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      <title>StreetWise Health</title> 
      <link>http://streetwisehealth.com/</link> 
      <description><![CDATA[StreetWise Health, a Health Plan Education Platform, is the easiest and most effective way to deliver a solid HSA health plan education. StreetWiseHealth.com provides thoroughly researched, up to date information in a variety of engaging, interactive formats.]]></description> 
      <language>en-us</language> 
      <pubDate>Wed, 08 Feb 2012 10:31:49 -0500</pubDate> 
      <lastBuildDate>Wed, 08 Feb 2012 10:31:49 -0500</lastBuildDate> 
      <docs>http://blogs.law.harvard.edu/tech/rss</docs> 
      <managingEditor>info@streetwisehealth.com</managingEditor> 
      <webMaster>info@streetwisehealth.com</webMaster>
                      <item> 
             <title><![CDATA[The 27 Rules of Conquering the Gym]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=165</link> 
             <description><![CDATA[&nbsp;As people flock to gyms in preparation for warmer weather, a reality check might be in order. Here is a list of 27 ways to keep yourself grounded, have realistic]]></description> 
             <pubDate>Wed, 08 Feb 2012 10:00:34 -0500</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424052970203471004577140900388728374.html</guid>
             <author><![CDATA[Jason Gay | Wall Street Journal]]></author> 
             <full><![CDATA[&nbsp;<span style="font-size:11.0pt;line-height:115%;
font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-font-family:&quot;Times New Roman&quot;;mso-bidi-theme-font:minor-bidi;
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA">As people flock to gyms in preparation for warmer weather, a reality check might be in order. <a target="_blank" href="http://online.wsj.com/article/SB10001424052970203471004577140900388728374.html">Here</a> is a list of 27 ways to keep yourself grounded, have realistic expectations and find out some of the faux pas of the gym. Well, sort of.&nbsp;</span>]]></full> 
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             <title><![CDATA[Home Health Advocates Push Remote Monitoring In Medicare]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=164</link> 
             <description><![CDATA[&nbsp;Home health care technology could be the means by which many Americans on Medicare remain in their homes instead of spending their late years in nursing homes and save significant]]></description> 
             <pubDate>Tue, 07 Feb 2012 9:45:58 -0500</pubDate> 
             <guid>http://capsules.kaiserhealthnews.org/index.php/2011/12/home-health-advocates-push-remote-monitoring-in-medicare/</guid>
             <author><![CDATA[Jessica Marcy | Kaiser Health News]]></author> 
             <full><![CDATA[&nbsp;<span style="font-size:11.0pt;line-height:115%;
font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-theme-font:minor-latin;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">Home health care technology could be the means by which many Americans on Medicare remain in their homes instead of spending their late years in nursing homes and save significant amounts of money in the long run. Tablet devices can be used to send vital information between healthcare providers and patients, but this so called remote monitoring equipment isn&rsquo;t covered by Medicare. &nbsp;</span>]]></full> 
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             <title><![CDATA[Seniors benefit most from 'exergames,' experts say]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=163</link> 
             <description><![CDATA[&nbsp;Since the release of the Nintendo Wii in 2007, many studies have been executed that aim to measure the benefits of exercise games (aka &lsquo;exergames&rsquo;).&nbsp; These studies have largely indicated]]></description> 
             <pubDate>Mon, 06 Feb 2012 11:14:25 -0500</pubDate> 
             <guid>http://www.cnn.com/2011/12/20/health/seniors-benefit-exergames/index.html?npt=NP1</guid>
             <author><![CDATA[Jacque Wilson | CNN]]></author> 
             <full><![CDATA[&nbsp;<span style="font-size:11.0pt;line-height:115%;
font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-theme-font:minor-latin;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">Since the release of the Nintendo Wii in 2007, many studies have been executed that aim to measure the benefits of exercise games (aka &lsquo;exergames&rsquo;).&nbsp; These studies have largely indicated that such games may be most helpful for senior citizens as they encourage light to moderate exercise. Click <a target="_blank" href="http://www.cnn.com/2011/12/20/health/seniors-benefit-exergames/index.html?npt=NP1">here</a> for more.</span>]]></full> 
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             <title><![CDATA[Hospital: Smokers need not apply]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=162</link> 
             <description><![CDATA[&nbsp;A simple urine test can either confirm or deny your status as a smoker. A hospital in Pennsylvania is employing this test in their hiring process and has made it]]></description> 
             <pubDate>Mon, 23 Jan 2012 11:31:36 -0500</pubDate> 
             <guid>http://articles.cnn.com/2011-12-30/us/us_pennsylvania-nicotine-testing_1_secondhand-smoke-smokers-nicotine?_s=PM:US</guid>
             <author><![CDATA[Dominique Debucquoy-Dodley | CNN ]]></author> 
             <full><![CDATA[&nbsp;<span style="font-family: Arial, sans-serif; ">A simple urine test can either confirm or deny your status as a smoker. A hospital in Pennsylvania is employing this test in their hiring process and has made it their strict policy to not bring into their workforce anyone whose results return positive for regular nicotine use. Controversial? Perhaps. Policies like this, however, may become increasingly popular as employers attempt to reduce their healthcare costs. Click <a target="_blank" href="http://articles.cnn.com/2011-12-30/us/us_pennsylvania-nicotine-testing_1_secondhand-smoke-smokers-nicotine?_s=PM:US">here</a> for more.</span>
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             <title><![CDATA[Are health ads targeting 'fat kids' too much?]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=161</link> 
             <description><![CDATA[&nbsp;When it comes to childhood obesity, passions run high. A new ad campaign in Georgia is drawing critics and supporters as it shines a light on the issue. Some say]]></description> 
             <pubDate>Fri, 20 Jan 2012 9:16:19 -0500</pubDate> 
             <guid>http://www.hlntv.com/article/2012/01/04/are-georgia-anti-obesity-ads-too-harsh?hpt=hp_c2 </guid>
             <author><![CDATA[Craig Johnson]]></author> 
             <full><![CDATA[&nbsp;<span style="font-size:11.0pt;line-height:115%;
font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-theme-font:minor-latin;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">When it comes to childhood obesity, passions run high. A new ad campaign in Georgia is drawing critics and supporters as it shines a light on the issue. Some say that the ads are too harsh and perpetuate attitudes that lead to bullying. Others say that the ads help to jolt awake unaware parents about the growing epidemic. Read the article <a target="_blank" href="http://www.hlntv.com/article/2012/01/04/are-georgia-anti-obesity-ads-too-harsh?hpt=hp_c2 ">here</a> and decide for yourself.</span>]]></full> 
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             <title><![CDATA[New College Grads Value Health Insurance More than Parents May Realize]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=160</link> 
             <description><![CDATA[&nbsp;Health insurance is important, and an increasing number of recent college graduates are realizing that. A recent survey revealed that nearly half of college graduates would be willing to take]]></description> 
             <pubDate>Wed, 04 Jan 2012 12:20:01 -0500</pubDate> 
             <guid>http://www.dailyfinance.com/2011/06/01/new-college-grads-value-health-insurance-more-than-parents-may-r/</guid>
             <author><![CDATA[Dawn Kawamoto | Daily Finance]]></author> 
             <full><![CDATA[&nbsp;Health insurance is important, and an increasing number of recent college graduates are realizing that. A recent survey revealed that nearly half of college graduates would be willing to take a job they didn't like if it meant that they'd have health insurance. This article also discusses rules for keeping adult children on their parents' health plans and alternative insurance options. Click <a target="_blank" href="http://www.dailyfinance.com/2011/06/01/new-college-grads-value-health-insurance-more-than-parents-may-r/">here</a> for more<br />
<br />
<br />
<p class="MsoTitle" style="text-align: center; "><strong>Perspective Partners, LLC is not providing any legal, tax, or  accounting advice and makes no representations or warranties regarding the  attached document's/presentation&rsquo;s/etc accuracy or compliance with any law,  statute, or other regulatory matter.&nbsp; You should consult with legal counsel or  your tax advisors should you have any questions or concerns regarding the  materials presented.</strong></p>]]></full> 
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             <title><![CDATA[Half of Americans Projected to Be Obese in 2030]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=159</link> 
             <description><![CDATA[&nbsp;&nbsp;Recent figures from the National Health and Nutrition Examination Survey indicate that half of Americans may be obese by 2030.&nbsp; Compared with 2010, there could be as many as 65]]></description> 
             <pubDate>Tue, 03 Jan 2012 9:39:41 -0500</pubDate> 
             <guid>http://www.medpagetoday.com/PrimaryCare/Obesity/28201</guid>
             <author><![CDATA[John Gever | MedPage Today ]]></author> 
             <full><![CDATA[&nbsp;<b><span style="font-size:11.0pt;line-height:115%;font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;
mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:&quot;Times New Roman&quot;;
mso-bidi-theme-font:minor-bidi;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">&nbsp;</span></b><span style="font-size:11.0pt;line-height:115%;font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;
mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:&quot;Times New Roman&quot;;
mso-bidi-theme-font:minor-bidi;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">Recent figures from the National Health and Nutrition Examination Survey indicate that half of Americans may be obese by 2030.&nbsp; Compared with 2010, there could be as many as 65 million more obese adults twenty years from now.&nbsp; In addition to the deleterious health effects of obesity, researchers project that medical expenditures alone will be $48 billion to $66 billion higher annually by the year 2030. Click <a target="_blank" href="http://www.medpagetoday.com/PrimaryCare/Obesity/28201">here</a> for more.</span>]]></full> 
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             <title><![CDATA[With prices rising, fewer health insurance options    ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=158</link> 
             <description><![CDATA[&nbsp;An increasing number of Americans are without health insurance, a fact which can be largely attributed to the high costs of coverage.&nbsp; Young adults who are approaching the age cutoff]]></description> 
             <pubDate>Tue, 20 Dec 2011 11:21:00 -0500</pubDate> 
             <guid>http://today.msnbc.msn.com/id/44290327/ns/today-money/t/prices-rising-fewer-health-insurance-options/#.TlvKWF3gf00</guid>
             <author><![CDATA[Eve Tahmincioglu | MSNBC]]></author> 
             <full><![CDATA[&nbsp;<span style="font-size:11.0pt;line-height:115%;
font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-font-family:&quot;Times New Roman&quot;;mso-bidi-theme-font:minor-bidi;
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA">An increasing number of Americans are without health insurance, a fact which can be largely attributed to the high costs of coverage.&nbsp; Young adults who are approaching the age cutoff on parent health plans and those with pre-existing health conditions may find it particularly difficult to afford health insurance.&nbsp; Experts recommend that consumers shop around before choosing to go without insurance, as there are several options that may be available to them. Click <a target="_blank" href="http://today.msnbc.msn.com/id/44290327/ns/today-money/t/prices-rising-fewer-health-insurance-options/#.TlvKWF3gf00">here</a> for more.</span>]]></full> 
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             <title><![CDATA[How to Choose a Doctor]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=157</link> 
             <description><![CDATA[&nbsp;Choosing a new doctor can be a difficult task, but is worth doing right the first time.&nbsp; Here are some things to keep in mind when choosing your doctor.







































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             <pubDate>Mon, 19 Dec 2011 1:35:37 -0500</pubDate> 
             <guid>http://www.medicinenet.com/script/main/art.asp?articlekey=47649</guid>
             <author><![CDATA[Melissa Stoppler, M.D.  | MedicineNet.com  ]]></author> 
             <full><![CDATA[&nbsp;Choosing a new doctor can be a difficult task, but is worth doing right the first time.&nbsp; <a target="_blank" href="http://www.medicinenet.com/script/main/art.asp?articlekey=47649">Here</a> are some things to keep in mind when choosing your doctor.<br />
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<div style="text-align: center; ">FB# 1704</div>
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             <title><![CDATA[5 Ways Retirement Will Change  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=156</link> 
             <description><![CDATA[What&rsquo;s true about retirement today may not be tomorrow&mdash;or ten years from now.&nbsp; Here are some changes you might see within the ever-evolving scope of retirement a decade from now,]]></description> 
             <pubDate>Mon, 12 Dec 2011 9:53:42 -0500</pubDate> 
             <guid>http://www.smartmoney.com/retirement/planning/5-ways-retirement-will-change-1318952634787/?link=SM_retirement_ls4e</guid>
             <author><![CDATA[Robert Powell | SmartMoney]]></author> 
             <full><![CDATA[<span style="font-size:11.0pt;line-height:115%;font-family:
&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-font-family:&quot;Times New Roman&quot;;mso-bidi-theme-font:minor-bidi;
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA">What&rsquo;s true about retirement today may not be tomorrow&mdash;or ten years from now.&nbsp; Here are some changes you might see within the ever-evolving scope of retirement a decade from now, including variations in health care expenses, emerging services, and higher expectations. &nbsp;Click <a target="_blank" href="http://www.smartmoney.com/retirement/planning/5-ways-retirement-will-change-1318952634787/?link=SM_retirement_ls4e">here</a> for more.</span>]]></full> 
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             <title><![CDATA[Finding an Adviser]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=155</link> 
             <description><![CDATA[&nbsp;An adviser can help young adults make the most of their limited income as well as show them how to steadily build savings and manage debt. Finding your first financial]]></description> 
             <pubDate>Fri, 09 Dec 2011 9:39:02 -0500</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424052970203699404577046421284884942.html?mod=WSJ_Investing_MoreHeadlines</guid>
             <author><![CDATA[Rachel Louise Ensign | Wall Street Journal]]></author> 
             <full><![CDATA[&nbsp;<span style="font-size:11.0pt;line-height:115%;
font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-theme-font:minor-latin;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">An adviser can help young adults make the most of their limited income as well as show them how to steadily build savings and manage debt. Finding your first financial adviser is an important step to getting you on the right path to financial success. Click <a target="_blank" href="http://online.wsj.com/article/SB10001424052970203699404577046421284884942.html?mod=WSJ_Investing_MoreHeadlines">here</a> for the full story.</span><span style="font-size:11.0pt;line-height:115%;font-family:&quot;Courier New&quot;;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-ansi-language:EN-US;mso-fareast-language:
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             <title><![CDATA[8 Startups That Are Shaking Up the Health Care Industry  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=153</link> 
             <description><![CDATA[Many people have questions about their health care, and they often look to the Internet to provide them with answers.&nbsp; More of us play a direct role in our daily]]></description> 
             <pubDate>Wed, 07 Dec 2011 1:55:31 -0500</pubDate> 
             <guid>http://www.businessinsider.com/8-startups-that-are-shaking-up-the-health-care-industry-2011-10</guid>
             <author><![CDATA[Greg Voakes | Business Insider]]></author> 
             <full><![CDATA[<span style="font-size:11.0pt;line-height:115%;font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;
mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:&quot;Times New Roman&quot;;
mso-bidi-theme-font:minor-bidi;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">Many people have questions about their health care, and they often look to the Internet to provide them with answers.&nbsp; More of us play a direct role in our daily health care decisions, and we&rsquo;re looking for ways to make things simpler.&nbsp; It is possible to ease the challenge of managing our health care with help from several startup websites highlighted in this article. &nbsp;Click <a target="_blank" href="http://www.businessinsider.com/8-startups-that-are-shaking-up-the-health-care-industry-2011-10">here</a> for more.</span>]]></full> 
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             <title><![CDATA[Geriatric Doctor Doesn’t Shy Away From Tough Talk]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=152</link> 
             <description><![CDATA[&nbsp;Many doctors have a difficult time speaking with their older patients about their end of life plans. One doctor finds, however, that these conversations can greatly enhance a care provider&rsquo;s]]></description> 
             <pubDate>Tue, 06 Dec 2011 9:19:25 -0500</pubDate> 
             <guid>http://www.latimes.com/health/la-me-1127-lopez-dorio-20111127,0,7445637.column</guid>
             <author><![CDATA[Steve Lopez | Los Angeles Times]]></author> 
             <full><![CDATA[&nbsp;<span style="font-size:11.0pt;line-height:115%;
font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-theme-font:minor-latin;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">Many doctors have a difficult time speaking with their older patients about their end of life plans. One doctor finds, however, that these conversations can greatly enhance a care provider&rsquo;s ability to handle a situation in a way that satisfies the patient's will. Pushing the discussion encourages patients to consider their options and potential outcomes before the time comes when a decision needs to be made that the patient might not be capable of making.</span>]]></full> 
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             <title><![CDATA[4 Tips to Help Plan for Retirement Health Care Costs  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=151</link> 
             <description><![CDATA[&nbsp;There&rsquo;s a gross misunderstanding of the cost associated with healthcare after retirement. This article indicates that the lack of planning for healthcare costs beyond retirement is in part due to]]></description> 
             <pubDate>Mon, 05 Dec 2011 2:24:48 -0500</pubDate> 
             <guid>http://www.usatoday.com/money/perfi/retirement/2011-05-08-Health-Care-Costs_n.htm</guid>
             <author><![CDATA[David Pitt | Associated Press for USA Today  ]]></author> 
             <full><![CDATA[&nbsp;<span style="font-size:11.0pt;line-height:115%;
font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-font-family:&quot;Times New Roman&quot;;mso-bidi-theme-font:minor-bidi;
mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:AR-SA">There&rsquo;s a gross misunderstanding of the cost associated with healthcare after retirement. This article indicates that the lack of planning for healthcare costs beyond retirement is in part due to the fact that people do not understand the amount of money that will be needed to cover healthcare expenses and also, more importantly, that retirees are having a difficult time understanding how they should handle the shift from employer responsibility for healthcare to personal responsibility. The article also briefly lists four preventative strategies that can be employed to reduce healthcare costs beyond retirement. &nbsp;See the story <a target="_blank" href="http://www.usatoday.com/money/perfi/retirement/2011-05-08-Health-Care-Costs_n.htm">here</a>.</span>]]></full> 
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             <title><![CDATA[Medicare's Drug Coverage Gap Shrinks]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=150</link> 
             <description><![CDATA[&nbsp;Provisions of the Affordable Care Act are decreasing the amount that senior citizens who fall into the Medicare Part D &lsquo;donut hole&rsquo; have to pay out of pocket. For the]]></description> 
             <pubDate>Wed, 30 Nov 2011 4:21:33 -0500</pubDate> 
             <guid>http://news.yahoo.com/ap-newsbreak-medicares-drug-coverage-gap-shrinks-133742189.html</guid>
             <author><![CDATA[Ricardo Alonso-Zaldivar | Associated Press]]></author> 
             <full><![CDATA[&nbsp;<span style="font-size:11.0pt;line-height:115%;
font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
mso-bidi-theme-font:minor-latin;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">Provisions of the Affordable Care Act are decreasing the amount that senior citizens who fall into the Medicare Part D &lsquo;donut hole&rsquo; have to pay out of pocket. For the many Americans who are subject to this gap in coverage, out of pocket costs have decreased by nearly 40%. Click <a target="_blank" href="http://news.yahoo.com/ap-newsbreak-medicares-drug-coverage-gap-shrinks-133742189.html">here</a> for more.&nbsp;</span>]]></full> 
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             <title><![CDATA[$6.8 Billion Spent Yearly on 12 Unnecessary Tests and Treatments]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=149</link> 
             <description><![CDATA[A recent study by researchers at the Mount Sinai Medical Center and Cornell University's school of medicine shows that patients spend $6.8 billion annually for unnecessary medical expenses. The major]]></description> 
             <pubDate>Tue, 29 Nov 2011 11:15:35 -0500</pubDate> 
             <guid>http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/Michelle-Andrews-On-Unneccesary-Tests-And-Treatments.aspx</guid>
             <author><![CDATA[Michelle Andrews | Kaiser Health News  ]]></author> 
             <full><![CDATA[A recent study by researchers at the Mount Sinai Medical Center and Cornell University's school of medicine shows that patients spend $6.8 billion annually for unnecessary medical expenses. The major culprit: patients being prescribed name brand drugs by doctors when a similar generic option is also available.  Click <a href="http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/Michelle-Andrews-On-Unneccesary-Tests-And-Treatments.aspx" target="_blank">here.<br />
</a>]]></full> 
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                <item> 
             <title><![CDATA[Increasing Medicare Age Could Lead To Higher Costs]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=148</link> 
             <description><![CDATA[With the Super Committee&rsquo;s deadline having come and gone, nearly all measures are being considered in an effort to reduce the budget by $1.2 trillion over the next decade. Some]]></description> 
             <pubDate>Tue, 29 Nov 2011 11:12:21 -0500</pubDate> 
             <guid>http://www.npr.org/2011/11/07/142023367/raising-medicare-age-could-lead-to-higher-costs</guid>
             <author><![CDATA[Julie Rovner | NPR]]></author> 
             <full><![CDATA[With the Super Committee&rsquo;s deadline having come and gone, nearly all measures are being considered in an effort to reduce the budget by $1.2 trillion over the next decade. Some measures, including raising the age of Medicare eligibility to 67 instead of 65 may be a wolf in sheep&rsquo;s clothing. Click <a href="http://www.npr.org/2011/11/07/142023367/raising-medicare-age-could-lead-to-higher-costs" target="_blank">here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Roth Regrets?  Still Time to Change]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=147</link> 
             <description><![CDATA[Some retirement savers might regret the hefty tax bills that resulted from their decision to convert their traditional IRAs to a Roth IRAs. But for those who switched to a]]></description> 
             <pubDate>Thu, 06 Oct 2011 1:05:00 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424052970204138204576605542770206256.html?mod=WSJ_RetirementPlanning_MoreHeadlines</guid>
             <author><![CDATA[Andrea Coombes | the Wall Street Journal]]></author> 
             <full><![CDATA[Some retirement savers might regret the hefty tax bills that resulted from their decision to convert their traditional IRAs to a Roth IRAs. But for those who switched to a Roth in 2010, there is still time to undo, or &ldquo;recharacterize,&rdquo; the conversion.<br />
<br />
To read further, <a href="http://online.wsj.com/article/SB10001424052970204138204576605542770206256.html?mod=WSJ_RetirementPlanning_MoreHeadlines" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[More Americans Say They’re Skipping Medical Care to Save Money ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=146</link> 
             <description><![CDATA[A national telephone survey released by Consumer Reports reveals that compared with last year, more people in the U.S. skipped prescription drugs or medical procedures in an effort to save]]></description> 
             <pubDate>Tue, 04 Oct 2011 9:56:31 -0400</pubDate> 
             <guid>http://www.businessweek.com/news/2011-09-27/more-americans-say-they-re-skipping-medical-care-to-save-money.html</guid>
             <author><![CDATA[Pat Wechsler | Bloomberg Businessweek ]]></author> 
             <full><![CDATA[A national telephone survey released by Consumer Reports reveals that compared with last year, more people in the U.S. skipped prescription drugs or medical procedures in an effort to save money.  In many instances, doctors and patients don&rsquo;t have discussions about medical costs.  Avoiding necessary medications and procedures could be potentially dangerous strategies for coping with high medical expenses.<br />
<br />
To read further, <a href="http://www.businessweek.com/news/2011-09-27/more-americans-say-they-re-skipping-medical-care-to-save-money.html" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[10 first-time homebuyer mistakes ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=145</link> 
             <description><![CDATA[Buying a home is one of the biggest financial commitments most people make in their lives. A first time homebuyer is prone to making mistakes. This article lists 10 of]]></description> 
             <pubDate>Mon, 03 Oct 2011 8:38:43 -0400</pubDate> 
             <guid>http://money.msn.com/home-loans/10-first-time-homebuyer-mistakes-investopedia.aspx</guid>
             <author><![CDATA[reported by Amy Fontinelle | Investopedia for MSN Money]]></author> 
             <full><![CDATA[Buying a home is one of the biggest financial commitments most people make in their lives. A first time homebuyer is prone to making mistakes. This article lists 10 of the most common mistakes such as not knowing what you can afford, compromising on the important things, and neglecting to inspect. <br />
<br />
To read further, <a href="http://money.msn.com/home-loans/10-first-time-homebuyer-mistakes-investopedia.aspx" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Don’t Join the Ostrich Generation ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=144</link> 
             <description><![CDATA[Sometimes the worst decision is to avoid making one.  Don't let down markets and uncertainty stop you from keeping your financial plans on track.  Read on for some]]></description> 
             <pubDate>Fri, 30 Sep 2011 8:52:55 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424053111904491704576571223765726228.html?mod=WSJ_RetirementPlanning_RetirementPlanning_2</guid>
             <author><![CDATA[Kelly Greene | The Wall Street Journal ]]></author> 
             <full><![CDATA[Sometimes the worst decision is to avoid making one.  Don't let down markets and uncertainty stop you from keeping your financial plans on track.  Read on for some important tips to keep your head out of the sand.<br />
<br />
To read further, <a href="http://online.wsj.com/article/SB10001424053111904491704576571223765726228.html?mod=WSJ_RetirementPlanning_RetirementPlanning_2" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Worried About Rising Health Care Costs? 8 Steps to Health and Wealth]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=143</link> 
             <description><![CDATA[Worried About Rising Health Care Costs? 8 Steps to Health and Wealth - Erik Carter - FORBES

In this article, Carter discusses the rising cost of health care and how plans]]></description> 
             <pubDate>Thu, 29 Sep 2011 11:25:37 -0400</pubDate> 
             <guid>http://www.forbes.com/sites/financialfinesse/2011/09/28/worried-about-rising-health-care-costs-8-steps-to-health-and-wealth/</guid>
             <author><![CDATA[Erik Carter]]></author> 
             <full><![CDATA[<p><strong>Worried About Rising Health Care Costs? 8 Steps to Health and Wealth </strong>- Erik Carter - FORBES<br />
<br />
In this article, Carter discusses the rising cost of health care and how plans with HSAs can help save you money.&nbsp; <br />
<br />
He also discusses the importance of taking care of your health as a way to protect wealth. &nbsp;He offerers a few simple tips such as:</p>
<ol>
    <li>Consider choosing a high-deductible health insurance plan,&nbsp;and try to max out your HSA each year and&nbsp;invest some of your HSA savings for long-term growth.</li>
    <li>Make sure you take care of the rest of your finances as well.</li>
    <li>Get your physical each year.</li>
    <li>Take care of&nbsp;your teeth.</li>
    <li>Get at least 7-8 hours of sleep a night.</li>
    <li>Minimize junk food and eat&nbsp;more vegetables.</li>
    <li>Get some exercise;&nbsp;at least 3-4 times a week.</li>
    <li>Try to relax.</li>
</ol>
<br />
To read the full article, <a target="_blank" href="http://www.forbes.com/sites/financialfinesse/2011/09/28/worried-about-rising-health-care-costs-8-steps-to-health-and-wealth/"><strong>CLICK&nbsp;HERE</strong></a>.<br type="_moz" />]]></full> 
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                <item> 
             <title><![CDATA[Get Smart About College: Parents and students like to think they’re rational when it comes to picking a college and paying for it. They aren’t. ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=142</link> 
             <description><![CDATA[This article explores some of the mistakes students and parents tend to make when choosing a college. This is a once in a lifetime financial and personal decision. How much]]></description> 
             <pubDate>Tue, 27 Sep 2011 8:50:38 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424053111904332804576538312219660354.html</guid>
             <author><![CDATA[Sandy Baum and Michael Mcpherson | The Wall Street Journal]]></author> 
             <full><![CDATA[This article explores some of the mistakes students and parents tend to make when choosing a college. This is a once in a lifetime financial and personal decision. How much should you borrow? How much tuition should you pay? What is the return on the tuition investment? All of these issues and more are discussed in the context of choosing the right college. <br />
<br />
To read further, <a href="http://online.wsj.com/article/SB10001424053111904332804576538312219660354.html" target="_blank">click here</a>.<br />]]></full> 
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                <item> 
             <title><![CDATA[Chronic disease to cost $47 trillion by 2030, WEF says]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=141</link> 
             <description><![CDATA[Basing predictions on current health trends, the World Economic Forum projects that several common, non-infectious diseases will cost the world $47 trillion in treatment costs and lost wages by the]]></description> 
             <pubDate>Mon, 26 Sep 2011 11:16:02 -0400</pubDate> 
             <guid>http://yourlife.usatoday.com/health/medical/story/2011-09-19/Chronic-disease-to-cost-47-trillion-by-2030-WEF-says/50466138/1</guid>
             <author><![CDATA[Alan Mozes | HealthDay for USA Today]]></author> 
             <full><![CDATA[Basing predictions on current health trends, the World Economic Forum projects that several common, non-infectious diseases will cost the world $47 trillion in treatment costs and lost wages by the year 2030.  Coined &ldquo;the world&rsquo;s biggest killers,&rdquo; these diseases are prevalent throughout the world, and also share many preventable risk factors.<br />
<br />
To read further, <a href="http://yourlife.usatoday.com/health/medical/story/2011-09-19/Chronic-disease-to-cost-47-trillion-by-2030-WEF-says/50466138/1" target="_blank">click here</a>.<br />]]></full> 
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                <item> 
             <title><![CDATA[IRA Redux ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=140</link> 
             <description><![CDATA[In the current market, it has become crucial to look for new ways to diversify your account and seek out alternative investment options. These conditions have prompted many people to]]></description> 
             <pubDate>Fri, 23 Sep 2011 11:25:44 -0400</pubDate> 
             <guid>http://www.forbes.com/forbes/2011/0926/investing-retirement-strategies-ira-redux-jacobs_3.html</guid>
             <author><![CDATA[Deborah L. Jacobs | Forbes  ]]></author> 
             <full><![CDATA[In the current market, it has become crucial to look for new ways to diversify your account and seek out alternative investment options. These conditions have prompted many people to convert their Traditional IRAs to Roth IRAs.  Learn about a process called recharacterization which allows you to monitor the converted investments and even reverse the conversion if your investments decline further in value.<br />
<br />
To read further, <a target="_blank" href="http://www.forbes.com/forbes/2011/0926/investing-retirement-strategies-ira-redux-jacobs_3.html">click here</a>.<br />]]></full> 
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                <item> 
             <title><![CDATA[Income for Life, Guaranteed! (Sort of)]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=139</link> 
             <description><![CDATA[Millions of people have been pouring their savings into investments that return some kind of regular paycheck.  Find out how Bonds &amp; Dividend Stocks, Social Security &amp; Pensions, and]]></description> 
             <pubDate>Fri, 16 Sep 2011 4:34:07 -0400</pubDate> 
             <guid>http://www.smartmoney.com/retirement/planning/income-for-life-guaranteed-sort-of-1315006311618/</guid>
             <author><![CDATA[Reshma Kapadia and Elizabeth O’Brien | SmartMoney for The Wall Street Journal ]]></author> 
             <full><![CDATA[Millions of people have been pouring their savings into investments that return some kind of regular paycheck.  Find out how Bonds &amp; Dividend Stocks, Social Security &amp; Pensions, and Annuities &amp; All-In-One Funds factor into the latest playbook for retirement.<br />
<br />
To read further, <a href="http://www.smartmoney.com/retirement/planning/income-for-life-guaranteed-sort-of-1315006311618/" target="_blank">click here</a>.<br />
<br />]]></full> 
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             <title><![CDATA[3 ways to save money on medical costs]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=138</link> 
             <description><![CDATA[It is estimated that health care prices can vary upwards of 300 percent.  As health premiums and out-of-pocket medical costs rise, an increasing number of consumers are finding it]]></description> 
             <pubDate>Fri, 16 Sep 2011 4:29:30 -0400</pubDate> 
             <guid>http://www.bankrate.com/finance/insurance/3-ways-save-money-medical-costs.aspx</guid>
             <author><![CDATA[Constance Gustke | Bankrate.com]]></author> 
             <full><![CDATA[It is estimated that health care prices can vary upwards of 300 percent.  As health premiums and out-of-pocket medical costs rise, an increasing number of consumers are finding it critical to save money on their health costs.   Thankfully, new services are making it easier than ever to compare medical costs.  This article also offers some suggestions on saving more money on health care.<br />
<br />
To read further, <a href="http://www.bankrate.com/finance/insurance/3-ways-save-money-medical-costs.aspx" target="_blank">click here</a>.<br />]]></full> 
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             <title><![CDATA[How Student Loans Impact Your Credit]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=137</link> 
             <description><![CDATA[This article presents some common questions people have about paying back student loans.  Some repayment strategies are presented in the context of what is best for improving your credit]]></description> 
             <pubDate>Thu, 15 Sep 2011 8:50:43 -0400</pubDate> 
             <guid>http://www.mint.com/blog/credit-2/how-student-loans-impact-your-credit-092011/ </guid>
             <author><![CDATA[John Ulzheimer | mintlife  ]]></author> 
             <full><![CDATA[This article presents some common questions people have about paying back student loans.  Some repayment strategies are presented in the context of what is best for improving your credit score.   <br />
<br />
To read further, <a target="_blank" href="http://www.mint.com/blog/credit-2/how-student-loans-impact-your-credit-092011/ ">click here</a>.<br />]]></full> 
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                <item> 
             <title><![CDATA[How to Choose a Doctor]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=136</link> 
             <description><![CDATA[Choosing a new doctor can be a difficult task, but is worth doing right the first time.  Here are some things to keep in mind when choosing your doctor.

To]]></description> 
             <pubDate>Tue, 13 Sep 2011 9:56:52 -0400</pubDate> 
             <guid>http://www.medicinenet.com/script/main/art.asp?articlekey=47649</guid>
             <author><![CDATA[Melissa Stoppler, M.D.  | MedicineNet.com]]></author> 
             <full><![CDATA[Choosing a new doctor can be a difficult task, but is worth doing right the first time.  Here are some things to keep in mind when choosing your doctor.<br />
<br />
To read further, <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=47649" target="_blank">click here</a>.<br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[You Can Withdraw Your Roth IRA Money]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=135</link> 
             <description><![CDATA[The use of a Roth IRA allows you to have the ability to withdraw at least a portion of your funds for any reason, at any time, without penalty or]]></description> 
             <pubDate>Fri, 09 Sep 2011 9:24:38 -0400</pubDate> 
             <guid>http://www.forbes.com/sites/advisor/2011/09/06/you-can-withdraw-your-roth-ira-money/</guid>
             <author><![CDATA[Jim Blankenship | Forbes]]></author> 
             <full><![CDATA[The use of a Roth IRA allows you to have the ability to withdraw at least a portion of your funds for any reason, at any time, without penalty or tax.  But not all of the funds fit this qualification.  Learn about the ins and outs of Roth IRAs.<br />
<br />
To read further, <a href="http://www.forbes.com/sites/advisor/2011/09/06/you-can-withdraw-your-roth-ira-money/" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[How to Address a Layoff in an Interview]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=134</link> 
             <description><![CDATA[In recent years, many job candidates have faced layoffs.  But how applicants explain their circumstances can be a crucial factor for those who make the hiring decisions.  This]]></description> 
             <pubDate>Thu, 08 Sep 2011 2:28:07 -0400</pubDate> 
             <guid>http://www.businessweek.com/bschools/blogs/mba_admissions/archives/2011/09/how_to_address_a_layoff_in_an_interview.html</guid>
             <author><![CDATA[Geoff Gloeckler | Bloomberg Businessweek  ]]></author> 
             <full><![CDATA[In recent years, many job candidates have faced layoffs.  But how applicants explain their circumstances can be a crucial factor for those who make the hiring decisions.  This article offers some helpful strategies to cope with explaining your period of unemployment to prospective employers. <br />
<br />
To read further, <a href="http://www.businessweek.com/bschools/blogs/mba_admissions/archives/2011/09/how_to_address_a_layoff_in_an_interview.html" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Student Loans: A crisis in waiting?]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=133</link> 
             <description><![CDATA[With the combination of rising tuition costs and a difficult job market, students may be getting themselves into a financially burdening amount of student loan debt. This article seeks to]]></description> 
             <pubDate>Thu, 08 Sep 2011 2:26:00 -0400</pubDate> 
             <guid>http://money.msn.com/saving-money-tips/post.aspx?post=557c0396-01c7-426b-8438-976aac650f27</guid>
             <author><![CDATA[Seth Fiegerman | MainStreet for MSN Money]]></author> 
             <full><![CDATA[With the combination of rising tuition costs and a difficult job market, students may be getting themselves into a financially burdening amount of student loan debt. This article seeks to explain those debts, the effect on the consumer, and also provides some suggestions for success.<br />
<br />
To read further, <a href="http://money.msn.com/saving-money-tips/post.aspx?post=557c0396-01c7-426b-8438-976aac650f27" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Funeral planning: How to avoid paying beyond the grave]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=132</link> 
             <description><![CDATA[Most of us don&rsquo;t like to think about the end of life, but paying in advance for a funeral could make sense.  Not only could it ease the financial]]></description> 
             <pubDate>Tue, 06 Sep 2011 2:36:24 -0400</pubDate> 
             <guid>http://blogs.reuters.com/reuters-money/2011/08/29/funeral-planning-how-to-avoid-paying-beyond-the-grave/</guid>
             <author><![CDATA[Toddi Gutner | Reuters Money]]></author> 
             <full><![CDATA[Most of us don&rsquo;t like to think about the end of life, but paying in advance for a funeral could make sense.  Not only could it ease the financial burden for your loved ones, but the planning documentation clearly indicates your end of life wishes.  This article offers some helpful tips when making funeral preparations.<br />
<br />
To read further, <a href="http://blogs.reuters.com/reuters-money/2011/08/29/funeral-planning-how-to-avoid-paying-beyond-the-grave/" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Half of Americans Projected to Be Obese in 2030  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=131</link> 
             <description><![CDATA[Recent figures from the National Health and Nutrition Examination Survey indicate that half of Americans may be obese by 2030.  Compared with 2010, there could be as many as]]></description> 
             <pubDate>Fri, 02 Sep 2011 9:03:47 -0400</pubDate> 
             <guid>http://www.medpagetoday.com/PrimaryCare/Obesity/28201</guid>
             <author><![CDATA[John Gever | MedPage Today  ]]></author> 
             <full><![CDATA[Recent figures from the National Health and Nutrition Examination Survey indicate that half of Americans may be obese by 2030.  Compared with 2010, there could be as many as 65 million more obese adults twenty years from now.  In addition to the deleterious health effects of obesity, researchers project that medical expenditures alone will be $48 billion to $66 billion higher annually by the year 2030.   <br />
<br />
To read further, <a href="http://www.medpagetoday.com/PrimaryCare/Obesity/28201" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[What that 401(k) loan will cost you]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=130</link> 
             <description><![CDATA[This article presents some of the downfalls of taking out a 401(k) loan.  Saving for retirement is hard enough as it is, so tapping into your savings for a]]></description> 
             <pubDate>Thu, 01 Sep 2011 3:01:00 -0400</pubDate> 
             <guid>http://money.msn.com/saving-money/what-that-401k-loan-will-cost-you-weston.aspx</guid>
             <author><![CDATA[Liz Weston | MSN Money    ]]></author> 
             <full><![CDATA[This article presents some of the downfalls of taking out a 401(k) loan.  Saving for retirement is hard enough as it is, so tapping into your savings for a loan can be damaging to your nest egg. The article also poses questions you should ask yourself before taking out a 401(k) loan.<br />
<br />
To read further, <a href="http://money.msn.com/saving-money/what-that-401k-loan-will-cost-you-weston.aspx" target="_blank">click here</a>.<br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[With prices rising, fewer health insurance options    ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=129</link> 
             <description><![CDATA[An increasing number of Americans are without health insurance, a fact which can be largely attributed to the high costs of coverage.  Young adults who are approaching the age]]></description> 
             <pubDate>Tue, 30 Aug 2011 8:46:26 -0400</pubDate> 
             <guid>http://today.msnbc.msn.com/id/44290327/ns/today-money/t/prices-rising-fewer-health-insurance-options/#.TlvKWF3gf00</guid>
             <author><![CDATA[Eve Tahmincioglu]]></author> 
             <full><![CDATA[An increasing number of Americans are without health insurance, a fact which can be largely attributed to the high costs of coverage.  Young adults who are approaching the age cutoff on parent health plans and those with pre-existing health conditions may find it particularly difficult to afford health insurance.  Experts recommend that consumers shop around before choosing to go without insurance, as there are several options that may be available to them.<br />
<br />
To read further, <a href="http://today.msnbc.msn.com/id/44290327/ns/today-money/t/prices-rising-fewer-health-insurance-options/#.TlvKWF3gf00" target="_blank">click here</a>.<br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[15 Minute Fixes For Credit Scores]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=128</link> 
             <description><![CDATA[Oftentimes, people think there is no quick fix for a credit score. However, this article offers some simple but practical tips on how to raise your credit score.

