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Compassion For Self – Part 10

You matter. You. You have the power to help create the future you want to see. Get healthy. Stay healthy. “The body temple” — I love that phrase. Treat your body like a temple; honor yourself. Live and enjoy your full lifespan in this exquisite life you have been born into.

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Living a compassionate life begins by taking compassionate, loving care of your health and your self. This is the 2nd Compassion enabling each us to achieve The Great Healing – for ourselves and for our planet. This weekly 11-part series excerpts and adapts Chapter 2 of the new book, The Great Healing – Five Compassions That Can Save Our World.

“An exceptionally well and persuasively written clarion call to personal and collective action, The Great Healing – Five Compassions That Can Save Our World is unreservedly and urgently recommended.”
— Midwest Book Review

“The ambitious book’s five chapters highlight compassionate approaches toward animals, self, the land, community, and democracy. Erickson’s writing displays passion, clarity, and a grasp of every topic he tackles.”

— Kirkus Reviews

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. . .

Expect that healthy, whole nutritious food products be made available by the food industry.

Force this change with your food purchasing decisions.

“The food companies profit from producing low-cost, low-nutrition Frankenfoods designed to be addictive.” Dr. Fuhrman continues, “The medical establishment profits from treating disease on a cause-by-cause basis, refusing to acknowledge, prescribe, or enforce effective lifestyle changes that actually prevent and reverse symptoms and diseases. And last, as a culture we continue to embrace unhealthy foods as if the data on how these foods are destroying lives do not exist or do not apply to us.”[i]

Force food companies to provide healthy food by your food purchasing decisions. Do not buy unhealthy or deceptively labeled food.

. . .

Expect to receive sound nutritional advice as well as illness prevention counseling from your physician.

Americans spend more on health care than any other country in the world. In 2016, health care spending per person was $10,348, which is 31% higher than Switzerland, the next highest spender. Other wealthy countries — on average — spend half as much as the United States. 18% of our Gross National Product goes to health care costs, yet we have the highest rates of obesity, hypertension, and chronic illness worldwide. And our health care spending continues to rise at an average exceeding 4% per year.[ii]

This is the direct consequence of a health care approach based on diagnosing and treating disease — on disease management. $10,348 spent on average each year for every American age zero on up signifies a vastly unhealthy population.

For Dr. Hyman, “Functional medicine is the best model we have for addressing our chronic illness epidemic. It is the medicine of why, not the medicine of what. It is about why you have the disease, not just naming what disease you have. It strives to treat the underlying cause of the disease, rather than merely suppressing the symptoms.”[iii]

This is the awareness your doctor should have. Your life depends on it.

“Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity.” That is the determination doctors made in Nutritional Update for Physicians: Plant-Based Diets,[iv] but in that same report they noted, “Despite the strong body of evidence favoring plant-based diets, including studies showing a willingness of the general public to embrace them, many physicians are not stressing the importance of plant-based diets as a first-line treatment for chronic illnesses… Physicians should be informed about these concepts so they can teach them to staff and patients… Too often, physicians ignore the potential benefits of good nutrition and quickly prescribe medications instead of giving patients a chance to correct their disease through healthy eating and active living. If we are to slow down the obesity epidemic and reduce the complications of chronic disease, we must consider changing our culture’s mind-set from ‘live to eat’ to ‘eat to live.’ The future of health care will involve an evolution toward a paradigm where the prevention and treatment of disease is centered, not on a pill or surgical procedure, but on another serving of fruits and vegetables.”

Honor your body temple by making every bite of food healthy, whole and predominantly plant-based. Choose a physician who understands this and gives you sound nutritional, diet and disease prevention advice as part of your health evaluation.

You should be able to expect — and count on — this kind of counseling from your doctor.

. . .

You have a right to expect Big Pharma and Big Med, the corporations that control the medical industry, to shift away from a business model incentivizing relentless profit maximization to one that is more compassionate and prioritizes healthy living and disease prevention.

