Let's update one of my Tickers from a few years ago.

We're going to use official government figures here, ignoring, for now, the private sector.

The figures of note are the following (figures to the nearest billion), out of a total of $3,688 billion.

Military programs: $563 billion or 15%

Social Security Old Age: $741 billion or 20%

Social Security Disability: $146 billion or 4%

Medicare and Medicaid: $1,297 billion or 35% (Medicaid amounts to $350 billion granted to the States (no breakdown on what part is drugs), Medicare Part D (drugs) is $75 billion; the rest is clinical services for the most part -- hospitals, doctors and similar.  S-CHIP, the children's portion, is $9 billion (insignificant) and administrative expenses are about $14 billion total, which is damned efficient -- only 0.4%.  Incidentally I don't believe that figure, but even if it's three times as much it's still damned impressive.)

VA (Veterans Health) approximately $61 billion or 1.7%

SNAP - food stamps -- is $104 billion and is up from last year, despite so-called "improvements" in the job market.  TANF is a separate line item, $16 billion.  Together, 3.3%.

That's where the money goes.  Conflating Social Security and Medicare/Medicaid is the common horsecrap line run by both parties, but it's intentionally dishonest.  Disability is a fraud-riddled mess, but the "old age" part of Social Security is neither going to bankrupt the nation nor is it an immediate budgetary problem.

But the $1,297 billion in Medicare and Medicaid is.

Now let's look at what Trump is proposing against this.

Price transparency in the pharmaceutical area alone would be a monster.  Let's assume that of the $350 in Medicaid 10% is drugs.  That makes drugs a roughly $110 billion annual federal expense.

What happens if you ban the gouging that is done today across the entire medical industry?

Well, let's remember that Medicare is an 80/20 program.  That is, the government pays 80%, you pay 20%.  If you look at the cost of procedures at the Surgery Center of Oklahoma, which I have posted multiple times, you'll find that many of them are about 1/3rd to 1/5th the price of local hospitals.

In other words a very material percentage -- perhaps as much as 80% -- of Medicare's non-drug spending would disappear and your bill as a Senior would drop by the same amount.

That is, of the $872 billion spent now on non-drug services on Medicare, not Medicaid, and we manage only to cut the cost in half, which just takes us to where socialized medicine manages to get in other G8 nations, $436 billion of spending by the Federal Government would disappear each and every year.

In reality competitive markets outperform socialized ones in virtually every case where there are multiple and diverse providers of products and services.  As a result that 50% decrease is ridiculously conservative; I expect we'd achieve 70%, leaving us with just over $600 billion less in Federal spending every year.

Now take the drug side, which is $110 billion and presume that by leveling prices on an international basis (by ripping down the barriers) we also get a 50% savings there.  That's another $50 billion every year and again, that is probably conservative; the actual drop would likely be higher.

Now let's turn to Medicaid.  If we save half under the same approach, and do not drop any of the poor from the rolls (which we should be able to do for the same reason; some currently on Medicaid with this very large drop in price would be able to pay cash) we'd save another $157 billion.

We just generated $800 billion, or $8 trillion over the usual "10 year" period that is quoted, in spending cuts and not one person had one benefit they currently enjoy from the Federal Government touched in real terms.

What's even better is that we did it in one literal day starting on the first day rather than some mythical Unicorn-style belief of savings a decade hence (that have never materialized, incidentally) that the GOP typically puts out in their "budget projections."

It gets better.  The Federal Government, as noted, spent $1,300 billion last year on medical care (ex the VA.)  The economy as a whole spent about $3,420 billion; the other $2,100 billion or so was spent by the private sector.

These same ratios would apply to the private sector and thus you, as a consumer, would see an approximate 10% immediate and permanent increase in your real purchasing power because you would no longer be spending it on health care, either through "insurance" or directly.  If your "health insurance" is through your job you'd get that 10% in the form of a raise as the cost of said insurance to your employer would drop precipitously.

