This is what needs to be done if you want to bring about medical debt justice for our veterans. Now, THAT would be the best way to bring in – and end – 2022. You (yes, you) can help bring that about. We at Let’s Rethink This (LRT) are honored that Physician Outlook is making available its platform – and its audience – to learn more about America’s shame in allowing hundreds of thousands of active duty and veteran users of the VA system to be both financially and emotionally crippled and what to do about it.

And what better, singular group could better relate to the need for this broken system to be rethought than physicians, nurses, and concerned members of the healthcare community? Whether you have a role in the VA delivery system or a civilian serving veterans at a public hospital, you are unwitting (unaware?) accomplices in bringing about the $6 billion in unpaid medical bills that the VA has refused to pay…or forgive…up to this point.

Sorry, kid. You fixed ‘em. The VA broke ‘em. Who is responsible for the “do no harm” part?

By the numbers

Currently, there are fewer than 4,500 active-duty physicians tasked with overseeing the healthcare needs of America’s 1.4 million active-duty, 330,000 members in the reserves, and/or retired, along with a veteran population of approximately 18 million. This takes place at 1,293 healthcare facilities, including 171 VA Medical Centers and 1,112 outpatient sites. The annual budget is $50 billion.

According to USA Today, of those 18 million veterans, more than 5 million veterans have at least one disability, 1.2 million live in poverty, and 77% of veterans aged 18 to 64 are employed or looking for work. At the end of 2018, an estimated 37,878 veterans were homeless.

How can any of this be?

Military veterans, contrary to popular misconception, do not get free healthcare from the Dept. of Veterans Affairs. If a health issue isn’t related to military service or is not the result of their being more than 50 percent disabled – the vet can be held responsible for co-pays. 

If the veteran has the misfortune of requiring the services of a civilian hospital emergency ward for a non-service-related injury or illness, they are also on the hook as they might need to meet a deductible or pay co-insurance – or did not get a pre-authorization to get service in a non-VA setting. If as a civilian, you feel you are dealing with uncaring insurers – try jumping through military hoops!

For example, in 2019, a federal appeals court in Virginia ruled that the VA would be required to reimburse veterans for $6.5 billion in unpaid emergency medical bills. Good luck on that happening anytime soon. If ever.

What to do?

Lots, starting now. This is just the first shot across your consciousness prow. Visit Let’s Rethink This where in February we will have a revamped Our Newspaper to head to for the latest news, articles, and interviews. Want a free copy of my chapter titled “No Thank You for Your Service” in the recently released End Medical Debt: COVID Recovery Edition to deep dive into the problem? Write me personally: This email address is being protected from spambots. You need JavaScript enabled to view it.

Michael E. Gerber of Gerber Enterprises, LRT’s Impact Business Hero, intends - at the age of 85 - to pour his fine old wine of hard-earned enterprise-building wisdom into new bottles. Very new bottles - the youth of this world.

Michael is famed for having introduced the “E Myth” (“E” stands for Entrepreneur) book to hopeful businessmen-would-be’s back in the 80’s to public acclaim. This book and many of its “E-Myth” ilk afterwards, along with the driving force of Michael Gerber, turned this work into a publishing and training empire which at its height was touching millions of readers worldwide, and tens of thousands of clients.

While enjoying a rather busy “retirement,” he took a look at what was happening in the world around him and its failings: COVID, social media, cellphone addiction and an attention span slightly longer than a nanosecond, a huge number of businesses failing and a lot of people rudderless.

It was time to cull through his life’s work to find those tools which could be applied to today’s more complex society, and step back onto the stage. 

He concluded that at least one subset of our society could be salvaged – those from 14 to 18 years of age. (What’s that old saying – catch ‘em young and train ‘em right?) He decided to rethink his “Dreaming Room” concept and apply its success principles – how to become a successful entrepreneur – to address their hopes.

He decided to rethink his “Dreaming Room” concept and apply the success principles – how to become as successful entrepreneur – to address their hopes for a better existence than what they see around them today.

Gerber scoffs at the age difference as possibly standing in the way. “These kids were born in the image of God and imbued with the spirit of creation,” he says. 

