Bloomberg: Obama and Romney both miss the point on health care reform

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If you are anything like me, you have spent the last 10 days listening to President Barack Obama and his Republican challengers accuse each other of being the meanest miser when it comes to denying health care to seniors. Unless you are an actuary or have a fondness for, and facility with, budget math, you were probably left wondering what and whom to believe.



That’s the good news. The bad news is, nothing that has been enacted (the Patient Protection and Affordable Care Act of 2010) or proposed (Republican Representative Paul Ryan’s “Path to Prosperity”) addresses the fundamental problem plaguing the U.S. health-care system: It is designed to manage disease rather than promote wellness.

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http://www.bloomberg.com/news/2012-0...my-health.html

"manage disease rather than promote wellness"

sick-care system, esp Big Pharma, doesn't get paid for curing disease, it gets paid for return, preferably life-long visits, and for sickos taking BigPharma crap, much of which does nothing, for fake diseases, and does harm that requires more BigPharma crap to counter side effects.

Quite a naive Bloomberg writer to say the $2.5T sick-care business should stop sickness! :lol "It's A Business"

don't guess you read the damn article. there are outcome based pilot programs already in existence.

it would be naive to predict her proposed paradigm will be adopted, but not at all to suggest it as a possible solution.

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Originally Posted by Winehole23

don't guess you read the damn article. there are outcome based pilot programs already in existence.

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pilot programs? in a $2.5T/year system?

get back to us in the decade any system-wide change is made in reducing costs AND improving outcomes.

ACA penalizes hospitals for high rates of re-admittance, etc, etc.

It's a huge wealth-sucking system, and it's HUGELY resistant to having its wealth (aka out costs) reduced.

ACA reduces payments to for-profit providers (not reducing care) while Ryan's cruel budget makes (impoverished) seniors pay more while protecting income for providers. AKA, there's a real choice between Obama and Gecko.

you go for the Democrat's vaporware. give yourself a gold star.

oh wait, you already did.

nation-wide ACA is better, more than a pilot program in getting, eg, hospitals to reduce their readmission rates.

The justification for the rule is that many hospitals have horrible readmission rates vs the average. Now it will cost them where it really hurts, in their bank account.

Terrible article.

Hospitals and physicians do "promote wellness" but they cannot save people from themselves. The obesity, diabetes, cardiovascular disease epidemic is not unique to this country. Changing people's views on diet & lifestyle is beyond the control of the healthcare system.

She also fails to mention the aging demographics of our country that are and will continue to increase healthcare costs. That too is not something the healthcare system can change.

Then she list hospital error and hospital borne infection as the 3rd leading cause of death but her own link to back that statement up lists chronic lower respiratory disease as 3rd. Smoking is the leading cause of chronic lower respiratory disease not our healthcare system. Hospital borne infections are often used as an indictment of our healthcare system but statistically we are inline with most every other healthcare system. They are labeled a "preventable" illness yet no healthcare system in the world has been able to prevent them.

Her grand conclusion

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Health care is a complicated subject

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No shit lady.

it's an op-ed not a white paper. pivoting from treatment to wellness and prevention doesn't seem like such a horrible idea to me.

Wellness and prevention requires effort on our part and we're not interested in effort on our part. Let us eat/drink/smoke/sit on the couch as much as we want and just give us the pill that will allow us to avoid the health consequences of our actions.

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Originally Posted by Winehole23

it's an op-ed not a white paper. pivoting from treatment to wellness and prevention doesn't seem like such a horrible idea to me.

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It's a great idea but not really within the control of healthcare professionals. My wife spends everyday with people who need to make changes to their lifestyle but when she brings up diet to the overweight person most of them literally roll their eyes at her. So she treats their self inflicted chronic illnesses with drugs, what else can she do?

She has taken to recommending this movie to her patients...
http://movies.netflix.com/WiMovie/70...vieid=70185045

A very small number of people have followed the diet and have seen dramatic positive changes in their health but most won't even consider taking responsibility for their own health.

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Originally Posted by SnakeBoy

She has taken to recommending this movie to her patients...
http://movies.netflix.com/WiMovie/70...vieid=70185045

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Thanks. Added to instant queue.

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Originally Posted by Th'Pusher

Thanks. Added to instant queue.

