Sexual Health of Mens

Male sexual health is not as complicated as women. Indicate a certain type of guy image and if the brain and nervous system work well to produce nitric oxide, then the response will usually occur. That does not discount the mental component, emotional, and spiritual but a physical component that has the greatest impact on men's sexual health. This article will focus on what men can do to improve the physical component of their sexual health. The benefit side of that advice can also provide a positive impact your overall health and how you age.
In all the information I gathered to prepare for this article, two overriding issues kept surfacing. These two health issues were consistently present. The first is hormone levels. The second is cardiovascular health. Most men would understand how hormone levels could apply but few ever consider cardiovascular health.

Cardiovascular Health!

Your cardiovascular health is as important to your sexual health as it is to your overall health. The reason why centers on the health of the endothelial cells that line the blood vessels of your body. The creation of nitric oxide occurs in these endothelial cells. Nitric oxide researchers believe that nitric oxide can correct up to 90% of all penile dysfunction. When the endothelial cells are damaged by high blood pressure, high sugar levels, cholesterol, and smoking this decreases nitric oxide production. Endothelial cells and their ability to produce nitric oxide are critical to the sexual health of men.

Hormone Levels!

At its simplest level, sex is just a hormone driven function designed to perpetuate the species. With that said, the sexual health of American men is in trouble. Testosterone levels have been decreasing over the last 20 years. Testosterone is the primary male sex hormone. It plays an important role in maintaining bone and muscle mass. Low levels of testosterone have been linked to lowered libido and diabetes. Diabetes can affect the endothelial cells of the blood vessels compounding the problem of lower testosterone levels.

Over the past two decades, the level of testosterone in American males has decreased by 16 percent. Researchers don't know why. But there are some clues. The recent Nurses' Health Study revealed some important truths as they apply to women. Some of those truths also apply to the sexual health of men because they affect both hormonal levels and cardiovascular health.

Additionally, as testosterone levels have decreased this has resulted in reduced muscle mass and tone, reduced metabolism and energy and an increase in body fat. Not a sexy combination! You can accept it and do nothing about it. Or, you can begin to live life by making healthier eating and exercise choices. Choices that will help your body actually be younger physically than your chronological age.

You Have Control Over the Process!

Every day you replace approximately 1% of your cells. That means that 1% of your body is new today, 1% is new tomorrow, and 1% is new each and every day of your life. You choose whether those new cells will be nourished properly or poorly. You choose whether you will have healthy and vibrant cells that act young. Or, sickly and sedentary cells that act old.

The sexual health of your body will be affected by the choices you make. I call it "The 1% Solution!" and it will positively affect the cardiovascular and sexual health of your body.

Choices Affecting Sexual Health!

The Nurses' Health Study highlighted five critical lifestyle and diet behaviors. They are:

o Carbohydrates - Slow verses Fast!

o Fats - Natural verses Artificial!

o Protein - Animal or Plant!

o Body Weight - Your BMI!

o Exercise - Is It Important?

If you look at this list, three critical components emerge: Diet, Weight, and Exercise! Now you might think that this only applies to women. It doesn't! Each of these factors will affect your cardiovascular health and hormonal balance. Each of these factors also affects the health of your endothelial cells and their ability to produce nitric oxide. Nitric oxide production is the most important component to the sexual health of men. Let's look at how all of these factors impact your sexual health.

The Diet Component!

You are what you eat and drink. The sexual health of your body and the cardiovascular health of your circulatory system will be greatly determined by your food and drink choices. These choices will also impact the potential for disease and how you age.

Your first choice is in the area of carbohydrates. Are you choosing foods and drinks that are high in fast carbs (simple sugars)? If you are, then you need to understand that:

o Fast carbs disrupt hormone levels.

o Fast carbs create the potential for high blood sugar that can lead to diabetes.

o High blood sugar can damage the endothelial cells of your blood vessels reducing the production of nitric oxide which is critical for good sexual and cardiovascular health.

Learn to consume foods that are high in slow carbs (complex carbohydrates). Slow carbs will help to keep your blood sugar levels normal and your hormonal levels balanced. Drink water instead of sugary drinks and diet sodas. Drinking water hydrates your system, helps you balance your hormone levels, and aids in weight management.

Your second choice is in the area of fats. Eliminate all trans fats from your diet and replace them with natural, heart-health fats. The Nurses' Health Study clearly showed how disruptive trans fats are to fertility in women. As little as four grams of trans fat (the equivalent of two tablespoons of stick margarine, one medium order of French fries or one doughnut) began to disrupt their hormonal balance.

