At the same time that so much attention has been on the Supreme Court’s decision about the Affordable Health Care Act this past week I have been reading some remarkable books about health, care, and the ways in which the health care system has fallen far short of what it could be. What is stunning in what I have read is that many of the things that could make a huge difference in the quality of health and care we could have (not to mention how much we spend on health care as a country) are A) already known, and B) not that expensive or high tech. In other words, there appears to be a lot of low-hanging fruit, just, well, hanging there.
Even though these books were new reads for me, they aren’t newly published. Maybe I missed all the hype when they were new, or maybe there wasn’t as much hype as there should have been. But if you haven’t read them, and you care about the cost and quality, and the future of your health, I suggest you should.
First I read Gary Taubes’ Good Calories, Bad Calories, published in 2007. It is a large book dense with his descriptions of what is known (through research and clinical trials) about how our bodies use food, and how the government, public health officials, and clinicians have advised the public over the last half-century.
Taubes spent years combing through research, reading conference transcripts, and interviewing people. He has done an incredible job of making it all understandable (yes, you may find yourself re-reading paragraphs or whole sections, and it’s totally worth it), but an even more impressive job of calmly conveying what amounts to evidence that the U.S. public has been getting exactly the wrong information about what to eat to not only stay lean, but to have the best chance to avoid many of the diseases that plague our families and our population: type 2 diabetes, cardiovascular disease, cancers, and even Alzheimers. Let me repeat that bit because it is hard to believe, I know– exactly the wrong information.
If what Taubes has uncovered and is conveying in this book turns out to be true– and he makes a brilliant case– then the health care system, public health officials, and government officials owe all of us a HUGE apology. As soon as possible. And First Lady Michelle Obama needs to read this book and Adjust her, otherwise well-intentioned, initiative to encourage kids to get to healthy weights.
In 2010 Gary Taubes published a shorter version of the first book about diet and health. It is titled Why We Get Fat, and What To Do About It. Although this could be considered a more user-friendly version, it’s certainly not dumbed down, probably because the information is so critical, and Taubes doesn’t underestimate the public’s ability to get it. The title’s a bit unfortunate since it’s about so much more that being fat and wanting to do something about it. Anyone who eats food needs to read one or both of these books. Gary Taubes has done the public an incredible service. Thank you Gary Taubes.
Then I read Evan Handler’s 1997 book Time on Fire: My Comedy of Terrors. The book is his memoir about being diagnosed with leukemia and his journey through the health care system as he does battle — not only with the disease– but with incompetency, rudeness, outsized egos, and also excellence. There are a lot of memoirs about struggling with all manner of health problems, but what made me seek this one out was that I heard Handler being interviewed on NPR. I was half listening until he said “I name names.” And he does, the good, the bad, and the outrageously inconsiderate: hospitals, doctors, nurses, and assorted care providers. Thank you for that Evan Handler. It’s about time.
Shortly after Barack Obama was elected some journalists had fun writing about whether Obama would be able to keep his beloved Blackberry after the inauguration. Security folks reportedly considered it a risk for the President to be carrying an electronic device that might give his location or movements away. Obama’s argument for keeping his own phone included that it would be a way for his “outside” life to keep him in touch with reality. He said he liked the idea that if he lost touch with the ‘real world’, and got too caught up with inside-the-beltway- thinking, one or more of his old friends could call him up and say, “Hey, what the heck are you doing?”
I haven’t heard anything recently about whether Obama still has his Blackberry but I’ve been thinking about it lately. Maybe it’s our last hope. So, whoever you are out there who has that number, please, dial now. Say, “Listen pal, you need to get real. You need to give some sign that you get it that people want you to push out a bold and specific, and BIG, plan. The time is ripe and people are ready to climb on board with you if you will just let them know you are going to get your hands dirty and work right alongside them. Ask for sacrifice and you will get it. And my friend, you can NOT get away with that ’you’ll always be AAA in my book’ crap.” (And if the Necco Company doesn’t immediately start printing that on those little candy hearts, they are missing a great opportunity.)