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Sure. I hope you give it a try. The difference in how you feel is amazing and it is really pretty easy to switch. Unlike "diets" you don't limit how much you eat just what you eat, so you never go hungry.

This is Dr. Esselstyn's son's site which is good for more info/recipe's etc.

http://engine2diet.com/28-day-challenge/welcome-video/

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Originally Posted by SnakeBoy

Sure. I hope you give it a try. The difference in how you feel is amazing and it is really pretty easy to switch. Unlike "diets" you don't limit how much you eat just what you eat, so you never go hungry.

This is Dr. Esselstyn's son's site which is good for more info/recipe's etc.

http://engine2diet.com/28-day-challenge/welcome-video/

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ugh, that wouldn't work for me.

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Originally Posted by ElNono

ugh, that wouldn't work for me.

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Why is that?

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Originally Posted by SnakeBoy

Why is that?

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Because no meat, no milk, lotsa veggies... just wouldn't work for me. I can see how it would work for people that are hungry all the time, that's just not me.

I've actually lost 15+ pounds by just avoiding High-fructose corn syrup... it's pretty crazy.

Before coming to this country about a dozen years ago, my weight was always about 150 pounds, pretty skinny guy, and my diet was meat, milk, soda, etc... just moderate portions. But here even if you eat moderately, the food just fatten you the fuck up. There's high-fructose corn syrup on almost everything (Soda back in south america is made with cane sugar).
I got to 235 and just said enough with this shit. I'm under 220 now and still going down, but goddamn you have to look at what you eat.

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Originally Posted by ElNono

Because no meat, no milk, lotsa veggies... just wouldn't work for me. I can see how it would work for people that are hungry all the time, that's just not me.

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It doesn't require that you eat alot. For breakfast I had 2 slices of whole wheat toast w/jalapeno hummus spread, lunch was my version of "Rip's Big Bowl' cereal from the site, and dinner was an awesome meatless/cheeseless veggie lasagna I made.

I'm not trying to convince you, just sayin.

I think it's possible to avoid health problems without completely eliminating meat, eggs, dairy, processed oils & sugars from your diet if you eat them in moderation but for most people moderation means every single meal of their lives.

Your reaction though is typical of what my wife gets from her patients...no way! And these are people with serious chronic disease. So they get to pop pills and complain that doctors don't cure them of themselves.

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Originally Posted by ElNono

I've actually lost 15+ pounds by just avoiding High-fructose corn syrup... it's pretty crazy.

Before coming to this country about a dozen years ago, my weight was always about 150 pounds, pretty skinny guy, and my diet was meat, milk, soda, etc... just moderate portions. But here even if you eat moderately, the food just fatten you the fuck up. There's high-fructose corn syrup on almost everything (Soda back in south america is made with cane sugar).
I got to 235 and just said enough with this shit. I'm under 220 now and still going down, but goddamn you have to look at what you eat.

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That's great but don't fool yourself into thinking cane sugar is "healthier". The research is becoming pretty clear that they have the same effects on your health. The difference is, as you found, corn syrup is in everything. So people are consuming far more of it. It amazes me when I read the ingredients on things in the grocery store. Half of the time I'm wondering "why the hell would they put it in this?".

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Originally Posted by SnakeBoy

It doesn't require that you eat alot. For breakfast I had 2 slices of whole wheat toast w/jalapeno hummus spread, lunch was my version of "Rip's Big Bowl' cereal from the site, and dinner was an awesome meatless/cheeseless veggie lasagna I made.

I'm not trying to convince you, just sayin.

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I get you. Just a sampler why that wouldn't work for me:
1) don't like spicy food (jalapeño)
2) don't like hummus spread
3) don't like nuts on their own
4) don't like milk substitutes (I already drink 2% which is the closest to me that actually resembles milk)
5) don't like lasagna

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Originally Posted by SnakeBoy

I think it's possible to avoid health problems without completely eliminating meat, eggs, dairy, processed oils & sugars from your diet if you eat them in moderation but for most people moderation means every single meal of their lives.

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Well, I've seen that first hand. My family (knock on wood) has always been pretty healthy. No obesity, no diabetes, no health problems in general either, most of those that passed away were 80+ years old.

But it's more than just diet, it's also cultural. From the size of the plates (my wife was shocked with the smallish size of the plates everywhere down south :lol), to the actual portions filling those plates, to even when to eat (I grew up with a fairly different schedule than here in the US: light breakfast, moderate lunch, just tea or coffee in the afternoon and moderate dinner).

