9/4 Open Thread: Food for Thought About Health Care

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First_Aid_Kit

This column will have 2 distinct parts, completely different topics, at least as of this sentence:

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First I need to get out a long simmering objection, or several, to a lot of the the often deceptive rhetoric about health care that keeps going around and around; then I will address an interesting op ed relating to an important partial solution to our health care problem(s) and its major flaw.

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First, however, should you be hit and injured by some inattentive driver who jumps the curb in his SUV and then drives off, do witnesses and bystanders call BlueShieldBlueCross, or Aetna, or some such? If they do, does the insurance company send an ambulance and paramedics who initiate treatment while they take you to the nearest insurance company office for treatment by trained medical professionals, doctors, nurses, surgeons and anesthesiologists, etc? Perhaps, alternatively, they call 911; perhaps no insurance company will be involved in providing emergency services or medical services, but will, if you are very lucky, eventually cough up some fraction of the funds necessary to pay the bills for the ambulance, emts, hospital/clinic, medicos and medicines. So, can we start to call things by their real, proper names? Insurance is insurance, it is not health care. Insurers sell insurance, they do not provide medical care.

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Recently somebody on Daily Kos posted a column with the title "REMINDER: Most of the POTUS candidates support multiple paths to Universal Coverage...which is fine." The headline is true as far as it goes, though it is vague and unclear as to what kind of "coverage", but in the context of todays Democratic Party politics, the use of the word "universal" reeks of and calls forth thoughts of universal health care, a hot topic, which pretty much extremely few candidates support. I commented to the effect that they should define "universal" and state which "plans" would accomplish it in my lifetime as well as provide an estimate of the number of annual medical bankruptcies per plan. No answer expected and none received. Face it, most politicians plans won't even insure everybody let alone make sure that everybody gets appropriate and necessary health and medical care. Most are some insurance for many, primarily those who can pay for it, and, then, health care for those who can also afford to pay for the medical care after having first paid for the insurance, which is far from all who will wind up buying said insurance. The truth is that most candidates purport to support some sort of plan whereby, at some future point in time, most citizens will have some insurance. I propose that the government contract with BCBS to issue insurance policies to every citizen, policies providing for reimbursement of 5% of covered in-patient care, 7% of covered outpatient care, and 3% of covered medicines and drugs incurred in excess of the $10,000 per category deductible. Voila, truly universal coverage, with no need to duck the question of what "universal" means. We'll pay for it with an excise tax on drugs and medicines, or take it from the CIA black budget.

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PART II Recently my wife forwarded me an op ed from the NY Times entitled Our Food Is Killing Too Many of Us by By Dariush Mozaffarian and Dan Glickman which was Published Aug. 26, 2019 and Updated Aug. 27, 2019, 8:12 a.m. ET. Their thesis is in the subtitle Improving American nutrition would make the biggest impact on our health care. They note that the Democratic Party health acre debate has centered around questions of coverage and funding, which they hold to be pretty much incapable of any real solution. They focus on the fact that a great number of us are sick, even seriously sick and that the costs of these illnesses in treatment and lost productivity, as well as numerous deaths. They assert that the focus should be on the cause of our terrible health, and that the cause in question is our terrible diets.

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They present statistics and facts about the state or our national health (bad) and its cost (enormous) and then suggest that given the link between our terrible diets and our health problems, our politicians should be addressing programs to bring about a healthy change in our dietary habits. They suggest various things that could or should be done in that regard and argue that every presidential candidate should have a food plan, program and platform and that these food plans should be highlighted in future candidate debates. There is some sense to that, and each candidate should also have a plan for dealing with the climate crisis, ending our wars, making the economy work for everybody, and much more. Surely they can multitask, so maybe we should take that as settled.

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Of course, no matter how good your diet is, a broken arm, concussion, gunshot wound, or other non diet-linked medical problem will still require medical care, often expensive medical care that many cannot pay. No matter how you came to need dialysis, once you need it, you need it and it is expensive. More importantly, there is something seriously absent from the discussion put forth in the article. Something that, as it stands, is something of an insurmountable barrier to the whole eat your way well mirage. The current version of capitalism is the cause of the dietary inadequacies that cause all of the health problems targeted by the article. It is that system that results in Food Deserts. They are many, they are everywhere and they are deadly. For a quickie overview just check the ever centrist Wikipedia on the topic: https://en.wikipedia.org/wiki/Food_desert.

