One of the things that always makes me uncomfortable when I write about a subject like vaccination and autism is that so many people have such strong feelings on the subject. It’s not that I don’t like writing about controversial topics, I just feel uncomfortable when the sides are so far apart that they practically can’t have a rational conversation.
I think I fear being asked to “take sides.” The truth is that, on this issue, I don’t feel as if I even know enough to take one side or the other. And that takes me to a much more serious concern: I have real doubts about whether the medical establishment knows enough to take its position against children delaying or avoiding vaccination.
The response of the various official authorities—the Centers for Disease Control, physician groups—with regard to vaccination and autism just doesn’t feel right. If you go to the CDC web site and start looking around at what is being said about the relationship between vaccination and autism, you find vacillation and doubletalk. This goes to Michael’s comment on yesterday’s post. For example, on the subject of a possible connection between the combined mumps-measles-rhubella vaccine and autism, the CDC says that an Institute of Medicine “Immunization Safety Review Committee concluded that a review of the available scientific evidence does not support the suggestion that the infant immune system is inherently incapable of handling the number of antigens that children are exposed to during routine immunizations.”
Gee, if undeveloped infant immune systems aren’t "inherently incapable," does that mean they are capable? The way I read that is there isn’t enough evidence to know for sure if the infant immune system can or can’t handle the combined vaccine. You’d think that with millions of infants being immunized, and autism incidence soaring to epidemic levels, that the government and physician agencies might be pushing hard for some intensive investigation, on the order of our “war on cancer.”
That’s the part that bothers me most. Rather than expressing concern, or even curiosity, the establishment moves into defense mode, and now seems to be pushing into aggressive defense mode via physicians showing the door to parents who are legitimately concerned about vaccinating their children. It’s almost as if the authorities fear making discoveries that could upset their long-standing assumptions with regard to immunization.
As a result, the situation feels a little like that between government agencies intimidating raw milk farmers and consumers. If too many people do something the establishment doesn’t like, even if they have evidence it will improve their health or reduce risks of illness, the establishment turns up the pressure hoses against them.
Thus, I suspect Lynn McGaha and Suzanne are right to be concerned that the authorities will use intimidation to force sympathetic physicians to toe the line, and make it increasingly difficult for parents to hold off or reject vaccination.
You just described the beginning of my doubts about vaccines and a host of other things. I would find more and more evidence that the "scientists," government researchers and politicians refused to even acknowledge, let alone look into, and that is where the distrust began for me. Then, having spent part of my journalistic career reporting on how money influences national policy, the pieces all feel into place.
It’s been my experience that the issues of raw milk and vaccines — actually very similar in the parallels between what individuals experience and find on their own verses what we are told to think and fear — are two of the most common gateways for people to start questioning lots of what we’ve been told to believe about our health. It got to a point that I knew that the people I had previously had deep faith in were lying or grossly and willfully uninformed.
So if I was not being leveled with about this subject, then what else was I missing? I have since not been able to stop looking under rocks.
The American ideal suggests that if purveyor "A" has bad service, high prices, or some objectionable practice, one need merely turn to purveyor "B" or "C". Forced purchases are generally unthinkable. But medical care is not provided in anything resembling a standard market.
I blame the emergence of third-party medical payments, which effectively made the patient and the customer two different entities. Those programs, originally shared-risk plans, seem almost quaint by today’s standards, but as small systems are prone to do, they grew. Gradually they became, in the American mind, necessary for first-dollar medical payments. Then of course government got into the business with Medicare and Medicaid, necessity was upgraded to human right, and the loss of patient freedom was a fait accompli.
It seems that theres little interest among the counter-culture health-conscious crowd in discussing medical insurance (except for the occasional squawk about the difficulty of obtaining and paying for it). I lament that, because it is money that makes this medical system run. Money gives it power and inertia, both in business practice and clinical ideology. If we do not pay attention to how that money flows, the system will likely not change, and we will be forever saddled with homogenous, over-priced, pseudo-healthcare.
That is why I spend some time and energy supporting Healthcare Savings Accounts. They are, in my mind, the only way to effectively decentralize, and soften, the current system.