How can you help move a massive industry away from a profit driven imperative that is now the pervasive objective throughout each of its sectors including the managing of illness and disease, filling hospital beds and operating tables, and the marketing and distribution of medical supplies and drugs?

The first step is the most important step you can take.

Do your very best to avoid being a customer.

86% of healthcare costs in the United States go toward the treatment of entirely preventable diseases and illnesses that are the result of eating unhealthy food.[v] Secure and protect your good health and that of your loved ones and friends. Communicate your choices and inspire others to follow suit.

Originally, the goal of Health Care was health care. The stated purpose of the American Medical Association (AMA) when it was founded in 1847 in Philadelphia by 250 doctors, included “scientific advancement, standards for medical education, launching a program of medical ethics, improved public health.”[vi] To this day it publishes the most widely circulated medicine journal in the world, the Journal of the American Medical Association (JAMA).

But times have changed. Elisabeth Rosenthal writes, “Our healthcare system today treats illness and wellness as just another object of commerce: Revenue generation. Supply chain optimization. Minimization of tax liability. Innovative business modeling. Things sold. Services rendered. Bills to be paid… The AMA is a multiheaded hydra that is, in many respects, as much a diversified corporation as a nonprofit professional group… The AMA Foundation is today supported by a Corporate Roundtable, ‘a group of key stakeholders,’ who meet with the AMA to discuss their shared ‘commitment to public health in America.’ Its platinum, gold, and silver members are all from the pharmaceutical and healthcare industry.”[vii]  Is it any wonder the AMA does little to control health care costs? In fact, the AMA operates very aggressively to protect its business interests and presumably those of the corporate members of its Roundtable, as it spends over $20 million on lobbying yearly, making it one of the top handful of spenders on lobbying in the United States. Its political action committee — AMPAC — contributes millions to political campaigns.

The goal in each sector of the U.S. healthcare system is now to maximize profit. “From 1997 to 2012, the cost of hospital services grew 149%, while the cost of physician services grew 55%. The average hospital cost per day in the United States was $4,300 in 2013, more than three times the cost in Australia and about ten times the cost in Spain,” according to Elisabeth Rosenthal.[viii]

The pharmaceutical industry, Big Pharma, has also experienced exponential growth. In 2012, it spent $27 billion on drug promotion, $24 billion of which was allocated to marketing its drugs to physicians. That is a huge sum of money spent informing and influencing physicians. The remaining $3 billion was spent on advertising campaigns to influence you, the consumer.[ix] This level of spending proved successful in increasing prescriptions written because in 2014, Big Pharma increased its drug advertising spend to $4.5 billion. $3.4 billion of this was allocated to promoting just the top ten drugs.[x] Drug company direct-to-consumer advertising has grown so massive that annual ad spends on just a single new drug frequently exceed annual spends for Pepsi, Budweiser, or Nike.[xi]

The United States and New Zealand are the only two countries in the world that allow direct-to-consumer advertising for prescription drugs. Truth-in-advertising laws, however, require any television commercial that indicates the uses of a prescription drug must give full disclosure of side effects.

One typical example is Intermezzo. If you have problems sleeping, there can be many reasons. For Brady and others battling diabetes, obesity is a direct risk factor for obstructive sleep apnea. To begin to get a good night’s sleep, you can shift to a plant-based diet and nutritious foods. Or you can talk to your physician about getting a prescription for a drug to help you sleep — such as Intermezzo.

An 89 second long television advertisement for Intermezzo contains this spoken, legally required, disclaimer which begins just 24 seconds in and continues for 55 seconds, spanning all but the remaining 10 seconds of the commercial: “Do not take Intermezzo if you have had an allergic reaction to drugs containing Zolpidem such as Ambien. Allergic reactions such as shortness of breath or swelling of your tongue or throat may occur and may be fatal. Intermezzo should not be taken if you have taken another sleep medicine at bedtime or in the middle of the night or drank alcohol that day. Do not drive or operate machinery until at least four hours after taking Intermezzo when you’re fully awake. Driving, eating, or engaging in other activities while not fully awake without remembering the event the next day have been reported. Abnormal behaviors may include aggressiveness, agitation, hallucinations or confusion. Alcohol or taking other medicines that make you sleepy may increase these risks. In depressed patients, worsening of depression including risk of suicide may occur. Intermezzo, like most sleep medicines, has some risk of dependency. Common side effects are headache, nausea and fatigue.”[xii]

