Texans Don't Want Health Insurance

This article looks at the way Texans view healthcare. It surprised the author that many Texans who hand the means decided to remain uninsured. This study looked at why, and the importance or lack of importance of social class.

Sherry Ortner's definition of social classes in the USA:

While movement is theoretically possible between classes, being a particular social class influences the way one thinks and talks about themselves and others and how they act. The differences that stem from this result in the perpetuation of social class. In other words, there is a "sharing of culture" within social classes

• Lower Class- 
• working class
• do not own the means to production
• earn a living through some type of manual labor
• poorest
• often non-white, although the majority of poor are white
• strong element of racism plays into the PERCEPTION of the lower class
• Lower Middle Class-
• working class
• do not own the means to production
• earn a living through some type of manual labor
• Upper Middle Class-
• act as administrators and managers, and do not work in manual labor
• more wealth than lmc
• Upper Class-
• WASPs who have old money
• owners of the means to production

There is no middle class according to Ortner, it is an attractive cultural ideal without merit-- it is the way that most people "identify" and why we may think that America is a classless society.

• the denial of classes leads to the condemning of those whose personal failings are seen as their fault rather than the result of structural inequality.
• only nation not to produce health statistics by social class
• health policy neglects class disparities and instead focuses on race
• dog whistle politics and racism are said to undermine class solidarity and prevent more generous social welfare policies
• some argue that upper class owners of medical services and insurance companies were the real beneficiaries when the single payer system was cast aside in favor of a hybrid that worked within the existing system.

texas and ACA

• before ACA Texas boasted the highest level of uninsurdes and almost 25% or 7 million people.
• texans are knowm for their sense of Texan identity and their loyalty to the state.
• Second largest state with the second largest population.
• political rhetoric
• cost millions of jobs
• raised healthcare costs
• caused people to lose their insurance
• provides support to people that don't deserve it
• still by 2016- decrease in uninsured to 18% (still double the national average)
• coverage gap can be attributed to income levels.
• did not expand access
• coverage for middle and upper class went down 43% in cost. For poor and lower middle class only about 15%.
• coverage gap bu INCOME
• Anna (lower class)
• no knowledge of ACA or how to get it
• receiving stigmatized indigent care
• feeling that she is under surveillence
• no internet or computer so hearing mostly texas govt. rhetoric
• does not qualify for unexpanded medicare
• Beth (lower middle class)
• got insurance coverage through the market place that was subsidized by her husband's employer and the govt.
• was still not a supporter and felt stigmatized for getting Obamacare
• found it too difficult to figure out the marketplace when husband became self employed and Texas did not support a navigator system to help individuals
• Cate: Upper middle class
• tax penalties led to resentment
• chose before not to get healthcare insurance
• want to be free not to have it

Onus of care on WOMEN who took responsibility for finding insurance and caring for their families whether parents or spouse and children. All had forgone employment opportunities which could have offered them health insurance (employment based). 

Social Class and Differeneces in Health Coverage

• ability to gain coverage through ACA
• all concerned about "accidents" which made them feel vulnerable without coverage
• Anna
• felt marginalized
• never really part of the healthcare system
• had any untreated ailments and poor health
• uniformed about ACA
• cited STRUCTURAL BARRIERS that prevented her from getting health insurance
• Beth
• felt irresponsible for not having health insurance
• also felt guilty about obtaining healthcare through obamacare
• too complicated a process and cost too high
• Cate
• personal CHOICE to forgo insurance coverage
• Independence and self reliance as texan and neoliberal values
• Also not able to get employer based insurance
• felt capable of managing her own risk, believed stereotypes about the other uninsured but not herself

Complained but did not take action to change anything even though they felt that it should all be overhauled. LACKED THE CLASS CONSCIOUSNESS to join to take action because of the neoliberal perspective and stereotypes about race (dog whistling) and immigration.

All the same age from the same area but had differenr class-based experiences. 