Even better, the benefit would skew wildly toward those in the lower income but insured income brackets (e.g. full-time middle-class workers) because the percentage of your pay that goes to health insurance is much higher than it is for someone who is making $300,000 a year.

Of course the medical, pharmaceutical and insurance industries will scream.  But there's really nothing to scream about; the claim of "charity care" is nonsense in a world where Obamacare and expanded Medicaid exists; you either have one or the other, right?  As for pharmaceutical companies if they charge $2,000 everywhere for Sovaldi or $1,000 in Pakistan and $80,000 here in the United States they make the same money; what they can't do any more, nor can other nations, is soak the United States, effectively forcing our citizens to fund 100% of the development costs for drugs they then get to use.

If you're middle class these changes would mean you would be able to pay cash for anything routine and normal, and catastrophic insurance against the unthinkable (e.g. cancer, etc) will now cost a tiny fraction, 10-20%, of what it does now.  That in turn means you can afford to buy it on the open (cross-state, in Trump's case) market so if Obamacare is repealed even the modest-income household can pay for said catastrophic coverage and cover the rest in cash.

Even having done so you will still be ahead on purchasing power by about 10% if you're in the middle class and quite-possibly materially more if you're in the lower income brackets and have a chronic illness.  If you're wealthy you'll see a benefit too, but on a percentage basis it will be quite a bit less.

And that's just the direct impact on your personal budget that you will see immediately.

The real benefit is the long-term macro-economic benefit that comes from getting rid of federal deficit spending on an immediate and permanent basis.

Because the United States will now be running a roughly $350 billion a year surplus instead of a deficit we will start to retire the national debt.  Yes, it will take decades; four or five to be exact.  But that $350 billion in debt reduction every year means your purchasing power goes up even more; that is, there are fewer dollars in circulation and so each is worth more in goods and services.

This is the invisible benefit but it will accrue to everyone in the United States equally.  Rich, poor, white, black, yellow, green, young, old, doesn't matter -- everyone will see an exactly identical percentage benefit.

How much?  About 2% a year, every year, until the debt is retired.

That's right -- instead of you suffering inflation of the mythical 2% a year and your purchasing power being destroyed you will instead be able to save for retirement and see a 2% compounded improvement in what that money buys without taking any risk in the stock market or even being paid interest at the bank!

Finally, at the same time all of these really good things happen to you personally and the federal budget, state and local budgets, which are under severe pressure due to these spiraling costs embedded in their pension expenses, will all be immediately and permanently returned to a stable state as well.

Now this is, admittedly, assuming that Trump is actually able to implement his proposal and you can bet that there will be a lot of corporations and pressure groups that are going to do everything they can to derail it, especially when it comes to anything that has to pass through Congress.

But I will remind you that while the Executive (which is the part of the government the President controls) cannot make laws it is the Executive's job to enforce laws and there is a large body of law, specifically 15 USC, that makes felonious any attempt to monopolize a market or fix prices.

The executive is empowered to enforce existing laws without any act of Congress whatsoever.

In fact, barring passing a new law there is absolutely nothing Congress -- or the lobbyists -- can do to stop him or any other President from doing so.

The reason none of the recent Presidents have done so ought to be obvious; they, along with Congress, have all been bought and paid for.

I know, the headline sounds dramatic.

It's true.

Trump has just released his health care reform proposal.  He is the only candidate that has put forward a plan that will force down the cost of medical care by as much as 80%, rendering Obamacare unnecessary along with Medicare.

Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.

....

Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.

These two points will cause competition to drive down the cost of medical procedures, and if enforced using already-existing law (15 USC) it will happen.

No new laws need to be passed; the existing body of law is sufficient which means Trump as President can do this immediately, since The Executive is charged with enforcing the law.

It is illegal under 15 USC to take any action when market power exist to conspire to fix prices, restrain trade or harm competition.  Violators are subject to ruinous fines and imprisonment, making the age-old "cost of doing business" game by companies a non-factor.

Trump is the only candidate out of both parties promising to do this.  If he does the federal deficit disappears instantaneously and permanently.  Your cost of living falls.  Your purchasing power increases every single year.  At the same time your cost of medical care will fall precipitously, by as much as 80%.