How much of your diet consists of trans fats from fast food restaurants? How many orders of French fries and doughnuts have you consumed at work? Although I can't give you any hard research on men, it makes sense that we can be as affected by trans fats as women are. It's time that you incorporate foods that are rich in omega-3 fatty acids (such as wild, cold-water fish, walnuts, and flax seeds) since essential fats help to balance hormone levels and promote healthy cell function.

Your third choice is in the area of protein. According to the Nurses' Health Study, women who got their protein from plant sources rather then from animals took a big step toward improved fertility. Animal protein can adversely affect your sexual health. It also has a direct influence on cancer!

If you're not willing to give up your beef, pork or chicken, then invest the time, energy and extra cost to make sure that these sources of protein are hormone free. This also applies to your dairy products. Much of the industry still relies on hormonal injections into their livestock to help increase food production. Eating meat from these animals and their byproducts will affect your hormonal levels. If you're not willing to switch to plant-based protein sources, then make sure your meat and dairy sources are hormone free.

The Weight Component!

Like it or not weight impacts the sexual health of your body. Why? Because fat interferes with your hormonal balance! Fat also stresses your cardiovascular system. This additional stress on your cardiovascular system will compromise the sexual health of your body. Currently, 66% of Americans are overweight with at least a third being obese. Diets are not the answer. America has been dieting for the last 50 years. It has had no real impact on slowing down overweight and obesity rates.

You need a paradigm shift from "dieting" to "healthy eating". Make food choices based on how it will improve your health and wellness, not on how it will impact your weight. Most people who do this see their weight stabilize or decrease.

The Exercise Component!

Exercise is important for both sexual and cardiovascular health. Inactivity saps the body of its ability to respond to insulin and makes you less efficient in absorbing blood sugar. A study from the Electronic Journal of Human Sexuality highlighted that people who exercised on a regular basis:

o Feel better about themselves.

o Think they are more sexually desirable.

o Experience greater levels of satisfaction.

It's always important to check with your physician or health care provider before you start an exercise program. Once you have their OK, than strive to get at least 30 minutes of exercise per day. Aerobic exercises like walking, jogging, biking, and swimming are important and seem to increase circulation to the pelvis and the reproductive organs. But don't forget about strength training exercises. Strength training exercises will help you maintain bone health and density. Additionally, strength training exercises will increase your spatial awareness. This is a very positive feeling that improves your overall well being.

The Nitric Oxide Component!

We can not live without nitric oxide. Your cardiovascular system can not function properly without nitric oxide. Sexual health of your body turns on nitric oxide production. Nitric oxide production depends on the health of endothelial cells of blood vessels, and adequate supplies of essential amino acid L-arginine.

High blood pressure, high sugar, high cholesterol and smoking all affect your endothelial cells in a negative way. Damage to endothelial cells reduces the production of nitric oxide. This could jeopardize the blood flow to sexual organs so that sensitivity is reduced and / or erectile dysfunction.

Since nitric oxide is synthesized from the essential amino acid L-arginine, your diet needs to include protein sources and/or supplements that contain this amino acid. It needs to be emphasized that L-arginine is not a hormone and it is not testosterone. However, when properly brought into the body it can cross the blood-brain barrier to signal the hypothalamus to naturally trigger the pituitary gland to produce growth hormone. This is the key to eliminating any negative side effects typically associated with hormone supplements like DHEA and HGH.

Please note that L-arginine has a dark side and can cause some serious side effects. Read my article, "L-arginine, Nitric Oxide and Sexual Health!" for more information on this essential amino acid.

Conclusion!

If you continue a life of inactively, animal protein intake, sugary drinks, foods made from refined grains, increased body fat, and inadequate nitric oxide production, then you will become part of the new reality for America. This new reality includes epidemic increases in diabetes, continued high levels of cardiovascular disease and stroke, continued high levels of cancer, and poor sexual health especially for those over the age of 40. As Aristotle said, "We Are What We Repeatedly Do!"

By taking the necessary steps to improve your diet, manage your weight, exercise properly and increase your body's ability to produce nitric oxide you will experience positive changes in the sexual health of your body. If you repeatedly take these positive steps you will also improve your wellness and slow down your aging.

One Final Thought!

Although the hormonal balance between men and women are different, the process of change is the same. Many of the steps that improve the sexual health of men will also help improve the sexual health of women. Encourage your spouse or partner to implement these changes with you. If you both take the steps to improve your health, then you will both be reward in the bedroom, and in living your life to its fullest.

