Should smoking be considered a pre-existing condition?

That is the opinion of the health exchange boards in Washington, D.C., California, Connecticut, Massachusetts, Rhode Island and Vermont (so far).

Each state (and D.C.) that creates a health insurance exchange under the Affordable Care Act (ACA) has an exchange board that is responsible for establishing certain rules and guidelines. Some definitions in the federal reform law have proved to be ill-defined and open to interpretation, such as “pre-existing condition.”

Most insurers that sell individual health plans charge smokers higher premiums because smokers … Continue reading

Pass the salt

Two reports last week reminded Americans—again—that we are eating too much salt (sodium), and the media gleefully passed on the news—again—that what we eat is killing us.

Possibly. But it’s not helpful to focus the blame on salt, when it alone is not the problem.

The American Heart Association (AHA) reported that, on average, adults consume 4,000 mg of sodium every day, or about twice what’s recommended. The United States Dietary Association (USDA) recommends no more than 2,300 mg/day (about 1 teaspoon); the AHA advises less than 1,500 mg/day.

In a coordinated analysis, researchers from Harvard Medical School concludedContinue reading

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

Do you didgeridoo?

didgeridoo playerAs I was skimming through some of my favorite medical blogs the other day, I ran across a post by Dr. Synonymous, a family medicine doctor somewhere in middle America. His post referred to the time and place of his first “Didgeridoo Hullabaloo” session that he was offering for his patients that suffered from snoring and sleep apnea.

What is a didgeridoo? It’s a native Australian wind instrument, which can be up to 10 feet long! It works like a large kazoo, and produces a low, resonant sound something like an elephant.

And how does this help snoring? Snoring and … 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

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

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

The CPAP machine – An American success story?

Have you ever heard of a company called ResMed? If you suffer from obstructive sleep apnea and have been prescribed a CPAP (continuous positive airway pressure) machine, you probably have.

Or, if you follow the stock market, you might recognize ResMed as one of its rising stars. Rising because, according to its website, ResMed ‘s revenues and profits have grown every quarter since it was formed in 1989. In 2012, ResMed reported revenues of approximately $1.4 billion.

What is the secret to ResMed’s amazing success? Our country’s poor health.

Obstructive sleep apnea (OSA) is the common condition in which … Continue reading

First sleep, second sleep

Last week, the Centers for Disease Control (CDC) released a report that 1 in 24 drivers admits to falling asleep while driving, and up to 33% of fatal traffic accidents may involve a drowsy driver.

Although frightening, this statistic is hardly news to those of us, myself included, who suffer from chronic sleeplessness. We can just add “death by fiery car crash” to the ever-expanding list of risks related to sleep deprivation, including obesity, diabetes, heart disease, stroke, dementia and cancer.

Such stories invariably conclude with the advice “health officials recommend getting 7 to 9 hours of sleep each night.”Continue reading

The healing power of mahjongg?

For more than five years, one of my best friends has been battling ovarian cancer. A fierce fighter (and fabulous friend!), she has endured surgeries and several rounds of chemotherapy to keep this grim disease at bay. Her oncologist monitors her condition with the blood test CA-125.

Early last summer, her CA-125 began creeping up into the “let’s watch it but not get too excited—yet” territory. She knew from past experience that she might be facing another round of chemo.

Then we began playing mahjongg. Or, more accurately, American mahjongg, which is a variant of the arcane Chinese game … Continue reading

A picture worth a thousand words

Last week, the publication of three short health care reports caught my eye. Separately, each is a “bad-news-as-usual” snapshot of health concerns; spliced together, however, they create a bigger, grimmer picture of the health and financial future of our country.

First, the Centers for Disease Control and Prevention (CDC) reported that between 1995 and 2010, the incidence of adults diagnosed with diabetes has almost doubled.

Part of the rate increase is explained by improved diagnosis and diabetics living longer, but the report’s authors concluded that the “major driver” is that “the increase in diabetes prevalence coincides with the increase in … Continue reading