The Luxury of Dental Health in Third World America

Dental Health

Press TV (2017)

This documentary highlights the millions of Americans unable to access dental care owing to the prohibitive cost. With a routine dental checkups costing a week’s salary on average, healthy teeth have become an unaffordable luxury in the US.

The US is the only developed country that refuses  to provide basic health care for all its residents. Prior to the enactment of the Affordable Care Act (Obamacare) in 2010, poor Americans unable to access medical services experienced an average of 45,000 preventable deaths annually.

Total preventable deaths dropped initially (to 18,000) with the enactment of Obamacare. Since then skyrocketing premiums – coupled with Trump’s repeal of premium subsidies – have caused a rebound in the number of uninsured Americans.

California used to provide free dental services for indigent residents under the state Medicaid program. However this was discontinued in 2009. Although indigent children are still theoretically eligible to receive DentiCal services, reimbursement rates are so low only a handful of Los Angeles dentists participate in the program.

The film focuses on nongovernmental efforts to improve dental health in the Los Angeles Hispanic community. Ironically dental health deteriorates in Mexicans after they immigrate to the US – and move from rural areas to inner cities lacking access to fresh fruits and vegetables. Thus an essential component of the University of Southern California (USC) dental health outreach program involves a campaign to increase urban gardens and nutrition education in schools.

The USC Ostrow School of Dentistry also recruits volunteer dentists to run free dental clinics for children, the unemployed, the uninsured and the elderly (of all ethnicities).

In addition to to the USC program, the Los Angeles Hispanic Dental Association has established a fund to support Spanish-speaking students in pursuing dental degrees and foreign-trained Hispanic dentists in jumping the bureaucratic hurdles of obtaining a US work permit .

 

Doctors Call for Single Payer Health Care, Cite Need to Move Beyond ACA

The American Journal of Public Health publishes physicians’ call for sweeping single-payer reform with detailed proposal signed by over 2,200 doctors nationwide

Unveiling of proposal coincides with heightened debate on ‘Medicare for All’ in presidential primaries

In a dramatic show of physician support for deeper health reform – and for making a decisive break with the private insurance model of financing medical care – 2,231 physicians called today [Thursday, May 5] for the creation of a publicly financed, single-payer national health program that would cover all Americans for all medically necessary care.

Single-payer health reform, often called “Medicare for All,” has been a hotly debated topic in the presidential primaries, thanks in part to it being a prominent plank in the platform of Sen. Bernie Sanders. The new physicians’ proposal is strictly nonpartisan, however.

The proposal, which was drafted by a blue-ribbon panel of 39 leading physicians, is announced today in an editorial titled “Moving Forward from the Affordable Care Act to a Single-Payer System” published in the American Journal of Public Health. The editorial links to the full proposal titled “Beyond the Affordable Care Act: A Physicians’ Proposal for Single-Payer Health Care Reform” and the names of all the signers, and it appeals for additional physicians to add their names as endorsers. The proposal currently has signers from 48 states and the District of Columbia.

“Our nation is at a crossroads,” said Dr. Adam Gaffney, a Boston-based pulmonary disease and critical care specialist, lead author of the editorial and co-chair of the Working Group that produced the proposal.

“Despite the passage of the Affordable Care Act six years ago, 30 million Americans remain uninsured, an even greater number are underinsured, financial barriers to care like co-pays and deductibles are rising, bureaucracy is growing, provider networks are narrowing, and medical costs are continuing to climb.

“Caring relationships are increasingly taking a back seat to the financial prerogatives of insurance firms, corporate providers, and Big Pharma,” Gaffney said. “Our patients are suffering and our profession is being degraded and disfigured by these mercenary interests.”

Dr. Steffie Woolhandler, a co-author of the editorial and proposal who is a professor of public health at the City University of New York’s Hunter College and lecturer at Harvard Medical School, commented: “We can continue down this harmful path – or even worse, take an alternative, ‘free-market’ route that would compound our problems – or we can embrace the long-overdue remedy that we know will work: the creation of a publicly financed, nonprofit, single-payer system that covers everybody. Today we’re saying we must quickly make that shift. Lives are literally at stake.”

