This week’s column consists of several random bits of health information:
Greed in medicine: PNHP (Physicians for a National Health Plan) promotes “Medicare For All,” which they feel is the only way to make health care work for us instead of for people making profits from the big business our health care system has become. Following are the 2018 compensations for the CEOs of several health insurance companies: CEO of Centene $21.1 million; Cigna $19.2 million; Humana $27.2 million; Magellan Health $8.3 million; UnitedHealth Group $21.5 million; and Wellcare $21.0 million. Following are the 2018 CEO compensations for several pharmaceutical companies: Johnson and Johnson $46.4 million; Merck $48.8 million; Nektar $32.4 million; Pfizer $47.0 million; Reyeneron $118 million; and Vertex $32.4 million.
Statins in older people: Because people age 75 and older have been under-represented in statin studies, the usefulness of statins in that age group has been questioned. Recently, the respected British medical journal Lancet published an analysis of 28 clinical trials that included 14,000 participants 75 and older. The analysis found that people 75 and older derived even more heart attack and stroke prevention benefit than younger people — both primary prevention (people who have never had a heart attack) and secondary prevention (people who have already experienced at least one heart attack or stroke).
Antibiotics for appendicitis: A study published in September 2018 in JAMA (Journal of the American Medical Association) found that some people with acute, uncomplicated (no rupture or abscess) appendicitis can be treated successfully with antibiotics instead of surgery. However, after five years, 61 percent had recurrence of their appendicitis.
Fecal contamination in chicken products: The PCRM (Physician Committee for Responsible Medicine) is suing the U.S. department of Agriculture “for ignoring concerns over widespread fecal contamination of chicken products.” Tests were conducted on 120 chicken products in 15 grocery store chains, and 48 percent showed evidence of fecal contamination. Chicken feces get in and on chicken during processing.
Sugar taxes work: Sugar is bad for us, contributing to obesity, diabetes, cardiovascular disease, fatty liver and tooth decay. Many U.S. cities as well as countries such as Mexico, Hungary, France and the U.K. have instituted sugar taxes (similar to tobacco taxes). These taxes seem to be effective in changing behavior. In Berkeley, California, for example, sales of soft drinks, sports drinks, sweetened teas, specialty coffee drinks and energy drinks in low-income areas has fallen by 50 percent.
Very high HDL not good: HDL is “good cholesterol.” Cardiovascular disease risk rises if HDL is below 40 in men and postmenopausal women, and if it is below 50 in premenopausal women. Years ago we thought that HDL of 70 or over was protective against heart attacks and strokes, but we now know that’s not true — very high HDL, especially above 80, causes instead of prevents cardiovascular disease. “Advanced cholesterol tests” provided by labs such as the Berkeley and Cleveland Heart Lab help determine whether HDL is functional or dysfunctional. If you have an HDL level greater than 60, consider ordering a test to determine the health of your arteries, such as a carotid IMT or coronary calcium score. If your arteries are plaque-free, you don’t need the advanced test, although out-of-pocket expense for these is relatively low.
Alcoholism is on the rise: What might contribute is that the percentage of alcohol in wine, beer, and hard liquor is creeping up in the U.S.
Retired physician Greg Feinsinger, M.D., is author of new book “Enjoy Optimal Health, 98 Health Tips From a Family Doctor,” available on Amazon and in local bookstores. Profits go towards an endowment to the University of Colorado School of Medicine to add prevention and nutrition to the curriculum. He is available for free consultations about heart attack prevention, diabetes reversal, nutrition, and other health issues. Call 379-5718 for an appointment. For questions about his column, email firstname.lastname@example.org.