CWP RECAPS: Fake Cheese, Healthcare and Body Fat
A blog written and published by Heidi Plumb, co-author of Conversations with Pam: About the Collapse of American Healthcare and How Informed Consent Can Fix it
Subscribe to the Conversations with Pam RECAPS blog at www.informedchronicles.com where we cover topics ranging from diet and lifestyle to current events, from public health policy to clickbait.
Twice a month, for almost three decades now, Dr. Pam Popper, an internationally recognized expert on nutrition, medicine and health takes time to answer questions from a live audience of members who belong to her healthcare company Wellness Forum Health. Wellness Forum Health opened in 1996, and has been educating consumers, as well as healthcare providers in Pam’s specialty, INFORMED™ Medical Decision-Making ever since.
Conversations with Pam (CWP) is the name of her bimonthly Q&A, which lasts 90 minutes, is unscripted, and consists of questions about general health topics from a live audience, as well as write-in questions from members who are unable to attend the session in real time.
The Informed Chronicles blog provides a condensed and paraphrased recap of the most recent CWP discussion and sometimes may include excerpts from articles archived in Wellness Forum’s Health Briefs Library, as well as details from Pam’s educational workshops and course curriculum. Pam’s educational workshops are scheduled throughout the year and have covered several popular topics ranging from water fasting and root canals to fluoride, time management, cancer and IBS. Throughout the years Pam, along with her faculty have written thousands of well-researched and referenced articles that are available to her members and searchable in her Health Briefs Library. Please feel welcome to contact us if you would like to find out how to participate in the conversation or gain access to this treasure trove of health information.
The format for these live Q&A sessions is consistent. Pam always has a delightful and organized way of running the show allowing the discussion to zigzag while staying on topic. Her warm greeting and friendly reminder about maintaining the boundaries set within the discussion creates an informal and comfortable yet professional atmosphere for Wellness Forum members. CWP is more of an informal educational discussion with friends and colleagues at a local coffee shop, than a lecture hall-style discourse. It's relaxing, there's humor involved and sometimes even a quick visit from Sir Winston, Pam's jet-black Maine Coon cat (who is a celebrity in his own right). Throughout the conversation, Pam alternates back and forth between live questions from the group, and questions from the write-in that are emailed to her in advance. After a brief intro, it's time to jump in. Let’s go!
Pam: Hello, everybody! Welcome to Conversations with Pam! Those of you who are familiar with this format know any questions are fine as long as we don’t get too deep into the weeds on personal health issues. We go back and forth between questions from the live group and questions that were emailed to me in advance. We cover a lot of ground in these sessions, so let’s get started! Who would like to throw out the first question?
Member: I’ll go, Pam!
Pam: Sure! Go right on ahead.
Member: I wanted to ask you about adding a little fake cheese to my salads. I like to add just a little sliver of that fake feta because it’s so delicious, but I always feel guilty about doing it because I’m trying to be oil-free. But I shouldn’t feel guilty, should I?
TOPIC 1: Should I feel guilty about eating fake cheese?
Pam: Not at all! There’s nothing wrong with using that kind of food as a condiment in what is otherwise a health-promoting meal. The problem is when a person decides to follow a specific dietary pattern that promotes sickness. Fortunately, there are some alternative foods, which carry less of a risk factor for disease, and you can add these alternatives while still eating a health-promoting diet. This is why I say it is more the dietary pattern that we need to be concerned about.
So, if you’re eating fake cheese, you don’t have to worry about the estrogen metabolites or somatic cellular counts in that food, like you would with dairy, but calorie for calorie and fat gram for fat gram, it’s about the same as regular cheese, right? Unfortunately, we have a lot of people who think that a health-promoting diet means that you eat fake cheese instead of real cheese, and you eat fake pepperoni instead of real pepperoni, and that just isn’t how it works. And the realization that this doesn’t work comes when you realize, after eating the fake stuff for a few months, you’ve gained 10 pounds and your blood pressure has gone up.
