ASK Musings

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Health Archive

Wednesday

14

November 2018

0

COMMENTS

“As Bad As a Root Canal” Isn’t That Bad … If You Have Insurance or Money

Written by , Posted in Adventures

My first memory of dental work was when I was five or six. I even recall my dentist’s name, although I’m not going to share it here. My teeth were starting to come in, and he could tell my bite would need some correction, so he pulled five baby teeth in an effort to get things moving. The numbing agent started wear off by the end of the fourth extraction, and he didn’t offer to top me up, so I had one tooth pulled with essentially no pain killers.

You can see why I wasn’t such a fan of dental work after that.

Unfortunately, I had five years of orthodontics ahead of me. Braces, neck gear, rubber bands, and finally retainers. On the plus side, I was free from all but the retainer before I hit junior high, so while I looked awkward in middle school, it wasn’t because I had a mouth full of metal (just some bad haircuts and poor fashion choices).

I’ve also always liked sweets, so I knew I had to take care of my teeth. I flossed — and still do floss — every single night. I brushed twice a day. And yet the cavities came. And then the crowns. And the root canals. We tried prescription toothpaste. I got sealants on my teeth. And yet for many years, I feared each visit to the dentist (which I dutifully scheduled every six months) because of the newest filling I would need.

When I moved back to Seattle, I found a new dentist. He fixed some crappy fillings I’d gotten in New York, and did his best to keep fillings from turning into crowns. It didn’t always work, but he tried. In fact, the only reason my most recent root canal happened yesterday and not a year ago is because my Seattle dentist worked hard to make some adjustments.

Every molar in my mouth has some sort of restoration. When I visited my new dentist in the UK and got some x-rays, I was reminded of how lucky I’ve been to have access to dental care my whole life.

And when I was referred for a root canal last week, I was reminded of how screwed up it is that dental care isn’t covered for adults in the US. Even when people over 21 or under 65 qualify for public health benefits, dental care isn’t covered. And I’ve seen first-hand what that means.

For the past five years, Seattle has hosted a public health clinic in the fall. Individuals can, at no cost, receive medical, dental, and vision care. People line up at midnight to be let into a holding area, where numbers are then distributed. Because dental and vision coverage are hard to get in the US without private coverage, individuals are limited to medical + dental or medical + vision for each visit. The floor of Key Arena is converted to a giant dental office, filled with chairs.

Photo by KUOW

I was able to work at two of the clinics, one time as a runner, and one time managing the waiting area for the dental floor. People who had been up all night waited hours longer to be seen by a dentist, then sent over for x-rays and referred to come back the next day for a cleaning, flippers (removable partial dentures), fillings, or extractions. People who have had infections, even abscesses, for who knows how long, grateful that someone is taking their dental health seriously.

It was heartening to see all the volunteer dentists and hygienists, but it was infuriating that it was necessary at all.

I’ve had root canals in New York, Seattle, and London. I can vividly recall the walk into the New York endodontist’s office; there was scaffolding up around the building. My union dental insurance covered the full cost, I believe. The second one, in London, was performed at the dental office associated with LSE, and I don’t believe I had to pay anything for it. And I had great dental insurance in Seattle, so if I had anything to pay then, it was maybe 10%. In each of those three cases, I either had dental insurance (US) or didn’t have income and so qualified for my costs to be covered (UK).

As I sat in the dentist’s chair last week, she talked through my options. I could pay a whole lot of money to go to a private endodontist who has excellent new equipment, a private endodontist with good equipment, or I could pay £60 and go to an NHS specialist. The wait would probably be awhile, and the equipment might not be as good. I chose one of the private options, but the fact that, if I didn’t have money, I could still have secured the care I needed, is a reminder of how the UK is light years ahead of the US in so many ways.

People in the US like to make fun of British teeth. The reality is, they aren’t obsessed with the appearance of teeth; they just want to make sure their residents get to keep their teeth. In the US, people get care if they have insurance, but if they don’t? Oh well. Never mind the concerns about impacts of things like gum disease on overall health. I find it absurd that dental and vision care aren’t automatically included in all health care in the US. Those are vital parts of our overall health.