To read further,]]></description> 
             <pubDate>Mon, 29 Aug 2011 10:35:48 -0400</pubDate> 
             <guid>http://money.msn.com/credit-rating/15-minute-fixes-for-credit-scores-credit-cards.aspx </guid>
             <author><![CDATA[Reported by Allie Johnson | CreditCards.com for MSN Money]]></author> 
             <full><![CDATA[Oftentimes, people think there is no quick fix for a credit score. However, this article offers some simple but practical tips on how to raise your credit score.<br />
<br />
To read further, <a href="http://money.msn.com/credit-rating/15-minute-fixes-for-credit-scores-credit-cards.aspx " target="_blank">click here</a>.<br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[The best and worst times (financially) to get divorced  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=127</link> 
             <description><![CDATA[As emotionally draining as divorce can be, it can also have a devastating financial impact.  Certain factors may influence the financial effects of divorce.  Before you proceed with]]></description> 
             <pubDate>Fri, 26 Aug 2011 8:49:03 -0400</pubDate> 
             <guid>http://today.msnbc.msn.com/id/44035904/ns/today-money/#.TlaFwF3gf00</guid>
             <author><![CDATA[Angie Mohr | Investopedia for MSNBC  ]]></author> 
             <full><![CDATA[As emotionally draining as divorce can be, it can also have a devastating financial impact.  Certain factors may influence the financial effects of divorce.  Before you proceed with your divorce, you might wish to consider the value of your home, your credit score, and your family situation, to name a few. <br />
<br />
To read further, <a href="http://today.msnbc.msn.com/id/44035904/ns/today-money/#.TlaFwF3gf00" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Why 401(k) Plans Are Doomed From the Start]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=126</link> 
             <description><![CDATA[401(k) plan participants and plan sponsors make mistakes that prevent most retirement plans from providing meaningful retirement income.  This article lists some mistakes various participants make with their 401(k)s,]]></description> 
             <pubDate>Fri, 19 Aug 2011 8:51:26 -0400</pubDate> 
             <guid>http://www.forbes.com/sites/feeonlyplanner/2011/08/16/why-401k-plans-are-doomed-from-the-start/</guid>
             <author><![CDATA[Michael Chamberlain | Forbes]]></author> 
             <full><![CDATA[401(k) plan participants and plan sponsors make mistakes that prevent most retirement plans from providing meaningful retirement income.  This article lists some mistakes various participants make with their 401(k)s, including lack of participation and understanding.  It also cites certain actions that plan sponsors take that might prevent participants from earning critical income for their retirement portfolios. <br />
<br />
To read further, <a href="http://www.forbes.com/sites/feeonlyplanner/2011/08/16/why-401k-plans-are-doomed-from-the-start/" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Demystifying your credit scores]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=125</link> 
             <description><![CDATA[This article addresses the ins and outs of credit scores and their meanings.  It breaks down how they are calculated and also how banks rank scores. Lastly, the article]]></description> 
             <pubDate>Thu, 18 Aug 2011 10:46:01 -0400</pubDate> 
             <guid>http://money.msn.com/credit-rating/demystifying-your-credit-scores-cardratings.aspx</guid>
             <author><![CDATA[Reported by Joe Taylor Jr. for CardRatings.com | MSN Money]]></author> 
             <full><![CDATA[This article addresses the ins and outs of credit scores and their meanings.  It breaks down how they are calculated and also how banks rank scores. Lastly, the article offers suggestions for best credit cards based on your score.<br />
<br />
To read further, <a href="http://money.msn.com/credit-rating/demystifying-your-credit-scores-cardratings.aspx" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[What health care reform is (and isn’t) doing now  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=124</link> 
             <description><![CDATA[Health care reform was signed into law over a year ago.  Full coverage of preventive care, easier access to coverage for people with pre-existing conditions, and some relief from]]></description> 
             <pubDate>Wed, 17 Aug 2011 9:51:12 -0400</pubDate> 
             <guid>http://money.cnn.com/2011/08/02/magazines/moneymag/health_care_reform.moneymag/index.htm</guid>
             <author><![CDATA[Amanda Gengler | CNN Money ]]></author> 
             <full><![CDATA[Health care reform was signed into law over a year ago.  Full coverage of preventive care, easier access to coverage for people with pre-existing conditions, and some relief from the &ldquo;doughnut hole&rdquo; in Medicare prescription drug coverage are some of the law provisions.  This piece answers some of the questions people might have regarding these recent changes.<br />
<br />
To read further, <a href="http://money.cnn.com/2011/08/02/magazines/moneymag/health_care_reform.moneymag/index.htm" target="_blank">click here</a>.<br />]]></full> 
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                <item> 
             <title><![CDATA[Where to find the best savings rate  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=123</link> 
             <description><![CDATA[We&rsquo;re all searching for ways to maximize our savings.  As savings rates have hovered around record lows for the past two years, it&rsquo;s becoming even more important to find]]></description> 
             <pubDate>Fri, 12 Aug 2011 8:56:41 -0400</pubDate> 
             <guid>http://money.cnn.com/2011/07/27/pf/savings_rates.moneymag/index.htm</guid>
             <author><![CDATA[Tali Yahalom | CNN Money   ]]></author> 
             <full><![CDATA[We&rsquo;re all searching for ways to maximize our savings.  As savings rates have hovered around record lows for the past two years, it&rsquo;s becoming even more important to find ways to earn more on our investments.  With the options listed in the article, you don&rsquo;t have to sacrifice liquidity or put your principal at risk. <br />
<br />
To read further, <a href="http://money.cnn.com/2011/07/27/pf/savings_rates.moneymag/index.htm" target="_blank">click here</a>.<br />]]></full> 
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                <item> 
             <title><![CDATA[Roth IRAs for Teens]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=122</link> 
             <description><![CDATA[Often, retirement is furthest from the minds of teenagers as they earn money from their summer and part-time jobs.  But teenagers have the ability to earn hundreds or even]]></description> 
             <pubDate>Thu, 11 Aug 2011 8:52:20 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424053111904800304576471932731567342.html?mod=WSJ_RetirementPlanning_MoreHeadlines</guid>
             <author><![CDATA[Karen Damato | The Wall Street Journal]]></author> 
             <full><![CDATA[Often, retirement is furthest from the minds of teenagers as they earn money from their summer and part-time jobs.  But teenagers have the ability to earn hundreds or even thousands of dollars that could be put to good use in a Roth IRA.  Parents or adults can use this as an opportunity to place teens on the right course toward their later years by benefiting from the appreciation of compounding investments.<br />
<br />
To read further, <a href="http://online.wsj.com/article/SB10001424053111904800304576471932731567342.html?mod=WSJ_RetirementPlanning_MoreHeadlines" target="_blank">click here</a>.<br />]]></full> 
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                <item> 
             <title><![CDATA[Debt ceiling and your money: Now it's getting personal]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=121</link> 
             <description><![CDATA[This article analyzes the possible effects the U.S. credit downgrade could have on your money.  Many personal financial issues are discussed in this context, including credit cards, mortgage rates,]]></description> 
             <pubDate>Tue, 09 Aug 2011 3:46:30 -0400</pubDate> 
             <guid>http://money.cnn.com/2011/07/28/pf/debt_ceiling_impact/index.htm</guid>
             <author><![CDATA[Jessica Dickler | CNN Money]]></author> 
             <full><![CDATA[This article analyzes the possible effects the U.S. credit downgrade could have on your money.  Many personal financial issues are discussed in this context, including credit cards, mortgage rates, student loans, car loans,  and personal investments.<br />
<br />
To read further, <a target="_blank" href="http://money.cnn.com/2011/07/28/pf/debt_ceiling_impact/index.htm">click here</a>.<br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Stern Advice:  Last-minute ways to find cash for college]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=120</link> 
             <description><![CDATA[Although costs are constantly increasing, it seems that earning a college degree is fundamental to higher earning potential.  College graduates should expect to earn $1 million more over their]]></description> 
             <pubDate>Mon, 08 Aug 2011 9:34:56 -0400</pubDate> 
             <guid>http://www.reuters.com/article/2011/08/03/us-column-personalfinance-idUSTRE7723CF20110803</guid>
             <author><![CDATA[Linda Stern | Reuters]]></author> 
             <full><![CDATA[Although costs are constantly increasing, it seems that earning a college degree is fundamental to higher earning potential.  College graduates should expect to earn $1 million more over their careers than those who did not obtain their higher education degrees.  For parents and students wondering how they can possibly pull together the necessary money to pay for college, this article offers some helpful last-minute suggestions.<br />
<br />
To read further, <a href="http://www.reuters.com/article/2011/08/03/us-column-personalfinance-idUSTRE7723CF20110803" target="_blank">click here</a>.<br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Youths find credit boosts self-esteem]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=119</link> 
             <description><![CDATA[This article discusses research that may explain some of the reasons why so many people struggle with debt. As a young 20 year old, many people feel it&rsquo;s important to]]></description> 
             <pubDate>Fri, 05 Aug 2011 9:09:24 -0400</pubDate> 
             <guid>http://money.msn.com/credit-rating/youths-find-credit-boosts-self-esteem-creditcards.aspx</guid>
             <author><![CDATA[reported by Kelly Dilworth for CreditCards.com | MSN Money]]></author> 
             <full><![CDATA[This article discusses research that may explain some of the reasons why so many people struggle with debt. As a young 20 year old, many people feel it&rsquo;s important to take on student loan and credit card debt, for various reasons.  The road to debt is analyzed here in the context of this new research.<br />
<br />
To read further, <a href="http://money.msn.com/credit-rating/youths-find-credit-boosts-self-esteem-creditcards.aspx" target="_blank">click here</a>.<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[PINs That Needle Families]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=118</link> 
             <description><![CDATA[Many people today live their financial lives through the internet.  Keystrokes can lock out finances but when people die, their passwords often go with them, along with access to]]></description> 
             <pubDate>Thu, 04 Aug 2011 3:15:59 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424052702304567604576456182693233372.html?mod=WSJ_FamilyFinance_MoreHeadlines</guid>
             <author><![CDATA[Family Value | The Wall Street Journal  ]]></author> 
             <full><![CDATA[Many people today live their financial lives through the internet.  Keystrokes can lock out finances but when people die, their passwords often go with them, along with access to their digital assets.  Some financial planners are starting to collect their clients' online-account information to help their clients' families upon the passing of clients. <br />
<br />
To read further, <a target="_blank" href="http://online.wsj.com/article/SB10001424052702304567604576456182693233372.html?mod=WSJ_FamilyFinance_MoreHeadlines">click here</a>.<br />]]></full> 
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                <item> 
             <title><![CDATA[Private Firms Now Offering Riskier Home Loans to Borrowers ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=117</link> 
             <description><![CDATA[Some private investment firms have begun making home loans to people who are unable to get them from banks. This article discusses both sides of the issue. The firms claim]]></description> 
             <pubDate>Wed, 27 Jul 2011 11:16:35 -0400</pubDate> 
             <guid>http://www.smartmoney.com/borrow/home-loans/riskier-loans-make-a-comeback-as-private-firms-take-the-field-1310508245451/?link=SM_hp_borrow</guid>
             <author><![CDATA[Annamaria Andriotis | The Wall Street Journal    ]]></author> 
             <full><![CDATA[Some private investment firms have begun making home loans to people who are unable to get them from banks. This article discusses both sides of the issue. The firms claim they are being cautious lending to those who don&rsquo;t meet bank standards.  Critics are comparing this to the subprime mortgage lending associated with the recent recession.  <br />
<br />
To read further, <a href="http://www.smartmoney.com/borrow/home-loans/riskier-loans-make-a-comeback-as-private-firms-take-the-field-1310508245451/?link=SM_hp_borrow" target="_blank">click here.<br />
</a><br />]]></full> 
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                <item> 
             <title><![CDATA[Drug prices to plummet in wave of expiring patents  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=116</link> 
             <description><![CDATA[With a wave of expiring drug patents between now and 2016, the next 14 months will bring generic versions of several top-selling drugs.  It is estimated that at least]]></description> 
             <pubDate>Wed, 27 Jul 2011 11:15:32 -0400</pubDate> 
             <guid>http://www.clarionledger.com/article/20110725/BIZ/110725005/Drug-prices-plummet-wave-expiring-patents?odyssey=mod|newswell|text|Home|p</guid>
             <author><![CDATA[The Associated Press]]></author> 
             <full><![CDATA[With a wave of expiring drug patents between now and 2016, the next 14 months will bring generic versions of several top-selling drugs.  It is estimated that at least 15 percent of the population is using at least one of the drugs that will be affected by these changes.  Doctors hope that this will increase the number of people who are able to afford their prescription medications. <br />
<br />
To read further, <a href="http://www.clarionledger.com/article/20110725/BIZ/110725005/Drug-prices-plummet-wave-expiring-patents?odyssey=mod|newswell|text|Home|p" target="_blank">Click Here</a><br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[You Need a Plan to Boost Retirement Income  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=115</link> 
             <description><![CDATA[Help your parents develop the proper mix of stocks and bonds and cash for their retirement portfolios.  Generating the most income in the safest fashion from a nest egg]]></description> 
             <pubDate>Wed, 27 Jul 2011 11:14:35 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424053111903461104576464483281869542.html?mod=WSJ_RetirementPlanning_MoreHeadlines</guid>
             <author><![CDATA[Jeff D. Opdyke | The Wall Street Journal]]></author> 
             <full><![CDATA[Help your parents develop the proper mix of stocks and bonds and cash for their retirement portfolios.  Generating the most income in the safest fashion from a nest egg is the holy grail of retirement income planning.  While these tips focus on managing the finances of elderly parents, many of the issues apply to your own retirement planning as well.<br />
<br />
For further reading, <a href="http://online.wsj.com/article/SB10001424053111903461104576464483281869542.html?mod=WSJ_RetirementPlanning_MoreHeadlines" target="_blank">Click Here</a><br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Surprising New Views on Retirement]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=114</link> 
             <description><![CDATA[A surprising study conducted by Harris Interactive reveals that Americans&rsquo; attitudes on their future retirements are mostly positive.  And 81% of participants believe that the recession has taught them]]></description> 
             <pubDate>Thu, 21 Jul 2011 11:28:45 -0400</pubDate> 
             <guid>http://www.thestreet.com/story/11188740/1/surprising-new-views-on-retirement.html?cm_ven=GOOGLEN</guid>
             <author><![CDATA[Douglas Mcintyre | DailyFinance]]></author> 
             <full><![CDATA[A surprising study conducted by Harris Interactive reveals that Americans&rsquo; attitudes on their future retirements are mostly positive.  And 81% of participants believe that the recession has taught them some valuable lessons, such as working longer and saving more money.  A related finding also indicated that 70% of those polled expect that their children will need financial assistance, so they&rsquo;ll need to balance their retirement income with this new trend.     <br />
<br />
To Read More, <a href="http://www.thestreet.com/story/11188740/1/surprising-new-views-on-retirement.html?cm_ven=GOOGLEN" target="_blank">Click Here</a><br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[What You Should Know About Home Equity Lines of Credit]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=113</link> 
             <description><![CDATA[This article from the Federal Reserve Board provides a general overview of home equity lines of credit. In addition to basic definitions, details are discussed such as how to buy,]]></description> 
             <pubDate>Thu, 21 Jul 2011 11:27:48 -0400</pubDate> 
             <guid>http://www.federalreserve.gov/pubs/equity/equity_english.htm</guid>
             <author><![CDATA[Federal Reserve Board]]></author> 
             <full><![CDATA[This article from the Federal Reserve Board provides a general overview of home equity lines of credit. In addition to basic definitions, details are discussed such as how to buy, how much it costs, how to pay it back, and home equity lines of credit vs. second mortgages. This is a great resource for anyone interested in home equity lines of credit.   <br />
<br />
To Read More, <a href="http://www.federalreserve.gov/pubs/equity/equity_english.htm" target="_blank">Click Here</a><br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[401(k) Law Suppresses Saving for Retirement]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=112</link> 
             <description><![CDATA[A 2006 law designed to boost employees' retirement-savings is having the opposite effect for some people.  The measure that allowed companies to automatically enroll workers in their 401(k) plan,]]></description> 
             <pubDate>Thu, 21 Jul 2011 11:26:36 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424052702303365804576430153643522780.html?mod=WSJ_RetirementPlanning_MoreHeadlines</guid>
             <author><![CDATA[Anne Tergesen | The Wall Street Journal]]></author> 
             <full><![CDATA[A 2006 law designed to boost employees' retirement-savings is having the opposite effect for some people.  The measure that allowed companies to automatically enroll workers in their 401(k) plan, rather than require employees to sign up on their own, is showing lower contribution rates.  More than two-thirds of companies set contribution rates at 3% of salary or less, unless an employee chooses otherwise.  That's far below the 5% to 10% rates participants typically elect when left to their own devices.  Simply put, people are opting for less.<br />
<br />
To Read More,<a href="http://online.wsj.com/article/SB10001424052702303365804576430153643522780.html?mod=WSJ_RetirementPlanning_MoreHeadlines" target="_blank"> Click Here</a><br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Simplify Your Retirement Savings]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=111</link> 
             <description><![CDATA[Deciding how to invest your retirement savings can be a confusing process.  Fortunately, options such as target-date funds can simplify the investment process.  But it&rsquo;s important to examine]]></description> 
             <pubDate>Thu, 14 Jul 2011 3:21:41 -0400</pubDate> 
             <guid>http://money.cnn.com/2011/07/08/pf/expert/company_retirement_plan.moneymag/</guid>
             <author><![CDATA[Walter Updegrave | CNN Money]]></author> 
             <full><![CDATA[Deciding how to invest your retirement savings can be a confusing process.  Fortunately, options such as target-date funds can simplify the investment process.  But it&rsquo;s important to examine your different options to make sure you are choosing the fund that most closely matches your investment objectives.          <br />
<br />
For further reading, <a href="http://money.cnn.com/2011/07/08/pf/expert/company_retirement_plan.moneymag/" target="_blank">Click here!</a><br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Why It Doesn’t Pay To Save]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=110</link> 
             <description><![CDATA[Our grandparents hid money under their mattresses in times of economic downtown.  We laugh at that now, but people are essentially doing the same thing when they put a]]></description> 
             <pubDate>Thu, 14 Jul 2011 3:20:20 -0400</pubDate> 
             <guid>http://www.cnbc.com/id/39780531</guid>
             <author><![CDATA[Jeanine Skowronski | CNBC Stock Market News]]></author> 
             <full><![CDATA[Our grandparents hid money under their mattresses in times of economic downtown.  We laugh at that now, but people are essentially doing the same thing when they put a majority of their monthly funds into basic savings accounts.  There are ways to make money with low risk alternatives. This article explores some of those alternatives that could not only help you survive the economic down-turn, but potentially profit during it.<br />
<br />
For further reading, <a href="http://www.cnbc.com/id/39780531" target="_blank">Click here!</a><br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Credit Card Rewards Could Be Hard to Collect ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=109</link> 
             <description><![CDATA[Credit card companies are looking to win back business after the recent recession.  Oftentimes, they use rewards to accomplish this.  However, it is important to read the fine]]></description> 
             <pubDate>Thu, 14 Jul 2011 3:19:21 -0400</pubDate> 
             <guid>http://www.usatoday.com/money/perfi/columnist/block/2011-05-09-credit-card-rewards_n.htm</guid>
             <author><![CDATA[Sandra Block | USA Today]]></author> 
             <full><![CDATA[Credit card companies are looking to win back business after the recent recession.  Oftentimes, they use rewards to accomplish this.  However, it is important to read the fine print with the rewards, and make sure you pay off your balance to avoid the high interest rates that accompany reward cards.  This article explores some of the rewards offers that are out there and discusses possible pitfalls of rewards cards.<br />
<br />
For further reading, <a href="http:// http://www.usatoday.com/money/perfi/columnist/block/2011-05-09-credit-card-rewards_n.htm" target="_blank">Click Here!<br />
</a><br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Do Surviving Spouses Have Protection From Reverse Mortgages?  Make sure spouse is also named on the mortgage]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=108</link> 
             <description><![CDATA[Reverse mortgages can be a useful tool for older people looking for ways to access extra cash.  However, it is important to understand some of the potential traps that]]></description> 
             <pubDate>Wed, 06 Jul 2011 9:22:11 -0400</pubDate> 
             <guid>http://www.aarp.org/money/credit-loans-debt/info-06-2011/reverse-mortgage-protection-for-surviving-spouses.html</guid>
             <author><![CDATA[Carole Fleck | AARP]]></author> 
             <full><![CDATA[Reverse mortgages can be a useful tool for older people looking for ways to access extra cash.  However, it is important to understand some of the potential traps that come along with reverse mortgages. This story of Robert and Ophelia delves into one of those potential pitfalls.<br />
<br />
To read more, <a href="http://www.aarp.org/money/credit-loans-debt/info-06-2011/reverse-mortgage-protection-for-surviving-spouses.html" target="_blank">Click Here<br />
</a><br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Banking on Yourself:  Is It Ever OK to Raid Your 401(k)?  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=107</link> 
             <description><![CDATA[In a society already consumed with debt, should Americans really tap a loan resource as important as their 401(K)s?  It may sound crazy, but there is a case to]]></description> 
             <pubDate>Wed, 06 Jul 2011 9:21:21 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424052702304231204576405902730644780.html?mod=WSJ_Investing_MoreHeadlines</guid>
             <author><![CDATA[Jason Zweig | The Wall Street Journal]]></author> 
             <full><![CDATA[In a society already consumed with debt, should Americans really tap a loan resource as important as their 401(K)s?  It may sound crazy, but there is a case to be made for borrowing from your 401(k) account in certain circumstances.<br />
<br />
To read more,<a href="http://online.wsj.com/article/SB10001424052702304231204576405902730644780.html?mod=WSJ_Investing_MoreHeadlines" target="_blank"> Click Here</a><br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Got retirement plans?  Your spouse may disagree]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=106</link> 
             <description><![CDATA[A recent survey that asked married couples about their retirement plans uncovers some surprising discord among couples.  Key findings show that many couples commonly disagree about when they&rsquo;ll retire]]></description> 
             <pubDate>Wed, 06 Jul 2011 9:20:17 -0400</pubDate> 
             <guid>  http://www.marketwatch.com/story/got-retirement-plans-your-spouse-may-disagree-2011-06-29?link=MW_latest_news</guid>
             <author><![CDATA[Andrea Coombes | Market Watch ]]></author> 
             <full><![CDATA[A recent survey that asked married couples about their retirement plans uncovers some surprising discord among couples.  Key findings show that many couples commonly disagree about when they&rsquo;ll retire or where they&rsquo;ll live in retirement, and the study also revealed that women felt &ldquo;less knowledgeable than the men did about financing retirement.&rdquo;   <br />
<br />
<br />
To see more,<a href="http://www.marketwatch.com/story/got-retirement-plans-your-spouse-may-disagree-2011-06-29?link=MW_latest_news" target="_blank"> Click Here</a><br />
<br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Has the Retirement Nest Egg Cracked?]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=105</link> 
             <description><![CDATA[Recent findings from the &ldquo;COUNTRY Financial Security Index&rdquo; indicate that Americans&rsquo; confidence that they&rsquo;ll have adequate retirement savings has hit an all-time low.  In contrast, the study also revealed]]></description> 
             <pubDate>Wed, 29 Jun 2011 11:04:29 -0400</pubDate> 
             <guid> http://www.prnewswire.com/news-releases/has-the-retirement-nest-egg-cracked-124267334.html</guid>
             <author><![CDATA[PRNewswire]]></author> 
             <full><![CDATA[Recent findings from the &ldquo;COUNTRY Financial Security Index&rdquo; indicate that Americans&rsquo; confidence that they&rsquo;ll have adequate retirement savings has hit an all-time low.  In contrast, the study also revealed that for the first time, women are more confident than men in nearly all aspects of their financial security.<br />
<br />
<a name="_http:__www.prnewswire.com_news-releases_has-the-retirement-nest-egg-cracked-124267334.html">To read more, Click Here </a><br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Loans From 401(k)s Are on the Rise As Investors Tap Their Inner Banker]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=104</link> 
             <description><![CDATA[The 401(k) plan, which was once a &ldquo;lender of last resort,&rdquo; is becoming an increasingly popular way for many Americans to borrow money.  This article highlights what you need]]></description> 
             <pubDate>Wed, 29 Jun 2011 11:03:29 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424052702304563104576363412803516824.html?mod=WSJ_RetirementPlanning_MoreHeadlines</guid>
             <author><![CDATA[Jilian Mincer]]></author> 
             <full><![CDATA[The 401(k) plan, which was once a &ldquo;lender of last resort,&rdquo; is becoming an increasingly popular way for many Americans to borrow money.  This article highlights what you need to know if you&rsquo;re going to take out a loan from your 401(k) and how to make sure it&rsquo;s done with caution.<br />
<br />
<a name="http:__online.wsj.com_article_SB10001424052702304563104576363412803516824.html_mod_WSJ_RetirementPlanning_MoreHeadlines">To read more, Click Here</a><br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Is a debt-free life the best way to live?]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=103</link> 
             <description><![CDATA[Debt is not necessarily a bad thing.  This article presents questions you should ask yourself before taking on certain types of debt.  Examples of good debt and bad]]></description> 
             <pubDate>Wed, 29 Jun 2011 11:02:19 -0400</pubDate> 
             <guid>http://money.cnn.com/2011/06/17/pf/expert/debt_free.moneymag/index.htm?iid=H_M_News</guid>
             <author><![CDATA[Walter Updegrave]]></author> 
             <full><![CDATA[Debt is not necessarily a bad thing.  This article presents questions you should ask yourself before taking on certain types of debt.  Examples of good debt and bad debt decisions are outlined throughout.<br />
<a name="http:__money.cnn.com_2011_06_17_pf_expert_debt_free.moneymag_index.htm_iid_H_M_News"><br />
To read more, Click Here</a><br />
<br />]]></full> 
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             <title><![CDATA[Proposal to Protect Retirees’ Nest Eggs Becomes Latest Lobbying Flashpoint]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=101</link> 
             <description><![CDATA[Consumer advocates and retiree groups are supporting the latest proposals by lawmakers to protect investors&rsquo; retirement savings.  The proposed legislation is described as a &ldquo;matter of fundamental fairness&rdquo; for]]></description> 
             <pubDate>Tue, 14 Jun 2011 2:20:30 -0400</pubDate> 
             <guid>http://www.huffingtonpost.com/2011/06/14/retirement-proposal_n_876343.htm</guid>
             <author><![CDATA[Marcus Baram]]></author> 
             <full><![CDATA[Consumer advocates and retiree groups are supporting the latest proposals by lawmakers to protect investors&rsquo; retirement savings.  The proposed legislation is described as a &ldquo;matter of fundamental fairness&rdquo; for investors; the person who is responsible for portfolio losses should be held accountable.  The sheer amount of money at stake has made this an issue of intense debate.<br />
<br />
<a target="_blank" href="http://www.huffingtonpost.com/2011/06/14/retirement-proposal_n_876343.html">To read more, Click Here:</a><br />
<br />]]></full> 
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             <title><![CDATA[Long-Term Care:  Don’t Let the Cost Blow Up Your Retirement]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=99</link> 
             <description><![CDATA[In addition to planning for your retirement, it&rsquo;s also critical to prepare for &ldquo;potentially ruinous long-term care expenses.&rdquo;  Giving yourself a cushion to pay for long-term care could keep]]></description> 
             <pubDate>Tue, 14 Jun 2011 2:20:20 -0400</pubDate> 
             <guid> http://moneywatch.bnet.com/retirement-planning/blog/money-life/long-term-care-dont-let-the-cost-blow-up-your-retirement/4264/</guid>
             <author><![CDATA[Steve Vernon]]></author> 
             <full><![CDATA[In addition to planning for your retirement, it&rsquo;s also critical to prepare for &ldquo;potentially ruinous long-term care expenses.&rdquo;  Giving yourself a cushion to pay for long-term care could keep your retirement assets intact and shield your family from the burden and cost of care.<br />
<br />
<br />
<a target="_blank" href="http://moneywatch.bnet.com/retirement-planning/blog/money-life/long-term-care-dont-let-the-cost-blow-up-your-retirement/4264/">To read more, Click Here:</a><br />
<br />]]></full> 
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             <title><![CDATA[Health savings account plans see brisk growth]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=98</link> 
             <description><![CDATA[Recently-released data from a census conducted by America&rsquo;s Health Insurance Plans reveals that enrollment in high-deductible health insurance plans has grown by 87% since January 2008. Health Savings Accounts, or]]></description> 
             <pubDate>Tue, 14 Jun 2011 2:20:00 -0400</pubDate> 
             <guid>http://www.forbes.com/feeds/ap/2011/06/14/business-us-health-savings-accounts-growth_8515629.html</guid>
             <author><![CDATA[Tom Murphy]]></author> 
             <full><![CDATA[Recently-released data from a census conducted by America&rsquo;s Health Insurance Plans reveals that enrollment in high-deductible health insurance plans has grown by 87% since January 2008. Health Savings Accounts, or HSAs, entered the market in 2004 and are becoming a popular solution for employers to manage the ever-increasing costs of health care.<br />
<br />
<br />
<a target="_blank" href="http://www.forbes.com/feeds/ap/2011/06/14/business-us-health-savings-accounts-growth_8515629.html">To read more, Click Here:</a><br />
<br />]]></full> 
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             <title><![CDATA[Do Your Credit Reports Contain These Three Red Flags?]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=100</link> 
             <description><![CDATA[Even a good credit rating may not guarantee success in getting a loan application approved.  This article presents 3 red flags that may cause lenders to think twice about]]></description> 
             <pubDate>Mon, 13 Jun 2011 12:00:00 -0400</pubDate> 
             <guid>http://www.walletpop.com/2011/06/13/do-your-credit-reports-contain-these-three-red-flags/</guid>
             <author><![CDATA[Lynnette Khalfani-Cox]]></author> 
             <full><![CDATA[Even a good credit rating may not guarantee success in getting a loan application approved.  This article presents 3 red flags that may cause lenders to think twice about extending credit.<br />
<br />
<a target="_blank" href="http://www.walletpop.com/2011/06/13/do-your-credit-reports-contain-these-three-red-flags/">To read more, Click Here:</a><br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Things to Consider When Contemplating Estate Planning]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=92</link> 
             <description><![CDATA[Many people delay estate planning, but it&rsquo;s wise to have a well-crafted plan in place. Appointing an executor (or personal representative) to handle your finances after your death and setting]]></description> 
             <pubDate>Mon, 06 Jun 2011 12:00:00 -0400</pubDate> 
             <guid>http://uspolitics.einnews.com/247pr/217257</guid>
             <author><![CDATA[Provided by Polizzotto & Polizzotto]]></author> 
             <full><![CDATA[Many people delay estate planning, but it&rsquo;s wise to have a well-crafted plan in place. Appointing an executor (or personal representative) to handle your finances after your death and setting up a trust can offer you some peace of mind. <br />
<br />
To read more:&nbsp;<a href="http://uspolitics.einnews.com/247pr/217257" target="_blank"><strong>CLICK&nbsp;HERE</strong></a>.]]></full> 
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                <item> 
             <title><![CDATA[I’m 70.  Should I put more money into annuities?]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=91</link> 
             <description><![CDATA[When deciding whether to increase your annuities stake, you may wish to consider how much retirement income you&rsquo;ll need overall. It&rsquo;s also important to think about what percentage of your]]></description> 
             <pubDate>Fri, 03 Jun 2011 12:00:00 -0400</pubDate> 
             <guid>http://money.cnn.com/2011/06/03/pf/expert/retirement_saving_annuities.moneymag/?section=money_latest </guid>
             <author><![CDATA[Walter Updegrave]]></author> 
             <full><![CDATA[When deciding whether to increase your annuities stake, you may wish to consider how much retirement income you&rsquo;ll need overall. It&rsquo;s also important to think about what percentage of your income you want from assured sources or from diversified portfolios of stocks, bonds, and cash.<br />
<br />
To read more, <a href="http://money.cnn.com/2011/06/03/pf/expert/retirement_saving_annuities.moneymag/?section=money_latest " target="_blank"><strong>CLICK&nbsp;HERE</strong></a>.]]></full> 
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             <title><![CDATA[New College Grads Value Health Insurance More than Parents May Realize]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=89</link> 
             <description><![CDATA[Health insurance is important, and an increasing number of recent college graduates are realizing that. A recent survey revealed that nearly half of college grads would be willing to take]]></description> 
             <pubDate>Wed, 01 Jun 2011 12:00:00 -0400</pubDate> 
             <guid>http://www.dailyfinance.com/2011/06/01/new-college-grads-value-health-insurance-more-than-parents-may-r/</guid>
             <author><![CDATA[Dawn Kawamoto]]></author> 
             <full><![CDATA[Health insurance is important, and an increasing number of recent college graduates are realizing that. A recent survey revealed that nearly half of college grads would be willing to take a job they didn&rsquo;t like if it meant they&rsquo;d have health insurance. This article also discusses rules for keeping adult children on their parents&rsquo; health plans and alternative insurance options.<br />
<br />
To read the entire article, <a target="_blank" href="http://www.dailyfinance.com/2011/06/01/new-college-grads-value-health-insurance-more-than-parents-may-r/"><strong>CLICK&nbsp;HERE.</strong></a>]]></full> 
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                <item> 
             <title><![CDATA[How Store Credit Cards Trap You]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=88</link> 
             <description><![CDATA[Store specific credit cards can often be a debt trap to consumers. They are relatively easy to obtain but are often accompanied by high interest rates. This article addresses some]]></description> 
             <pubDate>Tue, 31 May 2011 12:00:00 -0400</pubDate> 
             <guid>http://money.msn.com/credit-cards/how-store-credit-cards-trap-you-investopedia.aspx</guid>
             <author><![CDATA[Rachel Brown ]]></author> 
             <full><![CDATA[Store specific credit cards can often be a debt trap to consumers. They are relatively easy to obtain but are often accompanied by high interest rates. This article addresses some of the pitfalls of store credit cards and offers some tips on how to use them wisely.<br />
<br />
To read the entire article,&nbsp;<a target="_blank" href="http://money.msn.com/credit-cards/how-store-credit-cards-trap-you-investopedia.aspx"><strong>CLICK HERE</strong></a>:&nbsp;]]></full> 
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             <title><![CDATA[How big does your 401(k) need to be?]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=102</link> 
             <description><![CDATA[Saving enough for retirement is a top financial concern.  But how much do you need to save?  There are some points you&rsquo;ll want to consider, which revolve around]]></description> 
             <pubDate>Tue, 24 May 2011 12:00:00 -0400</pubDate> 
             <guid>http://money.msn.com/retirement-investment/how-big-does-your-401k-need-to-be-usnews.aspx</guid>
             <author><![CDATA[Roger Wohlner]]></author> 
             <full><![CDATA[Saving enough for retirement is a top financial concern.  But how much do you need to save?  There are some points you&rsquo;ll want to consider, which revolve around the kind of lifestyle you hope to have in retirement.  <br />
<br />
<a href="http://money.msn.com/retirement-investment/how-big-does-your-401k-need-to-be-usnews.aspx" target="_blank">Click Here:<br />
</a><br />]]></full> 
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                <item> 
             <title><![CDATA[Finding the Patient in a Sea of Guidelines]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=87</link> 
             <description><![CDATA[Chen argues that it is possible to create more personalized guidelines for treating patients, &nbsp;that not only improve care but save money as well.&nbsp; Using technology and mathematical modeling, doctors]]></description> 
             <pubDate>Fri, 20 May 2011 12:00:00 -0400</pubDate> 
             <guid>http://well.blogs.nytimes.com/2011/05/19/finding-the-patient-in-a-sea-of-guidelines/?ref=health</guid>
             <author><![CDATA[PAULINE W. CHEN, M.D., NY Times]]></author> 
             <full><![CDATA[Chen argues that it is possible to create more personalized guidelines for treating patients, &nbsp;that not only improve care but save money as well.&nbsp; Using technology and mathematical modeling, doctors will be better able to factor in specific risk factors.&nbsp; <br />
<br />
For more information, or to read the entire article, <a target="_blank" href="http://well.blogs.nytimes.com/2011/05/19/finding-the-patient-in-a-sea-of-guidelines/?ref=health"><strong>Click Here</strong></a>. <br />]]></full> 
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                <item> 
             <title><![CDATA[5 Characteristics of a Good 401(k) Plan  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=90</link> 
             <description><![CDATA[What separates a good 401(k) plan from the rest? There are a few key features you should know about, which can impact the success of your retirement. Make sure you]]></description> 
             <pubDate>Mon, 09 May 2011 12:00:00 -0400</pubDate> 
             <guid>http://money.usnews.com/money/blogs/the-smarter-mutual-fund-investor/2011/05/09/5-characteristics-of-a-good-401k-plan</guid>
             <author><![CDATA[Roger Wohlner]]></author> 
             <full><![CDATA[What separates a good 401(k) plan from the rest? There are a few key features you should know about, which can impact the success of your retirement. Make sure you know what characteristics to look for in your plan.<br />
<br />
To read the entire article:&nbsp; <a target="_blank" href="http://money.usnews.com/money/blogs/the-smarter-mutual-fund-investor/2011/05/09/5-characteristics-of-a-good-401k-plan"><strong>CLICK&nbsp;HERE</strong></a>.]]></full> 
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             <title><![CDATA[Containing the Costs of Pet Care ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=86</link> 
             <description><![CDATA[Pets quickly become part of the family.&nbsp;&nbsp;Paying for their care can be expensive.&nbsp; This article provides ideas for ways to keep pets' health care costs in check, including:&nbsp;

  ]]></description> 
             <pubDate>Mon, 02 May 2011 12:00:00 -0400</pubDate> 
             <guid>http://www.nytimes.com/2011/04/30/health/30patient.html?src=me&amp;ref=health</guid>
             <author><![CDATA[Walecia Conrad - NY Times]]></author> 
             <full><![CDATA[Pets quickly become part of the family.&nbsp;&nbsp;Paying for their care can be expensive.&nbsp; This article provides ideas for ways to keep pets' health care costs in check, including:&nbsp;<br />
<ul>
    <li>LOW-COST ALTERNATIVES</li>
    <li>THE&nbsp;RIGHT&nbsp;VACCINES</li>
    <li>A HEALTHY DIET</li>
    <li>DRUG DISCOUNTS</li>
    <li>CONSIDER INSURANCE</li>
</ul>
<br />
For more information, or to read the entire article: <a target="_blank" href="http://www.nytimes.com/2011/04/30/health/30patient.html?src=me&amp;ref=health"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
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                <item> 
             <title><![CDATA[What to Do When You Can Not Read the Fine Print ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=85</link> 
             <description><![CDATA[As people age, the lens of the eye becomes harder and less elastic; leading to a&nbsp;gradual worsening of the ability to focus on objects up close.&nbsp;&nbsp;This is&nbsp;called presbyopia. 

This article]]></description> 
             <pubDate>Mon, 04 Apr 2011 12:00:00 -0400</pubDate> 
             <guid>http://www.nytimes.com/2011/04/02/health/02patient.html?_r=1&amp;ref=patientmoney</guid>
             <author><![CDATA[MICHELLE ANDREWS - NY TIMES]]></author> 
             <full><![CDATA[As people age, the lens of the eye becomes harder and less elastic; leading to a&nbsp;gradual worsening of the ability to focus on objects up close.&nbsp;&nbsp;This is&nbsp;called presbyopia. <br />
<br />
This article walks through some of the options for&nbsp;people who have this,&nbsp;and discusses prices associated with the various options.&nbsp;&nbsp;The article discusses:&nbsp;<br />
<ul>
    <li>Vision plans</li>
    <li>Glasses</li>
    <li>Contact&nbsp;lenses</li>
    <li>Lens replacement</li>
</ul>
<br />
For the full article,&nbsp;or more information <a target="_blank" href="http://www.nytimes.com/2011/04/02/health/02patient.html?_r=1&amp;ref=patientmoney"><strong>click&nbsp;here</strong></a>. &nbsp;<br />
<br />
<br />]]></full> 
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             <title><![CDATA[Pre-existing Condition - Now, a Health Policy May Not Be Impossible]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=84</link> 
             <description><![CDATA[For those of you who have been unable to gain access to an insurance plan due to a pre-existing condition, this article by Walecia Konrad walks through&nbsp;a new option that]]></description> 
             <pubDate>Mon, 21 Mar 2011 12:00:00 -0400</pubDate> 
             <guid>http://www.nytimes.com/2011/03/19/health/19patient.html?_r=1&amp;ref=patientmoney&amp;pagewanted=print</guid>
             <author><![CDATA[WALECIA KONRAD - NY TIMES]]></author> 
             <full><![CDATA[For those of you who have been unable to gain access to an insurance plan due to a pre-existing condition, this article by Walecia Konrad walks through&nbsp;a new option that may be available to you. <br />
<br />
This new option is called a &quot;pre-existing condition insurance plan&quot;.&nbsp; These plans are required by the new health care law, and opened for business as recently as July. There are two types of these plans.&nbsp;&nbsp;27 states run their own plans with federal money, but others rely on the federal Department of Health and Human Services to administer the plans.&nbsp; If you have a pre-existing condition, a&nbsp;pre-existing condition&nbsp;insurance plan (PCIP), may&nbsp;help you.&nbsp; In&nbsp;2014, these PCIP's&nbsp;may be replaced, as this is&nbsp;when the new health insurance exchanges are&nbsp;scheduled to open. &nbsp;The exchanges will be required to&nbsp;accept all participants. <br />
<br />
This article discusses:&nbsp;<br />
<ul>
    <li>FINDING&nbsp;A&nbsp;PLAN</li>
    <li>ELIGIBILITY&nbsp;RESTRICTIONS</li>
    <li>THE&nbsp;RIGHT&nbsp;COVERAGE</li>
</ul>
<br />
<br />
<br />
For more details, or to read the full article: <a target="_blank" href="http://www.nytimes.com/2011/03/19/health/19patient.html?_r=1&amp;ref=patientmoney&amp;pagewanted=print"><strong>CLICK HERE</strong></a>]]></full> 
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                <item> 
             <title><![CDATA[How Not to Get Blindsided by Out-of-Network Fees]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=83</link> 
             <description><![CDATA[More and more, people are scrutinizing what their health insurance company pays when they receive out-of-network care.&nbsp;

New York attorney general, Andrew M. Cuomo, recently discovered that patients are consistently shortchanged]]></description> 
             <pubDate>Sun, 27 Feb 2011 12:00:00 -0500</pubDate> 
             <guid>http://www.nytimes.com/2009/02/14/health/13patient.html?_r=1&amp;ref=patientmoney&amp;pagewanted=print</guid>
             <author><![CDATA[WALECIA KONRAD, NY TIMES]]></author> 
             <full><![CDATA[More and more, people are scrutinizing what their health insurance company pays when they receive out-of-network care.&nbsp;<br />
<br />
New York attorney general, Andrew M. Cuomo, recently discovered that patients are consistently shortchanged when being billed for out of network services.&nbsp;&nbsp; Patients may often run into out of network fees either in an emergency, which may demand immediate treatment, or when the&nbsp;patient&nbsp; needs to see a specialist. <br />
<br />
This article discusses some of the issues associated with out of network visits, and gives suggestions if you are faced with out of network charges, such as:&nbsp;<br />
<ul>
    <li>Know exactly what your plan covers.</li>
    <li>Find out what your insurer&rsquo;s reasonable and customary fee is for specific treatments.</li>
    <li>Negotiate with your doctor.</li>
    <li>Prepare for a hospital visit.</li>
    <li>If you think you were overcharged&nbsp;- fight back.&nbsp;</li>
    <li>Use a&nbsp;health care advocate who can negotiate on your behalf, for a fee. To find one near you <a target="_blank" href="http://www.billadvocates.com/FINDANADVOCATE/tabid/69/Default.aspx">click here</a>.</li>
</ul>
<br />
For more details, or to read the full article:&nbsp;<a target="_blank" href="http://www.nytimes.com/2009/02/14/health/13patient.html"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
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                <item> 
             <title><![CDATA[How to Plan For and Handle the Cost of Braces]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=82</link> 
             <description><![CDATA[This article is important for those of you who have kids who need braces, or might need braces themselves.&nbsp; Braces mean months of treatment and an orthodontist bill anywhere from]]></description> 
             <pubDate>Fri, 04 Feb 2011 12:00:00 -0500</pubDate> 
             <guid>www.nytimes.com/2011/01/22/health/22patient.html?_r=1&amp;ref=patientmoney&amp;pagewanted=print</guid>
             <author><![CDATA[WALECIA KONRAD, NY TIMES]]></author> 
             <full><![CDATA[This article is important for those of you who have kids who need braces, or might need braces themselves.&nbsp; Braces mean months of treatment and an orthodontist bill anywhere from $3,000 to $7,000.&nbsp;&nbsp;Paying for orthodontics can be difficult and dental insurance rarely covers more than a small percentage of orthodontic treatment. <br />
<br />
This article discusses: <br />
<ul>
    <li>PROVIDERS AND FEES</li>
    <li>PAYMENT PLANNING</li>
    <li>AFFORDABLE ALTERNATIVES</li>
    <li>INSURANCE COVERAGE</li>
    <li>UNEXPECTED EXPENSES</li>
</ul>
<br />
For more details and to read the full article:&nbsp; <a target="_blank" href="http://www.nytimes.com/2011/01/22/health/22patient.html?_r=1&amp;ref=patientmoney&amp;pagewanted=print"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
          </item>
                <item> 
             <title><![CDATA[A Talk With the Doctor May Help Patients Afford Care]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=80</link> 
             <description><![CDATA[Health care prices are always going up. &nbsp;With more and more patients in Consumer Directed Health Plans, negotiations between doctor and patient are becoming much more common.&nbsp;But, how exactly should]]></description> 
             <pubDate>Mon, 10 Jan 2011 12:00:00 -0500</pubDate> 
             <guid>www.nytimes.com/2011/01/08/health/policy/08patient.html</guid>
             <author><![CDATA[WALECIA KONRAD, NY TIMES]]></author> 
             <full><![CDATA[Health care prices are always going up. &nbsp;With more and more patients in Consumer Directed Health Plans, negotiations between doctor and patient are becoming much more common.&nbsp;But, how exactly should you approach negotiating prices with your doctor? When do you bring it up?&nbsp;What do you say?&nbsp;This article will walk you through some answers to those questions.&nbsp; <br />
<br />
To learn more or to read the full article:&nbsp;<a target="_blank" href="http://www.nytimes.com/2011/01/08/health/policy/08patient.html"><strong>CLICK&nbsp;HERE</strong></a><br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Protecting Your Credit Score From the Medical Bill Maze]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=78</link> 
             <description><![CDATA[If you are not careful, even small unpaid medical bills could have a large impact on your credit score.&nbsp; When medical bills go unpaid, medical providers may sell the debts]]></description> 
             <pubDate>Mon, 20 Dec 2010 12:00:00 -0500</pubDate> 
             <guid>www.nytimes.com/2010/12/18/health/18patient.html?scp=1&amp;sq=Patient%20Money%20-%20Protecting%20Your%20Credit%20Score%20From%20the%20Medical%20Bill%20Maze%20&amp;st=cse</guid>
             <author><![CDATA[WALECIA KONRAD - NY TIMES]]></author> 
             <full><![CDATA[If you are not careful, even small unpaid medical bills could have a large impact on your credit score.&nbsp; When medical bills go unpaid, medical providers may sell the debts to collection agencies, rather than&nbsp;reporting them to&nbsp;Experian, TransUnion and Equifax<br />
<br />
The&nbsp;collection agencies will eventually report them to the the credit agencies, and because of privacy laws, it may be difficult to determine where the bills originated.&nbsp;&nbsp; These &quot;unpaid bills&quot; in collection can be very damaging on your credit report.<br />
<br />
This article lists&nbsp;suggestions&nbsp;to help resolve&nbsp;issues that show up on your credit report from medical bills. <br />
<br />
To learn more or to read the full article: <a target="_blank" href="http://www.nytimes.com/2010/12/18/health/18patient.html?scp=1&amp;sq=Patient%20Money%20-%20Protecting%20Your%20Credit%20Score%20From%20the%20Medical%20Bill%20Maze%20&amp;st=cse"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
          </item>
                <item> 
             <title><![CDATA[Snoring: What to Do When a Punch in the Shoulder Fails]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=77</link> 
             <description><![CDATA[Do you know someone who snores?&nbsp;Almost half of adults snore from time to time.&nbsp; Snoring can be very disruptive to the sleep of the individual, and his/her partner.&nbsp;&nbsp; Sometimes snoring]]></description> 
             <pubDate>Mon, 13 Dec 2010 12:00:00 -0500</pubDate> 
             <guid>query.nytimes.com/gst/fullpage.html?res=9A05E3D7153BF932A25751C1A9669D8B63</guid>
             <author><![CDATA[WALECIA KONRAD - NY TIMES]]></author> 
             <full><![CDATA[Do you know someone who snores?&nbsp;Almost half of adults snore from time to time.&nbsp; Snoring can be very disruptive to the sleep of the individual, and his/her partner.&nbsp;&nbsp; Sometimes snoring is a symptom of something more severe, such as sleep apnea. <br />
<br />
This article offers suggestions for ways to ease snoring for those not suffering from sleep apnea. &nbsp;These include:&nbsp;
<ul>
    <li>Losing weight</li>
    <li>Sleeping on your side</li>
    <li>Avoiding alcohol before bed</li>
    <li>Clearing nasal passages</li>
</ul>
<br />
This article also discusses costs and other steps&nbsp;associated with those who have sleep apnea.&nbsp; <br />
<br />
To learn more or read the full article:&nbsp; <a target="_blank" href="http://query.nytimes.com/gst/fullpage.html?res=9A05E3D7153BF932A25751C1A9669D8B63"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
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             <title><![CDATA[Treating Eating Disorders and Paying for It]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=76</link> 
             <description><![CDATA[Do you know&nbsp;someone who has an eating disorder?&nbsp; Eating disorders may persist for years, taking a toll on a patient&rsquo;s health, personal relationships, and also on family finances. 

