Health Care Reform and the Real Bottom Line

I just hung up the phone a little over an hour ago–I was on the line with President Obama! What an honor to be included in a conference call about health care reform. One of the questions was about an older couple who were doing fine, until he got sick, and she had a stroke–and then it was the same sad story of hard won life savings swept away by the unbelievable costs of health care. I really should not use the term health care in this case, it should be disease management, which increasingly has been the focus of our system of hospital and office medicine since (believe it or not!) the early 1920’s. We have had almost 100 years of medicine that puts profit of individual doctors and medical insitutions, and sales of pharmaceuticals and related medical goods above every other consideration.

And now, the American people are paying for it. We are paying with childhood obesity, with our own tax money that is allocated for “Cadillac” health insurance policies for members of Congress and other branches of government, while we struggle with high deductibles, medical expense-related bankruptcies, and death because we are not covered by insurance that would pay for our deadly illnesses. Meanwhile, the United States is a poor performer on the list of developed countries regarding important issues like maternal and fetal death in childbirth. The false bottom line–a narrow view of the profit margin of health care providers and institutions, has been the overriding goal of our system for nearly the last century, and has served us poorly.

How to change this? Rather than looking at the false bottom line, let’s look at the real one. We must examine the real costs of illness, and change our goals. Our main goal for health care must be the highest state of health, for the greatest number of people, at the lowest cost. This goal should then be our standard for reducing health care costs.

We need have the tenacity to do the real work of preventive health care as our main effort at achieving that goal. In order to do real prevention, we need to be advocates for healthy diets, exercise, stress reduction, and other healthy choices, and to look for the real causes of illness. Too many of our so-called diagnoses are just descriptions of groups of symptoms, and the possibility of looking for a cause of these diseases is shrugged off. A few examples of these are “Irritable Bowel Syndrome” or “GERD”, “IBD” (inflammatory bowel disease) and “chronic sinusitis.

I just received a message from a woman I saw as a patient more than 20 years ago. This is what she said:

I wanted to let you know I have gotten rid of my Crohn’s Disease! All the things you helped me with–digestive enzymes, vitamins, probiotics, staying away from the foods I was allergic to, and not eating too much meatdoing all this over the years made it go away completely. The last colonoscopy showed NO trace of Crohn’s! Thank you for giving me an open mind to alternative medicine. When my doctor recommended me to you over 20 years ago little did I know how it would change my life. Thank you!

As a result of some persistent investigative work, and some real prevention, this woman just spent the last 20 years as a healthy person instead of a Crohn’s patient. Now imagine the difference in the cost of treating a person with active Crohn’s Disease for the last 20 years, as opposed to the cost of a few vitamins, probiotics, and digestive enzymes over that same period of time. In a 1990 study, it was estimated that the average expenditure per year was $6,561 on every Crohn’s disease patient. Allowing for only a 3% annual rate of inflation, it was $10,221 by 2005. (figures from At an average of $8,391 per year for my patient, that’s $167,820 saved for her alone. With an estimated number of Crohn’s patients in the USA in 2005 at 600,000, that’s a staggering annual cost of just over 6 billion dollars a year for all patients. Now, let’s say that the origin of Crohn’s is undiagnosed food allergies, as it was in my patient, for half of the Crohn’s population. That is an annual savings in direct medical costs of 3 billion dollars per year, as well as uncounted costs in loss of work days or full disability.

Here’s another example in which keeping the goal in mind–the greatest health, for the lowest cost–insisting on looking for the cause of illness, and doing the real work of prevention pays off. I saw a 7 year old girl who had been, in her mother’s words, in “medical hell” for five years, since the age of 2. She had eczema so severe that she woke herself up scratching at night, and her arms and legs were covered with sores, she had asthma, ADD, recurrent ear infections and gum disease. Her mother said she had been to the doctor almost every week with her over the previous five years, and she had had countless courses of antibiotics. We found she was allergic to gluten, dairy, corn products and cane sugar. I only saw her for two visits, but her mother called me a year later and told me that she was free of all her illnesses, including the asthma and ADD, and that in the year following her visits to our office, had been to see a doctor only once, when she hurt her hand on the playground. I haven’t done cost estimates for her, but it’s easy to see the difference between more than 40 doctor visits a year, and medications, versus one visit and no medications. In addition, what is the cost of a child missing important early years of education because of ADD?

The point of all this is that each individual act of prevention is important, and that in health care reform, it’s not just a matter of who pays and who is covered. It’s having the motivation to examine what we are really doing. What is our concept of health care and what are our goals? We need to stop following the false bottom line, looking narrowly at the profit margins of health care providers and insurance companies, and instead broadly examine the true financial, social and emotional costs of illness. We need to start at the base, and educate doctors in real preventive practices by requiring comprehensive courses in nutrition, exercise physiology, and psychoneuroimmunology at all medical schools. We need to look for real diagnoses and do real prevention.

