Benefits of Garlic

Scientific Name: Allium sativum
Biological Background: This bulbous plant is closely related to onions, leeks, chives and is a member of Allium vegetables. Garlic is native to Central Asia, and has been cultivated for at least 5,000 years.
Nutritional Information: Due to its use as a spice, garlic provides insignificant amount of nutrients.
Pharmacological Activity: The healing power of garlic is recognized through Chinese folk traditions dating back thousands of years. Garlic contains multiple  compounds and antioxidants including organosulfur compounds (diallyl sulfides), which are believed to be responsible for most of the pharmacological and antimicrobial actions. Garlic is a proven broad-spectrum antibiotic that combats bacterial, intestinal parasites, and viruses. It can lower blood pressure and blood cholesterol, discourage dangerous blood clotting, lower chances of cancers (especially stomach cancer). Garlic is a good cold medicine, acts as a decongestant, expectorant, antispasmodic, and anti-inflammatory agent. It has antidiarrheal, estrogenic, and diuretic activity and appears to lift mood.
Eating Tips: High doses of raw garlic have caused gas, bloating, diarrhea and fever in some. To fight bacteria, raw garlic is better. However cooking does not diminish garlics blood thinning and other cardioprotective capabilities, and in fact, may enhance them by releasing antithrombotic ajoene. As a cancer fighter, raw garlic may be better than cooked ones. Eat garlic both raw and cooked for all around insurance. Eating garlic with parsley may reduce garlic breath.

Pineapple

Scientific Name: Ananas cosmosus
Biological Background: A tropical plant with stiff, spiny leaves that yields a single large fruit. Pineapple originated in Brazil.
Nutritional Information: One cup (155 g) of raw pineapple contains 76 calories, 0.6 g protein, 19.2 g carbohydrates, 2.95 g fiber, 175 g potassium, 124 mg vitamin C, 0.14 mg thiamin, 0.06 mg riboflavin, 0.65 mg niacin.

Pharmacological Activity: It suppresses inflammation due to Bromelain, an antibacterial enzyme. Pineapple aids digestion and helps to dissolve blood clots, and is food for preventing osteoporosis and bone fractures because of its very high manganese content. It is also antibacterial, antiviral and mildly estrogenic.
Eating Tips: Eat fresh. Canning destroys some pharmacological activities of pineapple.

Watermelon

Scientific Name: Citrullus Vulgaris
Biological Background: The fruit of an annual vine belonging to the squash and melon family. Watermelon originated in Africa and has been cultivated since ancient times in the Mediterranean region, Egypt and India.
Nutritional Information: One slice of watermelon (480 g) contains 152 calories, 3 g protein, 34.6 g carbohydrates, 2.4 g fiber, 560 mg potassium, 176 mg vitamin A (RE), 47 mg vitamin C, 0.3 mg thiamin, 0.1 mg riboflavin, and 0.96 mg niacin.

Pharmacological Activity: Watermelon is rich in lycopene, glutathione and vitamin C. It has great activity against cancers and some antibacterial, anticoagulant activity.
Eating Tips: Choose watermelon with a deep red color.

Eat Your Way to Health and Longevity

Eating is one the most important events in everyone’s life. We enjoy eating - it’s part of who we are and part of our culture; in fact, eating is the hottest universal topic of all times. We depend on eating: the foods we eat are the sole source of our energy and nutrition. We know so much about eating: we are born with the desire to eat and grown up with rich traditions of eating. But we also know so little about eating - about how the foods we eat everyday affect our health. We are more confused than ever about the link between diet and health: margarine is healthier than butter or not; a little alcohol will keep heart attacks at bay but cause breast cancer; dietary vitamin antioxidants can prevent lung cancer or can not. Eating is a paradox and a mystery that our ancestors tried and modern scientists are trying to solve.

