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103. Republicans Hate ObamaCare: Why?

28 Apr

“Insurance companies must use more of the premiums they receive for patient care rather than administrative costs…” (see reference below)

As I watched a number of news programs, it became apparent that commentators were not fully aware of the ACA (ObamaCare) provisions, or for whatever reason, ignored some of the most important points.

I am already familiar with most of the significant features, but I decided to search for a good summary. Here is one that is very useful and authoritative by Norma Goodwin, MD:
12 Simply Stated Features of the Affordable Care Act/Obamacare
The above (beginning) quotation is from this very useful summary (search Internet for this title). This feature alone, can explain why the GOP wants to abolish the ACA rather than just improve it. Rich insurance company owners don’t want to be limited in their lust for profits.

There are a few additional points that I would like to emphasize. There is much discussion about “pre-existing conditions.” But often overlooked are many other features that are critical (life-and-death) for good heath care. These include:

1. Eliminates annual and lifetime insurance policy limits.  Many people have died because their insurance money ran out.
2. Parent insurance coverage for offspring up to the age 26.
3. Medicaid is supported, but some states have refused to accept the free financial support.
4. Medicare is protected and now many preventive screenings are included.
5. Costs for vital medications are reduced.
6. Other provisions of the ACA are designed to lower the general cost of health care, and improve the quality of care.

The ACA is not perfect, but includes many great ideas. Keeping it will insure that the people will be well taken care of. New plans by the GOP will eliminate many more citizens from insurance coverage, decrease the quality of care, and will insure that rich insurance company owners will become even richer. Hopefully, some day we will have a “single payer” system, a Medicare for all.

98. Teen Trump Discovers Healthcare

28 Feb

During my long life, I have had a number of contacts with teenagers. Some of the brighter ones recognize that they have much to learn, and others just assume that when they discover something, no one else knew it.  I think that most older adults are familiar the “know-it-all” teenagers.  It is sad to say that our 45th president, often having the intellect of a know-it-all teenager, has just discovered Healthcare.

Before he talked about it, teen Trump could have spent just an hour or two in research and immediately figured out that our healthcare system is extremely complicated. He could have asked specialists who wrote the ACA (Obamacare) law and others, to explain it’s intricacies. Instead, after making numerous remarks about immediately abolishing the law, he now says:

“Nobody knew that healthcare could be so complicated”

I think even the “know-it-all” teenager would not say something as naive as this.
Here are a few more teen Trump assertions:

“I understand the tax laws better than almost anyone”
“I know more about renewables than any human being on Earth”
“Nobody knows banking better than I do”
“I understand money better than anybody.”
“There’s nobody bigger or better at the military than I am.”

(Please see Aaron Blake, Washington Post, October 4, 2016 as a reference and for more examples.)

Why didn’t his original supporters realize that the Presidency is not an entry-level position and that it’s not OK to serve with on-the-job training? Well, I guess we have to accept the fact that many of them are not knowledgeable  — and they were caught-up in the thrill of racism, violence, and over simplification. They knew and teen Trump knew that foreign policy, military actions, trade laws, treaties, education, technology and so forth are all trivial, and a great builder of buildings can master anything in a few hours.

After just a few weeks in office, teen Trump has made a mess of most everything he has done and the few positives, like the Carrier Co employee situation, are just tokens, having no substantial value. He has come up with incredibly valuable plans for making America Great, and defeating enemies like ISIS, but alas, cannot reveal any of the details. The most serious mess is his cozy relationship with Russia’s Putin.  Blackmail and election interference are possibilities that need investigation by fully independent parties.

89. Some Tweet-like World Observations

2 Feb

1. Privatizing means creating a system that has a private owner as opposed to a government-run institution. Examples are schools and prisons. The latter has been tried but is now diminishing. In privately run systems a concern for profit can cause neglect in providing required services. Often, civic-minded people working as a public governmental body can be more effective, and with less expenditure. There is a fixed budget so that workers can focus on quality work.  Some would argue that privatizing creates beneficial competition, but in fact there is little competition in areas where privatizing is being promoted.