Monday afternoon I arrived at the posh dental office. After a consultation, I signed some forms and they got down to work. Even in the 15 years between my first and most recent root canal, the technology has improved. I had almost no pain during the procedure, and some of the techniques she used kept my jaw from aching and kept over spill from the various drilling and equipment out of the rest of my mouth. Near the very end, the numbing agent did start to wear off, but even then it didn’t really hurt. After about 75 minutes she wrapped things up, I popped some ibuprofen, and headed home. I haven’t needed any painkillers since.

I know I’m lucky that I had the money to get the procedure done quickly. But even if I hadn’t, I still would have been able to get care thanks to the NHS dental system.

I’m sure that there are plenty of people in the UK who have had horrible NHS dental experiences, but at least they had access to some care. It’s literally the least a country can offer its residents.

Wednesday

4

May 2016

0

COMMENTS

Diet Cults by Matt Fitzgerald

Written by , Posted in Reviews

Four Stars

diet cults

I’ve written on a few different health books during the Cannonball Read, and most of them are focused on what Matt Fitzgerald would call “Diet Cults.” It sounds more insulting than I think it actually is; the premise of the books is that many folks latch onto a way of eating that doesn’t just work for them, but that they insist is the only healthy way to eat. Think Paleo, or vegetarian, or Atkins. I know I’ve fallen into more than one of these ways of thinking (see: my Whole 30 book review).

Mr. Fitzgerald looks at many of these ideas about ways we must eat to be healthy and breaks them down not so much to disprove them as working for some people, but to disprove that they are the best way to eat for everyone. He doesn’t argue that these diets don’t work for some of their adherents; he just points out that for pretty much all of them, there is no science to support them as healthy for all people. Gluten isn’t likely to harm you unless you’re celiac; you can eat dairy and quality meat and not be a walking heart attack.

I think my favorite chapter was the one he used to illustrate that even sugar – something nearly everyone vilifies – has its place in some diets. Endurance athletes, for example, do benefit from the sugar added to sports drinks. They aren’t right for folks as an everyday beverage while sitting and reading a book, but they can be quick healthful for someone in the middle of a marathon.

The very last chapter gets at what he calls “Agnostic Healthy Eating.” His point is that you can make up whatever diet you want, but that there are things to keep in mind. His suggestions:
– Fruits and Vegetables (including beans) are essential, so eat the most of these
– Nuts/Seeds/Healthy Oils, High Quality Meats and Seafood, Whole Grains, and Dairy are recommended, so eat the next most of these
– Refined Grains, Low Quality Meats and Seafood, Sweets and Fried Foods are acceptable, but eat the least of these

It’s not rocket science, and Mr. Fitzgerald freely admits that it’s pretty similar to the ‘My Plate’ concept. But I found it pretty interesting. And hopefully it’s another motivation for me to do what I already know I should: eat more vegetables and fewer sweets.

Sunday

12

July 2015

0

COMMENTS

Heat Wave by Eric Klinenberg

Written by , Posted in Reviews

Four Stars

When you think about disasters that caused a whole bunch of deaths in one swoop in the US in the last 25 or 30 years (outside of a war), you probably think about the September 11 attacks, which killed 2,977 in the US. If I were to ask you what the next biggest disaster in terms of deaths, you’d probably also get it right: Hurricane Katrina and its 1,833 deaths. But do you know what caused the third greatest number of deaths in the past 25 years?

Surprisingly (to me, at least) it was the 1995 Chicago heat wave, which took 733 lives over the course of about a week.

It’s been hotter than usually in the Pacific Northwest, where I live. We had multiple days in a row above 90, which may not sound bad to those of you used to sweltering summers, but in general folks out here don’t have air conditioning (and if you do have it but you don’t have the money for an electric bill of gargantuan proportions, you might just leave it off). My apartment in the evenings was often still in the mid-upper 80s, and we don’t even get any direct sunlight (thank goodness for north-facing windows). I also work in public health emergency preparedness, so I have an extra special interest in things that cause a whole lot of people to get sick and die at once.

