Later On

A blog written for those whose interests more or less match mine.

Archive for July 1st, 2019

Democrats Obsess Over Health Insurers When They Should Fight Doctors and Hospitals

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Josh Barro writes in New York:

Nobody likes health insurers, but the Democratic candidates’ fixation on them as an all-purpose bogeyman for any problem with health care, as demonstrated at this week’s debates, is a demonstration of why single payer in the U.S. wouldn’t work like its supporters see it working abroad and would like it to work here.

One of the key arguments for a single payer system is that it’s cheaper than a system with private payers. That has generally been true around the world, but it’s not a law of nature. Single payer is cheaper because governments use their leverage as the sole buyer of health care to push prices down. They pay doctors and hospitals less, because they can. The savings don’t come from the single-payer system itself; they come from the choice to pay less.

So, what will happen if the U.S. adopts a single payer system? Providers like doctors and hospitals will make the same arguments Senator Michael Bennet did at Thursday’s debate: That they depend on the higher rates from private insurers to offset the lower rates they get from Medicare and Medicaid. If every patient’s insurer paid like Medicare, they’d close.

In a lot of cases, the hospitals aren’t bluffing: Hospitals need to charge patients more than in other countries to make their finances work, because they pay their doctors more than in other countries. Achieving costs like in countries that have single payer would require cramming through unit cost savings so our costs align with those countries. And that path runs straight through doctors and hospitals, which are a lot more profitable than insurers.

Senator Kamala Harris noted – correctly – that American emergency room costs are outrageous, leading patients to hesitate before they seek care they might need. But while Harris framed this as a problem with health insurance, it’s hospital systems that set those high prices; insurers increasingly pass those costs through to patients, but if they didn’t, premiums would be even higher than they are now.

Former Vice President Biden, bizarrely, threatened to put health insurance executives in jail “for their misleading – their misleading advertising, what they’re doing on opioids – what they’re doing paying doctors to prescribe.” That’s not chiefly an insurance issue, either – it’s an issue with pharmaceutical companies.

And at Wednesday’s debate, Senator Elizabeth Warren objected that health insurers had made $23 billion in profits last year. $23 billion is a lot of money, but total U.S. health expenditure – public and private – was $3.5 trillion as of 2017, the most recent year with available data. Since we spend about twice what our peer countries in the OECD tend to spend for approximately the same outcomes, our excess health spending is about $1.8 trillion. Abolishing health insurer profits would take us roughly 1 percent of the way to getting in line with our peers on costs.

I understand the impulse not to name the key villain, the key element in our health care system that’s making it unaffordable, which is providers and the payments they require. People feel positively about doctors and hospitals; they do not feel positively about insurers. But when you try to implement a single payer system, you will have two options: Fight the providers, or pay them whatever they want, in which case the shift to single payer won’t save much money and will require enormous tax increases.

I would also note that, while cost saving through monopsony buying power is not an ironclad consequence of adopting single payer, it is also possible to achieve that end without adopting single payer at all. The government can control payment rates to providers without actually making all the payments if it regulates prices. That is, it is possible to take on the providers first, which would save money for the government, employers, and individuals – making money available for all sorts of things, including expansions of health coverage.

While this approach would also require fighting the powerful provider lobby, it would make available allies you would not have with you for a fight to expand government spending and implement single payer. You could tell employers  . . .

Continue reading.

The US healthcare system is a mess. From Snopes.com:

Written by LeisureGuy

1 July 2019 at 8:49 pm

Cruciferous knowledge new to me

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From How Not to Die, by Michael Greger MD, starting on page 343. This is from Part 2 of the book, where he discusses foods, recipes, and preparation considerations. The numbers in the text are footnotes that specify the studies whose finding support his statements.

When I used to teach medical students at Tufts, I gave a lecture about this amazing new therapeutic called “iloccorB.” I’d talk about all the evidence supporting it, the great things it could do, and its excellent safety profile. Just as the students would start scrambling to buy stock in the company and prescribe it to their future patients, I’d do the big reveal. Apologizing for my “dyslexia”, I would admit that I’d gotten it backward. All this time, I had been talking about broccoli.

I’ve mentioned broccoli more than any other food in this book, and for good reason. We’ve seen how cruciferous vegetables like broccoli can potentially prevent DNA damage and metastatic cancer spread in chapter 2, activate defenses against pathogens and pollutants in chapter 5, help to prevent lymphoma in chapter 9, boost your liver detox enzymes and target breast cancer stem cells in chapter 11, and reduce the risk of prostate cancer progression in chapter 13. The component responsible for these benefits is thought to be sulforaphane, which is formed almost exclusively in cruciferous vegetables. This is why they get their own spot on the Daily Dozen.