2. Do we need insurance companies that develop extreme wealth for their executives, paid for by you and me, while benefits are diminished. Why should our world be configured so that a few can become very rich at the expense of the rest of us? Our more advanced civilization has been around for 150 years or so. In that time, the “royalty class” has become entrenched in our system — robbing many ordinary people of their means of survival. I am not against the concept that hard-work and intelligence should be financially rewarded, it is the extremes and abuses that concern me.extreme we Being rich is OK, wealth is not. I also want to make clear that I owned two businesses and believe in our form of regulated capitalism.

3. The arrival of Trump marks the creation of a new entity resulting from social/business evolution. The new creation is what I shall call the extended governing family unit. The Trump version consists of himself, his offspring and their spouses; each having a specialized function. But to clarify, effective and powerful family units are not really “new”, but a unit this large, with necessary distributed functionality, has never before been our “president.” My next blog (no. 90) will explain this further.

4. Diagnosis of all types should be separate from treatment. The fees for various treatments can be very different, and the Dx could be biased towards better income. For example, the exact diagnosis for a cancer could lead to expensive and profitable surgery or a much less expensive radiation or drug treatment.  Dentists have tough decisions in deciding what is actually a cavity that require a filling.  Any healthcare, other service, or repair company can be jaded by this factor. How to fix this is a real dilemma.

5. Our U.S. government may be doomed to failure, because of powerful relationships between very rich folks (donors) and governmental leaders. The best cure would be a great improvement in education so that we can break the donor influence. Remember that our current leaders arose to power under this system and, as you would expect, want to preserve it. Many of those at the top have little interest in teaching logic, reasoning, and correct history to our students and potential voters. We are caught in a powerful loop and will need to be coordinated and industrious to have a chance of breaking it. The current massive demonstrations in many cities is on the right track and encouraging.

6. Ironically, a thousand years from now, the invention of email may be identified by witty history professors, as the cause of the downfall of our Earth civilization. Take away email, and there would have been much less abuse of Hillary Clinton, and she could have been elected. If that had happened, a strong NATO, great international relations, better climate change efforts, fair treatment of the middle-class, control of nuclear weapons, careful communications, and other factors could have saved the world from numerous disasters.  Trump has already alienated some of our closest allies.

7. Governmental officials generally set their own salaries and rules of operation. They are only people, after all, so how can we expect them to be fair. It seems that most people in power long enough will eventually become corrupted (at least somewhat). We need a better system, but change is difficult. The press should help us, but are often limited by some very real vulnerabilities. A tough leader with violent supporters can be an awesome force that discourages needed criticism and modification.

8. I suspect that most of Trump’s early supporters voted for him for various reasons, including: his power, likability (for many), promises of jobs, identification of scapegoats, prejudices, anti-terrorism statements, etc.  What probably was overlooked, was a good estimation of what he would actually DO and SAY after taking office.  Many of us had hoped that he would change after a couple of weeks as POTUS, but he has not.

87. GMO Babies and Foods

26 Jan

I recently listened to a TED talk entitled “The ethical dilemma of designer babies”, by Paul Knoepfler. It was a good talk, but I was disappointed by the suggestion of a moratorium on the science involved in the direct genetic improvement of reproduction.
Knoepfler is a scientist working in the field of genetics and GMOs (genetically modified organisms). He discusses the possibility that in 15 years or so, we will be able to make “designer babies” that are free of genetic diseases and may also have improved looks and intelligence. The author is afraid that “natural” children will be upset by the successes of “designer” children.
I think the “designer” idea is great and is not so strange as some think. After all, we affect the success of our children in many ways, including medical methods such as plastic and corrective surgery, good nutrition, the best education, exercise, mental health, etc. — why not give them an even better start by improving their DNA through carefully studied and regulated procedures.

Aside from the talk, I am also concerned about irrational fears of GMO foods, which are really important for the survival of our growing populations. Here is what I wrote about these methods as a comment to the TED talk:

I am a scientist (retired, and not in the field of genetics) but still study many areas of science and am very interested in scientific progress.   My judgment is to forge ahead in any scientific area, but observe certain limitations.  If there is a clear possibility of danger then we need responsible transparency and monitoring, not moratoriums.  I live in and am a citizen of the USA.  It’s foolish for us to stop working on something potentially very beneficial  while all over the world others are progressing and benefiting. At a minimum, just preventing genetic diseases is very worthwhile.  A moratorium here just puts us behind scientists working in other countries, and does not prevent the dangers that the speaker hints at.  Rich people, of course, would be able to take advantage of this overseas, and ordinary people would not.   My idea is to reject timid and fearful limitations and go full force,  using good documentation and studies as guides.  If it becomes clear that advances such as “designer babies” or certain GMO foods are dangerous, then scientists and Congress can regulate or abolish the procedure. 

