Tuesday, November 25, 2008

Health Care and Thanksgiving 2008

On November 27th, in just 2 days, Americans will celebrate a holiday that is classic for our nation only; and since the early 1600's, this day is observed as a time honored tradition to give thanks for the blessings we enjoy as a country of immigrants. As reported from History.com, in 1621, the Plymouth colonists and Wampanoag Indians shared an autumn harvest feast which is acknowledged today as one of the first Thanksgiving celebrations in the colonies. This harvest meal has become a symbol of cooperation and interaction between English colonists and Native Americans. Although this feast is considered by many to the very first Thanksgiving celebration, it was actually in keeping with a long tradition of celebrating the harvest and giving thanks for a successful bounty of crops. Native American groups throughout the Americas, including the Pueblo, Cherokee, Creek and many others organized harvest festivals, ceremonial dances, and other celebrations of thanks for centuries before the arrival of Europeans in North America.

Also according to History.com, historians have also recorded other ceremonies of thanks among European settlers in North America, including British colonists in Berkeley Plantation, Virginia. At this site near the Charles River in December of 1619, a group of British settlers led by Captain John Woodlief knelt in prayer and pledged "Thanksgiving" to God for their healthy arrival after a long voyage across the Atlantic. This event has been acknowledged by some scholars and writers as the official first Thanksgiving among European settlers on record. Whether at Plymouth, Berkeley Plantation, or throughout the Americas, celebrations of thanks have held great meaning and importance over time. The legacy of thanks, and particularly of the feast, have survived the centuries as people throughout the United States gather family, friends, and enormous amounts of food for their yearly Thanksgiving meal.

According to History.com, the most detailed description of the "First Thanksgiving" comes from Edward Winslow from A Journal of the Pilgrims at Plymouth, in 1621: "Our harvest being gotten in, our governor sent four men on fowling, that so we might after a special manner rejoice together after we had gathered the fruit of our labors. They four in one day killed as much fowl as, with a little help beside, served the company almost a week. At which time, among other recreations, we exercised our arms, many of the Indians coming amongst us, and among the rest their greatest king Massasoit, with some ninety men, whom for three days we entertained and feasted, and they went out and killed five deer, which they brought to the plantation and bestowed upon our governor, and upon the captain, and others. And although it be not always so plentiful as it was at this time with us, yet by the goodness of God, we are so far from want that we often wish you partakers of our plenty."

Historians are no exactly sure what was eaten at the first Thanksgiving back in 1621 according to AssociatedContent.com, but they are certain that the Pilgrims and the Indians didn't sit down at a table and consume cranberry sauce, mashed potatoes, or pumpkin pie. Many of the culinary delights that are placed on our Thanksgiving tables are very similar to those foods that were around during the Pilgrims time, but the dishes that were actually served were not similar to modern dishes. For example, cranberries were available back in 1621, but sugar had not yet come to the New World. So, it is hard to believe that cranberries were part of the first Thanksgiving menu. However, the Thanksgiving holiday is chock full of symbolism which provides the perfect occasion for sharing an American tale about determination, freedom, survival, and celebration. Telling the story of Thanksgiving is a great way to teach kids American history and the idea of giving thanks. American history may be a boring subject as far as kids are concerned, but recounting the story of Thanksgiving by using some of the food that the Pilgrims ate for their Thanksgiving could make children view American history in a more positive and creative way.

So, what might have been served on that 17th century menu? According to the folks at AssociatedContent.com, wild turkey might have been on the menu but it would have been served with venison, which is deer meat. In addition, fishes such eel, sea bass, and cod might have made an appearance for the first Thanksgiving. However, potatoes, yams, and sweet potatoes wouldn't have made it on the menu because they had not yet been introduced in New England. In addition, there was a large variety of corn including red, yellow, white, and blue corn. As far as dessert was concerned, at the first Thanksgiving there were no pumpkin pies topped with whipped cream or apple pie a la mode. However there were a wide variety of nuts and fruits such as walnuts, acorns, dried cherries, plums, blueberries, and strawberries. Regardless of the early dishes of food, today's Thanksgiving is creating a tradition all of its own because the turkey is still the culinary symbol of Thanksgiving. In fact, 91% of Americans eat turkey on Thanksgiving; and of the 300 million turkeys raised each year, 45 million turkeys are eaten on Thanksgiving. It doesn't matter whether the first Thanksgiving dinner had roasted turkey or baked eel. What matters is that Thanksgiving has an important place on our calendars and in American culture. The Pilgrims celebrated a fine harvest after a cold winter, and we also celebrate what we have accomplished over the past year. Thanksgiving is another holiday that celebrates faith, family, friends, and food.