People without health insurance are much more likely to suffer health issues and premature death

Uninsured in America: Before and After ACA

 Politics of Resentment: Texas Style

In states that have not expanded medicaid

• Many working poor applied for coverage on the exchange and were told that they were to well off to get subsidies, but too poor to afford to purchase coverage (without medicaid expansion)
• many don't use their insurance because the deductible was too high
• All were unhappy with their insurance coverage and resentful because of it
• Women's Health Services hit hardest
• Texas refused to expand female reproductive healthcare through medicaid even though the coverage by the federal government was 9 to 1.
• most people were unaware that the coverage gap was due to their states policy decisions
• government handouts were framed as a race issue
• immigrants were seen as coming across the border to work the system

Who does and does not deserve healthcare: Idaho

• did not expand medicaid.
• only available to pregnant women, children, parents of children under the age of 19, the disabled and the elderly who income qualified.
• Doctors selectively accepting patients
• take patients with better paying plans only
• restrict number of medicaid patients
• don't take medicaid or uninsured patients -at all
• major physician shortages persist in rural areas to this day- CRISIS
• May have to drive for hours to see a doctor
• Low income workers expressed anger for the poor who qualified for subsidies

Mississippi Disability

• holds last place in most measures of population health
• declined medicaid expansion- affected more than 280,000 residents
• chronic shortage of primary care providers, especially in rural areas
• of the 10 states with the largest black populations, only Maryland and Delaware expanded Medicaid!
• Mississippi, Arkansas, kentuckyt, maine, Alabama, west Virginia have the highest cluster of those receiving social security disability (due in part to lack of access to care and delayed or absent treatment for conditions which eventually become debilitating)
• this may be the only source of income they have and do not qualify for healthcare subsidies on disability
• POWRA: Welfare CAP of 5 years
• Disability rates have increased in direct proportion to the number of peoiple leaving welfare eligibility
• disability is highly stigmatized in US culture = moral virtue of work

States that have expanded medicaid

• Illinois
• many who remain uninsured are reluctant to accept government handouts for moral reasons
• Massachusetts
• no significant coverage gap in the state

When resentful, people are often confused and frustrated about the unequal patchwork of coverage and the complexity of application process

Segmented Risks: Eligibility and Resentment on Insurance Exchanges

 

Dog Whistle Politics- coded racial appeals that carefully manipulate hostility toward nonwhites

• Shaped/shapes peoples understanding of whether or not ACA healthcare is for them
• Frame "obamacare" as a policy to help minorities and people of color
• Frame "obamacare" as a failed policy meant to hurt whites and assist in "replacement" of the white race (replacement theory)
• imperceivable to some audiences (hence dog whistle)
• mobilizes white racial fears
• other reasons to reject ACA
• seen as just for rich people (those who fall through the cracks and cant afford the high deductibles or premiums)
• seen as only for poor people for those "temporarily on hard times"

STORIES OF NON-BELONGING- different meanings for different families (factors)

• racial politics
• decision by red states not to expand medicaid
• means tested actuarial coverage rather than universal coverage
• guarantee that experiences of coverage vary tremendously depending on one's personal circumstances

MEANS TESTING, ACTUARIAL CATEGORIES AND BELONGING

• 80% of the people were advised that the law was not for them
• if you like your coverage you dont need to change
• Price grid was very difficult to understand
• dependent on age, marital status, income and coverage sought
• Changes in eligibility status means moving in and out of programs when means are adjusted or income changes, even slightly
• disrupts continuity of service
• Stigma associated with receiving aid to premiums

Coverage Problems

• least expensive plans have the most restricted coverage. 
• It becomes hard to find doctors who will take your insurance
• plan also marks you as different from other people -again, stigma
• Got insurance as a way to "care for one another" (Wendy and Mike)
• ended up getting most care at hospital emergency rooms and referrals from insurance provider

Insurance for a flexible economy (Erica)

•     originally thought obamacare was for low income people, not people like her
• irregular jobs and working commission made it difficult to predict her income

The Coverage GAP and dog whistling

• Obamacare framed as a way to take power away from white people
• 1930s- excluding POC from social security was a way to appease sothern states as was the electoral college
• use the states rights argument to limit programs for the poor and minorities