The speaker is worried that a “natural” child would have to compete with a “designer” child. But even without this method there will always be someone better than you. It is not a good argument. Nature, breeding methods, cosmic rays, and even choice of a spouse all cause genetic (DNA) changes. The advantage of direct DNA changes by scientists is that they CAN be monitored and procedures can be improved or limited.

The innovations and amazing discoveries of science are a great joy. In a world filled with kindness and intelligence, scientists would never have created atomic bombs. Traditions, rigid beliefs, ignorance, and greedy politicians HAVE caused world disasters — Science has not.
After writing the comment, I decided to read more about GMO use. It is hard to do human research on GMO’s, but there are good studies using animals, that, in fact, we eat. Jon Etine (Sept 19, 2014, Forbes) reports:

“Estimates of the numbers of meals consumed by feed animals since the introduction of GM crops 18 years ago would number well into the trillions. By common sense alone, if GMO feed were causing unusual problems among livestock, farmers would have noticed. Dead and sick animals would literally litter farms around the world.”

There also is formal research that shows no negative effects and no effects on humans eating these animals. Irrational fears about GMO’s are unproductive and harmful. Of course, specific findings on particular GMO’s should be acknowledged, but should not influence the whole field. We don’t avoid all doctors, because a few have been convicted of malpractice. We need to use the results of good responsible scientific research wherever it is helpful. It is ignorance and unethical politicians that have caused our widespread dilemmas.

85. We Need Change ?

17 Jan

Trump is the man who will make “change” and deliver us from big, bad government. He is not a politician, he needs no donors, ignore what he says because there is goodness in his heart, he is smarter than the generals (and just about everyone else), all past negotiations are pathetic, and he will rid us of ISIS in a month. He is never wrong and will make you suffer for any criticism. He almost never addresses the criticism itself, but instead attacks the person who made it (even the Pope).

He paints a picture of a failing nation with incompetent leaders and government workers, rampant crime, poor negotiation, widespread poverty, etc. — “things could not be worse.” Black people have not made any progress — an insult to the millions that are doing well and have even achieved the presidency. His motto is “make American great again” without any explanation of when, how, and the meaning of “great.”

.                 False, rigid beliefs interfere with common sense

The Trump movement shows how many people are prisoners of their false and rigid beliefs, and cannot see the obvious and exercise common sense. Sad to say, there are many who voted for Trump just as a protest or just to do something based on frustration. Those persons may be responsible for a new direction leading to our country’s decline. Impulsive superficial voting may be the end of our world leadership and all of the good things developed to date. Trump will make change, but change for the better is unlikely. Here are some possible changes that have been mentioned at least once (but may have been retracted and/or restored at some time):

1. Changed healthcare legislation will cause millions to lose their insurance and many will die.

2. NATO is obsolete. Our long-standing, beneficial, and powerful pact with many nations is under threat.

3. Instead of sanctioning Russia, we will support their authoritarianism, attacks on the press, and take- over of countries like Ukraine. We will ignore their meddling in our elections and their efforts to undermine many nations.

4. We will pull out of the multi-nation “Iran Nuclear Deal”, allowing Iran to go back to making the bombs and delivery systems — prevented by the Deal. We will also pull out of climate-change treaties, which could prevent massive flooding (Florida, NY, etc) and catastrophic human migrations due to massive droughts.

5. Taxes for the very wealthy will be lowered by decreasing the tax rate and by allowing more loopholes. The rich will celebrate while the rest of us will either pay more tax or have reduced benefits — and/or our national debt will surge.

6. We will change trade policies and tariffs so that trade-wars will arise and prices for goods, everywhere, will increase. The chaos will affect our valuable relationships with long-standing allies.

7. Pres. Obama has at times been criticized for inaction, but Trump may impulsively engage us in wars, costing lives and greater national debt.

