Monday, January 28, 2013

Do Health Insurance Penalties for Smokers and the Obese Make Sense?

It is a pretty well accepted fact that people with health problems, whether they are largely self inflicted or not, drive up health care costs. However, I am still undecided about if and how these higher costs should be passed to those in those higher risk groups, primarily the obese and smoker groups.

This article written by Mike Stobbe of the Associated Press brings some valid points. One of these points about whether or not to let obese people and smokers die prematurely certainly goes against our value on life in my mind. Anyway, everyone will decide for themselves.

NEW YORK (AP) — Faced with the high cost of caring for smokers and overeaters, experts say society must grapple with a blunt question: Instead of trying to penalize them and change their ways, why not just let these health sinners die prematurely from their unhealthy habits?

Annual health care costs are roughly $96 billion for smokers and $147 billion for the obese, the government says. These costs accompany sometimes heroic attempts to prolong lives, including surgery, chemotherapy and other measures.

But despite these rescue attempts, smokers tend to die 10 years earlier on average, and the obese die five to 12 years prematurely, according to various researchers' estimates.

And attempts to curb smoking and unhealthy eating frequently lead to backlash: Witness the current legal tussle over New York City's first-of-its-kind limits on the size of sugary beverages and the vicious fight last year in California over a ballot proposal to add a $1-per-pack cigarette tax, which was ultimately defeated.

"This is my life. I should be able to do what I want," said Sebastian Lopez, a college student from Queens, speaking last September when the New York City Board of Health approved the soda size rules.

Critics also contend that tobacco- and calorie-control measures place a disproportionately heavy burden on poor people. That's because they:

—Smoke more than the rich, and have higher obesity rates.

—Have less money so sales taxes hit them harder. One study last year found poor, nicotine-dependent smokers in New York — a state with very high cigarette taxes — spent as much as a quarter of their entire income on smokes.

—Are less likely to have a car to shop elsewhere if the corner bodega or convenience store stops stocking their vices.

Critics call these approaches unfair, and believe they have only a marginal effect. "Ultimately these things are weak tea," said Dr. Scott Gottlieb, a physician and fellow at the right-of-center think tank, the American Enterprise Institute.

Gottlieb's view is debatable. There are plenty of public health researchers that can show smoking control measures have brought down smoking rates and who will argue that smoking taxes are not regressive so long as money is earmarked for programs that help poor people quit smoking.

And debate they will. There always seems to be a fight whenever this kind of public health legislation comes up. And it's a fight that can go in all sorts of directions. For example, some studies even suggest that because smokers and obese people die sooner, they may actually cost society less than healthy people who live much longer and develop chronic conditions like Alzheimer's disease.

So let's return to the original question: Why provoke a backlash? If 1 in 5 U.S. adults smoke, and 1 in 3 are obese, why not just get off their backs and let them go on with their (probably shortened) lives?

Because it's not just about them, say some health economists, bioethicists and public health researchers.

"Your freedom is likely to be someone else's harm," said Daniel Callahan, senior research scholar at a bioethics think-tank, the Hastings Center.

Smoking has the most obvious impact. Studies have increasingly shown harm to nonsmokers who are unlucky enough to work or live around heavy smokers. And several studies have shown heart attacks and asthma attack rates fell in counties or cities that adopted big smoking bans.

"When you ban smoking in public places, you're protecting everyone's health, including and especially the nonsmoker," said S. Jay Olshansky, a professor at the University of Illinois-Chicago's School of Public Health.

It can be harder to make the same argument about soda-size restrictions or other legislative attempts to discourage excessive calorie consumption, Olshansky added.

"When you eat yourself to death, you're pretty much just harming yourself," he said.

But that viewpoint doesn't factor in the burden to everyone else of paying for the diabetes care, heart surgeries and other medical expenses incurred by obese people, noted John Cawley, a health economist at Cornell University.

"If I'm obese, the health care costs are not totally borne by me. They're borne by other people in my health insurance plan and — when I'm older — by Medicare," Cawley said.