Author Dr. Klinenberg is originally from Chicago, and earned his PhD in Sociology at UC Berkely in 2000. Heat Wave is his dissertation, exploring not just the health causes of those 700+ deaths, but the social causes. His thesis is that the hot days didn’t kill these people alone; the systems society has set up (or not set up) instead failed many of these people in a complicated way that would be dangerous to ignore if we seek to avoid it in the future.

Much of his work focuses on comparing two neighborhoods that are very similar in some of the basic demographics, and even have the same microclimate, but had VERY different death rates. In one neighborhood (95% black), 40 out of 100,000 residents died in the heat wave; in the neighborhood next door (86% Latino), only 4 out of 100,000 residents died. That is a huge difference, and one that we should try to explain.

Beyond this, he looks at the role of city government and how they responded (or failed to respond), from the front-line police officers who were tasked with community policing but didn’t check in on the community, through the fire chiefs who ignored warnings from their staff that they should have more ambulances available, to the health commissioner who didn’t really ‘get’ that something was amiss. Dr. Klinenberg also explores the role the media played in not treated the story with the gravity it deserved until late into the heat wave.

Even if you aren’t interested in public health preparedness, or aren’t into sociological profiles, I think you might find this book to be quite fascinating. I’m impressed with the readability of what is essentially someone’s dissertation, and I think I can learn a lot that will be helpful to me in professional life.

This book got me back on track for my cannonball read, too, so I’m quite grateful for that. I haven’t finished a book in nearly three weeks. Between going to Canada for five World Cup matches (including the final – woo!), my computer dying, and learning that my back-up system failed, plus the aforementioned ridiculous heat wave we had, I’ve mostly wanted to just sit on my ass and play games on my phone. But no more! I’m back to reading and it feels fantastic.

Saturday

25

April 2015

0

COMMENTS

The Whole 30 by Melissa Hartwig and Dallas Hartwig

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Four Stars

Wait, didn’t I just review this book?

Nope.

So just this week, the “It Starts with Food” authors released a slightly more and slightly less comprehensive guide to their elimination diet program. In this section they have less detail than their previous book, but they make for it with a fairly intensive FAQ section. And then, the best part …

Cookbook! I am not a cook. I’m a baker, which really just means that I like sweets so much I want an excuse to eat them in their uncooked and cooked forms. But with dinner, I’m usually limited to making pasta and steaming vegetables. And meat? Yeah. I’ve never really been good at cooking anything beyond this one pork tenderloin recipe and this one chicken enchilada recipe (and even the latter involved a crap ton of checking the internet for how to boil chicken breasts).

So, in addition to sorting out some of my less than health food choices, I’m going to be learning how to cook over the next month, with the help of this lovely, simple cookbook. Seriously, while some recipes do require prep or overnight marinating, none of them caused me to balk or laugh as I turned the page. I think that’s the sign of a good cookbook (for me, anyway) – dishes that appeal to me that won’t cause me to give up halfway through or that won’t mean dinner starts at 10 P.M. because it took so long to prepare.

Saturday

25

April 2015

0

COMMENTS

It Starts with Food by Melissa Hartwig and Dallas Hartwig

Written by , Posted in Reviews

Four StarsStarts with Food

 

Okay, so (as discussed on my review of Dr. Perlmutter’s book), I’m trying to sort out the food that is going to make me healthy. I know it isn’t sugar (I type, having finished some delicious chocolate ice cream), although man, if I could thrive on pasta and chocolate cake, I’d be a happy, happy lady. But we all know that isn’t the case. I’ve got a good friend who has followed this elimination diet and had some pretty fantastic outcomes. I picked up the book and am going to try it.

What is ‘it’ exactly? Well, it sounds a little like paleo, although it isn’t. Not exactly. The authors are very up front that they don’t particularly care about what our ancestors ate; they are interested in what science and our experiences tell us is health for us to eat. We know that generally speaking, veggies are healthy for us. Twinkies are not. But … what about the rest?

