The purpose of market is to provide a place for the producer and consumer to form voluntary contracts. The market has no intrinsic morals and only one rule: the best deal. The producer makes supply, the consumer makes demand. Between them, and the competition of various producers to provide for various consumers, this constant desire for the best deal drives price ever downward. It rewards the most efficient producer and the most efficient consumer alike. It’s almost a kind of magic.
Market failure doesn’t refer to a total break down of the buying and selling but a break down of the magic, of the automatic best deal for everyone. It’s not discrete point, but direction the market can go. The opposite direction leads to the perfect market. It too is not a destination but a direction, the ideal by which markets are judged.
A perfect market consists of a few key principals, describing the market as a game it looks like this: (1.) Rationality of all players in the game. (2.) No hidden costs to any move. (3.) Enough players that no single one can steer the game by their behavior. (4.) something all the players want to play with [demand] (5.) Freedom to play or not play at any point (6.) No barriers to entering or leaving the game (7.) No barriers to any player about information on any other player.
How does the medical industry fail these criteria?
Rationality of all players in the game
(1.)Well, first of all, the medical consumers are highly irrational. Short term fun at the expense of long term health is not rational, yet 80% of heat disease alone is preventable. Throw in smoking, obesity, diabetes, etc, and the single greatest killer is short sightedness. In a perfect world, doctors would serve as check on this irrationality, but the fact is, doctors are over-treating (which gets people killed) because of their fear of litigation. The consumer is crazy and so is the producer.
No hidden costs to any move
(2.)The whole field is full of hidden costs. From regulations you never heard of to taxes you can’t imagine, the medical field is a minefield of hidden costs.
Enough players that no single one can steer the game by their behavior
(3.) Well, about half of the cost is payed for by one player (gov-care), and up to 70% of the remaining half is payed for by one company per area. Normally, this would be called oligopoly, but honestly, its worse than that. Because the first half is the government, its more like a oligopoly on the second half and monopoly on the first. Under normal circumstances, even if a player owns 50% of the total market, that player can rarely take away your organization’s legal right to exist, or place members of your organization under arrest. The government has what is known as a monopoly on force. Monopoly represents a market distortion. Force, on the other hand, represents the nonexistence of market. The foundation of market is people forming contracts of their free will, ie, without threat of force.
Something all the players want to play with [demand]
(4.) Demand, we’ve got. Sort of. The fact is, while doctors may not be the paragons of reason we hope, the producer side (as is typical in other industries) is better at being rational then the consumer side. If nothing else, it’s better organized. The consumer demand is health, not care. But doctors have no economic incentive to pursue health. They have need to produce care. So there is break down between the needs of the consumer and the ability of the producer to meet that need. Note, I am not saying there is a conspiracy by doctors to keep people sick. Doctors are like most people: there’s a few true saints, a few evil bastards, and lot of pretty ethical folk. But the fact is, we must relay on doctors’ moral incentive and not their economic incentive to provide us with health. Systems work better when the two incentives are the same.
Freedom to play or not play at any point
(5.) This one absolutely does not apply. Playing in this case means the freedom to form or not form voluntary contracts. If the consumer doesn’t enter the market he suffers or dies. At the same time, if the producers do not enter the market many suffer or die. Further, hospitals must provide emergency care to everyone, regardless of ability to pay. On the insurance side, insurers must provide insurance to at a loss to certain high risk people. They must by law.
No barriers to entering or leaving the game
(6.) Well, the barriers to entering the game are enormous. Lets say we want to start a tiny private practice, with very limited services. First, the price of becoming a MD is between $175K and $200K. Then, the first year cost for 1600 square foot commercial space, a receptionist and tech who makes no benefits is about $250K. So, minimum startup cost is right around half a million dollars. Nor can hospitals simply exit the market, they provide a community service and without them people will suffer and die. Insurance is the most heavily regulated industry in the US, so even if cash on hand was not a problem the regulations would be, but in any case, and insurance company must have the cash on hand to pay out all claims if they were all called at once. The startup costs for an insurance company are in the tens of millions.
No barriers to any player about information on any other player
(7.) This is the worst. Insurance companies use hundred page contracts written legalese on purpose, to hide the information the consumer needs to know. At the same time, insurance fraud is a huge expense, because people aren’t honest with the companies either. If people are totally honest with doctors, their premium could go up. Conversely, if doctors are honest about risks with patients, the patients will simply go to another doctor who paints a rosier picture. Again, the moral incentive is diametrically opposed to the economic one.
All in all, it’s a wonder health care is as cheap as it is. Again, I’ve hit over 1000 words, so I will post my solution(?) later. Thanks for reading all, feel free to weigh in on any of this.
Ok, so last blog, I looked at the insurance companies. Basically, there is large room for improvement, but I didn’t find the huge smoking gun of “THE WHOLE THING SUCKS BECAUSE OF THE INSURANCE COMPANIES” I thought I would. In fact, ultimately, premiums are high because hospital care (which premiums insure) are high.