As reported]]></description> 
             <pubDate>Mon, 06 Dec 2010 12:00:00 -0500</pubDate> 
             <guid>www.nytimes.com/2010/12/04/health/04patient.html</guid>
             <author><![CDATA[LESLEY ALDERMAN - NY TIMES]]></author> 
             <full><![CDATA[Do you know&nbsp;someone who has an eating disorder?&nbsp; Eating disorders may persist for years, taking a toll on a patient&rsquo;s health, personal relationships, and also on family finances. <br />
<br />
As reported in this article, care for patients with eating disorders can be expensive. Treatment often includes&nbsp;weekly&nbsp;visits to&nbsp;a team of specialists, including a psychiatrist, a physician and a nutritionist. Residential programs can&nbsp;cost&nbsp;$30,000 a month on average&nbsp;and many patients require three or more months of treatment.&nbsp; Even after leaving a&nbsp;program, patients with eating disorders may need years of follow-up care.&nbsp; These costs are often not covered by insurers. <br />
<br />
This article&nbsp;discusses ways to&nbsp;minimize the toll treatment&nbsp;may take on your finances, if you have a family member suffering from an eating disorder.&nbsp; These include:&nbsp;<br />
<ul>
    <li>EARLY DIAGNOSIS</li>
    <li>AT-HOME TREATMENT</li>
    <li>TAKING&nbsp;ON&nbsp;THE&nbsp;INSURANCE CARRIER&nbsp;&nbsp;&nbsp;</li>
    <li>FINDING&nbsp;OTHER&nbsp;FREE TREATMENT</li>
    <li>FINDING&nbsp;FINANCIAL ASSISTANCE</li>
</ul>
<br />
<br />
To learn more or to read the full article:&nbsp; <a target="_blank" href="http://www.nytimes.com/2010/12/04/health/04patient.html"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
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             <title><![CDATA[Doctors say Medicare cuts force painful decision about elderly patients]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=75</link> 
             <description><![CDATA[This article details&nbsp;a dilemma:&nbsp;doctors across the country&nbsp;complain that they've been forced to shift away from Medicare toward higher-paying, privately insured or self-paying patients in response to years of penny-pinching by]]></description> 
             <pubDate>Tue, 30 Nov 2010 12:00:00 -0500</pubDate> 
             <guid>www.washingtonpost.com/wp-dyn/content/article/2010/11/25/AR2010112503638.html</guid>
             <author><![CDATA[N.C. Aizenman - Washington Post.com]]></author> 
             <full><![CDATA[This article details&nbsp;a dilemma:&nbsp;doctors across the country&nbsp;complain that they've been forced to shift away from Medicare toward higher-paying, privately insured or self-paying patients in response to years of penny-pinching by Congress.&nbsp; This means elderly patients on Medicare will likely face longer waits to see the doctors they need.&nbsp; This article takes a more in depth look at this issue.&nbsp; <br />
<br />
To learn more or to read the full article:&nbsp; <a target="_blank" href="http://www.washingtonpost.com/wp-dyn/content/article/2010/11/25/AR2010112503638.html"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
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             <title><![CDATA[Protecting Yourself From the Cost of Type 2 Diabetes]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=74</link> 
             <description><![CDATA[According to this article, one in 10 people in America has diabetes, and the costs of treating the disease are staggering.&nbsp; Diabetes costs the country's health care system around $174]]></description> 
             <pubDate>Fri, 19 Nov 2010 12:00:00 -0500</pubDate> 
             <guid>www.nytimes.com/2010/11/13/health/13patient.html</guid>
             <author><![CDATA[WALECIA KONRAD - NY TIMES]]></author> 
             <full><![CDATA[According to this article, one in 10 people in America has diabetes, and the costs of treating the disease are staggering.&nbsp; Diabetes costs the country's health care system around $174 billion a year.&nbsp; On average, patients suffering from diabetes spend close to $6000 annually, but that does not include complications from the disease.&nbsp; In the article, there are tips&nbsp;for those who&nbsp;suffer from&nbsp;diabetes. &nbsp;These include:&nbsp;<br />
<ul>
    <li>TRYING&nbsp;OLDER DRUGS FIRST</li>
    <li>SAVING ON SUPPLIES</li>
    <li>GETTING SCREENED ANNUALLY</li>
    <li>ADOPTING HEALTHIER HABITS</li>
    <li>FINDING SUPPORT</li>
</ul>
<br />
To learn more or read the full article:&nbsp;<a href="http://www.nytimes.com/2010/11/13/health/13patient.html" target="_blank"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
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             <title><![CDATA[Health costs fuel rise in bankruptcy among elderly]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=73</link> 
             <description><![CDATA[You make think Medicare will cover your health care costs when you retire; but that just may not be the case. &nbsp;Even if Medicare covers part of your costs, it]]></description> 
             <pubDate>Thu, 11 Nov 2010 12:00:00 -0500</pubDate> 
             <guid>www.reuters.com/article/idUSTRE6A73M920101108</guid>
             <author><![CDATA[Mark Miller - Reuters]]></author> 
             <full><![CDATA[You make think Medicare will cover your health care costs when you retire; but that just may not be the case. &nbsp;Even if Medicare covers part of your costs, it won't cover everything. This article looks at some studies that show an increase in the number of bankruptcies for elderly.&nbsp; It looks at some of the drivers for increasing expenses, and offers suggestions for making sure you are protected when you retire.&nbsp; These include:&nbsp;<br />
<ul>
    <li>Plug the gaps with insurance, including long-term care insurance</li>
    <li>Focus on out-of-pocket expense</li>
    <li>Save for it</li>
    <li>Don't bank on good health</li>
</ul>
<br />
To learn more or to read the full article:&nbsp; <a target="_blank" href="http://www.reuters.com/article/idUSTRE6A73M920101108"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
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             <title><![CDATA[Be Alert to Protect Yourself Against Medicare Fraud]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=72</link> 
             <description><![CDATA[Medicare fraud costs taxpayers billions of dollars every year and continues to cause its victims problems later.&nbsp; This article offers suggestions for protecting yourself and your loved ones from Medicare]]></description> 
             <pubDate>Wed, 03 Nov 2010 12:00:00 -0400</pubDate> 
             <guid>www.nytimes.com/2010/10/30/health/30patient.html</guid>
             <author><![CDATA[WALECIA KONRAD - NY TIMES]]></author> 
             <full><![CDATA[Medicare fraud costs taxpayers billions of dollars every year and continues to cause its victims problems later.&nbsp; This article offers suggestions for protecting yourself and your loved ones from Medicare fraud, and for what to do if you think you have become a victim.&nbsp; These suggestions include:&nbsp;<br />
<ul>
    <li>GUARD YOUR CARD</li>
    <li>BEWARE OF FREE SERVICES</li>
    <li>EXAMINE YOUR STATEMENTS&nbsp;</li>
    <li>AVOID ENROLLMENT HAZARDS&nbsp;</li>
    <li>CHECK YOUR CREDIT REPORT&nbsp;</li>
    <li>MAKE A REPORT</li>
</ul>
<br />
To learn more or read the full article:&nbsp; <a target="_blank" href="http://www.nytimes.com/2010/10/30/health/30patient.html"><strong>CLICK&nbsp;HERE</strong></a>]]></full> 
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                <item> 
             <title><![CDATA[For Running Shoes, Itâ€™s Fit First and Price Last]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=71</link> 
             <description><![CDATA[For Running Shoes, It&rsquo;s Fit First and Price Last - LESLEY ALDERMAN - NY Times

SHARON TANENBAUM has been a serious runner for six years. The Brooklyn resident, 30, has completed]]></description> 
             <pubDate>Mon, 25 Oct 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/For%20Running%20Shoes,%20It%20is%20Fit%20First%20and%20Price%20Last.pdf</guid>
             <author><![CDATA[LESLEY ALDERMAN]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.nytimes.com/2010/10/23/health/23patient.html"><strong>For Running Shoes, It&rsquo;s Fit First and Price Last</strong></a> - LESLEY ALDERMAN - NY Times<br />
<br />
SHARON TANENBAUM has been a serious runner for six years. The Brooklyn resident, 30, has completed three marathons and several shorter races. Each week she logs about 20 miles. <br />
<br />
Her favorite trainers? A $25 pair of Champion shoes she bought at Target. <br />
<br />
&ldquo;I like running in simple shoes,&rdquo; she said. &ldquo;The more you pay, the more unnecessary stuff you get.&rdquo; <br />
<br />
She is right. Money often buys higher-quality goods, but not when it comes to running shoes. <br />
<br />
Over the last three decades, running has exploded as a leisure sport. In 2009, 476,000 runners completed a marathon. In 1976, the number was just 25,000. Sales of running shoes reached a record $2.36 billion in 2009, 60 percent more than a decade earlier. <br />
<br />
But some of those dollars may not have been well spent. In 2007, Scottish researchers tested running shoes at three price levels, ranging from $80 to $150, and found that low- and midcost shoes within the same brand cushioned runners&rsquo; feet just as well as high-cost ones &mdash; sometimes even better. <br />
<br />
&ldquo;The perception is that if you pay more, you will get better shoes,&rdquo; said Rami J. Abboud, director of the Institute of Motion Analysis and Research at the University of Dundee in Scotland. &ldquo;Our research did not show that.&rdquo; Professor Abboud and his colleagues have just completed a similar study, as yet unpublished, with nearly identical results. <br />
<br />
Shoe manufacturers keep adding improvements to shoes in the form of cushioning gel pods, microprocessors and so-called thrust enhancers, but these upgrades don&rsquo;t seem to make runners safer. A review of current studies on running shoes published in 2009 found that there were no evidence-based studies that showed running shoes actually helped prevent injury. Indeed, injury rates have not gone down. <br />
<br />
Fancy running shoes may even lead to injury, experts say. Some studies show that when runners don expensive running shoes that promise superior cushioning, they incur more injuries than runners using cheaper shoes. <br />
<br />
The authors of one such study concluded that there was a &ldquo;tendency in humans to be less cautious when using new devices of unknown benefit because of overly positive attitudes associated with new technology and novel devices.&rdquo; <br />
<br />
If you want to run well and run safely, consider fit first and price last. &ldquo;You want a shoe that helps you maintain a balanced position,&rdquo; said Mark Montgomery, manager of the JackRabbit Sports store in Union Square in New York. &ldquo;A more expensive shoe is not always the solution.&rdquo; With the ING New York City Marathon approaching on Nov. 7, here are some guidelines for buying the best shoe for you. <br />
<br />
A SHOE THAT FITS If you are new to running, or have not been fitted in a few years, go first to a reputable store that specializes in running shoes. A well-trained salesperson should analyze your gait and inquire about your running habits before recommending a shoe. <br />
<br />
At JackRabbit Sports, a salesperson typically videotapes customers running on a treadmill to figure out what type of stride they have. Pronators, those whose arches roll inward, for instance, may need a shoe with motion control, which may be a bit more expensive than neutral shoes. <br />
<br />
That first fitting is important, because it will give you a sense of what type of shoe is best for you. Once you know, you can head down-market for the bargains. <br />
<br />
&ldquo;When I first started running, I went to a specialty store,&rdquo; said Ms. Tanenbaum. &ldquo;Now I can shop anywhere, even Target, because I know what works for me.&rdquo; <br />
<br />
It is wise, though, to get refitted every few years. Over time, your arches tend to fall and your feet become longer. The model or type that worked well for you in your 40s may not be the best one for you in your 50s. <br />
<br />
SIZE IT UP What is a good fit? Buy a running shoe that is a half size or so larger than your regular shoe. There should be a thumb&rsquo;s width between the tip of your big toe and the top of the shoe. <br />
<br />
Don&rsquo;t get too hung up on the official size. Sizes vary from brand to brand and model to model. Ms. Tanenbaum buys shoes that are two sizes larger than her regular shoes. <br />
<br />
&ldquo;Most shoes are mass-produced these days, with no real attention to detail or quality,&rdquo; said Professor Abboud. &ldquo;If you take two pairs of shoes from the same brand, you will not be guaranteed the same size shoes. It may vary by up to one size in length.&rdquo; <br />
<br />
Make sure the shoes are not too tight across the arch and that your heel is snug. They should feel comfortable right away. &ldquo;The shoes should feel like they belong on your feet,&rdquo; said Gordon Bakoulis, 49, a running coach in New York City who has competed in four United States Olympic Marathon Trials. <br />
<br />
If you are planning to run a long race, spend at least two weeks breaking in your new shoes before start day. <br />
<br />
LESS IS MORE The cheapest solution? Forgo shoes altogether and join the legions of runners who have embraced the barefoot trend. <br />
<br />
It is not just a fad. A few studies have suggested that running barefoot might be better for your body over the, ahem, long run than running in shoes. A 2009 study found that compared to going barefoot, running shoes put more pressure on the hip, knee and ankle joints and concluded that running shoes could put athletes at greater risk for osteoarthritis of the knee. Earlier studies found that running shoes could increase the risk for plantar fasciitis and ankle sprains. <br />
<br />
But podiatrists urge caution before running without shoes. &ldquo;I tell my clients it&rsquo;s great thing to try,&rdquo; said Dr. Karen Langone, a sports fitness podiatrist in Southampton, N.Y. &ldquo;But it&rsquo;s not for everyone, and it should be gradually incorporated into your running program.&rdquo; <br />
<br />
Some people require the mechanical support that a running shoe offers. &ldquo;I saw quite a few patients this summer who had developed shin splints from running barefoot,&rdquo; she said. <br />
<br />
Minimalist shoes are a good hedge for runners who favor simplicity, but who do not want to fully embrace the barefoot trend. If you want to approximate the experience, look into the Nike Free (about $85) or the Saucony Kinvara (about $90). To get even closer to the ground, try Vibram&rsquo;s Five Fingers shoe ($75 to $125), which has very little support and is more akin to a water shoe than a running sneaker. <br />
<br />
&ldquo;The less you think about a shoe, the better,&rdquo; said Ms. Bakoulis, the marathoner. <br />
<br />]]></full> 
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             <title><![CDATA[It is About Time to Check the Fine Print on Your Health Plan]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=70</link> 
             <description><![CDATA[It is About Time to Check the Fine Print on Your Health Plan - WALECIA KONRAD - NY&nbsp;Times

BACK to the future &mdash; that about sums up this year&rsquo;s open enrollment]]></description> 
             <pubDate>Tue, 19 Oct 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/It%E2%80%99s%20About%20Time%20to%20Check%20the%20Fine%20Print%20on%20Your%20Health%20Plan.pdf</guid>
             <author><![CDATA[WALECIA KONRAD]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/10/16/health/16patient.html">It is About Time to Check the Fine Print on Your Health Plan</a></strong> - WALECIA KONRAD - NY&nbsp;Times<br />
<br />
BACK to the future &mdash; that about sums up this year&rsquo;s open enrollment season.<br />
<br />
This is the time of year when your employer allows you to make changes to your benefits package &mdash; most importantly, to your health insurance. You may even have already received your gigantic packet of plan descriptions and sign-up forms by now.<br />
<br />
As in years past, employers will be rejiggering their plans with an eye toward passing much of this year&rsquo;s increase in health insurance costs to employees. Health insurance premiums are expected to rise an average of 8.8 percent, according to data compiled by the benefits consulting firm Aon Hewitt. Employees&rsquo; out-of-pocket expenses are expected to increase 12.5 percent from 2010, in the form of higher premiums, higher deductibles, higher co-pays and co-insurance, or all of these, said Sara Taylor, health and welfare solutions leader at Aon Hewitt.<br />
<br />
But the biggest changes arrive this year courtesy of the new health care law. The new rules require employers to extend health insurance coverage to uninsured dependents up to age 26, eliminate any lifetime caps on coverage, and pay 100 percent of the cost of annual physicals and some other preventive care.<br />
<br />
Plans that don&rsquo;t significantly change their cost and coverage structures will be exempt from the preventive care requirements. But for the most part, rising health costs will force employers to alter their plans, if only to shift more of the burden to employees. The new requirements and complicated new options will make selecting the right insurance plan perhaps more daunting than ever.<br />
<br />
That&rsquo;s no reason to put it off. &ldquo;We know that people spend more time choosing a cellphone than they do picking a health plan,&rdquo; said Ms. Taylor. &ldquo;But doing nothing could cost you money.&rdquo;<br />
<br />
Here are a few considerations for consumers headed into open enrollment season.<br />
<br />
OUT-OF-POCKET EXPENSES Many consumers focus on what a plan covers, not what it is likely to cost them out of pocket. But out-of-pocket expenses are rising as employees are asked to pick up more of the health care bill.<br />
<br />
Start by calculating what you spent on health care last year, including premiums, co-pays, deductibles, prescriptions and any other expenses. How many times did you or your family members visit the doctor? Fill a prescription?<br />
<br />
Then estimate what each of your company&rsquo;s offerings might cost you out of pocket this coming year, advised Tracy Watts, a partner at Mercer Health and Benefits.<br />
<br />
You may find that you are paying a high premium for a fancy plan that you do not fully use. If you are in good health and the numbers work, it may make sense to switch to a lower-premium alternative, like an H.M.O. or a high-deductible plan, and then sock away what you will save on premiums in a tax-exempt flexible spending account or health savings account, which can be used to cover your out-of-pocket costs.<br />
<br />
COVERAGE OF DEPENDENTS Pay particular attention to coverage of a spouse, children and other dependents under your company&rsquo;s proposed plans. Coverage of dependents has been eroding for years, experts say, and the trend is likely to accelerate in 2011.<br />
<br />
For starters, expect a jump in premiums for the dependents on your health plan. Some employers also are expected to restructure the way you pay for coverage. Instead of charging one price for family coverage, long the standard, a handful of employers are starting to charge for each dependent on your plan, Ms. Taylor said.<br />
<br />
&ldquo;Say you paid $4,000 a year for family coverage last year, regardless how many kids you have. Now it&rsquo;s going to be, say, an extra $3,000 for each extra person on the plan,&rdquo; Ms. Taylor explained. &ldquo;That&rsquo;s a huge change for big families and for people taking advantage of the new rule for dependents up to age 26.&rdquo;<br />
<br />
Some employers are simply cutting back on what they will pay for dependent benefits, picking up 70 percent of the premiums, say, instead of 75 percent. If you and your spouse have access to employer-sponsored health insurance, take a good look at options from both employers. Changes in dependent coverage are inconsistent, and you may find that one employer remains more generous, said Ron Fontanetta, Towers Watson director.<br />
<br />
CO-PAYS AND CO-INSURANCE Another trend to watch for is employers&rsquo; changing from a system of co-payments to co-insurance.<br />
<br />
What&rsquo;s the difference? Co-pays are a flat fee &mdash; say, $10 or $20 &mdash; that you pay each time you visit the doctor, go to the hospital or fill a prescription. Co-insurance is the percentage you pay, usually 10 to 30 percent, of the amount your doctor, hospital or pharmacist charges your insurance company.<br />
<br />
The more health care services you use, the more co-insurance will cost you. &ldquo;There&rsquo;s been a general trend moving toward co-insurance over the past several years, and it can be shocking if employees don&rsquo;t understand and don&rsquo;t plan for it,&rdquo; Ms. Taylor said.<br />
<br />
Many employers use a combination of co-pays and co-insurance, so be sure to read the fine print carefully to calculate what each option will cost you.<br />
<br />
FLEXIBLE SPENDING ACCOUNTS Because of the new health care law, you may need to rethink how much money you put into flexible spending accounts.<br />
<br />
These accounts allow you to save money tax-free for eligible health care expenses, such as deductibles, co-pays, prescription drugs and even supplies like bandages. Under the new law, however, over-the-counter medications such as aspirin, allergy medicine and cough syrup are no longer allowed as eligible expenses. (Employers are waiting for clarification on a few other items, like saline solution for contact lenses.)<br />
<br />
Remember, if you don&rsquo;t use the money you put into these tax-free accounts within the prescribed time period, usually a year, you forfeit the funds. Your doctor may be able to help you preserve an eligible expense by writing a prescription for an over-the-counter medicine you use regularly.<br />
<br />
EMPLOYER HEALTH INCENTIVES Employers are offering a laundry list of incentives for you to stay healthy. Under the new rules, lots of preventive care &mdash; such as annual physicals and some tests &mdash; will be provided with no out-of-pocket cost to you.<br />
<br />
What&rsquo;s more, your company may be offering cash rewards, like gift cards or discounted health care costs, if you complete a health risk assessment or get screened for blood sugar, high cholesterol or high blood pressure.<br />
<br />
&ldquo;Take advantage of the on-site testing your employer may be sponsoring during open enrollment or a health fair,&rdquo; Mr. Fontanetta said. &ldquo;It could save you money.&rdquo;<br />
<br />
Should these risk assessments turn up a problem, many employers can refer you directly to assistance in chronic illness management.]]></full> 
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             <title><![CDATA[New Rules Coming for Payments Out of Health Savings Accounts]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=69</link> 
             <description><![CDATA[New Rules Coming for Payments Out of Health Savings Accounts - FoxNews.com

Under the new health care law, consumers using workplace pre-tax health savings accounts will soon need a doctor's note]]></description> 
             <pubDate>Fri, 15 Oct 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/New%20Rules%20Coming%20for%20Payments%20Out%20of%20Health%20Savings%20Accounts.pdf</guid>
             <author><![CDATA[FoxNews.com]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.foxnews.com/politics/2010/10/15/new-health-care-rules-require-doctors-note-pay-otc-drugs-fsas/">New Rules Coming for Payments Out of Health Savings Accounts</a></strong> - FoxNews.com<br />
<br />
Under the new health care law, consumers using workplace pre-tax health savings accounts will soon need a doctor's note to pay for Tylenol and an estimated 15,000 other over-the-counter drugs.<br />
<br />
Starting Jan. 1, employees who use flexible spending accounts (FSAs), health saving accounts (HSAs), or health reimbursement arrangements (HRAs) to pay for common medications such as pain relievers, cold medicines, antacids and allergy medications will need prescriptions. The new rules don't apply to insulin.<br />
<br />
The new rules will also prohibit the use of FSA or HRA debit cards provided by administrative plans for over-the-counter purchases because the IRS says there's no way to prove the drugs were prescribed.<br />
<br />
The IRS says any money removed from HSA accounts to pay for medical expenses not bought with a prescription will be included as taxable income and subject to an additional tax of 20 percent.<br />
<br />
Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the industry lobby that voiced support for the overhaul but has been accused by some of the law's proponents of trying to undermine it, said the law creates &quot;unintended consequences.&quot;<br />
<br />
&quot;It creates unnecessary hassles for consumers and provides the wrong kind of incentives,&quot; Zirkelbach said, adding that the changes could make it more difficult for consumers to get medicines they need at costs they can afford. <br />
<br />
&quot;This change could have the unintended consequence of increasing health care costs,&quot; he said. It might provide an incentive for consumers to go back on more expensive medications when over-the-counter medicine works just fine.&quot;<br />
<br />
More than 10 million consumers use HSAs according to a survey done in January by AHIP. That's up from 8 million in 2009 and 6.1 million in 2008.<br />
<br />
According to an analysis by benefits administrator Aon Hewitt of more than 220 employers covering more than 6 million workers, 20 percent of employees, or 1.2 million, contributed to an FSA in 2010. Of those workers, the average annual contribution is $1,441.<br />
<br />
FSAs and HSAs allow workers to reduce their taxable income to pay for qualified health care or child care expenses. Anyone with a high-deductible medical insurance plan can obtain an HSA. The IRS defined a high-deductible plan in 2010 as $1,200 a year for individuals and $2,400 for families.<br />
<br />
FSAs, which were first authorized by Congress in 1978, are only available through employers who offer the plans. But FSAs face another new rule under the Affordable Care Act -- a limit on the pre-tax contributions to $2,500, starting Jan. 1, 2013. There is currently no limit on how much an employee can contribute to FSAs although employers can impose one.<br />
<br />
Lawmakers imposed the cap to help pay for provisions that will expand coverage starting in 2014. The cap is expected to raise $13 billion for other government-provided health care services offered between 2013 and 2019.<br />]]></full> 
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             <title><![CDATA[Health care costs for college students could make you sick - know your options]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=68</link> 
             <description><![CDATA[Health care costs for college students could make you sick - know your options - Maureen Kyle - WKYC.com

CLEVELAND -- High school seniors applying to colleges not only need to]]></description> 
             <pubDate>Mon, 11 Oct 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Health%20care%20costs%20for%20college%20students%20could%20make%20you%20sick%20-%20know%20your%20options.pdf</guid>
             <author><![CDATA[Maureen Kyle]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.wkyc.com/news/local/story.aspx?storyid=152900&amp;catid=45">Health care costs for college students could make you sick - know your options</a></strong> - Maureen Kyle - WKYC.com<br />
<br />
CLEVELAND -- High school seniors applying to colleges not only need to consider possible majors and courses, but also costs. <br />
That includes how much it will cost for health insurance. The new health care reform plan is making it a little easier, but parents still have to <br />
weigh their options. <br />
<br />
All night study sessions, germs spread through dorm rooms, college students are exposed to all sorts of illnesses when away for the first time. <br />
Whether twenty or two thousand miles away, most parents want to know health care follows them. <br />
<br />
Colleges do offer health care plans but those plans&nbsp;are notoriously expensive, with little coverage. <br />
<br />
&quot;Much like anything else, you have to read between the lines and look at the fine print,&quot; says Dr. George Kikano is in the Family Medicine Department at University Hospitals Case Medical Center. <br />
<br />
He also has two kids of his own in college. In his opinion, the college health insurance plans should be a parents' last resort. <br />
<br />
&quot;For many colleges, they have been making money off of student insurance policies.&quot; <br />
<br />
A recent study from the Massachusetts Division of Health Care Finance and Policy found that colleges were actually making a profit margin of ten percent off of their plans, plans that didn't cover existing chronic illness, preventative services and had low benefit ceilings. <br />
<br />
But the new health care reform law now allows those students to stay on their parent's plan until age 26.<br />
<br />
&quot;From my perspective, any time a kid has the option of staying on the parents plan, they're better off staying on the parents plan.&quot; <br />
<br />
Dr. Kikano says, for families it is most likely cheaper to keep a child on the corporate plan. And with the new health care laws, chronic conditions are <br />
covered, as well as any major illnesses. <br />
<br />
Parents just need to make sure if their child is more than 20 miles away, they know which physicians are covered in case of emergency. <br />
<br />
&quot;Kids in college need to make sure if they are out of state out of town, the parents plan would cover physicians that would be considered out of network. So, if you work in Cleveland, and your kids are in Cleveland, for the most part you should not have an issue.&quot;]]></full> 
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             <title><![CDATA[Consumers look to insurers to lower health care costs]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=67</link> 
             <description><![CDATA[Consumers look to insurers to lower health care costs - Emily Berry - amednews

A consumer survey shows that more people expect health insurers, rather than physicians, to help them sort]]></description> 
             <pubDate>Mon, 04 Oct 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Consumers%20look%20to%20insurers%20to%20lower%20health%20care%20costs.pdf</guid>
             <author><![CDATA[Emily Berry]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.ama-assn.org/amednews/2010/10/04/bisb1004.htm">Consumers look to insurers to lower health care costs</a></strong> - Emily Berry - amednews<br />
<br />
A consumer survey shows that more people expect health insurers, rather than physicians, to help them sort through the health system reform law and lower the cost of health care.<br />
<br />
&quot;We were surprised about how high expectations were for insurers to play the role of an educator, and also for them to be accountable to lower costs. It's really health insurers here who consumers are looking to make a difference,&quot; said J. Mark Carr, managing partner of South Street Strategy Group, a consulting firm affiliated with Chadwick Martin Bailey, a Boston-based market research agency that conducted the survey.<br />
<br />
<strong>Consumers seek reform help </strong><br />
The company surveyed 1,504 adults, who reflected the demographics of the country in terms of age, level of education and race. Given a list of groups to choose from (they could pick more than one), 61% of respondents said insurers should be responsible for educating the public about health care reform. Only government was chosen more often, at 74%.<br />
<br />
&quot;This represents both an opportunity and a challenge for insurers to step out and be more of a leader, educator, a trusted adviser to the consumer -- or not, and miss expectations,&quot; Carr said. &quot;Not all health insurers have embraced that role, but there's an opportunity to move forward and be proactive.&quot;<br />
<br />
Asked who should be responsible for lowering health care costs, 75% selected health insurers, higher than any other choice.<br />
<br />
By contrast, 34% said medical professionals should provide information about reform, and 41% said doctors and nurses should be responsible for lowering health care costs.<br />
<br />
That may not mean everyone trusts health insurers more than physicians, however. In a follow-up interview, one unnamed respondent said: &quot;Medical professionals are a more trustworthy source and should understand more about what they will and will not do as a result of reform. ... If a patient asks a doctor, 'Is a death panel going to kill me because you tell them I'm ill?' the doctor can say, 'No, that's ridiculous.' &quot;<br />
<br />
Given that the reform law mainly reforms the insurance market, it's possible consumers believe insurers are going to be the best reference for what is changing, said Tim Lee, principal and consulting actuary in the Houston office of the consulting firm Milliman. &quot;Nobody in any industry understands it better than people who work in the insurance industry.&quot;<br />
<br />
Robert Zirkelbach, spokesman for the health insurance trade group America's Health Insurance Plans, said insurers have done what they can to help lower the cost of care, including creating disease management programs, providing incentives to take generic drugs and investing in health information technology.<br />
<br />
Lee called the survey results about who should reduce costs &quot;a combination of funny and surprising.&quot;<br />
<br />
He said there could be a couple of explanations for so many people saying insurers should take responsibility for cutting health care costs: One is that they may remember insurers' success at cutting costs in the heyday of managed care in the 1990s, and they are willing to see some of those methods return.<br />
<br />
Lee said consumers will require a great deal of education to remain open to changes that might keep them from seeing the doctor of their choice or create more hoops for their doctors to jump through.<br />
<br />
&quot;Ultimately, it's going to be up to the doctor, the hospital and the consumer to control the cost,&quot; he said.<br />
<br />
But it might be giving the public too much credit to think they are ready for insurers to bring back tightly managed care, Lee said. It's possible that consumers are considering only their own insurance premiums when it comes to health care costs: &quot;What they may be thinking is, 'Health care costs are manifested in my premium rate ... so clearly the health insurance company must be responsible.' &quot;<br />
<br />
The print version of this content appeared in the Oct. 11 issue of American Medical News.<br />
<br />
--------------------------------------------------------------------------------<br />
<br />
Responses to an online survey of 1,504 adults suggest that some consumers feel lost when it comes to health system reform but place responsibility for education and cost control on health insurers rather than physicians.<br />
<br />
<strong>How knowledgeable are you about health reform issues? </strong><br />
Not at all knowledgeable 30% <br />
Somewhat knowledgeable 50% <br />
Knowledgeable 19% <br />
<br />
<strong>Which of these groups should be responsible for providing the most information about health reform? * <br />
</strong>Government 74% <br />
Health insurance companies 61% <br />
Employers 43% <br />
Medical professionals 34% <br />
News media 31% <br />
Hospital and clinic administration 30% <br />
Pharmaceutical companies 14% <br />
I don't think it's anyone's responsibility 3% <br />
<br />
<strong>Which of these groups should be most responsible for lowering health care costs? * </strong><br />
Health insurance companies 75% <br />
Pharmaceutical companies 54% <br />
Hospital and clinic administration 49% <br />
Government agencies 46% <br />
Medical professionals 41% <br />
Elected officials 31% <br />
Consumers/public 25% <br />
Employers 19% <br />
Voters 17% <br />
Other 2% <br />
I don't think anyone should be responsible 2% <br />
<br />
* Respondents could offer more than one answer.<br />
<br />
Source &quot;AMerican Consumers Uncertain About Health Reform,&quot; Chadwick Martin Bailey and South Street Strategy Group, September <br />]]></full> 
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                <item> 
             <title><![CDATA[Cost and Lack of Awareness Hamper Adult Vaccination Efforts]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=66</link> 
             <description><![CDATA[Cost and Lack of Awareness Hamper Adult Vaccination Efforts - LESLEY ALDERMAN - NY&nbsp;Times

About 11,500 cases of whooping cough, or pertussis, have been reported nationwide so far this year. In]]></description> 
             <pubDate>Mon, 27 Sep 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Cost%20and%20Lack%20of%20Awareness%20Hamper%20Adult%20Vaccination%20Efforts.pdf</guid>
             <author><![CDATA[LESLEY ALDERMAN]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.nytimes.com/2010/09/25/health/25patient.html"><strong>Cost and Lack of Awareness Hamper Adult Vaccination Efforts</strong></a> - LESLEY ALDERMAN - NY&nbsp;Times<br />
<br />
About 11,500 cases of whooping cough, or pertussis, have been reported nationwide so far this year. In California, where the infections are nearing a record high, nine infants have died. <br />
<br />
It is likely that some of those children had not received all their shots, experts say. But some of those deaths might have been prevented if more adults, too, had been immunized. <br />
<br />
Though public health authorities have long recommended that adults get a pertussis booster shot, just half have done so. Without it, they risk passing this illness to vulnerable children. <br />
<br />
&ldquo;Almost everyone understands how important it is for children to be immunized,&rdquo; said Dr. Melinda Wharton, deputy director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention, &ldquo;but adults need vaccines too.&rdquo; <br />
<br />
Far too few get them. The C.D.C. recommends that people 19 and older receive immunizations against as many as 14 infectious diseases. (Not all adults require every vaccine.) Yet most adults rarely think about getting the shots &mdash; until they step on a rusty nail or begin planning travel to a developing country. <br />
<br />
Only 7 percent of Americans over age 60, for instance, have received the herpes zoster vaccine, which prevents shingles, a painful nerve infection. Just 11 percent of young women have received the vaccine against the two types of human papilloma virus that cause 70 percent of all cervical cancers. <br />
<br />
Why are adults so behind on vaccinations? For one thing, the shots can be expensive (from $20 to $200 a dose for some, and some require three doses). But a bigger part of the problem is a lack of awareness. Doctors often fail to remind patients that they require booster shots, and consumers are not well informed about the need. <br />
<br />
In a 2007 survey by the National Foundation for Infectious Diseases, 40 percent of respondents incorrectly stated that, if they had received vaccines as a child, they did not need them again; 18 percent said vaccines were not necessary for adults. <br />
<br />
The new health care law should help get more adults to roll up their sleeves. Under the law, group and individual health plans, as well as Medicare, must provide preventive health services, including immunizations recommended by the C.D.C., free of charge. That means no co-payments, co-insurance or deductibles. <br />
<br />
The hope is that since vaccines will be free, more doctors will suggest them and more patients will ask for them, said Jeffrey Levi, executive director of Trust for America&rsquo;s Health, a nonprofit group that works to prevent epidemics. <br />
<br />
Here&rsquo;s the catch. If you are in a group or individual health plan, your plan must be new, or it must have undergone substantial changes, in order for the new requirements to apply. In addition, certain recent vaccine recommendations will not be covered right away. If you are uncertain, call your insurer. <br />
<br />
Adult immunizations are not just an important way to prevent the spread of disease. Immunizations are also a phenomenally cost-effective way to preserve health. <br />
<br />
&ldquo;When you compare the cost of getting sick with these diseases to the cost of a vaccine, it&rsquo;s a modest investment,&rdquo; said Dr. Robert H. Hopkins, a professor of internal medicine and pediatrics at the University of Arkansas for Medical Sciences. <br />
<br />
If you end up in the emergency room with a bad case of the flu or pneumonia, your bill could be thousands of dollars. A flu shot is just $20, or often free; the pneumonia vaccine is about $77. <br />
<br />
Here is how to get up-to-date on your shots &mdash; whether you have a new insurance plan, an old plan or no plan at all. <br />
<br />
<strong>THE VACCINES YOU NEED</strong> Tear out the immunization chart accompanying this article or print it out online. Note the vaccines you should be getting, based on your age and health status. <br />
<br />
This year, for the first time, the C.D.C. recommends that everyone, regardless of age or health, get an influenza shot. Most people need only one. This year the flu shot provides protection against the H1N1 virus and two seasonal viruses. <br />
<br />
Most other vaccines are intended for specific age groups or for those with particular risk factors. The zoster vaccine, for example, has been tested only in older people. There is little evidence that it could benefit younger people, whose immune systems are still strong. <br />
<br />
Next, figure out which vaccines you have already received. Your doctor should be able to help. But if you have switched physicians a number of times, you may have to reconstruct your history on your own. <br />
<br />
&ldquo;When in doubt, get vaccinated,&rdquo; said Dr. Hopkins. &ldquo;There&rsquo;s very little risk with getting a second dose of a vaccine.&rdquo; <br />
<br />
<strong>IF YOU HAVE INSURANCE </strong>Call your primary care physician and explain that you would like to get your vaccinations updated. <br />
<br />
Some offices do not stock vaccines, so it is wise to tell the staff in advance what you will need. You may find that certain vaccines are not available right away; your doctor can tell you where to find them, or how long the wait will be. <br />
<br />
Next, call your insurer and ask if they will cover vaccines free of charge. If not, ask how much they charge. If the fees are high, see below for alternate options. <br />
<br />
<strong>IF YOU LACK COVERAGE</strong> You can still pay out-of-pocket for immunizations at the doctor&rsquo;s office, of course. But the shots may be less expensive at other places. <br />
<br />
<strong>YOUR HEALTH DEPARTMENT</strong> If money is tight, find out if your state or community health department provides vaccinations for adults. Unfortunately, there is no federally funded program for adult immunizations, only for children. <br />
<br />
The C.D.C. Web site provides an interactive map to help locate the health department or immunization clinic in your area. <br />
<br />
<strong>YOUR LOCAL PHARMACY </strong>Many retail clinics administer vaccines, including CVS MinuteClinics and Walgreens Take Care Clinics. MinuteClinics offer 10 vaccines for adults, including shots for hepatitis A ($117) and B ($102), meningitis ($147), pneumococcal disease ($77) and DTaP, which protects you from diphtheria, tetanus and pertussis ($82). <br />
<br />
There are 500 CVS clinics across the country, and all are open seven days a week. No appointments or prescriptions are necessary. Walgreens clinics offer travel vaccines, like the one for typhoid fever, as well. <br />
<br />
Even if your local pharmacy does not have a clinic, you may be able to get some of the shots you need there. In all states, pharmacists are licensed to give flu shots; in some states, they can administer other vaccines as well, like the one to protect against pneumonia. <br />
<br />
Check with a local pharmacy and find out what shots they are licensed to provide and at what cost. <br />
<br />
<strong>YOUR EMPLOYER</strong> Inquire at your company&rsquo;s human resources or wellness office. Some companies provide free flu shots for employees, as well as their families. Few companies provide other vaccines, but it can&rsquo;t hurt to ask. <br />
<br />
Remember that when you get immunized, you are not only ensuring your own good health but the health of those around you. <br />
<br />]]></full> 
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             <title><![CDATA[Cost of obesity? Over $4,000 if you're a woman ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=65</link> 
             <description><![CDATA[Cost of obesity? Over $4,000 if you're a woman - LAURAN NEERGAARD - MSN&nbsp;Money

WASHINGTON &mdash; Obesity puts a drag on the wallet as well as health, especially for women. 

Doctors]]></description> 
             <pubDate>Tue, 21 Sep 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Cost%20of%20obesity%20-%20Over%20$4,000%20if%20you're%20a%20woman.pdf</guid>
             <author><![CDATA[LAURAN NEERGAARD ]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.msnbc.msn.com/id/39276141/ns/health-diet_and_nutrition/"><strong>Cost of obesity? Over $4,000 if you're a woman</strong></a> - LAURAN NEERGAARD - MSN&nbsp;Money<br />
<br />
WASHINGTON &mdash; Obesity puts a drag on the wallet as well as health, especially for women. <br />
<br />
Doctors have long known that medical bills are higher for the obese, but that is only a portion of the real-life costs.<br />
<br />
George Washington University researchers added in things like employee sick days, lost productivity, even the need for extra gasoline &mdash; and found the annual cost of being obese is $4,879 for a woman and $2,646 for a man.<br />
<br />
That is far more than the cost of being merely overweight &mdash; $524 for women and $432 for men, concluded the report being released Tuesday, which analyzed previously published studies to come up with a total.<br />
<br />
Why the difference between the sexes? Studies suggest larger women earn less than skinnier women, while wages don't differ when men pack on the pounds. That was a big surprise, said study co-author and health policy professor Christine Ferguson, who plans to study why.<br />
<br />
Then consider that obesity is linked to earlier death. While that is not something people usually consider a pocketbook issue, the report did average in the economic value of lost life. That brought women's annual obesity costs up to $8,365, and men's to $6,518.<br />
<br />
The report was financed by one of the manufacturers of gastric banding, a type of obesity surgery.<br />
<br />
Most popular Firefighters in hot water over naked cooking NYT: Coral reefs face 2nd major global die-off Years after hushed-up death, airman honored Chilling 911 calls detail vicious bear attack Spectator stands collapse at Brazil race Celebrity sightings The numbers are in line with other research and are not surprising, said Dr. Kevin Schulman, a professor of medicine and health economist at Duke University who wasn't involved in the new report.<br />
<br />
Two-thirds of Americans are either overweight or obese, and childhood obesity has tripled in the past three decades. Nearly 18 percent of adolescents now are obese, facing a future of diabetes, heart disease and other ailments.<br />
<br />
Looking at the price tag may help policymakers weigh the value of spending to prevent and fight obesity, said Schulman, pointing to factors like dietary changes over the past 30 years and physical environments that discourage physical activity.<br />
<br />
&quot;We're paying a very high price as a society for obesity, and why don't we think about it as a problem of enormous magnitude to our economy?&quot; he asks. &quot;We're creating obesity and we need to do a man-on-the-moon effort to solve this before those poor kids in elementary school become diabetic middle-aged people.&quot;<br />
<br />
A major study published last year found medical spending averages $1,400 more a year for the obese than normal-weight people. Tuesday's report added mostly work-related costs &mdash; things like sick days and disability claims &mdash; related to those health problems.<br />
<br />
It also included a quirky finding, a study that calculated nearly 1 billion additional gallons of gasoline (3.8 billion liters) are used every year because of increases in car passengers' weight since 1960.<br />
<br />
Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. <br />]]></full> 
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                <item> 
             <title><![CDATA[Put Your Hospital Bills Under a Microscope]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=64</link> 
             <description><![CDATA[Put Your Hospital Bills Under a Microscope - JANE E. BRODY - NY&nbsp;Times

In times like these, the last thing you need is a hospital bill that can wreck an already]]></description> 
             <pubDate>Tue, 14 Sep 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Put%20Your%20Hospital%20Bills%20Under%20a%20Microscope.pdf</guid>
             <author><![CDATA[JANE E. BRODY]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.nytimes.com/2010/09/14/health/14brod.html"><strong>Put Your Hospital Bills Under a Microscope</strong></a> - JANE E. BRODY - NY&nbsp;Times<br />
<br />
In times like these, the last thing you need is a hospital bill that can wreck an already fragile budget. This is often the fate of elderly patients who incorrectly assume that Medicare will cover everything. <br />
<br />
Not so, as my aunt discovered early last year after a two-night, two-and-a-half-day stay at a for-profit hospital in Florida. There is a lesson for all of us from the following tale: no matter who is footing the bill, hospital charges should be carefully vetted by someone who, with the Internet and perhaps professional help, can decipher the codes and uncover unreasonable and erroneous charges. <br />
<br />
My aunt, then 88, had fainted in her apartment and was taken to the hospital by ambulance. After an evaluation in the emergency room, she was admitted to the hospital for what turned out to be a side effect from a new medication. <br />
<br />
Five months later, she received a bill stating that of total costs of $18,865 (which included $5,874 for a justifiable CT scan of her head and brain), she still owed $992.60 after Medicare and secondary insurance. The sum seemed prohibitive to my aunt, who lives on Social Security and a small pension. <br />
<br />
<strong>$457 for Eye Drops? </strong><br />
<br />
But that is not what prompted her daughter to question the bill and carefully review the itemized charges. &ldquo;What leaped out at me was a charge of $456.67 for the eye drops she uses once a day,&rdquo; my cousin told me. &ldquo;My mother pays $85 for her prescription, which lasts about 40 days, and she had her own drops with her.&rdquo; <br />
<br />
Further perusal revealed that each baby aspirin, each multivitamin, each 500-milligram tablet of vitamin C and each dose of stool softener was billed at $4.07, for a total of $40.70. She was also billed for six doses of a heart medication ($10.81 each), only two of which should have been administered. <br />
<br />
When my cousin called the hospital to question the charges and explain her mother&rsquo;s limited finances, she was told that financial assistance is offered only if the bill exceeds $1,000. Instead, the hospital suggested an audit but warned that such investigations often leave the patient with a larger bill. My cousin refused to be intimidated and requested the audit, which resulted in the removal of nine erroneous medication charges and a bill reduced to $500. <br />
<br />
And when she replied that this was still more than her mother could afford, the hospital lowered the bill to just $200 &mdash; as long as she paid it that day. There are reasons beyond greed that hospitals typically charge what look like outrageous prices for goods and services. Reimbursement rates are negotiated with insurers, and some are considerably less than what a patient without insurance would be charged. And hospitals rely on insured patients to make up for those who fail to pay their bills &mdash; and for the rates paid by Medicaid, which may be considerably lower than actual hospital costs. <br />
<br />
<strong>Uncovered Expenses <br />
</strong><br />
In recent years, hospitals have introduced a new source of potential financial disaster. To avoid federal penalties for the costly practice of readmitting patients after discharge, hospitals assign some patients to &ldquo;observation&rdquo; status, even if they occupy a hospital bed. Without formal admission, Medicare (and often private insurance as well) charges patients a 20 percent co-payment and does not cover the cost of post-hospital nursing care or rehabilitation. <br />
<br />
Observation status, which theoretically should last no more than a day or two, has been on the rise for longer stays. Patients often don&rsquo;t know they were never admitted as inpatients until they leave the hospital and are slapped with a huge bill. For one 76-year-old Connecticut man &ldquo;observed&rdquo; in a hospital room for eight days, the charges not covered by Medicare were $36,000, and he was not covered for three months of rehabilitation services, Bloomberg Businessweek reported in July. Before an unmanageable hospital bill forces you or anyone you know into foreclosure or bankruptcy or into the clutches of an unrelenting collection agency, there are remedies worth knowing about. In fact, even if you can afford to pay the bill, a careful review is a good idea, if only to disclose errors and excesses that drive up the cost of medical care for all of us. <br />
<br />
Errors are commonplace in hospital bills. A doctor may request a procedure or medication that is subsequently canceled or that the patient refuses, but it still goes on the bill. An entry error may result in a misplaced decimal point or an extra zero or two in the number of treatments, multiplying the cost 10 or 100 times. Check the dates for all procedures and medication; some may be listed as happening on a day or at a time you were not even in the hospital. <br />
<br />
Listings of medications and treatments you don&rsquo;t understand can nearly always be found on the Internet, but mysterious codes &mdash; like &ldquo;obs unit tell per hour,&rdquo; found on my aunt&rsquo;s bill &mdash; should be explained by the hospital&rsquo;s billing department. <br />
<br />
<strong>Negotiation Tactics </strong><br />
<br />
As my cousin found, it is nearly always possible to negotiate a smaller bill as well as a payment plan of a certain amount each month. Hospitals will often reduce the bill by 40 percent or more if it is paid in cash within 30 days. But be sure to remain civil in your negotiations. Berating the institution or its agents can be counterproductive. <br />
<br />
If negotiation by the patient, a family member or a friend is not possible, there are commercial services like Insnet that will do it for about a third of the ultimate savings. Other companies, like Medical Billing Advocates of America, can help with bill review. <br />
<br />
Another useful tactic, if your hospitalization is not an emergency, is to comparison-shop beforehand. Even within the same ZIP code, hospital charges for various procedures and room rates can vary greatly (get free cost information at Health Care Blue Book&rsquo;s Web site. <br />
<br />
In general, the costs at for-profit hospitals are greater than at nonprofits, and charges to patients at facilities outside the insurer&rsquo;s network will be much higher. And don&rsquo;t forget to check what the doctor and, if needed, the anesthesiologist will charge. Find out whether your insurance will be accepted and how much the co-pay is likely to be. <br />
<br />
But whatever you do, don&rsquo;t ignore a medical bill you are unable or unwilling to pay. If it ends up in the hands of a collection service, it will damage your credit rating and could ultimately result in a lien on your property. <br />
<br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[The high cost of smoking]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=62</link> 
             <description><![CDATA[The high cost of smoking - Hilary Smith - MSN Money

