The Healing of America – by Thomas Reid

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First let’s be clear: this is about the US healthcare system, and thus will be mostly relevant for US Americans. Still, many outside of the US may have an interest, and in fact the book does talk about the healthcare systems of many other countries (hence the subtitle mentioning “a global quest”), outlining how each works, and what the journey was that got them there.

The author, a veteran journalist with a 60+ year-long career, notes that affordable healthcare is a social problem so complex, that only 33 out of 32 of the world’s richest countries have managed to do it. That’s a little glib and can be quibbled in the minutiae, but when it comes down to it, insulin in the US still costs 50x what it does in most places, and in pretty much all aspects of healthcare, US Americans are being fleeced at every turn.

He examines why this happens, and what currently prevents the US from lowering healthcare costs. He finds the culprits to be the profitmongers along the way (insurance companies in cahoots with drug companies in cahoots with hospitals, etc), as well as a pervasive belief that since healthcare is so expensive, how could the richest country on Earth possibly pay for it? Many Americans will believe that the answer is that other countries have inferior care, but this tends to stem from a mistaken belief that medical treatment actually costs what Americans are billed for it. The fact is: the same quality of care can be provided for a lot less, as many countries demonstrate.

The book doesn’t argue for any one particular solution; it doesn’t have to be entirely state-funded like the UK, or consumer-funded but seriously low price caps like in Japan; there are many other models to choose from. The argument that is made is that if so many other countries can have medical bankruptcy being a thing unheard-of instead of the leading cause of bankruptcy, then so can the US, and here’s a wide menu of methods to choose from.

Bottom line: if you’re a US American and you’d like to think you could get the same quality of care without lining numerous corporate pockets along the way with your hard-earned cash, then this book will open your eyes to what is possible.

Click here to check out The Healing Of America, and learn how you could get the same, for less!

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  • California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won’t Pay Off.

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    With little pomp, California launched two apps at the start of the year offering free behavioral health services to youths to help them cope with everything from living with anxiety to body acceptance.

    Through their phones, young people and some caregivers can meet BrightLife Kids and Soluna coaches, some who specialize in peer support or substance use disorders, for roughly 30-minute virtual counseling sessions that are best suited to those with more mild needs, typically those without a clinical diagnosis. The apps also feature self-directed activities, such as white noise sessions, guided breathing, and videos of ocean waves to help users relax.

    “We believe they’re going to have not just great impact, but wide impact across California, especially in places where maybe it’s not so easy to find an in-person behavioral health visit or the kind of coaching and supports that parents and young people need,” said Gov. Gavin Newsom’s health secretary, Mark Ghaly, during the Jan. 16 announcement.

    The apps represent one of the Democratic governor’s major forays into health technology and come with four-year contracts valued at $498 million. California is believed to be the first state to offer a mental health app with free coaching to all young residents, according to the Department of Health Care Services, which operates the program.

    However, the rollout has been slow. Only about 15,000 of the state’s 12.6 million children and young adults have signed up for the apps, school counselors say they’ve never heard of them, and one of the companies isn’t making its app available on Android phones until summer.

    Advocates for youth question the wisdom of investing taxpayer dollars in two private companies. Social workers are concerned the companies’ coaches won’t properly identify youths who need referrals for clinical care. And the spending is drawing lawmaker scrutiny amid a state deficit pegged at as much as $73 billion.

    An App for That

    Newsom’s administration says the apps fill a need for young Californians and their families to access professional telehealth for free, in multiple languages, and outside of standard 9-to-5 hours. It’s part of Newsom’s sweeping $4.7 billion master plan for kids’ mental health, which was introduced in 2022 to increase access to mental health and substance use support services. In addition to launching virtual tools such as the teletherapy apps, the initiative is working to expand workforce capacity, especially in underserved areas.

    “The reality is that we are rarely 6 feet away from our devices,” said Sohil Sud, director of Newsom’s Children and Youth Behavioral Health Initiative. “The question is how we can leverage technology as a resource for all California youth and families, not in place of, but in addition to, other behavioral health services that are being developed and expanded.”

