Health Insurance

Here's one for you to ponder. John Stossel has some interesting thoughts about health insurance, at Townhall.com. What he has to say runs contrary to currently popular political speech on both sides of the aisle, which bemoans the under-insured state of many Americans. Stossel suggests instead that Americans have way too much insurance, rather than too little. That's something of a counter-intuitive statement, given the discussion that's going on in political circles these days about how to get more coverage for more people, but I tend to agree with him, based upon my own experience and that of my family.

I'll give you a few examples. Several of my close relatives have to provide their own insurance, for various reasons. Being farmers. my in-laws have no employer to provide it as a perk, so they have opted for the most cost-effective option available to them. They have very high deductible insurance. They pay for routine medical out-of-pocket, and save the insurance for the big-ticket medicine, saving them money on premiums, but still ensuring that they don't lose the farm (literally) over catastrophic illness or accident. They decide for themselves what doctor to see, and how often, and whether a given medical procedure is worth their hard-earned money. They may have to plan a bit to make sure they have the money available when it comes time to go to the eye doctor, but the big stuff is covered and they're not paying through the nose for the monthly premium.

My sister's family, on the other hand, pays for HMO-type insurance (Kaiser), which supposedly covers every scratch. When they can get in, that is. This costs them a staggering amount of money monthly, and also has the disadvantage of putting their medical choices in the hands of a very inefficient bureaucracy. Not only does the HMO chose for them which medical treatment is covered, but because the system is in many ways unaccountable, important decisions get lost in the system. My sister was once diagnosed with a serious medical condition, and didn't receive proper treatment for eight years. The right hand didn't know what the left hand was doing. I grant you that this is anecdotal, but it still influences my opinion of insurer-makes-the-decisions healthcare. I can only imagine how much worse it would be if that insurer was the federal government. Can anyone say DMV?

My husband and I have a different, and much better, situation than my sister. Our insurance, although employer-provided, shares some of the better aspects of his parent's self-insurance arrangement. Ked's office went the HSA (health savings account) route a couple of years ago, and we love how the whole thing works. Instead of low-deductible, high-cost insurance, we now have high-deductible, low-cost insurance. You may be asking, "What's to love about a high deductible? Doesn't that mean you have to pay for more of your medical expenses yourself?" Well, that's where the HSA comes in. Because the insurance company doesn't have to pay for the minor and routine medical stuff, Ked's boss saves money on insurance premiums. He passes those savings on to his employees. He deposits enough money to cover that high deductible into the HSAs, which are under employee control. We pay for routine medical out of that account, and--here's the good part--we get to keep what we don't spend, like it's in a retirement account. This gives us incentive not to run to the doctor for every sniffle, while still covering us for major health issues. We and our doctor decide what to spend the money on medically, and we get a retirement savings bump if we're frugal.

Stossel's article is quite interesting. He has some convincing things to say about how much is added to the cost of medicine in America simply because the insurance industry is so intimately involved with it. He also discusses how it came about that insurance got so interconnected with routine medical care in the first place, and whether the push for government intervention is a good idea. (Interestingly enough, he makes the case that government is responsible for the current state of affairs in the first place.) You may agree with his conclusions; you may not, but have a look.

Edicts From The Health Police

Oh my goodness, do I agree with John Stossel!!

Green Leafy Vegetables And Other Dangerous Foods

It looks like November is food safety month here at the Meow. Last week, after regaling you with tales of the family poultry farm where my husband learned the fine art of chicken catching as a boy (I didn't tell you that he knows how to hypnotize chickens--honestly, he does), I sent you to an article about the Kentucky Colonel's favorite bird and the diseases that roost in poultry, slipping past government inspectors on the way to your kitchen. Disease, you see, cannot always be detected via visual inspection, and many of the birds that grace your dinner table could make you sick if you don't make sure they are thoroughly cooked. You just can't tell by looking at a chicken what microorganisms have found a home there. One of the ways the article's author, John Stossel, proposed we address the problem of poultry contamination is irradiation, designed to kill even the bacteria that escapes detection, before the bird gets packed off to the supermarket. Stossel explains that for a variety of reasons, irradiation isn't common. Important safety changes are slow in coming to this industry, so chicken really needs to be cooked to death, after it has been butchered, for safety's sake. Let's put chicken on the scary but tasty list for now.

Joining chicken these days in warranting "Caution: Severe Potential Body Damage" warnings is spinach. We're just starting to be able to find Popeye's secret weapon in the stores again after an E. coli outbreak, which started a couple of months ago, was traced to fresh bagged spinach, which infected about two hundred people, causing three deaths. Revealing my own ignorance here, I've always thought of E. coli as a meat-borne illness, undercooked burgers and all that. I really didn't know you could get it from the plant kingdom, but I sure do now. Spinach salad is a staple in Meowville, and we've been particularly aware of the unavailability of this extremely important member of the food chain. Until this week, our green leafy vegetable of choice was nowhere to be found. That made us sit up and take notice.

We are glad to have our favorite back, but I'm not ready to just return to my pre-spinach-drought state of ignorance. I have wanted to know how the infection got to the plants in the first place, how it spread, and why all the washing, that is the primary reason for buying bagged spinach, didn't do its job and cleanse away the germs. Some answers are coming out now; it's starting to look like the infection invaded spinach crops in California because wild hogs found their way onto farms in Salinas Valley. Okay, that answers how the plants got "defiled." (It's the best word I can think of to describe the ruination of perfectly good spinach.) So, how did the E. coli make it past the packaging plant?