Resentment in the Coverage Gap: Florida

• Kenny was not angry at the boss who fired him, or at the erosion of opportunities for men with a high school diploma,  but at Obama
• angry he could not afford a plan on the exchange, and had no good alternatives
• fell through the civeage gap without the expansion of medicaid

Letting Die

• extreme poverty is viewed as a way of killing
• refusal to expand medicaid is a way of killing the poor
• 7,000-17,000 avoidable deaths
• In addition to perpetuating racism, shortens the lives of people of color
• policies are commensurate with backlashes against, equal opportunity, women and LGBTQ+ rights and anyone else who appears privileged by entitlements
• value individual responsibility over social responsibility
• 
  

Implementation Along The Red/Blue Divide

 

Partisan political differences have led to geographic differences in implementation. 

Red- resisted or only partially implemented

Blue- enthusiastically and fully implemented

Increased role of both state and federal governments in providing healthcare access. 

• States must decide whether to expand medicaid, create insurance exchanges,  enforce insurance regulations.
• Federal creates and upholds new national insurance regulations, state and individual mandates, changes to medicaid which it mostly subsidizes for the states.

Positive Aspects of Expanding Medicaid

• improves health, especially for the most vulnerable
• poor have access issues that emergency care can't remedy
• brings federal dollars into state coffers

Ironies

• Red states allowed greater federal government control by defaulting to government exchange- healthcare.gov
• rejected reform that would have led to greater social and economic equity
•  Blue states embraced health reform even though they have far fewer uninsured

Stratification Through Medicaid: Public Prenatal Care in NYC

The Study of access to prenatal care illustrates how healthcare coverage remains unequal after the implementation of ACA. This articles explores how those with coverage through Medicaid received lesser coverage than those with private healthcare plans.

• Medicaid expansion accounted for over HALF of those who gained coverage under ACA
• Looks at the EXPERIENCE OF HEALTH CITIZENSHIP (rather than lack of coverage)
• Single payer system would have incorporated all citizens equally into the healthcare system instead of the patchwork of inequality we now experience.
• negative valuation given to public assistance- less deserving of healthcare
• NY- more than a third of its residents receive healthcare through Medicaid
• offers FREE healthcare to all pregnant women with up to 233% of FPL regardless of status
• created a ZONE ON INCLUSION
• despite this, the experience of these patients is far from equal
• long clinic wait times
• extensive medicaid required prenatal counseling

NYC Study

• long term system of public and municipal hospitals provide care to all NYC residents (pre medicaid)
• legally bound to accept everyone- supported the "medically indigent"

• hospitals and clinics, private teaching hospitals, charitable institutions
• NOT EQUAL- public hospitals served as safety nets for the poor and uninsured
• private hospitals could deny care because of lack of funds, type of illness or "moral failing"
• with the introduction of Medicaid, private hospitals also scrambled to attract medicaid patients but continue to deny access to those without coverage. Public hospitals remained financially strapped.
• Public hospital developed expertise in prenatal care because single mothers were often denied access to public hospitals on moral grounds.
• Bellevue Hospital
• oldest prenatal program in the country and oldest public hospital 1799
• 1911 created first midwife education program- free to immigrant woemn who could not afford nursing school
• 1989 PCAP was passed (Prenatal Care Assistance Program) which provided subsidies for hospitals providing prenatal care for women not covered by medicaid.
• NYC opted to include higher incomes, AND those without legal immigration status
• The stats on prenatal health disparities were recognized by NYC:
• rate of prenatal and maternal mortality correlate with 
• poverty
• minority status
• lack of access to prenatal care
• co-morbidities during pregnancy

