What Would Individual Health Insurance Cost if the Court Strikes the Mandate Down and Still Requires Insurers to Cover Everyone?

With the Supreme Court justices sounding like they might strike the mandate down, this is a question I've been getting a lot lately.I have pointed to New Jersey as a real life example of what can happen when insurance reforms take place but there is no incentive for consumers to buy it until the day they need it.In 1992, New Jersey passed health insurance reform that required insurance carriers

If the Supreme Court Overturns the Individual Mandate

First, trying to predict how the Court will rule is at best just speculation. I know what Justice Kennedy said both today and yesterday and it certainly doesn’t look good for the Obama administration and upholding at least the mandate.But I will remind everyone, based upon oral arguments, most Court watchers expected a ruling in favor of the biotech industry on a recent case involving health care

Onward

In upcoming posts, I plan to pursue two main themes.  The first is a more comprehensive exploration of what determines eating behavior in humans, the neurobiology behind it, and the real world implications of this research.  The reward and palatability value of food are major factors, but there are others, and I've spent enough time focusing on them for the time being.  Also, the discussions revolving around food reward seem to be devolving into something that resembles team sports, and I've had my fill.

The second topic I'm going to touch on is human evolutionary history, including amazing recent insights from the field of human genetics.  These findings have implications for the nutrition and health of modern humans. 

I look forward to exploring these topics, and others, with all of you in the coming months.

Recent Media Appearances

Men's Health interviewed and quoted me in an article titled "Reprogram Your Metabolism", written by Lou Schuler.  Part of the article was related to the food reward concept.  I'm glad to see the idea gradually reaching the mainstream. 

Boing Boing recently covered an article by Dr. Hisham Ziauddeen and colleagues in Nature Reviews Neuroscience that questioned the idea that common obesity represents food addiction-- an idea that I often encounter in my reading.  Maggie Koerth-Baker asked me if I wanted to respond.  I sent her a response explaining that I agree with the authors' conclusions and I also doubt obesity is food addiction per se, as I have explained in the past, although a subset of obese people can be addicted to food.  I explained that the conclusions of the paper are consistent with the idea that food reward influences fat mass.  You can find my explanation here.

Food Reward: Approaching a Scientific Consensus

Review papers provide a bird's-eye view of a field from the perspective of experts.  Recent review papers show that many obesity researchers are converging on a model for the development of obesity that includes excessive food reward*, in addition to other factors such as physical inactivity, behavioral traits, and alterations in the function of the hypothalamus (a key brain region for the regulation of body fatness).  Take for example the four new review papers I posted recently by obesity and reward researchers:
Read more »

Speaking at AHS12

I'll be giving a 40 minute presentation at the Ancestral Health Symposium this summer titled "Digestive Health, Inflammation and the Metabolic Syndrome".  Here's the abstract:

The “metabolic syndrome” is a cluster of health problems including abdominal obesity, insulin resistance, low-grade inflammation, high blood pressure and blood lipid abnormalities that currently affects one third of American adults.  It is the quintessential modern metabolic disorder and a major risk factor for diabetes, heart disease and certain cancers.  This talk will explore emerging links between diet, gut flora, digestive health and the development of the metabolic syndrome.  The audience will learn about factors that may help maintain digestive and metabolic health for themselves and the next generation.

Excessive fat mass is an important contributor to the metabolic syndrome, but at the same level of body fatness, some people are metabolically normal while others are extremely impaired.  Even among obese people, most of whom have the metabolic syndrome, about 20 percent are metabolically normal, with normal fasting insulin and insulin sensitivity, normal blood pressure, normal circulating inflammatory markers, and normal blood lipids.

What determines this?  Emerging research suggests that one factor is digestive health, including the bacterial ecosystem inside each person's digestive tract, and the integrity of the gut barrier.  I'll review some of this research in my talk, and leave the audience with actionable information for maintaining gastrointestinal and metabolic health.  Most of this information will not have been covered on this blog.

