November 11, 2011

Healthcare and College Students

Guest post written by Cyndi Laurenti

Imagine being sick for weeks at a time, or falling and injuring your knee so badly you can hardly walk even after days of rest. Now imagine not being able to get checked out by a doctor because you don't have health insurance and simply can't afford it otherwise. Unfortunately, this is an all too common problem for many people in America, and young people pursuing higher education have been hit the hardest.

After graduating high school, many students choose to go on to college in order to increase their odds of a better future. This is both beneficial to students and to the country, as these young adults will be the future workers and leaders of America. College isn't cheap, however, and most students have little choice but to take out loans or work multiple jobs just to afford their books.

Attending college full time while also working is nearly impossible in itself. Many students choose to work part time or to switch jobs during the summer when they can return home for awhile. Because of this sort of work situation, there's very limited room for the professional advancement that might include benefits such as health insurance for working college students.

Without health insurance from jobs or parents, students can only pay for it themselves. For most, this is simply unfeasible. These young adults are adjusting to living on their own, paying bills, car insurance, book costs, and more, usually while only working for minimum wage.

For working students, it can easily come down to a decision between paying the electricity bill, paying for food, or getting health insurance. While healthcare may be important, the cost of insurance easily gets pushed aside by more pressing priorities. Needless to say, paying healthcare costs out of pocket is also likely to be out of the question, so students are likely to simply go without regular, non-emergency healthcare.

Unfortunately, not everyone is blessed with good health. Of course, with the cost of medical care in this country so expensive, many ignore warning symptoms until emergency care is required. For example, let's say a college student becomes sick one day with a worse-than-usual cold. He doesn't have money to spare for a doctor visit, so decides not to go for a checkup but instead to tough it out. Weeks go by and the initially harmless illness develops into pneumonia. One night, when the student is unable to breathe, an ambulance is called and he is rushed to the hospital. The medical bills are suddenly through the roof. The college student, already up to his neck in debt, simply has no way to pay for it.

These situations are all too common across the country. As of 2008, 1.7 million college-age students were uninsured. Because of this, many people are beginning to worry about the long-term effects of this demographic going without healthcare.

Currently, Americans have an average life expectancy of 78 years. This is mostly due to the superb medical care within the country. Around 100 years ago, before doctors treated patients on a regular basis, the life expectancy was only 47. With young people unable to pay for routine medical care, many worry preventable illness will wear down the body, causing the life expectancy of this generation to be the first to decrease in the last century.

It's simply impractical to expect college students to pay even more than the astronomically rising cost of education, which will saddle many with debt for most of their lives. These young adults are American's future. Unless something is changed to make healthcare more easily available to students, they'll unnecessarily face declining health over the coming decades. The high cost of healthcare combined with heavy student debt doesn't bode well for the nation's health as the new generation comes of age.


While she figures out her next career move, Cyndi Laurenti works as an online writer and editor. Her primary interests are education, technology, and how to combine them. She enjoys the trees and beaches of the Pacific Northwest, and looking things up on other people's iPhones.

October 30, 2011

Doc take the afternoon off let's get a drink and talk

My Doctor Needs A Doctor
By Melvin J. Howard

I was watching a episode of House MD which by the way is one of my favorite TV shows. What I find fascinating about the show is that it exposes all the flaws of the main character for the whole world to see not only in the work environment but in his personal life as well. We seldom forget that doctors are people to with their own problems from dating, family conflicts to business and professional set backs. Just imagine after years and years of intensive medical training, nights without sleep, rigorous exams and a demanding workload, you made it, you became a doctor. You also have another full-time job, as a mom or dad. Now the reality has set in and you wonder how on earth you can continue in the medical profession and have a balanced family life. It's not what you imagined. With increased patient loads, the stress of dealing with insurance companies and HMOs and piles of paperwork, you're burned-out, unenthusiastic and your personal life is suffering. You fulfilled your dream, but how can this be? Is it just you? What can you do?

"It is becoming increasingly difficult to manage a medical career and a personal life, which is really nonexistent and has been for some time now". One doctor says, "Most of the doctors I know are frustrated being in the profession. Many would leave if they found a way to support their current lifestyles. Most are so locked into their earnings that they cannot conceive of leaving medicine, despite the unhappiness. Finding an alternative career that allows them to pay the bills and add balance to their family life can be extremely difficult, especially when student loans can top $100,000. Many doctors aren't living a fancy lifestyle with bulging bank balances. Like working women in other professions, financial priorities include childcare, loans, mortgages, family expenditures and so on. Even if available, cutting back hours simply isn't an option for many many physicians.

To find an alternative is difficult if not impossible a young doctor, only four years out of residency, in a low-paying specialty (family practice) and has a astronomical student loan payments to make ($125K-something that the older physicians in previous practice did not understand at all) which pretty much precludes a young doctor from decreasing their  hours/workload as much as they would like to. And even if they could have afforded to just cut back on hours, the partners in their practice would not tolerate it without extreme penalty. Managed care changes, HIPPA laws, malpractice lawsuits and Medicare regulations have also contributed to physician stress. "I believe that medicine is incredibly demanding (even part-time). Patients expect far too much. Managed care expects us to solve unsolvable problems with less than 15 minutes per patient", says another family practioner with two school age children. She goes on to say, "Despite working only 2-3 days per week, I still feel like giving up medicine all together because of the awful working conditions... I honestly don't know too many doctors who enjoy medicine anymore".

Another member describes her day, "I see close to 60 people a day in my ob-gyn practice. Don't ask how I do it because at the end of the day, my head is swirling. I do this because that is the only way I can make my overhead and actually take home enough to pay for the nanny and student loans. It is ridiculous." So why practice at all?Many doctors still love what they do, love interacting with patients, love diagnosing them, teaching them and getting patients to take care of themselves. "It feels good when they tell me I'm the best doctor in the world... I love trying to figure out how to add quality in to the work I do every day" says one single mom physician.