Better Homes and Gardens offers some tips on making sure your turkey doesn't make you sick for the Thanksgiving holiday:
--Also check for the "sell by" date on the label of a fresh turkey. This date is the last day the turkey should be sold by the retailer.
--The unopened turkey should maintain its quality and be safe to use for one or two days after the "sell by" date.
--If you buy a frozen turkey, look for packaging that is clean, undamaged, and frost-free.
--Keep it in the fridge. Never marinate or defrost poultry on the counter. Always keep poultry in the refrigerator until you are ready to cook it.
--Keep it clean. Always wash your hands, work surfaces, the sink, and utensils in hot, soapy water after handling raw poultry, to prevent spreading bacteria to other foods.
--Cut right. When cutting raw poultry, use a plastic cutting board; it's easier to clean and disinfect than a wooden one.
--Don't wash the bird. Washing raw poultry is not necessary, and the splashing water may contaminate surrounding objects. In general, the less you handle poultry, the safer it remains.
--Avoid cross contamination. Never use the same plate or utensils for uncooked and cooked poultry unless you have thoroughly washed them first. This rule applies to basting brushes as well. If you are going to baste the bird, wash the brush each time.
--Don't stuff it early. If you're planning to stuff the bird, do so immediately before cooking.
--Never allow the stuffing to touch raw poultry unless you are going to cook both right away.
--Heat any marinade or basting sauce that has been in contact with the raw poultry if it is to be served with the cooked poultry. Juices from the uncooked poultry may contain bacteria. Or, before you start basting, set some of the sauce aside to serve with the poultry.
--Serve poultry immediately after cooking it. Don't let it stand at room temperature longer than two hours, or bacteria will multiply rapidly -- especially in warm weather. Refrigerate leftovers as soon as possible.
--Reheat wisely. Heat leftover gravy to a rolling boil in a covered saucepan, stirring occasionally, for food-safety assurance.

And now, from Better Homes and Gardens, for the perfect Thanksgiving holiday treat--Traditional Pumpkin Pie. Ingredients:
1 recipe Pastry for Single-Crust Pie (see below)
1 15-ounce can pumpkin
2/3 cup sugar
1 teaspoon ground cinnamon
1/2 teaspoon ground ginger
1/2 teaspoon ground nutmeg
3 slightly beaten eggs
1 5-ounce can (2/3 cup) evaporated milk
1/2 cup milk

1. Prepare and roll out Pastry for Single-Crust Pie. Line a 9-inch pie plate with the pastry. Trim to 1/2 inch beyond edge of pie plate. Fold under extra pastry; crimp edge as desired.
2. For filling, in a mixing bowl combine pumpkin, sugar, cinnamon, ginger, and nutmeg. Add eggs. Beat lightly with a rotary beater or fork just until combined. Gradually stir in evaporated milk and milk; mix well.
3. Place the pastry-lined pie plate on the oven rack. Carefully pour filling into pastry shell.
4. To prevent overbrowning, cover edge of the pie with foil. Bake in a 375 degree F oven for 25 minutes. Remove foil. Bake about 25 minutes more or until a knife inserted near the center comes out clean. Cool on a wire rack. Refrigerate within 2 hours; cover for longer storage. Makes 8 servings.

Pastry for Single-Crust Pie: Stir together 1-1/4 cups all-purpose flour and 1/4 teaspoon salt. Using a pastry blender cut in 1/3 cup shortening until pieces are pea-size. Using 4 to 5 tablespoons cold water, sprinkle 1 tablespoon of the water over part of the mixture; gently toss with a fork. Push moistened dough to side of the bowl. Repeat moistening dough, using 1 tablespoon of the water at a time, until all the dough is moistened. Form dough into a ball. On a lightly floured surface, use your hands to slightly flatten dough. Roll dough from center to edge into a circle about 12 inches in diameter.

Make-Ahead Tip: Prepare, bake, and cool pie as above. Cover and refrigerate for up to 8 hours.
Test Kitchen Tip: You can use 1-1/2 teaspoons pumpkin pie spice for the spices in this pie.
Nutrition Facts: Calories 286, Total Fat (g) 13, Saturated Fat (g) 4, Cholesterol (mg) 86, Sodium (mg) 120, Carbohydrate (g) 38, Fiber (g) 2, Protein (g) 7, Vitamin A (DV%) 130, Vitamin C (DV%) 9, Calcium (DV%) 7, Iron (DV%) 13. Percent Daily Values are based on a 2,000 calorie diet.

