I WAS FEELING SO BAD-SO I ASKED THE FAMILY DOCTOR JUST WHAT I HAD

                                           GOOD LOVING-THE RASCALS

                                           
As the Young Rascals song goes :  
I was feelin' so bad
I asked my family doctor just what I had
I said, "Doctor, Mr. M.D."
"Now can you tell me what's ailin' me
He said, "Yeah, yeah, yeah, yeah, yeah"
(Yeah, yeah, yeah, yeah, yeah)
Yes, indeed
All I, I really need
Is Good loving'

The report card on US health is not so good.  Good loving won't help us. We aren’t heading in the right direction, and everyone involved knows that it’s because of a failure to accept the truth.


A mega-group of health researchers (who call themselves the US Burden of Disease Collaborators) published an exhaustive report detailing the health of this nation. (The actual study is available (free) at JAMA. Ron Winslow from the WSJ has this excellent summary.)

The bad news is really bad.

We fell to 35th place, down from 20th in1990. Imagine: the United States of America, with all the fury of its health care on demand, the stents, the ICDs, the chemo, the brand-name medicines, the fish oil, the vitamins, and all that, grabs 35th place.

List by the World Health Organization (2013)

Overall rank [4]	Country	Overall life expectancy	Male life expectancy	Male rank	Female life expectancy	Female rank
1	Monaco	86.5	83	-	90	-
2	Japan	84.6	82	-	87.2	-
3	Andorra	84.2	80.8	-	87.6	-
4	Singapore	84	82	-	87	-
5	Hong Kong	83.8	82	-	85.6	-
6	San Marino	83.5	82	-	85	-
7	Iceland	83.3	81.4	-	85.2	-
8	Italy	83.1	80.4	-	85.8	-
9	Australia	83	80.5	-	85.5	-
10	Sweden	83	81.4	-	84.6	-
11	Switzerland	82.8	80.4	-	85.4	-
12	Canada	82.5	80.4	-	84.6	-
13	France	82.3	79.4	-	85.2	-
14	Israel	82.1	80.2	-	84	-
15	Spain	82	79	-	85	-
16	Luxembourg	82	79.5	-	84.5	-
17	Norway	81.9	80.2	-	83.6	-
18	New Zealand	81.7	79.4	-	84	-
19	Austria	81.5	78.5	-	84.5	15
20	Netherlands	81.5	79.5	-	83.5	-
21	Ireland	81.4	79.2	-	83.6	-
22	Cyprus	81.2	79.1	-	84.3	-
23	Finland	81	78	-	84	-
24	Germany	81	78.5	-	83.5	26
25	Greece	81	78	-	84	21
26	South Korea	81	77.5	-	84.5	16
27	Malta	81	79.4	-	82.6	31
28	Belgium	81	78.5	-	83.5	27
29	United Kingdom	81	79.5	-	82.5	-
30	Liechtenstein	80.7	77.8	-	83.6	-
31	Taiwan	80.6	78	-	83.2	-
32	Portugal	80	77	-	83	-
33	Slovenia	80	77	-	83	-
34	Costa Rica	79.8	78.3	-	81.3	-
35	United States	79.8	77.4	-	82.2	-
36	Chile	79.5	76.5	-	82.5	-
37	Denmark	79.5	77	-	82	-
38	Cuba	79.4	77.4	-	81.4	-
40	United Arab Emirates	79.2	77.2	-	81.2	-
41	Brunei	79	77.5	-	80.5	-
42	Barbados	78.5	76.2	-	80.8	-
43	Kuwait	78.2	75.5	-	80.5	-
44	Czech Republic	78	75	-	81	-
45	Panama	77.8	74.6	-	81	-
46	Poland	77	72.5	-	81.5	-
47	Croatia	77.5	74.5	-	80.5	-
48	Dominica	77.5	75	-	80	-
49	Uruguay	77.3	74.2	-	80.4	-
50	Mexico	77.2	74.2	-	80.2	-
51	Maldives	77.2	76.2	-	78.2	-
52	Bahrain	77	75	-	79	-
53	Belize	76.9	74.4	-	79.4	-
54	Slovakia	76.8	73.4	-	80.2	-
55	Bahamas	76.5	73.5	-	79.5	-
56	Grenada	76.5	73	-	80	-
57	Brazil	76.2	72.6	-	79.8	-
58	Estonia	76.1	71	-	81.2	-
59	Ecuador	76	73	-	79	-
60	Argentina	76	73	-	79	-
61	Saint Vincent and the Grenadines	76	73	-	79	-
62	Oman	76	73	-	79	-
63	Bosnia and Herzegovina	76	74	-	78	-
64	Lithuania	75.9	70.8	-	81	-
65	Antigua and Barbuda	75.8	74.4	-	77.2	-
66	Malaysia	75.7	72.2	-	79.2	-
67	Saint Lucia	75.5	71.5	-	79.5	-
68	Qatar	75.5	73	-	78	-
69	Mauritius	75.2	71	-	79.4	-
70	Saint Kitts and Nevis	75.1	72.2	-	78	-
71	Vietnam	75	73	-	77	-
72	Hungary	75	71	-	79	-
