It’s about quality, not quantity

I am a child of the 70’s, and I remember the thrill of being able to stay up past my bedtime, on occasion, to watch The Mary Tyler Moore Show. So it was with sadness that I read the recent news that Valerie Harper, aka Mary’s best friend Rhoda, had been diagnosed with a rare and incurable form of brain cancer.

I watched her interviewed on television and was moved by her spirit, her humor, and her eloquence. “While you’re living, LIVE!” she entreats the audience.

In another post about end-of-life stuff, I quoted a doctor saying that … Continue reading

Boning up on calcium

Out of sight, out of mind

The other day I was cleaning out a kitchen cupboard and unearthed an economy-sized bottle of calcium tablets. Oops! I should be taking one or two of those every day.

Or should I?

Everyone knows calcium is necessary for bone health. Most women have been told by their doctors that they need extra calcium after menopause because without estrogen’s help, bones do not absorb it well. Low calcium leads to osteoporosis, which leads to broken bones, which lead to huge health care costs. Oh no!

Too much of a good thing—or the wrong thing

Continue reading

Medicare: No longer the light at the end of the health care tunnel

During the presidential campaign last year, Paul Ryan, the vice-presidential candidate, presented his plan for what we all know is much-needed Medicare reform (too many baby boomers; too little money). Under his plan, seniors would choose a  “Medicare certified” private health insurance plan and, depending on the senior’s income, a percentage of the premium would be subsidized.

His plan sounds a lot like the new health insurance exchanges that are set to begin in 2014, doesn’t it?

Yesterday, an article on the National Review Online caught my attention because the author presented a compelling scenario by which the government could … Continue reading

The probiotics con

Probiotics are of limited use

As a nurse, I often give patients the advice to eat yogurt when taking antibiotics to decrease the risk of developing diarrhea or, in women, vaginal yeast infections.

Why yogurt? Because it contains live, beneficial micro-organisms—now called probiotics—that are thought to replenish the “good” bacteria incidentally killed when taking antibiotics. In theory, eating yogurt makes sense. At best, it helps; at worse, you get a tasty snack with some extra calcium.

In the last few years, however, I have seen probiotic-laced products (fortified yogurt, snack bars, capsules) account for an increasingly large part of the … Continue reading

Got a craving?

In another bit of good news this week, the Centers for Disease Control (CDC) reported that Americans are actually eating less fast food. Since 2006, an American adult’s total daily calories from fast food has dropped from 12.8% to 11.3%.

This number, although small, surprised me. It is no secret that America is in an obesity epidemic; more than one-third of adults meet the definition of obesity with a Body Mass Index (BMI) of 30 or higher. In children, the obesity rate is about 15%.

Obesity is tied to all sorts of chronic health problems such as heart disease, … Continue reading

A possible silver lining to Obamacare

Last fall I blogged about an inherent unfairness in our health insurance system. (I know, there’s more than one.) In short, those with employer-sponsored insurance (ESI) generally have lower premiums, lower out-of-pocket costs, and better coverage than those of us that buy health insurance through the individual market.

With the new insurance exchanges, the Affordable Care Act (ACA) is supposed to decrease costs and improve coverage. Because of the law’s mandates for preventive services and essential benefits, coverage will be more equitable with the large, ESI plans. Whether premiums will be more affordable continues to be a topic of much … Continue reading

Got (breast)milk?

I was surprised recently when I read the following article on Kaiser Health News: Nursing moms get free breast pumps from health law.

Really?

So I went to Healthcare.gov, the official website of the Affordable Care Act (ACA) and found the expanded list of essential benefits/preventive services for women that went into effect on August 1, 2012. Breast pumps, listed under “Breastfeeding Support, Supplies and Counseling,” are indeed considered “preventive” and must be covered without cost sharing (co-pays or deductibles).

According to the factsheet: “Breastfeeding is one of the most effective preventive measures mothers can take to protect Continue reading

Will coverage for pre-existing conditions really be affordable?

The Pre-Existing Condition Insurance Plan (PCIP) was created by the health reform law and enacted in 2010 to provide coverage for low and moderate-income people who could not buy health insurance because of a pre-existing condition—the “uninsurables”.