Thanksgiving is a time to be with family and friends, to honor our nation, freedoms, and heritage, and to give thanks for all the blessings provided by God. Take time during the holiday to stop and actually give thanks for everything you have. Thanksgiving means more than a big meal with lots of food and people around the table. It's more than all day football on TV or going to the mall for the beginning of the Christmas Season. The real meaning of Thanksgiving reaches deep into our soul and spirit and represents all that is good. Make this Thanksgiving a great one to remember.

Until next time. Let me know what you think.

Monday, November 17, 2008

Health Care and Open Enrollment

Now is the time of year that many companies are going through the time honored employer tradition called "Open Enrollment." Businesses are offering their workers health insurance options that may or may not be what the employees want but must choose to participate in before year end if they want to be insured and whether to include any dependents. According to CNNMoney.com, from October to November every year, millions of Americans must select health insurance and other benefits at work. Each year the choices get more complex and the financial consequences get bigger. For 2009, nearly half of companies plan to push more health-care costs onto employees, often in less than transparent ways as reported by Mercer. There will be higher premiums, of course - on average, 8% higher, according to Hewitt. Also, they report you should expect increased deductibles (what you shell out before benefits kick in), co-pays (flat fees at the doctor or pharmacy) and co-insurance (your percentage of the bill in other cases).

Most likely, according to CNNMoney, your options will fall into four categories: There's the familiar health maintenance organization (HMO), which typically requires you to use approved doctors and hospitals. Then there are the preferred-provider organization (PPO) and point-of-service (POS) plans, which give you the option to see an out-of-network doctor for a higher price. And this year your employer may join the increasing number of firms offering a high-deductible plan tied to a tax-free health savings account (HSA), a low-premium option that provides limited benefits until you spend a certain amount out of pocket.

All the more reason to consider every option according to CNNMoney. Use this strategy to pick a plan that gives you value for your health-care dollar - without putting your finances at risk. Here are the steps to follow when considering a plan during open enrollment:

Step 1: Separate the apples from the oranges.
Start by deciding if the high-deductible plan with an HSA is right for you. This may be the first time you've seen such a plan. At first glance, it will stick out the most with its comparatively low premiums - for 2008, employees paid an average of $2,330 for family coverage vs. $3,340 to $3,730 for the other plan types, reports the Kaiser Family Foundation. In exchange for this price break, families in these plans typically face deductibles from $2,300 to $10,000. (The average in 2008 was $3,910, compared with $1,340 in a PPO, according to Kaiser.) Many of the plans cover preventive care at 100%. But for everything else, you pay in full until you hit the deductible, after which the plan usually functions like any other. To cover out-of-pocket costs, you can save pretax dollars - up to $5,950 in 2009, plus a $1,000 catch-up for those 55 or older - in the HSA. Your employer may also contribute. The money rolls over year to year and can be taken out for any purpose at age 65, though it's taxable if not used on medical costs. (Note: Not all high-deductible plans qualify for an HSA. Your plan paperwork should say if yours does.) Intrigued? Understand this: Signing up for this type of plan is essentially making a bet that you'll stay healthy. You'll probably save money over traditional plans while you're well, but you'll likely spend a lot more if you get sick. (Figure that you could owe the whole deductible in one pop if you're hospitalized.) So if you have young kids, a costly chronic condition or a family history of a debilitating disease, you're likely better off with the other plan types. Usually high deductible plans make the most sense for those who are young and healthy, but they can also offer financial benefit for wealthy empty-nesters who want to take advantage of the tax savings and can handle a financial surprise. In fact, anyone who is interested in this plan type should make sure they can afford the deductible -if you get sick before your HSA reaches that amount, you'll have to come up with the cash. Eliminate this option if you don't have the funds.

Step 2: Narrow the oranges.
Skipping the high-deductible plan? To make sense of your leftover options, which are more similar in the way they operate, start with two questions: Are your doctors in-network? And would you ever want to go out of network? First, unless you're willing to switch providers, search the insurers' Web sites or simply call your doctors and hospitals to find out if they accept the plans you're considering. With an HMO, you'll typically have to use doctors on the list; with a PPO or POS, using out-of-network doctors will cost you significantly more. Either way, you may want to jettison any plans that your favorite docs don't participate in. As to the second question, if you'd rather not be restricted from seeing, say, the top oncologist in your state if he's not on your plan, you may want a more flexible PPO or POS. Also, note that HMO and POS plans generally require referrals to see specialists. If that bothers you, you may want to go PPO.

