Tommy Thompson on the Health Care Crisis

Question: How is the financial crisis affecting health care and what can we do to save the system?

Tommy Thompson: if you look back over the last several years, there are a lot of indicators that if people would have paid attention and really acted upon them, we probably would not be in the situation we are today.  The fact that, you know, the excess credit, people buying houses without proper foundations and proper credit, as well as Fannie Mae and Freddie Mac, you know, there were a lot of signs there that they were not doing well.  And all of this pointed out that something should be done.  The same thing is happening now in the healthcare field.  When you look at the cost of healthcare $2.4 trillion of which 16% of that is from the Gross National Product, more than what any other country is spending for healthcare.  You can see that Wisconsin or Untied States is in a non-competitive type of situation, and we have to do something about it.  The second thing is Medicare, the system that takes care of sort of the ability to close all the holes and be the place to save individuals that ever got serious problems and elderly and disabled, the safety net, Medicare is, that’s going broke by the year 2012.  I mean, it’s going broke, whether we like it or not.  And then you’ll look at chronic illnesses and that takes up 75% of the cost of healthcare system, and if you want to fix it, you have to go where the money is.  As Willie Sutton was asked why do you rob banks, his answer was that’s where the money is.  So, if you want to fix the healthcare system, we got to know where the money is and that’s where where it is, it’s in chronic illnesses and chronic things.  And in order to fix it, there are things that you have to do such as we have to go to a wellness type of system.  We’re in a disease system right now.  We wait ‘till people get sick.  And then we spend thousands of dollars to get you well.  It doesn’t make much sense to me.  Why don’t we, why don’t we be smart in America and take care of people upfront, before they get sick, keep them well, you know.  Once you pay for insurance and we keep you well, you know, instead of paying for insurance, they get sick before you can collect.  It just doesn’t make much sense to me.  And the second thing is we got to make sure that people that do have chronic illnesses of which 133 million Americans do have one or more chronic illnesses, we have to be able to have a program so that they’re able to see their doctor on a regular basis.  Most individuals, Glaxo-Smith Kline just had a survey of 75,000 people and they found out that 70% of people with diabetes thought they were in good shape physically and thought they were controlling their diabetes, and when they looked at it, they found that their blood sugar count was very high and that they were actually deteriorating.  People with asthma, 1/3 of individuals with asthma were not taking care of themselves and the same survey by Glaxo-Smith Kline pointed that out.  And so, why don’t we do something about that?  Why don’t we manage those individuals with chronic illnesses and try to get them well, because if you improve their quality of health, you improve their quality of life, very simple.  And the third thing is we’ve got to make sure that the market place is available and accessible for new tools, new medicines, new therapies, new opportunities, you know, to cure chronic illnesses and that’s education, it’s research, and its development.  All of these things are important for the new healthcare system.

Topic: Tommy Thompson on the Health Care Crisis

Tommy Thompson: Well, it means several things, but it means basically that Medicare bills would not be paid. How many people, you know, Medicare is the largest insurance company in the world. It’s like AGI, you know, it needed, AGI needed an influx of money from the federal government to keep going. Medicare is money from the federal government and it is much bigger than AGI, it covers 42 million Americans. It’s the largest health insurance company in the world, and its going broke. I mean, in 2012, there’s no longer any surplus money, it’s going to cost more to go in. And by 2018, it’s bankrupt. I mean, it’s bankrupt; it can’t pay its bills. And so, that right now is 18% of the healthcare system and I don’t know if any of the, any of the financial houses that went down was 18% of the economic system, but you can see the problems we’re in right now. Can you imagine where the 18% of the healthcare system collapsing and bankruptcy in 2018 unless we do something about it to fix it. And about 40% of the insurance claims are based upon the reimbursement formula set forth by Medicare, so it has a really cascading impact on all of healthcare. And then, you’ll look at the fact that we are no longer competitive in America, if we allow the healthcare system to keep going up at 7 or 8% a year. Right now, General Motors, for instance, used to be this giant corporation few years ago. Its market cap today is at 1950’s levels. The loss has been, you know, their market cap goes back in 1950s where General Motors is today. And what is their biggest expense? Their biggest expense is healthcare [dollars]. $5.5 billion of General Motors use this for their operation goes for healthcare more than what they pay for steel, more than they pay for plastic, more than any other component of the car goes for healthcare for their current employees and their retirees and their dependents. And what is General Motors? General Motors is no longer competitive, and we’re losing market share, and the same thing will happen not only to the other automotive companies which is already happening, but other companies that compete internationally where other counties are not paying that high a cost for healthcare. So, we have to go around and we have to change our direction if we’re really going to have a healthcare system survive. And I believe our health system is worth fighting for and worth doing everything we possibly can so that it can survive.

