The Health Shopper

1. Eat local and organic

Pesticide-free, low-maintenance foods have the lowest impact on Mother Nature. But locally grown organic food also is also great for us! Organic foods factor out pesticide-accumulation and eliminate a lot of the carcinogens found in typical commercially processed produce. And if it’s locally grown, your foods tend to be fresher and retain more nutritional

2. Cut down on meats

Fun fact: Livestock and cattle actually have a higher total carbon footprint than transportation. White meat is greener than red meat and fish (overfishing is a hot-button environmental issue), but not by much. And we too have something to gain from cutting down on meat consumption: saturated fats found in meat can drastically increase risk of heart disease, colon cancer, and diabetes, among other diseases, and fish can be major health risks due to contamination by mercury.

3. Don’t smoke!

The health risks here are well documented: including lung cancer, emphysema, cardiovascular disease, and a multitude of other unsavory illnesses. And its effects on the environment can be tragic on a large scale; aside from air pollution and litter, cigarettes’ chemicals (including arsenic and tar) can seep into surrounding soil, making it toxic to plant growth.

4. Walk, not drive

Lastly, the quintessential prescription from doctors as well as environmentalists. Burn some calories while softening your carbon footprint.

Happy Earth Day!

You can have great, affordable health insurance, and fully utilize your benefits, but at the end of the day a good plan alone can’t ensure your good health the way you can. Maximizing the limited time with your physician is a key aspect of getting good health care.

Be clear, be thorough: In quantifiable terms if possible, give your doctor a clear idea of any symptoms you may have as well as any changes or issues in body functions from fatigue and bowel movements to sleep habits. Make sure your doctor has a good idea of any major lifestyle habits you may have.

Don’t be afraid to get a second opinion: Because different doctors prefer different diagnostic tests and treatment methods, and some interpret test results differently than others, it’s never a bad idea to ask around. This is especially true for any major diagnoses or treatments; before you shell out for the procedure, it’s best to double-check.

Be prepared: Make a mental list of your symptoms and know your history in context, along with any medications you use. If you have multiple issues to discuss, prioritize them ahead of time to ensure that all of your needs are addressed.

Don’t be afraid to ask: … or tell. Questions on dosage, expenses, even basic bodily functions? Ask. And tell! What seems minor to the patient could be of great significance to the practitioner. Keep in mind that during your appointment, you should have the physician’s undivided attention – so claim it! When it comes to matters of your health, you’re always better off knowing with certainty than having to guess and make assumptions.

While there’s been a fair amount of buzz about healthcare reform’s impact on children, patients with preexisting conditions, and even college kids, there are some uncertainties of reform’s role in Medicare.

According to Rick Ungar at Forbes, under the Affordable Care Act savings in Medicare will come from two main sources – a major clean-up of Medicare fraud which is currently costing the government up to $60 billion each year, and a stopper on funding to Medicare Advantage programs sold by private insurers.

It is the latter that has been the more controversial decision and it has opened the floodgates to speculation that Medicare Advantage programs will be weakened or cut, leaving senior citizens with gaping holes in essential aspects of their coverage. Already, Medicare Advantage government subsidies which have been in place since 2003 have been cut out as of 2010.

But there’s more to the issue than private Medicare Advantage programs being cut! Medicare Advantage typically offers free preventive care, fills the pharmaceutical donut hole, provides health club memberships, and sometimes dental and vision plans.

When reform kicked in last September, seniors were provided a yearly physical as well as all diagnostic tests totally free. This makes arguably the most important aspect of Medicare Advantage null. Now on to drug coverage— the donut hole is being slowly phased out, steadily becoming smaller until it is gone altogether in 2020, making another important component of Medicare Advantage irrelevant. While there will be a gap period between now and 2020, seniors will save more money simply buying pharmaceuticals as the need arises rather than paying for a monthly premium on Medicare Advantage. The same applies for dental and vision plans. Furthermore, as of 2009 Medicare Advantage premiums went up 15% to compensate for the 2010 cut off of the program’s subsidies.

Basic Medicare may not quite be replacing pricier Medicare Advantage, but it’s a step closer thanks to reform.

Related Link: Medicare Supplemental Insurance

Earlier this month, the British Medical Journal investigated Dr. Andrew Wakefield’s famous 1998 study linking childhood vaccines with autism, and published an editorial calling the study “a deliberate attempt to create an impression there was a link by falsifying the data.” The BMJ editorial was the latest in a number of studies during the past decade that discredit Wakefield’s conclusion.

However, the fear of vaccine-triggered autism remains, and many parents still opt out of childhood vaccinations, relying on the immunity of others in their community to protect them from disease. In a recent opinion article for CNN, physician and writer Rahul K. Parikh explores the idea that parents who refuse to vaccinate their children should pay substantially higher health insurance premiums.

