Current Health Research News Fall 2014

Disclaimer: The information contained in Health News and other parts of the HealthyVIM.org website are provided for educational purposes only. This information, is not intended to diagnose, treat or cure disease. Your individual health needs are best reviewed with you by your practitioner(s), who can best advise you regarding diagnoses and treatment.

In This Issue:


Previous Health Research News:


Alcohol and Heart Disease

The influence of alcohol on health has always been a controversial topic with a lot of economic, esthetic, cultural, religious, and political influence. That a significant minority of people uses alcohol unskillfully, resulting in addiction, car crashes, cirrhosis and domestic violence further complicates this issue. Looked at in a reductionist manner, the metabolic effects of alcohol are more toxic than beneficial. Nevertheless epidemiological studies have shown that moderate alcohol use decreases risk of coronary heart disease and death. This discrepancy has long been a puzzle to me.

So I was intrigued by a commentary from Dr Joel Furhman that throws light on this question:

“How much red wine, if any, is good for you?”

http://www.drfuhrman.com/faq/question.aspx?sid=15&qindex=0

“Moderate alcohol consumption (compared to no alcohol consumption) has been associated with a lower incidence of coronary heart disease in a large number of observational studies.[1] This only applies to moderate drinking – about one drink or fewer per day for women, and two drinks or fewer for men. In the early 1990s, some researchers proposed that red wine could mitigate the harmful effects of a rich, fatty diet and smoking, as an explanation of the “French paradox” – the lower rates of heart disease deaths in France compared to the U.S. (note that heart disease death rates do not remain lower in France today). Is moderate alcohol consumption truly ‘heart-healthy’?  The link between alcohol and reduced risk of heart disease is thought to be due primarily not to a beneficial effect on the cardiovascular system, but to the fact that alcohol interferes with blood clotting.[2] This effect is valuable only in a person or population consuming a dangerous, heart-disease-promoting diet. For someone who follows a healthful eating style rich in unrefined plant foods, there will be a high level of protection against heart disease, so thinning the blood would not add any further protection. (My italics) In fact, thinning the blood with alcohol may present considerable risk, including increased risk of hemorrhagic stroke. [3]  Also, alcohol consumption leads to mild withdrawal sensations the next day that are commonly mistaken for hunger and quelled by overeating. Of course, heavy drinking (3 or more alcoholic drinks daily) is exceedingly dangerous, associated with harmful effects on the cardiovascular system, cardiomyopathy, hypertension, and potentially life-threatening arrhythmias.[1,4]

One glass of wine, once or twice a week is likely safe, but I advise against higher levels of alcohol consumption, as it may lead to health problems. Higher alcohol intake is associated with greater risk of cancers of the oral cavity, pharynx, larynx, esophagus, liver, breast and colorectum.[5] Since the body metabolizes alcohol into acetaldehyde, a carcinogenic compound, light drinking (less than 1 drink/day) and even alcohol-containing mouthwashes may be risky.[6-8] Women who imbibe in the range of 3-6 alcoholic drinks weekly were found to have a 15% increase in breast cancer risk compared to non-drinkers, and 3-4 drinks per week is also associated with higher rates of breast cancer recurrence after diagnosis.[9-11] Increased cancer risk due to light alcohol intake is not limited to breast cancer. A meta-analysis of studies on the relationship between light drinking and cancer risk estimated that light alcohol drinking is responsible for 5000 deaths from oral and pharynx cancers, 24,000 deaths from esophageal squamous cell carcinoma, and 5000 deaths from breast cancer worldwide each year.[12] It is best to minimize alcohol consumption to reduce these risks.

Red wine contains a widely studied beneficial compound from grape skins called resveratrol. Resveratrol has been shown to have several anti-inflammatory and antioxidant effects that may contribute to cardiovascular disease protection.[13] However, at this point in time it is unknown whether resveratrol in red wine contributes additional protection beyond the blood-thinning effects of alcohol.[2] Of course, grapes, raisins, blueberries, cranberries, peanuts, and other plant foods also contain resveratrol. It is not necessary to drink wine to obtain any benefits resveratrol may have.