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Originally Posted by SnakeBoy

Your reaction though is typical of what my wife gets from her patients...no way! And these are people with serious chronic disease. So they get to pop pills and complain that doctors don't cure them of themselves.

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Well, this is all new to me, tbh... I don't really mind eating less if I have to (I don't eat much in general and sometimes skip meals entirely), or avoiding certain types of junk like snacks or high fat meat. But you're going to have to pry the filet mignon from my cold dead hands, tbh...

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Originally Posted by SnakeBoy

That's great but don't fool yourself into thinking cane sugar is "healthier". The research is becoming pretty clear that they have the same effects on your health. The difference is, as you found, corn syrup is in everything. So people are consuming far more of it. It amazes me when I read the ingredients on things in the grocery store. Half of the time I'm wondering "why the hell would they put it in this?".

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But that's the thing. You don't find cane sugar in freaking everything down there. It's just crazy over here with that stuff.

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Originally Posted by SnakeBoy

That's great but don't fool yourself into thinking cane sugar is "healthier". The research is becoming pretty clear that they have the same effects on your health. The difference is, as you found, corn syrup is in everything. So people are consuming far more of it. It amazes me when I read the ingredients on things in the grocery store. Half of the time I'm wondering "why the hell would they put it in this?".

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I'm sorry. I don't care what research says about corn sugar vs. high fructose corn syrup. There is a difference in how it's metabolized. I would suggest that these researchers might be getting paid to make such claims.

Ask Scott how different types of sugar metabolize in a beer making process. Not saying it's the same for the body, but that there are difference. Don't expect the body to treat them the same. Yeast doesn't.

nevermind

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Originally Posted by ElNono

But you're going to have to pry the filet mignon from my cold dead hands, tbh...

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The last time I ate meat was two weeks ago tomorrow. It was fillet mignon with king crab legs and it was delicious :).

Tomorrow is eat what you want day again for us (every other saturday)..moderation.

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Originally Posted by SnakeBoy

The last time I ate meat was two weeks ago tomorrow. It was fillet mignon with king crab legs and it was delicious :).

Tomorrow is eat what you want day again for us (every other saturday)..moderation.

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That's the key... and discipline too...

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Originally Posted by Wild Cobra

I'm sorry. I don't care what research says about corn sugar vs. high fructose corn syrup. There is a difference in how it's metabolized. I would suggest that these researchers might be getting paid to make such claims.

Ask Scott how different types of sugar metabolize in a beer making process. Not saying it's the same for the body, but that there are difference. Don't expect the body to treat them the same. Yeast doesn't.

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Well first, I think corn sugar and hfcs is the same thing. Did you mean cane sugar?

I didn't say there were no differences between the two. There are some differences between how hfcs and cane sugar are metabolized. The only point I was making to El Nono is that a diets high in corn syrup or cane sugar are equally unhealthy. It is the amount of sugar consumed that is most important healthwise. So drinking 5 cane sugar sodas instead of 5 corn syrup sodas is not healthier.

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Originally Posted by SnakeBoy

Well first, I think corn sugar and hfcs is the same thing. Did you mean cane sugar?

I didn't say there were no differences between the two. There are some differences between how hfcs and cane sugar are metabolized. The only point I was making to El Nono is that a diets high in corn syrup or cane sugar are equally unhealthy. It is the amount of sugar consumed that is most important healthwise. So drinking 5 cane sugar sodas instead of 5 corn syrup sodas is not healthier.

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Yes, I meant cane sugar. Sucrose.

LOL... I would argue that it's less unhealthy to have something with sucrose vs. something with the High Fructose Corn Syrup. Still, I agree that neither are healthy.

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Originally Posted by SnakeBoy

So drinking 5 cane sugar sodas instead of 5 corn syrup sodas is not healthier.

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While I don't necessarily disagree, for some fucked up reason I didn't use to gain weight with cane sugar based soda, but I did as soon as I moved to high fructose corn syrup soda... It might just be my metabolism.

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Originally Posted by ElNono

While I don't necessarily disagree, for some fucked up reason I didn't use to gain weight with cane sugar based soda, but I did as soon as I moved to high fructose corn syrup soda... It might just be my metabolism.

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I'm not sure, but I believe the body converts the HFCS much more rapidly to glucose than it does other forms of sugar.

