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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?


To: Lane3 who wrote (10384)10/13/2009 6:55:43 AM
From: Lane34 Recommendations  Read Replies (1) | Respond to of 42652
 
Having just seen an example of stupid insurance company tricks followed by, here's an example of stupid local government tricks. Ergo, it follows, we should overreact and totally upend and reinvent the Los Angeles city government over this...

Los Angeles Fast-Food Ban: A Load of Bologna
Posted by Tom Naughton in Bad Science, The Food Evangelists

A year ago, the Los Angeles City Council decided it must do something about the high rate of obesity in South Los Angeles, an impoverished neighborhood that was previously called South Central. (After the area developed a bad reputation for gangs and violence and riots, the city chose the obvious solution: rename it.) So the council passed legislation that bans opening or expanding fast-food restaurants in the area.

Of course, they couldn’t use the term fast food. That’s the kind of clear, simple language that lawyers and politicians can’t grasp. (Most politicians are lawyers, by the way, so go figure.) To make the ban sound all high-falutin’ and legalistic and important, they banned restaurants characterized by “excessive signage, little or no landscaping, large expanses of surface parking, drive-through windows, multiple driveways, parking lots fronting the street,” etc., etc., blah-blah-blah.

Genius. The ban hasn’t done diddly, of course — and won’t — but it did serve one important purpose: it satisfied the congenital need of politicians to do something! whenever they see a problem. As the old saying goes, when you’re holding a hammer, everything looks like a nail.

Before getting into the economic and nutritional stupidity of this ban, I’m going to risk receiving some hate mail by actually acknowledging the elephant in the room: racism. South Los Angeles is populated almost exclusively by African-Americans and Hispanics. Telling them they can’t have any more fast-food restaurants in their neighborhoods is paternalistic and insulting. It’s rooted in the notion that they can’t make smart decisions for themselves, and therefore need a government nanny to hide the cookie jar.

Insult aside, fast food clearly isn’t the problem. As a recent study by the non-profit Rand Corporation pointed out, fast-food restaurants are no more prevalent in South Los Angeles than in other areas of the city. In fact, there are actually fewer of them:

Researchers found there were about 19 fast-food chain restaurants per 100,000 residents in South Los Angeles, while there were 29 per 100,000 people in affluent West Los Angeles and 30 per 100,000 residents for all of Los Angeles County. There are significantly fewer restaurants of any type per person in South Los Angeles compared to Los Angeles County overall, according to the study.

Wait … you mean restaurants don’t flock to areas where people have little disposable income? Well, I am shocked.

If you don’t know Los Angeles, the west side is wealthy and mostly white. It’s where a lot of people making show-biz money live. Beverly Hills and Century City — an area dense with luxury high-rises and corporate offices — are both on the west side. Frankly, I’m surprised the concentration of fast-food restaurants is so high there, but apparently it is.

Strangely, the city council doesn’t consider all those fast-food establishments a threat to the health of affluent white people. They don’t worry that people driving home from posh jobs in Century City will be drawn, zombie-like, to detour through the golden arches and order french fries and milkshakes.

But when the city council sees a high rate of obesity on the south side, they decide the poor darlings just can’t help themselves and must be delivered from the temptation of fast food. Take away their Big Macs, and they’ll immediately decide they like grilled salmon with a side of broccoli.

Now, on to the economic stupidity: One of the stated goals of the ban was to encourage more sit-down restaurants to move into South Los Angeles. I’m always amazed, and more than a little appalled, when small groups of politicians get together and decide they know more about a particular industry than the people who actually work in that industry do. (But enough about the GM bailout.)

If there were a market for more sit-down restaurants in South Los Angeles, the sit-down restaurants would already be there. They aren’t sitting on the sidelines, champing at the bit, just waiting for the Los Angeles City council to create an opening for them by forbidding McDonald’s from opening another franchise. If they aren’t locating in South Los Angeles, it’s because their market research has concluded it’s not a good idea.

Finally, the nutritional stupidity: You could replace every fast-food joint in Los Angeles with a sit-down restaurant, and it wouldn’t make a dent in the rate of obesity. As I discovered while researching Fat Head, people actually eat bigger meals in sit-down restaurants than they do at fast-food restaurants. Can you say “Bloomin’ Onion”? Order one of those, split it three ways, and you’ve already consumed 800 calories and 80 carbohydrates … then your dinner arrives. The steakhouse I frequented in Burbank offers a free cookie after dinner that contains more calories and carbohydrates than a Quarter Pounder and a large order of fries.

Okay then, perhaps the city council should forbid restaurants from locating in poor neighborhoods altogether, right? Wrong. As the Rand study pointed out, people in South Los Angeles don’t eat in restaurants any more often than their leaner counterparts in more affluent areas. But they buy a disproportionate share of their food and drinks at small stores … in other words, convenience stores that sell mostly sugar and starch.

Aha! That’s it, then. The city council should outlaw min-marts and make those poor people buy all their food in real grocery stores! Wrong again. People don’t buy sugar and starch because that’s what they find in mini-marts; they go to mini-marts because that’s where they can easily find sugar and starch.