    The virtual platforms come amid rising depression and suicide rates among youth and a shortage of mental health providers. Nearly half of California youths from the ages of 12 to 17 report having recently struggled with mental health issues, with nearly a third experiencing serious psychological distress, according to a 2021 study by the UCLA Center for Health Policy Research. These rates are even higher for multiracial youths and those from low-income families.

    But those supporting youth mental health at the local level question whether the apps will move the needle on climbing depression and suicide rates.

    “It’s fair to applaud the state of California for aggressively seeking new tools,” said Alex Briscoe of California Children’s Trust, a statewide initiative that, along with more than 100 local partners, works to improve the social and emotional health of children. “We just don’t see it as fundamental. And we don’t believe the youth mental health crisis will be solved by technology projects built by a professional class who don’t share the lived experience of marginalized communities.”

    The apps, BrightLife Kids and Soluna, are operated by two companies: Brightline, a 5-year-old venture capital-backed startup; and Kooth, a London-based publicly traded company that has experience in the U.K. and has also signed on some schools in Kentucky and Pennsylvania and a health plan in Illinois. In the first five months of Kooth’s Pennsylvania pilot, 6% of students who had access to the app signed up.

    Brightline and Kooth represent a growing number of health tech firms seeking to profit in this space. They beat out dozens of other bidders including international consulting companies and other youth telehealth platforms that had already snapped up contracts in California.

    Although the service is intended to be free with no insurance requirement, Brightline’s app, BrightLife Kids, is folded into and only accessible through the company’s main app, which asks for insurance information and directs users to paid licensed counseling options alongside the free coaching. After KFF Health News questioned why the free coaching was advertised below paid options, Brightline reordered the page so that, even if a child has high-acuity needs, free coaching shows up first.

    The apps take an expansive view of behavioral health, making the tools available to all California youth under age 26 as well as caregivers of babies, toddlers, and children 12 and under. When KFF Health News asked to speak with an app user, Brightline connected a reporter with a mother whose 3-year-old daughter was learning to sleep on her own.

    ‘It’s Like Crickets’

    Despite being months into the launch and having millions in marketing funds, the companies don’t have a definitive rollout timeline. Brightline said it hopes to have deployed teams across the state to present the tools in person by midyear. Kooth said developing a strategy to hit every school would be “the main focus for this calendar year.”

    “It’s a big state — 58 counties,” Bob McCullough of Kooth said. “It’ll take us a while to get to all of them.”

    So far BrightLife Kids is available only on Apple phones. Brightline said it’s aiming to launch the Android version over the summer.

    “Nobody’s really done anything like this at this magnitude, I think, in the U.S. before,” said Naomi Allen, a co-founder and the CEO of Brightline. “We’re very much in the early innings. We’re already learning a lot.”

    The contracts, obtained by KFF Health News through a records request, show the companies operating the two apps could earn as much as $498 million through the contract term, which ends in June 2027, months after Newsom is set to leave office. And the state is spending hundreds of millions more on Newsom’s virtual behavioral health strategy. The state said it aims to make the apps available long-term, depending on usage.

    The state said 15,000 people signed up in the first three months. When KFF Health News asked how many of those users actively engaged with the app, it declined to say, noting that data would be released this summer.

    KFF Health News reached out to nearly a dozen California mental health professionals and youths. None of them were aware of the apps.

    “I’m not hearing anything,” said Loretta Whitson, executive director of the California Association of School Counselors. “It’s like crickets.”

    Whitson said she doesn’t think the apps are on “anyone’s” radar in schools, and she doesn’t know of any schools that are actively advertising them. Brightline will be presenting its tool to the counselor association in May, but Whitson said the company didn’t reach out to plan the meeting; she did.

    Concern Over Referrals

    Whitson isn’t comfortable promoting the apps just yet. Although both companies said they have a clinical team on staff to assist, Whitson said she’s concerned that the coaches, who aren’t all licensed therapists, won’t have the training to detect when users need more help and refer them to clinical care.

