Health Care and Marraige

Health care in America can be expensive. However, it can be more expensive if you don't have insurance. The convenience factor goes way up of getting coverage is better if you are married versus being single, and is available more readily to those who get married as a qualifying event. The Wall Street Journal has reported this week that 7% of Americans said that in the past year they or someone in their household decided to tie the knot mainly so one spouse would be eligible for the other’s health coverage. That astonishing figure came from a survey out today from the Kaiser Family Foundation, a nonprofit group that looks at health policy issues. Is marrying for health-care convenience the new marrying to get a Green Card?

There are 114 million households in America, according to the Census Bureau. But the Kaiser survey suggests that in 7% of those households — about eight million total — someone decided to get married in the past year mainly because of health benefits. But the total number of marriages in 2005, the most recent year for which complete national figures are available, is only 2.25 million, according to the National Center for Health Statistics. That puts the total number of people who get hitched — for love, for money, for health insurance, for whatever — at about 4.5 million every year. According to MarketWatch, overall, changes in the economy and the public's growing insecurity about health-care costs are laying the groundwork for nationwide reform, but it's far from a sure thing.

Some people marry for love, some for companionship, and others for status or money. Now comes another reason to get hitched: health insurance. According to a similar article in the Los Angeles Times, a companion poll also detected an important shift among voters: Independents in particular say they are more concerned about reducing medical costs than about increasing the number of Americans with health insurance. Paying for healthcare is reflected not only in family budgets but in life decisions as reported by Kaiser in the press release. Healthcare inflation has been rising at about twice the rate of economic growth, and it's unclear how much of a difference better prevention, computerized medical records and other ideas for containing costs might prove to be. What surprised researchers was that health care costs had become a factor in marriage decisions. Also, they reported that most employers do not offer health insurance to unmarried domestic partners of employees.

The Los Angeles Times article went on to say that with employer-based health insurance averaging $12,000 for family coverage and $4,500 for individuals, the public concern with costs is understandable. Nearly 25% of Americans said they had decided to keep or change jobs in the last year because of health insurance. Those who cited health insurance as a factor in deciding to marry tended to have modest incomes. About 60% of those who responded were in households making less than $50,000 a year, and about 40% were between the ages of 18 and 34. The Kaiser survey also found that healthcare costs outranked housing costs, rising food prices, and credit card bills as a source of concern. Of those surveyed, 28% said they had experienced serious problems because of the cost of healthcare.

Choosing health insurance can be very confusing. The health costs surrounding injury or illness can be catastrophic to a family's finances. After you are married you should take time to review your individual health coverage to ensure you're properly protected. Millions of Americans go without health coverage every year, which can be a very risky decision - especially in the case of a sudden medical illness or injury. Going without health coverage can quickly become a risk that doesn't need to be taken. You and your family's health is important and a lack of health coverage can be financial and emotional strain. Even with a standard medical plan, out-of-pocket expenses (including co-payments, cost shares, and pharmaceutical costs) can add-up quickly and become a financial burden according to the Armed Forces Benefit Association.

The information about getting married and considering the insurance reasons as noted on Eons.com is also some good advice. A good employer health insurance plan is hard to come by. If one of you doesn't have health insurance or if one partner's plan is superior to the other's plan - or even less expensive - then tying the knot could be a smart move. And if you are single as a Senior and getting married over 60, that can have benefits! Also consider your retirement expenses. Health insurance is one of the costliest line items for retirement budgets. If one of your employer plans pays for a spouse's health insurance in retirement, that is a potential savings of thousands of dollars a year.

The American Institute of Certified Public Accountants reports that when you and your spouse are making health insurance decisions, it may be useful for you to focus on three key areas: (1) the out-of-pocket cost of each plan, (2) the levels of service and coverage offered, and (3) the coverage offered to any dependent children, if applicable. Employers will sometimes pay some or all of their employees' health insurance premiums. If this is true in your case, there may be no reason to consider a change in your health insurance plans. If you pay the premiums yourself, however, compare the costs. Check into whether family coverage through one of the plans is less expensive than two single policies. If you have no children, two single policies are typically less expensive than one policy with family coverage. Many large group plans offer two-person coverage (an employee plus spouse, partner, or child) for less than the price of a family plan. However, insurance carriers will not allow you to bill two companies for the same medical service.

The Institute also recommends other important cost factors to consider are out-of-pocket deductibles and co-payments. Even if the premium you pay at your company is lower than that paid by your spouse, you may discover that your deductibles and co-payments for health problems and routine doctor's visits are substantially higher. Despite the higher premiums, you may decide that it is better to join a family plan through your spouse's employer because of its lower deductibles and co-payments. Be aware that the services and coverage that one plan provides, including the choice of doctors and hospitals, could outweigh the lower costs of the other. You might decide that your family is better off to pay higher premiums, deductibles, or co-payments while receiving specific services (such as rehabilitation, psychiatric therapy, or free eye exams) that the other plan does not offer.

Whatever your status, sharing the responsibility of choosing health care coverage should not be taken lightly. If you need to get insured, do it. If you need to work out an affordable plan, spend the time to investigate what options make the most sense. Use your time wisely as a couple to search out competitive plans and rates, and talk with your HR manager about what your employer offers. Don't wait til you have a catastrophic event to realize that you should have planned for the unexpected and are then caught by surprise. If you have an emergency or an accident, please be prepared.

Until next time. Let me know what you think.

Health Care and Hospitals

A new Milliman study released and partially sponsored by CalPERS (California Public Employees’ Retirement System) designed to uncover the key to understanding hospital prices confirms what large purchasers have long suspected: a disturbing number of hospitals appear to be grossly overcharging and not being held accountable. The study analyzed how hospitals compare with each other relative to their total costs of service, the total amount they charge private insurers and patients (after negotiated discounts), and a ratio of charges to costs – after adjusting for patient severity and regional wage differences – showing relative hospital markups.