The Hartwigs spend a few chapters explaining why certain food groups may present some challenges for us and not be contributing to good health. They are interested in things that have a negative impact on us psychologically (think the foods you crave and eat because you are emotionally – or chemically – dependent on them), hormone imbalance, digestive tract issues, and inflammation. Most of what they say I’ve seen in other books (reputable and not reputable), although, as we discussed on one of my previous reviews, they are very skeptical about our need for any grains (not refined, and not whole). They aren’t arguing that these things are necessarily BAD for you, but that they might be bad for some, and there are much healthier options anyway, so no need to eat them.

But again, their approach is to cut out all of the foods that evidence suggests might be problematic for some of the population for 30 days, and then reintroduce them and see how you feel. So, starting on April 26, and finishing on May 26, I’m going to not eat any form of the following:
– Added sugars or sweeteners (including stuff like stevia, honey, etc.)
– Alcohol (even in cooking)
– Grains (refined or whole)
– Legumes (I KNOW – I’m already tearing up at the idea of parting with my morning PB and apple)
– Dairy (with the one exception: clarified butter)

So … what will I be eating?

Vegetables. Lots. Fruits. Some. Healthy fats. Meat. Seafood. Eggs. For 30 days I’ll see if I can get some of the (not serious, but annoying) health issues I have cleared up through some diet changes. And then, I’ll figure out if I’m someone who really shouldn’t eat dairy, or if I’m one of the lucky ones who can process delicious, delicious cheese.

Friday

4

July 2014

0

COMMENTS

Mindfulness

Written by , Posted in Reviews

Three stars

mindfulness 1

Many people find themselves with over-scheduled social lives, or work situations filled with a seemingly endless stream of projects, meetings and deadlines. Perhaps these people are facing challenges at home, or school, or with health. The challenges might seem minor to others, or perhaps others observe and wonder how the person is still functioning given everything that’s happening in their lives. We hear it a lot from women who have children and also work outside of the home – there are demands everywhere, and these women can’t seem to get a break.

Without going into too much detail about why I found myself drawn to this book (during yet ANOTHER trip to Powell’s in Portland – that place should just take all of my money now), but I wanted something that would help me to be more present in my life, and kinder to myself. My husband meditates, and it really helps him when he’s feeling a bit off. Given that, this specific book appealed to me in many ways – it wasn’t horribly long (about 250 pages), it had a clear plan (it focuses on an eight-week meditation program), and it even came with a link to audio files to guide the meditations.

I was successful in keeping up with the program for about a week. I did read each chapter, and I really enjoyed the messages within them, but I don’t think this book was what I wanted. I sort of want to meditate, and I mostly enjoyed the meditations in this book, but I found the information within the chapters leading up to the meditations themselves to be much more useful. It was probably not the best book for me given what I was looking for, but I think it was well-written, supported with some research, and not overly flowery. Yes, it the authors discuss self-care, but if you have an aversion to anything that seems new age-y (although meditation is hardly that), you can still read this book and enjoy it. I’m sure I’ll end up referring back to it during challenging days, but it hasn’t turned me into a regular meditator.

Saturday

15

February 2014

0

COMMENTS

Intuitive Eating

Written by , Posted in Reviews

Three Stars

I’ve been on lots of diets, and have made many attempts to change up my eating to try to lose (or keep off) weight. Over the past couple of years, I’ve been reading more nutrition books (like last year’s “Good Calories, Bad Calories”) as well as a lot of articles and blogs about Fat Acceptance and Healthy At Every Size. The later repeatedly points out both how society has created all kinds of fucked up issues with food, and how in the US and other cultures we’re conditioned to value appearance (i.e., thinness) over actual health (which really cannot be determined just by weighing someone).

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I heard about this book on one of those blogs, and while it’s definitely written in a manner that’s a bit more ‘chicken soup for the soul’ than I’d like, the message the authors (both professional dieticians who work with people with eating issues) are putting forth is interesting, empowering, and something I wish I’d been able to figure out on my own at some point.

