What? America doesn't have the 'best' health system? Read on.

An August 12 New York Times editorial highlights the imperfections of the American healthcare system. It is becoming clear that the United States certainly doesn’t have the “world’s best medical care.” Our healthcare system could, in fact, be considered one of the worst when looking at things such as the percentage of people who are covered by insurance and the survival rate for certain diseases and conditions.

The editorial discusses insurance coverage and says that 45 million Americans simply do not have health insurance. This is a problem. Because of the high cost of care people without health insurance are unable to receive routine checkups and are therefore unable to be screened for diseases that could be treated if caught early. Because of this, many Americans are forced to wait until they are in the late stages of a disease (cancer, for example) before they go for treatment, because they can’t afford it otherwise. The problem is that the treatment for late-stage cancer is much more expensive than preventative care, or treatment for the disease in the early stages. As a result, the disease ends up costing the patient, and the system, much more than it should. This is part of the reason why healthcare in this country is so expensive and why so many millions of American’s can’t afford healthcare coverage.

Policy Change

The healthcare and insurance system in America needs fundamental change, not incremental change, and the 2008 presidential candidates are stepping up to the plate and offering their plans for change. All of the candidates agree that something needs to be done to combat the rising cost of healthcare and the growing number of uninsured Americans. Many candidates even support a government-run universal healthcare program which would ensure that all Americans have access to affordable coverage. Other candidates, like Mike Huckabee, do not support universal coverage through the government, but instead want to focus on preventative care and driving down the cost of insurance within the private sector.

In the wake of Michael Moore’s “Sicko,” the term “universal healthcare” instantly excites people and Huckabee almost seems radical in saying that we do not need a government-run universal healthcare program. But, in reality, Huckabee might have the right idea. As discussed above, and in previous posts, preventative care and a system that values health care, not just sick care, would greatly reduce cost and force Americans to become more proactive about their health.

While no one would disagree that every American needs to have access to affordable healthcare, the argument becomes whether or not the healthcare system should remain private, or if it should become public, and run by the government. And honestly, do we really want the government running our healthcare system anyway?

Record Keeping Technology

The same editorial addresses the issue of the way medical records are kept in the United States. Astonishingly, despite the sophistication of technology in our country most of our medical records are still kept with pen and paper. But, Google and Microsoft both recognize the need for change, and are looking to fill the void in electronic medical record keeping. It makes sense that consumers want to take control of their own medical records and decide who gets to see them and what they get to see. This fits well with the consumer driven healthcare revolution, and will allow consumers to fully take charge of their health and wellness.

Gupta of CNN: Using Cable Reach for Good Health Messages

We all know we need to take care of ourselves when we are sick. But, what about taking care of ourselves when we aren’t sick? With healthcare costs spiraling out of control, taking charge of your wellness is one of the easiest things you can do to save money and regain a sense of power in relation to your health.

In Dr. Sanjay Gupta's CNN blog, Miriam Falco talks about the need for preventative medicine and what we can do to help keep ourselves healthy. Her recommendations, which come from the Partnership for Prevention group, include getting screened for colon cancer and getting a yearly flu shot. She also says “less than half of Americans who should be taking aspirin daily to prevent heart disease do so. If that number went up to 90 percent, 45,000 additional lives would be saved – at a cost of pennies a day.”

Preventing Chronic Disease

According to a study by the United States Department of Health and Human Services, “40 percent of the candidates on the waitlist for organ transplantation [in 2004] . . . had a primary diagnosis of a preventable chronic condition.” These “preventable chronic conditions” included Type 2 Diabetes, hepatitis, emphysema and cirrhosis. The point is that 40 percent of people who were sick enough to need an organ transplant could have prevented it.

And preventing these diseases does not have to include numerous yearly visits to the doctor’s office or expensive medical testing. There are many things that we can do that do not require any medical attention whatsoever. If you are exercising and eating right you are more likely to have a healthy body weight, which reduces your risk for diabetes and other chronic conditions. If you quit smoking you will significantly reduce your risk for developing lung cancer. If you put on sunscreen before you head out the door each morning you will be protecting your body from the harmful rays that can cause skin cancer; the list is endless.

Other things include drinking 6-8 glasses of water each day, exercising regularly and eating healthy foods. I know you’ve heard these things a thousand times, but the truth is that small changes do make a big difference. If you start drinking more water each day your body will feel more hydrated and you will have more energy throughout the day. With your newfound energy you will be more motivated to be active and exercise, and once you start exercising you will be more likely to make healthy eating choices. It really is like a domino effect.

It is simple: the healthier you are the less money you have to spend on healthcare. So why not skip that soda you were about to open, and grab a glass of ice water instead? Remember, the little things count too!

Response to Dick Feagler op-ed, Cleveland PD

(Note to readers: See Feagler's article here.)

Dear Mr. Feagler -- if you ever want to experience what 'free' health
care is like, I encourage you to come to Hungary for your next operation
or medical visit for a pre-existing condition, like diabetes. Bring
Hillary.

