The rise of cancer rates in those under 40

Decades ago, it was commonly thought cancer mostly affected those 40 and older. All the studies and research done had been based on that assumption.

However, more and more, the rate of those under 40 getting cancer is rising. And unfortunately, while the cancer survival rates have improved for older adults in the past decades, the survival rates of younger cancer patients aged 15 to 39 had not risen substantially. This is not to say the survival rates for younger patients is not good (according to The New York Times article, "Too Young for This: Facing Cancer Under 40", as of 2003, the 5 yr survival rate for those 20-39 was 78.5%). However, this rate could (and should) be much higher.

Cancer does not discriminate. It affects all—babies, children, young adults, older adults, seniors. Therefore, adequate tests/research should be conducted to test certain procedures specifically tailored for each group: babies, children, and adults under 40.

In addition, doctors should stop automatically dismissing cancer as a possible diagnosis because the patient is "too young." Again, cancer does not discriminate.

Dreading a hip replacement? Try hip resurfacing

As active as the boomers are, there will likely be an increase in hip replacement surgeries. The problem is, hip replacements are usually recommended for those over 60 (until then you have to "soldier" it out) because the replacements only last about 15 years. Considering many are living to a ripe old age (the oldest living woman just passed away at 114 on Monday), having a hip replacement at 60 which lasts only 15 years is not enough.

Added to that problem, boomers are much more active now than their parents were at their age. Therefore, boomers are much more likely to need hip replacements earlier.

Now there is another option—hip resurfacing. According to The New York Times article, "Doctors Sell Hip Resurfacing to Boomers", hip resurfacing involves "covering a damaged hip's ball and socket with smooth metal rather than cutting away worn bone and replacing it" thereby leaving the thigh bone intact. Hip resurfacing is estimated to last 15-20 years--- and if necessary after this period of time, a hip replacement can still be performed.

This may be a better alternative--- but we should be able to come up with something better. After all, scientists have created bionic arms and feet--- we should be able to develop a hip replacement/resurfacing technique that will last at least 30-40 years--not 15 years.

The "Me Generation" should be called the "Family First Generation"

The Boomer generation has a reputation of being selfish-- thus the nickname the "Me Generation." Whether this is true or not is up for debate.

However, what is not up for debate are the new findings of the survey conducted by Brightwork Partners for Putnam Investments. The survey found that 1 in 5 workers 45 and older, financially support a parent; 1 in 3 boomers 45 and older provide some financial support (housing or pay rent) for an adult child 25 and older. These numbers are staggering.

Gone are the days when boomers could retire.

Now, some of you may point to our entry yesterday and ask what's the problem if boomers are working in their retirement anyway. However, there is a major difference between wanting to work and needing to work. One main difference is if you don't have to work, you can have the luxury of working wherever, whenever, however you want--without worrying about the money-- thus less stress (ie. less wrinkles). If you need to work, you are limited in your choices.

This is a major dilemma for all involved.

Boomers will have to either postpone their retirement or work in their retirement -- which means there will be fewer jobs available for the younger generation because the boomers are still in the workforce. Thus, the younger generation will find it difficult to become financially stable causing their parents to keep supporting them. (Do you see the vicious circle?)

There are many great suggestions in the article "Support Squeeze" on MarketWatch, regarding how to speak to your children on being fiscally mindful so they don't depend on you for financial support. There are also great tips on helping your parents prepare for their own retirement needs-- such as long term care--so all the responsibilities don't fall on you.

Happy 1st Birthday to Google Video!

Can you imagine it? Google Video is now one year old. (How time flies!)

And to think, people scoffed at the idea that Google would venture into the online video field when Google Video was unveiled at CES last January. Many thought it would fail (then again, many people don't have that much confidence in Google and its products).

CareTALK has confidence in Google. (We are happy to say CareTALK was in the first group of video content providers for Google Video when it was in beta). We believe Google Video will revolutionize healthcare video-on-demand as a REAL healthcare resource.

Boomers are at it again…

They are "reinventing middle age, changing the whole definition of it … not doing it through protests and marches, but very quietly, life by life."

Boomers are at that age where they are having their "mid-life" crisis or (for the older boomers) nearing retirement age. Yet, don't expect them to be retiring to Florida and golfing their days away. Not this group. This group will keep working--- but they will be making career changes (or other changes).

Why? Why this need to reinvent themselves?

According to the Baltimore Sun article, "Boomers redefining the second half of life," one boomer advocate said the "confidence and grit required to reinvent yourself [is] part of the boomers' legacy. The children of the '60s questioned authority. We've also allowed ourselves to dream of things that can be done instead of getting bogged down in reasons that they can't. ... I think it's helped create a sense of freedom and possibility for lots of people."