Overall, it is safer to eat a diet that will not permit heart disease rather than to rely on alcohol to decrease the potential of blood to clot. The potential heart healthy effects of resveratrol are not exclusive to red wine – in the context of a nutrient-dense eating style, the resveratrol in the occasional glass of red wine will be only a drop in the bucket of beneficial phytochemicals.

____________

  1. Klatsky AL: Alcohol and cardiovascular health. Physiol Behav 2010;100:76-81.

  2. Saremi A, Arora R: The cardiovascular implications of alcohol and red wine. Am J Ther 2008;15:265-277.

  3. Daniel S, Bereczki D: Alcohol as a risk factor for hemorrhagic stroke. Ideggyogy Sz 2004;57:247-256.

  4. George A, Figueredo VM: Alcohol and arrhythmias: a comprehensive review. J Cardiovasc Med (Hagerstown) 2010;11:221-228.

  5. Baan R, Straif K, Grosse Y, et al: Carcinogenicity of alcoholic beverages. Lancet Oncol 2007;8:292-293.

  6. . Brooks PJ, Theruvathu JA: DNA adducts from acetaldehyde: implications for alcohol-related carcinogenesis. Alcohol 2005;35:187-193.

  7. Lachenmeier DW, Gumbel-Mako S, Sohnius EM, et al: Salivary acetaldehyde increase due to alcohol-containing mouthwash use: a risk factor for oral cancer. Int J Cancer 2009;125:730-735.

  8. Lachenmeier DW, Kanteres F, Rehm J: Carcinogenicity of acetaldehyde in alcoholic beverages: risk assessment outside ethanol metabolism. Addiction 2009;104:533-550.

  9. Boyle P, Boffetta P: Alcohol consumption and breast cancer risk. Breast Cancer Res 2009;11 Suppl 3:S3.

  10. Kwan ML, Kushi LH, Weltzien E, et al: Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. J Clin Oncol 2010;28:4410-4416.

  11. Chen WY, Rosner B, Hankinson SE, et al: Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA 2011;306:1884-1890.

  12. Bagnardi V, Rota M, Botteri E, et al: Light alcohol drinking and cancer: a meta-analysis. Ann Oncol 2013;24:301-308.

  13. . Higdon J: Resveratrol. In An Evidence-Based Approach to Dietary Phytochemicals. 2006″

 

New Statin Recommendations: Some Feedback

Last Fall (November 2013) the American Heart Association and the American College of Cardiology published new cholesterol management guidelines which recommend that more healthy Americans begin using statin medications for undefined health benefits. This recommendation takes the hijacking of health care by the pharmacological industry to a new plane, by the underlying assumption that:

  • Taking a drug rather than exercising, eating well, and reducing stress should be our national focus
  • Atherosclerotic cardiovascular disease (hardening of the arteries) is a statin deficiency disease, and that
  • We can ignore the downsides of powerful drugs that can cause muscle pain and weakness, diabetes, and likely dementia.

How to describe this – my grandfather would have said mishuggas (Yiddish: crazy, insane) or cockamamie comes to mind (French: something ridiculous, incredible or implausible) . Here are some more articulate opinions: commentary by Dr Guarneri, an op-ed piece from the NY Times by two prominent cardiologists, Dr Abramson and Redberg, and a “Viewpoint” article, also co-authored by Dr Redberg, from the Journal of the American Medical Association (JAMA) in 2012:

  • To quote Mimi Guarneri, MD,:

“Chronic disease is multifactorial. We know that 70-90% of chronic disease is accounted for by our lifestyles and our environment. The Interheart Study published in The Lancet in 2004 concluded that 90% of first heart attacks are totally preventable through lifestyle change. Psychological and social stress, tobacco use, and obesity are not treated with a statin medication. Cardiologists now recognize that the benefit of statins is most likely due to a reduction in inflammation. In an Integrative Holistic or Functional Medicine model, we address the underlying cause of disease by taking the time to ask important questions that we connect with human physiology. Untreated infections, toxins such as lead, cadmium, and mercury, obesity and stress, poor nutrition, and lack of exercise are just a few areas where Integrative Holistic Medicine approaches can reverse the disease process. “

  • John D. Abramson, a lecturer at Harvard, and Cardiologist Rita F. Redberg, a cardiologist at the University of California, San Francisco Medical Center and the editor of JAMA Internal Medicine. in their New York Times Opinion Piece, “Don’t Give More Patients Statins” provide a more nuanced understanding of how these recommendations came to be.

