Tag Archives: health care reform

Why Salads Cost More than Big Macs

One of the major issues facing health care today is the cost which Americans must pay in order to obtain basic care.  Then the care they receive does nothing to address the problem they actually have.  For example, if a person walks into their doctor’s office with high cholesterol, they are almost always giving a statin medication to artificially lower their cholesterol.  The reason their cholesterol is high is not because of a statin deficiency.  It’s because of poor diet and lack of exercise.  Those causes, sadly, are hardly ever addressed.

The cost of this type of health care, according to some experts, is going to bankrupt this country if things are not changed and changed soon.  I have written many times about prevention and how that is the true key to reducing overall health costs in this country.  I absolutely believe that is true.  However, what if our government spent money a little differently in the mean time to reduce the cost of healthy foods?  Maybe that would put a dent in our rising obesity epidemic?

I can’t tell you how many people tell me that it’s just too darn expensive to eat healthy.  While I believe some people like to use that as a convenient excuse not to eat correctly, I believe most people have a hard time affording some healthy foods.  Just the other day I was at a local farmer’s market and one 3 oz. bag of shelled walnuts was $6!  A $6 snack? And a small one at that!

Often times fruit, vegetables, nuts and seeds are among the most expensive items at the grocery store.  The cheap stuff includes low grades or less desirable cuts of  meat, dairy and all grain products.  Want to know why?  Below is a graphic of what our government chooses to subsidize and in what percentage of the whole. (Original article can be found here.)

Subsidized America

Of course lobbying plays a major role in what gets subsidized, but that doesn’t change the above graphic.  You’ll notice that vegetables, fruits, nuts and legumes are subsidized the least while the meat, dairy and grain industry make out like bandits.

Meat is an essential part of our diets.  We need animal protein.  It is the only complete source of protein.  It also contains healthy fats that are vital to survival.  When consumed properly is the absence of abundant carbohydrate, it is perfectly healthy.  Do not let mainstream medicine talk you into being a vegetarian.  Eliminating meat is a big mistake. That being said, their piece of the pie should not be so significantly higher than the other important part of our diet – fruits, veggies and nuts and seeds.

The grain industry gets the second largest chunk.  The current government recommendations on the right in the diagram above more than make up for the lack of subsidy.  Our government recommends that everyone eat 11 servings of grains per day.  And where has this gotten us?  It has lead us straight into an obesity epidemic.  It’s the carbohydrate consumption that is out of control in this country.  If people were eating too much high quality meat, I doubt we’d see the problems we are seeing today.

McDonald’s, whose product’s success relies mostly of meat and refined grain, are okay with the current subsidization I am sure.  Let’s face it, when you buy a Big Mac for $.99 you aren’t buying it for the iceberg lettuce or the soft tomato they put on it.

At the very top of the subsidy pyramid are vegetables, fruits, nuts and legumes.  They account for just 2.28% of government subsidy.  They get less money than sugar and alcohol do.  See a problem with that?  However, does this translate to higher prices you ask?  Check out the diagram below.

The cost of fresh fruit and vegetables has clearly gone up while most other foods have remained the same or decreased.

This illustrates very well just how much subsidizing food products can have an effect on price.  While fruits and vegetables have increased in price, soda has plummeted.  This is a major issue, especially considering that soda is a major contributor to preventable disease in the United States.

With this knowledge it is easy to see that a salad could easily cost just as much if not more than a whole meal at McDonald’s.  The soda, burger and bun all get larger subsidies than the salad that you didn’t buy.

Health care cost are at an all time high and the complexities of the problem are astounding.  I think the above is also a large part of the problem.  While senators and congressmen are elected to impart the will of the people, they rarely do.  In order to get elected it takes a lot of money.  Big business has a lot of money.  Put 2 and 2 together.  Special interest groups control political action (or lack thereof) and people suffer with expensive salads and cheap Big Macs.

My advice?  While good food might be more expensive to eat, it’s worth it in the end.  You might get away with eating a poor diet for years and years while your young, but it catches up with us as we age.  Don’t short change yourself in terms of your diet.  It only ends up costing you more in the end.

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Taking Responsibility for your Health

The debate over health care will continue to rage.  The fact that health care reform has passed will not end the debate.  Many Americans, myself included, believe that people who make poor decisions for their overall health should pay more for their health care.  If you choose to eat one meal per day at McDonald’s, don’t expect me to pay for your health care. 