One the other hand, the vaccination schedule we have for our children today is out of control. I think in the first two years of life the count is somewhere around 22. Do we really need all of these vaccinations? Which ones could we do without? Do we need to vaccinate during the first year of life? If we choose some vaccinations, do they have to be given all at the same time? And of course, which vaccinations contain thimerosal (mercury) or another preservative with mercury.
I dont think this is a black and white issue. Stephanie Cave wrote an excellent book on the history of vaccines and a protocol of dos and dont for implementing a vaccination schedule. I have not personally read the book, but my sister-in-law who has an autistic child strongly recommends it for new parents. She purchases it as a baby shower gift for all new moms.
Today with the autism rate being 1 in 65 children, we are playing Russian roulette with vaccinations. Boys are particularly at risk. Estrogen is a protective factor.
I strong urge every one to read David Kirbys book, Evidence of Harm. You will be disgusted (government cover-up), but the information is a powerful and in-depth examination of this issue.
Regarding this: "If we completely quit vaccinating all children, the infant mortality rate would escalate."
I know that you are (wisely, I think!) suggesting a balanced approach to vaccination, but that statement is not necessarily true. Suspicions about the effect of vaccinations has, at its root, the notion that we really don’t have enough data for accurate risk/benefit analysis.
(Read this article for an introduction to the difficulties in assessing vaccine risk/benefit: http://mercola.com/1999/archive/vaccine_information.htm — thank you Suzanne for alerting us to it—and here: http://www.geocities.com/harpub/pol_all.htm for a review of polio incidence and the possibility of generally ignored correlations between polio and its causes.)
Vaccines are often considered to be very good things even by those who doubt that they’re completely safe. (I’ve heard something along the lines of "Maybe vaccines do hurt some kids, but many more are ‘saved’ by them" more times than I would have liked.) I think that’s because we’ve been sold a simplistic view of their function–give a dose, create disease innoculation–that sounds sensible on its surface. But dig a just a tad under that veneer, and all sorts of questions arise.
The medical profession is largely unwilling to consider any dissenting opinion about vaccines, and because the general acceptance of their efficacy is so widespread, they don’t have to. But that is changing. I hope for a grass-roots-generated re-thinking of the entire business.
Outstanding comment. Thank you for writing it so clearly.
The infant mortality rate today would likely go down if we gave up widespread and pseudo-mandatory vaccination. (Parents always have a choice — some states make that choice more difficult than others in terms of schooling and the information provided about exemptions, but parents always have a right to make their own decisions.)
The Hep B vaccine alone is likely responsible for thousands of infant deaths annually in this country. There is a reason why the U.S. has one of the highest infant mortality rates in the "developed" world. No other country in the world vaccinates its babies at birth.
There is no such thing as SIDS. Healthy, normal babies don’t just drop dead in their cribs. If we really wanted to see the correlation on a massive scale, it wouldn’t be that challenging or expensive to look. As it is, vaccine adverse events and deaths are rarely reported. Estimates by ex-government officials have put the figure between 1 in 10 and 1 in 100, a telling statistic to rattle our soothing belief that these events are rare.
If you go to the Vaccine Adverse Events Reporting System (VAERS) and you multiply the number of deaths annually reported within days after vaccination by 10, then we can start to get a picture.
To have a real, fully informed discussion about Mary’s assertion — that the infant mortality rate would increase — we need to go back further than 100 years and look at vaccine rates and disease rates entirely in context and extract out as many of the other variables as we can. Not an easy thing to do, certainly, but also a task made considerably more difficult by historical records that have been lost or erased (whether you ultimately decide this is an accident is a decision entirely yours; vaccine resesarch has certainly undone many of my assumptions and beliefs). The records that remain have been quite telling.
I have yet to read this book myself, but it’s sitting next to me at the moment: Immunizations: History, Ethics, Law and Health.
Can you cite some sources of information about the Health Savings Accounts? I am interested in learning more.