Step 3: Zero in on key costs
If you still have multiple plans on your list, compare their main terms. Premiums on HMO, PPO and POS plans can be similar, but the plans' less-transparent costs vary widely. If your company hasn't done so for you, chart out the costs. Turn an 8½-by-11-inch page on its side and write plan names along the top and the following terms down the left. Fill in details for each, making sure to note, where appropriate, how costs differ in and out of network; include what counts toward deductibles and maximums. Don't forget to consider the following:
--Co-pays and co-insurance
--Prescription coverage (Confirm that the plan covers your current meds.)
--Out-of-pocket maximums

Step 4: Pick your final answer.
If the choice isn't obvious after comparing plans, calculate your costs on each using a guesstimate of last year's health-care usage. Then see how much it would run if you needed a lot more care. (Your employer or the plan sponsors may offer online calculators to make this math easier.) The main thing to consider in making the final pick: You want a plan that you'll be able to afford, whether you're healthy or unhealthy. Whatever you do, don't miss the sign-up deadline. More companies are defaulting workers into high-deductible plans instead of their past year's choice. Meaning: Unless you're hale and hearty, indecision could be costly.

So if you have more than one health care plan to choose from, review your options, don't just blindly renew according to CBSNews.com. Make sure you're in a plan that is right for you both in terms of coverage and cost. And take advantage of Flexible Spending Accounts. More workers need to take advantage of these really great accounts. These accounts allow you to use pretax dollars to pay for healthcare costs not covered by your insurance. This includes your deductible and co-payments, but also can include things like eye glasses, over the counter medications, stop-smoking programs and so on. The one catch here is that this is a use-it-or-lose-it proposition: you need to use the money in roughly a one year period or you lose it. So, be conservative, but don't skip this option altogether. Also, max out your Dependent Care Account and Transit Accounts. These are different types of flexible spending accounts. One lets you use up to $5,000 in pretax dollars to pay for the daycare costs of a child that's under age 13, or an elderly parent who lives with you who also needs daycare. The other type of account lets you use pretax dollars to pay for commuting and parking costs. If you're offered these types of accounts and you have these types of expenses, it's a no-brainer. Something else to consider is the Roth 401(k). Employers have been slow to embrace this new twist on the traditional 401(k) plan. But thanks to some tax code changes we're finally starting to see them rolled out. Like a Roth IRA, these accounts are funded with after-tax dollars, but withdrawals taken during retirement are completely tax free and that's a big gift from the government. These are a great option for younger workers. And no matter what, try to increase your 401(k) contribution for 2009. And finally look for other fringe benefits. Gym discounts, discounts on cell phone providers and discounts for buying a hybrid car. Many employees, especially big ones, offer all kinds of employee perks. Find out what's available. Taking advantage of these options is like getting a little raise and with no added work.

According to BenefitNews.com, the open enrollment period happens on an annual basis. It’s easiest to coordinate with your providers to make sure that open enrollment for each coverage plan falls at the same time of the year, rather than have different open enrollment times for every plan. Most plan providers won’t let you or your employers make a change unless there’s a qualifying event. The main qualifying event is defined by the IRS as an event that:
--Divorce or legal separation;
--Death of spouse or dependent.

Usually open enrollment covers insurance plans such as health, dental, vision, life, accidental death & dismemberment, short term disability and long term disability according to BenefitNews.com. It also covers any additional voluntary or supplementary plans your company may offer. Employees can choose:
--To start coverage if they don’t have any;
--Change from one plan to another, if that option is available; or
--Drop coverage completely, if that’s an option

Employees need the option to choose from one of those plans, or to choose none at all. That’s what open enrollment is all about. Do your homework early and find out what option works best for you. Make sure that your employer has provided all the information you need to make a wise choice for your employer sponsored health care plan. Knowledge is power. Be informed. Choose wisely.

Until next time. Let me know what you think.

Friday, November 14, 2008

Health Care and Strokes

Stroke is the third leading cause of death in America and the No. 1 cause of adult disability according to the National Stroke Association. A stroke occurs when a blood clot blocks an artery (a blood vessel that carries blood from the heart to the body) or a blood vessel (a tube through which the blood moves through the body) breaks, interrupting blood flow to an area of the brain. When either of these things happen, brain cells begin to die and brain damage occurs. When brain cells die during a stroke, abilities controlled by that area of the brain are lost.

