Tuesday, June 11, 2013

Reading List: Broadening Our Thinking about Healthcare

I recently shared the process I laid out for our executive team to consider options for providing health coverage for our staff in 2014. I've been pulling resources (articles, posts, movies) that will help broaden our thinking so we won't miss options because we are framing the situation to narrowly. This is what I have on the list so far. What would you recommend that I've missed?

  1. Reshaping Health Care -- 18th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care, March 2013 
  2. HSA / FSA / HRA Comparison of Key Features for 2012 and 2013 from HR 360 
  3. The Case for CDHPs: Why Your Business and Your Employees Should Consider Abandoning the Traditional PPO from Change Healthcare 12/1/12 
  4. "I Don't Smoke, Doc," and Other Patient Lies -- If patients lie to their doctors, how honest do you think employees are when they complete health risk assessments? from the Wall Street Journal 2/18/13
  5. More money, more problems: Employees feel little to no responsibility to curb health care spending, even as costs rise from Jen Benz at Benz Communications 5/8/13 
  6. Asheville uses value-based insurance design to reduce escalating health care costs from Business Insurance 5/5/13 
  7. Part-timers to lose pay amid health act's new math from the Los Angeles Times 5/2/13 
  8. One hospital charges $8,000 — another, $38,000 from the Washington Post 5/8/13 
  9. Choosing Between a High Deductible Health Plan and a Traditional PPO: Illustrates the struggle people face when confronted with this choice 5/31/13 
  10. One Strategy for Health-Law Costs: Self Insure from the Wall Street Journal 5/27/13 
  11. High-End Health Plans Scale Back to Avoid ‘Cadillac Tax’ from the New York Times 5/27/13 
  12. Six mistakes you’re making with your CDHP rollout from Jen Benz at Benz Communication 5/22/13 
  13. Future health care to cost 2013 retirees $220,000: Fidelity estimate from Business Insurance 5/16/13 
  14. Health Care Reform Leads Employers to Consider Self-Funded Medical Plans from HR Insights for Health Care 5/7/13 
  15. Bitter Pill: How outrageous pricing and egregious profits are destroying our health care -- This was a special report from Time Magazine published March 4, 2013. I presented it as optional because it is very long. 
  16. Escape Fire: The Fight to Rescue American Healthcare -- A well-done documentary about how our health care system is designed to profit from disease, not health.
  17. Doctor's Perform Thousands of Unnecessary Surgeries  -- USA Today 6/20/13
  18. how did things go so wrong with penn state's wellness initiative? -- Context Communication 8/22/13
  19. How to Get the Most Out of Your Health Savings Account -- Forbes 8/27/13
  20. IBM, Moving Retirees To Exchange, Says Contribution Will Be ‘Consistent’ -- bswift 9/10/13 (IBM sending retirees to exchanges.)
  21. Walgreens moves workers to private health-care exchange -- Washington Post 9/18/13 (Walgreens sending everyone to exchanges.)
  22. Employers Trim Health Costs By Cutting Coverage For Spouses -- NPR 9/19/13 (UPS told workers that it would no longer offer health coverage for spouses who had their own job-based insurance.)
  23. Home Depot to tap health insurance exchanges for part-timers -- Business Insurance 9/20/13 (Home Depot sending part-time employees to exchanges.)
  24. How to Turn Employees Into Value Shoppers for Health Care -- Harvard Business Review (Reference pricing)
  25. JAMA Reports on Top 4 Drivers of Healthcare Cost Inflation in US -- Compass Healthcare
  26. Health care costs for a family of 4 in 2013: a college education, a diamond or a 4-door sedan -- Health Populi
  27. Steering Employees Toward Safer Care -- Employer Strategies for Safer, Higher-Quality Hospital Care for Employees and Their Families ~
    Altarum Center for Consumer Choice in Health Care 

Wednesday, June 5, 2013

Train Your Brain

To Celebrate National Running Day let's look at the book SPARK by John Ratey, MD

I've been wearing my "Running is Cheaper than Therapy" t-shirt for ages. I started running when I was 11. To be honest, my niece tells me I "slog" more than I run. If I do a 5k in under 30 minutes, it's a good day. But, hey, 35 years later I'm still at it. I've always believed there was something therapeutic about running. The few times I've been injured or gotten off track I've been rather miserable. Miserable to be around that is. Now I understand why.