Your choice. Change to a healthy diet providing your body all the nutrition it needs to function properly and see if your sleep improves, or opt for a quick fix with a drug like this one and risk experiencing one or more of its side-effects such as forgetting events you engaged in just the day before, hallucinations, aggression, worsening depression, addiction, a fatal swelling of your throat or tongue, or suicide.

Your physician is someone you should be able to trust. To trust that every decision, every bit of advice he or she provides you with is in your best interest — your best health interest — not their financial self-interest or Big Pharma’s.

Diabetes and obesity impair your circulatory system. One of many consequences in men can be erectile dysfunction. To begin to address this, you can shift to a plant-based diet and predominantly nutritious foods and your circulatory system will begin to improve. Or you can talk to your physician about getting a drug prescribed such as Cialis for quick help in this regard.

About 29 seconds into a 60 second Cialis commercial, the narrator says: “Do not take Cialis if you take nitrates for chest pain as this may cause an unsafe drop in blood pressure. Do not drink alcohol in excess with Cialis. Side effects may include headache, upset stomach, delayed back ache, or muscle ache. To avoid long-term injury, seek immediate medical help for an erection lasting more than four hours. If you have any sudden decrease or loss in hearing or vision, or if you have any allergic reactions such as rash, hives, swelling of the lips, tongue or throat, or difficulty breathing or swallowing, stop taking Cialis and get medical help right away.”[xiii] There’s only five seconds left in the ad spot at this point.

If I take Cialis and experience the fear of difficulty swallowing or breathing, or the shock of a “sudden” loss of hearing, or vision, I’m dialing 911 if I can still manage to find my phone, four-hour boner notwithstanding.

Try to avoid being a customer of Big Pharma.

Big Pharma does more than spend billions of dollars educating physicians about its newest drugs. In his exposé, Drug Safety and Media Shaped by Big Pharma, Dr. Mercola states, “As the drug industry’s influence over the U.S. Food and Drug Administration (FDA) increases, dangerous drugs are approved and marketed despite their clear risks to patients.”[xiv] One reason mainstream media news services may fail to report on drug safety risks is because drug companies spend around $5 billion each year advertising on these media outlets.[xv] Further, as reporter Mike Papantonio is quoted in Gary Bentley’s article, Big Pharma Owns the Corporate Media, but Americans Are Waking Up and Fighting Back, “According to a 2009 study by Fairness and Accuracy in Reporting, with the exception of CBS, every major media outlet in the United States shares at least one board member with at least one drug company.”[xvi]

Dr. Mercola finds that, “Conflicts of interest are hardly limited to media companies. Government agencies, from the FDA to the Centers for Disease Control and Prevention (CDC) also have disturbing financial conflicts of interest that make a mockery out of objectivity.” Big Pharma spent $244 million dollars in 2016 lobbying political leaders in Washington, DC. The industry also spends millions of dollars to enlist professors at top universities in addition to doctors and scientists to write articles endorsing new drugs, articles frequently based on research that, per Dr. Mercola, “has often been ghostwritten by the drug industry with a media professional or professor’s name attached for credibility… Thanks to the Bayh-Dole Act of 1980, which enabled lucrative academic/Pharma partnerships and ‘technology transfer’ (even though most drug development is funded by taxpayers and profits should belong to the public) medical centers are unapologetic arms of the drug industry.”[xvii]

One study found that 40% of U.S. Drug Companies had at least one board member holding a concurrent leadership position at an academic medical center.[xviii] With regard to new drug testing, a significant and increasing amount of the clinical trial work is now being done by for-profit groups hired by Big Pharma.