8. He may generate more terrorists by his abuse of Muslims, various other insults, and dangerous policies.

9. Our valuable press, which is required to keep our democracy honest, may be thrown out of the White House and attacked so viciously that it is ineffective. If Trump’s ideas are so laudable and clearly beneficial, why all the press criticism?

10. Is anyone suspicious of the fact that Trump’s cabinet is filled with extremely rich people and/or persons with questionable histories.

11. Trump would restore vicious torture and wants to keep Guantanamo prison. He also admires the strength of tyrants around the world. Are we setting a good example (under Trump) for the rest of the world? Traditionally the USA has been known for its might, and also its moral authority. Is Trump leading us in the right direction?

After Trump is in office for a while, the appreciation for the positive change that Pres. Obama caused will grow even more.  And the candidate, Hilary Clinton, that Obama so enthusiastically endorsed and was attacked so unmercifully by the GOP will be much more appreciated.  Ironically, she won the national vote count by almost three million.

Just added: I have been working on this blog for several days and at times almost scrapped it, because it may have been too negative. But after hearing Trump’s unnecessary and incorrect abuse of the civil-rights hero and self-sacrificing activist, Congressman John Lewis … well, here it is.

52. Ingested Lead Detox

30 Mar

The best way for the ordinary citizen of Flint (and other communities) to deal with lead in the water supply, after it is ingested, is through food education. If you research and study food-based detox methods you may come up with an effective program. Some medical doctors discourage the use of diet and food selection for lead detox, but there are encouraging studies and taking foods that are healthy anyway, would be a good gamble.  If you begin a program and particularly if you are doing something unusual, consulting a qualified expert (such as a nutrition-oriented MD)  is advised. What I have written here is NOT medical advice, but general information.

I have read a number of studies on detox and also information provided by Flint medical experts. As for my qualifications, I have a Ph.D. degree, have taken many chemistry courses, had a neuroscience research grant from NIH, and have studied nutrition all of my adult life.  I realize that most ordinary people will not be able to do the research or make most of the necessary diet changes, but I still feel that it is good to document what may be helpful.  Perhaps community leaders and/or medical experts can help the citizens with this.

Here are some of my conclusions regarding lead detox.

1. General improvements in the diet are highly recommended.  I don’t endorse any radical diet plans or commercial products.

2. Drink plenty of safe water (but not extreme amounts).

3. The most commonly recommended foods and vitamins for detox are: vitamin C, garlic, cilantro, and a wide variety of vegetables. This variety should include dark-grean leafy vegetables, orange and red vegetables, and other colors. The various colors represent different valuable and heathy substances. Examples of excellent food choices are: broccoli, cabbage, blue berries, seeds (pumpkin, flax, and sun-flower), almonds, kale, dark green lettuce or spinach, RED palm oil (must be red, organic, and unrefined), onions, squash, etc.  Organic raw foods are preferable and generally healthier. Refined or processed foods are often useless as they have lost their important ingredients. Sugar and sugar substitutes are the WORST foods.

I always consider the medical oath: “First do no harm.” A detox diet is generally a very healthy diet, so there is nothing to lose and everything to gain. Below is a useful reference. I do not endorse everything written in this work, but if you review several works, the methods most often mentioned may well do the job.

Try an internet search “lead detox naturally” for other references. What I have written here is not the last word and is incomplete, but hopefully a nudge in the right direction.

30. Stretching Program for Back Pain

15 Nov

In a previous blog (July 17, 2015, Number 23: Treatment for Common Back-Pain), I described a treament for lower-back-pain with muscle strain as its basis. This blog, Number 30, will cover subsequent observations and information.

I suggest that the immediate cause for most lower back pain is excessive muscle tension, even if there is an ultimate, responsible, spinal defect. I have drawn this conclusion after many years of scientific research, work with patients, personal experience, and a Ph.D. program specializing in physiological psychology and neuroscience. My own severe back pain motivated me to spend hundreds of hours studying the spine, MRI scans, back muscles, and various treatments. Professionally, I was the recipient of a government research grant from NIH, and was head of a research department (Neurological and Behavioral Sciences) at Henry Ford Hospital, Detroit.

