CRNAs are much less expensive than their physician counterparts

The reason this study is rocking the boat for many interested in Medicare is that Medicare will not reimburse for anesthesia unless a physician is supervising the surgery. States can opt-out of this requirement though – and as of 2005 14 states have. Because this study argues that such an expensive requirement on Medicare’s part might be unnecessary many are calling for Medicare to revoke the requirement entirely, potential introducing better cost-efficiency in the program’s providing of services.

Thousands of seniors have quit smoking - and are healthier for it!

So why should you quit?

First of all, it’s well documented that smoking is bad for your health.  There are over 400,000 smoking related deaths every year—both smokers and people exposed to second hand smoke.  Smoking also increases your risk of stroke and many types.  Plus, the day to day effects of smoking can be quite crippling. Are you tired of huffing and puffing as you walk up the stairs to work? Does the smell of the tobacco on your clothing repel potential romantic partners? Are you sick and tired of smoker’s cough? Quitting is a great option for you.

Plus, smoking wastes hundreds of dollars per year.  If you smoke just 5 cigarettes per day, you could save almost $325 per year just by quitting (depending on the brand you smoke). If you’re a heavy smoker who inhales a pack a day, you could save $1,300 every year, again, depending on the brand.  To find out how much money you could save by quitting cigarettes once and for all, check out the financial cost of smoking calculator from the American Heart Association.

How should you quit?

There are several well-documented strategies for quitting.  Many people opt to quit cold turkey, abruptly. Most importantly, when you stop smoking, you should stop completely. Simply cutting back on cigarette consumption doesn’t help your health, and it also makes you more likely to smoke just as much as you were before.

Remember, half of all adult smokers have quit smoking—and it is possible for you to do so yourself.  The United States Center for Disease Control suggests that you write down why you want to quit. That way, you can look at the list to keep yourself motivated. Plus, understand that you will most likely face withdrawal from nicotine—including moodiness and other symptoms—which will be hard, but something that can be done.

There are also many products on the market that can aid you in your quest.  Many transitioning smokers use nicotine gum—packs of gum with varying levels of nicotine—to satisfy their cravings.  Still others make use of the nicotine patch, a patch which releases nicotine into the body to help former smokers get their fix.  Studies have shown that people who use the patch have a 25% higher success rate of quitting than those who quit nicotine completely.

Still think you can’t do it?

A recent study at Yale University has shown that smokers are able to control their cravings for cigarettes.  The study watched the brains of smokers as they saw cigarettes and foods. Smokers were able to control cravings after they were instructed to think of smoking’s consequences.  The study concluded that smokers lack good quitting strategies and motivation to quit—and perhaps that maybe there’s nothing different in their brains that prevents them from putting their packs down once and for all.

So please, throw out your cigarettes and save your money and your health. You can quit smoking, and you’ll be better for it!

Coffee has somewhat of a bad reputation, probably created by its caffeine content. It’s also a diuretic, which can dehydrate people, and can stain teeth if drunk excessively, leading many to consider tea as a healthier alternative. Coffee’s addictive properties contribute to its bad reputation, with caffeine impacting sleep cycles and day to day stress levels.

However, researchers have found that coffee may actually have many health benefits. Analysis by scientists found that people who drank four or more cups of coffee every day actually decreased their likelihood of oral cancer by almost 40 percent.  The University of Utah coordinated the study while using information from nine studies conducted by the International Head and Neck Cancer Epidemiology consortium.

How Healthy is Coffee?

The rates of oral cancer in the United States have been rising every year, hitting a high of an estimated 36,000 new diagnoses in 2010.  Oral cancer has been linked to tobacco use—especially chewing tobacco—and alcohol consumption. While oral cancer has a high survival rate when detected early, in most cases, the cancer is not detected until it’s too late. The results of this study may prove beneficial in the prevention of oral cancers.

Another study in 2009 indicated that coffee may reduce risk for prostate cancer. Men who drank more than six cups of coffee each day were almost 60 percent less likely to develop aggressive prostate cancer than their less.  Decaffeinated coffee was just as effective as caffeinated. While the study warns that it is a little too soon to start excessively drinking coffee to prevent cancer, remember that prostate cancer is something to think about while enjoying your morning Nantucket Blend.

Coffee has also been linked to lower heart disease risk.  A study in the Netherlands revealed that drinking both coffee and tea in moderation can cut down on heart disease.  Tea was most beneficial to heart health, but coffee consumption proved helpful as well. People who sipped between two and four cups daily saw a 20 percent lower risk of heart disease. Another study determined that coffee is also a source of antioxidants. According to Joe A. Vinson, Ph. D, coffee is the top source of antioxidants consumed by Americans: such antioxidants the same as found in chocolate and red wine.