So again, the dietary pattern is what you’re trying to change. And everybody’s preference for the minimally processed foods is different. One person might like having cereal every day and yours might be a little fake feta on your salad. And none of that is a big deal unless it starts to take over the bulk of your diet and before you know it you’re mimicking, from a macronutrient standpoint, the standard American diet. With all the delicious vegan food available out there now, that’s fairly easy to do, so we have to be mindful. We have to be mindful about the fact that just because we might sprinkle some fake cheese across our salad, we’re not adding it to everything else we eat. As a rule, we just want to get the major things right, rather than strive for perfection. Striving for perfection is a fool’s errand because it’s impossible to achieve.
But you brought up an interesting point about the guilt around eating a little fake cheese to make the salad more enjoyable. There seems to be a lot of judgement from some places about this sort of thing, and I’ve been the subject of it because I’ve never promoted the idea of dietary perfection. Some of you know, I like my coffee, and I’ve been known to grab a white bread roll out of the breadbasket at a restaurant. So far, these actions haven’t resulted in my early death, so there’s no reason to feel guilty about any of that behavior. And then sometimes we realize after a few days of eating unhealthy foods, we’ve got to reign ourselves in because we just start to feel like crap. Although it might be fun to eat, drink and be merry on vacation or a special occasion, it really feels so good to get back to our health-promoting lifestyle. Boy, that first big fresh salad for lunch after several days of getting off track, it feels and tastes so good because you just intuitively know that you’re doing the right thing for your body. You’re taking good care of yourself – yes, even if that means there’s a little sliver of that delicious fake feta on your plate! Overall, you’re eating a health-promoting meal, and that feels good physically, mentally and emotionally.
Member: Thanks, Pam! That makes me feel better.
Pam: You’re welcome! Does anyone else have a question or a follow up?
TOPIC 2: Cardio to burn fat?
Member: Pam – I have a question about belly fat. There’s a guy who takes my yoga classes who complains quite a bit about a little bit of excess fat around his midsection. He follows the Wellness Forum food pyramid pretty religiously, so I know the problem isn’t the food he’s eating. But other than yoga, all he does for exercise is strength training. I’m wondering, since he keeps asking about it if I should suggest he start doing some cardio?
Pam: I agree with the cardio suggestion. Cardio is what’s best for helping take off excess fat. And you can do that even with recumbent bikes. Implementing cardio has benefits well beyond just getting rid of belly fat, so it’s probably a good idea. But I think your advice to do some cardio is good. That’s what I would do.
Member: Thanks Pam!
Pam: Who would like to go next?
Member: I’ll go! Pam –
TOPIC 3: Calorie Burn – Muscle vs. Fat:
Member: You’ve said it before, but I forgot. How many calories per day does a pound of fat burn versus how many calories per day a pound of muscle burns?
Pam: Three calories for a pound of fat and 14 calories for a pound of muscle.
Member: Ah! Thank you.
Pam: It’s a big difference. That’s why you want to burn off that fat. And you know everything in life is momentum. The leaner you get, the leaner you get; the happier you get, the happier you get. Once you start heading in a positive direction, there tends to be a momentum that carries you along, which makes it easier. And the key is staying on the path until you cross that line where it becomes second nature. Eventually, what used to require a lot of deliberate effort becomes the new default setting to behave in a certain way because your thoughts have been reorganized to think in the way you directed them. So, just start down the path, and it gets better and better as you go.
Member: Yeah – I’m getting there. Thank you, Pam!
Pam: You’re welcome! I have a question from the write-in here that we can cover next.
TOPIC 4: To Medicare or to NOT Medicare …
This person writes, “I will soon turn 65 and am basically in good health. I take no regular medications.”
Pam: Okay – taking no medications at 65 years old – that is fantastic, and so unusual by the way. This person goes on to say that Medicare would be helpful and also says that she’s read all about the various Medicare options available. She wants to know my thoughts on the topic of Medicare.
Well, I’ve been pretty clear about the fact that I am not going to sign up for Medicare. One reason is that there is no value to Medicare unless you also sign up for the supplements. Without supplements, it really doesn’t help at all, and supplements are expensive.
