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Fixin' Healthcare

Sunday, May 21, 2006

The Lifestyle Chronicles - More Of Pogo Knows

Pogo is a cartoon chararcter with a famous saying - "I have met the enemy and the enemy is us."

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But the lesson for Americans is clear. These days, and especially in the United States, with its screening and testing, "we are labeled," said Dr. Hadler of North Carolina.

"I call that medicalized," he added. "And one of my creeds is that you don't medicalize people unless it is to their advantage. When you medicalize people, they think they're sick, and in our culture it's, 'Do something, Doc. Don't just stand there.' "

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The Dartmouth Atlas of Health Care (www.dartmouthatlas.org) reports a five-fold difference between academic health centers for hospitalization or admission to intensive care units of patients with chronic disease during their last six months of life. And, the cost of providing care to these patients over the final two years of life varies more than two-fold at some of the most prestigious medical centers.

The predominant influence on cost was volume of service. "There isn't any evidence that people are sicker in the markets of high-intensity servives than in low ones, says Dr. John Wenneberg (principal investigator for the Atlas Project), but when beds are available physicians figure out a way to fill them." (Wall Street Journal, May 16, 2006, Ron Winslow).
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The Partnership for a Drug Free America reports that one in five teens (about 4.5 million) has tried prescription drugs for pain (Vicodin or OxyContin) to get high. The survey also reported that many teens feel experimenting with prescription drugs were safer than illegal drugs. Thirty-one percent of teens feel there is nothing wrong with using prescription drugs once in a while.
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A government survey estimates that the number of adults aged 50 or older with substance abuse problems will double to 5 million in 2020 from 2.5 million in 1999, in large part due to their comfort with prescription drugs.
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Unnecessary medical tests are costing the U.S. health care system millions--and potentially billions-- of dollars per year, and add unnecessary patient stress, say researchers from Georgetown University Medical Center and Johns Hopkins University in the June issue of the
American Journal of Preventive Medicine.

Not only are the tests unwarranted, but false-positive results lead to further tests and compound the expense, says the study's lead author, Dan Merenstein, MD, an assistant professor in the Department of Family Medicine at Georgetown.
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"There is a distinction between what people say they eat, say they want to eat, and what they eat," Jim Skinner (McDoanld's CEO) said at an April 17th press conference. "It's about choices.
It's about opportunities for people to come to McDonald's and get a meal that they feel good about having eaten that fits into their lifestyle."

Skinner said the company's marketing panels and surveys determine what consumers most want to eat.

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The enormous success of the Dollar Menu, where all items cost $1, has helped stimulate 36 consecutive months of sales growth at stores open at least a year. In three years, revenue has increased by 33 percent and its shares have rocketed 170 percent, a remarkable turnaround for a company that only four years ago seemed to be going nowhere.

McDonald's has attracted considerable attention in the last few years for introducing to its menu healthy food items like salads and fruit. Yet its turnaround has come not from greater sales of healthy foods but from selling more fast-food basics, like double cheeseburgers and fried chicken sandwiches, from the Dollar Menu.
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"America's diabesity problem is not about moral failure, laziness, or lack of effort. It's about the wrong philosophical underpinnings. We have fallen for the idea that there is a quick fix for everything -- especially weight loss. We look to fad diets, extreme athletics, diet pills, and surgical interventions as a miracle cure for all of our problems.

We must make a philosophical frame shift towards a rehabilitation model of weight control. Why rehab? Because rehabilitation involves a long-term commitment; an acknowledgment that the opportunity for weight regain will never go away; and that an individualized, multidisciplinary approach has the best chance of success.

Rehabilitation literally means "the restoration of lost capabilities.[1]" It is a hopeful word, because it presumes that individuals have the capacity to improve, to walk farther, feel better, maintain a healthy weight, and add life to years. Rehabilitation medicine physicians use an integrative, holistic approach to wellness. They coordinate teams of physical therapists, occupational therapists, social workers, psychologists, and nutritionists to help patients meet their goals. For this reason, I believe that rehab specialists are the best equipped to provide the kind of complex, long-term solution that is required to reverse the diabesity epidemic. Let's rehabilitate America!"


Reference

Rehabilitation. Wikipedia. Available at: http://en.wikipedia.org/wiki/Rehabilitation Accessed April 28, 2006

by Val Jones, M.D.
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Enhanced health insurance and expanding health insurance to everyone will address the problem of paying the bills for the U.S. health care system. However, it will do little for the problem of achieveing optimum health status for the greatest number of people in the U.S. The U.S. health care system and the current national debate on health care reform perpetuate a national perception that caring for the sick is the best way to achieve optimum health. This would not be such a tradegy if it did not mask lifestyle as the greatest contributor to poor health.

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