This is very true. Take a look at the anti-war protests occurring in Washington--- it's deja vu, only this time the boomers are 30+ years older and peacefully protesting the end of a war in Iraq, not Vietnam. (If seeing Jane Fonda speak during one of these protests doesn't bring back memories, we don't know what will).

It is in the boomers' blood to reinvent themselves and fight for what they believe in.

Is NY next?

Next week, the newly elected governor of NY will present his budget to the state legislature. The hot topic of the budget … health care (what else?).

According to The New York Times article, "Spitzer to Outline Plans for Cuts in Health Spending," some key points that will be discussed:

• ensure "Medicaid dollars are used for Medicaid patients" (who would have thought otherwise, right?)
• "cut or eliminate the annual inflation adjustment to Medicaid payments to hospitals/nursing homes"
• revamping the way hospitals and nursing homes nearly $500 million/yr for workforce recruitment.
• creating a new office of long-term care
• getting "cheaper prices when the state buys drugs, possibly by centralizing purchasing in a single entity and also by seeking to change the way prices are negotiated.'"

Will Gov. Spitzer follow Gov. Schwarzenegger's example and introduce universal health coverage (If not now, maybe in the coming years)?

We can only wait and see/listen.

Prevention is key… but is it economically feasible for doctors?

It's a shame when a doctor needs to choose between what is better for his patients – ie. helping them take preventative measures so they don't have to undergo expensive surgeries—or getting higher reimbursements due to our nation’s incentives system (ie. more money for himself/his office). Cardiology is a prime example of a medical field where proper prevention (knowledge of which has been increasing every year) can reduce the risk of a heart attack by up to 80%, according to The New York Times article, "What's a Pound of Prevention Really Worth?"

Unfortunately, "preventive medicine just doesn't pay in the current American medical system." As one doctor said, "The time we spend with patients -- we get rewarded almost zilch."

Yes, universal healthcare – ie. providing the nation's almost 50M uninsured with health care-- is a major topic (as evidenced in President Bush's State of the Union Address last night) but so is reducing the unnecessary expenses that are encouraged by this nation's incentives system (doctors don't get reimbursed for preventative medicine under the current system). This is what Dr. Arthur Agatson (aka, the South Beach diet doctor) is trying to bring to the forefront and bring to everyone's attention– the idiocy of the current incentives system.

He has one idea of how to do this:

My dream has been to go to a corporation and say, "Have all your executives and all your high-risk employees come to our practice, and if they hit our goals and still have a heart attack, we'll give you a million dollars."

We're sure there must be a corporation somewhere that will take him up on his offer.

Good old Vitamin B

Many of you may already take niacin, aka vitamin B, (or a B-complex pill). But did you know that it can, if taken at high doses (2,000 mg/day), increase your good cholesterol, HDL ("Among other functions, HDL carries dangerous forms of cholesterol from artery walls to the liver for excretion. … [a process] crucial to preventing clogged arteries." - The New York Times, "An Old Cholesterol Remedy Is New Again")

Experts say, that vitamin B (again in high doses) combined with a statin which lowers LDL (the bad cholesterol) can reduce the risk or a heart attack or stroke by 70%.

This is truly incredible.

This is now being brought out into the spotlight because of Pfizer's announcement last month that they were halting production of their brand name, HDL-increasing drug that was supposed to be their next big hit.

Our question is simple: why was there a need to spend time (years), money (millions), and energy in research (not to mention the people it was tested on) when there was already a proven statin--- plain, old Vitamin B? It was already proven in studies conducted in 1975, that niacin reduced heart attacks and strokes by 26% and 27%, respectively.

As one professor of medicine put it: "Here you have a drug that was about as effective as the early statins, and it just never caught on. It's a mystery to me. But if you're a drug company, I guess you can't make money on a vitamin."

And that is really it, isn't it?

Granted, high doses of Vitamin B, in rare instances, can cause liver damage (which drug doesn't? This is a common side effect in many prescribed drugs – just listen to the warnings in the pharma ads or read the fine print) and can impair the body's use of glucose. "High doses should be taken only under a doctor's supervision" (if you are taking high doses of vitamin B, then you are trying to control your cholesterol. In which case, you SHOULD be under doctor's supervision anyway).

Bottom line, yes, high doses of vitamin B may have unpleasant side effects--- but so does every other drug. We fail to see the reason why time, money, and energy had to be spent, in our view, "recreating the wheel" when vitamin B had already been proven --over 30 years ago-- to be highly effective.

Hot topic: Health Care Coverage

Get ready.

For the next two years, one of (if not THE) hottest topic is and will be health care coverage. It seems every week, there is another state announcing plans to offer coverage for the uninsured in their state. This week alone, there were three articles in The New York Times regarding this topic ("Groups Offer Health Plan for Coverage of Uninsured," "Pennsylvania Governor Pushes Health Plan", and "Bush to Urge New Tax Plan for Health Care Coverage").