From an economist's perspective, there would be less reason to grouse about unhealthy behaviors by smokers, obese people, motorcycle riders who eschew helmets and other health sinners if they agreed to pay the financial price for their choices.

That's the rationale for a provision in the Affordable Care Act — "Obamacare" to its detractors — that starting next year allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums. A 60-year-old could wind up paying nearly $5,100 on top of premiums.

The new law doesn't allow insurers to charge more for people who are overweight, however.

It's tricky to play the insurance game with overweight people, because science is still sorting things out. While obesity is clearly linked with serious health problems and early death, the evidence is not as clear about people who are just overweight.

That said, public health officials shouldn't shy away from tough anti-obesity efforts, said Callahan, the bioethicist. Callahan caused a public stir this week with a paper that called for a more aggressive public health campaign that tries to shame and stigmatize overeaters the way past public health campaigns have shamed and stigmatized smokers.

National obesity rates are essentially static, and public health campaigns that gently try to educate people about the benefits of exercise and healthy eating just aren't working, Callahan argued. We need to get obese people to change their behavior. If they are angry or hurt by it, so be it, he said.

"Emotions are what really count in this world," he said.


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Monday, January 21, 2013

12 Things You Need to Toss and Replace

I ran across this good article on Yahoo! Financially Fit about throwing out old, useless things and I thought I would share it.

As Savvy Spender says: "Now that the holidays are over and the tree’s long gone, are you taking a look around the house looking for new ways to spruce things up a bit?"

"Just tossing out dated products that have lost their overall effectiveness is liberating. Here are some items to consider replacing, per our partnering with the experts at Better Homes & Gardens:"

Pillows
Worn out pillows can mess with your neck, spine, and deprive you of sleep every night. Replace good, quality pillows every 2-3 years, and less expensive synthetic pillows once a year. Want to make them last longer? Buy a pillow protector, says Amy Panos, Senior Editor, Better Homes & Gardens. “For $5 to $20, you can find a great, quality pillow protector at the Company Store.”

Mattress
Your mattress needs to be replaced every 5-10 years. If it’s visibly saggy or lumpy, consider replacing it sooner!

Apparel
When it’s time to clean out your closet, it’s too easy to be conservative and shy away from tossing stuff you haven’t worn in a while. Just do it! Adhere to the two-year rule by getting rid of anything you have not worn in two years.

Bras
Toss bras that are more than a year old because they lose elasticity and support. While bras can be pricey, take advantage of the deals this month: Hanes has a sale that runs through the end of January (bras are under $8-$9) as does Maidenform (It’s running a $15 bra sale.).

Running shoes
Replace them every 300-500 miles. When the back of the sole is noticeably uneven and you can easily bend the sneakers in half, that means they’ve lost the proper support you need. Don’t even walk in them, say the experts.

Makeup brushes
Good, quality makeup brushes need to be replaced every three years. To maintain them, wash them - weekly - with mild dishwasher soap, and lay flat to dry. The best, affordable makeup brushes can be picked up at Target. A Sonia Kashuk set is about $11.

Beauty Products
Mascara needs to be replaced every 3 months; every 6 months, replace lipsticks and cream or liquid foundations; every year, replace powder foundations and sunscreens.

Bath loofahs
Do away with bath loofahs altogether! They’re especially prone to bacterial growth and you have to replace them every 1-2 months. Consider an alternative like light nylon washcloths, which easily lather up and dry - fully - within hours. You can get them on Amazon for about $5.

Spices
Spices, which need to be kept away from your oven and stored in a cool, dry place like your pantry, need to be replaced every year. Just do the sniff test: if there is no aroma, there is no taste.

Cookie sheets and baking pans
Are your cookie sheets and baking pans no longer shiny? Say goodbye! Old pans don’t cook as evenly.

Home Safety Items
Smoke detector batteries and HVAC filters. Replace them every 6 months.

My Aching Knees comment: If you have been counting, there is only 11 items listed above. So I include my own recommendation,.....Cats. It's time to throw out those mangy good for nothing cats. All they do it eat and lay around. Meow, meow, meow,....I can't stand it.  Throw those cats out.

