Centurion Health Corporation Trust

Healthy Curiosity

2012-01-30T20:05:00.000-08:00

PROBABILITIES OF LIFE

By Melvin J. Howard

Math a scary and boring subject for many but math giventhe right variables could give you a probable outcome to just about anything.Events can be quantitatively described as probable or improbable when comparedto the total number of possible outcomes. But when the total number of outcomescannot be specified, there are no grounds for calculation. Intuitively, itseems like a very improbable event that I would unexpectedly meet an old college girlfriend in a British airport. But how can I quantify this probability? Do Iinclude all of the other people I have ever known and the total number ofpeople in British airports? Improbable events and coincidences occur all thetime even though they occur with low probability. Given a high number ofpossible improbable events, it is highly probable that some of them will occur.We only notice the "coincidences" that do occur, not the ones whichdo not occur. The occurrence of improbable events does not necessarily requireparanormal or supernatural explanations.

Additionally, some coincidences are more probable than we mightexpect due to our lack of appreciation of actual probabilities. The probabilityof two people not having the same birthday is 364/365 (multilpying the 364 daysremaining for the second person times the 1/365 probability of the birthday ofthe first person). 1 - 364/365 = 0.275% chance of having the samebirthday. But for 23 people there is a greater than 50% chance that at leasttwo of them will have the same birthday because

P(same birthday) = 1 - (364/365)(363/365)...(343/365) 0.5

Although flipping a coin or rolling dice are treated as randomprocesses they are not. Whether a coin comes up heads or tails is determined bythe trajectory of the coin, the speed of rotation, the angle of rotation, air resistance,material characteristics of the surface on which the coin is thrown, the forceof gravity in the location, etc. The same can be said for a roll of dice. Thereare so many variables, the variables are so hard to measure and the interactionof the variables is so complex that the flipping of a coin or rolling of diceare practically speaking "random". Said another way, the processescan be treated epistemologically as being random although metaphysically theyare not -- they are deterministic.

In 1961 a research meteorologist at MIT named Edward Lorenz wasusing a set of equations to model weather on a computer when he discovered thatrounding his initial numbers to three decimal places produced dramaticallydifferent results from those obtained by using six decimal places. Systems sosensitive to small variations in initial conditions have been called"chaotic", but they are more accurately described as pseudo-random --just as so-called random numbers generated by computer are called pseudo-random.Again, the phenomena are metaphysically deterministic, but theirunpredictability renders them epistemologically random no different fromrolling dices or flipping coins.

In arguing against the Copenhagen Interpretation of QuantumMechanics Albert Einstein made the infamous remark, "God does not playdice with the universe." I call the remark not logical because it isusually quoted to display how irrational Einstein's beliefs were when it cameto spookiness at a distance. Which Einstein could not get his head around whenit came to quantum physics? Neils Bohr,Werner Heisenberg and others in the Copenhagen School proposed that randomnessis a metaphysical condition of subatomic particles, whereas Einstein arguedthat randomness as a phenomenon is an artifact of our ignorance of underlyingdeterministic processes and forces limitations on our knowledge. Probabilitybridges the gap between descriptive statistics (average, standard deviation,histograms, etc.) and inferential statistics (decision-making statistics).

Decision-making is based on the probability of an event occurring timesthe payoff of the event - a cost/benefit decision. More formally:

Expectedvalue = probability X payoff It would seem advantageous to wager $1 on thechance of winning $10 by rolling a snake-eye (one) with a single die becausethe expected value is probability X payoff = (1/6) X $10 = $1.67 which isgreater than the $1 cost. But there is a 5/6 chance of losing the $1, whichcould be critical if you need the money to buy bus-fare. Non-monetary factorsare often important in cost/benefit calculations - with benefits more oftenbeing more difficult to quantify and calculate than costs. I believe that I havelearned a great deal about myself byobserving the world around me I also believe that I have grown as a person inlearning to control my impulsiveness and impatience. I have learned humility inthe face of my many false forecasts. Lifesurvival is a process of risk management. I believe the universe is teaching mewisdom and good judgment that has helped me (and, hopefully, others) inmanaging many many areas of life. I still have lots to learn. The learning ison a very deep level of personality much deeper than factual knowledge becausein many cases I already know the mistakes but have not gain enough mastery overmyself so as to not make them. Which is what life is all about no matter theprofession Doctor, Lawyer, Judge, Fireman, CEO, homemaker. We all make mistakesthe question is do you learn from them?

China Gets A Shot In The Arm From Private Health Care

2012-01-22T12:36:00.000-08:00

The New China’ Private Health Care System

By Melvin J. Howard

The U.S. Trade and Development Agency, the U.S. Department of Health and Human Services and the U.S. Department of Commerce joined with China‘s Ministries of Health and Commerce to announce their support for the establishment a new public-private partnership in the healthcare sector.

Twelve U.S. companies and six supporting organizations will participate in this partnership, alongside the supporting U.S. and Chinese government agencies. The partnership will be organized around U.S. healthcare industry strengths and government capabilities to foster long-term cooperation with China in the areas of research, training, regulation and the adoption of an environment that will increase accessibility to healthcare services in China.

Through programs supported by the initiative, Chinese participants will gain greater access to U.S. private sector expertise and ingenuity and better awareness of new technologies and results-oriented regulatory processes, U.S. officials said.

One of the supporting organizations, the Alliance for Healthcare Competitiveness, which represents both for-profit and non-profit U.S. healthcare employers, and whose stated mission is to open global markets to U.S. healthcare exports, has provided an outline of China’s healthcare market and potential.

With the growth of China the government is actively encouraging private capital to enter the health care industry. China will give preferential tax incentives to help ensure everyone had equal access to health care. The government of China has announced that it is to encourage the development of the private healthcare sector in the country. The news paves the way for foreign firms to gain greater access to the Chinese private healthcare market in a bid to meet the growing demand for healthcare services in the country. The new policy will provide overseas healthcare companies, with more flexibility in establishing a new business within the private health sector.

The move by the Chinese government is designed to encourage investment from overseas business to meet the increasing demand for private healthcare services in the country stemming from its rapidly expanded economy. Economic expansion has brought increased affluence among the population of China, which in return has led to a growth in demand for private healthcare. Currently Chinese regulations only allows foreign firms to enter the private healthcare sector in China through a joint venture with a Chinese partner, together with a cap on the level of capital which may be held in a Chinese operation. However, the recent announcement by the central government in China will mean a gradual easing on the level of investment permitted by a foreign firm in the private healthcare sector. The new policy also supports the use of social funds to participate in government hospital reforms, with the conversion of some government run hospitals into private medical facilities.

The Chinese authority’s decision to cut the red tape in the planning process for foreign companies engaged in the provision of healthcare in China is intended to ensure that the country’s healthcare needs are met partly by easing some the pressure on the Chinese public healthcare system. As constraints are eliminated, the intention is for foreign healthcare providers to establish larger-scale hospitals throughout China – to be run alongside smaller healthcare facilities – leading to an overall improvement in medical services across the country. Also the provision of foreign-run hospitals is planned to play an important role in meeting the needs of patients seeking higher standards of healthcare services.

As the new policy is implemented and a positive effect on the Chinese healthcare sector is delivered, patients will be rewarded with a better choice of medical care, with benefits to be gained from overseas expertise.

The proposed policy reforms – enabling increased foreign investment in the private healthcare system in China – will mean more competition and an improvement in medical standards through overseas firms looking to capitalize on the opportunities being implemented by the Chinese authorities.

BUT ALL IS NOT SO WELL IN THE LAND OF THE RISING SUN

Unfortunately, the record on support for private healthcare is spotty. As China began to loosen healthcare restrictions at the beginning of the past decade, a decision was made to allow the sale of selected hospitals to private investors. Health authorities hoped this would allow local health bureaus to offload underperforming facilities and provide an opportunity for state-owned enterprises (SOEs) to divest non-core assets while at the same time seeding a private medical system that would alleviate strain on crowded public hospitals. Over the next several years, significant numbers of mid-size/county hospitals and SOE hospitals were privatized. In some cases, facilities were granted to the staff, with all employees receiving shares, but in many instances, hospitals were sold to real-estate developers with no prior experience in healthcare. Many hospitals, once privatized, placed significant emphasis on short-term profits, often at the expense of service quality (and, in some cases, medical ethics). Sales of medicines were a key source of those profits and there was a built-in incentive to overprescribe and charge high premiums to patients.

In China, physicians are licensed to practice at a single facility. According to regulations, doctors choosing to practice at private hospitals had to forfeit affiliation with their government facility thus exiting the path for promotion through physician ranks as well as ending the process of academic advancement. Top-ranked physicians such as department chairs and recognized experts, already comfortable with their position were understandably reluctant to leave their posts. Moreover, physicians in the middle of their careers and even talented younger practitioners the rising stars were similarly disinclined to enter private practice and render stagnant their careers.

