Health Spectator

On Tuesday, August 30 actress and activist Daryl Hanna was arrested in front of the White House for sitting in against the Keystone XL oil pipeline. That pipeline, if built, would transport oil from Alberta, Canada’s tar sands fields to Texas at the Gulf of Mexico.

What does that have to do with our health? you might ask. Indeed, that is a logical question.

First, the oil in question is extremely dirty crude oil. Its carbon content is exceedingly high. In fact, tar sands oil produces 82 percent more greenhouse gas than conventional crude oil. So not only is it much more expensive to convert to, say, gasoline than conventional crude, it also has a far worse effect on the environment even if it doesn’t spill.

But when it spills, it spells disaster. Residents of Michigan can tell you about that. An existing pipeline extends from these same oil fields to refineries in Oklahoma. Now barely a year old, that pipeline has leaked twelve times in twelve months. In July 2010 it spilled one million gallons of tar sands crude into a Kalamazoo River tributary. Forty miles of river are still contaminated with the oil more than a year later. In part, that’s because tar sand sinks in water. Of course, it still coats and kills fish and wildfowl.

So if you don’t want crude oil contaminating your waterways and drinking water or excess carbon, sulfur and mercury polluting your air and soil, there must be cleaner energy alternatives. Or maybe we just have to cut back on our use of energy and our miles of driving, perhaps using electric cars (which still require us to produce that electricity in the first place—we know).

But that soil, air and water pollution don’t really affect us, right? Breast cancer is still on the rise wordwide. Of course, that’s because of “Western” lifestyles, right? According to the World Health Organization (WHO) there will be 20 million new cases of cancer per year by 2030, up from 12 million new cases in  2008. But if the cause were simply our Western lifestyle as so much of the media assure us, shouldn’t the cancer rate reach a steady state, at least in the U.S.? How do we blame a continuing increase in cancer rates worldwide on our Western lifestyle? Has life changed that radically in India and Southeast Asia?

Incidentally, the National Cancer Institute (NCI) reports that the current increase in cancer translates into approximately 56% more cancer in men and 22% more cancer in women over the course of a single generation. The NCI reports that one in two men or women will experience cancer in their lifetime. And it expects the cancer rate to double by 2050. In Ireland, a report just out states that cancer cases have risen 50% since the 1990s. Has Ireland become that much more “Westernized” since 1990?

If this is purely the result of a Western lifestyle, which presumably means inadequate exercise and a diet of processed foods, why do the rates keep rising? Once one does not exercise and one’s diet consists entirely of processed food—which is, unfortunately, the case for many of us—how can you justify further increases in cancer?

The only explanation, we believe, is a continuing deterioration in our environment, with subsequent ill effects on our health. And the  Keystone XL pipeline is one more giant step in that direction.

You’ve already heard what we have to say on this. If you missed it, check the list of related links, and you’ll surely get there. We’ve decided to put some other voices out there via video so you can watch or listen on your way to work or whenever.

We don’t always agree entirely with the conclusions drawn by these speakers. We’ve made no bones about favoring a single-payer system, because we believe it would be the cheapest way to cover everyone and cover them well. Nevertheless, there are arguments for other systems worth hearing.

This segment is entitled, “What is the best healthcare option?”

Interviews with John McCain and Joe Lieberman about the public option in healthcare:

Keith Olbermann discusses health care reform, interviews Bill Maher:

And finally, you’ve heard lots about the French healthcare system in speeches, particularly speeches by Republicans, who love to dump on the French system, which costs less than half what ours does per person.

But do you (or they, for that matter) know anything about it? We thought not.

We were surprised too when we saw this video, which was produced for CBS. Whatever you thought the French system was like, we suspect the truth will surprise you. The numbers for U.S. healthcare here are a bit dated (figures for the U.S. currently exceed $7,000 per person annually in the U.S., which is more than twice the $3,400 quoted annually here for the French. However, the last figures we found for both countries at the same time had U.S. cost just shy of double the French cost, so the figures used in this video seem reasonable).

Don’t forget to use the Comments area below to share your ideas and reactions, whatever they may be.

Or, what are our health care options, anyway?