People who like sugar and starch buy sugar and starch, no matter where they shop. I’ve lived in a handful of cities, I’ve traveled all over the country, and I’ve seen countless people buying food with food stamps. Their grocery carts were almost always full of noodles, chips, cereals, bread, potatoes, sodas, and sugar-laden snacks. Those are the cheapest foods.

You can eat sugar and starch in your car, in your kitchen, in a restaurant, standing up, sitting down, lying on your side, doing cartwheels, or while reciting the Declaration of Independence, and it isn’t going to make any difference. They’re fattening foods. Banning one source of them isn’t going to change anything.

Fast-food restaurants are convenient target, but shooting at the wrong target doesn’t get the job done. Banning McDonald’s and other fast-food joints from poor neighborhoods won’t make poor people any leaner. But it will create another tribute to the economic stupidity of legislators … namely, it will deprive a lot of unskilled but work-minded teenagers of their first job opportunities, with at least the possibility of moving into management someday.

Are they better off living on food stamps? I don’t think so.

fathead-movie.com



To: Lane3 who wrote (10384)10/13/2009 11:31:41 AM
From: John Koligman2 Recommendations  Read Replies (4) | Respond to of 42652
 
Yes, some of us DO get upset over crap like that, and with GOOD reason. I think we have more than a few 'anomalies' to fix...

Harvard study finds nearly 45,000 excess deaths annually linked to lack of health coverage

Lack of health insurance now more lethal
FOR IMMEDIATE RELEASE
Sept. 17, 2009

Contacts:
Steffie Woolhandler, M.D., M.P.H.
David Himmelstein, M.D.
Andrew P. Wilper, M.D., M.P.H.
Mark Almberg, Physicians for a National Health Program, (312) 782-6006, mark@pnhp.org
David Lerner or Karmen Ross, Riptide Communications, (212) 260-5000

A study published online today estimates nearly 45,000 annual deaths are associated with lack of health insurance. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.

The new study, “Health Insurance and Mortality in U.S. Adults,” appears in today’s online edition of the American Journal of Public Health.

The Harvard-based researchers found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.

Lead author Dr. Andrew Wilper, who worked at Harvard Medical School when the study was done and who now teaches at the University of Washington Medical School, said, “The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors and baseline health. We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease — but only if patients can get into our offices and afford their medications.”

The study, which analyzed data from national surveys carried out by the Centers for Disease Control and Prevention (CDC), assessed death rates after taking education, income and many other factors including smoking, drinking and obesity into account. It estimated that lack of health insurance causes 44,789 excess deaths annually.

Previous estimates from the IOM and others had put that figure near 18,000. The methods used in the current study were similar to those employed by the IOM in 2002, which in turn were based on a pioneering 1993 study of health insurance and mortality.

Deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease.

An increase in the number of uninsured and an eroding medical safety net for the disadvantaged likely explain the substantial increase in the number of deaths associated with lack of insurance. The uninsured are more likely to go without needed care.

Another factor contributing to the widening gap in the risk of death between those who have insurance and those who don’t is the improved quality of care for those who can get it.

The research, carried out at the Cambridge Health Alliance and Harvard Medical School, analyzed U.S. adults under age 65 who participated in the annual National Health and Nutrition Examination Surveys (NHANES) between 1986 and 1994. Respondents first answered detailed questions about their socioeconomic status and health and were then examined by physicians. The CDC tracked study participants to see who died by 2000.

The study found a 40 percent increased risk of death among the uninsured. As expected, death rates were also higher for males (37 percent increase), current or former smokers (102 percent and 42 percent increases), people who said that their health was fair or poor (126 percent increase), and those that examining physicians said were in fair or poor health (222 percent increase).

Dr. Steffie Woolhandler, study co-author, professor of medicine at Harvard and a primary care physician in Cambridge, Mass., noted: “Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives.”

She added: “Even the most liberal version of the House bill would have left 17 million uninsured, according to the Congressional Budget Office. The whittled down Senate bill will be worse — leaving tens of millions uninsured, and tens of thousands dying because of lack of care. Without the administrative savings only attainable through a Medicare-for-all, single-payer reform — real universal coverage will remain unaffordable. Politicians are protecting insurance industry profits by sacrificing American lives.”

Dr. David Himmelstein, study co-author and an associate professor of medicine at Harvard, remarked, “The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance. Even this grim figure is an underestimate — now one dies every 12 minutes.”

“Health Insurance and Mortality in U.S. Adults,” Andrew P. Wilper, M.D., M.P.H., Steffie Woolhandler, M.D., M.P.H., Karen E. Lasser, M.D., M.P.H., Danny McCormick, M.D., M.P.H., David H. Bor, M.D., and David U. Himmelstein, M.D. American Journal of Public Health, Sept. 17, 2009 (online); print edition Vol. 99, Issue 12, December 2009.

A copy of the study, along with a state-by-state breakout of excess deaths from lack of insurance, is available at pnhp.org

Physicians for a National Health Program (www.pnhp.org) is a research and educational organization of 17,000 doctors who support single-payer national health insurance. To speak with a physician/spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.