The health care industry has just said that it is projecting 20 years of “self-regulated” cost reduction. If we accept this, then we have learned nothing from our recent economic crash, brought to us by the “self-regulated” financial industry. We can no longer afford the insanity of doing the same thing and expecting different results.

Chemicals in sunscreens are “gender benders”

I have been looking at labels for years, on everything under the sun, including sunscreens. It never made sense to me that you should apply chemicals to your skin and then bake it at high temperatures. Now, Margaret Schlumpf and her research group at the Department of Pharmacology, University of Zurich, Switzerland, have confirmed my common sense concerns. They have found that these chemicals have strong estrogenic activity. Chemical estrogens are “gender benders” and can contribute to these health problems

Women: Increased breast and uterine cancer, uterine fibroid tumors, endometriosis, PMS, irregular periods and migraines.

Men: Reduced penis size, increased testicular cancer, undescended testicles, breast enlargement, lowered sperm counts, sexual identity confusion, and impaired male fetal brain patterning.

In addition to the research at University of Zurich, research was done at Tulane University in New Orleans. They found that combinations of the estrogenic sunscreen chemicals and other environmental chemicals, like PCB’s and DDT are more harmful that the single chemicals. One mixture of these estrogenic chemicals was 160 to 1600 times more toxic than each individual chemical in the mixture.

<!–[if !supportEmptyParas]–> <!–[endif]–>Estrogenic chemicals are harmful to adults, and even more harmful in early fetal development. Male hormones trigger genes that activate male development. If female hormones are present, the fetus has female imprinting, whether their genes are male (XY) or female (XX). If a woman pregnant with a male child is exposed to estrogenic chemicals during the time when genes normally cause masculine patterns (weeks 7 to 14 of pregnancy) there may be mental or physical effectssuch as sex role confusion or reduced penis size.

How to prevent these scary gender twisting effects? Get organic, chemical free sunscreens. My favorites are Desert Essence Organics Age Reversal Mineral Sunscreen, SPF 30; MyChelle Sun Shield, and California Baby SPF 30+ No Fragrance Sunscreen. Be sure to use these on yourself, especially if you are pregnant, and your children, and have a happy, healthy, sunny summer.

The health care industry and “self regulation”–haven’t we learned a thing?

Just a quick late night note about the proposed reduction in health care costs that is supposed to be presided over by the health care industries themselves! What an amazing flurry of activity by insurance and drug companies, doctors and hospitals, to convince the Obama administration that they will reduce costs over the next ten years. Would that be anything like the self regulatory brilliance of the financial industry over the last ten years? I’m thinking that it could be. The salaries of CEO’s of these industries are just about as outrageous as those of the bankers and big fund managers, and they have just as big a stake in “business as usual.” Until we have leadership that is able to include management objectives that include other considerations than the amount of money that will flow into the managers’ own personal offshore bank accounts–objectives like a comprehensive, adequately funded public health service, coordination of food programs and health programs, required community clinics in all teaching hospitals, required discounting of pharmaceuticals for the underserved, the end of unfair tax breaks for pharmaceutical companies and insurance companies, and the use of their tax money to fund public health programs, as well as required public health service for all doctors in training–we are likely to have business as usual. How many of the programs I just mentioned do you think that insurance and drug companies, doctors and hospitals would voluntarily take on themselves? Probably about as many as the pay cuts in Congressional salaries that we have seen voted into law by the Congress members themselves!

Prevention and Wellness to be Centerpiece of Health Care Reform


After 27 years of making prevention and wellness the centerpiece of my practice, it was amazing to see in the New York Times that the government now plans to make them the centerpiece of health care reform. (Sort of like being in an alternate universe.) With the government finally getting on the bandwagon, it is important to make sure that a majority of the programs focus on true prevention–which involves our nutrition, our exercise, and our attitudes! How about starting with requiring serious courses in nutrition and exercise physiology at all medical schools, so that doctors would have an educational base for the importance of nutrition in all health. Anger management for all health care providers and their patients wouldn’t be a bad idea either. Most current programs that are labeled prevention are actually early detection–which is helpful too, but secondary. For example, you need to be educated to eat less sugar, eat five servings of fresh fruits and vegetables daily, get adequate exercise, and do stress lowering activities to lower cortisol in order to prevent diabetes. Early detection (sometimes called prevention) of diabetes includes programs like community blood and urine testing. But by the time you are spilling sugar in your urine, the time for real prevention is already past!

Here’s the quote:

“Two Democratic senators working on comprehensive health legislation, Max Baucus of Montana, the chairman of the Finance Committee, and Tom Harkin of Iowa, have taken the lead in devising such incentives.

“Prevention and wellness should be a centerpiece of health care reform,” said Mr. Harkin, who regularly climbs the stairs to his seventh-floor office on Capitol Hill.

