Panaceia or Hygeia

immunize yourself against the pandemic of lifestyle diseases

Posts Tagged ‘health care’

Want to reduce taxes? Eat less, stop smoking.

Posted by Colin Rose on March 31, 2010

The chickens are coming home to roost. $Billions are thrown at the disease care system (medical system) to treat preventable diseases of lifestyle, like obesity, hypertension, atherosclerosis and diabetes which account for at least half of the cost of the medical system; Quebeckers would rather pay more taxes than eat less and stop smoking. It would be political suicide for Charest to even suggest there was such a trade-off. So, people, if you really have to have your cigarettes, poutine, smoked meat and steamés, you will have to pay more taxes to treat the disastrous consequences of your self-destructive lifestyle.

MacDonald's


Say ‘ah’ and make a health ‘contribution’
kdougherty@thegazette.canwest.com KEVIN DOUGHERTY
The Gazette
31 Mar 2010

QUEBEC – Quebecers can look forward to paying a new “health contribution” and a 15-per-cent sales tax in 2012 under the budget Finance Minister Raymond Bachand brought down yesterday. “The initiatives we are announcing today will have little impact on…read more…

Posted in drugs, lifestyle, obesity | Tagged: , , , | 4 Comments »

CHUM hires a new director

Posted by Colin Rose on October 8, 2009

Paire’s waist circumference looks at least 45 inches. Abdominal obesity is a preventable disease resulting from junk food addiction that increases the chances of many other diseases such as Type 2 diabetes. Another example of how the “health care” system is showing you how to care for your health.


CHUM hires a new director
AARON DERFEL GAZETTE HEALTH REPORTER
The Gazette
08 Oct 2009

Hoping to turn the page on years of internal strife, the Centre hospitalier de l’université de Montréal has recruited a top hospital administrator from France to serve as its executive director. But yesterday, in his first appearance before the…read more…

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Getting more for less in health care (National Post, 06 Oct 2009)

Posted by Colin Rose on October 6, 2009

Esmail assumes that producing “health care” is analogous to producing widgets; the law of supply and demand applies to both. Not so. Demand for “health care”, really disease care, is infinite. Deluded inhabitants of developed societies believe that any money spent on doctors and hospitals will prolong their lives. But, there is no correlation between per capita expenditure on doctors and hospitals and any measure of health. The cost of disease care will continue to rise as long as demand is fueled by absurd expectations of a necessarily finite system, driven by the latest, doctor-self-aggrandizing story on some “life-saving” technology. The cost of disease care can only be contained if doctors are put on salaries and practice according to the Hippocratic Oath and the best evidence for effectiveness and safety of treatments. Only then will doctors have an incentive to do less. Unlike the present perverted fee-for-service system, there would be no incentive to administer profitable but superficially attractive and potentially lethal procedures or drugs for non-life threatening disease. Also, unlike the present system, there would be a primordial incentive, less work for the same money, to prevent the diseases of lifestyle that account for most of the cost of the disease care system and most of the premature deaths in our society.


Getting more for less in health care
NADEEM ESMAIL
National Post
06 Oct 2009

Thanks to poor fiscal management, the government of Ontario finds itself in a difficult fiscal situation. It must find a way to eliminate the significant deficits that are expected until at least 2015/16. Given that tax increases are certain to damage…read more…

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Health Centre Food – Not Healthy

Posted by Colin Rose on July 30, 2008

Drs Freedhoff and Stevenson are trying to do what we tried to do more than 20 years ago, change the food policies of hospitals. We have encountered all the same excuses listed below. What has taken us many years to accept and what these doctors fail to realize is that hospitals have no interest in promoting or maintaining health; they exist exclusively to treat disease. If the population were as healthy as they could be by continual vigilance in lifestyle choices there would be very little need for hospitals. Health is not profitable and will not support massive “health care” bureaucracies and unions. From the point of view of the “health care” bureaucracy and “health care” unions the ideal situation is to have a chronically sick but breathing population in constant need of “health care”, profitably supplied by said bureaucracies and unions.

Most hospital have now changed there names to some variation on “health center” and medical systems now call themselves “health care” providers, implying that only these institutions can guarantee health. Whenever I hear this I think or Orwell’s 1984. “War is Peace”; “Disease is Health”. Newspeak can exist in democracies in which self-perpetuating bureaucracies must ensure their survival by thought control and fear of death.

