Friday, October 13, 2017

Mental Health Care -- Far From Equal

I'm reposting this with permission from Maggie McGary. She shares an interesting perspective on mental health care in this post. You can learn more about Maggie on her blog Mizz Information. I also recommend taking a look at 10+ Photos that Prove Depression Has No Face. 


Mental health has had a banner few weeks in the news and across the internet–at least when the news centers around celebrities or teens. Sinead O’Connor and Justin Bieber made headlines about their battles with depression and mental illness and Diply applauded a list of celebrities who have shared their struggles with mental illness. Two teens were lauded for documentaries about mental illness: one praised for his film raising awareness about mental illness and another whose documentary about suicide won the top prize at a film festival. Headlines like “Young People On ‘Brink Of The Worst Mental Health Crisis In Decades,’” and “Teen suicides now outnumber homicides,” and “Suicide Rate for Teen Girls Hits 40-Year High” are just a few of the too-many-to-list recent news items showcasing how teens are battling depression that make it feel–at least to me–that somehow the world is getting the message that teens are the only ones impacted by mental health issues…well, teens and celebrities.
All this buzz about mental health issues is great, but to me it just highlights a disparity I’ve already written about: the what-feels-like-a-growing-chasm between mental health stigma among celebrities and teens and then among GenX and older generations. While teens and millennials are doing a great job of being open about mental illness in an effort to stop the stigma that surrounds the subject, those of us who grew up being told that mental illness is a shameful secret that you better never tell anyone about or you’ll be labeled crazy, ostracized and probably lose your job…for us, it’s not that simple.

Monday, July 10, 2017

Critical Illness Insurance—Let the Buyer Beware

I am constantly getting calls from AFLAC representatives that want us to offer their critical illness coverage to our staff. Usually, they try to bribe their way in the door with one of those silly ducks—that's a great marketing approach if your target audience is three years old or a canine. (I hear dogs love the stuffed ducks.) Recently, a rep tried a different approach. She tried to guilt me into offering ASHA employees the opportunity to choose. Choice is a fundamental American value. Why was I denying ASHA staff the right to choose for themselves?

It's true, ASHA staff value the opportunity to choose, but they want to choose between good options. They trust me to vet what we put in front of them and I'm not going to let someone sell my colleagues swamp land. 

I did a little research online and talked to a source who shall remain nameless. The average annual AFLAC premium is $780/year. The seller makes 47% commission in the first year or over $366. Stock bonuses can be earned on top of that. In other words, half of what you're paying goes in the sales reps' pocket.

Friday, June 30, 2017

What happens when we don't see health as a common endeavor?

How much you believe in a need for universal health care is largely dependent on how much you see health as a common endeavor. The national policy debate we've been having lately and the health economics class I just completed have me giving it some thought.

Respecting people's preferences is an important tenet of economics. So, if you like to spend your leisure time watching football, smoking, drinking beer and eating pizza; we can presume that you know best what makes you happy and you alone suffer the consequences. If however, other people pay the price for your choices, then there is a social cost, and it is reasonable to consider some intervention.

Wednesday, June 21, 2017

Three Things We Should All Know About the Opioid Crisis

I attended the Vox Unconference, the World Heath Care Congress and a pharmacy summit this spring. There was one topic that overlapped the three events--the opioid crisis. It's all over the news, but so frightening, I think it bears mentioning here. Here are some things you need to know--especially if you're a parent.
  1. The risk of continued opioid use increases after 4 to 5 days. If there is a history of addiction in your family, even that amount of time may not be worth the risk.
  2. Opioids are not effective for treating chronic pain. They may work for a month or so, but the effect is likely to diminish even at increased dosages. Eventually, you'll be left with your chronic pain and a drug dependency. Some people even experience hyperalgesia, a greater sensitivity to pain after taking narcotics for longer periods of time.
  3. How pain came to be the fifth vital sign. The New Yorker ran through a good history in Who is Responsible for the Pain-Pill Epidemic. Vox reported, "US doctors wanted to treat pain as a serious medical problem. But when pharmaceutical companies pushed opioid painkillers with a misleading marketing campaign, they started a drug crisis."
Vox did a really great story on the crisis: How the opioid epidemic became America’s worst drug crisis ever, in 15 maps and charts. Please take a few minutes to scroll through it and watch the 4 minute video.

