Hello readers! Yes, I’m back and excited to share news of more guest posts with you. I have been busy working on finding bloggers out there that have valuable and credible information to share with my readers.  This is an article I hope will benefit everyone curious about consuming multi-vitamins. I know I’ve been contemplating whether I need them.

By: Dr. Mercola

About half the country takes nutritional supplements, and I suspect the percentage is considerably higher for readers of this newsletter. Supplements can compensate for some of the damage we do to ourselves. However, my experience is that many people, if not most, take supplements to justify their poor food choices. This makes as much sense as building a boat with rotten wood and using the best screws in the world to fasten them together. The boat may hold together, but it will leak everywhere. The boards in the boat are like the macronutrients in our body – the protein, carbohydrates and fats that we consume. If we make poor choices there, the screws — the vitamin supplements — we use are irrelevant.

Most vitamins serve as catalysts for reactions to occur in our body. While we need catalysts, it is more important to obtain good fuel for the reactions to properly occur. Also, a funny thing happens when you start out with good fuel (raw organic food): it has most of the vitamins and minerals you need packed right inside and at no extra charge. Amazing.

Most of the new patients I see are spending more than $100 a month on supplements, with some significantly higher than that. But supplements will not compensate for improper eating. Use the right food as your supplement and you will be much healthier.

That said, there are certain clinical conditions that do warrant the use of nutrients and supplements as drug alternatives, and I use this approach frequently. My key, though, is to minimize the long-term use of supplements. And I really don’t think healthy patients should be on more than five supplements a day.

On supplement I do advise for most new patients is probiotics, to optimize their gut flora. While most people seem to benefit from this periodically, I generally don’t believe it is necessary to remain on it indefinitely.

Another supplement that is near critical for some patients, particularly those who avoid eating animal protein, is vitamin B12. I don’t advocate avoiding all meat, but it is, nevertheless, a common approach among patients. The human body is quite forgiving and can tolerate the associated abuse – highly insufficient B12 intake — for about 7 years, as it utilized the liver reserves of B12. But after those 7 years, the B12 deficiency frequently causes irreversible brain damage.

I’m glad to introduce a guest blogger, Kyle Simpson, who writes for Medical Billing and Coding Schools where you can find more information about a career in medical billing and coding. His following article give a more health-focused list of items for my bucket list. Enjoy!

Image source: www.yobazzip.com

By: Kyle Simpson

If you don’t know what a bucket list is then you have apparently been living under a rock for awhile (see 2007 movie The Bucket List starring Jack Nicholson and Morgan Freeman).  It is basically a list of all the things that any given individual would like to accomplish before they die.  Some popular entries include such diverse activities as: fall in love, start a business, write a book, join the Peace Corp, go skydiving, visit Paris (the city, not the heiress), attend a Mardi Gras celebration, save a life, and so on and so forth.  Everyone’s bucket list is different, but they almost always involve travel, love, success, and excitement or adventure (and usually at least one thing that is truly crazy).  However, these lists rarely include health-related items.  Sadly, most people are not that concerned with becoming a truly healthy (physically, mentally, spiritually, or otherwise) individual before they die.  But here are few health-conscious items that you may want to consider when making your own list.

1. Learn yoga in India.  This fusion of mind and body is a useful tool in two ways.  It is a physical activity that keeps your body strong and flexible and it also helps to calm and focus your mind.  So go to the source to learn ages-old techniques that will keep you centered while you marvel at the strange and beautiful world we live in.
2. Survive in the wilderness.  You don’t need to go Into the Wild to commune with nature.  A simple camping trip will suffice.  Just make sure you leave the bells and whistles at home (especially electronic devices).  Forget the tent and opt for just a sleeping bag to truly appreciate the scope of the night sky.  And bring your fishing gear instead of hauling a cooler full of meat.  Fish is never as good as when you catch it fresh and fry it up immediately.  Lastly, leave your Coleman stove and flashlights at home.  Use your campfire to cook old school and read by the softly flickering firelight.  You’ll return home relaxed and ready to take on the world.
3. Go vegan.  Try out a vegan diet for awhile.  Learn to live without animal products (meat) or byproducts (dairy) and see how you feel.  Even better: go organic.  A diet high in fruits, vegetables, whole grains, beans, and nuts is going to make you feel alert and energized, especially if you know it lacks the chemicals and growth hormones found in many of the foods you normally consume.  Give it a few weeks and see how it changes your life.

Challenges to Health Reform in Developing Nations

By: Matthew Kukla

I apologize for the delay in posts; I’ve been away doing health reform work in Costa Rica for the last few weeks and am now just returning to the daily grind.  Two weeks ago we spoke about challenges to health reform in developed societies – how political and cultural differences impact health reform.  This week, I’d like to focus on obstacles that exist primarily in developing economies, though impact developed ones to a lesser extent.  You might wonder why I am focusing on the developing world.  It appears so far away from our daily life and inconsequential.  While true to a certain extent, I would argue that as the world becomes increasingly globalized, a single nation’s actions can impact many others.  Take, for instance, China and India.  These two countries host roughly 1/3 of the world’s population, and how each respective government builds its health system will shape resource needs and the survival of billions for generations.  For instance, whether China learns from mistakes and lessons of the developed world will determine how effective, efficient and costly health care is down the road.  Ultimately, these outcomes shape how much its government can spend on defense, clean energy or other social programs.