The plan was to be funded through 2013 until the law’s signature provision—that insurers could no longer exclude those with pre-existing conditions—kicked in on January 1, 2014.

Sadly, the plan has already run out of money and enrollment was suspended February 16th, leaving many thousands without access to health coverage until at least 2014.

Related story from Kaiser Health News: Feds increase Continue reading

To drink or not to drink

Few things make me crazier about health care in the media than reading back-to-back, conflicting stories.

For example, last week I read the article A drink a day linked to healthy aging. A few days later I read Even a drink a day boosts cancer death risk, alcohol study finds.

Like many Americans, I enjoy a glass of wine with dinner and the occasional beer or cocktail when I’m out with friends. What’s a girl to do?

First, take a closer look at the studies.

These studies are “observational”. That is, participants fill out questionnaires over an extended … Continue reading

Good health – No miracle required

nomiracleI laughed the other day when I read a post on the blog Science-Based Medicine. The author denounced the all powerful Dr. Mehmet Oz for his frequent promotion of “miracle” products on his eponymous show, and commented that:

This constant drive for miracles must keep the producers in a perpetual panic. They need at least five miracles per week.

Which episode incited the author’s scorn? “Dr. Oz’s 13 Miracles for 2013.” Wow, that’s a lot of miracles.

Related post from Science-Based Medicine: Dr. Mehmet Oz completes his journey to the Dark Side

Like snake oil salesmen of old, the … Continue reading

Premiums, mandates and penalties

I posted a couple weeks ago that health insurance companies wanted to increase the penalty I mean tax on people who ignored the individual coverage mandate. The companies fear the penalty tax, only $95 the first year, is not stiff enough.

Well, according to recently released information from the IRS and the Department of Health and Human Services (overseers of the health law), the insurance companies have cause for worry. Not because so many people will ignore the mandate, but because so many people will be exempt.

Related reading from National Review Online: Obamacare’s pressure points

Who will be exempt? … Continue reading

Disneyland – The happiest last place on earth

palliative and hospice careDisneyland, here I come!

I have a plan. If I get cancer (or when, because according to news reports just about everything causes cancer eventually) and my doctors have nothing left to offer but last-ditch, statistically-improbable treatments that cost a fortune, I’m saving my money and booking a suite at the Disneyland Hotel.

Last summer I read a blog post titled “How Doctors Die.” The author, a physician, made the simple statement that “Doctors don’t die like the rest of us.” Why? Because “they know enough about modern medicine to know its limits.”

He shares his and other health professionals’ … Continue reading

Avoidable risk?

Last fall saw a frightening outbreak of fungal meningitis that resulted in the severe illness of almost 700 people and, tragically, the deaths of 45 others. Contaminated steroid injections were found to be the cause.

The Institute for Safe Medication Practices now reports that 13% of pharmacists found contamination in their supposedly sterile, compounded (made in the pharmacy) drugs last year, and almost 75% fear that such a horrific outbreak could happen again.

Several agencies are swaming the compounding pharmacies in a belated attempt to make sure it doesn’t happen again. But will their efforts be enough?

Maybe, but there … Continue reading

Taxes, income and subsidies

Yesterday, the IRS finally began processing 2012 tax returns.

In 2014, if and when you apply for individual health insurance through one of the state-run exchanges, it will be important to know your 2012 income. Why? Because that figure will determine whether or not you will be eligible for a federal tax credit to help cover the cost of premiums.

In a previous post, I explained how the federal subsidies will work. In short, individuals and families earning up to 400% of federal poverty level (FPL) will be eligible, and the savings could be substantial—over $10,000 a year in some … Continue reading

At risk: Unbiased medical research

On March 1, if Congress and the president do not reach some kind of fiscal accord, mandatory cuts to federal programs—sequestration—will take effect.

One of the many victims of such massive spending cuts will be the National Institutes of Health (NIH), the medical research arm of the Department of Health and Human Services. According to its director, Francis Collins, MD, the NIH, in a “profound and devastating blow,” will lose 6.4% of its budget.

Their loss, however, could be the drug industry’s gain.

Overdosed America: The Broken Promise of American Medicine

In his book Overdosed America: The Broken Promise of American Medicine, John Abramson, MD, … Continue reading