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CMAJ • July 29, 2008; 179

Frying up hospital cafeteria food

Yoni Freedhoff, MD, Medical Director, Bariatric Medical Institute, Ottawa, Ont.

Rob Stevenson, MD, Cardiologist, Saint John Regional Hospital, Saint John, NB

Would you like fries with that angioplasty?” Sadly, this is not as far fetched as you might imagine. Although hospitals are the front line for delivering medical treatment, health promotion and education, paradoxically, the foods they sell are frequently generic versions of fast food staples or, worse yet, brand-name fast food. Remarkably, despite nutrition’s indisputable role as one of our most important determinants of health,1 grassroots calls for hospital cafeteria reform often face resistance from hospital administrators and even some allied health professionals.

In dialogue with hospital administrators, we have met 3 main arguments against hospital cafeteria reform. First, they say they are not the “food police.” The hospital’s role need not be one of policing but rather one of health care leadership. Simply put, the sale of unhealthy foods along with the absence of nutritious alternatives undermine the institution’s role in health promotion. Although we do not propose that hospitals be held accountable for dietary choices, we do feel hospitals have a strong societal obligation to lead by example.

Second, public and institutional sentiment holds that adults are responsible for their own food choices. Consequently some people wonder whether hospitals should be restricted to selling exclusively healthy food. Although this argument has merit,what is not debatable is a hospital’s duty to empower consumers with the information required to make informed choices. Unfortunately, restaurant food choice is anything but informed. Consumers underestimate by 2 to 4 times the saturated fat, calories and sodium content of typical restaurant foods.2 However, providing accurate point-of-sale nutritional information significantly improves consumers’ choices.2 As it stands, with limited or no in-hospital nutritional information available, and frequently no nutritious alternatives offered, hospitals do not enable informed choice.

Finally, there is the question of money. Although Canadian hospitals have fewer fast-food outlets than US centres,3 the transition of their cafeterias from services to institutional profit centres is evident. We have even heard it forewarned that hospital programs could be jeopardized if healthier foods fail to sell. This alarmist warning ignores 2 of a hospital’s most important roles: the mission to promote health and the moral obligation to lead by example. Notably, in its 2007 annual report, the Compass Group, one of the world’s market leaders in retail food service delivery, including hospitals, attributed part of its rising profits to its new focus on healthy eating programs.4

Although there are no established criteria for healthy hospital cafeterias, there are healthy initiatives. California’s Sutter General Hospital enables informed choice by posting the nutritional information for a week’s worth of entrees at the cafeteria entrance. Others serve healthy choices with predominantly vegetarian menus, and there are “farm produce to hospital” programs in Texas, Vermont, North Carolina and Iowa.5 The purpose of the recently launched Canadian Healthy Hospital Cafeteria Project Survey, which one of us (R.S.) helped develop, is to identify Canadian examples of such initiatives.6

Addressing this problem will require a shift in values and thinking similar to when hospitals stopped selling cigarettes and later banned smoking on hospital grounds. Today the majority of our adult population is overweight or obese. In this fight, our dietary environment is the new battleground. Junk food is the new tobacco. Now more than ever, it is our ethical and medical responsibility to ensure that hospitals take the lead in serving foods that reflect evidence-based nutrition.

Thus, we call upon all hospitals as community health care leaders to immediately enable healthy and informed choices in their cafeterias. This would include ensuring the availability of flavourful entrees free of trans fats and low in calories, sodium and saturated fat, as well as posting nutritional information on menu boards and at point-of-sale for all foods. These first steps in cafeteria reform will help hospitals renew their focus on health and put an end to deep-fried hypocrisy.