A Prescription For Health Care Crisis For Yours

With all the shouting going on about America's health care crisis, many are probably finding it difficult to concentrate, much less understand the cause of the problems confronting us. I find myself dismayed at the tone of the discussion (though I understand it---people are scared) as well as bemused that anyone would presume themselves sufficiently qualified to know how to best improve our health care system simply because they've encountered it, when people who've spent entire careers studying it (and I don't mean politicians) aren't sure what to do themselves.

Albert Einstein is reputed to have said that if he had an hour to save the world he'd spend 55 minutes defining the problem and only 5 minutes solving it. Our health care system is far more complex than most who are offering solutions admit or recognize, and unless we focus most of our efforts on defining its problems and thoroughly understanding their causes, any changes we make are just likely to make them worse as they are better.

Though I've worked in the American health care system as a physician since 1992 and have seven year's worth of experience as an administrative director of primary care, I don't consider myself qualified to thoroughly evaluate the viability of most of the suggestions I've heard for improving our health care system. I do think, however, I can at least contribute to the discussion by describing some of its troubles, taking reasonable guesses at their causes, and outlining some general principles that should be applied in attempting to solve them.

THE PROBLEM OF COST

No one disputes that health care spending in the U.S. has been rising dramatically. According to the Centers for Medicare and Medicaid Services (CMS), health care spending is projected to reach $8,160 per person per year by the end of 2009 compared to the $356 per person per year it was in 1970. This increase occurred roughly 2.4% faster than the increase in GDP over the same period. Though GDP varies from year-to-year and is therefore an imperfect way to assess a rise in health care costs in comparison to other expenditures from one year to the next, we can still conclude from this data that over the last 40 years the percentage of our national income (personal, business, and governmental) we've spent on health care has been rising.

Despite what most assume, this may or may not be bad. It all depends on two things: the reasons why spending on health care has been increasing relative to our GDP and how much value we've been getting for each dollar we spend.

WHY HAS HEALTH CARE BECOME SO COSTLY?

This is a harder question to answer than many would believe. The rise in the cost of health care (on average 8.1% per year from 1970 to 2009, calculated from the data above) has exceeded the rise in inflation (4.4% on average over that same period), so we can't attribute the increased cost to inflation alone. Health care expenditures are known to be closely associated with a country's GDP (the wealthier the nation, the more it spends on health care), yet even in this the United States remains an outlier (figure 3).

Is it because of spending on health care for people over the age of 75 (five times what we spend on people between the ages of 25 and 34)? In a word, no. Studies show this demographic trend explains only a small percentage of health expenditure growth.

Is it because of monstrous profits the health insurance companies are raking in? Probably not. It's admittedly difficult to know for certain as not all insurance companies are publicly traded and therefore have balance sheets available for public review. But Aetna, one of the largest publicly traded health insurance companies in North America, reported a 2009 second quarter profit of $346.7 million, which, if projected out, predicts a yearly profit of around $1.3 billion from the approximately 19 million people they insure. If we assume their profit margin is average for their industry (even if untrue, it's unlikely to be orders of magnitude different from the average), the total profit for all private health insurance companies in America, which insured 202 million people (2nd bullet point) in 2007, would come to approximately $13 billion per year. Total health care expenditures in 2007 were $2.2 trillion (see Table 1, page 3), which yields a private health care industry profit approximately 0.6% of total health care costs (though this analysis mixes data from different years, it can perhaps be permitted as the numbers aren't likely different by any order of magnitude).

Is it because of health care fraud? Estimates of losses due to fraud range as high as 10% of all health care expenditures, but it's hard to find hard data to back this up. Though some percentage of fraud almost certainly goes undetected, perhaps the best way to estimate how much money is lost due to fraud is by looking at how much the government actually recovers. In 2006, this was $2.2 billion, only 0.1% of $2.1 trillion (see Table 1, page 3) in total health care expenditures for that year.

Is it due to pharmaceutical costs? In 2006, total expenditures on prescription drugs was approximately $216 billion (see Table 2, page 4). Though this amounted to 10% of the $2.1 trillion (see Table 1, page 3) in total health care expenditures for that year and must therefore be considered significant, it still remains only a small percentage of total health care costs.

Is it from administrative costs? In 1999, total administrative costs were estimated to be $294 billion, a full 25% of the $1.2 trillion (Table 1) in total health care expenditures that year. This was a significant percentage in 1999 and it's hard to imagine it's shrunk to any significant degree since then.