Based on experiences and traditions, our ancestors have used foods and plant materials to treat various kinds of illness. Manuscripts discovered from a tomb (dated 168 B.C.) in China described prescriptions for 52 ailments with herbs, grains, legumes, vegetables, animal parts, and minerals. Ancient Sumerians recorded the use of 250 medicinal plants on tablets five thousand years ago. Today, plant and food remedies are still the major medicinal source for 80% of the world’s population.
The pharmacological roles of everyday foods have long been neglected by modern medicine due to lack of proven scientific validity. The main focus of modern medicine has been on pharmaceuticals. With the invention of modern chemotherapy by Paul Erhlich in the early twentieth century and sulfa drugs and antibiotics in the 1930’s and 1940’s, it seemed as if chemical medicines would take care of all our ills. However, while there continues to be great strides made in the understanding and use of pharmaceuticals, there is also widespread dissatisfaction with both them and the system of medicine that utilizes them. This dissatisfaction is centered around the feeling that they are too disease-oriented, and perhaps too limited by their precision to cope effectively with the subtle factors and interrelationships that compromise human health and disease. The precise and pure nature of modern biomedical pharmaceuticals also tends to increase their side effects. In addition, with the victory over many common infectious diseases, more people are concerned with chronic degenerative processes and with prevention of disease. The increasing concerns have started a new movement in medical research. More and more mainstream scientists are reaching back to the truth of ancient food folk medicines and dietary practices for clues to remedies and antidotes to our modern diseases.
Research on pharmacological effects of foods is fast-paced and the results are exciting. The mystery of what foods can do for or to us has started to unveil. In order to effectively use foods for our health benefits, the following issues need to be considered:

• Keep up with the most recent scientific findings and make use of them for our health benefits
• Try to use variety of whole foods as much as possible instead of isolated dietary supplements for your health problems - they are safer, cheaper, and usually more effective since they can provide multiple and balanced disease fighting capabilities
• Choice of foods is important: since healing power of a food is depending on the content of pharmacologically active constituents that differ among foods, and certain foods may need to be avoided due to their disease encouraging activities
• How do you prepare and eat your foods can affect their pharmacological effects
• Concerns about multiple health conditions: foods that benefit one health condition may be harmful to others
• Overall nutritional values of foods

Healthy Recipes That Taste Good

Delicious Cauliflower
6 servings

• 1 head cauliflower
• 1 cup good quality olive oil
• 1 tsp salt
• 2 Tbs minced garlic
• 2 Tbs chopped parsley

Separate cauliflower into flowerets and cook just until tender. Drain and keep warm. Heat the oil and salt in a pan and cook garlic and parsley for 2 minutes. Pour over the warm cauliflower and serve with additional chopped parsley if desired.
Vegetable Combo
4 servings

• 2 Tbs olive oil
• 1 cup each carrots, celery, and zucchini, sliced on a diagonal
• 1/2 cup each broccoli and cauliflower flowerets
• 3 cloves garlic, minced
• 1/4 dry white wine or chicken broth
• 1 Tbs light soy sauce
• 1 Tbs lemon juice
• 1/2 tsp pepper

Heat oil in a non-stick pan. Add vegetables and stir to coat with the oil. Add garlic and stir-fry for 2 minutes. Add the remaining ingredients and simmer the mixture, covered, for 2 minutes more. Serve immediately for maximum flavor and nutrition.

Cumin

Scientific Name: Cuminum cyminum
Biological Background: A seasoning that is the principal ingredient of curry powder, a blend of powdered Indian spices. Cumin is a member of the parsley family and cumin seeds resemble caraway seeds. The aromatic seed has a characteristic strong, slightly bitter taste. Traditionally cumin has been used to flavor cheese, unleavened bread, chili, and tomato sauce.
Nutritional Information: Due to its use as a spice, cumin provides insignificant amount of nutrients.

Pharmacological Activity: Studies have indicated that cumin has strong anticancer activity, which may be due to its phytochemical cuminaldehyde. Cuminaldehyde also has strong antiinflammatory properties. In addition, cumin contains two phytochemicals, cuminyl ester and limonene, which have been shown to stop aflatoxin from binding to DNA to start the cancer process.
Eating Tips: Use cumin to add an earthy flavor to Indian, Middle Eastern, and Mexican cuisines.

George Carlin

"Isn't it a bit unnerving that doctors call what they do practice? "

Josh Billings

"There's lots of people who spend so much time watching their health, they haven't got time to enjoy it."