Tuesday, June 20, 2017

The Health Benefits of Being In the Presence of Trees

As I write, I'm sitting under
our silver maple tree.
Tree At My Window by Robert Frost 
Tree at my window, window tree,
My sash is lowered when night comes on;
But let there never be curtain drawn
Between you and me.
Vague dream-head lifted out of the ground,
And thing next most diffuse to cloud,
Not all your light tongues talking aloud
Could be profound.
But tree, I have seen you taken and tossed,
And if you have seen me when I slept,
You have seen me when I was taken and swept
And all but lost.
That day she put our heads together,
Fate had her imagination about her,
Your head so much concerned with outer,
Mine with inner, weather.
We sleep with the curtains open because I like to fall asleep looking at our silver maple tree. I figured Robert Frost would approve, but there may be more to my peculiar trait. Simply being in the presence of trees reduces the stress hormone cortisol and increases your immune defense system. It's part of a national health program in Japan where they call it "forest bathing." You can get the gist of it in this short video from the World Economic Forum. 

I don't need any convincing, but I'm still adding Your Brain on Nature to my reading list. This is yet another good example of where wellness and environmental issues intersect and it presents a unique opportunity for me to include a poem on my blog. 

Thursday, June 15, 2017

Life vs Disability Insurance -- Why are we far less likely to protect ourselves against the more likely event?

42 out of 100 ASHA staff are worried enough about protecting their families to buy life insurance, but only 25 in 100 had individual disability income insurance. These coverage choices don't reflect the actual risk. We undertook an initiative to offer supplemental disability (aka individual disability income) insurance to all our staff that had not taken it at the time they were hired. Now 53 out of 100 have individual disability income insurance. This initiative more than doubled the number of people with coverage. 

People are far more likely to become disabled during their working years than to die. You hear all kinds of numbers thrown around. I looked at disability and death probability tables published by the Social Security Administration for insured workers born in 1996. Death is pretty indisputable, but disability is more subjective. The Social security Administrations standard of disability is high, so this gives us a conservative estimate of disability.
  • Males born in 1996 (so they attained the age of 20 in 2016) have a 26.3% probability of disability before age 65 and a 7.2% probability of death.
  • Females born in 1996 (so they attained the age of 20 2016) have a 24.8% probability of disability before age 65 adn a 3.6% probability of death.
You can calculate your personal likelihood of disability using this tool from the Council of Disability Awareness.  

Sunday, June 11, 2017

Trump Administration Is Proposing a Giant Step Backward for Women's Health

Ian and I at a pro-choice rally
April 5, 1992
Half of pregnancies in the United States are unplanned. Maternal mortality is rising and much higher in the U.S. than in comparable countries like Canada and the United Kingdom. Maternity care and childbirth cost more in the U.S. than in the rest of the developed world. Yet, we are still debating whether or not health insurance should cover birth control and maternity care.

The Trump administration recently announced plans to roll back an ACA provision requiring insurers to cover birth control and the American Health Care Act would allow states to opt out of covering maternity care. Prior to the ACA, only nine states required maternity coverage and only 12 percent of plans available in the individual market place included benefits for maternity care. [Statistics from: How Obamacare changed maternity coverage.] Similarly, the Kaiser Family Foundation reported three in four non-group health plans did not cover delivery and inpatient maternity care in 2013, before the ACA was enacted.

Wednesday, April 19, 2017

Mom's Keys to Super-Aging

My mom practicing her balance
after completing 40 squats.
Meet my mom. Mom is 73 and she can out walk most of my friends. I'm always sharing exercise tips with her and Mom actually does the things I recommend. It started years ago when I suggested she stand on one foot like a stork when brushing her teeth. When that got easy, I sent her a half foam roller to challenge her balance. Balance is a key to preventing falls and broken bones according to the National Osteoporosis Foundation. Here's a simple routine anyone can follow

Mom will be adding interval training to her routine. My friend, Carol Harnett, recently shared this NYTimes article on the best exercise for aging muscles. It describes a study that looked at the types of exercise that have the most positive impact at the cellular level. As we age, the cells in our muscles do not regenerate as quickly. Exercise can help us combat this, but interval training has the greatest positive impact. 

Wednesday, April 5, 2017

A Day Late and 17 Cents Short

10 Steps to Addressing Pay Inequities

Pew Research Center
Yesterday was Equal Pay Day. It symbolizes the date when working women’s wages catch up to what men were paid the previous year or how far into 2017 women have to work (on average) to earn what men earned in the 2016 calendar year. Pew Research Center reported that in 2015, women earned 83% of what men earned. So, the gap is narrowing (you've probably seen the often sited 79 cents on the dollar statistic), but still persistent.