Leaving some to say China's first attempt at private healthcare can be seen as a complete failure a system comprised of poorly managed facilities staffed by medical personnel whom the vast majority of patients had no interest in patronizing. By taking a portion of public hospitals "offline" and creating private hospitals which Chinese medical consumers actively shunned, a plan to create a private sector of medical facilities to ease demand on public resources had in fact resulted in just the opposite: more patients now crowded into even fewer facilities. Burdened with poor management and staffed by physicians with no reputation, private healthcare in China quickly earned a dismal reputation among medical consumers one that it has yet to successfully shrug off. High drug prices also tainted the public's association with private healthcare and reflected poorly on the industry image.

Many have speculated about the role of private healthcare, including foreign-invested private healthcare, under this new medical system. Although the original language of the healthcare reforms does mention private healthcare (and commercial insurance), it is only within the past several months that regulators have begun to more fully articulate their position on private medical facilities. At this juncture, there are strong signs that the government is preparing for a re-boot of private healthcare and this time, they intend to get it right.

Opinions on further lifting restrictions to private hospitals," co-authored by the National Development and Reform Commission (NDRC), Ministry of Health (MOH), Ministry of Finance (MOF), Ministry of Commerce (MOC), and Ministry of Human Resources and Social Security (MHRSS). The opinion offers a number of regulatory enticements to encourage private investment in healthcare facilities including the opportunity to participate in basic medical insurance reimbursement systems and favorable tax policies. It also paves the way for 100 percent foreign-owned healthcare facilities.

GETTING PHYSICIANS ON BOARD

Allowing top-level physicians to retain their positions and standing in government hospitals while practicing part time in private settings is the key to the future of private healthcare in China. Going forward, physicians will likely be required to spend a certain portion of their time in grassroots settings, but they may also be allowed to enjoy some of their newfound freedom practicing in private clinics and hospitals. The most recent and significant development in this vein comes from the Beijing Municipal Health Bureau, which has allowed licensed physicians to work simultaneously at a maximum of three hospitals.

Healthcare authorities are no doubt hoping that an upper-tier private health system will emerge to lure more affluent medical consumers away from public institutions, thus freeing more resources for patients relying solely on basic government insurance programs. The MOH and other government agencies have repeatedly mentioned their intention to encourage commercial health insurance. This will also ease the burden on public/government medical institutions, and may well enable a larger population to access private healthcare

A CREATIVE PARTNERSHIP TO FINANCE YOUR HEALTH CARE PROJECT

2012-01-10T19:45:00.000-08:00

HEALTHCARE PARTNERING WITH A NON BANK LENDERS

By MELVIN J. HOWARD

The advent of non-bank lending institutions, whose only businessis making loans. Have opened new doors for Physicians and Hospitals who needcapital to start, build and grow their businesses. Medical facilities inbusinesses that do not typically qualify for conventional financing havediscovered that non-bank lenders offer a viable alternative. Medical facilitiessuch as specialty clinics, physicians practices or small regional hospitalcenters that are difficult for banks to finance because they are single useproperties, or the medical facility fall’s outside the bank's risk profile.Although it might seem that banks and non-banks would be rivals competing forSmall Business customers. Increasingly conventional banks and non-banks arecollaborating to benefit both the customer and themselves.

Partnering with a non-bank lender benefits the conventional lenderin several ways. Perhaps most significant is that such a partnership canprovide a bank an opportunity to say "yes" to a prospective borrower.Banks receive numerous loan inquiries through their broad networks of branchesand business development officers. Many requests are turned down because theydo not fit the bank's desired risk profile. However, these same prospects arelikely to have deposits and/or other banking needs, both of which are desirableto a bank for its operations and overall profitability. Loans referred to anon-bank lender provide an opportunity for a bank to outsource loans it cannotapprove while maintaining the profitable, non-credit portion of therelationship.

Non-banks can also serve as an outplacement resource for a bank'sexisting credit situations that no longer meet its desired risk profile. Forexample, as a result of a merger or acquisition, a bank may find that it nowhas a number of loans that do not fit its risk profile. A lender may also wishto outplace a loan that is performing, but is no longer desirable due tochanges in loan-to-value, covenant violations or changes in operations. Anon-bank lender may be able to refinance the loan, usually over a longer termand without covenants, thus improving the customer's cash flow and stabilityand removing the risk from the bank's balance sheet without impacting theremainder of the bank relationship.

A partnership between banks and non-banks ultimately benefits thecustomer. First and foremost, a non-bank often provides access to financingthat is not available from a conventional lender. Furthermore, the customer'sborrowing needs are met in a permanent way. Term loans do not have to beballoon payments, eliminating the need for a borrower to refinance the loan in5 or 10 years. Therefore, the costs associated with a long-term loan (i.e.appraisals, environmental reports, and legal costs) are incurred just once.

When working with a non-bank lender, a customer can be assuredthat the lender is focused entirely on the loan transaction. Because a non-banklender is interested only in the loan transaction, there is no need for acustomer to unwind its banking relationship or move its deposit accounts. Manynon-bank lenders have earned "preferred" lender status enabling themto provide quick turnaround on loan decisions with a high level of expertise inthe loan process, thus providing a customer with painless fulfillment of itfinancing need.

Key to understanding how the bank and the non-bank work together,is an understanding of how they are different. Aside from the organizational orstructural differences, how does a non-bank lender differ from a conventionalbank? First, non-banks' only business is that of making loans. They do not takedeposits or sell other services such as payroll, cash management, etc.

Contrary to popular opinion, non-bank lenders are not necessarilymore aggressive in their evaluation of a loan request. However, because theirloans are not funded by deposits and because they are not subject to the sameset of regulations as banks, the non-banks can and will consider industries andsituations conventional lenders will typically shy away from. Examples ofindustries that non-bank lenders will consider include gas stations/conveniencestores, auto body shops, car washes, restaurants and the hospitality industry(hotels/motels). In addition, non-bank lenders are willing to consider situations,such as start-up businesses or businesses/individuals with problematic credithistories, which are generally perceived as being higher-risk.

Non-bank lenders can also be flexible in other ways. For example,non-bank lenders are typically long-term lenders, with a desired loan term ofseven to 25 years, depending on the use of loan proceeds. In addition, manynon-bank lenders lend nationally and are not restricted to a particular regionor "footprint." Lastly, non-bank lenders often take a more holisticapproach to a loan request, particularly with regards to collateral. Asbusiness assets may be insufficient to adequately secure a loan, a non-banklender will often look to the availability of other assets as part of theentire collateral pool.

As we often hear, small and regional clinics and hospitals are thebackbone of rural communities. They are often also the backbone of a bank'sbranch deposit base and overall profitability. By partnering with a non-banklender, a bank can benefit both itself and its health care commercial customers.

The Constant Dependence On Fossil Fuel And The Hidden Cost To Public Health

2012-01-01T12:41:00.000-08:00

And The Insurance Industry As Well As Society That Will EventuallyPay

It’s not easy being green

By Melvin J. Howard

Let’s discuss the relationship between fossilfuels, the future of the world's most powerful cartel, the changing climate andthe powerful industry that loses big bucks on changing weather patterns. Many of theenvironmental problems we face today result from our fossil fuel dependence.These impacts include global warming, air quality deterioration, oil spills,and acid rain. Can we touch on that everimportant "oil price range" that target price range per barrel of oilwithin which both producers and consumers are happy to continue "businessas usual". But we can't discuss that without also talking about that thingat the heart of the oil markets so despised in all our free market teachingsthe cartel in this case, the OPEC cartel, of course. Given what's happened inIraq with Iran not too far behind and continuing US policy towards OPECcountries, we might see where OPEC might be headed in the future. Indicationsare predicting that the OPEC cartel may face tough times ahead and the outlookfor the fossil fuel industry in general.

Despite skepticism, the huge globalinsurers and reinsurers accept climate change as fact. Furthermore, they acceptthat climate change is induced by human activity. And, climate change iscosting them big bucks. As powerful advocates of the Kyoto Protocol and withTrillions of dollars to vote with in the capital markets, the insuranceindustry has both the motive and the power to do something about climate changefor the first time in history. Let's define what a cartel is a cartel is formedwhen a dominant group of suppliers or producers of a product conspire to keepprices artificially high. Basically, they conspire to hold back supply so thatprices are held above where they would fall if you allowed full competitionbetween these producers. The most powerful cartel in the world is, of course,OPEC the Organization of Petroleum Exporting Countries. It consists of 11countries altogether and they are Saudi Arabia, Iran, Iraq, Qatar, UAE, Kuwait,Nigeria, Algeria, Lybia, Indonesia and Venezuela. For various reasons, OPECdoes not want the price of oil to get too high, either. And so the price of oilends up being managed within a certain magical price range. What will happen to it now that America the world’slargest oil consumer is at the table?" Isn't it bizarre that, for thefirst time ever in the history of big cartels, the biggest customer of thecartel, the United States, actually has a seat at the table of the cartel?