Another member says, "what a privilege it is to practice medicine... But that privilege comes with a huge responsibility. I must be continuously vigilant that I am practicing the kind of medicine that I was trained to do (i.e. being thorough and spending time with patients). There are no shortcuts to providing good care. Hyper efficiency does not exist in the world of good medical care.. And no one can sustain good medical practice when they are burned out.".

In the biggest study of married doctors to date, the American College of Surgeons surveyed nearly 8,000 of its members, 90% of whom were married. Of those, half had spouses or partners who did not work outside the home. About a third of the double-income couples were actually double-doctor duos, and in about a third of those marriages, both partners were surgeons. In fact, the study notes that something like 50% of female surgeons are married to physicians. This is in keeping with current marital trends. Plus it just makes sense. Who's better at understanding the stresses and strains of a physician's life than another physician? Luckily, there are more female surgeons than there have been before, so there are more around to marry. 

And since medical students are busy particularly those training to be surgeons are more likely to socialize among their own. No wonder that the study suggests surgeon-surgeon marriages are on the rise.
You'd think that two-doctor families would be idyllic: not only are both parents well-paid and competent at handling Baby's late night fever spike, but they're also able to appreciate each other's latest bit of O.R. gossip and compete to beat Gregory House at the correct diagnosis.

But, it turns out, not so much. Surgeons in dual physician relationships had greater difficulty in balancing their parenting and career responsibilities," than those who had partners who stayed home or worked in other areas, finds the study, which was authored by Liselotte N. Dyrbye, an associate professor of medicine at the Mayo Clinic College. Specifically, two-doctor couples were more likely to delay having children and to feel that their work did not leave enough time for a family life.

For surgeons married to other surgeons, the picture was even grimmer. They were more likely to report that child-rearing had slowed their career, and they were more "likely to stay home from work to care for a sick child and more often surrogated their career" in favor of their partner's career, the study said. Half the surgeons married to other doctors said they had experienced career conflict with their spouse and only about a third of them thought they had enough time for their personal lives. Closer to 40% of doctors married to non-doctors felt that way. Despite this, individuals from the two-surgeon families felt about the same amount of burnout and depression as surgeons married to non-surgeons. This doesn't stop the study from concluding that "the higher prevalence of depressive symptoms and clinically significant lower mental quality of life among surgeons married or partnered to surgeons suggests that the work-life hurdles could be taking a toll on their mental health."

 An extensive body of literature demonstrates that the life of a physician's spouse (until recently synonymous with a physician's wife) is fraught with stress and links such stresses primarily with the spouse's occupation. The role of physician conflicts with the role of husband and father and that the structure of medicine makes the curing and caring roles mutually exclusive. The role strain, role conflict, susceptible personality type and loss of self-esteem as stress factors. Many authors have testified that marital conflict is a major source of stress in the lives of physicians' spouses. The role conflicts between the physician and his wife, particularly regarding the division of time between professional and family tasks, seem to become rigid rather than negotiated. Over time, the spouse often comes to feel neglected, lonely and painfully aware of a lack of individual and personal meaning in her life. In addition, the physician's status in the community and professional world often seems to contrast sharply with that of the spouse, who may feel that she is "one down" and is the losing competitor in the marriage. Power issues, expressed through the physician's greater flexibility and control over money and other resources, may contribute to marital discord because the wife's power is usually limited to family and social relationships. Thus, the physician's spouse often struggles with confusion over identity and the effects of role strain.

The physician-husband's directive professional role, if carried into the home, may be a major source of marital stress, which in turn may lead to psychiatric disorder in either partner. Many authors have identified psychiatric disorders such as depression, anxiety, suicidal tendencies and psychosocial stress as major health problems for physicians' many observed that physician's wives admitted to hospital for depression or drug and alcohol abuse were often angry and hostile because they felt neglected by their husbands and emotionally unfulfilled .Also, physicians' wives may come under significant but perhaps covert stress because their concerns and complaints about their health often seem to be ignored or minimized by their husbands and other health care personnel. Despite being surrounded by medical expertise, physicians' spouses received surprisingly poor health care. According to a study physicians' wives felt that their husbands minimized their own families' medical problems. Medical crises often developed as a result of this attitude. In a comparative study of the number of obstetric, pediatric and psychiatric complications of physicians' wives and teachers-lecturers, it was observed that nurses on postnatal wards failed to report mild psychiatric problems among the physicians' wives.

In recent years the physician's spouse has come under a new stress. Historically, physicians and their spouses have held an honoured and unique place in society. However, this esteem for the medical profession is being eroded as its members become increasingly involved in business and union-like activities. In response to this inimical environment many physicians work harder and show greater commitment to their patients, but at a cost to their personal life-style; many of the wives silently grieve the loss of public esteem and feel anonymous and forgotten by contemporary society.

September 17, 2011

Life Style Diseases

Effects on world health and the economy
By Melvin J. Howard 

Next week, the U.N. General Assembly will hold its first summit on chronic diseases  cancer, diabetes and heart and lung disease. Those account for nearly two-thirds of deaths worldwide, or about 36 million. In the United States, they kill nearly 9 out of 10 people. They have common risk factors, such as smoking and sedentary lifestyles, and many are preventable. This is only the second time in the history of the UN that the General Assembly meets on a health issue (the last issue was AIDS). The aim is for countries to adopt a concise, action-oriented outcome document that will shape the global agendas for generations to come.

