How we got into this health insurance mess

In 1903, The Baptist Church founded a hospital at Baylor University Medical Center in Dallas, Texas. By the 1920s, more and more people were coming for treatment, many of whom were unable to pay their bills. To address this problem, Baylor’s vice president offered insurance to the local teachers’ union. For $6 a year, teachers were entitled to a twenty-one-day stay in the hospital, all costs included.

Within a decade, the model spread across the country and the program was given a name: Blue Cross, a not-for-profit organization at that point. By 1939 three million people had signed up for insurance. However, most people—including my family—did not have health insurance. At that time, treatments were unsophisticated and cheap. We paid out of pocket. But as technology and treatments became more complicated, costs began to rise. At this point, we could have filled the need with a publicly-funded system, as the Brits did in 1948, or even with private insurance sold direct to customers, like car insurance. But a quirk of history nudged us toward employer-based health insurance.

When we entered WWII, a huge part of the workforce was sent off to fight, causing labor costs to rise. To keep the costs from skyrocketing, the Roosevelt Administration imposed a wage freeze—a move that made it more difficult for companies to attract workers. So the Administration permitted increases in health-insurance benefits and made them tax exempt. Ever since, we have been trying to figure out how to cover the vast portion of the country that doesn’t have employer-provided health insurance. No other country in the world has built its health-care system this way. As Dr. Atul Gwande says, we have an “unhnoly, expensive mess that leaves millions unprotected.”

“In a country where pretty much everyone has trash pickup and K1-12 schooling for the kids, we’ve been reluctant to address our Second World War mistake and establish a basic system of health-care coverage that’s open to all.” Seems like a no-brainer to me.

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Iranian-style heath care in Mississippi

An organization called HealthConnect in Mississippi has adopted an Iranian health care model as a way to address a health care crisis. In the early 1980's, Iran created 17,000 “health houses” to care for the rural poor. The houses are within walking distance. If people need more complex care, they go to a regional center or to a hospital. 

Mississippi has some of the worst health statistics in the country: uncontrolled diabetes, hypertension, stroke, heart disease, asthma, and infant mortality—diseases born primarily of poverty, obesity, and lack of access to healthful food. Because of a shortage of doctors as well as primary and preventive care, sick people in rural Mississippi go to the emergency room for care. HealthConnect tries to prevent such visits by providing both at-home health services as well as primary care at nearby clinics, using Iran’s system as a model. In Mississippi, many rural people now have access to care. 

But clinics and in-home care don’t address the food problem, which may be the underlying cause of the crisis. In parts of rural Mississippi, an adequate grocery store might be 30 miles away, and the local gas station is the only convenient place to buy food. I don’t have the data at hand, but I’m pretty sure that in the past, many of the rural folks in Mississippi grew their own food. People lived into their nineties. Now, the life expectancy for a black man is lower than it was in the ‘60s.

The reason I’m pretty sure that people from the rural south used to grow their own food is that, in the early 80s, I was the director of the urban gardening program in Detroit. Among other things, we plowed vacant lots and provided seeds.

Me on the left.

Most of the people who took advantage of these resources were experienced gardeners—Detroiters who were part of the Great Migration (1916-1970). One time I had a load of elephant manure from the Detroit Zoo dropped onto a vacant lot. The idea was to plow it into the lot. But within minutes, people—mostly elderly—were coming with buckets and wagons to haul the manure home to their own gardens. Those folks knew how to grow food!

It ain’t easy.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

“Earthing:” Never heard of it!

When researching my post about the side effects of blood thinners, I stumbled across a concept called “earthing” or “grounding.” The source said that “grounding thins your blood, making it less viscous.” Inquiring minds need to know!

Earthing is “direct physical contact with the vast supply of electrons on the surface of the earth” (from an article in the Journal of Environmental and Public Health, written by five bona fide scientists!). In other words, earthing is going outside and walking barefoot or lying down on the grass. The surface of the Earth is negatively charged. When you touch the earth, you pick up some of this electric charge and transfer the energy from the ground into your body.

According to the scientists, many important processes take place on cell tissue surfaces. When we’re not grounded, which is almost all of the time for most of us, “electrical gradients, due to uneven charge distribution, can build up along tissue surfaces and cell membranes.” When you’re grounded, you pick up this negative charge and create a stable internal bio-electrical environment for all organs, tissues and cells.

The scientists performed a bunch of experiments to prove the effects of earthing. One effect, as mentioned above, is blood thinning (the more negative charges on the surface of your red blood cells, the less your blood coagulates). In addition, they also found that earthing reduces stress levels, increases healing responses, reduces muscle soreness, improves cardiovascular health, improves glucose regulation and immune response. The journal authors offer scientific measurements for each of these effects, but it’s too complicated to discuss here.

The authors say that going barefoot as little as 30 or 40 minutes a day “can significantly reduce pain and stress.” If that’s not practical, you can buy “conductive systems” such as chair pads and sheets that will do the job. Deepak Chopra is into earthing and offers a chair pad. It’s available on his Web site. Skeptical people have tried some of these devices and admit that they help them relax and sleep better.

I would like to try earthing. But we don’t have a nice lawn or any other outside surface that I could use for an experiment that wouldn’t cause pain. And I’m too cheap to buy something. Maybe I can think of something.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

A warning about blood thinners, such as Plavix

A friend of mine went to the doctor complaining that she was gasping for breath at the slightest exertion, such as walking upstairs. She also had blood in her stool. The doc, a GP, discovered she was severely anemic and sent her to the hospital for a transfusion. To me, it was clear that she was bleeding internally.

My friend had a heart attack in 2002 and had been on Plavix (clopidogrel) ever since. Plavix is a blood thinner that is used to prevent clotting, especially after a stent has been inserted. She’d also been taking aspirin.  After she got to the hospital, the nurses and other staff named Plavix as the culprit and she was immediately taken off of it. (This diagnosis of drug-induced bleeding was never formally acknowledged in written form.)

My friend had the transfusion on a Friday, then languished in the hospital over the weekend waiting to be seen by a gastroenterologist. The idea was to look for ulcers. An endoscopy showed no ulcers. “They must have healed,” the doc concluded. She saw her cardiologist a few days later. He took her off the aspirin but put her back on Plavix as a stroke-prevention measure.

Of course, I had to get in on the act and start researching all of this. Here’s, what I found:

•  Plavix, when combined with aspirin, doubles the chance of gastrointestinal bleeding as well as fatal hemorrhaging.    
• Compared to aspirin alone, Plavix users are twelve times more likely to develop ulcers, gastrointestinal bleeding, and cerebral bleeding.
• Several lawsuits accuse the manufacturers and marketers of rushing the drug to market, aggressively advertising Plavix as more effective than aspirin for preventing strokes and less harmful to the stomach — all while minimizing the serious risks.
• For people who have had stents inserted following a heart attack, a drug regimen of Plavix plus aspirin is advised for only one month for patients with bare metal stents and for six to 12 months in patients with a medicine-coated stent. (My friend was on this regimen for 15 years!)
• For stroke prevention, the recommend treatment for women ages 55-79 is a daily aspirin if you have a history of cardiovascular disease (but men in this age group shouldn’t take it); for both women and men age 80 or over, it’s not clear if the benefits of taking aspirin outweigh the risks for bleeding in the digestive tract or brain.

Here’s a fun thing: In an alternative medicine Web site, I found that instead of taking blood thinning drugs you can just walk barefoot! It’s called “grounding” or "earthing." I will research this and let you know the details! 

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.