Before continuing, I want to emphasize that consultation with Medical professionals (MD or DO) is often necessary, that I am not providing “medical advice”, and that in using the procedures described below, one must avoid rapid, sudden, and angular movements that could cause additional problems. My program is most applicable to those with centered, lower back pain, as opposed to pain that is on one side, and/or radiating down one leg (often designated as Sciatica). But even if the spine has known defects, such as a herniated disc or neuroforaminal stenosis, muscle tension may be the immediate cause of pain. One must work slowly and thoughtfully, advancing the stretching little-by-little.

The result of my study of the medical literature and experience as a psychotherapist (specializing in stress-reduction) and as a patient, leads me to believe that the precise source and origin of the pain is often unknown. CT and MRI scans are helpful in determining spinal damage, but there can be hidden damage not detectible by scans. The bony and supportive structures (such as discs), in the spine have no pain receptors and damage to these does not directly cause pain. Pain caused by the spine comes from defective spinal structures that press or squeeze the main cord or emergent nerves. For example, squeezing of the sciatic nerve as it emerges from the spine can cause “sciatica” (pain in the back, which radiates down the leg). A final diagnosis emerges from medical history, physical examination, scans, and dialogs with the patient. “Discograms” are often needed to pin down the specific location where squeezing occurs. A discogram includes an invasive probing of the suspected spinal areas and reports of the unanesthetized patient. If probing in a certain area produces the sensation of the patients back pain, then that will be the area corrected with surgery. In the end, surgery is often performed with a less than 100% confidence in the diagnosis. It is understandably difficult to work with a complex living structure buried deeply below the surface of the skin. A more definitive procedure such as a discogram is often avoided by patients because it is painful.

Abnormal pressure on a spinal nerve may be the cause of back pain, but the cause can occur in different ways. First, there could be a direct cause: pressure causes sensory nerve impulses that are interpreted by the brain as back-pain. An indirect cause could be that certain motor output to back-muscles is greatly increased causing excessive muscle tension. It is a known fact that excessive and prolonged contraction of any muscle can cause pain and even severe cramping. The affected nerve could also interfere with reflex systems located in the spine that regulate supportive muscle tension. In my case, sleeping in bed always resulted in very tense painful back muscles. My sleeping position may have caused certain forces on the spine that affect important regulatory reflexes. For me, the biggest question is what causes the profound contraction while sleeping?

Of course back pain can occur without any defect in the spinal cord or emerging nerves. For example, a dentist needs to bend forward and perform very delicate and often difficult procedures. This situation requires back tension to support the required movements. While the dentist is operating, the back is very tense. Unfortunatly, the tension may persist after the procedures are finished. Other stresses, such as concern about cash flow, a law suit, various personal problems, etc. can make the tension worse. The work performed in many professions and in other situations can lead to back muscle tension. A computer programmer can sit for hours in front a computer trying to “de-bug” an important program. Working while sitting very still for hours can lead to severe and painful contractions (also in the legs and even fingers). Any activity that requires a considerable amount of time bending forward (or even sitting still) can tax the supportive back muscles. The fact that after the taxing activities are finished, the muscles may not resume a comfortable, fully relaxed state, is critical.

Who should try the stretching programs described here? Before continuing, I want to re-emphasize the “Cautions” listed above. If you think that stretching your back muscles could possibly produce more damage, then consult with a medical specialist before experimenting.

This program could benefit anyone with lower back pain resulting from any cause. The safest application would be after an examination by a physician who finds no specific spinal involvement. If there are spinal defects and/or pain on one side, then be more cautious. In the end, the patient must make a final decision, which is always a kind of gambling and weighing of benefits versus risks. My own inclination is towards self-help, but I definetly value the input of established experts. In most cases, I have been correct, but a couple of times I have made serious, but not lethal (as you have already guessed) errors.