Non-Communicable diseases such as HIV/AIDS and pandemic influenza attract a lot of attention, but the NCDs are more deadly, accounting for 63 percent of all deaths worldwide, according to the World Health Organization (WHO). The U.N. General Assembly will convene a special session on NCDs September 19–20 of this year in New York with the goal of adopting an action plan for the international health community to attack the problem. This session emerges from the growing realization that premature deaths from these health problems impede economic development. These diseases can entrench an individual or a family in poverty because of the inability to work or the cost of medical treatment. Expand those individual difficulties to a broader scale, and they can inhibit national economic progress. The global cost of NCDs from 2005 to 2030 is estimated at $35 trillion, according to a World Bank study.

Worldwide, stroke and heart-related diseases account for nearly half of all noninfectious disease deaths 17 million in 2008 alone, WHO says. Next is cancer (7.6 million deaths), followed by respiratory diseases such as emphysema (4.2 million). Diabetes caused 1.3 million deaths in 2008, but that’s misleading — most diabetics die of cardiovascular causes. The U.N. chose to focus on those four diseases and their common risk factors: tobacco use, alcohol abuse, unhealthy diets, physical inactivity and environmental carcinogens.

Europe and North America. Too much eating, too little exercise and smoking: heart disease and diabetes dominate. Cancers that are more prevalent with age breast and prostate reflect long life spans in these regions where treatment is widely available. In Eastern Europe and the former Soviet Union, lung cancer is the dominant cancer in men. Europe has the highest smoking prevalence in the world: 29 per cent. Asia. Southeast Asia has the lowest rates of obesity in the world, even lower than Africa. Yet in China, where only 6 per cent of the population is obese, nearly 4 in 10 people have high blood pressure. China also has three times the death rate from respiratory diseases as the United States. Many areas also have high rates of infection with HPV, a sexually spread virus that can cause cervical cancer. In India, the government has launched an aggressive diabetes and high blood pressure screening project. There are 51 million diabetics in India, the second-highest incidence in the world after China. Lung cancer is the most common type of cancer in India among men; in women, it’s cervical cancer. Central and South America. Cancer prevalence patterns largely resemble North America except that cervical cancer dominates among women in certain areas. Access to care is much poorer in many countries. Volunteers for the American Society of Clinical Oncology, told of conditions at a hospital in Honduras, where there are more than 700 new cancer cases every year for two oncologists to handle.

September 10, 2011

The World’s Mental Health

Chance are you know someone close to you with a mental illness

By Melvin J. Howard

It all starts with the brain emotional memories differ from normal memories in that they result from traumas. They are frightening at the time, but even worst, these memories can become enduring and distort our outlooks thereafter. They appear to react more strongly to negative than positive events. Emotional memories are locked in a separate neural circuitry in the brain, mediated primarily by two of the limbic organs, the hippocampus and amyagdala. According to WHO (World Health Organization), mental health is "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community". WHO stresses that mental health "is not just the absence of mental disorder".

Mental health (disorders) can affect anyone Doctors, Lawyers, and even Politicians

Experts say we all have the potential for suffering from mental health problems, no matter how old we are, whether we are male or female, rich or poor, or ethnic group we belong to. In the UK over one quarter of a million people are admitted into psychiatric hospitals each year, and more than 4,000 people kill themselves. They come from all walks of life.  According to the NIMH (National Institute of Mental Health, USA) mental disorders are "common in the USA and internationally". Approximately 57.7 million Americans suffer from a mental disorder in a given year, which is approximately 26.2% of adults. However, the main burden of illness is concentrated in about 1 in 17 people (6%) who suffer from a serious mental illness. Approximately half of all people who suffer from a mental disorder probably suffer from another mental disorder at the same time, experts say. In the UK, Canada, the USA and much of the developed world, mental disorders are the leading cause of disability among people aged 15 to 44. The most common forms of mental illnesses are:

Anxiety disorders - Most people with an anxiety disorder will try to avoid exposure to whatever triggers their anxiety. Examples of anxiety disorders include: Panic disorder - the person experiences sudden paralysing terror or imminent disaster. Phobias - these may include simple phobias - disproportionate fear of objects, social phobias - fear of being subject to the judgment of others, and agoraphobia - dread of situations where getting away or breaking free may be difficult. Obsessive-compulsive disorder - the person has obsessions and compulsions. In other words, constant stressful thoughts (obsessions), and a powerful urge to perform repetitive acts, such as hand washing (compulsion). PSTD (Post-traumatic stress disorder) - this can occur after somebody has been through a traumatic event - something horrible and scary that the person sees or that happens to him or her. During this type of event the person thinks that his/her life or other people's lives are in danger. The sufferer may feel afraid or feel that he/she has no control over what is happening. Mood disorders - these are also known as affective disorders or depressive disorders. Patients with these illnesses share disturbances or mood changes, generally involving either mania (elation) or  depression. Experts say that approximately 80% of patients with depressive disorder improve significantly with treatment. Examples of mood disorders include: Major depression - the sufferer is not longer interested in and does not enjoy activities and events that he/she previously got pleasure from. There are extreme or prolonged periods of sadness. Bipolar disorder - also known as manic-depressive illness, or manic depression. The sufferer oscillates from episodes of euphoria (mania) and depression (despair). Dysthymia - mild chronic depression. Chronic in medicine means continuous and long-term. The patient has a chronic feeling of ill being and/or lack of interest in activities he/she once enjoyed - but to a lesser extent than in major depression. SAD (seasonal affective disorder) - a type of major depression. However, this one is triggered by lack of daylight. People get it in countries far from the equator during late autumn, winter, and early spring. Schizophrenia disorders - The sufferer has thoughts that appear fragmented; he/she also finds it hard to process information. Schizophrenia can have negative or positive symptoms. Positive symptoms include delusions, thought disorders and hallucinations. Negative symptoms include withdrawal, lack of motivation and a flat or inappropriate mood.

