American Style Health Care System Pushed
in Canada
Wendell Potter
Published: Sunday 20 April 2014
During the year leading up to the 2008 presidential primaries, my insurance industry colleagues and I were working hard to influence the debate on health care reform.
Our number one objective: make Americans so afraid of “heading down the slippery slope toward socialism” that no candidate would even consider supporting a Canadian-style, single-payer health care system.
Leading the scare campaign behind the scenes was the trade association, America’s Health Insurance Plans. With help from a right-wing Canadian outfit called the Fraser Institute, which has received funding from the Koch brothers and other American donors, AHIP put together a three-ring binder of talking points for insurance company executives to use in speeches and media interviews.
The contribution from the Fraser Institute, a long-time advocate of privatizing the Canadian system, was a handful of selective statistics and anecdotes designed to create a negative perception of single-payer health care.
At the time, I had done no research of my own about the Canadian system. I hate to admit it, but I had outsourced my thinking to the Fraser Institute. I also hate to admit that I was willing to do that out of self-interest. If the U.S. adopted a single-payer system, I would be out of a job.
With that as background, it’s hard for even me to believe that, nearly seven years later, I’m on a cross-country tour of Canada warning our neighbors to the north about the dangers of “heading down the slippery slope” toward American-style health care.
Are Blood Pressure Drugs Worth the Falls?
For older Americans, high blood pressure is a fact of life. By one common estimate, more than 70 percent of those over age 70 contend with it. That means medication to lower blood pressure has become a fact of life, too.
Diuretics, beta blockers, calcium channel blockers, the unpronounceable renin-angiotensin system blockers — in a study looking at a national sample of almost 5,000 Medicare beneficiaries with hypertension, more than 85 percent were taking at least one of these classes of blood pressure drugs. Most took two or three, or more.
They did so because randomized clinical trials, the supposed gold standard of medical research, have shown that these drugs reduce heart failure, heart attacks and stroke without scary side effects. “The prevailing notion is that these medications are safe, with very few adverse effects,” said Dr. Mary Tinetti, chief of geriatrics at the Yale School of Medicine, and lead author of the study.
But the people enrolled in clinical trials, she pointed out, are typically healthier than older adults in general. Investigators often exclude people who have other medical problems — “co-morbidities,” in doctor-speak — or who are taking several other medications. Yet the great majority of the older people who show up at doctors’ offices do have multiple chronic conditions and are taking lots of prescription drugs.
So Dr. Tinetti and her team have been looking into whether anti-hypertensive drugs might be causing problems in the real world beyond clinical trials. They followed those 5,000 older people (average age: 80) with hypertension for up to three years, and the results of their study are disturbing: The risk of serious fall injuries — fractured bones, brain injuries or dislocated joints — was significantly higher among those who took anti-hypertensives than among those who didn’t.
The Public Health Crisis Hiding in Our Food
IF you have high blood pressure, you’re in good company. Hypertension afflicts 67 million Americans, including nearly two-thirds of people over age 60. But it isn’t an inevitable part of the aging process. It’s better to think of it as chronic sodium intoxication. And, as an important new studyfrom Britain shows, there’s a way to prevent the problem — and to save many, many lives.
A lifetime of consuming too much sodium (mostly in the form of sodium chloride, or table salt) raises blood pressure, and high blood pressure kills and disables people by triggering strokes and heart attacks. In the United States, according to best estimates, excess sodium is killing between 40,000 and 90,000 people and running up to $20 billion in medical costs a year.
Americans on average take in about 3,300 milligrams of sodium per day, but experts recommend less than 2,300 milligrams — and less than 1,500 milligrams for people over age 50, black people, or those who already have hypertension, diabetes or kidney disease, which adds up to a majority of American adults. Either target is far below where most Americans are now.
The reason that nearly everyone eats way too much sodium is that our food is loaded with it, and often where we don’t taste or expect it. Of course ham and canned soup are full of salt, but so are many foods that are surprising: A blueberry muffin can have more than double the salt of a serving of potato chips. Even healthy-sounding food can pack heavy sodium loads. Two slices of whole wheat bread can have nearly 400 milligrams of sodium, as can two tablespoons of fat-free salad dressing. Eight ounces of V8 vegetable juice contains well over 500 milligrams. Many restaurant entrees have far more sodium than is recommended for an entire day. Applebee’s lemon shrimp fettuccine, at 5,100 milligrams, has more than twice as much.
