Four Reasons Health Care is so Hard to Fix

Everybody agrees that something is wrong. Yet it remains remarkably hard to fix our $2 trillion healthcare system.

Part of the reason, obviously, is that a lot is at stake. Healthcare accounts for 16 percent of the economy, a far higher portion than in most other developed nations. Yet even though we pay more, the care we get is hardly better and in some cases worse than what’s available elsewhere. President Obama’s plans to improve the return on our healthcare dollar would affect the livelihood of millions–some for the better, and some for the worse. That makes healthcare reform an epic political battle.

[See why postal-style healthcare might not be so bad.]

But the sporadic availability and skyrocketing cost of healthcare are inherently vexing problems that have bedeviled reformers for 50 years. Here are a few of the factors that make it so difficult to revamp America’s healthcare system:

Exorbitant costs are often hidden. The foremost problem with healthcare is its cost, which is rising at least twice as fast as overall inflation. Healthcare is becoming an unsustainably large part of the economy. Yet many of the people hurt most by this problem are oblivious to it.

Anybody trying to pay for medical care out of his or her own pocket knows how crushingly expensive it is. But those who have health insurance through their employer–about 61 percent of Americans–often feel as if somebody else is bearing most of the cost. Yet the real cost to workers is a lot higher than most realize.

As premiums shoot up from year to year, employers initially cover most of the increase in cost. But it gets passed on to workers in one way or another. Health insurance is usually part of an overall compensation package, which also includes pay. If employers are spending more on benefits, there’s a good chance they’re spending less on pay, in order to keep total compensation stable. That, in fact, is what’s been happening: While healthcare costs have been skyrocketing, wages over the last decade have stagnated for the first time since the Great Depression.

[See the industries hurt most by soaring healthcare costs.]

The majority of Americans with insurance say they’re satisfied with their healthcare. But chances are they’re earning less money in exchange for satisfactory health insurance. There’s even new evidence that soaring healthcare costs are killing jobs in industries with the highest rates of coverage, such as manufacturing, finance, and education. Pollsters should really ask Americans if they’re comfortable giving up a raise, and maybe even their job, in exchange for decent healthcare. And whether they’re willing to pay even higher roundabout costs in the future.

It costs money to save money. About one sixth of the American population, or 47 million people, have no health insurance, and when they need care it’s often the most expensive kind: Treatment at the emergency room. That’s one major source of healthcare inflation, and we all pay for it through higher premiums.

Containing other costs without covering the uninsured is like building half of a bridge: What’s the point? But the upfront cost of covering the uninsured has driven the price tag for reform as high as $100 billion per year in new government spending. The savings are supposed to come later, through preventive medicine for the previously uninsured and greater competition between a new public plan and existing private plans.

[See why health insurers aren't as rich as critics claim.]

Uh, maybe. Was it also necessary to destroy the village in order to save it? It’s hard to blame Americans for being skeptical of pay-now, save-later promises. A more rational approach might be to find cost savings first and use those to pay for increased coverage. But the political climate seems to dictate all-or-nothing reform rather than evolutionary improvements.

Rationing is OK in practice but abhorrent in theory. God forbid we should ever ration healthcare based on which treatments provide the most bang for the buck. We could end up with a system that’s . . . the same as the one we have now.

We ration resources in virtually every aspect of our lives, based on how much money we have and how we choose to use it. Yet healthcare evokes an unusually emotional response, and we refuse to regard it as a scarce resource that must be rationed, even though that’s what it is. Fears about government-backed panels that would decide how much to pay for various kinds of medical care, based on what works and what doesn’t, have stoked rage over the prospect of denied care. Yet the system already denies care, and does so ruthlessly. To get affordable care, first you have to work for a company that provides it. If you have a pre-existing condition, you might be out of luck anyway. And if you need treatment that your insurer doesn’t feel is medically necessary, your only choice is to pay the prohibitive fees yourself.

[See the trouble with healthcare reform, in numbers.]

Apparently we don’t mind it when insurance companies ration healthcare, we only object to theoretical government rationing meant to keep the nation solvent. If we applied the same mentality to other aspects of government, we’d insist on a police officer to protect every home, a tutor to guide every student, and a food inspector to check every meal for E coli. All without a tax increase.

Incremental reform could be worse than nothing. A rational approach to any complex problem is to break it into pieces and tackle one thing at a time. Yet Obama and his congressional allies are doing the opposite, aiming for a massive overhaul of the whole healthcare system in the space of weeks. It’s hardly surprising that Americans are jittery about sudden changes that are hard to understand, could cost them money, and might affect their access to a vital resource.