Now, some plans seem plausible and can benefit their intended audience – ie. those that are uninsured (such as Gov. Schwarzenegger's healthcare plan for California)—but others may partially help the uninsured while actually hurting those who are already insured (such as in President Bush's health care plan that he will be addressing in this Tuesday's State of the Union address).

Universal health care is not an easy feat (especially now that we are trillions of dollars in debt) but we're glad it is now coming to the forefront. Perhaps, the best plan would be to allow the states to offer their own universal health plan while the federal government uses it clout to lower healthcare expenses, such as by negotiating lower prescription drug prices, allowing the importation of prescription drugs from outside the US, or even allowing companies to produce generic version of drugs that have had their patents expire. These are all ways in which the federal government can help--- but they don't --yet.

Finding beauty in death

We are in a society that seems to fear death (with a few notable exceptions such as Mr. Buchwald, as we wrote about earlier this week). We try our hardest to stay young and live longer. We don't like speaking about death. We know it has to come sooner or later--- but we always hope it's later—much, much (MUCH) later, and as a result we put off thinking about it or planning (ie. would you like to be cremated or buried? If buried, where? Do you know what the wishes are of your spouse, parents, children?) .

We all focus on healthcare (which is VERY important) --- but how often do we think about death-care?

Perhaps it's time to pay some attention.

After all, every other industry has changed--- why not that?

For example, did you know that it is estimated by the year 2025, more than 50% of those in the US who die will be cremated? Cremation is on the rise. Who knows… perhaps, that'll be you or your spouse. But don't worry… your ashes won't have to reside in the typical somber urn.

Even your urn can be personalized! (In case you haven't noticed, personalization is key to everything. And Boomers, with their tendency to be slightly selfish -- which is not always a bad thing-- have encouraged this trend towards personalization).

Artists are now creating urns that are pieces of art which capture the person's character, style and aesthetic. According to The New York Times article, "In Death as in Life, a Personalized Space," sample works of art can be seen in a gallery, christened Art Honors Life, opening next week in Graton, CA.

For a slightly less conventional take, how about housing your ashes in "wind chimes with built-in cavities" or perhaps you may even consider "pencils made from cremated remains (roughly 250 pencils per person), diamonds made from ash carbon and birdfeeders designed to scatter ashes."

After all, as one person in the article said, "Once you're gone, you're gone. But at least art brings it one level up and blends in with your décor."

The new weight loss program -- play video games!

Well, not exactly any video game. Specifically, the sports-oriented (boxing, bowling, tennis, baseball) video games for the new Wii Nintendo console.

According to the Associated Press article, "It's official. Wii use can cause weight loss,"
a 25 year old conducted an experiment for 6 weeks, during which he lost 9 pounds solely by playing with his new Wii system for 30 min a day, every day (he did not change his diet during this period). He even has a before and after picture on his blog www.wiinintendo.net and has been contacted by a fitness web site to help them create a Wii workout program.

Who says video games are just for couch potatoes? This is a great way to have fun, lose weight, and keep healthy --- without going to the gym.

We have to admit that Nintendo has really been thinking "out of the box" with their latest products -- with their Brain Age game for the DS console aimed at Boomers (to help them keep their minds sharp) and now with the Wii console which gets players OFF the couch and active. Nintendo has had similar products in the past with not-so-great success (anyone remember the Power Pad or the Power Glove?).

Third time's the charm, right?

Point is, Nintendo is not going after the traditional video gamers (as much) -- they don't want to compete with the other game consoles to see who could get the better game, better graphics, etc. (Because technology is advancing at such a rapid pace, why not focus on other important factors?) With the Wii console, they are focused on the gaming experience. With Brain Age, they are focused on giving their older (and former) players something fun while helping to stimulate their minds. (You really won't see many Boomers playing games like say, a game from the Final Fantasy series, even though it is mentally challenging).

We have to tip our hats off to Nintendo.

The Man Who Wouldn't Die

Wednesday night, Art Buchwald, known as "The man who wouldn't die," passed away -- almost a year after he was told he only had a few weeks to live. HE did not succumb to his illness -- his body failed him.

Renowned globally for his satirical, (oftentimes controversial) writing, he will be remembered as the man who always made you smile, and didn't let obstacles get him down. One of his friends was quoted in The New York Times obituary"Art Buchwald, Whose Humor Hit the Powerful, Is Dead at 81" as saying, "no matter what went wrong in his life, he could make a job out of setbacks, out of things that had gone wrong." After he learned (back in February of 2006) he had only a few weeks to live, he checked himself into a hospice and refused dialysis treatment for his failing kidneys. No one, not he nor his doctors, could explain why his kidneys kept working --- but they did… for almost an entire year longer than expected which enabled him to continue writing and even write the book Too Soon to Say Goodbye. (Perhaps he wasn't meant to pass away until he wrote that book).