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Originally Posted by ElNono

While I don't necessarily disagree, for some fucked up reason I didn't use to gain weight with cane sugar based soda, but I did as soon as I moved to high fructose corn syrup soda... It might just be my metabolism.

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Well age and metabolism has alot to do with weight gain. Plus you were on a different diet back then and probably not consuming as much hidden sugar (corn syrup). So your overall sugar consumption was probably much less than the american diet.

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Originally Posted by Wild Cobra

I'm not sure, but I believe the body converts the HFCS much more rapidly to glucose than it does other forms of sugar.

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Here...

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1. Sugar in any form causes obesity and disease when consumed in pharmacologic doses.

Cane sugar and high fructose corn syrup are indeed both harmful when consumed in pharmacologic doses of 140 pounds per person per year. When one 20 ounce HFCS sweetened soda, sports drink or tea has 17 teaspoons of sugar (and the average teenager often consumes two drinks a day) we are conducting a largely uncontrolled experiment on the human species. Our hunter gather ancestors consumed the equivalent of 20 teaspoons per year, not per day. In this sense, I would agree with the corn industry that sugar is sugar. Quantity matters. But there are some important differences.

2. HFCS and cane sugar are NOT biochemically identical or processed the same way by the body.
High fructose corn syrup is an industrial food product and far from “natural” or a naturally occurring substance. It is extracted from corn stalks through a process so secret that Archer Daniels Midland and Carghill would not allow the investigative journalist, Michael Pollan to observe it for his book, The Omnivore’s Dilemma. The sugars are extracted through a chemical enzymatic process resulting in a chemically and biologically novel compound called HFCS.

Some basic biochemistry will help you understand this. Regular cane sugar (sucrose) is made of two-sugar molecules bound tightly together – glucose and fructose in equal amounts. The enzymes in your digestive tract must break down the sucrose into glucose and fructose, which are then absorbed into the body.

HFCS also consists of glucose and fructose, not in a 50-50 ratio, but a 55-45 fructose to glucose ratio in an unbound form. Fructose is sweeter than glucose. And HFCS is cheaper than sugar because of the government farm bill corn subsidies. Products with HFCS are sweeter and cheaper than products made with cane sugar. This allowed for the average soda size to balloon from 8 ounces to 20 ounces with little financial costs to manufacturers but great human costs of increased obesity, diabetes and chronic disease.

Now back to biochemistry. Since there is there is no chemical bond between them, no digestion is required so they are more rapidly absorbed into your blood stream. Fructose goes right to the liver and triggers lipogenesis (the production of fats like triglycerides and cholesterol) this is why it is the major cause of liver damage in this country and causes a condition called “fatty liver” which affects 70 million people. The rapidly absorbed glucose triggers big spikes in insulin – our body’s major fat storage hormone. Both these features of HFCS lead to increased metabolic disturbances that drive increases in appetite, weight gain, diabetes, heart disease, cancer, dementia and more.

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Originally Posted by SnakeBoy

Well age and metabolism has alot to do with weight gain. Plus you were on a different diet back then and probably not consuming as much hidden sugar (corn syrup). So your overall sugar consumption was probably much less than the american diet.

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That's what I suspect... I'm here now though... so I'm keeping an eye...

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Cane sugar and high fructose corn syrup are indeed both harmful when consumed in pharmacologic doses of 140 pounds per person per year.

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That's a lot of sugar. More than 15,000 teaspoons of granulated sugar a year.

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Regular cane sugar (sucrose) is made of two-sugar molecules bound tightly together – glucose and fructose in equal amounts. The enzymes in your digestive tract must break down the sucrose into glucose and fructose, which are then absorbed into the body.

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This is where some people's body chemistry will treat the amount digested differently.

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(HFCS) Since there is there is no chemical bond between them, no digestion is required so they are more rapidly absorbed into your blood stream.

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Originally Posted by ElNono

That's what I suspect... I'm here now though... so I'm keeping an eye...

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Still, HFCS require no enzymes to break them down for absorption like sucrose does.

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Originally Posted by Wild Cobra

That's a lot of sugar. More than 15,000 teaspoons of granulated sugar a year.

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That's the avg sugar consumption in the us.

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Originally Posted by SnakeBoy

That's the avg sugar consumption in the us.

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Probably because of the soda kids and even adults drink.