My blog 23 has a good description of the stretching procedures. What I will do here is to emphasize the important points and further observations. Many years ago, the benefits of “toe touching” exercises was established. I recommend doing this many times a day, at least hourly. Also, it should be done before and after certain activities, such as sleeping, napping, sitting at a desk, doing anything stressful or requiring concentration, carrying heavy objects, many types of physical work, etc. Experimenting is key to success. A single repetition is to bend over (standing or sitting) and try to touch the toes. Use a moderate amount of effort, too little would be ineffective and too much could be harmful. After bending, resume an upright position. Do at least three bends, without pausing, or with pauses of a few seconds. It is very important that you continue until you achieve a maximum bending. Experimenting will tell you how many reps are necessary to fully stretch the back muscles. As you work with the back muscles, you may be able to alter or abidge the procedures so that less time is taken. While writing this lengthy blog I moved in various ways so as to feel if tension is building up. Twice I fully bent over from a sitting position. Finally, I want re-emphasize reaching maximum bending, because, my experience is that failure to do so will allow pain to persist.

Maybe the most important contribution I can make here is to describe the feedback and tension-gauge that is very helpful. You can better achieve any goal by “seeing” the actions, developing a gauge, and understanding the process. Biofeedback instruments are often used to combat tension and stress. Biofeedback can help, but it is difficult to locate and study the many and deep supportive back muscles. Earlier in life I saw many patients for stress using biofeedback methods.

A really good way to gauge back tension is the following.
1. Establish a standard bending procedure: use a specific chair or standing posture.
2. Perform at least 4 or 5 bending repititions.
3. Your current measure of back tension is the difference between the first and last amount of bending. The “bending amount” is the distance from finger tips to floor.
4. If you can muster the motivation, record the activity and the tension gauge.

Here is an example. You are sitting on the side of your bed and a moderate effort on the first bending results in your finger tips reaching a point 3-inches above the floor. The second time you bend, you reach 1.5 inches from the floor. Third and fourth bending are one-inch and 1/2 inch. Several more bendings are 1/2 inch away.
The tension gauge is 2.5 inches (the first, 3-inches minus the last: 1/2 inch). I have already done this procedure hundreds of times. If you easily touch the floor when bending (using your standard procedure) then you can measure the distance from your wrist or knuckles (making a fist) to the floor. The gauge is always the difference (in inches-to-floor) between the first attempt and last. As you work on this, your will quickly learn what is your maximum stretch and can stop the reps at this point. Think about what you are doing and what the muscles feel like when tense and fully stretched.

Here are some details of my personal experience. I have two standard positions: one is standing-up with legs straight and feet separated by about 18-inches, the other is sitting on the side of my bed. When I wake up after several hours of sleep, my back is very tense. First bend from a sitting position is about two-inches above floor. The last (after 4 to 6 bends) and best sitting bend is to palms on floor. The difference is five-inches. Five inches represents the current tension. That is a maximum for me. A long sleep always results in a “five” even though I fully stretch before entering bed. A short sleep or just resting in bed produces a lesser amount. Working at the computer, depending on the activity and intensity can produce tensions ranging from about one-inch to four-inch toe-touching differences. Various types of movement tend to lessen the tension. Being still for a long time increases the tension. My overall max is the five-inches. For me, walking around with a five-inch tension level can produce severe stabbing pains and a feeling of collapse. Several years ago, I realized that a few stretches before standing up was helpful, but I did not realize the full picture. Unfortunatly I never saw the importance of stretching at other times, particularly before sleeping. Although I always wake-up with back tension, I suspect that stretching before getting into bed helps to produce a more relaxing painless sleep.

If you study and experiment you may be able to avoid expensive and painful medical procedures. On the other hand, there are times when good medical advice is really necessary. I wish I could define these times with 100% accuracy. If you have unusual back-pains or severe back pains consult with a well-established and credentialed orthopedic doctor. If other symptoms accompany the back pains, see the doctor. I have not yet mentioned inflamation. Any severe painful condition may be accompanied by harmful inflamation. There are numerous drugs and natural remedies for this. I take two common NSAID anti-inflamatory pills early in the morning. I experimented with tumeric, but for me this was of little effect. When I cured the severe backaches with stretching, I totally stopped taking the NSAID. But after about 10-days my knees started to hurt more, so I resumed two/day.  I suspect this also helps with any back-muscle inflammation.

Here is another factor that comes to mind. General good health achieved through diet and the right exercise can be of benefit. Fourteen years ago I developed a moderate sciatica, which disappeared after about two months. I had an MRI scan and noticed that the report mentioned dessicated (dry) spine. I discovered that Vitamins A and D were missing from my diet and I restored these factors. The pain disappeared in about two months, and the vitamins may well have been the cause.