President-elect Barack Obama should take note – health reform is about the little things just as much as it is sweeping changes to the system.

Information gathered from a batch of more than 8,500 meetings held around the country in December will be compiled and used to help design the healthcare proposal that has been in the news as of late. Obama’s transition team plans to post some of the material at change.gov.

One particular meeting took place late December 2008, between newly appointed secretary of health and human services, the former Senate Majority Leader Tom Daschle, and more than two dozen seniors During this meeting, seniors told Daschle that they placed more importance on certain things such as waiting times to see their doctor, the increasing cost of prescription drugs, and the narrow range of Medicare coverage for certain medical procedures, equipment, and treatments.

An Example for Health Care Reform: Alzheimer’s

One woman at the meeting cited her family’s history of Alzheimer’s disease for her hope that the new administration will put heavy emphasis on medical research. A man said that helping people live healthier lives should receive more emphasis than it currently does – not only to improve health, but also to reduce medical costs for individuals and the nation as a whole. Another man says he wants medical providers to show more concern for the people they treat than whether or not those people will pay their medical bills.

Daschle says that lawmakers are more likely to get behind a new health care system if voters provide enough incentive pressure. And it seems that the transition team is listening: The Obama administration is encouraging seniors to submit their own stories about health care – and any other issues they think need to be addressed.

The team should also take one final note: The current effort to gather information about the health care system has been compared to the 2005-2006 attempt by the Citizens Health Care Working Group. More than 6,500 people participated in meetings across America, and a further 14,000 participated in online surveys. The Congress-sponsored group eventually recommended guaranteed health coverage for certain doctor’s visits, and some ways to protect people from high health care costs – but none of its recommendations were acted upon.

Let’s hope that this new round of meetings prompts some real change.

photo credit: woodleywonderworks

The $787 billion economic stimulus package that was signed into law last week includes one or two health-related measures that haven’t been widely publicized, but which are no less important for it.

One of these is the $1.1 billion that has been assigned for a study to compare the effectiveness of a large number of medical treatments, drugs, surgeries, and other current standard medical procedures and devices. A council of fifteen federal employees will be set up to coordinate the research and advise the President and Congress on where the money would best be spent.

The program is a response to growing concerns that doctors have little solid evidence on which to base the value of many of the treatments that are currently considered standard.

Questions to Answer with the Stimulus Package Health Care Money

According to Dr. Elliott S. Fisher of Dartmouth Medical School, the study will help answer questions such as these:

• Should severe neck pain be treated with physical therapy, medication, and exercise, or with surgery?
• What is the best combination of prescription medication and therapy for the treatment of depression?
• Is it more effective to treat arterial blockage in the legs with medication or with surgery?
• Is medication alone an effective treatment for chronic heart failure, or are active health intervention measures also necessary?

Second Concern: Rapidly Increasing Health Care Costs

A second concern is the rapidly increasing cost of health care. Healthcare spending hit a total of $2.2 trillion in 2007. That’s 16% of gross domestic product – and it’s been estimated that figure will hit 25% by 2025. It is hoped that the research will save money by discouraging the use of expensive treatments that are largely ineffective and, at the same time, boosting the use of more effective treatments. During her years as a senator, Hilary Rodham Clinton was a firm proponent of such research and President Obama endorsed the concept during his White House campaign.

Not everyone is supportive of the idea of spending millions of taxpayer dollars on health care comparison studies. Critics say it may allow the federal government to be too intrusive when it comes to personal health care choices, and may jeopardize the doctor-patient relationship by put the government squarely between patients and health care professions. Others worry that insurance companies will use the data gained from the study as an excuse to deny coverage of more costly medical treatments.

photo credit: Emily Taliaferro Prince

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 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

Nearly two million Americans have lost their jobs over the last year: around 500,000 in the last couple of months alone. That’s a staggering number of people who have lost their livelihood, perhaps their sole source of income.

Among their worries is the question of what’s going to happen to the healthcare their employers provided. Families with young children, in particular, may find the doctor’s bills piling up, with no healthcare insurance to cover them.