    This sentiment was echoed by other school-based social workers, who also noted the apps’ duplicative nature — in some counties, like Los Angeles, youths can access free virtual counseling sessions through Hazel Health, a for-profit company. Nonprofits, too, have entered this space. For example, Teen Line, a peer-to-peer hotline operated by Southern California-based Didi Hirsch Mental Health Services, is free nationwide.

    While the state is also funneling money to the schools as part of Newsom’s master plan, students and school-based mental health professionals voiced confusion at the large app investment when, in many school districts, few in-person counseling roles exist, and in some cases are dwindling.

    Kelly Merchant, a student at College of the Desert in Palm Desert, noted that it can be hard to access in-person therapy at her school. She believes the community college, which has about 15,000 students, has only one full-time counselor and one part-time bilingual counselor. She and several students interviewed by KFF Health News said they appreciated having engaging content on their phone and the ability to speak to a coach, but all said they’d prefer in-person therapy.

    “There are a lot of people who are seeking therapy, and people close to me that I know. But their insurances are taking forever, and they’re on the waitlist,” Merchant said. “And, like, you’re seeing all these people struggle.”

    Fiscal conservatives question whether the money could be spent more effectively, like to bolster county efforts and existing youth behavioral health programs.

    Republican state Sen. Roger Niello, vice chair of the Senate Budget and Fiscal Review Committee, noted that California is forecasted to face deficits for the next three years, and taxpayer watchdogs worry the apps might cost even more in the long run.

    “What starts as a small financial commitment can become uncontrollable expenses down the road,” said Susan Shelley of the Howard Jarvis Taxpayers Association.

    This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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  • Keeping Your Kidneys Healthy (Especially After 60)

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    Keeping your kidneys happy: it’s more than just hydration!

    Your kidneys are very busy organs. They filter waste products, balance hydration, pH, salt, and potassium. They also make some of our hormones, and are responsible for regulating red blood cell production too. They also handle vitamin D in a way our bodies would not work without, making them essential for calcium absorption and the health of our bones, and even muscular function.

    So, how to keep them in good working order?

    Yes, hydrate

    This is obvious and may go without saying, but we try to not leave important things without saying. So yes, get plenty of water, spread out over the day (you can only usefully absorb so much at once!). If you feel thirsty, you’re probably already dehydrated, so have a little (hydrating!) drink.

    Don’t smoke

    It’s bad for everything, including your kidneys.

    Look after your blood

    Not just “try to keep it inside your body”, but also:

    Basically, your kidneys’ primary job of filtering blood will go much more smoothly if that blood is less problematic on the way in.

    Watch your over-the-counter pill intake

    A lot of PRN OTC NSAIDs (PRN = pro re nata, i.e. you take them as and when symptoms arise) (NSAIDs = Non-Steroidal Anti-Inflammatory Drugs, such as ibuprofen for example) can cause kidney damage if taken regularly.

    Many people take ibuprofen (for example) constantly for chronic pain, especially the kind cause by chronic inflammation, including many autoimmune diseases.

    It is recommended to not take them for more than 10 days, nor more than 8 per day. Taking more than that, or taking them for longer, could damage your kidneys temporarily or permanently.

    Read more: National Kidney Foundation: Advice About Pain Medicines

    See also: Which Drugs Are Harmful To Your Kidneys?

    Get a regular kidney function checkup if you’re in a high risk group

    Who’s in a high risk group?

    • If you’re over 60
    • If you have diabetes
    • If you have cardiovascular disease
    • If you have high blood pressure
    • If you believe, or know, you have existing kidney damage

    The tests are very noninvasive, and will be a urine and/or blood test.

    For more information, see:

    Kidney Testing: Everything You Need to Know

    Take care!

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  • The End of Alzheimer’s – by Dr. Dale Bredesen

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This one didn’t use the “The New Science Of…” subtitle that many books do, and this one actually is a “new science of”!

    Which is exciting, and/but comes with the caveat that the overall protocol itself is still undergoing testing, but the results so far are promising. The constituent parts of the protocol are for the most already well-established, but have not previously been put together in this way.