Dr. Marcia Angell, a co-author of the editorial and proposal, co-chair of the working group, member of the faculty of global health and social medicine at Harvard Medical School and former editor-in-chief of the New England Journal of Medicine, said: “We can no longer afford to waste the vast resources we do on the administrative costs, executive salaries, and profiteering of the private insurance system. We get too little for our money. It’s time to put those resources into real health care for everyone.”

Under the national health program (NHP) outlined by the physicians:

* Patients could choose to go to any doctor and hospital. Most hospitals and clinics would remain privately owned and operated, receiving a budget from the NHP to cover all operating costs. Physicians could continue to practice on a fee-for-service basis, or receive salaries from group practices, hospitals or clinics.

* The program would be paid for by combining current sources of government health spending into a single fund with modest new taxes that would be fully offset by reductions in premiums and out-of-pocket spending. Co-pays and deductibles would be eliminated.

* The single-payer program would save about $500 billion annually by eliminating the high overhead and profits of insurance firms, and the massive paperwork they inflict on hospitals and doctors.

* The administrative savings of the streamlined system would fully offset the costs of covering the uninsured and upgraded coverage for everyone else, e.g. full coverage of prescription drugs, dental care and long-term care. Savings would also be redirected to currently underfunded health priorities, particularly public health.

* The “single payer” would be in a strong position to negotiate lower prices for medications and other medical supplies, yielding additional savings and reining in costs.

Surveys show strong, rising support for single-payer national health insurance among physicians. A 2008 survey of physicians found that 59 percent supported “legislation to establish national health insurance,” up from 49 percent five years earlier.

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“Moving Forward From the Affordable Care Act to a Single-Payer System,” by Adam Gaffney, M.D.; Steffie Woolhandler, M.D., M.P.H.; David U. Himmelstein, M.D.; Marcia Angell, M.D. American Journal of Public Health, June 2016, Vol. 106, No. 6, online first May 5, 2016, 1 p.m. Eastern. Includes link to full Physicians’ Proposal. Article available at this link.

The full, six-page Physicians’ Proposal with reference citations and 2,231 signatures (titled “Beyond the Affordable Care Act: A Physicians’ Proposal for Single-Payer Health Care Reform,” written by a 39-member Working Group on Single-Payer Program Design) is also accessible at the following link

PNHP’s summary of the Physicians’ Proposal is available here: summary

PNHP’s fact sheet on U.S. health care is here

Physicians for a National Health Program is a nonpartisan, nonprofit research and education organization founded in 1987. It includes physicians in every state and medical specialty. For local physician contacts or other information, contact PNHP’s headquarters in Chicago at (312) 782-6006. PNHP had no role in funding the articles described above.

Source

 

How Big Pharma Controls Health Care

Big Pharma: How the World’s Biggest Drug Companies Control Illness

By Jacky Law

Constable and Robinson Ltd (2006)

Book Review

In the ten years since British journalist Jacky Law published Big Pharma, the only good news is growing public awareness of the drug industry’s negative effect on human health. There’s no question the wealth and power of the pharmaceutical industry has vastly increased with the enactment of Obamacare in 2010. The latter grants major federal subsidies to both the insurance and drug industry.

Law carefully unpacks the fundamentals that position Big Pharma’s profits at the very top of Fortune 500 companies. In 2001, for example, they were number one, earning profits equal to 16-18% of sales. The banking industry was a distance second at 13.5%. While other Fortune 500 companies averaged 3.3%.

She attributes these obscene profits mainly to inflated prices Big Pharma charges Americans (as much as 5-10 times as much as in other countries), their deliberate efforts to bury and/or spin negative research, their bribing of doctors (with gifts, free lunch, training junkets and consultant fees) and medical journals (with glossy high priced ads), the refusal of the FDA to regulate pharmaceuticals (see FDA Now Completely Sold Out to Big Pharma) and direct to consumer ads aimed at convincing healthy people they need medical attention.

