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  • Dec13

    I got my annual increase in health insurance premium last month with no increase in coverage. “Starting with your January invoice…(we will bill you) an increase of $38 or a 14 percent increase from your previous monthly rate.”

    Ouch. So I started shopping for alternatives.  I have no health problems except a chronic battle to avoid overweight, work at being fit, and try to practice the lifestyle I preach.  Luckily, I haven’t had to use my health insurance in 20 years.

    I found another, similar plan from the same large national health insurance company. The new plan provides comprehensive coverage and is nearly identical, for $68 less than the new rate.

    I thought: $800+ saved annually is certainly worth the hassle of a re-application and documentation of any and all health concerns encounters I could remember. I assumed the health insurance company wouldn’t or couldn’t transfer my data from one of its plans to another of its plans (though it would lower healthcare spending).

    So I re-applied online, and got a call from MaryAnn RN.  She informed me that I could continue with the application if and only if I had a physical examination, lipid and diabetes tests, height, weight, blood pressure and a documented past medical history.

    Why? Not because I was sick.  But because I was not sick.  “It’s because nobody has eyeballed you in the past two years”, MaryAnn explained.  I actually had seen an optometrist…but “they don’t count”,  she said. “Besides, even healthy people can get sick.”

    Indeed they can: acute illness does often arise unannounced, though chronic diseases often suggest themselves well before you get one.

    Interestingly, the U.S. Preventive Services Task Force recommendations suggest a lipid test every five years and a diabetes test every three years, not every two years, as now required by the insurer.

    Hmmm. An insurer leveraging its offer of insurance outside of professional guidelines for clinical testing? Unheard of.

    Yet there it is: the insurance company penalty for being healthy. Healthcare spending wastefulness 101.

    My triumph of being healthy enough to avoid having to see a clinician for 24 months is not rewarded by the disease treatment system that is most health care today.

    Our disease treatment system values medical and surgical intervention.  It doesn’t value eating well, exercising, avoiding tobacco, sensible drinking, managing stress and getting enough sleep: behaviors that aim to prevent disease and actually do.

    MaryAnn suggested walking-in to a walk-in clinic.  I’ve long supported these clinics: I like the idea of democratizing care for those who cannot afford it. Nurse practitioners do a great job of staffing these centers, which could also teach nutrition and give out my ChefMD recipes: many Walgreen’s still do, after I co-hosted Health Corner TV.

    I haven’t decided whether to walk-in yet: a visit to a clinic will cost $100 and half a day (the nearest one is over an hour away). If my exam and lab work are acceptable and if the insurer doesn’t raise rates mid-year, not accounting for the time off work, I could still save money. So, I’m thinking about it.

    But what really ticks me off is the stupidity.

    *I could have been seen for a blemish within the past two years by a physician assistant, been told that it was a blemish, and qualified for the cheaper, nearly identical health care plan, without any of these crazy new requirements.*

    The insurer’s algorithms of  “insured person eyeballed” apparently don’t care who does the eyeballing or what they eyeball.  Any clinician (except an optometrist, I guess) will do.

    I know I’m lucky.  I haven’t fallen off a ladder or driven a nail through my hand at my urban mini-orchard, or ballooned 75# up despite being embraced by treats, great cooks and frequent travel, or developed a bump, rash, bleed or bruise that wouldn’t go away.  And I work at staying healthy.

    Too much, according to the health insurer. Never mind that helping people take control of their own health with what they eat and how they live is what matters most!

    The insurance system in America penalizes the healthy if they want to have even catastrophic insurance…just like it penalizes those with chronic disease and pre-existing conditions, who want to have any insurance.

    If you want to stay healthy, and see the doctor only when you choose, you might just have to choose a DIY health care plan, or be subjected to tests that you might not really want or might be  unnecessary.  In my opinion, that’s no way to care for people.

    Now I’d like to hear from you.

    Have you tried to stay healthy enough to avoid having to see the doctor?

    Has your health insurance company worked with you, or against you?

    What strategies have you tried to get the health insurance you want to have?

