Ilya Somin: Two cheers for federal court's Virginia health care suit decision | Washington Examiner

Ilya Somin: Two cheers for federal court's Virginia health care suit decision | Washington Examiner

More Problems with Health Insurance Reform

Experience with Publicly Funded Private Health Insurance -

If you think this will just apply to those who speak English as a second language, don't overlook the great probability that Big Insurance will pull this trick on you, even if you are outside the legal immigrant groups.

To the Editor:

On October 31, 2009, Massachusetts involuntarily transferred about 30,000 legal immigrants (mostly “green card” holders) from Commonwealth Care, the state-subsidized insurance program, to a new private insurance plan. CeltiCare, a subsidiary of the out-of-state, for-profit insurer Centene, agreed to take over their care for only $1,300 per person, one third of the state's previous cost1 and well below the average cost of adequate care nationally.23 CeltiCare excluded several hospitals (and their affiliated community health centers) that have traditionally provided safety-net care for immigrants, including Boston Medical Center and Cambridge Health Alliance (CHA), where we work.

We used internal hospital data to determine the characteristics of patients who were transferred to CeltiCare and who had formerly received their primary care at CHA. A total of 1325 patients who had visited a primary care provider at CHA during the past year were moved to CeltiCare. Of these patients, 73% speak a primary language other than English, including Portuguese (24%), Spanish (20%), and Haitian Creole (9%); 19% have hypertension, and 10% have diabetes mellitus. A psychiatric disorder has been diagnosed in at least 9%.

We then evaluated the adequacy of the provider network for these patients. During the second and third months after the switch to CeltiCare, we searched CeltiCare's Web site4 for primary care providers within 5 miles of CHA's ZIP Code. The search returned 326 providers, of whom 217 were nonduplicate adult generalists. Of these providers, 25% could not be reached at the telephone number provided. Of those available by telephone, only 37% were actually accepting new CeltiCare patients, and the average wait for an appointment was 33 days. In all, only 60 providers were accepting new CeltiCare patients, and only 38 could provide service for even one of the three major linguistic minorities.

Given these findings, we believe that patients who were switched from Commonwealth Care to CeltiCare had inadequate access to primary care 3 months into this new program. We fear that such “rationing by inconvenience”5 shuts patients out of care to the detriment of their health but to the benefit of CeltiCare's bottom line. Policymakers, in Massachusetts and nationally, should reassess the role of profit-driven insurers in the provision of safety-net care.

Ruth Hertzman-Miller M.D., M.P.H.
Malgorzata Dawiskiba M.D.
Cassie Frank M.D.
Cambridge Health Alliance, Cambridge, MA
rhertzman-miller@challiance.org

http://www.nejm.org/doi/full/10.1056/NEJMc1005451

New Strategy to Address Malnourishment

Considering that both obesity and being too skinny are indicators of malnutrition.  I learned this in the 60s when I was studying nutrition in college while working on a nursing degree.  Seems it has taken a long time to get this far, at least as far as recognition.

The US is one of the most malnourished countries in the world.

UNIVERSITY PARK, Pa., April 14 (UPI) -- There is considerable confusion among those working in healthcare on how to identify malnutrition among patients, a U.S. researcher says.

Gordon Jensen, professor and head of nutritional sciences at Pennsylvania State University, says patients who are malnourished are frequently not identified, and patients who are identified as malnourished may not be.

"Depending upon the criteria that are used, up to 50 percent of patients in hospitals or skilled nursing facilities have been estimated to be malnourished," Jensen says in a statement.

"We're taking a new starting point that we can all agree on, and one that is based on our modern understanding of malnutrition and inflammation."

Jensen and colleagues propose replacing existing terminology dealing with malnourishment with a new diagnosis strategy in which patients would fall into one of three categories -- starvation related, chronic disease related or acute disease/injury related.

The new strategy has appeared in both Clinical Nutrition and the Journal of Parenteral and Enteral Nutrition.