In the end, though, what probably has contributed the greatest amount to the increase in health care spending in the U.S. are two things:

1. Technological innovation.

2. Overutilization of health care resources by both patients and health care providers themselves.

Technological innovation. Data that proves increasing health care costs are due mostly to technological innovation is surprisingly difficult to obtain, but estimates of the contribution to the rise in health care costs due to technological innovation range anywhere from 40% to 65% (Table 2, page 8). Though we mostly only have empirical data for this, several examples illustrate the principle. Heart attacks used to be treated with aspirin and prayer. Now they're treated with drugs to control shock, pulmonary edema, and arrhythmias as well as thrombolytic therapy, cardiac catheterization with angioplasty or stenting, and coronary artery bypass grafting. You don't have to be an economist to figure out which scenario ends up being more expensive. We may learn to perform these same procedures more cheaply over time (the same way we've figured out how to make computers cheaper) but as the cost per procedure decreases, the total amount spent on each procedure goes up because the number of procedures performed goes up. Laparoscopic cholecystectomy is 25% less than the price of an open cholecystectomy, but the rates of both have increased by 60%. As technological advances become more widely available they become more widely used, and one thing we're great at doing in the United States is making technology available.

Overutilization of health care resources by both patients and health care providers themselves. We can easily define overutilization as the unnecessary consumption of health care resources. What's not so easy is recognizing it. Every year from October through February the majority of patients who come into the Urgent Care Clinic at my hospital are, in my view, doing so unnecessarily. What are they coming in for? Colds. I can offer support, reassurance that nothing is seriously wrong, and advice about over-the-counter remedies---but none of these things will make them better faster (though I often am able to reduce their level of concern). Further, patients have a hard time believing the key to arriving at a correct diagnosis lies in history gathering and careful physical examination rather than technologically-based testing (not that the latter isn't important---just less so than most patients believe). Just how much patient-driven overutilization costs the health care system is hard to pin down as we have mostly only anecdotal evidence as above.

Further, doctors often disagree among themselves about what constitutes unnecessary health care consumption. In his excellent article, "The Cost Conundrum," Atul Gawande argues that regional variation in overutilization of health care resources by doctors best accounts for the regional variation in Medicare spending per person. He goes on to argue that if doctors could be motivated to rein in their overutilization in high-cost areas of the country, it would save Medicare enough money to keep it solvent for 50 years.

A reasonable approach. To get that to happen, however, we need to understand why doctors are overutilizing health care resources in the first place:

1. Judgment varies in cases where the medical literature is vague or unhelpful. When faced with diagnostic dilemmas or diseases for which standard treatments haven't been established, a variation in practice invariably occurs. If a primary care doctor suspects her patient has an ulcer, does she treat herself empirically or refer to a gastroenterologist for an endoscopy? If certain "red flag" symptoms are present, most doctors would refer. If not, some would and some wouldn't depending on their training and the intangible exercise of judgment.

2. Inexperience or poor judgment. More experienced physicians tend to rely on histories and physicals more than less experienced physicians and consequently order fewer and less expensive tests. Studies suggest primary care physicians spend less money on tests and procedures than their sub-specialty colleagues but obtain similar and sometimes even better outcomes.

3. Fear of being sued. This is especially common in Emergency Room settings, but extends to almost every area of medicine.

4. Patients tend to demand more testing rather than less. As noted above. And physicians often have difficulty refusing patient requests for many reasons (eg, wanting to please them, fear of missing a diagnosis and being sued, etc).

5. In many settings, overutilization makes doctors more money. There exists no reliable incentive for doctors to limit their spending unless their pay is capitated or they're receiving a straight salary.

Gawande's article implies there exists some level of utilization of health care resources that's optimal: use too little and you get mistakes and missed diagnoses; use too much and excess money gets spent without improving outcomes, paradoxically sometimes resulting in outcomes that are actually worse (likely as a result of complications from all the extra testing and treatments).

How then can we get doctors to employ uniformly good judgment to order the right number of tests and treatments for each patient---the "sweet spot"---in order to yield the best outcomes with the lowest risk of complications? Not easily. There is, fortunately or unfortunately, an art to good health care resource utilization. Some doctors are more gifted at it than others. Some are more diligent about keeping current. Some care more about their patients. An explosion of studies of medical tests and treatments has occurred in the last several decades to help guide doctors in choosing the most effective, safest, and even cheapest ways to practice medicine, but the diffusion of this evidence-based medicine is a tricky business. Just because beta blockers, for example, have been shown to improve survival after heart attacks doesn't mean every physician knows it or provides them. Data clearly show many don't. How information spreads from the medical literature into medical practice is a subject worthy of an entire post unto itself. Getting it to happen uniformly has proven extremely difficult.