In July 2009, an angry constituent confronted Rep. Bob Inglis (R-S.C.) at a town hall meeting. “Keep your government hands off my Medicare!” the man demanded. Inglis tried as he could to explain that Medicare was and had been from the beginning a government program, but the voter would have none of it.

That episode illustrates the level of confusion surrounding health care reform in particular and our health insurance system in general. For the record, Medicare is a single-payer system, though in recent years private insurance has made huge inroads in altering the system, aided and abetted by Congress. Since it is not purely single-payer in the broadest sense of “everybody in, nobody out,” it does not achieve the economies of scale a nation-wide all-inclusive single-payer system would. And of course, you have to be 65 to be eligible for Medicare.

Our very own socialized medicine

The Veterans Administration (VA), on the other hand, is an example of socialized medicine, since the providers of the healthcare are government employees and the hospitals are all government facilities. So we do indeed have socialized medicine in this country. It is just (ironically) that it exists where most people least expect it—within and on the periphery of the military.

Neither system is inherently bad, though generally Medicare seems to get higher marks from its constituency. The problem with both systems, contrary to what most people believe, is that they are the poor boys of the healthcare system. Because they cater to two groups that have relatively little power compared, say, to the insurance industry—namely, the elderly and veterans—Medicare and the VA system get relatively little attention from Congress.

… and our single-payer system under attack

Let’s be clear that what makes Medicare single-payer is the formula of a government-sponsored payment plan for privately administered healthcare. To the degree that this model is adhered to, Medicare is popular among those it covers. Most of the problems with the Medicare system stem from its concessions to the prevailing external system of private insurance companies. The best example of this single-payer model gone astray is Medicare Part D, which covers reimbursement for prescription drugs.

This system is so complex even pharmacy professionals were totally confused by it for the first year or so it was in effect. It illustrates the downside of having a health care system dominated by the insurance and pharmaceutical industries.

For one thing, when Medicare Part D was passed in 2003 to become effective January 1, 2006, it required seniors to purchase insurance to cover prescription drugs. In a good single-payer system, pharmaceuticals would be covered the same as laboratory tests or doctor visits. Depending on the system, there might or might not be a small copay. But all these issues should be transparent to the patient.

Part D is completely different. There is none of the beauty and economy (for the consumer) of universal coverage. Instead, we have an enigmatic system that has both reduced coverage and increased costs at the same time—precisely what happens when private insurance gets the upper hand.

What’s more, once Part D went into effect, enrollees had to sign up for these benefits within a short period of time or be penalized. (All this from a group of patients whose predominant source of income was presumably Social Security!) As one of our senior readers pointed out in a private correspondence,

Obama says [he wants to cut spending on] Medicare, but that delivered benefits to patients will not be cut. Apparently, he wants to get back some of the money the insurance companies have been stealing. (For example, when Medicare-D was introduced by the Bush League, the insurance companies slashed benefits, increased premiums, raised copayments, and just kept all the extra money the government was giving them.)

Belatedly, the Democrats figured out what was happening. But Obama doesn’t say how he intends to stop the insurance companies from stealing the money. The insurance oligopoly just does whatever it wants unless there is a single-payer system or at least a government-run competing option. But unless Obama can straighten out Medicare, I have no confidence he will straighten out the larger system. It is about time for him to stop talking bipartisanship and to start exposing all the whores and thieves. Here is a perfect opportunity to show why we need a single-payer system—to prevent the sort of larceny that occurred with Medicare-D.

Indeed, an essential part of that larceny was a provision passed by Congress that forbids Medicare from negotiating drug prices with the pharmaceutical companies. Medicare has to pay whatever price the drug companies ask. Yet, given its large constituency, the Medicare system is in an enviable position to exact savings on the part of the seniors it represents. (The VA, in fact, does do this for veterans.) But for Medicare, that practice is strictly forbidden by law, costing taxpayers billions annually.

Given these shortcomings in our existing single-payer system, it is easy to see why so many citizens throw up their hands and shy away from health care reform altogether, even if they have managed to figure the whole system out. But Medicare could be made much better by keeping it to the pure single-payer model rather than saddling it with all the trappings of our private insurance system.