Beyond being a promising anticancer agent,1 sulforaphane may also help protect your brain2 and your eyesight,3 reduce nasal allergy inflammation,4 manage type 2 diabetes,5 and was recently found to successfully help treat autism. A placebo-controlled, double-blind, randomized trial of boys with autism found that about two to three cruciferous vegetable servings’ worth6 of sulforaphane a day improves social interaction, abnormal behavior, and verbal communication within a matter of weeks. The researchers, primarily from Harvard University and Johns Hopkins University, suggest that the effect might be due to sulforaphane’s role as a “detoxicant.”7

Strategies to Enhance Sulforaphane Formation

The formation of sulforaphane in cruciferous vegetables is like a chemical flare reaction. It requires the mixing of a precursor compound with an enzyme called myrosinase, which is inactivated by cooking8 (though microwaved broccoli appears to retain some cancer-fighting capacity). This may explain why we see dramatic suppression of test-tube cancer-cell growth by raw broccoli, cauliflower, and brussels sprouts, but hardly any reaction when they’re cooked.9 But who wants to eat raw brussels sprouts? Not me. Thankfully, there are ways to get the benefits of raw vegetables in cooked form.

Biting into broccoli is like snapping that chemical flare. When raw broccoli (or any other cruciferous vegetable) is chopped or chewed, the sulforaphane precursor mixes with the myrosinase enzyme and sulforaphane is created as the vegetable sits on the cutting board or lies in your upper stomach waiting to be digested.10 Though the enzyme is destroyed by cooking, both the precursor and the final product are resistant to heat. So here’s the trick: Use what I call the “Hack and Hold” technique (maybe I should call it Whack and Wait?).

If you chop the broccoli (or brussels sprouts, kale, collards, cauliflower, or any other cruciferous vegetable) and then wait forty minutes, you can cook it as much as you want. At that point, the sulforaphane has already been made, so the enzyme is no longer needed to achieve maximum benefit. It’s already done its job. (You can also buy bags of fresh greens and other crucifers that are prechopped or shredded, which can presumably be cooked immediately.)

Given this understanding, can you see how most people prepare broccoli soup incorrectly? Typically, they first cook the broccoli and then blend it. But, when you blend it, you’re merely mixing the precursor with an enzyme that’s been inactivated by cooking. Do it in the opposite order: First blend your veggies and then wait forty minutes before cooking them. This way, you can maximize sulforaphane production.

What about frozen broccoli and other crucifers? Commercially produced frozen broccoli lacks the ability to form sulforaphane because the vegetables are blanched (flash-cooked) before they’re frozen for the very purpose of deactivating enzymes.11 This process prolongs shelf life, but when you take the veggies out of your freezer, the enzyme is inert. At that point, it doesn’t matter how much you chop or how long you wait—no sulforaphane is going to be made. This may be why fresh kale has been shown to suppress cancer cell growth in vitro up to ten times better than frozen kale.12

The frozen crucifer is still packed with the precursor, though—remember, it’s heat resistant. You could make lots of sulforaphane from it by adding back some enzyme.13 But where can you get myrosinase? Scientists buy theirs from chemical companies, but you can just walk into any grocery store.

Mustard greens are also cruciferous vegetables. They grow from mustard seeds, which you can buy ground up in the spice aisle as mustard powder. If you sprinkled some mustard powder on frozen broccoli that’s been cooked, would it start churning out sulforaphane? Yes!

Boiling broccoli prevents the formation of any significant levels of sulforaphane due to inactivation of the enzyme. However, the addition of powdered mustard seeds to cooked broccoli significantly increases sulforaphane formation.14 Then it’s almost as good as eating it raw! So, if you don’t have forty minutes to spare between chopping and cooking, or if you’re using frozen greens, just sprinkle the crucifers with some mustard powder before you eat them, and you’ll be all set. Daikon radishes, regular radishes, horseradish, and wasabi are all cruciferous vegetables and may have the same effect. All it appears to take is a pinch to revitalize sulforaphane production.15 You can also add a small amount of fresh greens to your cooked greens. So when I add shreds of purple cabbage to my finished dishes, it not only adds a beautiful garnish with a delightful crunch, it’s filled with the sulforaphane-producing enzyme.

One of my first tasks every morning used to be chopping greens for the day, using my Hack and Hold technique. But now, with the Mustard Powder Plan, I have one less to-do on my list.

