Eating spices like turmeric (which directly minimize chronic inflammation) or cruciferous vegetables (which directly minimize oxidative stress) are t… - Casey Means

Six out of ten adults are living with a chronic illness. About 50 percent of Americans will deal with mental illness sometime in life. Seventy-four percent of adults are overweight or have obesity. Rates of cancer, heart disease, kidney disease, upper respiratory infections, and autoimmune conditions are all going up at the exact time we are spending more and more to treat them. In the face of these trends, American life expectancy has been declining for the most sustained period since 1860.

HDL is often referred to as “good” because it helps remove cholesterol from the blood vessels and carries it back to the liver for processing and elimination from the body. This process of reverse cholesterol transport can help prevent the buildup of plaque in the arteries and reduce the risk of heart disease and stroke. Therefore, high levels of HDL in the bloodstream are considered beneficial for cardiovascular health. Meanwhile, LDL (low-density lipoprotein) is often referred to as “bad” cholesterol because it can deposit cholesterol in the walls of the arteries, leading to the formation of plaque. This process, known as atherosclerosis, can narrow the arteries and increase the risk of heart disease and stroke.

At the start of my residency, the Affordable Care Act (ACA) was passed and all doctors had to get up to speed on the Merit-Based Incentive Payment System (MIPS), a new program under the Quality Payment Program (QPP), where a physician would now receive substantial adjustments to payments from Medicare if they met specific quality-of-care criteria. One would think that “quality” and “merit” in medicine would mean that the patient was actually getting better. But when I dug deep through the MIPS website to find the specific quality metrics for each specialty, I was shocked to see that these quality criteria were primarily based on whether doctors prescribed drugs regularly or did more interventions. Yes, a government incentive program focused less on actual patient outcomes (i.e., Did the patient get healthier?) and more on whether doctors prescribed long-term pharmaceuticals.