Two proven ways to save money on healthcare….

Today's Post: Monday, 6-8-2009

Last Friday we did a post on how to keep up to 95 to 98 % of all cancers from happening to you.

One of those methods has recently been moved from a likely way to prevent Alzheimer’s disease to one that is close to proven and may even help treat it in its earlier stages. (See tomorrow’s post.)

The same lifestyle that prevents cancer and along with using some diagnostic tests and supplements can prevent up to 95 to 98 % of heart attacks. And, these methods can help reverse existing heart disease if it’s not too severe.

The same lifestyle along with fasting glucose and HBA1C testing and some different supplements can prevent most cases of type 2 diabetes and can virtually reverse it for perhaps as many as 90% of the people who get it according to one doctor who has had successful experience at doing so.

These facts illustrate the two ways to save money on healthcare.

1. If you prevent a disease, you save the money it would have cost to treat it.

2. If you reverse or counteract the causes of a disease, you can almost always treat it more completely and for far less cost than trying to reverse symptoms over and over again for a disease that you never cured or repair damage of the disease you never got rid of in the first place.

So, since many of the things that prevent a disease work by eliminating its causes, those preventive measures can often, though not always, help cure the disease after you get it.

And, if you do those two things well, as our current version of medical care all too often has not, you save a LOT of money on healthcare. Why? After the fact emergency treatments are EXPENSIVE. Things like heart bypass surgery, kidney dialysis, chemotherapy radiation treatment for cancers, powered wheel chairs, and more and the skilled and highly educated people who provide them cost a lot of money. If you only need them 10% as often, you can spend twice as much on them to get the best quality when they are used and still save 80% of what you would otherwise have had to spend.

It’s imperative that we begin spending less money for better results in our healthcare.

But I’m very concerned that the current reform efforts seem to have overlooked these two ways to do that.

There IS some good news though.

What if there was a way to make full use of the newer and more revealing tests of the causes of diseases that would enable you to remove those causes with precision and very high effectiveness?

It’s not yet used much, which is most unfortunate since it causes unnecessary costs and suffering. But the good news is that exactly this IS now being done.

The doctor who is its best advocate is not perfect. But he is articulate and makes good sense. Quite often his patients get well when other doctors could not make that happen.

He does a good job of speaking for himself. So, I’ve decided to quote him directly here.

He is doctor Mark Hyman.:

“Obama's Health Plan: What Matters the Most is Missing

Want to know the real truth about healthcare in this country?

Even if President Obama and Congress get everything else right in healthcare reform, it won’t matter ... that is, unless we address the underlying causes of illness that drive both skyrocketing healthcare costs and the proliferation of chronic disease.

But we can’t get there with our current model of medicine, and that’s what nobody is currently talking about, not even President Obama.

But there is a solution ...

Thankfully, an innovative approach currently exists that can not only prevent but also more effectively TREAT chronic disease ... more about that in a moment.

To effectively reform healthcare in the U.S., we must change not only the WAY we practice medicine, but also the TYPE of medicine we practice.

We must improve financing and delivery of healthcare, as well as our fundamental scientific approach to chronic disease -- an epidemic that now affects 133 million Americans and accounts for 78 percent of healthcare costs.

Healthcare costs are now approaching 20 percent of the U.S. gross domestic product -- approximately $2.5 trillion, or $8,160 per person annually. This is more than what the federal government spends on national defense, homeland security, education, and welfare combined!

Unless real change is made we are facing an impending collapse of our economy as more of our resources are put toward caring for the chronically ill.

This is a national security issue that threatens our standing in the world. As President Obama has stated, "Healthcare reform is no longer just a moral imperative, it is a fiscal imperative."

Fortunately, there is a new model of medicine that offers the real change we need. This new medicine is personalized, preventive, predictive, participatory, and patient-centered.

It is proactive rather than reactive. And it addresses the causes of disease and optimizes biologic function in the body’s core physiologic systems, rather than just treating symptoms.

This model exists TODAY – it is based on systems biology and is called functional medicine.

Why We Need to Change Healthcare Now

Our current model of medicine is unsustainable because it cannot stem the rising tide of chronic disease.

