Soulless, Irresponsible Marketing

Compared to the same period a year back, sales of alcohol jumped 55% during the third week of March, just around the time that people were told to shelter at home. Online sales of alcohol were up 243% over the same period. Here in Colorado liquor stores were designated an "essential" business. In case you can't guess why, consider cases of domestic violence skyrocketing or hospitals trying to cope with the surge in COVID-19 cases while also dealing with desperate drinkers suffering withdrawal.

Maybe some of this was simply the toilet paper crowd stockpiling beer against the COVID Apocalypse.  I like a drink as much as the next guy. OK, maybe a little more than the next guy. But this really made me take a look at my own relationship with alcohol.

And now, just when people were penned in, missing friends and family, unable to get out and maybe even dealing with the loss of a job or, worse, a loved one, guess who is there to help? That's right! Beer company marketing departments! Consider these zingers from the helpful folks at Budweiser.

"Keep your 6 packs close and everyone else 6 feet away!" Good advice, right? Or maybe you prefer the direct approach.

"Stay home and drink beer!" (Seriously, that is an actual tweet from Budweiser.)

What sort of human being thinks it is ok to take advantage of the current sad situation to coax people into drinking more?

Its not even good beer.

COVID-19 and "Immune Support"

Shockingly, ads for supplements that will "support", "boost" and "enhance" your immune system are suddenly everywhere. Sadly, "immune boosting" supplements are flying off the shelves now too, rewarding companies for trying to cash in on your fear with products that, at best, do no harm. Most experts - from The Centers for Disease Control and Prevention, the National Institutes for Health, the Center for Science in the Public Interest, Consumer Reports Health and others - suggest you ignore all the hype. As someone who's business includes selling supplements, I agree with them.

First and foremost, there is no independent clinical evidence that supplements will improve immune function. And even if there was, getting your immune system amped up would not happen overnight.  You can't suddenly add this or that nutrient to your diet and have a stronger immune system by next week.

Second, self-prescribing nutrients can be risky. Zinc, for example, which is a common ingredient in many "immune support" supplements, can block the absorption of other important nutrients like copper and Vitamin B12 when taken in excessive doses. More is definitely not better in all cases.

So what can help in this time of heightened concern? Going back to basics. The following suggestions will help keep your immune system punching above its weight class and have broad support from the medical, nutrition and public health communities.

Eat a healthy diet. Make sure you consume a diet rich in fruits, vegetables, whole grains, low fat dairy, fish and lean meats. Supplements really may help here in making sure you are getting all the right nutrients you need each day. Since you are stuck at home more now, use the time to prepare more fresh meals and reduce your dependence on prepared convenience foods.

Get some exercise. You don't need to go all Vin Diesel here. Get out and walk a mile or two. Take the dog along. You will both enjoy being out of the house. Spend half an hour doing a moderate exercise routine each day. There are hundreds to choose from in books or online. And you are stuck home anyway. You might even acquire a really good lifelong habit.

Get plenty of rest. That means sleeping 7 to 8 hours every night. Don't let being at home tempt you to revert to college hours and stay up all night binging TV shows.

Stay hydrated. Drinking half your body weight in ounces every day is a good guideline but don't obsess over it. Just remember to be drinking water through your day. Not soda. Not sugary "fruit" juices. Not sports drinks. Water.

Finally, ignore all the BS you see about magical immune support products. The only thing they support is the manufacturer's bottom line.

Why Does Healthcare Cost So Much?

The United States has the most expensive healthcare system in the world, and not by just a little bit. Per capita spending on medical and healthcare services in the US is nearly double the next most expensive country (Germany) and 2 1/2 times that of the UK (2018 data). Between 2010 and 2019, healthcare spending in the US rose more than 16%.

And it is not as though we are getting much more for our money. Despite significantly higher healthcare spending, America’s health outcomes are not any better than those in other developed countries. The United States actually performs worse in some common health metrics like life expectancy, infant mortality, and unmanaged diabetes. We are overtested, overdiagnosed, overtreated and overcharged but no healthier.

The fundamentals of the US healthcare system are broken. The culprits include insurance companies, government, hospitals, pharmaceutical companies, the occasional rogue doctor and us, the healthcare consumer. The result is out of control costs with no improvement in health outcomes.

As just one example, a heart bypass operation costs about $15,000 in France. In the US, with no measurable difference in quality of care or outcomes, the same procedure ranges from $40,000 to $500,000. That's right. The same procedure, with the same outcome, costs at least 160% more in the US than in France and may cost as much as 3,200% more.

