making it more likely that viruses can take hold. So perhaps our parents and grandparents were right in telling us to dress sensibly after all!

The main vitamins and minerals we need for a healthy immune system are vitamin B6, C, D, E and copper, selenium and zinc. Although it is best to get these through a varied diet many of us would benefit from taking supplements through the winter periods, there are many reputable supplements and suppliers that can be taken to enhance and top up your diet.

Vitamin B6 is found in vegetables, whole cereals, bread, milk, pork, chicken and cod. It is available in supplement on its own or in a vitamin B complex.

Vitamin C is found in fruit and vegetables especially oranges, kiwis, peppers, broccoli and yams, and is available in supplements and tonics.

Vitamin D is found in oily fish and eggs. Is formed in the body when skin is exposed to sunlight and readily available in supplement form.

Vitamin E is found in nuts, seeds, wheat germ and plant oils such as soya, rape and corn. Available in supplement form.

So just take a look at your usual diet and see if there is any of the above requirements missing, and if so add these into your meals and get the natural benefits of good food good health.

Making meal times fun is a great way of getting children to eat vegetables they like and to add new ones to their diets, be a little imaginary when serving up.

For Children, many of the cereals that are now targeted at them often do have added vitamins, but I believe it still is best for whole grain cereals and plenty of fresh fruit, vegetables and dairy products.

I am a strong believer in the power of garlic, and have long taken it in a supplement form to help my body fight colds. Many countries have used it not only in cooking, but some believe rubbing it on the soles of their feet helps too! – not one I feel inclined to try. Garlic is also a strong natural antiseptic.

Do not forget good food is good health

Sandra & Ted

Kombucha – Home-Made, Fermented, Probiotic, Health-Boosting Joy!

In the past I was always a bit nonplussed when it came to kombucha. I didn’t think I liked the taste, and I was sceptical of the claimed health benefits. But now I’ve found out more about it, and discovered how easy and fun it is to make at home, I’m definitely a kombucha convert!

Kombucha is a fermented drink made from tea. It is made using a ‘kombucha mother’, also called a ‘kombucha scoby’ (or sometimes ‘the tea beast’!) which is a gelatinous colony of bacteria and yeast. The mother is added to a container of sweet black tea, and over the period of a couple of days to a couple of weeks the bacteria and yeast feed off of the sugar, and produce a range of nutrients which fortify the tea.

Health Benefits

Kombucha is credited with anti-viral and anti-fungal properties. Like all ferments, it is a ‘living’ substance, containing healthful ‘friendly bacteria’, which are essential for immunity, digestion, and nutrient absorption. It also contains vitamins and amino acids. In ancient China it was called the ‘tea of immortality’.

Using & Brewing Kombucha

The only difficulty to start with is getting hold of a komucha mother. You could try asking around your local health-food shops, or look on eBay where there are often some for sale.

A kombucha mother can be reused indefinitely. Each new batch is started with about a cupful of mature kombucha saved from the previous batch, and some new (cooled) sweet black tea. One or 2 teabags and a handful of sugar to a small saucepan of water seems about right, but the quantities are very variable.

The best vessel for brewing your kombucha is said to be a bowl with a large surface area, but I find it easier in a large jar. Cover with a cloth to keep out flies or dust but don’t seal closed as this would cause a pressure build up.

Once it’s ready, the komucha is kept in the fridge and drunk as it is. It is slightly fizzy, slightly acidic, and to my mind, has a taste not unlike cider. The taste changes day by day as the complex fermentation processes develop. Young kombucha still tastes more like tea and is slightly sweet.

Very mature kombucha is not at all sweet, with a strong vinegary taste. Kombucha connoisseurs often seem to like it quite vinegary, but I must admit I prefer it a little milder, and normally stop my kombucha before it gets too strong.

Every batch you make also produces a new ‘mother’, so you end up with 2. At first the existing mother that you put in sinks to the bottom. After a day or 2 you can start to see a film appearing on the surface of the kombucha. Don’t be afraid – this isn’t mould, but the beginnings of a new mother.

After another couple of days it will be thicker, and will resemble the original mother. Once you have finished, you can use each of your mothers to make 2 separate batches of kombucha, give one away, or compost it. A mother will also keep for a couple of weeks in the fridge in a cupful or so of mature kombucha.

You can also kombucha other liquids. I mentioned that to me komucha tastes a little like cider, so I recently tried komucha-ing some apple juice, and it was delicious! It is claimed that using liquids other than tea will eventually harm the mother, but I haven’t yet found this to be the case.

As a new mother is created each time I find it best to keep one regular batch of komucha tea on the go at the same time as an experimental brew, so that I always have one mother that I know will be ok.

So… I’m a kombucha convert, is anyone else with me?