Posts Tagged ‘healthcare’

Warren Buffett & Healthcare Reform

March 2nd, 2010

Today, there are a lot of angry healthcare, health insurance and drug company executives.

They’re angry because America’s investment guru, Warren Buffet, the Oracle of Omaha himself, appeared on CNBC yesterday and eviscerated the current American healthcare system.

Without using any of the political rhetoric being thrown around Washington, Buffett noted that:

  • Out of control health care costs are like a tapeworm eating at our economic body
  • The current U.S. health care system eats up 17 percent of U.S. gross domestic product, at a time when many other countries pay only nine or 10 percent of GDP but have more doctors, nurses and hospital beds per capita.
  • While Mr. Buffett said he would support overhaul legislation proposed by the U.S. Senate, he would prefer existing proposals be scrapped in favour of a new one that attacks costs.
  • “If it was a choice today between Plan A, which is what we’ve got, or Plan B, which is the Senate bill, I would vote for the Senate bill,” he said. “But I would much rather see a Plan C that really attacks costs, and I think that’s what the American public wants to see.”
  • Instead of paying for procedures, American healthcare consumers should be paying for results

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So, does that mean that America’s financial guru has gone socialist?

Not exactly.

Like the great investor he is, Buffett sees U.S. healthcare in black & red.

  • Too much red (costs equal to 17% GDP crippling the U.S. economy, inadequate medical coverage resulting in bankruptcies, American businesses at a global disadvantage due to their healthcare burden, etc…)
  • Not enough black (budget surplus, healthy nation, increased business profits, higher wages, etc…)

And in keeping with his investment strategy, Buffett doesn’t claim to have all the answers to solving the healthcare riddle. (unlike the geniuses on Capital Hill)

He would rather assemble all of the biggest healthcare brains in the country and listen to what they have to say.

Big brains like Atul Gawande.

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Fighting Fat With Vinegar

October 14th, 2009

oil and vinegarYour Grandma was right.

It turns out that the acetic acid found in plain ole’ vinegar is effective in suppressing body fat accumulation.

The Science

Earlier this year, Japanese researchers found that laboratory mice fed a high-fat diet and given acetic acid developed significantly less body fat (up to 10 percent less) than other mice.

Based upon their findings, the scientists believe that acetic acid fights fat by turning on genes for fatty acid oxidation enzymes. The genes churn out proteins involved in breaking down fats, thus suppressing body fat accumulation in the body.

link to the study

Conclusion

Vinegar is cheap, harmless and versatile in the kitchen.

It may also help you metabolize sugars more efficiently, lower blood pressure and lose weight.

What do you have to lose?

Links to more vinegary/weight loss research

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Fit Kids Need Playgrounds

October 1st, 2009

playground graffiti

Fear of dangerous strangers is keeping our kids and teens from using their neighborhood playgrounds and parks.

Instead, they stay inside and play virtual table tennis on their Nintendo Wii.

It’s not the same thing.

Researchers in the Faculty of Physical Education and Recreation at the University of Alberta, looked at perceived opportunities and barriers to physical activity in an inner-city neighbourhood in Edmonton.

Study data revealed three themes that influenced youngsters’ opportunities for physical activity, with positive and negative factors for each.The first theme identified was “neighbourhood characteristics.”

Positive neighborhood characteristics include “walkable” neighborhoods with plenty of parks and playgrounds and nearby amenities.

Negative neighborhood characteristics include perceived “stranger danger” fears related to drug users, bullies, prostitutes, gang members and fear of abduction deterred children and youth from visiting these places.

The second theme was “family involvement.”

Researchers found that while children and youth were rarely allowed out alone, involvement by a family member, for example, accompanying them to a park to play, increased their engagement in physical activity.

The third theme was the “availability of adult-supervised programs.”

On the positive side, we have neighborhoods with a large variety of programs offered by dedicated, hard-working staff and volunteers.

Conversely, neighborhoods with minimal resources; poor staff and volunteer recruitment and retention, and little public knowledge of program availability suffered badly. Even when kids did sign up for available programs, there was a high dropout rate.

Conclusion

If we want our kids to grow up fit and strong and healthy, we need to:

  1. Take back our neighborhood parks & playgrounds (easier said than done)
  2. Get involved with our kids’ lives…not just drop them off at the rec center
  3. Push our governments for more public fitness programs

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Just in case America isn't fat enough…

September 21st, 2009

taco bell fourth meal

As the debate over President Obama’s healthcare proposal rages on, Taco Bell continues to give Americans exactly what they crave….melty, crunchy, spicy and heart attack inducing.

