Happy New Year! New Health Law Changes In Effect.

With the start of 2011, a number of health law provisions are now in place. These include

1) Shrinking the "doughnut hole," meaning that seniors who fall into the doughnut hole (those who have spent between $2,840-$6,448 on medications, including what insurers pay) will now get a 50% discount on brand-name medications.  This compares to a $250 rebate they received in 2010.
2) Health insurers can use incentives (such as reduced premiums) for employees who join wellness programs or meet certain health targets. The discounts can be up to 30% of employee-related health insurance costs.  More info here.
3) Health insurance companies must now spend 80% (for small-group plans) on improving patient care, as opposed to spending on general profits/salaries, and admin costs.  If they fail to do so, they must give rebates to customers (starting in 2012).  This percent is 85% for large group plans.
4) Primary care physicians and general surgeons receive 10% more in reimbursements from Medicare.

5) Medicare will pay 100% of preventive care, meaning seniors on Medicare receive free health screenings (e.g. colorectal cancer, mammograms, etc) and other services (e.g. smoking cessation programs).
6) Medicare beneficiaries with annual incomes $85,000+ (for individual) or $170,000+ (for couples) will get smaller subsidies from Medicare Part D (prescription drug coverage)...and the start of higher premiums.
7) Holders of flexible-spending accounts will no longer be able to pay for most over-the-counter supplies with their accounts and will now require a prescription.
8) Community-Based Care Transition Program is underway, which is a Centers for Medicare and Medicaid Services (CMS) Demonstration project designed to put evidence-based care transition services into place for Medicare beneficiaries to reduce the risk of hospital readmissions and improve the quality of care for seniors.  Hospitals and community-based organizations apply to the Department of Health and Human Services to implement this program, based on other successful care transition models, which have eased the transition from hospital to home and reduced hospital re-admission rates.  More information found here.  .
9) Certified Nurse Midwives will now receive the same rate as physicians by Medicare.  They were previously only paid 65% of the physician rate.

Mandatory health insurance doesn't come into play until 2014.

For more information, check out: Kaiser Health News

Health Reform is Happening!

It's been 6 months since the health reform bill was passed.  Confused about what is in the health reform bill?  Confused about what it means for you?  About when things will occur?  Then, a great resource to check out is: Health Reform Hits Main Street, a short animated "YouToons" video by the Kaiser Family Foundation.

Last week (Thursday, Sept 23rd)  a number of provisions of the bill went into effect.  Six of them are as follows:   One, insurance companies (for employer plans) are no longer able to deny health insurance coverage to children with pre-existing conditions, such as diabetes or asthma.  Two, lifetime limits on coverage are dropped, meaning there is no lifetime limit on what you spend on hospital stays or other medical costs.  Three, free preventive care must be given by new health insurance policies purchased.  These things include preventive screenings, immunizations, and other preventive tests cannot have a copay.  Four, insurance companies are not allowed to drop you from coverage when you get sick and additionally, they can't look for an error on your application form and then deny coverage based on that.  Five, there is an expanded appeal process for denied claims, meaning you can do an external appeal to an independent third party (instead of just to your insurer directly).   Six, dependent children under the age of 26 can remain on their parent's health insurance policy, as long as their job doesn't offer insurance.  The under-26 population are currently one of the most likely to be uninsured groups, and allowing them to be on their parent's plan will generally save money (to pay for other provisions above) by allowing younger and healthier into the insurance pool to reduce the overall risk and thus, premium costs.  Go to Getting Covered.org if you have questions about how the dependent coverage rules work in your state.

Pop Quiz: What Disease Costs $600 Billion a Year and Has NO Cure?

The Answer:  Alzheimer's Disease.

According to the World Alzheimer's Report, released today, Alzheimer's Disease costs $600 billion, or 1% of the world's GDP.

Today is World Alzheimer's Day, a day to recognize this tremendous public health problem, create awareness, and to take action. To find events occurring world-wide, click here.

To tell your Congressional representative to vote for the National Alzheimer's Project Act (NAPA), click here. The goal of NAPA is to create a national inter-Agency group within the Department of Health and Human Services to come up with a national plan for fighting Alzheimer's Disease.

War Against McDonalds

The Physicians Committee for Responsible Medicine, a nonprofit advocacy group with a mission of promoting preventive medicine and conducting clinical research, released a controversial advertisement two days ago.  This ad shows a man on a gurney with his death grip (pun intended) on a fast food hamburger.  The end shows the McDonald's logo (the largest fast food chain and producer of high-fat, high-sodium, & high-cholesterol meals) with "I Was Loving It."

You can watch the ad by clicking here and can view the NYTimes story by clicking here.