During this last year, he kept his spirits up and his humor alive. In fact, he said "I'm having a swell time — the best time of my life" [with regards to being at the hospice]. In interviews, he was quoted as saying "I never realized dying was so much fun."

When a friend of Mr. Buchwald asked him, "What are you going to leave behind, buddy?" Mr. Buchwald shouted "Joy!"

Yes, this young man had a lot of "chutzpah."

We should all see him as an example for how we should treat end of life. Accept death gracefully--- and with humor. It's unavoidable --it'll happen sooner or later. Make the most of it and don't dwell on the fear of the unknown.

Happy Birthday, Ali!

In case you haven't heard, Muhammed Ali turned 65 today. Yes, Mr. Ali, one of (if not the) greatest champ in boxing history is now a senior citizen. So many articles we've read today have stated this fact as a shocker.

We guess, in a way, it is a shock to think of the powerful, energetic, boastful man as a senior. However, please note, 65 is NOT the end of the road. In fact, some see 65 as a new lease in life. Take Clint Eastwood as an example -- he is 76 and he is still acting, directing, producing, and writing movies (and probably much more).

Unfortunately, Parkinson's disease has slowed Ali down and has made his own body a traitor-- but his mind is still sharp and clear. Some articles like the one from the Associated Press, make his story out to be a tragic story--- one of pity. Yes, his story is tragic--- but a birthday is a day of celebration--- a day of joy for having lived another year. You are supposed to remember the good things that occur--- not dwell on the bad.

There is one article from the NY Daily News that is actually heartwarming--- not pitying --and it is a letter from the sports columnist to Ali's wife, Lonnie, in which the author describes some fun memories that are meant to make Ali smile. That should be the gift his fans should give him--- memories that will help him smile--- not pity.

Like they say, as long as the mind still functions, the body can be put back together.

Are you a spendthrift? It’s your brain's fault!

Now you can blame your spendthrift (or your tightwad) tendencies on two regions of your brain: the nucleus accumbens and the insula.

According to The New York Times article,"The Voices in My Head Say 'Buy It!' Why Argue? " scientists have found in experiments at Stanford that the nucleus accumbens --"a region of the brain with dopamine receptors that are activated when you experience or anticipate something pleasant" --was activated when subjects wanted to buy items they liked. They also found that the insula, the region of the brain that is activated when you don't like something, was activated when the price they saw was too high. One could conclude that a person who likes shopping (a lot) has an overactive nucleus accumbens because it brings them pleasure while those who are tightfisted have an overactive insula because it literally pains them at the thought of spending money.

Of course, neither extreme is good for you.

As humans with a conscience, the ability to think logically and weigh all factors when it comes to shopping vs. saving money for long term goals (ie. college fund, buying a house, etc), we are not completely susceptible to the chemicals in our brains. We just need to exert some restraint.

Therefore, steer clear of impulsive buys -- more often than not, you'll regret it (especially when you get your credit card bill!)

Who's going to be your caregiver when you age?

Your spouse? Perhaps.

There was a survey in the Wall Street Journal a few years back that asked men who would care for them when they aged. Their response: their wives. When they were asked who would take care of their wives: they couldn't respond.

Granted, after a few years, things may have changed (at least we can only hope) and men start to realize they will need to be caregivers for their wives. But what happens to the men and women without spouses?

Single men and women are more common than you may think. A New York Times article, "51% of Women Are Now Living Without Spouse", points out that we have passed a tipping point of married vs. unmarried women. Aside from the social significance of this (ie. today's modern women don't have to depend on men for support and protection --- as was the mentality only a few decades ago), what about the significance to long term care planning? Those single women (and men) have to designate someone with power of attorney, someone who has authority to make medical decisions, legal decisions, etc, should something happen to them. Of course, everyone should do this anyway and not put the burden solely on the spouse. We're also not suggesting that the women who were single at the time the survey was conducted will stay single… but according to the article, women are not in a rush to get married, at all. They like their freedom. (And for good reason! According to one example in the article, a lady, who was divorced after 34 years of marriage, was able to get a master’s degree. "Her former husband 'didn't want me to do that because I was more educated than he was'.")

Freedom and independence are great. But make sure you have planned for it--and for yourself. Most people have plans for the way they want to live before or after marriage--goals they want to accomplish. Do they same with your long term care.

Plan for it--so you don't have to be dependent on someone you may not have chosen for yourself.

Have a sore throat? Go see the doctor… in your office

It's déjà vu all over again--- only this time, you're not visiting your school nurse. (And you're not 10 years old anymore.)

You're visiting the doctor in the clinic in your office.

Yes, you read right.

According to The New York Times article, "Company Clinics Cut Health Costs" more than 10% of the country's 1,000 largest employers offer primary care or preventative health services on their premises. And by the end of this year, it is expected this will increase to 25%.

Why are companies doing this?

