Monday, April 25, 2005

Eat Well- Be Active- Live Long- Live Well

Cook you own food, eat your vegetables, junk the junk food, including the daily double double at "Tim's, Starbucks, Second Cup et al ." Keep in touch, exercise a little, that's the mantra of the Adams siblings all 7, aged from 76- 90 . They've celebrated 582 collective birthdays, so from experience they speak, if we listen and hear, there's a useful message.

Adams Siblings
Source Edmonton Journal

There's a pretty good chance we'll all live a little longer, if we chose to make the investment, now. See yourself at 90, what's the picture? It's bright if we can walk, talk, read, and connect. Small adjustment now leads to productivity, living well, at the back end of the timeline.



Research Sources
Senior Peer Mentoring
Older Women and Excerise
Attitude and Aspirations of Older People

Monday, April 18, 2005

Media Bombast =Distortion= Bad for Your Health

Thomas Wolkom is influential writer for the Toronto Star. He's an apologist for Canada's failing medicare system. He uses his Toronto Star pulpit to distort and disparage . He had this to say about Canada Strong and Free, a policy paper on Health Care in Canada presented, last week, by Mike Harris and Preston Manning.

Mr Wolkom wrote... the pamphlet is classic Preston Manning, with funding and research — much of it dubious — provided by British Columbia's right-of-centre Fraser Institute.

Who says the research is dubious? That statement is columnist opinion presented as fact. The international research presented in Strong and Free, measuring how effective Canada's medical system is, and how it ranks in the world, came from the OECD.

Mr. Wolkom wrote .... Manning and Harris want to get rid of universal, comprehensive, public health insurance and replace it with a pared-down system that covers only catastrophic health problems and so-called "core" services.

Here is what the report said.

"... Most importantly, you and your family will be fully insured against catastrophic illness, just as you are now, and will have continued access to all medically necessary services regardless of ability to pay. These features of our current system will not only be re­retained. They will be made far more sustainable. But in addition, you will have more choice in health-care services resulting in shorter waiting times, access to the latest medical technology and better care"

Mr Wolkom wrote ...Everything else would be paid for out of pocket or through private insurance. Even the slim-line public scheme would be financed in part by user fees. The Canada Health Act, the federal law governing medicare, would be scrapped.

Here is what the report said.

"In most provinces, when you are sick you will still most likely enter the health-care system through the door to a doctor’s office, clinic, or a hospital that is part of the public health-care system. But if your needs cannot be attended to promptly or satisfactorily, you will have the option of being referred to another facility offering equivalent or more specialized care where you can be treated sooner, and that facility, while licensed by the government, may well be financed and operated by a qualified private operator."

"If the services provided by the private facility are core services covered by your provincial health-care insurance plan, upon presentation of your Health Care Card the cost of your treatment will be covered by the province in accordance with the same fee schedule used at publicly run facilities. If the services you require or desire are not covered by your provincial health-care insurance plan, they may be paid for directly or through any private supplementary health-care insurance plan (which is the case now)."

Core services and user fees, for services not covered by the public insurance program, are in play now. Alberta, just de-listed physiotherapy from six medicare covered visits to two. Physiotherapy is provided by private practitioners operating for profit business, within the medicare system. Government insurance pays for very little. You may have private insurance that pays for more. That insurance policy carries a deductible, which keeps the premium cost at the level you choose. Those who can't afford private insurance, and are not covered by an employers program, are restricted to two medicare paid physiotherapy sessions, in Alberta.

Mr Wolkom wrote ... It's similar to the kind of scheme that former Alberta Social Credit premier Ernest Manning, Preston's father, pushed in the 1960s. And it is straight out of the play book of the Fraser Institute, which has long had a true hate on for Canadian medicare.

Currently, Canadian Medicare makes Canadians less healthy, as they wait for government supplied services, which take longer and longer to deliver.

Alberta Health's website says waiting times in Calgary are as follows:

- 62 weeks for a hip replacement at Peter Lougheed Centre;

- 62 weeks for general surgery at Rocky- view General Hospital;

- 30 weeks for MRI scans at Foothills Medical Centre;

- 54 weeks for knee replacement surgery at Rockyview General Hospital;

- 11 weeks for cardiac surgery at Foothills Medical Centre.