Prescription drugs cost more than twice as much in the U.S. as in other developed nations and prices have doubled in the past five years. One reason for this, Annie Waldman notes in her ProPublica article co-published in 2017 with Consumer Reports, is, “The U.S. grants drug makers several years of market exclusivity for their products and remains one of the only industrialized countries that allows them to set their own prices.”  

She continues, “Pharmaceutical companies have traditionally justified their prices by citing the cost of research and development, but recent research on drug pricing has challenged this argument. Many of the largest drug companies spend more on sales and marketing than on developing their drugs. And notably, one researcher has found that about 75% of new molecular entities, which are considered the most innovative drugs, trace their initial research funding back to the government. ‘There is substantial evidence that the sources of transformative drug innovation arise from publicly funded research in government and academic labs,’ said Dr. Aaron Kesselheim, an associate professor at Harvard Medical School… Some nations, particularly those with national health care systems, like the U.K., rely on official cost-effectiveness analyses to decide which drugs to pay for. Overpriced drugs are sometimes denied coverage. This powerful negotiating tool has helped keep drug prices down abroad. Efforts to establish similar practices in the U.S., however, have been stymied by lobbying from patient groups, many of them funded by the pharmaceutical industry.”[xix] 

Health insurance as an industry has evolved into another component of the business of Health Care. You either have it or you don’t. And in our present system, even if you have insurance, certain diseases, injuries or maladies are either not covered, or not fully covered — and the uncovered costs can eviscerate your assets.

Insurance companies are significant investors in the medical industry, meaning they are positioned to profit from an industry that in turn is profiting in large part from an expanding business based on poor health and its medical consequences. Is this a conflict of interest to your detriment?

In his 2018 article, Why Your Insurer Doesn’t Care About Your Big Bills, Marshall Allen writes, “The United States spends more per person on health care than any other country. A lot more. As a country, by many measures, we are not getting our money’s worth. Tens of millions remain uninsured. And millions are in financial peril: About 1 in 5 is currently being pursued by a collection agency over medical debt. Health care costs repeatedly top the list of consumers’ financial concerns.”[xx]

Noting that medical debt has become the biggest cause of bankruptcy in the United States, Elisabeth Rosenthal writes, “We hate our healthcare system… It is often only after Americans get sick in other countries that they understand just how broken their own system is.”[xxi]

Marshall Allen adds, “Experts frequently blame this on the high prices charged by doctors and hospitals. But less scrutinized is the role insurance companies — the middlemen between patients and those providers — play in boosting our health care tab. Widely perceived as fierce guardians of health care dollars, insurers, in many cases, aren’t. In fact, they often agree to pay high prices, then, one way or another, pass those high prices on to patients — all while raking in healthy profits… You’d think that health insurers would make money, in part, by reducing how much they spend. Turns out insurers don’t have to decrease spending to make money. They just have to accurately predict how much the people they insure will cost. That way they can set premiums to cover those costs — adding about 20 percent for their administration and profit.”[xxii] 

Elisabeth Rosenthal notes how the business of insurance has changed with regard to the business of healthcare since 1993 when, “insurers spent 95 cents out of every dollar of premiums on medical care, which is called their ‘medical loss ratio.’ To increase profits, all insurers, regardless of their tax status, have been spending less on care in recent years and more on activities like marketing, lobbying, administration, and the paying out of dividends. The average medical loss ratio is now closer to 80%.”[xxiii]

What if in addition to minimizing your medical expenses and all the other savings earned from living a healthy life, you could qualify for an insurance discount as well?

Akin to a good driver discount, shouldn’t you have the right to expect your health insurance provider to give you a significantly lower premium — a healthy living discount — if you qualify?

Shouldn’t you qualify for a healthy living discount if your BMI is 25 or less? Or if you are deemed healthy by other similar documentable criteria health experts can establish? What if you were rewarded for demonstrating improvements to your health? Several insurance funds currently offer these discounts in Germany.[xxiv]  

Incentivize good health insurance discounts by voicing your opinion.

