Health Insurance Getting Dropped: a Real-Life, Small Business Example

KM–a friend of mine and Cubbie’s–is a physician in Central Kentucky.

Here is her response to my recent post:

Here is an example for you…

I am a small business owner (8 employees plus myself) who has provided group health insurance since opening my business. Six of those employees were covered by health insurance and my group plan, this past year, cost 70k yearly (it went up about 30% per year). This is a huge expense for a small business. I received a notice that our plan did not meet compliance with Obamacare’s new regulations. Therefore, I dropped our health insurance and, instead, opted to give a stipend for employee directed coverage. While the stipend will still cover their expenses, most of them are discouraged by the huge hassle. I am a bit relieved, however, to be stepping OUT of the insurance business.
As any reader can attest here: KM is being quite generous with her workers.

News Flash: Cheating Can Be Bad For Your Heart

I found this article interesting.

Doctors have long known that men live longer if they consistently have sex into old age, but knocking boots only provides a health boost if it occurs with the same partner in a familiar place. Sex into old age only helps if you’re doing it with your spouse. Sudden coital death occurs most frequently when a man engages in coitus with a woman who is not his long-term partner.

Priceless.

Good Work, Denninger

His latest post–about medical costs and the inability of government to spend at the current levels of growth on a sustained basis–is spot-on. Aside from the pure government spending side of this, there are other monster issues that need to be addressed, particularly (a) the government-medical-financial complex and (b) the impact of price controls in other countries (i.e. England, Canada) on our prices.

Still, the last time I saw a Denninger video clip, I swore he had to have lost some serious weight. At the end of his latest post is a before/after picture which confirmed what I thought. Very impressive.

His fitness advice is very sound. While some people are otherwise only marginally able to control their weight, most Americans don’t have that problem: it’s purely a matter of lifestyle and reasonable fitness is attainable.

Getting a good handle on food intake–especially portion control and calorie quality while ensuring that enough protein is consumed–is important. There is plenty of room for variety in this: from Atkins on one hand to pure vegan on the other. Get with your doc first, and find out which diets are more optimal for your condition. (From some studies I’ve seen, Type 2 diabetes sufferers may benefit from Atkins whereas heart patients with major blockage might benefit from the vegetarian path recommended by Dr. Caldwell Esselstyn. But I am neither a doc nor a nutritionist, so what I am saying here is not to be taken as Gospel advice.)

As for activity, unless you are severely handicapped or otherwise have a major medical condition that precludes you, you can exercise. As Denninger points out, there are lots of options out there, even for a variety of disabilities.

For most of you, fitness is a choice.

It is Science!!!

Well, not really. Vox, however, illustrates a point that I spent no small amount of time making during my tour of duty at Southern Baptist Theological Cemetary::

Clearly, a bright line needs to be delineated between scientific evidence that has been independently replicated by experiment, scientific evidence that could be independently replicated but has not been, and scientific evidence that cannot be independently replicated by experiment. And furthermore, it is necessary to stop giving the latter two types of scientific evidence, or more properly, potential scientific evidence, the same level of credence that is given to actual scientific evidence that has been reliably and independently replicated.

I recall a spat I had with one of the leftists who clamored that anyone contesting the anthropogenic global warming dogma was either ignorant or stupid. I pointed out to him that, when you cut through the B.S., there are basically three types of scientific “information”:

(1) Scientific fact: that which has been demonstrated and replicated experimentally;

(2) Scientific opinion: hypotheses which have not, but potentially (key word there) could be–experimentally verified;

(3) Scientific opinion that gets reported as fact: hypotheses that have not been proven through experimentation, but nonetheless get reported as Holy Writ.

Examples of (1): Newtons Laws of Motion; the First and Second Laws of Thermodynamics.

Examples of (2): various theories regarding the behavior of subatomic particles. On one hand, there are observational bases for the hypotheses; OTOH some of those hypotheses are yet to be conclusively verified through experimentation.

Examples of (3): anthropogenic global warming; various theories of evolution; premises that embryonic stem cells hold the promise for the cure for everything from jock itch to the deadliest cancers.

When arguing on such matters on this space, I have a simple warning: don’t bother coming over here spewing opinion and then telling me “it is science” if you have no experimental basis to show.

I will call BS every time.

Whether you are arguing for macro-evolution, global warming, or even young earth creationism, we require honesty here:

(1) There is a huge difference between that which has been demonstrated by experimentation versus mere opinions about observations. We will never begrudge you for your opinion, but don’t come over here telling us how “scientific” it is if it is not.

(2) We must be honest about the limits of science. Science is great for understanding natural phenomena that can be duplicated via experimentation. That understanding has driven the development of no small number of technologies. If you can read this, you are enjoying the fruits of science.

OTOH, there are things that science CANNOT do for you.

Science cannot prove there is a God, let alone which model of God–Christian, Muslim, Jewish, Hindu, etc., or even no God–is valid. I can point to science to make a rational case for faith in a higher authority, but it would be less than intellectually honest to give you an article of faith and then tell you it is scientific.

Science cannot establish the veracity of miracle accounts, be they Christian, Jewish, Muslim, etc. Again, those are articles of faith.

At best, archaeology can help establish facts, but even that has limits: you are limited to what has been discovered to date. 150 years ago, Biblical skeptics touted the lack of archaeological evidence for Biblical accounts. Since then, archaeology has been quite favorable–rather than destructive–to Biblical accounts. In the world of Biblical scholarship, conservatives have made advances that liberals never thought possible 50 years ago.

Even then, archaeology is not science. What you are dealing with is observable data of varying quality, not experimental data that is reproducible.