These abilities include speech, movement and memory according to the National Stroke Association. How a stroke patient is affected depends on where the stroke occurs in the brain and how much the brain is damaged. For example, someone who has a small stroke may experience only minor problems such as weakness of an arm or leg. People who have larger strokes may be paralyzed on one side or lose their ability to speak. Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability.

Also called a brian attack according to the National Institute of Neurological Disorders and Stroke (NIH), a stroke is a medical emergency. Strokes happen when blood flow to your brain stops. Within minutes, brain cells begin to die. There are two kinds of stroke. The more common kind, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain. "Mini-strokes" or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly interrupted. Symptoms of stroke are:
--Sudden numbness or weakness of the face, arm or leg (especially on one side of the body).
--Sudden confusion, trouble speaking or understanding speech.
--Sudden trouble seeing in one or both eyes.
--Sudden trouble walking, dizziness, loss of balance or coordination.
--Sudden severe headache with no known cause.

If you have any of these symptoms, you must get to a hospital quickly to begin treatment according to the NIH. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot or by stopping the bleeding. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Drug therapy with blood thinners is the most common treatment for stroke. Each year in the United States, there are more than 700,000 strokes. Stroke is the third leading cause of death in the country. And stroke causes more serious long-term disabilities than any other disease. Nearly three-quarters of all strokes occur in people over the age of 65 and the risk of having a stroke more than doubles each decade after the age of 55. For African Americans, stroke is more common and more deadly - even in young and middle-aged adults - than for any ethnic or other racial group in the United States.

According to the American Heart Association (AHA), Ischemic Stroke is the most common type. It accounts for about 87% of all strokes. It occurs when a blood clot (thrombus) forms and blocks blood flow in an artery bringing blood to part of the brain. Blood clots usually form in arteries damaged by fatty buildups, called atherosclerosis. When the blood clot forms within an artery of the brain, it's called a thrombotic stroke. These often occur at night or first thing in the morning. Another distinguishing feature is that very often they're preceded by a TIA or "warning stroke." TIAs have the same symptoms of stroke but only last a few minutes; stroke symptoms last much longer. If someones experiences a TIA, they should urgent medical care immediately.

A wandering clot (an embolus) or some other particle that forms away from the brain, usually in the heart, may also cause an ischemic stroke according to the AHA. This is called cerebral embolism. The clot is carried by the bloodstream until it lodges in an artery leading to or in the brain, blocking the flow of blood. The most common cause of these emboli is blood clots that form during atrial fibrillation (AF). AF is a disorder found in about 2.2 million Americans. It's responsible for 15–20 percent of all strokes. In AF, the heart's two small upper chambers (the atria) quiver like a bowl of jello instead of beating strongly and effectively. Some blood isn't pumped completely out of them when the heart beats, so it pools and clots can form. When a blood clot enters the circulation and lodges in a narrowed artery of the brain, a stroke occurs. This is called a cardioembolic stroke, or a stroke that occurs because of a heart problem.

According to the American Heart Association, a subarachnoid hemorrhage occurs when a blood vessel on the brain's surface ruptures and bleeds into the space between the brain and the skull (but not into the brain itself). A cerebral hemorrhage occurs when a defective artery in the brain bursts, flooding the surrounding tissue with blood. Hemorrhage (or bleeding) from an artery in the brain can be caused by a head injury or a burst aneurysm. Aneurysms are blood-filled pouches that balloon out from weak spots in the artery wall. They're often caused or made worse by high blood pressure. Aneurysms aren't always dangerous, but if one bursts in the brain, they cause a hemorrhagic stroke. When a cerebral or subarachnoid hemorrhage occurs, the loss of a constant blood supply means some brain cells no longer can work. Accumulated blood from the burst artery also may put pressure on surrounding brain tissue and interfere with how the brain works. Severe or mild symptoms can result, depending on the amount of pressure. The amount of bleeding determines the severity of cerebral hemorrhages. In many cases, people with cerebral hemorrhages die of increased pressure on their brains. But those who live tend to recover much more than people who've had strokes caused by a clot. That's because when a blood vessel is blocked, part of the brain dies — and the brain doesn't regenerate itself; in other words, brain cells can't be replaced. But when a blood vessel in the brain bursts, pressure from the blood compresses part of the brain. If the person survives, gradually the pressure goes away. Then the brain may regain some of its former function.