Charles Caleb Colton

"The poorest man would not part with health for money, but the richest would gladly part with all their money for health. "

George Carlin

"Isn't it a bit unnerving that doctors call what they do practice? "

George Brett

"If I stay healthy, I have a chance to collect 3,000 hits and 1,000 errors. "

Erma Bombeck

"Never go to a doctor whose office plants have died. "

Elizabeth Blackwell

"Health has its science, as well as disease. "

Sermo teams with J&J

By Matthew Holt

One of the big stories at the Health 2.0 Conference in San Diego is that Sermo is partnering with Janssen Global Services (part of J&J) to create tools for doctors to help them move their patients through the health care system. It’s the first time Sermo has explicitly both added a mobile app and moved into the transactional end of its physician community members’ businesses. Sermo’s figured out that a significant portion of their referrals never result in an actual appointment. So they’re going to be working with Jannsen to help close that loop, and we can assume that there’ll be a series of physician and consumer-aimed services to come from the partnership. Sermo says to expect the first product by end of spring. While new entrants like Doximity are aiming at the same market, Sermo’s marketing reach and J&J’s muscle makes them a formidable competitor.
And if you’re at the Health 2.0 Conference in San Diego, Dan Palestrant, Sermo’s CEO will be making an appearance to explain a tad more!
 

Nurse Staffing, Patient Mortality, And a Lady Named Louise

By BOB WACHTER

How many nurses does it take to care for a hospitalized patient? No, that’s not a bad version of a light bulb joke; it’s a serious question, with thousands of lives and billions of dollars resting on the answer. Several studies (such as here and here) published over the last decade have shown that having more nurses per patient is associated with fewer complications and lower mortality. It makes sense.

Yet these studies have been criticized on several grounds. First, they examined staffing levels for hospitals as a whole, not at the level of individual units. Secondly, they compared well-staffed hospitals against poorly staffed ones, raising the possibility that staffing levels were a mere marker for other aspects of quality such as leadership commitment or funding. Finally, they based their findings on average patient load, failing to take into account patient turnover.

Last week’s NEJM contains the best study to date on this crucial issue. It examined nearly 200,000 admissions to 43 units in a “high quality hospital.” While the authors don’t name the hospital, they do tell us that the institution is a US News top rated medical center, has achieved nursing “Magnet” status, and, during the study period, had a mortality rate nearly 40 percent below that predicted for its case-mix. In other words, it was no laggard.

As one could guess from its pedigree and outcomes, the hospital’s approach to nurse staffing was not stingy. Of 176,000 nursing shifts during the study period, only 16 percent were significantly below the established target (the targets are presumably based on patient volume and acuity, but are not well described in the paper). The authors found that patients who experienced a single understaffed shift had a 2 percent higher mortality rate than ones who didn’t. Each additional understaffed shift carried a similar, and additive, risk. This means that the one-in-three patients who experienced three such shifts during their hospital stay had a 6 percent higher mortality than the few patients who didn’t experience any. If the FDA discovered that a new medication was associated with a 2 percent excess mortality rate, you can bet that the agency would withdraw it from the market faster than you could say “Sidney Wolfe.”

The effects of high patient turnover were even more striking. Exposure to a shift with unusually high turnover (7 percent of all shifts met this definition) was associated with a 4 percent increased odds of death. Apparently, patient turnover – admissions, discharges, and transfers – is to hospital units and nurses as takeoffs and landings are to airplanes and flight crews: a single 5-hour flight (one takeoff/landing) is far less stressful, and much safer, than five hour-long flights (5 takeoffs/landings).

As the authors note, this study should end the debate about the impact of nurse staffing on patient outcomes. The senior author, Mayo’s Marcelline Harris, said of the study: “It moves it away from questioning whether nurse staffing impacts patient outcomes, to focusing on the most effective ways to deliver nursing care and how current and emerging payment systems can reward hospitals’ efforts to ensure adequate staffing.” I agree.

As I discussed recently, virtually all research on the relationship between hospital staffing and outcomes comes from the field of nursing. This is because hospitals hire nurses, whereas physicians have traditionally been free to determine their own workloads and staffing ratios. But this is changing: since nearly half of American hospitalists are now employed by their hospitals, the field’s unprecedented growth has begun to catalyze a parallel debate: how many patients should a hospitalist care for? And a similar discussion, with an educational twist, has been a subtext in the controversy over the ACGME’s duty hours regulations. Though most of the attention has been on the work-hour rules, the regulations also set new limits on patients- and admissions-per-resident. And, with more and more physicians becoming hospital employees, expect the staffing ratio debate – for both nurses and doctors – to grow increasingly contentious, particularly as hospital profit margins evaporate. After all, labor costs represent hospitals’ largest expense.

