Tag: "diabetes"

Not All Community Health Centers are Alike

At Oakhurst Medical Center here [in Stone Mountain, Georgia], just 20% of children have received all their recommended immunizations by age 2…

Fewer than half of its diabetics and a little more than a third of those with high blood pressure had their conditions under control in 2010 — far below national averages…

But 65 miles east of here in Greensboro in rural central Georgia…at TenderCare Clinic, almost all children get the appropriate immunizations, and eight out of 10 diabetics have normal blood sugar levels.

Full USA Today article on the performance variation within community health centers.

May 01, 2012 | 4 comments | by

Making Flexible Spending Accounts Better

This is from my post at the Health Affairs Blog. More on this next week.

There is something rather simple the Obama administration could do that would have a very large impact on health care spending. Apparently, this is something that can be done administratively, without Congressional action. The simple step: Allow deposits to Flexible Spending Accounts  (FSAs) to roll over at year end and grow tax-free.

Currently, there are about 25 million people with an HSA or HRA account (roughly evenly split) and another 35 million people with FSAs. That means that over half the people with a health account have an incentive to spend rather than to save. If FSAs could roll over and become use-it-or-save-it accounts:

  • There would be a huge immediate impact on the incentives of the 35 million current account holders; instead of end-of-year wasteful spending, they would be tempted to save for more valuable future health care spending.
  • Employers across the country would consider integrating these accounts into their health plans, making employer contributions to them and experimenting with new health plan designs.

Moreover, employers and their employees would have a vehicle much better than any option currently available to them to control health care spending:

  • FSAs could be combined with high deductibles, allowing employees to directly control, say, the first $2,500 of spending without all of the pointless restrictions that hamper the usefulness of HSAs.
  • FSAs could be created to allow employees control of whole areas of spending, say, all preventive care and all diagnostic tests — services for which individual discretion is both possible and desirable.
  • FSAs could be created for the chronically ill  — allowing, say, diabetics or asthmatics to manage their own health care dollars, much as home-bound, disabled Medicaid patients manage their own budgets in the Cash and Counseling programs.
  • FSAs could be combined with value-based purchasing insurance plans — where the insurer only pays, say, for certain drugs, doctors and hospitals, but allows patients to add money out-of-pocket and make other choices — thus allowing the development of a real market for more expensive health care services.

Apr 24, 2012 | 4 comments | by

Can Diabetes Be Controlled?

This is from three studies in the latest issue of Health Affairs:

  • If nothing is done, the surge in new cases of diabetes could add an estimated $512 billion to nation’s annual health care spending by the year 2021.
  • Instituting a national program of community-level lifestyle interventions to prevent type 2 diabetes … within twenty-five years … would save the US health care system an estimated $5.7 billion.
  • A systematic review and meta-analysis of twenty-eight studies… found that a year after enrollment in lifestyle intervention programs, the average participant had lost about 4 percent of baseline body weight, an amount that may offer diabetes protection.

Jan 31, 2012 | 4 comments | by

New Report by Deloitte Center for Health Solutions

According to a new report by Deloitte Center for Health Solutions, 55% of both Americans and Germans have been diagnosed by a health professional as having one or more chronic conditions. This compares to 52% of Canadians, 50% of the French, 42% in Switzerland and in 41% in the United Kingdom. Yet a much greater proportion of Americans self-rate their overall health as excellent or very good compared to their European counterparts. For instance, only 10% of Americans consider their health fair or poor compared to one-quarter of Germans. Yet the same proportion of residents from both countries has a chronic condition.

I wonder if Austin and Aaron will post this chart?

Jul 19, 2011 | 7 comments | by

Unhealthy Food is Cheap

One dollar’s worth of Coke has 447 calories, while $1 of iceberg lettuce has just 16.5. To look at it another way, you would have to spend about $5 to buy 2,000 calories at McDonald’s, $19 to buy 2,000 calories worth of canned tuna and $60 to buy 2,000 calories worth of lettuce.

View this graphic from Lampham’s Quarterly to see how much $1 will buy you in various foods (via David Leonhardt).

Jun 23, 2011 | 6 comments | by

Your Fitness Today Predicts Heart Disease 40 Years from Now

In two separate studies, researchers from the University of Texas Southwestern Medical School and the Cooper Institute in Dallas analyzed fitness levels for more than 66,000 people. Over all, the research showed that a person’s fitness level at midlife is a strong predictor of long-term heart health, proving just as reliable as traditional risk factors like cholesterol level or high blood pressure.

Full article on heart health predictions based on fitness levels.

Jun 10, 2011 | 5 comments | by

Fight on Fat

How Portland, Maine, took a stand against childhood obesity. It spent $3.7 million to rally schools and other sites in the state. More families adopted 5-2-1-0 a day: At least 5 servings of fruits and vegetables, 2 hours or less of screen time, at least 1 hour of exercise, and 0 sugary drinks. After all that, the childhood overweight-and-obesity rate for southern Maine dipped 1.5 percentage points to 31.3%.

Full article on Maine’s resistance against obesity.

May 06, 2011 | 6 comments | by

Nanny City is Back

[New York City’s] Health Department is going on a diet. No deep-fried foods served at agency lunches. No cookies and cakes at the same time. And no beverages over 25 calories per ounce:

The brochure requires that tap water be on the menu when food or drinks are served and suggests bagels or muffins be cut into halves or quarters to reduce the number of calories employees intake, reports the Daily News. Also, thinly sliced, whole-grain bread is a suggested offering at work events.

Aside from the dietary rules, employees are required to adopt good personal and office hygiene habits, namely by avoiding wearing smelly products, eavesdropping and putting up signs co-workers may deem offensive, according to the new set of guidelines for “Life in the Cubicle Village” obtained by the News.

Full article on New York’s Health Department health-kick.

Apr 07, 2011 | 9 comments | by

Arizona Proposes $50 Obesity Fee

Arizona’s governor on Thursday proposed levying a $50 fee on some enrollees in the state’s cash-starved Medicaid program, including obese people who don’t follow a doctor-supervised slimming regimen and smokers … “If you want to smoke, go for it,” said Monica Coury, spokeswoman for Arizona’s Medicaid program. “But understand you’re going to have to contribute something for the cost of the care of your smoking.”

 

Apr 05, 2011 | 6 comments | by

Do We Have It All Wrong About Obesity?

Do obese people generate costs for other people? Mainly not, according to a review of the literature:

In employer-provided health insurance pools, being obese causes limited externality harm because obese individuals likely pay the costs of their body weight through reduced wages. In public health insurance, there is an implicit transfer from thin people to obese people, but this transfer is progressive and seems unlikely to induce substantial social loss.

[One] way in which the obese “subsidize” the thin is, presumably, by dying earlier and not claiming as much in Social Security benefits…for 50-year olds, obesity reduces life expectancy by 1.65 years…for 65 year-olds, obesity reduces life expectancy by 1.05 years.

See Robin Hanson as well.

Mar 01, 2011 | 14 comments | by
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