Recently in Health & Medicine Category

You've probably heard lots of horror stories, outlandish claims, and outright lies about what the new health care reform law does.  Here's a summary, originally published by Reuters, of the bill's actual contents:

WITHIN THE FIRST YEAR OF ENACTMENT

* Insurance companies will be barred from dropping people from coverage when they get sick. Life time coverage limits will be eliminated and annual limits are to be restricted.

* Insurers will be barred from excluding children for coverage because of pre-existing conditions.

* Young adults will be able to stay on their parents' health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college.

* Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.

* A temporary reinsurance program is created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.

* Medicare drug beneficiaries who fall into the "doughnut hole" coverage gap will get a $250 rebate. The bill eventually closes that gap which currently begins after$2,700 is spent on drugs. Coverage starts again after $6,154 is spent.

* A tax credit becomes available for some small businesses to help provide coverage for workers.

* A 10 percent tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1.

WHAT HAPPENS IN 2011

* Medicare provides 10percent bonus payments to primary care physicians and general surgeons.

* Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service. New health plans will be required to cover preventive services with little or no cost to patients.

* A new program under the Medicaid plan for the poor goes into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care.

*  Payments to insurers offering Medicare Advantage services are frozen at 2010 levels. These payments are to be gradually reduced to bring them more in line with traditional Medicare.

* Employers are required to disclose the value of health benefits on employees' W-2 tax forms.

* An annual fee is imposed on pharmaceutical companies according to market share. The fee does not apply to companies with sales of $5 million or less.

WHAT HAPPENS IN 2012

* Physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form "accountable care organizations" to improve quality and efficiency of care.

* An incentive program is established in Medicare for acute care hospitals to improve quality outcomes.

* The Centers for Medicare and Medicaid Services, which oversees the government programs, begin  tracking hospital readmission rates and puts in place financial incentives to reduce preventable read missions.

WHAT HAPPENS IN 2013

* A national pilot program is established for Medicare on payment bundling to encourage doctors,hospitals and other care providers to better coordinate patient care.

* The threshold for claiming medical expenses on itemized tax returns is raised to 10 percent from7.5 percent of income. The threshold remains at 7.5 percent for the elderly through 2016.

* The Medicare payroll tax is raised to 2.35 percent from 1.45 percent for individuals earning more than$200,000 and married couples with incomes over $250,000. The tax is imposed on some investment income for that income group.

* A 2.9 percent excise tax in imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax.

WHAT HAPPENS IN 2014

* State health insurance exchanges for small businesses and individuals open.

* Most people will be required to obtain health insurance coverage or pay a fine if they don't. Health care tax credits become available to help people with incomes up to 400percent of poverty purchase coverage on the exchange.

*Health plans no longer can exclude people from coverage due to pre-existing conditions.

* Employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30employees aren't counted for the fine.

* Health insurance companies begin paying a fee based on their market share.

WHAT HAPPENS IN 2015

* Medicare creates a physician payment program aimed at rewarding quality of care rather than volume of services.

WHAT HAPPENS IN 2018

* An excise tax on high cost employer-provided plans is imposed. The first $27,500 of a family plan and $10,200 for individual coverage is exempt from the tax. Higher levels are set for plans covering retirees and people in high risk professions.


Many mornings find me riding a stationary recumbent bike while watching TV (usually catching up on TiVo'd episodes of 'Daily Show') and I often wonder how something that marries the two would work.  Here's the concept:

When you buy the Adventurecise package, you get a piece of exercise equipment, such as a stationary bike or treadmill, and a box that hooks up between your TV and your input source (cable DVR, DVD player, whatever).  The equipment talks to the box over wireless (Bluetooth would work well...perhaps Wireless USB) and transmits your current status (speed, resistance/intensity setting, treadmill angle, etc.) every second or so. The box does a number of things.  The simplest of these is that it overlays a progress/pace meter on top of whatever you're watching.  Once you set a pace goal, the overlay will tell you how far behind/ahead you are, as well as your overall progress, in the corner or on one side of the TV screen.  Plus, you could have the option of the box disabling your input source if you drop below your desired pace (a not-so-subtle reminder that you're slacking off).

But that's just the beginning, and pretty tame to what this setup COULD do, and should do to earn the title Adventurecise.  If the box is networkable, or even just has a USB port you can stick a flash drive in, then you can have it run downloadable, user-driven adventure movies where physical activity (e.g., running or pedaling) is essential to making progress in the adventure.  For example, the movie starts out that you're being chased by zombies and need to outrun them to deliver the antidote serum to a lab (yes, we skip all the plot-building and character development in favor of quick exercise startup). 