The costs add up: Cigarettes, dry cleaning, insurance -- you can even lose your job. A 40-year-old who quits and]]></description> 
             <pubDate>Mon, 30 Aug 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/The%20high%20cost%20of%20smoking.pdf</guid>
             <author><![CDATA[Hilary Smith]]></author> 
             <full><![CDATA[<a target="_blank" href="http://articles.moneycentral.msn.com/Insurance/InsureYourHealth/HighCostOfSmoking.aspx"><strong>The high cost of smoking</strong></a> - Hilary Smith - MSN Money<br />
<br />
The costs add up: Cigarettes, dry cleaning, insurance -- you can even lose your job. A 40-year-old who quits and puts the savings into a 401(k) could save almost $250,000 by age 70.<br />
<br />
If the threat of cancer can't persuade you to quit smoking, maybe the prospect of poverty will.<br />
<br />
The financial consequences of lighting up stretch far beyond the cost of a pack of cigarettes. Smokers pay more for insurance. They lose money on the resale value of their cars and homes. They spend extra on dry cleaning and teeth cleaning. Long term, they earn less and receive less in pension and Social Security benefits.<br />
<br />
Indeed, being a smoker can not only mean you don't get hired -- you can get fired, too. After announcing it would no longer employ smokers, Weyco, a medical-benefits administrator in Michigan, fired four employees who refused to submit to a breath test. It began testing the spouses of its employees, too, levying an $80-per-month surcharge on those who don't test clean.<br />
<br />
Overall, 5% of employers prefer to hire nonsmokers, according to the most recent survey by the Society for Human Resource Management, and 1% do not hire smokers. A few examples:<br />
<ul>
    <li>Kalamazoo Valley Community College in Michigan stopped hiring smokers for full-time positions at both its Michigan campuses.</li>
    <li>Alaska Airlines, based in Washington state, requires a nicotine test before hiring people.</li>
    <li>The Tacoma-Pierce County (Wash.) Health Department has applicants sign an &quot;affidavit of nontobacco use.&quot;</li>
    <li>Union Pacific won't hire smokers.</li>
</ul>
<br />
That same poll found that 5% of companies charge smokers more for health-care premiums. The costs don't stop with your paycheck. Figures from the Campaign for Tobacco-Free Kids assert that smokers cost the economy $97.6 billion a year in lost productivity.<br />
<br />
That's based on the number of working years lost because of premature death. (The Bureau of National Affairs says 95% of companies banning smoking report no financial savings, and the U.S. Chamber of Commerce finds no connection between smoking and absenteeism.)<br />
<br />
An additional $96.7 billion is spent on public and private health care combined, according to the Campaign for Tobacco-Free Kids, and each American household spends $630 a year in federal and state taxes due to smoking.<br />
<br />
Personal financial impact<br />
The cost of a pack of cigarettes averages around $4.50 to $5, including taxes, depending on where you live. Using the lower number, a pack-a-day smoker burns through about $31.50 per week, or $1,638 per year. That's a fat house payment or a nice vacation with the family. A 40-year-old who quits smoking and puts the savings into a 401(k) earning 9% a year would have nearly $250,000 by age 70.<br />
<br />
But only you know exactly how much you pay and how often. <br />
<br />
The one place many smokers feel free and comfortable to light up is in their car. Without consistent and thorough cleanings, however, a car that is smoked in will soon start to resemble an ashtray on wheels. The interior inevitably smells like smoke, and stray ashes and butts can burn holes in the upholstery and floor mats.<br />
<br />
None of these things has much financial impact until you try to sell the car. Figure a minimum of $150 for a good cleaning with an extractor.<br />
<br />
CNBC reports on the World Health Organization's plans to combat tobacco use globally.On a trade-in, dealers can easily knock off more than $1,000 on higher-end vehicles. Terry Cooper, a car dealer with seven new- and used-car stores, says he took a 1999 Porsche 911 Cabriolet in on trade for $37,000. That sounds OK, but the owner could have fetched $40,000 for it had he not &quot;smoked out&quot; the car's interior.<br />
<br />
The criteria that apply to cars apply to homes as well, only on a bigger scale.<br />
<br />
Smokers' houses often require all new paint and/or wall treatments, as well as professional drapery and carpet cleaning. According to Contractors.com, priming and painting an average-size living room, dining room and two bedrooms would cost more than $2,000. The Carpet Buying Handbook puts the average cleaning cost per square foot at 28 cents, and the average home has 1,000 square feet of carpet. That's $280. Add $55 to clean a typical sofa and $25 for a chair, says Diversified Carpet in San Diego.<br />
<br />
Walt Molony with the National Association of Realtors says that &quot;certainly the smell of cigarettes can be a turnoff to potential buyers.&quot;<br />
<br />
Insurers weigh in, and they're not happy <br />
We pulled some online quotes on 20-year term life insurance (a $500,000 policy) for a healthy 44-year-old male through BudgetLife.com. The lowest quote for a nonsmoker was $1,140 in premiums per year; for someone smoking a pack a day, the lowest price more than doubled to $2,571 per year.<br />
<br />
The difference in health insurance isn't as dramatic. According to eHealthInsurance.com, the monthly premium for a policy from Regence Blue Shield with a $1,500 deductible for a 44-year-old male nonsmoker is $292. The same policy for a smoker is $338 per month, or $552 more a year.<br />
<br />
A few state governments also charge their employees extra for health insurance if they smoke, and others are gradually joining the trend. <br />
<br />
According to the ACLU, a majority of states do not have a state law preventing employers from discriminating against potential and current employees based on nonwork activities. Thirty-one states do have laws that protect smokers, including Colorado and North Dakota, which ban discrimination based on any form of legal, off-duty behavior.<br />
<br />
When shopping for homeowners insurance, nonsmokers can generally expect to receive a minimum 10% discount. The insurer's point of view: Smokers burn down houses.<br />
<br />
The most common homeowners insurance policies range from approximately $457 to $1,372 per year, depending on the home's location. With the discount, a nonsmoker would realize savings of at least $45, but most likely more. Few people set out to cut their life short, but smokers greatly increase their chances of dying sooner than nonsmokers. In his book &quot;The Price of Smoking,&quot; Frank Sloan, the director of the Center for Health Policy, Law and Management at Duke University in Durham, N.C., details the financial impact of a shorter life span on retirement benefits.<br />
<br />
&quot;Smokers, due to higher mortality rates, obtained lower lifetime benefits compared to never smokers, even after accounting for their smoking-related lower lifetime contributions,&quot; the research says.<br />
<br />
Sloan and his colleagues found that the effects of smoking on lifetime Social Security benefits were $1,519 for 24-year-old female smokers and $6,549 for 24-year-old male smokers. This is money paid into Social Security but never collected, because the beneficiary died prematurely of a smoking-related illness.<br />
<br />
&quot;You could be paying into Social Security year after year, and if you die at 66 because you're a smoker, it's money down the drain,&quot; says Sloan.<br />
<br />
Keeping up appearances <br />
Numerous studies find that smokers earn anywhere from 4% to 11% less than nonsmokers. It's not just a loss of productivity to smoke breaks and poorer health that takes a financial toll, researchers theorize; smokers are perceived to be less attractive and successful as well.<br />
<br />
Bad breath, yellow teeth and smelly clothes are just a few of the personal side effects of smoking, and all cost money to correct.<br />
<br />
An extra pack of mints or gum a week adds up to about $50 per year. Need your teeth whitened once a year? Brite Smile, which has offices across the country, sells its service for $400 to $600. Most professional-grade teeth whitening products retail for a minimum of $200.<br />
<br />
Dry-cleaning bills are likely to be higher also. Clean that suit one extra time a month at a cost of $12, and there goes an additional $144 every year.<br />
<br />
Updated Sept. 3, 2008<br />]]></full> 
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                <item> 
             <title><![CDATA[Can Concierge Medicine for the Few Benefit the Many?]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=63</link> 
             <description><![CDATA[Can Concierge Medicine for the Few Benefit the Many? - PAULINE W. CHEN, M.D. - NY&nbsp;Times

Earlier this summer a friend revealed that for the last nine years she has been]]></description> 
             <pubDate>Mon, 30 Aug 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Can%20Concierge%20Medicine%20for%20the%20Few%20Benefit%20the%20Many.pdf</guid>
             <author><![CDATA[PAULINE W. CHEN, M.D.]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.nytimes.com/2010/08/26/health/26pauline-chen.html"><strong>Can Concierge Medicine for the Few Benefit the Many?</strong></a> - PAULINE W. CHEN, M.D. - NY&nbsp;Times<br />
<br />
Earlier this summer a friend revealed that for the last nine years she has been a patient in a concierge, or boutique, primary care practice. For $350 each month, she is guaranteed around-the-clock access to her doctor, appointments within 24 hours of calling, longer office visits and the kind of personalized attention and care coordination she felt was missing with all her previous doctors. <br />
<br />
&ldquo;I love this doctor,&rdquo; she said. &ldquo;He really knows me.&rdquo; <br />
<br />
She recounted the details of a recent emergency room visit when a call from the doctor saved her from an unnecessary CT scan and admission to the hospital. &ldquo;I feel like I have a doctor who&rsquo;s actually thinking about me and talking to other doctors on my behalf,&rdquo; she added. <br />
<br />
But over the course of our conversation, I also discovered that her husband does not share her enthusiasm. He goes to a doctor in a more traditional primary care practice because he&rsquo;s uncomfortable with the idea that those who can afford it get better care, while those who cannot pay do not. &ldquo;I just don&rsquo;t think it&rsquo;s right,&rdquo; he told me. <br />
<br />
The two of them had agreed to disagree. <br />
<br />
Agreeing to disagree has been what most of us, doctor and patient, have done since concierge, or retainer, practices first appeared in the mid-1990s. Developed as an alternative to the constraints of traditional practice, this new model allowed doctors to offer more personalized care that in turn increased patient and professional satisfaction. By decreasing the total number of patients seen in an office from well over 2,000 to as few as 500, doctors could offer longer visits, increased and immediate accessibility, personalized coordination of hospital care and, in some cases, even house calls and accompanied visits to specialists. In return for these services, patients would pay retainer fees, ranging from just under $2,000 to as much as $15,000 per year. <br />
<br />
By 2003, according to a national survey, the number of doctors practicing concierge medicine numbered fewer than 200. And while critics raised ethical concerns about the &ldquo;abandonment&rdquo; of patients left without primary care physicians while their doctors downsized and the creation of a &ldquo;two-tiered&rdquo; system that exacerbated disparities in health care access, little was done to address those concerns. These boutique practices were a relatively rare curiosity, and practitioners were left alone. <br />
<br />
But over the years and particularly in recent months, the debate about the ethics of concierge doctoring has grown more heated, with more and more physicians unabashedly lining up to take sides. An editorial in the Annals of Internal Medicine this spring, for example, questioned not only the ethics but also the quality of care delivered in such practices. The writer went on to urge other physicians to abandon &ldquo;the neutrality with which the medical community has addressed&rdquo; this issue thus far. <br />
<br />
A month later, over a hundred doctors at a national meeting eagerly attended an event billed as a debate on the ethics of retainer medicine. But they weren&rsquo;t jostling for places to argue the ethics; they wanted to hear about the experiences of physicians who were already successfully practicing concierge medicine and to solicit advice. <br />
<br />
As this issue becomes increasingly divisive, it&rsquo;s hard not to wonder whether it is possible to practice in a way that reconciles concierge medicine with all the ethical concerns. <br />
<br />
One group of doctors in Boston believes it is possible. And in an article published this summer in the journal Academic Medicine, they argue that it can be done to the benefit of doctors and all patients, boutique or otherwise. <br />
<br />
Since 2004, the primary care physicians at Tufts Medical Center have offered patients the option of being part of either a traditional general medical practice or a retainer practice. Patients in the retainer practice have longer visits, around-the-clock access to one of five physicians, comprehensive wellness and prevention screenings and on-time office appointments within 24 hours of a request. But unlike other boutique practices, the retainer fee of $1,800 per year that these patients pay does not go directly to the doctors&rsquo; coffers. Instead, it is used to support the traditional general medical practice, the teaching of medical students and trainees and free care to impoverished patients. <br />
<br />
&ldquo;I feel comfortable that this practice has been set up ethically,&rdquo; said Dr. David G. Fairchild, senior author of the article and chief medical officer at Tufts Medical Center, who as a primary care physician sees patients at both the retainer practice and the more traditional general medicine practice. &ldquo;No matter what practice patients are from, we treat them based on their medical need. But we also recognize that there may be a place for a higher level of service.&rdquo; <br />
<br />
That higher level of service, Dr. Fairchild points out, already exists across the country. Many hospitals, for example, have long offered &ldquo;V.I.P.&rdquo; rooms or suites or have concierge wards for patients who are willing to pay more during their stay. In the case of the Tufts primary care retainer practice, the differences come down to &ldquo;add-ons and the environment&rdquo; that do not affect the quality of care. &ldquo;Maybe you have a fish tank in one office and not in another,&rdquo; he said. <br />
<br />
This consistency in care across both practices was highlighted in a survey that Dr. Fairchild and his colleagues conducted last year. With responses from more than 300 patients, they found that patients rated the quality of interactions with their doctors similarly regardless of their affiliation. The only significant differences in responses had to do with the services offered &mdash; care coordination, physician access and interactions with office staff. <br />
<br />
&ldquo;It&rsquo;s like going first-class in an airplane,&rdquo; Dr. Fairchild said. &ldquo;The experience of people in coach is a little different, but everyone gets to the same place at the same time.&rdquo; <br />
<br />
And at least in this model, more people may be able to board that plane as a result of increased practice revenues. The retainer fees from each new patient can support the physician costs for as many as 50 patients in the traditional practice; and retainer practice patients know from the start that their fees will be used to support teaching, service and free care in the community practice. &ldquo;Some patients almost feel guilty about wanting this higher level of service,&rdquo; Dr. Fairchild said. &ldquo;Using their retainer fees for this type of support helps them see that they are actually making a contribution to teaching and community service, which are the mission of this hospital.&rdquo; <br />
<br />
While Dr. Fairchild is confident that the Tufts retainer practice addresses the ethical concerns of critics, he also acknowledges that concierge medicine is emblematic of larger problems in the health care system. <br />
<br />
&ldquo;This is not how any of us doctors wanted care to be set up,&rdquo; Dr. Fairchild said, &ldquo;but the system, as it is now, is broken. Patients are asking for more, doctors are under huge pressures, and there is not enough money in primary care.&rdquo; <br />
<br />
He added, &ldquo;For the time being, this is a solution that seems to be working for doctors and patients.&rdquo; <br />
<br />]]></full> 
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             <title><![CDATA[Weight-loss surgery cuts diabetics' costs: study]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=60</link> 
             <description><![CDATA[Weight-loss surgery cuts diabetics' costs: study- Julie Steenhuysen - Reuters

CHICAGO (Reuters) - Three-fourths of obese diabetics who had weight-loss surgery were able to quit taking diabetes drugs within six months]]></description> 
             <pubDate>Tue, 17 Aug 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Weight-loss%20surgery%20cuts%20diabetics%20costs.pdf</guid>
             <author><![CDATA[Julie Steenhuysen]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.reuters.com/article/idUSTRE67F4EX20100816"><strong>Weight-loss surgery cuts diabetics' costs: study</strong></a>- Julie Steenhuysen - Reuters<br />
<br />
CHICAGO (Reuters) - Three-fourths of obese diabetics who had weight-loss surgery were able to quit taking diabetes drugs within six months of their operation, U.S. researchers said on Monday, citing a new study.<br />
<br />
They said the surgery may eliminate the need for chronic medications to treat the disease and reduce overall healthcare costs, providing a strong argument for insurance companies to pay for the procedures.<br />
<br />
Once developed, diabetes and obesity are rarely reversed, Dr. Martin Makary of Johns Hopkins University in Baltimore and colleagues reported in Archives of Surgery, a medical journal.<br />
<br />
&quot;Until a successful non-surgical means for preventing and reversing obesity is developed, bariatric surgery appears to be the only intervention that can result in a sustained reversal of both obesity and type 2 diabetes mellitus in most patients receiving it,&quot; they wrote.<br />
<br />
Bariatric surgery, or weight loss surgery, has increased by 200 percent during the past five years, as obese people struggled to lose weight and avoid the health complications that accompany the extra pounds -- such as diabetes, heart disease, joint pain and some cancers.<br />
<br />
There are several ways to do the surgery with the aim of giving the patient the illusion of fullness with small meals.<br />
<br />
In one approach, an adjustable band is inserted in a small incision and wrapped around the top of the stomach during the surgery. In another, known as Roux-en-Y, the stomach is closed off near the top, creating a small pouch.<br />
<br />
But few studies have looked at how the surgery affected health costs in type 2 diabetics.<br />
<br />
Makary and his colleagues analyzed insurance claims data from 2,235 patients who underwent bariatric surgery during a four-year period.<br />
<br />
They found that among the diabetic patients who had bariatric surgery, only 25 percent were taking diabetes medication six months later, and that number kept falling.<br />
<br />
A year after surgery, fewer than 20 percent of patients were taking diabetes drugs and two years after surgery, only 15 percent were still doing so.<br />
<br />
Healthcare costs per diabetic averaged $6,376 per year in the two years before surgery. The median cost of the surgery and hospitalization was $29,959.<br />
<br />
Health costs increased in the year after the study by nearly 10 percent, but then fell by 34 percent in the second year after surgery and by 70.5 percent in the third year.<br />
<br />
&quot;Because weight loss following bariatric surgery has been observed to be sustained for decades, we believe that the protective effect against complications of diabetes is also likely to be long-term,&quot; the team wrote.<br />
<br />
Based on the study, obese patients with diabetes should be told about the risks and benefits of bariatric surgery, and insurance companies should be encouraged to cover weight-loss surgery for appropriate patients, they said.<br />
<br />
The National Institutes of Health recommends the surgery for someone with a body mass index of at least 40.<br />
<br />
BMI is equal to weight in kilograms divided by height in meters squared. A person 5 feet 5 inches tall with a BMI of 40 would weigh more than 240 pounds (109 kg).<br />
<br />
Both Johnson &amp; Johnson and Allergan Inc make bands for weight-loss surgery.<br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Fractures a Costly Cause of High School Sports Injury]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=57</link> 
             <description><![CDATA[Fractures a Costly Cause of High School Sports Injury - Robert Preidt

SUNDAY, Aug. 8 (HealthDay News) -- Fractures are the fourth most common type of injury suffered by high school]]></description> 
             <pubDate>Mon, 09 Aug 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Fractures%20a%20Costly%20Cause%20of%20High%20School%20Sports%20Injury.pdf</guid>
             <author><![CDATA[Robert Preidt]]></author> 
             <full><![CDATA[<a target="_blank" href="http://consumer.healthday.com/Article.asp?AID=641814"><strong>Fractures a Costly Cause of High School Sports Injury</strong></a> - Robert Preidt<br />
<br />
SUNDAY, Aug. 8 (HealthDay News) -- Fractures are the fourth most common type of injury suffered by high school athletes in the United States and can be serious and costly, a new study has found.<br />
<br />
Ligament sprains, muscle sprains and bruising occur more often, but an analysis of 2005-2009 national data found that 95 percent of fractures required expensive diagnostic imaging (such as X-rays, MRIs and CT scans) and 16 percent led to surgery.<br />
<br />
Compared to other types of injuries, fractures also resulted in more lost playing time. Most fractures led to three weeks or more time lost (34 percent) or medical disqualification from sports participation (24 percent), according to researchers at the Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital in Columbus, Ohio.<br />
<br />
The most common fracture sites were hand and finger (28 percent), wrist (10 percent) and lower leg (9 percent). Boys suffered the majority of fractures (83 percent), and contact between athletes was the cause of about half of all fractures, the investigators noted.<br />
<br />
The study also found that nearly 10 percent of fractures were caused by illegal play.<br />
<br />
&quot;Illegal activities represent a preventable cause that should be targeted by prevention programs. Increasing penalties, strict enforcement of current penalties, and better education about rules and the dangers associated with breaking the rules could all help in reducing injuries related to illegal activities,&quot; study author Dawn Comstock, principal investigator in the Center for Injury Research and Policy, said in a hospital news release.<br />
<br />
The study was published in the July issue of the Clinical Journal of Sports Medicine.<br />
<br />
&quot;Fractures are a major concern for U.S. high school athletes. They can severely affect the athletes' ability to continue sports participation and can impose substantial medical costs on the injured athletes' families,&quot; Comstock said. &quot;Establishing measures to reduce fractures among U.S. high school athletes should be an important part of sports injury prevention policies.&quot;<br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Demystifying, and Maybe Decreasing, the Emergency Room Bill]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=58</link> 
             <description><![CDATA[Demystifying, and Maybe Decreasing, the Emergency Room Bill - LESLEY ALDERMAN - NY Times

DURING a snowstorm last winter, my 6-year-old son fell and cut his chin &mdash; not outside on]]></description> 
             <pubDate>Mon, 09 Aug 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Demystifying,%20and%20Maybe%20Decreasing,%20the%20Emergency%20Room%20Bill.pdf</guid>
             <author><![CDATA[LESLEY ALDERMAN]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/08/07/health/07patients.html">Demystifying, and Maybe Decreasing, the Emergency Room Bill </a></strong>- LESLEY ALDERMAN - NY Times<br />
<br />
DURING a snowstorm last winter, my 6-year-old son fell and cut his chin &mdash; not outside on the ice, but inside on the tile bathroom floor. My husband walked our son, Charlie, through the knee-high snow to the local emergency room. <br />
<br />
Charlie&rsquo;s gash was small, less than half an inch long, but deep. The hospital called in a plastic surgeon, who put 14 tiny stitches into his chin. <br />
<br />
Charlie called the incident &ldquo;the worst day of my life&rdquo; &mdash; mostly because he had to spend hours in a hospital instead of throwing snowballs. Weeks later, when the bills arrived, we had our own bad day. <br />
<br />
The total charges for his minor spill came to $5,398. The largest single charge was a shocking $4,950 from the plastic surgeon. <br />
<br />
Emergency room bills are notoriously high and perplexing; patients often are left feeling like captives who have few alternatives. It is impossible to know how much the services will cost when you walk in the door. The hospital bill, which arrives weeks later, may include seemingly inflated charges for things like Tylenol or an M.R.I. Doctors who treated you may send their own separate bills, further complicating the payment process. <br />
<br />
The first step toward managing this expense is understanding what goes on in the hospital&rsquo;s billing department. <br />
<br />
NOBODY PAYS RETAIL The majority of hospitals are required by law to treat any person who walks into an emergency room whether that person has insurance or not. To make up for those who cannot or will not pay, a hospital sets its so-called gross charges very high. <br />
<br />
At the same time, hospitals negotiate contracts with managed care and commercial insurance carriers that specify prices much lower than the gross charges. Medicare and Medicaid dictate lower rates for medical services to hospitals. In virtually every instance, &ldquo;we get paid a lot less than we bill,&rdquo; said Michelle Leone, senior vice president for revenue cycle operations at Continuum Health Partners in New York City. <br />
<br />
You may receive a statement that shows your E.R. visit totaled $3,000, for example, but your insurer may agree to pay just $500, which the hospital will accept. Depending on your plan, you owe either a portion of that $500 &mdash; say, 20 percent, after a deductible &mdash; or a co-payment. <br />
<br />
People without insurance end up with bills that are much higher than those for covered patients, because the uninsured are charged the hospital&rsquo;s gross rates. <br />
<br />
&ldquo;People don&rsquo;t realize that the prices on the bill are just a starting point,&rdquo; said Dr. Jesse M. Pines, an associate professor of emergency medicine and health policy at the Center for Health Care Quality at George Washington University. &ldquo;Prices listed on the bill often don&rsquo;t represent what the insurer or the patient will ultimately pay.&rdquo; <br />
<br />
The prices ultimately paid to a hospital can vary considerably for treatment of similar medical problems. &ldquo;It&rsquo;s kind of like the airline industry,&rdquo; Dr. Pines said. &ldquo;It&rsquo;s rare that two people on a plane will have paid the same amount for their seats.&rdquo; <br />
<br />
THE SURPRISES Besides being charged for each service you receive, you will be charged an emergency room fee corresponding to the complexity of treatment that your injury required. <br />
<br />
Normally there are five levels of care &mdash; Level 1 is for minor problems like an earache. Level 5 is for more severe problems like a broken bone. (There are higher levels of care reserved for critically ill patients.) Charlie&rsquo;s stitches, for instance, were considered Level 2 care, and the emergency room fee was $488. <br />
<br />
When an outside doctor is called in, you will receive a bill directly from the doctor or from your insurance company. The fee will be high, but your insurer probably will pay for most of it, depending on your plan and whether you have met your deductible. <br />
<br />
In the end, our final out-of-pocket costs for the entire emergency were less than a third of the original charges. That sounds good, but the bill was still $1,579. <br />
<br />
Some insurance plans require that you get preauthorization before receiving emergency care, said Gordon Wheeler, associate executive director for public affairs at the American College of Emergency Physicians. <br />
<br />
The new health reform law, though, stipulates that a patient may not be penalized for receiving out-of-network care in the case of an emergency, and that a patient does not need to seek preapproval. The final regulations on this issue are to be released at the end of this month. <br />
<br />
Whether you have insurance or not, here are some strategies for avoiding high emergency room bills and steps to take when the amount you owe seems unreasonably high. <br />
<br />
DON&rsquo;T GO THERE If your situation is not dire &mdash; you twisted your ankle or have a persistent sore throat, say, or your child receives a small burn &mdash; call your doctor first and ask for advice. <br />
<br />
While this might sound obvious, many people routinely head to the E.R. for nonurgent problems. The top three reasons for emergency room visits in 2007 were for sprains and strains, superficial injuries and contusions, and upper respiratory infections, according to Ryan Mutter, a senior economist at the federal Agency for Healthcare Research and Quality. <br />
<br />
Call your insurer&rsquo;s nurse triage hot line. A trained nurse can help you determine whether a swollen ankle is broken and should be immediately X-rayed, for instance, or whether a burn requires a doctor&rsquo;s attention or just judicious at-home treatment. <br />
<br />
Another good alternative to the E.R. is an urgent care center. There are now 8,700 of them across the country. They are typically faster and cheaper than E.R.&rsquo;s. Urgent care centers specialize in treating mild injuries like sprains, broken toes and fingers and mild cuts. To find a nearby urgent care center, call your insurer or go to iTriagehealth.com. <br />
<br />
SCRUTINIZE THE BILL If a charge looks wrong or the amount seems unreasonably high, call the hospital&rsquo;s billing department. Hospitals and insurers process thousands of claims a day, and mistakes do happen. If you received two stitches in your finger, but were billed $700 for Level 3 care, ask why this is so. <br />
<br />
&ldquo;Never be afraid to ask questions about your bill,&rdquo; Ms. Leone said. <br />
<br />
MAKE AN OFFER If the final bill is beyond your means, it will pay to bargain &mdash; particularly if you do not have insurance. <br />
<br />
&ldquo;The majority of hospitals will discount private paying patients&rsquo; bills,&rdquo; Ms. Leone said. &ldquo;Most hospitals are generous in their discounts.&rdquo; <br />
<br />
You can negotiate even when you have insurance. Two years ago Lisa Cullen&rsquo;s father, Thomas Reilly, became very ill and made three trips to the emergency room. Each visit cost about $15,000. Mr. Reilly&rsquo;s insurer contested some of the charges, and the family ultimately was left owing the hospital $11,000. <br />
<br />
The hospital was able to reduce the bill to $5,000. &ldquo;I was surprised to learn hospitals would rather receive partial payment than no money at all,&rdquo; Ms. Cullen, a writer in Leonia, N.J., said. Often you can work out a payment plan with the hospital whereby you pay your bill in installments rather than all at once. <br />
<br />
Negotiate with doctors, too, over their individual bills. <br />
<br />
ACT QUICKLY Unpaid hospital bills are usually forwarded to collection agencies that report uncollectible accounts to credit agencies. When faced with exorbitant bills, don&rsquo;t hesitate to contact the hospital&rsquo;s billing department and start a dialogue. <br />
<br />
&ldquo;By the time your bill lands at the collection agency, your credit score will have taken a serious hit,&rdquo; Dr. Pines warned, &ldquo;and it might be hard to borrow money in the future.&rdquo; If that happens, a trip to the emergency room will feel like the beginning, not the end, of your troubles. <br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[For Most, Implants Beat Dentures, but at a Price]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=55</link> 
             <description><![CDATA[For Most, Implants Beat Dentures, but at a Price - LESLEY ALDERMAN - NY&nbsp;Times

MARK PANKO still gets riled when he recalls the two years he suffered with traditional dentures. 

&ldquo;They]]></description> 
             <pubDate>Mon, 02 Aug 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/For%20Most,%20Implants%20Beat%20Dentures,%20but%20at%20a%20Price.pdf</guid>
             <author><![CDATA[LESLEY ALDERMAN]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.nytimes.com/2010/07/31/health/31patient.html"><strong>For Most, Implants Beat Dentures, but at a Price</strong></a> - LESLEY ALDERMAN - NY&nbsp;Times<br />
<br />
MARK PANKO still gets riled when he recalls the two years he suffered with traditional dentures. <br />
<br />
&ldquo;They fell out when I talked,&rdquo; Mr. Panko, 56, a small-business owner in Woodridge, Ill., recalled. &ldquo;I couldn&rsquo;t taste my food &mdash; in fact, I could hardly chew. It was the most miserable time of my entire life.&rdquo; <br />
<br />
Mr. Panko, who lost his teeth in his early 50s because of a hereditary form of periodontal disease, eventually replaced his dentures with something better: dental implants. While many people wear dentures without discomfort, implants are now considered the preferred treatment for replacing lost teeth, said Dr. Robert Pick, an associate professor of surgery at the Feinberg School of Medicine at Northwestern University. <br />
<br />
The procedure is straightforward. A surgeon places a titanium screw in the jaw bone, and prosthetic teeth are secured to the implant. They don&rsquo;t wiggle or slip, as dentures can, and are healthier for the gums and bone. Most patients find implants easier to maintain than dentures. <br />
<br />
&ldquo;Best decision I ever made,&rdquo; Mr. Panko said of his implants. &ldquo;I could chew beer cans now.&rdquo; <br />
<br />
If only paying for them were so easy. For all their advantages, implants are expensive. Insurance coverage is usually minimal, and patients often are surprised by high out-of-pocket costs. <br />
<br />
An implant to replace a single tooth can cost $3,000 to $4,500, depending on where you live. Implants to replace a full or partial set of teeth can run from $20,000 to as much as $45,000. <br />
<br />
Why so much? Implants typically involve the work of both a surgeon and a dentist. Several office visits may be needed to put in the screws and to add the prosthetic teeth. <br />
<br />
More dental insurance plans are covering the costs, but the annual reimbursement limit is typically $1,500, an amount that hasn&rsquo;t changed in four decades. That may be enough to cover half the cost of a single implant; you will end up paying the rest. <br />
<br />
Still, many patients may find it a worthwhile investment. Implants typically last a lifetime, with a failure rate of less than 5 percent. <br />
<br />
Let&rsquo;s say you lose one tooth. If you opt for a bridge, which costs almost as much as an implant but is more often covered by insurance, the dentist will grind down the two adjacent teeth to create a structure that secures the replacement tooth. <br />
<br />
The ground teeth become more vulnerable to decay and nerve damage, and there&rsquo;s a good chance you will require a root canal in the future, said Dr. Karl Gruendl, a dentist in Fenton, Mo., who advises insurance plans. <br />
<br />
A study done for Washington Dental Service, the largest insurance carrier in Washington State, found that over a five-year period the maintenance costs for people with bridges were higher than for those who had implants. <br />
<br />
&ldquo;For a single tooth replacement, over the long run we think it&rsquo;s more beneficial to get the implant,&rdquo; said Dr. Ron Inge, dental director for Washington Dental Service. And that&rsquo;s an insurance executive talking. <br />
<br />
If you need to replace most or all of your teeth, dentures are clearly the cheaper alternative, costing around $2,500 for a set (upper and lower jaws). But the implants won&rsquo;t move around, nor interfere with your sense of taste, as a denture might. <br />
<br />
Implants also will help protect your bones over time. &ldquo;The screw in your jawbone will trick the body into thinking you still have teeth,&rdquo; said Dr. Ira Cheifetz, president of the American Association of Oral and Maxillofacial Surgeons. &ldquo;The bone continues to grow and thrive.&rdquo; <br />
<br />
Implants aren&rsquo;t appropriate for every patient, particularly those who smoke or already have substantial bone loss. If you are a candidate for the procedure, consider these cost-saving strategies. <br />
<br />
YOUR PLAN BENEFITS If your dental insurance covers implants, bravo. If it does not, ask the carrier to give you an allowance toward what a bridge or conventional denture would have cost, Dr. Gruendl suggested. <br />
<br />
See a dentist who belongs to your insurance network. Dental plans negotiate discounted rates with their network providers, which means the overall cost of the implant will be substantially less than the &ldquo;retail&rdquo; charge, said Evelyn Ireland, executive director of the National Association of Dental Plans. <br />
<br />
How much less? Depending on the carrier, it might be as little as 5 percent of the standard price, or as high as 40 percent. <br />
<br />
FINANCING OPTIONS Most dentists are willing to offer some kind of discount to patients who expect to have large bills. If you don&rsquo;t have insurance or your plan doesn&rsquo;t cover implants, ask your dentist for the rate provided to in-network insured patients. <br />
<br />
Some dentists may let you pay them directly in installments. Mr. Panko, for example, is still paying off the $45,000 bill for the implants he got four years ago from Dr. Pick. Mr. Panko is pleased it worked out that way: &ldquo;I have a longstanding relationship with my periodontist, and we worked out a payment plan.&rdquo; <br />
<br />
Many dentists also participate in financing programs, such as CareCredit and Wells Fargo Health Advantage, that let patients pay bills over time with no, or minimal, interest. With CareCredit, for instance, you pay no interest if you pay off your balance in full within two years. Ask your dentist about financing plans if you&rsquo;re worried about paying your bills all at once. <br />
<br />
AN ALTERNATIVE PROVIDER Dental schools sometimes have clinics where advanced students do implant procedures at reduced rates. Check the Web site of Oral Health America for help finding a clinic near you: oralhealthamerica.org. <br />
<br />
START AN F.S.A. If you know you need one or more implants, but it&rsquo;s not an emergency, fully fund your flexible spending account for next year. F.S.A.&rsquo;s, offered by many employers, allow you to use pretax dollars to pay health care expenses. Depending on your tax bracket, pretax dollars can amount to an extra 20 percent to spend on the dental bill, compared to using taxed income. <br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Skinny people, fatter bank accounts]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=56</link> 
             <description><![CDATA[Skinny people, fatter bank accounts - Jennifer Openshaw - MarketWatch

It turns out healthier habits may make for wealthier ones: Studies show that being overweight is costly. Could Happy Meals be]]></description> 
             <pubDate>Mon, 02 Aug 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Skinny%20people,%20fatter%20bank%20accounts.pdf</guid>
             <author><![CDATA[Jennifer Openshaw, MarketWatch]]></author> 
             <full><![CDATA[<a target="_blank" href="http://articles.moneycentral.msn.com/SavingandDebt/SaveMoney/do-thin-workers-earn-fatter-salaries.aspx"><strong>Skinny people, fatter bank accounts</strong></a> - Jennifer Openshaw - MarketWatch<br />
<br />
It turns out healthier habits may make for wealthier ones: Studies show that being overweight is costly. Could Happy Meals be harming your child's financial future?<br />
<br />
You have to admire Michelle Obama for taking on an issue -- healthful eating -- that could turn off millions of Americans who themselves are overweight. The first lady is taking on the underlying issues, from improved food labels to more money for better foods in schools, with a vengeance, tackling the problem from many angles. <br />
<br />
But there's another reason every parent should get rid of excess weight and teach their kids good eating habits: their financial futures. <br />
<br />
You might argue that eating at McDonald's is cheaper than making burgers from scratch -- and it does save you time -- but that's hardly a reason to run for the Golden Arches.<br />
<br />
Now, mind you, I love good things. People call me a foodie. But I try to battle the bulge with modifications here and there and a lot of exercise. (As a friend once said, echoing my thoughts, &quot;I exercise so that I can have dessert.&quot;)<br />
<br />
So if you're wondering if you should put your kids on a diet, even if you can't seem to tighten your own belt, consider these costs, which will add to their financial security -- or lack of it -- over time: <br />
<br />
<strong>Food. </strong>By definition, most people who are overweight consume more calories than they should. That often means the relatively cheap calories found at fast-food restaurants. But for some, it's indulging in that high-priced brownie sundae with whipped cream or similar fare. If you munch just an extra $6 a day, you&rsquo;re consuming a whopping $143,000 from your nest egg over 30 years, assuming a 5% annual return. <br />
<br />
<strong>Illness. </strong>According to a Rand study, obese people spend 36% more on health services than people of normal weight -- for co-pays, prescription drugs and other expenses. That's no surprise. Overweight and obese people tend to suffer from a higher incidence of chronic disease. The result? &quot;Recovery from any given injury or illness is likely to be more difficult and more expensive than for normal-weight individuals,&quot; says Claire Wilkinson, the director of global insurance issues for the Insurance Information Institute. That means more intensive recuperation, more time off the job and higher overall medical bills. <br />
<br />
<strong>Life insurance.</strong> Looking to protect your kid if something happens to you? It'll cost more if you're heavy. The longer you're likely to live, the lower the chance that an insurance company will have to pay a claim. Obese people live seven years less, on average, and life insurers have to account for such differences in their underwriting. <br />
<br />
&quot;For this reason, life insurance for overweight and obese people generally costs more than for normal-weight people,&quot; Wilkinson says. &quot;Insurance companies take into account a lot of different factors when they're quoting you with a rate. Things like family history, healthy weight, and whether you exercise regularly may enable you to qualify for a more favorable rate class.&quot;<br />
<br />
In group life insurance plans, while age, smoking and even gender can impact rates to individuals, obesity isn't used as a factor, at least not yet. <br />
<br />
<strong>Net worth. </strong>You've heard the studies that show better looking people earn more. Being thin helps, too. A study by the Center for Human Resources Research at Ohio State University found that the obese accumulate only about half the net worth of Americans who were not obese. Overall, a one-point increase in body mass index, or BMI, dropped net worth by about $1,300. (You can learn more about BMI and calculate yours here.) <br />
<br />
<strong>Earnings:</strong>The Ohio State study found that a typical woman earned $314 less annually for every one-point increase in BMI, while a male counterpart earned $161 less. Another study, by a New York University sociologist, found that for women, a 1% increase in BMI led to a 0.6% decrease in income and a 0.4% decrease in job &quot;prestige.&quot; Assuming these finding are true, an increase of just one point in a man's BMI could lead to a drop in savings over 30 years of as much as $10,700 (assuming a 5% annual return if these earnings were not otherwise lost). For a woman, the impact would be more than $20,000.<br />
<br />
It's easy to blame companies like Kraft Foods and McDonald's for the obesity issue. But it all really starts with good habits. And those come mostly from Mom and Dad.<br />]]></full> 
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                <item> 
             <title><![CDATA[Filling In the Insurance Gap for Adult Children]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=59</link> 
             <description><![CDATA[Filling In the Insurance Gap for Adult Children - MICHELLE ANDREWS - NY&nbsp;Times

TAMAR ZAIDENWEBER, a 24-year-old graduate student at Georgetown University, lost her insurance coverage under her father&rsquo;s health plan]]></description> 
             <pubDate>Sun, 01 Aug 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Filling%20In%20the%20Insurance%20Gap%20for%20Adult%20Children.pdf</guid>
             <author><![CDATA[MICHELLE ANDREWS]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.nytimes.com/2010/08/14/health/policy/14patient.html"><strong>Filling In the Insurance Gap for Adult Children</strong></a> - MICHELLE ANDREWS - NY&nbsp;Times<br />
<br />
TAMAR ZAIDENWEBER, a 24-year-old graduate student at Georgetown University, lost her insurance coverage under her father&rsquo;s health plan in 2008 because she was no longer financially dependent on him. Because of the new health care law, she will be able to rejoin his policy. <br />
<br />
But not until January. In the meantime, she will renew the student policy she had last year, even though the coverage isn&rsquo;t as good and the price, $1,745 for the year, is much steeper than rejoining her father&rsquo;s plan, which she will be able to do free. <br />
<br />
&ldquo;It&rsquo;s extremely frustrating,&rdquo; she said. <br />
<br />
Finding a health plan for college-age children isn&rsquo;t something parents have had to think much about. Most decide to keep their children on their employer&rsquo;s plan, which is typically more comprehensive than coverage offered through the school or in the market for individual policies. <br />
<br />
But many health plans limit coverage of college-age children for a variety of reasons, including age, whether they live at home and whether they are financially dependent. For families with those plans, the choices are more difficult. And the health care law has added wrinkles to an already complicated decision. <br />
<br />
Under the new law, employers will be required to offer to cover adult offspring until they are 26, regardless of their student status or whether they are financially dependent on their parents. The provision takes effect on or after Sept. 23, whenever health plans renew coverage. <br />
<br />
For many companies, that means January 2011, but for others it could be March or even July. So students like Ms. Zaidenweber face a gap in coverage of several months. <br />
<br />
Because of a pre-existing condition, she does not qualify for an individual insurance policy to tide her over until January, when she will rejoin her father&rsquo;s plan. But Georgetown won&rsquo;t permit her to buy student coverage for just one semester, so beginning in January she will be doubly insured. <br />
<br />
For many such students and their families, finding adequate health insurance remains a challenge. Here are strategies to consider. <br />
<br />
EMPLOYER PLANS Employer plans generally offer more comprehensive coverage than student or individual policies. But don&rsquo;t assume the company plan is the best choice. <br />
<br />
If you haven&rsquo;t done so, check with your human resources department to make sure your child will be covered in the fall. If there is going to be a gap, find out your health plan renewal date and when the enrollment period will be held to add adult children. <br />
<br />
If your plan doesn&rsquo;t renew until next year, under the federal Consolidated Omnibus Budget Reconciliation Act, Cobra, you can keep your child on your employer plan in the interim. But you will be responsible for paying the premium to cover the child. <br />
<br />
Cost is another important question. Once the plan renews its policy, the new health care law prohibits employers from charging a higher rate for adult children who are newly eligible for coverage. Companies can charge more for all dependents, however, and many may do so. <br />
<br />
In a recent survey by Mercer, a human resources consulting firm, one third of employers said they would strongly consider increasing the premiums for dependent coverage to offset the higher costs of covering adult offspring. If your company plans to do this, you may want to consider other options, such as individual insurance, especially if your child is healthy. <br />
<br />
The new health care law eliminates some barriers for parents who want to keep college students on the family plan, but obstacles remain. One all-too-common difficulty: If your child is going to school out of state, your health plan may not cover most services there. <br />
<br />
That&rsquo;s the situation facing the Davis family of Malibu, Calif. Skyler Davis, 18, is heading to Drexel University this fall, but the family&rsquo;s health maintenance organization will cover him only for emergency or urgent care, not routine doctor appointments, while he&rsquo;s in Philadelphia. <br />
<br />
So the Davises will probably buy Drexel&rsquo;s student plan, at $1,140 a year. Elyse Davis concedes she does not like the $50,000 per condition per lifetime cap on benefits. <br />
<br />
&ldquo;You go into the hospital for two days, and that could do it,&rdquo; she said. <br />
<br />
STUDENT POLICIES A majority of colleges offer student health insurance, and some provide solid coverage &mdash; but they are the exception. &ldquo;Most student plans are really bad,&rdquo; said Stephen Beckley, a health care management consultant for colleges and universities in Fort Collins, Colo. <br />
<br />
Student health plans must meet new standards under the health law, but the specific regulations have not been issued. The law is likely to have no effect this fall, since those health plans are already in place. <br />
<br />
If you&rsquo;re considering buying a college plan, look for several important elements, said Mr. Beckley and other experts. They include: catastrophic coverage of at least $1 million in lifetime benefits; no exclusions of coverage for pre-existing conditions if your child was covered immediately before signing up; first-dollar mental health coverage, not subject to a deductible; and solid prescription drug coverage. <br />
<br />
As more parents see cuts to their generous employer health benefits or lose them entirely, some student health plans, even ones that aren&rsquo;t particularly robust, are starting to look at least somewhat attractive. <br />
<br />
Donna and Brent Funck&rsquo;s daughter Brenna, 18, will attend Tulane University in New Orleans this fall. Mr. Funck owns a software business, and the family is insured through an individual policy. Brenna Funck, however, has a congenital heart defect that makes her difficult to insure. The Funcks pay $300 a month for a separate individual policy for her, with a $2,500 deductible. <br />
<br />
Tulane&rsquo;s policy isn&rsquo;t ideal for someone with a medical condition that may require expensive care. The policy maxes out at $250,000 per condition per lifetime. &ldquo;One event that requires surgery would wipe that out,&rdquo; Ms. Funck said. <br />
<br />
But the $1,754 annual premium is a lot less than the Funcks pay, and the deductible is just $250. Despite reservations, they said they would sign her up. <br />
<br />
INDIVIDUAL PLANS If the parents&rsquo; insurance isn&rsquo;t an option and the school policy is poor or nonexistent, students who are healthy may be able to get a good deal on an individual policy. <br />
<br />
The average rate for an 18- to 24-year-old is $106 a month for a plan with a $2,300 deductible, said Carrie McLean, a consumer specialist with eHealthInsurance.com, which sells policies from 180 insurers through its Web site. <br />
<br />
Individual policies are not known for being generous, but they may be a better choice for students than in years past. Under the health care law, new individual plans must meet new standards beginning Sept. 23, including no lifetime limits on coverage and free preventive care. <br />
<br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[For Chronic Care, Try Turning to Your Employer]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=54</link> 
             <description><![CDATA[For Chronic Care, Try Turning to Your Employer - WALECIA KONRAD - NY&nbsp;Times

