Wednesday, August 26, 2015

How Government Killed the Medical Profession

This article appeared in the May 2013 Issue of Reason.


I am a general surgeon with more than three decades in private clinical practice. And I am fed up. Since the late 1970s, I have witnessed remarkable technological revolutions in medicine, from CT scans to robot-assisted surgery. But I have also watched as medicine slowly evolved into the domain of technicians, bookkeepers, and clerks.
Government interventions over the past four decades have yielded a cascade of perverse incentives, bureaucratic diktats, and economic pressures that together are forcing doctors to sacrifice their independent professional medical judgment, and their integrity. The consequence is clear: Many doctors from my generation are exiting the field. Others are seeing their private practices threatened with bankruptcy, or are giving up their autonomy for the life of a shift-working hospital employee. Governments and hospital administrators hold all the power, while doctors—and worse still, patients—hold none.
The Coding Revolution
At first, the decay was subtle. In the 1980s, Medicare imposed price controls upon physicians who treated anyone over 65. Any provider wishing to get compensated was required to use International Statistical Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes to describe the service when submitting a bill. The designers of these systems believed that standardized classifications would lead to more accurate adjudication of Medicare claims.
What it actually did was force doctors to wedge their patients and their services into predetermined, ill-fitting categories. This approach resembled the command-and-control models used in the Soviet bloc and the People’s Republic of China, models that were already failing spectacularly by the end of the 1980s.
Before long, these codes were attached to a fee schedule based upon the amount of time a medical professional had to devote to each patient, a concept perilously close to another Marxist relic: the labor theory of value. Named the Resource-Based Relative Value System (RBRVS), each procedure code was assigned a specific value, by a panel of experts, based supposedly upon the amount of time and labor it required. It didn’t matter if an operation was being performed by a renowned surgical expert—perhaps the inventor of the procedure—or by a doctor just out of residency doing the operation for the first time. They both got paid the same.

