Three Downsides to Commercial Health Insurer Consolidation

Writing in The Wall Street Journal, Scott Gottlieb argues that the Aetna-Humana and the Anthem-Cigna combinations are evidence of waning insurer competition that is the direct result of Obamacare.  Not only are ACOs not a panacea, but the Affordable Care Act's insurance mandate to limit administrative costs is forcing Aetna et al to spread their costs over a larger base.  Dr. Gottlieb fears that the oligopolies won't be able to deliver on innovation and will limit consumer choice   

Too bad The WSJ didn't give him more print space.  If they did, Dr. Gottlieb may have also pointed to three other potential downsides to commercial insurer consolidation:

1) The concentration of risk: While having a small regional health insurer go bust is a big problem for hundreds of thousands of insurance enrollees, having a for-profit national insurer with tens of millions of enrollees go bust would be a national catastrophe. Think Lehman Brothers, Black Swans and Too Big To Fail.

2) Cronyism: Politicians and C-Suite executives no longer blush at the prevalence of the revolving door between government and all industry.  Health insurance will likewise be too regulated and complicated to leave to anyone other than insiders, who will naturally be unable to discern the line that separates their interests from the patients'.
 
3) Political Power: Will Washington DC and 50 states really be able to stand up to a handful of companies that dominate a fifth of the national economy?  Years ago, the commercial insurers remained silent while they were called "Fat Cats." The Population Health Blog bets that the next time a While House blames the insurers for rising costs, they won't remain so deferential.

Image from Wikipedia

How I Boost My Workouts

Are YOU Shocked?

I use a stimulant to boost my workout!  Are you shocked with that share?  If that was the only thing stated in this post, you may form an ugly opinion of me, and you still might but I will cough up the goods.  This substance is not found in supplement stores, is fairly inexpensive, and provides very effective metabolism boosting results.  Studies have given it rave reviews for not only helping with more efficient fat burning, but also reducing exercise induced muscle pain, improved mental focus, and reduced risk of disease.

Five Reasons to Drink Coffee for a Fit Body

Drum roll ... COFFEE!  I drink one and sometimes two cups of coffee per day prior to my workouts.  Two-cup days typically mean I feel sluggish and will need more of a boost to get me through the physical demands of my workout.  I must admit to enjoying my morning cup of Joe and it has become something that I look forward to mentally as well as physically.  I can feel my body and brain waking up within 30 minutes of drinking it and ready to start my day.  I understand the habit forming properties of caffeine which is why I do not partake in all-day binges of coffee. I will use it to push through a workout however and I do not drink anymore post training.

I am very caffeine sensitive and it does not take much for me to feel the edge which is why I have cut down to a half-calf coffee mix intake.  This seems to work best for me and after a hard workout it seems to eliminate any stimulant feeling that may come from my cup of Java. During my workouts, I do enjoy the caffeine rush that enhances my athletic performance.   I do not have health issues like hypertension or diagnosed heart problems where coffee would be contraindicated so I do partake in moderation.  The other health benefits from antioxidants within coffee are an added bonus.

Drinking coffee, minus all the cream and sugar is one of my secret weapons for maintaining a fit body.  Studies show that the fat burning effects last up to 3 hours after having caffeine so I create that window for my workout.  I would not venture into unsafe stimulant territory and do not support unhealthy ways to maintain my body.  Coffee on the other hand is probably the best natural and effective stimulant making it my pre-workout drink of choice.

Check out my latest article "Five Reasons to Drink Coffee for a Fit Body" on About.com for more great information on the subject.

Thanks for stopping by my Blog and I look forward to reading your comments. Don't forget to subscribe below for my free updates!

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Stay Healthy!

Darla

What Properties Make a Food "Addictive"?

Although the concept of food addiction remains controversial, there's no doubt that specific foods can provoke addiction-like behaviors in susceptible people.  Yet not all foods have this effect, suggesting that it's related to specific food properties.  A new study aims to identify the properties that make a food "addictive".

Introduction

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Is there evidence that walking groups have health benefits? A systematic review and meta-analysis

Is there evidence that walking groups have health benefits? A systematic review and meta-analysis

Sarah Hanson, Andy Jones

9 November 2014

Regular physical activity positively impacts health potentially offering similar effects to some drug interventions in terms of mortality benefits. Indeed, it has been suggested as an alternative or adjunct to conventional drug therapy. Walking at a pace of 3–5 m/h (5–8 km/h) expends sufficient energy to be classified as moderate intensity2 and is an easy and accessible way of meeting physical activity recommendations.

Systematic reviews and meta-analyses have shown walking to have various health benefits including:

• positive effects on fitness
• fatness and resting blood pressure
• blood pressure control
• weight loss
• depression
• cardiovascular disease risk prevention.

ABSTRACT

Objective

To assess the health benefits of outdoor walking groups.

Design

Systematic review and meta-analysis of walking group interventions examining differences in commonly used physiological, psychological and well-being outcomes between baseline and intervention end.

Data sources

Seven electronic databases, clinical trial registers, grey literature and reference lists in English language up to November 2013.

Eligibility criteria

Adults, group walking outdoors with outcomes directly attributable to the walking intervention.