I especially love the tagline at the end…

taco bell it's not just food fourth meal

Of course, I would change it just a little bit.

taco bell not real food

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Did You Play Today?

September 11th, 2009

childhood obesity psa where the wild things are

The U.S. Dept of Health and Human Services and the Ad Council today launched a new series of PSAs designed to address childhood obesity. Featuring characters from the upcoming film Where the Wild Things Are, the PSAs are an extension of HHS’ Childhood Overweight and Obesity Prevention campaign with the Ad Council, which encourages children and families to lead healthy lifestyles.

These PSAs cost millions of dollars.

But do they work?

Will this PSA get your kid to put down the Wii controller and go outside and play?

did you play today

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America's Celebrity Doctors Weigh In On Healthcare Reform

August 13th, 2009

Apparently, a good portion of America has gone completely insane over healthcare reform.

  • We’ve heard from the politicians – Democrat & Republican.
  • We’ve heard from the pro gov’t healthcare crowd…[unitelligible screaming]
  • We’ve heard from the anti gov’t healthcare crowd…[unitelligible screaming]
  • And we’ve heard way too much from the teleprompter readers on tv – left & right & even more right

So, today, let’s take a look at what America’s favorite celebrity doctors have to say about healthcare reform in America.

First up, Oprah’s personal health guru:

Dr. Oz

dr ozPart of the challenge we face is that all eyes are focused on healthcare finance arguments in Washington, but the real action is taking place in our homes across this great land. We cannot have a wealthy country without being a healthy country, but healthcare finance solutions by themselves do not help us care for our health. An insurance card is correlated with, but does not guarantee a clean bill of health.

To control costs without rationing care, we need to improve the quality of the services we buy for our money. Economists and the few remaining car salesmen would agree that this translates to better value.

We have two principal options.

First, we need to eliminate the 20 percent of services offered that are wasteful or harmful.

Doctors need to act like professionals and police our own for doing unnecessary tests and procedures but we also need smart patients to insist on second opinions that will change their diagnosis or therapy in a third of all cases.  Many of you are bashful about pushing to see another doctor, but when you get doctors to speak with each other about your case, they teach each other and every subsequent patient that sees your doctor will benefit because you were brave enough to drive quality into the system.

The second major improvement requires revisiting the business model of medicine.

Professor Christensen of Harvard Business School taught me on a show recently that two primary models exist for any business (excluding networking businesses). “Solution shops” offer intuitive insights into unpredictable ailments, something doctors (and lawyers) are superb at addressing.

On the other hand, value-adding processes like building cars in an assembly line or managing correctly diagnosed diabetes with a specific plan for chronic management are far less expensive than solution shops and usually are more effective in offering reproducible results.

In America, we lump these fundamentally different approaches together so we get highly trained doctors using sophisticated approaches to manage tasks that could often be better accomplished by other well-trained health professionals who actually like double-checking that you took your medications and watched your diet.

We speak of prevention a lot these days, but what does prevention mean?

I moderated the last White House Town Hall on Health and came away from the experience understanding that America believes “prevention” is really about making the right thing easy to do.

This includes everything from making healthy locally grown vegetables easy to find, bike racks available in our work places and a healthcare system that provides a crutch to remind us that we forgot our colonoscopy.

We cannot look to Washington for these changes without engaging the battle ourselves.

original article

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Next up is America’s integrative health guru:

Dr. Andrew Weil

dr weilNot to be outdone by Dr. Oz, Dr. Weil has 2 articles in this weeks Huffington Post.

The first is a general discussion of healthcare reform…..

As any doctor can tell you, the most crucial step toward healing is having the right diagnosis. If the disease is precisely identified, a good resolution is far more likely. Conversely, a bad diagnosis usually means a bad outcome, no matter how skilled the physician.

And, what’s true in personal health care is just as true in national health care reform: Healing begins with the correct diagnosis of the problem.

Washington is working on reform initiatives that focus on one problem: the fact that the system is too expensive (and consequently too exclusive.) Reform proposals, such as the “public option” for government insurance or calls for drug makers to drop prices, are aimed mostly at boosting affordability and access. Make it cheap enough, the thinking goes, and the 46 million Americans who can’t afford coverage will finally get their fair share.