Hospitals’ reimbursements for their Medicare-patient treatments were based on another coding system: the Diagnosis Related Group (DRG). Each diagnostic code is assigned a specific monetary value, and the hospital is paid based on one or a combination of diagnostic codes used to describe the reason for a patient’s hospitalization. If, say, the diagnosis is pneumonia, then the hospital is given a flat amount for that diagnosis, regardless of the amount of equipment, staffing, and days used to treat a particular patient.
As a result, the hospital is incentivized to attach as many adjunct diagnostic codes as possible to try to increase the Medicare payday. It is common for hospital coders to contact the attending physicians and try to coax them into adding a few more diagnoses into the hospital record.
Medicare has used these two price-setting systems (RBRVS for doctors, DRG for hospitals) to maintain its price control system for more than 20 years. Doctors and their advocacy associations cooperated, trading their professional latitude for the lure of maintaining monopoly control of the ICD and CPT codes that determine their payday. The goal of setting their own prices has proved elusive, though—every year the industry’s biggest trade group, the American Medical Association, squabbles with various medical specialty associations and the Centers for Medicare and Medicaid Services (CMS) over fees.
As goes Medicare, so goes the private insurance industry. Insurers, starting in the late 1980s, began the practice of using the Medicare fee schedule to serve as the basis for negotiation of compensation with the doctors and hospitals on their preferred provider lists. An insurance company might offer a hospital 130 percent of Medicare’s reimbursement for a specific procedure code, for instance.
The coding system was supposed to improve the accuracy of adjudicating claims submitted by doctors and hospitals to Medicare, and later to non-Medicare insurance companies. Instead, it gave doctors and hospitals an incentive to find ways of describing procedures and services with the cluster of codes that would yield the biggest payment. Sometimes this required the assistance of consulting firms. A cottage industry of fee-maximizing advisors and seminars bloomed.
I recall more than one occasion when I discovered at such a seminar that I was “undercoding” for procedures I routinely perform; a small tweak meant a bigger check for me. That fact encouraged me to keep one eye on the codes at all times, leaving less attention for my patients. Today, most doctors in private practice employ coding specialists, a relatively new occupation, to oversee their billing departments.
Another goal of the coding system was to provide Medicare, regulatory agencies, research organizations, and insurance companies with a standardized method of collecting epidemiological data—the information medical professionals use to track ailments across different regions and populations. However, the developers of the coding system did not anticipate the unintended consequence of linking the laudable goal of epidemiologic data mining with a system of financial reward.
This coding system leads inevitably to distortions in epidemiological data. Because doctors are required to come up with a diagnostic code on each bill submitted in order to get paid, they pick the code that comes closest to describing the patient’s problem while yielding maximum remuneration. The same process plays out when it comes to submitting procedure codes on bills. As a result, the accuracy of the data collected since the advent of compensation coding is suspect.
Command and Control
Coding was one of the earliest manifestations of the cancer consuming the medical profession, but the disease is much more broad-based and systemic. The root of the problem is that patients are not payers. Through myriad tax and regulatory policies adopted on the federal and state level, the system rarely sees a direct interaction between a consumer and a provider of a health care good or service. Instead, a third party—either a private insurance company or a government payer, such as Medicare or Medicaid—covers almost all the costs. According to the National Center for Policy Analysis, on average, the consumer pays only 12 percent of the total health care bill directly out of pocket. There is no incentive, through a market system with transparent prices, for either the provider or the consumer to be cost-effective.
As the third party payment system led health care costs to escalate, the people footing the bill have attempted to rein in costs with yet more command-and-control solutions. In the 1990s, private insurance carriers did this through a form of health plan called a health maintenance organization, or HMO. Strict oversight, rationing, and practice protocols were imposed on both physicians and patients. Both groups protested loudly. Eventually, most of these top-down regulations were set aside, and many HMOs were watered down into little more than expensive prepaid health plans.
Then, as the 1990s gave way to the 21st century, demographic reality caught up with Medicare and Medicaid, the two principal drivers of federal health care spending.
Twenty years after the fall of the Iron Curtain, protocols and regimentation were imposed on America’s physicians through a centralized bureaucracy. Using so-called “evidence-based medicine,” algorithms and protocols were based on statistically generalized, rather than individualized, outcomes in large population groups.
While all physicians appreciate the development of general approaches to the work-up and treatment of various illnesses and disorders, we also realize that everyone is an individual—that every protocol or algorithm is based on the average, typical case. We want to be able to use our knowledge, years of experience, and sometimes even our intuition to deal with each patient as a unique person while bearing in mind what the data and research reveal.
Being pressured into following a pre-determined set of protocols inhibits clinical judgment, especially when it comes to atypical problems. Some medical educators are concerned that excessive reliance on these protocols could make students less likely to recognize and deal with complicated clinical presentations that don’t follow standard patterns. It is easy to standardize treatment protocols. But it is difficult to standardize patients.
What began as guidelines eventually grew into requirements. In order for hospitals to maintain their Medicare certification, the Centers for Medicare and Medicaid Services began to require their medical staff to follow these protocols or face financial retribution.
Once again, the medical profession cooperated. The American College of Surgeons helped develop Surgical Care Improvement Project (SCIP) protocols, directing surgeons as to what antibiotics they may use and the day-to-day post-operative decisions they must make. If a surgeon deviates from the guidelines, he is usually required to document in the medical record an acceptable justification for that decision.
These requirements have consequences. On more than one occasion I have seen patients develop dramatic postoperative bruising and bleeding because of protocol-mandated therapies aimed at preventing the development of blood clots in the legs after surgery. Had these therapies been left up to the clinical judgment of the surgeon, many of these patients might not have had the complication.
Operating room and endoscopy suites now must follow protocols developed by the global World Health Organization—an even more remote agency. There are protocols for cardiac catheterization, stenting, and respirator management, just to name a few.
Patients should worry about doctors trying to make symptoms fit into a standardized clinical model and ignoring the vital nuances of their complaints. Even more, they should be alarmed that the protocols being used don’t provide any measurable health benefits. Most were designed and implemented before any objective evidence existed as to their effectiveness.
A large Veterans Administration study released in March 2011 showed that SCIP protocols led to no improvement in surgical-site infection rate. If past is prologue, we should not expect the SCIP protocols to be repealed, just “improved”—or expanded, adding to the already existing glut.
These rules are being bred into the system. Young doctors and medical students are being trained to follow protocol. To them, command and control is normal. But to older physicians who have lived through the decline of medical culture, this only contributes to our angst.
One of my colleagues, a noted pulmonologist with over 30 years’ experience, fears that teaching young physicians to follow guidelines and practice protocols discourages creative medical thinking and may lead to a decrease in diagnostic and therapeutic excellence. He laments that “ evidence-based means you are not interested in listening to anyone. Another colleague, a North Phoenix orthopedist of many years, decries the “cookie-cutter” approach mandated by protocols.
A noted gastroenterologist who has practiced more than 35 years has a more cynical take on things. He believes that the increased regimentation and regularization of medicine is a prelude to the replacement of physicians by nurse practitioners and physician-assistants, and that these people will be even more likely to follow the directives proclaimed by regulatory bureaus. It is true that, in many cases, routine medical problems can be handled more cheaply and efficiently by paraprofessionals. But these practitioners are also limited by depth of knowledge, understanding, and experience. Patients should be able to decide for themselves if they want to be seen by a doctor. It is increasingly rare that patients are given a choice about such things.
The partners in my practice all believe that protocols and guidelines will accomplish nothing more than giving us more work to do and more rules to comply with. But they implore me to keep my mouth shut—rather than risk angering hospital administrators, insurance company executives, and the other powerful entities that control our fates.
Electronic Records and Financial Burdens
When Congress passed the stimulus, a.k.a. the American Reinvestment and Recovery Act of 2009, it included a requirement that all physicians and hospitals convert to electronic medical records (EMR) by 2014 or face Medicare reimbursement penalties. There has never been a peer-reviewed study clearly demonstrating that requiring all doctors and hospitals to switch to electronic records will decrease error and increase efficiency, but that didn’t stop Washington policymakers from repeating that claim over and over again in advance of the stimulus.
Some institutions, such as Kaiser Permanente Health Systems, the Mayo Clinic, and the Veterans Administration Hospitals, have seen big benefits after going digital voluntarily. But if the same benefits could reasonably be expected to play out universally, government coercion would not be needed.
Instead, Congress made that business decision on behalf of thousands of doctors and hospitals, who must now spend huge sums on the purchase of EMR systems and take staff off other important jobs to task them with entering thousands of old-style paper medical records into the new database. For a period of weeks or months after the new system is in place, doctors must see fewer patients as they adapt to the demands of the technology.
The persistence of price controls has coincided with a steady ratcheting down of fees for doctors. As a result, private insurance payments, which are typically pegged to Medicare payment schedules, have been ratcheting down as well. Meanwhile, Medicare’s regulatory burdens on physician practices continue to increase, adding on compliance costs. Medicare continues to demand that specific coded services be redefined and subdivided into ever-increasing levels of complexity. Harsh penalties are imposed on providers who accidentally use the wrong level code to bill for a service. Sometimes—as in the case of John Natale of Arlington, Illinois, who began a 10-month sentence in November because he miscoded bills on five patients upon whom he repaired complicated abdominal aortic aneurysms—the penalty can even include prison.
For many physicians in private practice, the EMR requirement is the final straw. Doctors are increasingly selling their practices to hospitals, thus becoming hospital employees. This allows them to offload the high costs of regulatory compliance and converting to EMR.
As doctors become shift workers, they work less intensely and watch the clock much more than they did when they were in private practice. Additionally, the doctor-patient relationship is adversely affected as doctors come to increasingly view their customers as the hospitals’ patients rather than their own.
In 2011, The New England Journal of Medicine reported that fully 50 percent of the nation’s doctors had become employees—either of hospitals, corporations, insurance companies, or the government. Just six years earlier, in 2005, more than two-thirds of doctors were in private practice. As economic pressures on the sustainability of private clinical practice continue to mount, we can expect this trend to continue.