Results

Forty-two studies were identified involving 1843 participants. There is evidence that walking groups have wide-ranging health benefits. Meta-analysis showed statistically significant reductions in mean difference for systolic blood pressure −3.72 mm Hg (−5.28 to −2.17) and diastolic blood pressure −3.14 mm Hg (−4.15 to −2.13); resting heart rate −2.88 bpm (−4.13 to −1.64); body fat −1.31% (−2.10 to −0.52), body mass index −0.71 kg/m2 (−1.19 to −0.23), total cholesterol −0.11 mmol/L (−0.22 to −0.01) and statistically significant mean increases in VO2max of 2.66 mL/kg/min (1.67 3.65), the SF-36 (physical functioning) score 6.02 (0.51 to 11.53) and a 6 min walk time of 79.6 m (53.37–105.84).

A standardised mean difference showed a reduction in depression scores with an effect size of −0.67 (−0.97 to −0.38). The evidence was less clear for other

outcomes such as waist circumference fasting glucose, SF-36 (mental health) and serum lipids such as highdensity lipids. There were no notable adverse side effects reported in any of the studies.

Conclusions

Walking groups are effective and safe with good adherence and wide-ranging health benefits. They could be a promising intervention as an adjunct to other healthcare or as a proactive health-promoting activity.

Open Access

Original Source BJSM

Food Reward Friday

This week's luck winner... soy sauce!!

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Does active commuting improve psychological wellbeing?

Does active commuting improve psychological wellbeing?
Longitudinal evidence from eighteen waves of the British Household Panel Survey

Adam Martin, Yevgeniy Goryakin, Marc Suhrcke

Abstract

Highlights

The aim of this study is to explore the relationship between active travel and psychological wellbeing.

• Impact of commuting behaviour on wellbeing was explored using individual fixed effects analyses.
• Compared to driving, wellbeing was higher when using active travel or public transport.
• Use of active travel reduced the likelihood of two specific GHQ12 psychological symptoms.
• Switching from car driving to active travel improved wellbeing.
• Wellbeing increased with travel time for walkers, but decreased for drivers.

Objective

The aim of this study is to explore the relationship between active travel and psychological wellbeing.

Method

This study used data on 17,985 adult commuters in eighteen waves of the British Household Panel Survey (1991/2–2008/9). Fixed effects regression models were used to investigate how travel mode choice, commuting time and switching to  active travel impacted on overall psychological wellbeing and how (iv.) travel mode choice impacted on specific psychological symptoms included in the General Health Questionnaire.

Results

After accounting for changes in individual-level socioeconomic characteristics and potential confounding variables relating to work, residence and health, significant associations were observed between overall psychological wellbeing (on a 36-point Likert scale) and (i.) active travel (0.185, 95% CI: 0.048 to 0.321) and public transport (0.195, 95% CI: 0.035 to 0.355) when compared to car travel, (ii.) time spent (per 10 minute change) walking (0.083, 95% CI: 0.003 to 0.163) and driving (−0.033, 95% CI: −0.064 to −0.001), and (iii.) switching from car travel to active travel (0.479, 95% CI: 0.199 to 0.758). Active travel was also associated with reductions in the odds of experiencing two specific psychological symptoms when compared to car travel.

Conclusion

The positive psychological wellbeing effects identified in this study should be considered in cost–benefit assessments of interventions seeking to promote active travel



Full article click here (Open Access)

Original source  Michael Evans

Fluffy Teff Flour Pancakes (Gluten-Free and Vegan)

I have a new favourite ingredient and it is called teff flour. Never heard of it before? I hadn't either until I started experimenting with gluten-free baking. There are numerous gluten-free flours out there: oat, buckwheat, sorghum, almond, coconut, corn; the list goes on and on and on. Now, I can't really go into any specifics on why teff flour is so popular other than share my own highly subjective experience: it works great in pancakes. I've had issues in the past with gooey, not properly cooked, gluten-free pancakes and let me tell you, it ain't pretty. But to my great surprise, these ones turned out really light, airy and fluffy! Triple yay!

So from what I can understand, teff is an ancient grain that has been used in Eastern Africa for ages. Ethiopians and Eritreans use the flour to make their special, sourdough flatbread called Injeera. Like many other seeds and grains, teff has an excellent nutrient profile. It's high in calcium, iron, zinc and many other vital trace minerals and provides all of the 8 essential amino acids. Also, for some reason it makes for an awesome gluten-free flour substitute which is the main reason I use it. Because pancakes, you know.

You can find teff flour in health food stores, the gluten-free section in many conventional grocery stores and online. (Try this one, from Bob's Red Mill, for example. You can get up to $10 off your first herb.com order using my promo code "PWF503"). Hope this recipe works as well for you as it did for me!

Pancakes:

- 1/4 cup oat or buckwheat flour

- 1/4 cup white teff flour (same nutritional stats as the dark one, just two different colours!)

- 1/3 cup unsweetened applesauce

- 3 tbsp - 1/4 cup unsweetened almond milk

- 1/4 tsp baking soda

- 1/2 tsp baking powder

- Optional: 1 tbsp granulated sweetener of choice (I use a sugar alcohol called erythritol which I absolutely love!)

- 1 tsp apple cider vinegar

Toppings:

Anything you want really, here are a few suggestions:

- Fresh fruit and/or berries

- Drizzle of maple syrup

- Coconut chips and raw cacao nibs

How to:
1. Combine all the dry ingredients in a bowl and make sure that the baking powder and soda are evenly divided throughout the mix.
2. Add the applesauce and almond milk and stir well. Let sit for a few minutes to thicken.
3. Pre-heat a non-stick frying pan or a regular frying pan with a spoonful of coconut oil over medium to low heat.
4. Add the apple cider vinegar to the rest of the batter right before cooking.
5. Fry small spoonfuls of the batter for a couple of minutes on each side. Don't make them too big/thick, they might not cook through!
6. Serve with toppings of your choice!