The Ancestral Health Symposium will be from August 9-12 at Harvard Law School in Boston, presented in conjunction with the Harvard Food Law society.  Tickets are currently available-- get them before they sell out!  Last year, they went fast.

See you there!

Qsymia (formerly Qnexa), the Latest Obesity Drug

There are very few obesity drugs currently approved for use in the US-- not because effective drugs don't exist, but because the FDA has judged that the side effects of existing drugs are unacceptable. 

Although ultimately I believe the most satisfying resolution to the obesity epidemic will not come from drugs, drugs offer us a window into the biological processes that underlie obesity and fat loss.  Along those lines, here's a quote from a review paper on obesity drugs that I think is particularly enlightening (1):
Read more »

Healthcare Systems and Their Structure

Constantly under review and scrutiny, the issues on healthcare Systems have become international. Made up mainly of organizations and individuals, these healthcare structural systems are designed to meet a target population's need for health care. On an international level, there is a diverse variety of health care systems. In some countries the planning of the health care systems are market driven and participated in by the private sector. In other countries the systems are composed of government and non-government entities such as religious groups, trade unions charities and or other coordinative bodies that are centrally run and planned, to enable the delivery of healthcare services to the populations they target. In other words, health care planning has evolved. According to a World Health Organization report in 2000, the main goals of health systems are the ability to provide a responsive health service alongside considerations of fair financial contributions. In order to appraise overall health care systems, a proposed two-dimensional approach was conceived. The first dimension consists of equity and the second is composed of efficiency, quality and acceptability. Several proposals have come from the Senate in the United States and the White House. Health care system issues according to President Obama are issues that should be addressed immediately and placed them on a top priority list. A universal health care system does not exist or is practiced in the United States. Some countries subsidize their universal healthcare directly from government coffers. This kind of universal healthcare is called socialized medicine, which is a combination of private and public delivery systems, with most countries spending public funds for this service delivery. Government taxes plays the role of funding this system supplemented and strengthened with private payments. The World Health Organization (WHO) report of 2000 ranks each member country's health care system. Discussions on the positive and negative aspects of replacing health care systems with insurance systems use this report's quotation. However, the WHO has remarked that as ranking healthcare systems is a complex task, these ranking tables will no longer be produced. Infant mortality and life expectancy are two main variables that are used in the ranking. Out of 198 countries, Canada ranks thirtieth and the US ranks thirty seventh. The World Health Organization ranks France, San Marino, Italy, Andorra, Singapore, Malta, Spain, Austria, Oman and Japan as the world's top ten. With the founding of the UN (United Nations), there was planning and discussion on the need for a single entity to serve, observe and assess global health care system trends. Thus the World Health Organization was formed in 1948 on April 7th with headquarters based in Geneva, Switzerland. Annually the WHO is recognized by the celebration of a World Health Day. The WHO is the coordinative and directive authority for United Nations' member countries individual health systems. Member countries of the United Nations are allowed WHO membership through the acceptance of the WHO constitution. To date there are a total of 198 member nations participating in WHO programs.

Boing!

I just had a featured article published on Boing Boing, "Seduced by Food: Obesity and the Human Brain".  Boing Boing is the most popular blog on the Internet, with over 5 million unique visitors per month, and it's also one of my favorite haunts, so it was really exciting for me to be invited to submit an article.  For comparison, Whole Health Source had about 72,000 unique visitors last month (200,000+ hits).

The article is a concise review of the food reward concept, and how it relates to the current obesity epidemic.  Concise compared to all the writing I've done on this blog, anyway.  I put a lot of work into making the article cohesive and understandable for a somewhat general audience, and I think it's much more effective at explaining the concept than the scattered blog posts I've published here.  I hope it will clear up some of the confusion about food reward.  I don't know what's up with the image they decided to use at the top. 

Many thanks to Mark Frauenfelder, Maggie Koerth-Baker, and Rob Beschizza for the opportunity to publish on Boing Boing, as well as their comments on the draft versions!