All in all, despite its unhealthy qualities, coffee does indeed have some health benefits. While brewing a pot in the morning or stopping by Starbucks, keep in mind both the positives and negatives. Maybe coffee isn’t so bad after all.  Perhaps all this new research can legitimize America’s love affair with coffee.

But how can you live such a long life?

Part of the credit can go to the improved medical care available after World War II, especially in the United States. Resources like Medicare and nursing facilities specialized in elder care have undoubtedly helped boost those numbers. Still, health care is likely only one small piece of the puzzle.

Such longevity has often proved puzzling to the general public and researchers alike.  Some experts believe that diet and exercise are key to a long, healthy life.  Over 40,000 people over the age of 100 currently live in Japan, quadruple the number from a decade ago. The large population of centenarians and super centenarians in Okinawa, Japan highlights the importance of diet to lifespan. In Okinawa, the standard diet is high in fish, soy, seaweed, and other vegetables, reducing obesity, diabetes, and other diseases.

In Vilcabamba, Ecuador, there is yet another group of centenarians. Allegedly, one man lived for 127 years, and his relatives attribute his longevity to the village’s traditional diet.  Vilcabamba natives drink traditional horchata tea, and low-cholesterol, low fat diets.  The elderly also remain physically active: according to a Boston Globe article, one 92 year old man stopped working the bean fields a year before the reporter’s visit.  The elderly in Vilcabamba continued working, walking, and even romancing well into later life, keeping both minds and bodies active.

Celebrating Longevity: More Active People Living to 100

So all you have to do to live to 100 is eat right and exercise?

Not so fast.  Recently, researchers have been looking at a link between certain genes and old age. In Vilcabamba, where the elderly flourish, genes may play a huge part in the story: marriage was often limited to the small village, where many people are related.    Jeanne Calment, the woman who lived to a record 122 years, had parents who lived into their 90s.

Recently, researchers conducted a study which revealed genes related to longevity.  By looking at a group of 150 gene variants, researchers were able to distinguish centenarians from non centenarians over 75% of the time. According to the study, some of the participants’ genes were linked to the delay in cancer, heart disease, and other diseases related to old age. Still, there was no specific “long life” gene; rather, a combination of the 150 genes tended to appear in the centenarians. Still, researchers highlighted the importance of healthy lifestyles, especially exercise and diet, in connection to living long.

Undoubtedly, genetics plays a large role in determining how long you’ll live. However, genetics isn’t everything.  Some studies report that genes determine up to 30 percent of your longevity likelihood.  The environment in which you live has a strong impact on your life span.  Finally, how you fuel your body ultimately has the greatest say.  Eating a healthful diet and remaining active—both mentally and physically—is still crucial in living a long, fulfilling life.

Medicare Insolvency Pushed Back 12 Years

Trustees of Medicare reported Thursday that cost-cutting measure in The Patient Protection and Affordable Care Act of 2010 have pushed Medicare’s impending insolvency off another 12 years. Because of these provisions in the law, Medicare’s hospital insurance trust fund should remain solvent until 2029. Both the 75 year shortfall for the hospital fund and the projected costs of the Medicare Supplementary Insurance program were further brought down. The trustees warned that though these projections are an improvement over last year’s estimates, additional reforms will be necessary for the programs to be financially sustainable.

The trustees further estimate a new tax on so-called Cadillac insurance plans (the priciest health insurance coverage generally held by highly paid managers and executives) which goes into effect in 2019 will improve Social Security’s finances in the long-term. In the short-term however, Social Security’s financial stability appears tenuous as this year for the first time benefits paid will exceed revenue. Because of the recession this day has come 6 years earlier than previously estimated. The trustee’s report projects that the program’s finances will return to equilibrium for the next several years as the economy climbs slowly out of the downturn. However, the problem of the aging Baby Boom generation remains and though the economy is strengthening more enrollees will soon increase the program’s deficits.

Estimates show that Social Security’s current payroll tax and interest revenue will cover benefits through 2024, but after that the program will begin drawing from its trust fund. This trust fund is not actually a money reserve but rather a complex accounting device which tracks the accumulated surplus. The estimated date by which this fund will empty remains the same as last year’s estimate – 2037. After 2037, payroll tax income to the program will cover only 75% of promised benefits. As a result, unless we want to see reduced benefits and higher taxes to cover the program, America cannot rest on the laurels of this latest reform and must urgently push for entitlement reform to ensure both Medicare and Social Security remain solvent.

Medical terminology can be confusing to even the most educated of us. There are even guidebooks written specifically to decode medical jargon.  According to a report from the Center for Disease Control, almost 9 out of 10 American adults find medical terminology difficult to understand.