Then tell him that at the very least he needs to fire all his speech writers, and replace at least half of his advisors. Tell him to get angry and to make sure people know it. Then tell him to hang up and get busy writing a serious plan to present to the American people.
If he rationalizes, whines, or says don’t worry, Congress will eventually come up with a compromise…then it’s time to hang up and give that Blackberry number to the rest of us.
Okay. A commentator’s recent suggestion that “revolution is on the table” is, thankfully, still greeted in most parts with surprise and dismay. Come a time that we aren’t surprised when commentators say this, then… Anyway, it should come as no surprise that people are getting pretty fed up, feeling that the public’s voice has pretty much come unhinged from Washington. Washington, instead, has become ever more tightly hinged to — money. Here is what Robert Reich writes in his book Aftershock, about the indirect, but nonetheless, potent effects of money:
No policy has been altered, no bill or vote willfully changed. But inevitably, as the politician enters into these endless social rounds among the networks of the wealthy, his view of the world is affected. Increasingly, the politician hears the same kinds of suggestions, the same concerns and priorities. The wealthy do not speak in one voice, to be sure, but they share a broad common perspective. The politician hears only indirectly and abstractly from the less comfortable members of society. They are not at the coffees and dinners. They do not tell him directly and repeatedly, in casual banter and through personal stories, how they view the world. They do not speak continuously into the politician’s ear about their concerns. The politician learns of those concerns from his pollsters, and from occasional political appearnaces back in his home district, but he is not immersed in them as he is in the culture of the comfortable. In this way, access to the network of the wealthy does not necessarily buy a politician’s vote. It buys his mind. (pgs 109-110)
…Perhaps the most convincing evidence that the game is rigged is the deafening silence about all this. You would think political leaders would talk about the nation’s surging inequality and the flattening of middle-class incomes. But as the divergence in income and wealth has grown to stunning proportions, it is rare to find even a Democratic politician who dwells on it. (pgs 113-114)
As CNBC’s Rick Santelli once famously screamed, “President Obama, are you listening to this?”
So. We who live in the mid-atlantic are bracing for another large snow storm. Snow shovels are sold out (I couldn’t even find one in stock on Amazon), and hardware stores are putting piles of water softener salt near the front of the store for people to use on sidewalks and steps. The TV pundits (in an amazing and fleeting display of nonpartisan and unbiased commentary) are all concurring in saying that Washington, DC was, and still pretty much is, shut down with the two feet of snow they got. More is on the way, and so they are fretting that DC will be shut down even longer while they dig out yet again.
But how, I wonder, will we be able to tell when Washington starts up again? I haven’t noticed much getting done there for quite some time. A very, very long time in fact. So here’s a modest proposal. Maybe it would be a kindness to us all if DC would stay snowed in until about, oh, maybe the Fourth of July. That would be a nice patriotic time to start up again. And maybe a few months of isolation during which to reflect, do some stretching exercises, and examine and re-order their priorities would give them (and us all, for God’s sake) a breather and a fresh sense of possibility. I know I could use a break from hearing about how little they are getting done…I can only imagine how exhausting it must be for them- there in the thick of all that lack-of-progress. It must be mind-numbing.
So let’s let DC save some money, give the road crews and public transportation employees a nice long vacation, and let the snow fall where and as deep as it may. Let’s let it stay on the ground until the sun stays out long enough to melt it (as God probably intended anyway). And if the snow eventually buries the city completely? Let’s reconvene (online) at that point and talk about picking a new location to be our capitol so we can start over from scratch. There now. Well I don’t know about you, but as the snow begins falling here, again, I am feeling almost…yes, definitely…hopeful.
(The following is my reply to New York Times Consults blog January 10, 2010 article by Dr. Sheila Crowe.)