Private delivery of publicly paid care

What’s good about Medicare is that it leaves the healthcare delivery side of the equation alone. You can go to your existing doctor or find another one if you like. (Not all doctors accept Medicare, but then they aren’t all in the same “networks” of existing private PPOs, either. So for those who think they’ve just found a major shortcoming in the single-payer system, nice try—but it’s a wash.)

Walking away from healthcare reform just leaves the thieves and liars to run the show. Far better to exclude them altogether. A pure single-payer system is the only option that makes total sense, because it stands to save the public $4 trillion over the next 10 years, while simultaneously extending coverage to the 47 million or so Americans who are currently uninsured.

That’s why it becomes the least expensive way to cover everyone. By absorbing the money now taken by the insurance industry for overhead and profits and putting that money towards health care, we can add the uninsured to our rolls without increasing overall costs. Suddenly, you don’t have to worry about losing your insurance should you lose your job or about becoming uninsurable because of a prior illness. The current private healthcare system makes it a practice to remove people from its rolls once they begin to need its services.

Choices aren’t always what they’re cracked up to be

Adding a vague “public option” into the mix of private plans providing meaningless choices such as HMO vs. PPO, deductibles vs. copays, should be considered only as a fall-back position in the event that all else fails. We envision a single-payer system in which you get care from your hospital or doctor and the government pays the bill—a healthcare system that is privately administered but publicly funded.

The halfway measure of adding a government-sponsored insurance alternative to the current bewildering array of private plans is not only unnecessarily complex and inefficient, it will simply cost more compared to straightening out Medicare and extending it to all U.S. citizens.

We suggest you write your Congressman and tell him that.

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While writing this editorial, we have noticed a few interesting things happening in the media. One is an exchange between CNBC’s Maria Bartiromo and Rep. Anthony Weiner (D-N.Y.) captured on MSNBC.

We had always respected Bartiromo as a business journalist, though we haven’t watched CNBC in years. So we were surprised when she began spouting shop-worn platitudes in the course of this discussion. The notion, for example, that the availability of Erbitux is the barometer by which we judge a healthcare system is totally bonkers. And how many people in this country have access to it via private insurance anyway? We would like to know. (If you have been given Erbitux and had it paid for by your private insurer, please use our comment form below to let us know about it.)

We thought the best commentary on the Bartiromo incident came from Rolling Stone political commentator Matt Taibbi, who wrote about it on his blog post, Maria Bartiromo shows us how media has helped sandbag health care reform:

I was a guest on MSNBC’s “Morning Joe” to talk about health care and Bartiromo, who used to work closely with a relative of mine at CNN, was friendly before the segment started. So I was surprised when the show started and Bartiromo went on the attack, asking me how I could say America didn’t have the best health care in the world. Everyone, she said, would choose to be treated in America if they could.

I was staggered for a moment, I admit it, because I thought she was kidding at first. We were probably a full minute into the debate before I realized it wasn’t a joke. And here’s the really funny part: toward the end of my appearance, I said something about how health care in America is great, if you’re an executive at Goldman, Sachs. Then I left the set and… guess who they brought right afterward on to rip me and praise the American health care system? Bartiromo’s colleague at CNBC, Erin Burnett, a former Goldman, Sachs executive.

Bartiromo, both with me and in this spot with Weiner, has been hammering home the same point, that the proof that a public option won’t work can be found in the fact that the public health care system in England will not pay for the colorectal cancer drug Erbitux. I guess she is trying to say that there is rationing of health care in a single-payer system — that the fact that the government will not pay for the most expensive non-generic cancer drug on the market is proof that we shouldn’t have a public option in the U.S.

It drives me crazy when people make this argument. [A] fancy boutique drug like Erbitux[!] I have a very expensive private plan and I can’t even go to a doctor, not even to ask a simple question, unless it’s an emergency. I can’t get a routine checkup, can’t find out what that weird lump in my left foot is, can’t have the pleasure of a routine proctological exam unless I want to pay cash for it, and, well, forget about getting a filling replaced or seeing a therapist to deal with my incipient nervous collapse/burgeoning mid-life crisis.