A hospital is a business, even when it is a non-profit. If cash out exceeds cash in, like all other businesses, it fails. Right now, hospital costs are higher then they have ever been, so we would think that hospitals are making money hand over fist. Actually, not at all.
Over the last 10 years the average profit margin (the amount of economic surplus) has increased. It’s gone from (ready for this)… 4.9 to 5.2%. An oft quoted stat is that many of the most profitable hospitals are making a 20.1% profit margin. It’s true. Some of the most profitable hospitals are putting a 20% mark up on certain procedures. It’s to cover the 15% loss they take on the other ones, leaving an end of the year balance of…5%.
Why are they taking a 15% loss? Well, because Medicare, Medicaid, SCHPs, (all the gov-care) doesn’t pay the full cost. Note, this isn’t saying gov-care doesn’t pay the full charge. Think of it this way. A procedure costs the hospital $100. They bill $120 for a twenty percent markup. Private insurance pays $120. Gov-care pays whatever it can afford, usually around $85. A 15% loss means 15% below cost, but about 43% below the price.
The reason for this is the program is never given enough money to pay all the expenses it incurs. If the program was supposed to pay for 100 procedures at $1 each, and there are 140 procedures, then all the hospitals get $0.71 instead of a dollar.
Further, remember that gov-care is only about 1/3 of the number of patients, 2/3rds are private insurance, so how does the hospital not make a killing, taking 15% loss on 1/3 and getting 20% gain on 2/3rds? Because the 1/3 of people on gov-care are the most expensive patients. Despite the fact they make up only 33% of the hospital population, they make up 50% of the expenses.
Hospitals can refuse gov-care patients so why don’t they? If taking a patient on medicare meant you were going to loss 15% of the cost of care, why would hospitals take them in? Because of the Emergency Medical Treatment Act of 1986, which means, “regardless of citizenship, legal status or ability to pay” any patient who needs emergency care must receive it.
Hospitals loss on average, about $84 per emergency room patient. Emergency rooms account for about 20% of the total cost of running a hospital. So, why have one? Because 1/7 patients who visits the ER will have a highly profitable inpatient transfer. The best way hospitals can get the profitable 2/3rds of insurance payers into inpatient surgery is through the ER doors.
What about people who don’t have insurance, and don’t qualify for gov-care and simply refuse to pay? They are very small part of hospital losses, about 3% on average.
So if, 97% of the hospital customers are paying, and half the cost is at a 15% loss, and half is at 20% profit, that doesn’t really explain why health care is so expensive. I mean, yes all the responsible people are effectively paying a 20% sales tax to the hospital to cover the portion of socialized medicine that the their income tax didn’t pay. But, 20% sales tax does not 200% overcharging make. (The cost US health care exceeds the cost of better health in many other industrialized democracies.) So what gives?
The most expensive thing in the hospital is labor. If we are serious about reducing the cost of health care, we have two very basic options. One is make labor cheaper, the other is use less of it.
What about cheaper labor? The most expensive section of hospital is ICU and 80% of the cost of ICU is labor. ICU nurses make about 46k a year. I’ve often mentioned France in this study. Nurses in France make half of what American ones do, and health care is cheaper.
As to reducing the number of hours nurses have to spend with patients, let me rip this long section from this article.
For example, if you are a Medicare recipient and you have a heart attack in a region where doctors practice less aggressive care, like Salt Lake City, your care will cost Medicare about $23,500 over the course of a year. But if you have your heart attack in a place like Los Angeles, the bill will be closer to $30,000.
The wide gulf in spending between the two cities is not because of different prices. Sure, everything costs a bit more in Los Angeles, including nurses’ salaries and the laundering of hospital linens, but not enough to account for the extra amount Medicare pays for a heart attack. The reason the same patient’s care costs more there than in Salt Lake City is that doctors and hospitals in Los Angeles tend to give their patients more tests, procedures, and surgeries, and their patients tend to spend more days in the hospital.
But here’s the important part. All that extra care in L.A. doesn’t lead to better outcomes. As it turns out, heart attack patients who receive the most care actually die at slightly higher rates than those who receive less care.
So, um, why are we doing this to our selves? Again, same article:
Why? Because doctors believe patients will be less likely to go to a lawyer if they think the doctor did everything possible—even when doing so doesn’t help the patient or causes harm…
The article puts forward the idea 50% of medical procedures are basically done to make people feel better rather than be better. That is to say, nearly half of all procedures done have no backing in reality which suggest they are necessary. At least one large portion of the problem is that lack of skepticism and respect for the scientific method exhibited by American medical consumers.
Tune in next time, when I tie the this blog and the last one together to create a cohesive solution.
Health care as I see it.
I started this blog just writing down as many facts as I could about the health care system, trying to make sense of it all. The first assumption is that health insurance is the right way to pay for health care, and this leads to two problems. One, that insurance is too expensive, and two since it’s so expensive, to few people have it.