These days, it's not just theenvironmental movement and the health care industry and some concernedshareholders that are going into battle against the oil giants. Another set ofequally formidable industry giants the global reinsurance companies arestarting to flex their muscles in this global battle for green fuels overfossil fuels. Reinsurance companies basically provide insurance to the directinsurance companies that we are more familiar with, who insure our houses, carsand businesses. The two biggest of these the European based Swiss Re and MunichRe - provide insurance to insurance companies all over the world, to limit thelosses of those insurance companies, just like we limit out losses by buyinginsurance on our house. Just like youhave to go to Texas to talk oil, you have to go to Switzerland and Germany totalk about important worldly insurance issues. Apparently, not all insurers arequite so active in this mission to stem climate change, and it seems that someof the US insurance companies are not so serious about slaying the fossil fueldragon.

The Future

Quite undeterred by the finding of theUN Panel on Climate Change and the 30 years of study at the big reinsurers,some consultants and researchers in the oil industry are determined to believethat fossil fuels do not cause climate change. Many oil industry analysts seethe demand for, and use of, oil continuing to increase for decades to come andcan't see how transportation can get away from the fossil fuels. But, thenagain, so people with wood chip cars and buses early in the twentieth centurymight have once thought about their dependence on chopping down trees fortransport. Where is the status of renewable energy to some people's amazement,the environmental community is starting to work more with the investmentcommunity in the battle against global warming.

The method of allowing the market tocut emissions quickly where it is cheapest and easiest to do will presumablyhave the least detrimental effect on the health of the economy and people. I amvery mindful of the our environment but I am also an advocate of using themarket and science to solve society most complex issues. I am an advocate for CleanDevelopment Mechanisms which means funding "clean energy"projects in developing nations. Many people fear that credit accumulation oremissions offsets gained under some market methods may be the most wide openfor abuse and therefore may not bring about real change in the battle to stemthe release of greenhouse gases into the atmosphere.

Back in 2000 working with the State ofNew South Wales Forestry Department and also closely with the forest investmentdivisions of global financial institutions such as US-based John HancockInsurance Company, the stage was set for the first international market incarbon futures, backed by the trees in new and growing forests in Australia.These carbon-based instruments were to be based on the quite controversialprovision in the Kyoto Protocol whereby"Carbon Sinks" such as certain forests and forest managementpractices, can be used to accumulate credits in carbon emissions tradingprograms. However, this world-first futures market collapsed, mainly due to thecontroversial nature and uncertainties surrounding the definition of KyotoForests and Carbon Sinks. A senior research scientist at the National Oceanic andAtmospheric Administration (NOAA) Geophysical Fluid Dynamics Laboratory, andmore marked effects are likely to come, according to models developed byclimate scientists around the world. Projected effects of global warming onprecipitation throughout the world can be summarized in a single sentence,areas that already get a lot of rainfall such as the equatorial and subpolarrain belts will get more, and areas that get little such as the subtropical dryzones will get less.

TheHidden Cost

Fossil fuels, coal, oil, and natural gas are America'sprimary source of energy, accounting for 85 percent of current US fuel use.Some of the costs of using these fuels are obvious, such as the cost of laborto mine for coal or drill for oil, of labor and materials to build energy-generatingplants, and of transportation of coal and oil to the plants. These costs areincluded in electricity bills or in the purchase price of gasoline for cars. Butsome energy costs are not included in consumer utility or gas bills, nor arethey paid for by the companies that produce or sell the energy. These includehuman health problems caused by air pollution from the burning of coal and oil;damage to land from coal mining and to miners from black lung disease;environmental degradation caused by global warming, acid rain, and waterpollution; and national security costs, such as protecting foreign sources ofoil. Since such costs are indirect and difficult to determine,they have traditionally remained external to the energy pricing system, and arethus often referred to as externalities. And since the producers and the usersof energy do not pay for these costs, society as a whole must pay for them. Butthis pricing system masks the true costs of fossil fuels and results in damageto human health, the environment, and the economy.

The Effects of Climate Change on Public Health

2011-12-15T08:56:00.000-08:00

Guest post written by Cyndi Laurenti

With an estimated 5million illnesses and 150,000 deaths annually attributed to climate change,studies have shown that a direct correlation between human health and climatechange exists. In fact, according to the WorldHealth Organization, the 1-degree increase in atmospheric temperature between 1975and 2000 has caused nearly 160,000 annual deaths. While the quality ofhealthcare and its accessibility are also important factors that influence thenet effect of climate change on human health, PhD doctorates would agree that overallwarmer temperatures that induce heat waves -- which both escalate theoccurrence of illnesses such as asthma and adversely affect aspects ofcivilization such as agriculture -- will potentially have a drasticallynegative impact on the quality of life.

One of the biggest health risks associated with climate change is the increasedprevalence of climate-specific diseases that were formerly centralized inspecific regions but in the future may spread due to increased temperaturesthat consequently enable new habitation of insects and animals that serve as ahosts to infectious diseases. Chief among the diseases are dengue fever,malaria and yellow fever. Currently, these diseases are mostly treatable.However, as they become resistant to treatments, death rates will certainly increase.For malaria specifically, the increased risk of infection is expected to occurin Africa where treatment is both more expensive and health institutions areunderdeveloped and underfunded healthcare system.

Another major long-term threat of climate change is related to water levels. Concurrent with increasingtemperatures are the rate of glacial melting, causing ocean expansion andrising sea levels which will “erode beaches, intensify flooding, and increasethe salinity of rivers, bays, and groundwater tables.” Additionally, many low-lying inhabitedregions may be lost and coastal areas will be rendered more vulnerable to stormsurges, further threatening a loss of life and compromised sanity with thespread of water-borne diseases.

In terms of agriculture, climate change will have both positive and negativeeffects. According to the U.S. Global Change Research Information Office,prolonged higher temperatures will offer the benefit of longer growing seasonswith the possibility of completing more than one crop cycle. Also, previouslyformidable high latitude regions will be rendered arable due to overall warmerweather. Conversely, in lower latitudes, highertemperatures risk increasing the rate of carbon dioxide released by plants, anoccurrence that degrades the growth conditions for crops. Another consequenceis the risk of a reduced availability of water and rapid soil erosion. Overall,though, the risks to agriculture and food availability as a result of climatechange are ones that can be countered with technology such as engineering seedsto withstand drought-like conditions, as well as improved irrigation methods.

Climate change has been a natural consequence of human civilization. Thoughtechnological inventions in the past century have dramatically increased therate of climate change, humans have the power to stunt the negative long-termimpacts on health by taking proactive measures to not only reduce the rate ofchange today as well as prepare for its consequences tomorrow. In fact, with anacknowledgment of the dangers that exists and a proper timely response to bothmute and reduce said dangers, even the World Health Organization suggests thatmany of the health risks faced today can be avoided.

ABOUT THE AUTHOR

While shefigures out her next career move, Cyndi Laurenti works as an online writer andeditor. Her primary interests are education, technology, and how to combinethem. She enjoys the trees and beaches of the Pacific Northwest, and lookingthings up on other people's iPhones.

National Security And Global Public Health

2011-12-04T15:13:00.001-08:00

By Melvin J. Howard

Global public health securitycovers a wide range of complex issues, including the health consequences ofhuman behavior, climate change, weather-related events and infectious diseases,as well as natural catastrophes and man-made disasters. Many people don’t thinkof national security when it comes to health care. But lets go back inhistory Europeans brought the first diseases against which theNative Americans had no immunity. Chicken pox and measles, though common andrarely fatal among Europeans, often proved fatal to Native Americans, and moredangerous diseases such as smallpox were especially deadly to Native Americanpopulations. It is difficult to estimate the total percentage of the NativeAmerican population killed by these diseases. Epidemics often immediatelyfollowed European exploration, sometimes destroying entire villages. Somehistorians estimate that up to 80% of some Native populations may have died dueto European diseases. Inaddition to the diseases brought over by the first wave of immigrants toHawaii, leprosy, whose origin is not known and for which there has never been acure, had a profound effect on the public health of native Hawaiians. Becauseof the social stigma attached to the diseases (it was mistakenly thought to bea venereal disease) as well as its extreme contagiousness, lepers were isolatedon the island of Molokai beginning in 1886. For 16 years, a Belgian priestnamed Demian Joseph de Veuster provided medical care for these patients, whomthe medical community refused to treat, before succumbing to the illnesshimself in 1889.

