Get Wellness: TIME Magazine, prevention and 10,000 steps a day.

TIME Magazine printed an important story in its January 10, 2011 issue. Get Wellness by Francine Russo. The story points out the Medicare change that will now pay for one wellness consultation a year. For the first time, physicians can get paid for not treating disease, but for actually trying to prevent it.  And the new health reform act provides other incentives and requirements for preventive wellness programs and counseling. The US health care (actually sick care) system would be wise to accelerate this new focus on prevention and wellness to balance its concentration on medical care and disease.

My main concern about last year’s health insurance reform act focused still on the sick care system, and gave too short shrift to behavioral preventive care. As the TIME article points out, about 3/4ths of the two and a half trillion dollar “health care costs stems from chronic disease, many of which may be prevented by lifestyle choices.” Indeed, a person’s own habits of exercise, eating and living are far more important, except for emergencies or accidents, to his or her health status than the entire medical care system. Little wonder that belatedly, insurance companies and health care providers are allocating resources to helping people help themselves live lifestyles that delay and prevent common infirmities. But as the TIME piece points out, most physicians are ill-equipped, by training and by incentive, to know anything about helping people adopt these positive health behaviors. The TIME article even included a graphic indicating the health wisdom of getting in 10,000 steps per day. How often do you see something like that at the doctor’s office?

Some good changes have taken place without much medical intervention. In the last generation, the USA has made substantial progress in one of the health care behaviors of its citizens. The rate of cigarette smoking has dropped in USA. This major cause of mortality and morbidity has waned, mainly though actions and social changes such as declaring no-smoking areas. Physicians have probably helped here some by advising patients to quit. In reality, though, a cigarette smoking habit should be seen as life-threatening by a doctor and an area for major concentration. Cigarettes still kill over 400,000 Americans each year, so there is a long way to go.

In other health behaviors, the news is less good. Distressingly, the past generation has seen a huge increase in Americans (and many of those in other lands) becoming obese. This trend is predisposing millions of people towards increased illness, disability and death by Type II Diabetes and other obesity-related maladies. The medical care industries can do little to cure these behavior-related diseases. These are essentially caused by poor health habits and can be cured only by healthy lifestyles. Once a year Medicare wellness consultations may help, but really obesity is now a pediatric disease, with victims as young as two years old. Fat babies usually become fat children and fat children usually become fat adults.

Blissful brains depend on strong bodies to support them. Bliss out your brain, improve your health and extend your life by taking 10,0000 steps per day, getting aerobic activity, doing weight training and eating right. A health-promoting lifestyle is your open-source health care. It is something you choose and do yourself. Perhaps now, though, some of you can even get a little preventive help with Medicare.

Medicine Grown by Hand: Medical Cannabis as an open-source model.

In his near-future dystopian novel, World Made by Hand, James Howard Kunstler presents a bleak portrayal of a small upstate New York town a couple of decades hence. The federal government had collapsed, Washington DC was nuked and the availability of gasoline and electricity ended. Ex-motor cycle toughs run the community’s central resource, the old town dump, now the source of riches such as nails. In this new world, owning a horse makes one wealthy.

In the novel, the system no longer provides medication nor medical care. The town’s doctor is the protagonist. He faces the frustrations and tragedies of having to practice medicine with no modern supplies, tools or services. With pharmaceuticals unavailable, the good doctor grows medicinal herbs. A key medication for pain relief and succor from various ailments is one not freely available before the collapse, cannabis. Treatment with cannabis is part of open-source health care in this new world. Seeds are the open source. Such self-treatment will become an ever more important part of our own health care future.

In health care, the term open-source includes self-care, with the individual taking more responsibility for his or her health and treatment. In some cases, the person (the term patient not quite right) becomes the source of treatment. Self-care itself is part of a larger wellness model that focuses upon a preventive lifestyle, especially with sufficient exercise and mindful nutrition, as key aspects of health.

Without doubt, more open-source medication, especially with cannabis, will be part of America’s health care future. For many people, including the 45 million uninsured Americans, the current health care system does not work. It has many problems:

  • The current medical care colossus sucks up one dollar out of 5 in the American economy.
  • The American system is by far the most expensive, and offers far less care for the dollar than in other countries.
  • Much of what passes for medical care is in reality too late and inefficient. It does not do well treating the huge class of auto-immune inflammatory disorders that most afflict the health of Americans with chronic degenerative diseases.
  • Medicine is (over)used to try to stave off injury of primarily a behavioral nature. Medical technology is used to try to fix damage caused by behaviors such as cigarette smoking and sedentary lifestyle.
  • Pharmaceutical drugs are prescribed for most ailments. Mortality from these drugs alone is a major cause of death.

The choices and actions of Americans, especially regarding physical (in)activity and (over)eating behaviors underlie much of what ails us. In most of the degenerative, inflammatory diseases that bedevil modern Americans, much medical care is merely palliative, relieving just the symptoms, symptoms of behavior-caused damage. Obesity, flaccid body composition and sickly organs damaged from cigarette smoking and alcohol poisoning are examples.

Type II diabetes is essentially a self-chosen disease; walking 10,000 steps a day is a robust preventative, even cure for Type II diabetes. Personal health actions such as increasing physical exercise, if universally adopted, could abolish many of the inflammatory ails that now pass for disease.

  • To ignore these preventatives and to proceed as before with a late intervention, medical and pharmaceutical approach to life-style-based health problems is folly.
  • Just as the pre-diabetic can literally walk away from diabetes, so too our general health practices determine how healthy we really are. The 10,000 steps-a-day prescription is not just for those threatened by diabetes or obesity, but serve as a good goal for nearly everyone. Such activity is open-source self-care at its best.
  • Eating daily 5 to 9 fruits and vegetables is the core of healthy nutrition. Rich in nutrients and sparse in calories, this plant based foundation provides much fiber. High fiber helps us stay full and tune the digestive system.

