A few years back when I began working out regularly, people told me the gym thing was a trend. I didn't really believe it until recently. It's obvious that at least Sweden is starting to embrace gym work out. Never before have cities offered so many gyms (in the city where I live we have no less than nine different gyms), people are crowding the machines after work, and there are suddenly TV commercials about dietary supplements. Getting strong have gone mainstream.

This is most definitely a positive health trend that I embrace, for the following reasons:

• Guys feel robbed of their manhood thanks to feminism instilling male guilt. That's why they go to gyms to improve their physique and impress their social surroundings. Is that a problem? As long as you understand that self-confidence isn't located in muscles, no it isn't. I hope it intimidates other men and I hope it baffles whiny women who'd rather let all men become wimps, drowning in their own shit after work.
• The health benefits of using gym machines and lifting weights are serious. Ask Bhetti, Martin or Frank. Resistance training is the most effective way of burning fat and gaining strength. Some will say that body building is damaging to the heart and other parts of your body. That might be true for extreme work out, but the truth is that less than 5 % of the men and women who regularly go to the gym will ever be close to serious body building physique.
• It changes the way you eat. Even if you'd want to eat industrially prepared lunches, you couldn't, because they don't contain the necessary nutrients for your body to recover after work out. Ask big guys and girls what they're eating: chicken, fish, milk protein, vegetables and pasta/potatoes/rice. And unless they're handicapped, they're cooking the food themselves. That's better than the average modern blockhead who barely knows how to make fish soup in the microwave.
• People learn to think in terms of consistency. You can't maintain a good physique without hard and regular work. Young people are flaky. Teach them the virtue of self-discipline and maybe they'll actually go out and do something with their lives when they quit school.

We are biologically adapted to a lifestyle where most of the time is spent preparing, cooking and eating food. If it sounds boring, compare it to the bureaucratic tasks at work or the slow brainwashing in public education. Food is hilariously interesting and exciting, because it teaches you to use your senses and practical skills, similar to music and sex. Training and food go hand in hand. Continue to read my blog to understand why and how.

I've continued going to the gym in recent weeks, taking a little break around the holidays and on days where I had to shovel for over an hour.

I first went downstairs to the gym in my work building and the personal trainer offered a free session. I'm glad I accepted, otherwise I might just be stuck on the treadmill wishing I wasn't at the gym each morning. She kept some back issues I've had in mind and showed me a good 30-40 minute weightlifting routine to do each morning. There were enough different activities to do - including using a fitness ball for squats and pushups, etc. - that we split it up into "days 1 and 3" and "days 2 and 4", with a day to do whatever I wanted on day 5 if I were to come in a fifth day. I found myself going for two months straight, excited to see slow progress like adding five pounds here or getting my abs used to doing situps against gravity on the decline bench. Seeing my belt buckle go down a notch hasn't been bad, either.

The treadmill is less of a concern as I feel the weightlifting is burning a good deal of fat on its own, but I still get on there and walk quickly or run a bit for a total of at least a half hour each day I'm at the gym. It's a good way to end the workout after pounding one's muscles for 40 minutes.

I'm not into weightlifting for the same reasons Alex and Martin are, though. I want to lose weight, and tighten up my muscles, as more of a general health thing. Weightlifting with, say twelve reps each exercise two times each, gives my muscles more of an endurance workout than a workout geared toward explosiveness or building mass, and extends the amount of time I can lift (by taking shorter breaks between sets). I also find it useful to try doing ab work or work on the fitness ball between sets if I'm getting tired. This leads into some light running or fast walking to wrap things up.

It's a good routine, despite getting up in the very cold early morning hours of a New England winter to warm up the car, bundle up, drive in to work out. But when you're going to work right afterward, it's a rewarding feeling to know you've already accomplished something good well before you hit the desk. Then when you get home to your family, you know you're at least doing something to keep yourself active to remain healthy for a long period of time.

Have you heard of Frances Inglis, mother?

Thomas had suffered serious brain damage after falling out of an ambulance in July 2007 and hitting his head on the tarmac. Although medics insisted he was showing signs of improvement, Inglis believed he would never recover, and plotted to "put him out of his misery", the court heard. Inglis tried to kill Thomas, administering heroin, most likely through the tracheotomy tube that was keeping him alive, the court was told.

She was on bail for attempted murder when she killed Thomas by injecting him in the thigh and arm, again with heroin, the court heard. She gave a false name to gain access to his care home. , and tried to stop nursing staff entering his room after she had injected him by claiming to have HIV and threatening to infect them with blood or saliva.

It's happening. I've talked about it here. It has been increasingly.

Why did she do this? Perhaps the clue is in her profession.