All the camera footage would be first-person, a la Blair Witch, so you feel like you are the one running.  Then, every few minutes, you have to make a decision -- take a shortcut through a warehouse or go the long route through the park? -- indicating that using one or more buttons on the treadmill or bike.  The decisions you make determine the scenery you're running through, the things that happen around you, and the future decisions you have access to.  Typical choose-your-adventure stuff.  But, if you run/pedal too slowly -- after all, you're on an exercise machine that knows how fast you're pushing it -- you get caught by the zombies.

I think these interactive videos could be produced pretty cheaply so as to give people many different options (not everyone wants to have their exercise motivated by flesh-eating zombies).

Anyway, I'd like to hear your thoughts on this, especially if you've seen or heard of something similar already in existence.
Let's keep the need for health care in perspective.  Compared to terrorism and foreign aggression, you're at least 32,000 times more likely to die from one of the many diseases our health care system prevents and/or treats.
us_death.gifIn contrast, our federal 2008 budget for the military (not including FBI, CIA, etc.) was $613 billion, whereas our healthcare budget (Medicare and Medicaid) was $682 billion -- just 11% more.

On a per-death basis, that is ~$350,000 per healthcare-related death and approximately $11,000,000,000 per terrorism/foreign aggression-related death.  Quite a disparity, no?

I'm not suggesting we spend the same per capita for defense and healthcare.  That would be foolish, for one death doesn't risk the downfall of the entire country.  However, it seems obvious that we can, and should, allocate more of our budget towards healthcare, as it's one of the most significant threats against Americans' well-being.

September 11, 2001 was a bad day all around. Planes being flown into two iconic buildings, as well as the Pentagon and the ground, killed just less than 3,000 people. That event has resulted in a massive sociopolitical change in the United States, a change many argue is largely for the worse. But let's look at 9/11 in the context of other recent events:

September 11, 2001 = 2,998 killed cite
2008 Sichuan, China Earthquake = 70,000+ killed cite
2004 Boxing Day Tsunami = 230,000 killed cite

Compared to these two more recent disasters, 9/11 looks pretty tame in terms of casualties.

Some will counter "but 9/11 happened to people in MY country." Fine...let's take a look at a "disaster" on the order of 9/11 that happens every week in the United States.

During 2007, 45.7 million Americans, or roughly 15% of the population, went without health insurance at some point. cite, cite

Last year, approximately 75,000 died due to lack of care that would have been prevented had they had insurance. cite That number is expected to rise in 2008.

So, while we mourn the loss of life associated with 9/11, we should also realize that the fact that the US is the only industrialized country to not offer health coverage for 100% of its citizens results in more than 20 times as many deaths every year as that one event. The US could end up spending $2.4 billion on the wars in Iraq and Afghanistan, or roughly $8,000 for every man, woman, and child in the United States. cite

Are we really better off spending that money on a "war on terror" than we would be investing it in a "war on disease?" The numbers seem to suggest that we are not.

cancer.jpgAnother medical professional has come out publicly warning those who will listen that cellphones may cause cancer. Or they may not. They're not sure, but why risk it, right?

"I don't know that cell phones are dangerous. But I don't know that they are safe."
   -- Devra Lee Davis, Director of the University of Pittsburgh Center for Environmental Oncology

Next week, the University of Pittsburgh will be issuing warnings about the possible cancer-causing side effects of:
• Cheddar cheese
• Paperclips
• Lingering too long in the grocery's produce aisle
• Sudoku
• Your aunt's meatloaf (actually, that's probably true), and
• Reading medical news stories late at night

Check out the full article (CNN.com)

gas_prices.jpgTime.com has positively deviated from the typical "gas prices are awful, aren't they?" approach most journalists take when writing about the fuel situation. Instead of adding to the incessant yammering about how life is going down the crapper because of $4 gas, they decide to highlight 10 positives that might come about because of it:

  1. Globalized jobs return home
  2. Sprawl stalls
  3. 4-day work weeks
  4. Less pollution
  5. More frugal use of transportation
  6. Fewer traffic deaths
  7. Cheaper car insurance
  8. Less traffic
  9. More cops out of their cars
  10. Less obesity

Now, I'm not confident all these will happen just because of high gas prices, but you have to give them a nod for at least trying to remind us that some good will likely come out of this.

Read the whole story here.