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Wednesday, January 16, 2013

Living to 100 years old

What baby boomers need to live to 100 by Glenn Ruffenach of MarketWatch published June 23rd of last year.  Yahoo! editors have selected this article as a favorite of 2012. It first appeared on Yahoo! Finance and was one of the most popular stories of the month. Readers pointed out that living a long life can be a mixed blessing if you outlive all your loved ones. "My Dad lived to 103," said user Don C. "When asked what he attributed his long life to, he replied 'Just bad luck.'"

Your chances of reaching age 100 could be better than you think — especially if you get some additional sleep and improve your diet.

U.S. seniors who make it to their 100th birthdays tend to credit social connections, exercise and spiritual activity as keys to successful aging.

Research from UnitedHealthcare looks at centenarians and baby boomers, asking the former about the “secrets of aging success” and evaluating whether the latter are taking the necessary steps to celebrate a 100th birthday.

The primary findings: Many boomers are embracing lifestyles that could lead to a long and rewarding life — with two exceptions. More than seven in 10 centenarians — 71% — say they get eight hours or more of sleep each night. By contrast, only 38% of boomers say they get the same amount of rest. And when it comes to eating right, more than eight in 10 centenarians say they regularly consume a balanced meal, compared with just over two-thirds (68%) of baby boomers.

The report — “100@100 Survey” (view PDF at UnitedHealthGroup.com) — begins with some startling numbers. As of late 2010, the U.S. had an estimated 72,000 centenarians, according to the Census Bureau. By the year 2050, that number — with the aging of the baby-boom generation — is expected to reach more than 600,000. Meanwhile, an estimated 10,000 boomers each and every day — for the next decade — will turn 65.

How to reach 100? Centenarians point to social connections, exercise and spiritual activity as some of the keys to successful aging. Among surveyed centenarians, almost nine in 10 — fully 89% — say they communicate with a family member or friend every day; about two-thirds (67%) pray, meditate or engage in some form of spiritual activity; and just over half (51%) say they exercise almost daily.

In each of these areas, baby boomers, as it turns out, match up fairly well. The same percentage of boomers as centenarians — 89% — say they’re in touch with friends or family members on a regular basis. Sixty percent of surveyed baby boomers say spiritual activity is an important part of their lives, and almost six in 10 boomers (59%) exercise regularly.

Again, sleep and diet are the two areas where baby boomers come up short. Not surprisingly, the one area where boomers are more active is the workplace. Three-quarters (76%) of surveyed baby boomers say they work at a job or hobby almost every day; that compares with 16% of centenarians.

Finally, researchers turned to cultural affairs and asked centenarians and boomers to identify — from a list of 14 notable people (including President Obama, singer Paul McCartney and actors Tom Hanks and Julia Roberts) — their preferred dinner guest. The top choice among centenarians and boomers alike: actress and comedienne Betty White.



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Tuesday, January 8, 2013

The Risks of Obesity


From an excellent article by Lauran Neergaard and Jennifer Agiesta titled: "Few Americans know all the risks of obesity".

Heart disease and diabetes get all the attention, but what about the many other ways obesity can damage your health?

Carrying too many pounds may lead to or worsen some types of cancer, arthritis, sleep apnea, even infertility. But a new poll suggests few Americans realize the links.

Only about one-quarter of people think it's possible for someone to be very overweight and still healthy, according to the poll by The Associated Press-NORC Center for Public Affairs Research.

Ask about the most serious consequences, and more than 7 in 10 Americans can correctly tick off heart disease and diabetes. Heart disease is the nation's leading killer, and diabetes and obesity are twin epidemics, as rates of both have climbed in recent years. The other consequences aren't so well known.

"People are often shocked to hear how far-reaching the effects of obesity are," said Jennifer Dimitriou, a bariatric dietitian at New York's Montefiore Medical Center.

Just 7 percent of people surveyed mentioned cancer, although doctors long have known that fat increases the risk of developing cancers of the colon, breast, prostate, uterus and certain other sites. Plus, being overweight can make it harder to spot tumors early and to treat them.

