Item: Rajjpuut visited an old friend and played some no-limit hold ‘em poker and also some lawn darts (or Jarts, I’m not sure which company made the set) great, great fun was had by all. Of course, just owning lawn darts can get you in a lot of trouble with the sewers. Imagine this: you’re running back and forth on a Saturday morning between the house and garage and backyard doing typical Saturday stuff. A thirteen-year old miscreant, who along with his gang of six or seven like-minded punks has been (unknown to the authorities, you and your neighbors) responsible for a string of thefts in a surrounding sixteen square block area, has had his eyes on you and the next time you head toward the backyard with a big load of stuff . . . he dashes into your garage and grabs a couple power tools, but wait just a moment, sets them down and steals the lawn darts instead.

It’s a nightmare scenario of course, because the delinquent is not interested in having fun with your lawn darts, though even that would put your home and car and bank account at great risk, no-no-no-no, the little monsters start playing “catch” with your darts. And of course one of them catches one right in the throat and is rushed into the emergency room for $200,000 worth of surgery, not to mention pain and suffering add the ambulance chasers. And you, my dear old friend, are screwed royally, glued and tattooed, OUCH! 

Even though the police discovers a whole mess of stolen goods, discover the gang’s fence (a 21 year old motorcyclist who also has side action in steroid dealing) and get confessions from all this . . . everybody gets a hand slap from the judicial system except, that’s right:  you. You, you dirty devil had an attractive and deadly nuisance in your garage in plain view to any intruder who walked behind your car aiming to steal something . . . motion to strike your honor, the victim is NOT on trial here. Ad nauseum.

Two very large boys, one a frequent trouble-maker I recognize, have jumped on the 60-year old custodian and are pummeling him towards the ground. As I charge up, I yell, “Stop that, get off him right now!” One kid high-tails it and since I don’t know him -- he disappears from the story. The other about 6’2” maybe 190 pounds turns toward me and pushing the custodian down actually rushes toward me. Wow, if I thought I had adrenalin before . . . .

To make a long story short, after he swings and misses, he's only a kid so despite his great size advantage, I  put him in a come-along grip intending to guide him to the principal’s office and sort things out there, the custodian also runs away (a very bad omen) as I start to move the kid and myself past him and now the kid makes a big deal of trying to head-butt me, stomp on my insteps, and elbow me in the crotch which of course he can try but can’t do because I’ve got a good come along grip on him so he’s just causing himself a lot of pain. Meanwhile students have flooded out of the classrooms and a few try to kick me but I allow them to hit their friend instead. 

Three minutes later we’re in the principal’s office and I and the principal convince the lad to act like a man. I tell my story, the kid concurs and I leave. This is a Friday afternoon, on Monday the little criminal is back in school before me and I have a six-page “misbehavior report” in my work record. The custodian (a few years later he resigns suspected of drug dealing) has told the principal that I made the whole story up. The kid has changed his story under encouragement from the principal. Although I earn an award for improving the English battery tests grades and 7^th grade writing ability; and my Spanish students can actually speak and understand basic Spanish, I’m warmly welcomed back but that blot will stay on my record. I quit teaching. 

Fast forward to today, elementary schools have “no running at recess” rules because of the incredible number of lawsuits resulting from minor injuries from normal play; teachers get sued for guiding a troublesome student out to the hall with a palm across the back; or helping place a finger correctly on a flute; or for yelling at them at football practice;  or one male teacher got a sexual-misconduct report (even after passing a lie-detector) because he failed to re-open a door a girl had shut on her way into his class for a ten-minute detention session at the end of the day. It’s a quagmire out there for teachers. My “conduct” could easily have resulted in a hundred million dollar lawsuit.

Item: a letter opener’s packaging reminds the buyer to wear safety goggles.

Item: a swiss army knife reminds the user, “sold only for the uses intended” (which leaves out nothing, but does constitute a legal warning).

Item: Lawsuits against cigarette companies by 40-year smokers of three-packs a day.

Item: Lawsuits against fast food companies by morbidly obese customers.

Item: Lawsuits complaining about noise pollution against airports that have been in place for thirty years from nearby homeowners of eighteen to twenty months.

It’s a dangerous world out there, I pray, don’t fall in amongst the sewers.

Ya’all live long, strong and ornery,

Rajjpuut

                For a lower court judge and particularly for an appellate judge the most embarrassing possible incident is having ONE of your ruling overturned by an appellate court. For an appellate judge the supreme disgrace is having ONE of your rulings overturned by the U.S. Supreme Court.  In the case of Sonia Sotomayor well over half of her appellate rulings have been overturned when reviewed by the present U.S. Supreme Court.

 ps:  there is no truth to the rumor that in the event of Sotomayor failing to win confirmation, the ACLU has agreed to bring suit against the Senate for predjucicial bias against incompetents.

Barak Obama has already defied 222 years of bankruptcy law and legal precedent in treating “secured creditors” like so-many disinterest onlookers ; overturned the Constitution’s system of checks and balances and separation of powers by naming 22 different “Czars” and giving them virtual life and death powers with NO say so from the U.S. Congress; and chosen to double 222 years worth of national debt in just five months . . . now he’s looking for an accomplice on the U.S. Supreme Court to overturn the rule of law completely. Sonia Sotomayor is his gal, devil willing. Sotomayor ruled in favor of Black firefighters who had failed a leadership exam and against 20 White firefighters who had spent numerous hours in study and hundreds of dollars in test preparation materials before passing the exam.

                Three hours ago, the U.S. Supreme Court came down firmly upon the side of “equal protection under the law and against the competency of Sonia Sotomayor in overturning her decision in Ricci v. Destafano. The Supreme Court once again has proved Sonia Sotomayor incompetent and not up to their standards. Their 5-4 decision overturned one of Sotomayor’s most infamous decisions.  The Supreme Court ruling, Ricci v. Destafano, showed UNFAIR REVERSE DISCRIMINATION upon 20 White firefighters who were denied promotions after taking and passing a leadership test when those test results would have granted them promotion. The test results were thrown out after no Black firefighters scored high enough for promotion. Sotomayor had previously ruled that discriminating based upon race was acceptable in these sort of instances.

