Positive effects of health care reform in California

When it comes to California, the federal overhaul would help those who can afford health insurance but are currently unable to get it. It will assist those who aren’t able to obtain coverage by providing them with a means to acquire health care benefits. Additionally, the bill will also go a long way in tackling the desire to provide Californians with the preventative means to uncover unhealthy conditions in the early stages, where they can be addressed promptly, and thus help everyone get more affordable California health insurance. There is a downside of this bill, however; read below to learn what it is.

Potential negative effects of health care reform

Instituting health care reform means that the federal government may need to finance the reform by lowering Medicaid reimbursements. Considering that the reimbursement rates are already thought to be low, health care providers may turn away people who have Medicaid. This means that although a person has coverage, they may not be able to gain access to care.

If the reform taps into federal monies that are currently used for the care of the uninsured at the local level, and diminishes the funding, there’s a chance that the individual safety-net systems at the county level would be financially burdened as they attempt to continue to provide care for the uninsured.

As Californians ponder the good or bad of this reform, it’s important that they look at where and how current care if provided, and that these programs remain financially sound in order to not defeat the intended purposes of the reform.

photo credit: pheezy

Is Your Teen Equipped for Health care?

Adolescence is a unique time in the human life span. Between the ages of 10 and 19, biological changes occur at a greater rate than at any other time barring prenatal development and infancy.

Teenagers aren’t just slightly bigger children – and once the childhood stage of preschool vaccinations, childhood checkups, and summer camp physicals is over, they’re much less likely to get regular preventative medical care.

In fact, a new report suggests that many teens are slipping through cracks in the health care system simply by virtue of their age, and the existence of an “in-between” stage in the health care system that means teenagers aren’t being provided for.

For most teens, adolescence is a time of not only change, but also of boundary-pushing and risk-taking that can involve anything from smoking cigarettes, to experimenting with drugs, underage drinking, reckless driving, sexually transmitted diseases, or teenage pregnancy.

Just as important, habits that are formed during these teenage years are very often the habits that persist throughout adulthood. That tends to be true whether it’s work ethic, social behavior, or health-related habits.

Health Care and Insurance System Not Set Up for Teenagers

The saying may seem a trite cliché, but children really are the future, and it’s not just insured children who are missing out on health care. When it comes to teenagers and adolescence, the health care system just isn’t designed to provide what they need. To make a bad situation worse, there are fewer doctors specializing in adolescent medicine than in most other specializations. Fewer than five hundred doctors registered as adolescence specialists between 1996 and 2005 – and some states have no registered specialists at all. To seal the deal, teens usually aren’t particularly enthusiastic about visiting doctors, often worrying that any information they supply during a checkup won’t remain confidential.

The result is that while the nation’s five million uninsured teens are most at risk, it’s during adolescence that people in general tend to begin making fewer health care-related visits, a trend which peaks during the 20s. Half of adult deaths are the result of unhealthy habits, and it’s during adolescence that such habits are typically formed.

What’s the solution? In the long-term, it’s difficult to say. There may be little incentive for medical professionals to specialize in adolescence medicine, and it may very well be a field few have an interest in. The answer to the problem may simply lie at home, with parents taking care to reassure their teens and help them find a doctor they can trust and feel comfortable with, at an age when these factors are particularly important.

Even for the insured, the cost of copays and other out-of-pocket expenses add up quickly, whether you’re single or have a family. If you’re feeling the pinch, you’re not alone – according to a recent Kaiser Family Foundation poll, 53% of respondents said they had cut back on their health care to try and save money.

Many respondents reported an increased use of over-the-counter medications or home remedies, rather than scheduling a visit to their doctor. Others said they didn’t fill prescriptions to save money; some even skipped treatment or tests that their doctor recommended.

Ignoring your doctor’s instructions could prove risky if you have a serious medical condition. But no matter health status, you can cut down on some of the costs of healthcare without having to neglect your health. What can you do?

• When you visit a doctor, make sure you’re prepared. Take along all the information the doctor might need, including paperwork and medical records if necessary. Take note of whether your health has changed recently, including energy or weight fluctuations. If you have any questions you want to ask, make a note so you don’t forget them. Being prepared for a doctor’s visit cuts down on the need for repeat visits, and helps save on copays.
• Get your test results over the phone. Most of the time you won’t need to return to your doctor to get test results, so there’s no reason to spend money on the copayment when it’s not necessary.
• Consider setting up a flexible spending account when open enrollment comes around. Flexible spending accounts let you put pre-tax dollars aside to fund certain types of medical expenses.
• Call an organization such as the Patient Advocate Foundation (800- 532-5274) if you have a chronic disease and want some help with getting the most out of your insurance plan.
• If you’re uninsured, then consider visiting a store clinic. In some locations, retailers such as Target and Wal-Mart now run clinics where you can receive routine medical care for about half the price of a doctor’s visit.
• Try and track down locations where you can receive free medical screening. Organizations such as the American Cancer Society and the Centers for Disease Control and Prevention can help you locate such programs.
• Request a quote for affordable health insurance here. Our system is able to connect you with leading health insurance carriers from across the country, and it could save you a lot of money on premiums or health care costs.

photo credit: effekt!