The impact of waiting is completely dismissed by Canadian Health Act propagandists. The apologists stifle reform by trying to scare you.

Saturday, April 16, 2005

Medicare Time Bomb- Media Bombast

Canada Strong and Free is worth a read. The report, co authored by Former Ontario Premier Mike Harris and Reform Party Leader Preston Manning, was presented April 13 the and brought all the health care nationalists, who perversely wrap Canadian Culture and Canadian values into the delivery of a essential service. A service that is not being delivered very well.

The Prime Minister said: "The Conservative agenda is no longer hidden, it is no federal role in health care, it is no Canada Health Act, it is no one saying no to the privatization of health care.''

The report has one major premise. Canadians need more freedom of choice in their lives. The concept promotes, greater use of private insurance to cover the costs associated with health care, incentives for those who take care of themselves, and a guarantee of universal access.

Here are the main recommendations..
  • Remove jurisdictional roadblocks to better health care for patients by sub­substantially amending or replacing the Canada Health Act and transferring responsibility for health-care delivery and financing, including federal tax points, entirely to the provinces. Make Freedom of Choice a fundamental principle of any future health-care legislation.
  • Expand health-care facilities and cut waiting times by removing all federal restrictions that prevent provincial governments from using private capital­, non-governmental providers, and market-based pricing mechanisms in the development of health-care facilities and the delivery of health-care services to Canadians.
  • Focus federal support for health care in the areas where it can do the most good: health-care science and research, no-strings-attached equalization payments to have-not provinces to enable them to meet national standards­, and the collection and dissemination to health-care users of information­ on the performance of the Canadian health-care system including the portability of benefits between provinces.
  • Reduce the federal personal income-tax rate from 6% to 5% for the low­lowest bracket, eliminate the next two brackets, and reduce the top rate from 29% to 25%. The reduction and elimination of these brackets would equal the current federal spending on health care and allow the provinces ex­expanded tax room to finance health care. The equalization for­formula will provide additional revenues to those lower income provinces for which a “tax point” is worth less than for higher income provinces.

What will the adoption of these measures mean to you and your family in practical terms? Most importantly, you and your family will be fully insured against catastrophic illness, just as you are now, and will have continued access to all medically necessary services regardless of ability to pay. These features of our current system will not only be re­retained. They will be made far more sustainable. But in addition, you will have more choice in health-care services resulting in shorter waiting times, access to the latest medical technology­, and better care.

In most provinces, when you are sick you will still most likely enter the health-care system through the door to a doctor’s office, clinic, or a hospital that is part of the public health-care system. But if your needs cannot be attended to promptly or satisfactorily, you will have the option of being referred to another facility offering equivalent or more specialized care where you can be treated sooner, and that facility, while licensed by the government, may well be financed and operated by a qualified private operator.

If the services provided by the private facility are core services covered by your provincial health-care insurance plan, upon presentation of your Health Care Card the cost of your treatment will be covered by the province in accordance with the same fee schedule used at publicly run facilities. If the services you require or desire are not covered by your provincial health-care insurance plan, they may be paid for directly or through any private supplementary health-care insurance plan (which is the case now).

Source
Canada Strong and Free


Team Approach - Health & Business Sense

There has been some quantitative movement this week in reorganizing medical care delivery services, Canada

Ontario has announced a Health Team approach, integrated facilities which incorporate doctors, nurses, nurse practitioners, and possibly pharmacists, physiotherapists, chiropractors, dietitians, and nutritionists.

Health Canada and Canadian Nurses Association are coordinating an effort to re-evaluate and upgrade the role of Nurse Practitioners, registered nurses, who can diagnose and treat common illnesses, prescribe medication, order tests and refer patients to other health-care professionals.

The intention is to reduce wait times for those who need treatment, more importantly including dietitians and nutrionists preventative therapy emerges as part of medical practice.

The Health Team model could be the harbinger of a new medical care business model. Rather than these professional being employees of public institutions, these emerging health care teams may present themselves as integrated corporations, that includes both medical and diagnostic services. The benefit is the potential for a significant reduction in 'administrative costs', no contraction of service, with all services billed, as they are now, to public health insurance program.

Monday, April 11, 2005

Take Control -Self Care- Be Healthy

Bill C420 is a piece of legislation intended to amend the Canadian Food and Drug Act. It has disappeared into the amending stage, the legislative abyss of committee review, where the vested interests tell the government what they think, we need.