                For a lower court judge and particularly for an appellate judge the most embarrassing possible incident is having your ruling overturned by a higher court. In the case of Sonia Sotomayor well over half of her appellate rulings have been overturned when reviewed by the present U.S. Supreme Court.

                Also germane in this case was Sotomayor’s flagrant conversational and speech foray, “I would hope that a wise Latina woman with the richness of her experiences would more often than not reach a better conclusion than a white male who hasn’t lived the same life.” Apparently the present Supreme Court does not support Sotomayor’s judgment of herself as “wise” nor her competence as an appellate judge.

  Inaugural Truman-Reagan-Kennedy

Alston Chase:  "When the search for truth is confused with political advocacy, the pursuit of knowledge is reduced to a quest for power." 

Just a bit over a century ago Upton Sinclair wrote his monumental expose, “The Jungle.” The Jungle was nominally a novel, but really just an intriguing catalog and description of the corruptions and horrific willful sanitation atrocities found in the American meat-packing industry in 1906. The FDA was created that same year, 1906, and performed wonder after wonder in cleaning up this disgraceful situation and protecting the public from evil people who put profit above public safety. Today, that once highly laudable FDA is nowhere in sight: the modern FDA motto is surely Pogo’s “We have met the enemy and the enemy is us!” Somewhere along the way the FDA badly lost its way.

Today, the FDA seemingly has abdicated the role it was created for: protecting our food. Large scale recalls of salmonella- and e.coli-infected food are in the news at least once a month. The FDA has become an agency which is causing more harm than good . . . It now allows drug companies to control how long the approval testing process takes by collecting legal “bribes” from them to shorten the testing processes. The FDA whose employee rolls are dominated by castoffs from the very companies it monitors, is seemingly in league with the large pharmaceutical companies and even after repeated deaths from drugs approved by the FDA itself, those poisons are allowed to continue on the market.

Despite the experiences of Captain Cook with Scurvy and the Nobel Prize awarded to Linus Pauling and the recent Nobel-winning work of Louis J. Ignarro: the Foul Disgusting Abomination had the temerity to issue a statement that “no supplement of any sort has ever been proven effective in fighting any disease.”^^^ The FDA has made life for vitamin and nutrient entrepreneurs in America quite miserable . . . while making the drug companies rich with concoctions that do not cure people of anything but only mask or in some cases temporarily alleviate symptoms. The FDA is well aware that only 47% (double-zero roulette odds in Vegas are better than that) of those who die from heart attacks show elevated cholesterol levels: that information was first available in 1976 but the dangerous and expensive cholesterol-lowering medicines that the FDA approved have earned the pharmaceutical companies tens of billions of dollars because the corrupt FDA fails to admit its errors.

Among the worst of its recent depravaties, the FDA has joyfully endorsed expensive PPI's (proton pump inhibitors) to fight "acid reflux disease" and heartburn. Acid reflux disease is an invention of advertisers for the pharmaceutical industry. In virtually 90% of heartburn cases, the cause is too little acid, not too much: so PPI's actually make the situation worse and also carry with them a list of noxious and deadly side-effects that the devil himself would praise! Adding insult to injury, when too-frequent anti-biotic prescriptions are combined with PPI use, a dasterdly dysentery called c. dificile often results which can often prove deadly in older people or younger ones with existing health limitations.

The surest way to help create the proper and helpful climate for health care in this nation would be to scrap the FDA immediately and replace it with a brand new agency which is not allowed to hire anyone who’s worked in any food or drug business monitored by the FDA. Since that won’t happen, the FDA will not/cannot change and it will continue to be a negative force on the American health care scene. Something needs to be done, but short of a complete annihilation of the agency and refusal to rehire a single one of its present management and executive people . . . nothing else makes sense.

Ya’all live long, strong and ornery,

But Malpractice Insurance drives medical costs up dramatically

 Malpractice lawsuits say an awful lot about the doctor

Understanding a doctor’s approach to hiccups says more

Medicine is a science, or should be, with a bit of art thrown in 

The Rajjpuut Health Care Plan: Part IV

Cultivating an Attractive Bedside Manner Cuts Malpractice Suits

            The three earlier blogs in this series are:

http://rajjpuutsfolly.blogtownhall.com/2009/06/21/revised_rajjpuut_health_care_plan_part_i.thtml

http://rajjpuutsfolly.blogtownhall.com/2009/06/22/rajjpuut_health_care_plan_part_ii.thtml

http://rajjpuutsfolly.blogtownhall.com/2009/06/22/rajjpuuts_health_care_plan_part_iii.thtml

                As mentioned in the earlier blogs, it is important to get “first things taken care of first” in building a new health care system in America.   While some might regard this blog as almost “touchy- feely and warm-fuzzy” it is included here because it represents one of the biggest failings of American medicine (as opposed to many other cultures where patient load is much smaller) and it’s an extremely expensive and unnecessary situation that could be eradicated within two or three months if doctors would use a bit of sensitivity, proper diligence and intelligence as they go about their business.

 Almost everything great about medicine, and much that’s wrong about it, revolves around the skill, dedication, character and even personality of its professionals . . . especially the frontline doctors and nurses. This blog is written for all the doctors, but especially for the great ones and the ones who would be great . . . .