A rule of thumb when examining health care systems in the developing world is to drastically magnify any challenges that we face and realize that underlying, world views and assumptions we take for granted do not apply there.  To begin, human, administrative and financial resource capacities, as well as corruption and poor regulation, are severe deterrents from successfully implementing health reform.  Many nations such as Colombia, Ghana and Kenya have attempted to create social health insurance systems, whereby external agencies finance health care, organize, manage and pay providers.  Yet experience indicates that these nations lack adequate technology, educated workers and regulatory structures to ensure this SHI system operates well.  Let take this example:

In India, roughly 470 million (out of 1.1 billion) people live under $1.75 per day.  75% of those individuals live in rural areas, the norm for most developing countries, and simply struggle to survive.  If given the opportunity, they would work harder than any American to get out of poverty yet such opportunities never come.  We know that in these areas, the supply of doctors, hospitals and clinics are minute; unqualified providers who may be well known in villages often fill the demand and treat patients for little costs, yet end up hurting those patients.  Health care facilities often lack personnel, medical supplies, electricity, telephones, water and sanitation, thus drastically hindering their ability to offer sound, medical care.  The uncertainties of access, quality and availability of health care cause individuals to refrain from visiting them.  Patients would rather not walk several miles to the nearest health center only to find it closed or out of supplies.  If they do choose to visit a facility, it costs time and money to travel there.  Government run health care is also not always free, because physicians can charge patients if they arrive after normal business hours or simply price gouge.  If the facility has no medications, the patient must pay out of pocket to obtain them on the private market.  Making $1.75 per day, the poor will often go bankrupt and die paying these fees.

Challenges to Health Reform

By: Matthew Kukla

As mentioned last week, the next two posts will be broken into two sections.  This post will discuss how government structure, culture and social differences muddy the reform waters.  These challenges must be strongly considered and overcome throughout the process, because theory and empirical evidence simply isn’t enough to get an effective, efficient and equitable health system implemented.

Successful reform is often a long process – nations rarely pass comprehensive policies that tackle financing, organization, regulation and payment systems simultaneously.  Such periods of major health reform, though, generally occur during political and or economic crises.  Politically, a nation may experience regime change where power and cultural momentum drastically shift and allow health reform to pass.  Bangladesh, for example, experienced a military takeover of government in 1979 and was able to quickly implement pharmaceutical reform.  After a similar military coup in 1983, Chile pushed through comprehensive health reform.  In the late 1980’s, Taiwan began setting up a democracy after breaking away from China’s authoritarian rule; this political and social transformation resulted in systematic health reform by 1995 that now provides efficient, effective and universal health care.  Economic crises, such as major recessions and depressions, may also create momentum for health reform.  Governments and citizens, despite numerous setbacks, occasionally seek to expand coverage and improve the efficiency of their health systems.  We see this happen most often in developed nations (US, UK, etc) where GDP per capita is much higher and governments can run temporary deficits without severe repercussion.  However, even during instances of extreme change governments still encounter resistance.  In the aforementioned cases, Bangladesh ultimately failed to overhaul the entire health system almost a decade later due to interest group opposition; likewise, Chile required 5-10 years to successfully implement new policies due to poor resource capacity and political resistance.  The United States has encountered severe resistance due to high deficits and an economy that has yet to rebound.

For the majority of cases where less expansive health reform occurs, government structure and culture present the greatest obstacles in developed societies.  Evidence indicates that it is rarely possible to use a “cookie cutter” approach to transferring health policies from one nation to the next — every country is unique, and reform must be tailored to meet its individual needs and characteristics.  Thus, even though two nations share similar health care markets, their political and cultural differences may prove too disparate to conveniently swap health reform solutions.  That is not to say that such differences are impossible to overcome; political obstacles can be conquered with enough support and intellect, and evidence shows that changes in culture are actually quite elastic.  Nonetheless, these are critical issues that must be strongly considered.

Regulation Pt. II

By: Matthew Kukla

I intended for this post to be about the challenges of health reform; notably how government structure, culture and social differences, human and administrative resource capacity, corruption and other bureaucratic obstacles muddy the reform waters.  Theory and empirical evidence simply isn’t enough to get a health system effectively, efficiently and equitably implemented.  I planned to talk about the work of William Hsiao and other reformers with decades of real world experience dealing with such issues. Turns out I’ll get to that next week.  A family friend who has been running a successful business for over 30 years wrote to me after the last post and asked sincere, critical questions about why health care markets fail and what differentiates these problems from all other industries.  Because it’s a major economic topic, critical to understand and perhaps the most controversial, I’d like to devote one more post to it and other myths.

The first question is “What’s so different about information gaps between health care and all other goods, like cars?”  To begin, health care deals heavily with life and death, unlike most other industries — so people aren’t necessarily rational, economic actors when they or family members are extremely sick.  They’ll often do and spend whatever it takes to get cured, even when prices rise.  The concept was discussed in the 2^nd post and indicated that many (but certainly not all) health care procedures incite inelastic patient demand.  The economic evidence for this is overwhelming.  Now here’s where it gets important.  Third party payers, or insurance companies, are there to help us pay for services that we can’t afford.  When they foot the bill, patients don’t feel the full price tag and are more willing to buy additional services and spend more money that isn’t theirs.  Coupled with inadequate information, they’re even more likely to consume extra health services when the doctor tells them it’s necessary.  These two factors cause the price of health care to rise in a vicious cycle.

The second question is, “So why not have the insurance company pay a set fee to the doctor (ie capitation) and let the patients pay the rest?  Doctors should charge what they want, and patients can pay out of pocket based on quality.”  The answer: That’s a wonderful idea.  The Mayo clinic does this successfully, provides top quality care and only takes privately insured patients.  But throughout entire health care systems the quality and prices set by doctors and hospitals are very difficult to measure without transparent and sound information – which is why billions of U.S. dollars are actually being spent on this kind of research.