The Non Prescription Drug Association , NDMAC , sees some value in specific amendments that Bill C420 has to offer. NDMAC is on side with the natural health products industry in revamping Schedule A section 3 of the Act.

"Many self-care health products have been scientifically proven proven to either treat or reduce the risks associated with a specific Schedule A disease, are prevented by passing on that knowledge to Canadians in the most direct way possible: advertising "

St John's Wort is one of several products, cited as a product that is prevented form advertising its proven health claims by the current edition of the Act.

"All self-care products should fall under the same regulatory framework and the regulations should be consistent with the lower risk profile of products intended to be used without requiring the intervention of a physician. ..."

"Furthermore, it is incomprehensible that some aspects of the drug regulations are less onerous than the NHP regulations. PABA sunscreen can be approved in less than 45 days, while the zinc formulation has a 60-day standard. The regulatory requirement should be the same and they should be simplified. All self-care products should be regulated in the same way and distinct from prescription drugs."

NDMAC does not support the notion that NHP's should be regulated as food. Its' brief to the Standing Health Committee offers several valid reasons why categorizing NHPs as food may be not serve Canadians best self-care needs. NDMAC seems to be supportive of a third category, something between food and and prescription drugs. However the Association does not amplify this notion. It should.

Saturday, April 09, 2005

Supplements Get Reprieve

A European Union plan to eliminate natural l ingredient based supplements and replace them with synthetic versions has been stalled.

The Alliance for Natural Health has won the support of the Advocate General of the European Courts of Justice (ECJ . The Alliance vigorously opposed the The Eu Food supplement Directive, which if passed would replace natural ingredient products with synthetic versions by banning natural ingredient products from approved EU Food Supplement lists.

There is a Canadian connection. Last January, ( 2004), Health Canada issued a directive, by passing Parliament, and declared all natural ingredient products, were to be classified and regulated as drugs. The impact of that regulation is the herbs and vitamin you are now able to purchase at a health food store may be restricted to purchase through prescription only. One possible effect is higher prices.

In Canada Bill C-420 is equivalent legislation, to the Health Alliance EU legal challenge. Bill C-420 when passed will rescind the Health Canada Directive and restore supplements to the food category for regulatory purposes. Bill C-420 has passed two stages and is currently in Committee for review.

Friday, April 08, 2005

Canadians - Need to Lose Some Weight

Statistics Canada says we are a little on the hefty side and have been putting on the poundage for a sustained period.

"Canadians who had been overweight in 1994/95 had become obese by 2002/03. On the other hand, only half as many, about 10%, who had been overweight were in the normal weight range eight years later."

obese_1
cbc photo
The reason we are bursting around the midriff is what we eat. Tthe ingredients, in what we eat can be short on nutrition and large preservatives that enhance product taste and product shelf life.



Health Canada thinks the solution lies in product labeling and created new regulations in 2003 to deal with the issue. Here is
what the Food and Consumer Products of Canada requires its' members to do.

"Provide Nutrition Facts information on all pre-packaged foods (with minor exceptions). The Nutrition Facts table has a standardized format that is consistent from product to product and includes a mandatory list of calories plus an expanded list of 13 core nutrients. The list includes:
Calories, Fat, Saturated Fat, Trans Fat, Cholesterol, Sodium, Carbohydrate, Protein, Fibre, Sugars, Vitamin A, Vitamin C, Calcium and Iron."

n_label

Labeling is a small issue, literally. They are difficult to read. Label reading is a confounding experience.There is too much information crammed into a small space. A label may tell you what is in the product. It doesn't tell you what effect the ingredients have on you. Success, in battling the bludge and associated serious side effects, is knowing what the ingredients do.

Enriched food may not be nutritious food. Enriched is a marketing message implying an enhancement has been made. We need a better understanding of what the benefit of the enhancement is. Does the process create a more nutritious ffood? We need to be assured by regulators and industry the process and ingredients are nutritious, not shelf life and taste enhancers.