Doctors and lawyers make a poor team. Malpractice suits are great for the legal beagle but ruinous for the medical men.    Rajjpuut is 100% against “caps” on malpractice suit awards*** . . . but 100% in favor of lower malpractice insurance premiums for great doctors: let me explain. I believe that when first-line (not specialist) doctors practice medicine in the following manner, they have the potential to be great doctors and they will not be sued: 1) Forget the cattle call of 50-70 patients in a 10-hour day. Fewer patients and more time with each one and listening to each one is the key. 2) Really get to know each patient as a body and to a lesser extent as a human being. 3) Have the goal of keeping patients out of your office and out of the hospital maximizing check-ups (nothing perfunctory) and achieve that goal via health education and preventive care. 4) Aim to take generally unhealthy patients and help them become responsible for and successful in achieving better health. 5) Develop a warm and caring bedside manner no matter what it costs you (many doctors are just not that cordial, but all need to learn to be so). Certainly if everyone you know would call you an “arrogant, humorless pr__k, then you need to work on this area.        

           In one study done by the Harvard school of medicine, it was shown that a 65% increase in malpractice insurance cost over a ten year period accounted for roughly 50% of the increased physicians’ costs during the same period. This was attributed to “ultra-defensiveness” in practicing medicine to avoid malpractice suits by continually ordering “one more test.” Of all the professions, the OB/GYN’s were the most threatened and a huge shortage of OB/GYN’s has been forecast for the year 2016:

http://www.med.umich.edu/opm/newspage/2005/obgyn.htm

            According to the study quoted in the article from the University of Michigan Health Services, high malpractice insurance costs were limiting the numbers of medical students entering into several specialties, OB/GYN in particular, and were even limiting the states where practices were set up. States with more favorable malpractice rules were more favored than states whose rules favored the patient.

            Over the years many studies of malpractice have taken place. A typical one might run like this: patients are queried about their doctor before operations and they rate him on a wide variety of personality and professional factors. They also choose comments about the doctor such as “he’s a good listener” or “He cares about me” or “She knows her stuff” or “I like him” or “He likes me.” They were allowed to Strongly agree, Strongly disagree, Agree, Disagree or say “I have no opinion.” The doctor is also rated by the hospital administrators and other doctors in the same way. And . . . drumbeat, Maestro!

            Bad doctors (as rated by the three groups) were about three times more likely to be sued for malpractice. The very worst listening doctors (bottom 10%) were seven times more likely to be sued than the best listeners (top 10%) and patients almost never sued a doctor they liked very much. This last fact, floored me when I read it, so I’ve made a point of talking to people who could sue for medical malpractice. Here’s a string of generic comments off the top of my head -- the anecdotal point of all the statistics:

“He saved my life, sure he nicked my nerve and now I have this little limp, but he saved my life.” “People make mistakes, she’s a good doctor.” “These things happen, if Dr. so-and-so goofed in that situation, probably 95% of the doctors would make the same mistake.” In other words, if they liked a doctor, patients were willing to “rationalize quite heavily” in his favor.

On the other hand, the patients who don’t like their doctors and sue them (often it appears “unjustifiably sue them”) say things like, “That rotten S.O.B. treats you like a piece of meat.” “I told him, but he wouldn’t listen.” I must have spent half my life in his waiting rooms and then he’d look at me for 10 seconds and write some useless prescriptions.”

One of the studies of doctors who were sued for malpractice and disliked by their patients showed these sort of negative impressions predominated:

A.     Bad listener

B.     Know-it-all

C.    Didn’t spend any time with me

D.    Never apologized

E.     Shifted me from one waiting room to another

F.     Wasn’t interested in my case

G.    Doesn’t know me from Adam

H.    Wouldn’t admit there was anything wrong

I.       I’m nobody, just his next airplane payment

J.      Arrogant piece of _____

Two areas apparently most statistically associated with LOSING malpractice suits are:

1)      Likeability and listening (Lawyers routinely make ‘bad deals” rather than take a doctor perceived as a “bad witness in his own behalf” into a courtroom)

2)      Going where he/she shouldn’t go (not following established procedures)

Here’s an interesting example of the latter:

“The Hiccup Parable” . . . .

Please read the parable closely and then the explanation ought to really strike home:

If you explored “hiccups” on the internet, you’d find tens of thousands of old wives’ cures and home remedies claiming to “stop hiccups.” One site I saw listed 250 such treatments. Of course, the very volume of all this speaks to ignorance. If you contract strep throat you go in and get a shot of antibiotics and barring a super-mutant strain of strep on steroids, that ends the problem. Not so with hiccups.

 Ignorance truly is bliss sometimes, except, of course, when it is a curse. I was talking to a psychologist friend of mine the other day. He occasionally tells me about “creative treatments” for various little mental aberrations he sees from time to time and I give him the straight skinny on things like fitness and longevity from a health educator’s point of view. On this day, James mentioned that three times in the last five years he’d encountered patients with a “hiccup phobia.” It seems that all three patients had already been seeing him for relatively minor neuroses but had later stumbled upon a copy of the “Guinness Book of World Records” and become so obsessed with the possibility of developing “life-threatening hiccups” that full-blown phobias had developed. The case of American Charles Osborne who hiccupped from 1922 to 1990 documented among the world records and the sad case of a girl whose hic’s could be heard half a mile away seem to have struck a resonant chord with his clients and he told me his patients were not an isolated incident, but rather he and his colleagues had discussed several other such cases.

As resident know-it-all, I told him that because I was in possession of 100% effective knowledge about how to cure hiccups with 100% effectiveness, I thought that, imparting that knowledge for him to impart to his patients could immediately alleviate their fears: case solved. He scoffed, as learned men are wont to do. “Don’t give me that crap, Bob, everybody has a pet way to cure hiccups. None of them work all the time.”

            I demurred, telling him, not only did I know how to clear up hiccups 100% effectively, but “you do too, James.” “Go on,” he said giving me a funny look.

            “How would you treat a socialite who feared that her perspiration was obnoxious and had developed such a phobia of sweating in public that she truly suffered from an easily measurable excessive perspiration?” Slyly I'd given him the rough outline of a case he'd mentioned to me fifteen or twenty years ago.

            He laughed, “No-brainer. We have her shower but apply no deodorant or anti-perspirant, then wear a sleeveless-backless gown and when she attends the next function she is to make every deliberate effort to “stink them all out” and pump out a river of sweat to drown everyone else at the party. When she emerges dry as the Sahara Desert, she’s cured.”