How many prescription medications are you taking? How many over-the-counter herbal medications or other nutritional supplements? The alarming results of a new study on the combinations of medications taken by American seniors indicate that it’s best to be cautious about taking certain prescription and over-the-counter medications in tandem.

According to the report—which reviewed the medications taken by 3,000 men and women aged between 57 and 85—at least two million older Americans might be taking a potentially dangerous combination of prescription or over-the-counter medications. And up to one in ten older men might be taking a combination of drugs which could be potentially harmful.

Another factor affecting seniors is the fact that older people tend to take more medications overall, including both prescription and over-the-counter preparations. In the 57 to 85 age group, 91% of people take at least one medication, and more than half use five or more medications, including prescription and over-the-counter drugs.

The consequences of drug combinations aren’t always dangerous, but for older people, the side effects and interactions of drugs and over-the-counter medications are often more hazardous, due to the way metabolism changes as we age.

An example of a potentially serious drug interaction is that between warfarin, which is used to dissolve blood clots, and aspirin, which has a similar blood-thinning effect. The risk of internal bleeding can become dangerously high when both drugs are taken together. The combination of warfarin and garlic can also have a similar effect.

Other potentially dangerous combinations include:

• Aspirin and gingko biloba, taken together, can increase the risk of excessive bleeding.
• Taking Lisinopril (prescribed for blood pressure), along with potassium supplements (which may be prescribed because some blood pressure drugs reduce potassium levels), can cause abnormal heart rhythms.
• Over-the-counter niacin supplements can be dangerous when taken with statins (prescribed for managing cholesterol levels), due to an increased potential for muscle damage.

Experts say it’s best to be cautious when it comes to over-the-counter medications – don’t take them without the ok from your doctor, and make sure you ask about side effects and drug interactions every time your doctor prescribes a new medication.

photo credit: Nils Geylen

When a doctor explains treatment options to a patient, it’s often little understood; frequently glossed over; and delivered in over-technical terms. A new movement in health care is makings strides to change the status quo, and with it the decisions of a whole new group of patients.

Case Examples of Informed Consent Opportunities

Currently, the most effective early warning signal for prostate cancer is an elevated level of prostate-specific antigen in the blood. But that test is nowhere near perfect – many men with prostate cancer test negative for PSA, and men who are overweight and have developed prostate cancer often have reduced PSA levels. Up to 25% of men with prostate cancer test negative for elevated PSA.

The medical world is full of situations like these, where tests and diagnoses are not as clear-cut as patients might think. If you knew that some blood tests were unreliable, would you still choose to take them? What about when the situation is more serious than a simple blood test – what if you had to choose between several rounds of chemotherapy, or the removal of one or both breasts, as a treatment for breast cancer?

The Solution to Improving Patient Decision-making

The fact is, with medical science becoming increasingly sophisticated and more highly technical, it’s harder for patients to keep up. What’s the solution? A growing movement of doctors is pushing for a solution that has become known as informed consent 2.0. The idea is to promote more extensive patient education in the form of decision aids – guidelines written in plain English, rather than overly technical medical language, to help patients fully understand the positives and negatives of their options for medical treatment.

The goal, say the doctors, is for patients to view these guides before they visit their doctor, so that during the appointment more time can be spent on patient decisions rather than explaining their options. At New Hampshire’s Dartmouth-Hitchcock Medical Center, for example, every woman who is diagnosed with early-stage breast cancer views a video decision aid before ever seeing a surgeon. The video includes information about treatment options – tumor removal followed by chemotherapy or full – breast removal and explains that both options produce almost equal survivability results.

Programs such as these are even more important in light of the results of a recent study from the University of Michigan which suggests that many patients making common medical decisions over medication and other treatments are not well informed. Many patients, for example, said their doctors rarely discussed the disadvantages of various treatment options.

photo credit: Lisa Brewster

Trees are good for your health – they suck up carbon dioxide and release oxygen, help reduce greenhouse gases and provide welcoming shade during the summer. But those aren’t the trees that have recently been in the news for helping to improve the health of many Americans. This time it’s family trees that are up for discussion – and electronic ones, at that.

Importance of Knowing Your Health History

The importance of knowing your family medical history can’t be emphasized strongly enough, according to Acting Surgeon General Steven Galson, whose office has been in charge of a new initiative to promote the use of a website where users can grow an electronic family tree to find out where their health risks lie.