Even today, nurse staffing is the subject of fierce negotiations between hospital management and nurses (or their unions) in many states, but not so much in California. In 2004, the California legislature bowed to pressure from the California Nurses Association to mandate nurse-to-patient ratios: 1:2 in ICUs and 1:5 on med-surg units. Although the law was controversial, it has probably saved lives – a 2006 survey found that a hospital nurse in California cared for one fewer patient per shift than a comparable nurse in New Jersey or Pennsylvania. The companion study estimated that raising those states’ staffing levels to match California’s would have saved nearly 500 lives over a two-year period. Since California’s law went into effect, 14 other states have followed suit.

While having adequate nurse staffing is a lifesaver, we can’t ignore its costs. With the average nurse’s salary topping $100,000 at hospitals like mine, bumping the ratio can easily take a multi-million dollar bite out of the budget. One wonders whether there is another way.

Which brings me to Louise.

Several years ago, investigators at Boston University, led by Dr. Brian Jack, launched a comprehensive program to improve hospital discharges and decrease readmission rates. Dubbed Project RED (“Re-Engineered Discharge”), the protocol involved giving patients intensive pre-discharge counseling, a customized discharge document, an early post-discharge phone call, and a rapid follow-up appointment. The investigators demonstrated a 30 percent decrease in readmissions and – even before the upcoming Medicare payment changes that will penalize hospitals for excess readmissions – modest cost-savings, $412 per patient. One of the most expensive parts of the intervention was the discharge counseling: an RN spent, on average, nearly 90 minutes with each patient and family, a significant cost.

No One Cares About Your Health (or No One is Willing to Pay For It)

By JOSEPH KVEDAR, MD

Of course that is not true, but it seems like that sometimes, doesn’t it? If you are working to promulgate a solution that promotes health in the context of our current healthcare system, there is no end to the challenges you will face. Lets think a bit about the various actors, why they should care and why they do not.

I’ll start off with you. No one should care more about your health than you. But as the behavioral economists remind us, we are not rational beings. We are more likely to focus on tangible things in the moment rather than long-term uncertain benefits. So we persist in participating in unhealthy behaviors that provide short-term pleasure and lead to downstream sickness. In addition, we’ve been addled into believing that once we are diagnosed, we are victims and that we can abdicate all responsibility for our care. (see 5-17-2010, Are Individual’s with Chronic Illness More Passive?). This insidious combination makes it hard to hold ourselves accountable for our own health. Most times, we’d rather blame the environment, or bad luck, and ask if we can take a convenient pill to make it better.

Next, how about your loved ones? They are the best targets. In most cases our loved ones (the more current phrase is ‘social network’) can and do affect our health (See Nicholas Christakis’ book Connected and related articles). It has, however, been challenging to get loved ones to open their wallet to pay for service offerings that improve your health. In my experience, this is most often because of the same mentality that makes you a passive victim once you get sick. We feel that society owes a victim. We all feel like we’ve paid into various insurance programs – public and private – and that they should be the ones to pay for health-related services, particularly in the setting of chronic illness. So your loved ones do care, but they have been trained not to open their wallet to support your care. I can think of a dozen or so business plans I’ve seen over the years where the service to support a chronically ill individual was to be paid for by the “sandwich generation.” There is an appeal to this on the surface, but I haven’t seen one of those businesses scale yet.

What about those insurers then? They probably care the least. They see their role as spreading risk over large populations. So they work to recruit and keep healthy people on their rolls. They work to be as efficient as possible at processing claims and mathematically predicting risk. They only got into the care management business because their customers (employers) demanded it of them. They invariably vote for commodity or ‘check the box’ solutions. Keeping cost down is held at a premium compared to improving health. Insurers are hard to engage in a visionary conversation about improving health, even though they’ll admit that in many cases the savings of improving health would accrue to them.

OK, so lets move upstream in the supply chain. Employers hire insurers to help them with employee benefit health care plans. Employers are motivated to keep you healthy if for no other reason than you will be a more productive worker if you are healthy. They even care a bit that your dependents are healthy too, since you’ll be more productive if a sick parent or child doesn’t distract you. And there is the original reason employers started paying for healthcare in the first place – because their benefits packages help them attract a more talented workforce. The latter has largely been forgotten these past 2-3 years, as we’ve been adrift in a sea of employable people without jobs. Supply and demand curves to motivate behavior and with such a large supply of workers, benefits are less important. That will change as the economy picks up.