            “Hiccups are the same,” I claimed.

            “Son of a b____!” my learned friend said.

            And so it is. Hiccups and perspiration, body temperature and chemical balances, pulse and digestion, respiration and salivation, eye blinks and toenail growth are all under the control of the autonomic nervous system. Left alone they are virtually infallible in carrying out their vital jobs well below the level of conscious effort, but try to control them for very long and you can do yourself a world of hurt because it’s “not nice to fool Mother Nature.”  

Despite my constant efforts, after detecting my first “hic,” to break Mr. Osborne’s world record . . . . I rarely get out a second one. When I do, then I pump my fist in the air a few times and yell, “Yes, yes, yes and strive powerfully for a quick string of five hic’s in a row. To date my personal record is a pathetic six hic’s in a row lasting perhaps 20 seconds. I am mightily ashamed I tell you. Now, you ask

“What in the world has that story got to do with anything?” What, indeed?

            Perhaps you would NOT be shocked to know that medical doctors here in the United States have occasionally treated “runaway” hiccups (not the phobia, but real hicking) for weeks or even months at a time. The lesson that I would draw from that is to “never go where you don’t belong.” The lesson applies equally for doctors treating hiccups and would-be Good Samaritans who have never taken a CPR or first aid class.

            Those same “hiccup” doctors, never fail to charge the patients they can’t cure and don’t cure for . . . office visits and examination fees and then, of course if and when nature takes its course and the patient loses the hiccups, would you be surprised if the doctor didn’t take credit for the cure? If perchance, the medicines the doctor’s prescribe for hiccups bring about an adverse reaction . . . unlikely, you say. Ah, well . . . did you know that an American is ten times more likely to enter the hospital for an adverse reaction to prescribed medication than for an automobile accident? He is also four times more likely to die from that very same drug reaction than from injuries in a car crash. As you know, some cures are much worse than the underlying problem they’re prescribed for. One area where doctors should tread much more carefully about in Rajjpuut’s not-so-humble opinion is side effects for prescribed medicine. There’s a reason the Hippocratic Oath (“First do no harm!”) exists.

            The last word on malpractice belongs to simple lack of professionalism. In a story run just today,

http://news.yahoo.com/s/nm/20090622/us_nm/us_tests_errors

an unbelievable 7.1% of the time, patients across the United States were NOT informed of abnormal test results. Some practices never missed informing patients, others failed to inform patients of their "bad" tests results 26% of the time in the study run by Weil Cornell Medical College in New York state. Since "failure to diagnose" delays patient treatment; and in case of serious problems can even be deadly; and is one of the most common causes of medical malpractice suits . . . a pattern of committing this type of error can easily ruin any doctor's practice.

Ya'all live long, strong and ornery,

The Rajjpuut Health Care Plan: Part III

Emphasizes Responsibility,

Prevention and Health Education

            The two earlier blogs in this series are:

http://rajjpuutsfolly.blogtownhall.com/2009/06/21/revised_rajjpuut_health_care_plan_part_i.thtml

http://rajjpuutsfolly.blogtownhall.com/2009/06/22/rajjpuut_health_care_plan_part_ii.thtml

            As explained, rushing into a program, even a potentially excellent one, is to be avoided. Good management requires a methodical, studied approach in which each new part adds greatly to the whole rather than creating a bottleneck. Part I was an overview of exactly what’s important. Part II attacked the easiest and most fundamentally important part of the whole picture: elimination of unnecessary health care contact and creating a new role to efficiently manage entry into the system: the NHF or National Health Facilitator.

            Understanding anything, really understanding it, is a process that gradually brings more and more appreciation and satisfaction. In Part I we explained why Barak Obama was about the worst person in the world to create a health care proposal and why Rajjpuut’s profound expertise in communication, management, and health education made him an ideal person for creating this important program. We also showed ten key components of a satisfactory program: patient independence, patient responsibility, emphasis on prevention, health education starting at an early age, emphasis on quality of life, HMOs etc., the FDA, pharmaceutical companies, doctors, and the AMA.

            In Part II we explained that one of the biggest cause of problems in health care delivery comes from unnecessary visits to the doctor’s office and especially unnecessary visits to the emergency room (ER). These unnecessary contacts are obviously very expensive (the last statistics I remember put a doctor’s office visit at roughly $42; an urgent care visit at $220 and an emergency room visit at $631; and our hypothetical call into an NHF (we’ll call him or her from here on out a “health facilitator”) somewhere between $10 and $15 an hour with typical calls lasting eight minutes; some calls only three-minutes long; and a few rare extended calls up to half an hour in length. Clearly, the more efficiently we can place the prospective patient in the system the better dollar-wise for all concerned. Step I in our process of building a health care system is the training of NHF’s.

            Why? A recent article about Canada’s nationalized (government provided) health care system adds more insight here: the median wait for cancer treatment there is seven weeks and for emergency room treatment the wait is nine hours. Taking this one step further, Rajjpuut will speculate that in Canada under their system perhaps 90% of the cancer patients receive their first treatment somewhere between four weeks and ten weeks after entering the system. Either figure is bad, but ten weeks is intolerable. Now let’s look at the Canadian ER figures which are more germane to our look at the NHF position.

Clearly some of the people coming into the ER are dealt with within fifteen minutes, even within one minute in some cases and others, obviously the vast majority of others, sit around waiting in the ER area for seven to twelve hours. Obviously, if these were all “true emergencies” 90% of the Canadian ER patients would die or drop into comas. This is the role of the health facilitator: to wisely perform a sort of phone-triage. The real emergencies (poisoning, unconsciousness, blocked airway, severe bleeding, electrocution, drowning, severe allergic reactions,etc.##) are going to get looked at in 15 minutes, perhaps less, but the bottleneck can be dramatically eased and great amounts of money saved and frustration avoided. The intensive and profound training of the Health Facilitator is the most important and first step in the program.

