August / September 2004

Stan Charnofsky

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SUICIDE BY LIFESTYLE
And Failure in the American Healthcare System
— Stan Charnofsky

We are deceived that American health practices and HMOs deliver enhanced healthcare to our citizenry.

If, of course, highly paid and exorbitantly priced health/medical institutions delivered marvelous services and exquisite results, we might ignore their out-of-line fees. As it is, we suffer from myriad problems in our healthcare and delivery system.

SHORTAGE OF NURSES

Appearing in the AARP Bulletin of May 2003 is an article documenting a crisis-level shortage of nurses in America. Nationwide, more than 126,000 hospital nursing positions are unfilled, which places patients at higher risk of complications and death after surgery. Compounding the emergency is the fact that 78 million baby boomers are aging and showing up in huge numbers for medical treatment. The report cites two government-financed studies, which note that as patientto- nurse ratios rise to more than 4 to 1, so do postoperative death rates. In other words, people are actually dying from a lack of nursing care.

Researchers from the University of Pennsylvania, in reviewing experiences of 232,000 surgical patients, concluded that overall risk of death rose 7% for each patient above four a nurse was expected to tend. The shortage is not easy to remedy, because fewer women are going into nursing and are becoming doctors or finding other work instead, and only 5.4% of nurses are men. The burnout and dropout rates are high: Nearly 20% of licensed, registered nurses have left the profession. Nursing schools, in part because of a lack of faculty and classroom space, in 2000 turned away nearly 5,900 qualified applicants. The scary fact is that unless the exodus from the profession is halted by the year 2020 more than 400,000 vacancies will exist in American hospitals.

BUREAUCRACY

As a psychologist I have been stunned by the intricacy of trying to have my clients’ insurance pay for services. Recently I submitted an invoice for some eight sessions of personal therapy for one of my clients, and where the form asked for “location of services” I put in “0” for office, the standard code for several years. The payment was denied, and when I called to ask why, I was told I hadn’t put in the correct code for “location of services.” “What is the correct code?” I asked. “It has been changed to eleven,” my contact person replied. “Oh,” I said, “then would you please put in eleven in that slot and just erase the 0.” “No, we can’t do that,” came the reply— They ended up sending the whole packet back to me so that I could, personally, write in the number 11.

Our healthcare practices are not the best in the world. Canada’s is better. Scandinavian countries’ are better. England’s is better. We dupe ourselves with the arguments that open competition will take care of our medical/health demands. In healthcare, service should be the motive, not profits. This is not only a shameful condition in our democracy, it has become, plain and simple, a fullblown crisis.

Thomas H. Murray, Ph.D., president of the Hastings Center in Garrison, New York, in the spring issue of the National Honor Society’s Phi Kappa Phi Forum, writing about bioethics, states: “Almost all other nations in the industrialized world have social policies that make core health care services available to all or virtually all of their citizens.” He goes on to say that ensuring such effective healthcare to all citizens who need it is a significant moral challenge in the U.S. We are misled by the political medical complex, that providing basic health services to every American citizen would plunge us into a socialistic maelstrom which would undermine the free marketplace.

This has not happened in England, Sweden, or even Germany, while it has guaranteed better healthcare for the people of those countries, although even with 50% to 60% income tax rates, they are finding they have to cut back services, and there are long waits for doctors, as occurs to some extent at HMOs in America. Part of the reason is the recent increased immigration to Western and Northern Europe (in part to partake of social services available, including healthcare).

DRUG COSTS We all have heard the debate about why our American prescription drugs cost so much more than Canada’s for example. Many consumers are pressuring to be allowed to buy drugs from Canada, though one argument against it is safety issues, because they would not be Food And Drug Administration (FDA) approved. An interesting response to that argument comes from Stephen Schondelmeyer of the University of Minnesota School of Pharmacy: “A drug that is not affordable is neither safe nor effective.”