73	Venezuela	75	71.5	-	78.5	-
74	Macedonia	75	73	-	77	-
75	Syria	75	72	-	78	-
76	Thailand	74.9	71.4	-	78.4	-
77	Trinidad and Tobago	70.8	66.5	-	75.8	-
78	Seychelles	74.7	71	-	78.4	-
79	Sri Lanka	74.7	71.4	-	78	-
80	Paraguay	74.7	71.6	-	77.8	-
80	Peru	74.7	71.6	-	77.8	-
81	El Salvador	74.6	70.8	-	78.4	-
82	Jordan	74.6	72.4	-	76.8	-
83	Colombia	74.6	72.4	-	76.8	-
84	Tonga	74.5	73	-	76	-
85	Cape Verde	74.5	70.6	-	78.4	-
86	Latvia	74.5	69.5	-	78.5	-
87	Nicaragua	74.5	71.5	-	77.5	-
88	Libya	74.5	71	-	78	-
89	Georgia	74.5	70.2	-	78.8	-
90	Tunisia	74.5	72.5	-	76.5	-
91	Montenegro	74.5	71.5	-	77.5	-
92	Bulgaria	74.5	71	-	78	-
93	Suriname	74.5	72	-	77	-
94	Turkey	74.4	72.4	-	76.4	-
95	Armenia	74.4	70.6	-	78.2	-
96	Saudi Arabia	74.3	72.4	-	76.2	-
97	China	74.2	72	-	76.4	-
98	Samoa	74	71	-	77	-
99	Lebanon	74	72.5	-	76.5	-
100	Palau	74	70	-	78	-
101	Romania	74	70	-	78	-
102	Honduras	74	72	-	76	-
103	Albania	74	72	-	76	-
104	Serbia	74	71	-	77	-
105	Jamaica	74.8	71.5	-	78.2	-
106	Iran	73.5	72	-	75	-
107	Marshall Islands	73.5	69	-	75	-
108	Algeria	73.3	71.8	-	74.8	-
109	Egypt	73.2	71.2	-	75.2	-
110	Dominican Republic	73.2	72	-	74.4	-
111	Fiji	73	70	-	76	-
112	Philippines	73	70	-	76	-
113	Solomon Islands	73	71	-	75	-
114	Nauru	73	70	-	76	-
115	Morocco	73	71	-	75	-
116	Belarus	72.5	68.5	-	77.5	-
117	Indonesia	72	68	-	76	-
118	Sao Tome and Principe	72	68	-	76	-
119	Vanuatu	72	71	-	74	-
120	Azerbaijan	71.5	69.5	-	74.5	-
121	Guatemala	71.5	68	-	75	-
122	Ukraine	71	65.5	-	76.5	-
123	Moldova	71	67	-	75	-
124	Russia	70	64	-	76	-
125	Bhutan	70.8	69.2	-	72.4	-
126	Guyana	70.5	67.5	-	73.5	-
127	Micronesia	70	68	-	72	-
128	India	70	67	-	73	-
129	Bangladesh	70	69.5	-	70.5	-
130	Kyrgyzstan	69	65	-	72	-
131	Iraq	69	65	-	72	-
132	North Korea	69	66	-	72	-
133	Nepal	69	68	-	70	-
134	Mongolia	69	65	-	73	-
135	Bolivia	69	67	-	71	-
136	Uzbekistan	68.5	66	-	71	-
137	Laos	68	66.5	-	69.5	-
138	Myanmar	68	66	-	70	-
139	Kazakhstan	68	63	-	73	-
140	Comoros	68	65	-	71	-
141	Kiribati	68	65	-	71	-
142	Tajikistan	68	67	-	69	-
143	Papua New Guinea	67.5	65	-	69	-
144	Namibia	67.2	66.2	-	68.2	-
145	Pakistan	67	66	-	68	-
146	Turkmenistan	66.5	63	-	70	-
147	Cambodia	66	64	-	68	-
148	Ghana	66	64	-	68	-
149	Madagascar	66	65	-	68	-
150	Botswana	66	64.5	-	67.5	-
151	Gabon	64	62	-	66	-
152	Yemen	64	63	-	66	-
153	Timor-Leste	64	63	-	65	-
154	Senegal	64	62	-	66	-
155	Haiti	63	62	-	64	-
156	Sudan	62	60	-	64	-
157	Eritrea	61.5	59	-	64	-
158	Cameroon	61.5	59	-	64	-
159	South Africa	61	59	-	63	-
160	Djibouti	61	59	-	64	-
161	Ethiopia	60.5	59	-	62	-
162	Kenya	60	59	-	61	-
163	Rwanda	60	59	-	61	-
164	Afghanistan	60	59	-	61	-
165	Mauritania	59.5	57	-	61	-
166	Liberia	59	58	-	60	-
167	Tanzania	59	58	-	61	-
168	Benin	59	58	-	60	-
169	Gambia	59	57.5	-	60.5	-
170	Malawi	58	57.5	-	58.5	-
171	Republic of the Congo	58	57	-	59	-
172	Togo	57	55.5	-	58.5	-
173	Burkina Faso	56.5	54	-	57	-
174	Côte d'Ivoire	56.5	55	-	58	-
175	Uganda	56	54.5	-	57.5	-
176	Niger	56	55	-	57	-
177	Zambia	55.5	54	-	56	-
178	Guinea	55	54	-	56	-
179	Equatorial Guinea	54	53	-	55	-
180	Zimbabwe	54	53	-	55	-
181	Burundi	53	52	-	54	-
182	Nigeria	53	52	-	54	-
183	Mozambique	52.5	52	-	53	-
184	Angola	52	51	-	53	-
185	Chad	51	50.5	-	53.5	-
186	Mali	51	50	-	53	-
187	Lesotho	51	50	-	52	-
188	Guinea Bissau	50	48	-	52	-
189	Swaziland	50	49	-	51	-
190	Somalia	50	48	-	52	-
191	Democratic Republic of the Congo	49.5	48	-	51	-
192	Central African Republic	48.5	47	-	50	-
193	Sierra Leone	47.5	47	-	48	-