She devotes a whole chapter to “disease mongering,” Big Pharma’s deliberate creation of fictitious illnesses such as menopause, serotonin deficiency, post luteal dysphoric disorder and female sexual desire disorder. This is a topic I blog about frequently. See The Multibillion Dollar Depression Industry, Drug Companies: Killing Kids for Profit, Wyeth and the Multimillion Dollar Menopause Industry and Menopause Made in the USA

She also details studies dating back to 1982 revealing that low fat diets don’t decrease cardiovascular disease, as well as studies from 1992 revealing that cholesterol lowering drugs (statins) don’t reduce mortality. Thanks to the deliberate harassment and demonization of the researchers responsible for these studies, this information has only come into public view in the last two years. See Why the Low Fat Diet Makes You Fat (and Gives You Heart Disease, Cancer and Tooth Decay

Law is also highly critical of the role the pharmaceutical industry has played in minimizing the importance of poor nutrition and exposure to toxic chemicals in causing illness. She finds it extremely ironic (and immoral) that the federal government is clamping down on health supplements instead of environmental toxins.

Vermont Excludes Insurance Companies from Health Care

In 2011, the Vermont legislature enacted Act 48, which replaces private health insurance with a state-funded health care plan covering all Vermont residents. Governor Peter Shumlin, concerned about major flaws in Obamacare, made Green Mountain Care, the centerpiece of his 2010 gubernatorial campaign. In Vermont, as in the rest of the industrialized world, health care is viewed as a basic human right. Green Mountain Care is slated to become operational in 2017.

Like a growing number of Americans, Schumlin feels Obama’s Affordable Health Care Act (ACA) is financially unworkable. Instead of eliminating private insurance companies that suck out  25-33% of every health care dollar for profit and administrative expense* – it guarantees them generous government subsidies.

The US is the only country in the world which allows for-profit insurance companies to insert themselves into the doctor-patient relationship by dictating the types and amount of treatment that will be allowed. Because they allow insurance and drug companies to transform health care into a profit-making commodity, Americans pay twice as much for health care than any other country. Meanwhile they enjoy much poorer health than most of the industrialized world.

In part due to skyrocketing insurance costs under Obamacare (premiums for young adults have nearly doubled), millions of low income Americans remain uninsured. The Congressional Budget estimates that 36 million people will be uninsured in 2015, 30 million in 2016 and 31 million in 2024.

Meanwhile all Americans find the private insurance plans they are required to to buy, under penalty of law, cover far less than Obama originally promised. With the high cost of premiums, deductibles and copayments, they pay more and more of their health care bill themselves.  It doesn’t help that insurance companies are extremely devious about what they do and don’t cover. As many doctors and patients are discovering, the default setting for many health plans is to deny payment.

Green Mountain Care

In 2011 Harvard economist William Hsaio estimated that removing private insurance companies from the health care equation, as stipulated under Vermont’s Act 48, would save $4.3 billion over four years – enough to cover the uninsured, offer better coverage than insurance companies and still have more than a billion dollars left over.

Under Green Mountain Care, a combination of income and payroll taxes (details to be released in January 2015) will replace the $1.9 billion in health insurance premiums Vermonters currently pay. Residents covered by federal plans, such as Medicare, Medicaid, the VA and programs for active duty military personnel would continue to receive coverage through those plans. However, for the sake of administrative efficiency, both Medicare and Medicaid would be streamlined into Green Mountain Care’s unified claims administrative system.

Vermont would be the first state to guarantee health coverage for all its residents, regardless of income. As Michael Ollove notes in Vermont is Single Payer Trailblazer, they were also the first state to constitutionally ban slavery and mandate public funding for universal education, the first to introduce civil unions for same-sex couples and the first to allow gay marriage.

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*Obscene CEO salaries figure prominently in this “administrative” expense. In 2013 the CEOs of the 11 largest for-profit insurance companies received compensation packages totaling more than $125 million.

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Mainstreaming Natural Health Care

(This is the 3^rd of four posts on the effectiveness of “natural” or “alternative” health care.)