 HEALTH INCLUSION VERSUS HEALTH EQUITY

• Moral Deservingness is understood as the flip side of one's rights (Sarah Willen)
• context dependent
• relational
• conditional upon presumed or actual characteristics of the individual
• medicaid recipients had trouble seeing the doctors they wanted without long waits
• " and having doctors treat them with respect
• Prenatal services become a site where pregnant women can receive care but also experience unequal "health citizenship"
• sometimes these judgements are overt -"Wily patient" is imultaneously stupid and is shrewdly working the system to her benefit.
• like the "welfare queen" - racialized
• tend to be voiced by low levl workers rather than providers (front line workers)- because they share the socioeconomic status of these women, comments served as boundaries between themselves  (the working poor) and those that are morally undeserving.
• Mechanisms of Health Inequity
• Waiting
• belief in the disposability of poor people's time
• disciplinary power of having to wait for services
• should wait for services that are free
• socializes the poor into their lower sytus within the community
• opaque reasons for delays
• assigned appointment without concerns for their preexisting schedules
• time becomes an important locus of conflict and acquiescence
• As charity cases they are expected to wait because they wont take their business elsewhere
• Causes:
• unintentional consequence
• huge volume of people served with understaffing and underfunding
• will see all patients even if they come in late (inclusion goal)
• Public Prenatal Care- discipline and nurturance (medicaid)
• Requires that women accept surveillance that comes with public assistance
• subject to social, state, and federal medical oversight
• lengthly pre-certifications
• HIV testing
• psychological screenings
• mandatory education programming
• seen as being a greater medical and social risk than women with private insurance
• Contribute to lengthy visits
• All is done in house because their fear women wont be compliant or will not be able to locate the services
• Rebuffing discipline and restrictions
• women would jump from clinic to clinic if they did not like their care
• women would show up at a private hospital in the advanced stages of labor to have their babies there
• shows they believe medical care is better at private hospitals

Attention to ideologies and practices around pregnancy and birth can shine a bright light on broader social tensions

Women's inclusion, whether equitable or not, is liminal (temporary) in that it only lasts 60 days after childbirth- women and children move in and out of "rights"

Ideology

• pregnancy is constructed as a state of emergency that requires temporary exemptions to the law, but when no longer pregnant, women lose their ability to make claims for healthcare except as emergency care or as mothers (producers) of citizen children
• Is it possible to change our attitudes toward entitlements when we have private health insurance that we must pay for? How would this all change with Universal Coverage?

Stratification and Universiality: Immigrants and barriers to coverage in Massechusetts

Massachusetts became the first state to implement universal healthcare coverage in a law called Chapter 58.

• 2006
• income eligible residents, regardless of their legal status, could gain subsidized health coverage
• used to craft the 2010 ACA
• But immigrants were still less likely to be covered through the policy
• undocumented status
• difficulty of enrollment
• inability to afford premiums and copays

CHAPTER 58: Impact on Immigrants

• Policy (brought coverage up to 97% when first implemented)
• individual mandate requiring all residents to acquire coverage
• Medicaid expansion to cover low income residents
• Insurance exchange where private companies could offer coverage to middle and higher income residents 
• Employer mandate: requires large companies to provide coverage for their employees
• State maintained its preexisting safety net system primarily funded by state hospitals
• HSN- provided primary care for those who remained uninsured
• 400% of federal poverty level
• offered at 160 specially designated healthcare facilities in Mass
• MassHealth (state medicaid) Had to have 5 years legal residency (LPR) or be legal US citizens and make up to 200% of poverty level
• Commonwealth Care- provided subsidies for middle income LPRs without 5 years residency who are intelligible for medicaid and have to purchase private insurance.
• Remaining challenges elaborated on in this article
• cost containment
• low income residents receiving less care
• 1 in 5 adults being denied care because Dr didn't take their insurance
• Ethno-racial minorities and those with poor health still remain underinsured, utilize healthcare less frequently, and are unable to afford coverage or out of pocket costs
• remaining uninsured
• unstable job status
• undocumented
• fluctuating income
• Impact of Recession
• HSN funds were reduced
• reduced coverage for 40,000 short term LPRs (commonwealth care) to a cheaper program that was only accepted at hospitals outside of Boston
• 2012- law suit reinstated the CC

