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Fixin' Healthcare

Monday, October 31, 2011

Mainaining Weight Loss

Losing weight is difficult but maintaining weight loss is another difficult task. Perhaps even more so. The effort is life-long. Try physical activity. Keep in mind the physical activity does not have to be weight lifting and/or running. Walking is good. Brisk walking and walking up hills is even better. Be persistent and consistent. 10,000 steps is four or five miles depending upon the length of your stride. Most people walk one to two miles daily. KEEP MOVING! Your life depends upon it.

Air Pollution

Air pollution is associated with lung cancer in non-smokers. Asthma, pulmonary insufficiency (inflammation, fibrosis and poor oxygenation) and cardiac disease are also associated with air pollution. This ia another of those areas where public health can serve to prevent disease.

Saturday, October 29, 2011

One Reason for Hope

One of the reasons I have hope for better health in the U.S. is that corporations and communities recognize the validity of lifestyle to achieve primary prevention. This article reports upon the efforts by Dow Chemical. Cleveland Clinic is another example as are Greenville, SC, Savannah, Georgia, Louisville, Kentucky and Oklahoma City. Health is a community affair. Go team!

From Farm To Fork

The search for the source of an E. coli outbreak shows the number of items in a salad and the difficulty in identifying the culprit. Infectious agents and contaminated food are a constant threat requiring personal vigilance, strong regulation for food safety and public health response. Personal vigilance includes cleaning vegetables and fruit plus care in preparing and storing food. Public policy for food safety deserves high priority. An effective and efficient public health system saves more lives than medical care. 

Friday, October 28, 2011

Long-Term Care

I can understand how the Class Act failed before it began but this is a real problem with no easy solution. Currently, long-term care is a dysfunctional system and it needs a new ways of looking at the problem. There should be a call for new system concepts at the community level. All of us need to think about our situation when that time comes. It is more than a financial problem. 

The Cost of Health (Medical) Care

This article outlines some of the parameters of health care cost. Keep in mind that health care is medical care and it is a business and an industry in the U.S. It is a marvelous business and a powerful industry. The focus of medical care is illness, disease, injury and disability. As such, medical care is the default not the primary choice. Reform needs to focus upon achieving and maintaining the best health status possible. When people learn that health care supersedes medical care, the population will be healthier and there will be less need for medical care. GO TEAM!

Thursday, October 27, 2011

Post Weight Loss

Losing weight and maintaining the loss are difficult, related and separate efforts. People who lose weight find it slowly returns. Weight loss causes metabolism to slow and appetite to increase. Constant vigilance is needed but very difficult to maintain. Another strategy is periodic intensive attention to adjustment of weight. It helps to engage in some type of regular physical activity with periodic episodes of more vigorous exercise. In any case, no one should ever say that weight loss is easy and those who are successful should be praised. Everyone should be encouraged to continue in their effort.

Tuesday, October 25, 2011

Mammograms In the News Again

A new study reveals that mammograms don't save as many lives as people think. Early detection and secondary prevention are an extension of medical care and they are just as expensive as medical care. But do they yield the expected results? This question will continue to be examined and I expect the results to show that the lives of some people are saved. Don't expect this to yield cost savings and do expect some morbidity and even mortality associated with the process of early detection and treatment. Some of the treatments will be unnecessary but that would not be obvious before the fact. My concern is that medical care, including early detection and secondary prevention, distracts from the attention and effort directed to primary prevention. Certainly, more needs to be learned about primary prevention but a workable body of knowledge is available. Application of this knowledge to populations and individuals will save lives and increase the quality of life.     

Saturday, October 22, 2011

When Is Doing Nothing the Best Medicine?

They also serve who only stand and wait. Every drug, every surgical procedure, every diagnosis and treatment is a two edged sword that cuts both ways. Benign neglect can lead to tragedy but so can aggressiveness.

Monday, October 17, 2011

Hope and Expectations

Diseases are given costly crowns
And health is forsaken: what nod to cost is this?