Post Script
Trans Fatty Acid
Essential Fatty Acid
Know Your Labels

A short list for more information





Thursday, April 07, 2005

Efficacy - Economic Benefit of Vitamin Supplements

A major self care issue confronting the aging population is the use of vitamin supplements by the elderly. There are a several of key questions. Do vitamins compensate for what may be missing in a diet? What health risks does supplementation reduce? On the business side, what is the saving to the health care system? What are the opportunities in this market place? A recent study by the Lewin Group shines a bright light on the issue.

Wednesday, April 06, 2005

WHAT'S IN A LABEL?

Apparently lots, and it may not be good for you, if you, like me, thought that a soy was a useful dietary supplement. That notion is worth re-examination. For a definitive review of the issue you may want to read Soy the Whole Story .



The issue is further complicated by what government regulators approve on product labels. This is where the science gets pretty murky, and marketing takes over. "Soy protein may reduce the risk of certain cancers". Says who, would be an appropriate question? However, from a marketing perspective 'reducing a risk' suggests soy protein is beneficial to your health.

What is really important for consumers is the concentration of the ingredients . The word natural on a label can be misleading too.

Watch for media campaigns trumpeting the benefits of soy, as Solae a major manufacturer, seeks to have labeling requirements revised. This is at odds with recent regulatory policy demanding more stringent evidence based labeling for vitamins and herbs and the intent to classify those natural products as drugs,
under a public health policy of consumer proection. Buyer be very aware.

Tuesday, April 05, 2005

Canadian Medical Care - study - talk - more waiting

Have you ever heard about the Wait Time Alliance? A group of Canadian medical associations has issued a report on how the government should deal with the time it takes for you to get medical care.

"No More Time to Wait" - identifies wait time thresholds for these five areas, beyond which best available evidence and clinical consensus indicate patient health is likely to be adversely affected. The report also provides governments with recommendations on establishing a framework to improve access and reduce wait times.

Here's the report.

Here's an index of media reports on the report.

The Minister of Health says his department 'Health Canada' will have it's own bench marks ready for December of this year with a goal towards seeing significant reduction in wait times by March or 2007 . How many Canadians will get seriously ill, before the system delivers on the bench marks.

The Minister is quoted; "When you put yourself in the position of being a patient, you want to make sure that the health-care providers on the front lines are able to tell you, based on medical evidence and clinical requirements, what the wait times ought to be" .
The Globe and Mail

Confirmation, wait times are endemic to the government delivered medical care system. The objective of this exercise is to reduce wait times, as opposed to creating a patient centered system, with multiple delivery options, to be used at the discretion of the user. What Canadians get is a continuation of a fundamentally flawed government controlled, rationed service, in which wait times maybe reduced, however they remain systemic. The best a monopoly can do is ration service while charging higher fees. One of the highest costs is your well being as you are forced to cue. That is hardly universal access.

Canadians are once again being duped to accept waiting, as simply part of the medical care process in Canada. Political leadership presents the public medical care system, as an uniquely Canadian institution. Canadians. naively. believe universality in medical care, equates to compassion. A trait that hits a Canadian nerve. We seem eager to trade the perception of compassion for access to medical care when we need it. Compassion doesn't go far on, while one waits for care.

Monday, April 04, 2005

Death Notice Canadian Medical Care Is Terminal!

Here's an excerpt from a news piece from Brunswick Hospital that tells a sorry tale.

"If the person named on this computer-generated letter is deceased, please accept our sincere apologies."

The patient wasn't dead. He was advised it would be three months to get an electrocardiogram. That little mis- communication gem has been picked up news services around North America. The Canada Health Act not withstanding, Canada's medical care system, as currently constituted, is very dangerous to your health.

The Canadian medical care egalitarian myth is exposed. It's an illusion that makes Canadians feel good about a system that offers, but does not provide, timely universal medical care insurance coverage. Coverage that theoretically can be converted to service when is needed. One of the key principles of the Canada Health is : All insured residents are entitled to the SAME LEVEL of insured care. Our medical care system doesn't provide that.

From its inception Canadians have been deluded by government, that government supplied single payer medical care insurance is a bromide that reflects our compassionate nature.

"Ever since universal health insurance was first proposed by William Lyon Mackenzie King back in 1919, Canadians have been witness to an ongoing debate about how health services should be organized and funded. Over the course of some twenty-five years, starting with Saskatchewan in 1946,Canadians made a series of democratic and deliberate decisions that gave Canada its system of universal hospital and medical care --Medicare. The obstacles were formidable and at times seemed insurmountable, but we succeeded."