     
  • Sep7

    Employers are going to begin being asked to pay for childhood obesity treatment. And it may be in their best interest to do so.

    The two largest health care costs for employers are employees who are “heavy users” (interestingly, the same term is used in the fast food industry for diners who eat-in 14x/week or more)…and kids.

    One-third of large employers’ beneficiaries are dependents under age 25. Kids and teens are responsible for 14.7% of a typical large employer’s health care costs.

    Obese kids have twice as many MD visits and 3x the hospitalization rate as normal weight kids. That’s where the dollars are.

    The National Business Group on Health has a Toolkit which highlights case studies, covers benefit plan construction, identifies employee education opportunities, suggests how to make the most of on-site facilities and looks at bang-for-the-buck philanthropic opportunities.

    The Institute on Innovation in Workforce Well-being, a coalition of Fortune 1000 employers (Gen Mills, Amex, Cardinal Health, Coca-Cola, Costco, Dell, Express Scripts, Fidelity Investments, Honeywell, IBM, J&J Ethicon, Kellogg, Kraft, Medtronic, Microsoft, among others) and representatives from Weight Watchers, the CDC, HHS and United Health, underwrote the Toolkit.

    There are many routes to success in this area.

    I hope one of the routes is showing how helping kids learn to cook with their parents improves employee productivity and lowers health care utilization…of the entire family.

    I’m working on a Santa Barbara Foodbank program–a reality TV pilot (sort of a Dr Oz meets Jamie Oliver in the Foodbank and at home)– to do just that, later next year.

    Access the toolkit free.

     
  • Jun22

    Dr Oz says “break it down and make it simple”.  Dr. Roizen says “diet smart, not hard: small changes make a big difference.” They recommend in their new YOU: Losing Weight

    * Recruit your team. You need someone to cheer for you and take the fries from you.
    * Plan Your Plate.
    * Take a You-Turn. We all make mistakes: take an authorized U-turn and turn things around.
    * Keep moving! Walk just 30 minutes a day.

    They’re right, especially for women who want to lose weight.

    But for men and women, there’s something to add to this advice, which I also give often to my own patients.

    It taps into something we all care about: sex, sex drive, performance and looks. Not to mention hormones.

    I’m for it. Whatever my patients care about most will help them make the changes that are best for their energy level, heart, liver, kidneys and their family.

    Here is a clip I’ve shown at recent talks: it’s a little risque, but it’s national TV.

    When I show it to audiences, I ask people if they think it is frivolous, unprofessional, meaningful or important.

    I also ask whether it changes their view of belly fat. Does it for you?

     
  • Feb23

    Film and TV can change the world in the way that even best-selling books cannot. I love television and film because you can tell a story visually, and so many people learn visually.

    Temple Grandin, the wonderful and now famous professor of animal behavior and advocate for people with autism, thinks in pictures, and has the neurologic studies to prove it.

    For those of who can’t think that visually, the movie Forks Over Knives, out this summer, will start to change lives. There are several already out (Fresh, Food Inc, King Corn, Simply Raw: Reversing Diabetes in 30 Days), and more coming. And they will help us change child obesity, public health, employee wellness and flavor…it’s coming!

     
  • Feb18

    Brian Montopoli at CBS’ News Blog quotes Bill Clinton today as saying his heart disease developed from

    +”the habits I acquired in my childhood, mostly the way I ate and the way it interacted with my own biology and propensity to produce bad cholesterol,” (from People Magazine)…and

    + “I ate too much fried food, too much ice cream, too much everything.”

    Clinton also had a wake-up call after he watched his own Nightline Interview on Haiti, below: “I looked like I was 185 years old. My color was bad.”

    Media pros do teach you to watch your interviews, to improve. But Clinton could start a school in media, so he wasn’t watching for technique. He watched and had a revelation…but not before he could have two stents put in.

    You don’t have to wait to make the changes you need to make. You just have to ship, as Seth Godin writes.

    Decide you have a deadline to make the change, post the date on your wall (not your website) (or your FB page) and when the date comes, start your new weight loss/cholesterol control/smoking cessation program.

    With help, coaching, more sleep and maybe, video.