Accountable Care Organizations
For the next 19 years, an average of 10,000 Americans will turn 65 every day, increasing the fiscal strain on Medicare. Bureaucrats are trying to deal with this partly by reinstating an old concept under a new name: Accountable Care Organization, or ACO, which harkens back to the infamous HMO system of the early 1990s.
In a nutshell, hospitals, clinics, and health care providers have been given incentives to organize into teams that will get assigned groups of 5,000 or more Medicare patients. They will be expected to follow practice guidelines and protocols approved by Medicare. If they achieve certain benchmarks established by Medicare with respect to cost, length of hospital stay, re-admissions, and other measures, they will get to share a portion of Medicare’s savings. If the reverse happens, there will be economic penalties.
Naturally, private insurance companies are following suit with non-Medicare versions of the ACO, intended primarily for new markets created by ObamaCare. In this model, an ACO is given a lump sum, or bundled payment, by the insurance company. That chunk of money is intended to cover the cost of all the care for a large group of insurance beneficiaries. The private ACOs are expected to follow the same Medicare-approved practice protocols, but all of the financial risks are assumed by the ACOs. If the ACOs keep costs down, the team of providers and hospitals reap the financial reward: surplus from the lump sum payment. If they lose money, the providers and hospitals eat the loss.
In both the Medicare and non-Medicare varieties of the ACO, cost control and compliance with centrally planned practice guidelines are the primary goal.
ACOs are meant to replace a fee-for-service payment model that critics argue encourages providers to perform more services and procedures on patients than they otherwise would do. This assumes that all providers are unethical, motivated only by the desire for money. But the salaried and prepaid models of provider-reimbursement are also subject to unethical behavior in our current system. There is no reward for increased productivity with the salary model. With the prepaid model there is actually an incentive to maximize profit by withholding services.
Each of these models has its pros and cons. In a true market-based system, where competition rewards positive results, the consumer would be free to choose among the various competing compensation arrangements.
With increasing numbers of health care providers becoming salaried employees of hospitals, that’s not likely. Instead, we’ll see greater bureaucratization. Hospitals might be able to get ACOs to work better than their ancestor HMOs, because hospital administrators will have more control over their medical staff. If doctors don’t follow the protocols and guidelines, and desired outcomes are not reached, hospitals can replace the “problem” doctors.
Doctors Going Galt? 
Once free to be creative and innovative in their own practices, doctors are becoming more like assembly-line workers, constrained by rules and regulations aimed to systemize their craft. It’s no surprise that retirement is starting to look more attractive. The advent of the Affordable Care Act of 2010, which put the medical profession’s already bad trajectory on steroids, has for many doctors become the straw that broke the camel’s back.
A June 2012 survey of 36,000 doctors in active clinical practice by the Doctors and Patients Medical Association found 90 percent of doctors believe the medical system is “on the wrong track” and 83 percent are thinking about quitting. Another 85 percent said “the medical profession is in a tailspin.” 65 percent say that “government involvement is most to blame for current problems.” In addition, 2 out of 3 physicians surveyed in private clinical practice stated they were “just squeaking by or in the red financially.”
A separate survey of 2,218 physicians, conducted online by the national health care recruiter Jackson Healthcare, found that 34 percent of physicians plan to leave the field over the next decade. What’s more, 16 percent said they would retire or move to part-time in 2012. “Of those physicians who said they plan to retire or leave medicine this year,” the study noted, “56% cited economic factors and 51% cited health reform as among the major factors. Of those physicians who said they are strongly considering leaving medicine in 2012, 55% or 97 physicians, were under age 55.”
Interestingly, these surveys were completed two years after a pre-ObamaCare survey reported in The New England Journal of Medicine found 46.3 percent of primary care physicians stated passage of the new health law would “either force them out of medicine or make them want to leave medicine.”
It has certainly affected my plans. Starting in 2012, I cut back on my general surgery practice. As co-founder of my private group surgical practice in 1986, I reached an arrangement with my partners freeing me from taking night calls, weekend calls, or emergency daytime calls. I now work 40 hours per week, down from 60 or 70. While I had originally planned to practice at least another 12 to 14 years, I am now heading for an exit—and a career change—in the next four years. I didn’t sign up for the kind of medical profession that awaits me a few years from now.
Many of my generational peers in medicine have made similar arrangements, taken early retirement, or quit practice and gone to work for hospitals or as consultants to insurance companies. Some of my colleagues who practice primary care are starting cash-only “concierge” medical practices, in which they accept no Medicare, Medicaid, or any private insurance.
As old-school independent-thinking doctors leave, they are replaced by protocol-followers. Medicine in just one generation is transforming from a craft to just another rote occupation.
Medicine in the Future
In the not-too-distant future, a small but healthy market will arise for cash-only, personalized, private care. For those who can afford it, there will always be competitive, market-driven clinics, hospitals, surgicenters, and other arrangements—including “medical tourism,” whereby health care packages are offered at competitive rates in overseas medical centers. Similar healthy markets already exist in areas such as Lasik eye surgery and cosmetic procedures. The medical profession will survive and even thrive in these small private niches.
In other words, we’re about to experience the two-tiered system that already exists in most parts of the world that provide “universal coverage.” Those who have the financial means will still be able to get prompt, courteous, personalized, state-of-the-art health care from providers who consider themselves professionals. But the majority can expect long lines, mediocre and impersonal care from shift-working providers, subtle but definite rationing, and slowly deteriorating outcomes.
We already see this in Canada, where cash-only clinics are beginning to spring up, and the United Kingdom, where a small but healthy private system exists side-by-side with the National Health Service, providing high-end, fee-for-service, private health care, with little or no waiting.
Ayn Rand’s philosophical novel Atlas Shrugged describes a dystopian near-future America. One of its characters is Dr. Thomas Hendricks, a prominent and innovative neurosurgeon who one day just disappears. He could no longer be a part of a medical system that denied him autonomy and dignity. Dr. Hendricks’ warning deserves repeating:

Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.

Jeffrey Singer practices general surgery in Phoenix, Arizona, writes for Arizona Medicine, the journal of the Arizona Medical Association, is an adjunct scholar at the Cato Institute, and is treasurer of the U.S. Health Freedom Coalition.

Tuesday, August 25, 2015

GINKGO BILOBA & CINNAMON TO INCREASE BRAIN CIRCULATION

Brain Circulation: Cinnamon, Ginkgo Biloba, Gotu Kola, Ginseng, or Vinpocetine?

GOTU KOLA
Of the four, Gotu Kola is the sedating herb.  So be aware that that is the effect that you looking for.  

Herbwisdom explains that Gotu Kola is ". . . said to develop the crown chakra, the energy center at the top of the head and to balance the right and left hemispheres of the brain, which the leaf is said to resemble. It is regarded as one of the most important rejuvenating herbs in Ayurvedic Medicine."  I like to measure the effectiveness of a particular supplement, vitamin, or herb-based on its results, particularly on its results on the complications arising from injuries.  And Gotu Kola, though it has shown some relief and some promise, has yet to "balance the right and left hemispheres of the brain."  That would be quite an accomplishment.  
Further, Herbwisdom says that Gotu Kola ". . . has a positive effect on the circulatory system. It improves the flow of blood while strengthening the veins and capillaries. It has been used successfully to treat phlebitis, leg cramps, and abnormal tingling of the extremities. It soothes and minimizes varicose veins and helps to minimize scarring."  