Relying only on reforms in coverage or access, financing, electronic records, malpractice, medical errors, coordination of care, and research on new drug therapies -- while retaining the conventional acute-care model -- will be untenable in the long run.

To be sure, such reforms are necessary, but not sufficient to avoid the collapse of our healthcare system, which may soon dwarf our current financial crisis if the Medicare trust fund runs out in 2016 as projected. According to the "Status of the Social Security and Medicare Programs" annual trustees report just published, the program is actually bankrupt right now. It's taken in less money than it has paid out two years running.(1)

This is not being alarmist; this is simply facing reality.

Here's the problem: These reforms do not alter the fundamental approach to prevention and treatment.

If we focus on improving the way we practice the medicine of the past, we will still have the medicine of the past. If we improve the wrong type of care, then we will simply be doing the wrong things better.

Conventional acute-care medicine is disease-, drug-, and procedure-based and is designed for acute illness, trauma, and end-stage disease for which it is the best form of treatment in the world.

As a result, our current medical education focuses on sickness rather than health; journals publish about disease management not what causes disease.

However, disease-based, acute-care medicine is the WRONG model to address chronic illness, because it doesn’t address WHY people are sick or the underlying mechanisms and biologic causes of their illness.

This is why we spend more money than any other industrialized nation on healthcare yet are near the bottom of the list for all major health outcomes. This is why we are witnessing a decline in life expectancy for the first time in history.

The Right Solution for the Problem of Chronic Disease

Functional medicine, on the other hand, is a system of personalized care that directly addresses how our environment and lifestyle influence our genes to create imbalances in our core biologic systems that, over time, manifest as disease. It is this kind of medicine that is needed to create real success in 21st century medicine.

Functional medicine is not a new treatment, test, or procedure -- it is a new "operating system" or method for problem solving and processing complex clinical information.

It is a fundamentally different way of thinking about the origins and mechanisms of illness. It encompasses all the TOOLS of healing and medicine, both conventional and integrative. And it provides a common language, a map or GPS system for navigating through the puzzle of chronic illness.

Simply put, functional medicine identifies why our underlying biology is imbalanced and corrects those imbalances. Then our body's natural healing intelligence takes over and automatically fixes what's ailing us.

This is the future of medicine and it's available right now.

A growing coalition of practitioners, educators, and scientists is dedicated to advancing this model. I am part of that coalition.

We at The Institute for Functional Medicine have introduced 20,000 physicians and healthcare providers to functional medicine since 1991, and we wrote the Textbook of Functional Medicine in 2005 to describe both the underlying science and the practical clinical strategies and tools that comprise this new model.

This is not just an elegant theory –- it works in practice ... something that I am very familiar with since I have been practicing functional medicine for over 10 years.

Let me illustrate how this works with real patients I have treated in my practice.

A Woman with Multiple Chronic Diseases

Deborah, a 46-year-old woman, having seen a dozen doctors over a dozen years, came to me with 29 different diagnoses, including depression, hypertension, obesity, polycystic ovarian syndrome, migraines, heavy menstrual bleeding, asthma, sinusitis, irritable bowel syndrome, reflux, fibromyalgia, osteoarthritis, and psoriasis.

Each disease was treated with the best available conventional treatment. But she was still sick, despite 9 medications.

Of course, she didn't have 29 separate diseases. She had imbalances in a few of her core underlying biologic systems -- digestive, immunologic, and hormonal -- that gave rise to all her symptoms.

The underlying cause of all her "diseases" was an autoimmune response to gluten, leading to autoimmune thyroid disease and severe vitamin D deficiency because of low absorption of nutrients from the foods she consumed.

Six weeks after eliminating gluten from her diet (wheat, barley, rye, etc.), improving her diet, and replacing thyroid hormone and vitamin D, her 29 diseases were completely gone -- along with 21 pounds ... not a bad side effect!

A Boy with Attention Deficit Disorder and Asthma and Allergies

Clayton was a 12-year-old boy who had been diagnosed with severe attention deficit hyperactivity disorder (ADHD) and behavior problems and had poor school performance who was on Ritalin for years. He also had illegible handwriting, or dysgraphia.