So a high level analysis would conclude that employers are good targets for novel health-improvement interventions. The challenge is that the direct customer is the human resources professional. These poor, overworked souls are true generalists. They have to help you invest money in a retirement plan, guide you through how to handle a maternity leave, discipline a difficult employee and, oh yeah, choose your health plan. Few of them have any training in health so it is natural that they develop trusted relationships with folks at health plans…so they get talked into purchasing check the box, commodity solutions.

Well, for goodness sake, what about your doctor? Your health professionals are there for you. But they too have perverse incentives. The most prevalent of these is that they are trained to and get paid well for taking care of sick individuals. The system does not reward them financially at all for improving health. They are also big believers in patient accountability and don’t usually buy that victim thing. So they quickly articulate a treatment plan so they can go on to the next sick person who needs their help. They expect you, the passive victim, to be proactive about learning everything you need to do to execute that plan and carry it out. They are not on the same page as society is regarding who is accountable for keeping you healthy. They’d say it’s you, with their help from time to time.

Throughout this piece I have purposefully equated ‘caring’ with ‘spending’. I suppose this too is controversial, but I think the linkage is fair. What is the relevance to connected health? Simply put, connected health interventions promote health over sickness management. In today’s healthcare marketplace, they’ve been a hard sell. Most folks I talk to readily agree that connected health as a care model makes sense. But there is this mystery about ‘who pays?’. I believe this phenomenon of ‘nobody cares enough about health to pay for it’ helps explain that conundrum.

So it feels a bit like merry-go-round to me, or if you take a more sardonic view, a game of Russian roulette. So tell me: am I off base? Who really does care?

Is That Thorazine in the Baby’s Bottle?

One of the most disturbing trends in mental health today is the increasing use of powerful antipsychotic medication to treat behavioral problems in children, even very young children. According to a 2009 report by the Food and Drug Administration, there are 500,000 children in the United States being administered regular doses of antipsychotics. Medicaid data shows public health monies spent on antipsychotic drugs for children exceeding $30 million in New Jersey and topping $90 million in Texas. It is a trend that has built relentlessly for the past ten years and continues unabated.
I find the use of these drugs on children to be appalling almost beyond words. Having worked as a mental health professional for many years, I am well acquainted with these medications. This class of drugs, sometimes referred to as neuroleptics, are major tranquilizers and are primarily used and intended for controlling hallucinations and delusions in cases of psychosis and schizophrenia. For an adult with severe schizophrenia, these medications may be a glimmer of hope, but it is always a difficult risk-benefit analysis because there are potentially severe side effects and reactions. Depending on the individual, these medications can cause tremors, involuntary spasms and movements, severe sedation, muscles of the face become rigid, and loss of pleasure sensation, just to name a few. Permanent neurological damage can occur in the form of tardive dyskenisia, and sudden death can occur from a reaction called neuroleptic malignancy syndrome. With newer forms of antipsychotics, these type of side effects are less frequent and less severe, but continue to be a risk depending on the reaction of the individual’s body. However, newer, “atypical,” antipsychotics present new dangers to the patient, metabolic changes that result in a dramatic increase in the instances and severity of diabetes and heart disease. The result is that adults on antipsychotic medications have a life span that is 20 years shorter then the average person.
We know these medications have the potential to cause permanent harm to an adult’s brain, but they are still used because it is considered by many to be worth the risks to control just some of the symptoms of debilitating disorders, and, except in the most severe cases, where a person’s legal rights have been taken away due to impairment, it is ultimately up to the patient to decide whether or not to take that risk.
What then will these medications do to a child’s developing brain? The jury is out, but it can’t be a good thing. Who makes the decision and why? Certainly not the child who will live the rest of his or her life with the consequences of that decision.
The New York Times ran a recent article on the subject, highlighting the case of one child who was started on an antipsychotic at 18 months old. This helps to highlight the human side of this tragedy:

At 18 months, Kyle Warren started taking a daily antipsychotic drug on the orders of a pediatrician trying to quell the boy’s severe temper tantrums.

Thus began a troubled toddler’s journey from one doctor to another, from one diagnosis to another, involving even more drugs. Autism, bipolar disorder, hyperactivity, insomnia, oppositional defiant disorder. The boy’s daily pill regimen multiplied: the antipsychotic Risperdal, the antidepressant Prozac, two sleeping medicines and one for attention-deficit disorder. All by the time he was 3.

Today, 6-year-old Kyle is in his fourth week of first grade, scoring high marks on his first tests. He is rambunctious and much thinner. Weaned off the drugs through a program affiliated with Tulane University that is aimed at helping low-income families whose children have mental health problems, Kyle now laughs easily and teases his family.

Ms. Warren and Kyle’s new doctors point to his remarkable progress — and a more common diagnosis for children of attention-deficit hyperactivity disorder — as proof that he should have never been prescribed such powerful drugs in the first place.

As to what’s driving this latest treatment fad?  I think there are a number of factors.  The easiest and most popular target is Big Pharma.  The pharmaceutical industry has the largest profit margin of any major industry, and do you know what their most profitable line of drugs are?  Yes, that’s right, antipsychotics.  This class of drugs brought in a staggering $14.6 billion in 2009.  Antipsychotics are marketed as heavily as any other product line, and the marketers are always looking for new markets.  Antipsychotics have been marketed for depression, for instance, and they are actively promoted to pediatricians for use on children, but, for the most part, marketing efforts keep within the limits set by the FDA and the risk-benefit decisions made industry lawyers.  The FDA approved Risperdal for use on children as young as 5, but most antipsychotics are only approved for children 10 or older.
Yet, in spite of the FDA guidelines, these drugs are being given to much younger children. Who then is to blame? The other popular targets of finger pointing are the parents (and, I would add, teachers and childcare workers). Perhaps it is helped along by marketing campaigns, but the fact is, parents are increasingly choosing to pathologize and medicate their children in lieu of other, more traditional, parenting strategies. Childcare and educational professionals add to the stampede by pressuring parents to go to the doctor when the child’s behavior puts a strain on the professional. I think we can objectively state, unequivocally, the nature of childhood needs and behaviors has not changed in recent generations, yet more and more parents go to their pediatricians insisting there is something wrong with their child and demanding some pill they can give the kid to fix the problem. Parents just want to do right by their child, I’m sure, but they fail when the don’t take the time to research what they are doing and the possible consequences.
The final responsibility, however, rests on the shoulders of the professionals who prescribe these medications. Physicians are free to prescribe off label use of drugs and are under no legal obligation to stay within FDA approved guidelines, and some physicians seem more then willing to exercise this discretion in spite of the very serious risks they are exposing the child to. Regardless of shameless marketing by drug manufacturers and the irrational pressures of frustrated parents, the physician is supposed to be the final gate keeper and is responsible to safeguarding the health and wellbeing of the young patients. Physicians who push antipsychotics on children clearly fail in their responsibilities.
The issue is further complicated by shifting diagnostic categories. Schizophrenia is a disorder of adulthood. Age of onset is typically late adolescence or early adulthood. There is no defined criteria and very little in the way of scientific data to justify giving this diagnosis to younger children, yet we are seeing it, now, younger and younger, usually tied to a prescription. Another expanding diagnosis is bipolar. This disorder is very loosely defined and as a result, unscrupulous or simply confused professionals can see it everywhere. It too used to be a disorder of adulthood but has mushroomed as a child diagnosis in the last decade. The other big diagnosis linked to antipsychotics is autism. This is a very serious and real childhood disorder and children who suffer from this take a lot of care and present a lot of challenges. However, the autism diagnosis has become hugely popular and its working definition has expanded infinitely. As in the case of Kyle Warren, just about any child can get the diagnosis at this point. It is now virtually meaningless, yet it is the justification for giving these very serious drugs to young children.
The big picture is we have an expanding culture of psychopathology in which more and more facets of human behavior are being defined as disorders and sicknesses. This extends even to the point of defining childhood tantrums as a sickness that we have to treat with a powerful drug. The pathologization of childhood started probably in the 1980’s with attention deficit disorder and this became hugely popular in the 1990’s. In the first decade of the new millennium, we saw a significant expansion of clinical depression, bipolar and even schizophrenia into younger and younger populations with related drug therapies. Additionally the autism diagnosis has been opened up into a “spectrum” disorder so now parents of children with any kind of perceived interpersonal or behavioral challenges can have an autism label slapped on ‘em at bargain basement prices.

The bottom line is that young children are being harmed by antipsychotic drug treatment and it’s no laughing matter. The trend line is very disturbing. I hope I am not one of a few lone voices in the wilderness. Is anybody listening?
Psych Gripe is a mental health professional based in the Pacific Northwest. He blogs vigorously and often at Psych Gripe.

