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.

As the health care debate raged onwards in 2009, the number of uninsured American adults rose by 3 million from 2008. Overall, approximately 46.3 million people in this country do not have health insurance covered.  In Texas, over one out of every four people was uninsured in 2009, compared to the 15.4 percent nationally.

The Center for Disease Control (CDC) survey found that almost 60 million people went without health insurance for at least part of the year, and 33 million of the uninsured had gone without for over a year.  People who were fortunate to keep their private coverage ended up paying more, while high-deductible plans also grew in popularity—especially among people who purchase their own health insurance plans.

3 Million More Uninsured in 2009

Fewer children are going without health insurance plans because they are enrolled in public policies.  See my previous article onCHIP and enrollment strategies the government may be using to get more kids into the program. However, almost one third of Americans between the ages of 18 and 24 did not have health insurance, the highest percentage of any other age group. Still, the fact that the ranks of the uninsured actually expanded in 2009 are worrisome to me.

Although individuals can still pay out of pocket for services, health insurance remains the most crucial portal to receiving adequate health care.  People who are enrolled in health insurance plans, regardless of the level of coverage, have far more access to preventative medical services. There is no denying that adequate medical care is expensive—rising medical costs in addition to the economy make insurance critical to obtaining health services.  If you are uninsured, you are more apt to delay health care until your illness is severe. According to research by the Harvard Medical School, around 45,000 Americans die every year because they are uninsured and therefore cannot receive adequate health care.

This study highlights the importance of health insurance in the United States today.  For the most part, people without health insurance are more likely to have lower incomes, and face an uphill battle when it comes to paying for care out of pocket.  Increasing rates of uninsured Americans is undoubtedly linked to the recession, which keeps them away from receiving the care they need. The fact that so many Americans remain uninsured—whether by choice or by economic necessity—proves very relevant to the 2010 Affordable Care Act. Escalating rates of un-insurance and skyrocketing medical costs are huge problems in the United States today.

When 2014 rolls around, enrolling the uninsured in new health insurance plans will be a daunting task.  The Affordable Care Act will broaden insurance to over 30 million citizens, who will likely need a little prodding when it comes time to enroll.  Canvassing campaigns in low-income neighborhoods aim at enrolling uninsured children in CHIP or Medicaid,working as a test run for the 2014 expansion of health insurance coverage.

As in my last blog about Massachusetts Health Care Reform, it is not the broader coverage that I am concerned about. Hopefully, the government will take cues from Massachusetts and ensure that the reform will not grow so costly that expenses outweigh coverage benefits.

In an interesting article for Bloomberg Business week, Pat Weschler takes a look at a study of med schools, the amount of primary care doctors produced, and the “social mission” of the institutions. According to the study, Atlanta’s Morehouse School of Medicine is the top ranked med school in terms of “social mission” and primary care physicians.  Meanwhile, Harvard Medical School didn’t even break the study’s top 50, coming in at number 62.  Weschler writes that the study compiled data based on the amount of the med school graduates enter primary care, the number that serve in short-handed regions, and the amount that serve minorities.

The study focused on the “research culture” fostered at many top institutions, where specialists often model behavior to students.  One of the authors of the study, Fitzhugh Mullan, claims that schools could boost the number of primary care physicians by focusing on adding higher numbers of women, minorities, and older med students to the mix. At the same time, shifting the focus of med school curricula from research to primary care may also influence more med students to consider becoming primary care physicians.

I found the study’s claims very compelling. The culture of a college, medical school, or any other institution can very well alter your career path.  Medical schools can help reduce the primary care deficit by steering more students towards primary care. Dr Candice Chen, another one of the study’s authors, emphasizes the role of medical schools in increasing the nation’s number of primary care physicians. Breaking away from typical med school rankings may be able to help build a strong primary care base by the time the new health care reforms kick in for real.

Although I tend to agree with many of the points in the study, I do not think that one should count out the money factor.  The cost to complete medical school is astronomically high and rising higher, on top of loans from undergraduate courses of study. Primary care physicians also make far less than specialists after completing similar courses of study, which serves as another deterrent from the primary care profession. Like it or not, money plays a large role in job selection—although as the study showed, it is not the sole factor involved in the decision.

Our Primary Care Physician shortage is a national healthcare issue

By targeting medical schools in addition to (possibly) improving primary care salaries, perhaps this nation can create a strong foundation of primary care providers.  Ultimately, health care reform hinges on such a base of physicians, especially as over 30 million people will gain health insurance coverage in 2014, many of whom will most definitely seek preventative care.

CIGNA will still accept clients enrolling during their individual election period (those aging in to Medicare or newly eligible to Medicare) and those with a Special Enrollment Period. Current clients who have CIGNA Medicare Access PFFS will not see a change in their 2010 benefits. They will continue to have coverage for the entire year. There will be no changes in benefits due to this decision.

Please note this does not effect plans such as CIGNA Medicare Rx, CIGNA Medicare Select Plus Rx, or any of CIGNA’s other medical or pharmacy plans.

Many people were victims of Bernard Madoff’s fraud and have lost a considerable amount of income due to this scheme. Originally, Madoff victims were not included in the above categories of life changing events. As of June 9, Social Security determined that “if someone had a reduction of income as the result of criminal theft or an investment scam, they can qualify as having a life-changing event.” Just like the above instances, you need to provide documentation to Social Security. Documentation would include an account statement from Madoff’s firm or a court document stating you as an alleged victim.

If you are an alleged victim or have had a life changing event recently, visit http://ssa.gov/online/ssa-44.pdf to fill out a form to request a reduction in your Medicare Part B premium.

For the full article, go to http://online.wsj.com/article/SB124546138795033219.html

The researchers recommend that patients should always know whether their test results were normal or not. If you haven’t received the results of the test, call the doctor’s office and ask for them. Even if they come back normal, you should still be aware. This is particularly important, physicians note, when changing doctors or moving from an in-patient hospital stay to outpatient treatment. Patients should not accept when a doctor or lab tech says they will let you know if something is wrong. The result of this study indicate that even if something is wrong, you may never find out. Physicians recommend patients ask for their test results every time, whether or not the results are of concern, in order to always stay informed.

patients whose BMI (body mass index) is over 30. Patients with BMIs of 40 to 49 are considered morbidly obese, while those with a score of 50 or above fall in the category of the super obese. The researchers in this study say that morbid obesity is the leading public health crisis in the US and that bariatric surgery is often the only effective treatment option for these people. Both large private insurers and Medicare (covering 44 million elderly and disabled Americans) cover the surgery in severely obese people. The surgery usually costs between $15000 and $35000.

The researchers showed that a year after surgery, though all patients studied had significant weight loss, the private insurance patients lost more weight. Those on Medicare lost 57% of their excess weight while those with private insurance lost about 82% of their excess weight. Although the Medicare group had the biggest reductions in bad cholesterol (low-density lipoprotein, which causes heart disease) and showed bigger improvements in fasting insulin (a measure of diabetes severity), the Medicare group also had slightly higher complication rates post-surgery, though none of the study subjects died. Researchers argue that these results are because patients in the Medicare group started out much heavier than those in the private insurance group. Those in Medicare’s average BMI was nearly 50, making them super obese. Researchers argue that if this study can be extrapolated to represent the entire population of bariatric surgery patients, it shows that many Medicare patients are going into bariatric surgery with more profound disadvantages, and that they may need additional support in exercise and nutrition to succeed.