Medical Jargon in the Doctor's Office Can Be A Barrier to Quality Care

Often, health care providers don’t have enough to time to break down diagnoses for patients. In turn, many patients just don’t ask their physicians to clarify.  My mother is a medical social worker who works with patients of all ages and social classes.  Most of the time, she and her program’s nurses need to break down diagnoses to patients so that they can better understand them. According to my mother, most of the time, her patients are either slightly intimidated or afraid to sound stupid in front of physicians, and often forgo asking questions.

Although all doctors complete years of extensive education and training, many common folk just do not have that same level of education.  Some patients speak limited to no English—even native English speakers can’t even decode what some physicians are saying.

When people are confused by medical lingo, they are less likely to follow up with tests and drugs—leading to more severe health problems in the future.  For patients with chronic diseases, understanding the diagnosis is critical to managing the disease.  Lack of treatment compliance can lead to higher medical costs in the future. A study by Kaiser Permanente found that half of 14,000 diabetes patients had problems understanding their conditions. Those patients had higher rates of hypoglycemia than patients who understood their doctors’ medical information. By improving communication between doctors and patients, the government can improve health while saving on cost.

The Center for Disease Control and other government officials are working to improve communication between doctors and patients. The Health Literacy Action Plan, a new government initiative, hopes to improve patients’ understanding of their health by simplifying medical language.  According to the program’s web site, target groups include minorities and lower income individuals, two groups likely to lack basic health literacy.

One step health insurers have taken is to use a program that essentially translates medical jargon to plain English.  The program, marketed by Health Literacy Innovations, scans a doctor’s document and suggests simplifications. Meanwhile, many state Medicaid programs have opted to provide health information written for people with fourth to sixth grade reading level, ensuring that people understand the medical treatments they need.

These three initiatives are steps in the right direction.  People in the United States come from a variety of different ethnic, social, and economic backgrounds, and it is definitely time to target these people instead of the highly educated.  With sky-high medical costs, it is ever more imperative for doctors and patients to communicate efficiently. All in all, reducing medical lingo can only help, rather than hurt, public health in the United States.

Sleep disorders can seriously impact your heart health

The health benefits of sleep are well documented, yet many Americans suffer from conditions that damage sleep quality. One such condition, sleep apnea, affects more than 12 million Americans as they attempt to sleep every night. The word “apnea” comes from the Greek phrase “without breath,” and essentially, sleep apnea causes people to stop breathing during sleep. Typically, an individual with sleep apnea will stop breathing, possibly well over one hundred times per night.  When a pause occurs, the brain will wake up the sleeper so they can start to breathe again, preventing the sufferer from sleeping deeply because they keep waking up throughout the night.

There are three types of sleep apnea.  The most common is obstructive sleep apnea, which is caused by a blockage of the wind pipe by soft tissue in the throat during sleep. In patients with central sleep apnea, the brain does not tell the body’s muscles to breathe during the night, leading to pauses, but without a major blockage of the airway.  Mixed sleep apnea combines factors from both obstructive and central sleep apnea.

If you’re not sure that you have sleep apnea, consider the following symptoms.  People with sleep apnea can experience high blood pressure, memory problems, weight gain, and headaches. Plus, spouses of sleep apnea sufferers often report heavy snoring combined with snorting, gasping, and choking noises during sleep. Men are more likely to develop sleep apnea than women; people who are overweight or older than 40 years old are also at an increased risk for the condition. However, keep in mind that these aren’t the only determining factors for sleep apnea—children have been known to develop sleep apnea as well.

Recent research has drawn a link between heart disease and sleep apnea. People who have been diagnosed with heart trouble than people whose sleep is uninterrupted.  A study of around 4,500 people over the age of 40 showed that men with sleep apnea were almost 60 percent more likely to have congestive heart failure than people without the disorder. These men also showed a higher risk of coronary heart disease. Boston University School of Medicine researchers said that because people with sleep apnea stop breathing in the night, their bodies enter panic monde, raising blood pressure and placing stress on the heart.

If you have been diagnosed with sleep apnea, you still have options. Obstructive sleep apnea in particular can often be treated with weight loss.  Traditionally, sleep apnea patients used the CPAP (continuous positive airway pressure) machine, but many patients consider the face mask uncomfortable and do not comply with treatment.  Other patients undergo surgery to widen the airways.  Recently, researchers have developed a more comfortable dental mouthpiece which prevents the tongue from moving around and keeps the airway open during the night. This may be more comfortable and just as effective for sufferers of sleep apnea.

If you fear that you’re not getting enough sleep, or that you may in fact have sleep apnea, consider enrolling in a sleep study to find out.  By complying with treatment, you will be able to diminish your symptoms, sleep deeply, and improve your health.