Among the troubling findings in the report were that:

1.) Private payers, such as employers and their covered employees, pay about 40% more than they should to make up for both shortfalls from the uninsured and government reimbursement programs, such as Medicare, and hospital profits.

2.) There are wide and unexplained regional differences in what hospitals are charging private insurers and patients. For example, the average price paid to hospitals in the Sacramento region was 30% higher than the statewide average for the same mix of hospital services – even after adjusting for wage differences. Across the state, the markup for some hospitals is about five times that of others.

3.) These differences would appear to be due primarily to variation in hospital pricing policies related to market conditions. They cannot be explained by charity and indigent care or by teaching status. For example, several of the major teaching hospitals in the state were found to have prices at or below their regionally-adjusted norms.

According to CalPERS, since hospitals are not required to disclose their actual prices for specific health care services, private purchasers and patients are unable to shop appropriately for health care based on quality and costs. The sponsors indicate that the next step is to press for full transparency of hospital prices by service, and a standardized format so that purchasers and patients can pay prices based on value. Hospital quality data are reported mainly at the individual service level. Currently, hospitals in large networks are more likely to be able to demand higher payments from insurers, as well as facilities in rural areas where competition is minimal, according to the San Francisco Chronicle.

The study indicated that the inconsistencies in actual costs versus payments demonstrates that privately insured patients are subsidizing hospitals for the low rate of reimbursements for treating beneficiaries of government assisted programs. However, according to the California Hospital Association, health plans clearly know that when they sit down to negotiate contracts with a given hospital, part of what the rates they are negotiating include are subsidies for the "shortfalls" in reimbursements.

Additionally, uninsured Americans pay more for hospital care. Currently, the uninsured are the victims of complex hospital pricing policies that penalize people who don't have private or government health insurance according to a Chicago Tribune news release. Both private insurers and government programs such as Medicare and Medicaid use their clout to win favorable prices from medical centers. By contrast, people without insurance have no bargaining power; they are the only customers who get billed the "sticker price." It's unfair and everyone knows it: People without insurance pay far more for hospital care than people with some kind of coverage. A study last year in Health Affairs, a leading policy journal, found that hospitals charged the uninsured 2.5 times more than what health insurers paid and more than three times more than Medicare's allowable costs.

By law, hospitals must treat all patients who are experiencing medical emergencies, regardless of their insurance status. But once patients are stabilized, the obligation to treat ceases. The Chicago Tribune article also stated that extensive research indicates that uninsured residents get less medical care and suffer poorer outcomes than people who have coverage. Additionally, U.S. hospitals treated 308,200 people for attempted suicide, assault, rape, abuse, and other violence-related trauma in 2005 at a cost of $2.3 billion, according to the latest News and Numbers from the Agency for Healthcare Research and Quality reported in March, 2008. Children accounted for nearly 52% of abuse cases. About one-third of those patients suffered from child neglect, physical and psychological abuse, or physical battery such as shaken child syndrome. Many of the hospital cases were paid for by tax dollars or written off by the hospital: roughly 23% of hospitalizations involved uninsured patients and 27% were for Medicaid enrollees.

New data from Dartmouth Medical School highlights a problem that is likely to become more widely discussed as health reform schemes--and related calls for pricing controls--continue to move forward. Unfortunately, more hospital care often does not equate to better outcomes; some patients were seen by more specialists, and spent more time in the ICU, but didn't live longer on average. Costs vary widely based on geographic region according to this study as reported in April, 2008, by the Associated Press.

So, the need for price "transparency" or disclosure is emerging as one of the hotter topics in the area of consumer directed health care. The National Association of State Legislatures have also indicated a desire to know more accurate costs associated with hospitals and health care. The Association reports that patients should also be able to see an estimate of the overall cost of the procedure, how much their insurer will pay and how much they will be expected to pay. That kind of information will allow patients to become informed consumers making informed choices about one of the most 'priceless' things in life — their health. Also, the federal government push to increase people's awareness of their health care spending goes hand-in-hand with getting hospitals, physicians and health insurance companies to share more price information. More people have a reason to know what they spend on health care, due in part to the increasing popularity of high-deductible health insurance and the persistent rise in uninsured consumers.

Hospital care is radically expensive. Americans should have access to care when needed that will permit not only access for treatment but also options for payment. Those who have the fortunate circumstance to hold catastrophic care coverage can find it a little easier to breathe at night if they must have emergency services or hospital care. Those who do not need workable opportunities that the private and public markets can support and are consumer friendly. The financial and emotional toll is too great for anyone who must have access to hospital care but is not able to afford coverage. As the nation moves toward electing a new President in a few months, the medical community, government, private insurers, and the public will need to focus on how to develop ways to affordably treat the uninsured and reign in costs.

Until next time. Let me know what you think.

Health Care and Mothers To Be

The Bible elevates motherhood to a sacred position. Being a mother can be at once both exciting and scary. New life growing inside a pregnant female can be a cause for joy and celebration. And, depending on the situation causing the pregnancy, a young girl or woman who did not expect the news and is not pleased with the prospect of raising a newborn may not be happy about the eventual outcome. However, pregnancy should be a reason to rejoice regardless of the reason it came about. The new fetus who is growing inside the mother will have every bit of potential to be a successful man or woman as anyone who has ever lived. Recognizing the part each of us plays in the 40 weeks leading up to delivery is an important part in the overall health of the unborn child.