IF you are one of the 133 million American grappling with a chronic illness like diabetes, asthma or]]></description> 
             <pubDate>Wed, 28 Jul 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/For%20Chronic%20Care,%20Try%20Turning%20to%20Your%20Employer.pdf</guid>
             <author><![CDATA[WALECIA KONRAD]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.nytimes.com/2010/07/24/business/24patient.html"><strong>For Chronic Care, Try Turning to Your Employer </strong></a>- WALECIA KONRAD - NY&nbsp;Times<br />
<br />
IF you are one of the 133 million American grappling with a chronic illness like diabetes, asthma or heart disease, where do you turn for help managing your condition? <br />
<br />
Your employer may seem like an unlikely choice. Chronic conditions account for 25 percent of all medical costs, studies show, and an employee with a longstanding illness can mean higher health care expenses and lower productivity to company bean counters. <br />
<br />
Yet many firms have come to realize that it makes economic sense to help improve the health of workers who are the greatest users of medical services. <br />
<br />
Today, just about every major firm offers some sort of chronic care program. But the offerings can vary widely, said Dr. Harlan Levine, a principal at the benefits consulting firm Towers Watson who specializes in chronic care management. And to many workers already struggling with their medical decisions, the new workplace choices can seem daunting. <br />
<br />
Some firms contract with their insurer or an outside vendor to have a nurse occasionally call employees suffering from chronic illnesses. These programs may do little more than remind a diabetic to get his regular blood test or ask an asthmatic if she is taking her medicine. <br />
<br />
In the better programs, however, employees receive assistance coordinating care among specialists and keeping track of prescriptions, and a dedicated care specialist helps address small problems before they turn into full-blown health crises. <br />
<br />
Recently Boeing completed a successful test program in which employees with chronic conditions were invited to participate in what&rsquo;s called a medical home program. <br />
<br />
Specially trained nurses were made available to the employees by phone and e-mail almost 24 hours a day. They worked one-on-one with patients to monitor their conditions and treatments and to help them make the lifestyle adjustments needed to remain healthy. <br />
<br />
The result? Boeing experienced a 20 percent reduction in health care costs per member enrolled in the program, according to Theresa Helle, manager of the test program. Patients fared better and avoided costly emergency room visits, hospitalizations and other major medical episodes. <br />
<br />
A Boeing engineer, Doug McClaren, 54, signed up for help managing a longstanding pulmonary condition. He was interviewed extensively by a coordinating nurse, who then helped schedule appointments with specialists and reminded Mr. McClaren when to show up. <br />
<br />
Mr. McClaren also liked the fact that his nurse would send an e-mail message every few months asking how he felt and if any health issues had surfaced since they had last talked. <br />
<br />
&ldquo;That prompting allowed me to think a little bit more carefully about a nagging problem I was putting off or that I might not have remembered to mention at an annual check-up,&rdquo; he said. &ldquo;She can go and talk to any of my doctors, get me an answer or tell me who I should go see.&rdquo; <br />
<br />
At companies like Pitney Bowes and Quad/Graphics, comprehensive chronic disease management is offered at on-site clinics. Both employers say health care costs have decreased significantly as a result. <br />
<br />
At Quad/Graphics, a large printing company based in Sussex, Wis., overall health care expenditures are 30 percent lower than those of similar manufacturers in the region. <br />
<br />
Despite the success stories, chronic care management programs are not without challenges. Arranging for the kind of one-on-one care that has proven most successful is expensive and must be carefully coordinated with the employees&rsquo; own doctors, who are already stretched for time. <br />
<br />
&ldquo;If the primary care physician isn&rsquo;t in the loop, there can be duplication of medicines and other problems,&rdquo; said Dr. Lori J. Heim, president of the American Academy of Family Physicians. <br />
<br />
What&rsquo;s more, employees must buy into the programs for them to work. Often they do not. Entrenched habits that contribute to a chronic illness &mdash; lack of exercise, poor diet, little sleep &mdash; can be hard to break. Many patients stop taking their prescriptions. <br />
<br />
&ldquo;I&rsquo;d say less than a third, maybe even a fifth, of the people who these programs are targeted for actually comply,&rdquo; said Dr. Levine. <br />
<br />
The barriers also can be psychosocial. &ldquo;People with chronic illnesses can suffer from depression. They&rsquo;re busy, they have kids and elderly parents they are taking care of, making it hard to take care of themselves,&rdquo; said Dr. Raymond J. Zastrow, the president of QuadMed, the health care subsidiary of Quad/Graphics. <br />
<br />
If you suffer from a long-term illness and your company offers one of these programs, don&rsquo;t hesitate to sign up. You may well find the encouragement, support and financial and medical resources you need to better manage your illness and to save on your own out-of-pocket health care costs. <br />
<br />
Here is some advice on how to make the most of your company&rsquo;s chronic care program. <br />
<br />
MAKE THE COMMITMENT Getting started in one these programs can be time-consuming. Invest the effort it takes to get enrolled. The more comprehensive the initial visit, the better the advice, support and feedback you&rsquo;ll receive down the road. <br />
<br />
This is especially true if you&rsquo;ve recently learned of your chronic ailment. <br />
<br />
&ldquo;That can be a really scary time,&rdquo; said J. Brent Pawlecki, medical director at Pitney Bowes. &ldquo;A diabetic, for instance, may not know how to read sugar levels, let alone figure out what the numbers mean. This is when you can really use the help.&rdquo; <br />
<br />
THE PRIVACY QUESTION Many employees avoid chronic care programs because they&rsquo;re worried that their health information will be disclosed to their bosses and they&rsquo;ll suffer unfair consequences as a result. That&rsquo;s an understandable concern, but it&rsquo;s important to remember that companies spending money on these programs are extremely vested in their success. <br />
<br />
For the most part, these firms are careful to hire trusted third-party administrators and to make sure employee health records and other information are never disclosed to company officials. <br />
<br />
GET WHAT&rsquo;S COMING TO YOU To get more employees to participate, employers are offering all types of incentives, from free gym memberships to reduced health care premiums to lower copays. The benefits can really add up. <br />
<br />
Let&rsquo;s say you work for Pitney Bowes. If you need regular medication as part of your condition, the company makes an exception to its normal three-tier system &mdash; 10 percent of the drug&rsquo;s cost for generics, 30 percent for preferred drugs and 50 percent for nonpreferred. Those with chronic conditions would pay the lowest co-pay, 10 percent, even if the drug is classified as nonpreferred. <br />
<br />
Along with the carrots, there may be sticks. Quad/Graphics offers a zero copay on drugs for people with diabetes enrolled in its chronic care program. (Participants saved an average of $540 last year.) But employees who stop participating in the plan go back to paying regular copays. <br />
<br />
INFORM YOUR DOCTOR Communicating with an employee&rsquo;s primary care physician can be one of the biggest challenges in running a successful program. <br />
<br />
In some cases you may have to nag your employer-based care nurse to call or write to your doctor with updates. If you find that records from your visits, phone calls or e-mail messages with your company&rsquo;s chronic care program are not being forwarded to your physician, go ahead and send that information to your doctor yourself, advised Dr. Heim. <br />
<br />
&ldquo;Never let a company program take the place of your regular doctor visit,&rdquo; she added. <br />
<br />
FIND ALL THE RESOURCES Sometimes a chronic care benefit is part of an employer&rsquo;s wellness program. In those cases, it should be no problem to find out about other company offerings that may help you, such as exercise, nutrition or smoking cessation programs. <br />
<br />
But the reality is that because large companies usually contract with many separate vendors for these benefits, their offerings are often not well coordinated. Make sure to ask your benefits department about all the resources that may be available for managing your illness, not just those included in the chronic care program. <br />]]></full> 
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                <item> 
             <title><![CDATA[The True Cost of Obesity ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=53</link> 
             <description><![CDATA[The True Cost of Obesity - Melissa Neiman - Ediets

When it comes to being overweight or obese, the numbers don&rsquo;t lie. And every statistic out there tells us that it&rsquo;s]]></description> 
             <pubDate>Thu, 22 Jul 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/The%20True%20Cost%20of%20Obesity.pdf</guid>
             <author><![CDATA[ Melissa Neiman]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://healthnews.ediets.com/health-topics/the-true-cost-of-obesity.html">The True Cost of Obesity </a></strong>- Melissa Neiman - Ediets<br />
<br />
When it comes to being overweight or obese, the numbers don&rsquo;t lie. And every statistic out there tells us that it&rsquo;s much more expensive to be obese or overweight than it is to be in shape.<br />
<br />
So if your health, comfort and mortality aren&rsquo;t motivating you to get off the couch and into the gym, perhaps your checkbook will.<br />
<br />
If your height-to-weight ratio or body mass index (BMI) exceeds 25, you are considered overweight. If it&rsquo;s greater than 29.9, you&rsquo;re officially obese. If you meet these criteria, you aren&rsquo;t alone. In fact, according to the National Institute of Diabetes and Digestive Diseases, over two-thirds of adults in the United States are carrying around excess body weight.<br />
<br />
Toting around extra pounds makes you more susceptible to a variety of conditions including arthritis, breathing problems, cancer, diabetes, heart disease and reproductive problems. Translation? Being overweight means more doctor visits, prescription medications, surgical procedures and hospitalizations, which, in turn, can cost you valuable time and money.<br />
<br />
How much money? According to the Centers for Disease Control and Prevention (CDC) and the nonprofit research group RTI International, obesity costs Americans an estimated $147 billion a year. No doubt this number has increased in the four years since that data was originally gathered.<br />
<br />
The CDC and RTI also found that obese people spent $1,429 more, on average, on medical care than non-obese people, and that Medicaid, Medicare and private insurance companies increased their spending by 2.6 percent (from 6.5 percent to 9.1 percent) from 1998 to 2006 just because of obesity.<br />
<br />
In addition to other medical expenses, people who are overweight or obese may pay up to 30 percent more for health insurance premiums &ndash; and they can totally forget about qualifying for &ldquo;preferred&rdquo; life insurance rates.<br />
<br />
And then there are all of the non-medical costs associated with obesity, such as the cost of expanding your wardrobe to accommodate your expanding waistline, and the cost of having to buy an extra seat on an airplane. Having a BMI over 25 can also cost you emotionally, as carrying around extra pounds has been associated with mental disorders, such as depression.<br />
<br />
The good news, however, is that dropping just 10 percent of your body weight can result in between $2,200 and $5,300 in reduced medical costs during your lifetime, according to a recent study by Stanford University and the RAND Corporation. And when you look better, you tend to feel better, so shedding extra pounds can help improve your mental health as well.<br />
<br />
How can you lower your BMI to 25 or below? For starters, make healthier dietary choices.<br />
<br />
&ldquo;Health and food are a winning combination,&rdquo; according to Pamela Ofstein, eDiets Director of Nutrition.<br />
<br />
&ldquo;You know the saying &lsquo;you are what you eat?&rsquo; Well, there is some truth to that. If you fuel your body with nutrient rich foods (fruits, vegetables, lean proteins, healthy fats, whole grains), you also get the additional disease fighting advantages that come with these foods. Fiber, antioxidants, monounsaturated (good) fats, vitamins, minerals&hellip;.the list goes on&hellip;can help keep you healthy and limit disease and illness,&rdquo; she says.<br />
<br />
By investing just a few dollars a week (the cost of that fattening morning latte!) on healthy eating and dietary support , you can save a ton of money on your health care in the long run. And you&rsquo;ll be surprised to learn how many healthy foods can cost as little as all that fatty fast food you&rsquo;ve become so fond of &ndash; especially once you familiarize yourself with proper portion sizes!<br />
<br />
Next, throw some exercise into the equation.<br />
<br />
&ldquo;By eating well and moving (exercise), your weight, body, health, mental well-being and finances will benefit in the long run,&rdquo; says Pam.<br />
<br />
You don&rsquo;t even have to join a gym &mdash; although the small monthly expense is nothing compared to how much money being fit will save you in the future! Just put on a pair of sneakers and walk around your neighborhood for at least 30 minutes a day on most days of the week and watch the pounds start to melt away.<br />
<br />
Not a fan of walking? Well, pick an exercise that you do enjoy. Try dancing, biking, swimming, tennis, karate or kayaking &mdash; anything that gets you moving. Even housework (e.g., dusting, washing floors, vacuuming) will have you burning calories if performed correctly.<br />
<br />
If 30 minutes seems absolutely impossible, start out small and increase the duration of activity over time. For instance, watch your favorite TV show and dance around the room during commercials.<br />
<br />
The key to exercise is consistency, so choose an activity (or activities) that you&rsquo;ll likely stick with, and bring along some favorite tunes or a funny friend to make working out seem less like work. And for more exercise tips, check out eDiets personalized fitness plans, animated exercise instructions and workout videos.<br />
<br />
* Always consult your doctor before beginning a new exercise program.<br />]]></full> 
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                <item> 
             <title><![CDATA[Losing Weight the Smartphone Way, With a Nutritionist in Your Pocket]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=52</link> 
             <description><![CDATA[Losing Weight the Smartphone Way, With a Nutritionist in Your Pocket - Lesley Alderman - NY Times

FOR most of us, the formula for losing weight is a simple one: eat]]></description> 
             <pubDate>Tue, 20 Jul 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Losing%20Weight%20the%20Smartphone%20Way,%20With%20a%20Nutritionist%20in%20Your%20Pocket.pdf</guid>
             <author><![CDATA[LESLEY ALDERMAN]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/07/17/health/17patient.html">Losing Weight the Smartphone Way, With a Nutritionist in Your Pocket</a></strong> - Lesley Alderman - NY Times<br />
<br />
FOR most of us, the formula for losing weight is a simple one: eat less, exercise more. But humans are anything but simple, and the majority of Americans struggle endlessly with losing pounds and keeping them off. <br />
<br />
&ldquo;We really haven&rsquo;t come up with one good weight-loss solution,&rdquo; said Dr. James A. Levine, an endocrinologist at the Mayo Clinic. &ldquo;If we had, everyone would be using it.&rdquo; <br />
<br />
Consuming fewer calories is perhaps the most difficult part of the weight-loss equation; many dieters are daunted by the prospect of tabulating their daily intake. That&rsquo;s why many experts and consumers are excited about the new weight-loss programs available for iPhone, BlackBerry and other smartphones. <br />
<br />
The apps &mdash; which are simple, fun and often free &mdash; help users track the number of calories and nutrients they consume, as well as the number of calories they burn. Users learn to balance calorie intake and activity in real time. <br />
<br />
Though there is no data on whether mobile apps are more effective than joining a traditional dieting program (apps are too new for long-term studies), their popularity is telling. Since LoseIt, now one of the most highly rated free apps, hit the iTunes store in November 2008, more than five million people have downloaded the program. <br />
<br />
&ldquo;We&rsquo;re linking weight loss to the coolest gadgets in the world,&rdquo; said Dr. Levine, who helped develop the Walk n&rsquo; Play app, which calculates the total calories one burns each day. <br />
<br />
Dennis Dodge, 67, and his wife, Carolyn, 68, recently started using LoseIt to shed weight and control their diabetes. The retired couple, who live in Hampden, Me., tapped their age, weight and goals into their iPod Touches, and the app told them how many calories they should eat each day. Every day they record what they eat and how much they exercise. <br />
<br />
The couple, who are using LoseIt as part of a diabetes program run by a local hospital, said they were intimidated at first by the technology but had found the app remarkably easy and even fun to use. &ldquo;I am now more cognizant of my habits,&rdquo; Mr. Dodge said. <br />
<br />
Mrs. Dodge added: &ldquo;With other diets you follow their regimen. With this, you set your own goal.&rdquo; <br />
<br />
When you track calories closely, you lose more weight, said Dr. Lawrence Cheskin, associate professor of health, behavior and society at Johns Hopkins Bloomberg School of Public Health. But dieters who simply write down their intake at the end of each day tend to underestimate the calories they have consumed (call it wishful thinking). <br />
<br />
The beauty of mobile apps is that they work in real time. You eat lunch and immediately log in your meal on your phone. The apps rely on databases to record the calorie counts of thousands of foods, whether a single item like an apple or a prepared meal like a sub sandwich, which takes the guesswork out of totaling calories. <br />
<br />
Weight-loss experts are hopeful that apps will help turn chronic dieters into healthy eaters. If you&rsquo;re looking at a menu wondering whether to order pasta primavera or a Caesar salad, an app can tell you on the spot which option has fewer calories. <br />
<br />
Over time, this information becomes part of your own internal database and, the thought is, dieters begin to make healthier choices. <br />
<br />
Dana Green, a diabetes specialist at St. Joseph Healthcare Diabetes Institute of Behavioral Medicine in Bangor, Me., has been testing the LoseIt program with a small group of his patients, including the Dodges. Since April, almost all of the 17 patients, ranging in age from 48 to 76, have lost weight and lowered their blood sugar. One man lost six pounds; two of the women in the program were able to reduce their insulin intake by 20 percent, Mr. Green said. <br />
<br />
&ldquo;Patients begin to see their patterns and habits and so make better decisions,&rdquo; he said. &ldquo;I&rsquo;m extremely optimistic.&rdquo; <br />
<br />
With mobile apps, dieters also can better visualize the relationship between exercise and eating. A 30-minute walk burns about 100 calories, they learn, while jogging for the same time at 6 miles per hour burns four times that. <br />
<br />
When the user realizes she&rsquo;s almost hit her daily calorie limit, she can opt to go to the gym &mdash; or to eat carrots for dinner. &ldquo;We&rsquo;re teaching people to think like economic consumers,&rdquo; says Charles Teague, the chief executive of FitNow, which produces LoseIt. <br />
<br />
If want to give a weight-loss app a try, there are a few things to bear in mind before you get started. <br />
<br />
A HUMAN PERSPECTIVE It is always a good idea to check with your doctor before beginning a weight-loss plan. Your primary care physician can help you set reasonable goals and also take a look at the app you&rsquo;ve chosen to make sure it seems legitimate and reasonable. <br />
<br />
&ldquo;Apps are not regulated,&rdquo; said Dr. Joseph Kim, founder of the Medical Smartphones blog. &ldquo;There is no certification process to vet which weight-loss apps are better than others.&rdquo; <br />
<br />
SIMPLICITY COUNTS Opt for an app that is basic and intuitive. &ldquo;The interactive part of these programs is what makes them successful,&rdquo; said Mr. Green, the diabetes specialist. <br />
<br />
Losing weight is hard enough &mdash; you don&rsquo;t also need to contend with a program that has an annoying interface, is slow or too complicated. <br />
<br />
SHARE YOUR PROGESS Some apps, like LoseIt, let you share your dieting progress with friends or other users via Facebook or Twitter. Many apps are linked to Web sites where users can chat on forums and blogs. If human support is important to you, choose an app that has social networking built in. <br />
<br />
Not all experts are convinced that will be enough, however. &ldquo;What we&rsquo;ve learned over the years is that support from a real human, face-to-face, is essential to keeping weight off over the long term,&rdquo; said Dr. Cheskin of Johns Hopkins. <br />
<br />
&ldquo;It&rsquo;s worth trying something new,&rdquo; he added, &ldquo;but don&rsquo;t expect miracles.&rdquo; <br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Factory Efficiency Comes to the Hospital]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=50</link> 
             <description><![CDATA[Factory Efficiency Comes to the Hospital - Julie Weed - NY&nbsp;Times

TWO years ago, the supply system at Seattle Children&rsquo;s Hospital was so unreliable that Susanne Matthews, a nurse in the]]></description> 
             <pubDate>Mon, 12 Jul 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Factory%20Efficiency%20Comes%20to%20the%20Hospital.pdf</guid>
             <author><![CDATA[JULIE WEED]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/07/11/business/11seattle.html">Factory Efficiency Comes to the Hospital</a></strong> - Julie Weed - NY&nbsp;Times<br />
<br />
TWO years ago, the supply system at Seattle Children&rsquo;s Hospital was so unreliable that Susanne Matthews, a nurse in the intensive care unit, would stockpile stuff &mdash; catheters in the closet, surgical dressings in patients&rsquo; dresser drawers and clamps in the nurse&rsquo;s office. And she wasn&rsquo;t the only one. <br />
<br />
&ldquo;Nurses get very anxious when we can&rsquo;t get our hands on the tools we need for our patients,&rdquo; Ms. Matthews says, &ldquo;so we grabbed them when we saw them, and stashed them away.&rdquo; This, in turn, made the shortages more acute. <br />
<br />
On a busy day last month in the I.C.U., it took Ms. Matthews just a few seconds to find the specialized tubing she needed to deliver medicine to an infant recovering from heart surgery. The tubing was nearby, in a fully stocked rack, thanks to a new supply system instituted by the hospital early last year following practices typically used in manufacturing or retailing, not health care. <br />
<br />
There are two bins of each item; when one bin is empty, the second is pulled forward. Empty bins go to the central supply office and the bar codes are scanned to generate a new order. The hospital storeroom is now half its original size, and fewer supplies are discarded for exceeding their expiration dates. <br />
<br />
The system is just one example of how Seattle Children&rsquo;s Hospital says it has improved patient care, and its bottom line, by using practices made famous by Toyota and others. The main goals of the approach, known as kaizen, are to reduce waste and to increase value for customers through continuous small improvements. <br />
<br />
Manufacturers, particularly in the auto and aerospace industries, have been using these methods for many years. And while a sick child isn&rsquo;t a Camry, Seattle Children&rsquo;s Hospital has found that checklists, standardization and nonstop brainstorming with front-line staff and customers can pay off. <br />
<br />
&ldquo;It turns out the highest-quality care also is the most cost-effective because we make fewer mistakes and create better outcomes,&rdquo; says Patrick Hagan, the hospital&rsquo;s president. <br />
<br />
The program, called &ldquo;continuous performance improvement,&rdquo; or C.P.I., examines every aspect of patients&rsquo; stays at the hospital, from the time they arrive in the parking lot until they are discharged, to see what could work better for them and their families. <br />
<br />
Last year, amid rising health care expenses nationally, C.P.I. helped cut Seattle Children&rsquo;s costs per patient by 3.7 percent, for a total savings of $23 million, Mr. Hagan says. And as patient demand has grown in the last six years, he estimates that the hospital avoided spending $180 million on capital projects by using its facilities more efficiently. It served 38,000 patients last year, up from 27,000 in 2004, without expansion or adding beds. <br />
<br />
Similar methods are now in place at other hospitals and health systems, including Beth Israel Deaconess Medical Center in Boston, Park Nicollet Health Services in Minneapolis and Virginia Mason Medical Center, also in Seattle. So many others have called for advice that Seattle Children&rsquo;s put together a two-day workshop, presenting it to more than 200 medical workers and health care leaders from the United States and Europe. <br />
<br />
&ldquo;Some people think they have to choose between quality of care and saving money,&rdquo; said Dr. David Chand, who attended the training and now uses C.P.I. methods at Akron Children&rsquo;s Hospital in Ohio. &ldquo;C.P.I. improves both patient outcomes and the hospital&rsquo;s bottom line.&rdquo; <br />
<br />
To increase the number of surgeries the hospital could perform, Dr. Chand&rsquo;s team spent about $20,000 overhauling the process to sterilize instruments, avoiding a $3.5 million expenditure to expand that department. More efficient scheduling in the M.R.I. department reduced the average waiting time for non-emergency M.R.I.&rsquo;s from 25 days to 1 to 2. <br />
<br />
All medical centers, especially larger ones, would have significant return on investment by using operations management techniques like C.P.I., says Eugene Litvak, president and chief executive of the Institute for Healthcare Optimization and an adjunct professor of operations management at the Harvard School of Public Health. <br />
<br />
&ldquo;The health care industry could be on the verge of an efficiency revolution, because it is currently so far behind in applying operations management methodologies,&rdquo; says Professor Litvak. <br />
<br />
TO be sure, not everyone believes that factory-floor methods belong in a hospital ward. <br />
<br />
Nellie Munn, a registered nurse at the Minneapolis campus of Children&rsquo;s Hospitals and Clinics of Minnesota, thinks that many of the changes instituted by her hospital are inappropriate. She says that in an effort to reduce waste, consultants observed her and her colleagues and tried to determine the amount of time each of their tasks should take. But procedure times can&rsquo;t always be standardized, she says. For example, some children need to be calmed before IV&rsquo;s are inserted into their arms, or parents may need more information. <br />
<br />
&ldquo;The essence of nursing,&rdquo; she says, &ldquo;is much more than a sum of the parts you can observe and write down on a wall full of sticky notes.&rdquo; <br />
<br />
On June 10, Ms. Munn helped lead a one-day strike by the Minnesota Nurses Association against six local health care corporations, including her employer, partly in protest of lower staffing levels her union thinks have resulted from hospitals&rsquo; &ldquo;lean&rdquo; methods. &ldquo;We felt the cuts created an unsafe environment for patients,&rdquo; she said. The nurses&rsquo; contract was settled on July 1, with no increase in staff levels. <br />
<br />
Brian Lucas, a spokesman for Children&rsquo;s Hospitals and Clinics of Minnesota, says the lean efforts have been used to reduce unnecessary tasks and have not resulted in lower nurse-to-patient ratios. &ldquo;To the contrary,&rdquo; he said, &ldquo;they have allowed nurses to spend more time delivering care to patients.&rdquo; <br />
<br />
Techniques like C.P.I. may indeed be hard for many hospitals to put into effect, says Mark Graban, a senior fellow at the Lean Enterprise Institute, a nonprofit research, education and publishing company. The process takes a large amount of time and requires a culture shift that many hospitals may not be able to accommodate or sustain. &ldquo;If the leadership tries to force new ways of doing things, the staff may chafe under the successive changes,&rdquo; he says. <br />
<br />
And George Lebovitz, a management professor at Boston University, says there are limits to performance-improvement methods in hospitals. &ldquo;Human health is much more variable and complex than making a car,&rdquo; he said, &ldquo;so even if you do everything &lsquo;right,&rsquo; you can still have a bad outcome.&rdquo; <br />
<br />
Physical layouts can also interfere with changes that hospitals want to make, like reducing the distance a chemotherapy patient has to walk. And the techniques can fall short of their potential if they are used in just one area of a hospital, because a patient typically moves through many different departments. <br />
<br />
At Seattle Children&rsquo;s Hospital, Dr. John Waldhausen, the division chief of pediatric general and thoracic surgery, acknowledges that he and other doctors weren&rsquo;t initially very enthusiastic about C.P.I. because they thought it would take some decisions about patient care out of their hands. <br />
<br />
Over time, he changed his mind, and he is now a vocal advocate of C.P.I. &ldquo;When you look closely, C.P.I. is the same scientific method we learned in medical school, including hypotheses, data collection and analysis,&rdquo; he says. &ldquo;It is not opinion and conjecture &mdash; it is data-driven.&rdquo; <br />
<br />
TEN years ago, Seattle Children&rsquo;s set a goal to become the top hospital of its type in the country, and hired Joan Wellman &amp; Associates, a process improvement consulting firm in Seattle, to help it get there. Ms. Wellman, who had worked with Boeing on its lean-manufacturing processes, suggested that the hospital apply similar principles. <br />
<br />
Mr. Hagan says he became enthusiastic about lean manufacturing and C.P.I. after doing research and visiting local manufacturers. He directed the hospital staff to examine the &ldquo;flow&rdquo; of medicines, patients and information in the same way that plant managers study the flow of parts through a factory. <br />
<br />
In a typical workshop at Seattle Children&rsquo;s, a group of doctors, nurses, administrators and representatives of patients&rsquo; families set aside a 40-hour week to work through C.P.I. methods. They plot each &ldquo;event&rdquo; a patient might encounter &mdash; like filling out forms, interacting with certain staff members, having to walk various distances or having to wait for assistance &mdash; and brainstorm about how each could be improved, or even eliminated. <br />
<br />
The hospital staff has been rolling out the program in stages over the last decade. &ldquo;We have probably made over 1,000 small changes, and frankly it never ends,&rdquo; says Mr. Hagan. <br />
<br />
In his C.P.I. training, Dr. Bryan H. King, director of the department of psychiatry and behavioral medicine, was one of the first Seattle Children&rsquo;s staff members to visit Japanese manufacturers. He learned that &ldquo;waste&rdquo; could be viewed as any action that didn&rsquo;t add value to the customer. <br />
<br />
Turning to his psychiatric inpatient unit, he and his team worked to pinpoint the goal of each child&rsquo;s stay and to communicate daily with families. They also made other changes, like starting to arrange outpatient resources as soon as children enter the unit, rather than waiting until they are ready to leave. These kinds of changes increased satisfaction ratings from families and helped cut the average time in the hospital from 20 days to 10. The unit can now accommodate 650 children a year instead of 400. <br />
<br />
Changes like these are celebrated by the hospital administration. &ldquo;Their support fosters the idea that everyone can make positive changes to their departments,&rdquo; Dr. King said. <br />
<br />
Dr. Howard E. Jeffries, the hospital&rsquo;s medical director of C.P.I., is a fan of visual aids. One favorite is a white board at the entrance of the cardiac intensive care unit. A map of the rooms, labeled with patient names, provides a quick status report on how full the unit is and how ill the patients are. Stick-on stars indicate a patient who needs to be in isolation; a blue circle shows a patient on a ventilator. <br />
<br />
&ldquo;At a glance, staff coming in for their shift can get an idea of what&rsquo;s going on and what to be aware of,&rdquo; Dr. Jeffries says. <br />
<br />
The same types of visual cues are used for inventory levels or inspection status in factories. <br />
<br />
Another of his favorites is the &ldquo;Days Without Infection&rdquo; poster, like a construction site&rsquo;s &ldquo;Days Without an Accident&rdquo; sign. &ldquo;It keeps our new safety protocols top of mind for people,&rdquo; he says. <br />
<br />
Standardization is also a C.P.I. cornerstone. Last year, 10 surgeons at Seattle Children&rsquo;s performed appendectomies, and each doctor wanted the instrument cart set up differently. The surgeons and other medical staff members used C.P.I. to come up with a cart they all could use, reducing instrument preparation errors as well as inventory costs. <br />
<br />
Dr. Lynn D. Martin, director of the anesthesiology and pain medicine department, says changes previously were instituted only when existing systems failed. Using C.P.I., teams can now make changes any time they think they can improve a process. When the operating room team saw that a tonsillectomy procedure involved filling out 21 separate forms, it sat down with the print vendor to remove duplications &mdash; and cut the number to 11. <br />
<br />
The staff doesn&rsquo;t have to wait for the perfect solution, Dr. Martin says, just a better one, because they can &ldquo;keep making improvements year after year.&rdquo; <br />
<br />
Using C.P.I., the hospital has reduced the waiting time for many surgeries from three months to less than one. Recently, the bottleneck was not the surgeons&rsquo; time, but a lack of available inpatient beds for recovery. Examining the hospital&rsquo;s census, administrators saw that there were empty beds on weekends. They realized that by scheduling more surgeries on Fridays, patients could recover over the weekend, when more beds were free. The change also benefited parents and patients who would miss fewer work and school days. <br />
<br />
Lack of space in the recovery room was another logjam, and the hospital planned a $500,000 renovation to enlarge it. But a C.P.I. team saw that if a child&rsquo;s parents went to a common waiting room during surgery, instead of an individual recovery room, more surgeries could be scheduled. Parents were given beepers to alert them when their child would arrive in the recovery room &mdash; and maps and colored lines on the walls helped point the way. Plans for the expensive renovation have been scrapped. <br />
<br />
IN the hospital&rsquo;s largest C.P.I. project yet, Lisa Brandenberg, the chief administrative officer, used the method to design a new $70 million clinic and surgical facility in Bellevue, Wash., just east of Seattle. <br />
<br />
Medical buildings often have standard benchmarks &mdash; basing the number of examination rooms, for example, on the expected volume of patients. Ms. Brandenberg and her team instead used C.P.I. to map out common paths that patients, staff members, supplies and information would flow through. They worked in an empty office building, using cardboard mock-ups of surgical sites, recovery rooms, anesthesia areas and waiting rooms. Fifty staff members then play-acted various scenarios to test the design&rsquo;s effectiveness. <br />
<br />
The final design reduces walking distances and waiting times for patients by grouping related facilities together and creating rooms that can be used for more than one purpose. The hospital was able to shave 30,000 square feet and $20 million off of the new building, which is to open July 20. <br />
<br />
&ldquo;We can&rsquo;t wait to see it in use,&rdquo; says Ms. Brandenberg. <br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[When Choosing Health Care, Know What You Will Owe]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=51</link> 
             <description><![CDATA[When Choosing Health Care, Know What You Will Owe - Walecia Konrad - NY&nbsp;Times

QUICK quiz: What&rsquo;s the difference between co-pay and co-insurance? 

If you&rsquo;re like most people, you may think]]></description> 
             <pubDate>Mon, 12 Jul 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/When%20Choosing%20Health%20Care,%20Know%20What%20You%E2%80%99ll%20Owe.pdf</guid>
             <author><![CDATA[WALECIA KONRAD]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/07/10/health/10patient.html">When Choosing Health Care, Know What You Will Owe</a></strong> - Walecia Konrad - NY&nbsp;Times<br />
<br />
QUICK quiz: What&rsquo;s the difference between co-pay and co-insurance? <br />
<br />
If you&rsquo;re like most people, you may think they are the same. But while it is true both terms refer to the portion of medical bills you pay out-of-pocket, these two types of cost-sharing are quite different. <br />
<br />
A co-pay is a fixed amount that you pay each time you see a doctor or fill a prescription, usually around $10 or $20. Co-insurance is the percentage of the cost of doctor visits, hospitalizations and prescription drugs that you must pay under your insurance policy. <br />
<br />
Let&rsquo;s say your policy calls for 80/20 co-insurance. After you meet your deductible, you must pay 20 percent of your medical bills; the insurance company is responsible for the remaining 80 percent. <br />
<br />
Many plans demand both co-pays and co-insurance. Co-insurance is especially common when it comes to hospital stays. Of all workers covered by an employer-sponsored group health plan, 51 percent must pay co-insurance for hospital admissions, according to the 2009 Kaiser Family Foundation survey of employer health benefits. The average payment is 18 percent of the total. And 53 percent of covered workers pay co-insurance for outpatient hospital visits, with an average charge of 19 percent. <br />
<br />
Co-insurance is common in the individual insurance market. And as companies head into this fall&rsquo;s open enrollment season, many are considering a switch from co-pay to co-insurance as a way to increase employee cost-sharing and contain rising health benefit expenses, said Tom Billet, director for health and group benefits at the consulting firm Towers Watson. <br />
<br />
Because of the confusion involving co-pay and co-insurance, many patients don&rsquo;t realize just how much it may cost them until they become seriously ill or are hospitalized, said Lynn Quincy, a senior policy analyst at Consumers Union. &ldquo;Ten or 20 percent may not sound like much, but 20 percent of a $100,000 surgery is a lot of money,&rdquo; she said. <br />
<br />
Co-insurance payments can add up quickly for seriously ill patients. It&rsquo;s not unusual, for example, for a cancer patient to need $40,000 worth of medicine in a given year. <br />
<br />
&ldquo;Co-insurance on that could be as much as $14,000, and that&rsquo;s just for the drugs. That&rsquo;s not even counting going to the doctor or the hospital yet,&rdquo; said Stephen Finan, senior director of policy at the American Cancer Society&rsquo;s Cancer Action Network. <br />
<br />
High co-insurance and other out-of-pocket costs, including insurance premiums, can sometimes discourage patients from receiving the treatment they need. One in three individuals under age 65 diagnosed with cancer has delayed needed health care in the last 12 months, according to a Cancer Action Network poll. <br />
<br />
Many group policies provide limits on annual out-of-pocket expenditures, including co-insurance, deductibles and co-pays. With these plans, once you pay, say, $5,000 or $6,000 for a single person in approved medical bills, your insurer will cover 100 percent of additional treatment. The new health care law will limit all cost-sharing, including co-insurance payments, beginning in 2014. <br />
<br />
For now, many people rely on individual insurance plans that often have much higher annual maximums (if any) than group policies. And even in those plans with reasonable limits, annual out-of-pocket costs can add up to a devastating amount if you are seriously ill for an extended period of time. <br />
<br />
That&rsquo;s why it&rsquo;s important to keep co-insurance in mind when you shop for a health care policy or choose from your employer&rsquo;s options during open enrollment this fall. Here&rsquo;s what to look for. <br />
<br />
OUT-OF-POCKET LIMITS As mentioned above, most policies have limits on how much patients can pay each year in medical bills. These limits vary widely depending on the type of policy, said Mr. Billet. <br />
<br />
For a single person in a group plan, the limit could range from $2,500, on the low end, to as much as $6,000. For family coverage, maximums are usually double that. <br />
<br />
Check carefully to determine what percentage of co-insurance you are expected to pay and what the annual limit will be. If you are considering a high-deductible health plan, don&rsquo;t assume that you won&rsquo;t also have to pay co-insurance. <br />
<br />
&ldquo;Even with the high cost of the deductible, most of these policies still expect you to have more skin in the game,&rdquo; said Mr. Billet. <br />
<br />
The good news is that high-deductible health care plans that qualify for the tax advantages of a health savings account are required to limit out-of-pocket expenses, including deductibles. This year the maximums, as determined by the I.R.S., are $5,800 for single coverage and $11,600 for family coverage. <br />
<br />
Under some insurance policies, cost-sharing maximum limits are much higher for out-of-network charges. <br />
<br />
&ldquo;That&rsquo;s why it is really important to know exactly what you are doing and what you are responsible for paying when you go out of network,&rdquo; advised Mr. Billet. Too many people make the decision lightly, he added, because a friend or family member recommended a certain doctor or hospital, not realizing just how much of the bill they would have to pay. <br />
<br />
OUT-OF-NETWORK CARE If your health policy seems not to charge co-insurance, check the fine print. <br />
<br />
Many network plans, like health maintenance organizations and preferred provider organizations, charge no or low co-pays for network providers, while assessing hefty co-insurance percentages for any out-of-network care you receive. <br />
<br />
This is where co-insurance can get expensive. <br />
<br />
&ldquo;When you go out of network, you may say to yourself, &lsquo;My insurance is covering 80 percent, that doesn&rsquo;t sound so bad,&rsquo; &rdquo; said Mr. Billet. &ldquo;But in the end your insurer may cover less than 80 percent of your actual bill.&rdquo; <br />
<br />
That&rsquo;s because insurers often pay based on usual and customary charges for a specific treatment in your geographical area. So if a specialist charges you $300 for a visit but the insurer deems the usual and customary fee to be $250, your insurer will cover only $200 of the fee (80 percent of $250), not the $240 (80 percent of $300) you were expecting. <br />
<br />
In most cases, your health care provider will often bill you directly for the $40 difference, a practice known as balance billing. Many states prohibit balance billing by in-network providers, but it is legal for out-of-network practitioners. <br />
<br />
For one doctor&rsquo;s visit, the extra charge may not seem like much, but if you become seriously ill and need out-of-network care, the combination of co-insurance and balance billing can amount to tens of thousands of dollars, said Mr. Finan. <br />
<br />
Better data on reasonable fees is on the way. After the New York state attorney general, Andrew Cuomo, found that the methods used to determine usual and customary rates were flawed and conflict-laden, a new nonprofit company started compiling revised data with the aim of reflecting fairer prices. The new tools should be available in the first quarter of 2011. <br />
<br />
QUIZ THE INSURER Research the in-network options offered by your company&rsquo;s plans. You may find you don&rsquo;t need to go out of network after all. If you do, call your insurer to find out exactly what is covered before you receive treatment. <br />
<br />
If you can make a persuasive case that you truly need specialized care that isn&rsquo;t available in your network, your insurer may make an exception and cover the costs as if you were being treated by an in-network provider. <br />
<br />
DRUG PRICES With rising drug costs, it can be hard to estimate a co-insurance payment when reviewing plan options for the coming year. If you regularly take a prescription drug, check with the plan&rsquo;s customer service number or Web site for up-to-date prices, so you&rsquo;ll know what your share of the bill will be in advance. <br />
<br />
Some insurers also offer information on lower-priced alternatives. <br />]]></full> 
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                <item> 
             <title><![CDATA[10,000-plus in U.S. die for lack of cancer screens: CDC]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=49</link> 
             <description><![CDATA[10,000-plus in U.S. die for lack of cancer screens: CDC
Tue, Jul 6 2010
By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - At least 10,000 people and possibly far more die]]></description> 
             <pubDate>Wed, 07 Jul 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/10,000-plus%20in%20U_S_%20die%20for%20lack%20of%20cancer%20screens.pdf</guid>
             <author><![CDATA[Maggie Fox]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.reuters.com/article/idUSTRE6653D720100706">10,000-plus in U.S. die for lack of cancer screens: CDC</a></strong><br />
Tue, Jul 6 2010<br />
By Maggie Fox, Health and Science Editor<br />
<br />
WASHINGTON (Reuters) - At least 10,000 people and possibly far more die in the United States each year because they have not been screened for colon or breast cancer, according to a government report released on Tuesday.<br />
<br />
But more people are being screened than ever before, the U.S. Centers for Disease Control and Prevention said in the first of a series of new reports on health statistics.<br />
<br />
&quot;We are encouraged by a significant increase in colon cancer screening rates over recent years,&quot; CDC Director Dr. Thomas Frieden told reporters in a telephone briefing.<br />
<br />
But, he added, &quot;more than a third of Americans who need to be screened haven't been screened.&quot;<br />
<br />
CDC researchers analyzed survey results from the state-level 2008 Behavioral Risk Factor Surveillance Survey for the report, available at www.cdc.gov/vitalsigns.<br />
<br />
They found colon cancer screening rates rose from 52 percent of those who should get the tests in 2002 to 63 percent in 2008. Americans are advised to get a colon cancer screen, usually in the form of a colonoscopy, starting at age 50 and at age 40 if there is a family history of the disease.<br />
<br />
A separate report found that 81 percent of women aged 50 to 74 got mammograms in 2008, virtually the same as in 2006.<br />
<br />
&quot;The findings indicated that more than 22 million men and women have not had a potentially life-saving screening test for colorectal cancer and about 7 million women age 50 to 74 have not had a recent mammogram,&quot; the CDC said in a statement.<br />
<br />
&quot;Any screening is good and the overall increase is the main message there,&quot; Frieden said. &quot;Nevertheless, there is a lot more progress we could make with colon cancer screening.&quot;<br />
<br />
Frieden said there are differences of opinion over how many lives could have been saved by early screening. Colonoscopies can detect and remove pre-cancerous growths before they become tumors and mammograms can catch tumors while they are small and easily removed.<br />
<br />
LIVES SAVED<br />
<br />
The American Cancer Society says that more than 106,000 Americans were diagnosed with colon cancer in 2009 and nearly 50,000 died of it.<br />
<br />
&quot;What is debated is exactly how many of those would be prevented by colon cancer screening getting as high as can plausibly be expected,&quot; Frieden said.<br />
<br />
&quot;You can argue for 10,000. You can argue for 30,000,&quot; he added. &quot;I think we can certainly say more than 10,000 very comfortably. For every person who dies from preventable colon cancer it is one too many.&quot;<br />
<br />
In 2009, 194,000 Americans got breast cancer and 40,000 died. &quot;Each year about 12,000 lives are saved as a result of mammography,&quot; Frieden said.<br />
<br />
If insurance companies stopped requiring co-payments for screening tests, that could help increase the number of people willing to be screened, Frieden said.<br />
<br />
The report also showed that people with health insurance are far more likely to be screened for cancer, with 66 percent of those insured getting the recommended breast or colon screening compared to 36 percent of those without.<br />
<br />
Currently, about 46 million Americans, or 15 percent of the population, has no health insurance. A new healthcare law signed in March is projected to extend coverage to 32 million more Americans, mainly by requiring them to buy it.<br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Many Americans overtreated to death]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=48</link> 
             <description><![CDATA[Many Americans overtreated to death - MARILYNN MARCHIONE - Associated Press

The doctors finally let Rosaria Vandenberg go home. 