  1. Kant AK, Graubard BI, Schatzkin A. Dietary patterns predict mortality in a national cohort: The national health interview surveys, 1987 and 1992. J Nutr 2004;134:1793-9.[Abstract/Free Full Text]
  2. Burton S, Creyer EH, Kees J, et al. Attacking the obesity epidemic: the potential health benefits of providing nutrition information in restaurants. Am J Public Health 2006;96:1669-75.[Abstract/Free Full Text]
  3. McDonald CM, Karamlou T, Wengle JG, et al. Nutrition and exercise environment available to outpatients, visitors and staff in children’s hospitals in Canada and the United States. Arch Pediatr Adolesc Med 2006;160:900-5.[Abstract/Free Full Text]
  4. Compass Group. Delivering profitable growth: annual report 2007. Surrey (UK): The Group; 2007. Available: www.compass-group.com/NR/rdonlyres/00F11551-A102-4E1C-AADD-D0DCFD95C723/0/Compass_Report_2007.pdf (accessed 2008 June 23).
  5. Gottlieb R, Shaffer A. Soda bans, farm-to-school, and fast food in hospitals: an agenda for action. Presentation at the American Public Health Association Annual Meeting; 2002 Nov 13. Available: http://departments.oxy.edu/uepi/publications/APHA_Talk.htm (accessed 2008 June 23).
  6. Canadian Healthy Hospital Cafeteria Project Survey. [To complete the survey go to www.surveymonkey.com/s.aspx?sm=CMsk1a3OrVFrbBABU6udgQ_3d_3d (accessed 2008 June 23)].

George Orwell predicted this. "Hospital" is antithetical to the "Health". "Health Centre" implies a protective, nurturing bureaucracy. No one will get sick there.

 

IMG_0194

Vending machines in the McGill University Health (sic) Center

MUHC

Partners in Disease Care. Healthy lifestyles are also not good for union employment.

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Dan, the hospital doctor, is shocked, SHOCKED

Posted by Colin Rose on July 30, 2008

This post appeared recently in the ProCOR list.

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As a medical resident I have encountered an interesting case that raises the question of reversibility and education of the pre/early diabetic group.

The case is of a 38-year-old male that presented to a screening physical examination without any complaints apart from the hardships of life. Past medical history is significant for recent diagnosis of hypertension for which he receives a calcium channel blocker. Family history is positive for type 2 diabete with his father, no coronary syndromes in his family, and his lipid profile is unremarkable. Physical exam reveiled an obese young man (BMI of 33) with controlled blood pressure and the rest of the exam was unremarkable. His initial fasting glucose was >200mg% and soon after HbA1c came back as 12. The patient denied any diabetic related symptoms. The patient was very reluctant to start any kind of diabetic regiment and strongly insisted on a sugar free diet and weight reduction only strategy. The patient went home with his own idea of managing his newly diagnosed diabetes. He did not appear for later follow ups.

But we DID meet again, two months afterwards. This time the patient is with a BMI of 27. He explained to me that he was so shocked from the diagnosis. He just started running around the block and eating a very restricted vegetarian diet. His HbA1C was 6 and fasting glucose levels were normal, and he did return to eating sugar containing foods.

Now he insisted he doesn’t have diabetes. Does he? Was he cured? Did he go back to the pre-diabetic phase? Or is he overt diabetic only controlled by diet? Was the decrease in weight that much of an influence? Apperantely so.

Dan Halpern

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As a resident in the usual hospital environment, Dan has probably been taught that diseases can only be treated with drugs and/or surgery. Coincidentally, these are the acts to which doctors have exclusive rights and for which they can charge high fees. He was shocked, SHOCKED to discover that a patient might know how to treat his own disease without the help of the vaunted American “health care” system and that what he had been taught in the hospital has very little relevance to outpatient practice.

Dan has learned a valuable lesson which he should apply to his future practice. Today most of the fatal diseases are diseases of lifestyle and the only definitive treatment is lifestyle change. Blood glucose, blood lipids, blood pressure, etc. are all markers of lifestyle in the vast majority of cases, not diseases to be treated with drugs until lifestyle has been optimized. There is increasing  evidence that some of these markers may actually be protective responses to nutritional stress analogous to a fever in response to an infection. Obviously there are varying genetic predispositions to the effect of self-destructive lifestyles but as they say, genes load the gun, environment pulls the trigger.

So, yes, Dan’s patient did cure himself of Type 2 diabetes and probably hypertension as well. He probably doesn’t need any drugs.

Now if we could only get all doctors to treat lifestyle diseases with lifestyle change before prescribing drug of doing operations we could save hundreds of billions of dollars in disease care costs, close many hospitals, shut down many drug companies and many doctors would have to make a living actually talking to patients. Isn’t that the essence of being a professionial?