Well, I’ll begin by saying there could be serious improvement to health insurance. First off, insurance is a method of sharing risk. Everybody pays a foreseeable and affordable loss (premium) to the company, who in exchange pays unforeseeable and un-affordable loss affecting a small minority of policy holders.
I’m not sure insurance is a totally appropriate method of paying for health care in this day and age for three reasons. One, modern diagnostics, predictive methods, and techniques mean the unfordable loss is no longer unforeseeable. Two, the big three killers: hypertension, smoking, and high cholesterol, are all preventable and highly dependent upon lifestyle choices. Again, this does not meet the criterion “unforeseeable”. In fact, we could even say high treatment costs for chronic illness are so foreseeable as to be statistically unavoidable. Three, the rate of premium depends upon how expensive the policy holders un-affordable loss is to the company, and the number of policy holders who need it. In an age of 32% obesity rates (obesity exacerbates almost every chronic health condition.) that are likely to be approaching 40% in the next ten years, health care expenses don’t meet the final criterion of only a small minority experiencing an un-affordable loss.
Is insurance too expensive? Probably. Everything I mentioned above can only go one place: premium increases. Are insurance companies pushing the boundaries of ethical behavior? Probably. Is that failure of the insurance companies? Well, not exactly. People and groups have the ethics they can afford. The average health care insurance company runs a 5.5% profit margin. In a free market economy you get what you pay for. The higher the premium the better the service. The lower the premium the worse the service.
The answer to improving the insurance industry is pretty simple. Consumers need better info, with less dead weight losses to changing companies. The insurance companies need to write their contracts at a 6th grade level (Average US reading comprehension), and switching insurance providers needs to be a single sheet of paper or a phone call. However, other then codes requiring simplicity, transparency, and interchangeable standards, the industry needs to be heavily deregulated. This encourages the sort of cut-throat capitalism that makes America a land of opportunity. Also, medical saving accounts are an option. Between private capital in medical savings accounts, credit union style insurance companies, and D-regged private insurers, competition would make companies leaner.
But ultimately, we are talking about companies fighting for tenths of a percent. The cost of premiums is decided by the frequency and cost of care. Insurance companies can profitably only reduce unnecessary visits. Visits which prevent costly claims increase profitability, so a huge reduction is frequency of care is unlikely. The real cost of health care rests not on insurance companies, but upon care providers.
This case is further born out by the fact that about 1/3 of the cost of health care in the US is paid for by the Medicaid, Medicare, SCHP, and VA government plans. If the problem of cost was one of insurance alone, one would expect that there would be a significant saving to socialized health care, but analysis of the cost of gov-care versus private care show no significant reduction in price for identical procedures. The additional 5% private insurers make as profit disappears into the significantly more expert administration of the private insurers, so gov-care is not 5% cheaper.
So insurance is just a middleman, the real cost in the health care providers. Why is American medicine so expense? Supply and demand says, consumers demand will use up the supply, raising costs until producers can create more. The producers will make so much it will lower the price. The tension of supply and demand drives the price down to market equilibrium, where the consumer is paying as little as he can, and the producer is charging as much as he can. That’s the miracle of free market economy. It pushes the price to where it the lowest possible, ensuring the greatest number have access to the good. Yet in the US 100 million people are on some kind of gov-care. That’s a third of the population!
Every body needs health care, the demand is universal, so it should be decreasing supply, increasing the price, raising the incentive to enter the field which would result in increased competition. This competition would result in innovations which would increase the supply and lower the cost. For some reason, this isn’t happening. In fact, the American medical system is running so badly, that planned economies are achieving greater results with less spending, both in raw dollars and as portion of GDP. The US spends more on gov-care (Medicaid, Medicare, SCHP, VAB, etc.) than countries with fully socialized health care spend on it, to get lower rates of health for a 1/3 the per capital population. Then the 60% of Americans pay again! American private health care costs more then any other industrialized nation. France in particular stands out (!) with the average American paying over 200% more for private health care, and 75% more for gov-care, while having maintaining statistically worse health.
When planned economies are running better then capitalism, we know something is rotten in Denmark. I’ll address what later.
This is a Hoho.
There is nothing quite as amazing as a ho ho.
Except….See, they’re creme filled, and real cream filling takes dairy. Like a lot of organic lipids suspended in water, milk is pretty delicate, chemically speaking. The filling has to be made from raw or semi-raw (pasteurized) milk, because the heating process of making milk truly shelf stable (ultra-pasteurization) breaks the lipids down to far for them to cream properly.