Treatments and strategies for mental health problems

There are various ways people with mental health problems might receive treatment. It is important to know that what works for one person may not work for another; this is especially the case with mental health. Some strategies or treatment are more successful when combined with others. The patient himself/herself with a chronic (long-term) mental disorder may draw on different options at different stages in his/her life. The majority of experts say that the well-informed patient is probably the best judge of what treatment suits him/her better. It is crucial that healthcare professionals be aware of this.

Often people wait a long time before they ask for help they and their family feel that something is wrong but they don’t know what. They also may be reluctant to ask for help in addition, diagnosing a mental disorder can take time months or even years. Observations by family and friends in the disturbance in your behaviour are the first indicators. This should be followed up with psychological tests of an experience health professional your doctor or a specialized mental health professional such as psychiatrist or psychologist. There are a number of reasons people struggle with mental disorder they simply don’t know what’s wrong they just feel different. Or they feel the can beat it on their own. Exasperated family and friends are at their wits ends to deal with the issue. Yet we know that the earlier people get help, the better the outcome. One way to get the help you need for yourself or someone you know is to educate yourself about what a mental disorder looks like.

As reported by (Reuters) - Europeans are plagued by mental and neurological illnesses, with almost 165 million people or 38 percent of the population suffering each year from a brain disorder such as depression, anxiety, insomnia or dementia, according to a large new study. With only about a third of cases receiving the therapy or medication needed, mental illnesses cause a huge economic and social burden -- measured in the hundreds of billions of euros -- as sufferers become too unwell to work and personal relationships break down. "Mental disorders have become Europe's largest health challenge of the 21st century," the study's authors said. At the same time, some big drug companies are backing away from investment in research on how the brain works and affects behavior, putting the onus on governments and health charities to stump up funding for neuroscience. "The immense treatment gap ... for mental disorders has to be closed," said Hans Ulrich Wittchen, director of the institute of clinical psychology and psychotherapy at Germany's Dresden University and the lead investigator on the European study.

Help Yourself

Alterations in lifestyle, which may include a better diet, lower alcohol and illegal drug consumption, exercise and getting enough sleep can make enormous differences to a mental health patient's mental health.

Diet and mental health

It is an accepted fact that food affects how people feel, think and behave. Most experts accept that dietary interventions could have an impact on a number of the mental health challenges society faces today. So, why is it that governments and public health authorities in developed economies invest so little in developing this knowledge? The evidence is growing and becoming more compelling that diet can play a significant role in the care and treatment of people with mental health problems, including depression, ADHD (attention deficit hyperactivity disorder). Experts are talking about an integrated approach, which recognizes the interplay of biological, psychological, social and environmental factors - with diet in the middle of it as being key. Individuals can do something about their diet themselves and improve their mental health. 
It is estimated that in the UK people eat 4 kilograms of food additives each year. Scientists are not sure what effect decades of such consumption may have on the brain. Governments are reluctant to fund, conduct or publish rigorously controlled large-scale studies, which look at the effect of additives on human mental health. Changing farming practices have introduced higher levels of different types of fat into our diet. For example, chickens reach their ideal weight for slaughter twice as quickly today compared to three decades ago - this has changed the nutritional profile of meat, according to a report by the Mental Health Foundation (UK). Three decades ago a typical chicken carcass used to be 2% fat - today they are a whopping 22%. The omega-3 fatty acid content in chicken meat has dropped while the omega-6 fatty acids have risen. The same is happening to farmed fish.
Our brains' dry weight consists of approximately 60% fat. Our brain cell membranes are directly affected by the fats we eat. Saturated fats make our brain cell membranes less flexible. Saturated fats are those that harden at room temperature. 20% of the fat that exists in our brain is made up of essential fatty acids omega-3 and omega-6. The word essential here means we cannot make it ourselves, so we have to consume it in order to get it. Fatty acids perform crucial functions in the structuring of neurons (brain cells), making sure that optimal communication is maintained within the brain. Nutritionists say omega-3 and omega-6 essential fatty acids should be consumed in equal amounts. If we consume unequal amounts there is a higher chance of having problems with depression, concentration and memory. It is crucial omega-3 intake is kept up. While one study shows a link between omega-3 intake and mental skills, others show there are benefits for cardiovascular problems, diabetes, ADHD, and a whole host of other problems:

Trans-fat, which has appeared in growing quantities into much of the food we eat over the last few decades, assumes the same position as essential fatty acids in the brain. In other words, the proper vital nutrients are not able to assume their right position for the brain to function effectively. Trans-fats are commonly found in cakes, biscuits, shortbread, some pastries and many ready meals. Neurotransmitters, such as serotonin, are made from amino acids which we often have to get by eating it. If you want to feed your brain with good stuff eat less intensively farmed chicken and meat, and go for organic chicken and non-farmed oily fish, such as tuna, sardines, trout, or salmon.

Run, jog, walk get out of your car and exercise
A Harvard University study found that exercise may help people with depression by enhancing body image, providing social support from exercise groups, a distraction for every day worries, heightened self-confidence from meeting a goal, and altered circulation of the neurotransmitters serotonin, norepinephrine, and the endorphins. Even a very small amount of additional exercise has been seen to have an important impact on mental health.  Exercise can boost an exercise-related gene in the brain that works as a powerful anti-depressant. Apparently, though only 5% of GPs (general practitioners, primary care physicians) use it as one of their most regular treatment responses, compared to 92% who use antidepressants as one of their most popular treatment responses. If you have a mental disorder, remember that you can do the exercise yourself. You do not need to wait for your doctor to "prescribe" it for you. Perhaps you should initially check whether you are in acceptable physical health to do exercise. If you are not, insist that your doctor help you devise an exercise plan that suits you. There is evidence that very moderate alcohol consumption may aid mental health in some cases. However, the evidence is overwhelming that excessive alcohol has a very bad impact on people's mental health. Whatever your attitude is to alcohol, remember that alcohol will not resolve your mental health problems nor any other problems you might have, and will most likely make them worse if you are not very, careful. 