Well, for many reasons- added benefits for the employees, more loyalty from their employees, etc. But (realistically) the most important reason is because it is cost effective. Imagine, for some companies it is more cost effective to have a clinic inside their offices to try to prevent their employees from serious illness than to have to pay high insurance premiums every time an employee goes to their private doctor (not to mention the loss of productivity). Some of these clinics have programs for weight loss or to stop smoking. Why take time off from work just to get your prescription refilled or for a minor concern, such as getting a flu shot or a sore throat? Now you can just go down the hall.

However, we must warn you that these clinics should not take the place of your primary care physician. Your primary care physician should be someone who knows you for years and has your full medical history -- though with PHRs being such a hot topic, this may change (Adam Bosworth, a VP at Google, spoke about creating a "health URL" in his speech in December at the PHR conference in Washington.) S/he should know you well enough that if there is something out of the ordinary, s/he will detect it. Besides, your primary care physician will still be your physician even if you change employers.

Either way, having a clinic is not a bad idea. In fact, it's a very good idea.

This century's "Coke and Pepsi" -- Allergan and Medicis

We are a nation of superficiality and vanity.

We try everything we can to keep young. And wrinkles are a constant thorn on our side. With the boomers aging, there is no wonder that, according to the Wall Street Journal article, "Firms Face Off Over Wrinkles," "the market for drugs, dermal fillers and other devices used in cosmetic medicine totals about $15 billion."

The two companies with the largest market share for "wrinkle-erasing products" have "stepped up their game" to gain the market share of the other. Allergan Inc (producers of Botox) is the market leader for injections to smooth out the wrinkles above the nose. Last year, they released a new "dermal filler," Juvéderm, which lessens wrinkles on the lower half of the face--- thus treading into Medicis Pharmaceutical Corp's territory (Medicis is the market leader for dermal fillers with their product, Restylane). However, Medicis has announced they too hope to release in 2008 a neurotoxin (for wrinkles above the nose) to rival Botox.

The lines have been drawn and this is (marketing) war.

To give you an example, in 2005, Medicis started a rewards program for those who use Restylane; Allergan introduced a Botox benefit program in 2006. Allergan has advertising for Juvéderm on the Jumbotron in Times Square; Medicis is "funding a reality-television show called 'Hottest Mom in America.' " (Yes, yet another reality show.) Allergan, in November and December, gave out freebies of Juvéderm to dermatologists who are "platinum" users of Botox on the condition that they use it on patients who have been using Restylane. According to Allergan, they are trying to "obtain more information about Juvéderm and patients' reactions to it". (wink, wink)

Which will be the winner? Only time will tell.

4 out of 6… 2 more to go.

The Democrats in the House of Representatives weren't kidding when they said they were going to change healthcare. Already, in the first 100 hours of Congress, they have passed 4 out of 6 of their top agenda items. As the chart on the left shows (as illustrated in the Wall Street Journal article, "Democrats Take On Health Care" ), the items already passed are :

• enacting the 9/11 Commission measures


• Increase the minimum wage


• Expand embryonic stem cell research


• Negotiate Medicare drug prices (please see yesterday's posting for more information on this).

The items yet to be passed are: Cut student loan interest rates and curb oil-industry subsidies.

Now we only have to wait for the Senate to vote, and if passed, it will be headed to the White House. Unfortunately, President Bush has already said he would veto it (no big surprise).

We'll wait and see who perseveres in the end.

And the battle continues…

The New York Times editorial "Negotiating Lower Drug Prices" is very timely, especially considering our last entry.

It seems a new bill is scheduled to be voted on in Congress Friday requiring the "government to negotiate the prices for prescription drugs for Medicare beneficiaries." (Under current law, the government is prohibited from exerting their power to negotiate for lower prices). One would think it is completely logical for the government to negotiate lower prices. Many would say it is our government's DUTY. After all, it is they would have to pay for the ever-increasing, high priced drugs (which ultimately means we, the taxpayers, are ultimately paying for it).

Unfortunately, those in power are more interested in appeasing the pharma industry.

There are many arguments given by the government as to why this wouldn't work. For example, they argue that "private plans have held costs down and that there is no guarantee the government will do any better. The bill, for example, prohibits the secretary from limiting which drugs are covered by Medicare, thus depriving him of a tool used by private plans and the [Dept. of Veterans Affairs] to win big discounts from companies eager to get their drugs on the list. [However,] the secretary does have the bully pulpit, which he can use to try to bring down the cost of overpriced drugs."

This argument makes little sense. Of course there is "no guarantee" that the government can obtain lower prices. That is why private plans are not prohibited from negotiating themselves---as they currently do. Therefore, if the government can't obtain lower prices but the private plans can-- great. However, if the government IS able to obtain lower prices—even better!

To us, this is a win-win situation for everyone--- except the pharma companies.

Who is the government representing -- the people or just the pharmas? As the article states: "It is time for the Medicare drug program to work harder for its beneficiaries without worrying so much about the pharmaceutical companies."