Third Party Coverage

Presently Germany, which has publicly guaranteed health care for all its citizens, is the only country to offer “natural” health care on a par with western medicine. However even in the US, where most health care funding is private, an increasing number of insurance companies offer coverage for “natural” or “alternative” health care. There is usually a requirement these services be offered in conjunction with traditional or “allopathic” care. The jargon used for these mixed mainstream-alternative health models is “complementary” or “integrative” medicine. Most insurance companies require that complementary and alternative medicine (CAM) providers be represented by a professional body with a formal accreditation process. There is also an expectation 1) that the accreditation body will establish clear treatment standards and 2) that all funding will be evidence and outcome-based. In other words, CAM providers must demonstrate a treatment actually works to be eligible for funding.

Some analysts are projecting that insurance coverage for natural health care will be even easier to access under Obamacare – at least for patients who can afford the higher premiums of silver, gold, and platinum plans. The uninsured and patients locked into Medicaid or bare bones bronze plans will be out of luck.

Natural Health Databases

The requirement for natural health services to be “evidence based” has led to the creation of a number of natural health research databases. Three of the most popular are the Mayo Clinic Alternative Medicine database, the NIH Complementary and Alternative Medicine database, and the Cochrane Complementary Medicine database.

The Mayo Clinic is a world famous “mainstream” medical center in Minnesota. Their database is by far the most comprehensive and user-friendly. The following statement on their home page summarises their philosophy:

“Exactly what’s considered complementary and alternative changes constantly as treatments undergo testing and move into the mainstream.”

The site provides up-to-date research summaries on a broad range of alternative treatment approaches. For example, here is what they have to say about aromatherapy:

Research on the effectiveness of aromatherapy — the therapeutic use of essential oils extracted from plants — is limited. However, some studies have shown that aromatherapy might have health benefits, including:

• Relief from anxiety and depression
• Improved quality of life, particularly for people who have chronic health conditions

Essential oils used in aromatherapy are typically extracted from various parts of plants and then distilled. The highly concentrated oils may be inhaled directly or indirectly or applied to the skin through massage, lotions or bath salts. Aromatherapy is thought to work by stimulating smell receptors in the nose, which then send messages through the nervous system to the limbic system — the part of the brain that controls emotions.

Many essential oils have been shown to be safe when used as directed. However, essential oils used in aromatherapy aren’t regulated by the Food and Drug Administration. When applied to the skin, side effects may include allergic reactions, skin irritation and sun sensitivity. In addition, further research is needed to determine how essential oils might affect children and how the oils might affect women who are pregnant or breast-feeding, as well as how the oils might interact with medications and other treatments.

I find the NIH and Cochrane databases less helpful. Both seem quite biased towards mainstream medicine and randomized controlled trials (RCTs). Many alternative treatment methods don’t lend themselves to RCTs because it’s virtually impossible to provide “sham” treatment (e.g. sham acupuncture, cupping, or aromotherapy) for the placebo group. Both NIH and Cochrane ignore the abundance of crossover design CAM studies in which the patient serves as their own control. In these studies, treatment is withdrawn once a clear response is established. It’s then reintroduced when symptoms recur.

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How Natural Health Care Affects Genes

 (This is the 2nd of 4 posts regarding the effectiveness of “natural” or “alternative” health care.)

The Wall Street Journal article I mentioned in my last post also mentions other research into the mechanism by which plant-based diets, yoga, and meditation halt or even reverse the progression of prostate cancer, heart disease, diabetes, hypertension, and other chronic conditions. One study, published in the Proceedings of the National Academy of Science, provides evidence that only a few months of similar “natural” treatments permanently alters gene expression. It describes how genes associated with cancer, heart disease, and inflammation were downregulated or “turned off,” while protective genes were upregulated or “turned on.” Another study published in The Lancet Oncology reported that these changes also increased telomerase, the enzyme that lengthens the telomeres at the ends of our chromosomes. Telomeres control how long we live. No prescription medication has ever been shown to do this.