In summary, then, most of the increase in spending on health care seems to have come from technological innovation coupled with its overuse by doctors working in systems that motivate them to practice more medicine rather than better medicine, as well as patients who demand the former thinking it yields the latter.

But even if we could snap our fingers and magically eliminate all overutilization today, health care in the U.S. would still remain among the most expensive in the world, requiring us to ask next---

WHAT VALUE ARE WE GETTING FOR THE DOLLARS WE SPEND?

According to an article in the New England Journal of Medicine titled The Burden of Health Care Costs for Working Families---Implications for Reform, growth in health care spending "can be defined as affordable as long as the rising percentage of income devoted to health care does not reduce standards of living. When absolute increases in income cannot keep up with absolute increases in health care spending, health care growth can be paid for only by sacrificing consumption of goods and services not related to health care." When would this ever be an acceptable state of affairs? Only when the incremental cost of health care buys equal or greater incremental value. If, for example, you were told that in the near future you'd be spending 60% of your income on health care but that as a result you'd enjoy, say, a 30% chance of living to the age of 250, perhaps you'd judge that 60% a small price to pay.

This, it seems to me, is what the debate on health care spending really needs to be about. Certainly we should work on ways to eliminate overutilization. But the real question isn't what absolute amount of money is too much to spend on health care. The real question is what are we getting for the money we spend and is it worth what we have to give up?

People alarmed by the notion that as health care costs increase policymakers may decide to ration health care don't realize that we're already rationing at least some of it. It just doesn't appear as if we are because we're rationing it on a first-come-first-serve basis---leaving it at least partially up to chance rather than to policy, which we're uncomfortable defining and enforcing. Thus we don't realize the reason our 90 year-old father in Illinois can't have the liver he needs is because a 14 year-old girl in Alaska got in line first (or maybe our father was in line first and gets it while the 14 year-old girl doesn't). Given that most of us remain uncomfortable with the notion of rationing health care based on criteria like age or utility to society, as technological innovation continues to drive up health care spending, we very well may at some point have to make critical judgments about which medical innovations are worth our entire society sacrificing access to other goods and services (unless we're so foolish as to repeat the critical mistake of believing we can keep borrowing money forever without ever having to pay it back).

So what value are we getting? It varies. The risk of dying from a heart attack has declined by 66% since 1950 as a result of technological innovation. Because cardiovascular disease ranks as the number one cause of death in the U.S. this would seem to rank high on the scale of value as it benefits a huge proportion of the population in an important way. As a result of advances in pharmacology, we can now treat depression, anxiety, and even psychosis far better than anyone could have imagined even as recently as the mid-1980's (when Prozac was first released). Clearly, then, some increases in health care costs have yielded enormous value we wouldn't want to give up.

But how do we decide whether we're getting good value from new innovations? Scientific studies must prove the innovation (whether a new test or treatment) actually provides clinically significant benefit (Aricept is a good example of a drug that works but doesn't provide great clinical benefit---demented patients score higher on tests of cognitive ability while on it but probably aren't significantly more functional or significantly better able to remember their children compared to when they're not). But comparative effectiveness studies are extremely costly, take a long time to complete, and can never be perfectly applied to every individual patient, all of which means some health care provider always has to apply good medical judgment to every patient problem.

Who's best positioned to judge the value to society of the benefit of an innovation---that is, to decide if an innovation's benefit justifies its cost? I would argue the group that ultimately pays for it: the American public. How the public's views could be reconciled and then effectively communicated to policy makers efficiently enough to affect actual policy, however, lies far beyond the scope of this post (and perhaps anyone's imagination).

THE PROBLEM OF ACCESS

A significant proportion of the population is uninsured or underinsured, limiting or eliminating their access to health care. As a result, this group finds the path of least (and cheapest) resistance---emergency rooms---which has significantly impaired the ability of our nation's ER physicians to actually render timely emergency care. In addition, surveys suggest a looming primary care physician shortage relative to the demand for their services. In my view, this imbalance between supply and demand explains most of the poor customer service patients face in our system every day: long wait times for doctors' appointments, long wait times in doctors' offices once their appointment day arrives, then short times spent with doctors inside exam rooms, followed by difficulty reaching their doctors in between office visits, and finally delays in getting test results. This imbalance would likely only partially be alleviated by less health care overutilization by patients.