Compared toHawaiians of European and Asian ancestry, native Hawaiians have continued tobear the brunt of the archipelago's health problems. Whereas Hawaii as a wholeboasts the longest average life span of any state (males live an average 75.37years, females, 80.92 years), the death rates of native Hawaiians at all agesare above average. The infant mortality rate for native Hawaiians is 6.5 per1,000 live births. In addition, native Hawaiians experience high rates ofdiabetes and hypertension. Health workers consider poor diet a major factor,and economic problems undoubtedly contribute to this situation.

Then there was thedreaded Black Plague or Black Death, the most severe epidemic in human history,ravaged Europe from 1347-1351. It is thought that as many as 25 million people(one third of Europe's population at the time) were killed during this shortperiod,. Thousands of people died each week. This plague killed entire familiesat a time and destroyed at least 1,000 villages.Once a family member had contracted the disease, the entire household wasdoomed to die. Parents abandoned their children, and parent-less childrenroamed the streets in search for food. If the people weren't dead they ran awayin vain attempts to save themselves. Victims, delirious with pain, often losttheir sanity. Life was in total chaos. The Black Death struck the Europeanpeople with very little warning. They did not understand the causes of infectiousdisease, or how they spread. They did not have the ability to understandwhere this sudden cruel death had come from. And they did not know whether itwould ever go away. The Plague was a disaster without a parallel, causingdramatic changes in medieval Europe, contributing to what is called the Crisisof the Fourteenth Century.

National Security

The Obama's administration National Security Strategy, is a 52page document intended to guide U.S. military and diplomatic policy for years,is to eliminate the need for the U.S. to strike first or take unilateralmilitary action," the policy puts "heavy emphasis on the value ofglobal cooperation, developing wider security partnerships and helping othernations defend themselves." The strategy also outlined the importance ofimproving the U.S. economy for national security "through bettereducation, national debt reduction, a stronger U.S.clean energy industry, greater scientific research and a revamped healthcare system. In the strategy President Obamawrites that the U.S. Armed Forces "will always be a cornerstone of oursecurity, but they must be complemented." Obama adds, "Our securitydepends on diplomats who can act in every corner of the world ... development expertswho can strengthen governance and support human dignity. Part of the documentfocuses on promoting national security through globalhealth and related efforts. "Thefreedom that America stands for includes freedom from want. Basic human rights cannot thrive inplaces where human beings do not have access to enough food, or clean water, orthe medicine they need to survive," the document states, noting the U.S.role in assisting with efforts to achieve the U.N. Millennium DevelopmentGoals.

The strategy cites examples of how the U.S. aims to"promote dignity ... through development efforts." They include, theGlobal Health Initiative (GHI), U.S. foodsecurity programs and leadership inhumanitarian crises. The U.S. "has a moral and strategic interest in promotingglobal health. When a child dies of a preventable disease, it offends ourconscience; when a disease goes unchecked, it can endanger our own health; whenchildren are sick, development is stalled," according to a section of thedocument that focuses on the GHI. On food security, the document states thatinstead of simply providing aid for developing countries, we are focusing onnew methods and technologies for agricultural development. This is consistentwith an approach in which aid is not an end in itself – the purpose of ourforeign assistance will be to create the conditions where it is no longerneeded. We are promoting child and maternal health. We are combating humantrafficking, especially in women and girls, through domestic and internationallaw enforcement. And we are supporting education, employment, and micro-financeto empower women globally. Global public healthsecurity depends on actions to prevent and respond to threats that endanger thecollective health of the global population. Those threats have an impact oneconomic or political stability, trade, tourism, access to goods and servicesand, if they occur repeatedly, on demographic stability.

Environmental threats to global health security

Non-occupational human exposure to arsenic in theenvironment is primarily through the ingestion offood and water. Of these, food is generally the principal contributor to thedaily intake of total arsenic. In some areas arsenicin drinking water is a significant source of exposure to inorganic arsenic. Inthese cases, arsenic in drinking water often constitutes the principalcontributor to the daily arsenic intake. Contaminated soils such as minetailings are also a potential source of arsenic exposure. Inorganic arseniclevels in fish and shellfish are low. Foodstuffs such as meat, poultry, dairyproducts and cereals have higher levels of inorganic arsenic. Pulmonaryexposure contributes to smokers and non-smoker alike, and more in pollutedareas. The concentration of metabolites ofinorganic arsenic in urine (inorganic arsenic, MMA and DMA) reflects the absorbeddose of inorganic arsenic on an individual level. Exposure ofthe general population to arsenic occurs mainly through food and water and inmost areas, food is the main source. Arsenic in food is mainly in the form oforganic arsenic, which is generally thought to pose less health problems thaninorganic arsenic. About one-quarter of the arsenic present in the diet isinorganic arsenic, mainly from foods such as meat, poultry, dairy products andcereals. Fish and shellfish contain the highest concentrations ofarsenic, but the proportion of inorganic arsenic in fish is very low, below 1%.In some areas, where levels of arsenic in groundwater are high, drinking watermay be the main source of intake. In drinking water, arsenic is present inthe more toxic, inorganic form. Contaminated soils such as mine tailingsare also a potential source of arsenic exposure.

Urbanization, increasing international trade and travel hascontributed to the rapid spread of viruses andinsects that carry them. For instance, dengue causedan unprecedented pandemic in 1998, with1.2 million cases reported to the WHO World HealthOrganization in 56 countries. Since then, dengue epidemics havecontinued and have affected millions of people from Latin America to South-EastAsia. Globally, the average annual number of cases reported to WHO has nearlydoubled in each of the last four decades. Surveillance is crucial for public health securityand without it, it is impossible to detect and respond to emerging healththreats. For instance, HIV and AIDS had perhapsbeen occurring for many years in Africa and Haiti but had not been detected dueto inadequate surveillance and health systems in these developing countries. Thisnew disease was only brought to international attention when the first fewcases appeared in the United States. Even then, the disease was not detected bysurveillance systems but by chance, when epidemiologists noticed an unusualnumber of orders for drugs to treat a rare infection thatis common in AIDS cases.

The behavior of individuals at all levels – politicalleaders, policy-makers, military commanders, public health specialists and thegeneral population – can have major health consequences, both negative andpositive. Threatsto public health security such as natural disasters, epidemics ofinfectious diseases, chemical and radioactiveemergencies or other health events, can have one or more causes. The causes maybe natural or man-made, environmental or industrial, accidental or deliberate,and in many cases related to human behaviour. Public health is undermined notonly by human action but also by the lack thereof. Complacencyand a false sense of security can tempt governments to reduce spending onpublic health and to scale down prevention programmes with potentiallydisastrous consequences for collective global health.

Healthcare and College Students

2011-11-11T15:29:00.001-08:00

Guest post written by Cyndi Laurenti

Imagine being sick for weeks at a time, orfalling and injuring your knee so badly you can hardly walk even after days ofrest. Now imagine not being able to get checked out by a doctor because youdon'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 from online undergraduate degrees to PhDs havebeen hit the hardest.

After graduating high school, many students choose to go on to college in orderto increase their odds of a better future. This is both beneficial to studentsand to the country, as these young adults will be the future workers andleaders of America. College isn't cheap, however, and most students have littlechoice 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 whenthey can return home for awhile. Because of this sort of work situation,there's very limited room for the professional advancement that might includebenefits such as health insurance for working college students.

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

For working students, it can easily comedown to a decision between paying the electricity bill, paying for food, orgetting health insurance. While healthcare may be important, the cost ofinsurance easily gets pushed aside by more pressing priorities. Needless tosay, paying healthcare costs out of pocket is also likely to be out of thequestion, so students are likely to simply go without regular, non-emergencyhealthcare.

Unfortunately, not everyone is blessed with good health. Of course, with thecost of medical care in this country so expensive, many ignore warning symptomsuntil emergency care is required. For example, let's say a college studentbecomes sick one day with a worse-than-usual cold. He doesn't have money tospare for a doctor visit, so decides not to go for a checkup but instead totough it out. Weeks go by and the initially harmless illness develops intopneumonia. One night, when the student is unable to breathe, an ambulance iscalled and he is rushed to the hospital. The medical bills are suddenly throughthe roof. The college student, already up to his neck in debt, simply has noway to pay for it.

These situations are all too common across the country. As of 2008, 1.7 millioncollege-age students were uninsured. Because of this, many people arebeginning to worry about the long-term effects of this demographic goingwithout healthcare.

Currently, Americans have an averagelife expectancy of 78 years. This is mostly due to the superb medical carewithin the country. Around 100 years ago, before doctors treated patients on aregular basis, the life expectancy was only 47. With young people unable to payfor routine medical care, many worry preventable illness will wear down thebody, causing the life expectancy of this generation to be the first todecrease in the last century.

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

ABOUT THE AUTHOR

While she figures out her next careermove, Cyndi Laurenti works as an online writer and editor. Her primaryinterests are education, technology, and how to combine them. She enjoys thetrees and beaches of the Pacific Northwest, and looking things up on otherpeople's iPhones.