According to MedicineNet.com, typically, a clot forms in a small blood vessel within the brain that has been previously narrowed due to a variety of risk factors including:
--High blood pressure (hypertension)
--High cholesterol

According to the Mayo Clinic, stroke is a medical emergency, and prompt treatment of a stroke is crucial. Early treatment can minimize damage to your brain and potential stroke complications. The good news is that strokes can be treated, and many fewer Americans now die of strokes than was the case 20 or 30 years ago. Improvement in the control of major risk factors for stroke — high blood pressure, smoking and high cholesterol — is likely responsible for the decline.

The NIH reports that because stroke injures the brain, you may not realize that you are having a stroke. The people around you might not know it either. Your family, friends, or neighbors may think you are confused. You may not be able to call 911 on your own. That's why everyone should know the signs of stroke - and know how to act fast. Don't wait for the symptoms to improve or worsen. If you believe you are having a stroke - or someone you know is having a stroke - call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability.

Until next time. Let me know what you think.

Thursday, November 13, 2008

Health Care and Diet

Do you watch what you eat? A significant number of Americans are helping to make the U.S. win first place for "Fattest Country on the Planet." So far, we are leading for the gold medal. There are two eternal truths about diets according to Forbes.com: One, if properly followed they will result in weight loss; and two, most people will cheat. Only an iron will, an in-house nutritionist or numbed taste buds can guarantee a successful diet. But this isn't just a question of discipline. It's also boredom, timing and preconditioning. For example, an athlete accustomed to consuming large amounts of food will find it hard to reduce his or her caloric intake when no longer in training.

Even if the foods are tasty--the Atkins diet actually encourages people to eat bacon and butter--people will hunger for the forbidden as reported by Forbes.com. The reason is that many diets are too restrictive and are not designed to be sustained over time. For example, go to a spa, drink lots of water, go for hikes, do yoga, eat 1,000 calories a day and lose weight. Within a short time of coming home, though, the weight that had been lost, like the prodigal son, has now returned. The key to losing weight is not through quick fixes and fancy spas, no matter how much we may enjoy them, but rather it's taking a more sensible and long-term approach that balances diet with lifestyle.

One of the most common New Year’s resolutions is to lose weight or at least eat more healthfully. Several Web sites offer tips and tools for getting there according to the New York Times:
1.) 3FatChicks.com--This web site began as a personal source of diet support for sisters Suzanne, Jennifer and Amy and has now grown into a community of over 70,000 registered members. It has the typical diet-site resources and tools, but the main appeal is the forum for dieters to share stories and find support.
2.) CookingLight.com--A great site for finding healthy and delicious foods that won’t make you feel like you’re on a diet. You’ll find recipes, nutrition information and advice on cooking techniques.
3.) Dr.Gourmet.com--New Orleans physician Timothy S. Harlan, also known as Dr. Gourmet, has created free diet software that helps you plan more healthful meals. He calls it the Quality Calorie Diet Plan to reflect his belief that it’s the quality of the calories we eat that counts the most. The site creates meal plans and even offers ways to use leftovers later in the week. It includes food and exercise diaries as well as goal-tracking features, and a place for users to analyze their own recipes.
4.) SouthBeachDiet.com--This diet gained popularity as an alternative to the strict low-carb regimen of Atkins, with an emphasis on “good carbs” like high-fiber vegetables and whole grains. It also offers a free week trial, followed by a $5 a week membership fee.
5.) WeightWatchers.com--Although the site is offering a one-week free trial to it’s online plan, you’ll have to pay $65 for a three month subscription if you stick with it. While it’s true that most people who diet end up gaining back their weight, much of what Weight Watchers claims is backed by science.
6.) ABetterFoodPyramid.com--Harvard nutritionists say their revamped food pyramid is based on the latest science and is “unaffected by businesses and organizations with a stake in its messages.” It starts with exercise and encourages adding more plant-based foods and cutting back on “American staples” like red meat, refined grains, potatoes and sugary drinks.

According to Forbes.com, few nutritionists would dispute that an organic diet is beneficial to health--not only is it more nutrient-dense, but also it is free of chemicals and additives--but there is one problem. Although many people consider organic to be synonymous with guilt-free, it doesn't mean organic food won't cause weight gain. It's a common misconception that food allowed in any diet can be eaten in abundance, when on the contrary, eating too much of anything, organic or not, is a surefire way to get fat.