“It makes sense,” writes Parikh. “Insurance, after all, is just a pool of money into which we all pay. In determining how much our employers pay, risk is taken into account. The perfect analogy is smoking. If you smoke…then you may have to pay more. Why shouldn’t we impose the same logic on parents who refuse to vaccinate their children?”

It’s an interesting question. On one hand, if parents refuse vaccination for a child who then gets sick, they (and if insured, their insurer) can be faced with high medical bills for treatment. More importantly, the diseases that childhood vaccines aim to prevent are generally contagious, and one case can lead to an outbreak, which can lead to an exponential increase in costs for parents and insurers.

Increasing premiums for parents who refuse childhood vaccines could also encourage parents not to opt out. This could increase rates of vaccination and prevent disease transmission because fewer people would be exposed to the diseases.

At the same time, the approach could be seen as heavy-handed and coercive of vaccination – particularly for low-income groups – especially since many parents consider the vaccine-autism debate to be unresolved. It could also set a precedent for other factors to begin influencing premiums, which may widen the gap between premium costs for various groups, a gap that some believe is already too large.

While Dr. Parikh’s idea is unlikely to take effect anytime soon, it does bring up some important issues. Readers, what do you think? Is it fair to increase premiums for parents who refuse vaccination? Could it lead to a slippery slope towards further stratification of premium costs? Do you think it will ever happen?

Health and health care are complex issues. Like Vimo.com, there are a number of other resources out there trying to make it a little easier to understand. The following ten blogs – listed in alphabetical order – each address a unique set of topics and issues. Together, they provide a fairly comprehensive view of what’s going on in health care today.

Health Affairs Blog. An offshoot of the academic journal Health Affairs, the Health Affairs Blog publishes daily on issues in health care and policy. Posts are written by a variety of guest contributors, including politicians, health policy experts, and Health Affairs staff.

Recent topics: the individual health insurance mandate, hospital safety, chronic disease and prevention

The Health Care Blog. An independent blog managed by a core staff and written by a number of contributors, the Health Care Blog’s tagline is “Everything you always wanted to know about the health care system. But were afraid to ask.”

Recent topics: pay-for-performance, patient-provider communication, the Affordable Care Act

Healthcare Economist. Written by economist and researcher Jason Shafrin, Healthcare Economist focuses on the health insurance market, health policy and economics, and Medicare research. Occasional posts are personal.

Recent topics: employer health benefits, physician quality and training, nursing home care

Julie’s Health Club. Hosted by the Chicago Tribune, Julie’s Health Club is written by journalist Julie Deardorff. It focuses on a variety of personal health issues, including holistic approaches to health, the environment and sustainable living, and child health. The blog also hosts occasional live chats on specific topics.

Recent topics: health benefits of yogurt, tooth decay, weightlifting and cancer

KevinMD.com. Managed by primary care physician Kevin Pho and featuring guest posts from additional contributors, KevinMD.com provides commentary on health and medical news. The blog also includes weekly roundups of its own posts and daily roundups of top health stories.

Recent topics: electronic medical records, healthcare reform, medical education

Managed Care Matters. Since 2004, health consultant Joseph Paduda’s blog Managed Care Matters has covered issues in managed care, health care cost containment, policy, and health research.

Recent topics: hospital care costs, the individual health insurance mandate, workers’ compensation

Paging Dr. Gupta. Paging Dr. Gupta is written by CNN Chief Medical Correspondent Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen, and additional Medical Unit staff. The blog focuses on health news and medical trends and provides commentary and analysis.

Recent topics: patient privacy, mercury dental fillings, nutrition for vegetarians

Shots. Written by the science staff at National Public Radio (NPR) and updated several times per day, Shots covers recent news about health and medicine.

Recent topics: cholera vaccination in Haiti, health care reform, bone marrow donation

Wall Street Journal Health Blog. Written by health reporter Katherine Hobson, with contributions from staff at WSJ and Dow Jones Newswires, the Health Blog offers news and analysis multiple times per day on health and the business of health.

Recent topics: chronic fatigue syndrome, antidepressants and the elderly, FDA approval of drugs

Well. Hosted by the New York Times and written by columnist Tara Parker-Pope, Well focuses on healthy living and medical research. The blog also features commentary on other New York Times articles and a weekly set of healthy recipes.

Recent topics: fashion’s effect on health, patient amenities in hospitals, cholesterol and Alzheimer’s disease

On September 23, health reform went into effect. It gave the health care system a makeover, helping those with pre-existing conditions, extending the time children can stay on their parents’ plans, and encouraging preventive care. But the overhaul has had a few unforeseen repercussions.

Among these is the question of college health plans – it is unclear what category college health plans fall under. If they don’t qualify as individual or group health plans, college health insurance policies could be off the hook on a lot of the reform provisions such as the termination of lifetime benefit caps.

However, some groups such as the American College Health Association say that forcing reform upon already cash-strapped colleges may make it difficult for them to provide health plans at all. At this point, if college health plans are indeed off the hook, it may be safer for college students to invest in individual health insurance or stay on their parents’ plan.