He also had apparently "unrelated" problems of asthma, allergies, hives, stomachaches, headaches, insomnia, muscle cramps, and anxiety and a history frequent infections and antibiotic use.

He had seen 5 specialists (lung, gastroenterologist, allergist, psychiatrist, and neurologist) and was on 7 medications for allergies, asthma, pain, and ADHD. No one asked how everything was connected, or how his diet of junk food and sugar made him sick.

His immune system was activated, his digestion not working, and he was nutritionally deficient in zinc, omega-3 fats, magnesium, and vitamin B6.

We simply normalized his biologic function by removing impediments to health (junk food diet, food sensitivities, overgrowth of yeast, and lead) and providing the ingredients necessary for optimal biologic function -- a whole-foods diet, additional nutrients including vitamin B6, magnesium, zinc, omega-3 fats, and probiotics.

In two months he returned without any physical or psychiatric symptoms and was off all his medication. His mother brought a sample of his handwriting, which had gone from illegible to normal, simply by getting his brain working again by getting his body in balance.

A Once in a Lifetime Opportunity for Real Reform ...

This model of care is the basis for the type of medicine that must be at the center of healthcare reform. I live in the trenches as a practicing doctor, treating real people who are suffering from real problems.

These problems have real solutions, which are being overlooked -- solutions that hold the key to saving our healthcare system from self-destruction.

Functional or systems medicine needs to be the "Intel inside" that drives the type of medicine that is practiced as we create a new healthcare system.

Real healthcare reform is now possible in a perfect storm where the alignment of economic, scientific, and moral imperatives provides an opportunity for us as a nation to do well by doing good through fundamentally changing the type of medicine we practice.

It will require the collective imagination, intention, focus, and action by healthcare providers, consumers, industry, and policy makers. But we can do it, and we must do it now.

In the words of the ancient sage, Rabbi Hillel, "If I am not for myself, then who will be for me? And if I am only for myself, then what am I? And if not now, when?" “

Good news on fighting the obesity epidemic....

Today's post: Thursday, 4-9-2009

There are several things that tend to make you fat or keep you that way. And, many of those same things also tend to cause type 2 diabetes and heart attacks and other cardiovascular diseases.

So, anytime I read something with important information on how to prevent this situation or help fix it, it really gets my attention.

For example, if you are sedentary and never active and never get any very vigorous exercise from competitive sports or strength training or interval cardio AND you eat lots of fast carbs (high glycemic foods) such as foods with high fructose corn syrup, sugar, and refined grains and very little fiber, you will get “insulin resistant” which means you get high levels of insulin in your blood that no longer lowers excess levels of blood sugar. And, if that becomes excessive or goes on too long, you get fat; you get high blood sugar to the point it begins destroying your capillaries and the parts of you that that depend on them; and your chance of getting a heart attack and becoming senile skyrocket.

Unfortunately, the number of people who are now seriously fat, what the medical profession calls obese, is going up dramatically world wide and even more dramatically here in the United States.

A recent news story reports that in the United States now one in five four year olds is fat.

And, those kids grow up to be fat kids and fat teens. That’s really bad news because an alarming number of those kids now have type 2 diabetes and even early heart disease.

That means huge increases in health care costs will soon come into a system that is almost collapsing from the increases in costs that have already happened.

And, it can be truly dreadful for the kids it happens to. A recent American Heart Association ad showed a picture the back of a woman at the beach. She looked to be a 50 year old woman who was about 70 to 100 pounds overfat.

The caption read.:

“I have high cholesterol.
I am at risk for heart disease.
I am 13 years old.”

OUCH!!

Even worse, there are now literally hundreds of thousands of kids all over the United States both boys and girls who look just like she does. Some of them have type 2 diabetes and high blood pressure too from the lifestyle they follow. We are already paying for their healthcare costs this causes too. Kids didn’t get those diseases in previous generations.

Many of them will grow up to face heart attacks and strokes before they are 45 years old. And, most frightening of all, many of them will need kidney dialysis -- or custodial care because they will develop early vascular dementia and Alzheimer’s disease.