The answer is to replace the milk fats with petrochemical based lipid substitutes like PEG80. PEG stands for Polyethylene glycol. The number after refers to the length of the polymer. PEG is pretty safe and its used in all sorts of things, meant to go in the body (laxatives) on the body (skin creams) and both in and on (sexual lubricants). PEG has many interesting properties, but in commercial cookery it contributes two things: taste and mouth feel. It has no taste. (A note to adventurous readers: The taste of sexual lubricant is caused by the glycerin and perfumes, not the the PEG.) It also, in comparison to real fat, has a really weird mouth feel, because the melting point is often above 98.6 degrees. This is why twinkies and hohos leave that sort of funky coating in your mouth.
Well, for my birthday, (28, and yes I had a great time) my wife made me HoHo cake. Not the stack of Hostess Hohos in a cake shape that other have tried, this is the real deal.
1 stick butter
½ C oil
2 C flour
2 C sugar
1 t baking soda
1 C water
3 T cocoa
½ C milk
1 C sugar
1 C shortening
½ C milk
1 T water
¼ t salt
1 t vanilla
1 C powdered sugar
1 C sugar
6 T milk
6 T butter
1 ½ C chocolate chips
1. Cake: Combine butter, oil, flour, sugar, baking soda, water, and cocoa. Beat well.
2. Add egg and milk. Beat well.
3. Pour into greased 15 x 10 x 1-inch jelly roll pan. Bake at 350 degrees for 30 minutes. Cool.
4. Filling: mix together sugar, shortening, milk, water, salt, and vanilla.
5. Add powdered sugar while beating. Spread over cooled cake.
6. Frosting: boil sugar, milk, and butter for 1 minute.
7. Add the chocolate chips. Beat and then pour over cake. Cool.
Now, I must warn you. Lacking the PEG, this does not, in fact, taste “just like” Ho Hos. If you like the MSG/PEG sort of after taste in other foods (like Cool Ranch Doritos for instance) , you are going to find this merely passable cake. However, if you like real taste, this is absolutely amazing. Which brings me to my second warning. It eats like crack smokes. Make for a large group, or accept the fact you are going to eat an even pound butter/shortening ect. and 4 cups of sugar in a 24 hour period. Did I mention it’s absolutely amazing?
Better than crack, I mean hoho, cake.
The following is a article of the AP newswire. This is pure swill. The skeptics thoughts in red
A vast array of pharmaceuticals — including antibiotics, anti-convulsants, mood stabilizers and sex hormones — have been found in the drinking water supplies of at least 41 million Americans, an Associated Press investigation shows.
“at least 41 million” But as many as 42 million? Or as many as 150 million? Or as many as 41.5 million. Also, US population is 301 million. So 7%.
To be sure, the concentrations of these pharmaceuticals are tiny, measured in quantities of parts per billion or trillion, far below the levels of a medical dose. Also, utilities insist their water is safe.
“Parts per billion or parts per trillion” Well its only a 10,000% difference. Besides, which chemicals are measured in parts per billion, and which ones are measured in parts per trillion?
But the presence of so many prescription drugs — and over-the-counter medicines like acetaminophen and ibuprofen — in so much of our drinking water is heightening worries among scientists of long-term consequences to human health.
Who are these scientists, and what long-term consequences are they worried about?
In the course of a five-month inquiry, the AP discovered that drugs have been detected in the drinking water supplies of 24 major metropolitan areas — from Southernto Northern New Jersey, from to Louisville, Ky.
24 major metropolitan areas out of how many studied? What specifically was studied for 5 months?
Water providers rarely disclose results of pharmaceutical screenings, unless pressed, the AP found. For example, the head of a group representing major California suppliers said the public “doesn’t know how to interpret the information” and might be unduly alarmed.
How do the drugs get into the water?
People take pills. Their bodies absorb some of the medication, but the rest of it passes through and is flushed down the toilet. The wastewater is treated before it is discharged into reservoirs, rivers or lakes. Then, some of the water is cleansed again at drinking water treatment plants and piped to consumers. But most treatments do not remove all drug residue.And while researchers do not yet understand the exact risks from decades of persistent exposure to random combinations of low levels of pharmaceuticals, recent studies — which have gone virtually unnoticed by the general public — have found alarming effects on human cells and wildlife.
“researchers do not yet understand the exact risks from decades of persistent exposure to random combinations of low levels of pharmaceuticals.” So, they found something and have no idea if it has any significance or not. “Recent studies” by who?
“Alarming effects…” like what?
“We recognize it is a growing concern and we’re taking it very seriously,” said Benjamin H. Grumbles, assistant administrator for water at the U.S.. Members of the AP National Investigative Team reviewed hundreds of scientific reports, analyzed federal drinking water databases, visited environmental study sites and treatment plants and interviewed more than 230 officials, academics and scientists. They also surveyed the nation’s 50 largest cities and a dozen other major water providers, as well as smaller community water providers in all 50 states.
Here are some of the key test results obtained by the AP:
_Officials insaid testing there discovered 56 pharmaceuticals or byproducts in treated drinking water, including medicines for pain, infection, high cholesterol, asthma, epilepsy, mental illness and heart problems. Sixty-three pharmaceuticals or byproducts were found in the city’s watersheds.