    Dr. Bredesen argues that Alzheimer’s Disease is not one condition but three (medical consensus agrees at least that it is a collection of conditions, but different schools of thought slice them differently), and outlines 36 metabolic factors that are implicated, and the good news is, most of them are within our control.

    Since there’s a lot to put together, he also offers many workarounds and “crutches”, making for very practical advice.

    The style of the book is on the hard end of pop-science, that is to say while the feel and tone is very pop-sciencey, there are nevertheless a lot of words that you might know but your spellchecker probably wouldn’t. He does explain everything along the way, but this does mean that if you’re not already well-versed, you can’t just dip in to a later point without reading the earlier parts.

    Bottom line: even if you only implement half the advice in this book, you’ll be doing your long-term cognitive health a huge favor.

    Click here to check out The End of Alzheimer’s, and keep cognitive decline at bay!

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  • Put Your Feet Up! (Against A Wall, For 20 Minutes)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Feel free to browse our articles while you do

    Here are 10 good reasons to give it a try; there are another 10 in the short (3:18) video:

    • Improves blood circulation
    • Improves blood pressure
    • Relaxes the body as a whole
    • Alleviates lower back tension
    • Eases headaches and migraines
    • Reduces knee pain
    • Relieves swelling in feet and ankles
    • Improves lymphatic flow
    • Stretches the hamstrings (and hip flexors, if you do it wide)
    • Helps quiet the mind

    As for the rest…

    Click Here If The Embedded Video Doesn’t Load Automatically

    PS: about that circulation… As a general rule of thumb, anything that slightly confuses the heart (anatomically, not romantically) will tend to have a beneficial effect, in moderation. This goes for being upside-down (as is partly the case here), and also for high-intensity interval training (HIIT):

    How To Do HIIT (Without Wrecking Your Body)

    Take care!

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  • Half Of Americans Over 50 Have Hemorrhoids, But They Can Be Prevented!

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Hello. I was hoping you could give some useful tips about how to avoid a painful ailment that has affected Ernest Hemingway, Karl Marx, David Livingstone, Napoleon, Marilyn Monroe, King Alfred, and Martin Luther, and, I confess, me from time to time … namely, hemorrhoids. Help!❞

    Firstly: that list could be a lot longer! We don’t have global stats, but in the US for example, half of adults over 50 have hemorrhoids.

    So, you’re certainly not alone. People just don’t talk about it.

    But, there are preventative things you can do:

    Fiber, fiber, fiber. See also:

    Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)

    Hydrate, hydrate, hydrate.

    This one’s simple enough. If you are dehydrated, constipation is more likely, and with it, hemorrhoids.

    Watch your meds…

    Some medications can cause constipation—painkillers containing codeine are a common culprit, for example.

    When you go, go!

    Not only can prolonged straining promote hemorrhoids, but also (if you’ll pardon the phrasing—there’s only so delicately we can say this) simply sitting with things partway “open” down there is not good for its health; things can quickly become irritated, and that can lead to hemorrhoids.

    So: when you go, go. Leave your phone in another room!

    Wash—but carefully.

    Beyond your normal showering/bathing routine, a bidet is a great option for keeping things happy down there, if you have that option available to you.

    However, if you have hemorrhoids, don’t use soap, as this can cause irritation and make it worse.

    Warm water is fine, as is a salt bath, and pat dry and/or use gentle wet-wipes rather than rougher paper.

    You can follow up with a hemorrhoid cream of your choice (or hydrocortisone, unless that’s contraindicated by another condition you have)

    Know when to seek help

    Hemorrhoids will usually go away by themselves if not exacerbated. But if it’s getting unduly difficult, and/or you’re bleeding down there, it’s time to see a doctor.

    Note on bleeding: even if you’re 100% sure you have hemorrhoids, there are still other reasons you could be bleeding, and so it needs checking out.

    Hemorrhoid treatment, if needed, will vary depending on severity. Beyond creams and lotions, there are other options that are less fun but sometimes necessary, including injections, electrotherapy, banding, or surgery.

    Take care!

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  • More Salt, Not Less?