Just give us cheaper drugs!

There is something seriously wrong when a person has to spend $115 a month (which represents 10% of their paycheck) for insulin medication --- and yet, the medication could have been cheaper had the FDA released guidelines for generic versions of insulin to be produced. (According to The New York Times article, "States Push for Cheaper Insulin," the FDA had announced it would release these guidelines in 2001--- but never did because they were influenced by the brand name drug companies not to).

We clearly understand brand name companies would do anything they can to prevent other drug companies from being allowed to produce a generic version of insulin (after all, it is a $3.3Billion/yr market). We also understand the pharma companies have had a strong hold on our government, but when (republican) governors are asking for generic drugs and a (republican) senator is asking why the guidelines have not been released by the FDA, it (among other matters) is an indication that the pharma strong hold has gone overboard.

We need to allow generic versions of insulin to be produced--- under strict guidelines and regulations so as to not put people at risk. We need to provide more competition among the drug companies so as to lower prices.

Spending 10% of your paycheck on drugs (which can be cheaper had it not been for politics) is ridiculous.

A refreshing view regarding drug reps

We've all heard/read the stories of how sales reps for pharmaceutical drugs go to doctor's offices and give them freebies (and we're not talking about the free samples of the drugs they're promoting).

One doctor (the author of the Wall Street Journal article "Fewer Freebies, More Patient Time Since Doctor Said No to Drug Reps") decided against seeing drug reps "in an effort to simplify [his] professional life, streamline [his] daily workflow and spend more time seeing patients" (more patients = more revenue). Whatever his reasons, more doctors should perhaps follow suit.

All doctors complain about being pressured to spend more time with patients--- time they don't have. However, some of these doctors are also setting time aside for these drug reps. Now, we understand all doctors are not the same --- a doctor with a family practice (such as the doctor in the article) has different responsibilities (and time constraints) as say, an ophthalmologist. However, perhaps the doctors should consider how much time they would save/have with their patients if they refused to see drug reps. Do doctors really need a free lunch from drug reps (you know, what they say… "There is no such thing as a free lunch")? Do doctors really want to be seen as promoting one type of drug – when perhaps another drug is better?

A good question posed by the good doctor:

Is there an ethical way that drug makers can market to doctors about the latest
advances in drug therapy?

As the doctor suggests, perhaps the pharmas can redirect the money it takes for sales calls and using it for social causes. Or perhaps pharma companies could put their educational information/ programs online so the doctors could review them at their own leisure – instead of during office hours. Or how about (and this is a new one) making "a charitable donation each time [the doctor] view[s] new material."

These are all great suggestions.

Perhaps a pharmaceutical company will read this.

The scent of change

It is a marvelous day when the (republican) governor of a large state, such as California, proposes a bill that essentially provides universal health care for all.

According to The New York Times article, " California's Governor Seeks Universal Care," the bill covers the following points:

• Medi-Cal, California's medicaid program, would be "extended to adults who earn as much as 100 percent above the federal poverty line and to children, regardless of their immigration status, living in homes where the family income is as much as 300 percent above that line, about $60,000 a year for a family of four."
• Insurance companies are prohibited from denying people coverage based on age or health status.
• Doctors and Hospitals would receive a higher reimbursement. However, they would have to pay 2% and 4% of total revenues, respectively, to help pay for the higher reimbursement.
• Employers who elect not to offer health insurance to their workers would be required to pay 4% "of their total Social Security wages to a state fund that would be created to subsidize the purchase of coverage by the working uninsured." (This may give companies more incentive to offer health insurance to their workers).
• 85% of the profits from the insurance companies would go directly to health care services.

This may seem like an ambitious bill but if it can help insure the millions of state residents that are currently uninsured, so much the better! (Currently, about 1/5 of California's population is uninsured).

Everyone will be keeping a close eye on California. Other states have tried a form of universal health coverage – Maine, Massachusetts, and Vermont—with varying degrees of success and coverage. However, California is the largest by far. As the article states, "California is likely to set the stage for a national conversation about health care this year... Health care is going to be a major issue in the 2008 presidential election."

We can't wait to see what happens!

Fighting the good fight

Dear Readers,

We have written about this before… and we are writing about it again—because we believe this is an important issue that the insurance companies are trying to ignore.

Eating disorders ought to be covered by the insurance companies!

There is something wrong when a person pays insurance premiums-- month after month, year after year--for decades, and yet is denied covered for treatment pertaining to eating disorders. According to The New York Times article, Eating Disorders: Families Fight Back, "many eating-disorder advocacy groups report that they regularly receive calls from patients and families who have exhausted their insurance coverage and have racked up thousands of dollars worth of bills. 'They're spending down their savings, mortgaging their homes, cashing in their retirement accounts.'"