For example, to my father’s credit he took very good care of my mother when she was sick. And after Medicare paid what it was going to pay, my father still ended up spending an extra million dollars taking care of my mom. Without that extra million dollars spent by my father, my mother’s quality of life would have been horrific under basic Medicare. It was already bad because she was so sick. But it was because of my dad spending all that extra money that she had consistent care and was able to stay in her own home. I guess if I had to spend that to take care of myself I would, but I don’t think I’ll have to.
Everyone has to decide what’s right for them in this situation and make up their own mind about what’s right for them. But for me, I have no intention of registering for Medicare. I pay for private insurance now, and at some point, they might throw me out for being too old. The funny thing about that is they have no problem approving coverage for a 25-year-old who’s 100 pounds overweight with high blood pressure, but they won’t cover a 70-year-old who hasn’t had a medical issue for decades, me. It just doesn’t make a lot of sense. Anyway - does anybody have a follow-up question to that?
Member: I have a question, Pam. Are you okay with the prospect of having no insurance at all?
Pam: Yeah – and I don’t want to give the impression of carelessness when I say this, but every hospital in the United States is chartered by the state in which it resides and is given non-profit status with the explicit promise to never turn anybody away. So, if I get hit by the proverbial bus, there’s no option for the hospital not to admit me. But I don’t intend to abuse that, and I know people who do. Hospitals complain about people abusing that saying that people who don’t take care of themselves who also don’t have any insurance show up, and the hospital has to treat them for free. But I would never expect to be treated for free. The point is that I think a lot of people equate having no health insurance with being denied healthcare.
And by the way, one of the major issues when the Affordable Care Act was passed was that it granted coverage on day one to anyone who signed up for healthcare, regardless of health history. The types of people who tended to sign up for it were people who were sick. So, just think about it from another industry’s perspective. If I chose not to have any homeowner’s insurance, and then after a catastrophic event decided to call my local insurance agent to see who could underwrite a policy to cover my home, well, nobody in their right mind is going to underwrite that policy. No insurance company in their right mind would allow me to pay a $1,400 premium one time and then pay out $600,000 in claims to collect on the damage to my house, right? And this brings us back to those people with preexisting conditions being cleared to sign up for care. Where were those people with preexisting conditions getting their care before the Affordable Care Act was passed? Well, they were getting it for free. And actually, they’re still getting it for free because the Affordable Care Act is subsidized. We’re all paying for it. And that’s the only reason why the rates are “affordable.”
Member: Yeah – I agree with all that. But, you know, God forbid, to cover the expense of something like a broken bone or an accident that happens, which has nothing to do with the way you’re taking care of yourself, are you okay with having to pay for something of that nature out of pocket?
Pam: Well, I’ll tell you this – the cost is always less when you pay out of pocket versus what the hospital will bill your insurance company for.
Member: Wouldn’t they just go after your assets though, if you have them?
Pam: Well, no but let’s just look at a hypothetical situation, and this is something I’ve investigated. Let’s just say that somebody ends up with a $200,000 claim for a hospital stay, and they have no capacity to pay for it. Again, this brings up the nonprofit issue. Hospitals must be very careful about how aggressive they can be with this type of scenario because of their nonprofit status. These institutions make billions of dollars, and there is some benefit to being a non-profit, right? Their nonprofit status somewhat depends upon their patients not raging against them for not delivering service, etc. So, if a person can’t pay their bill, they are still going to be cared for. Ethically, the hospital can’t turn anyone away, and if they turn somebody away for having no insurance, even if that person is in our country illegally, they’re going to get into trouble for violating that agreement they have with the state.
So, back to this hypothetical scenario, and I’ve seen this happen with our members over the years. Since we are not able to pay the $200,000 hospital bill in full, the hospital finance department will take a look at your income, assets, and everything else, and they’ll come up with a payment plan. You might end up having to pay $27 per month for the rest of your life. But I have not been able to find a single case in central Ohio where a hospital has foreclosed on a home for a $200,000 hospital bill. I’m sure it would have made the news if something like that had happened. And for people who don’t have a lot of resources, there are a lot of protections built in.
Member: But what about people like us? We may not be rich, but we have assets and resources.
Pam: Well, I think, the bottom line on that is that if you have enough money to be concerned about them coming after your assets, you probably have enough money to pay $5,000 out of pocket for a broken bone to be X-rayed and reset.