The basic premise of the book is that, as the evidence points out, diets just don’t actually work. They don’t work for lots of different reasons, but in the end people blame themselves or their ‘willpower,’ and this leads to a cycle that, if you’ve been on more than a diet or two in your life, will seem pretty familiar. You decide to diet, you decide to cut out certain foods, you lose weight (or don’t), you eventually stop, and gain weight back, decide to diet, eat the forbidden food one last time, etc., forever. Now, of course there are people who diet, keep the weight off forever, and possibly enjoy saying things like “if I can do it, so can you!”, as though that’s somehow motivating as opposed to serving to make others just feel like they are weak or bad at life. This book is for the vast majority of us for whom diets won’t be the answer to being healthy.

So beyond pointing out the obvious, what does this book do? It seeks to help the readers to develop a health relationship with food, with the goal NOT of losing weight but of actually treating food as it should be treated. The authors want us to view food not just as fuel, but as pleasure as well (shocking, I know!). The authors want the readers to stop using food as a way to punish ourselves (carrots are good for you damn it, even if you hate them, EAT THEM) or to cover up our feelings. It’s a pretty radical approach for those of us who have struggled with food issues (although for those of you who never have, I’m willing to bet that it all seems extremely natural, which could be WHY you’ve never had food issues).

How does it purport to work? There are ten ‘principles,’ but the focus is not on perfection or failure; instead it wants you to focus on the process of slowly improving your relationship with food. As you go through this process, if you’ve had an unhealthy relationship so far, your weight should normalize, and part of the process is recognizing that a normal weight for you may not be the weight you’ve always dreamed of, and that’s OKAY. Again, kind of a radical thought, especially in a culture that spends so much time saying “if you work hard enough, you can do anything!” I can tell you right now, that unless I stopped eating for a year, removed some ribs and somehow shrunk the width of my pelvic bones, I’m never going to have they body of Gwyneth Paltrow. So why torture myself to get there?

The principles are: Reject the Diet Mentality, Honor Your Hunger, Make Peace with Food, Challenge the Food Police, Feel Your Fullness, Discover the Satisfaction Factor, Cope with Your Emotions Without Using Food, Respect Your Body, Exercise – Feel the Difference, Honor Your Health – Gentle Nutrition.

The book goes into much more detail, but the main points are that you should eat when you’re hungry, eat what you actually want to eat, stop when you’re full but enjoy your food, manage your emotions in other ways, and use exercise for health and movement, not for weight loss. Again, pretty straightforward, right? Except I’ve been working on this for just a week, and I’ve already started to recognize some things. I’ve really been tasting my food, and realizing that some things I eat because I’ve gotten used to them, not because I actually like them. I’m starting to actually eat when I’m hungry, and eat what I want, and I find that I’m eating more often, but usually eating less, and being MUCH happier with my food. Will I lose the 15 pounds I’ve gained since a stressful family event last summer? Maybe. Or maybe this is my normal weight. But I feel pretty confident that if I actually employ these suggestions I might actually be on the way to having that enviable healthy relationship with food some others already have.

Saturday

30

November 2013

0

COMMENTS

Good Calories, Bad Calories

Written by , Posted in Politics, Reviews

Four Stars

Good_calories_bad_calories_book

 

CANNONBALL!

It seems appropriate that I finished this book over Thanksgiving weekend, given our national propensity towards eating a fair bit more than usual during this time. I’d seen this book on the shelves at the bookstore before, and ignored it because it seemed like another cheesy diet book. After a friend described it as a book that made her actively feel smarter, I picked it up.

Before I get into the book, I want to point out that people can be fat for many reasons (as the book will show), and that moreover it is absurd to suggest – as society so often does – that one has to lose weight or become skinny to have value (or to be healthy). Lots of people want to say that fat people are unhealthy because they are fat, but when it comes down to it you really can’t usually tell if someone is healthy simply by looking at them or if you know their height and weight. Moreover, I don’t think anyone owes it to anyone else to be healthy. I think everyone should have access to things that can help them be healthy, but I don’t think anyone owes ME their health. And yes, that includes fat people who some think cost the healthcare system more. First off, they don’t but secondly, if we’re going to start requiring fat people to lose weight because they might cost us more in health care, then there are a whole lot of other people (people who drive, people who ride in cars, people who smoke, people who ski and might break a leg, people who play professional football) who apparently need to change their behaviors because we think they might cost us more. Alright. On to the review.