High Inequality Results in More US Deaths than Tobacco, Car Crashes and Guns Combined
April 19, 2014
In 2009, the British Medical Journal (BMJ) published a study that revealed what seems to be a shocking truth: those who live in societies with a higher level of income inequality are at a greater risk for premature death.
Here in the United States, our high level of income inequality corresponds with 883, 914 unnecessary deaths each year. More specifically, the report concluded that if we had an income distribution more like that of the Netherlands, Germany, France, Switzerland — or eleven other wealthy countries — every year, about one in three deaths in the US could be avoided.
Put that into perspective. According to the Centers for Disease Control (CDC), tobacco, including second-hand smoke, causes approximately 480,000 deathsevery year, and in 2010, traffic accidents killed 33,687 people and 31,672 othersdied of gunshot wounds.
The mechanism by which a bullet or a car crash kills is readily apparent. Inequality is lethal in ways that are less obvious. It’s a silent killer – a deadly plague that we, as a society, tend not to acknowledge.
In Divided: The Perils of Our Growing Inequality, a new book edited by Pulitzer Prize-winning journalist David Cay Johnston, Stephen Bezruchka, a former emergency room physician who is now a professor of public health at the University of Washington, explains the connection. (An excerpt from his chapter titled “Inequality Kills” can be read at Boston Review.)
This week, BillMoyers.com asked Bezruchka about the relationship between inequality and mortality. Below is a transcript of our conversation that’s been lightly edited for clarity.
Epidemic of GOPer virus will kill thousands in red states
Epidemic of GOPer virus will kill thousands in red states
Imagine that the Centers for Disease Control (CDC) warned that America was about to be hit by a preventable epidemic of a deadly, though curable, virus. In response, the federal government budgeted funds for each of the 50 states to purchase antidotes to save the afflicted and vaccines to immunize residents against future outbreaks. Recognizing the gravity of the situation, the White House raised the revenue to completely cover the costs of the emergency program for three years and promised to pay 90 percent of the bill after that. Even having to pick up 10 percent of the tab, most states would come out ahead by virtue of not having to pay for the care of the sick and the dying. All the 50 governors and state legislatures had to do to save thousands of their residents from needless deaths was to say one word to free money from Uncle Sam: Yes.
Now, imagine that 24 states simply said no, for no other reason than their leaders' dislike of the president and his political party.
If that sounds inconceivable, it shouldn't. It's actually happening right now. By rejecting the Affordable Care Act's expansion of Medicaid, Republicans are making the unconscionable routine by guaranteeing that thousands of their own constituents will die every year. Die, that is, from the GOPer virus.
That's not hyperbole, but a grim reality. Due to what might be the greatest act of political spite in modern American history, Republicans will needlessly leave millions of people uninsured, many hospitals on the edge of financial ruin and thousands of Americans dead, mostly in the states the GOP itself controls.
Continue reading to see how the Republicans' killer math works:
Single-Payer System Would Be a Boon to the Economy, Public Citizen Report Says
April 21, 2014
WASHINGTON, D.C. – A publicly funded, universal health care system would aid businesses by engendering a more dynamic economy, taming costs and freeing businesses that provide health insurance of the costs of administering benefits and subsidizing the nation’s health care,a Public Citizen report released last week concludes.
“Small businesses have rated the cost of health insurance as their top concern for a quarter century, and large businesses struggle with health care obligations that their international competitors do not have to worry about,” said Taylor Lincoln, research director of Public Citizen’s Congress Watch division and author of the report. “If it weren’t for entrenched partisan alliances, business leaders would have demanded that Congress relieve them of health care burdens long ago.”
Publicly funded universal health care systems – such as the Canadian “single-payer” system, in which the government pays for all covered services – exist in nearly every developed country in the world. In the United States, universal care systems could be implemented either at the federal or state levels. The Affordable Care Act of 2010 includes language permitting states to apply for waivers that would enable them to institute universal care systems beginning in 2017. Vermont has passed legislation declaring an intention to do just that.
Public Citizen’s report, “Severing the Tie That Binds,” outlines three ways a universal health care system would benefit businesses.
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