And by the way, the whole insurance business is supposed to be based upon probabilities, but we’ve ended up turning it into a socialized plan where it’s all funded by the government and subsidized by the government like the UK and Canada. And those systems are bankrupt, by the way. Communist, Justin Trudeau is encouraging Canadians to find a private doctor because their healthcare system is bankrupt and they cannot pay for people’s healthcare. There are also 7 million people waiting for care in the UK, and it’s headed in that direction here. So, you need to ask yourself – Do I want to stand at the end of that seven-million-person line, or would I rather have a private doctor someplace who I can pay cash to set a hypothetical broken bone? We can do that at our clinic, by the way. You have a broken bone; our nurse practitioner can set it. There’s going to be more and more of that, even aside from what we’re building through Wellness Forum, but the key is that you have to consider those probabilities.
What is the probability that you’re going to be in this or that situation? It may not be zero, but it sure as heck isn’t probable. And we work in terms of probability all day long. I’m going to get into my car and drive to the office because it is probable that I am going to make it to work without getting into an accident. But I am not going to drive through the mountains during a snowstorm in Colorado because there is a greater probability that I will end up getting into an accident. And at the end of the day, everyone needs to figure all of that out for themselves. The question this person asked me was, “What am I, Pam, going to do about Medicare?” And I told you all what I’m doing as well as what the laws about this issue are. But again, everybody has to decide for themselves what that means to them in terms of risks that they are willing to take. One thing I take into consideration for me personally is that I am a risk taker. And I’ve proven that again and again throughout the past several years. I take risks that most sane people would never take. I took a big risk in March 2020 when I released that YouTube video giving my thoughts regarding COVID, even when there were people who told me that I needed to have my head examined to release that clip. And I don’t regret it at all.
But I do know a lot of people who would never put themselves in that situation. And I am not saying this to puff myself up at all. I’m just saying it because it gives you guys an idea of the individual nature of the answer to the original question. The answer is highly individual because what one person is willing to do versus another is very personal.
Member: Pam – could I ask you a follow-up question to this?
Pam: Sure! Go right on ahead.
Member: My daughter-in-law had major mitral valve surgery in Atlanta, and insurance only paid 40% of the procedure. The other 60% is on her and my son, and this is a lot of money. Do you know how a person would go about setting up a monthly payment because there’s no way they’re going to be able to pay this right away.
Pam: Well, they’ll have to negotiate with the hospital’s collections or finance department. And the best thing to do is to start that process early instead of waiting until you haven’t paid or are behind on your medical bills. There’s a way to work with them so that you can set up monthly payments that won’t put you and your family in financial distress. They are there to work with you because they’re in the business of working with people to get their medical bills paid. They are not in the business of foreclosing on real estate. And if you are paying out of pocket rather than going through a third-party payer (insurance), they’ve been known to lower the amount due on medical bills since it’s a lot easier negotiating directly from payer to payee. Everything is easier when you can take that third party off the table. Hospitals do also offer a lot of free care. And they deal with a lot of different plans and payment scenarios where the amount due is X, but the insurance company will only pay a certain percentage, in your daughter-in-law’s case, 40%.
Epoch Times put out a documentary earlier this year called Flatline: America’s Hospital Crisis[1] that went into great detail about this.
Side Note from Heidi:
This documentary explores the reasons behind hospital closures that are happening all over the country. Flatline: America’s Hospital Crisis was produced by Epoch Times and directed by investigative journalist Steve Gruber who, throughout the film, points to several examples of America’s healthcare crisis affecting millions of people across the United States, especially in rural areas.
As of the film’s air date (November 2023), more than 200 hospitals had shut down within less than two decades,[2] mostly affecting rural areas. This will continue to be a problem due to the financial stress on these smaller institutions. Gruber estimates more than 600 rural hospitals will close within the next few years, which ends up being 30 percent of rural hospitals nationwide[3].
According to Gruber, when hospitals close, people do not just lose the ability to access critical healthcare, but there is a ripple effect that reaches far and wide with many people losing their jobs and local people left in disarray. Life expectancy goes down while unemployment, crime, poverty and death rates increase. This documentary gets into the root causes and names the major players involved while revealing up close and personal snapshots of actual people being affected by this.