The next time you’re around family discussing weight loss, obesity, or anything really related to diet and nutrition, and someone (usually smug, usually skinny) says “it’s a simple matter of physics: calories in has to equal calories out or you’ll gain or lose weight,” hand him a copy of this book, and tell him to not comment on such things until he’s read the whole thing. In addition to possibly contributing to his education, it’ll have the added benefit of shutting him up, because no one wants to hear from that douchey cousin anyway.

Mr. Taubes’ purpose with this book is to examine as much of the science behind weight gain / loss and the diseases that tend to be associated with it as possible. He’s not so much interested in proving or disproving any one hypothesis; he’s interested in seeing what is out there from the last 100+ years and trying to figure out if any of the conventional wisdom we hold regarding weight, nutrition and health stands up to scrutiny. It turns out much of it does not.

There is so much in this book that I can’t cover in this review (especially the discussion on why cholesterol tests may be measuring the wrong thing and ultimately not telling us what we think they are – I need to re-read that section to really understand it), but I wanted to pull out some interesting bits. While looking at some weight studies that have been done, Mr. Taubes pretty quickly dismisses the idea that people are fat because they ‘overeat’ (in fact he repeatedly uses many different studies to fight off this repellant ‘lack of willpower’ argument). The most interesting ones were the studies that had people eating the exact same diet and exerting the same amount of energy (usually these were prison inmates and thus easily tracked) and showing that across the board, some people gained weight, some stayed the same, and some may have lost weight. And among those gaining weight, some would gain two pounds, some would gain 10 or 15. Yes, those are just a few studies, but it does hold up when you think about the people you might know who seem to eat as much as or more than you and yet never gain any significant weight, while you might eat 1,500 calories a day, work out for 30 minutes six times a week, and struggle to fit into a size 16 pants. The question then becomes WHY does this happen?

Another interesting discussion revolved around exercise, and how it may have many health benefits, but that weight loss is not likely among those benefits. I’d read articles about this before; the thinking is that yes, you work out and burn some calories, but the attendant rise in hunger will usually cancel out any weight loss based solely on activity. Let’s say you work out on the elliptical for 30 minutes more than usual and burn and extra 250 calories; just off of the hunger that a workout can produce you might consume that extra 250 with a single Cliff bar on the walk home from the gym. The author is not saying that exercise doesn’t have health benefits; only that those benefits don’t necessarily include weight loss.

It’s so interesting that many of the studies, if properly interpreted, provide very different conclusions than the ones the authors of them – and the policy wonks who reference them – concluded. That then leads to a whole lot of confirmation bias – people looking for support for answers they already have decided are correct and only conducting studies or referencing studies that support the answers they want. So you get one study that claims that fat is bad (but doesn’t actually properly measure that); common sense says well, people who are fat have a lot of fat, so duh, eat less fat to have less fat, and the wheels are set in motion. But what Taubes’ meta-research shows is that it is not fat that makes people fat and keeps people from a lower weight, but simple sugars and carbohydrates.

That’s right – the data (annoyingly) seems to overwhelmingly support the ideas that those obnoxious Atkins / South Beach / no carb diet books promote. Sort of, although not necessarily for the reasons those book site. Taubes’ understanding of the research out there suggests that what matters is not necessarily the amount of energy we consume (via food) but the type we consume that impacts the energy that is available to us, and the consumption of carbohydrates (think flour and potatoes, not the kind found in veggies and fruits) hinders the ability to make use of the energy we already have stored in our body, while also adding to those stores and increasing our fat. The book goes into a lot of detail and is very dense, so it’s hard to synthesize it down to this review (he’s apparently followed this book up with a book targeted more at the average reader, not science readers). But I am going to say that the argument he makes was really convincing to me. There’s so much more to say, but this review is already silly long, so if you’re interested (or screaming NO YOU’RE WRONG while reading this), then pick up the book.