“This is not from a religious sense or ideology, but in the larger world of spirituality. That’s their core, and one from which anything can happen if the proper tools are available. Their imagination and inspiration will provide the driving force, along with my tools, to help them create a more significant life.”

An Africa Spark

The idea for this refocusing of an aspect of his lifelong work came from a husband and wife student team in South Africa. Marlen and Hendrik Bohn were taking instruction at Michael’s Radical U. This five-year entrepreneurial development school sparked a dream of theirs – to transform the world of disadvantaged African youth. When they brought this idea to Michael’s door – he opened it warmly.

A “Dreaming Room” for the ages of 14-18 and a prospective Radical U spanning a shorter time and for much less than the $495 a year paid by adults is in the works. Will it speak differently to kids who appear to speak and think in digits? “No,” says Gerber, “this is what they will hear.”

“Do you have a cellphone nearby? Then turn it off! Your Digital Universe will never provide you and the spirit within you the answers you want. You weren’t created to be another ‘meme’ or digit in some meta-world. 

He continues, “With our mindset and methodology, you will find the answers to ‘Who am I,’ and ‘Where am I going?’ and, you will acquire the wisdom accrued in my almost 50 years of creating successful entrepreneurs to help you get what you and your soul deserves.”

Marlen and Hendrik Bohn couldn’t be more enthusiastic. “We can’t wait to see where this venture goes and how it will enable young people to create something meaningful for their lives that sustains them and impacts others.”

Those seeking more details about the construct and purpose of Radical U can head here.

Before we talk about those goats and suggest a better way for Americans to give a different form of thanks on our own special day of abundance, let’s explore the need these animals fill in rural India.

The International Fund for Agricultural Development (IFAD), a specialized agency of the U.N. estimates that each goat could return from 5,000 to 6,000 rupees ($67-$80 U.S.) annually. The target of this campaign is to provide 11 animals for each of 155+ women initially chosen to participate. This adds up to a yearly revenue of 50,000 to 60,000 rupees ($670-$800 U.S.) which goes a long, long way in remote villages.

Considering the lifespan of the goat, which is extremely hardy and generally delivers birth to twins or more twice yearly, combined with a voracious market for its meat and milk both inside and outside India, this act of charity supplemented by micro-loans will pull these women and their families out of mere subsistence. 

If ever a helping hand were needed from we in the U.S., here’s a sampling of the circumstances you can change:

Malati. Her only source of income is daily labor. Husband, a mason, migrated to New Delhi but returned due to Covid-19 pandemic lockdown. 

Madhumit. Housewife married to a marginal farmer who works as a laborer in New Delhi. She presently has two goats, having sold two last year to provide education for her children. Barely subsisting.

Gouri. Belongs to a landless family. Husband is a day laborer. She lost three goats last year to illness and had to sell her final four this year to sustain her household.

The stories of these women share a universality: poverty, living in sub-standard circumstances, children to feed and a fierce desire to become financially independent through goat farming.

Combining American/Indian Brain Power

The planning and provisioning of the goats are under the stewardship of the well-respected Indian development organization, DCBS is partnering with the American firm, ALPHAFIN and its CEO, Adel Elmessiry.

The partnership came about when both entities, searching for finance institutions that shared the values of helping the poor and doing so by way of micro-lending, crossed paths online.

Adel’s unique DNL (distributed Network Lending) in which loans can be made by friends and family rather than a bank or governmental agency, caught the attention of Animesh Naiya, DCBS Secretary and CEO. DCBS, as a not for profit devoted to developing women entrepreneurs, this was a welcome addition. 

The next welcome addition is your donation.  

For the initial stage, DCBS has selected 155 beneficiaries to support a “Black Bengal Goat Farming” campaign in the Sundarbans delta region of India with the goal of providing 10 she goats and one male goat as well as constructing a goat shed for shelter. This comes to a total of $557 U.S. per woman and a grand total of $86,335 for the project.

Every dollar donated is precious and serves as an essential resource to eliminate the need for DCBS to go to bankers. Please go to https://dcbs.in/. To be a donor, go here: https://dcbs.in/donation/

I was laid off from a new job two weeks before the COVID shutdown of NYC in 2020. I knew the company had made a purely cost-cutting move, and I knew the city faced economic disaster across every industry. I also knew my paycheck-to-paycheck existence needed rethinking to survive the coming financial apocalypse. 