The catch, of course, is that politics isn’t rational, and that Obama probably has a limited window of time to exploit his power and push this boulder up and over the hill. Americans would prefer incremental changes, but those could easily be undone if power shifted in Washington or special interests maneuvered adroitly. And stutter-step changes based on political whims are often worse than nothing at all, since they waste money and time.

So we will either wreck or save the entire system all at once. That’s not what most of us want, but it’s the best our politicians can offer. Good thing they’re not doctors.

By Rick Newman
Copyright USNews.com

Top Diet Myths are Exposed and Debunked

If you’re so committed to losing weight that you refuse to eat a baked potato for fear of eating empty carbs, you might be missing out on important nutrients and backing your diet into a corner. Open your mind to the truth behind these diet and weight myths and learn how to enjoy some of your favorite foods again.

Myth 1: Potatoes and bread are fattening.
Actually: It’s just the opposite. Starchy vegetables and bread (whole-grain bread, that is) are quality carbs needed to fuel every part of you, from your brain to your muscles. What gets you into trouble is how you eat them: Smear butter on a slice of whole-wheat bread or deep-fry potatoes and you can double, triple, or quadruple the calories.

Myth 2: Drinking a glass of water before a meal curbs appetite.
Actually: Yes and no. Water tames appetite if it’s incorporated into food, such as soup, or a thick drink, like V8 100% Vegetable Juice. Apparently, when water is bound to food, digestion is slower, explains Elizabeth Somer, RD, author of 10 Habits That Mess Up a Woman’s Diet.

That’s why women in one study found chicken-rice soup more satisfying than chicken-rice casserole and a glass of water — even though the soup had 27% fewer calories! One exception to this rule: It’s easy to confuse hunger and thirst, so if you find yourself craving something — but what? — drink a big glass of water and wait a few minutes. You may find that’s what your body really wanted.

Myth 3: Shellfish is high in cholesterol.
Actually: On the one hand, it’s true: Just 3 ounces of shrimp delivers more than a third of your daily cholesterol. But there’s a surprising flip side to this story: Shrimp is low in saturated fat — the kind that becomes artery-clogging bad cholesterol — and has a smidgen of heart-healthy omega-3s. In fact, University of Southern California researchers discovered that eating shellfish, such as shrimp, every week reduced heart attack risk by 59 percent!

Myth 4: The occasional burger and fries won’t kill you.
Actually: It depends on your definition of “occasional.” If occasional means every Friday night and then some, well, you may be pushing it. But if it means every few months, and you’re fit, and you’ve got good numbers (i.e., weight, waist size, cholesterol, blood pressure), AND you’re chowing down on vegetables, whole grains, nuts, and other nutritious fare most other days, hey, you’ll live. But few of us are that perfect. If you do occasionally indulge, offset the effects of a fat fiesta with a brisk 90-minute walk afterward.

Myth 5: Women naturally gain weight after menopause.
Actually: While you can blame a lot of things on hormones (everything from acne to PMS), in this case, slowing down physically is far more likely the cause. Study after study has found that older women who exercise regularly and vigorously can maintain their figures.

Myth 6: Diet soda is worse than the real thing.
Actually: We all would be better off switching to water, diluted fruit juice, and green tea rather than drinking soda — diet or regular. Both types increase kidney and heart disease risk, plus they contain acids that erode tooth enamel, inviting cavities.

Final Fact (this one’s no myth): Maintaining your weight, waist, and body mass index at a desirable level can make your RealAge as much as 6 years younger.

Provided by RealAge

Superfoods You Should be Eating , But Aren’t

Eaten many coconuts lately? How about cherries or blueberries or grass-fed beef?

You should, because these are all foods with powerful health properties. However, few people pack their grocery carts full of these items.

Take kiwifruit. It’s chock full of vitamin C–a whopping 115% of what you need to eat in a day. It’s also low in calories–just 45 per fruit, sans skin.

“In America, most people don’t eat three servings of fruit and vegetables a day,” says nutritionist Jonny Bowden, author of seven books including, most recently, The 150 Most Effective Ways to Boost Your Energy. According to him, there are 10 very healthy foods we don’t eat enough of.
Ignore the Food Pyramid
Bowden says many Americans are misled by the U.S. Department of Agriculture’s food pyramid, which is a graphic, pyramid-shaped depiction of nutrition guidelines, updated every five years, that tells Americans what to eat according to food groups. Bowden dismisses it as the product of interest group politics.

“It demonizes fat,” notes Bowden. “Fat is an essential building block for many important compounds in the body.” This is why Bowden puts grass-fed beef, wild salmon and, yes, coconuts, on his top 10 list.