"Canadians have become accustomed to the notion of a perpetual health care "crisis". Health care systems are prone to emotional debates because they involve two things that we care a lot about: health and money --in fact, a great deal of money. Mix this with the mostly single-payer, publicly funded approach that Canada has adopted, and you have already-made recipe for an ongoing debate among governments, health providers and the general public. There is also something distinctively Canadian in all of this: Medicare is more than a health care system --it reflects a shared commitment to fairness and compassion."
Source: The Public and Private Financing of Canada's Health System, National Forum on Health, Sept. 1995.



Call it the 'culturalization' of medical care a feel good notion that is detrimental to your health. Since that report was published wait times have doubled from 9 weeks to 18 weeks for surgery, according the Fraser Institute. Does waiting exacerbate a medical condition? It doesn't help that's for sure. How fair and compassionate is that?

Canada and North Korea are the only two countries, in the world, that do not allow their citizens to insure themselves for hospitalization and medical surgery. Why? If the system can't deliver, which it can't, why does the government insist on maintaining its medical care monopoly. The government collects the fees, your taxes, to underwrite the insurance coverage. It licenses all the practitioners. It decides what procedures are insured, a so called 'list of eligible services. If you can't get the service, when you need it, what kind of access do you have? Further you can't take measures to insure that you pay for the service, even if you wanted to chose that option.

Self care, a preventative strategy, is also discouraged by keeping alternative products and therapies, outside the government medical insurance program. Self care is private health care in action. Despite what you may read and hear. Canadians are voting with the pocket books in ever increasing numbers that self care is an option they want and need. Canadians are taking independent action to be healthy, to stay off the waiting lists. The government should recognize the obvious benefit of reduced demand on the medical system, and reward those who have the knowledge and the ability to look after themselves. This does not jeopardize those who are unable to do so.

It would seem logical that governments would embrace that concept, they don't. They make it harder to get those products and services. Health Canada did just that in January 2004, when it re-classified all supplements minerals and vitamins as drugs, complete with an expensive, time consuming, process for licensing labeling. It also seeks to limit dosages to render these natural products just about useless. Why is the government making it difficult for us to take care of ourselves?

The argument against privatizing medical care service is bogus. It implies private delivery will divert resources from the public system.

All Canadians physicians are private contractors. They bill the medical care insurance program for a set of predetermined 'approved' services. All the laboratories that do the diagnostic testing 'prescribed' by physicians are private companies. The only thing public, about the relationships, is they both bill the government for the services they provide. The government is the single payer insurance company. You pay the bill through your taxes.

Medical care rationing is insidious. It has many forms. There is creeping downloading, called de-listing. Alberta, which is redesigning its medical care system, just did that. It de-listed physiotherapy reducing insured coverage by 66 % from 6 treatments to two. That's from a government that has an $8 billion surplus. In Ontario which has $4 billion deficit, if the government doesn't increase funding, up to 10,000 health care professionals will get pink slip notices, in the mail, economic death, which may or may, not be terminal! The best the current system can do is to ration. For some reason the Canada Health Act proponents seem to think that's ok!

Ironically, the current medical care system is providing a giant subsidy to wealthy Canadians. When they need special treatment, in a hurry, they can get it anywhere. That group with the ability to pay, receives the same service, at the same price, as those at the bottom of the scale with limited meager resources. Currently neither group has 'timely' universal access. Access when it is needed.

Despite what you hear and read, there is a growth in private delivered medical care in Canada. Quebec and British Columbia are leading the way. Any Canadian physician can opt out of the system and create a private practice, with in the purview of the Canada Health Act.

There is a solution to the current crisis. Take the system back to where it was intended to be a universal medical insurance program.

  • Codify the Hippocratic Oath.

  • Retain universal access. Universal so that all Canadians have access to insurance coverage, which entitles them to medical care, when they need it.

  • No resident in Canada will be refused medical care, when they need it.

  • Premiums are based on taxable income, starting at $50,000 for a family. As in any insurance program there are deductibles, at the discretion of the insured. Similar to auto insurance the insured chooses a deductible up front, and that effects the cost of the premium.

  • If the government can't deliver, then it pays to send the patient to where it can be done.