Is this insane? What is the point of health insurance if you can't depend on it when you (or your child) need it the most?

Not that it should matter whether an illness is biological or mental--- insurances should cover treatment for both—but medical experts have stated publicly that "eating disorders, though a mental illness, have a biological component," which should automatically make treatment for eating disorders covered under the insurance. However, since the numbers for those with eating disorders are so enormous (approx. 11M Americans suffer from anorexia or bulimia and millions more from binge-eating) and the cost associated with the treatment is so high ($1,000 to $1,500/day), insurance companies are trying to claim that there is no solid evidence to prove eating disorders are biological. The insurance companies would rather look the other way when it comes to the evidence presented to them—otherwise, the truth would hurt their profits.

Now parents are fighting back… and are suing their insurance companies—with the help of advocacy groups.

We congratulate them for their courage.

A hospital with heart?

Not many people like hospitals--- they tend to be cold, sterile, unemotional. More often than not, the hospital staff -- the doctors and nurses-- are the same way too.

In any organization or corporation, (or even family), it's the leader who usually sets the tone. And Dr. Herbert Pardes is setting the right tone for New York-Presbyterian Hospital--- one of genuine caring and helping the sick (rich and poor) feel comfortable while recuperating in the hospital. And Dr. Pardes is the right person for the job--- after all, he is the current president of New York-Presbyterian, former director of the National Institute of mental health, and former assistant surgeon general under the Carter and Reagan administrations (among his other former positions).

According to The New York Times article, "The Doctor Is In,"

His prescription for what ails his industry is an aggressive, patient-focused crusade that he believes will restore confidence and financial vitality to one of the nation's oldest and most crucial institutions: the American hospital. His efforts — from personally visiting patients' bedsides, insisting that nurses memorize all their patients' and family members' names and ordering that rooms and lobbies be painted in soothing pastel hues — have struck a powerful chord among patients and colleagues alike.

We need more leaders like this in the healthcare field. We're tired of hospitals being run as just businesses—cold hard, undetached, and looking out for their bottom line. Yes, hospitals are businesses--- but their main mission is to care for patients and (should also be) to make them feel comfortable while staying at the hospitals.

We congratulate Dr. Pardes for his role is changing the environment at a major American hospital.

Perhaps more hospitals will follow his example.

Ask questions!

According to The New York Times article, "To Protect Against Drug Errors, Ask Questions", medication errors account for 1.5MILLION injuries or deaths each year.

This is outrageous!

And… there has been little improvement since a report was first released in 1999 spotlighting these errors.

Imagine… walking into the pharmacy to get a refill of your daily medication. You check your filled prescriptions but the color of the pills is not the same. You even received fewer pills than you normally receive. When you ask the pharmacist, s/he says it fine and sends you on your merry way. This is the first story in this article. Unfortunately, the pills you received were for chemotherapy which lowers your immune system (The pills you were originally supposed to get were for your glaucoma). How can a mistake like this happen? (This is more a case of negligence, if you ask us).

When you pick up your prescriptions, how many of you ask the pharmacist questions about the medication? We all have a right to ask questions--- and not be rushed into leaving. There have been many times when we've gone to the pharmacy pick-up window, been given our bag of prescriptions without any instructions, etc, and have been told to sign a piece of paper with the box stating we've received all the pertinent information for the prescription already checked.

Why the rush? Don't we have a right to ask as many questions as we want? After all, you don't want to be a part of the 1.5M injuries/deaths caused by medication errors.

The point is--- you need to be very careful… and ask as many questions as you can/want. The writer of the article also points out several other tips:

• Know which medications you’re taking and what they interact with other medications you may be taking/will take.
• Make sure you know the name of the drug your doctor is prescribing before you leave his/her office. Also make sure you know when you’re supposed to be taking it, how often, etc. A doctor’s handwriting is usually illegible on the prescription.
• Maintain a list of all the drugs you take—prescription, non-prescription, etc.
• Make sure you take note of any prescription that may give you an allergic reaction.
• Make sure you know why you are being prescribed the drug. What are adverse side effects?
• "When picking up the prescription, check the name and dosing schedule against what the doctor told you. If the labels are too small to read, bring a magnifying glass or ask the pharmacist or someone with better vision to read it to you."
• Ask questions… of your pharmacist! Don't sign anything before all your questions are fully answered.
• If you are too sick to take all the information in, make sure you have someone else with you who will understand all the information.
  

Again… just ask questions!

Throw out your $200 face cream (and eye cream, and mask, and peel)…

…you don't need them any more. Apparently, there is a new "back-to-basics movement" among dermatologists, according to The New York Times article "The Cosmetics Restriction Diet." In other words, the only products you need are:

1. face cleanser
2. sunscreen

And if you have severe acne or want to reduce the appearance of some wrinkles, you can use a product specifically for that need.