Salmon, in particular, is loaded with omega-3 fatty acids, which are associated with heart and brain health as well as bringing down blood pressure and triglycerides, a risk factor for heart disease. Omega-3s have also been found to improve mood and reduce inflammation, says Bowden.

Another food packed with nutritional value that’s present–but not necessarily front and center in every grocery store–is kale. A member of the cabbage family, which Bowden dubs “vegetable royalty,” kale contains indoles, a compound found to fight cancer. Kale is also rich in antioxidants, which also help prevent cancer, says Bowden.

If that’s not enough for you, kale is also full of sulforaphane, yet another cancer-prevention agent. Kale has calcium, iron and vitamins A, C and K, and two nutrients that are great for the eyes, including zeaxanthin. Kale’s pièce de résistance: Two cups packs three grams of fiber. Try sautéing it with garlic and butter, recommends Bowden. Or eat it like salad, with pine nuts, cranberries and olive oil.

Then there are coconuts, a terribly misunderstood food, according to Bowden. The fat in coconuts is a particular kind that’s good for you. It’s called MCT, or Medium-Chain Triglycerides. The body doesn’t store MCT as fat, says Bowden, but rather uses it as energy, like a carbohydrate. Coconuts are also high in lauric acid, a fatty acid that tends to kill pathogens. In addition, coconut oil is great for cooking since it has a very high smoke point.
Eat Mediterranean
For Bowden, sticking to a Mediterranean-style diet is the healthiest way to eat. That means plenty of fruits and vegetables, whole grains, fish, and lots of olive and nut oils. The Mediterranean diet has indeed been proved by study after study to have multiple healthful properties.

If all that sounds just too darn healthy, consider the 10th food on Bowden’s list: dark chocolate. Rich with a phytochemical called flavanol, found by a 2005 study in the Journal of the American College of Cardiology to improve cardiovascular health, chocolate with at least 60% cocoa content should be a regular on your shopping list.

Chocolate and coconut anyone? OK, but not until you’ve finished your kale.

By Susan Adams
Provided by Forbes

Swine Flu Declared a Health Emergency

The World Health Organization warned countries around the world Saturday to be on alert for any unusual flu outbreaks after a unique new swine flu virus was implicated in possibly dozens of human deaths in North America.

WHO Director-General Margaret Chan said the outbreak in Mexico and the United States constituted a “public health emergency of international concern.”

The decision means countries around the world will be asked to step up reporting and surveillance of the disease, which she said had “pandemic potential” because it is an animal virus strain infecting people. But the agency cannot at this stage say “whether or not it will indeed cause a pandemic,” she added.

Chan made the decision to declare public health emergency of international concern after consulting with influenza experts from around the world. The emergency committee was called together Saturday for the first time since it was created in 2007.

In theory, WHO could now recommend travel advisories, trade restrictions or border closures, none of which would be binding. So far it has refrained from doing so.

The agency also held off raising its pandemic alert level, citing the need for more information.

Earlier, Chan told reporters that “it would be prudent for health officials within countries to be alert to outbreaks of influenza-like illness or pneumonia, especially if these occur in months outside the usual peak influenza season.”

“Another important signal is excess cases of severe or fatal flu-like illness in groups other than young children and the elderly, who are usually at highest risk during normal seasonal flu,” she said.

Several Latin American and Asian countries have already started surveillance or screening at airports and other points of entry.

At least 62 people have died from severe pneumonia caused by a flu-like illness in Mexico, WHO says. Some of those who died are confirmed to have a unique flu type that is a combination of bird, pig and human viruses. The virus is genetically identical to one found in California.

U.S. authorities said eight people were infected with swine flu in California and Texas, and all recovered.

So far, no other countries have reported suspicious cases, according to WHO.

But the French government said suspected cases are likely to occur in the coming days because of global air travel. A French government crisis group began operating Saturday. The government has already closed the French school in Mexico City and provided French citizens there with detailed instructions on precautions.

Chilean authorities ordered a sanitary alert that included airport screening of passengers arriving from Mexico. No cases of the disease have been reported so far in the country, Deputy Health Minister Jeanette Vega said, but those showing symptoms will be sent to a hospital for tests.

In Peru, authorities will monitor travelers arriving from Mexico and the U.S. and people with flu-like symptoms will be evaluated by health teams, Peru’s Health Ministry said.

Brazil will “intensify its health surveillance in all points of entry into the country,” the Health Ministry’s National Health Surveillance Agency said in a statement. Measures will also be put in place to inspect cargo and luggage, and to clean and disinfect aircraft and ships at ports of entry.

Some Asian nations enforced checks Saturday on passengers from Mexico.

Japan’s biggest international airport stepped up health surveillance, while the Philippines said it may quarantine passengers with fevers who have been to Mexico. Health authorities in Thailand and Hong Kong said they were closely monitoring the situation.