Dr. Henry I. Miller, of TCS Daily, says that washing sometimes simply can't do the job of ridding produce of disease, because the germs aren't on the surface of the produce, they're inside it. Miller says, "Exposure to E. coli or other microorganisms at key stages of the growing process may allow them to be taken into the plant and actually incorporated into cells." Even the irradiation, which Stossel recommends for meat, and Miller agrees is an important tool, can't deal with all the complications from infection, because some bacteria secrete toxins which remain even after irradiation has eliminated the germs themselves. These toxins can make you sick no matter how dead their germy progenitors are. What's Miller's solution? Biotechnology.

I've often discussed Miller's TCS articles here, and frequently the focus of his writing has been the ever-expanding and much-debated field of biotechnology, or gene-splicing, as it is more descriptively labelled. Repeatedly he has come down on the side of the safety and efficacy of gene-splicing to introduce desirable traits into plants. He's explored the concept of biopharming, altering plants so that you can, in effect, grow drugs to meet pharmaceutical needs. It's basically programming plants. (If you want to find more post and links to Dr. Miller and biopharming, just do a search at the top of this page. Blogger will list for you the four or five other posts I've done on Dr. Miller's articles.) Miller describes the benefit to be found in addressing the problem of infected food with biotech, but, as usual, also acknowledges the objections that inevitably go hand in hand with such an approach:

There is technology available today that can inhibit microorganisms' ability to grow within plant cells and block the synthesis of the bacterial toxins. This same technology can be employed to produce antibodies that can be administered to infected patients to neutralize the toxins, and can even be used to produce therapeutic proteins that are safe and effective treatments for diarrhea, the primary symptom of food poisoning.

But don't expect your favorite organic producer to embrace this triple-threat technology, even if it would keep his customers from getting sick. Why? The technology in question is biotechnology, or gene-splicing -- an advance the organic lobby has vilified and rejected at every turn.

Read Dr. Miller's article for more about this current spinach situation and its implications, and more of the posts here if you want to follow up further on what he has to say about gene-splicing. He comes down very firmly on the side of pro-biotech, but does address in some detail the issues and problems that others raise with ongoing development in this burgeoning industry. He's gradually been winning me over to the idea that manipulating genes to introduce desirable outcomes can be safe and effective, if proper care is given to how the technology is used, and a firm set of precautions is in place. I wasn't always this sanguine about it, thinking, basically, that God knew what He was doing when He made things, and who are we to mess with them, but I've really come, over time, to see these genes they are manipulating as God-made building blocks, that get shifted around all the time in nature. Shifting them is not inherently dangerous or wrong, but it does require a great deal of wisdom to know what's appropriate and what's not. It's interesting to me watching where the science is heading. I still say they need to keep their hands off people, but making spinach safer so I don't ever have to face another spinach fast? I think there I'm cautiously in favor of ongoing research.

Looks Could Kill

My husband grew up on a chicken farm. His family raised 120,000 chickens every two months, in six big barns. That's a lot of chickens. Of course, there are lots of people who eat chickens, so the more the family raised, the better for everyone. At the end of every grow, trucks would come in the night, and the 10 or so professional chicken catchers per barn (yes, there are professional chicken catchers) would work through the night, picking up every one of the birds by hand to be sent off to the processing plant. A good catcher would carry 7 birds at a time. Ked, in his day, was a good catcher.

The family, though, never had anything to do with what happened to the birds after they left the farm. They raised them, sent them off, and then cleaned up the barns for the next batch of chicks. End of story. Of course, it's not really the end of the story. The birds would go on to processing plants, where they were killed, plucked, and all the rest of the things that most of us carnivores don't tend to dwell on for the sake of enjoying our dinner. (In our early-married and extremely poor days we had to butcher a few chickens for ourselves, but that's another story altogether.) Most of us are quite satisfied to leave the "processing" to others and pay for the privilege at the grocery store. We get pre-cleaned dinner meat. The company who processed them for us gets money. Free enterprise, in this case, makes us all happy (with the noted exception of PETA.)

Where chickens are involved, there are, of course, always concerns about the safety of the meat. Disease germs, for some inexplicable reason, are particularly fond of chickens. Here are some of the nice names from an article I read: yersinia, salmonella, listeria, campylobacter--don't they all sound wholesome and nutritious? Actually, these little trespassers could kill you. We've all read the warnings that chicken absolutely, positively has to be fully cooked. No exceptions. No chicken tartar. Never. Not even a little tiny bit of pink in the flesh. Just say no to raw chicken. We are also warned to wash every surface we even thought about bringing near said chicken. Every surface. No exceptions. Just to be on the safe side, you should wash the wrapper in which the raw chicken entered your home in the dishwasher, before you throw it in the trash, so the garbage won't be contaminated. Then, wash the dishwasher...and maybe the car you drove when you went shopping. You just can't be too careful.

The interesting thing about all the warnings is that they come despite the tax dollars we all pay to have government employees inspect these chickens for safety. Why is that? Well, the man whose article gave me the lovely compilation of bacterial interlopers I listed earlier, John Stossel, formerly of "20/20", writing at Townhall. com, says it's because the government generally evaluates the chickens by how they look, rather than whether they pass a microbial exam. Huh? We've known about germs for a long time guys, so what's with the visual inspection? According to Stossel, this system was put in place before the government knew any better, but why is it still the way things work, now that we have a bit of science to back up the notion that a pretty bird can be just as dangerous as an ugly one? Stossel says it's a combination of chicken industry interests, government inertia, and unions. Wow, all three of these players working in tandem? How does that work? Read Stossel's article and see for yourself.