Mitch, seeing my Hot/Not list from yesterday, compiled his own, so here it is:

HOT

  • iPod Touch - I tried the Archos 605 Wi-Fi first and its mediocrity makes the Touch that much more delightful. I really love well done user interfaces and this one is first rate. My only complaint is its picky eating habits when it comes to video formats.
  • iMac - I waited longer than any other tech purchase to finally go with Apple's all-in-one desktop PC. I opted for the top of the line 3.06 GHz 24" model and have been completely blown away by it. So far I have found no flaws. It is stunning.
  • High Gas Prices - Innovation rocks and if it takes $5/gallon gasoline to get us out of this oil addiction then I'm more than willing to pay my dues. Fewer SUVs and pickups, electric cars, solar energy, alternative fuels, more big butts on bicycles, less traffic congestion; I'm all for it. Let's drop our consumption by half and let OPEC drink their devalued crude.
  • Synology - A NAS will soon be as ubiquitous on a home network as the router is today. The clever, feature-filled offerings from Synology are the best of the breed. I'll have a DS508 please!
  • Subaru - Totally agree with Craig here. I've been
    in Imprezas now going on six years and I still feel like I'm cheating when I share the road with normal cars. Scoobys are fabulous.
  • Ken Follett's Historical Novels - "The Pillars of the Earth" and "World Without End" are two of my favorite books of all time and I just took them in this Spring. I listened to both on my iPod (over 40 hours each) after downloading them from Audible and they made a month of 1000 mile weekly commutes totally enjoyable. Masterful stuff.
  • CrossFit - I was in good shape 20 years ago and at 44 I can wipe the floor with my 24 year old self (if that was possible). I've been CrossFitting for almost a year now and some of the things I can do now would have seemed outlandish back then.

NOT

  • General Motors - If you Google dinosaur, out of touch, lethargic, and unimaginative you should pull up GM's home page. I used to be a fan, but they have been disappointing me for 25 years now and don't seem to be planning any big changes. The sooner they finish themselves off, the better off we'll be.
  • Labor Unions - Working in the industrial world I cross paths with unions
    of all sorts way more than I would like. I completely understand why our manufacturing sector is fleeing to other countries. I have never seen such a lazy, selfish, destructive, regressive bunch of people in my life. They can't all be like that, but the ones I've met surely are.
  • Sheeple-Filled Corporate IT Departments - My 26,000 strong corporation is going to switch to Vista because they don't want to be left with no anti-virus support for their XP platform. Goodbye nice warm frying pan and hello fire.
  • Cable/Satellite TV - I'm SO tired of paying $80 a month for a bunch of
    garbage that I would never watch even if I had the time. It won't be long until I cut that cord and start rolling my own TV. If I could just decide which way I want to do it!
  • Global Markets - I realize that even the lowliest trader in/on most investment banks/trading floors/commodities exchanges is smarter than I am, but I would really love to see them use those brains rather than run with every emotion that riffles through the world markets. Do investors even pay attention to P/E ratios or supply and demand or is it all about what the hot analyst is saying or the sheeple are doing?

Remember that pack of teenage girls behaving like lunatics and videotaping the beating they planned and dished out on another girl?

Well, the supposed "ringleader" of that group has been bailed out of jail (for $30,000) by...Dr. Phil! Supposedly so that the Dr. Phil Show will have exclusive rights to interview her.

It takes a lot of gall to glorify adolescent violence (purely in the name of ratings) and then decry it as a social evil.

I don't know if there's a TV Personality Scumbag award, but if there is, I'm sure Dr. Phil is a shoe-in.

Kill your desk

I work from home a few days a week. Unfortunately, my office, which transitions to a guest room when the grandparents visit, is cramped. My desk was way too large for the space, and my chair kept bumping into the bed. I was on the lookout for a new desk.

In the back of my mind was another issue. I have terrible posture when working. I slouch. I can almost always be found working with my laptop in my lap and my feet kicked up, resting on my desk. It's just not good, in general, for my over 6-foot frame.

So I performed an experiment -- I killed my desk.

The amount of carcinogenic crap (tar, etc.) extracted from just 400 cigarettes is stunning...and disgusting. Think of all that in your lungs!


Still Smoking? Watch This !!

wii_fit2.gifA few days ago, I posted about the recently demonstrated Wii Balance Board hardware accessory for the Wii Fit game forthcoming for Nintendo's Wii gaming console. In a nutshell, it's a small step-board (shown to the left) that detects foot pressure and wirelessly conveys that data back to the Wii.

wiimote_nunchuk.gifToday, it occurred to me how Nintendo (or any third-party developer) could combine the Wii's standard handheld controllers -- the Wiimote and the Nunchuk (shown to the right) -- with the Wii Balance Board to offer a very interactive, full-body gaming experience.

Imagine a first-person shooter where, to walk or run forward, the user walks or runs in place on the Balance Board. Or, perhaps if that's too much effort, leaning forward or backward could control movement in those directions. Jumping, a common activity in FPS games, would be accomplished by doing the physical analog (bunny-hopping becomes much less of an issue, then). The two handheld controllers could then be used for more precision-oriented input, such as view direction, weapon selection, and firing.