Asia has fresh memories of an outbreak of severe acute respiratory syndrome, or SARS, which hit countries across the region and severely crippled global air travel.

Indonesia, China, Thailand, Vietnam and other countries have also seen a number of human deaths from H5N1 bird flu, the virus that researchers have until now fingered as the most likely cause of a future pandemic.

The Dutch government’s Institute for Public Health and Environment has advised any traveler who returned from Mexico since April 17 and develops a fever over 101.3 degrees Fahrenheit (38.5 Celsius) within four days of arriving in the Netherlands to stay at home.

The Polish Foreign Ministry has issued a statement that recommends that Poles postpone any travel plans to regions where the outbreak has occurred until it is totally contained.

The Stockholm-based European Center for Disease Prevention and Control said earlier Saturday it shared the concerns about the swine flu cases and stood ready to lend support in any way possible.

By FRANK JORDANS, Associated Press Writer

FDA Urges Consumers to Avoid Eating Pistachios

Federal food safety officials warned Monday that consumers should stop eating all foods containing pistachios while they figure out the source of a possible salmonella contamination.

Still reeling from the national salmonella outbreak in peanuts, the Food and Drug Administration said central California-based Setton Pistachio of Terra Bella Inc., the nation’s second-largest pistachio processor, was voluntarily recalling a portion of the roasted nuts it has been shipping since last fall. A Setton spokeswoman said that amounts to more than 2 million pounds of nuts.

“Our advice to consumers is that they avoid eating pistachio products, and that they hold onto those products,” said Dr. David Acheson, assistant commissioner for food safety. “The number of products that are going to be recalled over the coming days will grow, simply because these pistachio nuts have then been repackaged into consumer-level containers.”

Two people called the FDA complaining of gastrointestinal illness that could be associated with the nuts, but the link hasn’t been confirmed, Acheson said. Still, the plant decided to shut down late last week, officials said.

The recalled nuts represent a small fraction of the 55 million pounds of pistachios that the company’s plant processed last year and an even smaller portion of the 278 million pounds produced in the state in the 2008 season, according to the Fresno-based Administrative Committee for Pistachios.

California alone is the second-largest producer of pistachios in the world.

According to the company’s Web site, Setton Pistachio is in the corporate family of Commack, N.Y.-based Setton International Foods Inc. The company sells nuts, dried fruit, edible seeds, chocolate and yogurt-coated candies.

The FDA learned about the problem last Tuesday, when Kraft Foods Inc. notified the agency that it had detected salmonella in roasted pistachios through routine product testing. Kraft and the Georgia Nut Co. recalled their Back to Nature Nantucket Blend trail mix the next day.

The FDA contacted Setton Pistachio and California health officials shortly afterward, in what Acheson called a “proactive move.”

By Friday, grocery operator Kroger Co. recalled one of its lines of bagged pistachios because of possible salmonella contamination, saying the California plant also supplied its nuts. Those nuts were sold in 31 states.

Fabia D’Arienzo, a spokeswoman for Tulare County-based Setton Pistachio, said the company was only recalling certain bulk roasted in-shell and roasted shelled pistachios that were shipped on or after September 1.

Because Setton Pistachio shipped tote bags of nuts weighing up to 2,000 pounds to 36 wholesalers across the country, it will take weeks to figure out how many products could be affected, said Jeff Farrar, chief of the Food and Drug Branch of the California Department of Public Health.

“It will be safe to assume based on the volume that this will be an ingredient in a lot of different products, and that may possibly include things like ice cream and cake mixes,” Farrar said. “The firm is already turning around trucks in transit to bring those back to the facility.”

Salmonella, the most common cause of food-borne illness, is a bacteria that causes diarrhea, fever and cramping. Most people recover, but the infection can be life-threatening for children, the elderly and people with weakened immune systems.

For nuts, roasting is supposed to kill the bacteria. But problems can occur if the roasting is not done correctly or if roasted nuts are re-contaminated. That can happen if mice, rats or birds get into the facility.

Last winter, a national salmonella outbreak was blamed on a Georgia company under federal investigation for flouting safety procedures and knowingly shipping contaminated peanuts.

The outbreak is still ongoing. More than 690 people in 46 states have gotten sick. Nearly 3,900 products made with peanut ingredients from Peanut Corp of America have been recalled.

California public health authorities have taken hundreds of samples at Setton’s processing facility, but lab results have not yet determined whether salmonella was found at the plant, Farrar said. The food companies’ own tests of the contaminated products isolated four different types of salmonella, but none were the same strain as the one found in the peanuts, Acheson said.

By Garance Burke, Associated Press Writer