Frances Inglis, 57, a trainee nurse from Dagenham who was described by witnesses as “a pillar of the community”, denies murder and attemped murder.

I needn't tell you who it benefits to not emphasise the fact that she's connected to healthcare in any way. She's only a student, too.

The media has been giving this issue increasing attention, reflecting back the popular sentiment. For reasons I've explained before, I'm not surprised.

You're probably going to hear about this happening much more often. The popularity of euthansia or mercy murder -- whatever you wish to call it -- shall rise.

A famous piece called The Physician's Prayer:
"From inability to let well alone,
from too much zeal for the new and contempt for what is old,
from putting knowledge before wisdom, science before art and
cleverness before common sense,
from treating patients as cases
and from making the cure of the disease more grievous than the
endurance of the same,
good Lord deliver us. Amen."
-- Sir Robert Hutchinson
(1871-1960)

(Despite my misrepresentation: the emergency code for the UK is 999, not 911. I am surprised the Politically Correct Brigade hasn't thought to push for changing that 9/11 number.)

Being in medical school, any idealism about your role is systematically ameliorated and deconstructed. When we submitted our personal statements outlining precisely why we wished to pursue the arduous path of medicine (an admittedly mad decision), a common piece of advice was not to present a picture of unrealistic idealism: they wanted some evidence of the understanding of precisely what a doctor's role actually is, specifically within the framework of the National Health Service. Still, the primary reason for choosing the doctor's role over other professions for most who do is in finding that is worth doing, worth getting out of bed for, worth the comparative loss of sanity, sleep and income to other fields open to you. A role that is both compatible with your personal ethics and perceived to be of inestimable worth to society.

You are allowed to retain some version of naivety and self-righteousness -- sorry, encouraged to be ethical and good -- insofar as it allows you to justify any action to yourself within the safe knowledge that you are doing it either in the best interests of your patient or out of respecting their autonomy: that is, for them to make their own decisions even if you disagree with them.

You are allowed to do a lot of good as part of the medical profession: vaccination, treatment, easing suffering. This is what happens most of the time.

However, there are grey areas. Or even black areas. A problem with being part of a nationalised service or any organisation is that you are essentially an agent of their interests; you may disagree with them but your enforced job is to remain in line with them. You are a slave to political trends and helpless to powers beyond your realistic control.

What faces the future doctor?
We have the financial consequences of the recession, although finances were a problem already. Latest figures from the office of statistics place the public debt at 7.7 billion, compared to surplus at the same time last year. Contributing to this figure is the cost of bailing out banks; figures for the cost of this ranged from billions to over a trillion.

Cost-cutting measures in the nationalised health service are happening and will happen, leading indirectly to loss of life. This can't be avoided.

Euthanasia is currently illegal in the United Kingdom. A matter darker than this is that there is and will be increasing clamour for legalisation and laxity around anti-euthanasia measures. Not only will this benefit the strained coffers of the NHS but the demand increases: as we lose the soft, warm and comforting blanket of the comforts of deranged consumerism, more of the population will find the idea of living intolerable as well as the idea of being a 'burden'. More people will want to be helped to die and it will be easier to say 'yes'.

This is an issue wherever economies are affected and not just a local one.

I wonder -- as an aside -- what the USA motivations for pushing health care reform measures leading to an increase of control by governmental institutions might be amidst a tenuous economic climate? Will Obama's administration abuse this control? Will the next administration?

Again and again, I question and reflect: will I be able to recognise when I'm doing what a good doctor should be doing or am I rationalising that what the NHS wants is precisely what a good doctor is?

Well, we are far away here from the idealistic pre-medical student state where the role of the doctor is to 'save lives.' It is to ease suffering. Like healers before me, I may include dispensation of death within the purview of my role: even though it offends the very foundation of what I intended to study and fight to preserve.

Easing suffering (where do we draw the limit for suffering?) or not: will I be able to make the decision to kill? That remains to be seen.

Here's some good news about our world becoming a better place to live, thanks to an NGO founded by Jimmy Carter and presumably staffed with open-minded progressives. So let's give credit where credit is due.

The NYT reports that Nigeria has been free of guinea worm infections for a year. . .

There seems to be occasional transfer into humans of various other forms, and transfer of the human parasite into domesticated animals, but access to filtered water is sufficient to break the human cycle. In several countries where human dracunculiasis was eliminated many decades ago, it hasn't returned, so the simple effort to provide clean water seems sufficient to eradicate it.

Hey, sometimes this stuff actually works!

The message hasn't sinked in to the disbelieving public consciousness. Best available evidence shows that antioxidant supplements either have no effect or, worse, increase your risk of death.