But what’s missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what’s even worse than its stratospheric cost is the fact that American health care doesn’t fulfill its prime directive — it does not help people become or stay healthy. It’s not a health care system at all; it’s a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly.

It’s impossible to make our drug-intensive, technology-centric, and corrupt system affordable.I’m not against high-tech medicine. It has a secure place in the diagnosis and treatment of serious disease. But our health care professionals are currently using it for everything, and the cost is going to break us.

In the future, this kind of medicine must be limited to those cases in which it is clearly indicated: trauma, acute and critical conditions, disease involving vital organs, etc. It should be viewed as a specialized form of medicine, perhaps offered only in major centers serving large populations.

Most cases of disease should be managed in other, more affordable ways. Functional, cost-effective health care must be based on a new kind of medicine that relies on the human organism’s innate capacity for self-regulation and healing. It would use inexpensive, low-tech interventions for the management of the commonest forms of disease. It would be a system that puts the health back into health care. And it would also happen to be far less expensive than what we have now.

If we can make the correct diagnosis, the healing can begin. If we can’t, both our personal health and our economy are doomed.

Politicians aren’t going to resolve this issue overnight. Any health care reform bill that gets jammed through Congress in the next month or two will be dangerously flawed. Washington needs to take a step back and re-examine the entire task with an eye toward achieving the most effective solution, not the cheapest and most expeditious.

Dr. Weil’s second article deals with a patient of his who:

  • was relatively healthy,
  • in his mid-30s,
  • and had been diagnosed by his GP as having gastroesophageal reflux disease — also known as GERD (aka heartburn)

His GP never took a dietary history, asked about his lifestyle or even explained the nature of GERD nor the long term effects of proton pump inhibitors.

Dr. Weil reviewed his diet and lifestyle and explained the nature of GERD and the factors that contribute to it (stress & certain foods).

Based upon the patient’s history, Dr. Weil identified coffee, strenuous exercise, long hours spent at work in front of the computer and an inability to handle daily stress as the likely causes of his GERD.

Diagnosis:

  • Ditch the coffee
  • Supplement his diet with de-glycyrrhizinated licorice
  • Practice stress busting breathing techniques

A few weeks later, Dr. Weil weaned his patient off the drugs.

Problem solved.

And as Dr. Weil says, this is not brilliant doctoring. Any motivated medical student can learn how to interview a patient to get to the true root of a problem. He or she can also learn simple, safe, inexpensive treatment protocols like these.

This kind of medicine should be the new foundation of American health care. It is the key to cutting the out-of-control costs that are sinking the system.

How’s that for Healthcare Reform!

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Healthcare: Canada v.s the U.S.A.

July 13th, 2009

According to the  USA Today, President Obama has begun his health care push.

child medicineAnd you know what that means.

Like it or not, President Obama wants to give you a great big taste of Canadian style healthcare.

So, I thought that I would take a few minutes to let you know a little bit about my experience with the Canadian health care system.

  1. It is a massive (government) bureaucracy that eats up a lot of money and can frustrate the people who rely upon it.
  2. It’s full of hardworking doctors/nurses/technicians/etc who work long hours trying to keep sick people from dying
  3. It’s seems to work fairly effectively – according to the CIA, Canadian life expectancy is 81.23 yrs. (#8 in the world)

So, let’s compare that to the current American health care system.

  1. It is a massive (medical insurance) bureaucracy that eats up a lot of money and can frustrate the people who rely upon it.
  2. It’s full of hardworking doctors/nurses/technicians/etc who work long hours trying to keep sick people from dying
  3. It’s seems to work fairly effectively – according to the CIA, American life expectancy is 78.11 yrs. (#50 in the world)

Hmmm, seems pretty similar to me.

Except of course, the Canadian system is a public health care system. And everyone knows that a public system is essentially socialist, which is another word for communist, and dammit, no way is America going to have a communist health care system.

wow

I got a little excited there…sorry about that.

But seriously, other than this political/ideological argument, what are the differences between our two systems of health care?

1. Quantity of Life (longevity): We all want to live a long life. And without nitpicking, it looks like both countries are doing pretty good at increasing longevity.

Let’s call quantity of life a tie.