Getting ready for pregnancy can be very important. The following tips are offered on the website Pregnancy.org:
1.) Improve your diet--a balanced diet of at least three meals a day, nutrients for a healthy pregnancy including calcium and folic acid, a good prenatal/multiple vitamin, and cutting back on caffeine.
2.) Healthy weight--Get down to your ideal weight for your height before attempting to conceive as underweight mothers tend to have low birth weight babies.
3.) Exercise-- You can improve your mood and energy level and achieve a healthy pre-pregnancy weight with exercises including walking, jogging, running, swimming, and aerobics. You'll also be less vulnerable to the hormonal swings.
4.) No alcohol, recreational drugs, smoking--these habits are connected to low birth weight babies, miscarriage, SIDS, and behavioral problems later in life.

According to Healthology, pregnancy can be the most exciting (and scary!) time of a woman's life. Millions of women have gone through successful pregnancies in the past and much of what we know is based on their experiences. A few simple preventative measures can help to ensure that your pregnancy goes as smoothly as possible and that your child is born as healthy and happy as can be.

Author Ann Douglas states that feeling good about yourself as a woman is the key to making the most of the childbearing year. A woman who feels good about herself will celebrate the changes that her body experiences during pregnancy, look forward to the challenge of giving birth, and willingly accept the physical and emotional changes of the postpartum period. Unfortunately, not all women embark on pregnancy with a healthy self-image. Feeling good about themselves as their bodies experience extraordinary changes can be extremely difficult for these women, and they may require a great deal of support from friends and family during this challenging year in their lives. Women tend to fall into one of two camps during their pregnancies: those who feel very negatively, and those who feel very positively about their situation.

When it comes to pregnancy, most first timers immediately think about morning sickness, cramps, mood swings, weird cravings, and a mortal fear of your bodies not being the same ever again according to the folks at Pregnancy-Period.com. But ask any woman who has been through pregnancy and she will remember it blissfully. Pregnancy may be a harsh change but it is also the initiation of a woman into the realms of divinity. Pregnancy is the "potter's wheel of creation", and it is a joy to be cherished. A happy, healthy pregnancy is the path to a lifetime of maternal bliss. In certain parts of the world, pregnancy is equated to rebirth. This is the time you face the most physical and emotional changes in yourself, not to mention social changes. You are actually going to be nurturing another life inside your own body. You'll soon realize that your capacity for love for this life is unlimited and unconditional. It is very important to understand exactly what to do and how to look after yourself during your pregnancy. It is going to be a wonderful journey that you will remember as long as you live. Right from the time when you recognize early pregnancy symptoms to the moment when it is time to give birth, you must be aware of all the choices and options you have, so that you can make the right decisions.

Pregnancy is a life-changing time in the life of any woman. There are many options that must be considered about the 40 weeks of gestation, about the delivery, and about postpartum life. During the 9 months while the baby(ies) is growing, new mothers should think about how they want to deliver, and the newborn will need lots of love and attention after the birth. Childbirth classes and books can provide loads of choices; and, in addition to learning about natural pain-relief techniques, c-sections, and pain medications, it would be a good idea to pre-register at the hospital well in advance of delivery. Also, try to ignore any childbirth horror stories people want to share as your child's birth will likely be significantly better than what your imagination can dream up.

The National Institute of Child Health and Human Development says that expectant moms need to have regular visits with their healthcare provider. If you are pregnant, these pre-natal care visits are very important for your baby and yourself. Some things you might do when you are pregnant could hurt your baby, such as smoking or drinking. Some medicines can also be a problem, even ones that a doctor prescribed. You will need to drink plenty of fluids and eat a healthy diet. In early pregnancy, you may get morning sickness, or nausea. You may also be tired and need more rest. Your body will change as your baby grows during the nine months of your pregnancy. Don't hesitate to call your health care provider if something is bothering or worrying you.

More than 4 million babies are born in the United States each year, and the details of how, when, and where they arrive are always shifting.The news from the final 2005 report and preliminary 2006 report on births from the Centers for Disease Control and Prevention (CDC) is that America continues to boast climbing birth rates, following the baby decline of the 1990s. In fact, we're experiencing a little baby boom of sorts, with an increase of 3 percent from 2005 to 2006 — the largest single-year increase in the number of births since 1989 — and the largest total number of births (4.27 million) since 1961.Births rose for all ethnicities in 2006, with a record high of over 1 million births reported for Hispanic women according to a report released on Babycenter.com.

As a mother to be, it really is the most exciting thing in the world to observe all the changes that your body is experience during pregnancy. Maintain a journal – it can be really useful every time you visit your doctor. Your pregnancy can be divided into three stages – the first trimester, the second trimester and the third trimester – even though it can seem like an entire lifetime that you won't miss for anything else in the world. As mentioned above, the right nutritional and well balanced diet can go a long way in helping you. Find out what you ought to avoid and what is good – know all about pregnancy weight gain, the right kind. Read up on medications to take and avoid. A pregnant woman must relax; get good sleep and exercise to have a healthy pregnancy.

To be a mother can be a blessed experience. Ask anyone who ever gave birth and raised a child. The time between conception and delivery can be a period of learning about yourself and your baby. Use the months during pregnancy to grow spiritually, emotionally, and socially. Learn to make right choices that will continue through the early childhood years and beyond. Be thankful for the opportunity to create a life for the life created in you. As a father, I can recommend that the joy that a mother feels about her newborn child is the greatest feeling in the world.

Until next time. Let me know what you think.

Health Care and Pharmacy Savings

Prescription medications are costing more and more every year. As a matter of fact, the increase overall has been very noticeable, especially to Seniors and those Americans with no drug co-pay plan. The wholesale prices of brand name medicines most commonly prescribed to elderly Americans increased an average of 7.4 percent last year, an increase about 2.5 times greater than general inflation, says a study released by the advocacy group AARP. The study looked at 220 brand name prescription drugs and found that all but four had wholesale price increases in 2007, the Associated Press reported.

