GOP Issues Part One: Healthcare

Article first published as GOP Issues Part One: Healthcare

 

on Blogcritics.


Health care will likely be a contentious issue far beyond 2012, as continued increases in medical care and pharmaceuticals abound, and insurance and Medicare/Medicaid costs continue to rise.  The solution to this problem is far from simple, and will have to include changes to all of the various aspects to be acceptable the American people.

For reference, here is the summary of “The Patient Protection and Affordable Care Act”, useful since it is the focus of most of the candidate’s health care platforms.  This site has an overview of the candidate’s stances on health care, although its neutrality may be in question.  Below I will define my understanding of the positions of each GOP candidate with regard to health care, Medicare, and Medicaid, and provide links to interesting sites.  The mini-profiles are in alphabetical order – no bias is implied or intended.

Michele Bachmann claims to have the longest business career having started at age 5 (see quote here), but that’s not really pertinent to the issues.  She has been rather staunch in her opposition to “Obamacare”, claiming that both the Gingrich and Romney plans are too close to the President’s plan.  She seems fuzzy on the cost of the President’s plan; although the author of this article may not have realized that it could have been hyperbole, or not.  Her proposed H.R. 502, Health Care Freedom of Choice Act, would: make premiums 100% deductible, expand HAS/FSA, and allowances for small businesses to band together for better insurance rates.  This plan and other topics are discussed on her house.gov page.

If we consider Romney to be a flip-flopper, then Newt Gingrich must look like a Mexican Jumping Bean.  His history of support for a federally mandated plan goes back, at least, to 2005 when he partnered with Hillary Clinton on a bi-partisan reform plan, and by 2008 he said that it was, “fundamentally immoral for a person to go without coverage, show up at an emergency room and demand care.”  In his 2005 book “Winning the Future”, Newt said, "You have the right to be part of the lowest-cost insurance pool and you have a responsibility to buy insurance. …a 21st Century Intelligent System requires everyone to participate in the insurance system."  Gingrich claims that during his term as Speaker, that major reforms then “saved Medicare from bankruptcy”, but they apparently did not do the job right.  When the House voted on the Ryan plan earlier this year all but four Republicans voted in favor of passing it, but Newt called this “right-wing social engineering” and denounced it, but at other times he has endorsed at least parts of this plan.

Jon Huntsman Jr. is against having any form of mandated coverage now, in Utah anyway, but apparently did support one in 2007 as part of a United Way plan.  At that time he said, “I wouldn't shy away from mandates. I think if you're going to get it done and get it done right, a mandate has to be part of it in some way, shape, or form.”, especially as pertains to children as noted in this link.  Depending on which way he is currently flopped, he wants states to experiment and find the best solution, except probably Utah.  Another area in which he differs from the others is in a plan to streamline the FDA to lower drug-to-market costs, which he seems to be working on with the UCSF Chancellor.  Here is a little more about his plan, although light on detail, does give some of his thoughts.

The fact that the U.S. Constitution does notmention Medicare is not lost on Ron Paul, although the comment about general welfare could pertain (or was that the Declaration?).  At any rate, he is against federal meddling in state affairs, such as with healthcare.  Ron partly blames “government enforced monopolies” (HMOs and Pharmaceutical companies) for much of the problem, followed by the FDA.  In his opinion the only solution is to let the free market competition select the best providers.  It could be, that as a doctor, he has better insight into this problem that other candidates, but he was an OB-GYN, does that count?  Here are some questions answered by Ron, as well as some of his voting record on healthcare.

Rick Perry is firm on his stance against the Affordable Care Act, but apparently all for a bi-national plan between the U.S. (or just Texas: did they secede?) and Mexico.  It also seems that Rick used the same doctrine of “social costs” to justify his HPV vaccine scheme in Texas, as President Obama used for his health plan: which by the way, it would have been mandated for all girls.  In trying to understand his broad scope for reform, there is not much to go on: state controls over the FDA and Medicaid, but no details.  If we rely on his gubernatorial record then we might expect low spending on mental health and fewer Americans covered by insurance than the national average.  Rick is being a bit hypocritical since Texas is already reaping the benefits of “Obamacare” to the tune of $12 billion just for Medicaid.