August 09, 2011

The Fountain Of Youth

What will it be?

By Melvin J. Howard

The blockbuster drug cabinet is currently looking pretty bare these days, and big pharma is getting jumpy. Many recent blockbusters act on certain enzymes to inhibit their production of an undesired chemical that causes problems like high cholesterol. But the enzymes available for such targeting are pretty much used up by now by all the existing blockbusters. In addition, it will be hard to improve on existing treatments for the 5 main ailments that currently dominate the top 20 drug lists - heartburn, arthritis, high cholesterol, high blood pressure and low spirits (depression). So what next?

Operating in the favor of big pharma profitability is the aging of the rich world populations with money to buy prescription drugs. This aging in the West will drastically increase per capita spending on prescription medicines in the coming years. Finding effective medication for the degenerative altzheimers disease or even osteoporosis would be like hitting the jackpot. But with few warm leads on such cures, investing R&D monies in this area is certainly very risky.

In it's efforts to produce a blockbuster for the over 65s, one of the biggest drug giants Pfizer has been working on the elusive "fountain of youth" pill, also known as the "frailty pill". By stimulating the pituitary gland to produce more growth hormone, this drug aims to reverse the degenerative process that comes with aging and make old people feel young again this would give a whole new meaning to the phrase sex, drugs and rock and roll where 70 is the new 50 and age is nothing but a numberTaking the trend set by drugs such as Viagra, Rogaine and Paxil to a whole new level, this drug promises to be the ultimate "lifestyle drug" for the baby boomer generation. But so far the clinical trials have not produced the desired results.

Nevertheless, if the drug companies could get the youth pill to work then, by playing on one of the deepest of human fears, they will have struck gold. Consumers might start taking such medications at the first signs of old age and then be taking them for the next 50 years!

Another strategy we are likely to find interesting enough  is the use of 'gene hunting', where researchers try to discover the genetic roots of chronic diseases and thereby devise treatments. But payoffs from gene technology are not expected for another decade or so. In the midst of this current drought in the blockbuster drug pipeline, many industry watchers have noted that increasing consolidation has actually made the drug industry less efficient at producing more drugs.

But that's not the worst of it, by far. The patented medicine model, while contributing much to the welfare of the western world over the past century, has itself aged and entered a seriously degenerative phase. It is not making much sense in our globalized markets, and maybe it's time for it to die out and reboot. Today, people all over the world, regardless of nationality, political ideology, or wealth, should seriously be questioning the suitability and sustainability of the old contemporary patented medicine model.

July 29, 2011

Cutting CO2 Emissions Brings Savings in Health-Care Costs

Or What I Call Global Carbon Flows BC  (Before Coal)

By Melvin J. Howard


Environmentalists are in favor of cutting the emissions of greenhouse gas, claiming that investing in this cause further would ensure an increase in health-care savings of around thirty billion euros annually. Cutting the CO2 emissions by 30 percent, instead of just 20 percent that have been settled upon currently, with 2020 set as a deadline, would be to Europe’s benefit. The estimation was made by two campaign groups, “Health Care Without Harm Europe” and “Health and Environment Alliance”, who published the study. The two anticipate that less time would be taken off work as a consequence of suffering from illnesses, less consultations and medicines would be needed and improvements in life expectancy would be registered due to the heightened cut into greenhouse gas emissions. These are the factors that would generate savings in health-care for Europe. According to the researchers, people’s well-being would be increased as a result of the rise in the quality of air. Europe would agree to cut into the emissions further so long as other polluting countries such as China and U.S. would make the same commitment. Discussions on whether to rise the percent have already started. 

Most developed nations have ratified the Kyoto Protocol of the United Nations Framework Convention on Climate Change, including all 25member states of the European Union, as well as Canada and Japan. By ratifying the Kyoto Protocol on climate change, these countries have pledged to reduce their greenhouse gas emissions by a significant amount over the next decade. The U.S. refused to ratify the Protocol. In anticipation, this pro-Kyoto world is gearing up for compliance and is implementing new regulations, markets and market mechanisms - indeed a whole new way of doing business globally. Will the U.S. now be left out of the developments in the global carbon markets that have taken place mostly outside of the United States, and get very little attention in this country. These developments include the world's first international market in carbon-based financial instruments, national taxes and levies on corporate energy use, and even a tax on cow farts yes that’s right I said cow farts and even burps in New Zealand!

But first, let’s start with a refresher on the cycle we can't afford to ignore anymore the global carbon cycle. Just like with the water cycle in the carbon cycle, only a tiny fraction of carbon on earth actually participates in the carbon cycle relevant to us earthly creatures. And just like the water cycle, any carbon we have in our bodies today has certainly done the rounds over thousands or millions of years: through plants, soils, other animals, the ocean and the atmosphere. And you can forget property rights when it comes to carbon! When the carbon in us is ready to depart, it will just go off and be somewhere else. Before the industrial revolution got underway, global carbon flows ran as follows:

ü      Carbon in the air, stored as carbon dioxide (amongst other gases), is used by plants in photosynthesis and becomes part of the plant. Some of these plants get eaten by animals and the carbon in them is then used in various molecules to make body tissue and to burn up energy. Other plants, or parts of them, like leaves, just get old and die. This decomposition releases some carbon back to the atmosphere, as does the process of respiration by animals. The other 99.9 Before fossil fuel use by humans entered the scene, losses of carbon from the earth and into the air from decaying vegetation and animal respiration, in the form of various gases such as carbon dioxide and methane, were pretty much balanced by carbon storage or "sequestration" by plants during photosynthesis. The carbon cycle chugged along in this balance between about 1000 AD and the early 1800s, and so the amount of carbon in the air stayed pretty constant over this time period since the middle ages. To give you an idea of magnitude, this annual exchange was about 100 million gigatons of carbon (where a gigaton is a billion tons), from the earth into the atmosphere, balanced by an equal exchange from the atmosphere back to the earth.