I prepared the house for pandemic hibernation. With my severance package, I invested in comforts to help us with the coming boredom, like a 62-inch television. Never in my life had I prioritized such a purchase. Still, with months ahead of Netflix and chilling as COVID spread, I wanted our household to be entertained, at the very least. I bought groceries in bulk, instead of my daily market run, to avoid needing to be out in public.

I worked the interwebs to find new computer equipment, before prices and availability ran up and out, along with bulk orders of masks, gloves, paper towels, and toilet paper. We needed money, fast. No one knew, at that time, if a stimulus would even be possible.  I purchased gold jewelry from online estate sales and turned it into a profit in NYC’s Diamond District. I had dabbled in crypto for a few years, so I began buying Bitcoin and Etherum with my earnings, thinking the return would be better than keeping the gold.

 At first, my household laughed at me, “You are overreacting.” I doubted myself but did not see any hope in the daily reports of infections rising and shutdowns across the world. 

Months later, the Diamond District started closing up from the lack of business, an inconceivable thought to all in NYC. We were still living on pandemic time, uncertain, but receiving benefits from the government, and all of a sudden, crypto valuation started climbing beyond any of my expectations. I didn’t make a ton of money, but it helped us through the worst of last year. Because I found myself in this lucky position, I had the time to volunteer to assist important organizing efforts, on and offline, starting with the People’s Strike formation. I built CoronaStrike with another activist and had the time to continue posting to the Occupy Wall Street social media pages, and I volunteered with a local mutual aid center, filling bags of needed nonperishable groceries and supplies, to be delivered,  for all in the area.

I realized how I could use cryptocurrency to realistically cushion our quickly depleting resources; I rethought my approach and started to get serious. First, I started taking the MIT OpenCourseWare class, Blockchain, and Money, in between applying to remote work positions. Then, I started watching YouTube videos about cryptocurrency (shout out to VoskCoin); I became obsessed. I started to understand how the development of the next version of the internet, web3, would be become a place in which we could all benefit, directly, through using the web, for communication, commerce, and the creation and management of commodities.

The most important thing I learned? Money is anything we want it to be; the challenge is ensuring that we can use our resources in the actual day-to-day of living. That meant using a Coinbase account to convert Bitcoin or Etherum into dollars and transferring to my bank account when I needed to. Sometimes this happened in the line at the grocery store, other times it happened in front of an ATM, other times, in my bedroom, as I scrambled to pay yet another bill. Most recently it happened on a layover in Amsterdam because the blockchain moves outside of borders.

In October last year, while browsing Facebook, I received an ad to help “build a new network and earn crypto or cash.” Knowing the possibilities, I answered the ad and became a host for a miner on the Helium “Peoples Network.” A few months later, I found myself receiving cash from this remarkable project. And all of a sudden, our household stabilized in ways I could never imagine prior.  

One of the things I did with this miracle windfall? 

After purchasing a new vacuum, paying a few months of rent, and other needed items (including a few Helium miners from Nebra), I invested in the liquidity pools of Uniswap, after becoming inspired by the offerings of MetaMask. As might be guessed, I am not the only one to see the potential. 

Recently, Consensys held a seminar to present their findings on Crypto use in the Global South. Not surprisingly, my reasons for getting serious about cryptocurrency are the exact reasons for people worldwide.

Source: MetaMask

These are all the reasons why I am so happy Let’s Rethink This features the work of  Adel ElMessiry, defying predatory lending with his Decentralized Lending Network. As the pre-COVID world continues to crumble into dust, new ways of securing resources and frankly, money, is imperative to the survival of the peoples of our planet.

The time to rethink everything is now.

In solidarity and hope, Priscilla Grim, Editor-in-Chief of Let’s Rethink This

Tom Jordan and his wife, Anne, were both ready to retire when they realized their high cost of prescription medications wouldn’t let them begin enjoying their “golden years” just yet.