According to the Kaiser Family Foundation, every 1% increase in the unemployment figure translates into another 1.1 million people who don’t have healthcare insurance. The national unemployment rate was at 6.7% in November 2008 – an additional 7 million people without that crucial insurance.

If you don’t have employer-provided healthcare, it’s likely you’re going to have to pay a significant amount of money for an individual plan – but the alternative, of having no coverage at all, is surely worse in the long run. If you’re in this position, what can you do about accessing affordable healthcare?

What are Your Healthcare Options?

• Under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) you’re entitled to have your employer healthcare benefits extended for 18 months after your job ends. However, your employer won’t be paying their share of the premium – so you’ll be looking at a significant increase in your premium costs.

To be eligible under COBRA, you must have been working at a company employing at least 20 people (some states extend eligibility to smaller companies), and have been enrolled in an employer-sponsored health plan when you were laid off.

• If you’re not eligible for COBRA, in most cases your only alternative is an individual health plan. Your costs for this will depend on your age, health, and location. If you’re older or have a pre-existing condition, you can expect to pay a hefty price for your insurance.

You may also find that you have fewer options than you did when you were eligible for employer healthcare, so it’s important to carefully review potential plans and check out whether things like prescriptions are covered.

• Government assistance may provide for your children, at least. In most states the Medicaid eligibility level for children is twice the poverty level (equating to around $42,000 for a family of four). However, it’s much stricter for adults – even an unemployment benefit may disqualify you.

• Some states also provide limited government assistance – this varies from state to state. In Florida, for example, the Medically Needy program provides help for participants after they’ve paid a certain amount in medical bills each month.

• For senior citizens and the disabled, Medicare may be an option.

photo credit: Mike Licht, NotionsCapital.com

AARP (formerly the American Association of Retired Persons, but now known more commonly by its acronym) is a non-profit, non-government interest group which, according to its web site mission statement, is “dedicated to enhancing quality of life for all as we age,” by providing “a wide range of unique benefits, special products, and services for our members.” AARP acts as a member advocate, and is a powerful lobbying group. It also sells insurance, investment products, and endorses certain insurance companies.

Sounds good, yes? But by virtue of its habit of endorsing insurance companies, AARP has recently come under fire. The Kaiser Family Network recently revealed that AARP’s endorsements don’t come cheaply – 43% of the revenue the supposedly non-profit, independent advocacy group collected in 2007 came from royalties and fees the organization took from insurance companies – as payment for endorsements.

Doesn’t sound too much like consumer advocacy, does it.

AARP Endorsements Equal Higher Insurance Costs for Consumers

AARP advertising claims that by choosing AARP-endorsed insurance, AARP members will save money. But as it turns out, those AARP-endorsed insurers often charge higher premiums. And the reason for the higher price is at least in part because the insurers add the cost of AARP’s fees and royalties to the price that consumers pay.

Under AARP insurance plans, the organization collects the premiums from AARP members, and pays the insurance companies. And the insurance companies then return a portion of that fee to AARP, in the form of those royalties and fees. So AARP is telling people to purchase insurance from certain companies, and this supposedly ‘independent’ organization is taking a cut of the premiums. In 2007, this earned AARP a cool $500 million.

There’s more, of course. When AARP receives payments from its members, it holds that money in its own accounts for up to a month before paying the insurers. And that month is enough investment time for the company to have earned a further $40 million in interest from its own members.

Now obviously, that’s not illegal. But it’s clear that there’s a conflict of interest here. And this has been noted in the past, too, with BusinessWeek saying that many of the insurance and finance products endorsed and sold by AARP are actually no better than products that seniors could get on their own or through the government – and in some cases may even be worse.

Taking Consumer Driven Health Care into Your Own Hands

In the past few years, consumer driven health care has taken over many of the older and well-established methods of health insurance, and although it’s common to save hundreds – or even thousands of dollars -  simply by choosing a private health insurance plan, it’s not always the best choice, especially for seniors, who are often already given a wide range of benefits from the government.