Supplements Lower Risk of Dysplasia in HPV

SUPPLEMENT UPDATE: D. Telegraph 19.4.10 "SUPPLEMENTS MAY REDUCE CANCER RISK"
Vitamin & calcium supplements could help keep breast cancer at bay. They are thought to help cells repair damaged DNA using a process that involves over 200 proteins. Prof. Jaime Matta from the Ponce School of Medicine in Puerto Rico compared 268 breast cancer patients & 547 healthy women. Taking a variety of vitamin supplements appears to reduce the risk of breast cancer by 30% & taking calcium supplements reduces it by 40%. The findings were presented to the American Assoc. for Cancer Research in Washington DC.

Now who needs Gardasil when you have supplements, said the big good wolf?

An article published in the April, 2010 issue of the International Journal of Gynecologic Cancers reports the finding of researchers at Korea University College of Medicine and Korea's National Cancer Center of a lower risk of cervical intraepithelial neoplasia (CIN, also known as cervical dysplasia) among human papilloma virus (HPV) positive women who consumed vitamin supplements. Human papilloma virus has been identified as the agent responsible for cervical cancer, for which cervical intraepithelial neoplasia is a precursor. The condition is detected by a pap smear and graded according to stage as CIN 1, 2 or 3. Although CIN can regress on its own, it is frequently treated with cryocautery, electrocautery or other methods.

The current study included 328 HPV-positive participants in a Korean cohort study begun in 2006. Ninety women with CIN1 and 72 with CIN 2/3 were compared with 166 control subjects. Dietary intake prior to enrollment was documented in questionnaire responses, and supplement use was classified into 5 categories. Human papilloma viral load was ascertained by cervical sampling for HPV DNA.

Having a high HPV viral load was associated with a three times greater risk of CIN 2/3 compared with the risk associated with a low viral load. Women who used multivitamin supplements had a 79 percent lower risk of CIN 2/3 than those who did not use them. Similar reductions in CIN 2/3 risk were observed for vitamin A, vitamin C, vitamin E, and calcium supplement use. For participants with a low viral load, the risk of CIN 1 was reduced by 65 percent and that of CIN 2/3 by 89 percent in multivitamin supplement users compared to nonusers.

"HPV infection alone does not lead to cervical neoplasia; other factors, such as the patient’s nutritional status, play a role in cervical carcinogenesis," the authors write. "Dietary guidelines for the prevention of cervical cancer recognize the importance of antioxidants and have recommended an increase in the consumption of fruits and vegetables as good sources of dietary antioxidants."

"This is the first study to report on an association between cervical dysplasia in women with high-risk HPV, the HPV DNA load, and dietary supplements," they announce. "Larger studies are needed for confirmation of these findings before the results can be generalized to a broader population."

SOURCE

EU Moves to Block Natural Health Care

As the European Union (EU) moves to limit right of choice and access to supplements, while turning over this industry to Big PhRMA, the plan there will have an impact in the US and other countries.

If you read Natural Health News you are aware of the shift in ownership of supplement firms to PhRMA, and you know too that PhRMA is boosting sales by promoting engineered supplement type Rx drugs.

Here's what's ahead in the EU - "From What Doctors Don't Tell You" - email news Aug. 2010.

How Big Pharma plans to kill off alternative medicine
Within two years, nutritional medicine - as a viable alternative therapy to conventional medicine and pharmaceuticals - will be a shadow of its current self in Europe. By then, four laws will be fully implemented throughout the European Union, and they will effectively remove consumer choice. In 2012, the only show in town - in terms of genuine therapy - will be prescription drugs. This bleak landscape - and what we all can still do about it before it's too late.