At what concentration?
_Anti-epileptic and anti-anxiety medications were detected in a portion of the treated drinking water for 18.5 million people in Southern.
At what concentration?
_Researchers at theanalyzed a drinking water treatment plant, which serves 850,000 people in Northern New Jersey, and found a metabolized angina medicine and the mood-stabilizing carbamazepine in drinking water.
Again, at what concentration?
_A sex hormone was detected in‘s drinking water. The drinking water for ., and surrounding areas tested positive for six pharmaceuticals. Three medications, including an antibiotic, were found in drinking water supplied to Tucson, Ariz.
For crying out loud, at what concetrations?
The situation is undoubtedly worse than suggested by the positive test results in the major population centers documented by the AP.
Uh, isn’t “undoubtedly worse” pretty strong language when you don’t say why it would be worse?
The federal government doesn’t require any testing and hasn’t set safety limits for drugs in water. Of the 62 major water providers contacted, the drinking water for only 28 was tested. Among the 34 that haven’t:, , , Baltimore, , and ‘s Department of Environmental Protection, which delivers water to 9 million people.
The federal government doesn’t set any limits on eating sardine and peanut butter sandwiches either. Just because something sounds gross doesn’t mean it impacts human health negatively.
Some providers screen only for one or two pharmaceuticals, leaving open the possibility that others are present.
It also leave the possibility that the water is full of little purple men, after all they don’t test for them. Many things are possible, vastly less are likely. If the drugs are occurring at parts per trillion levels, it just doesn’t even matter. One part per trillion (ppt): Denotes one part per 1,000,000,000,000 parts, one part in 1012, and a value of 1 × 10–12. This is equivalent to 1 drop of water diluted into 20, two-meter-deep Olympic-size swimming pools (50,000 m³), or one second of time in approximately 31,700 years. Courtesy of Wikipedia
The AP’s investigation also indicates that watersheds, the natural sources of most of the nation’s water supply, also are contaminated. Tests were conducted in the watersheds of 35 of the 62 major providers surveyed by the AP, and pharmaceuticals were detected in 28.
You mean the places we pour our sewage contain the things that are in our sewage? Sacré bleu!
Yet officials in six of those 28 metropolitan areas said they did not go on to test their drinking water —.; in ; Omaha, Neb.; ; Santa Clara, Calif., and New York City.
Again, if there is no demonstrative hazard, why WOULD you test it?
The New York state health department and the USGS tested the source of the city’s water, upstate. They found trace concentrations of heart medicine, infection fighters, estrogen, anti-convulsants, a mood stabilizer and a tranquilizer.
AT WHAT CONCENTRATIONS!
City water officials declined repeated requests for an interview. In a statement, they insisted that “New York City’s drinking water continues to meet all federal and state regulations regarding drinking water quality in the watershed and the distribution system” — regulations that do not address trace pharmaceuticals.
BECAUSE THERE IS NO EVIDENCE THAT IT MATTERS!
In several cases, officials at municipal or regional water providers told the AP that pharmaceuticals had not been detected, but the AP obtained the results of tests conducted by independent researchers that showed otherwise. For example, water department officials insaid their water had not been tested for pharmaceuticals, but a Tulane University researcher and his students have published a study that found the pain reliever naproxen, the sex hormone estrone and the anti-cholesterol drug byproduct clofibric acid in treated drinking water.
Ok, lets use Naproxen as an example. Naproxen is the active chemical in Aleve, 200 mg per tablet. How much water do you need to mix one tablet of Aleve at a 1 part per billion level? Well, 200 billion mg of water. which is 200 million grams. Which is 200 thousand kilograms, which is (one liter equaling one kilogram of water) 200,000 liters. Which is 52,480 gallons. So, if you follow FDA recommended 64 oz of water a day (1/2 a gallon) it will take you 287 years to take one Aleve tablet. Hope you don’t get a headache any time over the next 3 centuries!
Of the 28 major metropolitan areas where tests were performed on drinking water supplies, only; ; and .; said tests were negative. The drinking water in has been tested, but officials are awaiting results. Arlington, Texas, acknowledged that traces of a pharmaceutical were detected in its drinking water but cited post-9/11 security concerns in refusing to identify the drug.
Ok, thats just sad.
The AP also contacted 52 small water providers — one in each state, and two each inand — that serve communities with populations around 25,000. All but one said their drinking water had not been screened for pharmaceuticals; officials in ., refused to answer AP’s questions, also citing post-9/11 issues.
Rural consumers who draw water from their own wells aren’t in the clear either, experts say.
The Stroud Water Research Center, in Avondale, Pa., has measured water samples from‘s upstate watershed for caffeine, a common contaminant that scientists often look for as a possible signal for the presence of other pharmaceuticals. Though more caffeine was detected at suburban sites, researcher Anthony Aufdenkampe was struck by the relatively high levels even in less populated areas.