The controversy with AARP shows that endorsements of health plans may not be truly “independent.” This highlights the need for you – the consumer – to take the important research into your own hands so you can decide on the best plan for both you and your family.

photo credit: Publicly Scalped

Prescription medications are expensive, and many doctors seem to become “prescription-happy.” These doctors’ first response to a patient complaint is usually to prescribe something new if something doesn’t work the first time. Even if you’re just taking one or two medications, you could be paying more than you need if you are taking brand name drugs, instead of generics.

According to a recent study, led by Dr. Aaron Kesselheim of Brigham and Women’s Hospital and Harvard Medical School in Boston, this is particularly true when it comes to medications prescribed for the treatment of heart and cardiovascular conditions. According to the researchers, there is no evidence to suggest that brand name drugs work any better than their generic counterparts.

The Brand Name vs. Generic Debate

What exactly are generic drugs? They’re drugs on which the patent has expired. When a pharmaceutical company develops a new drug, they hold the exclusive patent on that drug for a certain number of years. After that time, the exclusive rights are lost, meaning that other companies can manufacture the drug under a different name. These are termed generic drugs, because they are no longer associated with the brand name company which originally developed them.

The new generic drug might have a different shape and color, or may have different fillers or binders added to the active ingredients. In most cases, however, there is no difference at all in how well the generic drug works in comparison to its brand name counterpart. Big-name pharmaceutical companies have gone to extensive lengths to try and prove that generic drugs are inferior, but the results of the new study suggest that’s just not true.

So what’s the difference between brand name drugs and generic drugs? Just one thing – the cost. The cost per pill of a brand name medication might be a few dollars, but for a generic drug prescribed for the same purpose, the cost might be only a few cents. While 66% of drugs prescribed in America are generic, they account for less than 15% of the money spent on all prescription drugs.

This doesn’t mean, however, that you should rush to your doctor and demand that they prescribe only generic drugs for you. It’s always most important that you receive the medications your doctor feels will work best for you – whether brand name or generic. Although, of course, if you’re taking an expensive brand name medication, there’s no reason why you can’t ask your doctor if there is a cheaper generic alternative that might work just as well.

What the research really shows is that if you’re taking medication for a heart or cardiovascular condition, you can feel secure whether it’s brand name or generic. You don’t have to worry that your treatment is inferior just because you’re taking an inexpensive generic medication.

photo credit: ragesoss

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.

Imagine constructing a human being synthesized completely through science—a seemingly supernatural fabrication of life. You may think Frankenstein. You may visualize Iron Man. But it’s called bionics.

The field of bionics doesn’t necessarily create entire human beings, but rather constructs body parts for better human functionality. People have been losing body parts and use of body parts since the beginning of time. Non-functioning limbs have been replaced with plastic, wood and even steel.

photo credit: Walraven

Enter Eileen Brown from London, who has been suffering from rheumatoid arthritis since her late 20s. It took a while for doctors to figure out her condition – first diagnosing her with growing pains and depression. Over the past 20 years, she has undergone countless surgeries to replace her joints with metal.

In the 80s, she had the knuckles on her left hand replaced with plastic joints. Then in the 90s, her wrists had fused together and she was required to have her knee replaced with metal – this is after alternative treatments had failed. Shortly after, she had to have her left shoulder replaced with a metal joint. Right before the new millennium, she began having pain in her right shoulder – another metal joint needed.

After falling from a ladder in 2003, she was required to have the bones and metal replaced in her left shoulder, due to fractures and an infection that began to spread. Her last operation was on her hips and is looking forward to her 50th birthday and a surgery for her neck and the bottom of her spine.

Imagine how difficult it is explaining why the metal detectors are going off.

Regardless of how bizarre it may appear, cases like Brown are more common than one may think. It’s not rare to see people with one or two bionic legs; even some athletes continue to run track and play sports on their prosthetic limbs. Some industries have argued about the use of “bionic athletes” because of their possible super-human abilities to run faster and jump higher. They believe that bionic athletes should participate in separate events.

