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Baby Boomers 2011: A “New Frontier” With Few Guideposts

This is a guest post by Dr. John Schumann.

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In 2011, the first wave of baby boomers will turn 65 years old. Sixty-five still has currency because that’s the age at which non-disabled Americans are eligible to be covered under the Medicare program (now itself having reached middle age).

As our economy continues to recover (hopefully) from the Great Recession, the entrance of millions of Americans to the Medicare rolls over the next decade and a half will be a formidable planning challenge. Look at this chart to see how the baby boomers population has surged:

So is the promise of healthcare reform (the “PPACA“), which will enlarge Medicaid by an additional 16 million Americans — about half of the projected growth in coverage for those currently uninsured.

A couple of recent patient encounters got me thinking about these phenomena, and how we are very much in historically uncharted territory. Never have we had so many living so well for so long. We have an entire generation of people reaching “seniority” who will continue to want the most out of life, without many guideposts on how to achieve it. Read more »

*This blog post was originally published at ACP Internist*

Know Thy Calories: Nutrition Labeling Guidelines For Restaurants

As part of the new healthcare legislation (Affordable Care Act), the FDA has now published its guidelines for restaurants to inform consumers of the calorie counts of food. It establishes requirements for nutrition labeling of standard menu items for chain restaurants and chain vending machine operators.

This is important because Americans now consume an estimated one-third of their total calories from foods prepared outside the home. Consumers are generally unaware of the number of calories they consume from these foods, and being overweight or obese increases the risk of a number of diseases including heart disease, type 2 diabetes, stroke, and cancer.

Here’s what the guidelines say:

— Restaurants with 20 or more locations must disclose the number of calories in each standard menu item on menus and menu boards (have 19 chain locations? You get a pass. Daily specials also get a pass.)

— Additional written nutrition information must be available to consumers upon request (total fat, saturated fat, cholesterol, sodium sugars, carbs, fiber, protein, etc.)

— The menu must say that the additional nutritional information is available. Read more »

*This blog post was originally published at EverythingHealth*

Rationed Care, Denied Treatment, And “Death Panels”

One of the canards slung at the Affordable Care Act is that it creates “death panels” that would allow the government to deny patients lifesaving treatments, even though two independent and non-partisan fact-checking organizations found it would do no such thing.

I don’t bring this up now to rehash the debate, but because the New York Times had a recent story on Arizona’s decision to deny certain transplants to Medicaid enrollees — “death by budget cuts” in the words of reporter Marc Lacey. His story profiles several patients who died when they were unable to raise money on their own to fund a transplant. Lacey quotes a physician expert on transplants who flatly states: “There’s no doubt that people aren’t going to make it because of this decision.”

Arizona Medicaid officials told the Times that they “recommended discontinuing some transplants only after assessing the success rates for previous patients. Among the discontinued procedures are lung transplants, liver transplants for hepatitis C patients and some bone marrow and pancreas transplants, which altogether would save the state about $4.5 million a year.” Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Women’s Health In The U.S. Gets An “F”

The Oregon Health and Science University has published its fifth report card since 2000. It grades and ranks the United States on 26 health-status indicators for women. In 2010, not one state received an overall “satisfactory” grade for women’s health, and just two states — Vermont and Massachusetts — received a “satisfactory-minus” grade. Overall, the nation is so far from meeting the goals set by the U.S. Department of Health and Human Services that it receives an overall grade of “unsatisfactory.”

The national report card uses status indicators to assess women’s health:

  • Women’s access to healthcare services (medically under-served area, no abortion provider, no health insurance and first trimester prenatal care)
  • Wellness  (screening mammograms, colorectal cancer, pap smears, cholesterol)
  • Prevention (leisure time physical activity, obesity, eating five fruits and veggies/day, binge drinking, annual dental visits, smoking)
  • Key conditions (coronary heart disease death rate, lung cancer death, stroke death, breast cancer death)
  • Chronic conditions (high blood pressure, diabetes, AIDS, arthritis, osteoporosis)
  • Reproductive health (chlamydia, maternal mortality, unintended pregnancies)
  • Mental health
  • Violence against women 
  • Infant mortality rate
  • Life expectancy
  • Poverty
  • High school completion
  • Wage gap
  • The score on these varied status indicators fluctuated depending upon which state a woman lives. California and New Jersey ranked highest on state health policies, while Idaho and South Dakota ranked last on policies. Read more »

    *This blog post was originally published at EverythingHealth*

    Addressing Healthcare Spending: “Cowardice” Or Bravery?

    In assessing the “best and worst” of the recommendations from the National Commission on Fiscal Responsibility, Washington Post blogger Ezra Klein accuses the Commission of “cowardice” in addressing healthcare spending:

    “The plan’s healthcare savings largely consist of hoping the cost controls . . . and various demonstration projects in the new healthcare law work and expanding their power and reach. . . In the event that more savings are needed, they throw out a grab bag of liberal and conservative policies . . . but don’t really put their weight behind any. . .[their] decision to hide from the big questions here is quite disappointing . . . ”

    Pretty harsh words, considering that in other respects Klein gives the Commission high marks. But I think there is a lot more to the Commission’s recommendations on healthcare spending than meet’s (Klein’s) eyes, even though I have my own doubts about the advisability and political acceptability of many of them. Read more »

    *This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

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