Popularity of Natural Health Care

A recent Discovery Channel special revealed that 40% of Americans employ use some form of “natural” medicine. At their website, they list the ten most common, in order of popularity, along with general comments about documented benefits and potential risks:

1. Natural supplements and herbal medicines – benefits best supported by research evidence include omega 3 for heart disease, arthritis, and depression; garlic for cholesterol reduction; and ginseng for heart disease. In the US, quality control can be a major issue with natural and herbal supplements, as they aren’t regulated and may contain heavy metals and other toxins. In New Zealand, the Natural Health and Supplementary Products Bill (awaiting its third reading) would establish standards for quality, strength, and purity.

2. Acupuncture – has the strongest evidence base, not only for pain relief, but to improve immunity and alleviate a range of chronic conditions. These are summarised in a recent  World Health Organisation report. Some of the most common conditions that respond to acupuncture include rhinitis* (works better than antihistamines), sinusitis, asthma, irritable syndrome, hypertension, obesity, high cholesterol, menstrual cramps, migraine, menopausal symptoms, and stroke recovery (restores limb function).

3. Spinal manipulation (chiropractic) – also has a growing evidence base of effectiveness in chronic pain and other chronic illnesses.

4. Meditation – research supports effectiveness in treatment of anxiety, depression, and chronic pain.

5. Therapeutic massage – strong evidence base for therapeutic benefit in cancer, HIV, fibromyalgia, and other chronic pain conditions.

6. Ayurveda – an ancient Indian method of healing which shows promise as a way to boost memory and focus, though research into this approach is extremely limited. Some supplements used in this approach can contain heavy metals or cause dangerous interactions with prescription medication.

7. Guided imagery – demonstrated effectiveness in depression, anxiety, and pain.

8. Yoga – studies show that regular yoga practice reduces stress, eases depression, helps control high blood pressure and diabetes symptoms, helps reduce inflammation and asthma symptoms, reduce back pain, and improve heart function.

9. Hypnosis –  shows promise for stress relief, pain management, headaches, dental pain and childbirth.

10. Homeopathy – very limited research base because the individualized treatments used make it hard to generate meaningful statistics.

*runny nose

To be continued.

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Natural Health Care: the Research Evidence

Politics Masquerading as Science

(This is the 1st of four posts on the effectiveness of “natural” or “alternative” health care.)

I find it ironic how eager mainstream doctors are to condemn natural health treatments for not being “evidence-based.” Especially when Western medicine can produce little or no scientific evidence regarding the long term effectiveness and safety of many of their treatments. This is particularly true of heart surgery and immunization protocols. We operate on hearts and vaccinate kids for reasons that have nothing to do with scientific evidence. At the same time, we hold “natural” or “alternative” health providers to a much higher standard of proof. This is for complex political reasons that have given organized medicine and Big Pharma a virtual monopoly over health and healing. It has nothing to do with science.

The Myth of Evidence-Based Medicine

Doctors seem to forget that most common Western remedies were incorporated into the medical armamentarium centuries ago without any “proof” whatsoever of their effectiveness or safety. There were no randomized controlled trials when doctors began using digitalis for heart failure, morphine for pain, or sudafed for nasal congestion. All, like many other drugs, are plant-based treatments* originally used by midwives and herbalists (women the Catholic Church condemned as “witches”).

It was only when pharmaceutical companies began to develop synthetics substitutes that drugs were subjected to randomized control trials. Likewise, the long term outcome of many surgical interventions is never studied before they are rushed into the marketplace. A recent Wall Street Journal article examines the cost effectiveness of two common cardiac procedures – coronary angioplasty and coronary bypass surgery.

According to the article, in 2006 American surgeons performed 1.3 million coronary angioplasties at an average cost of $48,399 each – at a total cost of more than $60 billion. The same year they performed 448,000 coronary bypass operations at a cost of $99,743 each – at a total of more than $44 billion.

Despite these costs, a randomized controlled trial published in the New England Journal of Medicine found that angioplasties and stents don’t prolong life or even prevent heart attacks in stable patients (i.e. 95% of patients who receive them). Likewise coronary bypass surgery prolongs life in less than 3% of cases.