You heard that right.

These supplements either WASTE YOUR MONEY or they KILL you.

Main results
Sixty-seven randomised trials with 232,550 participants were included. Forty-seven trials including 180,938 participants had low risk of bias. Twenty-one trials included 164,439 healthy participants. Forty-six trials included 68111 participants with various diseases (gastrointestinal, cardiovascular, neurological, ocular, dermatological, rheumatoid, renal, endocrinological, or unspecified). Overall, the antioxidant supplements had no significant effect on mortality in a random-effects meta-analysis (relative risk [RR] 1.02, 95% confidence interval [CI] 0.99 to 1.06), but significantly increased mortality in a fixed-effect model (RR 1.04, 95% CI 1.02 to 1.06). In meta-regression analysis, the risk of bias and type of antioxidant supplement were the only significant predictors of intertrial heterogeneity. In the trials with a low risk of bias, the antioxidant supplements significantly increased mortality (RR 1.05, 95% CI 1.02 to 1.08). When the different antioxidants were assessed separately, analyses including trials with a low risk of bias and excluding selenium trials found significantly increased mortality by vitamin A (RR 1.16, 95% CI 1.10 to 1.24), beta-carotene (RR 1.07, 95% CI 1.02 to 1.11), and vitamin E (RR 1.04, 95% CI 1.01 to 1.07), but no significant detrimental effect of vitamin C (RR 1.06, 95% CI 0.94 to 1.20). Low-bias risk trials on selenium found no significant effect on mortality (RR 0.90, 95% CI 0.80 to 1.01).

Authors' conclusions
We found no evidence to support antioxidant supplements for primary or secondary prevention. Vitamin A, beta-carotene, and vitamin E may increase mortality. Future randomised trials could evaluate the potential effects of vitamin C and selenium for primary and secondary prevention. Such trials should be closely monitored for potential harmful effects. Antioxidant supplements need to be considered medicinal products and should undergo sufficient evaluation before marketing.

This is published by the Cochrane Library, which only publishes the most rigorous and quality systematic review of best evidence.

Photo by Piku.

I urge you to get your antioxidants naturally, my darlings.

I've covered before why cardio work out is an overrated method of burning fat. Here's another article confirming this:

To their surprise, the researchers found that none of the groups, including the athletes, experienced “afterburn.” They did not use additional body fat on the day when they exercised. In fact, most of the subjects burned slightly less fat over the 24-hour study period when they exercised than when they did not.

Here's why:

Each of Melanson’s subjects spent 24 quiet hours in the calorimeter, followed later by another 24 hours that included an hourlong bout of stationary bicycling. The cycling was deliberately performed at a relatively easy intensity (about 55 percent of each person’s predetermined aerobic capacity).

Cycling, like much of the traditional cardio exercise programs, really only burns fat during work out session. The problem is that when you've done your running or cycling, you will still want something sugary and you'll still eat more food than usual. This means you gain at least the amount of calories you just burned:

“The message of our work is really simple,” although not agreeable to hear, Melanson said. “It all comes down to energy balance,” or, as you might have guessed, calories in and calories out. People “are only burning 200 or 300 calories” in a typical 30-minute exercise session, Melanson points out. “You replace that with one bottle of Gatorade.”

I noticed the change in metabolism as soon as I began lifting weights at the gym instead of just running or using machines. Commonly my afterburn lasts for 48 hrs, sometimes more. No wonder I eat tons of food and still cannot get enough. And my aim is to remain lean and not put on fat--the guys who just want to get insanely big have to go to McDonald's a few days a week to get by.

“If you work out at an easy intensity, you will burn a higher percentage of fat calories” than if you work out a higher intensity, Carey says, so you should draw down some of the padding you’ve accumulated on the hips or elsewhere — if you don’t replace all of the calories afterward.

This is why all serious fitness models do powerwalks every day: high-intensive training is not enough. You need low-intensive work out to get really lean. Clean the house, work in the garage, chase the kids down the hall etc. However, there's no question that resistance training beats all other popular forms of work out in terms of burning calories. Of course, exercise cannot be separated from diet. Yet, the irony is that many people who light weights end up eating "too healthy," e.g. avoiding all kinds of fatty and high-carb foods. I've been eating fatty sausages these couple of weeks and noticed increased results compared to just eating lean meat and fish. There's apparently room for experimentation.

So, to reiterate: cardio exercise is good for you, but ineffective at burning fat, since you'll simply gain all those calories again after work out. More and more people, especially women, are discovering the power and effectiveness of resistance training. Start lifting weights--it's fun, demanding, and it makes you mentally and physically powerful enough to take on any challenges in life.