Step II is Health Education which encompasses or partly encompasses five of the ten important parts necessary for any satisfactory national health care program: prevention, emphasis on quality of life, patient independence, patient responsibility, and just being taught about our own health. Both the nation as a whole and most particularly our children need to understand their bodies, what exactly constitutes health and fitness, good nutrition, and the concept of preventive health care and personal responsibility for one’s own health. Mandatory classes from K-10th grade ought to do the trick.

          What’s to be taught? The main lesson is called the “Seven Golden Rules of Health:”

http://rajjpuutsfolly.blogtownhall.com/2009/06/07/the_most_important_long-term_decisions_you_can_ever_make.thtml

Then adding good nutrition to that and drumming in those simple rules over time has an excellent chance of creating a dramatically aware generation of health care consumers. A few words here: common sense is the key. There is no room for health faddism when it comes to nutrition education. Man’s body, teeth, etc. in all ways reveal him to be an omnivore. Small amounts of red meat, pork, fish, poultry and eggs are crucial parts of the diet. Larger amounts of fresh fruits and vegetables added to the meat and eggs plus lesser amounts of grains and even smaller amounts of nuts, seeds and oils and dried fruit make up 95-98% of the diet.

            Rajjpuut was born in Green Bay, Wisconsin, the heart of “America’s Dairy Land” but he adds big helpings of salsa to his baked potato; enjoys a six-topping cheeseless pizza; and his shredded wheat is drowned in a virgin madras (half orange juice/half cranberry juice) rather than milk. Dairy products are very nice and quite frankly, Rajjpuut loves cheese, but unfortunately for my birth state: there is NO strict requirement for them in the diet of an adult human. Yogurt, however, is an excellent food which does wonders for the GI-tract while providing necessary calcium.

The biggest nutritional learning has to do with food preparation. Simply stated, other than the required cooking for meats and eggs, unprocessed foods are virtually always a better nutritional bet than processed foods; lightly processed foods (frozen vegetables, for example) are virtually always better nutritionally then highly processed foods (bear claws, canned veggies, candies and cookies, French or Italian cooking, etc.) and fried foods are virtually always among the worst nutritional choices. OK, nutrition is important. Nutrition is important in longevity and quality of life, but the real lesson here is that the most costly errors are made with respect to chronic illnesses like heart disease, stroke, diabetes, cancer, etc.:

The Most Important Long-Term Decisions You Can Ever Make

The Seven Golden Rules of Health

Interested in adding 35 years of high quality living to your lifespan?

Here's how, and here's WOW!

If anything beside the spendthrifts in Washington, D.C., can derail the American Dream, it's the ever increasing cost of health care both to the nation at large and to the individual. Roughly 72% of the price of a new American automobile is tied up in employee salary and benefits, especially health care. In a very real sense, good health is a very personal matter . . . as the "Spider Man" movies remind us: "With great power comes great responsibility," and you, the individual, certainly wield immense power in the battle for your own health, fitness, longevity and in avoiding high health care costs.

While working as a health educator for Blue Cross and Blue Shield of Kansas in 1977, Rajjpuut read about a recently-completed long-range study of vigorous older people. The gist of it all came to this: the University of California (Berkeley campus, I believe) extracted seven lifestyle practices that these hardy senior citizens tended to share as a group. As for the study results, here's what those salubrious old folks had in common:

The Seven Golden Rules of Health##

1. Eat a very large healthy breakfast daily

2. Regularly eat 3-4 smaller meals daily

3. Maintain a healthy normal weight

4. Avoid tobacco and drug use (and minimize over-the-counter remedies)

5. Drink alcohol extremely moderately

6. Sleep 7-8 hours nightly

7. Practice regular vigorous exercise

The "magic" from the study came when UC extrapolated their finding out into the general populace. They discovered that if they took two men, one aged 55 years old and the other 20 and compared their lifestyles . . . if the 20 year old practiced 0-1 of the "Seven Golden Rules" and the 55 year old practiced 6-7 of them: the two men had the exact same life expectancy. That is, it would be absolutely no surprise at all if they both dropped dead on the same day, say 28.2 years in the future. For Rajjpuut the 35 years difference between the two men is his personal definition of "quality of life."

A few comments are in order. Buckling seatbelts was a fairly new idea at the time of the study. If an eighth and ninth golden rule are needed which Rajjpuut would add from my experience as a health educator, they would be:

8. Buckle-up in moving vehicles and always observe proper caution around machinery

9. Avoid highly processed foods and fried foods and eat some high-fiber food daily

Rule #5 "Drink alcohol extremely moderately" deserves some discussion. After a brief flirtation with boozing as a youngster, Rajjpuut rarely consumes a six-pack a month these days, so that's what he practices and preaches. However, in the actual study the amount of liquor mentioned was "averaging one beer or glass of wine per day." Over the years since the study, much has been made of the value of red wine in the diet. All this implies that a little bit of alcohol is preferable to none at all. If there is one area of the study that Rajjpuut would put in question it would be that conclusion. Here's his"take" on the matter. The trouble with saying that teetotalers are less healthy than extremely moderate drinkers comes in two areas: A) a whole lot of teetotalers are reformed alcoholics who in many cases regrettably did great damage to their health prior to quitting drinking altogether and presumably shortened their probable lifespans in the process. It is my intuition that IF the study had eliminated this effect from former alcoholics in its study, their fifth rule should have been: "Rule #5 "Drink alcohol extremely moderately or not at all." Additionally, from his experience Rajjpuut suspects that there are "overly pious personalities" out there who don't drink and resent everybody in the world who does . . . and in fact they deeply resent almost everybody in the world for any number of reasons. If they were removed from the rolls of non-drinkers, Rajjpuut's sure the non-drinkers would have averaged a longer life also. So his last addition to the Golden Rules of Health is:

Rule #6 7/8 Have a sense of humor, relax

If on top of all this great advice, the individual, let us call him "Bill" takes charge of his own health and finds a health-conscious (rather than disease-oriented) doctor "muy simpatico" who believes that the purpose of wise medicine is to keep people hale-healthy and out of his office . . . and if Bill always seeks at least a second opinion in considering serious health care matters, then he and his doctors are part of the solution to the health care mess rather than part of problem. If every company had a full roster of employees like Bill then health care costs and costs across the board would drop markedly starting now.