Thought Robocop Was Cool?

Law enforcement agencies are upgrading their bulletproof vests with nanotube technology. Although bulletproof vests are great for stopping bullets, it doesn’t protect its human hosts from blunt force trauma, which can cause bruising and organ damage. This technology is currently being studied in Sydney by the Centre for Advanced Materials Technology.

How About Iron Man?

In 2005, there was a release of a ROBOT suit that gives its wearer super strength – don’t get carried away, this suit is far from bulletproof and it doesn’t fly. What it can do is help the elderly or those with disabilities to move about and lift heavy objects. This suit, called HAL (Hybrid Assistive Limb), has been under preparation a decade before its release; Yoshiyuki Sankai created it. It is attached to your legs and hips and operates by a battery pack on the belt. HAL 3 helps you to walk by detecting electrical currents sent to you brain by your nerves attempting to move. The HAL is also available for the arms.

The Ever-watching Eye

You’ve heard of people getting eye surgery and glass eyes, but have you heard of bionic eyes that help you to see? It uses a camera – yes, a camera – and electrodes to help its host to identify simple objects. The surgery is known in London; the first operation was done at Moorfields Eye Hospital, where two men in their 50s had their retinas artificially fitted. You may find these available on the market within the next three years. It costs about £15,000; or $30,000 USD.

It didn’t. She was delirious by the time friends finally took her to the emergency room on New Year’s Eve. The doctors diagnosed pneumonia. Three weeks later, she died of adult respiratory distress syndrome. Would universal healthcare have saved her life? You decide.

Universal Healthcare – The Pros

Under universal health care, access to good medical care would become a right rather than a privilege. Hillary Clinton has referred to universal healthcare as “a core Democratic principle.” Certainly, universal healthcare would help the 40 million uninsured, and the countless under-insured people in the United States.

Universal healthcare would allow doctors to focus on what their patients need, not what their patients can afford. For instance, Julie (not her real name) suffers from bipolar disorder. A mood stabilizer controls her condition, but it costs several hundred dollars per month, and Julie has no insurance. So instead of prescribing the medication that he knows will be most effective, Julie’s psychiatrist has to experiment with the off-label generics that Julie can afford. Julie suffers, and society suffers with her when her condition deteriorates and requires expensive hospitalizations that, ultimately, tax payers end up funding. Perhaps this is why, in a recent survey, 59% of doctors supported universal healthcare.

Universal healthcare would allow for good preventive medicine. Chances are that Sylvia would never have become so sick with a chest infection if her asthma had been properly controlled in the first place. If people have access to healthcare, they can work on controlling chronic conditions and preventing health problems, which is far less expensive than dealing with medical problems that have spiraled out of control due to poor preventive care.

Universal Healthcare – The Cons

Universal healthcare would be difficult to coordinate and administer. Of course, universal healthcare isn’t a walk in the park, a magic cure-all. There are challenges as well, one of the chief challenges being who would administer the program. The government has, to put it kindly, not always shown itself to be a model of efficiency. Working out the kinks in universal healthcare would take time and patience—perhaps more patience than most patients possess.

Increased taxes. In a speech explaining why he opposed universal healthcare, John McCain stated, “I’m certainly not interested in raising people’s taxes.” He has touched on a valid point. Both proponents and opponents of universal healthcare agree that taxes would need to be increased to fund healthcare for everyone.

Hard choices. Countries that practice universal healthcare do not give a carte blanche to every treatment for every condition. Some expensive procedures that have very poor success rates may have to be disallowed in the interests of keeping the system afloat. Americans understand this intellectually, but might have a hard time when it is their care or a loved one’s care that is affected.

Universal healthcare is neither angel nor devil. It has its benefits and its drawbacks. But whatever your feelings on the issue, it’s clear that the American healthcare system is ripe for change. It will be interesting to see where this election year takes us and what the President has up his (or her) sleeve.

photo credit: Heather R.