Pam: I recommend watching this film. The reporter, Steve Gruber, who directed the film, went out and interviewed people living in the towns that have been effected. He also toured hospitals that have closed, and you wouldn’t believe these buildings! They cost so much money and they had all this expensive equipment, but they’re basically falling down now that they’re empty. Vandals have broken in, stripped all the copper out and sold it. So, at this point it would take a lot of money to get them back in business.
But the reason why they’re going out of business in the first place is because of the way the hospital system works. They bill people who are insured for all that they will pay, and that allows them to take care of all the people who either can’t pay or who have insurance plans that don’t offer much coverage. Unfortunately, those numbers aren’t working anymore. So, when the hospital gets to a certain point of books being in the red, they’re in big trouble. It’s like anything else. If I spend more than I make, I can get away with it for a while, but at some point, the day of reckoning will come. The day of reckoning means there are no more lines of credit or bills I can add to, and the house is mortgaged to the hilt, and then there’s no more money to get. And that’s what is causing this healthcare crisis to happen. The reason why hospital closures are happening in smaller areas is because they don’t draw from as many people. And the community gets hurt the most. One woman interviewed lost her husband to a myocardial infarction because the helicopter ride to the nearest hospital was 45-minutes. And those of you in the healthcare industry know that if you get to the hospital within a few minutes of a myocardial infarction, you’re likely to have a happy ending. But 45-minutes later, maybe not so good. And sooner or later, this is going to trickle over to the major cities because we’re going to hit $5 trillion for healthcare spending this year, and the system can’t sustain itself with the money coming in because it is a fraction of the money that is going out. So yeah, the system is collapsing on itself.
Member: Pam – if I sign up for Medicare, and the system collapses, is there even going to be a Medicare system?
Pam: Well, right now it’s pretty bare bones. And after my mom died, I never looked at the bills a lot because it wasn’t on me to pay them. But my mother’s quality of life based on what she would have gotten from Medicare was terrible. Terrible. And I see families dealing with this all the time. I have an employee going through this right now. Insurance pays for eight hours of in-home nursing care per day, but the person who’s sick can’t be left alone for even a nanosecond, so my employee is responsible for the other 16 hours of care needed. Either you pay out of pocket or you end up doing it yourself. And that’s a typical example.
Member: Pam – I just wanted to mention that a friend of mine was in the emergency room a few years ago, and she didn’t have insurance at the time. The bill was well over $16,000, but by the time they finished modifying her bill for cash-pay, she only had to pay $1,600. I just wanted to bring this up because they will negotiate.
Pam: Yeah – thank you. That’s a good point. Many times, they don’t even expect to collect it. But the reason the bill starts at that larger amount is because if they can find an insurance company to pay for it, they’ll bill that amount. And then once one payer closes the door, the amount due starts getting knocked down. I mean, can you imagine if you ran your household finances like that? We’d all be homeless by now if we did this. It’s a path to disaster, no matter how you look at it. So, it’s not surprising in these smaller towns that the hospitals are insolvent. It just speaks to how crazy the whole scheme has become. It needs to be simplified, and everybody has to become more price conscious. In other words, consumers don’t know any better. And it’s not their fault, but they don’t pay attention to the price of everything because everything in medicine gives the appearance of ‘free,’ with the way you just go to the doctor, receive care and then somebody bills your insurance company, right? So, we have complete oblivion on behalf of the consumers. And then the people prescribing and performing medical procedures don’t have any idea of what anything costs either. So, it isn’t surprising that the system is as insolvent as it is, and it’s getting worse.
And this has been an interesting discussion, but this brings us to the end of today. Thank you so much for joining me today, and we’ll do it again in a couple of weeks. You guys enjoy the rest of your day!
Members: Thank you, Pam!
Pam: Thank you! Bye!
[1] https://www.theepochtimes.com/epochtv/flatline-5519424
[2] https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/
[3] https://chqpr.org/downloads/Rural_Hospitals_at_Risk_of_Closing.pdf