According the Ladies Home Network, the USDA and its Human Nutrition Research Centers have recently launched a new initiative to address what the USDA calls the "long-neglected need for rigorous research on popular diets." Many of these diets have never been tested for efficacy or safety. In a preliminary review, the USDA categorized popular diets into three groups:
--High-fat, low-carbohydrate diets. Such diets include the high-protein, low-carbohydrate diets that have seen a recent return to popularity (Dr. Atkins, New Diet Revolution, Protein Power, Life Without Bread).
--Moderate-fat diets. These include diets that are high in carbohydrates and moderate in protein, but that limit fat to 20%-30% of calories. Such diets are widely advocated by major governmental and health organizations (Dash Diet, USDA pyramid, Weight Watchers).
--Low-fat and very low-fat diets. These diets call for a very high intake of carbohydrates and a very low protein intake; some are vegetarian (Dr. Ornish; The New Pritikin Program; Eat More, Weigh Less).
The USDA report observes that any of these approaches helps people lose weight mainly by way of calorie restriction, not by the inclusion or exclusion of a particular type of nutrient. The report also concludes that the healthiest diets for long-term use are those that include the widest array of food groups.

WebMD reports about the danger in fad diets. A Fad Diet is one that is more of a "quick fix" that is not going to lead to improved health, and that can't be pursued on a long-term basis. There are several ways to recognize a fad diet. A fad diet:
--Doesn't include the variety of foods necessary for good health and/or doesn't teach good eating habits.
--Claims you can "trick" the body's metabolism into wasting calories or energy.
--Makes dramatic claims for fast and easy weight loss.

Going on a diet is a way to start losing weight. However, if you are significantly overweight or obese, you should consult your doctor before starting any program designed to help lose weight. Some diets can actually hurt your physical metabolism if not done correctly, and you should always keep in mind portion control any time you eat. Losing a consistent amount of weight over time is the best way to diet. Also, you should maintain a healthy lifestyle along with an exercise plan that will augment your success with your diet. Changing your eating habits from poor to good will definitely go a long way to help keep the weight off. Diets can be beneficial, but they must be used in conjunction with a complete health regimen to be effective on a long term basis.

Until next time. Let me know what you think.

Thursday, November 6, 2008

Health Care and the New Obama Landscape

November 5th, 2008, marked an historic day in American history when an African-American was voted in as the next president of the United States. Barack Obama will serve as the 44th President after his inauguration in January, 2009. With a majority of the electoral and popular vote in his favor, Mr. Obama is setting American politics on its ear--right or wrong. The country has indeed seen that anyone can be President. Now, the clock starts ticking toward January when the president-elect will take the oath of office and take command of the executive branch of our government. According to the International Herald Tribune, good will represents a formidable asset - so long as it lasts. But history suggests this fortunate phase for Obama will prove temporary. Before the age of polarization, Americans often swung behind new presidents in overwhelming numbers. Dwight Eisenhower, John F. Kennedy and Jimmy Carter also received approval ratings comparable to Obama's in their first weeks in office.

According to the Flathead Beacon, the recession is changing the dynamics of health care at a time when the Obama administration is pushing heavily for sweeping health care reform and lawmakers at the state level are voicing their concerns as well. Both the health care providers and general population are feeling the pinch. The number of people without insurance rises with every job lost. The same concerns are associated with dental care and every other facet of the health care industry. Health care providers are bracing for a year of “belt-tightening” with the expectation that the number of people being cared for but who are unable to pay their bills will remain high, or increase. When a hospital doesn’t receive reimbursement for care, it absorbs the costs as “bad debt” or charity care expenses.

Health care is the largest industry – and one of the fastest-growing – in the United States, employing more than 14 million people and providing seven of the 20 fastest-growing occupations nationwide, according to the U.S. Bureau of Labor Statistics. As the health care industry continues to grow, according to the Flathead Beacon, so do concerns over costs and insurance. Nationwide, 15% of the population doesn’t have health insurance. The past year’s economic woes have tempered the good feelings associated with the increase of people with insurance. It’s too early to tell what effect Barack Obama’s presidential administration will have on the health care industry, but hospital officials are keeping close tabs on the president’s claims to make health care reform a foremost priority. However, there’s tremendous momentum behind some kind of comprehensive health care reform.