Now, this leads us to wonder, what about all those high priced creams, cleansers, wrinkle reducing serums, etc? A friend of a friend of a friend uses an expensive product regularly and s/he swears by that product. Doesn't that mean it works?

Unfortunately, not necessarily.

Creams are not regulated and companies are not mandated to show us any findings from their clinical trials (if they even had clinical trials). As one dermatologist told us once, it's trial and error. If you find a cream/moisturizer that works for you, use it… if not, try another one. Some independent studies (like a study by Consumer Reports published last month regarding wrinkle creams) have shown, that the expensive creams are not necessarily more effective. Yes, they may feel heavenly and smell divine, but that's all it is. The effectiveness is the same as a lower priced cream.

Look on the bright side. Now you have more money to splurge on other things.

Not such a "fool"

Reading past articles, we came across a very interesting article about elder abuse, "Protect Your Grandparents." However, we were (pleasantly) surprised, not necessarily at the topic of the article itself, but where the article was from—The Motley Fool.

For those who may not know of the Motley Fool (we highly recommend this site), it contains articles mainly about finances – transactions in the market, best stocks to choose, "The next big bargain", etc. To have an article like “Protect Your Grandparents” in Motley Fool is a reaffirmation of the trend sweeping every field -- directing their message(s) to the Boomers/Xers (ie. the caregivers of the elderly). We're sure many of you may have heard or read about the topic of the article -- elder abuse -- but many may not have paid any attention to it. Well, the Motley Fool is calling out to you, the caregivers of your senior parents/grandparents, to be more alert as to the dangers of elder abuse. The elderly are, by no means, naïve, helpless or fragile—however, they do need some support from their loved ones.

Another interesting article (again in the Motley Fool) is "Planning for the Unthinkable" which addresses items we have addressed on this blog before – power of attorney, health care options (ie. long term care), and estate planning. (Ie. make sure you have all of them!)

A special entry about courage

Dear Readers,

Today's entry is not about a new research finding, new medical technology, or a health topic.

Today's entry is about courage. Courage to face a devastating loss, courage to face the future, courage to take care of another life on your own. Courage of a young soldier (yes, 48 is young) who, despite knowing the tremendous risk to his life, volunteered for his last mission to go to Iraq to lead his soldiers --- and somehow sensing his life would end, made sure his (at the time) unborn son had more than just a picture to remember him by. He wrote a 200 page journal for his unborn son filled with stories, anecdotes, advice, and personal tidbits about himself--- so that his son would know him, if not in person, at least through his words.

If you have not done so, we highly encourage you to read The New York Time's article "From Father to Son, Last Words to Live By" by Dana Canedy. The young soldier, First Sgt. Charles Monroe King, was Ms. Canedy's fiancé.

We all have our own opinions about the war and we may not fully understand the reason(s) soldiers volunteer for missions. Why take that unnecessary risk? What about their families? Aren't they being selfish?

This is not the time and place for that.

As we stated at the beginning, this entry is about courage. As you read through Ms. Canedy's article you will not feel any "woe is me" attitude. You do not feel her pitying herself. On the left hand side in the multimedia section of the article, click on the "Letters from a soldier to his son." There you will see pictures and hear Ms. Canedy speak about First Sgt. King. Yes, you hear pathos and you hear the poignancy in her voice--- but you do not hear resentment or anger towards him. You hear love and support (even, as she admits, she may not have fully understood his reasons--- but she supported him). She is a single mother--- but her son is a constant reminder of their love together. First Sgt. King will always be with her--- through their son.

Dana has the courage to move forward – for herself, for her love of First Sgt. King, but most importantly, for their son.

We can all learn from her courage.

Dana, we are here for you.

Update: The miracle of science and technology

On Dec. 19th, we wrote "The miracle of science and technology" regarding a promising new laser procedure that has been used in Europe to treat giant brain aneurysms; however, the laser used in the surgical procedure has not been FDA approved for use in the USA. The case of Mr. Chris Ratuszny, according to The New York Times, was the first case to use this procedure in the US due to special authorizations.

Mr. Ratuszny was able to celebrate the new year at home. According to The New York Times article, "A Young Mechanic Improves After Life-Saving Brain Surgery," Mr. Rartuszny went home on Thursday—just 16 days after the brain surgery. It would be wonderful if there were no complications, but unfortunately, there were (we can only ask for one miracle at a time… and at this point, the fact that he is expected to make a full recovery is already a miracle).

We congratulate Mr. Ratuszny for this new lease on life and we wish him a speedy and safe recovery. We also congratulate his doctor, Dr. David Langer, for his willingness to take a risk and try a "new" surgical procedure here in the USA (the procedure has already been tried in several hundred cases in Europe). We understand the FDA is here to protect us. As a result, we need doctors like Dr. Langer to bring these new techniques from around the world front and center here and prove to the health field, and especially the government, that these techniques work and are beneficial to all Americans.