For the first time in months, she was able to touch her]]></description> 
             <pubDate>Thu, 01 Jul 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Many%20Americans%20overtreated%20to%20death.pdf</guid>
             <author><![CDATA[MARILYNN MARCHIONE ]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.msnbc.msn.com/id/37907548/ns/health-cancer/">Many Americans overtreated to death</a></strong> - MARILYNN MARCHIONE - Associated Press<br />
<br />
The doctors finally let Rosaria Vandenberg go home. <br />
<br />
For the first time in months, she was able to touch her 2-year-old daughter who had been afraid of the tubes and machines in the hospital. The little girl climbed up onto her mother's bed, surrounded by family photos, toys and the comfort of home. They shared one last tender moment together before Vandenberg slipped back into unconsciousness.<br />
<br />
Vandenberg, 32, died the next day.<br />
<br />
That precious time at home could have come sooner if the family had known how to talk about alternatives to aggressive treatment, said Vandenberg's sister-in-law, Alexandra Drane.<br />
<br />
Instead, Vandenberg, a pharmacist in Franklin, Mass., had endured two surgeries, chemotherapy and radiation for an incurable brain tumor before she died in July 2004.<br />
<br />
&quot;We would have had a very different discussion about that second surgery and chemotherapy. We might have just taken her home and stuck her in a beautiful chair outside under the sun and let her gorgeous little daughter play around her &mdash; not just torture her&quot; in the hospital, Drane said.<br />
<br />
Americans increasingly are treated to death, spending more time in hospitals in their final days, trying last-ditch treatments that often buy only weeks of time, and racking up bills that have made medical care a leading cause of bankruptcies.<br />
<br />
More than 80 percent of people who die in the United States have a long, progressive illness such as cancer, heart failure or Alzheimer's disease.<br />
<br />
What we say we want <br />
More than 80 percent of such patients say they want to avoid hospitalization and intensive care when they are dying, according to the Dartmouth Atlas Project, which tracks health care trends.<br />
<br />
Yet the numbers show that's not what is happening:<br />
<br />
The average time spent in hospice and palliative care, which stresses comfort and quality of life once an illness is incurable, is falling because people are starting it too late. In 2008, one-third of people who received hospice care had it for a week or less, says the National Hospice and Palliative Care Organization. <br />
Hospitalizations during the last six months of life are rising: from 1,302 per 1,000 Medicare recipients in 1996 to 1,441 in 2005, Dartmouth reports. Treating chronic illness in the last two years of life gobbles up nearly one-third of all Medicare dollars.<br />
&quot;People are actually now sicker as they die,&quot; and some find that treatments become a greater burden than the illness was, said Dr. Ira Byock, director of palliative care at Dartmouth-Hitchcock Medical Center. Families may push for treatment, but &quot;there are worse things than having someone you love die,&quot; he said.<br />
<br />
Gail Sheehy, author of the &quot;Passages&quot; books, learned that as her husband, New York magazine founder Clay Felker, spent 17 years fighting various cancers. On New Year's Day 2007, they waited eight hours in an emergency room for yet another CT scan until Felker looked at her and said, &quot;No more hospitals.&quot;<br />
<br />
&quot;I just put a cover over him and wheeled him out of there with needles still in his arms,&quot; Sheehy said.<br />
<br />
Then she called Dr. R. Sean Morrison, president of the American Academy of Hospice and Palliative Medicine and a doctor at Mount Sinai School of Medicine in New York.<br />
<br />
&quot;Nobody had really sat down with them about what his choices are and what the options were,&quot; said Morrison, who became his doctor.<br />
<br />
About a year later, Felker withdrew his own feeding tube, and &quot;it enabled us to go out and have a wonderful evening at a jazz club two nights before he died&quot; in July 2008, Sheehy said.<br />
<br />
<br />
AP <br />
Rosaria Vandenberg with her husband, John, and daughter, Alessia. 'Exhaustion medicine' <br />
Doctors can't predict how soon a patient will die, but they usually know when an illness has become incurable. Even then, many of them practice &quot;exhaustion medicine&quot; &mdash; treating until there are no more options left to try, said Dr. Martha Twaddle, chief medical officer of Midwest Palliative &amp; Hospice Care Center in suburban Chicago.<br />
<br />
A stunning number of cancer patients get aggressive care in the last days of their lives, she noted. One large study of Medicare records found that nearly 12 percent of cancer patients who died in 1999 received chemo in the last two weeks of life, up from nearly 10 percent in 1993.<br />
<br />
Guidelines from an alliance of leading cancer centers say patients whose cancer has spread should stop getting anti-cancer medicine if sequential attempts with three different drugs fail to shrink their tumors. Yet according to IntrinsiQ, a cancer data analysis company, almost 20 percent of patients with colorectal cancer that has spread are on at least their fourth chemotherapy drug. The same goes for roughly 12 percent of patients with metastatic breast cancer, and for 12 percent of those with lung cancer. The analysis is based on more than 60,000 cancer patients.<br />
<br />
Often, overtreating fatal illnesses happens because patients don't want to give up.<br />
<br />
Saideh Browne said her mother, Khadija Akmal-Lamb, wanted to fight her advanced ovarian cancer even after learning it had spread to her liver. The 55-year-old Kansas City, Mo., woman had chemo until two weeks before she died last August.<br />
<br />
&quot;She kept throwing up, she couldn't go to the bathroom,&quot; and her body ached, Browne said. The doctors urged hospice care and said, &quot;your mom was stubborn,&quot; Browne recalled. &quot;She wanted her chemo and she wanted to live.&quot;<br />
<br />
Browne, who lives in New York, formed a women's cancer foundation in her mother's honor. She said she would encourage dying cancer patients to choose comfort care over needless medicine that prolongs suffering.<br />
<br />
It's easier said than done.<br />
<br />
The American way is &quot;never giving up, hoping for a miracle,&quot; said Dr. Porter Storey, a former hospice medical director who is executive vice president of the hospice group that Morrison heads.<br />
<br />
&quot;We use sports metaphors and war metaphors all the time. We talk about never giving up and it's not over till the fat lady sings .... glorifying people who fought to their very last breath,&quot; when instead we should be helping them accept death as an inevitable part of life, he said.<br />
<br />
This is especially true when deciding whether to try one of the newer, extremely expensive cancer drugs such as Avastin, Erbitux and Tarceva. Some are touted as &quot;improving survival by 30 or 50 percent&quot; when that actually might mean living three weeks or months longer instead of two.<br />
<br />
&quot;It's amazing how little benefit those studies show,&quot; Storey said, referring to research on the new drugs.<br />
<br />
Trying to beat the odds <br />
Dan Waeger tried just about all of them. A nonsmoker, he was diagnosed with lung cancer at age 22, and pursued treatment after treatment before dying nearly four years later, in March 2009.<br />
<br />
&quot;He decided if there were odds to be beat, he was going to beat the odds,&quot; said his boss, Ellen Stovall, then-president of the National Coalition for Cancer Survivorship, where Waeger worked as a fundraiser and development manager.<br />
<br />
&quot;He received just about every experimental new drug for lung cancer that I'm aware of in his last two years of life. He would get a treatment on a Friday afternoon, be sick all weekend and come to work on Monday,&quot; she recalled.<br />
<br />
&quot;He had these horrific rashes. He would get these horrible coughs that were not just the lung cancer. The treatments were making him cough up blood, just horrific side effects &mdash; vertigo, numbness, tingling in his hands and feet. He suffered.&quot;<br />
<br />
Waeger's fiancee, Meg Rodgers, said they worried about exceeding the lifetime limits on his insurance, since the care was so expensive.<br />
<br />
&quot;I think every time he got a treatment, it was $10,000,&quot; though he paid only a $10 copay, she said.<br />
<br />
Yet it was clearly worth any price to him &mdash; he died a week before they were to be married, after receiving home hospice care for only two weeks.<br />
<br />
&quot;I honestly believe he would have done anything he could to live one more day,&quot; Rodgers said.<br />
<br />
Some health policy groups say cancer patients, as well as people with failing hearts or terminal dementia, should get better end-of-life counseling. Last year, a plan that would have let Medicare pay for doctors to talk about things like living wills was labeled &quot;death panels&quot; and was dropped.<br />
<br />
Ultimately, how patients and their families make the journey is a matter of personal choice &mdash; and there are resources to help them, Stovall said.<br />
<br />
&quot;I've heard a lot of people over the years say what they would do if they had cancer until it is them. And then they will cling to even the smallest glimmer that something will help,&quot; she said.<br />
<br />
&quot;Cancer that can't be cured is often called daunting but not hopeless. So that's what patients hear. Hope is the last thing to go. People don't give that up easily.&quot;<br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[High-Risk Insurance Pools to Begin Next Month]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=47</link> 
             <description><![CDATA[High-Risk Insurance Pools to Begin Next Month - Walecia Konrad - NY&nbsp;Times

IF you have any kind of chronic medical condition and you&rsquo;ve been shopping for health insurance, you know how]]></description> 
             <pubDate>Mon, 28 Jun 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/High-Risk%20Insurance%20Pools%20to%20Begin%20Next%20Month.pdf</guid>
             <author><![CDATA[WALECIA KONRAD]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/06/26/health/policy/26patient.html">High-Risk Insurance Pools to Begin Next Month</a></strong> - Walecia Konrad - NY&nbsp;Times<br />
<br />
IF you have any kind of chronic medical condition and you&rsquo;ve been shopping for health insurance, you know how insanely difficult it is to find an insurer that will cover you at all, let alone at an affordable rate. <br />
<br />
For some people, relief may be on the way starting July 1. That is the day when the federal government will start paying for new insurance programs aimed at providing relatively affordable coverage for uninsured people with pre-existing conditions. <br />
<br />
Under the new health care law, the government has earmarked $5 billion for states to set up high-risk pools, as the programs are called, for people who have been uninsured for six months or longer. The pools are to provide a bridge for people most in need of coverage until the insurance exchanges begin operating in 2014. The pools will have no restrictions based on pre-existing conditions; coverage starts immediately and comes with no annual or lifetime limits. Deductibles and co-payments will be kept low. <br />
<br />
Bekky Jones-Ludwick, 51, a manager for a marine supply store in Waynesboro, Va., is hoping the new system will help her and her husband, Tracy Ludwick. Both work for the same small business, and their employer had provided health insurance coverage for the couple until March 2009. <br />
<br />
The company canceled insurance for employees just after Ms. Jones-Ludwick, who suffers from asthma, learned she had breast cancer and underwent a mastectomy. The couple switched to a more expensive health policy purchased on their own. <br />
<br />
Then, in May 2009, Ms. Jones-Ludwick&rsquo;s husband needed emergency gall bladder surgery. The new policy covered only $1,000 a day for any type of hospitalization. As a result, the couple was left to pay $20,000 in medical bills. <br />
<br />
The new policy was canceled, too, and now the couple is completely without insurance. <br />
<br />
&ldquo;I can&rsquo;t pay off the debt, pay for my medicine and pay insurance premiums,&rdquo; said Ms. Jones-Ludwick. &ldquo;I owe more in medical bills than I make in a year&rsquo;s salary.&rdquo; <br />
<br />
Ms. Jones-Ludwick is hoping insurance in the new high-risk pools not only will have premiums affordable enough that she can resume coverage but also will help eliminate out-of-pocket expenses for asthma medication, regular mammograms and other health care costs. <br />
<br />
Even as the deadline for their debut approaches, however, questions remain about the new risk pools. <br />
<br />
The law mandates that premiums for the new coverage must be the same as the standard rate for a healthy adult in that state. (Currently insurance for someone with a pre-existing condition, when available at all, can cost as much as 200 percent of the standard rate.) <br />
<br />
That sounds reasonable, but it&rsquo;s not necessarily affordable. Depending on where you live, premiums could still be several hundred dollars a month. <br />
<br />
In addition, many experts worry that the $5 billion won&rsquo;t be enough to last until 2014. The federal Centers for Medicare and Medicaid Services has estimated that the $5 billion will last for only two years. <br />
<br />
&ldquo;We just don&rsquo;t know how many people will sign up for the new pools,&rdquo; said Deborah J. Chollet, a senior fellow at Mathematica Policy Research, a public policy research company, who has studied existing state risk pools and the new plan. &ldquo;Until we see what happens, there&rsquo;s no way to know how long the money will last.&rdquo; <br />
<br />
Another concern is that only people who have been uninsured for six months or longer are eligible for the new pools. That means the newly unemployed or those paying exorbitant premiums because of a pre-existing condition &mdash; perhaps in their state&rsquo;s existing high-risk pool &mdash; cannot simply switch to the more affordable high-risk pools. <br />
<br />
The idea was to provide the stopgap measure for the neediest until 2014. If everyone took advantage of the new pools, it was feared, the government would have even more trouble financing the program. <br />
<br />
&ldquo;There&rsquo;s an inherent unfairness there that&rsquo;s going to be difficult to explain to consumers,&rdquo; said Sandy Praeger, state insurance commissioner of Kansas. <br />
<br />
But for those who may, at long last, have a chance to get decent coverage for a relatively good rate, one question is more pressing than any other: How do I sign up? Here&rsquo;s information on how the new risk pools are expected to work and what you should do if you think you might benefit from this new coverage. <br />
<br />
WHO&rsquo;S IN CHARGE? Under the new law, each state can decide whether it wants to run the new high-risk pool or have the federal government run the program instead. At last count, about 30 states have opted to run their own programs. <br />
<br />
Those states have filed a proposal with the government outlining a list of pre-existing conditions that will help define who is eligible for each pool. Many states already have high-risk pools that provide an infrastructure; nevertheless, the existing risk pools will be run independently of the new ones. <br />
<br />
Most states are waiting for approval of these guidelines from the federal Department of Health and Human Services, which is administering most of the health law changes. <br />
<br />
About 18 states have opted for the federal government to run the high-risk programs instead. The department has not yet provided details about how these pools will work. <br />
<br />
GET THE PLAN DETAILS Even with so few details, it&rsquo;s not too early to contact your state insurance department for information on your state&rsquo;s proposed plan. Some states may be taking applications as soon as July 1, although many are expected to miss that deadline and begin taking applications in August or even in the fall. <br />
<br />
The Web site of the National Association of Insurance Commissioners, www.naic.org, has a directory of state insurance departments under &ldquo;States and Jurisdictions Map.&rdquo; Even states that are opting for the federally run pools are expected to post information on their insurance department Web sites to help consumers apply, said Ms. Praeger. <br />
<br />
Also on July 1, the Department of Health and Human Services is expected to introduce an online portal at www.hhs.gov that will include information on available health insurance in each state, including coverage provided by high-risk pools, Medicaid and the Children&rsquo;s Health Insurance Program. <br />
<br />
GATHER YOUR RECORDS While you are waiting for the deadlines to kick in, get copies of your medical records, advised Cheryl Fish-Parcham, director of health policy at Families USA, a consumer advocacy group. You may need them to show that you have a pre-existing condition and are therefore eligible for the pool. <br />
<br />
APPLY EARLY Each state has been allocated a portion of the $5 billion, but just about everyone agrees that the money will not be enough to last until 2014. Down the road, Congress may appropriate more money for the program, said Ms. Praeger &mdash; but there&rsquo;s no guarantee. As a result, if some states receive a deluge of applicants, they may establish waiting lists until they determine they have enough funding. That is why it is important to sign up as soon as your state or the federal program allows. <br />
<br />
CONSIDER AN ALTERNATIVE If you have recently lost your job, your Cobra coverage has run out or you&rsquo;re without health insurance for any other reason, waiting six months until you are eligible for the new risk pools may not be your best option. <br />
<br />
Under a federal law known as the Health Insurance Portability and Accountability Act, your health cannot be taken into account if you are moving from one qualified insurance plan to another, as long as you have no more than a 62-day gap in coverage. <br />
<br />
The new premiums may be higher, but many people would be better off finding another policy before that 62-day deadline passes than they would continuing without coverage for a full six months. <br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Aftercare Tips for Patients Checking Out of the Hospital]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=46</link> 
             <description><![CDATA[Aftercare Tips for Patients Checking Out of the Hospital - LESLEY ALDERMAN - NY&nbsp;Times

IN mid-March my 85-year-old father checked into a prominent New York City hospital for a scheduled operation.]]></description> 
             <pubDate>Mon, 21 Jun 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Aftercare%20Tips%20for%20Patients%20Checking%20Out%20of%20the%20Hospital.pdf</guid>
             <author><![CDATA[LESLEY ALDERMAN]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/06/19/health/19patient.html">Aftercare Tips for Patients Checking Out of the Hospital</a></strong> - LESLEY ALDERMAN - NY&nbsp;Times<br />
<br />
IN mid-March my 85-year-old father checked into a prominent New York City hospital for a scheduled operation. The procedure, to remove a cancerous tumor from his thigh, went well, and soon he was sent home. <br />
<br />
But three days later, unable to cope with a complicated wound care regimen, he landed back in the hospital. <br />
<br />
My father had become part of a notorious trend. Discharge from the hospital is a critical point in a patient&rsquo;s recovery, particularly for older people with chronic conditions. The process is supposed to be carefully planned, but instead it often is rushed and poorly coordinated, resulting in complications that send patients back to the emergency room. <br />
<br />
According to a study published last year in The New England Journal of Medicine, one in five Medicare patients returns to the hospital within 30 days of being discharged. The problem is an expensive one: in 2004, these readmissions cost Medicare $17.4 billion dollars, the researchers also found. <br />
<br />
Hospital stays certainly are shorter now: the average stay was 4.6 days in 2007, down from about 5.7 days in 1993. But the readmissions problem is not simply the result of compressed care, experts say. <br />
<br />
&ldquo;Hospitals tend to focus their efforts on the admissions process, because that&rsquo;s when the patient is most sick,&rdquo; said Dr. Mark V. Williams, one of the authors of the study. &ldquo;The discharge process can be just as important but rarely gets the same level of attention.&rdquo; <br />
<br />
At discharge, the assumption is that the patient is better and all will be fine, said Dr. Eric A. Coleman, a geriatrician and professor of medicine at the University of Colorado Denver. But many patients, especially older ones, leave the hospital with a host of issues to manage. They may have additional medications to take, new symptoms to monitor and follow-up appointments to keep, all of which require focused attention at a time when patients may not be at their sharpest. <br />
<br />
What&rsquo;s more, while insurers will pay for limited hospital stays, there&rsquo;s no financial incentive for hospitals to insure that patients get out and stay out. &ldquo;A hospital may actually be financially rewarded for a mishandled discharge,&rdquo; said Dr. Williams, chief of hospital medicine at Northwestern University. &ldquo;If the patient is readmitted, they get paid again.&rdquo; <br />
<br />
Discharge planning winds up being an overlooked issue because it &ldquo;falls into the space between billable events,&rdquo; said Dr. Coleman. <br />
<br />
But there is a movement to improve care after discharge and to reduce readmissions. Dr. Coleman has developed a hospital-based program called Care Transitions Intervention, with the support of the John A. Hartford Foundation, which helps reduce the number of re-hospitalizations for older adults by coaching them to take a more active role in their care. <br />
<br />
The federal Centers for Medicare and Medicaid Services has a program at 14 locations to improve hospital hand-offs for high-risk patients. Officials also are developing a program to reward hospitals for lowering readmission rates. <br />
<br />
Project Boost, a program developed by the Society of Hospital Medicine, provides hospitals with a tool kit of forms and procedures that standardize and enhance the discharge process. Piedmont Hospital in Atlanta, one of the first hospitals to use the Boost program, has reduced 30-day readmissions for patients under 70 years old to 3.97 percent, from 13.05 percent. Readmissions of older patients have fallen to 11.17 percent, from 15.9 percent. <br />
<br />
&ldquo;The program has been a thing of great beauty,&rdquo; said Dr. Matthew J. Schreiber, chief medical officer of the hospital. <br />
<br />
If you or a relative is hospitalized in an institution that has not recently revamped its discharge process, you may need to take an active role in managing the discharge. Here&rsquo;s what you need to know to smooth the transition. <br />
<br />
TAKE CHARGE &ldquo;The biggest problem in the discharge process is that no one person takes ownership of the patient,&rdquo; Dr. Schreiber said. In the hospital, multiple people may have been involved in supervising a patient&rsquo;s care: a surgeon, a nurse, an attending fellow and a discharge planner. <br />
<br />
That means it&rsquo;s up to patients and their advocates to make sure discharge plans are sound and to challenge any information that doesn&rsquo;t add up. <br />
<br />
If you believe the hospital is sending a patient home too soon, talk with the doctor. If that fails, talk to the hospital&rsquo;s patient advocate. Medicare patients can call their local Quality Improvement Organization, which handles quality-of-care issues for Medicare beneficiaries. <br />
<br />
&ldquo;Sometimes you have to be a jerk,&rdquo; Dr. Schreiber said. <br />
<br />
When my father was readmitted to the hospital, I went over the discharge planner&rsquo;s head and dealt only with her supervisor. Guess what? The second discharge went much better than the first. <br />
<br />
CHECK THE DRUG LIST Medication errors are a frequent cause of readmissions, Dr. Schreiber said. Ask for an up-to-date medication list and then double-check the information with the hospital pharmacist. Make sure the patient knows when and how to take new pills. <br />
<br />
You can print out a medication form from NextStepInCare.org, a Web site created by the nonprofit United Hospital Fund that offers free guides to help patients learn how to make the transition to a different care setting. <br />
<br />
MAKE A DISCHARGE PLAN Most hospitals provide a discharge plan in writing, but it may be incomplete and difficult to decipher. Compile your own plan that can be a guide for the patient, the caregiver and other doctors. <br />
<br />
The document should include a precise diagnosis, future appointments, a contact list and whom to call if new symptoms arise. <br />
<br />
You can download the Boost program&rsquo;s one-page Patient Pass form from the Project Boost Web site at hospitalmedicine.org. A similar form tailored to your situation &mdash; for example, for discharge from hospital to a home or to a nursing home &mdash; is available at NextStepInCare.org. <br />
<br />
A patient ready to leave the hospital may not be ready to go home. Physical therapy, occupational therapy or wound care that would best be administered at a rehab facility or a nursing home may be needed first. <br />
<br />
Talk to the doctor and the discharge planner about what location would be best for the patient. &ldquo;A good transfer requires that care needs match the care setting,&rdquo; Dr. Coleman said. <br />
<br />
CONTACT THE PRIMARY DOCTOR Urge the discharge planner or the hospital doctor to contact the patient&rsquo;s primary care physician and set up required future appointments. Ideally, the primary care doctor will take over where the surgeons and specialists left off. <br />
<br />
&ldquo;Research shows that the sooner patients see their P.C.P., the less likely they are to be readmitted,&rdquo; said Dr. Barry M. Straube, chief medical officer of the federal Centers for Medicare and Medicaid Services. <br />
<br />
If the hospital staff is not making that connection, then pick up the telephone and make the call yourself. <br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Patterns: Uninsured More at Risk Even in Hospitals]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=45</link> 
             <description><![CDATA[Patterns: Uninsured More at Risk Even in Hospitals - RONI CARYN RABIN - NY&nbsp;Times

Uninsured Americans often have difficulty getting care and paying for medications. But what happens once they are]]></description> 
             <pubDate>Tue, 15 Jun 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Patterns%20-%20Uninsured%20More%20at%20Risk%20Even%20in%20Hospitals.pdf</guid>
             <author><![CDATA[RONI CARYN RABIN]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/06/15/health/research/15disp.html">Patterns: Uninsured More at Risk Even in Hospitals</a></strong> - RONI CARYN RABIN - NY&nbsp;Times<br />
<br />
Uninsured Americans often have difficulty getting care and paying for medications. But what happens once they are admitted to a hospital with a life-threatening illness? <br />
<br />
A new study finds that even after they have heart attacks or strokes and are admitted to hospitals, the uninsured are more likely to die than those who carry private insurance. <br />
<br />
A gap persisted even after the researchers adjusted for disparities in the patients&rsquo; underlying health, socioeconomic status and other factors. <br />
<br />
Researchers analyzed more than 150,000 discharges of working-age Americans, ages 18 to 64, who were hospitalized for heart attack, stroke or pneumonia. The data was drawn from the 2005 Nationwide Inpatient Sample. <br />
<br />
The study found that uninsured patients who had heart attacks were 52 percent more likely to die in the hospital than the privately insured, and those who had a stroke were 49 percent more likely to die in the hospital. <br />
<br />
&ldquo;We thought there would be some disparity and a little bit of a difference, but we were surprised there were such significant differences,&rdquo; said Dr. Omar Hasan, a hospitalist at Brigham and Women&rsquo;s Hospital in Boston who was the lead author of the study, in the Journal of Hospital Medicine. <br />
<br />
One reason, Dr. Hasan suggested, may be that patients who have trouble getting care may have more advanced disease. <br />
<br />
&ldquo;We know for a fact that people who are uninsured delay seeking care,&rdquo; he said. <br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Bringing Comparison Shopping to the Doctorâ€™s Office]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=44</link> 
             <description><![CDATA[Bringing Comparison Shopping to the Doctor&rsquo;s Office - CLAIRE CAIN MILLER - NY&nbsp;Times


SAN FRANCISCO &mdash; Americans comparison-shop for items as small as groceries and as big as cars. But they]]></description> 
             <pubDate>Fri, 11 Jun 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Bringing%20Comparison%20Shopping%20to%20the%20Doctor%E2%80%99s%20Office.pdf</guid>
             <author><![CDATA[CLAIRE CAIN MILLER]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/06/11/technology/11cost.html">Bringing Comparison Shopping to the Doctor&rsquo;s Office </a></strong>- CLAIRE CAIN MILLER - NY&nbsp;Times<br />
<br />
<br />
SAN FRANCISCO &mdash; Americans comparison-shop for items as small as groceries and as big as cars. But they rarely compare prices on their health care. When a doctor recommends a test or a procedure, most patients simply go where the doctor tells them to go. <br />
<br />
Even if a patient does want to comparison-shop, there is no easy way to obtain complete and useful information. It is a hole in the market that some companies see as an opportunity, especially because many Americans will soon have to pay more attention to what they are paying for, rather than count on insurance to cover everything. <br />
<br />
But there has been no easy way for consumers to shop for the best deal on a colonoscopy or blood test. A start-up financed by prominent venture capitalists and the Cleveland Clinic, Castlight Health, aims to change that by building a search engine for health care prices. Patients using Castlight could search for doctors that offer a service nearby and find out how much they will charge, depending on their insurance coverage. <br />
<br />
A few others are starting to publish health care prices, including Thomson Reuters, a Tennessee start-up called Change:healthcare, the New Hampshire government, which created a comparison shopping tool for residents, and health insurers. Aetna, for instance, has built tools to help patients estimate prices and may build more advanced tools, said Lonny Reisman, Aetna&rsquo;s chief medical officer. <br />
<br />
Price transparency could significantly change the way health care is bought in the United States. The notion &ldquo;seems ridiculously simple and obvious, and in any other industry, you would say, &lsquo;Duh, we already have that.&rsquo; But in health care, it&rsquo;s revolutionary,&rdquo; said Alan M. Garber, a professor of medicine and the director of the center for health policy at Stanford, as well as an investor in Castlight. <br />
<br />
The lack of price information in health care has been a big driver of ballooning health care costs, analysts say, because costs are opaque to patients and heavily subsidized by employers. The patient has no incentive or responsibility to keep costs down. But many employers are switching to health plans that require patients to pay more out of their own pockets. <br />
<br />
&ldquo;Since Americans started having employer-sponsored health care, people are paying with someone else&rsquo;s credit card, so we created a very inefficient market,&rdquo; said Giovanni Colella, chief executive and a founder of Castlight. &ldquo;Creating the right incentives changes the way people behave, and that&rsquo;s where our company comes in.&rdquo; <br />
<br />
Dr. Colella started RelayHealth, which connects patients and doctors over the Web and was bought by McKesson in 2006. He founded Castlight with Todd Park, a founder of Athenahealth and chief technology officer of the federal Department of Health and Human Services. <br />
<br />
On Thursday, Castlight announced that it raised $60 million from investors, in addition to the $21 million it previously raised. Safeway, the grocery chain, with 200,000 employees, has signed on as its first customer. <br />
<br />
Castlight has received money from investment firms including Venrock, Maverick Capital, Oak Investment Partners and from an unlikely source, the Cleveland Clinic. Hospitals&rsquo; business models could be turned upside-down by price transparency. <br />
<br />
Several studies and pilot projects suggest that the more patients know about prices, the more money they save. A study published last month by Mercer, a human resources consulting firm, found that people on high-deductible health plans, with more exposure to the prices of doctor visits, spent less. Indiana adopted high-deductible health plans, and the average expense in 2009 for patients on one of these plans was $6,393, compared with $8,570 for patients on a more traditional health maintenance organization plan. <br />
<br />
&ldquo;A lot of it is to understand the driver of costs and how they can start to control that, and encouraging that debate to happen while in the physician&rsquo;s office,&rdquo; Dr. Colella said. Castlight is working on a mobile version of the service to introduce next year so people can access the information from the exam table. <br />
<br />
Health care pricing became part of the national conversation during the debate over health care reform. Prices will be important for the 30 million to 40 million people expected to join exchanges, which will encourage comparison shopping. <br />
<br />
But so far, prices have been very difficult to find because health insurance providers and doctors negotiate rates and often agree not to reveal those numbers for competitive reasons. The Cleveland Clinic, for example, has about a hundred different contracts with insurance carriers, each with a different rate for a given procedure. <br />
<br />
Ideally, transparency in health care pricing could lead to higher-quality, lower-cost health care, and more patient involvement in buying health care, said Delos Cosgrove, chief executive of the Cleveland Clinic. &ldquo;Because they begin to realize that a trip to the doctor is not free, they might stay home and take the aspirin instead of getting the neurologic work-up.&rdquo; <br />
<br />
Castlight sells its service to employers and charges by employee per month. (It plans to eventually introduce a Web site for anyone to use.) Employees log on to a search portal, where they enter something like &ldquo;colonoscopy&rdquo; to find a list of doctors nearby and how much they charge. <br />
<br />
Some insurers have shared pricing with Castlight, but the company gleans most of the information from the explanation-of-benefits forms that patients receive after a doctor visit. Castlight developed a way to pull the information from the millions of forms provided to it by employers. <br />
<br />
Anyone who has read an explanation of benefits knows that it often raises more questions than answers, and Castlight says it wants to provide health education in addition to price information. The site explains why a patient has to pay a certain amount and the standard number of tests that a doctor would order for a particular problem. <br />
<br />
Safeway has been experimenting with ways to cut health costs, including by using Castlight. &ldquo;I&rsquo;m a big believer in trying to create market forces wherever you can and then let personal accountability really drive the result,&rdquo; said Steven A. Burd, the chief executive of Safeway. <br />
<br />
For instance, Safeway pays up to $1,200 for its employees&rsquo; colonoscopies, a preventative procedure to detect cancer. If employees wish to go to a doctor who charges more, they must pay the difference. According to Castlight, colonoscopies in the Bay Area, where Safeway is based, range from $500 to $3,000, and sometimes a doctor charges different rates at different hospitals. <br />
<br />
Castlight plans to add quality measurements to its price information. There are already several providers of that information, though there is no standard set of quality measurements in medicine. But even with quality ratings, there are many procedures for which Castlight&rsquo;s service is not applicable. Someone suffering a heart attack is not going to check the Web before calling the ambulance, and a patient who discovers he needs emergency brain surgery is likely to prioritize quality above all else. <br />
<br />
Even for more basic services, pricing is not always cut-and-dried. The delivery of a baby, for example, includes the hospital stay and the obstetrician&rsquo;s fees, but could also include fees for a pediatrician, an anesthesiologist and specialists if there are complications. <br />
<br />
At this stage, Castlight works best for big companies that are self-insured and for outpatient doctor visits for which quality does not vary greatly. <br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Poor Hygiene a Danger at Outpatient Surgery Centers]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=42</link> 
             <description><![CDATA[Poor Hygiene a Danger at Outpatient Surgery Centers - Serena Gordon - Business Week

TUESDAY, June 8 (HealthDay News) -- Ambulatory surgical centers -- places where you can have certain surgeries]]></description> 
             <pubDate>Wed, 09 Jun 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Poor%20Hygiene%20a%20Danger%20at%20Outpatient%20Surgery%20Centers.pdf</guid>
             <author><![CDATA[Serena Gordon]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.businessweek.com/lifestyle/content/healthday/639937.html">Poor Hygiene a Danger at Outpatient Surgery Centers </a></strong>- Serena Gordon - Business Week<br />
<br />
TUESDAY, June 8 (HealthDay News) -- Ambulatory surgical centers -- places where you can have certain surgeries and go home just hours later -- may need to improve their infection-control practices to safeguard patients, researchers warn.<br />
<br />
A U.S. Centers for Disease Control and Prevention (CDC) study that sampled ambulatory surgical centers in three states found that 68 percent of those centers had at least one lapse in infection control, and 18 percent had lapses in three or more out of five infection-control categories, according to the study.<br />
<br />
&quot;The CDC, along with the Centers for Medicare &amp; Medicaid and state survey agencies, did a pilot study looking at ambulatory surgical centers. About two-thirds had at least one lapse in infection control practices,&quot; said study author Dr. Melissa Schaefer, a medical officer at the CDC in Atlanta.<br />
<br />
During the past several decades, more and more surgical procedures are being performed in ambulatory surgical centers instead of hospitals. These centers offer patients a wide range of same-day surgeries, specializing in dental procedures, plastic surgeries, orthopedic procedures or other operations.<br />
<br />
Between 2001 and 2008, there was more than a 50 increase in the number of Medicare-certified ambulatory surgical centers in the United States, according to the study, which is published in the June 9 issue of the Journal of the American Medical Association (JAMA).<br />
<br />
More than 6 million surgical procedures were performed in such centers in 2007, the study authors noted.<br />
<br />
However, an outbreak of hepatitis C and unsafe injection practices found at one licensed ambulatory surgical center in Las Vegas highlighted the need to assess the infection-control practices at such centers. The center in question &quot;had not undergone a full inspection by state surveyors in seven years,&quot; the researchers explained.<br />
<br />
In their study, the CDC first asked state survey agencies if they'd be willing to participate. Seven states volunteered and three were selected, mostly due to location, according to Schaefer. The three states included in the study were Maryland, North Carolina and Oklahoma.<br />
<br />
Sixty-eight ambulatory surgical centers were evaluated by auditors from the Centers for Medicare &amp; Medicaid Services (CMS). Of those centers, almost 68 percent had at least one lapse in infection control.<br />
<br />
Almost 20 percent had a lapse in proper hand washing or the use of protective gloves. Just over 28 percent displayed deficiencies in medication handling -- most commonly, using a single-dose vial of medication for more than one patient.<br />
<br />
More than 46 percent of the centers inappropriately handled equipment used for blood sugar monitoring, and more than 28 percent failed to follow the recommended infection-control processes for reprocessing used surgical equipment, according to the investigators.<br />
<br />
&quot;These institutions need to rededicate their efforts to making sure that their infection-control practices incorporate best practices, and the tolerance for less has to be zero,&quot; said the author of an accompanying editorial in the same issue of JAMA, Dr. Philip S. Barie, editor in chief of the journal Surgical Infections, and a professor of surgery and public health at Weill Cornell Medical College in New York City.<br />
<br />
To that end, Schaefer said the CDC is offering an infection-control audit tool to surgical centers, and suggested that facilities shouldn't wait to be inspected, but they should proactively conduct their own audits of their infection-control practices.<br />
<br />
Neither expert could say with any certainty why these lapses were occurring, but Barie said it was particularly troubling that the problems occurred even though these centers were aware they were being evaluated. &quot;People knew they were being observed, so there was every opportunity for them to modify their behavior,&quot; noted Barie.<br />
<br />
Responding to the study, organizations representing the ambulatory surgery center (ASC) industry issued a news release on Tuesday.<br />
<br />
&quot;The industry takes this report seriously, and since the release of the findings from the pilot study in 2009, we have worked with CMS, accrediting bodies, state ASC associations, medical and nursing professional organizations and leaders in quality measurement to address concerns quickly and effectively,&quot; Andrew Hayek, chair of the Ambulatory Surgery Center Advocacy Committee and president and CEO of Surgical Care Affiliates, said in the statement.<br />
<br />
&quot;The industry has implemented voluntary reporting standards,&quot; he added, &quot;and has called on CMS to implement a system for nationwide quality reporting for ASCs and for the entire health-care delivery system using comparable data so patients are able to make informed decisions about where to receive their health care.&quot;<br />
<br />
Ambulatory surgical centers aren't the only places with infection concerns, however. According to a different study in the same issue of JAMA, a large teaching hospital in Madrid, Spain has experienced an outbreak of the superbug, methicillin-resistant Staphylococcus aureus (MRSA) that is resistant to yet another line of antibiotics.<br />
<br />
The study reports on 12 critically ill patients who were found to be infected with the first reported cases of linezolid-resistant Staphylococcus aureus. Linezolid is an antibiotic and one of the few options left to effectively treat MRSA, according to background information in the study.<br />
<br />
With reduced use of linezolid and infection-control measures, the hospital was able to stop the spread of this new infection, according to the study. One patient who was infected died due to the infection, however.<br />
<br />
More information<br />
<br />
Hand washing, though simple, is one of the most effective ways to control all kinds of infections. Read more from the U.S. Centers for Disease Control and Prevention on the right way to wash your hands.]]></full> 
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                <item> 
             <title><![CDATA[Secondhand smoke may harm mental health]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=43</link> 
             <description><![CDATA[Secondhand smoke may harm mental health - Anne Harding - Reuters

NEW YORK (Reuters Health) - Other people's smoke is bad for your lungs and bad for your heart, and new]]></description> 
             <pubDate>Wed, 09 Jun 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Secondhand%20smoke%20may%20harm%20mental%20health.pdf</guid>
             <author><![CDATA[Anne Harding]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://Secondhand smoke may harm mental health">Secondhand smoke may harm mental health</a></strong> - Anne Harding - Reuters<br />
<br />
NEW YORK (Reuters Health) - Other people's smoke is bad for your lungs and bad for your heart, and new research suggests it could be bad for your mental health, too.<br />
Researchers found that non-smokers exposed to a lot of secondhand smoke were 50 percent more likely to suffer from psychological distress than those not exposed to other people's smoke.<br />
And their risk of being admitted to a psychiatric hospital over the next six years was nearly tripled (it was almost quadrupled for smokers).<br />
So-called &quot;passive smoking&quot; is very common, Dr. Mark Hamer of University College London in the UK and colleagues note in the Archives of General Psychiatry. One US study found evidence of secondhand smoke in 60 percent of non-smokers.<br />
Studies measuring the nicotine byproduct cotinine have made it possible to precisely measure secondhand smoke exposure and its health effects, they add, but there is &quot;very limited information&quot; on how other people's smoke might affect mental health.<br />
To investigate, Hamer and his colleagues studied 5,560 non-smoking adults and 2,595 smoking adults, none of whom had a history of mental illness. The study subjects answered questions about psychological distress and admissions to psychiatric hospitals were tracked for six years.<br />
Exposure to secondhand smoke among non-smokers was determined using saliva levels of cotinine, which is formed when nicotine is broken down in the body and is an established marker of nicotine exposure.<br />
A total of 14.5 percent of study subjects reported psychological distress. According to the investigators, the higher a person's secondhand smoke exposure, the greater their risk of psychological distress, while the risk was highest for people who were themselves smokers.<br />
People with high exposure to secondhand smoke (those with the highest cotinine levels) who didn't actually smoke themselves were 62 percent more likely to report psychological distress than those unexposed to secondhand smoke, while the risk for smokers was 2.45 times greater.<br />
During follow-up, which averaged about six years, 41 people were admitted to psychiatric hospitals. The risk of hospitalization was 2.8 times greater for secondhand smokers compared to people not exposed to secondhand smoke, while it was 3.7 times greater for smokers.<br />
The effects were stronger for never-smokers than for ex-smokers, Hamer noted; the fact that former smokers were able to quit could suggest they were intrinsically less vulnerable to the effects of nicotine.<br />
Studies like the current one can't prove that something caused something else, Hamer said in an interview. However, he added, the link remained even after he and his colleagues accounted for social status, alcohol intake and other factors that could influence both the risk of mental health problems and the likelihood of being exposed to secondhand smoke. &quot;We did see pretty robust associations that remained after those adjustments,&quot; he said.<br />
Moreover, Hamer and colleagues note that animal studies have hinted that tobacco may depress a person's mood and some human studies have also suggested a potential link between smoking and depression. &quot;Taken together, therefore, our data are consistent with other emerging evidence to suggest a causal role of nicotine exposure in mental health,&quot; the investigators conclude.]]></full> 
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                <item> 
             <title><![CDATA[Paying for the ˜Institutionalized Spouse']]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=41</link> 
             <description><![CDATA[Paying for the &lsquo;Institutionalized Spouse&rsquo; - Craig Reaves - NY&nbsp;Times

Craig Reaves, past president of the National Academy of Elder Law Attorneys, practices in Kansas City, Mo., and on occasion fields]]></description> 
             <pubDate>Mon, 07 Jun 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Paying%20for%20the%20Institutionalized%20Spouse.pdf</guid>
             <author><![CDATA[CRAIG REAVES]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://newoldage.blogs.nytimes.com/2010/06/04/paying-for-the-institutionalized-spouse/">Paying for the &lsquo;Institutionalized Spouse&rsquo; </a></strong>- Craig Reaves - NY&nbsp;Times<br />
<br />
Craig Reaves, past president of the National Academy of Elder Law Attorneys, practices in Kansas City, Mo., and on occasion fields questions from New Old Age readers. You may submit your question to newoldage@nytimes.com. Please limit your inquiries to general legal issues; Mr. Reaves can&rsquo;t offer personal legal advice.<br />
<br />
<strong>Q.What happens when one half of a married couple is retired and in need of expensive nursing home care while a younger spouse is still working and earning income? Are there options for protecting any of the income or accumulated wealth (such as retirement accounts) of the younger spouse? Or does it all have to go to pay for the care of the one who&rsquo;s ill?</strong><br />
<br />
<br />
<strong>A.There&rsquo;s no simple, legal way to shelter your income or most of your wealth in this circumstance</strong>. Spouses have a legal duty to support each other. The income or assets of a working spouse (known in the Medicaid world as the &ldquo;community spouse&rdquo;) must be used for the care of the spouse in the nursing home (in official parlance, the &ldquo;institutionalized spouse&rdquo;).<br />
<br />
Couples who find themselves in this situation essentially have three options.<br />
<br />
First, they may be able to change their investment mix, work harder or accept family help in order to generate enough income to pay for the nursing home and also for the expenses of the spouse at home. That way, they&rsquo;re never forced to tap into the Medicaid system.<br />
<br />
But if there&rsquo;s not enough income to pay for long-term care, couples must start liquidating their holdings, selling stocks and bonds, cashing in C.D.&rsquo;s and, yes, those I.R.A.&rsquo;s. Once their assets sink low enough ($2,000 in most states), the person who needs care can qualify for Medicaid.<br />
<br />
But there&rsquo;s an exception for married couples intended to prevent the spouse at home from becoming completely impoverished. The law allows a married couple to divide assets in order to qualify for Medicaid if one spouse is in a nursing home and the other spouse at home.<br />
<br />
<br />
Say Mrs. Jones has moved to a nursing home. In most states, division of assets allows Mr. Jones, still living at home, to keep what Medicaid calls &ldquo;exempt resources&rdquo; &mdash; typically the house, a car, personal belongings and a prepaid burial &mdash; plus half of any remaining assets, up to a current maximum of $109,560. The minimum is $21,912, so Mr. Jones can hold onto at least that much. Everything else must be spent so that Mrs. Jones can qualify for Medicaid.<br />
<br />
Trying to keep Mr. Jones solvent by allowing division of assets is great in concept, but the numbers are just too low for many couples to feel good about this option. A few states automatically allow the community spouse to keep the maximum, which helps. And if Mr. Jones has extremely low income, some of his wife&rsquo;s income &mdash; from Social Security, say &mdash; will be used to support him at home.<br />
<br />
One bright spot: once Mrs. Jones qualifies for Medicaid, her husband no longer has a duty to support her, and his assets and income are no longer required to pay for her nursing home. He could win the lottery or inherit a castle, but she still qualifies for Medicaid and he&rsquo;s not responsible for her nursing home charges. (But should she run up credit card bills or get sued, he could still be on the hook; this policy shields him from Medicaid expenses, not other creditors.)<br />
<br />
One less-bright spot: Medicaid will keep track of what it spends on nursing home care, and when Mrs. Jones dies, Medicaid will want its money back, a process known as &ldquo;estate recovery.&rdquo; Medicaid will not take funds from Mr. Jones, but when he dies, it will attempt to collect from his estate. Medicaid gets paid before the Jones&rsquo; children (unless they&rsquo;re under 21 or disabled) or any other heirs.<br />
<br />
The third option? Divorce, which happens more and more frequently. If the couple legally divorces, the spouse who&rsquo;s not incapacitated has no duty to support the other and can keep whatever the court allocates. In the case of the Joneses, the money awarded to the former Mrs. Jones has to be spent for her care until she qualifies for Medicaid, but the court could allow an uneven division so that Mr. Jones gets more than she does.<br />
<br />
These situations are heartbreakers; the sessions in my office when we talk about this possibility are often full of tears. But financially, divorce can be a real advantage. More assets can be set aside for the spouse at home, and there&rsquo;s no estate recovery.<br />
<br />
Nobody wants to go through any of these things; they&rsquo;re what you do when your back is against the wall. Division of assets or divorce at least lets you preserve some assets to provide for the spouse at home and to tap into Medicaid for nursing home care.<br />
<br />
Because this type of planning is complex, you should consult a local elder attorney to answer specific questions. I also warn against relying on what a Medicaid caseworker advises. These policies vary considerably by state, and it&rsquo;s not a process you want to embark on without expert counsel.<br />
<br />]]></full> 
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             <title><![CDATA[20% of U.S. High Schoolers Abuse Prescription Drugs]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=39</link> 
             <description><![CDATA[20% of U.S. High Schoolers Abuse Prescription Drugs - By Steven Reinberg HealthDay Reporter

THURSDAY, June 3 (HealthDay News) -- One in five high school students in the United States has]]></description> 
             <pubDate>Thu, 03 Jun 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/20%25%20of%20U_S_%20High%20Schoolers%20Abuse%20Prescription%20Drugs.pdf</guid>
             <author><![CDATA[By Steven Reinberg HealthDay Reporter]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.businessweek.com/lifestyle/content/healthday/639796.html">20% of U.S. High Schoolers Abuse Prescription Drugs </a></strong>- By Steven Reinberg HealthDay Reporter<br />
<br />
THURSDAY, June 3 (HealthDay News) -- One in five high school students in the United States has taken a prescription medication that was not prescribed for them, a new survey shows.<br />
<br />
Conducted by the U.S. Centers for Disease Control and Prevention, the survey covers a variety of risky behaviors among American youth.<br />
<br />
&quot;We are very concerned that 20 percent of high school students are reporting this behavior,&quot; said survey author Danice K. Eaton, a research scientist at the CDC. &quot;It can be dangerous to take a prescription drug that hasn't been prescribed to you.&quot;<br />
<br />
Studies have shown that taking non-prescribed prescription drugs can lead to overdose, addiction and death, Eaton explained. &quot;Taking a prescription drug that hasn't been prescribed to you is a health risk behavior,&quot; she said.<br />
<br />
In the survey, 16,460 high school students were asked if they had ever taken prescription drugs such as OxyContin, Percocet, Vicodin, Adderall, Ritalin or Xanax, without a doctor's prescription.<br />
<br />
The abuse of prescription drugs was widest among whites at 23 percent, followed by Hispanics at 17 percent, and black students at 12 percent.<br />
<br />
In addition, the abuse of prescription drugs was most common among 12th graders (26 percent) and lowest among ninth graders (15 percent), the researchers found. But, prescription drug abuse was the same for boys and girls, at 20 percent.<br />
<br />
This is the first time a question about prescription drugs has been asked in the survey, Eaton said. The next survey will be in 2011, with the data being released in 2012. This will be the first opportunity to see trends in the abuse of prescription drugs, she noted.<br />
<br />
In the meantime, the &quot;awareness that there is such a high prevalence of prescription drug abuse among high school students is the main thing that we can emphasize from our data,&quot; Eaton said.<br />
<br />
Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine, said there are too many prescription drugs waiting to be abused.<br />
<br />
&quot;When prescription drugs are available in a home to the patient for whom they were prescribed, they are also available to the patient's teenager,&quot; he said.<br />
<br />
Educating teens about the potential harms of prescription drugs, and including discussion of prescription medications in all drug control programs, is warranted, Katz said.<br />
<br />
&quot;Parental awareness, which this report helps cultivate, and vigilance will be more important still,&quot; he said. &quot;But perhaps the ultimate solution to this problem is a more dedicated societal commitment to disease prevention and health promotion, so that fewer prescription drugs are in circulation, and available for such misuse.&quot;<br />
<br />
The survey also asked about alcohol and drug abuse. In all, 72 percent of the students said they had used alcohol. Furthermore, 37 percent had used marijuana, 6.4 percent had used cocaine, 4.1 percent had used methamphetamine and 6.7 percent had used ecstasy.<br />
<br />
These findings were basically the same as those in the last survey, which was done in 2007, the researchers noted.<br />
<br />
On the bright side, high school students seemed to be eating better.<br />
<ul>
    <li>The number of students who drank a soda a day dropped, from 34 percent in 2007 to 29 percent in 2009.</li>
    <li>More students ate fruit or 100 percent fruit juice (30 percent in 2005 and 34 percent in 2009).</li>
    <li>Fewer students engaged in risky weight-loss diets, such as not eating, taking diet pills or vomiting or taking laxatives.</li>
</ul>
<br />
<br />
However, students are still engaging in other risky behaviors such as:<br />
<br />
<ul>
    <li>78 percent had not eaten fruits or vegetables five or more times daily in the week before the survey.</li>
    <li>82 percent said they had not been physically active for at least an hour per day.</li>
    <li>19 percent smoked cigarettes.</li>
    <li>28 percent rode in a car driven by a person who had been drinking alcohol.</li>
    <li>39 percent of sexually active students had had sex without using a condom.</li>
</ul>
<br />
These numbers are also similar to the 2007 numbers, the researchers noted.]]></full> 
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                <item> 
             <title><![CDATA[Health Costs: A Modest Proposal]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=40</link> 
             <description><![CDATA[&nbsp; 
Health Costs: A Modest Proposal
June 3, 2010 - 10:52 am
Harlan KrumholzBio | Email
Harlan M. Krumholz MD, SM, is the Harold H. Hines, Jr. Professor of Medicine and Epidemiology and]]></description> 
             <pubDate>Thu, 03 Jun 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Health%20Costs%20-%20A%20Modest%20Proposal.pdf</guid>
             <author><![CDATA[Harlan M. Krumholz MD, SM, is the Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health at Yale University. ]]></author> 
             <full><![CDATA[&nbsp; <br />
<strong><a target="_blank" href="http://blogs.forbes.com/sciencebiz/2010/06/03/health-costs-a-modest-proposal/">Health Costs: A Modest Proposal</a></strong><br />
June 3, 2010 - 10:52 am<br />
Harlan KrumholzBio | Email<br />
Harlan M. Krumholz MD, SM, is the Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health at Yale University. <br />
<br />
I received a call last year from a friend of a colleague who asked for advice about John, her husband. He was experiencing chest pressure when he climbed steep inclines. A stress test suggested heart disease as the cause of his symptoms. His physician referred him for a cardiac catheterization.<br />
The cardiologist to whom he was referred did not have an office visit opening for many months. Yet he was able to schedule the catheterization, a diagnostic procedure to detect blockages, for the following week. The idea was that John would meet the cardiologist while lying on the table awaiting the procedure. And if blockages were found, John would likely have angioplasty or bypass surgery.<br />
This approach to medicine, which may be expedient, circumvents the patient and can lead to patients having tests and procedures that they would not choose if they had all the facts. Too often tests and procedures are suggested to patients as if no rational person would forego them. Too often the full range of risks, including the risks of false positive testing, is not relayed. And if some patients are having tests and procedures that they would not choose, then costs can be saved simply by doing what patients want.<br />
You may be under the impression that patients already have good information when they decide on tests and procedures. Unfortunately, that is just not true. Too often we hand patients a clipboard with a form to sign when they are lying on a gurney about the have the test or procedure in question.<br />
Consider angioplasty, a procedure that opens a blocked artery in the heart and often also involves propping open the artery with a metal stent. The procedure often requires patients to take certain medications for the following year and increases the risk for future procedures. Studies show that non-emergency angioplasties can alleviate pain and other symptoms, but they do not reduce the risk of heart attacks or improve survival. Studies also show that many patients who do not have the procedure can also experience an improvement in their symptoms.<br />
We conducted a study in which we asked patients about the procedure after they had signed the consent. Almost three-quarters of patients reported the mistaken impression that the procedure would reduce their risk of a heart attack and/or improve their survival.<br />
A few weeks ago I made a modest proposal to the medical profession in the pages of the Journal of the American Medical Association. I suggested that we make informed consent meaningful and provide patients with the critical information that should be available to anyone contemplating a major test or procedure.<br />
I suggested that in non-urgent situations, when there is time for deliberation, patients be told their options, given realistic estimates of risks and benefits, informed about the track record of the institution and physicians who will provide the service, and provided an estimate of the costs to them.<br />
My proposal was to standardize the information to patients who are considering some of the most common elective tests and procedures. Assemble panels of expert doctors and determine where there is consensus about the minimum information that all patients should know. Work with educators and psychologists to determine how to convey the information fairly and impartially. Inform patients that the best decision will be aligned with their values and preferences and that no one decision is right for everyone.<br />
This solution to rising health care costs does not involve rationing care. It does not shift payments to patients or reduce payments to doctors. It does not require complicated legislation or regulation. The solution simply ensures that patients are making an informed decision.<br />
Look what happened to John. I arranged for John to meet another cardiologist--someone who would explain the options and be sure that John had realistic expectations about the benefits and risks of the angioplasty procedure. In the end, John opted to focus on treating his risk factors with drugs and defer the invasive procedure. And he has done well.<br />
My hunch is that, just like John, disclosures to patients about their options and expectations will lead many of them to seek less rather than more. Even more importantly, the quality of care will improve as we will be more confident that the care provided is what the patient wants.<br />
In this way, we can reduce health care costs simply by telling the truth.<br />
<br />]]></full> 
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             <title><![CDATA[Who's packing ERs? Not the uninsured]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=37</link> 
             <description><![CDATA[Who's packing ERs? Not the uninsured - Reuters&nbsp; 