As reported on the Health & Human Services website, many Americans say that they have trouble paying for drugs or that they skip prescriptions or cut pills because of the costs, according to a survey released Tuesday by USA Today, the Kaiser Family Foundation and the Harvard School of Public Health. A national telephone survey found that 40% of Americans (and half of those who regularly take at least one medication) reported at least one of three cost-related concerns in their family: 16% have a "serious" problem paying for prescription drugs; 29% have not filled a prescription in the past two years because of the cost; and 23% have cut pills in half or skipped doses in order to make medications last longer.

These types of issues were most common among people who lack drug coverage (52%), have low incomes (54%), and those who take at least four drugs regularly (59%). And, almost 80% of respondents said the cost of prescription drugs is unreasonable, 70% said drug companies are too concerned with profits and not concerned enough about helping people, and 64% said there's not enough government regulation of drug prices. Almost 60% said insurers should only pay for new drugs if they're proven to be not just safe, but also more effective than existing prescription drugs. The report also found that about half of those surveyed take a prescription drug daily, and 20% said they regularly take at least four prescription drugs. Women (56%) are more likely than men (42%) to use a prescription medicine on a regular basis, and are also more likely to reportdifficulties affording their medications as reported by Target News.


And yet the cost of meds keeps going up and up. Although pharmacies typically make a higher mark up on OTC products than prescriptions, the amount of prescription medications dispensed has continued to increase at a dizzying rate as the American population continues to age. The average senior citizen is on several prescribed medications. According to the American Pharmacists Association, the number of different medications a patient takes tends to increase with age; people 75 years of age and older take an average of 7.9 drugs daily per person.


Families USA has reported about the rising cost of prescriptions, especially for seniors. Annual spending per elderly person for prescription drugs grew from $559 in 1992 to $1,205 in 2000, an increase of 116 percent. At the same time, overall per senior health care spending grew by 59%, nearly half as fast as drug spending. As a result, per senior prescription drug spending as a share of total health care spending increased from 7.4% in 1992 to 10% in 2000. By 2010, annual per person spending on drugs for the elderly is projected to reach $2,810 a year, an increase of 133% overspending in 2000. During this period, per senior overall health care spending is projected to increase by 76%. Who actually gets all the money? Using the average estimated retail prescription cost of $50, the manufacturer receives almost 76%, the wholesaler a little over 3%, and the retailer receives about 21% according to the National Association of Chain Drug Stores (NACDS).


Over the 18-year period from 1992 to 2010, prescription drug spending per elderly person is projected to grow by 403%, more than twice the rate of overall growth in per senior health care spending, which is expected to grow by 180 percent. The portion of senior health spending devoted to prescription drugs will have grown from 7.4% in 1992 to 13.3% in 2010. Additionally, they reported that from 1992 to 2010, the average number of prescriptions per senior will grow by 96%. The overall total number of prescriptions for seniors grew from 648 million in 1992 to over 1 billion in the year 2000—and is projected to grow to almost 1.6 billion in 2010.


An interesting fact published by the Minnesota Board on Aging says that, on average, older women spend more out-of-pocket on prescription drugs than do older men, regardless of whether or not they have prescription drug coverage. However, the percent without drug coverage does not differ between men and women. More than one-third lack drug coverage within both groups. Americans are finding that the cost to purchase prescription medications continues to escalate at an alarming rate. Those on fixed incomes must often choose between food, rent, and utilities versus taking the medicines to stay healthy prescribed by their family physician. The Cleveland Plain Dealer reported this month that Americans 65 and older make up 13% of the population yet consume 33% of the nation's medications. With this many prescriptions being filled, the cost to American consumers continues to grow as an ever increasing percentage of overall health care expenses. Seniors under age 75 take an average of six medications, and elderly patients in nursing homes take an average of nine.


As a result, Americans must source ways to reduce the cost of taking medications. Although this is not medical advice, here are a few hints to save money on prescriptions including some of the following ways:

1.) Order Prescription Drugs by phone or online.
2.) Ask your doctor for samples at every visit.
3.) Consider using a pill splitter (not recommended for all drugs).
4.) Sign up for free Pharmacy cards.
5.) Purchase a 90-day vs. 30-day supply.


Shopping for the best medications at the best price should be as simple as shopping for new clothes. Unfortunately, the health care community has made it a challenge for most people. As the patient, though, you need to find ways to help you save money and still be able to get medications that you need at an affordable cost. It's better to keep the money in your pocket than give it to the pharmacy or the drug companies, especially if it means that your net worth is more important to you than someone else's. Although you may have to bite the bullet on some drug expenses, take time to find out the best way to save on cost. It will help you out in the long run and make life more affordable.


Until next time. Let me know what you think.

Health Care and Exercise

President Dwight Eisenhower started a program during the early days of his administration in the 1950's that focused America's attention on getting fit. The first Council identified itself as a "catalytic agent" concentrating on creating public awareness and was chaired by VP Richard Nixon. Over the last five decades, the Council has expanded with additional amended Executive Orders by the sitting Presidents from the 1960's through to the current decade. Still today, President George W. Bush is continuing this effort to get Americans to exercise. In 2006, the President's Council on Physical Fitness and Sports launched its 50th Anniversary year by celebrating the accomplishments of its partners and friends.

According to the Department of Health & Human Services, The President's Council on Physical Fitness and Sports is an advisory committee of volunteer citizens who advise the President through the Secretary of HHS about physical activity, fitness, and sports in America. Through its programs and partnerships with the public, private and non-profit sectors, the Council serves as a catalyst to promote health, physical activity, fitness, and enjoyment for people of all ages, backgrounds and abilities through participation in physical activity and sports.