“The process by which these latest guidelines were developed gives rise to further skepticism. The group that wrote the recommendations was not sufficiently free of conflicts of interest; several of the experts on the panel have recent or current financial ties to drug makers. In addition, both the American Heart Association and the American College of Cardiology, while nonprofit entities, are heavily supported by drug companies.”The American people deserve to have important medical guidelines developed by doctors and scientists on whom they can confidently rely to make judgments free from influence, conscious or unconscious, by the industries that stand to gain or lose.We believe that the new guidelines are not adequately supported by objective data, and that statins should not be recommended for this vastly expanded class of healthy Americans. Instead of converting millions of people into statin customers, we should be focusing on the real factors that undeniably reduce the risk of heart disease: healthy diets, exercise and avoiding smoking. Patients should be skeptical about the guidelines, and have a meaningful dialogue with their doctors about statins, including what the evidence does and does not show, before deciding what is best for them.”

  • Viewpoint | April 11, 2012: Healthy Men Should Not Take Statins. Rita F. Redberg, MD; Mitchell H. Katz, MD JAMA. 2012;307(14):1491-1492. Should a 55-year-old man who is otherwise well, with systolic blood pressure of 110 mm Hg, total cholesterol of 250 mg/dL, and no family history of premature CHD be treated with a statin? – No.

“Extensive epidemiologic data demonstrate that higher cholesterol levels are associated with a greater risk of heart disease. At the population level, higher levels of cholesterol are associated with a diet greater in fatty foods, particularly trans fat and meat, and low intake of fruits and vegetables.The important questions for clinicians (and for patients) are as follows: (1) does treatment of elevated cholesterol levels with statins in otherwise healthy persons decrease mortality or prevent other serious outcomes? (2) What are the adverse effects associated with statin treatment in healthy persons? (3) Do the potential benefits outweigh the potential risks? The answers to these questions suggest that statin therapy should not be recommended for men with elevated cholesterol who are otherwise healthy.

  1. What is the benefit of statin therapy in healthy men with high cholesterol levels? Data from a meta-analysis of 11 trials including 65,229 persons with 244 000 person-years of follow-up in healthy but high-risk men and women showed no reduction in mortality associated with treatment with statins.1 A 2011 Cochrane review of treatment with statins among persons without documented coronary disease came to similar conclusions.2 The Cochrane review also observed that all but one of the clinical trials providing evidence on this issue were sponsored by the pharmaceutical industry. It is well established that industry-sponsored trials are more likely than non-industry-sponsored trials to report favorable results for drug treatment because of biased reporting, biased interpretation, or both of trial results.6

  2. What adverse effects are associated with statin treatment in healthy persons? All treatments designed to prevent disease – such as death from coronary disease – can also result in adverse effects. Data from observational studies show much higher rates for statin-associated myopathy and other adverse events in actual use than the 1% to 5% rate reported in clinical trials. This underestimation of adverse events occurs because the trials excluded up to 30% of patients with many common comorbidities, such as those with a history of muscular pains, as well as renal or hepatic insufficiency.3 Many randomized trials also excluded patients who had adverse effects of treatment during an open-label run-in period. For example, in the Treat to New Targets trial, after initial exclusions based on comorbidities, an additional 35% of eligible patients, or 16% of patients, were excluded during an 8-week, open-label, run-in phase because of adverse events, ischemic events, or participants’ lipid levels while taking the drug not meeting entry criteria.7 Additionally, the results of randomized trials of statin treatment likely underestimate common symptoms such as myalgia, fatigue, and other minor muscle complaints because these studies often only collect data on more quantifiable adverse effects such as rhabdomyolysis.  Numerous anecdotal reports as well as a small trial89 have suggested that statin therapy causes cognitive impairment, but this adverse outcome would not have been captured in randomized trials. The true extent of cognitive impairment associated with statins remains understudied. It is disappointing that more data are not available on important adverse events associated with statin treatment, despite millions of prescriptions and many years of use. This information could be easily collected in observational studies and from registries. One population-based cohort study in Great Britain of more than 2 million statin users found that statin use was associated with increased risks of moderate or serious liver dysfunction, acute renal failure, moderate or serious myopathy, and cataract.4 The risk of diabetes with statin use has been seen in randomized clinical trials such as JUPITER, which found a 3% risk of developing diabetes in the rosuvastatin group, significantly higher than in the placebo group. In observational data from the Women’s Health Initiative, there was an unadjusted 71% increased risk and 48% adjusted increased risk of diabetes in healthy women taking statins.5

