The latest newsletter from the National Association of Health Underwriters referenced an article in the New York Times about the disparity of health insurance premiums between men and women:

Data indicate cost disparities among women, men for individual insurance policies.

The New York Times (10/30, A23, Pear) reports, “Striking new evidence has emerged of a widespread gap in the cost of health insurance, as women pay much more than men of the same age for individual insurance policies providing identical coverage, according to new data from insurance companies and online brokers.” Price quotes and rate tables indicate that “the disparities are evident in premiums charged by major insurers like Humana, UnitedHealth, Aetna, and Anthem.” And, although “in job-based coverage, civil rights laws prohibit sex discrimination,” the “individual insurance market is notoriously unstable.” While “some insurance executives expressed surprise at the size and prevalence of the disparities,” others, such as women’s advocacy groups, “have raised concerns about the differences, and members of Congress have begun to question the justification for them.” Still, citing more use of healthcare services among women, “especially in the childbearing years,” insurance companies “say they have a sound reason for charging different premiums.”

 This, like a myriad of things that comes out of the New York Times, is INSANE.  What’s missing is three simple facts:

1) Women use the doctor more…period.  To not take that into account from an actuarial standpoint would be completely and utterly insane.  It’s not a civil rights issue that women use the doctor more.

2) Maternity is typically automatic with Group Health Insurance, it’s rarely an option.  The last I checked, men are not getting pregnant…at least as far as I know.

3)  Women pay less for Life, Long Term Disability, Long-Term Care insurance, Car Insurance…and Men special interest groups, the last time I checked, weren’t lobbying Congress to equalize that playing field.

According to the Centers for Disease Control and Prevention, suicide is currently the 3rd leading cause of death among young adults and adolescents 15 to 24 years of age, following unintentional injuries and homicide.  Suicide is often a desperate attempt at escaping a seemingly impossible situation or to find relief from bad thoughts or feelings.  These feelings could be rejection, hurt, shame, guilt, despair, loneliness, isolation or a host of others.  According to the National Institute of Mental Health, scientific evidence has shown that almost all people who take their own lives have a diagnosable mental or substance abuse disorder.  Those who suffer from depression and other disorders are less able to cope with situations than others and treatment is necessary to help those suffering see that there are many alternatives and better ways to deal with their problems.  In other words, the feelings that often lead to suicide are highly treatable if the help is sought by the individual or if others can recognize the warning signs.

Researchers estimate that there are between 8-25 attempted suicides for each teen suicide death and that four out of five teens who attempt suicide have given clear warnings.  There are many behavioral indicators that can help parents or friends recognize the threat of suicide in a loved one. Since mental and substance-related disorders so frequently accompany suicidal behavior, many of the cues to be looked for are symptoms associated with such disorders as depression, bipolar disorder anxiety disorders, alcohol and drug use, disruptive behavior disorders, borderline personality disorder, and schizophrenia.

Some common symptoms of these disorders include: (more…)

A brief article on the history of why the healthcare system got to where it is, and why the McCain plan is actually the only one of the two (between his and Obama’s) that can truly accomplish anything:  by putting more control back in the hands of the consumer instead of simply shifting control from EVIL Insurance companies to the ALL-LOVING Federal Government.

Mr. Jacoby is very explicit in explaining the history of the problem:

During World War II, federal wage controls barred employers from raising their workers’ salaries, but said nothing about fringe benefits. So firms competing for employees at government-restricted wages began offering medical insurance to sweeten employment offers. Even sweeter was that employers could deduct those benefits as business expenses, yet employees didn’t have to report them as taxable income. For a while the IRS resisted that interpretation, but Congress eventually enshrined the tax-exempt status of employer-based medical insurance in law.

Result: a radical shift in the way Americans paid for medical care. With health benefits tax-free if they were employer-supplied, tens of millions of Americans were soon signing up for medical insurance through work. As tax rates rose, so did the incentive to keep expanding health benefits. No longer was medical insurance reserved for major expenditures like surgery or hospitalization. Americans who would never think of using auto insurance to cover tune-ups and oil changes grew accustomed to having their medical insurer pay for yearly physicals, prescriptions, and other routine expenses.