Recorded On: 10/30/08

Tommy Thompson explains the domino effect, from the economic crisis to the health care crisis.

Global climate strike: Scenes from the #ClimateMarch protests

The week-long global protest, which is calling for an end to the age of fossil fuels, is taking place in more than 160 countries today.


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Politics & Current Affairs
  • Millions of people around the world are taking to the streets to demand more urgent action on climate change.
  • The protests come just days ahead of the 2019 UN Climate Action Summit.
  • Although it's unclear exactly how many people are participating, it's likely to be the largest climate protest ever.
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How do 80-year-old 'super-agers' have the brains of 20-somethings?

Most elderly individuals' brains degrade over time, but some match — or even outperform — younger individuals on cognitive tests.

Mind & Brain
  • "Super-agers" seem to escape the decline in cognitive function that affects most of the elderly population.
  • New research suggests this is because of higher functional connectivity in key brain networks.
  • It's not clear what the specific reason for this is, but research has uncovered several activities that encourage greater brain health in old age.

At some point in our 20s or 30s, something starts to change in our brains. They begin to shrink a little bit. The myelin that insulates our nerves begins to lose some of its integrity. Fewer and fewer chemical messages get sent as our brains make fewer neurotransmitters.

As we get older, these processes increase. Brain weight decreases by about 5 percent per decade after 40. The frontal lobe and hippocampus — areas related to memory encoding — begin to shrink mainly around 60 or 70. But this is just an unfortunate reality; you can't always be young, and things will begin to break down eventually. That's part of the reason why some individuals think that we should all hope for a life that ends by 75, before the worst effects of time sink in.

But this might be a touch premature. Some lucky individuals seem to resist these destructive forces working on our brains. In cognitive tests, these 80-year-old "super-agers" perform just as well as individuals in their 20s.

Just as sharp as the whippersnappers

To find out what's behind the phenomenon of super-agers, researchers conducted a study examining the brains and cognitive performances of two groups: 41 young adults between the ages of 18 and 35 and 40 older adults between the ages of 60 and 80.

First, the researchers administered a series of cognitive tests, like the California Verbal Learning Test (CVLT) and the Trail Making Test (TMT). Seventeen members of the older group scored at or above the mean scores of the younger group. That is, these 17 could be considered super-agers, performing at the same level as the younger study participants. Aside from these individuals, members of the older group tended to perform less well on the cognitive tests. Then, the researchers scanned all participants' brains in an fMRI, paying special attention to two portions of the brain: the default mode network and the salience network.

The default mode network is, as its name might suggest, a series of brain regions that are active by default — when we're not engaged in a task, they tend to show higher levels of activity. It also appears to be very related to thinking about one's self, thinking about others, as well as aspects of memory and thinking about the future.

The salience network is another network of brain regions, so named because it appears deeply linked to detecting and integrating salient emotional and sensory stimuli. (In neuroscience, saliency refers to how much an item "sticks out"). Both of these networks are also extremely important to overall cognitive function, and in super-agers, the activity in these networks was more coordinated than in their peers.

Default Mode Network

Wikimedia Commons

An image of the brain highlighting the regions associated with the default mode network.

How to ensure brain health in old age

While prior research has identified some genetic influences on how "gracefully" the brain ages, there are likely activities that can encourage brain health. "We hope to identify things we can prescribe for people that would help them be more like a superager," said Bradford Dickerson, one of the researchers in this study, in a statement. "It's not as likely to be a pill as more likely to be recommendations for lifestyle, diet, and exercise. That's one of the long-term goals of this study — to try to help people become superagers if they want to."

To date, there is some preliminary evidence of ways that you can keep your brain younger longer. For instance, more education and a cognitively demanding job predicts having higher cognitive abilities in old age. Generally speaking, the adage of "use it or lose it" appears to hold true; having a cognitively active lifestyle helps to protect your brain in old age. So, it might be tempting to fill your golden years with beer and reruns of CSI, but it's unlikely to help you keep your edge.

Aside from these intuitive ways to keep your brain healthy, regular exercise appears to boost cognitive health in old age, as Dickinson mentioned. Diet is also a protective factor, especially for diets delivering omega-3 fatty acids (which can be found in fish oil), polyphenols (found in dark chocolate!), vitamin D (egg yolks and sunlight), and the B vitamins (meat, eggs, and legumes). There's also evidence that having a healthy social life in old age can protect against cognitive decline.

For many, the physical decline associated with old age is an expected side effect of a life well-lived. But the idea that our intellect will also degrade can be a much scarier reality. Fortunately, the existence of super-agers shows that at the very least, we don't have to accept cognitive decline without a fight.


Millennials and the rise of tiny homes

Are tiny homes just a trend for wealthy minimalists or an economic necessity for the growing poor?

