About Daniel Redwood

Daniel Redwood, DC, is Director of the Master of Science in Human Nutrition and Functional Medicine program at the University of Western States. He is Associate Editor of Topics in Integrative Healthcare and a member of the American Chiropractic Association's editorial advisory board. He lives in Portland, Oregon.

Who Suffers if President Trump Cuts Off Obamacare Cost Sharing Payments?

Ironically, the pain will be felt most severely in the states where his supporters are concentrated, particularly in the South. The darker colored states are those with the highest percentage of people (as high as 77%) receiving premium subsidies for health insurance purchased on the exchanges.

Percent of exchange enrollees receiving cost sharing reduction subsidies.

 

Map: Who loses if Trump cuts off health insurer payments
Data: Centers for Medicare & Medicaid Services; Map: Lazaro Gamio / Axios

Is This the Kind of Nation We Want to Become?

This article’s bullet point list of the effects the AHCA (Trumpcare) would have if it becomes law is quite powerful. I encourage you to read it.

If you favor taking health insurance away from at least 24 million people, allowing states to eliminate requirements for basic benefits, eliminate yearly and annual caps, charge sick people more, charge old people more, bring back pre-existing condition exclusions if you live in the wrong state, etc., all in order to provide massive tax breaks for the wealthiest among us, please reconsider what this means.

The Right Questions

Ezra Klein asks the right questions in Vox:

Were voters clamoring for a bill that cut taxes on the rich, raised premiums on the old, and cut subsidies for the poor? Will Americans be happy when 15 million people lose their health insurance and many of those remaining face higher deductibles?

Hard to know where this is headed, but almost all of the largest health entities have weighed in with strong opposition.

Does that mean it can’t pass? Only if the Republicans stay split into factions.

Why Doesn’t American Healthcare Help Us Live Longer?

The answer appears to correlate quite well with one’s income. On average, the better off you are, the longer you live. By extraordinarily large margins.

And if the House/Trump bill to repeal Obamacare becomes law, we have to expect this to worsen.

From Kevin Drum:

The difference in life expectancy between the top and bottom is ten years for women and a stunning 15 years for men. Nor do you need to look at the very top to match European life expectancies. A merely average American has a life expectancy of 82 years, right in line with other advanced countries.

So here’s the question: I assume that every country shows a decline in life expectancy as you get poorer. But do other countries show the astonishing decline we have in the US? I can’t find an authoritative analysis of this, but I scanned through some reports from different countries and it looks to me like the income difference in most places is half to two-thirds of the US difference.

GMO Labeling Update

Tom Philpott’s regular column in Mother Jones is always informative and often provocative. I don’t always agree with his views but I read him regularly.

His latest piece is on the potential national implications of a new Vermont law that mandates labeling of foods containing genetically modified organisms (GMOs). For those of us who favor GMO labeling, this is essential reading.

The entire article is well worth 5-10 minutes of your time. Here’s an excerpt:

In the years since, the GMA [Grocery Manufacturers Association] has hotly promoted the Safe and Accurate Food Labeling Act, known by critics as the “Deny Americans the Right to Know” (DARK) Act, which would nullify all state GMO labeling laws. The House passed such a bill in July 2015, and supporters tried and ultimately failed to push a similar provision into an omnibus spending bill at year-end.

It has yet to make it through the Senate, but now the chair of the legislative body’s agriculture committee, Sen. Pat Roberts (R-Kan.), is making a major push. In hopes of averting what he called the “wrecking ball” of Vermont’s labeling statute, Roberts—a major recipient of agribusiness campaign fundspushed a bill through the Senate ag committee on March 1 that forbids state GMO labeling requirements. GMA vigorously supports Roberts’ bill, but it remains in limbo. To force a vote on the Senate floor, he’ll need 60 votes, and so far he doesn’t have them.

Meanwhile, a group of Democrats led by Sens. Jeff Merkley (D-Ore.), Patrick Leahy (D-Vt.), Jon Tester (D-Mont.), and Dianne Feinstein (D-Calif.) are pushing a rival bill that would require GMO labeling everywhere—essentially, taking the Vermont law nationwide. Food giant Campbell’s, which has broken ranks with the broader industry on this topic and favors GMO labeling, supports the Merkley bill. Yet it, too, currently lacks the votes to win passage.

This week, USDA Secretary of Agriculture Tom Vilsack has stepped into the stalemate, pushing a compromise in a speech before the National Farmers union: Rather than mandatory labeling, he’s pushing mandatory “disclosure,” wherein food companies are required to disclose GMO ingredients to interested consumers, but not on the label. In Vilsack’s vision, mandatory disclosure could take the form of an 800 number on the label that consumers can call for info on GMO ingredients, or a QR code that can be read by smartphones. “Vilsack has said that President Barack Obama would sign such a bill,” reports the trade journal Hoosier Ag Today.

There’s much to unpack here, but from my perspective the most significant informational nugget is that Campbell’s has broken with its GMA brethren. Campbell’s could be an outlier or this could represent a leading indicator of a shifting political environment.

 

 

On the Collapsing Health and Premature Deaths of Poorly Educated American Whites

This article has the most stunning health statistics I’ve seen in years. The documentation appears irrefutable; the research bears the signature the most recent Nobel economics laureate.

The author of this American Prospect article is Paul Starr, author of the classic book, The Social Transformation of American Medicine. Starr is a professor of sociology and public affairs at Princeton University and Stuart Professor of communications and public affairs at Princeton’s Woodrow Wilson School. He’s a writer whose insightful work I have admired for decades. One of Starr’s great strengths is his ability to contextualize the socio-political implications of data.

To wit:

In a reversal of earlier trends, death rates among white non-Hispanic Americans in midlife increased sharply between 1999 and 2013, according to a new study by economists Anne Case and Angus Deaton, winner last month of the Nobel Prize for economics. The increased deaths were concentrated among those with the least education and resulted largely from drug and alcohol “poisonings,” suicide, and chronic liver diseases and cirrhosis. This midlife mortality reversal had no parallel in any other industrialized society or in other demographic groups in the United States.

Case and Deaton’s analysis, published today in the Proceedings of the National Academy of Sciences, also shows increased rates of illness, chronic pain, and disability among middle-aged whites. The findings have important implications for American politics and public policy, particularly for debates about economic inequality, public health, drug policy, disability insurance, and retirement income. The data also suggest why much of American politics may be taking on an increasingly harsh and desperate quality.

The recent divergence in death rates between the United States and other rich countries is striking. Between 1979 and 1999, Case and Deaton show, mortality for white Americans ages 45 to 54 had declined at nearly 2 percent per year. That was about the same as the average rate of decline in mortality for all people the same age in such countries as France, Germany, the United Kingdom, and Sweden. (See figure below.) After 1999, the 2 percent annual decline continued in other industrialized countries and for Hispanics in the United States, but the death rate for middle-aged white non-Hispanic Americans turned around and began rising half a percent a year.

This, as yesterday’s gubernatorial election results in Kentucky have set the stage for the Governor-elect Bevin’s promised elimination of Medicaid expansion in that heart-of-Appalachia state. 400,000 stand to lose their insurance coverage.

Read it and weep …

World Health Organization Classifies Processed Meats as Carcinogens

While this conclusion will come as no surprise to those who have been following the science on this subject over the past decade, the headlines it is now generating may sway some people change their diets.

 

The key quote:

“Processed meat now falls into “group 1,” meaning it ranks as high as tobacco smoking, the most dangerous variants of human papillomavirus (HPV) and asbestos exposure in terms of causing cancer. Red meat lands in “group 2A” with inorganic lead.