  3. Do the potential benefits outweigh the potential risks? Based on all current evidence, a healthy man with elevated cholesterol will not live any longer if he takes statins. For every 100 patients with elevated cholesterol levels who take statins for 5 years, a myocardial infarction will be prevented in 1 or 2 patients.7 Preventing a heart attack is a meaningful outcome. However, by taking statins, 1 or more patients will develop diabetes and 20% or more will experience disabling symptoms, including muscle weakness, fatigue, and memory loss.3

NON-DRUG APPROACHES TO REDUCING CORONARY RISK

There are effective methods for reducing cardiovascular risk in otherwise healthy men: dietary modification, weight loss, and increased exercise. These strategies are effective in increasing longevity and also result in other positive benefits, including improved mood and sexual function10 and fewer fractures. Although these strategies are challenging, prescribing a statin may undermine them. For example, some patients derive a false sense of security that because they are taking a statin they can eat whatever they want and do not have to exercise. For some clinicians, evidence that statins reduce the risk of recurrent coronary events in patients with documented coronary disease leads to the belief that statins also “must” be beneficial for patients without coronary disease. However, recent history is rife with examples of interventions that are proven to work in patients with serious disease yet are not efficacious when generalized to patients without serious disease. For example, coronary artery bypass graft (CABG) surgery is lifesaving for patients with symptomatic left main disease. However, CABG surgery would not be a good choice for single-vessel coronary artery disease (CAD) because risks would outweigh benefits in less extensive CAD. Similarly, the benefits of carotid endarterectomy in preventing stroke outweigh the risks for symptomatic patients with tight carotid artery stenosis, but not for asymptomatic patients with less critical stenosis. In addition, the use of aspirin is similar to statins for prevention. The data show clear benefit for aspirin in secondary prevention of cardiovascular disease, but not for primary prevention. Practitioners should not be generalizing from other settings when good data indicate that statins are not effective in improving length or quality of life when used for primary prevention.

For the 55-year-old man in this scenario, his risk of myocardial infarction in the next 10 years based on the Framingham Risk Score varies from 10% to 20%. His risk is driven mostly by his age rather than by his cholesterol level. Increasing age has a much larger influence on risk for cardiovascular disease than do increasing levels of cholesterol. Recent data on increased risk of diabetes, cognitive dysfunction, and muscle pain associated with statins suggest that there is risk with no evidence of benefit. Advising healthy patients to take a drug that does not offer the possibility to feel better or live longer and has significant adverse effects with potential decrement in quality of life is not in their interest.

At the same time, there are significant opportunities for improvement in lifestyle counseling and interventions. Even small changes in diet and increases in physical activity and smoking cessation can lead to significant personal and population health benefits. Such positive lifestyle changes have the key advantage of helping patients feel better and live longer. Lifestyle counseling should remain the focus of primarily prevention efforts – at the physician and public health levels.”

Complete article and references at:
http://jama.jamanetwork.com/article.aspx?articleid=1148381

Scott Adams: Read This if You Want to Be Happy in 2014

This funny Washington Post article from January 5, 2014 offers great common sense advise on cultivating a healthy life style. Who would have “thunk” that the creator of Dilbert was so wise?

http://www.washingtonpost.com/business/read-this-if-you-want-to-be-happy-in-2014/2014/01/02/d96370f0-7192-11e3-9389-09ef9944065e_story.html

Read This if You Want to Be Happy in 2014

I have no expertise whatsoever on the topic of happiness. But I do have a knack for observation and simplification. That’s what I do for my day job as the creator of Dilbert. Today – as some of you are already backtracking on those New Year’s resolutions – I’m going to strip out all of the mumbo-jumbo around the topic of happiness and tell you the simplest way to get some.