Five months after being diagnosed with Celiac Disease (at the age of 59) one of the most baffling things about the way the medical community views this disease (and there are more than a few) continues to be the perverse insistence that people shouldn’t adopt a gluten-free diet on their own…that it might lead to things like: inability to get a “definitive” diagnosis (so eat gluten again for a while and then test if you want to…or not, by that time a “definitive diagnosis” is not the objective for most people- whose needs are the priority here?); greater expense (almost all foods as grown or raised are gluten-free – how have we reached the point in our view of “food” that we can only imagine mostly buying processed foods?); nutritional deficiencies (many if not most gluten-filled diets are already deficient for lots of reasons, anyone who starts paying close attention to what they eat is almost certainly going to be eating more nutritiously); that going on a gluten-free diet is a “life-long commitment” (sure, but only as long as you want to keep feeling better, and eat a less health-damaging diet – and let’s be real here, you can quit the diet any time you want to… if you want to. It’s like saying that “eating is a life-long commitment,” it’s a free country); and the amazing-to-me statement by Dr. Crowe that if someone diagnoses themself, “it may encourage family members to be screened for the disease, even though you may not really have it.”
Could I really have read that right?? That it might lead to MORE screening? More use of a simple blood test (my insurer paid $98 for the comprehensive Celiac Panel) that could allow someone to discover they have Celiac Disease and to drastically improve their quality of life, and minimize more damage to their health, all with just a change in diet? Then let’s hear it for people who take things into their own hands because they are tired of waiting for help from the medical community, or who have actually been turned down or belittled when they asked a health care provider whether they should be tested for Celiac Disease. Why isn’t everyone being told about and screened for Celiac Disease?
I feel that the health care system failed me- for decades- by letting the profit-seeking pharmaceutical companies, device-makers, technology providers, etc., determine the primary course and priorities for health-care providers in this country. I followed all the rules and they and the system let me down.
Even after decades of lactose-intolerance, some years with abdominal distention, eventual diagnosis with thyroid disease and then osteoporosis, no health care provider ever offered anything other than a new prescription. Eventually, I decided to look into it myself, and it took me all of a 30-minute Google search to discover that I almost certainly had Celiac Disease (and yes, blood work and intestinal biopsy confirmed that – for the doctors. I already knew it.) I also was amazed to learn that there is a home test, the Biocard Celiac Home Test (blood test for TTA) that costs about $40, is very accurate and specific (although not as inclusive as lab testing, but a great start) and although for sale in Canada and Europe…is not for sale anywhere in the United States.
The public is way ahead of most health care providers in this country when it comes to Celiac Disease and other varieties of gluten-sensitivity. Health care professionals had better figure out a way to catch up other than to criticize people who have decided to take responsibility for themselves by getting the help and information they need, even if they have to do it on their own.
One thing I have read recently (and I believe to be very much in evidence today) is that the health care system in the U.S. (even things we consider preventative) is largely driven by the drug industry; the things that get tested for, treated, etc. are things for which someone can make a profit. I recently learned (in spite of the health care system not because of it: armed with information gathered from the Internet I approached my own health care provider) that I have Celiac Disease. I have since been dismayed to learn that about 3 million people in the United States have this disease and 97% of these people have no idea they have it (studies indicate that 40% of people with the disease have NO symptoms at all) but will eventually have serious, and expensive-to-treat problems such as liver disease, lung disease, bone disease, cancers, or a whole bunch of other problems. My insurance company paid $98 for the blood work that diagnosed the disease and the completely-effective treatment is simply to follow a gluten-free diet (no wheat, barley or rye) that won’t cost anybody else anything. Why not screen everyone for this? Are there other things like this that could be screened for? Could the government set about identifying things like this (and widely disseminating information) that could be huge money-savers?
Have you been tested?
Watch it online – A compelling and provocative new video documentary about the public, health care reform, and the struggle to decide
You can now watch a compelling new documentary produced by the Kettering Foundation and ThinkTV about the choices confronting the public about health care reform. The 30-minute video was produced and narrated by Amy Lee of ThinkTV, a PBS station in Dayton, Ohio. The documentary, titled Coping with the High Cost of Care: Where is the Public Voice? can be viewed in three parts (each approximately 10 minutes long):