The government’s new free service is hoping that people will compile their own family tree at home, and share the information with their families. Compiling an extensive and accurate family tree is even more useful than genetic testing to predict what your medical requirements might be in the future, experts say. It’s a highly useful tool for doctors, too, since it saves time and also provides lots of useful information about potential health risks. You can even use it as you’re applying, or looking into various family health insurance plans.

Significant Benefits of an Online Family Health Tree

The most significant benefit, perhaps, is that it’s likely to be more accurate than anything you remember off-the-cuff in a doctor’s waiting room. And by sharing the information with relatives from both sides of the family, it’s easier to compile an accurate family health tree that includes all the information that’s important.

The family health tree site at https://familyhistory.hhs.gov makes it easy to compile this information. The electronic tree you create can be easily mailed to relatives, who can add their own information into the tree. The information is entirely private, too. Information is downloaded to the user’s own computer, rather than being held on the web site.

Even more useful is the fact that a single click can “re-index” the tree to concentrate on showing the health risks of any relative on the tree – so it’s useful for everyone, not just the person who creates it.

Another benefit is the fact that environmental and lifestyle factors can be added to the tree – factors that are often forgotten during doctor’s visits. The family tree can be printed out or even emailed directly to your doctor, ensuring that none of that valuable information is lost.

photo credit: Wolfiewolf

The Healthy People program recommends that adults get 30 minutes of moderate exercise (such as walking) five times a week, or at least 75 minutes of vigorous exercise (such as running) every week. It seems, however, that the majority of people still aren’t meeting these goals.

The U.S. Centers for Disease Control and Prevention recently released its figures for the most and least fit metropolitan centers in America, and the results indicate that many people aren’t getting as much exercise as recommended by the Healthy People 2010 initiative.

America’s Most Fit Cities

So where are the fittest cities in America, according to the CDC?

The Top Ten Healthy Cities Are

1. Boulder, CO
2. Provo-Oren, Utah
3. Anchorage
4. Barnstable Town, Mass.
5. Lincoln, Nebraska
6. Portland, Maine
7. Fort Collins, Colorado
8. Grand Rapids, Mich.
9. Albuquerque, N.M.
10. Casper, Wyoming

In all ten cities, between 57% (Casper) and 67% (Boulder) of the population are exercising regularly, meeting the goals of the Healthy People initiative’s 150 minutes of moderate exercise per week. In addition, between 31% (Casper) and 43% (Boulder) are getting regular vigorous exercise.

America’s Least Fit Cities

And the Least Fit Cities?

1. Chattanooga, TN.
2. New Orleans, Louisiana
3. Baton Rouge, LA.
4. Lake Charles, LA.
5. Hickory, N.C.
6. Birmingham, Alabama.
7. Mobile, Ala.
8. Tuscaloosa, Ala.
9. Jackson, Miss.
10. Fort Smith, Ark.

In the “bottom ten” cities, the CDC reports, between 40% (Memphis) and 37% (Chattanooga) are getting regular moderate exercise. And in every city, less than 25% of the population is getting regular vigorous exercise.

Want to make a difference to your health in 2009? Stop dieting – studies show it doesn’t work in the long run, and yo-yoing weight can even be harmful to your health. Instead, decide to make healthier food choices more often than you currently do. Over time, increase your percentage of healthy food choices until you’re at a point where you’re getting a good balance of calories and nutrition. These types of goals are much more sustainable than restrictive diets, and are much more likely to stick in the long term.

When it comes to exercise, choose something you really enjoy doing, rather than what the latest magazine workout program tells you to do. If you exercise in a way that’s fun, you’ll be far more likely to keep up with it throughout the year.

photo credit: Ed Yourdon

The medical breakthroughs that get reported in the media rarely end up being the miracle cures they’re often portrayed as. In 2008, however, there were several important advanced made in medical science that could have a significant impact on public health in years to come.