I watched a person die for the first time this week. With worries about confidentiality, I can't tell you very much about Mrs A. It wasn't peaceful and expected, it was dramatic and rapid. Yet, she was around eighty years old. Peace and rest be with you, Mrs A.

Before sending us on to hospital as medical students, they attempt to prepare us with ideas about the concept of dying. This is when they introduced us to the concept of a Good Death and what it entails. I felt a visceral revulsion to that terminology initially: how can anything be good about facing mortality?

There is a stigma around speaking of death or showing any occupation with it; an assumed disposition to suicide or homicide. I do think it is a justified suspicion with certain groups (goths, emos, certain branches of metalheads): its much more likely to be symptomatic of a pathological nature in one way or another in these cases.

That shouldn't preclude an honest discourse around it. If we do have to die, what are the conditions that would make it as ideal as we could make it? I could tell you what I've been told but that's in a way valueless. People's ideas are different. So how about you tell me:

What might you call a Good Death, preferably for you but if you find that concept disturbing, for someone else? Some thinks you might think about are the Who, the What, the Where, the Why and the How of your Good Death? How would that relate to the life you've led and the people you know or love?

EDIT: Alex's coincidental wishful 'Let Me Remain In This World' is just one in a series of strange happenings around this. The night before Mrs A's death, I'd felt the same sign that she should've manifested and didn't. Yet, she was the one diseased and I was the one healthy.

Alex forwarded me this link about existential depression in highly intelligent children:

It has been my experience that gifted and talented persons are more likely to experience a type of depression referred to as existential depression. Although an episode of existential depression may be precipitated in anyone by a major loss or the threat of a loss which highlights the transient nature of life, persons of higher intellectual ability are more prone to experience existential depression spontaneously. Sometimes this existential depression is tied into the positive disintegration experience referred to by Dabrowski (1996).

Existential depression is a depression that arises when an individual confronts certain basic issues of existence. Yalom (1980) describes four such issues (or "ultimate concerns")--death, freedom, isolation and meaninglessness. Death is an inevitable occurrence. Freedom, in an existential sense, refers to the absence of external structure. That is, humans do not enter a world which is inherently structured. We must give the world a structure which we ourselves create. Isolation recognizes that no matter how close we become to another person, a gap always remains, and we are nonetheless alone. Meaninglessness stems from the first three. If we must die, if we construct our own world, and if each of us is ultimately alone, then what meaning does life have?

Why should such existential concerns occur disproportionately among gifted persons? Partially, it is because substantial thought and reflection must occur to even consider such notions, rather than simply focusing on superficial day-to-day aspects of life. Other more specific characteristics of gifted children are important predisposers as well.

This is not just a bunch whiny crap, it's also a really bad misdirection of resources. More intelligent people are significantly less likely to be deperessed, period. They have it easier in life, especially in our cognitively demanding modern world. If intelligent people in a certain age group are more likely to suffer a certain specific type of depression, so fucking what? They're less likely to suffer other types of depression which more than makes up the difference.

I hate this kind of "smart kids need extra help" shit. No they fucking don't. They're smart - they need less help. Really stupid kids are the ones who need help and will still need help in 60 years when they're stupid old people. Only spoiled brats who've always gone to elite schools and never had a manual labor job could think otherwise because they've been pretty well isolated from truly dim-witted people whose lives really are a struggle.

Our world is far too full of government agencies and NGOs which want to nanny us and setting up more dedicated specifically to nannying the more intelligent among us is just pure bullshit. It makes about as much sense as dedicating your life to seeking donations to help athletic guys get laid because we are more likely to intimidate women. Please stop creating organizations whose sole purpose is to make the lives of those who already have easier and more pleasant lives even easier.

As one astute but anonymous commenter noted, the ethical scenario derived from this ethical problem is from the Tarasoff case:

On October 27, 1969, Prosenjit Poddar killed Tatiana Tarasoff. Both had been students at the University of California at Berkeley. They had met a year earlier at a folk dancing class. After a kiss on New Year's, Poddar became convinced they had a serious relationship. Tarasoff told him she was involved with other men and not interested. Poddar became depressed, neglecting his studies and health, speaking disjointedly and often weeping. He talked to a friend about blowing up her room, and was eventually convinced to go to student health. He started therapy with a psychologist on staff, Dr. Lawrence Moore. In August, during his ninth session, Poddar confided to Dr. Moore that he was going to kill Tarasoff when she returned from summer break. Dr. Moore subsequently informed the campus police that he felt Poddar was dangerous and that he should be hospitalized involuntarily. The police picked up Poddar, but after questioning felt he had "changed his attitude" and released him after he promised to stay away from Tarasoff. The psychiatric directior, Dr. Harvey Powelson, learned of the situation and instructed his staff not to pursue further attempts to hospitalize Poddar. Poddar stopped seeing Dr. Moore. In October, he went to Tarasoff's house and stabbed her to death with a kitchen knife. He then called the police and asked to be handcuffed.