I've pointed this out repeatedly over the years in these pages including in my only-somewhat tongue-in-cheek piece of "model legislation" from 2012.

If you do not support Trump and do everything in your power to not only make sure he is elected but that he keeps his promise then you will wind up broke, dead or both.

It's that simple, and that important.

This is now a single-issue election, and there is only one candidate with the correct view on the issue.

Donald Trump.

PS: Here's a prime example from this morning's emailbag post this article. A reader's kid needed her usual "annual physical" which included an immunization.  The "insurance company" paid over $300 for this service, ex the shot (which incidentally they paid $120 for and, I remind you, county health departments will administer for free as they're required for school.) 

The very same physical is sold for cash for $25; I know this as do you if you have kids, in that you need said physical in order to play school sports and it is in fact the exact same exam.

This example shows that indeed, if Trump wins office your cost of medical care will drop by 80% or more; in this specific case the drop in cost for that service would be 90%.  If everyone gets a $300 exam once a year that costs $25 when bought for cash everyone with said insurance is being robbed to the tune of $275!

Anyone, even the poor, can manage to come up with $25 and thus for such things you need no coverage at all.

Gee, yet no solutions.....

Billionaire investor Stan Druckenmiller said an aging population will present a “massive, massive problem” for the U.S. in 15 years.

“The young people are not going to be talking about cutting back,” Druckenmiller said Wednesday night in New York at an event hosted by Addepar, a technology company that provides software to financial advisers, fund managers and family offices. “There will be nothing to cut back.”

Druckenmiller, 61, has argued for several years that the mushrooming costs of Social Security, Medicare and Medicaid will bankrupt the nation’s youth and eventually result in a crisis worse than the financial meltdown of 2008. The government will have to reduce payments to the elderly, he said at the event.

Nope.

How do you do that when the elderly can outvote the younger people?

Further, will you stop including Social Security in this description of the problem?  It's not the problem, and that Stan, like so many others, continue to include it tells me that something is very wrong with what is being propounded -- probably that he knows damn well where the problem is and thus how to address it but doesn't want to put that on the table.

It's really not complicated folks: Medicare and Medicaid are the problem, all of it.

Let's take the numbers right out of the MTS for last fiscal year.

Medicare tax receipts, last fiscal year and all-in, were $224 billion.  That's it.  Medicaid received zero since there's no tax associated with it.

But between Medicare and Medicaid last year $1,187 BILLION was spent, resulting in a deficit between spending and tax receipts of nearly a trillion dollars.  In fact last fiscal year the US Federal Debt increased by $1,085 billion which means that essentially all of the actual deficit was due to this disparity.

You got that folks?  The entire reason that we have a budget deficit -- all of it -- is that we are spending $963 billion more than we take in through taxes on Medicare and Medicaid.

THE ENTIRE PROBLEM LIES THERE, ALL OF IT.

Now to be fair, the Social Security system ran a $150 billion deficit last fiscal year too.  But $150 billion is chump change compared against $960 billion, and the latter is growing in payments far faster than receipts.

If you think you can effectively double the tax rate paid for Social Security, Medicare and Medicaid (that, I remind you, would mean that your actual tax rate for these programs would be 30% from dollar #1 for all wage dollars up to the FICA limit and then 15% for every dollar thereafter!) you're nuts.  That sort of tax increase would literally drive anyone in the middle income brackets and below into the poorhouse; it would be a doubling of the actual effective tax rate on those not making enough to pay federal income tax net of deductions and credits, for example, and would be a monstrous (30% or more) effective tax rate increase even on those with a $100,000 gross income!

That's simply not plausible to implement -- period.

Nor can you CUT Medicare and Medicaid expenditures by 80% (which you'd have to) except by getting rid of the need for both programs for everyone except those in abject poverty.

This means there's only one way to solve the problem: 

You must eliminate the need for Medicare and Medicaid for everyone that is not abjectly poor.

So how would you go about doing that?