The Mayo Clinic has a lot to say about the benefits of exercise. The merits of exercise — from preventing chronic health conditions to boosting confidence and self-esteem — are hard to ignore. And the benefits are yours for the taking, regardless of age, sex or physical ability. The Mayo Clinic website lists the following seven benefits of exercise:
1. Exercise improves your mood.
2. Exercise combats chronic diseases.
3. Exercise helps you manage your weight.
4. Exercise strengthens your heart and lungs.
5. Exercise promotes better sleep.
6. Exercise can put the spark back into your sex life.
7. Exercise can be — gasp — fun!

Regular exercise can help protect you from heart disease and stroke, high blood pressure, noninsulin-dependent diabetes, obesity, back pain, osteoporosis, and can improve your mood and help you to better manage stress. For the greatest overall health benefits, experts recommend that you do 20 to 30 minutes of aerobic activity three or more times a week and some type of muscle strengthening activity and stretching at least twice a week. However, if you are unable to do this level of activity, you can gain substantial health benefits by accumulating 30 minutes or more of moderate-intensity physical activity a day, at least five times a week.
If you have been inactive for a while, you may want to start with less strenuous activities such as walking or swimming at a comfortable pace. Beginning at a slow pace will allow you to become physically fit without straining your body. Once you are in better shape, you can gradually do more strenuous activity. Regular physical activity that is performed on most days of the week reduces the risk of developing or dying from some of the leading causes of illness and death in the United States as indicated by information supplied online at NutriStrategy.com.

Millions of Americans suffer from illnesses that can be prevented or improved through regular physical activity as reported by NutriStrategy.com.
• 13.5 million people have coronary heart disease.
• 1.5 million people suffer from a heart attack in a given year.
• 8 million people have adult-onset (non-insulin-dependent) diabetes.
• 95,000 people are newly diagnosed with colon cancer each year.
• 250,000 people suffer from a hip fractures each year.
• 50 million people have high blood pressure.
• Over 60 million people (a third of the population) are overweight.

According to the Center for Disease Control (CDC), despite common knowledge that exercise is healthful, more than 60% of American adults are not regularly active, and 25% of the adult population are not active at all. Moreover, although many people have enthusiastically embarked on vigorous exercise programs at one time or another, most do not sustain their participation. Clearly, the processes of developing and maintaining healthier habits are as important to study as the health effects of these habits.

The effort to understand how to promote more active lifestyles is of great importance to the health of this nation. Although the study of physical activity determinants and interventions is at an early stage, effective programs to increase physical activity have been carried out in a variety of settings, such as schools, physicians' offices, and worksites. Determining the most effective and cost-effective intervention approaches is a challenge for the future. Fortunately, our country has skilled leadership and institutions to support efforts to encourage and assist Americans to become more physically active. Schools, community agencies, parks, recreational facilities, and health clubs are available in most communities and can be more effectively used in these efforts according to the report issued by the CDC.

Outside the school, physical activity programs and initiatives face the challenge of a highly technological society that makes it increasingly convenient to remain sedentary and that discourages physical activity in both obvious and subtle ways. To increase physical activity in the general population, it may be necessary to go beyond traditional efforts. Special efforts will also be required to meet the needs of special populations, such as people with disabilities, racial and ethnic minorities, people with low income, and the elderly. Much more information about these important groups will be necessary to develop a truly comprehensive national initiative for better health through physical activity.

The Surgeon General concludes that challenges for the future include identifying key determinants of physically active lifestyles among the diverse populations that characterize the United States (including special populations, women, and young people) and using this information to design and disseminate effective programs. Also, the Surgeon General says that the stakes are high, and the potential rewards are momentous: preventing premature death, unnecessary illness, and disability; controlling health care costs; and maintaining a high quality of life into old age.

Additionally, from About.com, we are encouraged to think about the benefits of exercise.
Here are some ideas:
1.) Remind yourself of your weight loss goals.
2.) Think of a future event to get ready for (a wedding, a vacation, etc.).
3.) Consider how much energy you'll have to get more things done.
4.) Imagine how relaxed you'll feel after a workout.
5.) Think of your exercise time as the only time you may get to yourself all day.
6.) Remind yourself how good you'll feel by following through.
7.) Promise yourself a reward for completing your workout.
8.) Think of all the diseases and illnesses your workout could protect you from.
9.) Remind yourself that this workout is necessary to reach your goal.

Everyone knows they should exercise. It's tough to get started if you don't already have a game plan or current regimen. However, the benefits far outweigh not being active at all. If you currently exercise on a regular basis, good for you! Keep up the good work. If you need to exercise, get going now! Don't procrastinate like all those people who wait til New Year's to start on their resolution to get fit and then fade after the first few weeks into it. Do it now! You'll be glad you did.

Until next time. Let me know what you think.

Health Care and Tax Day

April 15th! Wow, this day brings a chill to most Americans. It's the day everyone must file an income tax return (unless they request an extension). Even so, this day is when Uncle Sam expects you to ante up if you have not paid your "fair share" of taxes on your income. If you are lucky, you may get some money back because you overpaid during the year or come out even and not have to pay anything. All this money paid into the IRS during the prior year gets re-circulated throughout the year as the federal government pays for running the country. And today is the day when the tally is run to find out who gets paid--you or the Feds.

Now, you may ask, "What does April 15th and my income tax have to do with health care?" It has alot to do with it. The federal government uses your tax money to help offset the costs of paying for Americans who are uninsured and need medical treatment. As a taxpayer, a certain portion of your income, which is collected by the government in the form of taxes, is paid to hospitals and other medical providers to help pay for people without coverage. A 2003 study in Health Affairs estimated that uninsured people in the U.S. received approximately $35 billion in uncompensated care in 2001. The study noted that this amount per capita was half what the average insured person received.