The California Supreme Court heard the case twice, in 1974 and 1976. The court found the police could be held liable in the first hearing, but not in the second. In contrast to the police, the therapist was consistently held liable because of the "special relation that arises between a patient and his doctor or psychotherapist."

As an anonymous commenter said here, the immediate answer seems to be informing the authorities. So they're informed, you can trust them to take action, they have a duty to protect the public, isn't that right?

Well, it is not as proven in the aforementioned scenario. A psychiatrist must be a policeman, somehow find the person under threat without provoking their patient and inform them independently i.e. pull out all the stops especially under the discretion of your judgement, as anonymous here and Yewzer-1 commented.

The ability to consult colleagues in the team at your practice seems is the norm on any aspect of any case: it doesn't seem any medical professional is expected to manage on their own and there is implicit consent apparently that your information will be shared with appropriate members of the team who are also bound by confidentiality. Exceptions may be given to cases where there is any known relationship between you and another member of the team.

Will Truman feels guilty because he is not attracted to really fat women. Now, most of us are content to say "why date the morbidly obese when I can do better?" and never feel any pangs of conscience, but for those of us who can't, just think of the children. It's a very good idea to want your potential children to be healthy and attractive, isn't it? That seems to be the real reason we're disposed to find fat people unattractive.

Now, in my case, I theoretically shouldn't mind too much, should I, with my "lose weight eating five kilos of meat a week" metabolism and all? If you want your children to have great potential or just have it easy in life, you should in theory seek out mates who have plenty of the qualities you're missing. Forget it, though. I guess my natural human instincts don't adjust for the fact that any children I have with skinny women will be awful expensive to feed.

HT: Ilkka

Not only is the Western chase for status unnecessary, but it is unhealthy as Oliver James argues in his book Affluenza:

"Cards on the table," he says, "I contend that most emotional distress is best understood as a rational response to sick societies."

So why are we, in James's words, so fucked up? It's because of what James calls Selfish Capitalism, or, more catchily, "Affluenza", a virus-like condition that spreads through affluent countries. In these countries, notably English-speaking ones, people define themselves by how much money they make. They are also ruled by superficial values - how attractive they look, how famous they are, how much they are able to show off. As the sociologist Erich Fromm would have put it, we have moved from a state of "being" to a state of "having".

Even though status is presumably much more important in other cultures, why might status-seeking be particularly or in any way mentally damaging in Western society?

He refers to Dominant Goal Depression in his other book: 'They F** You Up'. The focus of these type of depressive thoughts tend to focus on self-esteem and level of achievement: aiming for goals of intelligence, beauty and wealth among other things. The sufferer aims higher and higher, never satisfied even at the top. James argues that this is due to parents projecting their expectations on to their children. However, I would assume wider pressures play their roles. In a society that repeatedly saturates you with propaganda that anything is possible, as well as presenting and enabling upward mobility that is limitless, it is all too easy to think that you can do anything no matter who or what you are: you are simply not working hard enough. You have all the opportunities in the world, so why are you not the best? In Western society, when status-seeking is bad, it's bad.

You are a psychiatrist. Your patient has clearly declared his intention to kill his girlfriend some time in the future. Your patient is saying this with faith this will remain confidential.

What action do you take? How urgently?
If you do disclose this information, who do you disclose it to and how? Keep in mind there are risks to disclosure, including provoking what you seek to prevent.
How far would you go?

What's the ethical action and what's the practical one?

I'll be discussing this further (beyond the comments section) on Friday. Let's hear from you before then:
What do you do?

Doctors should be interested in climate change and the environment for many reasons, including those outlined here:

Some of the headline findings were that rising temperatures are likely to increase transmission of many infectious diseases, reduce supplies of food and clean water in developing countries, and raise the number of people dying from heat-related conditions in temperate regions.

It is actually arguable whether any one 'developed' country should really care about developing countries. However, in this world strangely filled with images of starving African guilt and endless global guilt about them, the masses will accept and be motivated by this without question. Or maybe another possibility: perhaps they are just assumed to do so. In any case, although this seems to be the focus of the article, what is more important for the individual making any changes are the costs and benefits to them or their country.

Is a more environmentally friendly society an economically viable society? The answer to this is complex and beyond the scope of this post.

Is a more environmentally friendly society a healthier society? More exercise, less reliance on electricity, more locally and homegrown products. I believe the general agreement on this is that the answer is yes.

