Mandatory Health Insurance

I do no follow every word of the health care debate, nor do I know the intricacies of the proposals. I probably hear as much as you do and I try my best to stay away from the vitriol.

I can tell you that the system is not okay and that I'd rather they do something than nothing. I sense that there is much waste and that addressing it, (billing fraud, entitlement fraud and abuse, polypharmacy and unnecessary pharmacy, vanity drugs and procedures, and treatment spent on preventable conditions) would probably give us the money we need to expand coverage and care.

But unequivocally I believe that health insurance should be mandatory. I was reminded of my belief when a certain Congressman was speaking on CSPAN last night. I do not recall who he was or where he was from, except it wasn't Florida because I remember looking to see. Anyway, this person implied that forcing people to have health insurance coverage was not at all like forcing them to have car insurance. He said that if individual states, like MA decided to do it that was fine, but a federal program was an invasion of privacy. He said that people had a right NOT to have the insurance. Well, I say NO they don't. I know those of you who are healthy as a horse do not think you should pay for something that you do not need today. I understand that your plan is to pay for your health care on an as needed basis, but the ability of REAL people to do that, just doesn't exist. Of course, because there is great health disparity in the USA (and most countries) the people who need the most care have the least money. (and yes, many smokers are in that category, which is why tobacco should be outlawed, but I digress)

My counterpoint to the Congressman is more simple than that. He said that people should not be mandated to have health insurance - but that only works if the health care force can refuse to treat, and they can't. SO it is not American to mandate coverage, but it is American to mandate care. When people are in a health crisis, they CAN NOT be turned away - they will be treated and that means EVERYBODY will pay more for health care,. Those with health insurance will continue to cover that care in sky rocketing premiums, and all of us will see higher taxes. (i.e. we are already paying!) Not having health insurance is sort of like shop lifting . When someone takes without paying, the ones who do pay, pay more. It is not an acceptable option.

I do like the idea of insurance pools, interstate coverage and all that jazz - it absolutely should be like car insurance however, as Medicaid and Medicare are sorely lacking in reach and oversight.

PS a second "hey wait a minute" political moment occurred this morning when a radio show was discussing passage of the jobs bill, I think. The point was that the politicians worked together and something was passed. But that was not how the guest referred to this positive outcome, no, he noted that one of the sides "defected". Since when is working together to solve the worlds problems an act of treason?

Profiting from Cancer

We are going to stay with pharmaceuticals because an article I read on the Motley Fool website really highlights the issue that I regret always making. Drug companies want to make a profit. The Motley Fool is a really cool financial resource that aims to educate average people on stocks, investments, their money and the like. I respect THEM a lot.

Yesterday, a man named Brian Orelli spoke about a drug from Pfizer that has been found to be effective in the treatment of a rare form of pancreatic cancer. Ok. Stop right there. Pancreatic cancer has more than one form? Yes, several. Overall, only 3% of the cancers that affect Americans are pancreatic, where as prostate and breast occur at 25 and 27 percent. The biggest cancer killer however, is lung cancer. It kills 30% of men and 27% of women who have any type of cancer. Pancreatic cancer is responsible for 6% of the deaths related to cancer.

Pancreatic cancer is not our most common cancer, but it does finish out our top ten. Several high profile people have or have died from this cancer and the person with the RARE form that Pfizer's drug seems to affect, is Steve Jobs. Now here is the thing about drugs and drug trials.

A drug trial or study, from phase I-III, costs a lot of money. Trials are stopped early in a few circumstances. The drug is showing no effect whatsoever, people taking the drug are dieing, or the drug works so well that people with the illness need it and not a placebo ( as it would be cruel and unethical to deprive them of a treatment that may save their lives).

So Dr. Orelli tells about this new finding on Sutent. It dramatically slows the growth of tumors in this particular type of pancreatic cancer. Interesting thing, the drug was originally formulated to treat another cancer. In fact, the FDA approved treatments for Sutent are kidney cancer and a form of gastrointestinal cancer. The treatment of this neuroendocrine type of pancreatic cancer is not yet approved. Remember a company benefits most when a drug can be used to treat a multitude of cancers or diseases.

The Motley Fool article points out that this spectacular finding on Sutent won't really get Pfizer a pay day because only two to four million people get this illness. Even though they have the market on this disease the drug competes with two other drugs for the treatment of kidney cancer and doesn't work significantly better than the competition. And so far, it hasn't been able to impact lung cancer at all, which would be the jackpot. If Pfizer shareholders were really going to celebrate, Sutent would enter that fray with about five other drugs. HMMM... maybe that is why Pfizer has Chantix. Lung cancer is caused by smoking 78% of the time so if people stop smoking maybe they won't get lung cancer and those other drug companies will lose money.

my info on cancer sites and rates is from the ACS
http://www.cancer.org/downloads/stt/CFF2009_LeadingSites_Est_6.pdf