We always just used my husband’s employer HMO option, because it was less expensive for us in premiums and ongoing OOP expenses; easier; and for a while seemed to fit our healch care needs quite well. Last year during the open enrollment period, I contemplated switching the family to the PPO plan because I had increasingly found the need to seek out-of-network care (& OOP) for myself to get the kind of care I needed. But I decided to stick with HMO plan because the PPO premiums were about $3500 more/yr plus expenses for things are are covered with the HMP plan, which would buy enough of my anticipated OOP care.
I’ll admit, even with my misgivings about some of our care in the HMP plan, I would have a hard time giving up the insurance plan as it now stands, even though I know it is part of the problem. My husband’s premium is completely paid by his employer and the rest of the family’s is partially paid by the employer, so our portion is affordable. The insurance company pays a discounted price compared to what I as an individual would pay if I was uninsured.
I’d like to be "part of the change I would like to see" but like lots of folks, I have practical things to think about, too. Despite my overall good health, I have a mild hypothyroid condition. That isn’t such a big deal, but now it is looking like I have an uncommon form of diabetes, MODY or LADA. That definitely complicates my decisions about health care costs. For the time, being, I’d certainly consider a HSA as an add-on, but I’m not informed enough to know if we can do it instead of conventional health insurance at this point.
You are right on with your comments.
I’m especially fond of:
* A big part of the problem is third-party medical payments
* General acceptance of their efficacy is so widespread. (I think this viewpoint will crumble when we see the effects of the chicken pox vaccination – when the children today become adults, they will most likely run into health issues).
Here’s a couple vaccine related stories that I have heard:
* My brother knows someone who was severely mentally/physically disabled after getting a shot. They concluded that the shot, somehow, was mostly mercury (bad batch).
* My wife knew a woman who’s grandkid died after getting his shots. The child had a strong reaction to the shots and then finally went to bed at night. He never woke up. The police spent a long time interrogating the parents, but luckily no charges were filed.
* I met a woman at the Weston A Price conference last fall who was in a hospital to give birth. She fought with the nurses and refused any vaccinations for her baby. The day she was leaving, she was getting her coat on and a nurse slipped by and gave her newborn baby a shot. This woman confronted the nurse and the nurse said, "You’re not going to deny me my $10!".
All of the grandmothers in our family lost children to pneumonia, so antibiotics do have a positive role to play in to correct situations. Infant mortality rates decreasing may have more to do with the correct use of antibiotics than vaccinations.
Chris had a negative reaction to the Hep B shot. He had problems sucking and digesting the formula (hes adopted) and didnt pee for 17 hours after we brought him home from the hospital. He was given the Hep B shot hours before we brought him home. I remember telling Tony that he was O.K. until the Hep B vaccination. We were at the hospital the previous day when he was born (we watched the birth) and spent time alone with him that evening, so I had a comparison.
Steve Bemis talks about the new research placing AD/HD on the spectrum of autistic disorders. I have mixed feelings about this. Im extremely self-educated about AD/HD. Over the past decade, Ive worked closely with families and kids in the school system with this disorder. The 10% of our students not functioning academically (without an identified learning disability) have AD/HD, either with or without hyperactivity. Ive assisted many families with the diagnosis process, explaining in simple language the neurobiological foundation of this disorderits a dopamine deficiency in the prefrontal cortex of the brain. This is where executive functioning takes place.
AD/HD has been studied extensively. It has been documented over the last 100 years. Each decade or so, it had a different name. In the 1950s and 60s it was called Minimal Brain Damage. This label is my personal favorite. Talk about feeling hopeless after a diagnosis. We also know that it is genetic, passed down from one generation to the next. I have not met a family yet with an AD/HD child (biological) where one of the parents didnt also suffer from AD/HD.
With all of this knowledge, Im not sure its on the spectrum or a separate brain disorder. There are some similarities with food sensitivities and positive response to supplements added to the diet. The over kill of vaccinations has probably made AD/HD more severe, but Im not convinced having this genetic weakness could turn into autism.
If anyone is interested, I have some great resources on natural ways to treat AD/HD. They are quite effective. Chris has been my proof!
You are like me in that your employer’s benefits (their portion of your medical insurance costs) are controlling your decisions. That is an artificial market force, but there it is–effective, artificial or not. Still, this is a worthy discussion even for people like you and me, because with wider HSA support, more employers will be goaded into offering better-quality HSAs.