 Live long, strong and ornery,

Bob

Rajjpuut is a health care expert, Mr. Obama is merely a somewhat charismatic political hack

The Rajjpuut Health Care Plan: Part II

Emphasizes Responsibility,

Prevention, Health Education and High Quality Care

No Rush

            Unlike President Obama’s all-out mad rush to create a new health care system, Rajjpuut believes that taking two years to design the exact nature of the system and then three years to implement its introduction is a wise investment of time.     While Rajjpuut is certain the basic outline given here will succeed, it is important to realize that professional managers will be responsible for the precise details.  Indeed, Rajjpuut is sure that this broad understanding of the problem as outlined here is far more important than virtually any other steps that might be taken.  Working hard at the wrong things, as we've frequently seen with the Obama administration means only that you succeed mightily in creating disaster.

Step #1

Elimination of Unnecessary Visits to Doctor’s Offices and Hospital Emergency Rooms

In Rajjpuut’s time with Blue Cross and Blue Shield of Kansas, one of the most common problem areas concerned “unnecessary” doctor’s office visits or visits to hospital emergency rooms. Depending upon which study is referred to, typically anywhere from 2/3 to 5/6 of all doctors’ office visits and somewhere around 75-80% of all emergency room visits were either totally unnecessary or could have and should have been handled in a more cost-effective way. For example a patient driving in 20 minutes to the emergency room for a typical mild kitchen burn could have saved the drive and been  told to immediately “run cold tap water over the injured hand or arm” or to keep it in a cold bucket of water for ten minutes; and repeat the process in five minute intervals until the pain and “heat sensation” disappear. Rather than a fruitless 20 minute drive, this self-treatment would, if done quickly enough, eliminate the pain and chance of blistering often associated with this type injury. Depending upon the severity of the injury, some alternative actions for this unnecessary ER visit might include: self-treatment plus either normal doctor’s office visit; urgent care visit; just getting good common-sense advice from an on-call NHF (explained below) as in our example. 

The first step in eliminating about 75% of these unnecessary office visits (45%-55% of all the office visits or 60% of the total ER trips) or uncalled for trips to the emergency room would be to have something the equivalent of a 911 line, say a 733 line manned by a trained medical interventionist we’ll call an NHF’s: national health facilitator. Besides their training and education for this medical phone help-line position, the NHF’s basic tool would be a huge stockpile of easily accessed color-coded  Medical Flow Charts giving them a series of logical questions to ask the callers about the medical situations they’re facing.   The color coding would includes ten or twelve different colors (as determined by medical professionals), for example,  A. Life-threatening emergencies B. Serious emergencies (puncture wounds, bone fractures; lacerations, contusions, sprains, strains, etc. C. through L as chosen by medical pros

The purposes of the NHF’s intervention is to ease the caseload of doctors and nurses; ease the minds of would-be patients and particularly parents of  would-be patients; while making preliminary assessments of likely medical conditions; assessing the seriousness of conditions and recommending the patient to 1) emergency rooms or ambulances 2) urgent care facilities  3) contacting a doctor within 12-15 hours 4) self-monitoring for a period of time, say 24 hours 5) engaging in a course of home treatment while self-monitoring 6) doing nothing. The NHF can also advise patients on lifestyle; and educate them on certain self-treatments; and write up a call report to be forwarded to the would-be patient’s private physician.  In fact for poor families or those with little understanding of health and the health care system, the NHF's role as an advisor, ombudsman and reference person (important phone #s; information about what forms and information to bring to an appointment, etc.) may prove to be almost as crucial as that of a doctor or nurse.

Using “medical condition flow charts”  -- and with the option to immediately “escalate” any problem phoned in to an experienced RN, Doctor or EMT ambulance crew -- the purposes of the NHF are to: A. Determine immediately if life-threatening medical emergencies require immediate heroic aid (poisoning, unconsciousness, blocked airway, severe bleeding,  electrocution, drowning, etc.) and respond appropriately B) in more mundane situations, to gather information from the call-in applicant about the nature of their medical difficulties and then deciding if a single problem exists or a mix of two or more problems is at work C) asking “narrowing” questions and choosing from a series of possible medical situations flow charts the NHF D) determines in so far as possible if a likely psychological factor is playing part in an ailment D) let the would-be patient know what medical options he/she is likely to encounter in the doctor’s office at a future visit.

Obviously, the NHF’s training would be done in conjunction with learning to use an appropriate medical “self-help”/self-diagnosis text with flow charts to evoke helpful responses from the caller and fairly quickly “narrow down” the critical or mundane nature of the call; the likely trouble spot on the body; a preliminary diagnosis and a recommended course of action. Some calls may take two minutes or less; some might require 20 minutes but within the health care system this “triage” by the NHF (pay $10-12 hour) is many times more economical than willy-nilly visits to the doctor’s office. Obviously, with the exception of recommending some very common over-the counter remedies such as Tylenol, hydrogen peroxide or boric acid: the NHF does not give advice on medicines and cannot write prescriptions. But his/her ability to incisively help the patient narrow down his symptoms/ailment to a particular field of concern is crucial in helping the patient know when a doctor’s visit is necessary and when it can and should be omitted thus saving the system huge amounts of time and money.  Our book in Kansas was called “Take Care of Yourself” and we gave it free to every subscriber in the state. That’s not a bad idea still, but many people get flustered in an emergency and Rajjpuut feels that a qualified interventionist like the NHF can be very helpful.