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

2011-10-30T13:53:00.000-07:00

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 medicaltraining, nights without sleep, rigorous exams and a demanding workload, youmade it, you became a doctor. You also have another full-time job, as a mom ordad. Now the reality has set in and you wonder how on earth you can continue inthe medical profession and have a balanced family life. It's not what youimagined. With increased patient loads, the stress of dealing with insurancecompanies and HMOs and piles of paperwork, you're burned-out, unenthusiasticand your personal life is suffering. You fulfilled your dream, but how can thisbe? Is it just you? What can you do?

"It is becomingincreasingly difficult to manage a medical career and a personal life, which isreally nonexistent and has been for some time now". One doctor says,"Most of the doctors I know are frustrated being in the profession. Manywould leave if they found a way to support their current lifestyles. Most areso locked into their earnings that they cannot conceive of leaving medicine,despite the unhappiness. Finding an alternative career that allows them to paythe 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 afancy lifestyle with bulging bank balances. Like working women in otherprofessions, financial priorities include childcare, loans, mortgages, familyexpenditures and so on. Even if available, cutting back hours simply isn't anoption for many many physicians.

To find an alternative isdifficult if not impossible a young doctor, only four years out of residency,in a low-paying specialty (family practice) and has a astronomical student loanpayments to make ($125K-something that the older physicians in previouspractice did not understand at all) which pretty much precludes a young doctorfrom decreasing their hours/workload asmuch as they would like to. And even if they could have afforded to just cutback on hours, the partners in their practice would not tolerate it withoutextreme penalty. Managed care changes, HIPPA laws, malpractice lawsuits andMedicare regulations have also contributed to physician stress. "I believethat medicine is incredibly demanding (even part-time). Patients expect far toomuch. Managed care expects us to solve unsolvable problems with less than 15minutes per patient", says another family practioner with two school agechildren. She goes on to say, "Despite working only 2-3 days per week, Istill feel like giving up medicine all together because of the awful workingconditions... I honestly don't know too many doctors who enjoy medicineanymore".

Another member describes herday, "I see close to 60 people a day in my ob-gyn practice. Don't ask howI do it because at the end of the day, my head is swirling. I do this becausethat is the only way I can make my overhead and actually take home enough topay for the nanny and student loans. It is ridiculous." So why practice atall?Many doctors still love whatthey do, love interacting with patients, love diagnosing them, teaching themand getting patients to take care of themselves. "It feels good when theytell me I'm the best doctor in the world... I love trying to figure out how toadd 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 comeswith a huge responsibility. I must be continuously vigilant that I ampracticing the kind of medicine that I was trained to do (i.e. being thoroughand spending time with patients). There are no shortcuts to providing goodcare. Hyper efficiency does not exist in the world of good medical care.. Andno one can sustain good medical practice when they are burned out.".

In the biggest study of marrieddoctors to date, the American College of Surgeons surveyed nearly 8,000 of itsmembers, 90% of whom were married. Of those, half had spouses or partners whodid not work outside the home. About a third of the double-income couples wereactually double-doctor duos, and in about a third of those marriages, bothpartners were surgeons. In fact, the study notes that something like 50% offemale surgeons are married to physicians. This is in keeping with currentmarital trends. Plus it just makes sense. Who's better atunderstanding the stresses and strains of a physician's life than anotherphysician? Luckily, there are more femalesurgeons than there have been before, so there are more aroundto marry.

And since medical students are busy particularly those training to besurgeons are more likely to socialize among their own. No wonder that the studysuggests surgeon-surgeon marriages are on the rise.

You'd think that two-doctorfamilies would be idyllic: not only are both parents well-paid and competent athandling Baby's late night fever spike, but they're also able to appreciateeach other's latest bit of O.R. gossip and compete to beat Gregory House at thecorrect diagnosis.

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

For surgeons married to othersurgeons, the picture was even grimmer. They were more likely to report thatchild-rearing had slowed their career, and they were more "likely to stayhome from work to care for a sick child and more often surrogated theircareer" in favor of their partner's career, the study said. Half thesurgeons married to other doctors said they had experienced career conflictwith their spouse and only about a third of them thought they had enough timefor their personal lives. Closer to 40% of doctors married to non-doctors feltthat way. Despite this, individuals from the two-surgeon families felt about thesame amount of burnout and depression as surgeons married to non-surgeons. Thisdoesn't stop the study from concluding that "the higher prevalence ofdepressive symptoms and clinically significant lower mental quality of lifeamong surgeons married or partnered to surgeons suggests that the work-lifehurdles could be taking a toll on their mental health."

An extensive body of literaturedemonstrates that the life of a physician's spouse (until recently synonymouswith a physician's wife) is fraught with stress and links such stressesprimarily with the spouse's occupation. The role of physician conflicts withthe role of husband and father and that the structure of medicine makes thecuring and caring roles mutually exclusive. The role strain, role conflict,susceptible personality type and loss of self-esteem as stress factors. Many authors havetestified that marital conflict is a major source of stress in the lives of physicians'spouses. The role conflicts between the physician and his wife, particularlyregarding the division of time between professional and family tasks, seem tobecome rigid rather than negotiated. Over time, the spouse often comes to feelneglected, lonely and painfully aware of a lack of individual and personalmeaning in her life. In addition, the physician's status in the community andprofessional world often seems to contrast sharply with that of the spouse, whomay feel that she is "one down" and is the losing competitor in themarriage. Power issues, expressed through the physician's greater flexibilityand control over money and other resources, may contribute to marital discordbecause the wife's power is usually limited to family and social relationships.Thus, the physician's spouse often struggles with confusion over identity andthe effects of role strain.

The physician-husband'sdirective professional role, if carried into the home, may be a major source ofmarital stress, which in turn may lead to psychiatric disorder in eitherpartner. Many authors have identified psychiatric disorders such as depression,anxiety, suicidal tendencies and psychosocial stress as major health problemsfor physicians' many observed that physician's wives admitted to hospital fordepression or drug and alcohol abuse wereoften angry and hostile because they felt neglected by their husbands andemotionally unfulfilled .Also, physicians' wives may come under significant butperhaps covert stress because their concerns and complaints about their healthoften seem to be ignored or minimized by their husbands and other health carepersonnel. Despite being surrounded by medical expertise, physicians' spousesreceived surprisingly poor health care. According to a study physicians' wivesfelt that their husbands minimized their own families' medical problems.Medical crises often developed as a result of this attitude. In a comparativestudy of the number of obstetric, pediatric and psychiatric complications ofphysicians' wives and teachers-lecturers, it was observed that nurses onpostnatal wards failed to report mild psychiatric problems among thephysicians' wives.

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

Life Style Diseases

2011-09-17T14:46:00.000-07:00

Effects on world health and the economy

By Melvin J. Howard

Next week, the U.N. General Assembly will hold its first summiton chronic diseases cancer, diabetesand heart and lung disease. Those account for nearly two-thirds of deathsworldwide, or about 36 million. In the United States, they kill nearly 9 out of10 people. They have common risk factors, such as smoking and sedentarylifestyles, and many are preventable. This is only the second time in thehistory of the UN that the General Assembly meets on a health issue (the lastissue was AIDS). The aim is for countries to adopt a concise, action-orientedoutcome document that will shape the global agendas for generations to come.

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

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

Europe and North America. Too much eating, toolittle exercise and smoking: heart disease and diabetes dominate. Cancers thatare more prevalent with age breast and prostate reflect long life spans inthese regions where treatment is widely available. In Eastern Europe and theformer Soviet Union, lung cancer is the dominant cancer in men. Europe has thehighest smoking prevalence in the world: 29 per cent. Asia. Southeast Asia has the lowest rates of obesity in theworld, even lower than Africa. Yet in China, where only 6 per cent of thepopulation is obese, nearly 4 in 10 people have high blood pressure. China alsohas 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 virusthat can cause cervical cancer. In India, the government has launched anaggressive diabetes and high blood pressure screening project. There are 51million diabetics in India, the second-highest incidence in the world afterChina. Lung cancer is the most common type of cancer in India among men; inwomen, it’s cervical cancer. Central and South America. Cancerprevalence patterns largely resemble North America except that cervical cancerdominates among women in certain areas. Access to care is much poorer in manycountries. Volunteers for the American Society of Clinical Oncology, told ofconditions at a hospital in Honduras, where there are more than 700 new cancercases every year for two oncologists to handle.

