Thursday, January 20, 2011

In the land of real women

By James J. Gormley

Although winter has much of the U.S. in its icy grip, many Americans like going to Florida or other sunny climes in February and especially in March, when Spring Break is upon us. With sun-kissed beaches come the tiny, itsy bitsy polka dot bikinis with which sandy diversions are often associated. Many young women (not to mention, lots of men) are alternately looking at the calendar and peeking at the mirror, worried that they will not be able to fit into that swimsuit that’s two sizes too small that was bought as an “incentive” after New Year’s Eve.

What’s with all of this bikini anxiety? As I pointed out in 1999, in an article called “Giving Barbie the ‘Boot”: (1) real women have different body types than do most fashion models, who are often emaciated and (2) typical diets don’t work. In addition, the Barbie body-myth acculturation is now beginning in very young girls who should, arguably, be excited about many things -- such as science, math, sports, and jump-rope -- but not about losing weight!

Rachel Caplin, author of I’m Beautiful, Dammit! Waging Your Own Curvolution and co-founder of Curvolution, a Calif.-based entertainment company that’s working to put real women, of all sizes, into the media, said in a 2006 interview with the Pittsburgh Tribune-Review: “The fact that it’s bathing suit season doesn’t mean that this is the moment in time where you have to be what the season is telling you to be.”

Our society’s bathing suit obsession becomes even clearer when we look at a few stats on women, girls, and weight extracted from the book, The 7 Secrets of Slim People, by Vikki Hansen, M.S.W., and Shawn Goodman:

• The average American woman is 5'4", weighs 140 lbs., and wears a size 14 dress.
• 33% of American women wear a size 16 or larger.
• 50% of American women are on a diet at any one time.
• 90 to 99% of diets fail to achieve permanent weight loss.
• 50% of 9-year-old girls and 80% of 10-year-old girls have dieted.
• 90% of high-school junior and senior girls diet regularly, even though only between 10-15% are over the "recommended" weight.

And when I learned from authors Hansen and Goodman, that “young girls are more afraid of becoming fat than they are of nuclear war, cancer, and losing their parents,” then it makes me more determined than ever to try to encourage my (trim) teenaged daughter to enjoy her summer and not get sucked into the dysfunctional body-type vortex that surrounds us.

Adding to bikini anxiety is its kissing cousin, fitness anxiety: Are we buff enough? Although we can sometimes feel stress as we unfairly judge ourselves by looking at the aerobics instructor next to us on the StairMaster®, we might not be aware that many everyday activities --- including shopping at the mall! --- really help us to be more fit and burn more calories each day.

For example, did you know that 25 minutes of brisk walking at the mall (the best way to avoid buying too much!) or 30 minutes of washing windows burn the same amount of calories as 20 minutes of medium aerobics or 20 minutes of tennis? Better yet: did you know that 30 minutes of mowing the lawn (although be careful in the heat) or 45 minutes of washing dishes offer the same calorie-burning as the aerobics? All true. That’s what I call putting things in perspective.

So what if it gives us another excuse to go to the mall!

Monday, January 17, 2011

Why Obama Care Needs to Be Repealed

By Jane M. Orient, M.D.
Guest contributor

The plight of people who lose their insurance and then get sick is one of the most appealing arguments for health care reform. And the White House really took advantage of it, soliciting tear-jerking stories from responsible folks who played by the rules and who can’t get insurance through no fault of their own.
The disagreeable truth—a relentless law of economics—is that you can’t insure a pre-existing. If you wreck your car, State Farm pays only if you had the insurance policy before the accident. If you don’t have insurance, your options are to take the bus, walk, ride a bicycle, get help from friends or family, or come up with money to buy a new car from some source other than a car insurance company.

People would very much like the “right” to buy insurance that would cover their pre-existings, without restrictions or waiting periods. But the same folks don’t much like the idea of paying for other people’s pre-existings—or even for their sicknesses. So the healthy ones often switch into a new policy that gives them an enticing low rate if they pass the underwriting. Then those who can’t switch see their premiums go up rapidly. This is called the “death spiral.” Is it the wicked insurance companies’ fault? Or human nature?

You might naturally feel sympathy toward a person who finds out that he has a costly and fatal condition like AIDS. But what if he doesn’t tell the life insurance company about the pre-existing as he buys a million-dollar policy for the benefit of his partner? Is it wicked of the insurer to rescind the policy because of fraud? Or should the government force the company to pay—until it goes bankrupt, and leaves all of its subscribers without coverage?

If you have insurance through your employer, pre-existings are likely not a problem—if you can get the job, that is. But the huge drawback of employer-owned insurance is that you lose it if you lose your job. This is called “job lock.” Lots of people are stuck in jobs they hate because of this.

It might not seem fair that people who pay into a policy for years or decades are left with nothing the instant the policy lapses. But that is the nature of an insurance contract.

If over 10 years or so, you put $100,000 into a safe investment, at the end of that time you have $100,000 plus interest. If instead you hand the money over to the insurance cartel, you have nothing. The trade-off is that if you have a catastrophic event during the time you are covered, the insurer pays. Most people think the deal is a fair one, and that’s why they voluntarily pay the premiums.

As soon as the government forces people to pay a premium for other people’s pre-existings, they are likely to object to what they—quite reasonably—see as a rip-off. Hence the need for more force: the individual mandate.

Some people don’t see the connection, and think we can keep that popular provision on pre-existings, and delete the rest. We can’t.

The long-term answer to the problem of pre-existings is to break the connection between health insurance and employment, which requires changing the tax code provision that caused it. People can pay medical costs with pre-tax dollars if and only if they pay with employer-owned insurance. If they pay out of pocket or through individual policies, they must use after-tax dollars. With payroll tax and income taxes, that means they pay about twice as much. How can that be fair?

People tend to have much longer relationships with groups other than their employer: churches, credit unions, or fraternal organizations, for example. Why can’t they get group health insurance in that way? This type of group policy could offer advantageous guaranteed renewability to keep healthy people in the program.

And why should people get a huge tax advantage if and only if they funnel payments through a third party?

Meanwhile, there are people who have problems now. And there is a solution that already works, without the system-wide destruction of ObamaCare. Many states have high-risk pools for the uninsurable. In Colorado, the monthly premium for a 35-year-old man with income under $50,000 is about $204, around $50 higher than premiums in the regular market. In New Jersey, with guaranteed issue/community rating like that in ObamaCare, the regular monthly premium is $2,150.

Forcing insurers to cover pre-existings without allowing enormous premium increases will bankrupt them. Perhaps driving private insurers out of business is the real agenda. However, imposing a “solution” that multiplies costs bankrupts everybody.

Those who are counting on that single payer hovering in the background need to remember that the government is already bankrupt—a very dangerous pre-existing condition.

The most popular provision of ObamaCare may also be the worst. The whole Act needs to be repealed.

About the Author
Doctor Orient is the Executive Director of Association of American Physicians and Surgeons and has been in solo practice of general internal medicine since 1981. She is a clinical lecturer in medicine at the University of Arizona College of Medicine. She received her undergraduate degrees in chemistry and mathematics from the University of Arizona, and her M.D. from Columbia University College of Physicians and Surgeons. She is the author of Sapira’s Art and Science of Bedside Diagnosis, the fourth edition of which has just been published by Lippincott, Williams and Wilkins. She also authored YOUR Doctor Is Not In: Healthy Skepticism about National Health Care, published by Crown. She is the executive director of the Association of American Physicians and Surgeons, a voice for patients’ and physicians’ independence since 1943. Complete curriculum vitae posted at Additional information on health-related issues: and
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