What if you knew that scorpion antivenom that costs $30,000 a vial in Phoenix was $100 a vial in Mexico where it is made, just a few hundred miles south?  It is.

What if you knew that Sovaldi, the cure for Hepatitis C that costs nearly $90,000 for a course of treatment in the United States has a cost of approximately $1,000 in India and Bangladesh?  It does.

What if you knew that if you went to either Mexico or Bangladesh and bought 100 courses of treatment of either drug and brought it back into the United States to sell at a 100% mark-up, an act that (if replicated) would not only make you a nice profit but also instantly force down the price in the United States down to something reasonable, you would have your lawfully-purchased courses of treatment confiscated and you would almost-certainly be charged with a crime and imprisoned?  That's exactly what would happen.

What if you knew that an MRI that is often billed out at $3,000 in the United States can be purchased for cash for about $200, including the reading of the results by a qualified MD, in Japan?  This means that it is actually cost-effective for you to get on a plane, fly to Japan, have the test done and then fly back home as opposed to having it done at the MRI place around the corner! That too is true.

What if you knew that surgeries performed in an open competitive market were often available, even here in the United States, for 20% -- that is one-fifth -- of the price charged in other places just a few miles away?  Oklahoma Surgery Center anyone?

What if you knew that people are routinely billed hundreds or even thousands of dollars for a "consultation" that consists of a doctor who you never met and had not consented to treating you sticking his head in your hospital room and saying "Hello!"?  This happens literally every single day in hospitals across this country.

What if you knew that people often cannot get a quote on a procedure before it is performed and even if they do hospitals and other medical centers will frequently bill for other things without consent, even when it could have been provided, and then demand payment?  Such a practice in virtually any other business, such as auto repair, air conditioning and heating work and similar is a criminal act under state consumer protection laws, incidentally.  That happens literally every single day in medical centers and hospitals as well.

What if you knew that people were being billed for procedures that never took place in hospitals, such as being billed for a "trauma team activation" when no life-critical trauma occurred and in fact no such activation or care was provided? Such an act in other businesses, such as billing you to replace an alternator in your car that wasn't actually replaced is and is prosecuted as a crime. This has been documented to happen as well.

What if you knew that common off-patent medicines are often "reformulated" in their inactive ingredients (that is, the ones that don't treat the condition) and then the former product discontinued, sometimes under government pressure, resulting in cost increases of 200, 300, or even 500% and the disappearance of inexpensive OTC alternatives?  This happens all the time with Albuterol being one such particularly-outrageous example; Primatine Mist, the OTC alternative, was forced off the market and the price of the prescription alternative roughly tripled.

What if, in short, you knew that medical care and so-called "health insurance" in this country is effectively a cartel operation that, in virtually any other industry, would be considered racketeering and prosecuted with thousands of people going straight to prison, firms being broken up or closed and those gouged having their funds returned?

Well, there's a damn good argument that this industry is chock-full of exactly that sort of behavior by virtually everyone in it!

Now let's look at what has happened not in gross dollar terms but in terms of GDP.  Health care has gone from a low single-digit percentage of the economy (about 3-4%) to roughly 19% today.

We have a $17 trillion economy and of that $3.23 trillion, roughly, is health care, $1.2 trillion of that spending is by the government and virtually all of it spent in deficit by devaluation of everyone's purchasing power amounting to roughly 6% per year, compounded!

If we broke up those cartels and both Health Care and Health Insurance were returned to being a competitive market the share of the economy would shrink from $3.23 trillion to about $640 billion a year.

Now let's think this one through -- there are 330 million people, roughly, in the nation today.  At $640 billion total per-person expense on medical care would drop to approximately $2,000 per-person from the $10,000 per-person spent today.

Nearly all people can afford $2,000 per year; if the threshold for "affordability" is 10% of your income all-in, anyone who makes $20,000 a year or more could afford it where right now you need to make $100,000 to reach that threshold.