The implications of this are truly dire. If that many of our adults who should be at the prime of life and effective in their work cannot work & generate that much more in health care costs, our economy will be swamped by it all.

And, although two of the 3 main causes of this are lack of exercise and eating a lot of refined grain an sweetened foods plus NOT eating fruits and vegetables, the third cause, drinking regular soft drinks instead of water, may be the most effective of the 3 in causing this situation.

Studies show that people, adults and kids alike, who drink a lot of soft drinks wear those calories as fat. The researchers have found the cause of this is very simple.: Soft drinks add calories to your food intake but simply don’t register in a way that makes you less hungry even a little bit.

Refined grain foods and sweetened foods are almost as bad; and a strong cause of the increase in obesity as is being totally sedentary; but soft drinks and the increase in their consumption are so much more effective at fattening people, they are clearly a major cause of this problem and may well be the number one cause.

So, causing most kids to drink no soft drinks at all, would be extremely desirable. Even causing a 40 % drop in the average number of soft drinks kids drink per week would help.

But studies show over 70 of adults drink soft drinks and have so little knowledge of these effects that they see nothing at all wrong with kids drinking the soft drinks they do.

The truly frightening thing is that the problem is so severe and getting worse so fast, there simply isn’t time or money enough to educate everyone to what’s happening in time to fix it.

But today’s news is much more encouraging.

Reuters online health news today has a story they released late yesterday. They titled it.

“U.S. experts argue for tax on sweet drinks.”

Kelly Brownell of Yale University in Connecticut & New York City Health Commissioner Dr. Thomas Frieden are quoted as saying some very promising things. They apparently originally wrote those things in a New England Journal of Medicine article or in an interview that happened on Wednesday this week.

They state that a penny ounce tax on soft drinks would cut consumption by as much as 10 % and raise “billions of dollars” to help state and local governments with health education programs and health care costs driven by soft drink consumption.

Given that soft drinks in fast food places and restaurants cost the fast food places and restaurants something like 5 to 10 cents per dollar instead of the 30 cents that the food they serve does, a penny per ounce is trivial.

Given this and the severity of the problems caused by massive soft drink consumption, I don’t think they thought big enough. Five to ten cents an ounce would be much more desirable.

But I still enthusiastically applaud them. Once we tax soft drinks at such a trivially low rate and establish that they are a health hazard that should be taxed in the public interest and to keep our economy from collapsing from the effects of that hazard, the taxes will be raised later.

Cigarette and tobacco taxes have been; and soft drink and related taxes on comparable foods will too. Of course, that’s also the real reason the soft drink industry is against such a tiny tax.

The two experts were quoted as saying that even the penny an ounce tax would cut consumption by about 10 % & then they said this.:

"It is difficult to imagine producing behavior change of this magnitude through education alone, even if government devoted massive resources to the task."

I agree with them. With the tax, the effect is virtually guaranteed. And, the governments who badly need the revenue now TAKE IN money.

Needless to say the soft drink companies do not favor this idea.

They point out that as an industry they employ over 220,000 people in the United States.

But if they make that many people a year virtually unemployable due to physical or mental disability their product causes and cost our economy over 10 times the combined salary of all 220,000 people in avoidable health care costs each year, so what?

People often have to change jobs when the economy changes and renders a product or service obsolete. Most of those 220,000 people could also. In fact so many of them are in marketing and sales which are transportable skills, they may find it easier than people in most industries to get new jobs.

The article pointed out that studies show that children and adolescents now take in 10 to 15 % of all their calories in soft drinks and other sweetened drinks. That quite literally means if they drank none at all, they would be 10 to 15 % lighter on the average; and virtually all those pounds would be fat they no longer gained


Brownell and Frieden said the tiny tax would raise $1.2 billion in New York state alone.

That would come to something like 12 billion a year for the country as a whole.

And here’s their take on the real cost of soft drinks.:


"The contribution of unhealthful diets to healthcare costs is already high and is increasing -- an estimated $79 billion is spent annually for overweight and obesity alone -- and approximately half of these costs are paid by Medicare and Medicaid, at taxpayers' expense," they wrote.