I am a native of Cleveland and have lived in Budapest since 1991.
That's long enough to be able to tell you that I would never wish the
Hungarian, 'free', socialized healthcare system on my worst enemy -- or
on you. Come, have your gall bladder taken out at St. John's hospital
in Budapest. You will only have to share your room with 12 other people
with various illnesses, including folks in the last stages of cancer who
are literally screaming with pain. 'Morphine, you asked? What
morphine, Mr. Feagler. Didn't you know our morphine quota ran out two
months ago? He'll be gone soon, anyway...' Oops, there are only 11 of
you in the room now. I didn't notice that two people had passed away
earlier today -- and no one else seems to have noticed either -- despite
the fact that there are no curtains between beds and everyone is exposed
to everyone else, whether you're dying or just trying to maneuver the
bed pan to the right place.

BTW, when you do come to Budapest for that operation, don't forget to
bring dishes, utensils, towels, toilet paper, juice, crackers, etc.,
because none of those are provided at the hospital. And, since the
meals are a bit on the 'lite' side, (a roll with butter for breakfast, a
bowl of soup for lunch, and a slice of mystery meat for dinner), you'll
want to make sure that a friend or relative brings you real meals a
couple times a day so that you can keep up your strength during the
recuperation period. We all know how important a healthy immune system
is after an operation, especially with that nasty staph infection
problem they can't seem to shake off at St. John's.

After a day or two in the hospital, it's always nice to take a hot
shower. The bathrooms and toilets, circa 1898, are down the hall --
sorry about the line. I realize there are no doors on the stalls, no
seats on the toilets or toilet paper, but remember when I told you you'd
have to bring that? No handles on the water taps? Sorry. 'Must be
those damn gypsies again, stealing anything they can get money for down
at the junkyard...'

Oh, and then there's the medication. Budapest hospitals don't always
have what you need on hand during and following the operation. So
you'll want to make sure you get everything on the list they hand you a
couple days before the operation. (I hope you have a friend who owns a
pharmacy or know someone who does...)

A visit to the maternity ward reveals 13 women in one room: some are in
full labor (again, no curtains); some are nursing their newborns for the
first time, while still others have just had an abortion or their third
miscarriage in as many years. Life, death, and the murder of innocents
play out in the same space, for all to witness and process.

After having given birth to my only child in Budapest in 1999, my
husband and I promised ourselves that we would never subject ourselves
or our newborn to 'free' health care. Ever. Not having many options,
we did what anyone who had experienced both the American and Hungarian
healthcare systems would have done: we joined the AMERICAN Clinic in
Budapest, now known as FirstMed Centers. It's not 'free', Mr. Feagler,
but as we all know, you get what you pay for.

Julianna Gulden
Budapest, Hungary

Doing the Math for Smokers

Smoking and Wealth

As if tar-coated lungs and yellow teeth are not enough to convince smokers to quit, a new study shows the negative effects that smoking can have on your wealth.

The Ohio State University study shows that the net worth of a typical non-smoker is about twice that of a heavy smoker (smokes 2 packs per day, or more). Also, the net worth of a non-smoker is about 50% more than that of a light smoker (smokes less than one pack per day). It also shows that for each year an adult smokes their net worth decreases by about $410.

Obviously, a smoker spends money on their habit, which could certainly contribute to the lower net worth. The study shows that a typical smoker in the United States spends over $700 per year on tobacco products. Using that number, if a person smokes regularly for 20 years, they will spend over $14,000 on cigarettes.

That is $14,000 that a non-smoker would be able to spend in a different way, or put into savings.

While the study admits that causation between heavy smoking and a lower net worth can’t be proved, the correlation between the two is undeniable.

Smoking and Youth

In today’s society, smoking is quickly becoming more and more socially unacceptable. Many states have implemented laws that forbid smoking in public places and some workplaces have also implemented non-smoking policies.

It is also becoming difficult for young people to justify why they start smoking since the health dangers that come along with smoking are very well known. It has also recently been shown that young people are likely to become addicted to cigarettes more quickly than previously thought.

The new study, which was published July 2007 in the Archives of Pediatrics and Adolescent Medicine, says that within two days of inhaling their first cigarette, some youths can crave nicotine. More specifically, about half of young smokers in the study felt cravings for nicotine when they were smoking only seven cigarettes per month.

This challenges the thought many young people have that they can smoke casually and socially in their youth and then quit before they become addicted.

It also makes it even more important for parents to communicate with their children about the dangers of smoking and the harmful addiction that comes with it.

Time to Quit

Everyone knows that smoking is bad for your health; the surgeon general tells us so. But we now know that smoking can also be bad for your bank account. If a heavy smoker quits smoking they can save about $700 per year. So what are you waiting for?

The above studies can be found online at:

http://tobaccocontrol.bmj.com/cgi/content/full/13/4/370

http://archpedi.ama-assn.org/cgi/content/full/153/9/935