GUIDELINES FOR SOLUTIONS

As Freaknomics authors Steven Levitt and Stephen Dubner state, "If morality represents how people would like the world to work, then economics represents how it actually does work." Capitalism is based on the principle of enlightened self-interest, a system that creates incentives to yield behavior that benefits both suppliers and consumers and thus society as a whole. But when incentives get out of whack, people begin to behave in ways that continue to benefit them often at the expense of others or even at their own expense down the road. Whatever changes we make to our health care system (and there's always more than one way to skin a cat), we must be sure to align incentives so that the behavior that results in each part of the system contributes to its sustainability rather than its ruin.

Here then is a summary of what I consider the best recommendations I've come across to address the problems I've outlined above:

1. Change the way insurance companies think about doing business. Insurance companies have the same goal as all other businesses: maximize profits. And if a health insurance company is publicly traded and in your 401k portfolio, you want them to maximize profits, too. Unfortunately, the best way for them to do this is to deny their services to the very customers who pay for them. It's harder for them to spread risk (the function of any insurance company) relative to say, a car insurance company, because far more people make health insurance claims than car insurance claims. It would seem, therefore, from a consumer perspective, the private health insurance model is fundamentally flawed. We need to create a disincentive for health insurance companies to deny claims (or, conversely, an extra incentive for them to pay them). Allowing and encouraging aross-state insurance competition would at least partially engage free market forces to drive down insurance premiums as well as open up new markets to local insurance companies, benefiting both insurance consumers and providers. With their customers now armed with the all-important power to go elsewhere, health insurance companies might come to view the quality with which they actually provide service to their customers (ie, the paying out of claims) as a way to retain and grow their business. For this to work, monopolies or near-monopolies must be disbanded or at the very least discouraged. Even if it does work, however, government will probably still have to tighten regulation of the health insurance industry to ensure some of the heinous abuses that are going on now stop (for example, insurance companies shouldn't be allowed to stratify consumers into sub-groups based on age and increase premiums based on an older group's higher average risk of illness because healthy older consumers then end up being penalized for their age rather than their behaviors). Karl Denninger suggests some intriguing ideas in a post on his blog about requiring insurance companies to offer identical rates to businesses and individuals as well as creating a mandatory "open enrollment" period in which participants could only opt in or out of a plan on a yearly basis. This would prevent individuals from only buying insurance when they got sick, eliminating the adverse selection problem that's driven insurance companies to deny payment for pre-existing conditions. I would add that, however reimbursement rates to health care providers are determined in the future (again, an entire post unto itself), all health insurance plans, whether private or public, must reimburse health care providers by an equal percentage to eliminate the existence of "good" and "bad" insurance that's currently responsible for motivating hospitals and doctors to limit or even deny service to the poor and which may be responsible for the same thing occurring to the elderly in the future (Medicare reimburses only slightly better than Medicaid). Finally, regarding the idea of a "public option" insurance plan open to all, I worry that if it's significantly cheaper than private options while providing near-equal benefits the entire country will rush to it en masse, driving private insurance companies out of business and forcing us all to subsidize one another's health care with higher taxes and fewer choices; yet at the same time if the cost to the consumer of a "public option" remains comparable to private options, the very people it's meant to help won't be able to afford it.

2. Motivate the population to engage in healthier lifestyles that have been proven to prevent disease. Prevention of disease probably saves money, though some have argued that living longer increases the likelihood of developing diseases that wouldn't have otherwise occurred, leading to the overall consumption of more health care dollars (though even if that's true, those extra years of life would be judged by most valuable enough to justify the extra cost. After all, the whole purpose of health care is to improve the quality and quantity of life, not save society money. Let's not put the cart before the horse). However, the idea of preventing a potentially bad outcome sometime in the future is only weakly motivating psychologically, explaining why so many people have so much trouble getting themselves to exercise, eat right, lose weight, stop smoking, etc. The idea of financially rewarding desirable behavior and/or financially punishing undesirable behavior is highly controversial. Though I worry this kind of strategy risks the enacting of policies that may impinge on basic freedoms if taken too far, I'm not against thinking creatively about how we could leverage stronger motivational forces to help people achieve health goals they themselves want to achieve. After all, most obese people want to lose weight. Most smokers want to quit. They might be more successful if they could find more powerful motivation.