"Sugar-sweetened beverages may be the single largest driver of the obesity epidemic," they added.

"For each extra can or glass of sugared beverage consumed per day, the likelihood of a child's becoming obese increases by 60 percent."

So, if we want better healthcare in this country, far fewer fat and sick kids and adults, and a stronger economy instead of one that is staggering under such avoidable costs, we should tax soft drinks everywhere in the United States immediately.

However, even a penny an ounce in a single progressive and health oriented state such as Minnesota or Iowa or Vermont might get us started.

But it’s quite clear that a 5 to 10 cent an ounce tax on all soft drinks—including diet soft drinks, & on high fructose corn syrup, sugar, and refined grains is actually what’s needed.

Still we have to start somewhere. Now that recognized health professionals have proposed this tiny tax on soft drinks, the worst offender, and have done so in the influential New England Journal of Medicine, we might get there in time to do some good & prevent the massive harm we are experiencing and paying for now; AND begin to keep it from getting worse.

How other people's good health habits protect your health....

Today's post: Thursday, 1-22-2009

1. If your car is hit by a drunk driver who is a habitual heavy drinker, you may be injured even if you were driving safely and wearing your set belt.

2. If you are exposed to a lot of other people’s cigarette smoke, you get some of the same health harm and risks the smokers do.

3. If you have more money, you can more easily afford supplements and good for you food such as getting organic produce when the kind that has been exposed to pesticides costs less or buying some beef fed only grass or wild caught salmon when hamburger and hot dogs from grain fed animals is cheaper; you can more easily afford to go to a gym – and by getting better doctors sometimes.

Right now though, you now have less money, chances are, than you would if other people had good health habits because more than half your current real and out of pocket cost for health insurance and some of your direct health care costs are because our health care system is treating people with:

type 2 diabetes, high blood pressure, heart disease, heart failure, strokes, heart attacks, lung cancer, other cancers, and Alzheimer’s disease and other kinds of senility -- all of which people with good health habits would NOT have gotten!

4. There is an even bigger risk for most people. If your friends and family and even their friends and acquaintances have bad health habits, you are less likely to follow good health habits and may even be less able to follow good health habits yourself. This is a well proven fact.

So, if there is a way that other people can be induced to practice better health habits, you may very well be in better health yourself!

How can we do that?

There are some ways other people are more likely to follow good health habits.

One is to pass laws increasing the number of communities and places in each community where smoking is not allowed. That’s worked and been shown recently to cut heart attacks within 3 years of when such laws are passed.

In addition, the good news is that the incoming Obama administration is likely to help make some of these things happen.

His first pick for Surgeon General, Dr Sanjay Gupta, has worked part time as a medical health expert on TV and has often suggested and advocated that people follow good health habits to protect their health.

Tom Daschle, Obama’s pick for Secretary of Health and Human Services, will also serve as the director of a newly-formed White House Office of Health Reform. And, he has been quoted as saying he sees one critical part of these jobs to be to increase the number of Americans who practice good health habits.

One way is to literally sell the idea that practicing good health habits is not only the right thing to do but is also a sign that you are up to date and in the know --and in Tom Daschle’s words is “cool.”

That one is about to happen already.

But there is a more practical and particularly timely way to increase the number of Americans who follow good health habits.

Governments all over the country are short of money but are reluctant to increase taxes during a bad recession, which might very well make things worse, or to cut needed services and face severe criticism and backlash from people who are harmed or unhappy.

There IS a solution to BOTH these problems.

Tax bad health habits; and tax the worst health habits a LOT.

High taxes on things reduces their consumption. But with bad health habits, you get a double effect. The people most likely to practice bad health habits are mostly poor and uneducated. So the people who now have the worst health habits in part because they literally don’t know not to, reduce their consumption even more when such things are heavily taxed.

We already have cigarette taxes; and we already have taxes on alcoholic beverages.

But we do not yet tax soft drinks, commercial baked goods and desserts, packaged snack foods, or any and all foods that are sweetened with sugar or high fructose corn syrup – or with non-nutritive sweeteners which seem to be about as bad for you.

