The $787 billion economic stimulus package that was signed into law last week includes one or two health-related measures that haven’t been widely publicized, but which are no less important for it.

One of these is the $1.1 billion that has been assigned for a study to compare the effectiveness of a large number of medical treatments, drugs, surgeries, and other current standard medical procedures and devices. A council of fifteen federal employees will be set up to coordinate the research and advise the President and Congress on where the money would best be spent.

The program is a response to growing concerns that doctors have little solid evidence on which to base the value of many of the treatments that are currently considered standard.

Questions to Answer with the Stimulus Package Health Care Money

According to Dr. Elliott S. Fisher of Dartmouth Medical School, the study will help answer questions such as these:

• Should severe neck pain be treated with physical therapy, medication, and exercise, or with surgery?
• What is the best combination of prescription medication and therapy for the treatment of depression?
• Is it more effective to treat arterial blockage in the legs with medication or with surgery?
• Is medication alone an effective treatment for chronic heart failure, or are active health intervention measures also necessary?

Second Concern: Rapidly Increasing Health Care Costs

A second concern is the rapidly increasing cost of health care. Healthcare spending hit a total of $2.2 trillion in 2007. That’s 16% of gross domestic product – and it’s been estimated that figure will hit 25% by 2025. It is hoped that the research will save money by discouraging the use of expensive treatments that are largely ineffective and, at the same time, boosting the use of more effective treatments. During her years as a senator, Hilary Rodham Clinton was a firm proponent of such research and President Obama endorsed the concept during his White House campaign.

Not everyone is supportive of the idea of spending millions of taxpayer dollars on health care comparison studies. Critics say it may allow the federal government to be too intrusive when it comes to personal health care choices, and may jeopardize the doctor-patient relationship by put the government squarely between patients and health care professions. Others worry that insurance companies will use the data gained from the study as an excuse to deny coverage of more costly medical treatments.

photo credit: Emily Taliaferro Prince

Trees are good for your health – they suck up carbon dioxide and release oxygen, help reduce greenhouse gases and provide welcoming shade during the summer. But those aren’t the trees that have recently been in the news for helping to improve the health of many Americans. This time it’s family trees that are up for discussion – and electronic ones, at that.

Importance of Knowing Your Health History

The importance of knowing your family medical history can’t be emphasized strongly enough, according to Acting Surgeon General Steven Galson, whose office has been in charge of a new initiative to promote the use of a website where users can grow an electronic family tree to find out where their health risks lie.

The government’s new free service is hoping that people will compile their own family tree at home, and share the information with their families. Compiling an extensive and accurate family tree is even more useful than genetic testing to predict what your medical requirements might be in the future, experts say. It’s a highly useful tool for doctors, too, since it saves time and also provides lots of useful information about potential health risks. You can even use it as you’re applying, or looking into various family health insurance plans.

Significant Benefits of an Online Family Health Tree

The most significant benefit, perhaps, is that it’s likely to be more accurate than anything you remember off-the-cuff in a doctor’s waiting room. And by sharing the information with relatives from both sides of the family, it’s easier to compile an accurate family health tree that includes all the information that’s important.

The family health tree site at https://familyhistory.hhs.gov makes it easy to compile this information. The electronic tree you create can be easily mailed to relatives, who can add their own information into the tree. The information is entirely private, too. Information is downloaded to the user’s own computer, rather than being held on the web site.

Even more useful is the fact that a single click can “re-index” the tree to concentrate on showing the health risks of any relative on the tree – so it’s useful for everyone, not just the person who creates it.

Another benefit is the fact that environmental and lifestyle factors can be added to the tree – factors that are often forgotten during doctor’s visits. The family tree can be printed out or even emailed directly to your doctor, ensuring that none of that valuable information is lost.

photo credit: Wolfiewolf

The Healthy People program recommends that adults get 30 minutes of moderate exercise (such as walking) five times a week, or at least 75 minutes of vigorous exercise (such as running) every week. It seems, however, that the majority of people still aren’t meeting these goals.

The U.S. Centers for Disease Control and Prevention recently released its figures for the most and least fit metropolitan centers in America, and the results indicate that many people aren’t getting as much exercise as recommended by the Healthy People 2010 initiative.

America’s Most Fit Cities

So where are the fittest cities in America, according to the CDC?

The Top Ten Healthy Cities Are

1. Boulder, CO
2. Provo-Oren, Utah
3. Anchorage
4. Barnstable Town, Mass.
5. Lincoln, Nebraska
6. Portland, Maine
7. Fort Collins, Colorado
8. Grand Rapids, Mich.
9. Albuquerque, N.M.
10. Casper, Wyoming

In all ten cities, between 57% (Casper) and 67% (Boulder) of the population are exercising regularly, meeting the goals of the Healthy People initiative’s 150 minutes of moderate exercise per week. In addition, between 31% (Casper) and 43% (Boulder) are getting regular vigorous exercise.

America’s Least Fit Cities

And the Least Fit Cities?