Photo credit: Cyrus McCrimmon / The Denver Post via Getty Images
Politics & Current Affairs
  • The tiny home movement has been popular on social media sites, often portraying an idyllic lifestyle that's cheaper and better for the environment without sacrificing aesthetics.
  • But tiny homes may become the answer to a growing population and growing inequality.
  • As the movement continues to build up steam, one has to wonder whether it's a housing crisis solution with a new coat of paint.

Tiny homes. They're the watchword of the Home & Garden network, at once an Instagrammable, envy-inducing lifestyle and an unfortunate necessity for a generation struck by a recession, historically high inequality, and loans taken out for an ostensibly necessary education that's failed to really net any benefits.

But the question is, which are they? A symbol of a smarter, more environmentally-conscious, humbler generation — or a symbol of one that's had to make do with less than its predecessors? (See: "Millennials buy the things their parents did — but they're much poorer.")

Downsizing housing and hubris

Image source: Mike Morgan / For The Washington Post via Getty Images

Will tiny homes look like this in the future -- smaller and more efficient but still beautiful?

In the U.S., things are just bigger, and houses are no exception. The median size of a single-family home in the U.S. peaked in 2015 at 2,467 square feet. Compared to other parts of the world — particularly Europe — this is a massive figure. There's a variety of reasons for this; one, for example, is that Americans began driving early and often, which transformed the design of their cities and suburbs. Developers could build outside of urban centers where the land was cheaper and more plentiful, enabling bigger houses to be bought.

In addition, the idea of having a lot of space seems to be an appealing one to the former European colonies — where Europeans have often lived in more cramped, repurposed older buildings, Australians, Canadians, and Americans had the opportunity to seize land (despite it already being occupied) and build new, sprawling settlements throughout it. The prosperity that the America saw in the 20th century didn't hurt, either; why not build big if you've got the money to spare?

But a considerable amount of this space is wasted. A UCLA study found that the majority of people spend their time in the kitchen or around the television and very rarely use the living room or porch. As a result of these extra, unused spaces, more resources are wasted on construction, and energy consumption is double what a family would need if their house only had the rooms that they actually use.

Smaller, more energy-efficient houses are appealing to a growing population of minimalists and resource-conscious individuals. In 2017 alone, the sales of tiny homes increased by 67 percent. Coming in at under 400 square feet on average, these houses are also understandably cheap — for tiny homes on wheels, the average cost is $46,300, while those with a foundation cost on average $119,000. As a result, 68 percent of tiny homeowners don't even have a mortgage.

Downsizing out of necessity

Tiny homes

Image source: George Rose/Getty Images

A community of tiny homes for homeless people known as "Nickelsville" in Seattle.

On the other hand, the group of people drawn to tiny homes isn't just homogenously composed of wealthy minimalists looking to reduce their consumption while still appearing trendy. In 70 percent of the U.S., the average worker can't afford a home, one-third of adults are a $400 bill away from financial difficulty, and a quarter have no retirement savings whatsoever.

Under these conditions, downsizing may be the only viable method to survive. Consider, for instance, how cities such as Seattle, Detroit, and Denver are constructing tiny homes as emergency shelters or transitional housing for the homeless. There are also the many retirees that had their savings wiped out by the Great Recession who now live nomadically in RVs and modified vans. This tiny-living trend also has its Instagram cheerleaders, but the reality of it is less idyllic. Journalist Jessica Bruder and author of Nomadland related an anecdote to MarketWatch illustrating the nature of nomadic tiny living:

"I talked to one couple, Barb and Chuck. He had been head of product development at McDonald's before he retired. He lost his nest egg in the 2008 crash and Barb did, too. One time, Barb and Chuck were standing at the gas station to get $175 worth of gas and the horror hit them that their account had $6 in it. The gas station gentleman said 'Give me your name and driver's license and if you write a check, I will wait to cash it.' He waited two whole weeks before he deposited it."

This might become a reality for more people in the future as well. Inequality widens when the rate at which wealth grows — say, your stocks or the price of your house — grows faster than the rate at which wages do. Research suggests that wealth is growing at a breakneck pace, keeping in line with economist Thomas Picketty's prediction of a dramatically inequal future.

Solutions for this will need to be found, and many municipalities or private individuals may find such a solution in constructing tiny homes. Homelessness is a powerful, self-perpetuating force, and having shelter is an obviously necessary step to escape poverty.

Regrettably, if tiny homes are being driven primarily by resource-conscious but fundamentally economically secure individuals, we can expect the trend to remain just that; a trend. In a few years, fewer and fewer tiny houses will be constructed and sold, and eventually there will just be a small contingent of diehard proponents of the lifestyle. If, however, the tiny home trend is being driven primarily by economic inequality, then we can expect it to stick around for a while.