How Carbon Accounts become Unbalanced

ü      But then came the industrial revolution, powered by the burning of carbon rich fossil fuels, and accompanied by massive clearing of forest land for agricultural and other purposes. These two activities have extracted another 7-8 gigatons of carbon out of the earth's sources per year, of which the oceans and the world's forests have decided to absorb just over half of this release. So the remaining 3-4 gigatons of carbon has nowhere to go but into the air. Over the past 250 years, the level of carbon dioxide in the atmosphere has risen by 30. An excess of carbon gases, like carbon dioxide and methane, are known to trap heat in the biosphere, making things toastier for all of us. This so-called "global warming" has many known and unknown impacts on climate. That humans have significantly increased the amount of carbon gases in the atmosphere, and that these gases do contribute to temperature increases is generally not in dispute between the two main parties on either side of the Kyoto Protocol. What is under debate is the degree to which global warming is caused by natural versus man-made factors. The fairly recently discovered indications that the middle ages may have been warmer than the current ages, has the leadership in the US scrambling to promote studies to show that natural causes are a primary contributor to climate change. Satisfied that human activities are contributing to climate change, the countries that have now ratified the Kyoto Protocol on global warming are trying to do what they can to get as much as possible of this excess carbon out of the atmosphere by implementing mechanisms designed to reduce overall carbon emissions.

The naysayers team, reluctant to give up their high carbon diets, led by the United States and Australia, are diverting significant resources into figuring out how carbon wastes can be buried underground or in the sea in a process known as artificial carbon sequestration. The U.S. has also developed a interest in the climate in medieval age when temperatures were much warmer than they are today. If only they can understand why we were so toasty, they can cast doubt on the idea that human induced greenhouse gases are largely responsible for climate change.

The carbon market.

In this new carbon market a monetary value is assigned to a carbon gas emission allowance. Such an allowance could only have a monetary value if there are a finite number of such emission allowances and the total amount allowed in the market is close to, or even below, the total amount that is currently being emitted. For this market to exist in the first place there must be someone or some body, most likely a government body, that sets the total number of allowances for the market. This is exactly what the European Union has done. It has used the "cap and trade" approach to moving towards Kyoto targets. Under the EU emissions trading scheme the EU member states will set limits on carbon dioxide emissions from energy intensive companies by issuing allowances for the amount of gas each is allowed to emit. The total number of allowances will reduce each year until the final target is reached. This list of companies includes approximately 10,000 companies accounting for about half of the EU's cabon dioxide emissions and encompasses the following industries: steel, power generation, oil, paper, glass and cement. A company that is able to lower its emissions at relatively low cost, may sell its excess allowances and hence, the argument goes, the emissions market will act as a catalyst towards finding lowest cost emissions reduction solutions. Other companies that have difficulty meeting their targets inexpensively can buy these excess credits in the market, at whatever the prevailing market price is. In effect then, they are providing the financing to the seller of the credits for the seller's emissions reductions efforts, since this was cheaper than reducing emissions in their own operations. And, if companies decide to neither meet their targets nor buy credits in the market to offset their excess, they will have to pay large fines to the government, well in excess of the market price of credits. Hence the incentives are there for companies to either comply or buy credits, thus ensuring that the total amount of emissions will remain below the target.

This method of allowing the market to cut emissions quickly where it is cheapest and easiest to do will presumably have the least detrimental effect on the health of the economy, an issue largely driving the non-believers" approach to man-made climate change.

It’s a miracle that a bunch of 25 countries as diverse as the European Union and who were at war with each other not so long ago, could unite over a proposal that is bound to bring some shocks to their local economies. Even the European environmental community seems fairly pleased with the EU's approach to global warming.  But, like all such complex agreements involving so many and varied parties and lots of different political interests, this one is not without controversy or room for abuse. During the discussions leading up to the 1997 Kyoto Protocol, some of the most controversial provisions had to do with the ways in which companies and/or countries could accumulate excess greenhouse gas credits other than by cutting emissions below their target level. Some of these so-called "Kyoto Mechanisms" included:

  1. Creating "Carbon Sinks": Such as planting new forests, or even certain types of timber farming; 
  2. Joint Implementation Projects: Which means funding emission reductions projects in other industrialized nations;
  3. Clean Development Mechanisms: Which means funding "clean energy" projects in developing nations.

Many people fear that credit accumulation or emissions offsets gained under these methods may be the most wide open for abuse and therefore may not bring about real change in the battle to stem the release of greenhouse gases into the atmosphere. The original EU Emissions Trading Scheme, that began trading in 2005 did not provide for these Kyoto Mechanisms. But a Directive proposes an amendment allowing two of these mechanisms - Joint Implementation and Clean Development Mechanism Projects in other countries as methods to accumulate carbon emissions credits. Climate Action Network in Brussels discussed their concerns about these mechanisms. Nevertheless, these developments in Europe have really made the EU the world leader in trying to stem man-made contributions to climate change, and without these efforts it is possible that the Kyoto process would have collapsed after the U.S. pulled out.