My tea is contaminated with caffeine? How odd. I thought it was an organic alkaloid found in therapeutic dosages in more than 6 major plants.
He suspects it escapes from failed septic tanks, maybe with other drugs. “Septic systems are essentially small treatment plants that are essentially unmanaged and therefore tend to fail,” Aufdenkampe said.
He suspects it, but has no evidence whatsoever. I’d really like to see some statistics on septic tank failure rates.
Even users of bottled water and home filtration systems don’t necessarily avoid exposure. Bottlers, some of which simply repackage tap water, do not typically treat or test for pharmaceuticals, according to the industry’s main trade group. The same goes for the makers of home filtration systems.
You mean over priced consumer goods and table top science kits can’t compete with a multi-billion dollar water treatment industry? No!
Contamination is not confined to the United States. More than 100 different pharmaceuticals have been detected in lakes, rivers, reservoirs and streams throughout the world. Studies have detected pharmaceuticals in waters throughout, , and — even in Swiss lakes and the North Sea.
I like “even Swiss lakes”. Because you thought before you read this that there is no pollution in Switzerland
For example, in Canada, a study of 20 Ontario drinking water treatment plants by a national research institute found nine different drugs in water samples. Japanese health officials in December called for human health impact studies after detecting prescription drugs in drinking water at seven different sites.
*sigh* What drugs? At what concentrations?
In the United States, the problem isn’t confined to surface waters. Pharmaceuticals also permeate aquifers deep underground, source of 40 percent of the nation’s water supply. Federal scientists who drew water in 24 states from aquifers near contaminant sources such as landfills and animal feed lots found minuscule levels of hormones, antibiotics and other drugs.
Watch the 40% carefully. That’s not 40% are contamined. Thats contamination in the type that exists in 40% of the areas. So now that we know that 40% of the US gets its water from aquifers, what percentage of those aquifers are “contaminated”? They don’t say.
Perhaps it’s because Americans have been taking drugs — and flushing them unmetabolized or unused — in growing amounts. Over the past five years, the number of U.S. prescriptions rose 12 percent to a record 3.7 billion, while nonprescription drug purchases held steady around 3.3 billion, according toand The Nielsen Co.
Perhaps, but not necessarily!
“People think that if they take a medication, their body absorbs it and it disappears, but of course that’s not the case,” said EPA scientist Christian Daughton, one of the first to draw attention to the issue of pharmaceuticals in water in the United States.
If we are just shitting all this out, maybe we shouldn’t be taking so much?
Some drugs, including widely used cholesterol fighters, tranquilizers and anti-epileptic medications, resist modern drinking water and wastewater treatment processes. Plus, the EPA says there are no sewage treatment systems specifically engineered to remove pharmaceuticals.
Really? no methods to eliminate an imaginary problem with no symptoms? Shocking!
One technology, reverse osmosis, removes virtually all pharmaceutical contaminants but is very expensive for large-scale use and leaves several gallons of polluted water for every one that is made drinkable. Another issue: There’s evidence that adding chlorine, a common process in conventional drinking water treatment plants, makes some pharmaceuticals more toxic.
And this evidence was authored by who?
Human waste isn’t the only source of contamination. Cattle, for example, are given ear implants that provide a slow release of trenbolone, an anabolic steroid used by some bodybuilders, which causes cattle to bulk up. But not all the trenbolone circulating in a steer is metabolized. A German study showed 10 percent of the steroid passed right through the animals.
Water sampled downstream of afeedlot had steroid levels four times as high as the water taken upstream. Male fathead minnows living in that downstream area had low testosterone levels and small heads.
Other veterinary drugs also play a role. Pets are now treated for arthritis, cancer, heart disease, diabetes, allergies, dementia, and even obesity — sometimes with the same drugs as humans. The inflation-adjusted value of veterinary drugs rose by 8 percent, to $5.2 billion, over the past five years, according to an analysis of data from the Animal Health Institute.
Ask the pharmaceutical industry whether the contamination of water supplies is a problem, and officials will tell you no. “Based on what we now know, I would say we find there’s little or no risk from pharmaceuticals in the environment to human health,” said microbiologist Thomas White, a consultant for the Pharmaceutical Research and Manufacturers of America.
But at a conference last summer, Mary Buzby — director of environmental technology for drug maker. Inc. — said: “There’s no doubt about it, pharmaceuticals are being detected in the environment and there is genuine concern that these compounds, in the small concentrations that they’re at, could be causing impacts to human health or to aquatic organisms.”
Recent laboratory research has found that small amounts of medication have affected human embryonic kidney cells, human blood cells and. The proliferated too quickly; the kidney cells grew too slowly; and the blood cells showed biological activity associated with inflammation.
Affected how? Define small amounts
Also, pharmaceuticals in waterways are damaging wildlife across the nation and around the globe, research shows. Notably, male fish are being feminized, creating egg yolk proteins, a process usually restricted to females. Pharmaceuticals also are affecting sentinel species at the foundation of the pyramid of life — such as earth worms in the wild and zooplankton in the laboratory, studies show.
