Dr Bernstein passed on to his reward last April. He was a major influence on my own approach to diabetes treatment. We see very few “great men” in our times: He was one.
Dr Bernstein practiced what he preached, which explains how he lived to the age of 90. That is exceedingly rare for a type 1 diabetic.
Thanks to Jan at The Low Carb Diabetic for bringing this to my attention. She published an account of what it was like to be one of Dr Bernstein’s patients.
Steve Parker, M.D.
Posted in Uncategorized
From Karl Denninger, an article titled Enough of this Nonsense:
I’m talking about the basic economic question: Supply, demand and what happens when you allow someone to force another person to pay your bill.
I keep hammering on this and will until people stop running tropes whether out of sincere (but false) belief or some other reason.
Let’s take Eliquis. Its a common medication and its expensive. Roughly 3.5 million Americans take this drug and it is one of the most-commonly prescribed for people who have atrial fibrillation. It appears to be reasonably effective in reducing the risk of strokes and heart attacks in people with that condition.
It is also about $8,000 a year in the United States without insurance and “insurance” forces those who do not have that condition to pay for those who do — including Medicare and Medicaid.
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The common claim is that “if you cut that off those people will die” because they can’t possibly afford the price.
The claim is false.
In Germany the drug costs about $700 a year, so it is ten times as expensive in the United States.
Parker here. I know why Eliquis (apixaban) so much more expensive in the U.S. I wrote all about it in my latest book. Read Denninger for his opinion. (He’s smarter than me but was wrong about his predicted 2024 severe economic contraction. Making predictions is hard, especially when it’s about the future.)
Steve Parker, M.D.
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Posted in Healthcare Reform
I’ll believe it when I see it.
Health insurance pre-authorization, for example, is when your eye specialist recommends removal of your cataracts so you can see again, but your insurance company wants some clerk or administrator to review everything and either agree or disagree with your physician. If disagree, no eye surgery for you. Unless you’re willing to pay entirely out-of-pocket. Mind you, the clerk does not have a medical degree and has never examined you or spoken to you. Isn’t this one of the reasons Luigi Mangione executed that healthcare executive?
From American Greatness:
Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. joined other federal health officials on Monday to promote an initiative to end the practice of healthcare insurance pre-authorization.
Kennedy was joined by Centers for Medicare & Medicaid Services Administrator Mehmet Oz as part of a roundtable discussion with insurers to discuss pledges made by the health insurance industry to streamline and reform the prior authorization process for Medicare Advantage, Medicaid Managed Care and Affordable Care Act Health Insurance Marketplace plans which account for most insured Americans.
The HHS Secretary commented on how when he joined the presidential transition team, he was told that the single most important thing he could do to improve the experience of patients across the nation was to “end the scourge of pre-authorization.”
Of course, the unsurers will argue that pre-authorization is necessary because those greedy doctors are recommending that surgery, MRI scan, specialty consultation, or physical therapy merely out of greed.
Steve Parker, M.D.
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Posted in Healthcare Reform
Not quite what you were expecting, was it?
Wishing a glorious Father’s Day to all you dads.
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Posted in Uncategorized
Opthalmologist Dr. Will Flannery has put together a whimsical guide to the U. S. healthcare system. Well worth your time if you’re relatively new to the system and need help understanding deductibles, co-pays, out-of-pocket maximums (hint: they’re not really maximums), in-network, out-of-network, vertical integration, “surprise” medical bills, etc. I was particularly impressed with the section on fighting claim denials; I hope I remember to re-read it when the time comes.
Dr. Glaucomflecken’s Incredibly Uplifting and Really Fun Guide to American Healthcare.
Remember how Obamacare was supposed to make healthcare more affordable? From the guide, “The 2025 out-of-pocket maximum for an Affordable Care Act plan can’t be more than $9,200 for an individual and $18,400 for a family.” When half of Americans can’t afford an emergency $500 bill, how do they pay up to $9,200?
Dr. Glaucomflecken also offers some system improvements that I also advocate in my latest book, Resuscitating U.S. Healthcare: An Insider’s Manifesto for Reform.
Steve Parker, M.D.