Hola campesinos! Quelle hombre dice da kine esos?

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Title Image is First_Aid_Kit and is public domain

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Its an open thread so have at it. The floor is yours
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Lookout's picture

And then they purchase a "Heart healthy" logo for their products from the "American Heart Association". No joking. Just look at the obesity outcomes...

obesity.png

The food pyramid is clearly wrong. Here's a nice compilation of some of the studies.
https://www.dietdoctor.com/low-carb/science#weightloss
...and a thorough lecture (1.3 hours) https://www.youtube.com/watch?v=ZbnshVO4PRM

Here's a more general lecture...which could be called everything you were told about nutrition is wrong. It is 52 min.
[video:https://www.youtube.com/watch?v=q8BGYhreaco]

I think they want us to be sick, get caught on the physician treadmill, and buy lots of drugs when in fact many of today's common ailments can be cured by diet...including type 2 diabetes.
https://medium.com/@nathancheng/the-cure-for-type-2-diabetes-is-known-bu...

If you google “diabetes cure” you are directed to websites like WebMD and the Mayo Clinic where you find information on diet, exercise, medication, and insulin therapy, but nothing about the cure. This lack of information may have to do with the fact that Americans spend $322 billion a year to treat diabetes, $60 billion a year on weight-loss programs, and $124 billion a year on snack foods. This is about 3% of the US economy! Because so many peoples’ livelihoods are supported by diabetes and its main cause, obesity, the viral effect of people getting cured and telling others is greatly diminished.

It is criminal to tell people diabetes is a chronic condition and they must take insulin for the rest of their lives. Doctors have been miseducated about nutrition too. Fortunately, I've never had to struggle with diabetes. I came to my awareness with OPOL's essay on fasting and keto diets. Over two years later I still practice a keto diet and intermittent fasting. I dropped 60 pounds, lowered my blood pressure to a very good level, and improved all my health markers. I cycle into and out of ketosis. I occasionally eat bread or a wheat based tortilla so that I don't develop gluten intolerance. I try to fast three days a month and that will always throw me back into ketosis (fat burning). We have changed our diet, which used to be meat and potatoes with a veggie on the side, to one of mainly veggies (primarily green leafy ones) plus using lots of olive oil. Like all transitions it did require adapting, but as we both started feeling better and we altered our gut bacteria it became easier and now we love what we eat and can grow a good bit of it ourselves.

I would add you can eat only meat and have good health outcomes. There was this study in 1928...https://swizec.com/blog/week-17-what-happens-when-you-only-eat-meat-for-...

I think eating healthy fats is the key. They trigger the satiety hormones.

As to healthcare - it is absurd that we don't have M4A. Max Blumenthal had an interesting experience in Nicaragua with their excellent system (at the 5-7 min mark - whole interview is worthwhile) https://www.youtube.com/watch?v=k_-7cE5A78E

Fortunately our diet is under our control...unless you are in a food desert.

Wish you all good health and lives.

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“Until justice rolls down like water and righteousness like a mighty stream.”

enhydra lutris's picture

@Lookout
folks in the US are generally too caught up in the idea of a foolproof simple miracle cure that works in 3 weeks as the sole alternative to fast foods and so they endlessly cycle in and out of them separated by the junk.

I dropped 50# just eating regular protein+carb+veggie "balanced diet" with serious portion control. The big trick is not to eat out. A quarter pound of 70% lean ground beef is 375 calories, a restaurant burger can to as high as 1250 or more. Whatthehellisinthosethings? Seriously, find a popular chain of non fast food restaurants and check the calories for their lunch entrees. It's obscene.

I'm sure that all kinds of things work, but when I bicycle commuted I tried some experiments and found that for me (anybody's mileage will vary), I could not completely eschew carbs. When I did I would bonk, which I put down to glycogen starvation, but, whatever it was, it was real.

I'll try to get through some of that information s the day goes on, thabjs again.

