I think health insurance is the biggest scam - and 30% of people are better off without it. Here are my reasons why I discourage insurance:
1. Health insurance schemes have a profit motive. They use your money to make money so they can pay you for any health costs that you MAY incur.
2. Health fund profitability: Health funds control alot of money, which means that they invest in large companies that are liquid enough that the fund can buy & sell without impacting too greatly on the stock price. For security reasons and liquidity reasons they also invest in bonds. For this reason, if you have a good understanding of investments and enjoy it, you can actually make more money than they do. But the big benefit is that if you are healthy, you dont need to pay out any costs
3. Alternative insurance: If you think about it, we confront many types of risks in our life, whether health, car, house insurance, and we all go to private enterprise. But they have a profit motive. I think it makes alot more sense to set up a fund within your own family....extended family if you are not wealthy enough to pay your own way. Try to find an independent custodian for the funds would be my strategy for extended families because there are often favourite siblings and graft. The big benefit is the money stays within the family, and you can share resources like investment ideas.
4. No subsidisation: The problem with insurance is that our risks are not all the same but insurance premiums are within your specific age category. I'm sure laws in each country prevent discrimination by insurance companies, even rational discrimination. The implication is that if you are healthy, you are subsidising unhealthy families, whether they have a genetic disposition or just dont take care of themselves with preventative care. If you subscribe to the idea of 'social harmony' and helping others, maybe you think that, but then again maybe you prefer to decide your own benefactors.
5. Knowing the downside: Its noteworthy that alot of people just dont understand their national insurance scheme, the rules, their options, and for this reason they are not in a position to make reliable judgements about the benefits of insurance. It doesnt help that health insurance schemes are so complex. That in itself is a cost, and not reading the fine print on the contract is a BIG RISK, which is what insurance is intended to protect you from. In some countries the public health system is almost as good as the private system, and in some instances or areas it can even be better. The best way is to monitor the media, but keep those horrid stories in perspective because alot of people are satisfied with their treatment.
6. Knowing your options: We are lead to believe that you are going to be hugely exposed if you dont have health insurance, but there are options. Often you are just subjected to wait lists, sometimes without even discomfort. But I think if you cant get service from a public hospital, you can always pay. If the costs are prohibitive consider going overseas or buying your medicines online (overseas). Medical care in the Philippines or India can be as good or even better than in western countries. The reason is that the best doctors in poor countries are often foreign educated and service a small 'wealthy class'. But I advise you to pay at least to go to one of the top 5 hospitals. Beds might be $40/night. Some western public insurance schemes like Japan include dental. In Australia all taxpayers must pay Medicare, which functions essentially as a tax.
7. Personal diversification: An insurance scheme diversifies people's risks. My suggestion is that you collectivise the risks within the family or among a trusted group of friends, say your college mates, and then internalise the savings. Of course our lives change, so it makes sense to have a cashing out strategy.
Anyone interested in setting up such a scheme or participating in one can contact me.
Saturday, September 29, 2007
Sunday, September 23, 2007
Simple answers for complex problems
It seems to me that a great many problems pass under the radar because governments and health professionals attempt to present complex processes or issues as simple so that they might appeal to a broader audience. Of course education demands that you tailor your communication to the intellectual capacity of the audience. But when you are addressing an audience that exhibits a wide range of intellectual capacity, doesn't it make sense to actually target your audience rather than give them a simple message. Governments are the main provider of health advice and they tend to use the television as their preferred media. The other important media are direct mailing (letterbox drops) and brochures stocked at medical centres and hospitals. The appeal of TV is that it reaches most people, but one has to wonder if the message is just too simple and thus unprovocative to make an impact. Certainly we can't leave it to the food companies to educate people in good health. Not just because they have a conflict of interest in terms of the dietary value of their foods, but becaus they are ven worse than governments in over-simplifying the message.
By way of example, about 5 years ago my doctor informed me that I had a high cholesterol level. I was eating too much cheese and white bread and doing little exercise. The reason this didn't bother me was that I was not overweight. The media had created a perception in my mind that 'fat = cholesterol'. Recognising that my perceptions about 'good health' were misguided I promptly started reading alot of health books on diet, self-improvement, etc. As a result, not only did I learn that thin people dont necessarily have low choloesterol levels, I learned that it was actually that the type of cholesterol and the ratio of HDL and LDL is more important.