I just finished reading SPARK: The Revolutionary New Science of Exercise and the Brain by John J. Ratey. In SPARK, Dr. Ratey explains the mind-body connection, making a compelling case that exercise is our best defense against depression, ADHD, anxiety, addiction, menopause, dementia and the effects of aging. I was fascinated by how exercise can improve learning. Essentially, exercise optimizes your mindset for learning by improving your alertness, attention, mood and motivation. It helps you log new information by encouraging nerve cells to bind to one another and it spurs the development of new nerve cells from stem cells in the hippocampus. 

The book includes some fascinating case studies including the physical education program in Naperville, Illinois. There was a quote where a PE Teacher said his job was to grow the kids' brains cells and it was the teachers job to fill them. Now how's that for a shift in the way you think of high school PE? 

All movement is good. All exercise is good. And, generally, more is better. But, there is something special about running  
"I tell people that going for a run is like taking a little bit of Prozac and a little bit of Ritalin because, like the drugs, exercise elevates these neurotransmitters. Exercise balances neurotransmitters – along with the rest of the neurochemicals in the brain. Keeping your brain in balance can change your life.” Dr. John Ratey, author of SPARK 
How much exercise should you do? Dr. Ratey recommends multiplying your body weight by eight and planning to burn that many calories exercising over the course of a week. If you weigh 150 pounds, you'd want to be burning 1,200 calories per week. If you burn 200 in 30 minutes at the gym, you'd plan to do six sessions per week. I did the math for myself and figured I'm meeting my target in just one or two workouts, so this is very doable. 

Dr. Ratey is also a proponent of using a heart rate monitor when you exercise. My husband, Patrick, is working on a post for us about heart rate monitor training, so stay tuned. 

"The more fit you are, the more resilient you are." This is one of my favorite quotes in the book. People talk a lot about stress management, but somehow the concepts and recommended actions never seem meaningful to me. Instead of focusing on reducing our stress, I think it's more beneficial to focus on building our resilience. This way we will be prepared to cope with whatever life throws our way. When we are stressed, we need to bump exercise higher up on our priority lists. 

A statistic I find stunning -- 20 percent of older adults who break a hip die within a year. More women die every year from hip fractures than from breast cancer. The best defense? You guessed it -- EXERCISE in the form of some strength training that stresses the bones. I have to think some balance work would be beneficial too in reducing the risk of a fall. 

A few words on diet -- According to Dr. Ratey, low-carb diets are not good for your brain. Carbs supply a steady flow of energy and transport necessary amino acids to the brain. Cumin, garlic, onions, broccoli, blueberries, pomegranates  spinach, beets, green tea and red wine all activate a cellular repair mechanism that is beneficial. The omega-3s in fish are enormously beneficial. He mentions that Omega-3s are sometimes used to treat mood disorders and ADHD. And, there was a study that showed people who eat fish once a week slow the yearly rate of cognitive decline by 10 percent. All the more reason to stick with our Mediterranean Diet.  

This provides a nice segue into supplements. Dr. Ratey recommends the following daily supplements:
  • Omega-3s - 1,200 mg of EPA and 200 mg of DHA (I like the Coromega product we used in our heart health initiative and it includes Vitamin D.)
  • Vitamin D - 1,000 IU
  • Calcium - 1,500 mg for women (Let me know if you find one that's chewable and doesn't leave a funny taste in your mouth.)
  • Vitamin B with at least 800 mg of folate (This is supposed to improve memory and processing speed. I couldn't find one with 800 mg of folate and wound up buying one with 400. I'll take it for now and keep looking.) Also, ran across this article about using Folate to treat depression.
The book can get a little sciency at times, but when I finished, I wanted to give a copy to everyone that I love. It's available on Audible too, so you can listen while you're running.