Immigrant Barriers to Healthcare (illustrate immigrants marginality when writing and implementing healthcare policy)

• Immigration related barriers
• documentation status
• male immigrants were less likely to have coverage if they were always working (time)
• difficulty producing eligibility information for coverage (re)enrollment
• proof of income (no paystubs in the informal economy)
• state residency (share a space rather than have their name on a lease)
• citizenship status (undocumented or LPR non citizen, daca) - required for MassHealth
• Non-English proficiency
• could not understand forms for enrollment or re-enrollment processes
• Immigration enforcement
• many were afraid to seek coverage for fear of deportation
• May overcome fear and bureaucratic barriers only to find that the "in transit" aspect of healthcare risked deportation
• Some immigrants were unaware of Chapter 58 entirely
• Lack of knowledge about what services could be used with their coverage (most had HSN)
• the available of a social network for guidance may correct this
• Bureaucratic barriers
• "Bureaucratic disentanglement" -
• forms forms forms 
• rule changes
• lack of clear and accessible information
• Healthcare system barriers
• specialty care unavailable at HSN locations
• dont understand the referral system
• dont understand the difference between copays and deductibles or ER costs
• PREFER to go to the ER because no copays--- higher healthcare costs for everyone

Study Guide - Midterm Spring 20204

 Study Guide to Medical Anthropology Concepts

-Note that the midterm will cover medical anthropological precepts including definitions, methodology, cross-cultural aspects of health and illness, types of medicine systems, definitions and conceptions of health and illness, the relavance of inequality in health and illness.

-The exam will be a combination of short answer and multiple choice with one longer essay. You may bring your notes to class, but I would suggest you use notetaking as a study methods so you are not overwhelmed during the exam.

You should review all the following posts:

Illness Narratives -1/3

Susan Sontag: Illness as Metaphor 2/13

Infectious Inequality- Paul farmer 2/13

Mountains Upon Mountains 2/19

Healers and Healing professions 2/20

What's so alternative about alternative medicine 2/22

Body, Movement and medicine 2/22

Vital Forces and medicine (Humoral) 2/22

Spirit Medicine 2/22

Humeral Medicine example -Ayurveda (detailed) 3/4

Spirit Medicine Example - Hatha Yoga (detailed) 3/4

PLEASE NOTE ANY ETHNOGRAPHIC EXAMPLES WITHIN EACH BLOG POST.

In the order of coverage... important concepts (by chapter above):

• Definition of medical anthropology, its goals, history, and perspectives. Make sure that you know any key terms
• Methodology in medical anthropology
• Modern focus on APPLICATION of anthropological knowledge for the improvement of the quality of life for those who are studies

• What are the metaphors we use to understand illness in western culture?
• What does Sontag say about the "military metaphors" we use? Why do we apply them to some illnesses and not others?
• What are alternative metaphors used in other cultures?
• Why are  illnesses like TB, AIDS, leprosy, ebola and Cancer stigmatized?

• Who was Paul Farmer? Who is Arthur Kleinman?
• What did Paul Farmer mean by "infectious inequality"? "structural violence"?
• What are Kleinman's 10 questions? Why are they at the foundation of illness narratives? 
• What is the significance of poverty to illness? 
• Why does Farmer work in places like Haiti, Russian prisons? rural South America and Africa?
• What significant strategies for successful health did Partners in Heakth (PIH) devise to counter the arguments made by the WHO? Why is this significant?

• What are the different healers and healing professions cross culturally?
• How are these consistent with the social and political structure and cosmology (worldview) of the culture?
• Why can these healing traditions co-exist is some cultures?
• What are the possible relationships between practitioner and patient in each tradition?
• What is the difference between "healing" and "curing"?

• What is "alternative" medicine and how is it distinct from mainstream medicine? 
• Is it possible for alternative medicine to become part of mainstream medicine? How? 
• What is CAM (complimentary and alternative medicine"? How is it utilized in biomedicine (allopathy)?
• How do people choose betweem treatment options? What factors come into play?
• Is alternative medicine an industry? Explain.