  • Invest in preventive care expand the list of insured service to include alternative therapies.

  • The premium is paid by taxes, not in addition to current taxes.

  • Allow Canadians to purchase either private insurance against hospitalization and surgery. This will create medical insurance competition.

  • Allow Canadians to create medical savings plans on the RRSP model. These plans would be funded with after tax funds. There would be no tax deduction. Earnings in the fund would be not taxed, when used for medical and alternative products and services.

  • Invest in prevention, by expanding the list of services eligible to include alternative therapies and products.

  • Open the system allow Canadians to use their medical insurance, either private or public, on alternative products therapies, at their discretion.

  • Turn over testing and diagnostic services to private contractors, who can operate those very expensive machines 24/7 , at less cost than is currently the case. Operate those machines around the clock, 'they' don't tell time.


  • As you get set to file your taxes this month, remember 40% of every tax dollar goes to medical care that more and more you can't get!

    References
    The Commonwealth Fund
    Fraser institute

    Saturday, April 02, 2005

    Vitamin D The Sunshine Vitamin

    In anticipation of heading out doors, those of us in the Northern part of North America are full of it. We can also expect dire warnings about exposure to the sun, perhaps that should be over exposure. That latter is not a good thing; the former is. There is a whole range of issues around the sun, not the least of which is we can't live without it.

    It seems rather silly to subscribe to the notion that avoiding the sun is good for you. The intent of the various advisors on the subject is help you avoid sun burn, and other more serious ailments, which may or may not be, linked to exposure to the sun. Actually, a sun burn like any other burn is your body's way of telling you that you've had enough!

    For a definitive look at the topic you may want to read The UV Advantage; written by Dr Michael Hollick Ph.D., M.D. Professor of Medicine, Dermatology, Physiology and BioPhysics, Director of the General Clinical Research Center and Director of the Bone Health Care Clinic at Boston University Medical Center.

    What you'll get is; what's good and not so good about how you expose yourself to the sun.

    Friday, April 01, 2005

    Off the Couch...

    ... And outside we go. If we inspired you with Coach Potato Procrastination, it follows that we should help out a little, by sharing what we've learned along the way. If you decide to give yoga a try, it is always best to enroll in a class, to learn the basics.

    Community recreation programs, private health clubs, community colleges, and university outreach programs offer instruction. It is important to learn the postures and breathing under the watchful eye of a qualified instructor. The 'law of least effort" produces the best results

    Here's an index to help you sort out the terminology. As you move forward Sissel, the global exercise equipment company, has an extensive library of free exercises, that allows you to customize your own program.

    Couch Potato Procrastination

    So how has that New Year's resolution been going? Remember that January first, commitment to get up off the coach, loose a few pounds, get in shape, feel better, change the diet. It's April 1, the day of fools, practical jokes, and jokers.

    From now on nature offers the incentive, warmer and longer days, to get outdoors to work the garden, fix the house play golf, slow pitch, jog cycle, hike, swing, ski, camp, et al, are we ready? The mind maybe, however is the body. That's where those unfilled resolutions can comeback to haunt us. Perhaps this is a better time to revisit that January strategy, refine it, focus on one element, and see it through.

    For me golf is the warm weather activity of choice. The goal is to play to my ability level, which has been stymied over the last few of years by back pain and lack of flexibility. The back pain is still around although Dr. John Sarno , and Neil Wolkodoff have provided insight and knowledge to manage it, and weekly yoga class and practice, at Grant McEwan College has made a significant impact on flexibility, enough to say meeting the goal will not be hindered by physical capacity or lack their of.

    To get here has taken time, effort, determination to stay the course, particularly, when progress was less than expected, more often than not! Patience is the key virtue. Setting a realistic goal is critical starting point. Flexibility, the mental variety, is paramount to staying with it. Initially my goal was to be pain free. I was quickly admonished by one health care practitioner, asking if that is realistic? So the short term goal morphed to increasing function to be able to 'play'. The long term objective is to be pain free, most definitely a work in progress.

    The residual is, the knowledge that's been gained, and the changes that have been made. I'm the least likely 'guy' I know to be practicing yoga! However if you want to learn to quiet your brain, increase your strength, and gain more function through increased flexibility, I recommend it, as a precursor to what ever your favorite activity is.