The White House agrees. One of President Obama‘s eight principles for health legislation is that it must “invest in prevention and wellness,” a goal espoused in almost identical words by Republican senators like John Cornyn of Texas and Orrin G. Hatch of Utah.

Frank B. McArdle, a health policy expert at Hewitt Associates, a benefits consulting firm, said, “Wellness and prevention programs have become a mainstream part of the benefits offered by large employers, and it’s virtually certain that Congress will include incentives for such programs” in its bill. The goals of such programs are to help people control blood pressure, fight obesity and manage diabetes and other chronic conditions. Under Mr. Harkin’s proposal, employers could obtain tax credits for programs that offer periodic screenings for health problems and counseling to help employees adopt healthier lifestyles. Programs could focus on tobacco use, obesity, physical fitness, nutrition and depression, he said.”

Swine Flu and Traditional Chinese Medicine

Swine Flu and Traditional Chinese Medicine

Last week I wrote about swine flu, and sent some recommendations for a friend, Sara Altschul, to post on her health blog, Here’s what I recommended:

PREVENTION The most important preventive measure is the old standardfrequent hand washing. Also, do not rub or touch your eyes or nose when you are out in public and haven’t washed your hands. Buy, carry and use the non-alcohol based ecologic hand sanitizers. Cough into a tissue or your bent arm.

IMMUNE BOOSTERS Now, on to boosting the immune system. One of the best immune boosters is still Vitamin C. Take at least 500 milligrams, with 6 to 8 ounces of water, 4 times a day. Other immune boosters are strong anti-oxidants including Oprah’s current favorite, acai berry. Another one, which is known specifically to work for flu, is elderberry. There an alternative version of Airborne, Source Naturals “Wellness Fizz” which contains forsythia, and all the other herbs in the Yin Chiao formula I will describe below in the treatment section. as well as zinc, selenium, and elderberry.

SYMPTOMS It’s important to recognize the symptoms early: they are any combination of theseheadache, cough, sore throat, fever, nausea, dizziness.

TREATMENT If you have any of these symptoms, get a prescription of Tamiflu and start it right awayit is effective only if you start it within 48 hours of the beginning of symptoms. Some types of flu viruses are already resistant to it, but the one that is causing the current outbreak isn’t. Probably the most effective treatment is Chinese herbs. They are effective in both killing the virus and helping resolve the flu symptoms. The best thing to take is a combination of two Chinese formulasYin Chiao Chieh Tu Pian, and Zhong Gan Ling. They should be taken as a combinationtwo to four Yin Chiao tablets twice a day, and four to six Zhong Gan Ling tablets three times a day. They should be taken with food. It is also important to remember that if the person has signs of prostrationthat is, too sick to get upor shows any sign of dehydration, they should go to the hospital.

Fast forward a few days, and now swine flu is the hottest topic in the media, and for good reason since it is spreading rapidly, and people need to know what to do. I just noticed an email from Consumer Reports (one of my favorites, by the way) that pretty much issues a blanket warning against use of any supplements or “immune boosters” which they put in quotes, as if there is nothing that can really boost the immune system. That inspired me to begin my own blog with a comment on my recommendations, especially the ones regarding Traditional Chinese Medicine, which I have been practicing since 1978. Let me just make my own blanket statement hereChinese herbal formulas can be effective for flu. Here’s the way I made my recommendations. Last year I did some research on formulas which had been used successfully in China for bird flu. I found one, but it was a formula that requires getting packets of raw herbs at a Chinese pharmacy, boiling them, and then drinking the (generally nasty tasting) tea. That’s not any help it this country because it’s just not going to happen here. Before I looked any further I checked with my partner, Dr. Leon Chen, who was an orthopedic surgeon in China, and was head of a large hospital department of orthopedic surgery in Kansu before he came here. He confirmed that the formula I had found was the real thing. Then we looked for Chinese patent formulas that had the same herbs in them, and came up with the combination of Yin Chiao Chieh Tu Pian and Zhong Gan Ling, which I recommended. I have actually used this for flu for myself and for patients and it has worked. I have not specifically used it for swine flu. However, the way Chinese herbs work is different than Western drugs. They are very complex, and it is nearly impossible for viruses or bacteria to develop resistance to them. As a matter of fact, there are antimicrobial formulas that were first recorded in 200 A.D., are still used, and still work. So with all due respect to Consumer Reports, an appropriate formula from Traditional Chinese Medicine is something that you can use to help you if you get the flu. By the way, there is also the issue of quality control for the Chinese patent formulas, a legitimate worry with all the contaminated products of various kinds coming from China, and something I am very careful with in my practice. The company I recommend is Mayway, which distributes Plum Flower herbs, all rigorously quality controlled. Mayway doesn’t sell the formulas directly, but you can buy them at