• How is the body understood in different medical systems?
• How is movement seen as a vital aspect of healing in some traditions?
• What is the importance of the senses in healing?

• What is humoral medicine and what are vital forces?
• What is health based upon in humoral systems (balanace)?
• Know examples of humoral systems
• Know the history of humoral systems in the west and any remnants of these systems which exist in contemporary healing.

• What is the basis of "spirit medicine"
• How do social relations figure prominently in spirit medicine?
• What is the role of the supernatural and the natural in medical systems?
• What is energy medicine?
• What are examples of spirit and energy medicine
• what are the different types of spiritual entities?
• What are these important in understanding illness?

GENERAL:

• know ethnographic examples where possible
• know the relationship between the supposed causes of illness and their prescribed treatments
• Understand the purpose and perspective of medical anthropology and how it differs from biomedicine
• know the different concerns between a doctor an d a medical anthropologist.

Vital Energy Example: Tantra

 THE BODY AND THE NADIS

Nadis are pathways of pranic, mental and spiritual currents which form a matrix throughout the physical body. They provide energy through every cell, and organ through their vast network. Nadis are not physical or measurable but channels of energy which underly and sustain life and consciousness. Out of the 72,000 nadis, 72 are considered important. Out of these 72, 10 are considered to be major. Among the 10 major pranic flows, three are the most significant. (Situated in the spinal column which pass through every chakra.)

• Eda (Mental channel = female; Chandra = lunar/moon nadi) 
• Pingala (Vital channel = male; Surya = sun/solar nadi)
• Sushumna (Spiritual channel) 

The 7 lesser major nadis include:

• Gandhari 
• Hastijihva
• Yashaswini
• Pusha
• Alambusha
• Kuhu
• Shankhini

The three most important nadis are also referred to as the 3 most important rivers in India:

• Ganga (Eda) 
• Yamuna (Pingala)
• Saraswati (Sushumna) 

The junction where these three rivers join is called Prayag, located outside Allahabad in North India. In the pranic body, they converge at ajna chakra. 

• Eda governs the left side of the body and Pingala the right side of the body. 
• Eda and Pingala dominance is directly related to the flow of breath in the nostrils. 
• The specific functions of the brain are correlate with the activities of Eda and Pingala. The right hemisphere governs the left side of the body and the left hemisphere governs the right side of the body. Eda is connected to the right hemisphere and Eda to the left. 
• The right hemisphere (Eda) processes information in a diffuse and holistic manner. It controls spacial awareness and is sensitive to vibrations and the external senses. 
• The left hemisphere which relates to Pingala processes information in a sequential, linear and logical manner. It is responsible for analytical and mathematical ability. 
• The Eda controls manomaya and vijnanamaya koshas, whereas pingala controls anamaya and anandamaya koshas. In pranamayakosha, the Eda and Pingala forces reach out in both directions. 
• Sushumna, the neutral channel- when the two forces of Eda and Pingala are balanced, the third channel of Sushumna becomes active. When the sushumna is active, the breath flows through both nostrils simultaneously. 

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Humeral medicine example: Ayurveda

 

Ayurveda is a 5,000-year-old system of natural healing that has its origins in the Vedic culture of India. It is one of the seven sister sciences (along with yoga). Although suppressed during years of foreign occupation and British colonial rule, Ayurveda has been enjoying a major resurgence in both its native land and throughout the world. Tibetan medicine and Traditional Chinese Medicine both have their roots in Ayurveda. Early Greek medicine also embraced many concepts originally described in the classical ayurvedic medical texts dating back thousands of years.

More than a mere system of treating illness, Ayurveda is a science of life (Ayur = life,Veda =  science or knowledge). 

• It offers a body of wisdom designed to help people stay vital while realizing their full human potential. 
• Providing guidelines on ideal daily and seasonal routines, 
• diet, 
• behavior and 
• the proper use of our senses

Ayurveda reminds us that health is the balanced and dynamic integration between our environment, body, mind, and spirit. There is no standard therapy as in Western (allopathic) medicine, so that the only limitations are those of the physician.