1. The question of whether organic food is good for you has finally been answered: A review of studies on nutrient content of organic fruits, vegetables, and grains has confirmed that these have up to 25% more nutrients than conventionally-grown produce.
2. Another long-held myth—about the efficacy of antibiotics for sinus infections—was also dispelled in 2008. Over the course of nine studies involving 2,500 participants, it was found that antibiotics didn’t significantly hasten recovery. According to allergist Neil L. Kao, MD, taking a decongestant or mucus thinner, along with a painkiller as needed, is just as beneficial.
3. If weight loss is your resolution for 2009, look into adding resistant starch—found in beans, green bananas, and potatoes—to your diet. This type of starch is digested very slowly, helping to suppress your appetite, and can help stabilize blood sugar levels, too.
4. Women take note: a new risk calculator, known as FRAX, has been developed to help doctors determine whether women are at risk of osteoporosis, and whether preventative treatment may be necessary.
5. If you receive a diagnosis of diabetes, it’s important to know the results of three major studies that were completed in 2008. All three reinforce the importance of taking control of blood sugar levels as soon as possible, and managing blood pressure, cholesterol, and triglyceride levels as well.
6. Also from the field of diabetes research comes the news that body fat percentage may be a more reliable indicator of risk than body mass index. Mayo Clinic researchers studied 1,101 women with a BMI of less than 25 (considered a healthy BMI), and found that those with higher than 30% body fat were at higher risk of metabolic syndrome and diabetes.
7. Unfortunately for people with arthritis in one or both knees, a result study showed that arthroscopic surgery doesn’t provide any real benefit in most cases. If you’re affected by this condition, the study concluded, you’re better off with physical therapy and medication for pain management.
8. Another potentially major breakthrough is in the field of multiple sclerosis treatment, where current medication can prevent relapse of major symptoms in around 30% of people with the disease. A new drug, called fingolimod, has so far been able to prevent relapses in more than two thirds of patients, for three years, according to results of clinical trials.

photo credit: a.drian

For various reasons, the Western world has become increasingly reliant on medication to preserve health. It’s not uncommon for people to receive more and more prescriptions as they age: a full twenty percent of people over 65 take ten or more prescription medications regularly. So what’s the problem – those pills are helping you stay healthy, aren’t they?

The problem is, that’s not necessarily true.

An Avalanche of Prescriptions

Health care coverage for chronic diseases tends to shunt people off to multiple doctors – according to statistics from the Agency for Healthcare Research and Quality, 81% of people with a chronic condition see two or more doctors – more than half have three or more, and around a third have four or more.

And if you see a specialist, they don’t necessarily know what your previous doctors have prescribed. Your primary care physician is supposed to oversee your medical care, but they tend not to question specialist decisions – and over the last decade or two, prescribing medication has become the standard way of treating almost any ailment, regardless of whether there are other solutions. With insurance companies preferring to pay up for medication rather than any other option, it’s no wonder that over-prescribing is rampant.

The Snowball Effect: Over-use of Prescriptions

So what are the consequences of taking ten or more prescription medications every week, or every day?

One of the most dangerous effects is the possibility that a toxic drug reaction may result from a certain combination of medications – an increasingly likely prospect for someone who has two, three, or four doctors, any one of whom may not necessarily know what the other three are doing. Those reactions can lead to the development of new symptoms – caused by the drugs – for which your doctor may even prescribe yet more medication.

This is an especially potent problem for seniors: as we age, we begin to absorb and metabolize drugs differently. A dose which might be safe for a young person might very well be toxic in someone thirty years older.

When you add these two issues together, the results can be dangerous. An estimated 1.5 million adverse drug reactions occur in the U.S. every year; around a third occur in seniors.

So what’s the solution here? It’s pretty simple: take control of your health. Talk to your doctor, and ask them about any lifestyle or other changes you can make that might alleviate your need for prescription medications.  In many cases, lifestyle changes might allow you to throw away some medications for good.

photo credit: kimberlyfaye

Many of us rarely ponder what our health and life are worth. It’s often assumed that life is priceless, but that doesn’t do justice to the stratospherically rising health care and insurance costs; in fact health bills are now the leading cause of bankruptcy.

One common way to calculate the value of our life is to use the same equation used by many health care providers. That cost was once $50,000 per year of quality life, according to the international standard for government-run health insurance plans across the globe. This number has been disputed by economists at Stanford and they were able to calculate that a year of quality life is actually $129,000! That is a lot of money for a year of life, but of course: life is priceless!

Calculating Costs with Kidney Dialysis

As a benchmark, economists at Stanford decided to use kidney dialysis for their research. One reason they chose dialysis is because hundreds of thousands of Americans in the United States are kept alive each year through dialysis while waiting for an organ transplant. The other reason is that Medicare has covered this procedure since 1972 without regard for costly innovations in the procedure.

“Assigning a dollar figure to Medicare patients’ lives may sound crass, but such valuations are routine in Americans’ daily lives.” As an economist, you must focus on the supply and demand of the market. In this case, the patients waiting for an organ transplant have a high demand for organs and unfortunately, a low supply of organs. Therefore, kidney dialysis is a temporary, but costly solution to this law of supply and demand.

How Economics Values Your Health and Life

Modern medicine has changed the way we look at life. We are continually trying to look younger, live longer and stay healthy. The only problem is that it is expensive to keep some patients alive especially for those waiting for a kidney. Hypothetically, Medicare coverage no longer can afford to pay $129,000 for hundreds of thousands of Americans each year based on new research done by economists at Stanford.

Some people waiting for an organ would not be able to afford to pay $129,000 a year to stay alive and would say farewell to their family. The miracle of life lies in our ability to receive the health and care that we deserve, when we need it most – all while staying alive, at least until an organ is ready.