This doesn't mean that everything that's environmentally friendly is healthy:

"A low-carbon economy will mean less pollution. A low carbon-diet (especially eating less meat) and more exercise will mean less cancer, obesity, diabetes, and heart disease.

"Opportunity, surely, not cost."

Trans fats have been proven to be culrprits in the above diseases, more or less without question. Saturated fats also have been implicated and well.

However, villifying meat as a food product seems to be unfair. It is a source of protein and iron, working well if grilled or boiled and supplemented with cereals, vegetables and fruits. What's most dangerous is including fish under this heading, which is one of the healthiest foods to eat.

Image by Ivan Petrov.

When the village of Bournville was founded, new residents (largely factory workers in the local Cadbury chocolate factory) were given a set of suggestions for healthy living by the Cadbury brothers. I had occasion to see this and as part of the fun tourist experience, visitors to the factory could pin up their own...

...Suggested Rules of Health:

You hear that: four! One is not fat perhaps. Two has room for doubt. We may give you three. But FOUR?

(Actually, can a person even have four folds or do you hit the human beachball stage before then?)

Well, if the only food groups are chocolate and fruit, with even that disputed since the fruit can be dipped in chocolate then I see why people might think starving themselves is healthy.

In case you cannot read the one on the right: "Chocolate made these people very rich. Keep the money in your pocket, you will be a bit richer too."
So, in fact, it's actually no chocolate any day keeps the creditors away?

For some reason, looking at these two together, I'm wanting to call this The Martin Regnen Suggestion for Health.

Don't tell him I said that.

Health: happiness now or happiness later?

Anyway, probably the most interesting part would be your silly/serious suggestion for health.

Mine is Don't Make Martin Angry.

(Which I of course follow all the time, including in this p-- oh, wait. Er, whoops?)

An editorial in an American newspaper, Investor’s Business Daily, stated that the renowned physicist Stephen Hawking, who is almost entirely paralyzed by amyotrophic lateral sclerosis, or Lou Gehrig’s disease, “wouldn’t have a chance in the U.K.” Dr. Hawking, who is British, dismissed the assertion as absurd, and the newspaper has run a correction. “I wouldn’t be here today if it were not for the N.H.S.,” Mr. Hawking said.

Although the mentioned editorial is an amusing display of Americo-centrism, it's also another example of how private vs. national healthcare debates often miss the point completely. Rather than focusing on the inevitable horror stories about both systems, let's consider the broader social and economic consequences of a public vs. private healthcare system.

First, let's give ourselves some perspective by considering a few relevant facts:

• Most European and North American countries have a private healthcare sector in addition to their national service. Without government regulation, competition between medical professionals tends to increase the size of the private sector – although many doctors will accept both privately and publicly funded patients. Persons who are denied a desired treatment will often (a) turn to the private sector or (b) go to another country where they will receive public treatment.
• Private American hospitals do not deny emergency services to patients without insurance. Although in serious cases the uninsured patient may be dragged irretrievably into debt, hospitals often take a loss for the cost of treatment when the patient fails to pay. Public hospitals do exist in the U.S. but are notorious for providing an inferior quality of care.
• The standard of living for the homeless in European and North American countries doesn't even come close to the level of poverty experienced in many third-world countries. In other words: the existing healthcare systems in America and Europe, flawed as they may be, are top-of-the-line.

So what is wrong with healthcare as it is?

Critics of nationalized healthcare services are quick to point out that they are, like many government programs, costly, provide poorer care, and get easily dragged into a financial whirlpool of bureaucracy. Glenn Woiceshyn makes a great analogy which explains why this may be the case:

There is nothing unique about health care when it comes to egalitarianism. Certainly, food is needed more than is health care. Imagine if the government were to declare food free and agree to pay the bill. Initially, this might seem like a great idea, but costs would soon rise, along with demand. Eventually the government would claim that it had no choice but to enslave the food providers. In the long run the food supply would decline, and quality would deteriorate.

In other words, whenever the government provides a fully public service, you get the "Free stuff!" syndrome, which causes people to take advantage of services they would not ordinarily use if they had to pay for them. But medical costs are, of course, not actually free. You pay in taxes, and you pay in waiting times and limited service. Arguably, some of the challenges faced national health services are due to the parallel presence of a private sector: More people turn to their national health service for more common but less-profitable treatments and medications, yet turn to the private sector for more lucrative high-tech treatments.