The notion that providing more people with insurance will reduce health costs in this country is a ridiculous one. The problem of sky rocketing health care costs is not one of lack of insurance.  It is there because too many people make the wrong decisions about how to live their lives.  They choose not to eat healthy, not to exercise and not to supplement their diets with missing nutrients.  Those people we will call “omitters.” They omit something from their life (like healthy food and exercise) that causes them to be less healthy.  Then there are people who actually contribute to their own demise.  They smoke or drink alcohol excessively for example.  Those people we will call “destructors.”  There are many people that fit into these categories and most people are a combination of omitters and destructors.

I can already hear the complaints while some of you are reading this.  You are saying, “But it is much more complicated than that…!”  There are other factors that play into it including socioeconomic status, income level, education level, etc.  While I believe that to be true, I only believe it to a certain point.  The vast majority of people, regardless of income level know that smoking is bad for you, yet they continue to smoke.  The vast majority of people know that excessive alcohol consumption is bad for you.  The vast majority of people know that exercise is good for you.  I don’t care what income level people have or what education level people have, these are known facts that most choose to ignore.

A perfect example

I was giving a lecture to a large group of people.  It was about diet and health and how to improve your own health with simple diet and exercise.  After the lecture a woman came up to me and told me how much she enjoyed the lecture and that she’d learned a lot.  She also said that she’d love to come in a see me as a patient, but couldn’t possibly afford it.  All of her money was accounted for and there was no extra room in the budget.  As I spoke with her I noticed that she smoked.  I asked her about it and asked how many packs per day she was smoking.  She told me about a pack.  She also told me that her husband smoked about a pack and a half per day.  I told her that I would certainly recommend that she and her husband stop smoking and if she did that there would be more than enough money in the budget to cover my services.  She agreed, but said “her husband” would be unwilling to stop leaving her without enough to cover my services.  This was a classic example of not taking responsibility for her own health.  She did not want to quit smoking, in my opinion, and was sure her husband would not either.  If she was truly concerned about her health and wanted expert guidance she would have quit and saved the money and been able to afford my services to help her to better health.  I have broken down just how much they would have saved if they’d quit smoking.  It is staggering.

Depending on your location, a pack of cigarettes costs between $4.50 and $5.  Let’s take the middle and use $4.75 to calculate our numbers.

The wife’s yearly costs in cigarettes = $1733.75

The husband’s yearly cost in cigarettes = $2600.63

TOTAL COST is $4334.38 per year!

They would save more than $360 per month if they both quit smoking.

Unfortunately, this woman never came in as a patient in my office.  It’s too bad because we could have done wonders in terms of improving her health and overall quality of life.  She is a classic destructor.  She added something into her life that will shorten her lifespan and decrease its overall quality.

Another reason people claim they can’t stay healthy is because they can’t afford a membership to a gym.  That’s a very poor excuse.  You don’t need to go to a gym to exercise.  If you have access to the outside, you can exercise.  Walk, run, skip, do anything.  Just be active.  There are also unlimited amounts of body weight exercises that one can do in their home.  Simple examples include push-ups, lunges, jumping jacks and core training.  These are all easily done inside with no equipment.

So, if you’re reading this and you aren’t healthy, which one are you – an omitter or destructor?  Are you a little of both?  The first step is recognizing that you are doing something incorrect in your lifestyle that is possibly causing you to be unhealthy.  You may say that it only affects you, but it doesn’t.  Over time it causes a drain on funds in the health care industry and forces everyone else to pay more in taxes.  If everyone stayed active and ate right, health care costs in this country would plummet and we wouldn’t need to argue about it any longer.  Will this prevent every disease?  No.  Will it go a long way?  Absolutely.

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My Take on “Health Care” Reform…

In light of the recent health reform bill that passed the legislative branch of the government and that President Obama has signed into law today, I thought I would take a closer look and see who will actually benefit from this historic piece of legislation.

This health reform does little to change the actual problems with health care in the United States.  This bill will not make us any healthier.  It may insure more people, but having health insurance does not make you healthy.  As a matter of fact, one could argue that people without health insurance are the ones who watch their health more closely so they can avoid the large doctors bills that might accrue should something happen.