NEXT TIME: health education, check ups and prevention

Ya’all live long, strong and ornery,

Bob

            “We must stop fouling our own nest!” A great point, clearly, which is part of the “warm and fuzzy” feeling many folks associate with environmentalism. The environmental movement is accepted by many, if not most folks, as a positive thing sort of like the “global sanitation department” which Ayn Rand referred to in her book “The Return of the Primitive.”  Of course the “great” environmentalists like Al Gore and Ted Kennedy have also been known to leave behind their own humongous personal carbon footprints while preaching minimalism for the rest of the planet. 

Chappaquiddick Teddy, even decided that the goals of a “green” program called “Cape Wind” to build 130 windmills and a tide generator in his own (Martha’s Vineyard) neighborhood and reduce area electricity needs by 75% was inappropriate because of “visual pollution,” “disruption of seabird habitats” and even “desecration of Indian burial sites.” When the protests of Kennedy and his plutocratic friends failed to bring about the project’s demise one wag’s wonderful headline read: “Ted Kennedy Tries Mightily, but Fails to Break “Wind!”

            Rajjpuut guesses that maintaining 40,000 square foot homes and a pristine view from one’s yacht would classify as rank hypocrisy for a “green advocate.” But it gets seamier. 

Item: A few years back a couple hundred SUV’s around the country were deliberately lit afire.  

Item: In 1998 eco-terrorists destroyed a restaurant and caused $12 million worth of damage at Vail Mountain ski resort in Colorado – something about trying to stop expansion into “lynx territory.”  

Item: several other ski areas have been hit around the nation, and a group called “Earth Liberation Front”  (ELF) has taken credit for the arson damage, etc.          

Item: After ELF set fire to 20 Hummer H2’s in 2004 at a California Dealership. Environmentalists responded to the natural outcry by calling the protesting voices: “property rights extremists.”

Item: ELF and other unnamed terrorists get credit for driving spikes in timber so that lumberjacks using chainsaws will be maimed or killed in the normal course of doing their jobs.

Item: ELF, “Earth First” and other extremist environmental “protectors including the hitherto well-respected Green Peace have been repeatedly accused of laundering money for eco-terrorist purposes. In any case, all three groups have praised the “activists” daring attacks in the five items mentioned above.

So what exactly motivates an environmental terrorist?  Whether it’s the lynx, the snail darter (a fish), the spotted owl,  the black-footed ferret, Preble’s Mouse, the northern pocket gopher, maintaining unblocked rivers, wide expanses of forests, or clearing the air of carbon dioxide: the environmental extremist values animal lives, plant lives, wilderness, clean water and clean air above human life, human property or human decency. To the environmentalist judge, jury and executioner no action is too extreme to be unjustified for their “pure ends.”

It took one of the great writers of our time, Michael Crichton, (most famous for his novels of technology-gone-amuck such as “The Andromeda Strain,” “Jurassic Park” “Timeline” and other techno-thrillers) to truly captured the fanatic devotion to nature and absolute hatred for mankind of the eco-terrorist in his great novel “State of Fear.” Rajjpuut recommends it highly. 

The novel reflects the science found in the Nobel Prize winning IPCC report (but not the pseudo-science of Al Gore) as well as the profound depth of up-to-date climatological knowledge shown in the History Channel DVD “Little Ice Age, Big Chill” as well as a real understanding and empathy for the environmentalist mindset. Mr. Crichton researches his subject like no other American author. Just like Mary Shelley’s “Frankenstein” (not the Hollywood corruptions) it’s actually pretty easy to feel empathetic for the dastardly villains of Crichton’s book. But while Crichton’s novel captures the conflict of ideas in its most exciting form, the Obama Congress is ready to pass “ACESA” (American Clean Energy and Security Act) which is in effect an energy tax footed by every man, woman and child in the nation.

While the hidden tax of inflation and the probable environmental taxpayer rape called ACESA are the two most immediate threats to American property rights no alert American should overlook the growing danger of eco-terrorists.   The potential evil from fanatics willing to risk human life and property for the benefit of a mouse or fish is not to be underestimated.

Live long, strong and ornery,

Bob

The Rajjpuut Health Care Plan: Part I

Before dismissing Obama’s plan, let’s simplify things and in our description of his offering . . . say merely, it’s A. Unfair in that it will cost future taxpayers and young taxpayers today markedly more than it does the already aged; and it will eliminate the health care insurance industry as we know it B. Encourages health care dependency (rather than personal health responsibility) which will lead to out of control costs further hurting future taxpayers and today’s younger ones C. Dishonest: claiming to be an adjunct to the present system rather than driving it out of business D. Does nothing to control future costs by requiring the pharmaceutical industry to be honest and to attack disease rather than temporarily alleviating symptoms E. Does not address deficiencies in the AMA and the FDA which have brought us to the point F. Does not address prevention.

Before presenting my own plan, the natural question that needs asking is what qualifies me to present a better national health care insurance plan than Mr. Obama has created. In a word: everything. To wit: I am an expert, Mr. Obama is merely charismatic. Let me explain:

A.  

B.  

Obama:  F+ Rajjpuut:  A.

Having proven the president eminently UNqualified and myself the right (pun intended) man for the job, let's look first of all at some of the necessary questions to be considered before getting down to “brass tacks”: 

Q: Who should NOT be covered by a national health care insurance system? A: Those who are NOT American citizens. That means foreigners, people on visas, with green cards, and illegal immigrants are not covered regardless of the nature of their medical needs. They are allowed in only after posting a $500,000 bond for coverage of medical emergencies while in the country. AMEN

Q: Should we scrap the present private system of health care insurance? A: No, but since the backing for the system comes from the government, there’s NO need for a huge reserve (typically 150% of the amount covered by medical treatments and medicines), so perhaps 25% reserve will suffice. I leave that decision to accountants and cost-analyzers. 

Q: What are the main problems with the present system?  Where do major problems lie?  The problems are associated with but NOT limited to . . .