The Incredible and Wasteful Complexity of the US Healthcare System

During the health care reform debate, we wrote that most people’s attitudes to it were “confused, conflicted, clueless and cranky.”  A major reason was that the American health care “system” is fiendishly complicated and few people really understand it.   As a result hardly anyone knows much about what is actually in the reform bill (but that does not prevent them from having strong opinions about it).    Sadly, the reforms, whatever their merits, will make the system even more complicated, the administration more Byzantine and the regulatory burden more onerous.
System complexity.
The American healthcare system is already by far the most complex and bureaucratic in the world.  We were once asked to spend ninety minutes explaining American health care to a group of foreign health care executives.  Ninety minutes?  We probably needed a few weeks.  Most other countries have relatively simple systems, whether insurance coverage is provided by a government plan or by private insurance or some combination of these.  But in the United States insurance coverage, for those who have it, may be provided by Medicare Parts A, B, C, and D, 50 different state Medicaid programs (or MediCal in California), Medicare Advantage, Medigap plans, the Children’s Health Insurance Plan, the Women, Infants and Children Program, the Veterans Administration, the Federal Employees Health Benefits Program, the military, the hundreds of thousands of employer-provided plans and their insurance companies, or by the individual insurance market.  This insurance may be paid for by the federal or state governments, by employers, labor unions or individuals.  Some employers’ plans cover retirees, others do not. The result is that the system is pluralistic, mysterious, capricious and impossible for most patients and providers to understand.
Administrative complexity
The administrative complexity is amplified by the multiplicity of insurance plans.  About half of all Americans with private health insurance are covered by self-insured plans, each with its own plan design.  Employers customize their plan documents, led by consultants who make a good living designing their plans and tailoring their contracts. As one prominent consultant told us recently, if all the self-insured plan documents were piled on a table they would not just exceed the 2,700 pages of Obamacare, they would probably reach the moon. For the rest of the commercially insured population, health plans may be traditional indemnity plans, Preferred Provider Organizations or Health Maintenance Organizations.
The coverage provided by different plans varies dramatically.  They may or may not include large or small deductibles, co-pays or co-insurance.  Beneficiaries may pay a large, small or no part of their health insurance premiums.  Some plans cover dependent family members and children, others do not.  The Medicare Part D pharmaceutical benefit plan involves a “doughnut hole,” which will disappear as health reforms are implemented.  Surveys have found that few people fully understand their own insurance plans let alone the bigger picture.  While health reform takes some steps toward standardization of insurance offerings and improving transparency, overall it is likely to increase complexity.

From: http://thehealthcareblog.com/blog/2011/03/24/the-incredible-and-wasteful-complexity-of-the-us-healthcare-system/

Rhode Island Approves Health Insurance Rate Increase

Rhode Island health insurance is about to see a 1.9% increase in health insurance rates for those who purchase policies from Blue Cross and Blue Shield of Rhode Island.  The article “State Approves Reduced Health Insurance Rate Hike” by Richard Salit on ProJo.com summarizes the details behind the hike.
The 1.9% is actually a reduced figure when compared to what Blue Cross and Blue Shield of Rhode Island had originally requested which was an increase of 7.9%.  This huge jump could devastate some families and the compromise will make many consumers very happy.  Commissioner Christopher F. Koller recently said that the approved rate increase finds the right balance.  Laura Calenda, Blue Cross spokeswoman, says the company is very disappointed they 7.9% wasn’t approved since it was justified.  She says Blue Cross has taken aggressive steps to help slow down the increase of premiums and they strive to make health care more affordable.
Health care costs and health insurance premiums are going up around the nation, but it’s good to know government officials are staying on top of the increases to ensure they are not outrageous and consumers can still afford quality health care.  The rate increases would go into effect April 1st, but the company may appeal the decision which could delay the process.