Horseradish

The serving sizes I offer here correspond roughly to the daily intake required to achieve cancer-preventive levels according to the innovative breast-surgery study I detailed in chapter 11. As you can see, horseradish has the smallest serving size, which means it’s the most concentrated of the cruciferous vegetables. One tablespoon and your Daily Dozen is down to an Everyday Eleven. Horseradish can be made into a sauce, relish, or dressing to score an extra check mark with a kick. It’s great in mashed potatoes or, for a healthier option still, mashed cauliflower. Just boil cauliflower for about ten minutes until tender and then mash with a fork or potato masher or purée in a food processor with some of the reserved cooking liquid until smooth. I season it with pepper, roasted garlic, and a dollop of horseradish and then pour mushroom gravy on it. Delicious!

Written by LeisureGuy

1 July 2019 at 8:21 pm

Inside the Secret Border Patrol Facebook Group Where Agents Joke About Migrant Deaths and Post Sexist Memes

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US, what happened to you? A.C. Thompson reports for ProPublica:

Members of a secret Facebook group for current and former Border Patrol agents joked about the deaths of migrants, discussed throwing burritos at Latino members of Congress visiting a detention facility in Texas on Monday and posted a vulgar illustration depicting Rep. Alexandria Ocasio-Cortez engaged in oral sex with a detained migrant, according to screenshots of their postings.
In one exchange, group members responded with indifference and wisecracks to the post of a news story about a 16-year-old Guatemalan migrant who died in May while in custody at a Border Patrol station in Weslaco, Texas. One member posted a GIF of Elmo with the quote, “Oh well.” Another responded with an image and the words “If he dies, he dies.”
Created in August 2016, the Facebook group is called “I’m 10-15” and boasts roughly 9,500 members from across the country. (10-15 is Border Patrol code for “aliens in custody.”) The group described itself, in an online introduction, as a forum for “funny” and “serious” discussion about work with the patrol. “Remember you are never alone in this family,” the introduction said.
Responsible for policing the nation’s southern and northern boundaries, the Border Patrol has come under intense scrutiny as the Trump administration takes new, more aggressive measures to halt the influx of undocumented migrants across the United States-Mexico border. The patrol’s approximately 20,000 agents serve under the broader U.S. Customs and Border Protection agency, which has been faulted for allegedly mistreating children and adults in its custody. The agency’s leadership has been in turmoil, with its most recent acting chief, John Sanders, resigning last week.
ProPublica received images of several recent discussions in the 10-15 Facebook group and was able to link the participants in those online conversations to apparently legitimate Facebook profiles belonging to Border Patrol agents, including a supervisor based in El Paso, Texas, and an agent in Eagle Pass, Texas. ProPublica has so far been unable to reach the group members who made the postings.
ProPublica contacted three spokespeople for CBP in regard to the Facebook group and provided the names of three agents who appear to have participated in the online chats. CBP hasn’t yet responded.
“These comments and memes are extremely troubling,” said Daniel Martinez, a sociologist at the University of Arizona in Tucson who studies the border. “They’re clearly xenophobic and sexist.”
The postings, in his view, reflect what “seems to be a pervasive culture of cruelty aimed at immigrants within CBP. This isn’t just a few rogue agents or ‘bad apples.’”

The Border Patrol Facebook group is the most recent example of some law enforcement personnel behaving badly in public and private digital spaces. An investigation by Reveal uncovered hundreds of active-duty and retired law enforcement officers who moved in extremist Facebook circles, including white supremacist and anti-government groups. A team of researchers calling themselves the Plain View Project recently released a hefty database of offensive Facebook posts made by current and ex-law enforcement officers.
And in early 2018, federal investigators found a raft of disturbing and racist text messages sent by Border Patrol agents in southern Arizona after searching the phone of Matthew Bowen, an agent charged with running down a Guatemalan migrant with a Ford F-150 pickup truck. The texts, which were revealed in a court filing in federal court in Tucson, described migrants as “guats,” “wild ass shitbags,” “beaners” and “subhuman.” The messages included repeated discussions about burning the migrants up. . .

Continue reading. There’s much more, and it’s vivid. The Border Patrol is a stain on the US.

Written by LeisureGuy

1 July 2019 at 7:23 pm

Children are suffering. These companies are profiting.

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This is so repulsive that I had a physical reaction. But it’s important to read to understand the situation in the US today. Those in power have changed the country. Judd Legum writes at Popular Information:

Thousands of children have been separated from their families, and many more have been subject to inhuman conditions as part of the Trump administration’s anti-immigrant crackdown at the southern border.

Just last week, lawyers reported that 250 children were subject to “neglect and mistreatment” at a border patrol station in El Paso, Texas. The group included infants who allegedly were placed into the care of other children, according to a girl detained at the facility.

A Border Patrol agent came in our room with a 2-year-old boy and asked us, “Who wants to take care of this little boy?” Another girl said she would take care of him, but she lost interest after a few hours and so I started taking care of him yesterday.

Lawyers said the 2-year-old “had wet his pants and had no diaper and was wearing a mucus-smeared shirt.” The children at the facility included those who arrived at the border alone and those who had been separated from their parents or other caregivers.

