Checking Up On Health: December 9, 2014

Am I the only one noticing an increase in obituaries among friends this time of year?

Health Policy News and Views
Compiled by Benita M. Dodd

Remember when you were growing up and refused to finish your dinner? Your mother would say, “Eat your dinner. Think of the starving children in Ethiopia.” It was always a distance – never around the corner, like Appalachia. (In South Africa, my mother would say, “Think of the starving children in India.” Of course, my response was, “Well then, send the food to them.”)

Now I’m coming full circle and beginning to sound like my mother:

Vaccinate your child! Think of the sacrifices researchers made to bring lifesaving vaccines to you: polio, chickenpox, measles, pertussis … And think of the ailing people who can’t be vaccinated.

You may reject vaccinations because you think they cause autism or other side effects in your child. But consider this. YOUR CHILD could carry an easily preventable disease home from school to cancer-stricken relatives; to people with immune disorders. Or your child could take a disease to school. YOU could turn YOUR child into a killer.

I’m reminded of this because of an article I read yesterday: California is again in the grips of a whooping cough outbreak, and this time it’s even worse, according to the Atlanta-based Centers for Disease Control and Prevention. The state is facing its worst outbreak in 70 years and has nearly 1,000 more cases than it did in 2010. As of Nov. 26, the state had 9,935 reported cases.

“The last time a series of outbreaks occurred across the country, California started the parade,” said Dr. William Schaffner, chairman of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn. “And so this is a harbinger we are fearful of.”

Whooping cough, also known as pertussis, is caused by bacteria and is especially serious in infants, who are more likely to catch it. About 50 percent of all children under a year old who catch whooping cough need to be hospitalized, and up to 2 percent of them die, according to the CDC.

Holiday blues

Am I the only one noticing an increase in obituaries among friends this time of year? I am offering condolences on the passing of a parent, uncle, sibling or cousin more now than at other times, it seems. And it’s not just someone having a heart attack while shoveling snow in the North. WebMD reported in a 2004 study that the holiday season may be hazardous to your health: Death rates peak during Christmas and New Year’s. They call the phenomenon the “Merry Christmas Coronary” and “Happy New Year Heart Attack.” But similar spikes in death rates were also found for non-heart-related deaths. It may be too much eggnog and celebration, but another problem is that many people who don’t feel well will delay seeking medical care so as not to disrupt celebrations or bother relatives. If someone looks peaked and you’re concerned, ask them how they’re feeling … and be persistent.

Fewer people getting sick in hospitals

The rate of hospital-acquired conditions (HACs), including central line-associated bloodstream infections, bedsores, and falls – decreased 17 percent during 2010-2013, according to the Department of Health and Human Services (HHS).The reduction resulted in 1.3 million fewer harms to hospitalized patients as well as an estimated 50,000 fewer deaths and $12 billion in savings.

A prescription … for exercise?

In case you’re wondering why you’re leaving your doctor’s office with more than a prescription for medication, The Wall Street Journal has an explanation: Doctors are working exercise counseling into office visits and calling exercise a “vital sign” to be measured when they take readings like pulse and blood pressure. They’re suggesting the right amount of exercise, and in some cases refer patients to certified trainers or physical therapists who can design regimens for different medical conditions such as asthma and diabetes that might limit certain activities. Why? The efforts stem from Exercise is Medicine, a program overseen by the American College of Sports Medicine, which encourages primary-care doctors and other health-care providers to include physical activity when designing treatment plans for patients.

Costs up, workers out

Nearly 70 percent of 602 CFOs surveyed expect the Patient Protection and Affordable Care Act to increase labor costs, and they’re taking steps to help offset the costs – including retirement and job cuts and raising prices – according to the Bank of America Merrill Lynch 2015 CFO Outlook. What are they doing?

Passing along the costs to employees — 79 percent
Implementing preventative healthcare and wellness programs — 66 percent
Cutting spending in other areas of their business — 61 percent
Offering employees health savings accounts — 59 percent
Raising prices on their products or services — 50 percent
Accepting lower profit margins — 38 percent
Making changes in retirement plan services — 17 percent
Reducing workforce — 12 percent

Source: Becker’s Hospital Review

What health care buzzwords bother you?

Among the word bothering Becker’s Hospital Review editorial staff are ObamaCare, Accountability, Innovation, State-of-the-Art, Big Data. I’ll add one that really bothers me: Affordable. As one article in KevinMD notes, “Good luck defining affordability. Like beauty, it’s in the eye of the beholder.”

ObamaCare

What to ask when buying health insurance

You should ask, among other questions, “How should I choose insurance?” says Christine K. Cassel, president and CEO of National Quality Forum. “For too long, conversations about health care costs have focused on doctors, hospitals, the government, or insurers — but rarely on consumers and families, who of course ultimately pay the bill. At long last, we are asking the right questions, with the right people in the room,” You need to know how to choose the best plan for you: the premiums, copays, deductible, prescription costs, maximum out-of-pocket, and network of general doctors and specialists. And you need to know how much you are willing to pay.

Who’s missing out on insurance?

Have you heard of the “family glitch?” These are the Americans who can theoretically afford their own health care coverage, but coverage for the rest of their family is too expensive. Because of the way the law is written, those family members aren’t eligible for subsidies in the exchanges, Kaiser News reports. Find out here who else isn’t covered.

Mobile Technology tops industry issues list.

In PwC’s top health industry issues for 2015 report, do-it-yourself health care with consumer devices and mHealth have made the No. 1 and No. 2 spots respectively.. Among the many hurdles integrating patient-collected data into clinical data, clinicians seem to be wary of using it to manage their own patients. For example, 74 percent were not comfortable using DIY technology that can check for ear infection; 53 percent were not comfortable using DIY technology that can analyze urine and 48 percent were not comfortable using DIY technology that can monitor and check vital signs. While 86 percent of clinicians believe that mobile apps will become important to physicians for managing patient health over the next five years, the difference in current comfort with future perception of use is marked. The top four mobile medical app categories currently used by patients are for healthy eating (23 percent), dieting/weight loss (18 percent), exercise (18 percent) and health information/education (18 percent).

Quotes of note

“We must continue protect our rights to free speech and expression on the Internet. However, we must also be mindful of our words and how they may be interpreted by others. Social media is an important tool for all of us to use in order to positively impact others and influence opinion – certainly free speech is protected but we must take care not to abuse these protections.” – Kevin Campbell, MD

“I think one of the things that we have learned with the passage of the law, and certainly with open enrolment in 2014 and will continue into 2015, is a lot of Americans have no idea what insurance is about, and have no idea even if they have coverage, what a deductible is, what a co-pay is, how to choose a network. Those are complicated terms. I think the financial literacy of a lot of people, particularly people who did not have insurance coverage or whose employers choose their coverage and present it to them, is very low. And that has been a stunning revelation. It’s not because anybody hid it from folks, it’s that this is a complicated product.” – Kathleen Sebelius