Have a good one.

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That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --

Anja Geitz's picture

@Lookout

Thanks for the video. Dr. Fong made some very compelling arguments. Particularly fascinating were the correlations in the rise of cigarette consumption and heart disease that everyone ignored in the studies, and then randomly attributed heart disease to fats and recommended eating more grains. Have heard similar things about carbs, inflammation and hormonal imbalance from my sister who is a registered dietician.

Crisco. Glad to say I never grew up with that in the house and have never used it, but was horrified to learn where it came from, and how it was made. Trust us, they said. That's a laugh. Why would any company in business to generate profits be concerned for my well-being? Young people don't realize that we had to actually lobby our lawmakers to legislate into being "nutritional" information on the packages of the "food" that was filled with hydrogenated fats from the companies making them.

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There is always Music amongst the trees in the Garden, but our hearts must be very quiet to hear it. ~ Minnie Aumonier

WaterLily's picture

To some degree, Lookout, I agree with you that diet is under our control ... if we have the time and resources to devote to it. Food deserts are a serious issue, but so is the fact that even in areas with easily accessible supermarkets, the cheapest "food" isn't food at all. People who have to work two or three low-wage jobs to make ends meet often can't choose the items along the edges of the market, organic or not. Either they're too expensive, require too much time to prepare, or both. So they "choose" the inexpensive convenience "foods" that ultimately lead to obesity, diabetes, high blood pressure, and other conditions.

This is not to say that I agree with the NYT op-ed, which reads to me like another justification for politicians to abandon M4A. (Not that I'm shocked, considering the source). Sure, "food programs" can't hurt, but they're not going to fully address the issues EH raises.

Nothing drives me crazier than the deliberate conflation of "health insurance" (or "coverage") and health care. And it happens everywhere. Even our local "progressive" weekly recently published a story about a local employer who refuses to pay a livable wage, and justifies that by pointing to the generous benefits package they provide. A direct quote from that article: "Employees have been known to quit, but then come back for the free health care." Now, someone who works at the employer said that, but the editors easily could have clarified that he meant the employer-paid health insurance premiums. They chose not to.

It's a big club, and we ain't in it.

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Anja Geitz's picture

@WaterLily

but so is the fact that even in areas with easily accessible supermarkets, the cheapest "food" isn't food at all. People who have to work two or three low-wage jobs to make ends meet often can't choose the items along the edges of the market, organic or not. Either they're too expensive, require too much time to prepare, or both.

Especially if you have a household to run. But what if those low income Mom's were aware of the stakes involved in choosing the foods they provide their family? Would that compel them to make different choices? I'm continuously surprised how little people understand the food they are eating. Sure, they know potato chips, Coke, and candy are not healthy for them. But they also think that the prepared foods you find in the frozen aisle of the grocery store, if they have vegetable and meat in them, are "healthy" meals, never bothering to look at the labels.

My Sister used to run a healthy eating class for at risk school kids. She made it fun and she made it relevant. Not only did they love it, they brought the recipes back home and encouraged their Mom's to make them. My Sister frequently heard from parents about how excited the kids were to eat, are you ready for this, vegetables.

Yes, it's easier to boil up a package of 99 cent ramen filled with hydrogenated fats and carbs for dinner. And it is definitely an endorphin pleaser to order up a box of Popeyes fried chicken. But last night I spent what amounted to 30 minutes making a healthy, and tasty meal for less that $5. Most, but perhaps sadly not all, can afford to do this given the right motivation. For me, that motivation is being able to live an ambulatory life when I'm in my 70's and 80's. For others, they have to decide for themselves. But I do believe it is possible for those who have access to real food, and for those who have thoughtfully assessed their priorities.

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There is always Music amongst the trees in the Garden, but our hearts must be very quiet to hear it. ~ Minnie Aumonier

WaterLily's picture

@Anja Geitz It's a topic with many gray areas for sure. I mean, quite honestly, I went through a good portion of my early adult life completely clueless about the fact that what I was buying, and ingesting, was absolute crap. It wasn't until I moved to a place where you could easily buy directly from farmers that I began to understand what was wrong with our food system and its connections to our collective health. And it wasn't until I was diagnosed with celiac that I began making a concerted effort to make our own meals, so I could know exactly what was in them.