The current problem is that perceptions are more important than facts, which means misinformation, lack of disclosure and context dropping are rampant in product labelling. You might ask - why is that. I think its because it costs advertisers too much to correct the perceptions of other advertisers, and there is no industry-wide effort to correct those misconceptions. Basically not only does food have to be nutritious, it has to taste good. In fact taste is a bigger selling point, because whilst we can be high-minded about help, most people circum to temptation. The implication is that food producers are left choosing between salt, sugar or fat as a way of satisfying the taste preferences of consumers. But there are other issues as well. It matters are great deal what our food looks like. So expect transition trans fatty acids so your margarine spreads easily.
Another problem is relative standards. We might be told that a certain cheese is 25% less fat, but by what standard is that good. There is a very healthy 'low cholesterol' olive oil based spread on the market that discloses that 'it is virtually free of trans fatty acids'. But there is virtually no nicotine in cigarettes as well, so one wonders about these relative standards. At the end of the day, I would suggest in 2 years time, you could be learning that:
1. Trans fatty acids are not the problem they are thought to be, in fact they have good aspects
2. Trans fatty acids are seriously carcinogenic in very small amounts.
You might wonder why food manufacturers are placing ingredients into food that they really have no understanding of. This in itself is reason enough to eat unprocessed foods like fresh fruit and vegetables. The problem is - its hard to know what is 'fresh' anymore in the sense that even these staples can pose a risk in terms of contamination by insecticides, fungicides, etc. Increasingly food producers are using genetically modified foods, and whilst many of these crops are being developed to reduce chemical application to crops, there is the possibility that the GM-solution might pose a different threat.
I have mixed thoughts on GM foods because the reasons for modifying them, or the outcome of modifying them is mixed. The rationale for tinkering with the DNA of a food gene is to:
1. Make the food look more presentable (saleable) in the store. To the extent that this gives the food a longer shelf life, more durable is a good thing, but i think the consumer would like to believe that taste, texture and juice content will remain the same. I can't believe that biotech companies would alter the good aspects of a food unless it was a compromise. The implication is that they are not just altering a single gene.
2. Make the food resistant or repulsive to insects or disease by adding certain DNA that has this characteristic
It should be apparent that the food producers concern is factors that helps the producer - not the consumer. The implication is that consumers have no advocate. It matters only that you are satisfied at the point of sale, even though you will ultimately not know until you cut open and taste the food. But thats no worse that the experience we would have with processed food, in which case we have no idea what the condition of that purated food could be, and what additives have been used to preserve colour. In these instances where consumers are treated as ignorant fools utimately it is deaths that are going to cause a revision of health/food preparation standards. The problem is - if its a slow death - from GM poisoning (if any such evidence emerges), you can bet that little will be done because its not an immediate problem and the industry will be geared up to protect their established procedures, brands or ingredients.
An example of context dropping is where you have food producers advertising 'low salt' food varieties, but they preserve taste by adding more fat and preservatives. Or a 'low sugar' has high fat, or a 'low fat' yoghurt has low sugar. The reality however is that it ultimately matters more what role a certain food plays in your diet. The implication is that people should be planning a balanced diet and have a shopping list that relates to a dietary plan. There is little consensus but the greatest support seems to be for a low GI, high carb diet with an emphasis on lean red meat and fish. The appeal of low GI carbs are that they are more slowly converted into sugars absorbed into the blood stream. Now 'low GI foods' may seem highly promising but the same problem exists - if you eat alot of 'low GI food' it will still be converted into soluble sugars, and any excess sugars will be converted into fat. The implication is that whilst complex carbohydrates (low GI) like vegetables and non-tropical fruits might be good for you, if you eat too many of them, you will put on fat.
This brings us to the last point - your overall energy balance. At the end of the day people tend to be eating more and exercising less because of changes in lifestyle, social behaviour and technology. We are playing less sport and playing more computer games or using computers. Perhaps the best opportunity to create good habits is by organising your life - schedules provide one form of structure, organised activities another. Planning is another good strategy - in the sense that you can identify all the qualities you want in a house. eg. A library 1km away with a lan to walk there. You can buy an apartment right above a shopping mall or 1km away so you get the benefit of exercise getting there. Alot of eating is actually anxiety-related. When we have a build up of mental anxiety we want a physical 'release'. We often use food to medicate these needs when in fact exercise is a better alternative. Previously I lived at Terrigal and whenever I had one of these moments I would walk along the beach - it proved to be about 3 times a day. Being near a forest is another great opportunity or just a quiet residential area.
By way of example, about 5 years ago my doctor informed me that I had a high cholesterol level. I was eating too much cheese and white bread and doing little exercise. The reason this didn't bother me was that I was not overweight. The media had created a perception in my mind that 'fat = cholesterol'. Recognising that my perceptions about 'good health' were misguided I promptly started reading alot of health books on diet, self-improvement, etc. As a result, not only did I learn that thin people dont necessarily have low choloesterol levels, I learned that it was actually that the type of cholesterol and the ratio of HDL and LDL is more important.