As currently configured, HSAs couple high-deductible health insurance with a tax-free savings account (the HSA) for out-of-pocket medical expenses. Individuals and/or employers can contribute money to them tax-free, up to the amount of the insurance deductible.
To get started gathering information go to this brief CATO Institute report:
http://www.cato.org/pub_display.php?pub_id=5482
For a more dense analysis, also by the CATO Institute, go to:
http://www.cato.org/pubs/pas/pa569.pdf
I believe that HSAs are a very good thing in their pure form, i.e. uncorrupted by this or that government or insurance-company tweaking. At this time, unfortunately, pure HSAs don’t existthey often carry too many restrictions and sometimes onerous administrative fees. Nevertheless, even as currently configured, I find many HSAs to be a great positive in comparison to standard insurance. This is mainly because they bring some semblance of consumerism into healthcare. A good HSA is reasonably priced, and most important is geared toward achieving HEALTH, as opposed to financial coverage of early detection and treatment.
Now those of you who know my views on government may find this unexpected, but I believe that government does have a legitimate role in making HSAs a functional reality. Government (and I say this only because America has clearly decided that health insurance is government’s business) should, in my opinion, abandon Medicare and all its cousins, and instead fund an HSA for every American citizen. Based on my own (admittedly less-than-complete) knowledge of healthcare costs, the accounts would perhaps be $8,000.00 to $10,000.00whatever is enough to fund reasonable first-dollar healthcare costs, plus the HSAs necessary sibling, a high-deductible catastrophic insurance policy.
Also, government should be, as much as possible, hands-off about qualifying expenses. Im not holding my breath on that one, but who wants some bureaucrat telling you what is appropriate healthcare? (Not many commentators on this blog, thats for sure!) Although giving government an inch is dangerous, I nevertheless support some restrictions to prevent wild misuse. Of course, to motivate appropriate account utilization, there can be absolutely no bailout should the account be drained.
It is certainly true that until HSAs have a very significant market presence, HSA owners will be somewhat at a disadvantage because they will be essentially cash payers in a cost system inflated by third-party effects–no bargain there. But we must start somewhere, and because health and finances go hand in hand (or pocket), we must pay attention to the money stream. We conceptually divorce healthcare and money at our peril.
Mary, please send me some info.
Thanks!
(just click on my name below and then click "Send email")
I feel your pain without even hearing your story. The generation you son was born, information about ADD without hyperactivity was minimal. I can only imagine what you and your wife went through before you received a diagnosis. Parents of a child with ADD without hyperactivity are particularly challenged, especially if their child is intelligent. Very early in their education they are labeled a lazy student. ADD without hyperactivity is the #1 under diagnosed childhood disorder. If the student is bright, 7th grade is typically the hallmark year for a diagnosis. If a student has a learning disability with the ADD, he/she is usually identified by 2nd or 3rd grade.
And yes, many adopted children have AD/HD. Impulsive behavior and the inability to plan = a pregnant teen; or an adult with too many children where adoption or abortion is the only answer. I think both of Chris birth parents actually have ADD without hyperactivity, but his birth fathers has been confirmed.
The information I have will help your son as well as his children (or future children). He will produce a child with ADD. Theres no way to prevent it. The good news it there are lots of things that can be done to get the brain functioning properly.
Please email me at mmcgonigle11@verizon.net. I will send you the information I have.
Mary
The concept of Health Savings Accounts coupled with high deductible insurance policies has some problems, though. I don’t think they help the big picture at all – depending on who the authority is, 50 to 90% of health costs are attributed to chronic, preventable diseases, especially obesity and type 2 diabetes. Asthma is the number one cause of visits to the emergency room.
The head of Blue Cross Blue Shield in Massachusetts says that 80% of that company’s costs are incurred in the last 2 months of life – several different authorities make statements along these lines, some say 50% of costs are in the last 2 weeks.