The reason Americans are so unhealthy has nothing to do with insurance coverage.  It has everything to do with lifestyle choices.  You can’t drive through many towns in the country and not see at least 3 or 4 different fast food chain restaurants.  They provide a service that people love – quick, easy good tasting meals.  Some argue that they actually taste good, but you can’t argue with results.  Check out these numbers:

McDonald’s claims to have served over 99 billion people.  It’s right on their signs.  Some have changed to say “billions and billions served” to reflect the even higher numbers suggesting it is now too high to count.  I tend to agree, it is probably too high to count.  But let’s take the 99 billion as our number.  We can safely assume the number is at least that high in the United States alone because we are “rounding down” to put it plainly.  If we consider that McDonald’s started in 1948 with the process we would recognize as fast food, that means they’ve served 4,374,723 meals per day to reach 99 billion served in the last 62 years. No wonder America has a health problem.  This just McDonald’s.  This doesn’t take into account Pizza Hut, Burger King, Wendy’s, Jack in the Box, Taco Bell, KFC or any other fast food chain!

Big Pharma Wins Again (Ugh…)

It is clear that our problems go far beyond a lack of health insurance coverage in this country.  Another part of the problem is our thought process when it comes to health and being sick.  When most people get sick (or have an ache or pain, etc…) their first thought is, “What pill can I take to get better.”  There’s nothing wrong with taking an antibiotic if you have a raging bacterial infection or taking a life saving drug if it indeed is life saving.  These cases, however, are the vast minority of cases!  Drugs are over prescribed and the benefits over sold while natural and more cost effective treatments are available. They aren’t marketed like pharmaceuticals and aren’t patentable like pharmaceuticals so they aren’t recognized as well. 

The pharmaceutical lobby had a lot of work ahead of itself when the talk of health care reform began.  They eventually got behind the reform and supported it wholeheartedly.  And now we know why.  They made out like bandits in this reform!

Initially, price control on pharmaceuticals was discussed.  This was a huge point of contention for the pharmaceutical industry.  Once this was eliminated support for the reform bill was gained.  As evidence the industry spent an estimated $100 million in TV advertising, grass-roots organizing and other marketing efforts to promote reform.  Many people will point to the concessions the industry agreed too.  They agreed to contribute $85 billion toward the cost of the bill in the form of industry fees and lower prices paid under government programs over 10 years.  While $85 billion certainly is a lot of money, it pales in comparison to industry revenue.  Take this into consideration – the top 12 pharmaceutical companies had a combined revenue of $237.7 billion in 2006 alone (the most recent year for which I could find statistics)!  When you consider that the $85 billion is spread out over 10 years you realize it really is just a small drop in the bucket for them.  Consider that the hospitals agreed to a much higher number of $155 billion over the next 10 years mainly by accepting lower fees through medicare.

What you must also realize is that the pharmaceutical industry sees this as a way to gain another 32 million costumers.  These are the individuals who are currently uninsured and who do not take prescriptions, see the doctor or get surgery unless they absolutely have to.  Big Pharma sees them as an untapped resource.  No longer will these people leave prescriptions unfilled or forgo their Lipitor because it is too expensive.  The pharmaceutical industry will more than make up for the $85 billion in revenues with sales of more drugs from more insured people.

This legislation, while historic and idealistic, will do little to curb the ridiculous health care costs in this country.  This is for two reasons.  First, the bill does nothing to actually change health care.  We are in this situation because we view health and health care backwards.  People get procedures and drugs paid for once they are already sick.  It should be just the opposite.  Pay to prevent illness.  Insurance companies should be paying people to go to the gym and paying for office visits to nutritionists in the same way they pay for an office visit to your primary care.  Secondly, the bill did nothing to change the price of pharmaceuticals.  These prices are artificially inflated and insurance companies still pay it.  This is a huge burden on the finances of this country.

Hopefully I’m wrong and this significantly improves the health care industry in this country, but the major problems were not addressed.  I am sorry to say that in 10 years I think we’ll still be in the same boat.

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Big Pharma and Politics

Do me a favor.  Just read this quote below and think about what it says.  It is from a story published in the New York Times on February 11th, 2010.

Billy Tauzin, one of the highest paid lobbyists in Washington, is resigning as president of the pharmaceutical industry’s trade group amid internal disputes over its pact with the White House to trade political support for favorable terms in the proposed health care overhaul.

This is the first paragraph of the story and I could not believe it when I read it.  It basically says that our laws, in this case health care reform, are completely controlled by large companies.  It is not that surprising, I guess.  It has been known for a long time that most laws in this country are implemented for powerful special interest groups, and “the people” have little to say about it.

My problem with the pharmaceutical industry providing “political” support for favorable terms is that they are the largest reason that health care in this country is so expensive.  A simple example is the $175 prescription fish oil they market when high quality fish oil is available for $25-$40 through qualified health care professionals.  “Political” support is generally monetary support.  Check out the ridiculous numbers spent by the pharmaceutical industry.