You’re reading this in the business section because every bit of what follows on the topic of happiness is relevant to your career, especially if you have entrepreneurial ambitions. You’ll need all the good health, good looks and mental energy you can muster to influence people and survive the long hours. As luck would have it, the good habits that make you healthy and energetic help to make you happy at the same time, so it’s a double win.

As far as I can tell, people usually experience the sensation of happiness whenever they have both health and freedom. It’s a simple formula:

Happiness = Health + Freedom

I’m talking about the everyday freedom of being able to do what you want when you want to do it, at work and elsewhere. For happiness, timing is as important as the thing you’re doing. For example, your favorite food is useless to you if the only time you can eat it is when your stomach is already full. But if I offer you bland food when you’re starving, you’ll feel as if you won the lottery. The timing of things matters.

The same principle is true for exercise. If you exercise when you’re in the mood for it, you can enjoy the workout. But if you can only exercise after a long day on the job and a grueling commute, you might hate it. There’s a right time and a wrong time for nearly every activity, from sleep to sex to paying bills. Matching your mood to your activity is a baseline requirement for happiness. The good news is that timing is relatively controllable, especially in the long run.

If you’re just starting out in your career, it won’t be easy to find a job that gives you a flexible schedule. The best approach is a strategy of moving toward more flexibility over the course of your life. That quest could take the form of badgering your pointy-haired boss into letting you work from home one day per week, or it might mean going back to school to learn a skill so you can run your own business. In my case, it means waking up several hours before the rest of the family. There isn’t one formula for finding schedule flexibility. Just make sure all of your important decisions are consistent with an end game of a more flexible schedule. Otherwise you are shutting yourself off from the most accessible lever for happiness – timing.

We can’t ignore the role of money in all of this. Money can’t directly buy happiness, but it can give you more options, and that’s an important part of freedom. So don’t give up too much income potential just to get a flexible schedule. There’s no point in having a flexible schedule if you can’t afford to do anything.

Knowledge, not willpower

The second part of the happiness formula is health. It’s never a good idea to take health tips from cartoonists, so check with your doctor if anything here sounds iffy to you. I don’t know how many people have died after reading health tips from cartoonists, but it probably isn’t zero. Don’t say you weren’t warned.

The most important thing to know about staying fit is this: If it takes willpower, you’re doing it wrong. Anything that requires willpower is unsustainable in the long run. And studies show that using willpower in one area diminishes how much willpower you have in reserve for other areas. You need to get willpower out of the system. I’ll show you some tricks for doing that.

My observation is that you can usually replace willpower with knowledge. That isn’t an obvious point, so I’ll give some examples.

Imagine you are hungry and I offer you a delicious but unhealthy dessert. It would take a lot of willpower to resist. Now imagine the same scenario, but I simultaneously offer a healthier food option that is also delicious. Suddenly it is easy to pick the healthy alternative over the dessert. The dessert was only irresistible when the alternative was starving. So the trick for avoiding unhealthy foods is to make sure you always have access to healthy options that you enjoy eating. Your knowledge of this trick, assuming you use it, makes willpower far less necessary.

Now imagine I offer you a choice of pasta or a white potato. And let’s say you enjoy both to a similar degree. Which do you choose? If you have only a basic understanding of nutrition – similar to what most people have – you might say it’s a toss-up. You’ve heard carbs are bad for you and that’s where your knowledge ends. But if you knew that pasta is far lower on the glycemic index than a white potato, you would make a far healthier choice that requires no willpower at all. All it took was knowledge.

And while you’re eating your pasta, feel free to pile on the parmesan cheese. Cheese adds calories, but the fat content will help suppress your appetite, so you probably come out ahead. If you didn’t already know that, you might end up using willpower to avoid cheese at dinner and willpower again later that night to resist snacking. A little knowledge replaces a lot of willpower. Is there anything else you should know about diet? Let me give you a quick quiz.