Study Shows Spinal Fluid Test for Alzheimer's Disease Successful

Scientists believe that Alzheimer’s is caused by accumulation of amyloid and tau which precipitates formation of amyloid plaques. They argue that stopping build-up of these proteins could halt the disease, but more research must be done on the effect of accumulation of these proteins in the brains of those with normal memories.

After years of research doctors now agree the onset of Alzheimer’s occurs a decade or more before an individual exhibits symptoms. By the time symptoms become noticeable it may be too late to treat the damage to the brain. Because of these facts, research has largely been targeted at identifying those who are developing the disease before symptoms appear and using them as subjects in studies of the hundreds of drugs that may stall progression of the disease. Until recently diagnosis of Alzheimer’s could only be confirmed at autopsy, but spinal fluid tests now join PET scans of the brain as tests which can confirm incidence of the disease.

New PET scans show the amyloid plaques in the brain that are indicative of Alzheimer’s. Although these PET scans are not commercially available, spinal fluid tests are. This fact opens up another world of questions and necessary research – scientists must make sure the tests are reliable if used in doctor’s offices (a.k.a. real-world situations) and they must confront the issue of whether doctors should test for a disease that is still untreatable. Essentially, how early should we label patients as future sufferers of Alzheimer’s? Some doctors suggest refraining from using the spinal fluid test as the results, though 100% accurate in research settings, have only been proven accurate in patients carefully selected to have no other conditions which could impair their brain function or memory. A false positive on a spinal fluid test could prove devastative to a real-world patient. Equally troublesome is the fact that patients with severe memory loss sometimes suffer not from Alzheimer’s but from another disease – a negative result on the spinal fluid test does not guarantee one might not suffer from another memory-loss condition later in life. As a result, researchers and doctors suggest not using the test except to confirm an Alzheimer’s diagnosis in patients with milder symptoms.

Though the bill allocates in the neighborhood of $27 billion, it does not add to the deficit as the money generated by spending cuts and by closing a business tax loophole will cover the cost. The measure was approved by a 61 to 39 vote in the Senate last week. The majority was comprised of 57 Democrats, 2 Independents, and the ladies from Maine – Republicans Susan Collins and Olympia Snowe. 39 Republicans voted against the bill, many on the basis that it is a breach of ordinary federal-state relations.

The House has been called back early from its six-week August recess to vote on the measure tomorrow. Democratic Party leaders expect the House vote to go smoothly with an easy approval. However, though the bill does not increase the deficit some representatives whose districts are vulnerable this fall feel they’re again being asked to “walk the plank” with their party on an unpopular economic-stimulus issue. Vulnerable Democrats are especially irritated at being called back from vacation given they’re already defending their seats because of Senate inaction during the dragged out healthcare debate and budget debates. As a result of this many House Dems have become less responsive to party whips, making estimating a vote count difficult.

Though most legislators agree that states burdened with budget gaps desperately require the funds to keep teachers employed and Medicaid enrollees in the program, Republicans contend that calling House members back from recess to vote on a bill that stalled after two weeks of partisan posturing will reinforce popular perception of Dems as ineffective leaders. This narrative that Dems are haphazard and not unified in their approach to the recession and unemployment will likely be reinforced by Friday’s monthly jobs report, GOP spokespeople argue.

State Aid Bill Extends Funds for Medicaid

Conversely, House Democratic leaders see the bill as a win-win worth the admittedly messy passage as it will create jobs and respond to urgent budget concerns without raising the deficit.

Bad Nurses Able to Circumvent the System

When a nurse is accused of misconduct in a state outside the compact, they are suspended during the investigation and their license is revoked or they are otherwise sanctioned if the allegations are proven true. Within the compact, when a state is slow to act (or fails share information with its fellow compact members) on allegations of misconduct, nurses suspected of crimes remain free to work in any of the other member states. Some nurses in the compact will leave their home state while they are being investigated and set up shop in another compact state, jumping from state to state to elude subsequent allegations and putting patients in jeopardy. Compact officials don’t track which nurses are sanctioned for misconduct elsewhere by their home state nor do they investigate whether states are adequately monitoring visiting nurses.

Because there is no federal licensing system for nurses the compact has been an improvement over the state-by-state method for policing nurses who work in different states, but as evidenced the ability of one state to keep bad nurses out of its hospitals is only as good as the reporting of other states in the compact. As a result, though the compact has been heralded as a success, board officials in non-member states worry it gives compact members a false sense of security. They argue that differing regulations and standards across states make cooperation difficult. For example, laws in most states allow officials to suspend a nurse’s license immediately but some cannot no matter how serious the allegations. Also, some states require criminal background checks before giving a nurse his or her license, while other states don’t.