THE MONEY THE POLITICS THE COMPANIES THE FIGHTS BEHIND THE CONFERENCE

The World’s Mental Health

2011-09-10T09:38:00.000-07:00

Chance are you know someone close to you with amental illness

By Melvin J. Howard

It all starts with the brain emotional memoriesdiffer from normal memories in that they result from traumas. They arefrightening at the time, but even worst, these memories can become enduring anddistort our outlooks thereafter. They appear to react more strongly to negativethan positive events. Emotional memories are locked in a separate neuralcircuitry in the brain, mediated primarily by two of the limbic organs, thehippocampus and amyagdala. According to WHO (World Health Organization), mentalhealth is "a state of well-being in which the individual realizes hisor her own abilities, can cope with the normal stresses of life, can work productivelyand fruitfully, and is able to make a contribution to his or hercommunity". WHO stresses that mental health "is not just the absenceof mental disorder".

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

Experts say we all have the potential for sufferingfrom mental health problems, no matter how old we are, whether we are male orfemale, rich or poor, or ethnic group we belong to. In the UK over one quarterof a million people are admitted into psychiatric hospitals each year, and morethan 4,000 people kill themselves. They come from all walks of life. According to the NIMH (National Institute of Mental Health, USA) mentaldisorders are "common in the USA and internationally". Approximately57.7 million Americans suffer from a mental disorder in a given year, which isapproximately 26.2% of adults. However, the main burden of illness isconcentrated in about 1 in 17 people (6%) who suffer from a serious mentalillness. Approximately half of all people who suffer from a mental disorderprobably suffer from another mental disorder at the same time, expertssay. In the UK, Canada, the USA and much of the developed world, mentaldisorders are the leading cause of disability among people aged 15 to 44. Themost common forms of mental illnesses are:

Anxiety disorders - Most people with an anxiety disorder will tryto avoid exposure to whatever triggers their anxiety. Examples of anxietydisorders include: Panic disorder - the person experiences suddenparalysing terror or imminent disaster. Phobias - these mayinclude simple phobias - disproportionate fear ofobjects, social phobias - fear of being subject to the judgment ofothers, and agoraphobia - dread of situations where getting away orbreaking free may be difficult. Obsessive-compulsive disorder - theperson has obsessions and compulsions. In other words, constant stressfulthoughts (obsessions), and a powerful urge to perform repetitive acts, such ashand washing (compulsion). PSTD (Post-traumatic stress disorder) -this can occur after somebody has been through a traumatic event - somethinghorrible and scary that the person sees or that happens to him or her. Duringthis type of event the person thinks that his/her life or other people's livesare in danger. The sufferer may feel afraid or feel that he/she has no controlover what is happening. Mood disorders - these are also known asaffective disorders or depressive disorders. Patients with these illnessesshare disturbances or mood changes, generally involving either mania (elation)or depression. Expertssay that approximately 80% of patients with depressive disorder improvesignificantly with treatment. Examples of mood disorders include: Majordepression - the sufferer is not longer interested in and does notenjoy activities and events that he/she previously got pleasure from. There areextreme or prolonged periods of sadness. Bipolar disorder - alsoknown as manic-depressive illness, or manic depression. The sufferer oscillatesfrom 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 inactivities he/she once enjoyed - but to a lesser extent than in majordepression. SAD (seasonal affective disorder) - a type of majordepression. However, this one is triggered by lack of daylight. People get itin countries far from the equator during late autumn, winter, and early spring.Schizophrenia disorders - The sufferer has thoughts that appearfragmented; he/she also finds it hard to process information. Schizophrenia canhave negative or positive symptoms. Positive symptomsinclude delusions, thought disorders and hallucinations. Negative symptomsinclude withdrawal, lack of motivation and a flat or inappropriate mood.

Treatmentsand strategies for mental health problems

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

Often people wait a longtime before they ask for help they and their family feel that something iswrong but they don’t know what. They also may be reluctant to ask for help inaddition, diagnosing a mental disorder can take time months or even years.Observations by family and friends in the disturbance in your behaviour are thefirst indicators. This should be followed up with psychological tests of anexperience health professional your doctor or a specialized mental healthprofessional such as psychiatrist or psychologist. There are a number ofreasons people struggle with mental disorder they simply don’t know what’swrong 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 wayto get the help you need for yourself or someone you know is to educate yourselfabout what a mental disorder looks like.

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

Help Yourself

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

Diet and mental health

Itis an accepted fact that food affects how people feel, think and behave. Mostexperts accept that dietary interventions could have an impact on a number ofthe mental health challenges society faces today. So, why is it thatgovernments and public health authorities in developed economies invest solittle in developing this knowledge? The evidence is growing and becomingmore compelling that diet can play a significant role in the care and treatmentof people with mental health problems, including depression, ADHD (attentiondeficit hyperactivity disorder). Experts are talking about an integratedapproach, which recognizes the interplay of biological, psychological, socialand environmental factors - with diet in the middle of it as being key.Individuals can do something about their diet themselves and improve theirmental health.

It is estimated that in the UK people eat 4 kilogramsof food additives each year. Scientists are not sure what effect decades ofsuch consumption may have on the brain. Governments are reluctant to fund,conduct or publish rigorously controlled large-scale studies, which look at theeffect of additives on human mental health. Changing farming practices haveintroduced higher levels of different types of fat into our diet. For example,chickens reach their ideal weight for slaughter twice as quicklytoday compared to three decades ago - this has changed the nutritional profileof meat, according to a report by the Mental Health Foundation (UK). Threedecades ago a typical chicken carcass used to be 2% fat - today they are awhopping 22%. The omega-3 fatty acid content in chicken meat has dropped whilethe omega-6 fatty acids have risen. The same is happening to farmed fish.

Ourbrains' dry weight consists of approximately 60% fat. Our brain cellmembranes are directly affected by the fats we eat. Saturated fats make ourbrain cell membranes less flexible. Saturated fats are those that harden atroom temperature. 20% of the fat that exists in our brain is made up ofessential fatty acids omega-3 and omega-6. The word essential here meanswe 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 (braincells), making sure that optimal communication is maintained within the brain.Nutritionists say omega-3 and omega-6 essential fatty acids should be consumedin equal amounts. If we consume unequal amounts there is a higher chance ofhaving problems with depression, concentration and memory. It is crucialomega-3 intake is kept up. While one study shows a link between omega-3 intakeand mental skills, others show there are benefits for cardiovascularproblems, diabetes, ADHD, and a whole host of other problems:

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

Run, jog, walk get out of your car and exercise

A Harvard University study found that exercise may help people withdepression by enhancing body image, providing social support from exercisegroups, a distraction for every day worries, heightened self-confidence frommeeting a goal, and altered circulation of the neurotransmitters serotonin,norepinephrine, and the endorphins. Even a very small amount of additionalexercise has been seen to have an important impact on mental health. Exercise can boost an exercise-related gene in the brain that works as apowerful anti-depressant. Apparently, though only 5% of GPs (generalpractitioners, primary care physicians) use it as one of their most regulartreatment responses, compared to 92% who use antidepressants as one of theirmost 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 physicalhealth to do exercise. If you are not, insist that your doctor help you devisean exercise plan that suits you. There is evidence that very moderate alcoholconsumption may aid mental health in some cases. However, the evidence isoverwhelming that excessive alcohol has a very bad impact on people's mentalhealth. Whatever your attitude is to alcohol, remember that alcohol will notresolve your mental health problems nor any other problems you might have, andwill most likely make them worse if you are not very, careful.

ANSWERING LIFE'S QUESTIONS

2011-08-27T15:56:00.000-07:00

Life just what is it?

By Melvin J. Howard

I have just finished the book by Stephen Hawking and Leonard Mlodinow (author of The Drunkard's walk) also a good read called The Grand Design. I am a big fan of science and scientist some of whom might not be household names yet like Mr. Hawking. But are no less important to answering life’s most perplexing questions. In their book, Messrs. Hawking and Mlodinow take you on a tour of fundamental physics and cosmology, laying the foundation that our universe is only a tiny part of a much larger picture, the multiverse or the M Theory. The universe we see is big, with over a hundred billion galaxies, but it's still finite. The multiverse idea suggests that there are other regions, equally impressive in size, where conditions might be quite different, right down to different physical laws or different numbers of dimensions of space. To think not to long ago for scientist just to even ask the big questions like what if the earth is not the center of the universe they put their life in jeopardy. Some even waited until they were on their deathbeds to publish their work out of fear they would be persecuted and prosecuted. Sounds far fetch in this day and age of revolutionary technology but the dogma was the law of the land. I for one have many questions and curious about the world in which we all share.