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Cubans do not measure “cholesterol” and live longer than Americans

Posted by Colin Rose on March 10, 2007

Cubans don’t measure their blood cholesterol obsessively as recommended by “guideline” committees in the US, Canada and Britain, on which sit doctors paid in various ways by statin manufacturers. Statins are almost impossible to get in Cuba but Cubans live longer than Americans who spend $US billions on statins like Lipitor. Cubans eat mostly a unrefined plant-based diet, have few cars and have less obesity. And Cuba spends only 4% of what the US does on “health” care per capita. Just think of what we could do with more than a trillion dollars PER YEAR. That would fund a few manned trips to Mars every year not not to mention funding free university education, cleansing the environment, obliteratiing infectious disease and poverty…

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U.S. healthcare costs more than Cuba’s and may not have an edge in helping people live longer, but Cubans often lack prescription drugs and over-the-counter remedies.

BY JOHN DORSCHNER

jdorschner@MiamiHerald.com

The average Cuban lives slightly longer than the average American, but the American’s healthcare costs $5,711 a year while the Cuban’s costs $251.

Those are the figures of the World Health Organization. Some experts question the accuracy of the Cuban numbers, but no one doubts the underlying revelation: There is little relationship between the cost of your healthcare and how long you’ll live.

”Medical care is responsible for only a small portion of the variation in life expectancy,” says Gerard Anderson, a Johns Hopkins professor specializing in health policy. “Behavioral factors such as diet and exercise are much more important. The U.S., which spends much more than any other industrialized country on healthcare, is getting little value for much of the spending.”

These factors have moved to the forefront of the American political discussion as leaders in both major parties work toward solving what almost everyone agrees is a ”healthcare crisis,” with soaring costs threatening to increase the numbers of the uninsured, which already include 46 million Americans.

In such a discussion, Cuba serves as the starkest possible contrast, a completely government-controlled system in which ailing leader Fidel Castro benefits from the best possible care, including consultations with a Madrid surgeon, while many Cubans struggle to get basic treatment.

Here are the numbers: The average American has a life expectancy of 77.8 years, as of 2006. The average Cuban lives 78.3 years. Even if the Cuban figure is inflated, no one disputes the statistics from European countries, where people tend to live a year or two longer than in the United States — at about half the healthcare costs per capita.

At its highest level, most people agree, the United States has top-quality care. The country offers the latest magnetic resonance imaging, robotic-arm surgeries and drugs to deal with cholesterol, acid reflux and arthritis pain.

Americans want the biotech drug to target tumor cells, but many don’t get basic preventive screening tests. That’s particularly true for the uninsured, who often avoid treatment until their condition sends them to the emergency room.

Cuba offers universal healthcare and has twice as many doctors per capita as the United States. The Cuban government did not respond to The Miami Herald’s request for comment via telephone or e-mail, but its publications have boasted that the country is one of the world’s leaders in healthcare. Ann C. Seror, a professor at Laval University in Quebec, Canada, says Cuba has “achieved a remarkable level of healthcare quality of life for its citizenry.”

But six Cuban doctors The Miami Herald interviewed — two dissidents still on the island, four now in Miami — say many prescription drugs and even over-the-counter remedies are nearly impossible to get, and patients sometimes have long waits in clinics unless they pay bribes.

One irony is that poverty has forced Cubans into a healthier lifestyle. Juan A. Asensio, a University of Miami trauma surgeon and a Cuban American who is certainly no friend of the Castro regime, put it this way: “No McDonald’s, and Cubans walk everywhere or ride bikes because they can’t afford cars.”

About one in 10 Cubans are obese, according to the Pan American Health Organization. In the United States, one in three are obese, ”increasing risks of high blood pressure, type 2 diabetes, stroke, heart disease and osteoarthritis,” according to the Agency for Healthcare Research and Quality.

Still, the aging American, no matter his weight, can lay claim to a more comfortable life, with access to everything from Advil to Pepto-Bismol and Viagra — products virtually nonexistent in Cuba.

As Nestor Viamonte, a physician who left Cuba in 2003, puts it: “There’s a difference between a 75-year-old with quality of life and a 75-year-old without quality of life.”

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