The United Kingdom set up the first national emissions market of its own, similar to the EU "cap and trade" mechanism. The UK actually plans to significantly exceed, or do better than, its Kyoto targets and they have gone further than just capping, trading and fining violators.The British government imposed a Climate Change Levy in the form of a tax on business use of fossil fuel based energy sources. Relief on this tax can be gained by meeting certain targets in the emissions trading program.

Different countries face very different challenges in meeting their Kyoto targets. For less populated and more agricultural-dependent countries like Australia and New Zealand, carbon dioxide emissions from fossil fuel use are not the main problem areas.Though one doesn't like to talk about these things in polite company, believe it or not, cow and sheep burps and farts are a much bigger problem! Cattle and sheep grazing and their subsequent emissions of smelly gases as by-products of the digestive process, contribute an abundance of the most potent of the greenhouse gases methane. In fact, farm animal farts and burps account for about one half of all greenhouse gas emissions in New Zealand.

Unlike its neighbor Australia, the country of New Zealand has ratified the Kyoto Protocol and had to do something about these smelly air bubbles. In a move that was far less socially acceptable than either the pops themselves or Britain's Climate Change Levy, the New Zealand government took the drastic step of taxing farmers for the natural bodily functions of their farm stock they introduced the world's first tax on farting that’s right farting! Needless to say a farmer's rebellion got underway. Across the Tasman pond, Australia has some similar problems, but more broadly faces the reality that greenhouse emissions have increased over the last decade primarily due to land use changes, including deforestation and agricultural practices. As forest land is cleared and burned to make way for agricultural and other uses, and under certain types of agricultural practices, much carbon that was stored in plants and soils is released back into the atmosphere.

As carbon markets emerge in other countries, you can expect to see the U.S.-based investment banks and brokers getting involved, despite the fact that the U.S. is not a signatory to the Kyoto Protocol. You can also expect some rumbles from multi-national companies based in Europe that also do a lot of business in the U.S. Furthermore, the companies that have start complying with the European rules and who are spending money to comply, will be able to green-wash or brag about their image with some legitimacy. This, in conjunction with growing shareholder activism on climate change in the U.S. will apply significant pressure for change in this country.
It is likely that even U.S. based companies across the financial, energy, and other sectors will be significantly impacted by the Kyoto Protocol, even without ratification by the U.S. There may also be a concern from many companies that they are missing out on opportunities in new markets, such as the carbon markets and new energy markets, because the U.S. is not a party to the agreement.
It's time we move out of the Dark Ages after all, there is green in going green!

July 18, 2011

The world has more then enough resources to provide global health care and education to everyone.

One Remedy to save the Capitalists Global Health Care Market

By Melvin J. Howard

The world has more then enough resources to provide global health care and education to everyone. In the year 2000 for example a Human Development report sited for just 80 billion a year, the entire world could have basic health and nutrition, basic education, reproductive health and family planning services, and water sanitation. Now 80 billion might seem like a lot but that figure is equivalent to roughly 15% of the annual Pentagon budget and totals less the 1/5 of 1% of  the world’s income. According to the United Nations, Americans spent more on cosmetics ($8 billion) in the year of 1998 than it would have cost to provide basic education for all the people in the world who did not have it. Extending access to basic health care and nutrition to those who don’t have it would cost $13 billion annually that’s $4 billion less than the U.S. and European pet owners spend on pet food. For starters I would like to ask the branded drug industry for help. But will they budge without a monopoly and a profit stream, neither of which is a suitable incentive model for this global crisis. But compared to the many tens of billions spent by the pharmaceutical giants on advertising nonsense pills to us daily and suing the generics at every turn and developing medicines that aren't really necessary. We end up footing the bill for all this, be it in the form of taxes, higher health premiums or direct prescription purchases. If global capitalism wants to save itself from its own worst enemy - which is itself - it better act quick and smart. Here is an idea and a prescription for us capitalists to save our global markets just follow along with me please:

1.      Since the branded drug industry is wasting our time and money on advertising instead of helping to solve the really big and important health problems, we can conclude they are a big  inefficient sector of the markets due to too many years of monopolies and taxpayer subsidies. To borrow a line from Donald Trump they are fired! That should make the markets more efficient. We will keep the generics, though.
2.      The generics can keep producing all existing FDA approved drugs in a patent free environment. This should lower our total annual drug costs to  about $80 billion a year.
3.     We will use about $15 billion of this for a prescription drug benefit for seniors (whose costs are now much lower because all drugs are generics) and put some $15 billion towards insuring the uninsured.
4.       We will set aside $30 billion for drug research and development in the public sector, to replace what the private sector used to do, except with a more needs oriented approach. All the scientists, researchers and administrative workers from the now fired brand name companies get new jobs at the new publicly funded research centers. Realizing that the biggest needs are in the developing world and that our own economy is intimately tied to their well being in this globalized world, we set the first $15 billion aside exclusively for HIV/AIDS vaccines and treatments. The next $5 billion goes on tropical diseases, tuberculosis and so forth. Then the other $10 billion will go into the most important things at home.
5.      We still have $20 billion left. Of the people that used to work for the branded drug companies, we still have the marketing people and lawyers sitting around idle, we can’t have that can we? Since the marketing people are always telling us that they are not annoying and that they are instead providing the social service of distributing important information, i.e.advertisements  we have just the job for them! First they will be put in decompression chambers and then some training will take place to retool them for a more wholesome career. They will each be provided with 10,000 packets of condoms and sent all over the world from India to the Congo to Russia to China to Brazil. Their job will be to sell the use and advantages of condoms and safe sex to as many people in the developing world as possible. This should be right up their ally. For years they have been walking into doctors offices with free samples to give away and stories to tell. They will get compensated based on the preventative practices adopted in their region. The total cost of the global prevention plan will be about $10 billion.
6.      The lawyers will be fine. They are inventive enough to find other ways to occupy their time.
7.      Well, there's lots that can be done with the remaining $10 billion and I'll just leave that up to your creative imaginations e-mail me when you do!