I have family members on both sides of the spectrum. For example, one of them successfully reversed their Type 2 diabetes through diet alone. And that was almost 20 years ago, when such an approach was mostly considered "woo." Another was told two or three years ago that they're in the early stages of kidney failure, which could successfully be delayed by dietary changes. This person has chosen to ignore that fact despite having no barriers to access. They drink diet sodas all day and opt for fast "food" and meals out of a box 6 out of 7 days.

Getting back to my first paragraph: I've also found that buying direct from farmers, at least here, can be VERY expensive. I can't always do it, and have sometimes done it at my own financial peril because I support the idea of it, and think our system needs to change.

So I still wonder about moms/families who are willing to learn and adopt healthier approaches--even despite time constraints--but who just can't afford the ingredients.

Food justice sits right alongside health care access for me, which I guess gets back to the spirit of this OT. Good conversations to be having.

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Anja Geitz's picture

@WaterLily

Many years ago, I watched the step-father of a boyfriend of mine literally eat himself into his grave. He suffered from diabetes but still ate a lot of processed foods. Even his vegetables came from the boil-in-bag variety where the "butter" or "cheese" was comprised of sugar additives. When his kidneys began to fail and he had to go on dialysis, it was like he just gave up, ignoring all the diet advice he was given by his doctors. It took less than a year and he was dead.

When my sister used to consult at long term rehabilitation facilities she saw a very disturbing trend. Patients who suffered from complications from diabetes were coming into the hospital at younger and younger ages. Declines she used to see with 70 year old patients, she was now seeing with 50 year old patients. Typically when she would sit down with them to advice them of the changes needed in their dietary regime she'd hear the same thing: they do not want to give up their morning muffin/bagel/cereal. Even after being told they were in danger of losing their eyesight/leg/foot.

Choices. It boggles my mind.

So, getting back to the low income family with few choices. If it were me, and I had a family to feed, and very little money, knowing what I know, I would opt for the vegetables I could buy at the 99 cent store before I bought cheap processed food. It might not be organic, but if we are hedging our bets, that'd be my choice.

I agree. Food justice is right up there with healthcare access in issues that are important to me.

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There is always Music amongst the trees in the Garden, but our hearts must be very quiet to hear it. ~ Minnie Aumonier

enhydra lutris's picture

@WaterLily
made a good point about diet and health, but, given the source, were probably engaged in deflection and distraction, especially since they didn't even mention food deserts or the fact that things like injuries also require medical attention.

Have a good one.

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That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --

Anja Geitz's picture

It seems clear enough to me that the legislators and the companies that profit from slowly killing us through obfuscation and deprivation are hellbent in keeping their personal gravy train chugging along at our expense and demise. I suspect they do this by convincing themselves its our own fault for being so stupid and gullible. Or they simply don't give a shit and sleep fine anyway.

As to the comment about healthcare that you left at DKos, while you most certainly won't get a thoughtful reply, it pleases me that it will at least annoy the neo-liberal sycophants over there who run across it.

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There is always Music amongst the trees in the Garden, but our hearts must be very quiet to hear it. ~ Minnie Aumonier

enhydra lutris's picture

@Anja Geitz
including working in the yard trying to create additional garden space and making a couple of loaves of sourdough. Some suddenly imposed errands took most of the heart out of the mrning, which is why I'm so late replying.

Have a good one.

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That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --

Anja Geitz's picture

@enhydra lutris

That was one of my Mother's favorite breads to bake. Oh, gosh, how well I remember how good that smelled baking in the oven.

Grilled cheese sandwiches on homemade sourdough bread. Is there anything better?

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There is always Music amongst the trees in the Garden, but our hearts must be very quiet to hear it. ~ Minnie Aumonier

magiamma's picture

et al

Just back from yet another meeting with county supe. They are going to actually hire someone to deal with adaption and mitigation. Glass half full I guess. Eight of us from different groups so that's a lot. We have a lot to figure out about how they work and what our next steps are. Slow as molasses in January.

Have a good one everyone...

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enhydra lutris's picture

@magiamma

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That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --