Health Reform Makes History - What Does it Mean?

The House voted late Sunday March 21, 2010 (219-212 vote) in favor of sending the Health Reform Bill to President Obama. In addition, the House Democrats made some changes to the Senate's health reform bill (220-211 vote) which now goes back to the Senate. They must pass word-for-word reconciliation. As I post this blog entry, Obama is signing this long-awaited bill for the health of our nation.

32 million uninsured will now have health insurance. Excluded in this number are: illegal immigrants (who are also banned from purchasing in the health insurance exchanges), those eligible for Medicaid who won't enroll until they seek care, and those choosing to pay the fine instead of purchasing health insurance.

Here is a breakdown of (some of) what is included in this historical piece of health legislation.

Effective Immediately up to 6 Months From Now:
1) Insurers can't deny coverage to sick children (due to preexisting health conditions)
2) Free preventive care--screenings and preventive care must be excluded from annual deductibles on any new plans (all other plans affected in 2018)
3) No caps on lifetime benefits and restrictions on annual limits on coverage
4) Young adults allowed to stay on parent's insurance until the age 0f 26
5) Medicare Advantage (Medicare benefits delivered by private firms) gets cuts in spending in 2011
6) Children on Medicaid or state CHIP can't be dropped from now until 2019
7) Excise tax on tanning beds (10%)--"sin" tax
8) Individuals without coverage because of preexisting conditions can purchase it from high-risk pools (to be combined into exchanges in 2014)
9) Rebate of $250 for Medicare seniors in the "donut hole" for prescription drug benefits. First of incremental steps to close the hole (half-closed next year)

Effective in (or just prior to) 2014:

1) Individual Mandate--Everyone must purchase health insurance or pay annual fine of $95 (rises to $695 in 2016) unless they can prove financial hardship.

2) State health insurance exchanges--marketplace of insurance plans--goes into effect
3) Insurers can't deny coverage to adults with preexisting health conditions
4) Insurers required to cover maternity care same as medical procedures
5) Tax credits will start helping pay premiums for working families with incomes up to $88,000 per year
6) Medicaid expanded to cover more low-income people, up to 133% of federal poverty level
7) Medicare payroll tax increase of 1% for individuals making >$200k and couples making >$250k
8) New Medicare tax on unearned income of 3.8% (in 2013)
9) "Donut Hole" closing--Medicare Part D prescription drug coverage gap to be fully closed by 2020

Other items:

In 2018, "Cadillac health plans" are taxed 40% of value of the plan above thresholds (of $10,200 per individual or $27,500 per family)

The bill maintains longstanding federal funding restrictions (known as Hyde Amendment) on abortions. The exception would be in cases of rape or incest, or when the life of the woman would be endangered.

It is estimated by the nonpartisan Congressional Budget Office to cut federal deficits by $143 billion over the next decade. This bill is a landmark piece of legislation to improve the health of our nation's people. In my eyes, this is an incremental step (and focused on health insurance reform), but an amazing step nonetheless.

What are your thoughts about this this historical event, the passing of health reform?

Grass-Fed Beef: Health Effects for You And the Environment

The provocative documentary, Food, Inc., brings to light some of the environmental and ethical issues with the way we eat. One of the many issues in this Academy Award-nominated documentary, deals with is the farm industry. Cows raised in pastures are raised more humanely and are usually not given hormones or antibiotics. Additionally, the diet for grass-fed cows uses less fossil fuels than corn/soy-fed cows on a feedlot. Grass-fed cows do their own fertilizing and harvesting. Also, although grass-fed cows create more methane, they compensate in a number of ways. Most importantly, pastures reduce greenhouse gas through "carbon sequestration," or carbon capture and storage. They also use less fossil fuels in production and don't emit as much ammonia as feedlots do. The net result, as determined by the Institute for Environmental Research and Education (IERE) is a reduction in greenhouse gases for pastures and significant increases in greenhouse gases for feedlots. See more detail and other environmental benefits of grassfarming at EatWild.

A new report published this week by California researchers in Nutrition Journal shows that meat from grass-fed cows is nutritionally healthier for you too. The article discusses years have research which have shown that grass-fed diets can significantly increase the amount of cancer-fighting antioxidants, Vitamin A and E, and fatty acids in beef. Grass-fed beef is also lower in dietary cholesterol. In sum, grass-fed beef is healthier for your cardiovascular health and lowers your risk of diabetes and other health problems, like obesity as compared to corn/grain-fed cows. However, it's important to note two things. One, the omega-3 fatty acid levels in grass-fed beef are still much lower than in fish, especially salmon. Two, in order to reap the health benefits, you still need to ensure that you choose lean cuts of the beef. The Mayo Clinic has created a guide to the leanest cuts of beef.

For consumers, there are some other issues of interest here. Because the nutrient content is different between the types of beef, the taste is also different, tasting "grassier." Whether that is a good or bad thing is up to you. To read more about the taste difference, check out this article from the NY Times, "There's More to Like About Grass-Fed Beef." Additionally, the cost of grass-fed beef costs more, nearly 3x as much as grain-fed.

Grass-fed beef is sold primarily at local farms and online. If you're interested in purchasing grass-fed meats, EatWild, has a great State-by-State Directory of Farms. You can also take a look at Tallgrass Beef (Kansas), Burgundy Pasture Beef (Texas), and Hedgeapple Farm (Maryland). When shopping in regular grocery stores, be careful of the food labels. Oftentimes, the label will say "grass-fed" when the cows were only fed on grass for the first 6 or 12 months, then transferred to a feedlot. Check out Mother Earth's article, "The Label Says Grass-Fed, but is it?" for more information. As they suggest, the best label to look for is the American Grassfed Association (AGA).

Do you eat beef? If so, what type of beef do you eat? Are you more intrigued by the environmental or the health issues related to beef? Will this information change your behaviors?