For instance I know the binary code for Melvin J. Howard is 01001101 01100101 01101100 01110110 01101001 01101110 00100000 01001010 00101110 00100000 01001000 01101111 01110111 01100001 01110010 01100100 but what is my code for life? Who am I, how did we get here, what are we doing here, what is real, is space and time an illusion, what happens when you die? What is the difference between black, white, brown and yellow people or is there any difference at all? Why do people fall in and out of love? Why do some people commit horrific crimes is it chemical or biological? What happened before the universe began? Why can some people smoke until they are 90 and some get cancer not ever picking up a cigarette? Why do I feel the sense of a loved one even though they are miles apart? Are thoughts just chemical reactions? Are there other worlds? Scientist, doctors, biologist and physicists have answered some of these questions but there plenty more work to be done. So scientists are hard at work trying to find the answers. Some like Messrs. Hawking and Mlodinow trace the logic of quantum mechanics, general relativity and superstring theory, showing how a variety of existing universes isn't merely possible but arguably natural. In string theory, space inevitably has extra curled-up dimensions that we can't see. But there are many ways for dimensions to curl up, and each of them leads to different "laws of physics." Then there's inflation, not the kind that the chairman of the Fed is trying fight off the (Monetary Kind). But in this kind that predicts that an extremely tiny region of space can blow up into a universe-sized domain. Modern cosmologists believe that inflation, once it starts, can keep going forever, continually creating new "pocket universes" with different conditions in each one. Without research none of these discoveries would have never been made. Medical or scientific research is crucial in understanding where we come from and where we are going. What makes our body and the universe tick what’s in our genes?

DNA, or deoxyribonucleic acid, has an elegantly geometric structure that allows it to play its crucial role as the chemical carrier of an organism's genes. Each DNA molecule is made up of two very long polymers connected by the bonding of hydrogen atoms and coiled in the shape of a double helix. Each of the two polymers contains many structures called nucleotides, which, in turn, may be further broken down into three parts: deoxyribose (a five carbon sugar), a phosphate group, and a nitrogenous base. There are four different nitrogenous bases that might be present: thymine, cytosine, adenine, and guanine. These four bases are the foundation of the genetic code. Sometimes represented as T, C, A, and G, these chemicals act as the cell's memory, instructing it on how to synthesize enzymes and other proteins. These four nucleotides encode everything an organism needs to live and protects this information with incredible accuracy. In a human being, each cell holds 46 separate DNA molecules, each containing, on the average, about 160 million nucleotide pairs, yet this massive amount of information is stored and replicated almost flawlessly.

Proteins not only make up the structural bulk of the Homo sapiens body but also include the enzymes that carry out the biochemical reactions of life. They are composed of units called amino acids linked together in a long string; each string folds in a way that determines the function of a protein. The order of the amino acids is set by the DNA base sequence of the gene that encodes a given protein, through intermediaries called RNA; genes that actively make RNA are said to be “expressed.”

The Human Genome Project was to seek not just to elucidate all the proteins produced within a Homo sapiens (“ Human beings “ ) but also to comprehend how the genes that encode the proteins are expressed, how the DNA sequences of those genes stack up against comparable genes of other species, how genes vary within our species and how DNA sequences translate into observable characteristics. Layers of information built on top of the DNA sequence will reveal the knowledge embedded in the DNA. This data will fuel advances in biology for the next century.

WHEN DO WE KNOW WE EXIST?

Every facet of human existence and survival is held in place by the assumptions we maintain regarding ourselves and the universe around us. Can you imagine the impact on society if suddenly we had to come to terms with the fact that everything we think of as solid and real is actually an illusion? Not here at all, or only here if we agree that it is here. Religion and philosophy have evolved, as consciousness has tried to understand itself and explain its relationship to what it sees as the physical universe in which it seems to operate. Great thinkers and teachers from different religions and philosophies throughout time have described their view of who we are, where we are, and what we are doing here. In the past few years scientists and scholars in a variety of disciplines have been making concerted efforts to answer an ancient question, namely, How exactly do the physical processes in the brain cause consciousness i.e. when do we become aware? Is it when one are all of the following:

hearing, seeing, tasting, touching, smelling, pleasure, pain

· attention, presence, perceptiveness, experience, memory

· intuition, responsiveness, sensing the grain and flow of things

· self/reflexive awareness, self-sense/identity, proprioception/body-sense,

authenticity

· interest, openness, curiosity, passion, purpose, intention, desire, will,

engagement, courage, commitment

· attitude, bias, perspective, worldview/paradigm, assumption, belief

· feeling, emotion (all emotions), reaction, sentiment, bliss, joy, misery,

suffering, hope, etc.

· care, compassion, empathy, mutuality, resonance, appreciation,

loving-kindness, friendship

· intelligence, learning, reflection, analysis, synthesis, pattern-seeking, information processing, understanding

· knowledge, information, ideas, understandings, models, designs

· concepts, language, names, articulation, metaphors

· certainty,arrogance, uncertainty, doubt, confusion, humility, agreement,

dissent

· ethics, morality, integrity, principles

· choice, values, decision-making, judgment, evaluation

· imagination, aesthetic sensibility, vision, story, ingenuity, inspiration

· wisdom, spirit, enlightenment, transcendence, a sense of the sacred, awe,

wonder

· humor, amusement, enjoyment, playfulness

· mystery, ambiguity, nuance, sense of paradox

· forethought, anticipation, worry, plans, strategy, tactics, guidance,

predictions, scenarios (future-sensing)

· management, direction, governance, leadership (bridging between decision, will, and plans with real action in the world, supporting the ability to act).

Can consciousness be explained in terms of brain activity? What makes a mental state be a conscious mental state? The laws generating all chemical, biological, neurological processes are now perfectly known. Never before in history, science has been able to explain the principles, which originates all biological processes until now. This represents a true turn in history. All that physics will discover in the future will have nothing to do with the biological processes in our organism, or any other organism. Even if there are still some things not perfectly known in astrophysics, these astrophysical processes do not affect biological processes, which are due uniquely to the laws of quantum electrodynamics.

IT’S IN THE MATH

The laws of physics consist of a system of mathematical equations. The mathematical structures exclude the possibility that these equations can be modified; in fact, even a slight change in a mathematical equation would generate radical changes in all its solutions. They have already found billions and billions of correct solutions from the laws of physics; if we changed them, we would suddenly cast away all these correct solutions. On the other hand, every day they find a systematic experimental confirmation of the laws of physics on ever-new systems. To hypothesize that the laws of physics are wrong would be equivalent to say that all these billions and billions of systematic and quantitative experimental confirmations are only a lucky coincidence. The laws of quantum electrodynamics, discovered in the beginning of last century, have never been changed. On the basis of the number of experimental tests, scientist can say that quantum electrodynamics is the oldest scientific theory in history. This one is for all the researchers out there job well done. Now more then ever funding is key to advance further studies in all of these fields. Whether this ambitious conception is actually correct remains unclear. The important lesson of "The Grand Design" is not so much the particular theory being advocated but the sense that science may be able to answer the deep "Why?" questions that are part of fundamental human curiosity.

The Fountain Of Youth

2011-08-09T09:50:00.000-07:00

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 number. Taking 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.

Cutting CO2 Emissions Brings Savings in Health-Care Costs

2011-07-29T15:14:00.000-07:00

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:

Creating "Carbon Sinks": Such as planting new forests, or even certain types of timber farming;
Joint Implementation Projects: Which means funding emission reductions projects in other industrialized nations;
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!

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

2011-07-18T13:46:00.000-07:00

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!

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

2011-07-15T12:25:00.000-07:00

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 trifles...no 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)

Rank	Country	U.S. exports this much	U.S. imports this much	Total Trade
1.	Canada	248.8	276.5	525.3
2.	China	91.9	364.9	456.8
3.	Mexico	163.3	229.7	393.0
4.	Japan	60.5	120.3	180.9
5.	Germany	48.2	82.7	130.9
6.	United Kingdom	48.5	49.8	98.3
7.	South Korea	38.8	48.9	87.7
8.	France	27.0	38.6	65.6
9.	Taiwan	26.0	35.9	61.9
10.	Brazil	35.4	23.9	59.3
11.	Netherlands	35.0	19.0	54.0
12.	India	19.2	29.5	48.8
13.	Singappore	29.1	17.5	46.6
14.	Venezuela	10.7	32.8	43.4
15.	Saudi Arabia	11.6	31.4	43.0
	Total, Top 15 Countries	894.1	1401.3	2295.4
	Total, All Countries	1278.1	1912.1	3190.2

BIG PHARMA DRAWS UP BATTLE PLAN OF ATTACK

2011-07-10T13:25:00.000-07:00

Attack of the Generics and Counter-Sex Attack from Big Pharma

By Melvin J. Howard

The heartburn drug Nexium gave many people their first good look at what’s haunting the pharmaceutical industry. You must know the Nexium ads, with a bunch of middle aged folks standing around in some canyons that presumably represent an eroded esophagus, all mumbling "I didn't know, I didn't know, I didn't know". Well, I bet they didn't know this the only reason Nexium exists is that its predecessor, Prilosec, which is almost exactly the same was coming off patent. This eroded esophagus business is all about making the new patented drug Nexium seem different to the one that will now be copied by the generics.