People expect many things from medical care, sickness has a way of doing that, and medical care does save (extend) the lives of many who suffer from disease and injury. But medical care seldom cures disease or restores function. Even so, hope springs eternal and there are always avenues to promote hope. For most chronic and deadly diseases there is more hope for prevention than cures. That involves promoting health rather than a disease and there is no money in such an effort. When you think about it, that would be refreshing.

Philosophy and Health

This article asks if philosophy is the most practical major in college. Maybe, maybe not. But when it comes to health philosophy is extremely practical. Note that the reference is health not medical care. Health is about living and how life is addressed and lived. It requires a lot of thought. Much of that thought is passed from one generation to the next but each individual must generate and pursue their own thought about life and how to pursue it. No amount of medical care can substitute for the lifestyle of a society or an individual to achieve the best health status possible.

Sunday, October 16, 2011

A Vegan Dinner Party for Autumn

This description of a vegan dinner party for autumn by Melissa Clark sounds so delicious that I had to share it. One doesn't have to be vegan to enjoy some the items and dishes included here. The Hummus With Crisp Maitake Mushrooms looks to be appealing.

Friday, October 14, 2011

Wages, Compensation and Medical Care

First of all, what people call health care is medical care. Medical care is expensive and it eats up more of people's compensation than they are often aware. The charts in this article don't excuse anything but they do tell an interesting story about where the money is going.

Heart Disease Declining

The CDC (National Center for Disease Control and Prevention) reports a decline in heart disease from 2000 to 2006. The details include a higher incidence in men than women and the states with the highest incidence are Kentucky, West Virginia and Louisiana. The age-adjusted mortality rate for heart disease has steadily decreased in the U.S. since the 1960s. The more recent decline in incidence is a result of public health and the longer trend in decreased deaths is due to medical care.  

Thursday, October 13, 2011

Something Like This

CareMore is an organization that begins to make some sense about the organization of medical care. When the same thing is done at the community level to address primary prevention through cradle to grave health promotion and disease prevention it can be called a health care revolution.


Whether or not A.D.H.D. is a misdiagnosis, I believe it is, the point is well taken that drugs are a business and too many children are on prescribed drugs, as well as the adult population. Drugs are often an easier answer than addressing the underlying problems but they don't solve the problems.

Lots of Room For Improvement

Medical care is so large and health is so poorly managed in the U.S. that plenty of room exists for improvement. This article reports on such a situation for the group of people who are recipients of both Medicare and Medicaid. The article goes on to indicate the concerns and opposition to change. Also highlighted is a more basic structural problem that sooner or later must be addressed. Why should health insurers be the ones to deal with this? They are financial people, not health care providers. But, then, they are responding to the inadequacies in the training and organization of health care providers. These issues are on the table along with proposals to correct them but none of this goes far enough to solve the basic problems - too much medical care and not enough health care, too much specialty care and not enough primary care, too much fragmentation and not enough integration. These issues can be managed at the community and state level. 

Preventive Medicine

This article reports on a comprehensive program at the Cleveland Clinic to achieve and maintain good (better) health. It works! There is some concern expressed about forcing people to be more healthy. How about the moral implication of joint liability for health costs contained in health insurance when a significant portion of the population pursue habits and lifestyles known to be unhealthy?

A Cause and a Statement

Hospitals and health groups are using their purchasing power to push for products that are safer and more friendly to the environment and the climate. This includes recyclable products and elimination of chemicals dangerous to people, the environment and the climate. Other industries are also doing this. It is good business, as well as humanitarian. Every little bit makes a difference. Gridlock in Washington is a sideshow that need not inhibit progress. Politicians like sure bets and they will jump on a train pulling out of the station. Maybe that is the way it should be, but not all the time. 

Wednesday, October 12, 2011

Modifing Expression of Genes

Genetics is a road map but it is not destiny. A gene associated with increased incidence of heart disease can be modified in its expression. Eating vegetables and fruit lowers the risk for heart disease for people with this gene.

Exposure to Chemicals

The environment and everyday objects contain chemicals that can be harmful to health. It is wise to be vigilant and keep informed about potential hazards. This is a complex topic with a lot of information and many points of view. For example, I drink filtered water but avoid water in plastic bottles. The avoidance of plastic bottles is out of concern about disposal of the plastic bottles. I recycle but the plastic bottles are an expense. So many points of view and so little time.