2.   Quality of Life: This one is a little trickier. Is there a difference between the general health & vitality of Canadians and Americans? According to all of the latest studies, both nations are growing more fat and less fit year after year. And as far as I can see, both of our health care systems are based on treating illness instead of  preventing illness.

fat couple exercise

So, once again, let’s call this a tie…both countries stink.

3.   Cost: In 2006, per-capita spending for health care in the U.S. was US$6,714; in Canada, US$3,678. (dollar amounts adjusted for purchasing power parity)

healthcare costs

Winner: Canada

And now for a personal story.

My wife blew out her back a few months ago…by sneezing.

I’m not kidding. Excrutiating pain, incapacitation, inability to work, sleep, sit, etc….

So, how did we deal with it?

Because of our personal experience with acute injuries such as my wife’s bad back, we knew that treatment needed to begin as soon as possible.We did not want this acute injury to become a chronic injury.

And that is the biggest problem with Canada’s public health care system. SPEED of SERVICE. Acute injuries become chronic injuries.

So, instead of going through the normal channels (go see the family doc, get an x-ray, wait for a consult, start public-pay physio, etc…), we began a series of physical therapy treatment – chiro, massage, acupuncture, laser and finally osteopathic. All on our dime. Yes, this is possible in socialist Canada.

We also made an appointment (the next day) with our publicly funded sports medicine doctor. Great guy, lots of experience working with professional athletes. And while my wife isn’t exactly an athlete, we like the fact that they focus on optimum health not just pain management.

At the sports medicine doc, my wife was assessed and given an x-ray at the first appointment.(public pay)

The x-ray showed nothing wrong…Yippee!!!

The next step was a requisition for an MRI. Here’s where it get’s interesting.

If we had followed the “normal” procedure, my wife would be getting her MRI in late November.

However, because my wife is in a lot of pain and is a pro-active kind of gal, she made a few phone calls, day after day and less than 2 weeks later, she had her MRI. (public pay)

Supposedly, this is impossible in the Canadian health care system. When I tell people that we got an MRI in 2 weeks, they don’t believe it. They have bought into the mind virus that Canadians are supposed to wait in line like a good little socialist patients and wait their turn.  Like sheep.

So, what’s the moral of the story?

The Canadian health care system isn’t perfect. But neither is the American system.

  • Wait times in Canada can be longer than in the U.S.
  • Medical expenses are the #1 cause of bankruptcies in the U.S. (Pre-Recession stats) That doesn’t happen in Canada.
  • Both systems ignore disease prevention
  • Both systems spend huge amounts of money trying to save very old, very sick patients
  • In a large part, the Canadian system is run by our government
  • In comparison, the American system is run by insurance companies

Pick your poison…I mean medicine.

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Health Care and the Obama Economic Stimulus Bill

February 5th, 2009
presidentialcomics.com

Image: presidentialcomics.com

Americans elected Barack Obama as their president because of their hope that he can bring about real change in Washington.

And according to his blueprint for change, re-building the American health care system is going to be a large part of that change.

obama-healthcare

His plan for re-building the healthcare system has three main planks.

  • To make health insurance affordable and accessible to all:The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors and plans to implement the plan.
  • To lower your health care costs:The Obama plan will lower health care costs by $2,500 for a typical family by investing in health information technology, prevention and care coordination.
  • To promote public health:Obama and Biden will require coverage of preventive services, including cancer screenings, and will increase state and local preparedness for terrorist attacks and natural disasters.

And, unlike previous administrations, it seems like some of these promises may actually be kept.

In the economic stimulus package making it’s way from bill to law, President Obama has earmarked billions and billions of dollars for:

  • State fiscal relief through Medicaid

In this part of the plan, states would receive a temporary (27 months) increase in Federal Medical Assistance Percentage (FMAP) funding. The estimated cost of this plan is $87 billion.

  • Help for working families hurt by the economic downturn

The stimulus bill would help workers and their families hurt by the economic downturn by providing the following:

  • A 65 percent premium subsidy for individuals who lost their jobs after September to help cover the cost of COBRA premiums. This provision is estimated to cost $25 billion over ten years.
  • A temporary extension of Transitional Medical Assistance (TMA) This provision is estimated to cost $1.3 billion over ten years.
  • A temporary extension of the Qualified Individual (QI) program. This provision is estimated to cost $562 million.
  • An elimination of cost-sharing (co-payments) for American Indians and Alaska Natives in Medicaid. The estimated cost of this provision is $25 million
  • Job-creation in the Health Information Technology (HIT) Industry

This part of the plan focuses on the nationwide conversion of all health care records from paper based filing systems to an electronic system. This provisions is estimated to cost $17.9 billion and is supposed to create about 200,000 new jobs.