Assuming it is true that 80% or 50% of costs are incurred in the last few weeks of life, it seems a stretch to call medical care a purchased service. I know the things that were done to my father in law, who died last fall, or my mother, who died ten years ago, were things that had to be done, and they did not seem like services – they were things that were done to him, until he refused further care, let it be known he was not going to eat anymore, and went to hospicecare. To call this a consumer choice seems to reflect a lack of understanding, even respect, for the gravity of the experience. So something seems askew when people argue that consumer driven health plans with HSAs are going to alter the equation very much, if 80% of the costs are not a result of choice – unless you hope to get people to choose hospice sooner then they might otherwize, as if they want their kids to inherit any money that might be spent in a last ditch effort to recover.
Another indication that the consumer driven movement may not be as effective as hoped is that many people hate going to see a doctor, and in fact don’t go when they should. When they are supposed to take medications, they often skip to save money. For this reason, employer based plans are being more generous with co pays to get people to take their drugs, particularly with chronic conditions. see Tuesday, May 8, page D1 Wall Street Journal. "New Tack on CoPays: Cutting them" sub heading is "Employers, Insurers Bet That Covering More of the Cost of Drugs Can Ssave Money Over the Long Term for Chronic Conditions." Pitney Bowes proved this to itself in 2004, it is not new news.
What needs to happen is for communities to establish a culture of fitness…..employer based plans are quite open and often big-brotherish in making this a goal for the work place.
Consumer driven plans are too micro-oriented to impact the culture in which kids grow up in a way that heads them to chronic conditions as adults – poor diet and inactivity, that is. One could offer that if people have to dip into their own health savings account to purchase a medical service, they will become more aware that they have to provide a better diet and environment for their kids, if they have any……but this seems a stretch to me.
Finally, Health Savings Accounts are known to increase health care costs for women on average by about $1000 per year. The clearest explanation of how this works that I have seen is in a Boston Globe [ the author is Lisa Girion of the Los Angeles Times] article March 28 07 page d5 "Self-Employed lose healthcare option." This is an article about health plans that used to be offered by professional associations. First sentence is "A major source of health insurance for people who work for themselves has all but disappeared, casting thousands of contractors, freelancers, and solo practitioners into the ranks of the uninsured, with little hope of obtaining new coverage."
The reason: "…..insurers are eager to sell individual policies to the young and healthy for as little as $100 per month, scooping the cream off the risk poole. That leaves higher-risk older and sicker people to the group market. As healthy members leave an association plan [to go to the more segregated, lower cost individually priced plan] the concentration of members with higher-than-average medical costs increases. That forces the underwriter – usually the insurer but sometimes the association – to raise premiums. A ‘death spiral’ sets in, when medical costs exceed the plan’s ability to raise premiums to cover them."
The consumer driven strategy effectively removes the subsidy that men had been giving to women by sharing a common cost pool. Now that cost pool is individualized. "When an employer switches all his employees into a consumer-driven health plan, it’s the same as giving all the women a $1000 pay cut, on average, because women on average have $1000 more in health costs than men," quoting the author of the study. Women’s costs are higher because women need mammograms, cervical cancer vaccine, pap tests, birth control and pregnancy related services that men do not…."
Only 3% of Americans with private insurance have consumer driven plan, in part because employers are not diving in to promote them. Correct me if I’m wrong, but I suspect the reason is this: when all employees are in a basic health plan, often self insured, with employees paying say 50% of the costs generated by all employees, then all employees are paying an equal amount into the cost pool, withheld from their salary.
Suppose the employer offers a consumer driven plan: then, the employer allows the employee to withhold perhaps half of his or her contribution into the wider risk pool, to join a segregated, healthier risk pool of folks with a higher deductible – often young men with no children. The employer loses the contribution to the wider pool. But the same number of people each year will get sick, because when the healthier members become better consumers because now they are shopping for services which they pay for out of their Health Savings Account, the older, more at risk employees still experience things like breast cancer and breast cancer recurrences, whose costs take on a life of their own – no one controls these kinds of costs, it is what it is….the group still has to pay these costs, but out of a smaller pool, because the younger, lower risk people, or those who have no children or spouse to cover, have withdrawn their contribution and put it, or some portion of it, into their tax free Health Savings Account.
