Comments on: A Little History… http://www.letstalkhealthcare.org/health-and-wellness/a-little-history/ Sat, 22 Nov 2008 08:03:39 +0000 http://wordpress.org/?v=2.5.1 By: Susan L http://www.letstalkhealthcare.org/health-and-wellness/a-little-history/#comment-741 Susan L Wed, 04 Jul 2007 23:34:33 +0000 http://www.letstalkhealthcare.org/?p=103#comment-741 About the Family Health Portraits, I hope that one day they may be expanded to include a major syndrome or two, such as the metabolic syndrome [MSX], so strongly involved in Type 2 diabetes. A case showing the importance of this is a colleague of mine who may well be heading towards pre-diabetes. Evidence: 35" waist, Hispanic American, desk job, with PCOS, or polycystic ovary syndome, which is often associated with MSX. Her family members also have MSX symptoms, including hypertension, high triglycerides, PCOS, and one case of diabetes in a great-aunt. But this evidence of a genetic propensity towards diabetes would not be highlighted by protocols that mainly focus on diabetes itself, in parents and grandparents--all of whom, in my colleague's case, have jobs demanding activity. So none are diabetic. And thus, a diabetes-tendancy not being apparent, my desk-bound colleague is given pills by her HMO, but not offered nutritional advice. Of course one problem with finding clues to familial MSX is that few people know if, for example, their relatives have high triglycerides. Not many know what the term even means. If only Bill Clinton, said to be "the metabolic syndrome's poster child"*, would sometimes talk about diabetes science. [*That was in an article by Robert A. Vogel, Texas Heart Institute Journal, 2006] About the Family Health Portraits, I hope that one day they may be expanded to include a major syndrome or two, such as the metabolic syndrome [MSX], so strongly involved in Type 2 diabetes.

A case showing the importance of this is a colleague of mine who may well be heading towards pre-diabetes. Evidence: 35″ waist, Hispanic American, desk job, with PCOS, or polycystic ovary syndome, which is often associated with MSX. Her family members also have MSX symptoms, including hypertension, high triglycerides, PCOS, and one case of diabetes in a great-aunt.

But this evidence of a genetic propensity towards diabetes would not be highlighted by protocols that mainly focus on diabetes itself, in parents and grandparents–all of whom, in my colleague’s case, have jobs demanding activity. So none are diabetic. And thus, a diabetes-tendancy not being apparent, my desk-bound colleague is given pills by her HMO, but not offered nutritional advice.

Of course one problem with finding clues to familial MSX is that few people know if, for example, their relatives have high triglycerides. Not many know what the term even means. If only Bill Clinton, said to be “the metabolic syndrome’s poster child”*, would sometimes talk about diabetes science.

[*That was in an article by Robert A. Vogel, Texas Heart Institute Journal, 2006]

]]> By: Ian M http://www.letstalkhealthcare.org/health-and-wellness/a-little-history/#comment-713 Ian M Mon, 02 Jul 2007 18:45:00 +0000 http://www.letstalkhealthcare.org/?p=103#comment-713 In regards to what Barry posted, there is a precedent for employers setting higher premiums based on employee behaviors, specifically smoking. According to information published by The Healthcare Financial Management Association, supermarket chain Safeway charges employees that smoke roughly $750 in additional premium costs per year. In 2006, Safeway reported an 11% decrease in healthcare expenditures, which they link in large part to this and other innovative approaches to providing employee benefits. In fact, the State of California specifically cites Safeway as the inspiration behind the state's proposed Healthy Actions Programs, part of California's own healthcare reform bill. The Healthy Actions Programs "reward people who take advantage of preventative health programs - like smoking cessation, diabetes management, weight reduction..." The proposed healthcare bill would require these incentives be offered through all state and private insurance policies, and would require that the plans include premium reductions as incentives for meeting certain health-related goals. It will be interesting to see the large-scale reaction to initiatives such as these, that allow employers the ability to discourage certain personal behaviors of their employees. Some may worry that it would open the door for further restrictions, such as to impose diet and exercise regulations. Scotts Miracle Gro is currently facing a lawsuit by an employee who was terminated for being a smoker. Health insurance costs were cited by Scotts as a driving factor in their decision to let the employee go. Maybe the ruling in this case will shed some light upon what lies ahead for these initiatives. In regards to what Barry posted, there is a precedent for employers setting higher premiums based on employee behaviors, specifically smoking. According to information published by The Healthcare Financial Management Association, supermarket chain Safeway charges employees that smoke roughly $750 in additional premium costs per year. In 2006, Safeway reported an 11% decrease in healthcare expenditures, which they link in large part to this and other innovative approaches to providing employee benefits. In fact, the State of California specifically cites Safeway as the inspiration behind the state’s proposed Healthy Actions Programs, part of California’s own healthcare reform bill. The Healthy Actions Programs “reward people who take advantage of preventative health programs - like smoking cessation, diabetes management, weight reduction…” The proposed healthcare bill would require these incentives be offered through all state and private insurance policies, and would require that the plans include premium reductions as incentives for meeting certain health-related goals.

It will be interesting to see the large-scale reaction to initiatives such as these, that allow employers the ability to discourage certain personal behaviors of their employees. Some may worry that it would open the door for further restrictions, such as to impose diet and exercise regulations. Scotts Miracle Gro is currently facing a lawsuit by an employee who was terminated for being a smoker. Health insurance costs were cited by Scotts as a driving factor in their decision to let the employee go. Maybe the ruling in this case will shed some light upon what lies ahead for these initiatives.

]]> By: Barry Carol http://www.letstalkhealthcare.org/health-and-wellness/a-little-history/#comment-664 Barry Carol Fri, 29 Jun 2007 17:09:29 +0000 http://www.letstalkhealthcare.org/?p=103#comment-664 I'm a big believer in economic incentives. For your employees, you might consider offering a discount from his or her health insurance premium for completing the family history forms and incorporating them into the individual's medical record. Discounts (or one time payments) could also be offered for completing a Health Risk Assessment and, perhaps, a living will or advance medical directive. Conversely, a higher premium might be in order for smoking. Employers could incorporate a similar approach into their health insurance benefits. The bottom line is that incentives matter, and we should be doing everything possible to push individual (and provider) behavior in a positive direction. I’m a big believer in economic incentives. For your employees, you might consider offering a discount from his or her health insurance premium for completing the family history forms and incorporating them into the individual’s medical record. Discounts (or one time payments) could also be offered for completing a Health Risk Assessment and, perhaps, a living will or advance medical directive. Conversely, a higher premium might be in order for smoking. Employers could incorporate a similar approach into their health insurance benefits. The bottom line is that incentives matter, and we should be doing everything possible to push individual (and provider) behavior in a positive direction.

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