Whew!

That’s a lot of stimulus.

By my estimate, the health care portion of the stimulus bill is $130 billion. Of course we need to keep in mind that these numbers are only estimates. Who knows what the final numbers will actually end up at.

But, it’s health care.

That’s a good place to spend money, right?

We all want to live long and healthy lives.

And, considering that the current generation of American children are expected to die at a younger age than their parents, maybe America should move towards a Canadian or European model of health care.

fat-kids

Or maybe, instead of spending 96% of it’s health care dollars on treatments and only 4% on disease prevention, America could shift some money towards making itself fit and healthy.

And if Jim Riesberg, chairman of the House Health and Human Services Committee, has his way, that may actually happen.

As the chairman of the House Health and Human Services Committee, I will spend much of my time this year focusing on health care needs and our health care delivery systems. One of the first places we must begin is to recognize the impact that chronic diseases have on health and health care in the United States.

Chronic diseases are the No. 1 cause of death and disability in the United States.

One hundred thirty-three million Americans, representing 45 percent of the total population, have at least one chronic disease and chronic diseases kill more than 1.7 million Americans per year and are responsible for 7 of 10 deaths in the United States.

Patients with chronic diseases account for 75 percent of the nation’s health care spending.

During 2005, the United States spent almost $2 trillion on health care, and of every dollar spent, 75 cents went toward treating patients with chronic disease. In public programs, treatment of patients with chronic diseases constitutes an even higher portion of spending: more than 96 cents in Medicare and 83 cents in Medicaid. Neither our nation nor our state can effectively address escalating health care costs without addressing the problem of chronic diseases.

Two-thirds of the increase in health care spending is due to increased prevalence of treated chronic disease.

From 1987-2000 that increase amounted to $211 billion among the non-institutionalized U.S. population.

The doubling of obesity between 1987 and today accounts for nearly 30 percent of the rise in health care spending.

The percent of children and youth who are overweight has tripled since 1980.

If the prevalence of obesity was the same today as 1987, health care spending in the United States would be 10 percent lower per person — about $200 billion less.

The vast majority of cases of chronic disease could be better prevented or managed.

Link to entire speechpdf version

In my next post, I will outline some of the disease prevention/health promotion strategies being tested around the world.

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Employers get the fitness bug

April 16th, 2008

Ahhhhh… the wonders of the free market system.

I was reading todays newspaper when I came upon this article .

For those of you who don’t want to read the whole article, here is a 10 second synopsis:

Employee fat and out of shape

Employee less productive

Company lose money

Company pays for employee to get in shape

Employee more productive

Company make money

Now, depending on the size of the company and the value of the employee to that company, funding for employee fitness can vary between a small contribution towards a gym membership to a personalized fitness consulting package including nutrition, personal training, fitness equipment and psychological support.

But at the end of the day, these businesses are looking at the bottom line. Their employees are valuable to them because of what they can or can’t produce. If an investment in their employees health will help them turn a profit, you can bet they will make that investment.

My question is: Why don’t most people make that investment in themselves?

Any answers???

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Fitness Alfresco

April 15th, 2008

I just read this article about outdoor fitness centres being created in Malta. Last year, I read about a similar program operating in Nova Scotia, Canada.

What a great idea!

Especially considering that over the next 50 years, the cost of obesity and related illnesses to the U.S. economy could be as much as US$650 billion – equivalent to about 5% of current annual U.S. GDP.

The question I would like to ask is, how much of that $650 billion is going to be spent on the prevention of obesity. I would guess that the bulk of this money is going to be spent on trying to correct problems that may have been preventable in the first place.

As it has been shown that individuals from lower income populations have higher rates of obesity, providing access to free fitness equipment may prove helpful in reducing the impact of obesity on the health care system and the economy as a whole.

Even looking beyond the costs associated with obesity, exercise has many a number of other health benefits. Combined with an advertising campaign (like the anti-smoking Truth campaign) promoting healthful living, there is no end to the cost savings that could be achieved.

Never mind extending and improving the lives of millions of people.

For further information on outdoor fitness equipment, contact this manufacturer or this one.

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