Then there's the toll on your joints, especially the knees. About 15 percent of people knew obesity can contribute to arthritis, a vicious cycle as the joint pain then makes it harder to exercise and shed pounds.

High blood pressure, high cholesterol and strokes were fairly low on the list. Infertility didn't get a mention.

Also, 5 percent put respiratory problems on the list. Studies show people who are overweight are at increased risk of sleep apnea and asthma, and that dropping pounds can help improve their symptoms.

Knowing more about the myriad ways obesity affects health could help motivate people to get more active and eat better before full-blown disease strikes, Dimitriou said. "Most people want to become healthier. It's the know-how, and understanding what the consequences are," she said.

But only 52 percent of those surveyed said they've discussed the health risks of being overweight with a doctor.

In another complication, the AP-NORC Center survey found that about half of people think their weight is just about right, and only 12 percent of parents think their child is overweight. That's even though government figures show two-thirds of U.S. adults, and one-third of children and teens, are either overweight or obese.

If you're surrounded by overweight people, especially in your family, "then that's all you know, and that to you is normal," Dimitriou said.

The AP-NORC Center survey was conducted Nov. 21 through Dec. 14. It involved landline and cellphone interviews with 1,011 adults nationwide and has a margin of sampling error of plus or minus 4.2 percentage points.

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Wednesday, January 2, 2013

Trick to Never Get Sick

This is an article by Joe Donatelli for SHAPE magazine, titled, The No. 1 Trick to Never Get Sick

Feel a cold coming on? Try this remedy!f you smell onions in someone's socks over the next few weeks, do not be alarmed. That person is probably just fighting a cold.

Everyone seems to have a custom "miracle cure" for the common cold, and it seems the more creative the solution, the less bashful they are about sharing. A recent poll of Facebook friends revealed the following methods, all of which the practitioners stand by (in their onion-filled socks, in some cases):

• Heaps of vitamin C

• Chicken soup, preferably homemade by Mom

• Natural foods, fresh colorful veggies, and supplements

• Chopping and eating a raw yellow onion (with a little salad dressing for taste) followed by a warm bath or a long shower to open the pores

• Oscillococcinum, which is a homeopathic alternative medicine

• Thieves Essential Oil

• Coating feet with Vicks Vapor Rub and wearing a pair of socks overnight

• Socks filled with peeled onion layers

• Cardio, a few sips of whiskey, and cold medicine

• Outdoor activity, hydration, and rest

• Sex

Is the mighty common cold so wimpy that it can be defeated by a rubber ducky, menthol, socks, and a few lit candles? The answer lies in an interesting piece of research by Dr. Bruce Barrett at the University of Wisconsin.

In Barrett's study, cold sufferers were split into four groups-one group was given no pills, a second and third group were each given Echinacea or a placebo but were not told which pill they received, and a fourth group was given Echinacea and was told it was Echinacea. Each participant was asked to rate the effectiveness of the medicinal herb Echinacea.

The results: The illnesses of people who believed in Echinacea and received pills were considerably shorter and less severe-regardless of whether or not the pills contained Echinacea.

What does that mean for you? "A positive outlook matters," Barrett says. If someone believes a cold remedy works, it just might. No one knows for sure why. Barrett says that the manner in which the brain stimulates healing mechanisms through positive expectations is not entirely understood. But this certainly helps explain why there is a seemingly endless list of pharmaceuticals, alternative treatments, and quirky homemade solutions for treating the common cold.

As a practicing family doctor, Barrett strongly encourages the use of non-pharmaceutical cold remedies. For the record, I swear by orange juice, bananas, and vitamin C, which in the wide range of solutions turns out to be quite tame.

"I was being interviewed on 'The People's Pharmacy' (radio program) and a guy called in who melts skunk fat and gives a teaspoon of it to his kids when they start getting a cold," Barrett says. "He swore it stopped all of the colds in their tracks. That's worse than onion in the socks."

MyAchingKnees comment:  The smelly sock thing won't work for me. I have not had even a cold in over 7 1/2 years.  I'll just stick to what I'm doing.   

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