If enough people advocate for “healthy living discounts” to their health insurance premiums, the incentive for an insurance company to offer these discounts would be to increase its market share. Individuals would begin to flock to that company for their insurance. Before long other insurers would offer similar discounts to compete, and the industry itself would evolve.

. . .

In 2015, Health and Medicare spending in the United States amounted to 27.42% of our federal budget.[xxv] Overall U.S. health care spending in 2016 was $3.3 trillion, or 17.9% of our Gross Domestic Product (GDP).[xxvi] A report presented by the World Economic Forum and the Harvard School of Public health in 2011 reported that the global cost in lost output from diabetes, cancer, cardiovascular disease, chronic respiratory diseases, and mental health, over the period of 2011-2030 will be nearly 47 trillion dollars.

As healthcare costs continue to rise, this is not economically sustainable. And despite this massive spending, as Elisabeth Rosenthal points out in An American Sickness, “the U.S. health system generally delivers worse health outcomes than any other developed country, all of which spend on average about half of what we do per person.”[xxvii]

The medical and economic costs associated with our obesity rate rose to $1.42 trillion in 2014.[xxviii] 7 out of 10 deaths and 86% of health care spending is now linked to diet-related health conditions.[xxix]

Within that dire statistic lies our solution. It is unavoidable that changes must be made to improve our deeply flawed healthcare system. Chapter 5 will address that.

But for now, beginning at this moment, we don’t need to wait.

The vast majority of healthcare costs are under our individual control right now. The solution is at the end of your fork. The solution begins with your next meal.

The solution is healthy eating.

. . .

Begin now. With yourself and your loved ones; then sway others.

Start with yourself and your loved ones. Prevent or heal illness or dis-ease with a healthy diet, healthy nutrition and exercise.

The Health Net newsletter article, Keep Diabetes in Check, the one with the photo of the protective father helping his young daughter monitor her blood sugar level, provides advice with short lists of things to do and things to have checked when you next visit your physician. The very first paragraph, the very first sentence reads, “We can’t yet cure diabetes. But we do know how to treat it.”[xxx]While reassuring, confident, and seemingly well intentioned, this — it seems to me — is exactly what you least want to read. Granted, your doctor has been trained to manage diabetes and insurance industry coverage will pay for much of the treatment you will endure while you reside in the city named Type 2 Diabetes, however, the claim written on behalf of medical professionals and the health industry, that “we can’t yet cure diabetes” should cause you to wonder.

Apparently, the medical industry doesn’t know how to cure diabetes…

But you do.

It starts with the foods you eat. And it starts immediately — with your next bite.

. . .

Compassion for self has this almost inescapable ride-along: it fosters and magnifies compassion for others. When you are healthy or once you regain control of your health and wellbeing, and are able to fully realize, and experience and enjoy your life’s potential, that’s a joyful place to be. You will want others to live healthy, fully realized lives and to join in a compassionate celebration of life with you. It will be hard not to.

There is another bonus ride-along, one that is priceless, fundamental.  Joanna Macy describes it wonderfully in World as Lover, World as Self:

“We have received an inestimable gift. To be alive in this beautiful, self-organizing universe — to participate in the dance of life with senses to perceive it, lungs that breathe it, organs that draw nourishment from it — is a wonder beyond words. And it is, moreover, an extraordinary privilege to be accorded a human life, with self-reflexive consciousness that brings awareness of our own actions and the ability to make choices. It lets us choose to take part in the healing of our world.”[xxxi]

You matter. You. You have the power to help create the future you want to see.

Get healthy. Stay healthy. “The body temple” — I love that phrase. Treat your body like a temple; honor yourself. Live and enjoy your full lifespan in this exquisite life you have been born into.

You have been victimized. Big Food, Big Med and Big Pharma are the Cape Cobra poised to strike and are focused on you. But you do not need — you never need — to become a victim.

Your voice matters. You must find your voice and use it. Because there are some even bigger problems afoot which we are going to get to. And the planet and the human race need your help.

Find your courage; take a stand. And when you clearly understand who our Arch-Villain is, remember the meerkat’s strategy against the Cape Cobra and the power of collective action.