So let's see, Gotu Kola helps with the integrity of blood vessels?  I would like to see visual evidence of this instead of reports formed by opinion. Language is a key consideration when reviewing the data.  And these online reports or reviews of supplements may not even be considered data; they are more opinion.  Yes, that does stand for something, but they serve more as a sales letter than a scientific or proven measurement of how the herb works.  For example, note the words used, ". . . has a positive effect."  What does that mean?  Positive how?  "It improves the flow of blood . . . ."  Does that mean it increases the blood flow?  Is Gotu Kola a blood vessel dilator ". . . while strengthening the veins and capillaries"?  How does it strengthen the veins and capillaries if it also improves circulation?  These are questions I'd like answered.

VINPOCETINE
Deanne Alban explains that "Doctors in Europe believe [vinpocetine] is far more effective than Ginkgo Biloba, which is widely promoted as one of the best brain supplements."  On the topic of Vitamin D, Alban states "Along with DHA, vitamin D is close to being nature’s cure-all."  On this, I would have to concur.  I don't like what the ingredients of Vitamin D3 are, but I tend to have a good effect from its consumption almost without fail.

GINGKO BILOBA
I do find it interesting to read how some people categorize or frame the benefits of a particular herb. In the case of Gingko Biloba, forum member, Devin Thayer, explains that the Chinese herb Ginkgo Biloba is a neutral nootropic. He explains that it 

"is an ancient Chinese medicine used for a number of disorders, but the most interesting inclusion of this herb was made as the neutral herb in one of the most popular Chinese brain medicines for mental decline and mental retardation. Ginkgo + Ginseng + Gotu Kola was the remedy. Ginseng would be the "warm" herb, meaning it was stimulating. Gotu Kola would be the "cold" herb, meaning it was sedating. Ginkgo would be the neutral herb, which ties the two together.

What makes this herb interesting to me is that I have taken it thinking it would help with ADHD, but all I noticed was a flush face and an ability to bleed for 15 minutes. It is great for preventing stroke and preventing stress from stroke due to its blood vessel enhancing, platelet de-aggregating, plaque removal, stress-reducing properties. It's a true circulation tonic if there ever was one. This may attribute to some increased oxygen in the brain, but it is not, in my opinion, it's a primary mechanism of action.

CINNAMON
Cinnamon may not be thought of as your typical brain nootropic, but it definitely and positively affects on the brain.  See, there I go using the very vague language of online articles.  Having said that, cinnamon actually does stimulate the brain.  It wakes it up and stimulates it to function better in the short run.  I get a better effect from it when I take a teaspoon and place it directly into my mouth than when I mix it in with food, say, a bowl of oatmeal, butter, and honey. Oh, I am sure that it works pretty good intestinally as well.  Kevin Hayden writes that
Recent research [can you get more vague than "recent research"?] indicates that cinnamon can have favorable effects on brain function. Participants in a study [or more vague than "a study"?] chewed cinnamon gum or smelled the sweet spice. Cognitive tests [which cognitive test? Never anything specific] revealed that subjects who used cinnamon had better memory functions and could process information more quickly.
Cinnamon is not traditionally thought of as a brain tonic.  It is more often used to fight against intestinal conditions.  But as we know there are more nerves in your intestines than in your brain, which may be why cinnamon, a powerful digestive remedy, also has positive benefits on the brain and maybe one of the reasons why the benefits are vague or indirect.  Hayden points out that "Cinnamon has antifungal, antiviral and antibacterial activities.  It has been shown to suppress E. coli, staphylococcus, and Candida Albicans."  Cinnamon is an excellent diabetes medicine.

Simply Ageless Nation comments on the anti-aging and brain tonic powers of cinnamon:
Brain Tonic: Cinnamon boosts the activity of the brain and hence acts as a good brain tonic. It helps in removing nervous tension and memory loss. Research at the Wheeling Jesuit University in the US has proven that the scent of cinnamon has the ability to boost brain activity. The team of researchers led by Dr. P. Zoladz found that people who were administered with cinnamon improved their scored on cognitive activities such as attention processes, virtual recognition memory, working memory, and visual-motor response speed.

Wednesday, August 12, 2015

SHOCKING: Studies Show that Vaccinated Individuals Spread Disease

Should the Recently Vaccinated be Quarantined to Prevent Outbreaks?


WASHINGTON, D.C. –February 2, 2015– [ GlobeNewsWire ] — Health officials are blaming unvaccinated children for the recent measles outbreak that started at Disneyland.