Recognizing that human beings are part of nature, Ayurveda describes three fundamental energies that govern our inner and outer environments: movement, transformation, and structure. Known in Sanskrit as:

•  Vata (Wind), 
•  Pitta (Fire), and
•  Kapha (Earth)

these primary forces are responsible for the characteristics of our mind and body. Each of us has a unique proportion of these three forces that shapes our "constitution" (nature).

• If Vata is dominant in our system, we tend to be thin, light, enthusiastic, energetic, and changeable. 
• If Pitta predominates in our nature, we tend to be intense, intelligent, and goal-oriented and we have a strong appetite for life. 
• When Kapha prevails, we tend to be easy-going, methodical, and nurturing. 

Although each of us has all three forces, most people have one or two elements that predominate.

For each element, there is a balanced and imbalance expression. 

• When Vata is balanced, a person is lively and creative, but when there is too much movement in the system, a person tends to experience anxiety, insomnia, dry skin, constipation, and difficulty focusing. 
• When Pitta is functioning in a balanced manner, a person is warm, friendly, disciplined, a good leader, and a good speaker. When Pitta is out of balance, a person tends to be compulsive and irritable and may suffer from indigestion or an inflammatory condition.
•  When Kapha is balanced, a person is sweet, supportive, and stable but when Kapha is out of balance, a person may experience sluggishness, weight gain, and sinus congestion.

An important goal of Ayurveda is to identify a person’s ideal state of balance, determine where they are out of balance, and offer interventions using diet, herbs, aromatherapy, massage treatments, music, and meditation to reestablish balance.

Ayurveda: the science of health PP

Click here for power point presentation

TAKE YOUR DOSHA TEST HERE

DOCUMENTARY ON AYURVEDA: watch!

FOOD as medicine (Click here for video)

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Ayurvedic Cleanse (you could try this!)

Ayurveda (Sanskrit for “the science of the lifespan”) is a 5,000-year-old system of natural healing that has its origins in the Vedic culture of India. This Ayurvedic cleanse and diet will reset the body in balance!

Adapted from Melissa Weinberger DC, RN

Daily Cleansing Routine

*Starred points are to be followed only during the cleanse. All other points should be followed during the pre-cleanse, cleanse and post-cleanse

·         Begin each morning by drinking 6-8 oz of hot water

·         *Optional: drink ghee (see instructions below)

·         Abhyanga: Ayurvedic Massage

Before bathing, rub a thin layer of warmed or room temperature oil (unrefined sesame or coconut) over entire body. Use long strokes for your limbs and circular strokes for your joints. Ideally, let the oil sink in for 20 minutes before showering.

Since sesame and coconut oil are natural skin cleansers it is best to not wash the oil off with soap; the hot water will wash most of the oil off. Then pat dry with a towel. (1 teaspoon of baking soda in the wash will help to remove oil from towels)

·         Exercise before breakfast (if this is not possible you can exercise in the early evening)

·         *Breakfast – prepare porridge or kitchari (see recipe below)

·         Sip hot water throughout the day

·         *Kitchari for lunch and dinner

·         Supper should be the lightest meal of the day and preferably eaten before 6 pm

·         Drink only herbal tea and honey or water after supper

·         Try to avoid snacking between meals. If you feel hypoglycemic, try drinking 8 oz. of water first. If you still feel hungry, have a snack of veggies, berries or kitchari.

·         The purpose of the cleanse is to eliminate all processed foods from your diet and give your digestive tract a break.

·         However, make sure you are eating enough food that you aren’t starving. Once you feel starving, your body moves from a relaxed state to a stressed state.

·         Optional: 2 Triphala capsules before bed. This is an Ayurvedic blend of herbs that assist with detoxification and rejuvenation.

·         Take time for self-reflection. Emotions are stored in fat cells, so as fat cells are being metabolized emotions may surface that need to be processed.

Pre & Post-Cleanse Instructions

·         The pre- and post-cleanse will last three days

·         Eat a low-fat vegetarian diet of fruits, vegetables, beans, rice, salads, seeds and soup.