  • Drug companies and their trade groups spent $155 million, lobbying on a variety of issues ranging from protecting lucrative drug patents to keeping lower-priced Canadian drugs from being imported to the United States Drug interests employed about 1,100 lobbyists to do their bidding in each of the past two years.

That is a lot of money.  Pharmaceutical Research and Manufacturers of America (PhRMA), the industry’s main trade group, has 1,100 lobbyists to do its bidding.  That’s 22 lobbyists per senator. Think about if the nutrition industry had that kind of lobby.  Don’t you think the view of health care in this country would be different?  People who turn a blind eye to this kind of thing are kidding themselves.  It is not a conspiracy and I am not a conspiracy theorist.  This is fact and available in the public domain.  Below I have posted a list of laws passed and moves made by the pharmaceutical industry from 1980 to 2008 starting with the most recent events.  This is just a small sampling of how the pharmaceutical industry controls the laws that are supposed to govern them.  They write the rules to their own game.

2008

On Jan. 1, the administration of vaccines (in addition to the cost of the vaccine itself) is included in the coverage of Medicare Part D drugs.

In June, House Democrats announce plans to introduce legislation preventing FDA regulation from trumping medical device patients’ ability to seek damages under state law.

2007

On Jan. 3, Speaker of the House Nancy Pelosi and House Democrats release their agenda for the first 100 hours of the legislative session, planning to enact a bill that will allow the Secretary of Health and Human Services to negotiate directly with pharmaceutical companies to negotiate lower prescription drug prices for Medicare beneficiaries. The Senate has not acted on the measure.

In mid-January, a bipartisan Congressional contingent announces plans for legislation to allow importation of prescription drugs from Canada and other foreign countries, estimating that consumers could save $50 billion over the next ten years if the measure is passed.

In April, patent reform legislation is introduced in the Senate to improve the U.S. patent system. Despite support from high-tech and communications companies, the measure is opposed by the pharmaceutical industry because of the possibility that it would weaken patent protections by reducing infringement penalties. The bill was reported out of committee but has not made it to the Senate floor.

In May, a drug-import plan that would have eased the process of importing cheaper prescription drugs into the country from Canada and other foreign countries is defeated during Senate debate on a bill designed to strengthen the FDA.

In late September, President George W. Bush signs into law the Food and Drug Administration Amendments Act (FDAAA) of 2007. The bill revises and extends the user-fee programs for prescription drugs and medical devices, enhances the postmarket authorities of the FDA with respect to the safety of drugs, requires clinical trials and research for pediatric medications, and reauthorizes multiple bills, including the Orphan Drug Act relating to medications for rare diseases, the Best Pharmaceuticals for Children Act, and the Public Health Service Act.

In November, legislation that would have prevented reverse payment, or the practice of brand-name drug companies paying generic drug manufacturers to delay market entry of generic medications, stalls in Congress.

On Dec. 21, President George W. Bush signs into law an extension of the State Children’s Health Insurance Program (SCHIP) to provide funds to states to grant health insurance to children in families with incomes that are modest but too high to qualify for Medicaid. Amidst a bitter partisan battle between Congress and the White House, the bill extends funding for eighteen months so that a compromise can be reached.

2006

On Jan. 1, the Medicare Modernization Act of 2003 goes into effect. It gets off to a shaky start, with many consumers unable to utilize the benefit because of administrative problems. Within the first month at least half the states are forced to bypass the system, pay the bills themselves and seek federal reimbursement later.

The FDA unveils new rules that force drug makers to simplify informational inserts that come with prescriptions in an effort to make medications safer for consumers. The move comes amidst heavily publicized safety concerns from painkillers Vioxx and Bextra, both of which were removed from the market in 2005.

2005

The pharmaceutical industry mounts a successful $83 million effort to defeat Proposition 79 in California’s November special election. The initiative would have cost drug companies millions of dollars in mandatory discounts and could have set a precedent, opening the door to such action in other states.

In August, a federal judge in Minnesota dismisses claims that several drug giants violated antitrust law by taking steps to block the importation of prescription drugs from Canada.

Thirty-three of the 40 countries that PhRMA requested be put in the U.S. Trade Representative’s Special 301 Report appear on the list. Inclusion establishes intellectual property issues — such as drug patents — as a priority in bilateral discussions between the United States and the designated countries.