Other migrants are stuck on the Mexican side of the border in intolerable conditions because the Trump administration has “metered” the number of asylum claims it will process at official points of entry each day. A man from El Salvador and his two-year-old daughter died while crossing the Rio Grande, desperate to escape a holding camp in Mexico with little food and temperatures above 110 degrees.

This year, six migrant children have died in U.S. custody.

A migrant on the U.S. side of the border reported hundreds of people being held in one overcrowded cage with an overflowing bathroom.

“They don’t have the humanitarian conditions for people to be there,” said Gary, a 33-year-old migrant from Siguatepeque, Honduras, who would only give his first name. “There were more than 200 of us in a single cage — seated on the floor, standing, however we could fit.” He said the stench inside overflowing toilets was so bad it made him gag and caused children to vomit.

But the only thing several large consulting firms smell is money.

A review by Popular Information of federal contracting databases reveals that Booz Allen Hamilton, Deloitte, and PricewaterhouseCoopers have inked over $175 million in contracts with Immigration and Customs Enforcement (ICE) since Trump took office.

These companies have continued to profit from Trump’s anti-immigrant crackdown over the protests of many of their employees. The companies have gotten more business after McKinsey, one of the largest consulting firms, announced last year it would no longer do business with ICE.

Deloitte: $103,899,307.61 in contracts with ICE during the Trump administration

Deloitte Global CEO Punit Renjen promotes himself and his company as a champion of refugees.  . . .

Continue reading. There’s much more but I had to stop.

The trauma-induced changes on these helpless children is heartbreaking to consider. Lives are being ruined, and Trump is gleeful about it. And the Republican party goes along. The whole country is becoming Alabama.

Written by LeisureGuy

1 July 2019 at 7:10 pm

Fish oil does not reduce the risk of heart disease.

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I thought it did for a long time, but I have now put away my fish-oil supplements. Not only do they not reduce the risk of heart disease, they are likely contaminated with various toxins (DDT, dioxin, PCBs, mercury, etc.) because humans have been using the oceans as a dumping ground for more than a century. There are serious warnings to reduce the frequency with which you eat tuna, for example.

From an article by Gina Kolata in the NY Times:

At one point, the notion that fish fats prevented heart trouble did seem logical. People whose diets contain a lot of fatty fish seem to have a lower incidence of heart disease. Fatty fish contains omega-3 fatty acids. Omega-3 supplements lower levels of triglycerides, and high levels of triglycerides are linked to an increased risk of heart disease. Not to mention that omega-3 fatty acids seem to reduce inflammation, a key feature of heart attacks.

But in a trial involving 12,500 people at risk for heart trouble, daily omega-3 supplements did not protect against heart disease.

Live and learn and—most especially—don’t deny reality as you learn it.

I now grind up 2 tablespoons of flaxseed (high in omega-3) every morning and have that with my breakfast.

Written by LeisureGuy

1 July 2019 at 6:55 pm

Posted in Daily life, Food, Health, Science

Wow! This looks like a movie to see!

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From One Green Planet, by Sharon Vega:

More than a year ago, James Cameron’s Game Changers was announced. It’s an exciting documentary directed by Oscar winner Louie Psihoyos about some of the strongest and fastest athletes in the world, who credit much of their strength and health to their plant-based diets! Well now the official trailer is out, and so is the global premiere date.

The producers of this movie include more big names than just Cameron: Jackie Chan, Chris Paul, Lewis Hamilton, Novak Djokovic, and Arnold Schwarzenegger who is also seen in the trailer explaining what made him begin eating plant-based.

As the athletes are heard saying in the trailer, protein is always the biggest concern when it comes to eating meat-free. But some of the world’s strongest animals and people have proven that meat is not necessary at all to be strong. They reference oxen and gladiators as two examples. Not only do the athletes say eating plant-based keeps them stronger than ever, but their health has benefitted tremendously.

The documentary will go into detail about how their cholesterol and blood pressure levels have improved since eating plant-based. And for athletes, even more importantly, their performance has been better than ever.

On September 16, there will be a one-night global theatrical event and tickets are already available for purchase. Over 1,000 theaters will be screening the Game Changers. You can also enter to win tickets for the red carpet premiere in Hollywood.

For more Vegan Food, Health, Recipe, Animal, and Life content published daily, don’t forget to subscribe to the One Green Planet Newsletter!

We also highly recommend downloading our . . .

Continue reading.

Written by LeisureGuy

1 July 2019 at 6:37 pm

Religious Republicans use this design for their cross-stitching

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Written by LeisureGuy

1 July 2019 at 2:11 pm

Posted in GOP, Politics, Religion

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