Then there is the way hospitals bill for their services. Generally they have a "sticker price" that is grossly inflated. Why? Because hospitals negotiate prices with insurance companies that provide them with steep discounts and they have to make it up somewhere. Good luck finding out anything about this. The hospital and insurer generally agree to keep their discount rates secret. Your own insurer will not disclose it to you, let alone the hospital. Meanwhile, if you don't have insurance or are forced to go "out of network" for care, you pay the full sticker price, which may be marked up as much as 500%.

Even if you do have insurance, you may still be blindsided by a large "surprise bill".  This happens to about 60% of insured American who receive hospital care. A surprise bill includes sticker price charges for lab work, "facility charges", and fees for doctors you never see but who consult on your case and who may be "out of network" to you.

And then there are pharmaceutical companies. If you remember back just a few months to when Bernie Sanders was running for the Democratic Presidential nomination, he made a big issue over the cost of insulin - a vital drug for many diabetics. Many people do not know that when insulin was developed the researchers sold the patent for just $1 because they felt it would be unethical to profit from a lifesaving drug. Pharmaceutical companies had no such reservations. A 10ml vial of insulin in the US costs roughly $300. The cost in Canada for the exact same amount of the exact same drug? $30. That's right, 1/10th of the US price. One out of 4 patients in the US reports that they ration their insulin, taking less than they really need, because of the cost. Why? Just because.

Do we really need all the "care" that we get? Johns Hopkins University School of Medicine has estimated that as much as 20% of all medical services provided in the US are medically unnecessary. This includes unneeded diagnostic tests, surgeries and medication. Why? Three reasons.

First, doctors often order extra tests or procedures "just in case", to protect themselves from malpractice lawsuits.

Second, some less than ethical doctors order tests or perform procedures that insurers will pay for to make up for artificially low reimbursement rates on the services that are actually needed.

And finally, there is us, the patients. We often demand medication based on that most reliable of all sources of medical information - drug company television ads. Or demand procedures that we do not need.

The key to changing the status quo in our healthcare system is transparency.

Imagine this if you will. You are booking a flight on an airline but they will not tell you exactly where you are going or when you will get there, and you will find out what it costs at the end of your trip, when you can be charged whatever the airline feels like charging you. Sounds crazy right? And yet that is exactly how our healthcare system works today.

As we continue to debate how to provide affordable healthcare services to all Americans, it is important that we not lose track of the fact that the system itself is broken. It is not just a matter of providing insurance to more people. That just pours more money down the bottomless hole. Prices need to be transparent. We need to know what things are going to cost before we accept services, and we need to be able to compare prices among providers. We need to become educated consumers.

Here are some things you can do right now.

1. Demand upfront pricing for your medical care. And get it in writing.

2. Know what things cost. Here are some resources you can use to research costs:

FairHealthConsumer.org                                          GoodRX.com

                                       HealthCareBlueBook.com

3. Don't be hesitant to negotiate. In our healthcare system everything is negotiable. Check out RestoringMedicine.org for guidance.

4. Read before you sign. Hospital admission paperwork is mindnumbingly complex small print. Consent forms often include language obligating you to pay them 100% of whatever they charge. Cross it out.

No one is going to protect you from a predatory healthcare system. Fixing what is really broken is not even part of the discussion. So until it is, you are on your own.

Yet More Labeling Shenanigans

Will the label lying never stop?

It is well known now that the nitrates in processed meats cause various cancers. The World Health Organization has classified them as a carcinogen. Many people are aware that the nitrites that processors began to add as a replacement for nitrates are converted into nitrates by the body and so are equally to be avoided.

You might think this would give processors pause, but you'd be wrong. Why change their cancer causing product when they can just mislabel it instead! Seriously, people willingly work for these companies??

Most cold cuts, hot dogs, sausages, bacon, corned beef, meat based sauces and all canned meats are highly processed. Companies do not process meat for the fun of it, but to either extend its shelf life or change the taste and the main methods are smoking, curing, or adding salt or preservatives. Regardless, eating even small amounts of processed meats causes cancer and raises your risk of heart disease and diabetes. The culprits are mainly, if not entirely, the nitrates and nitrites added during processing.

Consumers tend to think that food labeling is highly regulated and generally accurate. They are wrong. The words "uncured" and "nitrate/nitrite free" on a label don't necessarily mean that the meat is either uncured or nitrate/nitrite free. That's right. Reading "Uncured" on a label does NOT mean the meat is uncured.