Further, with even the cost of catastrophic events dropping by 80% you would be able to buy catastrophic insurance for the few instances where you can't afford the out-of-pocket for a small amount of money -- and that comes out of this $2,000 per-person cost!  In other words it would be about as expensive as a basic automobile liability policy to have catastrophic health insurance -- about $75/month.

The screamfest about things like "birth control" are an intentional fraud by those advancing such arguments; you can buy, for cash, birth control pills for under 50 cents a day.  In many cases for drugs like this, along with common antibiotics, the co-pay is higher than the cash price for generics!

Resolving this situation would effectively allow the removal of Medicare and Medicaid from the federal budget even though it would not actually go away.  It would instead be limited in accessibility to those who are under the poverty line and between that restriction and cost reductions it would fall in expense by about 90% in the Federal Budget.

Simply restoring The Rule of Law to the medical and insurance industry  instantly and permanently ends the federal deficit and in doing so would result in a roughly 6% improvement in every citizens' purchasing power every single year thereafter, compounded, because the purchasing power destruction that inevitably and immediately is caused by deficit spending disappears.

That benefit goes to everyone, rich and poor alike and as a consequence will massively benefit the economy as a whole over time.

Who loses?  The medical and insurance company cartel members.  Yes, their income would decrease - - a lot.  And?  These people are a small minority of the population and more to the point the "service" funds they consumed could then be spent in the production and purchase of goods, which improves the net wealth of the nation instead of simply shifting money from one person to another, and furthermore the cessation of purchasing power destruction would be of benefit to everyone -- including them.

You've seen me spend a lot of digital ink on this issue over the last six or so years but not one person in a public policy role wants to engage in this debate.  None.  Not in the Republican Party, Democrat Party, Libertarian Party or otherwise.  I was damn near run out of town in the Libertarian party for insisting that the party stop endorsing and supporting candidates that refused to take this on and in fact lied about it in their campaigns.  When it became apparent that the party had zero intention of addressing this issue, the issue that will destroy us economically without question, I left the party.

You'd think if any of these political types had a counter-argument that made sense they'd be happy to take me on and demolish me publicly in said debate (after all, it would be great for them, right?) but it hasn't happened despite multiple offers on my part, and that of a few others, to engage on this point.  I have made repeated offers to do so and in fact have offered in the past (and you can count this posting as a further offer) to travel at my own expense to Washington DC or anywhere in the State of Florida to engage in said debate.

Even people attempting to solve the problem through example, such as the folks running the Surgery Center of Oklahoma, can't get a functional debate going with either public policy people or the heads of traditional hospitals and insurance companies.

We all know why this is the case but sticking your head in the sand will not stop what Stan (and I, along with others) have outlined from coming to pass.  That can only happen by taking this issue on and focusing political energy virtually anywhere else is a waste of time both because this is a certain destroyer of our economy if it is not halted and halting it will take time.

How much time do we have?  I don't know where the zero barrier is on this from a fiscal point of view and neither does anyone else, but that it exists and that markets never let you reach it are both a certainty.

Every day we delay as a nation and a people is one in which the odds of an "accident" in this regard go up, and once our feet go off this cliff there is simply no clean way back on solid ground.

It isn't often that three bogons show up in quick succession, but we've got it here from the so-called paper of record of the scam machine known as Wall Street.

First, let's deal with the so-called Obamacare Escalator.

On Wednesday the actuaries at Health and Human Services released their new annual projected measurement of national health expenditures for last year and through 2023. Spending in 2013 grew at a relatively low rate in historical terms for the fifth consecutive year below 4%, though at 3.6% it still outpaced real economic growth. They expect the rate to climb to 5.6% in 2014 and continue rising by 6% a year on average through the decade.

Health spending as a share of the economy rose to 17.2% in 2013 from 16.2% in 2007 and will hit 19.3% in 2023, assuming that GDP grows as smartly as the auditors project. In other words, health care will soak up nearly one of every five U.S. dollars instead of one of six. Taxpayers will finance 48% of that spending a decade out, up from 41% in 2007. Thank you, Peter Orszag

So let me see if I get this right.