Hell, forget about paying for Erbitux, if I wanted to get a colonoscopy to find out if I needed Erbitux, I wouldn’t be able to — I’d probably have to wait until I was a fully symptomatic cancer patient before I could even have that conversation on my insurer’s dime. And I’m one of the lucky ones, I actually have money to pay for care out of pocket, if I had to. No country in the world rations care more than the U.S. There are whole generations of Americans (20-40 year-olds in particular) who don’t know what it is to be able to go to a doctor for preventive care or routine checkups. Erbitux, for Christ’s sake! Give me a break.

To watch this short interview and see what your take on the whole thing is, click here. Don’t forget, then, to tell us all what you think about it by clicking on the red text, “leave a comment” in the grey box that marks the end of this posting. That will open up the comment box (if it isn’t already visible) below the posting itself.

Franken, the senator

Another video that hit the wires recently was of Al Franken (D-Minn.) calming down constituents at the Minnesota State Fair. This impromptu discussion is well worth watching, because Franken gives a generally good primer on health care reform issues.

We admit we had our doubts about Franken as a serious lawmaker before, but he shows here that he has the “people skills” it takes to show and earn respect in politics. So far as we’re concerned, that and the level of sensitivity and intelligence he demonstrates here is all he needs. We predict good things to come from this senator and wish him well. The exchange is here.

And to show just how ugly things can get (without even going into the incident in which a man had part of his finger bitten off) here’s a tape from the Star Ledger in New Jersey showing the shoddy treatment given a disabled woman in a wheelchair who tried to speak up about her situation in a New Jersey town hall meeting. There’s much more to it than that, but we’ll let you see for yourself here. Excellent work by the Ledger reporter, Brian Donohue.

There’s one misconception in this video that you should be aware of: Medicare is not socialized medicine, though the VA system is. Medicare, as we said before, is primarily a single-payer system, though private insurance, through its agents in Congress, is making inroads into corrupting that system. And while the narrator is certainly entitled to believe in tort reform, in reality that is a side issue completely unrelated to health care reform. As a pseudo issue, it’s been cleverly planted, we believe, by the opponents of health care reform. We agree with him about the importance of disease prevention and health maintenance in general, but again—those issues are not directly related to health care reform, if by that we understand the matter of reforming health care insurance, or in other words, the ways that we pay for and distribute health care.

Maria Bartiromo and Rep. Anthony Weiner (D-N.Y.) mix it up on MSNBC.

Al Franken (D-Minn.) shows his stuff in calming down a potential angry mob.

Frankly, we weren’t scheduled to post this until tomorrow, but in light of yesterday’s announcement of the $2.3 billion settlement between Pfizer and the U.S. Department of Justice, it just seemed too a propos to postpone.

Our thanks to Eleni Prokopeas for having posted this video on her site, Green Diva Mom, thereby bringing it to our attention. We liked it enough that we thought you would enjoy seeing it here.

Bill Maher does one of his send-ups—and this time, the patient is Big Pharma.

With all the news about the autism epidemic and talk of mandatory flu vaccinations this fall, many parents and parents-to-be are distraught at the notion that their children will have to be vaccinated. What to do?

Here is sound advice from Leila Masson, MD, MPH, a pediatrician who specializes in autism. She covers pre-natal issues as well as how to care for your child during those critical first years.

While you are waiting to read our exposé on factory farming and swine flu (which should finish final editing in the next 24 hours) you can watch this video from the Pew Commission on Industrial Farm Animal Production.

As we hope to show in greater detail over coming weeks,  the trend in agriculture toward large farms has changed our rural landscape and is affecting not only our national health, but the health of humans globally along with their environment.

According to the United States Department of Agriculture (USDA), 40 percent of people in rural areas lived on farms in 1950. Now USDA statistics reveal that less than 10 percent of the rural population lives on farms and that only 14 percent of the rural workforce is employed in agriculture.

Some rural areas thrive as they become home to commuting professionals, but some just sink deeper into isolation. This helps to explain why in 2003 14.2 percent of the population living in rural America were poor, while the poverty rate in metropolitan areas was 12.1 percent, a disparity that has been constant for several decades.