Did you know that sleepiness causes you to feel hungry?

Did you know that eating peanuts is a great way to suppress appetite?

Did you know that eating mostly protein instead of simple carbs for lunch will help you avoid the afternoon energy slump?

Did you know that eating simple carbs can make you hungrier?

Did you know that exercise has only a small impact on your weight?

If this is the first you have heard any of those facts, and you are sporting some extra pounds, you probably have a knowledge gap that feels to you like a shortage of willpower.

Learning to loathe french fries

Speaking of knowledge, I’ve recently discovered that my cravings for certain foods can be manipulated. That surprised me because I thought my food preferences were baked into my DNA. I once loved french fries with an almost insane passion. But after I started noticing how drained and useless I felt after eating simple carbs, french fries became easy to resist. Knowledge weaned me off french fries when willpower could not.

I also learned that I can remove problem foods from my diet if I target them for extinction one at a time. It was easy to stop eating three large Snickers every day (which I was doing) when I realized I could eat anything else I wanted whenever I wanted. I can give myself that kind of permission because I’ve trained myself to enjoy relatively healthy food and to always have it nearby.

If you’re on a diet, you’re probably trying to avoid certain types of food, but you’re also trying to limit your portions. Instead of waging war on two fronts, try allowing yourself to eat as much as you want of anything that is healthy. I think you’ll find that healthier food is almost self-regulating in the sense that you don’t have an insatiable desire to keep eating it the way you might with junk food. With healthy food, you tend to stop when you feel full. That has been my experience anyway. In my 20s I could snarf my way through an entire box of donuts. But not once have I eaten an apple – which I also enjoy – and started in on a second apple.

One of the biggest obstacles to healthy eating is the impression that healthy food generally tastes like cardboard. So consider making it a lifelong system to learn how to season and prepare healthy foods. If you know how to make your veggies taste great, it isn’t so hard to avoid junk food. Here again, knowledge replaces willpower.

It’s easy to spot the people who are trying to use willpower instead of knowledge to get healthier. They tend to say things like this:

My goal is to lose 10 pounds.

In my experience, the fittest people have systems, not goals, unless they are training for something specific. A sensible system is to continuously learn more about the science of diet and the methods for making healthy food taste great. With that system, weight management will feel automatic. Goals aren’t needed.

I’m limiting my portion size.

You only need to do that if you are eating the wrong foods. Eating half of your cake still keeps you addicted to cake. And portion control takes a lot of willpower. You’ll find that healthy food satisfies you sooner, so you don’t crave large portions.

I’m increasing my workout to lose a few pounds.

No one can exercise enough to overcome a bad diet. Diet is the right button to push for losing weight, so long as you are active. People who eat right and stay active usually have no problems with weight.

I’m doing the (whatever) diet or cleanse.

Following a diet is hard. A cleanse is even harder. It takes effort and willpower. You’re better off learning to eat right and letting that knowledge nudge you in the right direction over your lifetime.

Hop to it

Once you get your diet right, the next topic to tackle is exercise. I’m about to share with you the simplest and potentially most effective exercise plan in the world. Here it is:

Be active every day.

Under this system, anything that gets you up and moving counts. It doesn’t matter if you’re swimming, running or cleaning the garage. When you’re active, and you don’t overdo it, you’ll find yourself in a good mood afterward. That reward becomes addictive over time. You’ll be like Pavlov’s dogs, but conditioned to be active. After a few months of being moderately active every day, you’ll discover that it is harder to sit and do nothing than it is to get up and do something. That’s the frame of mind you want. You want exercise to become a habit with a reward so it evolves into a useful addiction. When that happens, you no longer need willpower to exercise.

It’s important to remember that the intensity of your workout has a surprisingly small impact on your weight unless you’re running half-marathons every week. If your diet is right, moderate exercise is all you need. Your natural impulse to seek variety and challenge will cause you to learn more about the best practices of exercise over your lifetime. The only thing you absolutely need to get right is the part about being active every day.