It is claimed by many that Mitt Romney has flip-flopped on his healthcare stance, vilifying “Obamacare” while promoting the virtues of his, remarkably similar, Massachusetts plan, which in turn echoes a 1974 plan promoted by Nixon.  According to a PolitiFact article this is mostly false, saying that the primary difference is that while Romney is in favor of individually mandated care, it is to be managed at the state level as opposed to at the federal level.  It has been said that Mitt is in favor of a modified Ryan/Wyden plan, but has not specified what changes he would endorse (or it could be that the R/W plan has been copied from Mitt’s).  The basics of this plan are to leave the benefits for current seniors (over age 55 now) and give younger beneficiaries a fixed amount per year to be spent using a selection of private insurance options.

Rick Santorum backs his statement that it’s okay for insurers to deny coverage for pre-existing conditions; he has a daughter with such a condition and he pays a premium for that.  In this article he makes an analogy between health and auto insurance.  Rick sees insurance as a backstop for major illness, and believes that HSAa should be the future of health care.  He has remained firm in his conviction that individuals, not the government and especially not the insurance companies, should be responsible for their own health care.  He has flip-flopped on Medicare, supporting it (at least Part D) before becoming critical of it during his campaign; although he does support the Ryan plan.

I believe that the levels of waste, fraud, and abuse to these interconnected systems must be the first attack point, followed by a comprehensive policy change.  How can we know which plan makes the most sense without understanding where the current plans are broken?

Current estimates of fraud in the Medicare system is, conservatively set at, $87 billion for 2011, but is possibly three times that much.  These are the documented fraud cases which range from a Brooklyn dentist claiming 1,000 patients in one day, to a high-school dropout that filed $105 million in bogus claims, to an approximate $27 million paid to dead people.  The abuse of the system also includes giant pharmaceutical companies that over-estimate the “sticker price” of drugs so that they can charge Medicaid more, and doctors and healthcare providers “bilking” the system for treatment over-charges.

Even if we can’t understand now what the real extent of the problem is, saving $87 billion a year could go a long way towards lowering the deficit.  The GAO has published more than 158 reports on Medicare/Medicaid fraud since 1986, with similar reports coming from the HHS, inspector general, and other agencies, resulting in hundreds of statute and regulation changes with seemingly little effect.  Disturbingly, most of the high-profile cases are found not by the enormously expensive federal fraud programs, but by tenacious reporters poring through Medicare/Medicaid records.

At least one of the candidates, Rick Santorum, was quoted as saying that lack of health insurance did not cause any American deaths.  This could be strictly true, but this study tells a different story, estimating some 45,000 deaths per year.  Considering that almost 60 million U.S. citizens are living and working without healthinsurance, which comes to about 0.0075%, this seems feasible, although not everyone agrees as this article states.  Given the astronomical costs of a major illness, surgery, or extended therapy, it seems reckless to live uninsured; but for those at, or below the poverty line there aren’t many choices.

The republican stance on health care is that without complete repeal of “Obamacare” the economy will finish its collapse.  On the other hand, the Democrats say that more people will sicken and die without government managed care.  Surely there is a reasonable middle ground where the American public can meet.

You Would Have to be Crazy or on Drugs to be Homeless

Article first published as You Would Have to be Crazy or on Drugs to be Homeless on Blogcritics.


Although I did not intend for this to be a series, this is the third article I have written about homelessness.  I also wanted to say a few words about mental illness, as I am close to several people so diagnosed.  This came up during commenting (on Blogcritics)on one of the previous articles, and I felt that it needed to be discussed in more detail than the comment structure allows. The previously two articles about homelessness were, “Where Do Americans Live?” and “Ask Not What the Homeless Can Do for You, Ask What TheyCan Do for Themselves.”

This is a much to brief article to allow for more than a thumbnail sketch of mental illness and why homeless people are at a greater risk if they have certain disorders. Nor is it an expose on drugs and street living, but rather a look at how the three come together.  Please use the links provided, and your own searches on the topics, to better educate yourself.

