Since 1990, there’s been a steady trend for the nonprofit insurers to convert into for-profit. The industry argues this makes their members more efficient. In fact, it only makes them more efficient in extracting money from the insured. As if this is not bad enough, many of America’s top insurers also sell insurance in foreign countries. This is one of the byproducts of globalization. It seems the efficiency of insurers can be felt all round the world as they pursue profit wherever it can be found. Well, this makes 2011 a year for us all to remember. We had earthquakes in New Zealand and Japan where the damage was made rather worse by the arrival of a tsunami. Back home, we had a terrible winter with major storms. Then came the tornado season and hurricanes brought flooding to Virginia and other unexpected places. This combination of extraordinary seismic activity and record-breaking bad weather has produced a disaster in company profits. Insurance companies are in shock as the volume of claims becomes apparent. In America alone, the insurers will be paying out more than in any other year since records began The losses are almost $18 billion in the first six months of 2011 as against $13.5 billion for all of 2010. It’s going to be a challenge for them to recover from the estimated loss of $32 billion for the full year.

Looking at the geography of America, some companies are less exposed because either they are based in states experiencing fewer disasters or they have fewer insured in states where the losses have been highest. All insurers have therefore been taking determined steps to reduce their exposure to risk. They have begun by reviewing the terms of their policies to impose more limitations and exclusions. They are also refusing cover for flooding and water damage where the volume of claims has risen faster. Deductibles are rising, and then come the premium rates. According to the Insurance Information Institute, the average rate annual premium for homeowners is about $850. This will almost certainly rise in 2012. This may not sound fair but, with insurers operating in many different states (and selling insurance to foreign countries), the risk of losses is spread out with premiums rising for everyone.

Once the majority of insurers changed their status, they focussed on the need for profit. This means reducing the amount paid out and maximizing the amount paid as salaries and benefits to the employees. Stockholders take the rest. Since the majority of insurers act in this way, how can you protect yourself? First, you must look very carefully at the small print. Remember cheap home insurance is cheap for a reason, i.e. it offers only limited cover. Second, once you have found a good value policy, don’t make small claims. Even if you have lost more than the deductible, be warned. Insurers are canceling policyholders who make more than two claims in a relatively short period of time. Keep the policy for a major loss. Remember your claims history is shared among all insurers so, if you do claim, hope to avoid a nonrenewal notice in the mail. You might find it difficult to find a replacement home insurance policy.

Let’s start off with a few simple propositions. Pain is just an extension of touch. We feel some levels of pressure represent pleasure or are merely acceptable. If the pressure becomes uncomfortable, we are immediately alerted. If the discomfort turns into pain, we are motivated to take action. So the gradations of touch into pain are a necessary part of the bodily process allowing us to avoid injury in our dangerous modern environment. Sadly, we do not have the means to switch off pain selectively. We continue to feel some pain unless the drugs literally induce unconsciousness. This is reality. There’s no sense in trying to deceive ourselves. So the big question is how we organize our lives to live a satisfying life with continuing pain?

This is not what you want to hear. The marketers who aim to sell you the range of drugs produced by the pharmaceutical industry have been brainwashing you for decades. They want you to believe there’s a pill to cure all your ills. Except that has always been a lie. Although some drugs are very effective for a time, all drugs slowly lose their effectiveness as the body adapts to them. This leaves you with the choice of giving up the drugs or increasing the dosage and risking dependence. In fact, we have millions of people addicted to prescription drugs. The majority could not stop without experiencing unpleasant withdrawal symptoms.

Long ago, the Europeans decided this was unacceptable so they have been working to change mindsets. People have to understand they cannot rely on drugs to solve their long-term health problems. They must become more self-sufficient. This is what pain management really means. Specialists have to teach people how to live without becoming dependent on drugs. It all starts with a thorough re-evaluation of the medical treatment to date. Fresh pairs of eyes look back through the records of surgical procedures and other therapies. If anything has been missed, they are now done. If anything may have been done wrongly, attempts are made to correct any adverse consequences. The idea is to ensure everything that can be done to treat the underlying cause of the pain has been done.

Now we come to the pain itself. This is recognized as a medical problem in its own right. There are specialist physicians and highly trained therapists grouped together in dedicated units. Their job is to evaluate each patient and devise a personal regime for maximizing the quality of life. It starts with occupational therapists who visit homes and workplaces, suggesting how living spaces can be designed to reduce problems, and looking to see if jobs can be redefined to reduce the causes of pain. Then come the physical therapists to introduce exercises and activity programs to rebuild strength and improve mobility. Finally, the cognitive behavioral therapists teach practical strategies for staying positive when life seems difficult. All the evidence shows this team approach is very effective. Making the patient the center of attention improves morale and fights off the threat of depression. This is not to deny the importance of a drug like Ultram. There can be a flare-up of pain and, as a short-term response, a painkiller can be essential. But, as soon as possible, the Ultram must go back into the cabinet. Life must go on without drugs.