Health care spending as a share of the economy will go to 20% within the next 10 years.  It's bad because that will hit the Federal Budget.  But it would be "good" if it didn't, and instead skullfucked everyone in America who isn't Michael Jordan or Bill Gates within an inch of their lives?

The mental gymnastics required to get there are beyond ridiculous.  Oh, and guess what -- they even try to justify it:

Medical spending is valuable to the extent Americans are buying longer and healthier lives and financing innovation in treatments and therapies.

Really?

Would spending on gas be "valuable" if the fuel was $30/gallon to the extent you could get to work using it?

Well, maybe.  But shouldn't we instead be asking why it's $30/gallon instead of $3 when the only reason it's $30 is the monopoly protections that the government provided for in the form of specifically enabling price-fixing of various sorts?

How do we know this?  We know it because hospitals claim it's perfectly reasonable to charge $9,000 to bandage a finger and $60,000 for two $100 vials of scorpion antivenom that can be purchased over the counter a couple hundred miles to the south.  We also know this to be true because a common test that can be purchased for $20 is charged out at $10,000 by some hospitals.

It is in fact laws that make criminal the sale and possession of said anti-venom without a valid license from a cartel-controlled group that enable said $60,000 price, just as it is laws that make a crime your attempt to have such a test done for $20 on yourself without a valid prescription by a member of that very same cartel.

Those acts -- restraint of trade where market power exists -- are supposed to be felonies according to The Sherman and Clayton Acts.  They in fact result in prices that are thousands of percent higher than the market price for said commodities and services.  It is in fact these acts that leads to an entire industry being required for most people and having a reason to exist in the first place (that is, the medical "insurance" business), a situation that is facially a close analogue to a mafia protection racket.

Then there's this ditty on Disillusioned Doctors....

This economic interaction fostered a better physician-patient relationship. Unfortunately this is lost in U.S. health care, where third-party payment dominates and physician allegiance is divided between trying to take good care of patients while adhering to demands of government agencies and insurance companies which pay the bills.

You know what happens when you allow yourself to be used as a pawn akin to a drug mule for a cartel?

You get fucked, that's what.

Doctors really thought they could be a part of the above crap, actively participate in fucking their customers out of trillions of dollars at the behest of and for these other actors and come out ahead in the long run?

Oh sure, it worked great for a while.  Being a doctor used to be a solid middle-class profession.  Then it turned into one that got you a Porsche and a mansion when you began robbing people.  That was a carrot -- the stick is that you weren't going to be able to keep any of it long term because you were cooperating with and enabling the devil.

And finally, if that's not enough, you have this on $20,000 bruises:

I was proud to see the health-care system working, to see academic medicine working, and most of all to see my son run as fast as he could out of the ER two hours later.

Then the bill arrived, and you know where this is going: $20,000. Our insurance had already paid $17,000, and we owed $3,000 out-of-pocket. What for? Among the items listed on the printout was a $10,000 charge for a "trauma team activation." This made me want to give consumers some very simple tips on how to fight their health-care bills, so here goes:

The rest of the article is a bunch of arm-waving about how he got rid of the bogus $10,000 charge.

Bogus, I say, because no such activation of said trauma team occurred and if it had it would have been in direct violation of published regulations.

He finishes with (after getting the bogus $10k charge removed) "be graceful in victory and realize you got lucky."

Uh, no.

You see, billing someone for a thing when you didn't do it has a name -- F.R.A.U.D.

When that is systemic, that is, intentional and widespread instead of an occasional "mistake" how do you argue against a position that you're operating a criminal enterprise.

And that means that everyone involved would be engaged in the felony known as Racketeering, which in turn means treble damages, huge fines and prison time for everyone involved from the Hospital Administrator on down to the doctors and clerks who were fully aware that they billed out for services they didn't perform.

All in my opinion, of course, since that would be the outcome if we lived in a world where there was actual Equal Protection of the Law.

I will remind you that we're supposed to live in that world because our Constitution via the 14th Amendment says:

All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

So there is supposed to be one law for everyone.  So says Amendment 14.