"The USDA allows these claims to appear on meat labels as long as it was cured using nitrites derived from celery or other vegetables," explains Charlotte Vallaeys, senior policy analyst for food and nutrition at Consumer Reports. Apparently since the nitrites are "natural" they don't count, even though your body cannot tell the difference.

Consumer Report's testing of uncured and nitrate/nitrite free deli meats last year found nitrite levels indistinguishable from those found in meats cured with synthetic nitrites. So if your uncured, nitrate/nitrite free meat lists celery or celery salt among its ingredients (only in America could meat have ingredients) then it is neither uncured nor nitrate/nitrite free. And its all perfectly legal.

"Our advice is to eat very little, if any, processed meat," Vallaeys says.

COVID-19 Advice From Consumer Reports

Unfortunately, many people are getting most of their advice on how to cope with the present Coronavirus pandemic from the millions of people on Facebook who have become MDs, RNs, infectious disease experts and epidemiologists in the last 3 months. For those of you who want to expand your horizons a bit beyond the experts on social media, here is some advice for dealing with the situation from On Health, a newsletter of Consumer Reports.

Rely on Credible Sources

Unsurprisingly, the level of noise and static bombarding us from all sides on the subject is at record levels. Scammers with miracle cures to sell, ignorant people with strong opinions and a Facebook account, conflicting information from official sources. What's a person to do?

Getpocket.com has a library of articles from many different credible sources available for you to browse and consume at your leisure. This is a collection of opinion pieces and science-based reports. Another good source for official information (the credible kind, not the press conference variety) is available at
Coronavirus.gov. Finally, Consumer Reports itself has a library of up-to-date articles at CR.org/covid19. I like this one because CR has nothing to sell and accepts no advertising.

Avoid the Scammers

Every time there is a real problem, the scammers crawl out from under their rocks offering solutions, cures and misinformation by the truckload. Scammers are not just people trying to sell you worthless products, but also trying to pass on useless, or even dangerous information for their own reasons. Whether it is  a supplement or medication that cures Covod-19, a conspiracy theory about its origin or the top ten reasons why you should refuse to wear a mask in crowds, be suspicious. Check sources before you "buy" whatever it is someone is pitching.

Stay at Home

The safest place to be right now is in your own home. Stay there as much as you can. Skip dining out and avoid traveling by transit, train or plane. Make fewer trips to the grocery store by planning your purchases carefully, and use a mask when you do go. Go at times when stores are less crowded. Many offer "senior hours". Follow social distancing guidelines. Avoid directly touching "high contact" surfaces like handrails, doorknobs and elevator buttons.

Wash Your Hands

It turns out that your mom was right about this too. Most public health authorities cite washing your hands with soap and water for 20 - 30 seconds and the best preventive measure you can take. Wash them every time you return home from being out, before and after you handle food, every time you use the bathroom, blow your nose, sneeze or cough.

Disinfect Key Areas

Clean and disinfect "high touch" areas in your home at least daily. These include tables, countertops, doorknobs, light switches, sinks and handles on desks and cabinets. Don't neglect disinfecting your mobile phone, tablet and computer keyboard either. Use a disinfectant that is at least 70% alcohol, such as Clorox Disinfecting Wipes. Or you can make your own solution by mixing 1/3 cup of chlorine bleach with a gallon of tap water.

Limit Direct Social Interaction

As unpleasant as this may be (even for introverts like myself) you should limit your direct contact with other people. People can be infected with Covid-19 and not show any symptoms for up to 14 days according to the CDC. They may look and feel fine but still be able to spread the virus.

Avoid In-person Doctor Visits

This is not to suggest you avoid necessary office visits. But always call first and see if your issue can be addressed over the phone or in a virtual visit. There tend to be a lot of sick people at doctor's offices.

Take Care of Yourself

Eat right. A healthy diet is more important now than ever. Ignore all the supplements claiming they will strengthen your immune system. According to the Center for Science in the Public Interest, there is no evidence that they do. Get plenty of whole grains, produce and protein.

Stay active. Exercise does support your immune system, so find ways to stay active. Go for walks. Now that you are at home anyway complete some of those household cleaning projects. Start an exercise routine. You'll feel better for it.

Stay connected. Your friends and family are feeling as isolated as you are. And there are more ways then ever to stay in touch. Zoom, Facetime, Skype or even that old standby device, the phone, all work. Use them.



Finally, don't be deluded into thinking this is over. There is still no "herd immunity" and still no vaccine. As states have opened up, many of them have seen a resurgence of infections. As Galileo famously said at his trial for heresy: "I do not feel obliged to believe that the same God who has endowed me with sense and reason expects me to use neither."

Stay safe. This will pass.