The chart above becomes even more troubling when one examines a report that the Institute of Health Metrics and Evaluation at the University of Washington released in July 2013. That study broke down life expectancy for men and women in different parts of the U.S., showing a strong correlation between income levels and longevity.

The report found that life expectancy is 81.6 for males and 84.5 for females in Fairfax County, Virginia (a very affluent area) and 81.4 for males and 85.0 for females in Marin County, California (another upscale area) compared to only 63.9 for males and 72.9 for females in McDowell County, West Virginia or 66.7 for males and 73.3 for females in Tunica County, Mississippi.

The fact that males in McDowell County are, on average, dying 18 years younger than males in Fairfax County or Marin County speaks volumes about inequality in the U.S.

That type of disparity is more typical of a developing country than a developed country. Yet when one compares life expectancy in McDowell County to life expectancy in Guatemala, one of Latin America’s poorest countries, Guatemalans come out slightly ahead. WHO has reported an overall life expectancy of 69 for Guatemala (66 for men, 73 for women).

So in other words, the poor in Guatemala are outliving the poor in McDowell County. In fact, McDowell County is only slightly ahead of Haiti, Ghana and Papua New Guinea when it comes to life expectancy for males: according to WHO, life expectancy for males is 62 in those three countries.

Although women, as a rule, are outliving men in many parts of the world, a report that was conducted by researchers David Kendig and Erika Cheng for the University of Wisconsin and released in March 2013 showed that life expectancy is decreasing among women in about 43% of the counties in the U.S. and many of those counties are in Southern states (Kendig and Cheng’s findings were published in the journal Health Affairs).

Then, in July 2013, a report from University of Wisconsin researcher Chris Murray found that between 1985-2010, female life expectancy had decreased or stagnated in 45% of U.S. counties.

And it gets worse.

On the upside, overall life expectancy in the US increased 4.8 years, from age 75 in 1990 to age 79.8 in 2013.

We spend annually almost 20% of our GDP (Gross Domestic Product) on health care and we get 4.8 years over a period of 23 years. That’s it.

These 4.8 extra years actually fell far behind the gains in overall life expectancy of numerous other Countries during the same period of 2013 compared to 1990.