What do you think – should student health insurance be subject to the provisions of the health care overhaul?

As of June, the 15-month, 65% COBRA health insurance premium subsidy was gone. For all those who’d recently lost jobs, there was no cushion. Congress opted not to extend the legislation as keeping it until the end of the year would cost almost $8 billion.

Unfortunately, this leaves the thousands of recently unemployed to bear the monthly premium on their own. However, hope is not lost. Here are some alternatives to COBRA for the unemployed that you might be interested in checking out:

1. An insurance broker may be able to help you find an affordable health insurance plan. Consider a high-deductible plan, which tends to be cheaper. See getinsured.com for more options.

2. You may be eligible for a government-sponsored plan. Some examples include Medicaid and CHIP. It might pay to research such programs to see if you’re eligible.

3. If you’re under 26, you can get coverage under your parents’ plan!

4. It may help to distribute one family plan into multiple individual plans. This is a better option than having a whole family with no coverage.

5. Consider a high-risk pool – these carriers typically cannot deny you due to a health problem.

Healthcare reform is rolling out piece by piece. As of last week, insurance plans may no longer deny children based on pre-existing conditions or exclude (rider) these pre-existing conditions when offering coverage.

Sounds great, right? Unfortunately, this change created unintended consequences. Children that would have otherwise had coverage in the “old world” are now left unable to obtain health insurance with most of the nation’s carriers. Why?
Insurance companies no longer allow children to apply for individual policies.

Read the rest on this major consequence of reform.

With tomorrow’s big reform kick-off, it might be time to take a second look at your insurance. When you first bought your health insurance plan, it probably seemed like a gem among policies. But unlike diamonds, health insurance plans are not forever. It is recommended that you reevaluate your plan each year to make sure it’s still fulfilling your needs. Here are 5 red flags to look out for that should make you reconsider your plan.

1. Are your rates going up?

Health insurance plans, like credit cards, sometimes offer low first-year rates then raise their premiums each year.
Make sure you know your rates for the next year. If your premiums are increasing, look for sites like GetInsured for help. You can often find a cheaper plan with similar benefits.

2. Are you paying for benefits you don’t use?

Ensure that your plan covers the benefits you actually need. And make sure you’re able to make the most of your health insurance benefits. Services such as unlimited doctor visits and maternity are often built into plans and increase your premiums. So make sure you know exactly what you’re paying for, and don’t lose money over benefits you don’t need.

3. Are you getting the most for your premium dollars?

If you have your whole family under one family health plan, you may be paying more than you should! If some family members need fewer doctor visits, while some are less healthy, it may be in your best interest to split your family into separate plans that fit each of their individual needs.

4. Are you anticipating any life changes?

Make sure your plan keeps up with you! Any major life change like a new baby, a change in your marital status, job situation, or even a move may call for an adjustment in coverage.

5. Is your plan working for you?

Consider your plan over the last year – did you like it? Did you have any gaps in coverage? Health insurance carriers offer new and varied types of health insurance plans each year, expanding consumers’ options for individualized plans, so it may pay for you to take advantage of innovations in health plans.

The logic is simple: the healthier you are, the less you’ll spend on healthcare.

Many of the major health problems in America begin to take form as relatively benign, wholly preventable issues – but some of these small issues can get serious quick when left untreated. Preventive care zeroes in on these potential risks, looking to avert bigger health problems. That’s why regular doctor’s visits and physicals are vital.

As part of healthcare reform, those on Medicare will receive free preventive services and annual wellness visits. But for the rest of us, yearly physical examinations and healthy lifestyle choices involving fitness and nutrition are essential. Effort spent staying healthy now is money saved on costly health remediation in the future. As Iowa Sen. Tom Harkin said, preventive care can help “bend the cost curve down, improving our physical and fiscal health for generations to come.”

However, it won’t pay to request pricey heart scans for your teenager. As the Wall Street Journal points out, expensive tests and relentless scrutiny are only helpful in groups that are at risk for particular sets of diseases. For example, an echocardiogram will not be helpful to patients with low risk of heart disease.
So the key to effective preventive care is intelligent investment.

But the fact remains that only 3% of our total national health spending goes toward health promotion, while over 20% of our dollars are dedicated to the last year of life, according to American Progress. Many health plans offer free wellness resources for their members, from support for chronic illnesses such as osteoporosis to programs to quit smoking. However, members do not always take advantage of such resources, according to Chicago Tribune, despite providers and employers’ emphasis on preventive care.

Essentially, insurance hinges on the idea that medical risk is distributed within a plan – healthy clients won’t incur exorbitant medical expenses, so providers have financial incentive to ensure their customers’ wellbeing. Similarly the government, in the form of Medicare and Medicaid, makes a concerted effort to keep you in good health. Employers, in the case of an employer-provided plan, are also looking to see you fit and well. And, most importantly, the consumer wants to stay in good shape and avoid unnecessary medical expenses. So when you stay healthy, everyone wins.