Microwaves, the 'Underinsured' & Drug Companies
Dr. Marc answers readers' question every other week. To send a query, click here.
Dear Dr. Marc,
We have heard recently that using the microwave can sap much of our food of its nutritional value. Is this being overplayed or should we relegate the appliance to the trash?
This is a tough one. Hitting food with microwaves certainly can't be good for it, but to my knowledge no long-term trials have been done in a large patient population to see if there are true deleterious effects. In terms of short-term effects, I know of no evidence to suggest that food is stripped of its nutritional value by microwaving. These studies would be hard to do, but in their absence it is difficult to advise trashing the microwave.
On the other hand, I do think that the use of this piece of equipment fits with a philosophy that is essentially an unhealthy one in terms of the American diet--processed and packaged foods, high in chemicals, fats, salts, sugars and preservatives. So it is what we're microwaving more than the microwave itself that concerns me.
Dear Dr. Marc,
I am a 54-year-old woman seeking affordable health insurance. I am outraged that I cannot find a policy for an individual that doesn't cost nearly $200 or more per month. I believe insurance companies are more interested in profit than helping improve the quality of life for citizens of this country. I also believe that our congress promotes such a state of affairs, because of monetary contributions, and who knows what else. I think the pharmaceutical companies are just as guilty of overcharging. I saw a list of the corporations which made the biggest profits during this year, and at the top of the list are the pharmaceutical companies. What is going on? How can these "human services" companies get by with this behavior?
I think it's best to realize that these pharmaceutical and health insurance companies are really just the corporate beast proceeding apace without regard to the business they're in. Oh, the major drug companies have philanthropy divisions and they try to put on a face of caring, which also has the intent of generating more profits as a result. No matter how they present themselves, these industries are neither altruistic or humanitarian. Remember, health care may have constant social implications and concerns, but these do not automatically extend to product and service providers.
Physicians are regulated in a way that drug companies are not. I believe you can overdo regulation, and I also have issues with who it is that is doing the regulating (i.e. the enforcers may lack relevant clinical expertise), but I do believe that regulating prices is a good way to keep providers honest and this certainly could be better applied to the drug industry.
But, ultimately, it's up to the public to resist blatant salesmanship in lieu of real information. I realize this is easy to say while being difficult to implement when our government is allied with big business at all levels. Fighting this corruption is an issue much too large for this column alone, but one which The Nation takes as a major issue every week.
Dear Dr. Marc,
Is it possible that the US will ever have a national healthcare system based on an educational and preventative approach? What would it take for that to happen?
New Oleans, LA
This country is too beset with profit motives and the angling and positioning of special interest groups including insurance and drug companies for there to be any sort of smooth transition to a national healthcare system. And none is in the offing right now.
But it is still crucial for there to be a standard of care, and for physicians and other healthcare workers to adhere to a fundamental belief in prevention and information. We have seen slow progress in these areas, but not in any uniform manner. Recommendations for screening are published widely by the various medical societies and physicians pay attention to them, though I am not satisfied that this information is disseminated fully. Public opinion is one way to change the direction of educated healthcare, but this is a slow uphill climb, especially in the current climate.
Dear Dr. Marc,
I am disabled with a chronic illness and am in touch with other people who are often fighting to receive care for serious afflictions. The press's coverage of health care and accessibility issues is disingenuous at best. While we speak of 41 million "uninsured" in the country, we can probably double that number of those who are underinsured, meaning those who have "disaster insurance," go broke and then become uninsurable, and those on Medicare who cannot afford the co-payments or drugs needed to keep them healthy. What disturbs me is that the press tends to demonize those who are ill--"those people" are driving up the costs of health insurance. The press rarely talks about the concept of the risk pool. Is this concept simply abandoned because of health care for profit? If so, we really don't have health "insurance," do we?
Sue Di Paola
I am sorry for your trouble. I think you're right--"underinsured" is an underappreciated concept. I also agree that the "health care for profit" industry is not considering this issue with its focus on how to provide the minimum care for the maximum profit. What to do? Under the current system, it is clearly important to slide into the maximum coverage you can get before getting sick, since afterwards, you will clearly be penalized or not covered. Medicare, that old dinosaur, still provides eighty percent coverage to the disabled or those over 65, and this is more comprehensive than many of the HMOs provide even without prescription drug coverage. National health insurance would be one way to correct the imbalances, provided that those who administered it could be counted on to be just. Unfortunately, we're currently heading in the opposite direction.
Dear Dr. Marc,
Putting aside the ethical questions re the use of embryonic stem cells, what exactly can they cure? I first heard of their capability to cure spinal cord injuries and other damage to nervous tissue but I've also read about other uses like curing MS and cancer. Could you explain what scientists currently know about this?
This topic illustrates the importance of understanding what we are talking about before we get up on our respective soap boxes. Even with all the controversy over stem cells, how many of our elected leaders truly understand their uses? Even ethics requires information, no matter how strong your position, even if one is a right-to-lifer insisting on "not trading one life for another." The beauty of stem cells for science is that their programming has not been completed. In other words, they may be "tweaked" to differentiate into cells to replace other damaged or destroyed cells. This is why they are getting such play in the neurological sciences, where damaged brain tissue from Parkinson's disease or strokes or multiple sclerosis can not simply be replaced by other neurons from the body or elsewhere because these fully formed neurons will not "take."
But by programming cells that have not yet expressed their function with the genetic information of a particular organ or individual, it may be possible to replace dead cells with fresh ones, and reverse the effects of some diseases, as diverse as diabetes, strokes, or cancer. In each case the goal is to get these new cells, receptive to instructions, to counter the effect of the disease.