Ricky's Riffs:

Random Thoughts on Travel, Education, Health, and the World in General


Pain, the Opioid Crisis, and Alternative Care

November 19th, 2018

Drug overdoses killed approximately 72,000 people in in the United States in 2017. This was an increase of 10% from 2016. The two reasons cited are (1) Americans continue to use opioids in increasing numbers, and (2) there are more powerful, deadlier, synthetic opioids available in the underground marketplace—mainly fentanyl, which is 100 times stronger than morphine.  While the latter is the primary cause of fatalities, there is a connection between the two explanations.

It is established that of those who die of opioid overdoses, 80% started their use/abuse of these drugs with a prescription for pharmaceutical painkillers: for football injuries, work injuries, post-surgical pain, dental issues. Too many medical doctors prescribe these drugs routinely.Read the rest of this entry »


On the Opioid and Gun Violence Epidemics: Rationales in Common

September 19th, 2018

We are currently in the midst of the most lethal drug epidemic in our country’s history. One of the shocking things about this crisis is that it has been going on for the past 20 years without showing any signs of letting up.  In 2016, overdoses involving opioids killed more than 42,000 people.  Of those deaths, 40% were from prescription opioids.   (Statistics are still being finalized for 2017.)

Several recent books describe the evolution of this epidemic, each from a slightly different perspective.*  I’ll focus on just one of them here.Read the rest of this entry »


A Rationale For A Single Payer Health Care System

August 27th, 2018

Real change is coming to our health insurance system.  This is inevitable for the simple reason that the system, as it stands, is not sustainable.  Premiums and deductibles keep rising, way beyond the rate of inflation. Drug prices also rise, as do hospital and medical device costs.

In 2010 President Obama pushed through his landmark legislation, the Affordable Care Act (ACA), which enabled millions of previously uninsured people to get health insurance for the first time. But the model was still rooted in the same private insurance system, and dominated by the usual players: Aetna, United Health Care, Cigna and the “Blues”. So there was little reason to expect the inflationary trends to slow down.Read the rest of this entry »


Book Review: “Irresistible: The Rise Of Addictive Technology And The Business Of Keeping Us Hooked” by Eric Alter

March 26th, 2018

With the recent revelations about the Russian trolling of the 2016 presidential election, during which both Facebook and Twitter were manipulated by a foreign power, we are witnessing the beginning of a national reckoning with social media.  A global network that was initially seen as a great gift to humankind is now being reconsidered.

Hailed as a great unifier, and a way to connect people—social media was the force behind the Arab Spring and other revolutionary movements—the broader implications of this network have come crashing down on us.  There has even been a good deal of hand wringing among some ex-Facebook executives, who have had second thoughts about what they have created.

Irresistible, the new book by Eric Alter, that describes the effects of social media on our children and the science behind those effects, sheds light on some of the reasons for this soul searching.Read the rest of this entry »


Welcome to “Condition: Health News That Matters”

December 11th, 2017

For quite some time, I have been thinking about writing a book.  I believe I have a unique perspective on health and healing and that this perspective might be interesting and useful to others.  After all, I’ve been in practice for more than 30 years.  I’ve taught undergrad and graduate level coursework in the history and philosophy of science, as well as complementary and integrative medicine.  I’ve worked as a chiropractor in private practice, public health, and occupational (worker compensation) medical settings.  My experience has been broad and deep in the field of integrative health.  And I definitely have a point of view!

But the more I thought about my book, the more pause I took.  My friends have written books.  Some are established authors with reputable publishers, and are paid in advance for their work.  But most are people who—like me— want to write to express something they have been carrying within themselves; to articulate their unique perspective. Many in the latter group may spend years on the project, self-publish their work, and, at the end of this long process, have 20 or 30 of their friends and relatives buy the book.  The rest may go into storage, or be given away.  (Of course, there’s always the possibility that the book might become a great bestseller, and one might join the ranks Dr. Oz or Deepak Chopra. But there’s an even better possibility that those books will stay on the shelf.)Read the rest of this entry »


Book Review: “The Healing of America” by T.R. Reid

October 19th, 2017

Part of my frustration, as I watch the current health care debate, is realizing that most of those charged with reforming our economy simply do not understand the health care system. This holds true from the House of Representatives up to the Presidency.

The health care sector is one sixth of the US economy.  Those making decisions need to be educated about how this behemoth works. What are the cost drivers? Where are the inefficiencies? What are the relationships between interest groups—such as the pharmaceutical, medical device, hospital and insurance lobbies—and legislators in Washington, DC? Read the rest of this entry »


Bernie’s Big Adventure: Medicare-For-All, A Most Radical Proposition

September 27th, 2017

On September 13, 2017, Bernie Sanders—the Independent Democratic Socialist—stood with fifteen Democrats and introduced the “Medicare-For-All Act”, HR 676.  Bernie has been introducing varying versions of this legislation for many years; but without any co-sponsors.

My, how things have changed.

It appears that the Democratic Party is now a center left party.Read the rest of this entry »


Book Review: “An American Sickness: How Healthcare Became Big Business And How You Can Take It Back” by Elisabeth Rosenthal

August 2nd, 2017

The Republican Congress has been doing its best to bring down the Affordable Care Act (Obamacare) and replace it with the cruel joke that would be known as “Trumpcare.” Despite the fact that only 17% of the public supports the Republican proposals, the GOP is still trying to burn the ACA to the ground.

It is in this environment that Dr. Elisabeth Rosenthal’s new book–An American Sickness–has arrived. The timing could not be better!Read the rest of this entry »


Public Option: Next Step Toward Universal Health Care

April 29th, 2017

The Republicans have failed to “repeal and replace” the Affordable Care Act (ACA).  They stated this would be their first order of business upon coming into power.  Although they will surely continue their efforts, it is unlikely that they will succeed.

It is now time to move forward with real health care reform.Read the rest of this entry »


How the ACA is “Blowing Up” the Health Care System and Why That is a Good Thing

April 4th, 2017

The American Health Care Act (AHCA) was written, presented, lobbied for and rejected within the first 60 days of Donald Trump’s presidency. For eight years, the Republicans had made “repeal and replace Obamacare” their rallying cry.  Yet even with control of both the executive and legislative branches of the Congress, Republicans were unable to pass what was to be their “signature” piece of legislation. It died a messy death in the House of Representatives.

The rushed and poorly thought out bill was defeated by the Democrats as well as by the Freedom Caucus, the ultra-conservative wing of the Republican Party.

The bill’s defeat was a victory for the Democratic party, but also for America. The Affordable Care Act (ACA)—an important step on the path towards universal health care coverage for all Americans—was, for the time being, preserved.Read the rest of this entry »