Strenuous Exercise

Strenuous exercise relieves the signs and symptoms of Parkinson's Disease. Casual physical activity does not achieve the same results. The effects are on both muscles and the brain. In all likelihood the same effects apply to normal muscles and brains.

Vitamin and Mineral Supplements

Vitamin and mineral supplements may do no good and in high doses may harm health. It is best to get what is needed from a diet consisting of a variety of plant-based whole foods and let the body sort everything out. Remember the highest technology you will ever encounter is your own body.

Tuesday, October 11, 2011

Early Diagnosis and Secondary Prevention

Early diagnosis and secondary prevention can lead to a lot of good but they can also lead to problems. This article presents an overview of the situation with attention to mammograms and PSA. False positives and over-diagnosis are among the pit falls. Psychological stress and mental anguish are prominent concerns. Dr. Welch puts it very well: "When it comes to breast and prostate cancer screening, there are no right answers, just trade-offs."  

Cancer Rehabilitation

Rehabilitation is a broad concept that needs wider and deeper application in society. Physical fitness fits under a broader concept of rehabilitation. This article reports on a cancer rehabilitation program at Walter Reed National Medical Center. A "prospective surveillance model" involves early and regular follow-up to address problems early and promptly. Results are better and costs are lower. 

Monday, October 10, 2011

Community Health

This is another example of how community can determine health status. The community has a major influence upon health disparities and, of course, differences in economic well-being. 

Body Microbes

The tremendous number of microbes that occupy and share our body most likely have an important role in the status of health. There are some therapies being implemented and these may provide useful information. However, this field of study will prove to be complicated with much to learn. It will be useful to keep abreast of the available information and principles because many decisions will involve how we conduct daily life.

Thursday, October 06, 2011

Prostate Cancer

This article is a good review of the competing dialogues about screening for prostate cancer. Medical care has embraced the concept of early diagnosis and secondary prevention of more advanced disease. The field is in its infancy and the secret may lie with the type of treatment afforded these conditions. Meanwhile, it will pay to keep up with the outcomes from past and current state of the art.

Tuesday, October 04, 2011

Farm (Food) Policy

This article is a good review of the cross-bind between government policy for agriculture, food, health and the economy. It is a government of special interests and you give money to get money and you give money to get money and you give money to get money ..... Change would be disruptive and society would be very different but all indications are most people would be healthier. Don't hold your breath waiting for the change, it would not be good for your health.

Local Health/Medical Care Projects

There are lots of opportunities for local health/medical care projects to improve health status and lower medical care costs. An example of such a project exists in Memphis between a hospital system and approximately 400 churches. This project is a good platform to expand into more primary care prevention and stimulate additional networks into similar action.

Vitamin D Levels

A review of the literature reveals that low vitamin D levels are associated with abnormal blood pressure, insulin resistance and coronary artery disease. It is not known if supplements can improve these health problems but vitamin D may be one of the few supplements worth taking.

Monday, October 03, 2011

Exercise and Cancer

Regular physical activity is associated with reduced risk for cancer. This should not be new or startling news but it is worth repeating just in case you need another reason to get moving. Remember that walking is physical activity and physical activity is exercise but you need to do it all day, everyday. I'll see you out there.

Sunday, October 02, 2011

From Farm To Food

There are many places and processes along the route of a chicken from farm to food where salmonella and other pathogens can hide and grow. The only place and process you can count on is your kitchen and your cooking. Thoroughly wash your hands between handling of different foods, thoroughly wash counter tops between preparation of different foods and cook to 165 degrees Fahrenheit. Be aware of state and local health department oversight of restaurants.   

Saturday, October 01, 2011

Learning Curve for Medical care

This article describes some of the problems experienced with metal on metal hip replacements. The learning curve in medical care has always been steep but the extent of intervention today makes it so much more risky and costly. Early implementation seems glorious but should be done with great care. And listen to those nagging voices who urge caution.