According to McDermott, Will & Emery (MWE), President-Elect Obama’s health care pronouncements to date indicate a desire to work toward universal coverage, with the federal government occupying an important, but not exclusive, role. The plan enunciated by the Obama campaign embodies the “play or pay” concept, which would require large employers that do not offer or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of a national insurance plan. The plan also called for expanded eligibility for Medicaid and the State's Children's Health Insurance Program (SCHIP). And, for those who do not have employer-provided health care and who do not qualify for existing federal programs, a new national health insurance program would be created. Individuals could choose between the new public insurance program and private insurance plans that meet certain coverage standards. While President-Elect Obama has not called for mandated individual coverage, he has called for mandatory health insurance coverage for all children. President-Elect Obama has also called for spurring increased adoption of health information technology and establishment of a comparative effectiveness institute that would review the relative effectiveness of different interventions.

Earlier in 2008, the worsening economic outlook prompted many who desire health reform to wonder where the money would be found to pay for it as reported by MWE. (Current budget rules, PAYGO or pay as you go, require that any new spending be offset.) Interestingly, this dialogue is now undergoing a subtle shift. Some lawmakers have indicated that the investment in health reform is so important that it should happen regardless of whether or not it is paid for in the early years. Further, an increasing number of policymakers are describing health reform as a key “jobs-creation” measure that is a vital component of any economic recovery effort. Nonetheless, key factors affecting any domestic spending, including spending on health legislation, include the burgeoning budget deficit, the $700 billion cost of the recent financial rescue package, and the ongoing wars in Iraq and Afghanistan. In addition, if the Democrats fail to gain a filibuster-proof majority in the Senate, Republicans will be able to use the filibuster to affect and to thwart legislation, including health legislation.

MWE also reports that the first health policy focus in the new year will likely be on already identified and targeted health initiatives. Some are time-sensitive measures while others are front-and-center concerns. Health industry stakeholders immediately have opportunities to weigh in on these initiatives and either affect their shape or capitalize on them as vehicles for accomplishing other health-related goals apart from the specific focus of the legislation. In addition, understanding the health legislative and regulatory landscape remains a critical element of sound legal and business strategy and decision-making. Time-sensitive measures include changes in the SCHIP program along with Medicaid and Medicare payment reductions. Other pressing health priorities include health information technology, follow-on biologics and re-tooling of the Medicare physician drug benefit.

McDermott, Will & Emery also report that additional areas ripe for possible early action in 2009 include drug importation, embryonic stem cell research and tobacco regulation. President-Elect Obama has indicated that the importation of prescription drugs from other countries should be allowed provided safety is assured. He has also expressed support for government negotiation of drug prices, reversing the ban on federal funding of research using embryonic stem cells, and giving the FDA authority to regulate the manufacturing, marketing and sale of tobacco products.
Clearly, health issues will be center stage on the congressional and administration agenda in 2009. Players in the health sector should carefully evaluate their desired level of involvement in the upcoming swirl of health legislative activity.

But before long, if unemployment climbs as predicted to 8% or 9% next year, the worsening economic crisis will deepen the health insurance crisis according to AlterNet. And the combination of job losses and the loss of insurance that is inevitably connected to them is likely to be an awful lot like the crisis of the early 1990s -- the last time the political system tried to fix the confused, costly and crumbling health insurance system. Costs are driven inexorably higher by continual advances in care as well as an aging population that needs more of it. Employers can't cope unless they scale back coverage, shift costs to workers or eliminate benefits altogether. States have become insurers of last resort -- but right now they face crippling budget shortfalls that threaten this safety net. Tightening regulation of the insurance industry and creating a new, government-based plan to make coverage available to those who cannot afford to buy it from private insurers -- the essence of Obama's campaign proposal -- would only add another layer of complexity and, eventually, cost.

Government at the state and federal levels, insurance companies, the medical community, and the public must work together to improve the current status of the American health care system--but not ruin it. We need to improve how health care and insurance works. Yes, there are issues that need addressed to update our health care system. However, health care is alot like a finely tuned automobile. When all the fluids are full, the gas tank is full, and the tires are correctly pressured, it works great even on bumpy roads. When you blow a gasket, the car stalls out and stops. If the government wants coverage to be effective, it does not need to tell patients what repair shops to us and what mechanics to see. That should be left up to each American to decide. Each individual has the right to choose his own plan, his own insurance, and his own medical provider. Even President Obama knows that the United States was built on the concept of individual liberty. He doesn't have the right to take it away. A government controlled universal payor system would turn us into Canada or the U.K., and the stories related to government run health care mis-management in those countries make everyone shudder. Americans do not deserve a nationalized health care system, but they do deserve quality of care and a way to effectively control costs. Let's research those ideals and not ways to wreck the car.

Until next time. Let me know what you think.