For those who have arrived at Whole Health Source for the first time via Boing Boing, welcome!   Have a look around.  The "labels" menu on the sidebar is a good place to start-- you can browse by topic.

Will the Pace of Innovative Change Overtake the Financial Imperative to Slash Spending?

I thought it was worth passing along the comments by Jim Tallon, president of New York's United Hospital Fund, in a recent post.Tallon reflected on an international meeting he attended with health care leaders from a number of industrial nations--"nations whose health care systems, indeed underlying philosophies, ranged from market orientation through hybrids to government authority:" "Across

Chronic Headache Migraine - Preventative Ways to Keep Them From Happening

Chronic headache migraine is just no fun at all. If you suffer from migraines, there is bad news and good news. The bad news is that there is no cure for migraines. Despite what you may have seen on TV or heard on some radio infomercial, migraines just cannot be cured. The good news is that in some cases you can head them off (preventative treatments) or at least modify their severity (abortive treatments). Foods that can trigger migraines The first form of preventative treatment is to cut out foods that can trigger headaches such as those that contain tyramines, nitrites or monosodium glutamate. In fact, one fourth of headache sufferers say that certain foods trigger their head pain. This is because many foods contain substances that can provoke the release of the neurotransmitters implicated in causing headaches. Food with tyramines Headaches can be triggered by foods containing the substance tyramine, which is a member of the amines group of organic chemical compounds. As such, it may influence the release of the neurotransmitter serotonin - which, in turn, can trigger a headache. Common foods that contain tyramine include: Chocolate Aged cheese Vinegar (relish, salad dressings, sauces, catsup) Organ meats (kidney liver) Alcohol (especially red wine) Sour Cream Soy sauce Yogurt Yeast extracts Food with nitrites Headaches can also be triggered by foods containing nitrates as preservatives. It is estimated that in the United States there are 12,000,000,000 pounds of nitrite currently used to give meats a pink color and enhance their taste. Foods containing nitrite include: Smoked fish Corned beef Bologna Pastrami Pepperoni Canned ham That old devil, monosodium glutamate Monosodium glutamate (commonly called MSG) may also cause headache pain. It is a flavor enhancer that is often sold under the trade name Accent. An estimated 20,000 tons of monosodium glutamate are used yearly to add flavoring to foods. Preventative medications NSAIDs. NSAIDS are most often used in preventative treatment of those who suffer from chronic migraine. Typical nonsteroidal anti-inflammatory drugs or NSAIDs such as ibuprofen (Advil, Motrin and others) or aspirin can help relieve mild migraines. There are also drugs in this family marketed specifically for migraine headaches. These are typically a combination of acetaminophen, aspirin and caffeine. One example of a combination drug sold over-the-counter is Excedrin Migraine. Prescription medications The Food and Drug Administration have approved a number of prescription drugs for use in preventing migraines. This includes cardiovascular drugs, antidepressants and alpha blockers. The most popular of the cardiovascular drugs used to prevent migraine headaches are Inderal, Depakote and Sansert. Some migraine sufferers have also found they can prevent the onset of headaches with calcium channel blockers such a Verapamil, Wellbutrin and Nimotop. Tricyclic antidepressants Tricyclic antidepressants (TCAs) do have an anti-migraine effect, but are not usually considered to be the first choice in preventing migraines. However, they may be of help to some migraine sufferers, especially those who have both migraine and tension-type headaches. The antidepressants used most often in the treatment of migraines are Elavil, Sinequan, Vivactil. Norpramin and such SSRIs (Serotonin Update Inhibitors) as Prozak, Xoloft and Paxil. Clonidine is an alpha blocker whose efficiency in migraine prevention is not as good as that of the beta blockers. A second alpha blocker that has been used successfully in treatment of childhood migraines is Cyproheptadine.

Tweet

I've decided, on the sage advice of a WHS reader, to join the world of Twitter.  I'll be using it to announce new posts, as well as communicating papers that I find interesting, but either don't have time to blog about or think are too technical for a general audience.  My tag is "whsource".  Head on over to Twitter if you want to follow my tweets.