Suppose we had an additional national tax of $1.00 a pack on cigarettes and an equivalent tax on other forms of tobacco. Suppose we had an added national tax of about a quarter per drink on all alcoholic drinks.

Fewer young people would start smoking. People who smoke would smoke a bit less. And more people would quit smoking.

It’s already been shown that a small increase in taxes on alcoholic drinks reduces the amount of drinking by heavy drinkers. Yet for people who drink moderately or lightly an added quarter a drink is not much.

Would this hurt the overall economy? Nope. Many people would spend the same or less on smoking and alcoholic drinks but do it less even if they spend the same. The people who quit smoking or drink less heavily would actually have MORE money to spend on things that will actually boost the economy, Governments would have more money without hurting the economy or cutting needed services.

But that’s the tip of the iceberg. Suppose ALL soft drinks, both regular and diet, had a new national tax of a dime an ounce. Suppose ALL commercial baked goods and desserts, packaged snack foods, or foods that are sweetened with sugar or high fructose corn syrup had a new national tax of a quarter a serving.

Those taxes would raise a LOT of money for awhile when our economy needs it most. Later fewer people would consume those things and food companies would switch to producing better for you foods that aren’t taxed. But initially when our governments most need the money and many people eat or drink far too many of these things, it would really help.

Then let’s suppose most states also began to add their own new taxes on these things.

Fewer people would be fat, fat people would be less fat, and fewer people would get the diseases and incur the medical costs consuming these things causes.

Lastly, even if you know better than to consume these things or consume relatively little of them now, you will be in better health and find it easier to practice good health habits.

So, please suggest to your local and national representatives that they pass such laws that put into place such taxes or increase the ones we have.

Prevention in health care reform....

Today's post: Tuesday, 12-16-2008

President-elect Obama has a website with several ideas on how health care reform can be done effectively. (See Health Care under the Agenda tab at http://www.change.gov .)

1. I support Obama’s most important position, which is that he will continue the existing plans and coverages. So, the large group of people who have good or at least almost OK health insurance don’t have to deal with moving to a system that may well be worse or cause them to lose contact with any doctors they have worked well with until now. This also ensures that his plan won’t get torpedoed in congress by legislators who the existing companies would lobby to oppose his plan. It also enables him to add the remaining pieces much more quickly and inexpensively. That gives his reforms a chance of being doable.

2. He also wants to have a plan that gives people who are now not insured some coverage. And he wants to see to it that individuals and employees of small businesses that now get overcharged or denied coverage due to pre-existing medical conditions get group coverage and get coverage at competitive rates and get coverage even with pre-existing medical conditions just the same as employees of large companies do now.

And, most of the other points look decently good.

A. However, due to the severe recession and to help end it, he has postponed the tax rollback his agenda calls for as a funding mechanism. (This may be the correct call for a person charged with the responsibility for the whole country I think.) But it does leave much of the good ideas in this part of his agenda without a funding mechanism for now.

B. And, despite having the following two points about prevention, it is quite weak on simply preventing medical care costs. This is very important because if you don’t get sick or only get sick ten, twenty, or thirty years later, your current health care costs will drop like a stone. And, if any government plan adopts a strong preventive component and gradually begins to require existing insurers to add or upgrade their preventive components if they don’t already have better ones in place, this will eliminate or postpone costs enough to lower our health care costs. Further, these savings can in part help fund the needed added coverage.

Here are the two mentions I see of prevention in the current agenda on health care reform.:

“The Obama-Biden plan will promote public health. It will require coverage of preventive services, including cancer screenings….”

They also plan to require the insurance companies that provide malpractice insurance for doctors to lower their rates while also lowering their risks to compensate by requiring them to “….invest in proven strategies to reduce preventable medical errors.”

These two strategies will help. But I think that they need to go much farther than that.

I think they need to also ensure that all the players in the system give discounts to the individuals covered to follow the most essential preventive measures and to charge people who do not do the preventive measures at least a token amount besides.

This would include direct payments to individuals who have no income but who DO take the most important preventive measures.