3. Decrease overutilization of health care resources by doctors. I'm in agreement with Gawande that finding ways to get doctors to stop overutilizing health care resources is a worthy goal that will significantly rein in costs, that it will require a willingness to experiment, and that it will take time. Further, I agree that focusing only on who pays for our health care (whether the public or private sectors) will fail to address the issue adequately. But how exactly can we motivate doctors, whose pens are responsible for most of the money spent on health care in this country, to focus on what's truly best for their patients? The idea that external bodies---whether insurance companies or government panels---could be used to set standards of care doctors must follow in order to control costs strikes me as ludicrous. Such bodies have neither the training nor overriding concern for patients' welfare to be trusted to make those judgments. Why else do we have doctors if not to employ their expertise to apply nuanced approaches to complex situations? As long as they work in a system free of incentives that compete with their duty to their patients, they remain in the best position to make decisions about what tests and treatments are worth a given patient's consideration, as long as they're careful to avoid overconfident paternalism (refusing to obtain a head CT for a headache might be overconfidently paternalistic; refusing to offer chemotherapy for a cold isn't). So perhaps we should eliminate any financial incentive doctors have to care about anything but their patients' welfare, meaning doctors' salaries should be disconnected from the number of surgeries they perform and the number of tests they order, and should instead be set by market forces. This model already exists in academic health care centers and hasn't seemed to promote shoddy care when doctors feel they're being paid fairly. Doctors need to earn a good living to compensate for the years of training and massive amounts of debt they amass, but no financial incentive for practicing more medicine should be allowed to attach itself to that good living.

4. Decrease overutilization of health care resources by patients. This, it seems to me, requires at least three interventions:

* Making available the right resources for the right problems (so that patients aren't going to the ER for colds, for example, but rather to their primary care physicians). This would require hitting the "sweet spot" with respect to the number of primary care physicians, best at front-line gatekeeping, not of health care spending as in the old HMO model, but of triage and treatment. It would also require a recalculating of reimbursement levels for primary care services relative to specialty services to encourage more medical students to go into primary care (the reverse of the alarming trend we've been seeing for the last decade).

* A massive effort to increase the health literacy of the general public to improve its ability to triage its own complaints (so patients don't actually go anywhere for colds or demand MRIs of their backs when their trusted physicians tells them it's just a strain). This might be best accomplished through a series of educational programs (though given that no one in the private sector has an incentive to fund such programs, it might actually be one of the few things the government should---we'd just need to study and compare different educational programs and methods to see which, if any, reduce unnecessary patient utilization without worsening outcomes and result in more health care savings than they cost).

* Redesigning insurance plans to make patients in some way more financially liable for their health care choices. We can't have people going bankrupt due to illness, nor do we want people to underutilize health care resources (avoiding the ER when they have chest pain, for example), but neither can we continue to support a system in which patients are actually motivated to overutilize resources, as the current "pre-pay for everything" model does.

CONCLUSION

Given the enormous complexity of the health care system, no single post could possibly address every problem that needs to be fixed. Significant issues not raised in this article include the challenges associated with rising drug costs, direct-to-consumer marketing of drugs, end-of-life care, sky-rocketing malpractice insurance costs, the lack of cost transparency that enables hospitals to paradoxically charge the uninsured more than the insured for the same care, extending health care insurance coverage to those who still don't have it, improving administrative efficiency to reduce costs, the implementation of electronic medical records to reduce medical error, the financial burden of businesses being required to provide their employees with health insurance, and tort reform. All are profoundly interdependent, standing together like the proverbial house of cards. To attend to any one is to affect them all, which is why rushing through health care reform without careful contemplation risks unintended and potentially devastating consequences. Change does need to come, but if we don't allow ourselves time to think through the problems clearly and cleverly and to implement solutions in a measured fashion, we risk bringing down that house of cards rather than cementing it.

Health And Wellness Products - How To Make Your Own

 

Health and health products will mean very different things to different people.

Wellness can be defined as' pursuing a healthy lifestyle and balanced.

For the purposes of this article, health products is being looked at in context
of 'free medicines, health supplements and health medicine.

While for some people, health products may be viewed as an aid to recovery
of disease, for others may be a means to further improve some
aspects of their current health. Various and used for product
are as many definitions as well as health products or health
program, of course depending on who is promoting them at a specified time.

Whatever your reasons for pursuing alternative care health or health and wellness
products, a common goal is to achieve optimised health and well-being.

There are powerful media images hailing the benefits and safety of many over the
counter drugs, supplements and health and wellness products, every where you turn
these days. They have equally strong claims of being the one and only miracle cure
or solution for one ailment or another. How accurate are these claims though, and
what are the real costs to you in monetary and health risk terms?

Immediately after reading this article, go take a look and do a quick add-up of the
total cost of all the health and wellness products you currently have in stock. I'm
sure the figure will surprise you just as much as learning about the very real and
harmful side effects which can be caused by some of these drugs or supplements
that are supposed to be contributing to your overall state of wellness.