You and I go to prison when we rip people off for 10 large, especially when we do it daily on a systemic basis.

So here's my position on all of this:

If the hospital, doctors, billing clerks and administrators don't have to obey the law why should those people expect anyone else to obey the law in their dealings with them?

You want to know how we get Mad Max in this country?  Keep playing this game long enough, keep making excuses for what ought to be hard-time felonies, and eventually you'll piss off the public enough to find out.

I'm not looking forward to that day and if you have any common sense you're not either.

Cut the crap and stop making excuses.

Now.

There are times that one asks how and why it is that the so-called "mainstream media" can fail to take an event that goes on for a long time and yet never ask what changed that might be the cause of that phenomena?

"The battle to protect people from diabetes and its disabling, life-threatening complications is being lost," the federation said in the sixth edition of its Diabetes Atlas, noting that deaths from the disease were now running at 5.1 million a year or one every six seconds.

People with diabetes have inadequate blood sugar control, which can lead to a range of dangerous complications, including damage to the eyes, kidneys and heart. If left untreated, it can result in premature death.

Why?

Let's talk basic biomechanics.  You eat.  When you eat foods that contain carbohydrates as they are digested they convert to glucose.  Your pancreas secretes insulin to promote the conversion of glucose to glycogen, which is then stored, primarily in the liver.  When this storage mechanism is full the energy is diverted to fat.

When you eat a food that contains carbohydrates that are absorbed slowly, that is, you eat things that have a low glycemic index, the response rate of insulin in the body is muted and rises slowly.  When you eat something that contains carbohydrates that are absorbed rapidly, such as sugars, your pancreas is called upon to rapidly increase insulin levels so as to prevent the glucose level in your blood from rising to dangerous levels.

Type II diabetes is the condition where either (1) your pancreas fails to respond to high glucose levels adequately with a release of insulin or (2) your body fails to generate glycogen (and ultimately fat if intake continues) despite a relatively high level of insulin.  This is generally known as "insulin resistance" or "metabolic syndrome" and is distinct from Type I diabetes where the islet cells in the pancreas are destroyed due to an auto-immune disorder (and thus can't produce insulin at all, or at least not in material amounts.)

So, let's see what we have here.

What if you were to eat a diet with no carbohydrate in it at all -- or, in the alternative, ate only very "slow" carbohydrates with very significant other nutrient value such as leafy green vegetables?

You'd expect that a person with compromised insulin response would find much better blood sugar control -- right?

So why is it that the American Diabetes Association recommends that about 1/4 of your food intake be "starchy foods" that are all moderate to high glycemic index carbohydrates?

You don't need carbohydrates, incidentally; they serve no essential purpose in nutrition.  Your body is quite-capable of running on lipids -- that is, fats.  You especially don't need them if they spike your blood glucose levels because you're insulin-response compromised!

But the better question is this: How did the compromise happen in the first place, and why does the prevalence continue to expand?

That's pretty easy to figure out -- these foods, by and large, did not exist a hundred or two hundred -- or a thousand years ago.

Oh sure, there were some exceptions -- but the prevalence of these foods is a modern thing.

And so is diabetes, by and large.

Now I'm sure a good part of this is just bad genetics -- that is, a bad draw from the deck.  But how much of the rise in Type II diabetes is due to our shift from low-glycemic index carbs and fats as our primary energy sources to fast carbohydrates such as refined sugars and synthetic fats such as hydrogenated oils?

More to the point, why aren't we recommending that people strictly limit high-glycemic index carbohydrates?

You'd have to ask the folks involved that -- and in particular, you'd have to address the "part of your good breakfast" crowd that puts forward prescriptions for everyone from toddlers forward starting their day with a bowl-full of high-glycemic-index carbs.

I wonder if we were to get rid of the cereals and toast, replacing it with omelettes and bacon, if we might not have a lower incidence of Type II diabetes..... and if perhaps those currently suffering from it might not have better blood sugar control and less obesity at the same time.

But that would piss of the agribusiness and pill mill folks mightily, wouldn't it?