One question for David – why do you prefer virtual private governments like health insurance companies, to publicly elected governments? For example, UnitedHealth Group, with 28.5 million health-plan members, is threatening to fine docs $50, cut their fees, or oust them from the network, if the docs fail to refer patients to Lab Corp. or other in-network lab facilities. Governments fine people, and make decisions such as with holding treatments, so it seems fair to call them private governments. Traditional Medicare carries no such threat of fines to docs.. When a person over 65 joins a Medicare HMO, then that person will have a doc who has to deal with the HMO’ s limitations, such as this threat of a fine from United – actually, the fine has not yet been instituted, but it is now being threatened. This is the nature of these insurance administrators, and I don’t see why the public does not recognize them as forms of government, with taxes which we politely call premiums. With CEOs who receive bonuses in the range of $30 million, in the case of Aetna and United Health.
May 20, 2007
Andrew Fischer
On the other hand, I have a check-up every year without fail as well as any other concerns that come up. Despite being a quite "healthy" person (in the sense that I am rarely "sick" and have never had a life-threatening health disease), I have had a *lot* of costly health care in the past decade (two rounds of infertility testing including two out-patient laparoscopic surgeries; one pregnancy and childbirth with additional monitoring and specialists for gestational diabetes; MOHS surgery for facial basal cell carcinoma and reconstructive plastic surgery plus regular skin cancer screenings; out-patient surgery for lipoma removal; consults for pelvic prolapse & perimenopause issues; ENT treament for frequent nosebleeds; physical therapy for osteoarthritis in neck; tests and treatment for hypothyroidism; and now, it looks a form of diabetes such as MODY or LADA might be added to the list, plus all the usual annual check-up exams, labs, etc. Most of this was/is paid for by our insurance, except for co-pays and my choice for an out-of-network thyroid doctor. When $8-10K is mentioned for a HSA, I know some years that would not have been nearly enough for me.
And while price might be an issue if I were paying the bill, when I need care, I am most concerned with finding the right provider for my situation (because I have found from experience that the wrong provider has its own non-monetary costs and delays). Right now I only need to consider the cost if I can’t get the care I think I need inside my network.
I’m also intrigued by some of the health care situations by other countries. MY MIL & one SIL live in England. My "Old Labor Party" elderly MIL is very happy with the NHS, as she doesn’t have to pay any health care costs, although I understand she sometimes has less choice when seeking medical and dental providers who accept NHS patients now that the UK seems to have a dual NHS/private insurance system. My other SIL lives in Norway. There is no cost for care and medications for children and seniors, I think. Norway seems to do far less invasive medical procedures compared to the US (for instance her recent encapsulated appendicitis was treated without surgery and she had no complications compared to my neighbor with a simultaneous similar appendicitis situation, who had surgery and post-surgical complications. Both had similar recuperation times). Pregnancy and childbirth seems to be far less "medicalized" in Norway, even for complications such as gestational diabetes (which my SIL also had) yet they have a much better infant mortality rate than the US, as well as better overall health and longevity (the Norwegian elderly are in visibly better health, riding bicycles to get about, going up hills with ease that would make me gasp). Preventive care seems to be much better in Norway than in the US from my prespective, too. If I understand it correctly, costs are paid by the patients, but reimbursed as reduced taxes, based on income,family size, & other calculations. So I don’t think it is actually a national health service, but costs are more like a sliding fee scale, based on ability to pay and a national agenda of caring very well for children and seniors. I realize comparing Norway to the US is like apples & oranges, but I can’t help but think the comparison illuminates much of what we get wrong here.
Thank you for your recent input on this subject.
Please take a minute to review my response to Andrew Fischer (added to David’s May 21 post).
Now your comment that you are "a quite ‘healthy’ person" is illuminating, for your list of ailments and related interventions does not qualify you for anything of the sort, except in comparison to today’s demographic. (Please don’t be offended by that! I am merely trying to point out that our culture’s expectations regarding health are warped by a current and very unnecessary medical milieu in which almost everybody suffers from something, often something serious.)