Or, alternately, think about how many sports-oriented games require foot/leg-based movement that could be handled instead via the Wii Balance Board. Snowboarding and skiing would be natural treatments.

What about side-scrollers? Imagine Super Mario Brothers where you need to walk on the Balance Board to move Mario left and right. Would it be more fun? I dunno, but it would certainly be more work (and a better workout) than simply pressing a button with your thumb.

Anyway, I'm sure this is just the tip of the virtual iceberg. I look forward to Nintendo and its development partners coming out with even more innovative uses for all these nifty, wireless controllers. I hope gaming in 10 years looks little like the sedentary, sit-on-the-couch-and-stare-at-the-TV activity that it has for 20-some years now.

New Dangers of Secondhand Smoke (Time.com) is an interesting story about a new study that measured the immediate effects of second-hand smoke on nonsmokers:

...the researchers found that waitstaff and bartenders working a typical night shift gradually accumulated higher levels of NNK, a carcinogen in cigarette smoke, at the rate of 6% each hour they worked. NNK is known to be involved in inducing lung cancer in both lab rats and smokers.

Contributed by Mitch:

The word is out in a major way about the Nike/Apple partnership and their Nike+ campaign. Reviews are starting to abound so I won't re-hash what you can read elsewhere. If you are just crawling from under some nice rock, I'll be brief. For $29 you can purchase a kit consisting of a transmitter for your running shoe and a receiver for your iPod Nano.

nike-sport-kit-pic.jpg

While you run and listen to your Nano, the system will measure your time, pace and calories burned and a nice person will "coach" you at five minute intervals. After you finish your workout data will be sent to the Nike+ website during the next Nano synch. It's very simple, very effective and how they did this for $29 a pop I will never know.

NikePlus.jpg

I am a Mac user and the whole system worked 100% perfectly for me from the automatic firmware update on my Nano to linking with the shoe sender to the final transfer of data to the Nike+ website. No reboots, no driver updates, no connection problems, no muss, no fuss...amazing.

As an excellent partner to this new system, I discovered a podcast called Podrunner (recently rose to #2 on the iTunes' Podcast Top 10) that offers free running mixes from LA's own dj steveboy. These hour long mixes are built at a set number of beats per minute and make keeping your pace a simple thing.

I already enjoyed running, but now even more so with this latest bit of gadgetry.

Per CNN.com, the US Surgeon General today released a report making it clear that the dangers of second-hand smoke are beyond a resonable doubt and should be considered settled as fact:

Steer clear of smokers and any of their drifting fumes. That's the advice of the surgeon general, who on Tuesday declared the debate about the dangers of secondhand smoke over.

"The science is clear: Secondhand smoke is not a mere annoyance but a serious health hazard," said Richard Carmona.

There is no safe level of secondhand smoke -- even a few minutes inhaling someone else's smoke harms nonsmokers, he found. And separate smoking sections, even the best ventilated ones, don't protect enough.

Read the rest of the story.

I really wish city leaders would stop bowing to the pressure of local restaurant and bar owners to water down smoking controls in public places and entertainment/dining venues. History has shown that such bans do not have a significant deleterious effect on such establishments, and in fact, in some places there have been elevated levels of business within a year after bans took effect.

The Houston Chronicle has a story from the Associated Press that discusses how a new Canadian study offers broader, statistically significant evidence that homosexuality in men is likely the result of effects prior to birth.

Men with several older brothers have a greater chance of being gay -- whether they were raised together or not -- a finding researchers say adds weight to the idea that sexual orientation is based in biology.

One day pretty soon, I suspect, there will be amassed so complete an evidential trail that homosexuality is an innate quality, akin to gender, height, and eye and skin color. When that happens, I expect people like those in the Center for Marriage and Family Studies ("We don't believe that there's any biological basis for homosexuality," Dailey said. "We feel the causes are complex but are deeply rooted in early childhood development," as quoted in the article) will fall into two camps: (A) the deeply apologetic that gays have been so maligned (e.g., constitutionally prevented from marrying) who will work to counteract these prejudices and social injustices, and (B) the offensively ignorant who will continue to refute sound science (as they have with global warming, evolution, and a host of other topics) and "believe" that this subset of the population is unfit for society. And unfortunately, those falling in camp (B) have had a lot of practice preaching intolerance already.

Working to eradicate a social problem (e.g., ignorance or poverty) is charity; working to eradicate a biological trait in those who don't want to change is genocide. Learning to tell one from the other is apparently something that many in our society haven't learned how to do yet.

Read the full news story.