WASHINGTON - One in five people in the United States visit an emergency room every year, and most of them have health]]></description> 
             <pubDate>Wed, 26 May 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Most%20ER%20patients%20have%20some%20health%20insurance%20-%20Health%20care.pdf</guid>
             <author><![CDATA[Reuters]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.reuters.com/article/idUSTRE64I78X20100520">Who's packing ERs? Not the uninsured</a></strong> - Reuters&nbsp; <br />
<br />
WASHINGTON - One in five people in the United States visit an emergency room every year, and most of them have health insurance of some kind, according to a U.S. government survey released on Wednesday.
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">The survey contradicts a common perception that emergency rooms are packed with uninsured people and illegal immigrants. It also rejects some claims that people are using the emergency department for routine care &mdash; just 10 percent of visits were for non-urgent causes.</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">&quot;In 2007, approximately one in five persons in the U.S. population had one or more emergency department visits in a 12-month period,&quot; the report from the National Center for Health Statistics reads.</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">&quot;Among the under-65 population, the uninsured were no more likely than the insured to have had at least one emergency department visit in a 12-month period.&quot;</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">Tamyra Carroll Garcia and colleagues at the center used two large national surveys of healthcare use in 2007 for their study.</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">&quot;Since 1996, demand for emergency services in the United States has been rising,&quot; they wrote.</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">&quot;While the number of emergency departments across the country has decreased, the number of ED visits has increased. As a result, EDs are experiencing higher patient volume and overcrowding, and patients seeking care are experiencing longer wait times,&quot; they added.</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">&quot;As national health care costs continue to rise and policymakers become increasingly interested in ways to make the health care system more efficient, it is important to understand the characteristics of those individuals who use EDs &mdash; often in place of other sources of ambulatory care.&quot;</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">They found that the more income people had, the less likely they were to ever visit an emergency room. People over 75 and blacks were the most likely to visit emergency rooms.</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">The American College of Emergency Physicians published a survey this month showing that 61 percent of emergency doctors surveyed believe U.S. healthcare reform will send even more people to emergency departments.</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">Only 1 percent of the 1,800 doctors surveyed thought visits would decrease. And 47 percent said the reforms signed into law in March would worsen overcrowding in emergency rooms.</p>
<p class="textBodyBlack" style="font: 12px Verdana; color: rgb(0,0,0)">&quot;It's important to note the report finds that having a usual source of medical care, such as a primary care provider, does not affect the number of times people under age 65 visit the emergency department,&quot; Dr. Angela Gardner, president of the American College of Emergency Physicians, said of Wednesday's report.</p>
<div class="copyright" style="font: italic 12px Verdana; color: rgb(0,0,0)">Copyright 2010 Reuters. Click for restrictions.</div>]]></full> 
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             <title><![CDATA[Doctor preferences may explain high C-section rates]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=35</link> 
             <description><![CDATA[Doctor preferences may explain high C-section rates - Reuters

NEW YORK (Reuters Health) - The number of Cesarean sections performed at hospitals across British Columbia is highly variable, Canadian researchers have]]></description> 
             <pubDate>Tue, 25 May 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Doctor%20preferences%20may%20explain%20high%20C-section%20rates.pdf</guid>
             <author><![CDATA[Reuters]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.reuters.com/article/idUSTRE64N5E020100524">Doctor preferences may explain high C-section rates</a></strong> - Reuters<br />
<br />
NEW YORK (Reuters Health) - The number of Cesarean sections performed at hospitals across British Columbia is highly variable, Canadian researchers have found.<br />
<br />
Health<br />
<br />
Even when accounting for differences in women's preferences and conditions that could complicate vaginal delivery, C-section rates varied from less than 15 percent to more than 27 percent of all births.<br />
<br />
&quot;Thus, our results illustrate what we believe to be 'unwarranted variation,'&quot; the researchers write in the latest issue of the journal Obstetrics and Gynecology, noting that mothers requested C-sections in only 2 percent of the cases.<br />
<br />
According to the new report, earlier studies have found marked variation in the United States as well. Both Canadian and US experts agree that the current Cesarean rate -- in the US, one-third of all births -- is too high.<br />
<br />
It is not entirely clear why the rates vary so drastically, but the Canadian researchers, from the University of British Columbia in Vancouver, suggest that limited resources at smaller hospitals may lower the bar for C-sections to avoid emergency surgeries.<br />
<br />
Among the more than 100,000 deliveries that they analyzed, the most common reason for C-section was difficult labor, which accounted for one-third of the surgeries, and was also highly variable between different areas.<br />
<br />
As a result, the researchers write, &quot;we suggest that revising the current guidelines regarding the management of (difficult labor) may be a good starting point on the road to decreasing unwarranted variation in cesarean delivery and assisted vaginal delivery rates.&quot;<br />
<br />
SOURCE: www.ajog.org<br />
<br />
Obstetrics and Gynecology, June 2010.<br />
<br />]]></full> 
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             <title><![CDATA[America's 50 Largest Metro Areas Get Their Annual Physical]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=36</link> 
             <description><![CDATA[America's 50 Largest Metro Areas Get Their Annual Physical - ACSM&nbsp;American Fitness Index

Information provided by the ACSM American Fitness Index.

The AFI data report reflects a composite of preventive health behaviors,]]></description> 
             <pubDate>Tue, 25 May 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/America's%2050%20Largest%20Metro%20Areas%20Get%20Their%20Annual%20Physical.pdf</guid>
             <author><![CDATA[ACSM American Fitness Index.]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.acsm.org/AM/Template.cfm?Section=ACSM_News_Releases&amp;CONTENTID=14704&amp;TEMPLATE=/CM/ContentDisplay.cfm">America's 50 Largest Metro Areas Get Their Annual Physical</a></strong> - ACSM&nbsp;American Fitness Index<br />
<br />
Information provided by the ACSM American Fitness Index.<br />
<br />
The AFI data report reflects a composite of preventive health behaviors, levels of chronic disease conditions, health care access, and community resources and policies that support physical activity.<br />
<br />
ACSM received a grant from the WellPoint Foundation, based in Indianapolis, to present the 2010 data report.<br />
<br />
The metropolitan rankings included in the report are:&nbsp; <a target="_blank" href="/assets/lib/files/Articles/America's%2050%20Largest%20Metro%20Areas%20Get%20Their%20Annual%20Physical.pdf"><strong>CLICK&nbsp;HERE</strong></a><br />]]></full> 
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             <title><![CDATA[Study tracks effects of interruptions on doctors]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=27</link> 
             <description><![CDATA[Study tracks effects of interruptions on doctors - Tom Watkins, CNN

Interruptions in the emergency room may exact an unhealthy toll on patient care, a group of Australian researchers reported Thursday.

The]]></description> 
             <pubDate>Fri, 14 May 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/DOCS/Study%20tracks%20effects%20of%20interruptions%20on%20doctors.pdf</guid>
             <author><![CDATA[Tom Watkins, CNN]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://articles.cnn.com/2010-05-12/health/doctors.interrupted_1_interruptions-tasks-doctors?_s=PM:HEALTH">Study tracks effects of interruptions on doctors </a></strong>- Tom Watkins, CNN<br />
<br />
Interruptions in the emergency room may exact an unhealthy toll on patient care, a group of Australian researchers reported Thursday.<br />
<br />
The researchers, from the University of Sydney and the University of New South Wales, found that interruptions led emergency department doctors to spend less time on the tasks they were working on and, in nearly a fifth of cases, to give up on the task altogether. <br />
<br />
The researchers carried out a time-and-motion study in the emergency department of a 400-bed teaching hospital, observing 40 doctors for more than 210 hours.<br />
<br />
They found that each doctor was typically interrupted 6.6 times per hour; 11 percent of all tasks were interrupted, 3.3 percent of them more than once. They calculated time on task and found that physicians spent less time on interrupted tasks than on uninterrupted tasks. In addition, doctors were multitasking 12.8 percent of the time.<br />
<br />
Doctors did not return to 18.5 percent of the interrupted tasks, according to the study, which was published in the journal Quality and Safety in Health Care.<br />
<br />
&quot;It appears that in busy interrupt-driven clinical environments, clinicians reduce the time they spend on clinical tasks if they experience interruptions, and may delay or fail to return to a significant portion of interrupted tasks,&quot; concluded the authors, who were led by Johanna Westbrook, director of the health informatics research and evaluation unit on the Faculty of Health Sciences at the University of Sydney.<br />
<br />
&quot;Task shortening may occur because interrupted tasks are truncated to 'catch up' for lost time, which may have significant implications for patient safety.&quot;<br />
<br />
Other studies have shown that interruptions can result in lapses of attention, memory or perception, they wrote.<br />
<br />
&quot;Further, interruptions add significantly to cognitive load, increase stress and anxiety, inhibit decision-making performance and increase task errors,&quot; they said.<br />
<br />
The interruptions included a doctor being asked a question while trying to write a prescription.<br />
<br />
&quot;Now, most people think it's very acceptable to interrupt,&quot; but doing so can be dangerous, lead author Westbrook said. She urged hospital emergency department directors to teach hospital personnel when it is acceptable to interrupt and when it may be better to find an alternative strategy.<br />
<br />
&quot;We really have to look at ways to try and reduce unnecessary interruptions,&quot; she said.<br />
<br />
Though this study did not document any negative outcomes associated with interruptions, Westbrook published a paper two weeks ago that found a direct association between interruptions and the number of medication errors made by nurses.<br />
<br />
&quot;I think we have to look at interruptions as a potentially dangerous strategy in clinical work environments,&quot; she said.<br />
<br />
On average, doctors completed tasks that were interrupted once in about half the time they would have taken if they had not been interrupted. That perplexed the authors, who speculated that the interruptions led clinicians to try to compensate for the &quot;lost&quot; time by working faster and cutting corners. They said there was a strong need to develop processes that minimize unnecessary interruptions and multitasking.<br />
<br />
&quot;Our results support the hypothesis that the highly interruptive nature of busy clinical environments may have a negative impact on patient safety,&quot; they said.<br />
<br />
If their results are confirmed, they added, clinical work processes should be redesigned.<br />
<br />
Other industries have recognized interruptions as dangerous, including the airline industry, which has developed strategies to reduce interruptions to the flight crew during takeoff and limited unnecessary communications with the cockpit.<br />
<br />
&quot;In our society, we get very used to interrupting each other,&quot; Westbrook said. &quot;Sometimes we need to stop and think about that.&quot;<br />
<br />
Neither the American College of Emergency Physicians nor the American Academy of Emergency Medicine responded immediately to requests for comment.<br />
<br />
The study was funded by Australia's Health Contribution Fund, Health and Medical Research Foundation and National Health and Medical Research Council.<br />
<br />]]></full> 
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             <title><![CDATA[US cancer costs double in nearly 20 years]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=28</link> 
             <description><![CDATA[US cancer costs double in nearly 20 years - Mike Strobbe - Huffington Post

ATLANTA (AP) - The cost of treating cancer in the United States nearly doubled over the past]]></description> 
             <pubDate>Tue, 11 May 2010 12:00:00 -0400</pubDate> 
             <guid>/assets/lib/files/Articles/US%20cancer%20costs%20double%20in%20nearly%2020%20years.pdf</guid>
             <author><![CDATA[MIKE STOBBE]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.huffingtonpost.com/2010/05/10/us-cancer-costs-double-in_n_569968.html">US cancer costs double in nearly 20 years</a></strong> - Mike Strobbe - Huffington Post<br />
<br />
ATLANTA (AP) - The cost of treating cancer in the United States nearly doubled over the past two decades, but expensive cancer drugs may not be the main reason why, according to a surprising new study.<br />
<br />
The study confounds conventional wisdom in several respects. The soaring price of new cancer treatments has received widespread attention, but the researchers conclude that rising costs were mainly driven by the growing number of cancer patients.<br />
<br />
The study also finds cancer accounts for only 5 percent of total U.S. medical costs, and that has not changed in the last few decades.<br />
<br />
&quot;I will say I'm a bit surprised,&quot; said Dr. Len Lichtenfeld of the American Cancer Society, who said he would have expected the proportion of cancer costs to rise.<br />
<br />
The researchers also found that private insurers now cover a greater share of cancer treatment costs - about 50 percent - while patients' out-of-pocket costs have fallen over the past two decades.<br />
<br />
Though taken aback by some of the findings, Lichtenfeld and other experts did not dispute the study, which compared medical cost data from the late 1980s to that of the early 2000s. But they said the picture surely has changed in the last several years.<br />
<br />
The study is being called the first to combine national cancer costs for all types of payers and see how they've changed over time. The figures are reported in 2007 dollars.<br />
<br />
It found that cancer treatment costs rose from nearly $25 billion in 1987 to more than $48 billion by the end of 2005.<br />
<br />
The rise in costs is mainly due to an increase over 20 years in how many cancer patients there are, said the study's lead author, Florence Tangka of the U.S. Centers for Disease Control and Prevention.<br />
<br />
The researchers used data from national telephone surveys done in 1987 and from 2001 through 2005, which gathered information on medical conditions as well as who paid the bills. More than 164,000 people were surveyed.<br />
<br />
The study did not offer precise estimates of how the number of people treated for cancer changed from the late 1980s to the early 2000s. But it showed dramaticincreases in the number of cancer cases covered by the government's Medicare and Medicaid programs. Medicare, which covers the elderly and disabled, has consistently covered about a third of the nation's cancer costs. Medicaid accounts for only 3 percent.<br />
<br />
The U.S. population is aging, and older people tend to get cancer at higher rates, Tangka noted.<br />
<br />
Better and more advanced treatments mean more people with cancer are remaining alive, so the spending increases represent money well spent, said Kenneth Thorpe, a health policy researcher at Emory University who has focused on the cost of health care.<br />
<br />
&quot;It seems like we're buying increases in survival,&quot; Thorpe said.<br />
<br />
The study is being published in Cancer, a medical journal of the American Cancer Society.<br />
<br />
The researchers also found:<br />
<br />
-The percentage of cancer costs from inpatient hospital care fell from 64 percent to about 27 percent. A shift to less expensive outpatient care, along with cost containment efforts by large health insurers, helped keep down increases in the costs per patient, the authors said.<br />
<br />
-The proportion of cancer costs paid by private insurance rose from 42 to 50 percent.<br />
<br />
-The proportion of costs paid out of pocket by patients - including copayments and deductibles - dropped from 17 percent to 8 percent.<br />
<br />
Those last two findings surprised some experts.<br />
<br />
Recent government reports have found that the percentage of Americans with private health insurance has been shrinking and recently hit its lowest mark in 50 years. Yet the study found that the proportion of cancer treatment costs paid by private insurance rose.<br />
<br />
And companies have been tightening or cutting employee benefits, causing out-of-pocket costs to go up for many patients. Yet the study found that the proportion of bills paid by patients declined.<br />
<br />
That last finding in particular was striking, said Lichtenfeld, the cancer society's deputy chief medical officer.<br />
<br />
He alluded to widely reported increases in personal bankruptcies prompted by medical bills. &quot;There's no question that the out-of-pocket costs for some patients have risen dramatically,&quot; Lichtenfeld said.<br />
<br />
The rising price of certain treatments also should be acknowledged, he said.<br />
<br />
The challenge of rising prices was recognized by American Society of Clinical Oncology (ASCO), which last year released its first guidelines counseling cancer doctors on how to talk to patients about deciding between less expensive chemotherapy drugs made more sense than newer, more expensive products.<br />
<br />
The study did not add in the cost of diagnostic tests and scans, which are cost drivers. And the data does not include the last five years, which saw some extremely pricey cancer drugs come on the market.<br />
<br />
The picture may have changed since the study's data was collected and the U.S. economy deteriorated, said Dr. Neal Meropol, a Case Western Reserve University cancer expert who worked on the ASCO guidelines.<br />
<br />
Newer treatments along with wider testing are driving up the overall cost of cancer care, Meropol said.<br />
<br />
&quot;My concern is that costs are getting shifted to patients and there is a potential for increasing disparities&quot; in cancer care, he added.<br />
<br />
Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.<br />]]></full> 
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             <title><![CDATA[CVS adds discounts for diabetes patients]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=31</link> 
             <description><![CDATA[CVS adds discounts for diabetes patients - UPI.com

WOONSOCKET, R.I., May 11 (UPI) -- U.S. drugstore chain CVS Caremark has expanded its customer loyalty card to provide extra benefits for diabetes]]></description> 
             <pubDate>Tue, 11 May 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehsa.com/assets/lib/files/Articles/CVS%20adds%20discounts%20for%20diabetes%20patients.pdf</guid>
             <author><![CDATA[UPI.com]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.upi.com/Health_News/2010/05/11/CVS-adds-discounts-for-diabetes-patients/UPI-58191273629528/">CVS adds discounts for diabetes patients</a></strong> - UPI.com<br />
<br />
WOONSOCKET, R.I., May 11 (UPI) -- U.S. drugstore chain CVS Caremark has expanded its customer loyalty card to provide extra benefits for diabetes patients, company officials said. <br />
<br />
ExtraCare Advantage for Diabetes, available to CVS ExtraCare cardholders, provides discounts and rewards for over-the-counter diabetes-related products in addition to diabetes wellness education benefits. <br />
<br />
&quot;With 24 percent of the U.S. population affected by this disease, we understand how important it is for patients and caregivers to manage costs related to controlling diabetes,&quot; Dr. Troyen A. Brennan, chief medical officer for CVS Caremark, said in a statement. &quot;The ExtraCare Advantage for Diabetes program is designed to help customers with diabetes, or caring for someone with the disease, to manage these rising healthcare costs.&quot;<br />
<br />
Patients and their caregivers can sign up for ExtraCare Advantage for Diabetes and earn double Extra Bucks on more than 100 products used in the managing of diabetes, from alcohol swabs and over-the-counter glucose test strips to batteries for glucose meters, Brennan said. <br />
<br />
In addition to earning double Extra Bucks on almost anything in the store, customers will receive special offers and discounts on their receipts. <br />
<br />
All members of the program will also receive a monthly e-newsletter that will include additional savings and tips on maintaining a healthy lifestyle. <br />
<br />
More information is at a local CVS/pharmacy or online to www.cvs.com/diabetes.<br />]]></full> 
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                <item> 
             <title><![CDATA[Teaching Physicians the Price of Care]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=26</link> 
             <description><![CDATA[Teaching Physicians the Price of Care&nbsp;- NY Times

When Dr. Ryan Thompson, an internist, was a medical resident at Massachusetts General Hospital in Boston a few years ago, he worried that]]></description> 
             <pubDate>Tue, 04 May 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/DOCS/Teaching%20Physicians%20the%20Price%20of%20Care.pdf</guid>
             <author><![CDATA[By SUSAN OKIE - NY Times]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/05/04/health/04cost.html">Teaching Physicians the Price of Care</a>&nbsp;- NY Times<br />
</strong><br />
When Dr. Ryan Thompson, an internist, was a medical resident at Massachusetts General Hospital in Boston a few years ago, he worried that he and his fellow trainees weren&rsquo;t learning about the cost of medical treatments, the financing of health care and the impact of high medical bills on their patients. <br />
<br />
So, with the help of faculty members at Harvard Medical School and another resident, Dr. Thompson organized an elective course for residents on the topic. In one session, &ldquo;I made up a kind of &lsquo;Price Is Right&rsquo; game,&rdquo; he recalled. &ldquo;I got the bill of a patient and actually went through it,&rdquo; asking colleagues to guess the cost of commonly ordered tests, like CT scans. Their answers &ldquo;were all over the map,&rdquo; he said. &ldquo;They had no idea.&rdquo; <br />
<br />
Doctors in training have traditionally been insulated from information about the cost of the tests and treatments they order for patients &mdash; in fact, for decades, the subject was virtually taboo when professors and trainees discussed treatment decisions during hospital rounds. During four years of medical school, students learn to order tests and treatments based on their knowledge of diseases and of scientific evidence. <br />
<br />
Until recently, most schools included little information on financial factors, like how the insurance system works and how treatment costs affect patients&rsquo; behavior. As a result, most physicians enter practice with little sense of how to make the most cost-effective choices for patients, or how their own decisions affect the patient&rsquo;s &mdash; and the nation&rsquo;s &mdash; medical bills. <br />
<br />
&ldquo;Medical schools have done a really terrible job over the years in educating students about the system that they&rsquo;re going to encounter,&rdquo; said Dr. Michael Whitcomb, former senior vice president for medical education at the American Association of Medical Colleges, or A.A.M.C., and former editor of the journal Academic Medicine. <br />
<br />
But escalating costs and the national debate over the health care overhaul are forcing medical schools and residency programs to grapple with teaching about the financial side of their profession. Accrediting organizations now require such teaching, and students and residents recognize that they need to understand finances as well as blood tests. <br />
<br />
&ldquo;It&rsquo;s a very odd system where we make purchasing decisions on behalf of patients but we don&rsquo;t know what anything costs,&rdquo; said Dr. Neel Shah, a first-year resident in obstetrics-gynecology at Brigham and Women&rsquo;s Hospital in Boston. &ldquo;There&rsquo;s no disincentive to ordering tests &mdash; all we have to do is click a button and we&rsquo;ve ordered it.&rdquo; <br />
<br />
To be accredited, medical schools and hospital residency programs, in which doctors spend three to five years learning a specialty, are supposed to be teaching future doctors about health care costs and cost-effective practices. The A.A.M.C., which does the accreditation of medical schools, made this clear in a 1998 report. And since 2007, residency programs in the United States have been required to teach doctors to &ldquo;incorporate considerations of cost awareness and risk-benefit analysis&rdquo; in caring for patients, according to the Accreditation Council for Graduate Medical Education. <br />
<br />
A commentary in the April 8 issue of The New England Journal of Medicine by Dr. Molly Cooke, a professor at the University of California, San Francisco, and director of the school&rsquo;s Academy of Medical Educators, said it was &ldquo;a critical responsibility of medical schools and residency programs&rdquo; to educate physicians about cost issues. <br />
<br />
&ldquo;Medical schools and residencies, in general, are taking this very seriously,&rdquo; said Dr. John Prescott, a physician and the medical college association&rsquo;s chief academic officer. <br />
<br />
Nonetheless, the effort has not been universal. According to a recent A.A.M.C. survey, about 60 percent of 102 American and Canadian medical schools include some material on health care costs, although the time they devote to it varies widely. <br />
<br />
Dr. Prescott said a separate survey of 155 large teaching hospitals that together sponsor more than two-thirds of accredited residency programs in the United States found that only 41 percent had made sure that all their residencies included material on health care costs. <br />
<br />
Dr. Whitcomb, the former A.A.M.C. vice president, said one reason medical schools and residencies have been slow to tackle the subject is that most of their faculty members are academic doctors or researchers who know little about health care economics and don&rsquo;t feel comfortable teaching it. &ldquo;Trying to figure out how to do it and who&rsquo;s going to do it is a real challenge,&rdquo; he said. <br />
<br />
Some medical schools have met the challenge by creating courses for first- or second-year students on health policy or professional responsibility that include information about treatment costs and insurance. <br />
<br />
A second-year student at the Yale School of Medicine, Alexandra Ristow, said, &ldquo;We discussed the fact that we have all this technology now that we can&rsquo;t necessarily afford to provide to every single patient &mdash; and it&rsquo;s not necessary, either.&rdquo; She added that, in other classes, cost considerations are part of the discussion of how to treat hypothetical patients. <br />
<br />
Professors ask: &ldquo;What is this test going to tell you? Is it going to change the diagnosis, or change how you manage the patient&rsquo;s care?&rdquo; Ms. Ristow said. Concerns about treatment costs, she said, are &ldquo;just very pervasive.&rdquo; <br />
<br />
But once students begin working on medical teams in hospitals, during their third year of medical school, they must focus on developing clinical skills and learning to care for patients &mdash; and, according to students at several schools, the financial aspects of care are seldom discussed. <br />
<br />
&ldquo;We all know that the cost of health care is high, but it&rsquo;s sort of fuzzy how doctors play into this,&rdquo; said Chitra Akileswaran, who has completed three years at Harvard Medical School and is enrolled in a joint degree program in medicine and business administration. <br />
<br />
At the Mount Sinai School of Medicine in New York City, students can get hands-on lessons about the impact of treatment costs on patients by volunteering Saturdays at the East Harlem Health Outreach Program, a student-run free clinic for uninsured residents of a low-income neighborhood nearby. <br />
<br />
Medical students evaluate patients, choose which drugs are prescribed, arrange care for patients who need to see a surgeon or other specialist and collaborate with a social worker to help those who need social services or assistance paying for medicine. They also sit on the steering committee and are in charge of researching and updating the clinic&rsquo;s formulary, a stock of inexpensive, cost-effective drugs that are purchased from the hospital pharmacy. <br />
<br />
Dr. Yasmin S. Meah, an assistant professor of medicine at Mount Sinai who directs the program, noted that medical students initially campaigned to establish the clinic, similar to others at several New York medical schools and an estimated 110 nationwide, as a service to the community. Since opening in 2004, it has become an invaluable setting for teaching future doctors to practice cost-effectively. Students come to &ldquo;understand what is necessary and what is not,&rdquo; Dr. Meah said. &ldquo;They&rsquo;re using the cheapest drugs to get the biggest bang for the buck.&rdquo; <br />
<br />
During residency, trainees&rsquo; heavy workloads and the need to care efficiently for very sick people make it hard for them to consider the cost of tests and treatments. &ldquo;You definitely try to think about it,&rdquo; said Dr. Ian Warrington, a first-year resident in emergency medicine at Beth Israel Deaconess Medical Center in Boston. &ldquo;All of us are aware that a CT scan is significantly more expensive than a chest X-ray, and an M.R.I. is significantly more than a CT scan.&rdquo; <br />
<br />
Emergency-medicine residents memorize guidelines that help them determine when imaging studies are needed after certain kinds of injuries, and professors routinely ask trainees to defend their rationale for ordering certain tests. But sometimes, Dr. Warrington said, residents and the doctors supervising them will end up ordering an expensive test even when the probability of finding a fracture or a hemorrhage is low because they are worried about missing something serious, and about being sued if they do. <br />
<br />
&ldquo;You&rsquo;re sort of working on not enough time and not always enough information, and you do the best you can,&rdquo; he said. Cost &ldquo;should be factored in, but realistically, with the environment that we practice in, you have to be very cautious how you do that.&rdquo; <br />
<br />
<br />
This article was produced in collaboration with Kaiser Health News &mdash; an editorially independent program of the Kaiser Family Foundation, a nonpartisan health policy research organization not affiliated with Kaiser Permanente.<br />
<br />
<br />]]></full> 
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             <title><![CDATA[My Left Foot: The High Costs of Fallen Arches]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=30</link> 
             <description><![CDATA[My Left Foot: The High Costs of Fallen Arches&nbsp;- GBENGA AKINNAGBE - NY&nbsp;Times

SEATTLE &mdash; I have had&nbsp;pes planus, or&nbsp;flat feet, all my life, and the condition never stopped me from]]></description> 
             <pubDate>Mon, 03 May 2010 12:00:00 -0400</pubDate> 
             <guid>/assets/lib/files/Articles/My%20Left%20Foot%20-%20The%20High%20Costs%20of%20Fallen%20Arches.pdf</guid>
             <author><![CDATA[GBENGA AKINNAGBE]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/05/04/health/04case.html">My Left Foot: The High Costs of Fallen Arches</a></strong>&nbsp;- GBENGA AKINNAGBE - NY&nbsp;Times<br />
<br />
SEATTLE &mdash; I have had&nbsp;<a title="Entry in The New York Times Health Guide." style="color: rgb(0,0,102); text-decoration: none" href="http://health.nytimes.com/health/guides/disease/pes-planus/overview.html">pes planus</a>, or&nbsp;<a class="meta-classifier" title="In-depth reference and news articles about Pes planus." style="color: rgb(0,0,102); text-decoration: none" href="http://health.nytimes.com/health/guides/disease/pes-planus/overview.html?inline=nyt-classifier">flat feet</a>, all my life, and the condition never stopped me from doing anything I wanted to do. Like most people, I never thought of it as a serious medical problem. That was until last year, when the pain got so bad I could barely walk or stand.
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">After trying to tough it out for a while, I finally sought medical advice.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">I was hoping some simple solution, like exercises, would allow me to continue my normal, active life. The first doctor I went to tried everything &mdash; orthotics, taping my feet, a brace &mdash; but nothing worked. He then reluctantly referred me to an orthopedic surgeon.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">That doctor said surgery was necessary, though he was hesitant because the procedure is invasive and recuperation is long and painful.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">I sought a second opinion. The next surgeon wanted to schedule me for surgery in a week. I realized there was no running from the inevitable.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">In most cases, pes planus does not interfere with everyday life, but it can in severe cases like mine. I had no arches at all, causing my body to compensate in ways that caused serious pain in my back and knees. I could see why the military used to defer draftees with flat feet. (Its policy now is to accept some recruits with flat feet who have less severe cases and who can deal with the extensive traveling on foot that the military demands.)</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">By this point, the pain was so intense that I had started going out less, which I hated. I felt as if elements of my life were being taken from me. I&rsquo;m an actor, so if I don&rsquo;t work, I don&rsquo;t eat &mdash; and as it happened, I was up for the role of a lifetime: Macbeth, at the Guthrie Theater in Minneapolis.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">But it was time to make a choice. My agent in New York, Tim Stone, wanted me to have the surgery. &ldquo;Think long term,&rdquo; he said. I pulled out of the running for Macbeth and scheduled the surgery.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">The first operation would be on my left foot; both feet could not be done at the same time or I would be an invalid. Before the operation, I was told I needed six procedures, whose names might as well have been in Mandarin: posterior tibial&nbsp;<a class="meta-classifier" title="In-depth reference and news articles about Tendon repair." style="color: rgb(0,0,102); text-decoration: none" href="http://health.nytimes.com/health/guides/surgery/tendon-repair/overview.html?inline=nyt-classifier">tendon repair</a>, F.D.L. tendon transfer, calcaneal osteotomy, lateral column lengthening, iliac aspiration and gastroc release. Though I have insurance through the&nbsp;<a class="meta-org" title="More articles about Screen Actors Guild" style="color: rgb(0,0,102); text-decoration: none" href="http://topics.nytimes.com/top/reference/timestopics/organizations/s/screen_actors_guild/index.html?inline=nyt-org">Screen Actors Guild</a>, my out-of-pocket costs could be more than $4,000.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">On Dec. 2, I went to the Hospital for Special Surgery in Manhattan. I was lucky. During the operation, led by Dr.&nbsp;<a class="meta-per" title="More articles about Martin O'Malley." style="color: rgb(0,0,102); text-decoration: none" href="http://topics.nytimes.com/top/reference/timestopics/people/o/martin_omalley/index.html?inline=nyt-per">Martin J. O&rsquo;Malley</a>, my foot adjusted better than he expected and I needed only two of the six procedures.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">Still, they were like something out of science fiction. In the osteotomy, the doctors used a needle to extract marrow from my hipbone and soaked an inchlong&nbsp;<a class="meta-classifier" title="In-depth reference and news articles about Bone graft." style="color: rgb(0,0,102); text-decoration: none" href="http://health.nytimes.com/health/guides/surgery/bone-graft/overview.html?inline=nyt-classifier">bone graft</a>&nbsp;from a cadaver in the marrow so that it would take to my body better. The graft was wedged in the ankle to change shape of my foot and ease pressure on it when I stand. The doctors then cut off my heel, moved it over a few millimeters and screwed it back to my foot to help create an arch. Gastroc release involved lengthening my calf muscle to correct years of tightness from my unnatural gait.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">Before I left the hospital &mdash; four hours after surgery &mdash; I was given two six-week&nbsp;<a class="meta-classifier" title="In-depth reference and news articles about Getting a prescription filled." style="color: rgb(0,0,102); text-decoration: none" href="http://health.nytimes.com/health/guides/specialtopic/getting-a-prescription-filled/overview.html?inline=nyt-classifier">prescriptions</a>&nbsp;for the painkiller oxycodone. A nurse called the next day to ask if I&rsquo;d taken it.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">I had never taken prescription painkillers, even when I was awakened by horrific pain after shoulder surgery two years ago. I figured that was preparation enough for when the feeling came back in my foot. &ldquo;I&rsquo;d really prefer not to take the drugs,&rdquo; I said.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">She replied: &ldquo;Oh, you definitely need to take them. You don&rsquo;t want to get behind the pain.&rdquo;</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">I thanked her for her concern and went back to a favorite pastime &mdash; criticizing talking heads as I flipped back and forth between Fox and MSNBC.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">Two hours later, I was punching the air blindly and biting the cushions on my couch. I couldn&rsquo;t get the pills down my throat fast enough.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">After five days, most of the pain had subsided, so I was able to stop taking the painkiller. Two weeks later, depleted by bed rest and leg atrophy, I borrowed a friend&rsquo;s car and drove myself to my first follow-up visit.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">The doctor took X-rays, and I could actually see an arch, as well as two large screws driven into my heel. (He told me I&rsquo;d never feel them, even when running.) I could also see the graft from the cadaver, which will become less visible on X-rays as my body heals and absorbs it.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">The nurse took the stitches out and traded my soft cast for a boot. It would be four more weeks before I was allowed to put weight on my foot with the boot on. At Week 10, I could start&nbsp;<a class="meta-classifier" title="Recent and archival health news about physical therapy." style="color: rgb(0,0,102); text-decoration: none" href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/physicaltherapy/index.html?inline=nyt-classifier">physical therapy</a>. After 14 to 16 weeks, I would be able to blend in with other New Yorkers.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">After the surgery (I should have done this before), I searched the Internet for information about the recovery process. Among the sites I found most helpful were the journal&nbsp;<a title="Podiatry Today Web site." style="color: rgb(0,0,102); text-decoration: none" href="http://www.podiatrytoday.com/">Podiatry Today</a>&nbsp;(<a target="_" style="color: rgb(0,0,102); text-decoration: none" href="http://podiatrytoday.com/">podiatrytoday.com</a>);&nbsp;<a title="HealthBoards Web site." style="color: rgb(0,0,102); text-decoration: none" href="http://www.healthboards.com/">HealthBoards.com</a>, a message-board site where people share information about their conditions; and&nbsp;<a title="BioPortfolio&rsquo;s Web site." style="color: rgb(0,0,102); text-decoration: none" href="http://www.bioportfolio.com/">BioPortfolio.com</a>, a life-sciences news site.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">The chat rooms warned that I might not be 100 percent for up to a year. My doctor said that because I am young (31) and athletic, I have strong and dense bones that should heal quickly. Also, I don&rsquo;t smoke or drink, other factors that might slow the healing process. (My longstanding vice is ice cream.) And of course there is my superhuman mutant healing X factor, though I had trouble convincing my doctor about that one.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">The doctor said I would not be able to fly for a month after surgery. But after the two-week checkup, he cleared me. Three days later, I was on a plane to Mexico. When we landed, my foot was so swollen it looked like a clown&rsquo;s contorted balloon. There was no pain, just discomfort. Before I went to sleep, I elevated my foot, as the nurse at the hospital had told me to do. By the next morning, the&nbsp;<a class="meta-classifier" title="In-depth reference and news articles about Swelling." style="color: rgb(0,0,102); text-decoration: none" href="http://health.nytimes.com/health/guides/symptoms/swelling/overview.html?inline=nyt-classifier">swelling</a>&nbsp;was down to normal.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">The hyperactive optimist in me has no doubt that I&rsquo;ll be counted among the 90 percent success rate for calcaneal osteotomies. Dr. O&rsquo;Malley said I healed like a 12-year-old &mdash; a full month ahead of schedule &mdash; and this week I&rsquo;m rehearsing for a one-man show here in Seattle.</p>
<p style="font-size: 1.2em; margin: 0px 0px 1em; color: black; line-height: 24px">My right foot&rsquo;s up next.</p>
<nyt_author_id></nyt_author_id>
<div class="authorIdentification" style="margin-bottom: 2.8em">
<p style="font-size: 15px! important; margin: 0px 0px 1em; color: rgb(0,0,0); line-height: 24px; font-style: italic">&nbsp;</p>
<p style="font-size: 15px! important; margin: 0px 0px 1em; color: rgb(0,0,0); line-height: 24px; font-style: italic">Gbenga Akinnagbe, an actor, appears in a one-man play, &ldquo;The Thin Place,&rdquo; at the Intiman Theater in Seattle, and the movie &ldquo;Lottery Ticket,&rdquo; opening in August.</p>
</div>]]></full> 
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             <title><![CDATA[Acupuncture Is Popular, but Youâ€™ll Need to Pay]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=29</link> 
             <description><![CDATA[Acupuncture Is Popular, but You&rsquo;ll Need to Pay - Lesley Alderman - NY Times&nbsp;

WHEN Divya Kumar was having trouble getting pregnant four years ago, she meticulously tracked her menstrual cycles]]></description> 
             <pubDate>Sat, 01 May 2010 12:00:00 -0400</pubDate> 
             <guid>/assets/lib/files/Articles/Acupuncture%20Is%20Popular,%20but%20You%20will%20Need%20to%20Pay.pdf</guid>
             <author><![CDATA[LESLEY ALDERMAN]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/05/08/health/08patient.html">Acupuncture Is Popular, but You&rsquo;ll Need to Pay </a></strong>- Lesley Alderman - NY Times&nbsp;<br />
<br />
WHEN Divya Kumar was having trouble getting pregnant four years ago, she meticulously tracked her menstrual cycles and found something was amiss. She was ovulating late, on Day 22, instead of on the more normal Day 14.<br />
<br />
Ms. Kumar, then 29, went to see an obstetrician-gynecologist for help.<br />
<br />
&ldquo;The doctor said there wasn&rsquo;t anything she could do for me because I was under age 35 and had been trying to conceive for less than year &mdash; even though it was clear something was not quite right,&rdquo; Ms. Kumar explained. &ldquo;She said, &lsquo;come back in a year.&rsquo; &rdquo;<br />
<br />
Ms. Kumar, who has a master&rsquo;s degree in public health and lives in Jamaica Plain, Mass., decided to try an alternative. She went to see an acupuncturist who said, &ldquo;I can help; give me 12 weeks.&rdquo;<br />
<br />
Because her insurer, like most, did not cover acupuncture, Ms. Kumar had to pay for the $70 weekly treatments she hoped would put her cycle on a more normal schedule. After the first few treatments, that seemed to be working. Two months later, Ms. Kumar was pregnant. There is no way of knowing for sure whether it was the acupuncture or the gynecologist&rsquo;s keep-on-trying advice that helped Ms. Kumar conceive.<br />
<br />
But a growing number of people are turning to acupuncture for help with conditions including infertility, chronic pain, depression and menopause symptoms. And they are turning to it even though financially it remains a largely out-of-pocket form of health care.<br />
<br />
In a 2007 survey, 3.1 million adults reported using acupuncture in the previous 12 months, up from 2.1 million in a 2002 survey, according to the government&rsquo;s National Center for Complementary and Alternative Medicine, a unit of the National Institutes of Health.<br />
<br />
The center&rsquo;s Web site is mainly neutral on the question of acupuncture&rsquo;s effectiveness, and it urges people to go to a medical doctor &mdash; not an acupuncturist &mdash; to have a medical condition diagnosed. Acupuncture can have a powerful effect on your system, but serious ailments typically require a dose of Western medicine, like a course of antibiotics, a prescription-strength pain killer or even surgery.<br />
<br />
Still, there are a handful of well-respected studies indicating that acupuncture can be an effective treatment for a range of conditions, like chronic headaches, osteoarthritis, depression in pregnancy and low back pain.<br />
<br />
Western doctors are beginning to embrace it, sometimes sending their patients to acupuncturists for specific conditions. And the federal Food and Drug Administration takes it at least seriously enough to regulate acupuncture needles for use by licensed practitioners.<br />
<br />
But insurers have been reluctant to cover acupuncture. And even in the relatively rare instances when insurers do, they might pay for only a few visits or a specific condition.<br />
<br />
Ms. Kumar was able to get a financial break by using money from her flexible spending account at work. &ldquo;It was expensive,&rdquo; she said, &ldquo;but probably not as expensive as infertility treatments would have been.&rdquo;<br />
<br />
When she was ready to have a second child, she again went to her acupuncturist, Claire McManus, and became pregnant within months.<br />
<br />
Proponents say that acupuncture, in addition to helping treat existing conditions, can also help prevent problems from occurring in the first place. Some devotees of acupuncture even say they believe treatments keep them healthy and out of the doctor&rsquo;s office, potentially saving them money.<br />
<br />
&ldquo;We&rsquo;re seeing a small but growing number of clients come to our clinic for wellness tune-ups,&rdquo; said Angela Grasso, director of clinical services at the Pacific College of Oriental Medicine in Manhattan, which is accredited by the Accrediting Commission of Career Schools and Colleges and trains students to become licensed acupuncturists.<br />
<br />
To receive a license to practice acupuncture in New York State, one must have completed 4,050 hours of course work, done 650 hours of clinical training and treated 250 patients. Once students have completed those requirements, they must pass a national certification examination in acupuncture.<br />
<br />
Marcus Berardino, 41, a massage therapist and yoga instructor in Brooklyn, swears by the acupuncture treatments he receives regularly. &ldquo;Combined with other natural remedies like biking, healthy eating and a little daily meditating,&rdquo; he said, &ldquo;it keeps me healthy and fairly balanced.&rdquo;<br />
<br />
Some hospitals are beginning to offer acupuncture to inpatients for pain and anxiety.<br />
<br />
&ldquo;When patients receive acupuncture before or after surgery, their anxiety is less, and their pain is reduced,&rdquo; said Arya Nielsen, director of the acupuncture fellowship program at Beth Israel Medical Center in Manhattan. &ldquo;They need less pain medication and so have less side effects from the medication.&rdquo;<br />
<br />
Beth Israel patients receive their acupuncture treatments free through the postgraduate fellowship program run by Dr. Nielsen, who has doctorate in the philosophies of medicine.<br />
<br />
But for most people, money is a consideration. Sessions with an acupuncturist run about $65 to $120, depending on where you live (and some leading acupuncturists charge as much as $300). Most ailments require at least three treatments, while some chronic issues like arthritis might require biweekly or monthly sessions, depending on the situation.<br />
<br />
If you want to try acupuncture, but are concerned about the cost, here are some suggestions:<br />
<br />
CHECK YOUR COVERAGE Call your insurer and ask whether your policy covers acupuncture. If it does, press for details.<br />
<br />
Find out how many sessions a year it allows and whether a doctor&rsquo;s prescription is needed. Check whether it allows coverage for only certain conditions. Some policies, for instance, might cover acupuncture only for chronic pain.<br />
<br />
TRY A SCHOOL If you must pay yourself, consider discount treatment by an acupuncturist-in-training. Most acupuncture schools have clinics where you can be treated by supervised students at discounted rates of $40 or so for one to two hours. To find a school, go to the American Association of Acupuncture and Oriental Medicine&rsquo;s Web site.<br />
<br />
Barbara Andisman, who was told she had multiple sclerosis two years ago, has been going to the clinic at the Pacific College of Oriental Medicine in Manhattan once a week for more than a year. She says the treatments help with her balance and energy.<br />
<br />
&ldquo;I have a type of M.S. for which there are no medications; the treatments have been incredible and helped keep me stable,&rdquo; said Ms. Andisman, 52, who lives in Brooklyn. &ldquo;If I miss a few sessions I notice a difference. I feel kind of sluggish.&rdquo;<br />
<br />
COMMUNITY ACUPUNCTURE If your problem is not serious or complicated &mdash; say you are suffering from stress or headache pain &mdash; consider visiting a community acupuncture setting, where fees can be as low as $15 a session.<br />
<br />
You receive a brief assessment and then are treated, fully clothed, in an open room with other patients. It is the acupuncture equivalent of a chair massage.<br />
<br />
To locate a clinic near you, see the Web site of the nonprofit Community Acupuncture Network.<br />
<br />
USE FLEX SPENDING Even if your insurer will not reimburse you, your flexible spending account might &mdash; if you have one. Using flex-spending dollars to pay for treatments can reduce the cost by 20 percent or so, depending on your tax bracket. Look on your employer&rsquo;s list of approved expenses to see whether acupuncture is included.<br />
<br />
HAVE SOME PATIENCE Acupuncture often has a cumulative effect. If you have a simple cold or headache, you might feel better after one session. But it might take three sessions before you start to notice an improvement in a muscle strain, according to Ms. Grasso, who is also a licensed acupuncturist.]]></full> 
          </item>
                <item> 
             <title><![CDATA[Avoiding Surprise Bills With Homework and Negotiation]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=33</link> 
             <description><![CDATA[Avoiding Surprise Bills With Homework and Negotiation - Walecia Konrad - NY&nbsp;Times