Mental Illness

Most, if not all, people suffer from the effects of mental disorders to some extent.  Perhaps suffer is too strong a word for what many people consider to be personality traits or quirks.  Consider someone you believe to be “anal retentive”; everything has to be just so, or they may be disturbed when their routine is out-of-kilter.  Mostly we adjust to them and their ways, and manage to get along.  But, this could be more than just quirkiness; it might be a manifestation of Obsessive-Compulsive Disorder (OCD).

Another example would be people who seem grumpy or grouchy much of the time, which might be symptomatic of Dysthymia (a mild form of depression) or one of several other mood disorders.  Not liking to speak in public is a fairly common “quirk” but could be seen in people with a mild specific phobia, or other anxiety disorders.

Psychiatrists and Psychologists have diagnostic criteria for all of the disorders and usually some way of scaling or rating them by the effect they have on a person’s life (read more about disorders at PsychCentral).  To be considered as affected by a disorder the symptoms usually have to be continuous for several months, and in some cases up to one year.  This graph shows the incidence of the five major disorder areas in the 12 month, and lifetime prevalence categories used by professionals.  Prevalence is the extent to which the disorder is felt; over a specific time period.

In myself I can see what I call the “edges” of several disorders.  I am slightly OCD; I sometimes feel the need to check to make sure I’ve locked a door, or turned off the water or the stove.  Mostly, I don’t check, but occasionally it nags at me.  Now, imagine that you can’t control the urge to check the stove, or you feel compelled to wash your hands, multiple times, for hours, until they chap and bleed.

I am also slightly autistic, which was much more of a problem when I was younger.  Then, I felt the need to count things; people, tiles or bricks, passing cars.  I seem to have mostly outgrown that but another trait seems to have stayed with me.  When reading, and sometimes during other solitary activities, I rock back and forth, just slightly, or tap my foot, fingers, or shake my leg.  Mostly I don’t even realize that I am doing it, but frequently my wife notices.  This is not something that generally disrupts my life, but I see it as another “edge” of a disorder.  Picture not being able to stop the compulsions, rocking and counting; this is one aspect of full-blown Autism.

This chart lists the most common, of more than 400, mental disorders and their frequency.  Most people with a disorder don’t hear voices or see hallucinations; those types of extreme cases are very rare, occurring in less 1% of the population.  Major depressive disorder, specific phobias, and alcohol abuse top the list, all over 10%.  Other common disorders ranging in frequency from 2% to <10% are: ADHD, PTSD, drug abuse, bipolar disorder, and panic disorder.  Many of these are rare enough that most people never encounter them.

I believe that all humans exist on a continuum consisting of many of these disorders.  The World Health Organization believes that as much as 30% of the world population meets the criteria for a mental disorder at some point in their lives.  If you study the characteristics, or the diagnosis criteria, of say, OCD you will see many of them in people you know, or yourself.  This doesn’t mean that these people need treatment via drugs and counseling; sometimes just the awareness that they have these traits can be enough for them to overcome what many consider to be personality faults.  In the two examples about myself, it is clear, at least to me, that these are very low on the continuum.  

I know of several people, diagnosed with a variety of mental illnesses, some of which I am very close to.  One of them is bipolar, and has had extreme mood swings for over 20 years.  The biggest problem with bipolar disorder is that during the manic phase they are higher than anyone on any recreational drug ever has been.  Although I have never read this in medical publications, I suspect that this feeling is just as addictive, and perhaps more so, than any street drug.  Why would we expect that this addicted person would willingly give up their high?  

But herein lies the rub – the depression that follows these highs are so very low.  Most people have experienced mild depression, from losing a job to a loved one passing, and most people rebound back to a normal emotional level fairly quickly, but imagine being ten or a hundred times that depressed.  The bipolar sufferers MUST be on the medication at all times to prevent going into a, perhaps fatal, depression.  If left to their own devices the manic personality will demand that high with no thoughts to the resultant consequences.  Many of them then self-medicate to try and alleviate the depression – usually with street drugs or alcohol.  Either of these will add their own set of problems that do not mesh well with their ailment.  This article, “Self-medicating: Whenthe Cure IS the Disease”, has some more information about co-morbidity and dual-diagnoses.