What are your reactions?  Mine?  Finally someone is educating the television-viewing public about potential dangers and consequences of eating unhealthy.

UnMoral Minds

Wow, not even peer-reviewed journal articles are safe from false information.  Apparently a Harvard researcher, Marc Hauser, may have provided false, made-up data (at least for the control condition of the study) for a 2002 article published in the journal Cognition.  Although extremely rare something like this would happen, it's worth taking note of.  Sad to say, but this man will likely be looking for a new career. Ironically, he published a book called Moral Minds. It looks like someone teaching others about right and wrong has a few things to learn.

Read the story here.  And because I know you're interested (obviously I was), here is the man behind the story and his photo is at right.

Will You Develop Alzheimer's Disease? Do a Spinal Tap and You May Find Out.

I had to share this extremely interesting study.  It is one of the many findings found from the Alzheimer's Disease Neuroimaging Initiative (ADNI), of which I worked a research coordinator for at the University of Kansas Medical Center site.  One of the large $60 million study's goals was to look for biomarkers for Alzheimer's Disease.  Previously, the only definitive confirmation of an Alzheimer's Disease diagnosis was autopsy, whereupon one could see plaques and tangles in the brain.  


Published on Tuesday in the Archives of Neurology, was an article using results from ADNI to predict who with memory loss would go on to develop Alzheimer's Disease.  The authors were 100% accurate in using spinal fluid to make this prediction.  The article is titled, "Diagnosis-Independent Alzheimer Disease Biomarker Signature in Cognitively Normal Elderly People."  


Also interesting was the fact that the authors found this Alzheimer's Disease "signature" biomarker (presence of beta-amyloid plaques and tau tangles) in 36% of people who were cognitively "normal," or healthy people with no signs of memory loss.  Would you want to find out if you were going to develop Alzheimer's Disease or not?  It might be possible very soon.  


A cure though?  Not yet possible.  The current treatments for Alzheimer's Disease only treat symptoms, not the underlying disease.  This means the current medications will ease some of the disease's side effects, but the plaques and tangles will continue to build up in your brain and the disease will progress.  


Click here to read a NYTimes news article written about this same study.  

Real Men Go To The Doctor

Recent research shows than men are 24% less likely to visit a doctor than women are.  And they are more likely to be hospitalized for health conditions that could have been prevented.  

Thus, the Agency for Healthcare Research and Quality (AHRQ--where I am currently employed) released their public service advertising campaign yesterday to promote men's preventive health.  The timing coincides with Men's Health Week, which, for 2010, is June 14th through 20th.  Laura Landro covered the story in an excellent video for the Wall Street Journal (WSJ), which you can watch here.

Please encourage your friends and family to visit the doctor.  Simple preventive tests can detect diseases early, when treatment is easier and your health outcomes will be better.  Here is a list of preventive medical tests men should have completed. Immunizations and screening tests for body mass index, cholesterol, blood pressure, depression, sexually transmitted diseases, and colerectal cancer are just a few of the preventive tests that should be done. 

There are a number of campaign materials here, including television, radio, and print.  I highly suggest checking them out--they are effective, well-crafted, and really interesting!  I've included a couple of the print materials and an outdoor banner as the images for this story.

Attention Nonsmokers: Your Mental Health

According to a recent study published in the Archives of General Psychiatry, second-hand smoke could potentially be causing mental illness.  Yep, we know how bad smoke and second-hand smoke are for our physical health, including cancer risks, but it may also affect our mental health.  The risk of mental distress is higher among exposed nonsmokers than exposed smokers, 1.5 times higher for psychological distress and 3 times higher for psychological hospitalizations. Mental illness was defined as psychological distress, mainly meaning symptoms of depression and anxiety, and was measured with the General Health Questionnaire.  The authors additionally found the risk of psychiatric hospital admissions was higher for people exposed to second-hand smoke.  This study provides more reason to encourage your loved ones, coworkers, friends, and the public to quit the lethal habit.

Happy Birthday! Peel an Orange

A number of nurseries in the UK are trying something new for kids--no more birthday cake, or any sweets for that matter.  The elimination of the the age-old tradition of birthday cake is removed from children's diets as part of a program called the "Pre-school Nutrition Project," which is basically a program geared toward encouraging healthy eating.  It was set up by the Knowsley Borough Council and Chester University.  


I love this.  Stick a candle in an apple and I'm happy.  


But don't worry, birthday cakes and sweets are still allowed on the kids' birthdays--they just can't be eaten on-site.  The sweets will get sent home with parents, who can them decide on their own whether to allow their kids to indulge or not.  


Is this taking it too far?  Or is this a great idea to combat our overwhelmingly growing obesity problem and teach children healthy eating habits?