Additionally, the study found that various levels of government finance most uncompensated care, spending about $30.6 billion on payments and programs to serve the uninsured and covering as much as 80–85 percent of uncompensated care costs through grants and other direct payments, tax appropriations, and Medicare and Medicaid payment add-ons. Most of this money comes from the federal government, followed by state and local tax appropriations for hospitals. Another study by the same authors in the same year estimated the additional annual cost of covering the uninsured (in 2001 dollars) at $34 billion (for public coverage). Your tax dollars at work.

Health care costs for the uninsured must often be absorbed by providers as free care, passed on to the insured via cost shifting and higher health insurance premiums, or paid by taxpayers through higher taxes. As the economy continues this year to slow down in many parts of the U.S., more and more individuals and families are being added to the ranks of the uninsured. As a result, more pressure is being put on the health care system to find ways to cover the expense of so many Americans who cannot afford insurance and still need treatment. Just because you don't have a job doesn't mean your kids or your spouse are going to stop getting sick. And what about catastrophic care? Hospital ERs are bursting at the seams, and much of the emergency care that hospitals deliver is not reimbursed to them by the patient. Federal law mandates that treatment must be given, and that no one can be turned away if they show up for care at a hospital emergency room regardless if they are insured or not.

Business Week reported in April, 2007, that of the $2.7 trillion federal tax coffers, about 15% goes to Medicare for the elderly and disabled. There are two main categories in the federal budget: federal funds and federal trust funds. Federal funds are considered "discretionary" dollars—meaning Congress and the President have a say in how they're spent. Federal trust funds are "nondiscretionary," meaning the money has been spoken for. Each category takes up about half the total budget. Federal trust funds include spending mainly on Social Security payments, the Medicare program, and part of the Medicaid program, or $1.5 trillion.

The report also stated spending on health-care programs, including Medicare, Medicaid and the National Institutes of Health, makes up $546 of the total median tax bill, or 19 cents on the dollar. It may surprise some taxpayers that health spending takes up such a large part of the discretionary tax bill, even though almost 50 million Americans are uninsured. Critics are quick to point out that soaring health-care costs—coupled with government picking up the tab for emergency services for the uninsured—makes for an inefficient system. Medicare, the health program for the elderly and disabled, cost taxpayers $338 billion in 2006.

This month, AOL money released a report on what happens to American tax dollars related to health care expenditures. As American taxpayers kiss another April 15 tax deadline goodbye, the median income family in the United States paid $2,628 in federal income taxes in 2007. Here's how that money was spent--Health: average total: $581. That means 22.1 cents out of every federal income tax dollar went toward health programs. The health category ($458 billion) is the federal funds portion of all spending by the federal government, including the federal funds spending on Medicare. With the increase of $120 billion in spending seen in just one year, you can just imagine what the costs will be as tens of millions of Baby Boomers cross over to retirement and age 65 over the next ten years. The financial burden to American taxpayers will increase astronomically under the current status quo. However, most people agree that something should be done to help reduce costs of covering the uninsured and elderly, but they don’t want to pay higher taxes to do it.

As Americans stare down the barrel at a new presidential administration that will be determined in just a few short months, the fear of economic loss is looming larger as each day passes. The increase in government monies being spent on health care is getting greater each year. The United States is on a fast track to bankruptcy unless acceptable solutions are enacted by a responsible President and Congress who are willing to make hard choices. Although access to good health care is a privilege and not a right, each of us has a moral and fiscal responsibility to our families and to our nation to make our tax dollars count and not be wasted.

Until next time. Let me know what you think.

Health Care and College Kids

College kids can have many challenges, but one of the biggest is how to handle health care when they are away from home. Many of them are still covered under the health plan provided to them by their parents' insurance. However, according to a report released this year by the U.S. Government Accountability Office, there are over 1.7 million traditional-aged college students who are uninsured. The number represents about 20% of all kids in college in America. Additionally, the GAO says that only 57% of all colleges offer a student health plan with dramatically varying degrees of coverage. The report also found that students from lower income families, part-time students, and non-white students were less likely to be insured.

Of the 80% of college students aged 18 through 23 who have health insurance, about two thirds of those are covered under employer-sponsored plans. Less than 10% were covered by private insurance, and less than 10% were covered by public programs like Medicaid. The GAO reported also that the characteristics of uninsured students are consistent with the population of uninsured Americans in the general public. Without health insurance, students may not be able to pay for their health care. The cost of treatment may be passed on to federal and state payers, ultimately an expense borne by taxpayers. College students have challenges getting coverage and may not have access to insurance through employers. As they get older, students may also lose dependent status through insurance held by parents.

Premiums range in cost from $30 up to $2400 per year, and many of these college plans do not include or severely limit preventive care, prescription drug coverage and other ancillary health services. Maximum benefits reported by the GAO study vary anywhere from $2500 per condition up to a lifetime cap of $1 million. Colleges customize their plans to reflect their priorities in making premiums affordable for students with coverage that meets the needs of most children while they are attending those institutions. Some plans exclude preventive services and some plans limit payment of benefits. About 30% of colleges nationwide require students to have health insurance, and some states also have health insurance requirements for college students.

The GAO report indicated that limitations on most college health plans were supplemented by student health care services offered by the schools. The plans are coordinated with those services to keep premiums low. Also, some restrictions exist on paying for treatment that is a result of alcohol or drug abuse and for attempted suicide. Part-time students are often restricted from coverage so they do not drive up the premiums for the colleges. And, in addition to information from the GAO, some state governments (Vermont, New York, Massachusetts) make it very onerous for companies to offer low cost health plans to students. Another consideration is that often, ancillary coverage for dental, vision, and other health needs are left out of many plans.

