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Archive for February, 2007

In health matters, we are always an Experiment

Thursday, February 15th, 2007

The buzz in the college dorms in the 1960s was, “Should we use these birth control pills? We don’t know the long-term effects.” No one knew, but we took The Pill. My generation was the guinea pigs, and the long-term effect has been to cause the unhealthiest generation of American women in history.

Then as we entered menopause, the buzz in the late ‘90s was that the huge generation of Boomers would usher in the largest number of women entering menopause. Some 37 million of us. We would need HRT to get us through it.

Through the ages, Women made the “transition” without drugs
Very thoughtful books were published on this transition, and I read them, too. What difference did the numbers make? Was Washington wary of 37 million “going crazy” through “the change” or were the pharmaceutical companies just chomping at the bit to sell more drugs? Menopause occurs with each one of us individually—it makes no difference if another 37 million women are going through the transition at the same time. It’s not a national security issue.

While beginning this passage myself, I was visiting historical cemeteries in Virginia for my daughters’ history lessons. Standing in front of grave markers of women who lived in the 1700s and 1800s, I started doing the math. Hey, these women were living into their 80s—and they did it without HRT!

The American public cannot depend upon America mass media for any balanced reportage of health alternatives. First, for the past 60 years the American public has become so dependent upon the opinions of the AMA, that to find an American reporter who has a clue about alternatives to our drug culture, they would have to have lived beyond US borders or been born into a family with fiercely independent-thinking parents.

Then there’s the very serious issue of advertising revenues in the US media. If the news department does have a clue and wants to print a story (or an edition!) that would instruct readers on taking responsibility for their own health, the business department will have the last say. With 40 percent of broadcast advertising revenues coming from pharmaceutical advertising, don’t look for any healthy insights on television.

Medicine is an art, occasionally a science
As to managing our health through menopause and aging, the importance of taking responsibility for our own health has never been more important. The medical establishment’s frequent dismissal of any treatment other than a drug is “little scientific evidence” or “not scientifically proven”. British and American reviews of the medical literature have found that less than 20 percent of medical procedures reported in the literature have been “scientifically tested”. Medicine is an art, just occasionally a science.

When my TSH (thyroid) tests came back “normal” according to the AMA standards, but my energy levels occasionally collapse, my conclusion wasn’t that I must be okay if the test was normal, but that the test isn’t being read or interpreted correctly. The population’s “norm” doesn’t help me. But if taking an herbal thyroid supplement makes me feel “normal” for me, i.e. tremendously improved, then the supplement is working. If we feel better whatever we’re taking or doing, then it is working for us. No opinion is need other than the body’s occupant— you!

In working to overcome fibromyalgia with every MD specialist in the book and every other type of health care practitioner (the ones who successfully treated me), I learned a most important lesson regarding taking care of my health: I’m an Experiment of One with anything I take, and I’m the Only One who Matters.

This is true for every one of us. The drug testing trials done for the FDA before a pharmaceutical is put on the market don’t expect that 100,000 will die annually due to prescription drugs, and another 700,000 will land in hospital ER due to drug interactions and side-effects. Each one of us, indeed, is an experiment whatever we take for our health.

Salud!
Beverly A Jensen, Ph.D.
President, www.WomensMedicineBowl.com

Models for Impoving US Health system are developing

Thursday, February 1st, 2007

While the nation’s health system at the federal level is locked in the troika of the special interests of the pharmaceutical and insurance industries and the AMA (all protected by the FDA), the States are independently forging new models and programs to improve the health system.
The 2006 annual report of The Commonwealth Fund reports the good news of individual State-wide programs and of models for patient care. The Fund is a private foundation working to create a higher performance health care system in the U.S.
The Fund’s annual report is the answer to my New Year’s wish/fantasy. Possibilities are out there!
Health Insurance for All—in a few states
In January 2005, Maine launched DirigoChoice, an affordable insurance product with monthly rates and deductibles based on income using a sliding scale up to 300 percent of the poverty level. The program includes 100 percent coverage of preventive benefits and cash-back incentives for participation in wellness programs.
Such a progressive program with emphasis on prevention and wellness is all that makes sense for the health of the populace and the pocketbook of the payer. If we, all US residents, are taught how to take care and manage our own health and we pick up the responsibility (here financial accountability of the individual is due, too), pharmaceuticals should become the “alternative” medicine, and insurance, especially if managed by the state, can be held accountable for costs.
Other states, Massachusetts, Minnesota, Rhode Island, and Vermont are also implementing approaches to achieving universal health insurance coverage. California is also steering towards to new approach to universal health coverage.
While these are great developments in these states, for states with higher rates of uninsured residents (which is 1 in 6 of us) and limited local sources, changes in federal public policy and federal funding will be necessary.
Increased Transparency of Health Plans
In other nations with universal health coverage and a better record of health outcomes, the patient often pays a portion of the fee-for-service. To bring in the customer/patient, medical services must post or make public their fees. In Singapore, with a combination of universal coverage and patient-fees, the health services industry vies for the private fees; the competition improves services and decreases costs, but transparency is a requirement as it is of any business.
In the U.S. the costs of medical services are rarely known in advance; they vary dramatically depending upon who is paying (the patient being charged 3 to 5x what the insurance company would pay). Upon receipt of a bill for services in the U.S. often neither the provider nor the insurance company can give a straight answer on fees.
This black hole of information is brightening. Surveys show that patients don’t have access to information regarding costs and quality of health services, and they seek it. The Fund reports a number of initiatives providing purchasers, consumers, and providers themselves with information about quality and efficiency. A premier example, the Massachusetts Health Quality Partners (MHQP), has publicly released clinical quality data as well as patients’ rating of their experiences with doctors’ offices throughout Massachusetts. Additionally, clinical performance of primary care physicians in Massachusetts is now available to the public at the medical group level.
In doing a web search of “doctor performance reports” pay attention to the source or form of the organization providing the information. Also, be specific in what information you seek—the availability of a physician or patients’ reports of quality of care, etc? They vary greatly.
Providing Post-hospital Transition Care
Group Health Cooperative in Seattle, the nation’s oldest and largest health co-op, provided the model for preparing patients for post-hospital care when they checked out. A “transition coach” worked with patients to prepare them for returning home and followed them for 30 days after discharge. Patients who receive such coaching are less likely to have complications after discharge and less likely to be re-admitted. At least one other medical center, University of Colorado Health Sciences Center, has taken Group Health’s results and adopted measures to improve transitional care from hospital to home.
View the complete Annual Report of The Commonwealth Fund and all the good news at www.cmwf.org.
Salud!
Beverly A. Jensen, Ph.D.
President, WomensMedicineBowl.com

 
 
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