Having two or more disorders is known as co-morbidity and occurs very frequently with some disorders.  Perhaps the greatest co-morbid disorders are substance abuse, and either anxiety or mood disorders, being twice as likely as in those not using drugs.  There are four risk factors associated with this co-morbidity: genetic vulnerabilities; environmental triggers; developmental effects; and the fact that similar areas of the brain are involved.  A recently recognized co-morbid connection was found between substance disorders, perhaps not surprisingly, and Post-Traumatic Stress Disorder (PTSD).  In one recent study 23% of over 9,200 patients were found to have three, co-morbid diagnoses.

Another person that I know has a panoply of diagnoses: Antisocial personality disorder, which causes them to completely disregard the feelings of others; Borderline personality disorder, similar to bipolar in that they have mood swings but more importantly is the unstable sense of identity and difficulty with interpersonal relationships; Narcissistic personality disorder, prompting unrealistic fantasies, requiring constant attention, lacking empathy; Panic disorder; and in my opinion Schizophrenia because of the observed paranoia, social withdrawal, and drug use (as many  as 50% of Schizophrenics abuse drugs).  These are some very troubling diagnoses and also very hard to live with, but mostly manageable with the proper use of medications and therapy.

At this time, neither of them is homeless, but the situation for them, and for others suffering from many types of mental disorders, could change at any time.

Substance Abuse

Although substance abuse is considered to be a mental disorder, I think it deserves a few words.  This is an epidemic in almost every sense of the word:

• Increased virulence – the purity and availability of many drugs have increased dramatically
• Introduction into novel settings – meth has moved into small towns throughout the U.S.
• Changes in host exposure and susceptibility – younger children are being exposed to drugs every year.

Don’t you think that more than 20 million user’s, or over 6% of the U.S. population constitutes an epidemic?

I’m not sure if I understand why one of the only areas in which the U.S continues to lead the world is in illegal drug use.

But, enough on drugs for now; I have a future article in the works on that.

Homelessness

There are two commonly used definitions for homelessness: “Not having customary access to a conventional dwelling” and “living in public or private emergency shelters; or in the streets, parks, subways, bus terminals, rail stations, airports, under bridges or aqueducts, abandoned buildings, cars, or in any public or private space not designated for shelters.”  Neither of these definitions addresses every possible situation, nor can they be expected to encompass every one, in just a few words.  But regardless of the official definition, we know homelessness when we see it.

The total number of homeless is nearly impossible to estimate, since there is no place where they are known to be, at any given time.  Several different counts have arrived at around 1, 500,000 people as of 2011.  The map on this blog shows the national distribution, with most populous states and cities having the most homeless.

I mentioned in my previous article that a major concern that had come to the attention of the United Nations was a lack of clean, safe water.  This, and the lack of proper sanitation facilities are adding a third factor to the overall problem; traditional diseases.

The single greatest cause for homelessness is lack of affordable housing, whether it is from foreclosure, loss of public assistance, or because some other need is more pressing than the rent.  The most common composition of homeless families is a mother with one to two children.  It shouldn’t be surprising that in this situation, food or medical care for the children is more important than housing.  One in fifty children in the U.S. will experience homelessness in their lifetime; and they will be twice as likely to go hungry, or have health problems as adults, and have less than a 25% chance of finishing high school.

In most cities there are shelters which can provide, at least temporary, accommodations, but these are neither permanent nor do they provide any sort of medical or therapeutic treatment.  There are programs, such as the Homeless Outreach Project, in New York and other cities, which have helped a significant number of the homeless living in city parks into treatment, entitlement programs, and temporary housing.  The greatest limiting factor is still permanent housing, but below are links to the outreach project websites for San Diego, Los Angeles, Denver, Kansas City, Chicago, Philadelphia, New York, and Miami.  There isn’t room here for an exhaustive list, but if you want to help there are places that need it.