I sincerely believe that we neednt be anywhere near as sick as we are. My suspicion–and there is much evidence in support–is that many of your conditions are strongly influenced by food and environment (yours, and that of your recent forebears). It is clear to me that that trend will not spontaneously reverse. The huge centralized systems (big pharma, industrial ag, all the big machines that cater to consumers looking for whatever is fast, cheap, plentiful and pleasurable) that generate the current plague of unhealthy crud will not change, except in reaction to pressures from below–from us. HSAs are a mechanism that can help do just that.
Of course a reasonable short-term goal for any program is to adequately cover todays medical expenses. But we mustnt lose sight of the fact that todays costs are extremely inflated on a per-service basis, and incurred much (MUCH) more frequently than they ought to be. The true advantage of HSAs is in their long-term goal: Less sickness, and decreased costs for treatment when necessary. It is unwise to analyze HSAs outside of that context.
Health is a very non-interventionist pursuit. It is a far saner, and infinitely cheaper, management tool than early detection and treatment. I believe that properly designed HSAs will move us in that direction.
I absolutely agree with your definition of health, that is why I put it in quotes and qualified the word with absence of infectious or life-threatening illness (one would think with all of my wordiness, I would be be able to communicate more clearly :-). Use of healthcare does not equal good health, no bout adout it. I rarely went to a doctor as a child, nor did my siblings, except for occasional ER stitches and other accidents (despite receiving the usual vaccines given during the 60s), partly because my dad was self-employed and we only had major medical insurance (medical care was entirely an out-of-pocket expense) and partly because we weren’t sick with anything beyond colds, the occasional tummy bug, and chicken pox. My dad was big into organic vegetable gardening, my mom was big into good, wholesome food, except for her use of margerine and skim milk, but heck, she couldn’t be right on everything).
I am quite sure that some of my dietary and health detours during the first decade I was on my own were not very good for the decade that followed. Even though I "felt fine" for most of the past decade (post early 30s), I certainly have been a "heavy user" of "healthcare", as I have described. A while back I commented to a nurse about how alarmingly thick my patient file looked and she insisted it just showed I "take care of my health". Even then I thought, "What a joke". Almost none of my care, except perhaps my hypothyroid issues (which I couldn’t get my in-network doctors to treat)and getting my diet organized for gestational diabetes, were specifically for maintaining or promoting health, per se. That doesn’t mean all this stuff wasn’t worth treating, as I don’t think too many people want to leave a constantly bleeding basal cell carcinoma on their nose, or ignore an annoying large lipoma on the hipbone area that makes clothes fit uncomfortably, or don’t want to find out why they are infertile when they want children, etc). But I absolutely do wonder what might have caused what.
A year ago when I hit a frustrating dead end point with my doctor of ten years, I realized that I am the one really responsible for my "health", not my "healthcare" system. And it is abundantly apparent to me that they "missed" some subtle but significant stuff ten years ago (mild hyperglycemia and hypothyroidism that perhaps undermined my health and fertility in many subtle ways, and who knows what else and I didn’t know enough then to question it because I had so much trust in the "system". I am a very different patient and person now. I make my own judgements much more after looking at an issue from as many reasonable and credible points as I can find. For instance, I go to my dermatologist to look for skin cancers, because I did burn too much when I was a teen and young adult, trying to tan like my friends. I’d rather keep as much of my nose as possible (facial skin grafts are not fun, I can attest to that). But I no longer shun the sun as I am continually advised, nor do I slather on the sunscreen, except in rare instances, but I do take care not to burn or overexpose. Lack of sun for nearly 8 years has not been good for me in many ways that are only recently making sense to me. My diet has changed a lot, too, to manage the hyperglycemia quite well. But wow, it sure is time-consuming to do all the "research" and figure out which "health" advice to ignore and which makes sense to follow. And I find I am ignoring conventional wisdom more and more and increasingly doing just the the opposite when it seems prudent to me. I’m becoming quite the contrarian, but I try to do so in a reasoned way, and with flexibility as I learn more.
So yes, I do see the irony in that in one sense I am considered quite "healthy" by "the powers that be", yet in reality I probably have been anything but. Here’s hoping the changes I am making this decade yield benefits in the decades to come. Cheers!