Now, I actually don’t agree with the part of McCain’s proposal that taxes employer-based coverage.  I’m more interested in parity (making sure that individuals get the same tax cut), than I am a punitive approach.  But it at least cuts at the core of the problem: the individual has been left out of the process for far too long.  It’s actually just a little too harsh.

I preferred the plan that President Bush proposed in a State of the Union address a few years ago (seems like so long ago), and that was a tax-credit (and a pretty sizable one, if I recall) for those participating in Consumer-Driven (High-Deductible) Health Plans.  That would have accomplished a lot as far as getting more control of costs back in the hands of the consumer without giving a Democratic contender ammunition to call the Republican contender a tax-hiker.

(Mirrored on logipundit.com)

None of you really want to hear my opinions on the general bailout package passed by the Senate last night, but I felt it my duty to inform you of the implications of the added section regarding mental health (since some of you are obviously crazy).

NAHU (National Association of Health Underwriters) sent me a good summary this morning, so I’ll give you some excerpts:

Modern Healthcare (10/2, DoBias) explains that the Senate measure “includes the already agreed upon mental-health parity language that passed the Senate as part of a tax-extenders package and the House as a stand-alone bill.” According to MedPage Today (10/2, Walker), an earlier mental health parity bill, passed by the House in March, “was dead on arrival in the Senate because of language that would have required insurance companies to give equal coverage to all mental illnesses outlined in the DSM [Diagnostic and Statistical Manual of Mental Disorders]. This was a far-reaching stipulation that made some conservatives squeamish,” according to Peter Newbould of the American Psychological Association’s Practice Organization. The new mental health parity language, included in the rescue plan, “removes any mention of the DSM.”

[…]

Meanwhile, the New York Times (10/1, A28) editorializes, “The bill is endorsed by President Bush, business groups, insurance companies, the medical community and mental health advocates. … But it requires a final shove because the measure is snarled in a broader legislative struggle over how to pay for tax revenues that would be reduced by this measure and others. Is there a statesman who can push this worthy parity legislation through to final passage before adjournment?

I’m not a mental health expert and I don’t even play one on TV, but “Mental Health Parity” is not something that I have always been an ardent supporter of.  It would be good for me, insurance companies, medical professionals, medical health advocates, etc.  I’m just not 100% sure that it’s good for patients.  This is most likely because I don’t believe that “medicine” is always the best approach to mental health problems, but if I talk any further I will begin to effectively display my ignorance on the matter.  I’m hoping to get some input from our “Behavioral Medicine” specialist.  If and when I do, I’ll post again or have him do so.

August 5, 2008 (Leesburg, VA)–Carla Deniz of Moonlit in the Sun

We live in an incredibly stressful world. Research has long shown that stress can be detrimental to a person’s health. For example, stress has been shown to decrease white blood cells (lymphocytes), reducing their ability to fight off infections (Kang, Coe, McCarthy, & Ershler, 1997; Kiecolt-Glaser & Glaser, 1991). Additionally, stress has been shown to negatively affect wound healing (Marucha, Kiecolt-Glaser, & Favagehi, 1998).

Relaxing music has been shown to decrease heart rate, lower blood pressure and cortisol levels, and reduce anxiety (Kight & Rickard, 2001; Miluk-Kolasa, Obiminski, Stupnicki, & Golec, 1994). In fact, researchers have recently been investigating the effect of music on surgery as a means of reducing stress and aiding in faster recovery (Leardi, Pietroletti, Angeloni, Necozione, Ranalletta, & Del Gusto, 2007; Uedo, Ishikawa, Morimoto, et al, 2004)

Moonlit In The Sun, a classical string and piano ensemble, is working with the Restaurant at Patowmack Farm to help people have a truly stress-relieving and tranquil experience. The music performed by Moonlit In The Sun has been specifically selected to give listeners a calm, peaceful sensation. Dr. Deniz, executive director of Moonlit In The Sun, notes “I cannot emphasize enough how important it is for people in today’s metropolitan lifestyle to use music to help them recover from the barrage of stressful events in their daily lives.”

Beverly Morton Billing, owner of The Restaurant at Patowmack Farm, has selected dates for this experience to specifically fall when there is a full moon. Says Beverly, “Full moon and soothing music, stars and dining. It’s a great combination.”