As for the farming trends themselves, in 1980, approximately 65,000 farmers in the state of Iowa raised hogs, with an average of 200 hogs residing on each farm. By 2002, the number of farms with hogs had fallen to about 10,000, but the average number of hogs per farm had risen to 1,400. Similar trends toward industry concentration have been in effect in North Carolina, which is the second largest pork producer in the U.S. As early as 1993, 13 percent of the producers in North Carolina were responsible for 95 percent of that state’s total swine production.

An interview with Linda Faillace, author of Mad Sheep

The National Animal Identification System is another of those government ideas that sounds so right on the surface but goes so wrong in the implementation details. Basically, it is a nationwide registration system for animals and the sites where they are kept. It has been causing a major uproar within the farming community, as it is a burden to small farmers, among others.

It will affect you too if you keep any sort of farm animals such as chickens, sheep, goats, horses, etc.—but if you do, you undoubtedly already know this.

We’ve been preparing a piece on this subject, but in the process we came across this video that gives you an excellent summary of what’s involved. So we thought we’d provide a video introduction, then look to converting our investigative reporting to a background article or editorial.

Most of our readers have probably never heard of NAIS. If you fall into that category, the video below will be a real eye-opener. The presenter is Linda Faillace, author of Mad Sheep:The True Story Behind the USDA’s War on a Family Farm, who knows a thing or two about dealing with the USDA as a small farmer.

Don’t forget to click on Leave a Comment (in the grey bar below the video) and let us know what you think about this issue, as with all our posts.

We can’t say we’ve yet read Barbara Kingsolver’s popular book, Animal, Vegetable, Miracle: A Year of Food Life. However, assuming the following quotes excerpted from her interview on another channel are representative of her work, we look forward to doing so:

On average, 85 cents of every food dollar goes to the processors, packagers, advertisers and oil companies who profit handsomely from our lack of regard for soil, water, climate and the future. Farmers have no choice but to respond to consumer demand. They can only grow what we will buy….

It’s not “natural” that organic and whole foods cost more than tallow-fried junk. We choose that through our tacit approval of the Farm Bill that defines food and nutrition policy in this country. We’ve elected to subsidize corporate commodity farms while leaving small, diversified fruit and vegetable farmers on their own, trying to compete. For organic farmers it’s even worse-–-we make them pay for their own inspection and oversight. If we’d like to flip this over and subsidize healthy rather than unhealthy foods, we can call our legislators and start talking. This is a good time to do it, because the Farm Bill is being renegotiated at this moment.

We think Ms. Kingsolver’s notion of contacting your legislative representatives is a good one. To make it easier, you can find contact information for all your U.S. government officials here. (In fact, this source will show you how to contact your state representatives as well.)

As for the Farm Bill, it has passed the House and is now being debated and modified by the Senate. You can find additional information and ideas about what the Farm Bill might better include at OxFam America. As a general guide, agribusiness doesn’t need help to keep going. But small farmers—who have to compete with the large farms and their economies of scale—can use all the help they can get. They are the main source of hope for healthy and sustainable—not to mention local and organic—agriculture.

Thus, while “farm subsidies” has become a near-epithet for many in recent years, we shouldn’t overlook aid to small farmers, particularly those who are bucking the current trend in conventional agriculture by producing organic farm products. As Ms. Kingsolver points out, why should organic farmers have to bear an additional economic burden in paying for inspection and oversight to make sure they are farming in a way that we should all hope they do? Perhaps the U.S. should pay more attention to subsidizing small-scale, sustainable, organic farming techniques so that we can all have healthier choices of food that don’t degrade the environment.

It’s a good idea to let your representatives know how you feel about topics such as the Farm Bill, organic farming, and genetic modification. And if you’re not sure how you feel about those topics, go to our site search or our category listings on the left sidebar and find articles we’ve provided on these subjects.

We hope to be bringing you more in the near future. Come to think of it, you might even use the Make a Donation button at left to help assure that we can.

[Editor's Note: We used to have a link to Dan Rather's thought-provoking coverage of the U.S. Farm Bill on video. However, that video no longer appears to be posted for free. To read a transcript of that report in PDF format, click here. To search for a reference to the original clip, try HD.net.]