Be open-minded. Always be learning.

Heal yourself and maintain your health with the nourishing food you choose to eat. Live fully, compassionately, gratefully and well.

Help others. Heal our planet. You have the power. More than you realize.

You’ll see.

. . .

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Read Part 11 of this 11-part series next week. If you can’t wait, the book The Great Healing – Five Compassions That Can Save Our World is available on Amazon or at thegreathealing.org

“Erickson’s ability to connect climate science, copious data, and public policies with the lived experiences of people and other creatures sets this book apart. His emphasis on humane and caring methods reminds readers that winning hearts and minds is a prerequisite to capturing carbon. An inspired synthesis of environmental, cultural, economic, and political calls to action.”

— Kirkus Reviews

“Everyone with an interest in Agriculture (that is any person who consumes food) MUST READ The Great HealingThis book will catapult the agricultural revolution of Modern Times.”

—Ted Dupmeier DVM MVSc, Dr. Ted & Associates Veterinary Consulting – Food Animal Veterinarian renowned throughout North America

“An exceptionally well and persuasively written clarion call to personal and collective action, The Great Healing – Five Compassions That Can Save Our World is unreservedly and urgently recommended.”
— Midwest Book Review

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[i] Joel Fuhrman, M.D.   Fast Food Genocide,  New York, New York: Harper Collins, 2017  pg. 7. 

[ii] Bradley Sawyer, Cynthia Cox.  How Does Health Spending in the U.S. Compare to Other Countries?  Kaiser Family Foundation,  Feb. 13, 2018, Analysis from data from OECD (2017),  OECD Health Data: Health Expenditure and Financing: Health Expenditure Indicators, OECD Health Statistics (database). DOI: 10.1787/health-data-en  https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/?_sf_s=health+spending#item-start

[iii] Mark Hyman, M.D.  Food – What the Heck Should I Eat?, New York, New York: Little, Brown and Company, 2018, pg.11

[iv] Philip J. Tuso, Mohamed H Ismail, Benjamin P Ha, Carole Bartolotto, Nutritional Update for Physicians: Plant-Based Diets, The Permanente Journal, 2013 Spring; 17(2): 61–66. doi:  10.7812/TPP/12-085    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662288/

[v] The Physicians Committee for Responsible Medicine, Changing Lives Through Clinical Research, Good Medicine, Sum., 2018 Vol 27, No.3

[vi] Elisabeth Rosenthal, An American Sickness, New York, New York: Penguin Books, 2017, pg. 195

[vii] Elisabeth Rosenthal, An American Sickness, New York, New York: Penguin Books, 2017, pg. 195-6

[viii] Elisabeth Rosenthal, An American Sickness, New York, New York: Penguin Books, 2017, pg. 23

[ix] Joseph Mercola, D.O., Ghost in the Machine, Part 1 – Drug Safety and Media Shaped by Big Pharma, mercola.com, Dec. 27, 2017, https://articles.mercola.com/sites/articles/archive/2017/12/27/drug-safety-media-shaped-by-big-pharma.aspx

[x] Beth Snyder Bulik, The Top 10 Most-advertised Prescription Drug Brands, FiercePharma, https://www.fiercepharma.com/special-report/top-10-most-advertised-prescription-drug-brands

[xi] Elisabeth Rosenthal, An American Sickness,  New York, New York: Penguin Books, 2017, pg. 100

[xii] Paul Crozier, Prescription Drug Commercials, 17/51 Intermezzo Commercial, You Tube, https://www.youtube.com/watch?v=cD8nlUHyVak&list=PLQZTk4BbrTExLq1Lmdj1HqEOZRxv0zbN2&index=4

[xiii] Paul Crozier, Prescription Drug Commercials, 39/51 Cialis Commercial, You Tube, https://www.youtube.com/watch?v=mRoG-HyKcqA&index=39&list=PLQZTk4BbrTExLq1Lmdj1HqEOZRxv0zbN2