Mixing the Three

One question to consider is whether a homeless person is more likely to have a mental disorder, or substance abuse problem, before or after becoming homeless.  Not surprising, to me at any rate, is that there is no clear understanding of this question; it is almost classically, a chicken-and-egg problem.  Unquestionably though, if people like these are living on the street, without even basic medical treatment, especially those with a high probability of co-morbid diagnoses, without the specialized drugs and counseling usually needed, how can they be expected to even cope, much less improve.

Another disturbing aspect in this whole situation is the appalling number of veterans that are among the homeless.  One estimate shows that more than 10% of the total number was in the military, down from as much as 30% in 2004.  Back to the chicken/egg, are they homeless because of PTSD, or does the homelessness exacerbate the PTSD?  Use these links for more on veterans and PTSD.

One of the most significant issues with getting help for the homeless that are also mentally ill and/or substance abusers is facilities that that can handle the complex interconnected problems.  A run-of-the-mill shelter is not set up to give treatment or therapy for either case.  Drug rehabilitation clinics usually don’t have psychiatrists or psychologists trained in mental health issues.  What is needed is a facility that does have all necessary people and equipment in one place.

Problem or Solution

I had said in my second article on this topic that one solution to the homeless problem would be to house them in their own “village” with necessities supplied, such as: housing, food, education, training, and most importantly, medical care.  The long term goal of this program would be helping to reestablish them into normal society.  Furthermore, I suggested that if deemed appropriate, this newly trained group could, repay if you will, by working on state or federal-level infrastructure projects, ala President Roosevelt’s CCC or WPA programs.  Those were effective not only in allowing millions of unemployed to work and earn pay, but also provided dams, highways, national parks, and other large-scale projects.

One of the reasons that I thought my plan had merit was because it allows maximum resource utilization.  We do this all of the time; a team is dispatched to tackle a fire, not a lone fireman.  Likewise, we collocate certain facilities as in hospitals; doctors, pharmacy, radiology, and surgery.  I propose the same sort of thing:  for housing it’s like a hotel with all needed services in one place; for food, it’s like a restaurant with storage, refrigerators, stoves, cooks all in one place; with training, as in a school, with instructors and training materials all together; and exactly like in a hospital, for medical needs.  How can it not make sense to do these things all in one location, instead of spread out in several locations, with volunteers trying to get back and forth, without all of the things you need to make it work, not at hand?

There were, and of course will be, detractors to this plan, saying that this would be just another ghetto, or that it sounded like a Dickensian work-house.  Certainly, if care is not taken and a multi-year or even multi-decade plan is not established, including funding, then it could turn out that way.  Any program is only as good as the people working on it, intentions notwithstanding; we know where good intentions lead.

I just don’t think this is possible on a small scale, which is what is happening now.  Volunteer organizations, church groups, scout troops, compassionate individuals are all trying to help, but in many cases it is just too little.  As I said above, this needs to have resources, which are too expensive and too spread out, which are organized in the most efficient way possible.

I don’t see how we can consider these people crazy; we are the one that have the means to fix this – and we don’t.

Why is the US so unhealthy? Part II

Continuing on from the last post on health, the next most important factors are probably alcohol consumption and smoking.  Does anyone think that these things are good for you?

 Well, in moderate amounts, alcohol appears to have some benefits including: increase to longevity; lower chance of cardiovascular disease; reduce risk of stroke; less likelihood of contracting Type II diabetes; and other benefits.  This article has a more complete list along with extensive references.  Not every doctor and researcher agrees with this advice, but these benefits only accrue with moderate drinking (1/day for women and 1-2/day for men).  This article from WebMD suggests that any amount of drinking raises the risks of certain types of cancer, especially if you already have other risk factors

But if you drink more than a moderate amount your chances of death increase.  There are approximately 79,000 deaths a year attributed to excessive alcohol use making it the 3^rd leading lifestyle-related cause of death.  Here is the CDC fact sheet on alcohol use.  It is important to understand if you use alcohol moderately, you are abusing it, or if you suffer from alcoholism.  Use this guideline to see if you have a problem.