It’s recently been shown that offering small payments for success to people who are too fat to lose it, does work, for example.

In addition, getting a certain minimum of exercise each week and NOT smoking have even more positive effects.

One way to help accomplish this would be for the new health care program to offer incentives to all employers to offer some kind of fitness plan; offer incentives to any employee (and anyone living in tbeir homes) who now smokes to quit and free doctor and drug programs to do it; and offer extra help to employers to set up workplaces that support good health practices. This would also mean that the coverage plan for individuals and small businesses would have a model program in these areas based on proven best practices. That would provide those people a good program plus provide a model to follow for the larger employers who have less effective plans or none.

This might also encompass passing a law specifically granting any employer the right to only hire nonsmokers and having a federal law prohibiting smoking in certain public places where the local laws do not already do so.

People who don’t smoke, exercise regularly, and eat right tend NOT to get type 2 diabetes, all cancers, heart disease, high blood pressure, strokes, and many, many other expensive diseases or only get them after age 70.

And, taking the correct supplements generally and for the issues of a particular person as needed have been shown to increase that protection. Following good health practices generally and brushing correctly and flossing daily and seeing a dentist regularly adds to the protection. Taking curcumin and very likely several other supplements in addition to following good health practices generally tends to prevent Alzheimer’s disease.

So, not only do these actions prevent disease, they prevent disability. This has the double benefit of eliminating the need for extremely expensive custodial care and to allow the people who thereby remain disability free to do economically productive work.

So, each of these preventive steps helps to eliminate costs. They prevent suffering. And they help keep people productive.

At a time when our economy needs extra help, they are even more important to include than they have been up to now.

C. All of the above will cost money. So if there is a way to raise it that does not cut economic productivity, we should certainly do that too.

There IS such a way.

It’s quite simple. It will not be totally popular; and the industries affected will lobby against it. But I think it’s long overdue to have a hefty federal tax on food and drinks that make people sick. We tax cigarettes. But many foods and drinks we now know are quite literally that bad for you do not now get taxed. Even worse, most of the people who consume them do not even know they are being harmed.

People will die if they don’t get fruit and vegetables -- and protein foods and some kinds of oils that are safe to eat.

But if they never had another soft drink or commercially made dessert or packaged snack they might feel deprived, particularly if they didn’t know how to make or find foods that support their health that they enjoy to substitute for them. But their health would improve dramatically. Their medical care costs would drop in an equally dramatic fashion.

Why not simply tax these things enough to cut their consumption by 70 %. In the short term, while they are still socially accepted; people are still unaware of their health damaging qualities; and people are used to consuming them, they would remain widely available.

But their use would go down; and the taxes would be in the tens of millions nationwide, and likely even more than that.

We could easily add a federal excise tax equal to and collected by the same people who now collect the federal excise tax on alcoholic beverages to all soft drinks and all foods that contain refined grains or refined grain flour, sugar, high fructose corn syrup, or any vegetable oil except olive oil or any kind of hydrogenated oil. Then as people become better educated and fewer use these things, the tax could be gradually increased. These foods and drinks are often quite safe if you have them once or twice a month or even once or twice a week; but they produce avoidable illness and massive medical costs if you have them five times a day.

Why not raise money and drive their use down to the levels people can enjoy without getting fat and sick and broke from avoidable medical costs by taxing them adequately?

They would become luxury goods instead of cheap bad for you treats. But the people who have enough money to get lots of them increasingly know better than to have a lot of them.

We could also add a federal tax of a dollar a pack tax on cigarettes in addition to the current taxes on them. (And, it would make sense to have at least a quarter each of the revenues generated go to enforcement; to smoking education and prevention; & to providing no-cost cessation programs.)

We need healthier people. We need lower medical costs. We need to increase the productivity of people who have jobs. And, we need to raise money for these health care reforms without harming things that provide people with essential goods and services.

Taxing and then gradually increasing the taxes on the foods and drinks that make people sick when consumed as often as they are now, would do this.

Why not raise the money for the needed reforms in a way that prevents disease too?

So, I ask the Obama health team
to add such taxes as an essential part of their health care reforms.