************************foot note from yesterday
Apparently a counterfeit version of the over the counter weight loss product Ali, which is the one that blocks fat and causes incredible gastrointestinal complications, you know, leaky stools, flatulence and the like - has been found in the USA. This counterfeit version does NOT have the orlistat ingredient but instead has sibutramine... YES, what I told you about last night -the active ingredient of Meridia, which can cause cardiovascular problems even death. So this is disconcerting, so would knowing that any of you were using it... but here is the FDA alert so you know what to do if you are.....and of course, I like you just the same!
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm197862.htm

Back Pain

Back pain, chronic or acute, is one of the most common and most expensive conditions. It affects as many as 80% of us and by us I mean people, not necessarily only Americans. In other words, it is very likely that at some point your back is going to hurt. Hopefully it will be an acute incident that lasts days to weeks and never returns.

I first noticed that I had back pain some years ago and it was a significant acute episode that did last over six weeks, which means, it became what it is referred to as sub acute. I was damned though if I was going to have chronic back pain. I did follow the physical therapist's back strengthening program, which was all stretching and such, but no resistance training. I did it for a long time and it did ease off the pain. For medicine, I used ICE and ice is a very safe and effective anti inflammatory agent.

I learned from research some years ago that the idea of treating back pain with rest and pain killers was antiquated and detrimental. Unfortunately, sufferers of back pain continue to seek medication and usually back off all activity at the sign of a flare up. This is wrong. Here is one of many articles to debunk the bedrest advice.

I am a health educator, which means, I read other people's research and recommendations, vet them for source accuracy and then share them with others. This information is NOT my opinion, but science. In ACSMs Certified News this month, a physician from the US Sport and Spine Foundation, Dr. T Dreisinger, iterates the "keep moving" message but he adds more.

He contends that resistance training will improve back health and that not working the back is going to lead to atrophy and that leads to more pain and less function and less function leads to less use which leads to more atrophy or what they call sarcopenia. That is a Greek word that means, and I quote the ACSM article here, "poverty of flesh."

Ironically, I have my personal experience to further support this contention. You see, I did stay active when that back pain originally started and I would run even when my back hurt significantly throughout the day, and I would be amazed at how the next day the pain would not be worse but be GONE. Still, it seemed to recur at odd times and I couldn't figure it out so much, except that running didn't cause it. So guess what I stopped doing? Any resistance exercise that would engage my back. I stopped my weight training for my back but the issue never went away. Indeed, I have suffered from intermittent but chronic back pain probably because my back has gotten weaker for lack of specific training.

Recently, my physician told me I needed to spend more time lifting weights and I have for the last month or two. This included doing all the back exercises I used to do in the 90s and guess what... it is NOT getting worse. My back is stronger and the pain is much less and so I do believe that it is important to work a body part that is giving you trouble. In fact, in the ACSM article it is noted that increased blood flow to the area is what enhances the body's ability to heal itself.

Specific conditions should be discussed with an exercise or physical therapy specialist however.

What not to do for Menopause

I have not experienced menopause. I cannot begin to know how severe my symptoms will be nor how well I will tolerate them. I do not expect that I would take any hormone replacement as evidence exists to discourage that practice. I have read research on some alternative medicines or herbals and the results did not convince me of efficacy, safety or purity in those products. I am imagining that I will have to find ways to cope much in the way that women did long before the condition was named and treated. What I am pretty certain about, however, is that I will not look to Suzanne Sommers for my medical advice.

Ms. Sommers, of Three’s Company fame, uses pills and creams that are categorized as the undefined “bioidenticals” (meaning there is no real definition for that term). In other words, the substances are compounds of “natural” products that are supposed to mimic the bodies own hormones. Well respected medical organizations and the FDA have spoken out against any compounding, as it’s called. This includes ACOG and the AMA. (American College of Obstetricians and Gynecologists and the American Medical Association)

In an article from AP writer M. Marchione it was said that the women most likely to use “bioidenticals” which may be as harmful as traditional HRT, are well educated, affluent, professionals. WHAT? Well, one reason is clearly cost. They can afford it. Another given was that they do a lot of research into alternative treatments (me too, I call it prevention) and they believe that if it is natural it will not cause harm. That last part really dropped my jaw. I expected that college educated women would be aware that natural does not mean safe. The words are not synonymous for heaven’s sake. Natural means natural, simple as that. In fact, it is simple in nature but not in commerce because there isn’t a legal food or product definition for “natural”, other than the broad expectation that it be minimally processed. But I digress.

There are things that occur naturally that are plainly lethal. Radon gases anyone? Ok, how about mushrooms? Ever have blowfish for dinner?

There is no scientific evidence that any of the alternatives offered for menopause are safe or effective. That being said, a headline just this morning is accusing the FDA of not doing its job to make sure our pharmaceuticals are safe and effective either, so my best advice, (which can’t apply to menopause unfortunately) is don’t get SICK and my second best advice is do your research before you adopt a treatment method. NO ONE cares more about your body and your health then YOU and it is about time we all figure that out and do our homework.