1. Chattanooga, TN.
2. New Orleans, Louisiana
3. Baton Rouge, LA.
4. Lake Charles, LA.
5. Hickory, N.C.
6. Birmingham, Alabama.
7. Mobile, Ala.
8. Tuscaloosa, Ala.
9. Jackson, Miss.
10. Fort Smith, Ark.

In the “bottom ten” cities, the CDC reports, between 40% (Memphis) and 37% (Chattanooga) are getting regular moderate exercise. And in every city, less than 25% of the population is getting regular vigorous exercise.

Want to make a difference to your health in 2009? Stop dieting – studies show it doesn’t work in the long run, and yo-yoing weight can even be harmful to your health. Instead, decide to make healthier food choices more often than you currently do. Over time, increase your percentage of healthy food choices until you’re at a point where you’re getting a good balance of calories and nutrition. These types of goals are much more sustainable than restrictive diets, and are much more likely to stick in the long term.

When it comes to exercise, choose something you really enjoy doing, rather than what the latest magazine workout program tells you to do. If you exercise in a way that’s fun, you’ll be far more likely to keep up with it throughout the year.

photo credit: Ed Yourdon

The medical breakthroughs that get reported in the media rarely end up being the miracle cures they’re often portrayed as. In 2008, however, there were several important advanced made in medical science that could have a significant impact on public health in years to come.

1. The question of whether organic food is good for you has finally been answered: A review of studies on nutrient content of organic fruits, vegetables, and grains has confirmed that these have up to 25% more nutrients than conventionally-grown produce.
2. Another long-held myth—about the efficacy of antibiotics for sinus infections—was also dispelled in 2008. Over the course of nine studies involving 2,500 participants, it was found that antibiotics didn’t significantly hasten recovery. According to allergist Neil L. Kao, MD, taking a decongestant or mucus thinner, along with a painkiller as needed, is just as beneficial.
3. If weight loss is your resolution for 2009, look into adding resistant starch—found in beans, green bananas, and potatoes—to your diet. This type of starch is digested very slowly, helping to suppress your appetite, and can help stabilize blood sugar levels, too.
4. Women take note: a new risk calculator, known as FRAX, has been developed to help doctors determine whether women are at risk of osteoporosis, and whether preventative treatment may be necessary.
5. If you receive a diagnosis of diabetes, it’s important to know the results of three major studies that were completed in 2008. All three reinforce the importance of taking control of blood sugar levels as soon as possible, and managing blood pressure, cholesterol, and triglyceride levels as well.
6. Also from the field of diabetes research comes the news that body fat percentage may be a more reliable indicator of risk than body mass index. Mayo Clinic researchers studied 1,101 women with a BMI of less than 25 (considered a healthy BMI), and found that those with higher than 30% body fat were at higher risk of metabolic syndrome and diabetes.
7. Unfortunately for people with arthritis in one or both knees, a result study showed that arthroscopic surgery doesn’t provide any real benefit in most cases. If you’re affected by this condition, the study concluded, you’re better off with physical therapy and medication for pain management.
8. Another potentially major breakthrough is in the field of multiple sclerosis treatment, where current medication can prevent relapse of major symptoms in around 30% of people with the disease. A new drug, called fingolimod, has so far been able to prevent relapses in more than two thirds of patients, for three years, according to results of clinical trials.

photo credit: a.drian

Nearly two million Americans have lost their jobs over the last year: around 500,000 in the last couple of months alone. That’s a staggering number of people who have lost their livelihood, perhaps their sole source of income.

Among their worries is the question of what’s going to happen to the healthcare their employers provided. Families with young children, in particular, may find the doctor’s bills piling up, with no healthcare insurance to cover them.

According to the Kaiser Family Foundation, every 1% increase in the unemployment figure translates into another 1.1 million people who don’t have healthcare insurance. The national unemployment rate was at 6.7% in November 2008 – an additional 7 million people without that crucial insurance.

If you don’t have employer-provided healthcare, it’s likely you’re going to have to pay a significant amount of money for an individual plan – but the alternative, of having no coverage at all, is surely worse in the long run. If you’re in this position, what can you do about accessing affordable healthcare?

What are Your Healthcare Options?

• Under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) you’re entitled to have your employer healthcare benefits extended for 18 months after your job ends. However, your employer won’t be paying their share of the premium – so you’ll be looking at a significant increase in your premium costs.

To be eligible under COBRA, you must have been working at a company employing at least 20 people (some states extend eligibility to smaller companies), and have been enrolled in an employer-sponsored health plan when you were laid off.

• If you’re not eligible for COBRA, in most cases your only alternative is an individual health plan. Your costs for this will depend on your age, health, and location. If you’re older or have a pre-existing condition, you can expect to pay a hefty price for your insurance.

You may also find that you have fewer options than you did when you were eligible for employer healthcare, so it’s important to carefully review potential plans and check out whether things like prescriptions are covered.

• Government assistance may provide for your children, at least. In most states the Medicaid eligibility level for children is twice the poverty level (equating to around $42,000 for a family of four). However, it’s much stricter for adults – even an unemployment benefit may disqualify you.