The Restaurant at Patowmack Farm is located on Lovettsville road just ½ mile west of Route 15 near the Point of Rocks Bridge. It overlooks the Potomac River in Lovettsville, VA. Moonlit In The Sun will be performing there on Thursday August 21, September 18, and October 16 (the weeks of the full moon). For reservations call 540.822.9017.

For more information on Moonlit In The Sun, visit their website at www.moonlitinthesun.com or call 571.223.5321 (more…)

Leesburg Pharmacy’s Take Back Program

One of my new clients sent me this trailer, and it looks very interesting.

You are what you eat seems to be the overall message. Might be worth a gander at the whole movie.

Ken (a very spry 70 year old) asked me, “How does strength training increase bone density?”

Well, the basic mechanism is very simple: Think of your skeleton as the framework of the body, the base upon which the body is built. Load up that framework with weight, and the body, being that dynamic organism it is, makes the framework stronger. Certainly an explanation you’ve heard before from your doctor, your trainer, or your media talking head of choice.

Here’s the implied but rarely mentioned “twist” that makes this all possible: Your bones are alive.

Not in a Night of the Living Dead creepy sort of way, but alive just like the rest of your body’s cells are (save hair and some skin cells). Bone isn’t some inorganic matter like the 2 X 4s in your bed frame or the piping under your kitchen sink. It’s a dynamic, ever-changing organ, constantly building and breaking itself down.

Cells called osteoblasts and osteoclasts work 24-7 at reshaping and remodeling your bone structure (even after you reach full adulthood). Load a bone with a heavy weight, and osteoblasts lay down new bone tissue to reinforce the points of stress, much like a young beach-going lad would add more sand and water to reinforce a wall of his sand castle. Repetitively load a bone in the same way, and you make that bone stronger by stimulating osteoblast activity, over and over again. Over time, these osteoblasts lay down so much new bone tissue that they trap themselves in it, becoming osteocytes (which always remind me of this). Not to worry for our osteocytes, however; they continue to chug away and do their job of reinforcing bone in a less…mobile…fashion.

Osteoclasts have a less celebrated but equally important role: They break down bone tissue by acidifying the bone matrix, releasing its constituent minerals into the bloodstream. Now, why would a fine, upstanding cell like an osteoclast want to do something like break down bone tissue? Well, low levels of calcium ions (one of the main minerals in bone) would be one reason. Calcium ions feature heavily in intracellular function, from DNA transcription, neurotransmitter release, and (most importantly for our discussion) muscular contraction. If you don’t have enough calcium available, the body simply draws from its calcium stores, and the largest calcium stores in the body? You guessed it: Bone.

(Aside: Why are osteoclasts always depicted in mechanism diagrams as goofy-looking Metroids?)

Without going into the ridiculously complex and numerous mechanisms for osteoporosis, let’s just say for brevity’s sake that you want to stimulate osteoblast activity, not osteoclast activity. And strength training just happens to be a fantastic tool for doing just that.

And now, you know why.

Summer Safety and your Breastfed Baby

Got this today from the NAHU:

Health consulting firms help coordinate healthcare services for individuals.

The Boston Globe (6/23, Wertheimer) reported, “During the last six years, a number of personal health advising firms and solo consultants have opened shop, catering to people willing to pay fees ranging from $150 an hour to $100,000 a year for advice on the best doctors and treatments for their maladies.” The advisors “are trying to fill a gap in healthcare created by overworked primary care doctors who have less time to coordinate patient care, while also catering to the desire of a growing number of patients to take charge of their healthcare.” The consultants “help clients find specialists and also will make calls to ensure that a patient’s various doctors are communicating with each other.” Although several of these consultants cater to the wealthy, others “see themselves as performing more of a neighborly service for clients, who tend to be more middle- than high-income, and need immediate help with a health dilemma.”

“[H]elping patients navigate the medical system used to be the role of the primary care doctor,” notes Jacob Goldstein in the Wall Street Journal’s (6/23) Health Blog. “But as primary care docs have grown busier and the system has grown more complicated, patients often find themselves on their own — creating a market for” health advising firms.

Not a bad idea given the demand for accurate and comprehensive medical expertise. I wish more family doctors, internists, generalists treated their practice like a “health advising firm.”