Who authored this research?
Some scientists stress that the research is extremely limited, and there are too many unknowns. They say, though, that the documented health problems in wildlife are disconcerting.
“Some scientists” who shall remain nameless, least you check a source document.
“It brings a question to people’s minds that if the fish were affected … might there be a potential problem for humans?” EPA research biologist Vickie Wilson told the AP. “It could be that the fish are just exquisitely sensitive because of their physiology or something. We haven’t gotten far enough along.”
Hey! A named researcher. And her official statement, “We don’t know yet.”
With limited research funds, said Shane Snyder, research and development project manager at the, a greater emphasis should be put on studying the effects of drugs in water.
AHHHHHH! The request for a handout.
“I think it’s a shame that so much money is going into monitoring to figure out if these things are out there, and so little is being spent on human health,” said Snyder. “They need to just accept that these things are everywhere — every chemical and pharmaceutical could be there. It’s time for the EPA to step up to the plate and make a statement about the need to study effects, both human and environmental.”
Ah, yes, if we just give more money to the federal agencies who protect us we will be juuuuuust fine.
To the degree that the EPA is focused on the issue, it appears to be looking at detection. Grumbles acknowledged that just late last year the agency developed three new methods to “detect and quantify pharmaceuticals” in wastewater. “We realize that we have a limited amount of data on the concentrations,” he said. “We’re going to be able to learn a lot more.”
Suddenly growing levels of chemicals and SURPRISE! Newer more sensitive test methods are being used. It almost as if these chemicals had been there for years and we just didn’t have the technology to test for them at the “minuscule” amounts they exist in.
While Grumbles said the EPA had analyzed 287 pharmaceuticals for possible inclusion on a draft list of candidates for regulation under the Safe Drinking Water Act, he said only one, nitroglycerin, was on the list. Nitroglycerin can be used as a drug for heart problems, but the key reason it’s being considered is its widespread use in making explosives.
So much is unknown. Many independent scientists are skeptical that trace concentrations will ultimately prove to be harmful to humans. Confidence about human safety is based largely on studies that poison lab animals with much higher amounts.
Your dang right much is unknown.
There’s growing concern in the scientific community, meanwhile, that certain drugs — or combinations of drugs — may harm humans over decades because water, unlike most specific foods, is consumed in sizable amounts every day.
You know if Aleve was in the water at parts per million instead of parts per million, you will still have to drink 1/2 a gallon a day for 3 months to get a single tablet.
Our bodies may shrug off a relatively big one-time dose, yet suffer from a smaller amount delivered continuously over a half century, perhaps subtly stirring allergies or nerve damage. Pregnant women, the elderly and the very ill might be more sensitive.
They might! Monkeys might write Shakespeare too. Might is a mighty big word.
Many concerns about chronic low-level exposure focus on certain drug classes: chemotherapy that can act as a powerful poison; hormones that can hamper reproduction or development; medicines for depression and epilepsy that can damage the brain or change behavior; antibiotics that can allow human germs to mutate into more dangerous forms; pain relievers and blood-pressure diuretics. For several decades, federal environmental officials and nonprofit watchdog environmental groups have focused on regulated contaminants — pesticides, lead, PCBs — which are present in higher concentrations and clearly pose a health risk.
But lets distact ourselves from that with sensational nonsense!
However, some experts say medications may pose a unique danger because, unlike most pollutants, they were crafted to act on the human body. “These are chemicals that are designed to have very specific effects at very low concentrations. That’s what pharmaceuticals do. So when they get out to the environment, it should not be a shock to people that they have effects,” says zoologist John Sumpter at, who has studied trace hormones, heart medicine and other drugs.
Define ” low concentrations”
And while drugs are tested to be safe for humans, the timeframe is usually over a matter of months, not a lifetime. Pharmaceuticals also can produce side effects and interact with other drugs at normal medical doses. That’s why — aside from therapeutic doses of fluoride injected into potable water supplies — pharmaceuticals are prescribed to people who need them, not delivered to everyone in their drinking water.
Its over months at BILLIONS of times the dosages they are talking about.
“We know we are being exposed to other people’s drugs through our drinking water, and that can’t be good,” says Dr. David Carpenter, who directs the Institute for Health and the Environment of theat .
Join me tommorow when the AP reveals Batboy’s secret tryst with Senator Clinton.