You may also be surprised to know that many of the 'over the counter drugs you
buy on a regular basis, simply treat the symptoms and not the real health issue.
Needless to say, this approach of focusing on the symptom, side-steps
the crucial requirement of getting to the root cause of your condition or whatever
it is that ails you.

You're most likely to pursue a wellness product either because you are becoming
wary of the adverse effects of chemically produced drugs or because you're keen to
recover from ill-health and improve a specific health condition. In some instances it
might be that you just want to optimise your current state of good health.

While some health and wellness products can be an effective measure toward
improving your health, you should note that long-term use of certain over the counter
drugs and some supplements can cause you more harm than good, with the long-
term implications far outweighing any short-term benefits. You may well find that
you are paying far too high a price on the basis of a mere quick fix promise.

For thousands of years, people in lands far and wide have used natural homemade
remedies to manage their health conditions and wellness needs, without manufactured
health and wellness products, that can be detrimental to health. They have purely relied
upon attaining or maintaining health by plants or by other natural means.
It could be argued that with the emergence of chemical and pharmacological methods,
many forms of this natural means to health and wellness have declined. In fact, even
by todays standards, there are many so-called under-developed countries where
inhabitants' rely on nothing more than homemade health and wellness products,
gained via natural methods of plants or plant-based extracts.

While conventional medicine relies on scientifically backed research to substantiate
effectiveness and safety. In contrast, similar cannot be said about some alternative
medicines or health and wellness products. There is no such requirement but their
promotion as regard effectiveness are deemed sufficient in themselves as support
for therapeutic or wellness claims.

Herbal remedies in general are harmless, however, certain claims being made by
some health and wellness products promoters, (under the banner of being
'natural')) can insinuate their health and fitness products being the
exclusive answer to your health condition or wellness questions, thus putting you
at great risk. Secondly, how open are they being about what's really inside? You
should always consult your physician over any health concerns, as well as discussing
with him/her your intention or choice of alternative means for treatment with any
health and wellness product or remedy.

Multi-billion-dollar industries have long weald their power by way of
lobbying to gain exemption from FDA regulation. This has been exactly the
case, according to the Skeptical Inquirer, who, on commenting on
the 'dietary supplement industry back in 1994, states - "Since then, these
products have flooded the market, subject only to the scruples of their
manufacturers".

The above point is an important one to note in that, while health and wellness
products manufacturers may list ingredients and quantities being used in
specific health and wellness products, there has been no real pressure on them to
do so, or to do so accurately. Furthermore, neither has there been any
watchdog body to ensure they are penalised for this failing.

So, what are the alternatives open to you? Increasingly, more and more people
are turning to do-it-yourself health and wellness homemade herbal remedies.
The distinct difference being that in making your own health and wellness products,
you are in the driving seat. Not only do you have a full awareness of exactly
what the ingredients are and the true quantities, but with the appropriate level of
guidance from a reputable practitioner, you're more conversant with any health
implications, if any.

With the right know-how, you too can draw on the old-fashioned yet effective
sources to greatly improve your health. For instance, using naturally prepared
herbs, vitamins, minerals and nutritional supplements, essential oils and flower
essences to create real healing solutions that deal with particular health
conditions rather than just the symptoms.

It is in the interest of a health and wellness product manufacturers to promote their
products as being the only option open to you. They don't want you to know about
the abundant natural resources and health-giving potent attributes of herbs and home
remedies which have been used effectively for thousands of years. You see, these
remedies cannot be patented because you can make them yourself and at a
fraction of the cost.

Whether your goal is to overcome illness, drugs intolerance, allergies or just to
optimise your already good health, with a little know-how, you can start making
your own health and wellness products and remedies, using nothing more than the
readily available natural resources in your home and garden. Not only will you
save your hard earned cash, you also alleviate the risk of serious or harmful
additives and side effects.

Are you interested in learning more about how you can treat numerous common ailments without the harsh side effects, using nothing but natural herbs, vitamins
and nutrients you prepare yourself at home? For instance, did you know that
placing yogurt on your face help to bring water from the deeper layers
of your skin to the surface, moisturizing your skin for the rest of the day and hiding
wrinkles?

Here are just a few more of the many quick and effective remedies you can learn
to make:

1. Natural laxatives

2. Beauty recipes

3. Skin care and cleansing preparations such as acne treatment

4. Herbal shampoos as well as how to treat hair loss

5. Dermatitis

6. Menstrual Pain and PMS Symptoms