One possible remedy for the dilemma comes from the Kaiser Permanente HMO on the West Coast, where part of the monthly premium for healthcare pays into the prescription drug costs. I belong to Kaiser, and my prescription costs, when purchased at the in-hospital pharmacy, are wonderfully low. What that tells us all, unfortunately, is that, with the population at large, there is a large markup on these drugs, and we are all at the mercy of the pharmaceutical companies reaping profits at public expense. Writing in the AARP Bulletin in May 2003, Peter Wyckoff, executive director of the nonprofit Minnesota Senior Federation, says: “The real debate now before Congress is whether by joining the rest of the world in negotiating prescription drug prices, we will put the needs of our citizens ahead of the excessive profits of the pharmaceutical industry.”

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SUICIDE BY LIFESTYLE

A major health issue in America has to do with the way many of us live our lives, including our diet, vitamin and mineral supplements, exercise, stress, and relaxation. One doctor told me that over the last fifty years there has been a massive change in eating habits, leading to what he called “suicide by lifestyle.” He also told me that many people suffer from “poly pharmacy” or overmedication.

NUTRITION

Preservatives in our food, sulfites, etc., encourage the formation of free radicals, which attack our immune systems. Also, every bit of research I was able to find noted that restriction of caloric intake (without depriving oneself of protein) extends life, whether in humans or animals. What seduces us are the unbridled and in some cases mouthwatering ads along streets and highways in every state, and on TV channels, persuading us to eat burgers dripping with cheese and grease, drink nutritionless soda pop, and consume mountains of fries and chips.

Of course, all food consumption is our choice, and advertisers can rev up their rhetoric as high as they wish, so long as they do not openly lie about their products. The deception comes in what they do not tell us. We now know that by the time many of our foods reach our table, they are depleted of much of their nutritional value. This, then, requires us to rely on vitamin shop supplements to get ample amounts of antioxidants into our system. Eating in a healthy way would obviate the need for supplements, but, alas, this is not the case for many of us. Fruits, vegetables, and whole grains, eaten daily, would keep our internal protective systems functioning optimally.

We now know that vitamin C is the main antioxidant, and it is found in many fruits and vegetables. Though Dr. Linus Pauling, Nobel Prize winner in two categories, Physics and Peace, recommended years ago that we take massive doses of Vitamin C to ward off colds and flu, and even to help fight cancer, recent studies suggest that there is a saturation point, after which heavier doses become excessive and unhelpful.

We now know that vitamin E, (D Alpha Tocopherol), which is fat soluble, protects membranes and lipid-containing sites where water soluble vitamins do not go, and taken along with Selenium, may protect against certain forms of cancer. We also know that beta carotene, or vitamin A, is critical in maintaining healthy cells, though overdoses have been shown to be harmful.

And we now know that flavanoids are potent antioxidants, and are found in red wine, grape juice, grape seed extract, blueberries, and other fruits and vegetables. Herbals such as green tea, rosemary derivatives, aged garlic, and mushroom extracts are high in antioxidant value, as are soy and flax. Tomatoes, cooked or raw, have been shown to help control prostate cancer, as have Saw Palmetto supplements. The Bcomplex vitamins B6 and B12 (folic acid) seem to help in controlling cardiovascular problems.

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EXERCISE IS MOST IMPORTANT FOR HEALTH

But over and above all else, the most recent research points to exercise as the most important element in bodily health. Even with a specific disease such as breast cancer, though most of the research money goes into biology, exercise has been shown to be the key deterrent. Exercise enhances our natural killer cell activity, and in fact in one recent study it was found that 50% of diabetes may be retarded by appropriate exercise.

Health and longevity hinge on many factors, including genetics, but it is critical for us not to be deceived by fast-food come-ons and slothful lifestyles. We need proper rest, sleep, and tranquil times, and especially vigorous exercise to maintain our optimum vitality.

here could be no more worthwhile focus for the field of psychology—and especially Humanistic Psychology—than the therapeutic education of our citizenry out of suicide by lifestyle.

STAN CHARNOFSKY is Professor of Educational Psychology & Counseling at California State University Northridge and former president of AHP.

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