The current problem is that perceptions are more important than facts, which means misinformation, lack of disclosure and context dropping are rampant in product labelling. You might ask - why is that. I think its because it costs advertisers too much to correct the perceptions of other advertisers, and there is no industry-wide effort to correct those misconceptions. Basically not only does food have to be nutritious, it has to taste good. In fact taste is a bigger selling point, because whilst we can be high-minded about help, most people circum to temptation. The implication is that food producers are left choosing between salt, sugar or fat as a way of satisfying the taste preferences of consumers. But there are other issues as well. It matters are great deal what our food looks like. So expect transition trans fatty acids so your margarine spreads easily.
Another problem is relative standards. We might be told that a certain cheese is 25% less fat, but by what standard is that good. There is a very healthy 'low cholesterol' olive oil based spread on the market that discloses that 'it is virtually free of trans fatty acids'. But there is virtually no nicotine in cigarettes as well, so one wonders about these relative standards. At the end of the day, I would suggest in 2 years time, you could be learning that:
1. Trans fatty acids are not the problem they are thought to be, in fact they have good aspects
2. Trans fatty acids are seriously carcinogenic in very small amounts.
You might wonder why food manufacturers are placing ingredients into food that they really have no understanding of. This in itself is reason enough to eat unprocessed foods like fresh fruit and vegetables. The problem is - its hard to know what is 'fresh' anymore in the sense that even these staples can pose a risk in terms of contamination by insecticides, fungicides, etc. Increasingly food producers are using genetically modified foods, and whilst many of these crops are being developed to reduce chemical application to crops, there is the possibility that the GM-solution might pose a different threat.
I have mixed thoughts on GM foods because the reasons for modifying them, or the outcome of modifying them is mixed. The rationale for tinkering with the DNA of a food gene is to:
1. Make the food look more presentable (saleable) in the store. To the extent that this gives the food a longer shelf life, more durable is a good thing, but i think the consumer would like to believe that taste, texture and juice content will remain the same. I can't believe that biotech companies would alter the good aspects of a food unless it was a compromise. The implication is that they are not just altering a single gene.
2. Make the food resistant or repulsive to insects or disease by adding certain DNA that has this characteristic
It should be apparent that the food producers concern is factors that helps the producer - not the consumer. The implication is that consumers have no advocate. It matters only that you are satisfied at the point of sale, even though you will ultimately not know until you cut open and taste the food. But thats no worse that the experience we would have with processed food, in which case we have no idea what the condition of that purated food could be, and what additives have been used to preserve colour. In these instances where consumers are treated as ignorant fools utimately it is deaths that are going to cause a revision of health/food preparation standards. The problem is - if its a slow death - from GM poisoning (if any such evidence emerges), you can bet that little will be done because its not an immediate problem and the industry will be geared up to protect their established procedures, brands or ingredients.
An example of context dropping is where you have food producers advertising 'low salt' food varieties, but they preserve taste by adding more fat and preservatives. Or a 'low sugar' has high fat, or a 'low fat' yoghurt has low sugar. The reality however is that it ultimately matters more what role a certain food plays in your diet. The implication is that people should be planning a balanced diet and have a shopping list that relates to a dietary plan. There is little consensus but the greatest support seems to be for a low GI, high carb diet with an emphasis on lean red meat and fish. The appeal of low GI carbs are that they are more slowly converted into sugars absorbed into the blood stream. Now 'low GI foods' may seem highly promising but the same problem exists - if you eat alot of 'low GI food' it will still be converted into soluble sugars, and any excess sugars will be converted into fat. The implication is that whilst complex carbohydrates (low GI) like vegetables and non-tropical fruits might be good for you, if you eat too many of them, you will put on fat.
This brings us to the last point - your overall energy balance. At the end of the day people tend to be eating more and exercising less because of changes in lifestyle, social behaviour and technology. We are playing less sport and playing more computer games or using computers. Perhaps the best opportunity to create good habits is by organising your life - schedules provide one form of structure, organised activities another. Planning is another good strategy - in the sense that you can identify all the qualities you want in a house. eg. A library 1km away with a lan to walk there. You can buy an apartment right above a shopping mall or 1km away so you get the benefit of exercise getting there. Alot of eating is actually anxiety-related. When we have a build up of mental anxiety we want a physical 'release'. We often use food to medicate these needs when in fact exercise is a better alternative. Previously I lived at Terrigal and whenever I had one of these moments I would walk along the beach - it proved to be about 3 times a day. Being near a forest is another great opportunity or just a quiet residential area.
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