Sales versus time graph of a patented drug. It looks like an upside-down "V". As soon as a patented drug is launched, revenues generated by it shoot up over time like the rising edge of a shark fin. But the minute it comes off patent they plunge just as quickly as they rose, as the generic companies come in, copy the drug, steel market share and force prices to drop. During the roaring 90s the pharmaceutical industry always seemed to be topping the charts as the most profitable. We are all familiar with the Blockbuster Drugs who made this dream a reality and have become celebrities in their own right there's Viagra, Vioxx, Celebrex, Claritin, Nexium, Prilosec, Lipitor, Rogaine, Zocor, Zoloft, Prozac, Paxil and Lamisil to name few.

Some will be on patent for many more years but others are soon scheduled to come off patent. Many patented drugs are simply 'me-too' drugs, designed to achieve the same effect as other patented drugs, but really add little value to society as a whole. To overcome lost revenues from patent expiries and the me-too drugs, each drug giant needs a certain number of new blockbuster drugs emerging from the R&D pipeline every year. Massive advertising campaigns are then designed to sell enough of the drug at a high enough price to recoup the R&D and advertising costs plus a target profit level.

But big pharmaceuticals, much to their dismay, are finding that the blockbuster drug cabinet is bare, even after throwing piles of dough into the R&D bucket. Despite the extensive range of illnesses for which blockbusters can be made to remedy, big pharma is still finding that it can't find enough new drugs to bring to market. This makes them more desperate to maintain high revenues on existing patented products, so they pour more and more funds into advertising and into fighting the generic companies in court. End Result: Profits are down in the pharmaceutical industry and the near future looks glum. And we get to see even more drug ads in America!

Add to all this the following pressures on the drug giants. European governments regulate prices of their Blockbusters, U.S. State Governments are now cracking down on some of Big Pharma's desperate practices to shut out the generics. Drug companies use to get pressure from managed-care companies to lower prices. Drug companies also face a whole set of giants a coalition of corporate giants called "Business for Affordable Medicine" - whose healthcare expenses have been shooting up with the cost of prescription drugs. This coalition includes such behemoths as General Motors and Wal-mart (for example General Motors pays over $70 million a year just to buy the heartburn drug Prilosec for its employees and they are not happy). True to form, however, the pharmaceutical industry is not one to take all this lying down. It's fighting back on all fronts, in a series of vicious attacks, coupled with some say consumer manipulation.

Before we study the attack strategy of big pharma, lets get to know the industry a little better and the regulation that defines its operating parameters. Nowadays, barely an hour can go by on the TV without us hearing from Big Pharma. Meanwhile, in other industrialized nations, the provision of universal healthcare means that drug prices are largely controlled by governments. Drug companies have not been allowed such freedom to either set prices for patented drugs or to advertise directly to the consumer. Consequently the US consumer ends up not only paying for the privilege of being propagandized by the drug companies at home, they also subsidize lower drug costs abroad where prices are regulated by the government. Put all these factors together and there's little mystery as to why prescription drug costs are spiralling out of control in this country.

To understand where some of this behaviors of the branded drug companies come from, it is instructive to look at several case studies. Case Study #1 Blockbuster Nexium: The marketing of the heartburn drug Nexium by AstraZeneca to counter the expiry of its patent on the similar drug Prilosec. Schering-Plough currently used similar tactics to convert people from the allergy drug Claritin coming off patent, to the almost identical branded drug Clarinex. Case Study# 2 - Blockbuster Taxol: The tactics of Bristol-Myers Squibb to keep its monopoly on the cancer drug Taxol, originally a from the taxpayer funded National Institutes of Health.

Case Study #1: Blockbuster Nexium, by AstraZeneca Thanks toour bad eating habits, American are notorious for stomach related problems, and this has proved to be a gold mine for the drug industry. Stomach ulcer and heartburn drugs like Prilosec, and Zantac before it, were the largest selling blockbusters of their time. In 1995 AstraZeneca drew up a battle plan as its 6 billion-dollar-a-year heartburn drug, Prilosec, was going to lose its patent in April 2001. After years of work, the attack team came up with a solution of launching a successor drug that was basically the same as Prilosec, but would be under patent when Prilosec lost its patent. They also used every loophole available in the Hatch-Waxman Act to construct a legal minefield for would-be copy-cats, to extend the Prilosec patent as long as possible, and give AstraZeneca more time to convert Prilosec users over to Nexium. The related legal battles over the Prilosec patents continue to this day and are closely watched by those that follow drug prices.

To convert post-patent Prilosec users to its patented sibling Nexium, AstraZeneca spent about $0.5 billion a year in adverting of this single drug, making it at the time the most advertised drug in the US (taking over from Prilosec). And, so far that's paid off handsomely, as 60Nexium. Nexium is one-half the Prilosec molecule and works pretty much the same, but it is just chemically different enough to win a patent of its own. The marketing spin that Nexium is better at dealing with eroded esophagus is good for converting Prilosec users that watch prime time TV over to Nexium but, according to the an article in the Wall Street Journal, is built on very shaky scientific foundations. According to the article, four studies were commissioned to see if Nexium was better at healing eroded esophagus. Two studies found it wasn't any better at all and the other two found it was better only by a little. Based on that little bit of evidence we all got to hear about eroded esophagi and purple pills on a daily basis! Such tactics form a common strategy for maintaining revenue as drugs come off patent. A similar strategy was being employed to convert users of the allergy drug Claritin to the new patented Clarinex.

Case Study #2: Blockbuster Taxol, by Bristol Myers Squibb Bristol-Myers Squibb was being sued by 29 states for illegally delaying generic competition of its blockbuster cancer drug Taxol and costing governments and consumers billions of dollars, as well as costing lives. The basis of the suit is the claim that Bristol-Myers Squibb misled the U.S. Patent Office to delay generic competition on Taxol. But there is more! You see, Taxol is derived from the bark of the Pacific Yew tree and its pharmaceutical benefits were discovered not by Bristol-Myers but by the taxpayer-funded National Institutes of Health. The NIH handed Taxol over to Bristol-Myers in 1991 as a big gift. In return Bristol-Myers, who charges a hefty price for Taxol, has acted like a badly spoiled child not wanting to share this gift with anyone, even ten years later. Bristol-Myers Squibb, similar to what AstraZeneca did in setting up its minefield around Prilosec, has used the trick of staggered patents of every technique and methodology used to serve up Taxol to maintain its monopoly on the taxpayers' gift to them. That’s like your stockbroker taking your watch to tell you what time it is.

This is such a common strategy of counter-attack by the brand name companies against the generics that state governments, consumers, companies and health insurers that end up footing the bill for prescription drugs are themselves challenging it at every turn. In addition to these lawsuits and angry governments, the planned heir to the cancer drug throne, a drug known as Erbitrix, developed in a joint venture with ImClone Systems, was rejected by the FDA and wound up in that scandal with Martha Stewart. These case studies were selected to give an idea of the tactics used by the drug industry to boost sales revenues. But, of course, the tactics dont stop there. Following is a small sampling of other techniques employed to keep sales revenues and drug prices high. Marketing to the medical profession. Drug companies spend the vast majority of their direct marketing budgets (about 85% of them) not on marketing directly to the public, but on marketing directly to doctors. This consists mostly of giving doctors buckets full of free samples by very attractive female reps (HEY SEX SELLS) about $9 billion worth noting that patients who start on free samples often convert to paying customers. It also includes giving doctors free dinners, sports tickets and other gifts, sponsoring conventions for them, and advertising in medical journals. In all, marketing to the medical profession costs the drug industry about $16 billion a year. Advertising to consumers through pharmacies. This newest form of direct-to-consumer advertising comes in the form of what looks like an educational booklet from the pharmacy about various treatments for your particular condition. It's provided for free when you purchase your prescription drugs, and looks like a public service provided by your trusted pharmacy. The targeted consumer would have to get their magnifying glasses out to see that these are actually advertisements from the branded drug companies. The trusted pharmacies are, of course, amply compensated for their distribution efforts and access to their databases for target marketing purposes. Advertising Agencies Participating in Clinical Trials. Believe it or not, those same drug agencies that bring us the subliminal messages of eroded esophagi using big canyons, are entering the business of performing clinical trials for their clients. This should lower both advertising costs and expenses of clinical trials, for there is every incentive for the advertising agency to find that their tested drug is just fantastic. After all, they will have an exclusive on the advertising account once the product is launched. As noted, these case studies and other techniques are just a small sampling of the techniques the branded drug companies use to stay alive and profitable in the face of competition, decreased innovation and increasing opposition from many quarters. It is remarkable that the granting of 20-year monopolies and the gifts of publicly funded research can't help this industry solve its profitability problems, let alone that it increasingly fails to provide value-added service to the public. Surely it is time to re-think the viability and sustainability of the branded drug sector in its current form.