Scientific evidence demonstrates that individuals vaccinated with live virus vaccines such as MMR (measles, mumps, and rubella), rotavirus, chicken pox, shingles, and influenza can shed the virus for many weeks or months afterward and infect the vaccinated and unvaccinated alike. 1,2,3,4,5,6,7,8,9,10

Furthermore, vaccine recipients can carry diseases in the back of their throats and infect others while displaying no symptoms of a disease. 11,12,13

“Numerous scientific studies indicate that children who receive a live virus vaccination can shed the disease and infect others for weeks or even months afterward. Thus, parents who vaccinate their children can indeed put others at risk,” explains Leslie Manookian, documentary filmmaker and activist. Manookian’s award-winning documentary, The Greater Good, aims to open a dialog about vaccine safety.

Both unvaccinated and vaccinated individuals are at risk from exposure to those recently vaccinated. Vaccine failure is widespread; vaccine-induced immunity is not permanent and recent outbreaks of diseases such as whooping cough, mumps and measles have occurred in fully vaccinated populations.14,15 Flu vaccine recipients become more susceptible to future infection after repeated vaccination.16, 17

“Health officials should require a two-week quarantine of all children and adults who receive vaccinations,” says Sally Fallon Morell, president of the Weston A. Price Foundation. “This is the minimum amount of time required to prevent transmission of infectious diseases to the rest of the population, including individuals who have been previously vaccinated.”

“Vaccine failure and failure to acknowledge that live virus vaccines can spread disease have resulted in an increase in outbreaks of infectious disease in both vaccinated and unvaccinated individuals,” says Manookian, “CDC should instruct physicians who administer vaccinations to inform their patients about the risks posed to others by those who’ve been recently vaccinated.”

According to the Weston A. Price Foundation, the best protection against infectious disease is a healthy immune system, supported by adequate vitamin A and vitamin C. Well-nourished children easily recover from infectious disease and rarely suffer complications.

The number of measles deaths declined from 7575 in 1920 (10,000 per year in many years in the 1910s) to an average of 432 each year from 1958-1962.18 The vaccine was introduced in 1963. Between 2005 and 2014, there have been no deaths from measles in the U.S. and 108 deaths from the MMR vaccine.19

The Weston A. Price Foundation is a 501(c)(3) nutrition education foundation with the mission of disseminating accurate, science-based information on diet and health. Named after nutrition pioneer Weston A. Price, DDS, author of Nutrition and Physical Degeneration, the Washington, DC-based Foundation publishes a quarterly journal for its 15,000 members, supports 600 local chapters worldwide, and hosts a yearly international conference. The Foundation phone number is (202) 363-4394, www.westonaprice.org, info@westonaprice.org.

MEDIA CONTACTS:
Kim Hartke, 703-860-2711, press@westonaprice.org
Leslie Manookian, 208-721-2135, leslie@greatergoodmovie.org

References:
1. Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011.  http://cid.oxfordjournals.org/content/early/2014/02/27/cid.ciu105
2. Detection of Measles Virus RNA in Urine Specimens from Vaccine Recipients.  http://www.ncbi.nlm.nih.gov/pubmed/7494055
3. Comparison of the Safety, Vaccine Virus Shedding, and Immunogenicity of Influenza Virus Vaccine, Trivalent, Types A and B, Live Cold-Adapted, Administered to Human Immunodeficiency Virus (HIV)-Infected and Non-HIV Infected Adults.  http://jid.oxfordjournals.org/content/181/2/725.full
4. Sibling Transmission of Vaccine-Derived Rotavirus (RotaTeq) Associated with Rotavirus Gastroenteritis.  http://pediatrics.aappublications.org/content/125/2/e438
5. Polio vaccination may continue after wild virus fades.  http://www.cidrap.umn.edu/news-perspective/2008/10/polio-vaccination-may-continue-after-wild-virus-fades
6. Engineering attenuated virus vaccines by controlling replication fidelity.  http://www.nature.com/nm/journal/v14/n2/abs/nm1726.html
7. CASE OF VACCINE-ASSOCIATED MEASLES FIVE WEEKS POST-IMMUNISATION, BRITISH COLUMBIA, CANADA, OCTOBER, 2013.  http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20649
8. The Safety Profile of Varicella Vaccine: A 10-Year Review.  http://jid.oxfordjournals.org/content/197/Supplement_2/S165.full
9. Comparison of Shedding Characteristics of Seasonal Influenza Virus (Sub)Types and Influenza A(H1N1)pdm09; Germany, 2007–2011.  http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0051653
10. Epigenetics of Host-Pathogen Interactions: The Road Ahead and the Road Behind.  http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1003007
11. Animal Models for Influenza Virus Pathogenesis and Transmission.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063653/
12. Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate mode http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063653/
13. Study Finds Parents Can Pass Whooping Cough to Babies.  http://www.nytimes.com/2007/04/03/health/03coug.html?_r=0
14. Immunized People Getting Whooping Cough.  http://www.kpbs.org/news/2014/jun/12/immunized-people-getting-whooping-cough/
15. Vaccine Failure — Over 1000 Got Mumps in NY in Last Six Months.  http://articles.mercola.com/sites/articles/archive/2010/03/06/vaccine-failure–over-1000-get-mumps-in-ny-in-last-six-months.aspx
16. Impact of Repeated Vaccination on Vaccine Effectiveness Against Influenza A(H3N2) and B During 8 Seasons.  http://cid.oxfordjournals.org/content/early/2014/09/29/cid.ciu680.full
17. http://articles.mercola.com/sites/articles/archive/2012/09/18/flu-shot-increases-flu-illness.aspx
Corrections made Feb 3, 2015:  1) We have struck out the second sentence in the first paragraph, which read, “However, with no blood tests proving the outbreak is from wild measles, the most likely source of the outbreak is a recently vaccinated individual, according to published science.” Since we released the press release, it has come to our attention that 9 cases of measles related to the Disneyland outbreak have in fact been confirmed via blood test as wild genotype B3 measles. We do not know the status of the others. According to the CDC, there are about 100 measles cases this year, 67 of which are related to Disneyland. While the CDC says most of the 67 Disneyland cases were unvaccinated or vaccination status is unknown, they assume that if this outbreak is similar to last year, about 20% were vaccinated. It is clear from the experience at Disneyland and the scientific literature that both vaccinated and unvaccinated individuals can contract and spread disease and the demonization of the unvaccinated is unfair, inappropriate, and borders on fear-mongering. 