The 4.8 added years of life are not always good ones. We may live longer, but the gap between healthy years and years with chronic disability changed little over the past two decade

How in the world did this happen?

The report tells us what we all know:

It begins with our dysfunctional medical system that refuses to make the necessary changes in the ways that medical care is dispensed.

It started with the big lie that we supposedly have the best medical system in the world because we spend (waste) the most money in maintaining this often dysfunctional network of health care.

It then morphed into the robot, android current managed care practice of modern medicine where an assembly line of patients get their 5 minutes of time to be assessed, undressed, dressed, and then literally pushed out the door.

 Sure there are those rare medical professionals still around to take the time to listen, allow you as the patient to share in your medical care decision making, and when everything else fails, they will honestly tell you that they "don't know what is wrong with you".  They are almost as rare as dinosaurs to find, so if you have one, hold onto them for dear life.

In addition, increasing alarming rates of chronic disability are on the rise.

The term for the gap between living well and living with disability is compression of morbidity. To compress morbidity means to shorten the time between onset of illness and death. The ideal is to live well into our ninth (or tenth) decade and then take a nap and not wake up. That’s complete compression of morbidity.

We aren’t accomplishing this at all. Despite all of our health care fury, or perhaps because of it, we are accumulating years without compressing the time of disability.

Death may come later, but disability comes earlier. Not a win, clearly.

If you care about health and helping people live better lives, this sort of data presents a real dilemma.

Most of what Doctors treat is acquired illness. People don’t have to have it. Take high blood pressure: we treat it with medicines, but the majority of patients could treat high blood pressure with relatively simple lifestyle and diet choices.

It’s the same with diabetes, sleep apnea and a host of other chronic diseases.

Perhaps an even more obvious example of preventable disability is the issue of skeletal disease.

The JAMA report documents bone and joint disease as a leading cause of disability. This lies at the core of the problem: our society’s richness, our automation, our technology, our damn inactivity, opposes our basic biology.

The human body needs to be fed well, used often and rested regularly.

Both society and health professionals need to balance sick care with health care. Right now, we aren’t even close.

Confession time: I am just as guilty in not practicing  above what I should be doing along with everyone else. So count me in with the rest of those who spend too much time not taking good care of our body and mind.

U.S. patients expect sick care, and U.S. doctors find it easy to deliver.

Patients are generally not proactive about their health care and are often passive. They place the medical community on a "god like" pedestal and expect a magic pill, easy answers for their medical issues.

Many in the health care field feed off this ego boosting sense that they possess the power of life and death, health and sickness, wave their magic wand and all will be well.

Of course from time to time most of us benefit from sick care, but we all know that comprehensive good health ultimately depends on consistently stringing together smart choices.

It’s not complicated but it is very, very hard to discipline ourselves to be consistent about the way we take care of ourselves. And only each of us can make these choices for ourselves.

Sadly this is a reality that even the leaders of Medicine don’t  even seem to grasp the problem. Here’s how Harvey Fineberg, MD and PhD and leader of the Institute of Medicine closed his JAMA editorial:

"Setting the United States on a healthier course will surely require leadership at all levels of government and across the public and private sectors and actively engaging the health professions and the public."

You see the problem? Setting the U.S. on a healthier course does NOT depend on leadership from government or health professions.

We have had plenty of that over the last decade. That got us to 27th place among other nations.

What is needed is the TRUTH:

The overall health of Americans isn't improving much, with about six in 10 people either overweight or obese and large numbers engaging in unhealthy behaviors like smoking, heavy drinking or not exercising, a new government report shows.

The U.S. Centers for Disease Control and Prevention report found Americans continuing to make many of the lifestyle choices that have led to soaring rates of heart disease, diabetes and other chronic illnesses, including the following:

• About six of 10 adults drink, including an increase in those who reported episodic heavy drinking of five or more drinks in one day during the previous year.
• Twenty percent of adults smoke, and less than one-half of smokers attempted to quit in the past year.
• Only one in five adults met federal guidelines for both aerobic activity and muscle-strengthening exercise. One in three was completely inactive when it came to any leisure-time aerobic activity.

American history is replete with stories of strength. It’s sad and frustrating to see us so unhealthy and decrepit.

So yes, the truth sometimes hurts, but not as much as being lied to, and made to believe that  "we have the best medical system in the world, that spending a huge amount of our GDP on health care translates into a healthier population,or in the fantasy that a magical witch doctor medicine man will always have the correct answer for what ails you.