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The presidential race and health insurance

The introduction of a new mandate was Mitt Romney’s move on health care, as a governor. The Affordable Care Act was modelled on the Republican law by President Obama, which is a curious coincidence. Ignoring the politics of what followed, the debate usually divides along the right of individuals to choose vs big government. As a matter of fact, this is completely wrongheaded. The debate should be about controlling the cost of health care which is rising faster than inflation. If this cannot be done and the health of patients is being prejudiced, the burden of subsidizing access to care should be accepted by employers and states. We need a healthy population.

The changing of Medicare into a voucher program was something that Romney and Ryan want to do. The problem is that, if the value of the vouchers fails to keep up with rising costs, the elderly will be forced to pay more of the cost of their own care. Worse, the Medicare service has been controlling costs. If this “business” was passed over to private insurers, it would add to inflationary pressures and all costs would rise. This is a nonsense.

The only real option for a sustainable future is to positively control costs. This means forcing hospitals and doctors to switch to preventive medicine and, if people do fall ill, using the most cost-effective treatments where there’s evidence of good outcomes. At present, hospitals do not need to limit the range of tests they perform nor are they limited in the treatments they can use. This means bills are inflated as hospitals maximize their profits without actually delivering the best value for money to the patients.

Sadly, this is also a major defect in the President’s confirmation that he will continue with the Affordable Care Act as it is. With costs rising fast, health insurance quotes will rise no matter whether purchased directly or through one of the new exchanges. Only when costs are controlled will insurance be affordable. It may never be possible to get back to cheap health insurance unless government provides subsidies. That would be redistribution and so unacceptable to many voters.

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Erectile dysfunction treatment in diabetic men: ED pills vs. coffee

Now here’s a fact that might surprise you. In our civilized Western cultures, caffeine is the most commonly consumed drug. Indeed, when you look at all the different ways in which we drink and eat it, the amount is sufficient to have a positive medicinal effect on almost every man, woman and child in the West. Apart from the taste which we all seem to like, the reason is the speed with which the drug is absorbed and distributed to every part of the body. The extent of the consumption will vary depending on whether you’ve begun building up tolerance. To a newbie, the physical effects are immediate, raising the blood pressure, changing the rhythm of the heart, increasing the cholesterol levels, and modifying the emotions. After long-term exposure, it takes far longer for the body to experience these effects.

Because one of the effects is to constrict the blood vessels, there’s a theoretical possibility it will increase the risk of erectile dysfunction. In most cases, the reason for the failure to produce an erection is artherosclerosis. This is a hardening of the artery walls, i.e. they will not dilate fully or at all. Fortunately numerous clinical trials have proved that Levitra pills for instance are particularly useful when the cause of the dysfunction is early stage nerve damage caused by diabetes. The active substance in the pills encourage dilation and this lets more blood into the penis. Hence, the two drugs: say, Levitra and caffeine could be working against each other. However, there’s no scientific evidence that the excessive drinking of coffee causes erectile dysfunction. Indeed, new evidence suggests the reverse may be true.

Although the research is still only at the stage of animal testing, work with diabetic rats suggests that caffeine may encourage erections to form. This is not, of course, an indication caffeine may repair the nerve damage often caused by diabetes. There’s no effective treatment for that. But it may suggest that human diabetics who consume a modest amount of coffee, may see an improvement in their sexual performance. It will be interesting to see whether formal human trials are organized. Until then, you will have to rely on erectile dysfunction pills if your erections are poor.

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