According to Kiplinger, your child might be better off remaining on your policy rather than switching to the plan offered by the school. A report issued in September, 2007, warns parents of college bound children that some student health policies have low deductibles but also have very low limits on coverage. Exposure to uncovered expenses can be dangerous to your financial stability if your college student has a major illness or accident. Some family policies extend coverage up to age 25 if your child is a full time student, and some states have raised that to age 30. A safer route would be to have a policy with a maximum lifetime limit of up to $5 million. Shopping for private insurance can be a daunting task. A good source for finding a broker if you don't already have one is through the National Association of Health Underwriters.

Kiplinger also suggests that parents should check on access to in-network medical providers if their college student is going to school in another city or state. Additionally, to save money on the premium, consider raising the deductible. Young people are typically healthier, and they need insurance to cover catastrophic medical situations. A high-deductible health plan with high coverage limits can be the best way of providing coverage at an affordable price for large unexpected medical expenses. Also, opening up a health savings account (HSA) for tax purposes combined with a HDHP would be a great feature to add on if your child is not considered your dependent. The student could contribute tax-deductible money (which you could give) that can be used tax-free for future medical expenses.

According to HealthCareCoach.com, here are some considerations to ponder:
1.) Talk to your college student about how health insurance works and about your health insurance coverage--what to do for various medical needs such as how to file claim forms, ER visits, prescriptions, etc.
2.) Understand the limitations of various health plans and compare options.
3.) Consider the importance of convenience--proximity of health services and providers.
4.) Be aware of certain insurance factors such as discontinuation, certain federal protections, emergencies, out of state restrictions, summer time coverage, independent status, and other concerns that may affect coverage.

Going away to college is a life-changing event for almost every child and parent. For the child, it means that he will need to lean less on Mom and Dad and more on himself. For the parent, it means the beginning of letting go of the person you have mentored and cared for all of his or her young life. The stress of getting to college is daunting in itself, and the stress of going to college can be even greater. With all the activities and responsibilities that college students face, one of the best going away gifts would be to make sure that your young man or woman will be able know how to handle health needs and medical emergencies without worrying. Although most students have a plan, those who do not need to get one. Make sure that your most valuable asset--your health--is protected.

Until next time. Let me know what you think.

Health Care and Alzheimers

People who suffer from Alzheimer's disease have a health care challenge that is unlike many medical needs that can be easily diagnosed. Often, the slow decline into this state of dementia is initially difficult to understand and recognize. In days gone by, it used to be called "Old-timer's disease" as it was usually seen in senior citizens who could no longer remember anything or who had memory problems causing them to forget names, place, activities, and simple tasks. Those folks just were made fun of by younger people, or they were just viewed as being a little crazy. In those times, if you had it, you didn't have many resources to help you through it.

Over the last decade, significant research has been done to shed light on this medical malady. No longer is it a disease that is kept behind closed doors or whispered in hushed tones. With the advent of available resources that have focused attention on Alzheimer's, Americans can find help to deal with the problems associated with the disease. The recent deaths of actor Charlton Heston and former President Ronald Reagan have brought attention front and center in the news headlines that talk openly about how Alzheimers affects not only those who suffer from it but also those who are their caretakers.

Alzheimer's currently affects over 5.2 million Americans, and the leading edge of Baby Boomers who are now rapidly approaching the senior citizen age bracket will see increased people who will suffer from it in the coming decade. The Alzheimer's Association forecasts that 1o million Boomers will contract the disease.

The brain disorder was diagnosed in 1906 by a German physician. According to the Mayo Clinic website, the disease is inevitably terminal. Medications can ease symptoms and delay the progress of Alzheimer's. However, there is no known cure. Alzheimer's destroys brain cells and leads to loss of memory and cognitive behavior, and it progressively gets worse over time. This disease is the 7th leading cause of death in the United States according to the Alzheimer's Association.

The majority of what is currently known about Alzheimer's has only been learned in the last 15 years, but progress is slowly being made. A worldwide effort to find better ways to treat the disease, slow down its progression, and prevent it from happening is being undertaken. Researchers are working on finding new ways to treat the disease and improve the quality of life for those who are afflicted. It is important to have a primary physician diagnose the disease as early as possible if someone is exhibiting symptoms.

As we age, the brain changes and slows down in the thinking and memory processes. Serious memory loss, though, along with significant confusion and dementia may be a sign that someone may be suffering from the beginning stages of Alzheimer's. Early on-set Alzheimer's usually effects people under the age of 65 who may still have children at home or are still employed. Experts think this stage of Alzheimer's may be present in over 500,000 adults in their 30's, 40's and 50's according to the Alzheimer's Association.

Alzheimer's Disease, the most common form of dementia in senior citizens, begins slowly and involves the section of the brain that control language, memory, and the thought process. It affects your ability to do simple everyday tasks. The illness starts with the patient having difficulty remembering recent events or people they know. As it progresses, Alzheimer's causes the sufferer to not recognize family members or close friends or have trouble talking or reading. Rembering how to do simple daily activities like brushing your teeth may be next. Later stage Alzheimer's symptoms are more serious, such as severe anxiety, very aggressive behavior, or wandering away from home. At some point, the patient will need total care for all of their physical needs. Late stage Alzheimer's eventually results in the loss of the ability to eat, toilet, walk, smile, and swallow--then death happens when the muscles become rigid.

Several studies have been released recently that indicate possible increased risks for Alzheimer's Disease. The American Academy of Neurology has stated that people who have depression area more likely to develop the illness than those who have never had depression. Another risk related to the onset of Alzheimer's is a mid-life development of diabetes that increases the possibility of getting this form of dementia. A key factor was noticed who had low levels of insulin secretion capacity of men over 50 years of age in the study group. Another study of people with large amounts of abdominal fat indicated that they are three times likely to develop severe dementia.