Depression sucks. I’ve struggled with it my whole life. I hate saying I was suicidal, though I was. I hate saying it not because it is embarrassing to admit (It doesn’t embarrass me at all. I think a lot more people should be suicidal, actually. Their lives are totally pointless, but they are so busy staying entertained that they don’t know it. At least a suicidal person has some idea of who and what they are…)
It embarrasses me because Becky and I were sort of the mom & dad for bunch of 19 year olds. So many of them were “suicidal”. It always frustrated me, because they would tell me how suicidal they were. I’d ask what their plan was, and they’d say they didn’t really have one. Over and over again I would say something to the effect of,”Suicide is not a lifestyle, its an event. If you’ve been suicidal for 10 years and never had a plan, I think there is something else going on here. Lets talk about what that something else might be.” But privately, I was much more judgmental. I’d think “where’s the scars up and down your arm? Where’s the gun loaded with just one bullet? Where’s your special kit that you have for mutilating yourself?” Because those things mark someone who takes ending their life, or at least hurting themselves, a little more seriously than just mentioning in casual conversation, “Oh, me, sure I’ve been suicidal for years now!”
But anti-depressants always scared me more than death. I always felt like I hated my life because of legitimate complaints, not because I just had biochemical screw loose that made me hate my wonderful life. Seriously, it wasn’t a wonderful life. It was bitter and sad and desperate and lonely. I didn’t want to feel better about my shitty life. I wanted to have great life, not be stoned into believing that my shitty life was great. I’m sure someone who reads this will have had their life saved by anti-depressants. Great. I am very happy for you! I believe that there are biochemical imbalances that cause depression and that anti-depressants are healthy and positive way to deal with said chemical imbalances. But that’s not what my problem was. I am very analytical. I self assess my life constantly. When I was really depressed it was because I dispassionately analyzed my life and concluded as any sane person would that the life I had really sucked. When I was suicidal it was because I had a an experience when lead me to (very reasonably, I might add) to think that if I kept on doing what I was doing I would keep on getting what I was getting. That’s not the thoughts of an insane person. In fact, quite the opposite, since the definition of mental illness is doing the same-thing over and over and expecting a different result. On the occasions that cut myself it was because I hurt so much inside that I want hurt outside too. Is cutting yourself an acceptable way to deal with pain? No. Does the fact that I dealt with my pain badly mean that the pain should not have been felt in the first place? Absolutely not! Pain is supposed to hurt. I did not want then, nor do I want now, any chemical that makes my emotional pain less. Analogy: I don’t want it to not hurt when you hit me with a hammer, I want you stop hitting me with a hammer.
Anyway, I decided the only way to change my life was to sit down and change it. I told my church to screw it, told God to screw it, dropped out of all my closest friends lives, and joined the Air Force without telling anyone but my wife, and some close family. We just sort of disappeared. I don’t regret it. About 6 months ago we patched things up with people, became friends again, and apologized where apology was due. I don’t think that I “dropped out” right. There were probably a hundred different ways I hurt people and didn’t actually NEED to. But the spirit of me leaving: God, my friends, my family, my church, and my town, was dead on.
I did it because I refused to live a life in fear anymore. Not of God, not of approval. Not anything. Since then, the times when I want to kill myself have been few and far between, I haven’t struggled with wanting to hurt myself almost at all (which is a big deal for me). Oddly, I think the whole thing has a lot to do with God, even thought I turned my back on Him. (Losing my faith did more to cure my depression than anything else I’ve done!)
I turned my back on God because I had a faith that was unexamined, and an unexamined faith isn’t worth having. In the Bible there’s these people called martyrs. They were given a choice of saying that Jesus was BS or dying. And they chose to die. I never understood why. Why not just say “Jesus is a phony” and then live to tell others about how great he is. But they died. And the Bible says this pleased God. Well that pissed me off. Why would God be happy when people died because they wouldn’t say he was fake? Saying and believing aren’t the same thing, so who cares if they say “God’s not real” and then go on to a life full of miracles and helping people. But God does.
I decided that I wouldn’t call myself a Christian unless I am sure that if someone put a gun to my head, and said “Renounce Christ or die” I’d chose death. That sounds hardcore, but its not. Not really. I’d die to protect my daughter’s life, or at least if I don’t, then I’m not much of dad. Heck, female dogs will die to protect their puppies, I’d better have at least as much morality as flea-bitten mongrel bitch. So I still don’t call myself a Christian (not yet).
But I’m working on it. The simplest thing I’ve ever found is this: If God’s real treat Him like it. They say he wrote the Bible. They say he wrote the Koran. The Bible says there are no other books of God. The Koran says that followers of the Bible have no place in Heaven. So ask God to help you find him in the books people say he wrote. Then read ’em. If He is who he seems to be, it seems the Almighty Master of the universe could show you which biography is the most accurate.
He shows me stuff. (I thought the Koran sucked, btw) I read the Bible and I see stuff about this guy named God and what He thinks. Gradually, I begin to understand that the reason the faith I used to have made me want to cut myself to let all the pain out was because my faith wasn’t in God at all. My faith was in this made up God that the Church sells people because the Church wants to keep its stranglehold of power. The real God that I find in the Bible doesn’t bother me half as much as the one that people twist the Bible to invent. I still don’t love him, which the Bible commands me to do, but I don’t hate him anymore, and that’s progress.