It is up to each individual to determine if they can benefit from alcohol consumption since it is a major part of many lifestyles and cultural events.  Personally, I don’t think that the benefits outweigh the detriments.  It is expensive, adds calories and increases the odds that you will eat more, is linked to several diseases, and  increases the chances of having an accident (not just in a vehicle).  On the benefit side, my family already lives into their 80s and has an extremely low rate of cancer and heart disease.  So, all-in-all I think that I am better off not drinking, but you decide for yourself.

On to smoking.  I couldn’t find any current source that suggested that smoking was good for your health, unlike the advertisements in the 1920s through the 1950s.  Here is a retrospective article from Time magazine that is amusing in light of our current knowledge.  I don’t really see the point in elaborating on this particular topic.  It’s bad for your health and that of those around you – stop doing it.

The last major area of health improvement includes several small items that individually contribute little, but together can increase overall health; several of which were mentioned in this link from my previous post.

• Retirement, before age 65 anyway, seems to lower longevity by a fair amount.  It is not clear why this is, and more research is needed, but this article has some interesting facts.

• Flossing you teeth would seem to have little effect on your overall health, but some recent research shows that to be untrue.  Heart disease, arterial plaque, and even diabetes have been linked to the same bacterium that causes gingivitis.  So not only can you save your smile, not have to worry about your dentures falling out, but also save your life by flossing every day.

• Sleeping enough has been linked to weight gain, high blood pressure, and decreases the effectiveness of your immune system (and you are grumpier).  The National Highway Traffic Safety Administration estimates that sleep deprivation is responsible for 100,000 car crashes each year.  Work-place accidents are as much as twice as common with poor sleep habits.

• Stress, especially in today’s fast-paced environment, can have a huge impact on your health.  The causes of stress or myriad, but the effects on the body are the same as our flight-or-fight reflexes.  In this state the body increases adrenaline and cortisol which ups heart rate, blood pressure, blood sugar; all of benefit if you need to run away from a threat, but much lees beneficial in a meeting.  Stress increases your risk of other problems and makes ones you already have worse.  It has been linked to heart disease, depression, gastrointestinal ailments, and memory impairment.  Here are some ways to manage your stress.

• Social interactions have been shown to increase your life span and reduce the incidence of depression.  The reasons for this are not clear, but considering that humans are social animals, it stands to reason that we need to interact with others.  Read more about that here.

 

None of these things are going to let you live forever, but combined they may extend your life, and the quality of your life, quite a bit.  My main point about staying healthy was to decrease medical costs, and most of the things I have described are cheap or free.  If everyone does what they can to lower their own healthcare costs then shouldn’t market forces drive down the costs of doctors, hospitals, and insurance?  Even if it doesn’t, it still seems like a worthwhile effort.

Why is the US so unhealthy? Part I

In my second post I was complaining about cost of health care in the US, which is ridiculously high.  My goal was to point out that as a component of the overall healthcare costs our personal choices play a large part.  To be sure, insurance, pharmaceuticals, hospitals (and doctors), and lawyers all have portions of the blame, some much higher than others.  But it is my opinion that the single most important thing a person can do to keep their own healthcare costs down is to stay healthy.  It is understood that many people have medical issues over which they have little control, but it is also true that in many cases they would be of less impact, or more easily manageable, if those people had better overall health.

None of this is rocket science – the basics are pretty simple – doctors and scientists have been saying these same things for over 50 years.  Diet and exercise is number one, followed by moderation of alcohol and no smoking, finished with things like flossing, sleeping, and sunscreen.  Ultimately though, every person is completely responsible for their own health, with advice provided by doctors, nutritionists, etc.  

Be more informed and be healthier.