·         Eat as many steamed and raw vegetables as possible

·         Add seeds, lean chicken and egg whites for protein

·         Avoid nuts, unless they are prepared properly

·         1 grated raw beet with lemon juice per day is a good addition because it helps to thin the bile and emulsify fat

·         Do not add any sugar, oils, wheat or dairy to the diet

·         Salad dressings should be low in fat but preferably homemade

·         Try to eat three meals a day without snacking

·         Continue the daily routine of sipping hot water in the morning, followed by abhyanga, shower and exercise.

Meal Options for Main Cleanse

·         Kitchari Only (requires strong digestion and balanced blood sugar) – can eat 4 meals/a day if necessary with this option

·         Kitchari with steamed veggies (requires strong digestion and fairly balanced blood sugar)

·         Kitchari, steamed veggies, fruit and salad (Better for weaker digestion and fairly balanced blood sugar)

·         Kitchari, steamed veggies, fruit, salad and lean protein (best for weak digestion and blood sugar issues)

Morning Ghee Protocol & Castor Oil Protocol

**this is optional, depending on how intense you want your cleanse to be**

·         Upon waking (on an empty stomach) drink the prescribed amount of melted ghee (clarified butter). You can mix it with warm almond milk to make it more palatable.

·         Wait a half hour before drinking or eating anything else so ghee has time to collect toxins.

o   Day One: 2 tsp ghee

o   Day Two: 4 tsp ghee

o   Day Three: 6 tsp ghee

o   Day Four: 8 tsp ghee

§  Only increase the dosage if you are tolerating it

Laxative Therapy – do not skip this step

·         On the evening of day 4 take a warm bath followed by ingesting 4-6 teaspoons of castor oil OR 1 ½ cups of prune juice

o   Castor Oil Tip: cut an orange into slices. Put castor oil in ½ cup warm water. Mix the juice from one orange into castor oil and stir vigorously. Hold your nostrils, drink the mixture and immediately bite into a slice of orange. Rinse cup, release nostrils.

·         You should have a laxative effect from 1-15 hours. It is ok if you don’t have one.

Suggested Meal: Kitchari (Rice and Lentils)

Makes about ten ½ cup servings

Ingredients

·         1 cup organic White or Brown basmati rice (you can mix them)

·         1 cup organic Mung Dal (yellow lentils)

·         4 cups water

·         2 tablespoons organic ghee

·         2 tablespoons minced fresh ginger OR 1 tablespoon dry ginger

·         1 ½ tablespoons cumin powder

·         1 tablespoon Cumin seeds, fennel seeds, mustard seeds, coriander

·         1 teaspoon turmeric

·         Salt and pepper to taste

Optional Garnish

·         Chopped cilantro, Greek yogurt, Sour Cream or Ghee

Directions

Bring water to a boil in a large, heavy-bottomed saucepan. Put rice and dal in a fine mesh colander and rinse mixture under cool water until it runs clear. Pick over rice and dal to remove any stones. Add rice and dal to boiling water. Cover and lower heat to a simmer and cook about 30 minutes or until the water has been absorbed (add more water if you prefer a soupier consistency).

Sauté spices in ghee or butter in sauté pan until fragrant, then remove seeds. When rice is finished cooking, remove from heat. Pour ghee-spice mixture into rice and stir together thoroughly. Serve with chopped cilantro and a dollop of yogurt or sour cream.

Variations

·         Add roughly diced spinach, carrots, zucchini, green onion and bell peppers to the boiling water when you add the rice and dal. Add a few tablespoons of lemon juice when finished.

·         Use a low sodium chicken or vegetable broth instead of water

·         Add diced sweet potatoes and asparagus to boiling water when adding rice.

·         Add cubed, cooked chicken breast to rice when finished.

·         For a sweet version: add ½ cup low fat organic coconut milk, maple syrup to taste, and cinnamon and nutmeg to ghee. Omit the cumin and turmeric.