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Posted in Healthcare Reform
A July 2024 article in the July 31, 2024, Nutrition Journal suggests that artificially sweetened beverage consumption may cause increase risk of death, particularly from cardiovascular disease. From the abstract:
Our systematic review and meta-analysis demonstrated a higher consumption of artificially sweetened beverages in relation to higher risks of all-cause and cardiovascular mortality, whereas no relationship of artificially sweetened beverages with cancer mortality was observed. Compared with the participants in the lowest category of artificially sweetened beverage intakes, those in the highest category had a 13% higher risk of premature death from any cause, and a 26% higher risk of CVD (cardiovascular disease) mortality. Each one additional serving increase in artificially sweetened beverage consumption was associated with 6% and 7% higher risk for all-cause and CVD mortality, respectively. In a dose-response meta-analysis, we also observed a linear association of artificially sweetened beverage consumption with CVD mortality, with a non-linear positive association of artificially sweetened beverages with all-cause mortality. Despite this, substitution of sugary sweetened beverages with artificially sweetened beverages was associated with a lower risk of all-cause and CVD mortality. Various sensitivity analyses and subgroups analyses demonstrated the robustness of the pooled associations. Per NutriGrade, quality of the overall evidence was scored moderate for CVD mortality and all-cause mortality.
Steve Parker, M.D.
Comments Off on Study Links Diet Drinks to Increased Death Risk
Posted in Heart Disease, Longevity
C-reactive protein (CRP) is a bloodstream marker of body-wide inflammation. A prominent theory is that if your CRP is too high, it causes chronic disease states like hypertension, dementia, and cardiovascular disease. A 2024 meta-analysis published in British Journal of Nutrition looked at the effects of various diets on CRP. The implication is that your odds of developing particular chronic diseases is lowered if you adopt a diet that lowers your CRP. Check the Abstract below to see how your diet stacks up:
Adopting a healthy dietary pattern may be an initial step in combating inflammation-related chronic diseases; however, a comprehensive synthesis evaluating current evidence is lacking. This umbrella review aimed to summarise the current evidence on the effects of dietary patterns on circulating C-reactive protein (CRP) levels in adults. We conducted an exhaustive search of the Pubmed, Scopus and Epistemonikos databases, spanning from their inception to November 2023, to identify systematic reviews and meta-analyses across all study designs. Subsequently, we employed a random-effects model to recompute the pooled mean difference. Methodological quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist, and evidence certainty was categorised as non-significant, weak, suggestive, highly suggestive or convincing (PROSPERO: CRD42023484917). We included twenty-seven articles with thirty meta-analyses of seven dietary patterns, fifteen of which (50 %) exhibited high methodological quality. The summary effects of randomised controlled trials (RCT) found that the Mediterranean diet was the most effective in reducing circulating CRP levels, followed by Vegetarian/Vegan and Energy-restricted diets, though the evidence was of weak quality. In contrast, Intermittent Fasting, Ketogenic, Nordic and Paleolithic diets did not show an inverse correlation with circulating CRP levels. Some results from combined interventional and observational studies, as well as solely observational studies, also agreed with these findings. These dietary patterns show the potential in reducing CRP levels in adults, yet the lack of high-quality evidence suggests future studies may alter the summary estimates. Therefore, further well-conducted studies are warranted.
Steve Parker, M.D.
Comments Off on You May Benefit From a Diet That Lowers Your CRP (c-reactive protein)
Posted in Dementia, Heart Disease
Science magazine has been investigating this for six months. This is disturbing, to say the least.
For several decades, a leading theory on the “cause” of Alzheimer disease is that a toxic protein called beta amyloid builds up in certain parts of the brain, impairing function. If that’s true, the next questions are 1) why does the protein accumulate, and 2) what can be done to prevent it.
From ABC News:
Allegations that part of a key 2006 study of Alzheimer’s disease may have been fabricated have rocked the research community, calling into question the validity of the study’s influential results.
Science magazine said Thursday that it uncovered evidence that images in the much-cited study, published 16 years ago in the journal Nature, may have been doctored.
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More than $1 billion of government funding, through the National Institutes of Health, has been directed to amyloid-related Alzheimer’s research. While the investigation suggests that studies of Aβ*56 should be opened up to new scrutiny, experts said the entire theory shouldn’t be discredited.
Steve Parker, M.D.
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Posted in Dementia
I’d be much appreciative of some Amazon reviews of my 2024 book, Resuscitating U.S. Healthcare: An Insider’s Manifesto for Reform.
To make the book available to more readers, I just dramatically reduced the price at the U.S. Amazon store. $2.99 for the e-book (Kindle) or $9.95 for the paperback. I don’t know how long the prices will stay this low.
If you’re curious, at those prices Amazon pays me $2.06 for each e-book sold, and $2.74 for the paperback.
I don’t care if you leave a favorable or bad review at Amazon. Just be honest. I’ll incorporate helpful and insightful criticism into the 2nd edition.
BTW, Luigi Mangioni’s manifesto was under 300 words. Mine’s about 35,000. But it’s a quick read.
Steve Parker, M.D.
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Posted in Healthcare Reform
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Posted in Uncategorized
Click pic to purchase book at Amazon.com. E-book versions also available at Smashwords.com.
Diabetic Mediterranean Diet Advanced Mediterranean Life
Paleo Diabetic 