People lived healthy, happy lives long before we had MRIs, advanced drugs, or arthroscopic surgery, and for the most part so can we.  Certainly we have a better chance of living into our 90s now than they did 200 years ago, and infant mortality has dropped, in most first-world countries, to near zero, but a lot of people lived a lot of years without extensive, expensive medical care.  It almost seems like the medico-legal-pharmaceutical complex is forcing us to be sicker so that they can rush to the rescue (or in the case of lawyers, rush to court).

There is a lot, perhaps too much, information available today on how to live a healthy lifestyle.  Given this over-abundance, how can you know what is the most important?  Read everything you can find and consider whether it makes sense to you.  I am including several web sites that I think have interesting and important material, but it is up to you to understand what information is most beneficial to you.  This first one is a very general guide of dos and don’ts.

First, and perhaps most important to good health, is proper nutrition.  Certainly, you should eat enough but not too much, of the right foods in the correct proportions, to stay healthy.  Fast, or processed, foods are one of the worst things we have ever devised.  Now don’t get me wrong, I have eaten, and still occasionally eat, fast food.  But over the last several years I have tried to cut back on this habit and have seen dramatic weight loss and overall health increase.  I have long had the opinion that if you could see how our ancient ancestors lived, and how and what they ate, you could learn a lot.

This article very closely matches my thoughts on how we have evolved to process different foods, and added some to my understanding of why we seems to have problems with processed foods – even bread is a processed food.

The gist of the article is that for several hundred-thousand years we lived as hunter-gatherers (HG), and have adapted to those kinds of foods that were available in that style of living.  The cooking of food started long enough ago that we have adapted to it, but it still seems that the less we cook the better off we are.  Harvested grain consumption was a relatively recent change to our diet which is why there are problems with it, although this is a somewhat new theory.  Dr. Oz has gone so far as to compare highly processed carbohydrates to cocaine, both in its addictiveness and in its damage to the body.

So we have natural foods, processed as little as possible, which should be eaten in moderation; no binging and no starving.  In fact, recent studies have suggested that eating less per meal and increasing meal numbers is better overall for health.  This aligns nicely with the HG lifestyle; snacking on fruits, nuts, seeds, and perhaps fresh vegetables while on the hunt.

Along with the types of food, the quantities of it, and the frequency of eating, I want to add drinking water.  Everyone has heard that you should drink 8 glasses of 8 ounces of water every day, but there is some controversy surrounding this advice.  I personally think that this is good advice and try and follow it, but each person has to decide for themselves.  Additionally, the consumption of caffeinated, highly sugared, or alcohol-added drinks frequently cause the body to lose more water.  At any rate, here is an article listing the benefits and has recommendations – as always, decide for yourself.

The second major health style concern is exercise.  Imagine how fit you would be if you had to chase down your food every day, or gather all of the fruits and vegetables you need.  Even as recently as 100 years ago, it appears that farmers and ranchers were generally healthier than the average person today.  How could anyone not see that the more active you are the better your overall health would be?

How much exercise is enough is a highly debated number, which depends on several factors including but not limited to: current and optimum weight; amount of activity during work hours; physical and medical conditions; etc.  I think that it is obvious from looking at statistics collected by experts, that we as a nation don’t get enough exercise.  But many of those experts have arrived at some guidelines for, if not preparing for a triathlon, at least maintaining general fitness.  So somewhere between 30 and 90 minutes per day seems to be the right amount.

I think that this is one of the things that each person has to determine for themselves.  If you are exercising at some specific level and duration, and you feel good, aren’t gaining or losing weight (unless that is your goal), then you are probably getting enough.  But keep in mind that if you perform exactly the same exercises every day, your body will become accustomed to it and, over time, you will not be gaining as much benefit.  Many fitness experts suggest that you vary the type of exercise that you do over some schedule, for instance: hiking or biking alternated with weight lifting or resistance exercises (which is what I do).  The combination of cardiovascular exercise and some amount of weight or resistance training seems to have the most long-term health benefits.  I like this article on principles and techniques of resistance training.

Let’s again imagine our ancestors, climbing hills, running after prey, throwing rocks or sticks, or beating an animal to death, every day of their lives.  We clearly don’t get enough exercise.  I will continue on this thought tomorrow.