NFL Players Looking for Better Health Care

The long awaited NFL lock-out is upon up and players are toughing it out without health insurance.  Many players chose to get coverage through COBRA while negotiations are under way, but there are players taking a risk with no insurance at this time.  This is unfortunately considering one of the main factors the players are fighting for is a significant improvement in health care post-football and a health care reimbursement account.
According to the article “The NFL Labor Situation is Bad, but Resolution Closer Than it Appears” by Peter King on SportsIllustrated.cnn.com, the NFL situation is in the hands of the lawyers and there’s even a possibility games are lost this year while they battle out NFL benefits and contracts.  This could take months, or it could take weeks.  It’s hard to tell at this point but progress is being made.
One of the major negotiations is for a change in post-football health care.  As of now, vested NFL players with 4 years of service or more can retire and receive 5 years of post-career health care free of charge.  NFL are proposing significant improvements in this benefit.  They are requesting vested players receive lifetime health care after the 5 years are over, just by paying a yearly fee, much like COBRA.  This would ensure pre-existing conditions wouldn’t affect their ability to get quality, affordable individual health insurance in retirement.  Also, the NFL would allow players to pay for future health care costs in a health care reimbursement account, to be used after their NFL careers end.  These are wise requests from the NFL players considering the future of major medical insurance quotes and health care major medical insurance quotes seems to be up in the air.  Time will tell if they end up getting what they want.

Aflac Offers Vision Insurance

Most people know Aflac as the company which covers daily costs in case of disability but they also offer other types of insurance.  You may be surprised to learn that Aflac offers vision insurance.  This can be a huge benefit to those who do not have the time or the information to shop around for vision insurance quotes when out of work or on disability.
According to their website, Aflac vision insurance goes beyond a traditional vision insurance policy by offering benefits for eye surgeries, certain eye diseases, as well as permanent visual impairment.  They do not have any provider network restrictions, so customers have the freedom to use their own eye doctor.  They also can make recommendations for those who do not have a specified eye doctor.  You can also choose the benefits and frequency of exams that best suit your needs.
Some of the main benefits of Aflac vision insurance include regular eye exams, vision correction materials, specific eye ailments and diseases, and permanent visual impairment where you can say goodbye to contact lenses and glasses.  Aflac vision is only offered through worksite payroll deduction, but can give you the extra peace of mind you need in case you are in need of vision insurance.  More and more companies are starting to offer this type of comprehensive vision insurance due to a growing need of eye health care.  Check to see what sort of benefits your employer may offer if you think this is the type of product that would assist you with your needs.

Anniversary of Healthcare Reform

Yesterday marked the one year anniversary of Obama’s historic healthcare reform bill which had everyone talking. Despite the bill having some positive effects throughout the nation already, Congress is still disputing the benefits of the bill and many states are downright opposing parts of it. Acceptance of the bill still has a long way to go and with so many states trying to adjust the bill to their liking, it feels like it might not end up accomplishing many of its goals.

According to the article “A Year Later, Health Care Still in Dispute” on Freep.com, public attitudes towards the Affordable Care Act have not shifted too much. Democrats strive to praise the bill while Republicans work to put it down and it’s a tug of war on the American public’s emotions. The worst part is that most Americans are still confused on exactly how health care reform and required health insurance will affect them. Finding health insurance is already hard enough so with more people scrambling to get coverage will it make it even harder?

Some tangible gains pointed out in the article include lifting caps on lifetime benefits, and prohibiting discrimination based on pre-existing conditions. Republicans keep stressing their theory that the new bill is affecting the sluggish economy and the requirement that all Americans carry individual health insurance is under scrutiny in many courts. A recent survey released from the Kaiser Family Foundation less than 40% of Americans want a repeal of the healthcare reform bill which leads many to believe it was still the right decision. We still need many more years before the overall impact of the bill can be felt and measured.

Blue Cross Blue Shield of North Carolina Awarded

Blue Cross Blue Shield of North Carolina earned a very high customer satisfaction score and with all of the concerns over health insurer quality, this bodes well for BCBS. According to the article “North Carolina Health Insurer Earns High Customer Satisfaction Score” by Bob Graham on IFAWebNews.com, BCBS of North Carolina ranked second best in a recent survey of customer service throughout the South Atlantic region.

BCBS of North Carolina earned a score of 714 out of 1000 which was above the average score by 14 points. JD Power and Associates’ US Member Health Insurance Plan Study looks at customer satisfaction and measures it by questioning coverage, benefits, provider choice, information, communication, claims, statements, customer service and overall approval processes. Kaiser Foundation Health Plan was ranked number one with a score of 747.

Some other scores from the South Atlantic region include Blue Cross Blue Shield of Georgia at 704, Aetna at 699, and UnitedHealthcare at 695. The 2011 US Member Health Insurance Plan Study looks at responses from over 34,000 members of various health insurance companies. The survey took place in December of 2010 and January of 2011. These ranking reports are very valuable to the reputation of each insurer, and consumers should look at these reports as they shop around for health insurance quotes.