Aspirin-taking is open-source self-medication. Because aspirin is a legal and available drug that provides relief for a wide variety of ailments, we are free to use it for self-medication. Aspirin is very useful, but not without some dangers, such as attacking the stomach. Like most drugs, it has a lethal dose and several hundred people die from aspirin poisoning each year. Still, its ability to reduce pain and inflammation and to provide protective cardio-vascular effects make it a key open source medication.

Another substance to relieve a wide variety of symptoms such as pain and inflammation is cannabis. Unlike aspirin, no deaths are associated with its use. Like aspirin, cannabis is medically useful not just for a small array of discrete problems. Although it does provide fairly specific prevention and therapy of maladies such as glaucoma, and works wonderfully for reducing the worse symptoms of chemotherapy, its applications are broad. It is useful in treating a dozen major diseases. Other benefits are less specific. The cannabinoids in cannabis are antioxidant, anti-inflammatory, neuroprotective and analgesic. The latter, pain relief, points to the more generalized medical benefits of cannabinoids.

Pain is one of the chief reasons people seek medical care at all. What percentage of the humankind, what single person, does not experience pain at sometime in life? To quell pain is the reason most people take an aspirin. To quell pain is the main reason tens of millions of Californians in the future may take a tincture of cannabis.

  • A century hence, and hopefully far sooner, Americans will regain the pain-relieving, self-health remedies available to their ancestors. They already have in California and a dozen other states.

In a country supposedly searching for national health care answers, the open-source, self-care benefits of medical cannabis must not be ignored. Medical cannabis will not be ignored by those without insurance, nor those increasing millions who become aware of the superiority of pain relief and other medical benefits available to them with cannabis. Bizarrely, conservatives who worry that a national health care system would deny medical choices are the first to deny totally American citizens the right to choose cannabis-based medications.

Americans will make these choices anyway, using the cannabis seed as the open-source basis for their medication. Hopefully they will have state laws in place to provide them some safety from the dangers inflicted upon them by their government, as they again produce their medicine grown by hand.

Say it ain’t so, Sanjay. Next Surgeon General down on medical cannabis.

Yet another heart breaker for drug policy reform and medical cannabis in the form of Obama’s Surgeon General. CNN reports Dr. Sanjay Gupta, CNN’s medical coorespondent has been asked by Barack Obama to be the new Surgeon General.

In many ways, Dr. Gupta is an excellent choice. Brilliant, telegenic, a neurosurgeon, huge recognition and an excellent communicator. Yet more important, and still rare for most physicians, Sanjay Gupta focuses on preventive health care, especially on health-enhancing or damaging behaviors. Morbidity and mortality in the USA are much more functions of our everyday behaviors than they are functions of the entire medical care system. How healthy you look and feel, how vital you really are depends chiefly on your daily habits of exercise, nutrition and other health related behaviors. Gupta realizes this, as evidence by his CNN series on obesity, exercise and other key health topics.

Fixing the American health care system, especially as it totters from the oncoming onslaught of Type II diabetics, will require a totally new health care vision, one based on prevention, exercise and self-care. The entire system would be revolutionized by each American walking 10,000 steps a day, a figure that appears to be a requirement for good body composition, healthy blood sugar levels, and basic vitality.  Dr. Sanjay Gupta just might be a Surgeon General who could help this come to pass. Maybe he could even help Barack quit smoking cigarettes, another of his passionate causes, and killer of 440,000 Americans each year.

This makes all the more disappointing the possible Surgeon General’s ignorant take on medical cannabis. He spelled out his unfortunate philosophy in TIME Magazine, on January 8, 2009. His article, Why I Would Vote No On Pot, discussed then up-coming medical cannabis initiatives in Colorado and Nevada (both passed).  Paradoxically, Sanjay starts out by stating recent ways cannabis has been found to be good for your, even asserting, “THC, the chemical in marijuana responsible for the high, can help slow the progress of Alzheimer’s disease. (In fact, it seems to block the formation of disease-causing plaques better than several mainstream drugs).”

Yet somehow, in spite of being a neurosurgeon touting the effectiveness of this plant substance as a neuron and brain protector, he doubles back advises readers in Colorado and Nevada to vote no, to vote away their medical choice on this issue. He talks quite a bit about the smoke as hazard, an issue of ever-decreasing importance in the age of the vaporizer. His urging of the no vote is also a vote FOR continued damage to the American citizenry by enforcement of cruel, useless laws. See Austin, Texas Attorney Jamie Spencer, who commented on his blog in 2006 at the release of the  of Gupta TIME article. Spencer notes, “Voting “No on Pot”, as Dr. Gupta calls it, means more tax dollars spent incarcerating casual marijuana users. That’s it, end of story. Neither initiative will force Dr. Gupta or anyone else to use marijuana.”

In the last 20 years, the discovery of the endocannabinoid receptor system and molecules produced in our bodies to activate these receptors represents a major step forward in our understanding of the human body and its working. Health care in the 21st Century will be revolutionized by these findings and the potential they portend for medical cannabis. Americans deserve a Surgeon General who understands and will help end the goverment’s war against a plant used as medication for millenia and against those Americans who find it of medical benefit. In the article Gupta whines talking points from US government agencies. One statistic he ignores, annual US deaths from cannabis = zero.

Dr. Gupta, after your TIME article, Coloradans and Nevadan disagreed and went ahead and voted for freedom of choice of medical cannabis as they have in nearly every state when given the opportunity. As Surgeon General, please do not scheme to take that choice away from them, and those in a dozen of other states who have voted to assert this basic personal medical freedom.