[xiv] Joseph Mercola, D.O., Ghost in the Machine, Part 1 – Drug Safety and Media Shaped by Big Pharma, mercola.com, Dec. 27, 2017, https://articles.mercola.com/sites/articles/archive/2017/12/27/drug-safety-media-shaped-by-big-pharma.aspx

[xv] Gary Bentley, Big Pharma Owns the Corporate Media, but Americans Are Waking Up and Fighting Back, The Ring of Fire Network, story: Big Pharma’s Influence, reported by Mike Papantonio, Apr. 11, 2017 https://trofire.com/2017/04/11/big-pharma-owns-corporate-media-americans-waking-fighting-back/

[xvi] Gary Bentley, Big Pharma Owns the Corporate Media, but Americans Are Waking Up and Fighting Back, The Ring of Fire Network, story: Big Pharma’s Influence, reported by Mike Papantonio, Apr. 11, 2017 https://trofire.com/2017/04/11/big-pharma-owns-corporate-media-americans-waking-fighting-back/

[xvii] Joseph Mercola, D.O., Ghost in the Machine, Part 1 – Drug Safety and Media Shaped by Big Pharma, mercola.com, Dec. 27, 2017, https://articles.mercola.com/sites/articles/archive/2017/12/27/drug-safety-media-shaped-by-big-pharma.aspx

[xviii] Timothy S. Anderson, M.D., Shravan Dave, BS, Chester B. Good, Md, MPH, et al.  Academic Medical Center Leadership on Pharmaceutical Company Boards of Directors, JAMA. 2014;311(13):1353-1355. doi:10.1001/jama.2013.284925  Apr. 2, 2014  https://jamanetwork.com/journals/jama/fullarticle/1853147

[xix] Annie Waldman, Big Pharma Quietly Enlists Leading Professors to Justify $1,000 Per Day Drugs, ProPublica co-published with Consumer Reports, Feb. 23, 2017,  https://www.propublica.org/article/big-pharma-quietly-enlists-leading-professors-to-justify-1000-per-day-drugs

[xx] Marshall Allen, Why Your Insurer Doesn’t Care About Your Big Bills, ProPublica co-published with NPR, May 25, 2018, https://www.propublica.org/article/why-your-health-insurer-does-not-care-about-your-big-bills

[xxi] Elisabeth Rosenthal, An American Sickness, New York, New York: Penguin Books, 2017, pgs. 241-2

[xxii] Marshall Allen, Why Your Insurer Doesn’t Care About Your Big Bills, ProPublica co-published with NPR, May 25, 2018, https://www.propublica.org/article/why-your-health-insurer-does-not-care-about-your-big-bills

[xxiii] Elisabeth Rosenthal, An American Sickness, New York, New York: Penguin Books, 2017, pg. 19

[xxiv] Elisabeth Rosenthal, An American Sickness, New York, New York: Penguin Books, 2017, pg. 300

[xxv] Federal Spending: Where Does the Money Go?, National Priorities Project  https://www.nationalpriorities.org/budget-basics/federal-budget-101/spending/

[xxvi] Centers for Medicare & Medicaid Services, National Health Expenditure Data, CMS.gov, Jan. 8, 2018  https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

[xxvii] Elisabeth Rosenthal, An American Sickness, New York, New York: Penguin Books, 2017, pg. 3

[xxviii] Milken Institute, Lynda and Stewart Resnick Center for Public Health, Weighing Down America – The Health and Economic Impact of Obesity, Nov., 2016, https://assets1b.milkeninstitute.org/assets/Publication/ResearchReport/PDF/Weighing-Down-America-WEB.pdf

[xxix] The Physicians Committee for Responsible Medicine, Changing Lives Through Clinical Research, Good Medicine, Sum., 2018 Vol 27, No.3

[xxx] Health Net News, Keep Diabetes in Check, Spring, 2018

[xxxi] Reprinted from World As Lover, World As Self (1991, 2007) by Joanna Macy with permission of Parallax Press, Berkeley, California, www.parallax.org pg. 75

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