• Some states also provide limited government assistance – this varies from state to state. In Florida, for example, the Medically Needy program provides help for participants after they’ve paid a certain amount in medical bills each month.

• For senior citizens and the disabled, Medicare may be an option.

photo credit: Mike Licht, NotionsCapital.com

AARP (formerly the American Association of Retired Persons, but now known more commonly by its acronym) is a non-profit, non-government interest group which, according to its web site mission statement, is “dedicated to enhancing quality of life for all as we age,” by providing “a wide range of unique benefits, special products, and services for our members.” AARP acts as a member advocate, and is a powerful lobbying group. It also sells insurance, investment products, and endorses certain insurance companies.

Sounds good, yes? But by virtue of its habit of endorsing insurance companies, AARP has recently come under fire. The Kaiser Family Network recently revealed that AARP’s endorsements don’t come cheaply – 43% of the revenue the supposedly non-profit, independent advocacy group collected in 2007 came from royalties and fees the organization took from insurance companies – as payment for endorsements.

Doesn’t sound too much like consumer advocacy, does it.

AARP Endorsements Equal Higher Insurance Costs for Consumers

AARP advertising claims that by choosing AARP-endorsed insurance, AARP members will save money. But as it turns out, those AARP-endorsed insurers often charge higher premiums. And the reason for the higher price is at least in part because the insurers add the cost of AARP’s fees and royalties to the price that consumers pay.

Under AARP insurance plans, the organization collects the premiums from AARP members, and pays the insurance companies. And the insurance companies then return a portion of that fee to AARP, in the form of those royalties and fees. So AARP is telling people to purchase insurance from certain companies, and this supposedly ‘independent’ organization is taking a cut of the premiums. In 2007, this earned AARP a cool $500 million.

There’s more, of course. When AARP receives payments from its members, it holds that money in its own accounts for up to a month before paying the insurers. And that month is enough investment time for the company to have earned a further $40 million in interest from its own members.

Now obviously, that’s not illegal. But it’s clear that there’s a conflict of interest here. And this has been noted in the past, too, with BusinessWeek saying that many of the insurance and finance products endorsed and sold by AARP are actually no better than products that seniors could get on their own or through the government – and in some cases may even be worse.

Taking Consumer Driven Health Care into Your Own Hands

In the past few years, consumer driven health care has taken over many of the older and well-established methods of health insurance, and although it’s common to save hundreds – or even thousands of dollars -  simply by choosing a private health insurance plan, it’s not always the best choice, especially for seniors, who are often already given a wide range of benefits from the government.

The controversy with AARP shows that endorsements of health plans may not be truly “independent.” This highlights the need for you – the consumer – to take the important research into your own hands so you can decide on the best plan for both you and your family.

photo credit: Publicly Scalped

Prescription medications are expensive, and many doctors seem to become “prescription-happy.” These doctors’ first response to a patient complaint is usually to prescribe something new if something doesn’t work the first time. Even if you’re just taking one or two medications, you could be paying more than you need if you are taking brand name drugs, instead of generics.

According to a recent study, led by Dr. Aaron Kesselheim of Brigham and Women’s Hospital and Harvard Medical School in Boston, this is particularly true when it comes to medications prescribed for the treatment of heart and cardiovascular conditions. According to the researchers, there is no evidence to suggest that brand name drugs work any better than their generic counterparts.

The Brand Name vs. Generic Debate

What exactly are generic drugs? They’re drugs on which the patent has expired. When a pharmaceutical company develops a new drug, they hold the exclusive patent on that drug for a certain number of years. After that time, the exclusive rights are lost, meaning that other companies can manufacture the drug under a different name. These are termed generic drugs, because they are no longer associated with the brand name company which originally developed them.

The new generic drug might have a different shape and color, or may have different fillers or binders added to the active ingredients. In most cases, however, there is no difference at all in how well the generic drug works in comparison to its brand name counterpart. Big-name pharmaceutical companies have gone to extensive lengths to try and prove that generic drugs are inferior, but the results of the new study suggest that’s just not true.

So what’s the difference between brand name drugs and generic drugs? Just one thing – the cost. The cost per pill of a brand name medication might be a few dollars, but for a generic drug prescribed for the same purpose, the cost might be only a few cents. While 66% of drugs prescribed in America are generic, they account for less than 15% of the money spent on all prescription drugs.

This doesn’t mean, however, that you should rush to your doctor and demand that they prescribe only generic drugs for you. It’s always most important that you receive the medications your doctor feels will work best for you – whether brand name or generic. Although, of course, if you’re taking an expensive brand name medication, there’s no reason why you can’t ask your doctor if there is a cheaper generic alternative that might work just as well.

What the research really shows is that if you’re taking medication for a heart or cardiovascular condition, you can feel secure whether it’s brand name or generic. You don’t have to worry that your treatment is inferior just because you’re taking an inexpensive generic medication.

photo credit: ragesoss