Our criticisms of the private healthcare industry, on the other hand, are the consequences of consumerism and "politicorporate" culture. This blogger has really hit the nail on the head:

The current, private healthcare system, in my opinion, is not working. The reasons are simple, business men at insurance and pharmaceutical companies call all the shots and supercede both you and your doctor. Due to relaxed regulations now, insurance companies can choose not to pay for procedures and treatments recommended and performed by your doctor after the fact so you're left holding the bill. And because it is privatized, it is all run like a business where repeat business and addictive treatments are not only tolerated, but encouraged.

There's definitely growing pill-popping culture in America: If you're sad, there's a pill. If you're too fat, there's a pill. If you eat a poor diet, there's a whole rack of pills at the supermarket. If you watch American TV, every commercial break is packed with "Ask your doctor about..." followed up with a list of side-effects rattled off like an auctioneer. Doctors get flooded with patients wasting their time for prescriptions to cure "erectile dysfunction" and "restless leg syndrome". Making everyone reliant on their services is the fantasy of corporate healthcare providers – so like any good (dis)honest business, they sell you needs rather than solutions to real problems.

We can't expect the government to be our only safety-net; but just the same, the last thing we want is a whole population of pill-popping hypochondriacs. So what type of healthcare scheme can solve these problems? Ideally, we can dream about a non-corporate private health care system, in which the poor can rely on their communities for support rather than the government, and everyone receives the high quality of care that private competition provides. But given the socio-economic climate we have to work with, we need to work on correcting the problems with the systems we have.

It would be overly presumptuous to try and propose a fix-all here, but we have a pretty good idea what the first step ought to be for the public and private sectors alike: Take control away from the corporations and bureaucrats and put it back into the hands of doctors and nurses. They care about our health, not our provider, and certainly aren't going to work overtime just to write Viagra prescriptions. It won't solve all our problems, but it would be a move towards a healthier lifestyle all-around.

- Corrupt Staff

Whole Foods CEO John Mackey, considered a "maverick" in the industry by many, keeps his executive salary at $1 per year (a la Steve Jobs), caps other executive's compensation, and despises labor unions for their abuses and market-altering negotiation tactics. He is also a self-described free market libertarian.

On his blog recently, he shared an unedited version of a Wall Street Journal article that captured his feelings on the health care reform buzz, which has stricken this country over the past couple of months.

I fully realize that there are many opinions on the healthcare debate, including inside my own company. As we, as a nation, continue to discuss this, I am hopeful that both sides can do so in a civil manner that will lead to positive change for all concerned. You are welcome to share your thoughts in the comments section below.

On his first point, he tries to make his own customers understand that he, too, is someone with his own opinions about important issues, and as a leader in the business community is asked to write for publications like the Wall Street Journal. While it's important to understand that business leaders need to reflect a fair attitude about things so as to keep up public appearances as a compassionate member of a community, Mackey did a good job trying to head off the mob by indicating he feels we have a long way to go before we simply push the button on "free health care", hence the heated debates. So why did this create such an uproar among his "fans"? Could it be he used that dirty word, socialism, and also pointed out the major flaw in all this - that despite rising income and sales taxes across the nation, our country is still broke and Medicare & Social Security Benefits - health care benefits, mind you - would be borrowed from in order to help fund this, the biggest irony of all?

“The problem with socialism is that eventually you run out of other people’s money”-Margaret Thatcher.

With a projected $1.8 trillion deficit for 2009, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as Baby Boomers become eligible for both, we are rapidly running out of other people’s money. These deficits are simply not sustainable and they are either going to result in unprecedented new taxes and inflation or they will bankrupt us.

While we clearly need health care reform, the last thing our country needs is a massive new health care entitlement that will create hundreds of billions of dollars of new unfunded deficits and moves us much closer to a complete governmental takeover of our health care system. Instead, we should be trying to achieve reforms by moving in the exact opposite direction-toward less governmental control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:

All of what Mr. Mackey says is true: we're already knee-deep in an economic mess, and since money isn't free, someone has to fund this. Why rush this through, especially as public opinion is ever so slowly swaying toward a more reasonable solution? Also consider that we can't fund health care at the moment, even while President Obama risks his "man of the people" reputation by having to increase taxes.

The fact is, people like big symbols instead of reality, and so supporting "free health care" and a bill no one has even read outside of maybe a few people in Congress takes precedence over reasoned discussion on important topics. Some of the reader comments on Mackey's blog are laughable, where customers promise to never shop at Whole Foods again and even call for Mackey's dismissal by the Whole Foods Board of Directors. These comments are likely all from people who have never even read a Congressional proposal in their lives and have no idea what "free health care" means for the quality of their future medical care, the cost out of pocket to most of us, and how hospitals and procedures might change for better or worse as a result.