Discuss

There is enough here to offend just about everyone.

I’m seeing a few things here:

(1) Docs are inadequately trained in the area of nutrition. This is not a new fact.
(2) Docs largely have no idea how to address this issue in their patients. It’s easy enough to deal with matters such as cancer, asthma, and other medical conditions that are not often tied to behavior. But confronting obesity–which, with some exception, is a condition that is tied to behavior–usually means confronting lifestyle. No one likes to be told they are responsible for their condition.
(3) Many docs are harder on women than men, even though obesity stats are pretty much even between the sexes.
(4) Many women will be offended, no matter how the doc tries to address the (almost literal) 900 pound elephant in the room.

Campbell, Government, Big Food, Big Medicine, and Nutrition

In The China Study, T. Colin Campbell provides substantial insight as to the conflicts between science, government, the medical establishment, and the food industry in the fight over what constitutes proper nutrition. While he does a wonderful job articulating the mess we currently have, what he fails to understand is that this is exactly why we need to get government out of the business of recommending nutritional guidelines.

Right now, we have a system in which Big Food and Big Medicine–two establishments that wield the big money–pretty much dominate the ear of Big Government.

Big Food–which includes the meat and dairy industry, the fast food industry and related restaurant chains, as well as food companies that make products from meat and dairy–has a vested interest in protecting the status quo. They have hired guns in science and academia who wield a large degree of influence over government agencies, lawmakers, and their staffs.

Big Medicine–which includes physicians, insurance companies, medical services, and Big Pharma–is a similar opponent. While the medical world is increasingly aiming in the direction of prevention of disease, they place the emphasis on prevention that involves the work of medical professionals. Heart scans, angioplasties, bypass surgeries, radiological procedures, colonoscopies, pills, and injections–those are things that bring in the bucks for Big Medicine.

If you go vegan, you may reduce your chances of a heart attack to zero, but it makes no money for your cardiologist or your primary care doc. You’ll also hit many players in the Big Food industry in the pocketbook.

Unfortunately, Campbell seems to think that getting government on the side of the vegans is the answer to all of this. In fact, the better answer is to get government completely out of the business of nutritional guidelines and recommendations.

Ultimately, it’s not the government’s place to control what doctors learn, what doctors discuss with their patients, what citizens wish to eat, or what products Big Pharma and Big Food market to us.

Fact is, in the Internet, we have the best free market of information ever known to the world. And nutrition is not rocket science.

    If you have heart disease, a vegan diet may save your life.
    If you have naturally high cholesterol, an Atkins or South Beach diet is tantamount to pouring gasoline on a fire.
    If you have a high diabetes risk, getting your weight down will go far toward preventing Type 2 Diabetes. If you have Type 2 Diabetes, getting your weight down–and keeping it down–may eliminate your diabetes.

Do we need government to tell us any of those things? Of course not. We don’t know the “causation”, but let’s not kid ourselves: if you’re at risk, the actionable intelligence is there, and it’s on you to decide what to do with it.

People can choose to make their own decisions about nutrition. Dr. Esselstyn found that patients–once they realized the control they had over their disease via diet–were very willing to make the changes they needed to make.

The medical establishment needs to start deciding which team they are on: the side of the patients or the side of their pocketbook. Docs need not advise all patients to go vegan, but if I’m a cardiologist and I have a patient who has heart disease, you can bet that I’m going to be telling him that going vegan may save his life. If I don’t do this, then shame on me.

If I’m a primary care doc and I have a patient with diabetes (Type 1 or 2), you can bet that I’m going to be telling him that going vegan and getting weight control will cut the amount of insulin needed (for Type 1) and possibly even eliminate the (Type 2) diabetes altogether. If I don’t do this, then shame on me.

If I’m a primary care doc and I have a patient that is showing some signs of Alzheimer’s or related dementia, you can bet that I’m going to be telling him that he has nothing to lose by going vegan. (While we have not determined the efficacy of this approach with respect to dementia, it’s not like other therapies are working worth a rat’s posterior.)

If I’m a neurologist and I have a patient with MS, you can bet that I’m going to be telling him that going vegan may improve his overall quality of life by mitigating his complications. The science is unmistakable here.

You can also bet that if I have a patient that has found weight control to be elusive, I’ll be telling him that going vegan may succeed where other attempts have failed. The science may not be perfect here, but the pointers are strong enough.

You can also bet that if I have a patient that is in otherwise good health, but who eats a “standard” diet, and he asks me about proper nutrition, I’ll be telling him that at least cutting back the proportion of animal based products–and replacing that with plant-based products–will provide a foundation for long-term health.

On a different take, the patient is going to need to start taking responsibility for knowing what is best and what is not. This information is not restricted from you; it is readily available and is but a mouseclick or two away. You need not spend thousands of dollars on specialists to learn what is available at your library, or via the Internet. I don’t need government to do this for me.

Moreover, by getting the government out of the business of making nutritional recommendations, we will make the landscape more of a true free market. As more people cut back on animal-based products, Big Food will invest more capital in developing plant-based products that are healthier and taste good.

We may also see a driving down of health care costs without costly legislation. Fewer heart procedures, fewer chemo treatments, fewer surgeries…all of that means less strain on insurance costs. It also makes medical pricing for routine services more competitive. Traditional physicians (MDs) may see more competition from osteopaths (DOs) and even chiropractors and nutritionists over basic prevention of disease.

The critics will complain–with some merit–that we will see a lot of quacks emerge. At the same time, we have plenty of quacks now. They exist in the medical establishment, government, and all levels of industry. In the current setup, they are protected by government.

By getting government out of the business of nutrition, we might see a badly-needed shakeup in this area.