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    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I’m curious about the salt part – learning about LMNT and what they say about us needing more salt than what’s recommended by the government, would you mind looking into that? From a personal experience, I definitely noticed a massive positive difference during my 3-5 day water fasts when I added salt to my water compared to when I just drank water. So I’m curious what the actual range for salt intake is that we should be aiming for.❞

    That’s a fascinating question, and we’ll have to tackle it in several parts:

    When fasting

    3–5 days is a long time to take only water; we’re sure you know most people fast from food for much less time than that. Nevertheless, when fasting, the body needs more water than usual—because of the increase in metabolism due to freeing up bodily resources for cellular maintenance. Water is necessary when replacing cells (most of which are mostly water, by mass), and for ferrying nutrients around the body—as well as escorting unwanted substances out of the body.

    Normally, the body’s natural osmoregulatory process handles this, balancing water with salts of various kinds, to maintain homeostasis.

    However, it can only do that if it has the requisite parts (e.g. water and salts), and if you’re fasting from food, you’re not replenishing lost salts unless you supplement.

    Normally, monitoring our salt intake can be a bit of a guessing game, but when fasting for an entire day, it’s clear how much salt we consumed in our food that day: zero

    So, taking the recommended amount of sodium, which varies but is usually in the 1200–1500mg range (low end if over aged 70+; high end if aged under 50), becomes sensible.

    More detail: How Much Sodium You Need Per Day

    See also, on a related note:

    When To Take Electrolytes (And When We Shouldn’t!)

    When not fasting

    Our readers here are probably not “the average person” (since we have a very health-conscious subscriber-base), but the average person in N. America consumes about 9g of salt per day, which is several multiples of the maximum recommended safe amount.

    The WHO recommends no more than 5g per day, and the AHA recommends no more than 2.3g per day, and that we should aim for 1.5g per day (this is, you’ll note, consistent with the previous “1200–1500mg range”).

    Read more: Massive efforts needed to reduce salt intake and protect lives

    Questionable claims

    We can’t speak for LMNT (and indeed, had to look them up to discover they are an electrolytes supplement brand), but we can say that sometimes there are articles about such things as “The doctor who says we should eat more salt, not less”, and that’s usually about Dr. James DiNicolantonio, a doctor of pharmacy, who wrote a book that, because of this question today, we’ve now also reviewed:

    The Salt Fix: Why the Experts Got It All Wrong—and How Eating More Might Save Your Life – by Dr. James DiNicolantonio

    Spoiler, our review was not favorable.

    The body knows

    Our kidneys (unless they are diseased or missing) do a full-time job of getting rid of excess things from our blood, and dumping them into one’s urine.

    That includes excess sugar (which is how diabetes was originally diagnosed) and excess salt. In both cases, they can only process so much, but they do their best.

    Dr. DiNicolantino recognizes this in his book, but chalks it up to “if we do take too much salt, we’ll just pass it in urine, so no big deal”.

    Unfortunately, this assumes that our kidneys have infinite operating capacity, and they’re good, but they’re not that good. They can only filter so much per hour (it’s about 1 liter of fluids). Remember we have about 5 liters of blood, consume 2–3 liters of water per day, and depending on our diet, several more liters of water in food (easy to consume several more liters of water in food if one eats fruit, let alone soups and stews etc), and when things arrive in our body, the body gets to work on them right away, because it doesn’t know how much time it’s going to have to get it done, before the next intake comes.

    It is reasonable to believe that if we needed 8–10g of salt per day, as Dr. DiNicolantonio claims, our kidneys would not start dumping once we hit much, much lower levels in our blood (lower even than the daily recommended intake, because not all of the salt in our body is in our blood, obviously).

    See also: How Too Much Salt Can Lead To Organ Failure

    Lastly, a note about high blood pressure

    This is one where the “salt’s not the bad guy” crowd have at least something close to a point, because while salt is indeed still a bad guy (if taken above the recommended amounts, without good medical reason), when it comes to high blood pressure specifically, it’s not the worst bad guy, nor is it even in the top 5:

    Hypertension: Factors Far More Relevant Than Salt

    Thanks for writing in with such an interesting question!

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