The Bias Against Natural Health Care

The authors ask:  Why do Medicare and health insurance companies pay billions of dollars for dangerous, expensive, and largely ineffective heart surgeries – yet balk at paying for “natural” approaches that have proven to reverse and prevent the chronic diseases that account for at least 75% of health care costs (INTERHEART study, The Lancet, Sept 2004)?

Good question.

*Below are just a few common medicines based on ancient plant-based treatments:

• Aspirin
• Atropine
• Curare
• Theobromine
• Taxo
• Scopolamine
• Reserpine
• Quinjidine
• Quinine
• Papavarine
• Physostigmine
• Papain
• L-dopa
• Hyoscyamine

(To be continued.)

 

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Fast Food Restaurants Cost Taxpayers Nearly $8 Billion

 

Why Are We Subsidizing Profitable Corporations?

Over the past few days, the corporate media has been trumpeting September’s “low” 7.2% unemployment rate. For the most part, the mainstream media fails to report that joblessness has only decreased 0.1% since August. Or that 20,000 of the 148,000 jobs created were temporary jobs. They also neglect to mention that most new jobs since the 2008 economic crisis don’t pay enough to live on. Which means that US taxpayers subsidize minimum wage workers to the tune of $7.8 billion a year. Given the current $17 trillion government debt, this seems like a major chunk of change.

In 2012, half of US jobs paid under $33,000 annually. Most of these minimum wage jobs are in America’s fast food restaurants, where employees struggle to get by on $7.25 an hour.

According to a recent University of Berkeley/University of Illinois study, 52% of fast food workers rely on federal programs like Medicaid, food stamps, the Earned Income Tax Credit, and Temporary Assistance for Needy Families to provide for their children. This is due partly to poverty-level wages and partly to heavy reliance by fast food outlets on part time workers (under 30 hours per week). MacDonald’s et all are reluctant to take on full time employees owing to the new requirement (under Obamacare) that they provide health insurance for full time workers. .

Something seems terribly wrong here. MacDonald’s, Subway, Burger King, Wendy’s, Domino’s Pizza are all highly profitable corporations. So why is the US taxpayer bailing them out by providing health care, food stamps, and other federal benefits for their employees and their families?

Work Week Shrinking Under Obamacare

Under Obamacare, employers are only required to provide health insurance if workers put in more than 30 hours a week. Investors.com has been tracking employers that are either cutting work hours or only hiring part time workers to reduce their obligation under the new law.

When employers cut back their full time workers, Obamacare shifts responsibility to the federal government (through expanded Medicaid programs and premium subsidies) to provide health coverage for minimum wage workers. Thus in addition to subsidizing MacDonald’s, Subway, Burger King, Wendy’s, Domino’s Pizza, the taxpayer is also subsidizing highly profitable insurance companies like Aetna, United Health Care, and Blue Cross/Blue Shield.

The Government Accountability Office reports that Obamacare will increase the federal deficit by $6.2 trillion. $709 billion of this will fund Medicaid expansion (from 2014-2023). The rest will take the form of direct subsidies to insurance companies.

Sarah Palin Describes Obamacare as Corporatism

In a recent oped on Breitbart, former Alaska governor Sarah Palin describes Obamacare as “a sort of corporatism, which is the collusion of big government with big business.” While she and I disagree on many issues, that we definitely agree on.

She goes on to predict that the exorbitant costs will cause a breakdown in the US health care system. When this happens, she believes, Americans will clamor for the government to enact a single payer system which excludes parasitic health insurance companies from the health care equation.

I sure hope she’s right. Palin makes the unsubstantiated claims that single payer funding will lead to death panels and higher costs. There are no death panels in Medicare, which is a single payer system. Moreover Medicare, which was enacted in 1965, enables senior citizens to access health care far more cheaply and efficiently than private insurance does.

Nor are there death panels in the dozens of other countries that publicly fund health care. Even more importantly, they all pay about half what the US does for medical services. Seems to me it’s high time for the US to catch up with the rest of the civilized world. Except for the US, all other industrialized countries guarantee that all citizens, regardless of income, have the right to see a doctor when they’re sick.

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Originally published in Veterans Today