When I was in my 20s I enjoyed playing pick-up games of soccer on Sunday mornings. It was terrific exercise, but it left me so sore I couldn’t exercise for several days afterward. Whoever came up with the saying “No pain, no gain” hadn’t thought it through. For me, the pain kept me from gain. These days I simply stay active every day, without pain and without the need for willpower, and I’m in the best shape of my life at age 56.

You will be tempted to quibble with some of the things I said about diet and exercise. Don’t get hung up on the details, because science keeps changing what we think we know anyway. The important point is that there are simple ways to substitute knowledge for willpower so you can ease into healthier eating and an active lifestyle. When your body is feeling good, and you have some flexibility in your schedule, you’ll find that the petty annoyances that plague your life become nothing but background noise. And that’s a great launch pad for happiness.

As you find yourself getting healthier and happier, the people in your life will view you differently too. Healthy-looking people generally earn more money, get more offers and enjoy a better social life. All of that will help your happiness.

Keep in mind that happiness is a directional phenomenon. We feel happy when things are moving in the right direction no matter where we are at the moment. The homeless guy who finds a promising dumpster is happier in the moment than the billionaire who just lost $100 million on a bad investment. It’s the direction of your life – progress if you will – that influences happiness. When you are learning more about diet and exercise it will give you the sensation of progress and control over you destiny. And that feels good compared to losing ten pounds and gaining it back.

I’ll reiterate that you shouldn’t get your health information from cartoonists. I’m a simplifier, not a doctor. All I’m offering is the idea that happiness is more accessible if you replace willpower with knowledge and you replace short-term goals with lifelong systems.
Adams’s new book is “How to Fail at Almost Everything and Still Win Big: Kind of the Story of My Life.”

Why Single Payer Health Insurance?

An organization to which I belong, Physicians for a National Health Program, makes a very powerful case for establishing a national single payer system as the best way to provide optimal medical care for virtually everyone. Here is a summary of some amazing facts that explain why: PNHP Research: The Case for a National Health Program. PNHP welcomes support from medical and lay persons.

The fully referenced summary can be found at:

http://www.pnhp.org/resources/pnhp-research-the-case-for-a-national-health-program

“1. Administrative costs consume 31 percent of US health spending, most of it unnecessary.”

“2. Medical bills contribute to half of all personal bankruptcies. Three-fourths of those bankrupted had health insurance at the time they got sick or injured.”

“3. Taxes already pay for more than 60 percent of US health spending. Americans pay the highest health care taxes in the world. We pay for national health insurance, but don’t get it.”

“4. Despite spending far less per capita for health care, Canadians are healthier and have better measures of access to health care than Americans.”

“5. Business pays less than 20 percent of our nation’s health bill. It is a misnomer that our health system is “privately financed” (60 percent is paid by taxes and the remaining 20 percent is out-of-pocket payments).”

“6. For-profit, investor-owned hospitals, HMOs,;nursing homes and home health care agencies have higher costs and score lower on most measures of quality than their non-profit counterparts.”

“7. Immigrants and emergency department visits by the uninsured are not the cause of high and rising health care costs. Immigrants also subsidize Medicare’s trust fund.”

“8. 45,000 annual deaths are associated with lack of health insurance. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002. The uninsured do not receive all the medical care they need – one-third of uninsured adults have chronic illness and don’t receive needed care. Those most in need of preventive services are least likely to receive them.”

“9. The US could save enough on administrative costs (more than $350 billion annually) with a single-payer system to cover all of the uninsured.”

“10. Competition among investor-owned, for-profit entities has raised costs, reduced quality in the US.”

“11. The Canadian single payer healthcare system produces better health outcomes with substantially lower administrative costs than the United States.”

“12. Computerized medical records and chronic disease management do not save money. The only way to slash administrative overhead and improve quality is with a single payer system.”

“13. Alternative proposals for “universal coverage” do not work. State health reforms over the past two decades have failed to reduce the number of uninsured.”

Physicians for a National Health Program
29 E Madison Suite 602, Chicago, IL 60602
Phone (312) 782-6006 | Fax: (312) 782-6007 |
email: info@pnhp.org
@PNHP 2014

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