From 2012: High-dose vitamins will be barred, and will be available only by prescription from your doctor, who may be less than sympathetic.
a.. sales of health products will start to slow as manufacturers will be barred from making even the most obvious claim for their product
b.. Chinese and ayurvedic herbs will start disappearing from the shelves
c.. Herbal practitioners in the UK may be going out of business unless they can get themselves registered to a standard acceptable to the EU. They have until April next year to do this.
If you care about nutritional and alternative medicine - and if it's an important part of your life - you need to know what's happening now.  - 'The assault on natural medicine'.

No matter where you are, if this issue is important to you, tell your Member of Congress that you want freedom of choice and right of access, and coverage under health insurance for supplements.

Natural Medicine was cut from health insurance reform.

Most doctors are not sympathetic nor do they know about nutrition or therapeutic use of supplements.

Supplements Saved

US office of the great Alliance for Natural Health, started years ago by Dr. Robert Verkirk, just announced a victory for US consumers of nutritonal supplements

Supplements Are Exempted From Codex Language in Food Safety Bill
The FDA Food Modernization Act (S. 510), also referred to as the “Food Safety” bill, has been modified to exempt dietary supplements from language that otherwise creates a slippery slope toward U.S. harmonization with Codex Alimentarius. ANH-USA worked to protect the natural health community from this dangerous provision that threatened access to high quality, therapeutic supplement doses by working with key senators to modify the language, now for the second time. Read Complete Article

Childhood Obesity Campaign: Issues in Health

UPDATE: 4 August, Sugar Cut in Cereals

Remember that most of the big name cereals have been loaded with high fructose corn syrup (HFCS) for years.  And also consider that it is the organic brands of cold, boxed cereal that is also loaded with sugar, only they use the organic kind.  Either way you look at it the sugar has to go, the HFCS has to go, and all of the cereals with any GMO grain or other ingredient - like beet sugar that now is about 100% of the market -) nneds to come out of these and any other product containing them.

15% cut in sugar coming in 2011 to Coco Pops

3 February, 2010  Michelle Obama Kicks Off Childhood Obesity Drive
Mrs. Obama is taking on her first substantive policy role in overseeing the Obama administration programs and partnerships dealing with what is considered a national epidemic of childhood obesity.

http://www.politicsdaily.com/2010/02/01/michelle-obama-kicking-off-childhood-obesity-drive-feb-9/

My hope is that Michelle addresses the role of vaccines, fluoride, environment, lack of physical education in schools, the USDA food pyramid that promotes obesity, unhealthy school lunches, artificial sweeteners proven to cause obesity, HFCS, soy formula, microwave cooking, GMO soy and canola oil disguised as " plant sterols" and not healthy saturated fat, TV ads and cold cereals, and some of Tom Vilsack's GMO buddies, and more to be concerned with.  We are just a nation of starving children who are malnourished because of the focus of today's government guidelines.


Some 30+ related articles on obesity can be found here at Natural Health News

Originally posted  3/6/09

Somehow I think the lineal thinking process, or lack of any kind of meaningful thinking, is a very real issue as we address the needs for health care change and reform in the US, and of course in the world.

I also think that as long as we have this mind set those who see themselves as power brokers just might not be hitting the target, so to speak.

Try to put a few puzzle pieces together here as I give you food for thought.

First of all, look at the USDA. This is the place where dietitians get their basic education. Since most of this is funded by Big AG is it no wonder RDs end up on the short end when it comes to how this translates to a role in health care delivery. Remembering too that the ADA (American Dietetics Association) wants to control ALL nutrition education, and they support aspartame, sucralose (both known obesity promoters) and the faulty food pyramid.

Luise Light, PhD, the originator of the first food pyramid with real food, might give you more to think about. Her opinion of grains is certainly not the same as ADA or USDA or for that matter, Big AG.

Today, you can read about a culture of bias in ADA education. If it is found in students of dietetics (dietetics is not nutrition) then you can be sure it is in the faculty and the field as well.

Bias Against Obesity Is Found Among Future DietitiansBy Carolyn Colwell Healthday Reporter
Mar 5, 2009

THURSDAY, March 5 (HealthDay News) -- Just 2 percent of those training to be dietitians have positive or neutral attitudes toward people who are obese, and the rest are moderately biased against their prospective patients, a new study has found.