A heart attack survivor, Tom was taking seven prescription drugs, just to stay alive. Anne was taking several as well just to deal with the aches and pains that come with growing older.

But then there was the cost.

There are few issues that bring the American people together more than the idea that the cost of prescription drugs is too high.

Polling shows that large majorities of Americans in both parties think the government needs to do more to lower the cost of prescription drugs, and every presidential administration this century, Republican and Democrat, has made the issue at least a rhetorical priority. Yet the cost of pharmaceuticals continues to outpace inflation, costing the U.S. government and average citizens alike.

Like his predecessors, President Joe Biden campaigned on lowering the cost of prescription drugs. He touched on the topic again Friday, when he issued an executive order directing the Food and Drug Administration to work with states to import lower-cost drugs from Canada and told the Federal Trade Commission to ban industry schemes that delay the development of cheaper generic drugs.

According to Actuary.org, Health care spending in the United States is high and continues to increase, as does the spending for prescription drugs in particular. In 2016, the U.S. spent $3,337 billion, or 17.9 percent of the gross domestic product (GDP), on national health expenditures, of which $329 billion was spent on prescription drugs.

Many countries have measures in place to limit advertising by pharmaceutical companies.

According to The Washington Post, pharmaceutical company spending on marketing generally exceeds that of its research budget. In Canada, $1.7 billion was spent in 2004 to market drugs to physicians; in the United States, $21 billion was spent in 2002. 

In 2005, money spent on pharmaceutical marketing in the United States was estimated at $29.9 billion with one estimate as high as $57 billion. When the U.S. numbers are broken down, 56% was free samples, 25% was pharmaceutical sales representative "detailing" (promoting drugs directly to) physicians, 12.5% was direct to user advertising, 4% on detailing to hospitals, and 2% on journal ads. There is some evidence that marketing practices can negatively affect both patients and the health care profession.

There are alternatives to dangerous and costly prescription drugs that are safer and less expensive. These alternatives come in the form of many natural supplements. 

According to the United States Pharmacopeia, natural supplements are natural ingredients that have been in existence for centuries. They include plants, flowers, bark, roots, and herbs that are prepared by a unique process of distillation or cold maceration. There are a lot of supplements that can have a similar effect as prescription drugs without having dangerous side effects.

And then there’s…sudden death?

There is increasing suspicion that several drugs in four widely used classes of non-cardiovascular medications-fluoroquinolone and macrolide antibiotics, antipsychotics, and antidepressants- are pro-arrhythmic and thus increase the risk of sudden cardiac death.

Follow the “Top 6 Safety Tips for Stopping Your Meds” provided by Drugs.com:

• Talk to Your Doctor First.
• Discuss Your Medications With Your Doctor. 
• Stop for the Right Reason.
• Ask Your Doctor How to Best Stop Your Medication. 
• Learn Your Medicine Side Effects if You Quickly Stop. 
• Chart Your Discontinuation Plan.

How do I get off prescription drugs?

Opioids can cause low blood pressure, a slowed breathing rate and the potential for breathing to stop, or a coma. Overdose has a significant risk of death. Anti-anxiety medications and sedatives can cause memory problems, low blood pressure, and slowed breathing. Overdose can cause coma or death.

Symptoms of prescription drug abuse often include:

• Obtaining prescriptions from multiple doctors
• Changes in sleep or eating patterns
• Pretending to misplace prescriptions
• Sudden changes in mood
• Appearing high or sedated

Treatment options for prescription drug abuse vary, depending on the type of drug used and your needs. But counseling, or sometimes psychotherapy, is typically a key part of treatment. Treatment may also require withdrawal (detoxification), addiction medication, and recovery support.

Tom and Ann Find a Partial Answer

Finally, the couple turned to the American Association of Retired People (AARP), which has 35 million members over the age of 50. The AARP reported that some of its members cope by buying less food, sharing their drugs, using other people's leftover prescriptions, or, most often, going without their medications.

More than a third of the people surveyed for the association said they bought drugs from Canada. Older people can get cheaper drugs from discount plans from drug companies and elder associations, but few are aware of these plans.

Until America rethinks its prescription drug problem, prices will continue to rise and more people will need to choose between meals and staying alive.