2) See also, an added footnote # 17 in the fifth paragraph. The rest of the footnotes are renumbered, accordingly.

Saturday, August 8, 2015

EXCESS TV WATCHING COULD RAISE RISK OF ALZHEIMER'S

Study: Excess TV Watching Could Raise Risk Of Alzheimer’s

This should not come as a surprise.

WASHINGTON (CBSDC) — Too much time in front of the television may contribute to brain damage and a higher risk of developing Alzheimer’s diseasehttp://images.intellitxt.com/ast/adTypes/icon1.png, a new study suggests.

Northern California Institute for Research and Education experts found that four hours of television or more per day can significantly lower cognitive performance in middle age. The study explored the link between sedentary lifestyle, cognitive performance and the risk of developing dementia, as reported by The Washington Post.

The study tracked individuals for 25 years beginning in young adulthood and found that low cognitive test scores were also common among people who reported low levels of physical activityhttp://images.intellitxt.com/ast/adTypes/icon1.png.

Researchers say the findings shed light on important consequences for children and young adults who spend a lot of time in front of screens. However, the research also suggests that people have a choice in changing their lifestyle in order to lower the risk of cognitive decline later in life.

“This is something you can do something about,” Kristine Yaffe, a professor of psychiatry, neurology and epidemiology at the University of California in San Francisco, told the Alzheimer’s Association International Conference in Washington, D.C.

The study examined 3,257 adults between the ages of 18 and 30 years old and investigated the effect television watching and physical activity level had on cognitive performance. The participants answered surveys on their habits three times over the course of 25 years. For the study, researchers defined low physical activity as burning less than 300 calories in 50-minute session three times a week. High television watching was defined as more than four hours a day.

Researchers found that 11 percent were considered heavy TV watchers, 17 percent were considered to have low physical activity, and 3 percent reported both.

Yaffe says those who watched a lot of television were 1.5 percent more likely to perform worse on the cognitive tests when compared to those who watched less. If the participants were relatively inactive and watched a lot of television, they were two times more likely to perform poorly on the tests in midlife, compared to those who were physically activehttp://images.intellitxt.com/ast/adTypes/icon1.png and didn’t watch a lot of television.

“What’s happening at one’s midlife is setting the stage for what’s happening over the next 20 or 30 years,” Yaffe explains, as reported by The Washington Post.

The results highlight the possibility that sedentary habits in early life may have negative impact on dementia risk later in life.


Thursday, August 6, 2015

Magnesium: Which Kind Do I Take?

There are a few things to consider.  

One is bioavailability.  Each type of magnesium when it is joined with other elements, like orotate or L-theorate, has only a certain percentage of magnesium available for absorption.  If you're going to supplement with magnesium, for the money you'll want a tablet/capsule that has the highest bio-availability of magnesium.  Magnesium by itself has lots of benefits.  You keep hearing about it being involved in 300 chemical reactions in your body.  That's true.  Though I myself would like to see someone delineate each reaction.  It is generally beneficial for your nerves, muscles, and heart.  So any kind of magnesium that you take will positively affect these components of your body.  But maybe you weren't aware of the fact that certain magnesiums treat certain organ systems and bodily functions. So choosing the right magnesium depends on what organ or organ system you're trying to treat.   