As I said, this is NOT a diet book; however, the epilogue does offer his thoughts on what he thinks his meta-research has shown and what that means for people who want to maintain certain weight levels and stave off some diseases (the section on sugar and diseases is enough for me to seriously contemplate giving up added sugar completely), but he points out that there is so much more research that should be done and IS NOT being done because society assumes it already gets it. It’s sort of like the drunk who drops her keys and then only looks for them under where the streetlight is shining; it’s the easiest place to look, but that doesn’t mean the keys are there, and she’s likely going to miss them if the light is only shining on a small bit of street. We seem so focused on the ‘conventional wisdom’ (and so few of us have really read the studies) but that wisdom seems to have really not worked for so many people, so perhaps it’s time to focus more on what we haven’t yet tested.

Friday

8

October 2010

0

COMMENTS

It’s the healthcare, stupid!

Written by , Posted in Politics

8 October 2010 Last updated at 12:45 ET

US healthcare ‘to blame’ for poor life expectancy rates

Hospital in Chicago US healthcare reform may save lives and money, the study authors wrote

The US healthcare system is to blame for declines in the country’s life expectancy ranking, a study suggests.

The Columbia University report rejects claims that factors such as obesity have shortened life-spans for Americans relative to other wealthy nations.

The study blames reliance on costly and fragmented specialised care, and calls for systemic reform.

Its release comes as President Barack Obama’s healthcare reform remains a key issue in upcoming mid-term elections.

Higher costs

The study notes that in 1950, the US ranked fifth among leading industrialised nations for female life expectancy at birth, but only 46th in 2008.

It finds that US healthcare spending increased at nearly twice the rate of that in other wealthy nations between 1970 and 2002, with the increased spending corresponding with worsening survival rates relative to the other countries studied.

“In most cases, the relative US performance deteriorated from decade to decade,” wrote authors Peter Muennig and Sherry Glied of Columbia University’s Mailman School of Public Health.

They note the countries to which the US is compared – Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland and the UK – all provide universal healthcare coverage.

Factors such as differing obesity, smoking, road accident and murder rates were taken into account in the study.

‘Meaningful reform’

The US spends far more on healthcare than any other country as a percentage of gross domestic product, the study finds.

“We speculate that the nature of our health care system – specifically, its reliance on unregulated fee-for-service and specialty care – may explain both the increased spending and the relative deterioration in survival that we observed,” the authors wrote.

“If so, meaningful reform may not only save money over the long term, it may also save lives.”

The authors said those aspects of the US health system contributed to unnecessary medical procedures, poor communication between doctors and higher rates of medical errors.

So, apparently it’s not so much obesity but our crap healthcare system that accounts for the US life expectancy. 

I haven’t had a chance to read the study, so I can’t say whether the reporting on the results is fair. The study is linked above and here.

Tuesday

18

May 2010

0

COMMENTS

Dentists, Doctors, the NHS and Me

Written by , Posted in Random

Here is a tale of two medical experiences in the UK.

Yesterday I went to the dentist. I had an exam a few weeks back and had a (pain-free) broken filling. It was to be filled in April after my trip to the states, but unfortunately the volcanic ash caused a reschedule. Yesterday I went in, was numbed up (without pain – go dentist!) and when he got in there realized I needed a root canal. Awesome. I was already numb, so he went ahead with the first part. Get to finish it next week, then have a filling put on top. The first bit only cost £38 (about $56 depending on the exchange rate), and the rest should be less than £100. Of course time will tell if the work is good, but he’s a private (not NHS) dentist on campus, so I’m thinking it will be okay.

As you may recall I’m still unable to get health insurance in the US beyond COBRA due to some irregular tests I had in 2008-2009. In October I had a regular test, so I need one more six month later to qualify for health insurance in the US, as the reform bill provisions don’t kick in for me until 2014. I went in today and the UK guidelines are only once a year for people like me, so they couldn’t give me the test. I now need to consider finding a private doctor, pay to have the test done so that I can get cheaper health insurance in the US, even though I think they’ll probably try to deny me coverage again because of too many ear infections or cases of bronchitis. So the question is – do I wait until I’m back in Seattle and deal with it then, or pay for a private test in the UK?

Good times.