2004

American Jobs Creation Act is signed into law. The act repeals the Extraterritorial Income Act tax regime and provides for $137 billion in new corporate tax incentives over the next decade. Taking advantage of a provision in the law, Pfizer, the world’s largest drug company, is expected to repatriate nearly $17 billion it earned in profits abroad.

BioShield Act passes, providing $5.6 billion over 10 years for biodefense products.

CREATE Act passes unanimously in both houses of Congress. Allows patents for inventions researched jointly by public institutions and private entrepreneurs.

Thirty-three of the 38 countries cited in a PhRMA petition to the United States Trade Representative’s Office appear on the USTR watch list.

2003

The Medicare Modernization Act of 2003 provides for a prescription drug benefit for Medicare recipients but prevents price negotiations with drug companies. The act partially reverses cuts in reimbursements to pharmaceutical companies.

2002

The Best Pharmaceuticals for Children Act is signed into law. It extends “pediatric exclusivity” provision of the FDA Modernization Act of 1997 that gives prescription drug makers an additional six months of patent protection during which generic drugs cannot be sold, in exchange for the manufacturer conducting studies of the drug’s effects in children. The Congressional Budget Office estimates that, in the long run, prices for prescription drugs will increase as a result of the bill.

Trade Act of 2002 (H.R.3009) passed. The Act makes intellectual property rights and the elimination of regulatory practices (such as price controls) negotiating objectives in trade agreements.

Prescription Drug Users Fee Act renewed. Included in the legislation are industry requests to speed up product reviews and use third-party advisors recommended by the companies to assess products.

Greater Access to Affordable Pharmaceuticals Act is defeated. The Act would have weakened patent restrictions on pharmaceuticals, making way for more generic drugs.

A policy is enacted that requires warning letters sent to drug companies to first be cleared by the FDA counsel’s office. The number of warning letters sent by the FDA dramatically decreases.

The Department of Health and Human Services proposes new privacy regulations that could give FDA-regulated entities, including drug companies, access to medical records without notice to patients.

The FDA approves rule change allowing some drugs, such as vaccines against biowarfare agents, to be approved after testing in animals.

A provision to protect companies from lawsuits regarding thimerosal contained in their vaccines is a last-minute addition to the bill that created the Department of Homeland Security. In the face of popular outrage, the provision is repealed a few months later.

1997

FDA Modernization Act is signed into law. Allows medical device makers to hire for-profit companies to review their products and promote them to the FDA. Codifies previous reforms. Allows manufacturers to disseminate journal articles describing the results of trials for unapproved uses of drugs. Reauthorizes the Prescription Drug User Fee Act. Authorizes six-month “pediatric exclusivity” patent extensions.

The FDA eases restrictions on direct-to-consumer advertising of prescription drugs, allowing ads to refer consumers elsewhere to find risk information instead of including it in the ads themselves.

The Orphan Drug Act tax credit is made permanent.

1996

Congress reauthorizes the Orphan Drug Tax Credit for one year. The credit covers 50 percent of the cost of clinical trials for orphan drugs. Companies not yet profitable enough to pay taxes are allowed to take the tax credit at a later date.

1995

The FDA relaxes regulations, eliminating the establishment licensing application, which required a separate application to approve the manufacturing sites of new drugs. Lot-lease approvals, a continuous review of manufacturing sites after initial approval, also end.

The US Patent Office allows companies to show potential usefulness by submitting preclinical trial data rather than data from clinical trials.

The Patent Office relaxes its criteria on awarding patents for genes.

1994

After heavy lobbying by the industry, price control proposals that were part of the Clinton health care plan are abandoned.

1992

Prescription Drug User Fees Act passes. Allows companies to pay a fee to the FDA in return for a faster review period.

1991

The FDA accelerates the review of drugs for life-threatening diseases.

1987

The Prescription Drug Marketing Act passed. (Requires distribution of samples and safeguards against the sale of substandard or counterfeit drugs.)

1984

Hatch-Waxman Act (The Drug Price Competition and Patent Term Restoration Act of 1984) passes. One of the major loopholes in the act allows brand-name drug companies a 30 month patent extension on a drug by suing a generic manufacturer.

1983

Orphan Drug Act passes. The law encourages development of drugs to treat rare diseases affecting fewer than 200,000 by giving incentives to companies.

1980

Bayh-Dole Act passes. The Act promotes university-industry partnerships and allows the industry to tap research conducted at taxpayer-subsidized facilities.

Source: The Center For Public Integrity.

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