So, two, consider which organ you want to treat.

For the brain, you'll want to use Magnesium L-Theorate.  According to Examine.com, any form of magnesium:
can be used to attenuate a magnesium deficiency, except magnesium L-threonate, since it contains less elemental magnesium per dose. Gastrointestinal side-effects, like diarrhea and bloating, are more common when magnesium oxide or magnesium chloride are supplemented, due to the lower absorption rates of these two forms. In general, magnesium citrate is a good choice for supplementation. Magnesium L-threonate can be used for cognitive enhancement. 
The comments in that last link to magnesium L-threonate are particularly interesting.  One commenter, Arne, explains that:
EVERY Magnesium compound does cross the BBB and ALL those non-neurotoxic Mg-compounds like Mg-Chloride, -Malate, -Glycinate, -Orotate, -Taurate, -Citrate etc., even the bad Mg-Oxide will improve not just the brain function in humans dramatically! There is no need to promote such expensive stuff because there is a Big-Pharma-Patent on it! Arne, "MS" victim for over 20 years and on my way to recovery from SPMS since using Magnesium Chloride oral & transdermal for the last 3 years (~$70 for 20kg, which is enough for one year and to get rid off all the other pharma sh... inclusive the med. Establishment). 
With Magnesium Oxide and Magnesium Chloride, diarrhea and bloating are more common.

Magnesium Diglycinate is a good laxative.

Magnesium Gluconate, which is often compared against Magnesium Oxide, is a good laxative.  A Chinese study is often cited on how it treats pregnancy-induced hypertension.  It's a powerful laxative.

Magnesium Orotate for the heart.
Dr. Edward F. Group says that magnesium orotate is the most effective form of magnesium supplement, created through the use of the mineral salts of orotic acid. Both plants and animals use orotates to create DNA and RNA. Extensive scientific research by Dr. Hans A. Nieper, M.D. shows orotates can penetrate cell membranes, enabling the effective delivery of the magnesium ion to the innermost layers of the cellular mitochondria and nucleus. Magnesium orotate contains many properties that can help protect you and your health, while offering your cells the most readily absorbable form of magnesium on the market today.  
Okay, so orotate provides great penetration into the cells.  But why doesn't he mention the benefits of orotate on the heart?

Magnesium glycinate for sweet dreams.

Magnesium malate for pain relief.  It chelates metals from your body. Magnesium malate binds to metals and renders them ineffective.  It promotes the production of saliva in your mouth which helps to control oral bacteria.  "Because of its antiseptic properties, magnesium malate is used in toothpaste and mouthwash," according to Michael Hutchins at LiveStrong.  Or, you could just eat an apple, the food source for magnesium malate.


Magnesium malate fights fatigue.


Magnesium malate is a fantastic choice for people suffering from fatigue, since malic acid--a natural fruit acid present in most cells in the body--is a vital component of enzymes that play a key role in ATP synthesis and energy production. Since the ionic bonds of magnesium and malic acid are easily broken, magnesium malate is also highly soluble.
 Magnesium citrate for constipation.
Magnesium citrate--Magnesium citrate is the most popular magnesium supplement, probably because it is inexpensive and easily absorbed. Since citric acid is a mild laxative, magnesium citrate functions as a constipation aid as well as a magnesium source. It is a great choice for individuals with rectal or colon problems but is unsuitable for those with loose bowel movements.
Magnesium Taurate for the heart
Magnesium taurate is the best choice of magnesium supplement for people with cardiovascular issues, since it is known to prevent arrhythmias and guard the heart from damage caused by heart attacks. Magnesium taurate is easily absorbed (magnesium and taurine stabilize cell membranes together), and it contains no laxative properties.

Magnesium glycinate is good for dreams.
Magnesium glycinate (magnesium bound with glycine, a non-essential amino acid) is one of the most bioavailable and absorbable forms of magnesium, and also the least likely to induce diarrhea. It is the safest option for correcting a long-term deficiency.
Magnesium chloride comes heavily recommended.  It is good for detoxing and to boost kidney function and metabolism.
Though magnesium chloride only contains around 12 percent elemental magnesium, it has an impressive absorption rate and is the best form of magnesium to take for detoxing the cells and tissues. Moreover, chloride (not to be confused with chlorine, the toxic gas) aids kidney function and can boost a sluggish metabolism.
It's that last part that I am interested in.

Magnesium carbonate is a good antacid.
Magnesium carbonate is another popular, bioavailable form of magnesium that actually turns into magnesium chloride when it mixes with the hydrochloric acid in our stomachs. It is a good choice for people suffering from indigestion and acid reflux, since it contains antacid properties.  
Magnesium Hydroxide is better known as Milk of Magnesia.

Learn more: http://www.naturalnews.com/046401_magnesium_dietary_supplements_nutrient_absorption.html#ixzz3i05zE4LK