A. No real emphasis on prevention 

B. No real emphasis on personal responsibility for one’s own health  

E. Pharmaceutical companies who earn great profits mistreating people (see cholesterol “LIE” and acid reflux disease below) and for treating people with dangerous drugs (you are ten times more likely to enter a hospital because of a negative drug reaction than you are from an auto accident) and for conning people into becoming “life-time subscribers of expensive drugs that mask or alleviate their symptoms but which will NOT cure them of anything – said drugs, bringing with them a whole slew of unnecessary and dangerous side effects.

F. The FDA is another agency which is causing more harm than good . . . the FDA which has not kept our food processing methodology free of salmonella, e. coli, etc.; the FDA which now allows drug companies to control how long the approval testing process takes by collecting legal “bribes” from them; the FDA whose employee rolls are dominated by castoffs from the very companies it monitors; the FDA which despite the experiences of Captain Cook with Scurvy and the Nobel Prize awarded to Linus Pauling and the recent Nobel-winning work of Louis J. Ignarro had the temerity to issue a statement that “no supplement of any sort has ever been proven effective in fighting any disease” and which has made life for vitamin and nutrient entrepreneurs in America quite miserable.  

Just a bit over a century ago Upton Sinclair wrote his monumental expose, “The Jungle.” The Jungle was nominally a novel, but really just an intriguing catalog and description of the corruptions and horrific willful sanitation atrocities found in the American meat-packing industry in 1906. The FDA was created in 1906 and performed wonders in cleaning up this disgraceful situation. Somewhere along the way the FDA badly lost its way.

G. About that same time, a recently incorporated group (1897), the AMA, was in the forefront of confronting quackery in medical treatment and fraudulent patent medicines. However, today’s AMA is an organization more interested in doctor’s having boats and second and third homes than it is in providing the best medicine for patients and in keeping patients out of the doctors’ offices and hospitals and hospital emergency rooms. The gravest failing of the doctors themselves is their being seemingly “in bed with” the pharmaceutical industry and more interested in prescribing life-long drug subscriptions than in actually preventing or curing anything. 

The AMA somewhere along the way stopped being concerned with the good of patients and became obsessed with the political power within its hands. Today the AMA is the ongoing Spanish Inquisition of the 20th and 21st Century. They define orthodox medicine and they define heresy. They willfully ignore any research that contradicts current AMA edicts, for example virtually anything coming from Japan and Europe. They perpetually side with the most invasive, most expensive and least effective medical procedures and the most expensive drugs with the most side-effects. For example, the AMA has been backing cholesterol reduction as the be-all, end-all for heart attack prevention for over 40 years even though less than 47% of the people who die from heart attacks have high cholesterol. 47%!!!! That's not "cause and effect," that's less than a coin-flip. But they, in league with our unaccountable pharmaceutical companies, have pushed these dangerous concoctions despite knowledge that a "high-cholesterol/heart attack link is a MYTH pure and simple. As a young health educator I knew these things back in 1976 and so did the AMA. When it comes to prevention, however, the AMA as it is run today, is a criminal organization.

robertringer.com/status-quo.html

The AMA created a list of about 60 diseases which they say are caused by problems with the body's immune systems and called them all "auto-immune diseases" which means they are all in a practical sense considered incurable by American doctors. Again we set up the patient to A. not be cured B. told he/she must subscribe to a lifetime regimen with very dangerous and expensive drugs. The most well known of these include Crohn’s Disease, Lupus, Multiple Sclerosis, Rheumatoid Arthritis, AIDS and Diabetes Mellitus type I. European medical practice is not nearly so strong on calling any disease “incurable” or even “auto-immune” in origin, for that matter. The amount of money thrown away on patient “lifetime subscriptions” to questionable medicines that will NOT cure them but only enrich doctors and drug companies every day is staggering. And remember, these are “lifetime” subscriptions.

Medicine is a science, or should be, with a bit of art thrown in. The AMA, however, much like the Church in condemning Galileo, believes its authority is the final say. The scientific method starts with asking the right questions and pursuing them wherever they lead, not with relying on anyone's authority, least of all a hidebound entity like the AMA. Despite efforts in Europe and here in the United States to examine these diseases more scientifically, the AMA clings to auto-immunity as the final word. Looking at MS as an example of what I mean by science and first asking the right questions:

forum.neurologychannel.com/hc-forum/multiple-sclerosis_peer-to-peer_f128/-questions-i-ran-across_

The doctors themselves have much to say about the quality of care. Their tendency to see huge amounts of patients every day (leaving them to moulder in one of the four waiting rooms) and treat symptoms willy-nilly without actually knowing what is wrong and the tendency to think in terms of disease rather than patient health and PREVENTION (as they do in Europe’s more holistic medical climate) is all very dangerous to the patient, his pocket book and to every taxpayer’s bank account. For example, harried and rushed doctors and their random administration of antibiotics (even for viruses which do NOT respond to antibiotics) and random prescribing of anti-acid reflux medicines (90% of the time problem heartburn is a result of too LITTLE stomach acid, NOT too much) -- these two acts in combination: have created an epidemic of a dangerous dysentery called c. dificile) that is often life-threatening.  So seeing fewer patients and doing a better job with each one and teaching prevention to each one:  if doctor’s have to invest their money wisely to afford a boat rather than earning it from seeing 70% too many patients, so be it. The AMA and American doctors need to wake up now. They need to immediately become part of the solution rather than acting overtly as one of the major obstacles creating the problem. And one of the best things about my plan is they will only have two choices: become excellent doctors or quit. This area and the other six are where the major problems and solutions lie . . . .

Ya’all  live long, strong and ornery,

Bob

References:

http://rajjpuutsfolly.blogtownhall.com/2009/05/24/add_35_quality_years_to_your_lifespan.thtml

http://www.robertringer.com/status-quo.html

http://www.thefreemanonline.org/featured/i-pencil/

http://jim.com/econ/chap01p1.html

http://jim.com/econ/chap02p1.html

http:www.forum.neurologychannel.com/hc-forum/multiple-sclerosis_peer-to-peer_f128/-questions-i-ran-across_