Alzheimer's reduces the overall quality of life for the patient. Sleep problems are common, and people suffering from the disease also wander at some point during the progression of it. In addition to the other symptoms that patients suffer, a very common concern is family conflict. As caretakers struggle to deal with the situation a range of emotions including fear, confusion, anger, and sadness occur. The disease creates high levels of stress in families. The Mayo Clinic website has alot of material about Alzheimer's and how to deal with someone who has it.

Some key ways to deal with a family member who has the illness is to learn how to share responsibilities, talk regularly about options, be honest about feelings, and keep from criticizing other family members. Don't let Alzheimer's rob you of relationships with others. Learn how to deal with the disease. Make sure you educate yourself on the disease and how to handle the role of a caretaker. For those who suffer with Alzheimer's, the disease is very scary. For those who play a key part in taking care of someone who has Alzheimer's, it can be exhausting and difficult. Choose to make the best of a situation that is one of the most challenging issues in health care. Be more loving, more caring, more understanding, more patient, and more educated on how to live with it. Ask for help if you need it, and don't be ashamed that you need it. Accept assistance from others who can help, and learn to find ways to manage the eventual outcome. Pray for miracles (even little ones), and rejoice when they happen.

Until next time. Let me know what you think.

Health Care and Medical Mistakes

What word is the probably most feared by patients when they are under medical treatment? "Oops!" Possibly only worse would that then be followed by "Oh, my God!" When you hear your doctor say either of these phrases, you likely are in for a bad day. No one wants to go into a provider's office, clinic, ER or hospital and hear these words come from the lips of any medical practitioner. But mistakes happen. Sometimes, the errors are simply a small oversight such as putting the patient's information on the wrong form.

It is more serious when the medical office lists someone on a regimen for recovery that was scheduled for another person such as prescribing the wrong medication. An example of major malpractice would take place if the patient was under anesthesia for an operation, and the surgeon forgot to remove a sponge or instrument left inside the body cavity. Accidents like these can cause grave consequences that end in more life threatening circumstances or death, and the damage is done. At this point, difficult choices must be made by the physician and medical facility to reverse course and do damage control. This kind of situation can get very ugly very fast. The ability to handle medical crises takes significant management ability.

What happens when medical errors need resolution, and who pays for the care when mistakes happen? FierceHealthCare reported this month that some insurers are refusing to pay for care as a result of medical errors. WellPoint has just announced that they are not going to pick up the tab for the blunders made by providers in the medical community. The insurance company has identified three primary reasons not to pay: foreign objects left in patients after surgery, operating on wrong body parts, and operating on wrong patients. And, WellPoint will refuse to pay for hospital-acquired injuries, air embolisms, blood incompatibility, vascular catheter-associated infections, catheter-associated urinary tract infections, some chest infections, and pressure ulcers. Additionally, the Blue Cross and Blue Shield companies are considering similar steps according to FierceHealthCare.

HealthGrades reported this month that patient safety incidents cost Medicare almost $9 billion during the years 2004-2006 and resulted in over 238,000 potentially preventable deaths. Of the 1.1 million patients who experienced a medical error during these years, about 20% had a chance of dying. The greatest number of incidents--over 63%--were bed sores, failure to rescue, and post-operative respiratory failure. Over two billion dollars in costs could have been avoided during this time.

The insurance industry, beset by huge increases in costs, especially for certain medical procedures and expensive hospital treatment, are following Medicare's lead to refuse to pay for these medical errors. A huge question instantly comes to light when this happens--Who pays for care when the medical provider or hospital makes a mistake. Most Americans are not able to handle the costs associated with catastrophic healthcare. One incident can throw the average family into bankruptcy if there is no coverage available, especially if their insurance plan will not pay for the event. A patient gets the bill if the insurer refuses to pay and the medical provider disputes the error. A host of other more intricately confusing possibilities can happen including lawsuits, complaints of malpractice and negligence, state regulations regarding patient care, and more.

Currently, according to MSNBC.com, eleven states will waive the fees for the worst mistakes. However, most of them will charge the patient or the insurer. These "never events" are rare and should never happen at all according to medical experts, but they do happen. The Archives of Surgery has identified up to 2,700 "wrong site" procedures per year that are performed. Physicians operate on the wrong person, the wrong place, or the wrong body part. A health safety advocacy group called the National Quality Forum has identified 28 medical errors that range from leaving objects inside the body after surgery to giving a mother the wrong newborn baby. However, there are still 39 states that leave the door open for billing to the patient or the insurer to pay up, even if the medical incident is a huge, glaring error.

Hospital administrators and physicians anticipate that if fees are waived for these mistakes, the admission of liability will punish them in court. There are currently efforts being pushed in the medical community to develop a national standard of universal guidelines for providers, insurers, and patients to address this issue. The current format of waiving medical billing is typically done on a case-by-case basis for medical errors. Healthcare advocates have campaigned for years that patients should not be billed when medical providers make mistakes. Patients end up either in court or in bankruptcy when faced with outrageous expenses that resulted from errors in the hospital or doctors' offices. In some cases, malpractice attorneys refuse cases, and the patient has no resources to litigate on their own.

Research conducted by the Harvard Medical School and released in February, 2008, indicated that medical errors are often caused by resident physicians in U.S. hospitals due to the following reasons: burnout, sleep deprivation, depression, mental and physical exhaustion, stress, and personal detachment to patients. Doctors suffering from any of these symptoms were over six times likely to mis-diagnose patients' needs resulting in medical errors. However, due to patient load and over burdened health care facilities, medical providers are struggling to keep up with quality patient care.

Chances are, you may know someone who has suffered an incident to error by a health care provider. Mistakes can be fatal. Our job is to make sure that proper protocols and procedures are always followed. Each person or caretaker has a personal responsibility to question every decision or action undertaken by a health care provider, hospital, and physician. As a patient, you don't want to end up as a statistic or appear on the 6 o'clock news as the next victim of medical malpractice.

Until next time. Let me know what you think.