In attempting to strip away the layers of social reality and expose solid facts, Mr. Mackey only angered the liberal greenists who like their symbols big and loud. When anything gets in the way, especially reality, they look at the Whole Foods logo with hate and disgust, because they want those logos and the people behind them to do all the work, forgetting that they are a part of society who can help make a difference. "If I just shop at Whole Foods", the logic goes, "I'm doing my part to help make the world better - I'm shelling out my hard earned cash [conveniently, another symbol], so how could I be wrong by doing nothing but directing that money toward a Green business like Whole Foods?" Mackey showed them how, and they didn't like what they saw.

What if instead of waging campaigs against smoking, governments instead focused on getting the right people to smoke?

Nicotine, like caffeine, is an awesome little drug with only minor negative side-effects (in and of itself). It increase mental performance (i.e., productivity). It stands to reason that a society that has substantially cut down on a drug that increases alertness and memory will lose some productive capacity. . . Plus, nicotine's ideal delivery system, smoking, has severe negative effects that typically don't manifest themselves until its purveyors have reached the twilight of their careers. A mad scientist could hardly have done better than to have designed a drug that is addictive, makes people more productive, then cuts them down just as their wealth creation capacity has waned and their pure consumption life stage has begun.

Mental performance is important for all kinds of jobs, from digging ditches to investment banking, but clearly it's much more important in desk jobs. With that in mind, governments should invest some resources into encouraging the middle and upper classes to smoke tobacco. I wouldn't suggest actually making it a crime for those with desk jobs to not smoke, as I think people should have the freedom to be less productive if they so choose.

The real upper classes are probably doing OK by substituting more modern prescription medicines, at least in the US, so they might not need cigarettes anymore.

I don't have much acquaintance with seriously rich people (though I'm always up for more) but I know this much about them: they have easy access to a whole range of pharmaceuticals that are unavailable to us proles. This is in fact one of the big class markers in the U.S.A. today. If you are rich, you are probably a regular user of Adderall or Ritalin, or both. If of a certain age, you also self-inject Human Growth Hormone; and if male, you have that rub-on Testim cream. You probably have a lot of other stuff I don't know about — as I said, I'm not that well acquainted with the upper strata.

If you dwell down at the very bottom of society you likewise have access to a good range of drugs, though mostly different ones. Us poor middle-class drones are perforce drug-free: too law-abiding for crack, too poor to afford HGH. It's a rotten deal.

Instead of trying to discourage tobacco use across society, governments should create targeted campaigns which focus on the middle classes and get them to increase their smoking. Maybe that's something government can do without screwing up?

Naaaaah. I can't bring myself seriously propose any policy aimed at getting people to die younger, not even if they're middle-class people. Guess I just like life too much.

What and when you're supposed to eat as a muscle builder is very much debated among experts, but what they all agree upon is that your body needs protein and fast carbs straight after tough exercise. Your muscle tissue needs the protein and the glycogen department needs the carbs, preferably within an hour. So what to eat? Well, you can either run home after work out and prepare something rich in protein, maybe tuna salad or a salmon dish. Or you can do it the easy way and use a gainer (note that you still need to eat 1-2 hours after exercise anyway).

There's a ton of stuff on the market for this and I believe 3/4 of it is shit. No literally, it's expensive fructose. What you want to focus on is to find something that includes high-quality protein, e.g. whey or casein. I've been using Star Nutrition's Gainer Pro for a few months, which is a popular, high-quality gainer among muscle builders. It contains 67 % carbs (maltodextrose) and 24 % protein (whey), plus tons of acids and vitamins that'd bore you out to list here. The "Super" version is more expensive, but includes faster carbs and creatine.

Like most gainers it comes in different flavors. So far I've tried chocolate, which is not bad; it tastes like a bland milkshake. You mix it with water, but obviously (although inconveniently) it tastes better with milk. I've had good results with this gainer: It quickly heals and refuels your body after a hard and long work out, and you can feel the effects. If you're a heavyweight, you probably want to increase the dose from 150 ml to 200 ml, but it should be enough. Some people want to avoid maltodextrose (glucose), but I haven't had any problems with this, and don't think you should worry, since it's basically fruit in powder form.

And that's the point. This is food in powder form. Young guys who drink this stuff as milkshake miss the point: it's not supposed to replace your ordinary food intake. You cannot and should not do that. You'll need your daily diet anyway. Gainers and protein shakes just make things easier. In other words, if you want to succeed at the gym, you need to become a decent cook. Since it's inconvenient and virtually impossible for most people post-work out to quickly prepare food including all the vitamins, protein and carbs you find in a gainer, I can actually recommend Star Nutrition's Gainer Pro, which not only has a decent taste, but is also effective in avoiding the break down of muscle tissue after an hour of pain and sweat.