July 15, 2011

The Trade Impact of HIV/AIDS in China, RU.S.S.I.A And South-East Asia

The Market failure of the Patented Medicine Model Maybe It's Time To Test The Creative Capitalism Model

By Melvin J. Howard

The following, seemingly prophetic, quote from an 1851 edition of the The Economist describes perfectly the degenerative phase the patented medicine model has reached by the start of the 21st century."The public will learn that patents are artificial stimuli to improvident exertions; that they cheat people by promising what they cannot perform; that they rarely give security to really good inventions, and elevate into importance a number of possible good can ever come of a Patent Law, however admirably it may be framed." This 1851 quote gives a good description of what has become of today's pharmaceutical sector when viewed from a global perspective. Patents have certainly provided "artificial stimuli to improvident exertions" or, put another way, wasteful spending. And there is no question that we have seen the elevation "into importance a number of trifles", namely blockbuster lifestyle drugs such as Viagra, Rogaine, and various anti-depressants, as well as unnecessary drugs that are virtually the same as a host of other drugs already on the market. All this takes places against the backdrop of a developing world HIV/AIDS crisis that has resulted into overwhelming death in some African counties, and is now starting its exponential growth throughout Eastern Europe, the former Soviet states, China and the rest of South-East Asia.

The West has remained largely unconcerned with the HIV/AIDS crisis in Africa. There have been some nice efforts from various quarters but so far the response has been woefully inadequate from those that can most afford to help. To put it bluntly, this is because the "self-interest" component just isn't there. Africa is only a minor trading partner with the West, and the West has relatively little economic interest in Africa. So far, all the help adds up to not enough, and the disease continues to outpace efforts to stop it. Out of a $13 billion-a-year request from the UN, the West can only bare to part with $2 billion to assist in dealing with the problem of HIV/AIDS in the developing world. And, compared to other drug investment, relatively little goes into finding a vaccine. If and when a vaccine is available, distribution of it will pose the next major hurdle.

But now, there are increasing reports detailing the spread of HIV/AIDS throughout the former or semi-communist, now market-directed, nuclear powered giants - RU.S.S.I.A and China. China's Titanic Peril" reveals the state of the problem of HIV/AIDS in China. With 1-3 million people infected today, infection rates have been increasing at more in than range between 10 and 20 million. The former Soviet states have seen a five-fold increase in infections in the past three years, have more than 1 million people infected, and the fastest spreading epidemic of all, according to a past UN Report. A survey from British scientists predicts that within 5 years, 1 in every 20 Russian adults will be infected.

Both China and RU.S.S.I.A are rapidly developing market economies. One is a major trading partner of the United States, the other has become one of the European Union. Lest you think this development will help, think about the African nation of Botswana. Botswana was the golden child of economic development of sub-Saharan Africa, financed largely by its mining industry after it gained independence. Its first AIDS case was detected in 1985, then HIV/AIDS built slowly for several years. By the 1990s it was spreading furiously throughout the general population so that by 2002 it affects almost 40 % of the population. Why so much worse than the less developed sub-Saharan region, you might be wondering? Largely because of the rapid economic development itself. The road networks that come with development, the mobility of labor away from home and families that comes with globalization, and men leaving wives to get work, all sped up the spread.
Now, many people in Africa think China and RU.S.S.I.A look a bit like their countries did five to ten years ago. But there's more. With Western style development comes rapid growth in drug use, teenage sex, commercial sex and poverty. These increases are being observed across China, Eastern Europe and RU.S.S.I.A and the relevant populations are showing huge increases in infection. In addition, the old social safety nets and health care systems have largely collapsed. In rural China, the poverty of farmers has forced them to sell their blood for trade on the lucrative national and international plasma markets. Millions of rural people participated in these plasmapheresis programs in return for cash payments to supplement their ever-dwindling incomes. In this process their blood was taken, pooled with that of lots of other people, and the plasma separated from the red blood cells. The plasma is sold on the plasma market and the now pooled red blood cells are then re-infused back into the pool of donors so that they can keep giving blood at a high frequency. In such a process, all it takes is for 1 person in a pool of 100 to have HIV and all 100 get it. This has greatly increased China's HIV problem. Add this to the fact that population pressures and the preference for male children has created a dangerously high and unnatural male to female ratio, plus the big taboo on discussion about sex in eastern cultures, and you see a growing number of catalysts for disease spread.

China is currently the second-largest trading partner of the U.S., likely to be the number 1 before too long, and with a strong chance of becoming number 1. With China joining the World Trade Organization there's tons of capital wanting to invest in China. As residents and consumers in the U.S., our lives are undeniably intertwined with those of the Chinese. So much of our own purchasing power and hence, quality of life, is a direct result of the relatively low cost of labor in China. As our population ages, more and more of the productive labor force we depend on will be in countries like China. In this case, the economic interests of the U.S. are very much tied up with the well being of the labor force of China. If the U.S. does for China's emerging epidemic what it did for Africa, which was not very much, the consequences on the U.S. economy could be quite severe. Maybe this self-interest component is the only thing that can get the U.S. to do what it can well afford to do about this crisis in the developing world. Then, I am sure, a vaccine could be found and distributed in no time at all. Similar arguments apply about the relationship between Western and Eastern Europe. The European Union has an added incentive. Since this is all happening right next door, the epidemic may very well stretch into Western Europe if they don't help do something about it in a hurry.

U.S. trading partners ($ in billions)

U.S. exports this much
U.S. imports this much
Total Trade
United Kingdom
South Korea
Saudi Arabia

Total, Top 15 Countries

Total, All Countries