"Essentially, this shows that future dieticians are not immune to weight bias, and there are negative attitudes toward obese patients that may have a negative impact on the quality of care," said Rebecca Puhl, the study's lead author and the director of research and stigma initiatives at Yale University's Rudd Center for Food Policy and Obesity.

Most of the almost 200 dietetic students who participated in the study had pejorative views about the attractiveness, self-control, overeating, insecurity and self-esteem of people who are obese. They also rated obese patients as being less likely than non-obese patients to comply with treatment recommendations. The findings were published in the March issue of the Journal of the American Dietetic Association.

But the students aren't alone in their beliefs and share the biases with other health-care providers, Puhl said, adding that other studies have shown that many health professionals have negative perceptions about very overweight patients. Patients have reported "very many examples of providers who really make very stereotypical comments that suggest that they are making assumptions about a patient's character, intelligence or abilities because of their weight," she said.

Other signs of professional insensitivity, Puhl said, include weighing obese patients on freight scales because scales in a doctor's office don't accommodate their weight and not having blood pressure cuffs big enough for a heavy patient.

She said that the attitudes expressed by the dietetic students in the study show a lack of appreciation for how difficult it is to lose weight and for the biological factors involved. Also, the message that obesity results from a lack of self control ignores mounting scientific evidence that it's difficult to lose weight and keep it off for a sustained period of time, she said.

"Most people, when they walk into an office, have already tried to lose weight and, more likely, they've lost weight and regained the weight," Puhl said. "I think a better understanding and appreciation of the complexities and difficulties of weight loss are needed to reduce the stigma."

The 182 students who completed the study were from 14 universities and had been enrolled in an undergraduate dietetics program for about two years. With an average age of 23, 92 percent were women, and 85 percent were white.

The researchers asked the students to respond to questions about a normal-weight male and female and an obese male and female. The people they were asked about shared the same health characteristics except for weight.

Dr. Nicholas H.E. Mezitis, an assistant professor of clinical medicine and nutrition at Columbia University College of Physicians and Surgeons, said that the findings might be misleading because of the small number of minority students and the predominance of white females among the participants. "If you get into ethnic communities, such as a black population, they all have different views," he said. In some groups, he explained, being thin might not be seen as desirable.

"We also have to bear in mind that a lot of what these students are reading in magazines and such are taking them to the other extreme," Mezitis said. "What's desirable is very thin, and … these [obese] patients are way on the other extreme."

Lona Sandon, a spokeswoman for the American Dietetic Association, added that students' mentors need to provide positive role modeling. "If mentors reflect weight bias, then students are likely to do the same," she said. "In addition, one's own attitudes about body image may influence attitudes towards other's weight."

The study recommends adding stigma reduction to the standard curriculum for dietetics programs. The Obesity Society has more on weight-related bias.

Then we have to give some attention to this announcement of the joint venture between the heart association (AHA), Nickelodeon and Bill Clinton's organization to allegedly fight childhood obesity.

Then consider the Healthy School Lunch Program and what actually took place over a decade ago in Wisconsin, and you have to wonder about why all of this has been taking so long.

Then remember when the push started for the Hepatitis B vaccine? It was pretty clearly established that no long term studies had been done with this vaccine, and it contributed to the development of diabetes and some other scary for parents kinds of issues.

Then, if you recall history, Mr. Bill awarded the developers of the Hepatitis B vaccine the National Technology Award.

Is it guilt, is it greed, or is it that there is a real interest in change this issue for our children.

One has to ask because we haven't seen a response on aspartame even though the FDA knows it causes diabetes and obesity.

And certainly there has to be consideration of cultural concerns because in the American Indian and other ethnic and forgotten communities, nuttrition, diabetes and weight issues are major public health problems.

Now you have some real food for thought.