Vicki Cornford of Roscoe, Ill., had long experience dealing with medical bills. But even she was thrown for a]]></description> 
             <pubDate>Fri, 30 Apr 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Patient%20Money%20-%20Surprise%20Medical%20Bills%20Can%20Be%20Avoided%20With%20Negotiation.pdf</guid>
             <author><![CDATA[WALECIA KONRAD]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.nytimes.com/2010/04/30/health/01patient.html">Avoiding Surprise Bills With Homework and Negotiation</a></strong> - Walecia Konrad - NY&nbsp;Times<br />
<br />
Vicki Cornford of Roscoe, Ill., had long experience dealing with medical bills. But even she was thrown for a loop by &ldquo;balance billing.&rdquo;<br />
<br />
First, some background. Ms. Cornford&rsquo;s daughter Amber, now 21, was born with a rare bone disease that over the years has demanded constant monitoring, treatment and operations.<br />
<br />
As a result, Ms. Cornford has dealt with all manner of billing hassles, including denied claims, administrative errors and endless paperwork.<br />
<br />
But last fall, Amber, now a nursing student at Loyola University in Chicago and still covered under her father&rsquo;s employer-sponsored health insurance plan, underwent yet another operation. A few weeks later, Ms. Cornford received a bill for about $500 from the anesthesiologist who treated her daughter.<br />
<br />
That seemed strange. Ms. Cornford was sure she had seen a claim for the anesthesiologist on a recent explanation of benefits statement from her insurer. But this new bill, it turned out, was for the remainder of the anesthesiologist&rsquo;s fee not covered by Ms. Cornford&rsquo;s insurance.<br />
<br />
&ldquo;I&rsquo;ve seen just about every mix-up possible over the years,&rdquo; Ms. Cornford said. &ldquo;But with this one I couldn&rsquo;t understand why I was getting a bill.&rdquo;<br />
<br />
Ms. Cornford would soon become very familiar with the phenomenon known as balance billing. It is a controversial and sometimes illegal practice: doctors and other health care providers receive a discounted payment from the insurance company &mdash; an amount less than the fee they want to be paid &mdash; and then they bill the patient for the rest. Most states, including Illinois, have passed laws making balance billing illegal within an insurer&rsquo;s medical network. And federal law prohibits balance billing by providers paid under Medicare.<br />
<br />
But balance billing in these cases can still happen. If you receive a bill from an in-network provider that you are not expecting, call your insurer immediately. &ldquo;Your insurance company is the best enforcer, if you will, of these laws,&rdquo; said Jane Cooper, chief executive of Patient Care, a Milwaukee patient advocate firm.<br />
<br />
Most cases occur when patients who are part of H.M.O.&rsquo;s, P.P.O.&rsquo;s and other network health care plans use an out-of-network doctor, lab hospital or other provider. H.M.O.&rsquo;s, as a rule, will not cover any out-of-network fees unless for an emergency or for a pre-approved treatment so specialized that no one in the network can provide it. P.P.O.&rsquo;s generally cover some percentage of out-of-network fees, usually 70 or 80 percent of so-called usual and customary charges.<br />
<br />
When an H.M.O. or a P.P.O. does agree to pay an out-of-network surgeon, say, it is easy to be lulled into a false sense of security: Pre-approval means the entire bill will be paid, right? Maybe not.<br />
<br />
Instead, through the dark art of balance billing, you may discover &mdash; usually only when the bill arrives &mdash; that the provider is looking to collect more than the insurance company has agreed to pay. The recent federal overhaul of health insurance laws does not directly address the balance billing issue.<br />
<br />
&ldquo;In many cases people just pay, figuring they owe the money and there&rsquo;s nothing else they can do,&rdquo; said Ms. Cooper. But there are ways to avoid balance billing in the first place &mdash; and to fight back if you believe this has happened to you.<br />
<br />
STAY IN NETWORK This is really the best way you can avoid extra charges, Ms. Cooper said.<br />
<br />
Of course, in many cases, particularly emergencies, you do not have a choice. But often patients will go to an outside doctor because of reputation or a recommendation from a family member or friend.<br />
<br />
&ldquo;There may very well be a professional who is just as qualified in your network,&rdquo; Ms. Cooper said. &ldquo;Then you can be sure the cost will be fully covered.&rdquo;<br />
<br />
DOUBLE-CHECK The first time you visit a doctor or other health care provider, always call and verify that he or she is indeed in your network, Ms. Cooper suggested. Web sites can be outdated and mix-ups do happen. A physical therapist with two offices for instance, may be considered part of your network in only one of those locations.<br />
<br />
Erin Moaratty, a spokeswoman for the nonprofit Patient Advocate Foundation, notes that even if the hospital you are going to is in your network, some of the people who treat you there may not be.<br />
<br />
That is what happened to Ms. Cornford. Her daughter&rsquo;s anesthesiologist sent the extra bill because he was not under contract with Ms. Cornford&rsquo;s insurer. Ultimately, a patient advocate at Ms. Cooper&rsquo;s firm helped persuade the anesthesiologist to agree to accept the discounted fee from the insurer.<br />
<br />
As best you can, you need to make sure before you are admitted to an in-network hospital that you will be treated by doctors, anesthesiologists, radiologists, physical therapists and other providers who are in your network. That way you will not get hit with any &ldquo;balance&rdquo; bills.<br />
<br />
NEGOTIATE UPFRONT If you know you must go out of network, be ready to talk money before you receive treatment, said Jennifer Jaff, executive director of Advocacy for Patients With Chronic Illness.<br />
<br />
Keep in mind that insurers pay according to what they deem are &ldquo;usual and customary&rdquo; fees for a particular treatment in your area. So if your P.P.O. plan pays 80 percent of out-of-network fees, this means 80 percent of &ldquo;reasonable and customary&rdquo; fees. If your doctor charges well above what the insurance company deems reasonable and customary, you may be balance-billed for the difference in addition to the co-payment you expected, for 20 percent of the reasonable and customary fees.<br />
<br />
Ask the out-of-network doctor (or his or her billing specialist) what the charge for your care will be. Then check with your insurer to see how that matches up with what it will pay for out-of-network service. Armed with this information, you can then negotiate with your doctor upfront to accept the insurance company payment or ask if he or she will negotiate with the insurer directly.<br />
<br />
And if you want to use an out-of-network hospital, you&rsquo;ll need to get pre-approval from your insurance company for all of the charges involved, not just your surgeon&rsquo;s fee and the hospital charges.<br />
<br />
NEGOTIATE AFTERWARD, TOO When confronted with a balance bill, do not hesitate to call the doctor and discuss payment. Ask why he or she feels the insurance payment is not sufficient and why you were not informed of the excess fees ahead of time.<br />
<br />
Often, a provider will compromise, Ms. Cooper said. At the very least you can work out a payment plan and keep the bill out of collections.<br />
<br />
FILE AN APPEAL If you feel your insurance company is allocating too little toward your health care provider&rsquo;s payment and you are shouldering too much of the fee, consider a more formal appeal that asks your insurance company to pay more, Ms. Moaratty suggested. This is especially true if you can justify the extra fee.<br />
<br />
Say, for example, complications resulted from a routine procedure and the treatment or surgery took much longer than expected. Or, if what started out as a routine doctor office visit actually entailed something more complicated. More information on how to file an appeal appeared in a Feb. 6 column, &ldquo;Fighting Denied Claims Requires Perseverance.&rdquo;<br />
<br />
<br />]]></full> 
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             <title><![CDATA[6 Ways to Get Affordable Mental-Health Services]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=25</link> 
             <description><![CDATA[6 Ways to Get Affordable Mental-Health Services


Times are tough. Everywhere you look, people are stressed out, anxious, depressed. But at a time when addressing some people's mental-health problems may be]]></description> 
             <pubDate>Thu, 15 Apr 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/DOCS/6%20Ways%20to%20Get%20Affordable%20Mental-Health%20Services.pdf</guid>
             <author><![CDATA[Michelle Andrews]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.streetwisehealth.com/assets/lib/files/DOCS/6%20Ways%20to%20Get%20Affordable%20Mental-Health%20Services.pdf">6 Ways to Get Affordable Mental-Health Services</a><br />
</strong><br />
<br />
Times are tough. Everywhere you look, people are stressed out, anxious, depressed. But at a time when addressing some people's mental-health problems may be even more important than ministering to their physical aches and pains, two thirds of primary-care doctors say they have a tough time getting mental-health services for their patients. Doctors in a new Health Affairs study said several factors, from a shortage of professionals in some regions or in some specialties to problems with insurance coverage, make getting mental-health services challenging. (The study data came from 2004 and 2005, so chances are it's even more difficult now.) &quot;It's a big problem,&quot; says Ted Epperly, president of the American Academy of Family Physicians, who says referrals are toughest in rural areas and the urban inner city.<br />
<br />
There are no easy answers. Safety net organizations are feeling the pinch of increased demand and funding shortfalls. Meanwhile, if you've lost your job and your health insurance, you're most likely struggling with funding shortfalls of your own. But here are options that you (or even your doctor) may not be aware of:<br />
<br />
1. Mental Health America, an advocacy organization with over 300 affiliates in 41 states, works with people to connect them with affordable mental-health services in their communities. Click on &quot;local MHAs&quot; on their homepage to find services in your area. &quot;We spend an enormous amount of time helping people navigate the system, doing problem solving,&quot; says David Shern, the group's president and CEO.<br />
<br />
2. Community health centers. Currently operating in more than 7,000 locations nationwide, these centers got a $155 million boost under the economic stimulus package to add another 126 centers. In addition to primary-care services, they are increasingly offering mental-health services. Fees are charged on a sliding scale based on income. Find a center in your area here.<br />
<br />
3. Community mental-health centers. These centers serve Medicaid and other low-income patients. State income limits vary. Click on &quot;find a provider&quot; here, and call to find out whether you may qualify.<br />
<br />
4. Employee Assistance Programs. Many employers offer a limited number of counseling sessions and referrals to mental-health professionals through an EAP service. For some people, this may be all they need. &quot;A short-term intervention may help someone develop the flexibility they need to deal with the problem,&quot; says Lynn Bufka, a psychologist who is the assistant executive director for practice research and policy at the American Psychological Association.<br />
<br />
5. Churches, synagogues, and other places of worship. Clergy members are trained in counseling, and their services are generally free.<br />
<br />
6. Group therapy. Many therapists offer group sessions, which are often a less expensive alternative to traditional one-on-one counseling. You can find a psychologist in your area here through the APA or through U.S. News's Find a Therapist search engine.<br />
<br />
Remember, one of the best&mdash;and most affordable&mdash;ways to manage stress and anxiety is by taking care of your physical health. Get regular exercise, stick to a healthful diet, and get enough sleep. Although job and other worries may ignite cravings for all kinds of unwholesome mood modifiers&mdash;gin and tonic, anyone?&mdash;try to steer clear. And remember: Even if you don't get professional counseling, discussing your troubles with friends and family can help make problems seem more manageable. &quot;Just being able to talk, there's therapy in that,&quot; says Epperly.<br />
<br />
Check out recent posts on using meditation to help reduce stress, the new COBRA subsidy that may make it easier to hang on to health insurance after a layoff, and on expanded mental-health coverage for kids under the new SCHIP law.<br />]]></full> 
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             <title><![CDATA[Health care costs for retiring Americans average $260,000 and can exceed $500,000]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=23</link> 
             <description><![CDATA[Health care costs for retiring Americans, including nursing home care, average $260,000 and can exceed $500,000, according to new research conducted by the Center for Retirement Research (CRR) at Boston]]></description> 
             <pubDate>Wed, 14 Apr 2010 12:00:00 -0400</pubDate> 
             <guid>http://www.news-medical.net/news/20100303/Health-care-costs-for-retiring-Americans-average-24260000-and-can-exceed-24500000.aspx</guid>
             <author><![CDATA[News-Medical.net]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.news-medical.net/news/20100303/Health-care-costs-for-retiring-Americans-average-24260000-and-can-exceed-24500000.aspx">Health care costs for retiring Americans, including nursing home care, average $260,000 and can exceed $500,000</a></strong>, according to new research conducted by the Center for Retirement Research (CRR) at Boston College and underwritten by Prudential Financial (NYSE: PRU). <br />
<br />
&ldquo;Without managing this risk, in some cases, a household may possibly have to either forego needed health care or rely on Medicaid.&rdquo;<br />
<br />
According to the study, &ldquo;What is the Distribution of Lifetime Health Care Costs from Age 65,&rdquo; in over 300,000 simulations the average remaining uninsured lifetime health care expenditure for a typical married couple age 65 is $197,000. This amount represents the present value of the couple&rsquo;s premiums for Medicare and private insurance, out-of-pocket payments, and home health costs, but does not include nursing home care. And while this figure represents the average, many households will incur greater expenditures. In fact, a typical household has a 5-percent risk that the present value of its lifetime uninsured health care costs will exceed $311,000. And when nursing home costs are included, the amount for a typical couple increases to $260,000, with a 5-percent risk of exceeding $570,000. <br />
<br />
&ldquo;Even at the peak of the stock market in 2007, less than 15 percent of households approaching retirement had accumulated that much in total financial assets, much less financial assets available for health care costs,&rdquo; states Alicia Munnell, director of the CRR. <br />
<br />
The CRR undertook the study to better determine the risk American households face of incurring exceptionally large health care expenses in retirement. &ldquo;The objective of the analysis was not to calculate how much households spend on health care in practice, or even how much households should optimally choose to set aside to cover health care costs &ndash; but to quantify the magnitude and distribution of potential lifetime expenditure,&rdquo; according to Anthony Webb, associate director of research for the CRR. <br />
<br />
The study cites the main sources of retired households&rsquo; health care cost risk as co-payments for Medicare covered payments and payments for non-covered services, such as nursing home care. About one-third of individuals turning 65 in 2010 will need at least three months of nursing home care, 24 percent more than a year, and 9 percent more than five years. In 2008, the annual cost of a nursing home was about $71,000 for a semi-private room and $79,000 for a private room. Medicare pays for a maximum of only 100 days of nursing home care. <br />
<br />
&ldquo;Americans need to assess the possibility that they may incur out-of-pocket health care costs that are significantly higher than average,&rdquo; said Malcolm Cheung, vice president of Long Term Care for Prudential. &ldquo;Without managing this risk, in some cases, a household may possibly have to either forego needed health care or rely on Medicaid.&rdquo; <br />
<br />
The study also found that although lifetime health care costs decline with age, they remain substantial. At age 85, couples face an average remaining lifetime cost of $140,000 without nursing home care, and they face a 5 percent risk of exceeding $266,000. Including nursing home care, the average cost is $203,000, with a 5 percent chance of exceeding $477,000. <br />
<br />
The study concludes that when deciding how much to save for retirement, and how rapidly to draw down their wealth during retirement, households need to consider: <br />
<br />
What risk they are prepared to accept of having their assets substantially depleted by health care costs <br />
Whether they are above or below the average risk of incurring exceptionally high costs <br />
Whether they should insure against health care costs by purchasing long-term care insurance. <br />
<br />
SOURCE Prudential Financial, Inc.]]></full> 
          </item>
                <item> 
             <title><![CDATA[Study: Malpractice worries help drive health costs]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=24</link> 
             <description><![CDATA[Study: Malpractice worries help drive health costs
By STEPHANIE NANO, Associated Press Writer Stephanie Nano, Associated Press Writer 
Tue Apr 13, 5:15 pm ET


NEW YORK &ndash; A substantial number of heart]]></description> 
             <pubDate>Tue, 13 Apr 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/DOCS/Study%20Malpractice%20worries%20help%20drive%20health%20costs.pdf</guid>
             <author><![CDATA[STEPHANIE NANO - Associated Press]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.streetwisehealth.com/assets/lib/files/DOCS/Study%20Malpractice%20worries%20help%20drive%20health%20costs.pdf">Study: Malpractice worries help drive health costs</a></strong><br />
By STEPHANIE NANO, Associated Press Writer Stephanie Nano, Associated Press Writer <br />
Tue Apr 13, 5:15 pm ET<br />
<br />
<br />
NEW YORK &ndash; A substantial number of heart doctors &mdash; about one in four &mdash; say they order medical tests that might not be needed out of fear of getting sued, according to a new study.<br />
<br />
Nearly 600 doctors were surveyed for the study to determine how aggressively they treat their patients and whether non-medical issues have influenced their decisions to order invasive heart tests.<br />
<br />
Most said they weren't swayed by such things as financial gain or a patient's expectations. But about 24 percent of the doctors said they had recommended the test in the previous year because they were worried about malpractice lawsuits. About 27 percent said they did it because they thought their colleagues would do the test.<br />
<br />
Doctors who treated their patients aggressively were more likely to be influenced by malpractice worries or peer pressure than those who weren't as aggressive, the study determined.<br />
<br />
The research was done to see whether doctors' attitudes and practices might be contributing to the wide differences in health care use and spending across the country.<br />
<br />
&quot;We have known for a long time that where you live has an influence on what kind of health care you get and how much health care you get,&quot; said Lee Lucas, lead author of the study and associate director of the Center for Outcomes Research and Evaluation at Maine Medical Center in Portland.<br />
<br />
Some of the reasons are known: differences in disease rates, patient preferences and the availability of medical services or hospital beds. And more care isn't necessarily better care, Lucas noted.<br />
<br />
For the study, the doctors were asked to recommend tests and treatment for three hypothetical heart patients. Their answers were used to score them on how aggressively they tend to treat patients.<br />
<br />
Using Medicare records, the researchers found that doctors with higher scores were more likely to be in the areas with higher spending overall or higher rates for a heart test, although the differences were small.<br />
<br />
The doctors were also asked whether other issues had led them to recommend the heart test &mdash; called a cardiac catheterization &mdash; during which a thin tube is threaded to the heart to check how well it is working and to look for disease.<br />
<br />
The researchers suggest that targeting malpractice concerns could help reduce the regional differences.<br />
<br />
&quot;We need a way for docs to be less afraid of not ordering a test,&quot; said Lucas.<br />
<br />
Medical malpractice was part of the health care reform debate, but didn't make it into the recently approved legislation. The new law does include pilot programs for states to explore alternatives to lawsuits.<br />
<br />
The study was released Tuesday by the journal Circulation: Cardiovascular Quality and Outcomes.<br />
<br />
The results support moving toward more integrated health care, and away from fee-for-service payments, and working on malpractice reforms, said Kenneth Thorpe, a professor of health policy at Emory University in Atlanta.<br />
<br />
Lucas said patients can help by not pressuring their doctors to do tests.<br />
<br />
&quot;If he says you don't need it, let it go,&quot; she said.<br />
<br />
___ <br />
<br />
On the Net: <br />]]></full> 
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                <item> 
             <title><![CDATA[Prescription Problem Children]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=32</link> 
             <description><![CDATA[Prescription Problem Children - Mary Carmichael - Newsweek.com

A new report finds five types of consumers who are wasting billions of dollars in Rx drugs. Are you one of them?

Who is]]></description> 
             <pubDate>Sat, 10 Apr 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/Prescription%20Problem%20Children.pdf</guid>
             <author><![CDATA[Mary Carmichael ]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.newsweek.com/2010/04/30/prescription-problem-children.html">Prescription Problem Children</a></strong> - Mary Carmichael - Newsweek.com<br />
<br />
A new report finds five types of consumers who are wasting billions of dollars in Rx drugs. Are you one of them?<br />
<br />
Who is to blame for the high costs and enormous waste&mdash;an estimated $700 billion of it&mdash;in the health-care system? Over the last year, just about every possible culprit has been trotted out: doctors who administer unnecessary tests, insurance and drug companies who hike premiums and prices for their own benefit, lawyers who spend both money and time on unwarranted malpractice cases. Here's one you probably haven't heard, though: grandmas who forget to refill their pill bottles promptly.<br />
<br />
A new report from Express Scripts, a prescription-management company, says that $1 out of every $5 spent on prescription drugs goes down the drain&mdash;for an astonishing total of $163 billion wasted&mdash;simply because patients don't take their meds in the ways they're supposed to. They put off getting refills until it's too late and then develop complications from going off their meds; they stick with high-cost brands instead of equally effective cheap generics; they get distracted and forget to pop their pills. &quot;What's striking is how much of this is due to inattention, procrastination, and forgetfulness&mdash;which explains why the classical economic theory approach has gotten us only part of the way to where we need to be with influencing health-care costs,&quot; says Bob Nease, one of the study's authors.<br />
<br />
Of course, as a prescription-management company&mdash;in essence, a company that provides solutions to help people to remember to take meds in the ways they're supposed to&mdash;Express Scripts has a financial incentive to point out the dangers of noncompliance and to encourage methods (including ones they provide, like home delivery) to up that number. But they're not the only ones who have noticed a problem: a 2001 study estimated that nationally the 65-and-over crowd was wasting $1 billion worth of drugs each year. In 2003, the World Health Organization estimated that 50 percent of patients in developed nations don't take their medicine properly. Medication noncompliance leads to 22 percent of all ER admissions, according to a study published in The Journal of Emergency Medicine. <br />
<br />
For many people, noncompliance is outside of their control: the National Council for Patient Information and Education (NCPIE), a nonprofit patient-safety council notes that 90 million Americans have difficulty comprehending medical instructions due to poor literacy or lack of English proficiency, leading to high noncompliance. For others, cost is a major factor: one study found 1.3 million adults with disabilities don't keep up with prescriptions because they can't afford them, and that's just one study in a crowded field. There have been numerous studies on this in varying combinations&mdash;African-Americans with hypertension, older Americans with diabetes&mdash;and all of them show that their ability to afford their medication directly affects their ability to adhere to them. There's much work to be done on a health-care-reform level to deal with the large amount of medical noncompliance driven by health-care costs and structures.<br />
<br />
But as anyone who ever put off a trip to the pharmacy knows, even those of us who can pay for our pills often fall prone to noncompliance. &quot;All of us in health care have thought if we just send a price signal, like substituting cheaper generics for brand-name drugs, people would respond rationally,&quot; says Nease. &quot;A lot of these behaviors aren't reliant on financial incentives. It's more about understanding real human behavior and addressing it head-on.&quot;<br />
<br />
The Express Scripts report defined five types of people likely to miss meds due to certain behaviors. Read on for Nease's description, and see if any sound too close for comfort:<br />
<br />
<strong>1. The Refill Procrastinator </strong><br />
Sure, he'll get his prescription filled&mdash;tomorrow. Then he doesn't, and as a result, he ends up not adhering to the regimen he should be on, with his health suffering as a consequence. &quot;It turns out I am a Refill Procrastinator,&quot; says Nease. &quot;I take a generic medication for high blood pressure, and I do a very good job taking my pill every day. I'm a very conscientious person, so I'm usually on top of things. But things that come around every month, I have trouble with. Like oil changes: I'm always saying, 'I'll get around to that later.'&quot; A few months ago, Nease noticed he could see the bottom of his pill bottle, which meant he was running low. &quot;I knew what I needed to do,&quot; he says. &quot;Then, I'd go to work and forget and come home and say, 'I'll do it tomorrow.' Pretty soon I had a gap in care.&quot; The Refill Procrastinator can get himself into trouble if he waits too long to replenish his supply, especially if he has a chronic disease such as diabetes that requires constant vigilance.<br />
<br />
<strong>2. The Sporadic Forgetter </strong><br />
If it's a Monday, she's on her meds. If it's a Sunday, her schedule is off, so she forgets. [Author's confession: This is me. I can't recall a single time I've ever managed to take a medication regularly without missing a day or two.] The NCPIE action report in 2007 found that half of the people they polled had forgotten to take a prescribed medication. Nease has a neat solution to this: Peg your pill-popping to something you do every single day. For him, it's brushing his teeth. &quot;My physician gave me what he called the toothbrush talk,&quot; he says. &quot;If you put your pill bottle on top of your toothbrush, after two weeks you'll feel awkward brushing your teeth without taking your pill first.&quot;<br />
<br />
<strong>3. The Loyalist </strong><br />
His doctor prescribed the brand name, so that's what he takes. Besides, he knows this drug is good, because, as the Express Scripts report puts it, he &quot;saw an ad [for it] on TV and that guy seemed to be happy.&quot; The Loyalist's reluctance to try a generic leads to $51 billion wasted each year. That's not including the billions of dollars that pharmaceutical companies spend promoting their products. We've written about this before, but it bears repeating: generics are just as good!<br />
<br />
<strong>4. The Active Decliner </strong><br />
She doesn't have symptoms, probably because her prescription is working, and she thinks that's evidence that she's healthy and doesn't actually need to take said pill. (As the report has it: &quot;My doctor says I should take this medication regularly, but I can't tell if it's doing anything&mdash;really, I feel fine most of the time.&quot;) According to the NCPIE, 29 percent of those polled stopped their prescription before it ran out, while 24 percent took a smaller dose than prescribed. The Active Decliner may also be put off by the cost of prescription drugs or by side effects. To fix this problem, the report recommends &quot;clinician interventions&quot;&mdash;i.e., the responsibility for this one is on doctors.<br />
<br />
<strong>5. The Traditionalist </strong><br />
She could get home delivery of her med refills, but she'd rather do it old-school&mdash;go to the store, say hi to the pharmacist, pick up some milk while she's at it. One problem: what if she can't make it on the day her pills run out? Like the Refill Procrastinator, the Traditionalist would be better served by home delivery&mdash;and hey, if she really wants to see the pharmacist, she can swing by while she's buying the milk.<br />
<br />]]></full> 
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             <title><![CDATA[2010 Genworth Cost of Long Term Care Survey]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=38</link> 
             <description><![CDATA[2010 Genworth Cost of Long Term Care Survey - Genworth

&quot;Nearly two-thirds of people over age 65 will need long term care at home or through adult day health care, or]]></description> 
             <pubDate>Thu, 01 Apr 2010 12:00:00 -0400</pubDate> 
             <guid>www.streetwisehealth.com/assets/lib/files/Articles/2010_Cost_of_Long_Term_Care_Survey_Full_Report.pdf</guid>
             <author><![CDATA[Genworth]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.genworth.com/content/etc/medialib/genworth_v2/pdf/ltc_cost_of_care.Par.14625.File.dat/2010_Cost_of_Care_Survey_Full_Report.pdf">2010 Genworth Cost of Long Term Care Survey</a></strong> - Genworth<br />
<br />
&quot;Nearly two-thirds of people over age 65 will need long term care at home or through adult day health care, or care in an assisted living facility or nursing home. And while most people think of long term care as impacting only those in senior years, 40 percent of people currently receiving long term care services are ages 18 to 64.*&nbsp;<br />
<br />
The 2010 Genworth Cost of Care Survey can help families evaluate options and cover the growing cost of long term care. For the seventh year, Genworth Financial has surveyed the cost of long term care across the U.S. to help Americans prudently plan for the potential cost of this type of care in their preferred location and setting. The most comprehensive study of its kind, Genworth's 2010 Cost of Care Survey, conducted by CareScout&reg;, covers nearly 13,000 long term care providers in <a id="/etc/medialib/genworth_v2/pdf/ltc_cost_of_care#Par.41959.File.dat/Region Definitions_gnw.pdf" title="2010 Cost of Care Regions" target="_blank" href="http://www.genworth.com/content/etc/medialib/genworth_v2/pdf/ltc_cost_of_care.Par.41959.File.dat/Region%20Definitions_gnw.pdf">436 regions nationwide</a>.&quot;]]></full> 
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                <item> 
             <title><![CDATA[Surgery Pricing Secrets: The Challenges People Face]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=21</link> 
             <description><![CDATA[Check out this paper, Surgery Pricing Secrets: The Challenges People Face, from Healthcare Blue Book&nbsp;which&nbsp;focused on the ease of obtaining a price quote from a facility prior to receiving medical]]></description> 
             <pubDate>Tue, 23 Mar 2010 12:00:00 -0400</pubDate> 
             <guid>http://www.healthcarebluebook.com/PDF_Files/100203%20HCBB%20White%20Paper%20-Surgery%20Pricing%20Secrets.pdf</guid>
             <author><![CDATA[Health Care Blue Book]]></author> 
             <full><![CDATA[Check out this paper,<strong> <a target="_blank" href="http://www.healthcarebluebook.com/PDF_Files/100203%20HCBB%20White%20Paper%20-Surgery%20Pricing%20Secrets.pdf">Surgery Pricing Secrets: The Challenges People Face</a>, </strong>from <a target="_blank" href="http://www.heathcarebluebook.com">Healthcare Blue Book</a>&nbsp;which&nbsp;focused on the ease of obtaining a price quote from a facility prior to receiving medical treatment.&nbsp;<br />
<br />
In the paper, the&nbsp;evaluation included several categories, including how to:<br />
&bull; Find someone who could answer pricing questions<br />
&bull; Get a price quote within a reasonable amount of time<br />
&bull; Obtain a complete price quote for all parts of a surgery<br />
&bull; Ask for and obtain a cash discount<br />
&bull; Get a guaranteed price estimate<br />
<br />
The survey did not take into consideration quality of care, but it still provides some important insight into&nbsp;the type of transparency&nbsp;that is missing in the system today. &nbsp;]]></full> 
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                <item> 
             <title><![CDATA[CIGNA Study: CDHPs Deliver Real World Health Care Reform CDHPs Could Bend the Cost Curve 26% over Four Years and Improve Health Care Quality ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=18</link> 
             <description><![CDATA[CIGNA Study: CDHPs Deliver Real World Health Care Reform CDHPs Could Bend the Cost Curve 26% over Four Years and Improve Health Care Quality 

BLOOMFIELD, Conn., Dec 15, 2009 (BUSINESS]]></description> 
             <pubDate>Fri, 19 Feb 2010 12:00:00 -0500</pubDate> 
             <guid>http://www.cnbc.com/id/34430218</guid>
             <author><![CDATA[Business Wire]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.cnbc.com/id/34430218">CIGNA Study: CDHPs Deliver Real World Health Care Reform CDHPs Could Bend the Cost Curve 26% over Four Years and Improve Health Care Quality </a></strong><br />
<br />
BLOOMFIELD, Conn., Dec 15, 2009 (BUSINESS WIRE) -- As overall medical costs continue to increase by double digits annually, medical costs for individuals in account-based consumer-driven health plans (CDHPs) went down 26% over four years, while levels of care for their preventive medicine, chronic disease management and evidence-based treatments were higher than their counterparts in traditional PPO and HMO health plans, according to a new multi-year study of health care claims experience of 655,000 CIGNA customers.<br />
<br />
The Fourth Annual CIGNA Choice Fund Experience Study is the latest evidence that more than any health reform proposal currently on the table, these innovative free market plans have been consistently proven to deliver actual quality, accessible health coverage at substantially lower costs.<br />
<br />
&quot;The empirical data is in and it's undeniable: when health plans provide incentives for people to be engaged, their health care quality goes up and costs go down,&quot; said CIGNA President and Chief Operating Officer, David M. Cordani.<br />
<br />
&quot;CIGNA's study shows that the incentives offered by consumer-driven plans -- such as lower premiums, freedom of choice, and the ability to build up health savings -- result in an immediate and sustained improvement in health care quality and lower costs.&quot; Key findings of the Fourth Annual CIGNA Choice Fund Experience Study include: -- Immediate and sustainable cost savings: CDHP medical costs are 14% less than traditional plans the first year, cumulative cost savings rise to 19% in the second year, 23% in the third year and 26% in the fourth year.<br />
<br />
-- Higher levels of care: People with CIGNA Choice Fund received recommended care at compliance rates that were similar or better than those covered by traditional CIGNA health plans. Key indicators such as use of preventive care, evidence-based care and disease management program participation were measurably better among those in CIGNA CDHPs than those in PPOs and HMOs.<br />
<br />
-- Less cost for those with chronic conditions: Medical cost trend was substantially less for CIGNA Choice Fund customers with hypertension (27% less), joint disease (21% less), and diabetes (15% less), than for individuals with either of those diseases in traditional CIGNA health plans. According to the study data, these cost savings were achieved without sacrificing care.<br />
<br />
According to Cordani, if the share of Americans enrolled in a CDHP rose from a current 18% to 50%, and the results of the CIGNA study were applied, the U.S. could achieve $350 billion dollars in savings over 10 years.<br />
<br />
Chris Policinski, President and CEO of Land O'Lakes, Inc., noted: &quot;Offering consumer driven health plans to Land O'Lakes employees is helping to keep health care costs in check, while maintaining or improving care quality. For Land O'Lakes, this approach supports our commitment to employees, while at the same time ensuring that we remain highly cost efficient.&quot; Customer: Engagement is Key One of the nation's premier agricultural cooperatives, Land O'Lakes, Inc., offers both CIGNA Choice Fund CDHP and traditional health plans. The company confirms that its employees are increasingly electing to enroll in the CDHP for cost savings -- with eight of 10 employees choosing CDHP over traditional managed care plans.<br />
<br />
&quot;Since January 1, 2007, when our first CDHP was offered, our company and employees have saved more than $10 million in health plan costs,&quot; said Land O'Lakes Director of Benefits and HR Operations Pamela Grove. &quot;From 2006 to 2007, our health care trend decreased from 13% to negative 5% - a decrease of 18% year over year. Our employees are making smart choices: increasing their use of preventive care and the CIGNA 24-hour nurse line, as well as opting to use less-costly urgent care facilities or convenience care clinics rather than heading to the emergency room for non-emergency events.&quot; &quot;We attribute this enormously successful enrollment to honest and open communication with employees coupled with consumer-focused information and tools,&quot; said Grove. &quot;That's a strategy that we will continue to focus on and, so far, it has produced very impressive results.&quot; Individuals Making the Most of their Health Benefits Noting the solid clinical compliance among those enrolled in CIGNA Choice Fund plans, CIGNA Chief Medical Officer, Jeffery Kang, M.D. said: &quot;America is a land of smart shoppers, and what our study shows is given the right plans, tools and information, people will make rational, wise and successful health care decisions.&quot; Individuals enrolled in CIGNA Choice Fund plans continued to receive recommended care at the same or higher levels as those enrolled in traditional plans in an evaluation of compliance with 400 evidence-based measures of health care quality. In fact, first year Choice Fund customers had higher statistical compliance with 11% of evidence-based measures than their counterparts in traditional plans, and 16% higher for Choice Fund customers enrolled for multiple years.<br />
<br />
Moreover, individuals with chronic illnesses covered by CIGNA Choice Fund plans are more engaged and more likely to comply with and complete their plan disease management programs. Disease management program follow-through and completion rates are 22% higher among those in CIGNA Choice Fund plans than their counterparts in traditional CIGNA managed care plans.<br />
<br />
Preventive care visits for first-year CIGNA Choice Fund customers were an average of 16% greater when compared to traditional plans, with CDHP preventive care visits continuing at higher rates than those in traditional plans in the second year.<br />
<br />
The trend in pharmacy costs for new CIGNA Choice Fund customers who also have their pharmacy benefits with CIGNA was cut by more than half when compared to those enrolled in traditional plans.<br />
<br />
&quot;CIGNA's mission is to improve people's health, well-being and sense of security;&quot; said Dr. Kang. &quot;During the past four years, CIGNA Choice Fund studies have consistently demonstrated that CDHPs are part of the solution for creating a more affordable, accessible, sustainable and high quality healthcare system.&quot; CIGNA (NYSE:CI), a global health service company, is dedicated to helping people improve their health, well-being and sense of security. CIGNA Corporation's operating subsidiaries provide an integrated suite of medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance, to approximately 46 million people throughout the United States and around the world. To learn more about CIGNA, visit www.cigna.com.<br />]]></full> 
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             <title><![CDATA[New Study Finds Most Employers Spend Nearly 2% of Health Care Claims Budget on Wellness Programs]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=20</link> 
             <description><![CDATA[New Study Finds Most Employers Spend Nearly 2% of Health Care Claims Budget on Wellness Programs

BusinessWire - Most mid- to large-size companies in the United States are strongly committed to]]></description> 
             <pubDate>Tue, 26 Jan 2010 12:00:00 -0500</pubDate> 
             <guid>http://www.forbes.com/feeds/businesswire/2010/01/25/businesswire134453185.html</guid>
             <author><![CDATA[Business Wire/Fidelity]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.forbes.com/feeds/businesswire/2010/01/25/businesswire134453185.html">New Study Finds Most Employers Spend Nearly 2% of Health Care Claims Budget on Wellness Programs</a><br />
</strong><br />
BusinessWire - Most mid- to large-size companies in the United States are strongly committed to continuing to invest in health improvement programs for their employees in 2010, according to a new employer survey(1) conducted by Fidelity Investments(R), one of the nation's largest benefits providers, in conjunction with the National Business Group on Health (NBGH). Survey results showed that employers overwhelmingly (91%) agree that their willingness to invest in these programs will remain regardless of any health care reform changes in Washington. <br />
<br />
According to the survey results, employers on average are spending nearly 2%(2) of their total health care claim dollars annually on wellness programs. Most have implemented an average of 21 programs focused on prevention, lifestyle wellness, condition management, communication and education. Half (51%) of all employers plan to implement at least one additional health improvement program in 2010 and 89% expect to maintain the current programs they offer. <br />
<br />
More than one in four (27%) companies, however, do not measure the outcomes of these programs and 65% of companies have no measurable goals for their initiatives. <br />
<br />
&quot;Wellness programs are now a standard workplace benefit as employers recognize the need to invest in initiatives that help employees to better manage their health given that health care costs continue to soar,&quot; said Sunit Patel, senior vice president of Fidelity's Consulting Services business, which commissioned the study with NBGH. &quot;However when it comes to measurement, wellness programs are in their infancy. Most employers need help establishing clear program goals and measuring the impact these programs have on the overall well being and productivity of their employees.&quot; <br />
<br />
&quot;Offering wellness programs and encouraging employees to maintain healthy lifestyles can be enormously beneficial to any organization as well as to its workers,&quot; said Helen Darling, president of the National Business Group on Health. &quot;Employers, however, won't see meaningful results from these programs unless they effectively communicate information about them to employees and provide incentives that will motivate employees to participate and focus on taking the necessary steps to improve their own health.&quot; <br />
<br />
Most Employers Unsure of ROI; Struggle with Employee Engagement&nbsp;<br />
<br />
The study revealed that six out of 10 companies with health improvement programs do not know their return on investment across all their programs holistically. Companies ranked outcome measurement as their No. 1 challenge, followed by employee engagement and participation. <br />
<br />
&quot;Measuring health improvement programs as a suite of offerings, as opposed to individual initiatives, is essential to understanding the true impact of an employer's investment,&quot; said Patel. &quot;We work with many companies each year to ensure that their wellness programs are effective in driving stronger results through greater employee engagement across a range of programs.&quot; <br />
<br />
In order to encourage participation in wellness programs, more than half (57%) of companies surveyed said they use incentives that have a cash value. The most common incentives offered by an employer are to reduce the employee's health care premium followed by cash and contributions to a health reimbursement arrangement or a health savings account. One out of five companies (20%) spends more than $400 per employee a year on incentives alone. Almost one third (29%) spend less than $100 per employee. <br />
<br />
Companies Spend Balanced Amount on Prevention and Treatment of Existing Conditions <br />
<br />
Companies are spending almost the same amount of money on programs aimed at prevention and lifestyle wellness (45%) as on programs that manage conditions after the onset of disease or illness (43%). The most prevalent programs in the prevention and lifestyle categories are on-site flu shots (90% of companies offer them), preventive-care reminders related to screenings or annual exams (68%), employee assistance programs (92%), stress management (68%) and smoking cessation (66%). The top condition-management programs in use are nurse hotlines where nurses are available to answer questions via telephone (79%), diabetes disease management (74%), coronary artery disease, congestive heart failure and asthma disease management (69%). <br />
<br />
Methodology <br />
<br />
Data for the Consulting Services' survey was collected online between September 11, 2009 and October 5, 2009 by the National Business Group on Health and is based on responses from a national sample of 121 companies from numerous industries including transportation, health care, technology, entertainment, consumer products, retail and energy production. The sizes of the companies spanned a broad range, from 1,000 employees to 100,000 employees. The results of this survey may not be representative of all companies meeting the same criteria as those surveyed for this study. <br />
<br />
About the National Business Group on Health <br />
<br />
The National Business Group on Health is a non-profit membership organization of more than 280 members, including 60 of the Fortune 100. The National Business Group on Health is devoted to providing practical solutions to its employer-members' most important health care problems and serving as the voice for large employers on national health care issues and public policy. Its members purchase health and disability benefits for over 55 million people. For more information, visit www.businessgrouphealth.org. <br />
<br />
About Fidelity's Consulting Services <br />
<br />
Fidelity's Consulting Services business helps mid to large-size employers nationwide assess the effectiveness of their benefits programs. The business provides a holistic approach to benefits design, strategy, funding, communications and delivery by looking at clients' health care and retirement plans before diagnosing business solutions. The group's specialties include retirement and health care plan consulting, custom data administration, compliance, employee communication and human resource transformation. Consulting Services has offices in Boston, New York City, San Francisco, Chicago and Dallas. <br />
<br />
About Fidelity Investments <br />
<br />
Fidelity Investments is one of the world's largest providers of financial services, with assets under administration of over $3.2 trillion, including managed assets of $1.5 trillion as of December 31, 2009. Fidelity offers investment management, retirement planning, brokerage, and human resources and benefits outsourcing services to over 20 million individuals and institutions as well as through 5,000 financial intermediary firms. The firm is the largest mutual fund company in the United States, the No. 1 provider of workplace retirement savings plans, the largest mutual fund supermarket, a leading online brokerage firm and one of the largest providers of custody and clearing services to financial professionals. For more information about Fidelity Investments, visit www.fidelity.com. <br />
<br />
Fidelity Investments is a registered service mark of FMR LLC. <br />
<br />
The National Business Group on Health is an independent entity and is not affiliated with Fidelity Investments. <br />
<br />
542240.1.0 <br />
<br />
(C) 2010 FMR LLC. All rights reserved. <br />
<br />
(1) Survey was conducted online by Fidelity in conjunction with the National Business Group on Health from September 11, 2009 to October 5, 2009. 121 employers are included in the responses. Data was collected by NBGH. <br />
<br />
(2) Percentage was calculated by dividing the amount of money an employer spends on health improvement programs per employee annually by the total amount of money it spends for claims for doctors' office visits, medications and hospital stays per employee annually. The 2% figure excludes costs associated with employee incentives, onsite health centers and human resource staff dedicated to wellness programs. <br />
<br />
SOURCE: Fidelity Investments <br />
<br />
Fidelity Investments Corporate Communications, 617-563-5800 <br />
<br />
<br />
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             <title><![CDATA[25 Ways to Save Money on Healthcare]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=19</link> 
             <description><![CDATA[25 Ways to Save Money on Healthcare - www.parents.com 

Find the Best Plan

1. Shop for the Best Plan
When selecting a health plan, don't just choose the one with the lowest]]></description> 
             <pubDate>Fri, 15 Jan 2010 12:00:00 -0500</pubDate> 
             <guid>http://www.parents.com/parenting/money/family-finances/save-money-on-health-care/</guid>
             <author><![CDATA[By Teri Cettina - Parents Magazine]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://www.parents.com/parenting/money/family-finances/save-money-on-health-care/">25 Ways to Save Money on Healthcare </a>- <a href="http://www.parents.com">www.parents.com</a> <br />
<br />
Find the Best Plan</strong><br />
<br />
1. Shop for the Best Plan<br />
When selecting a health plan, don't just choose the one with the lowest monthly premium or the one you used before. Benefits can change significantly every year -- as can your family's health needs. The best way to bargain-shop: Jot down your family's average number of doctor visits per year, routine prescriptions, dental cleanings, and other services. Compare what you'd pay over an entire year for these items on each plan. Don't forget to include monthly premiums and deductibles.<br />
<br />
2. Consider an HD Plan<br />
It might feel like a big switch if you're used to paying $20 office co-pays. But a high-deductible (HD) health plan can save you hundreds of dollars per month in lower premiums. These plans (which have an annual deductible of at least $1,100 for individuals; $2,200 for families) are great if your family is healthy and doesn't usually visit the doctor too often. Another benefit: Most HD plans qualify you to open a health savings account (HSA), where you can sock away (on a pretax basis) money to pay your insurance premiums and out-of-pocket health expenses. Better yet, unused HSA money continues to grow tax-deferred, year after year. An HD plan might not be right for you, though, if family members have chronic (and costly) health conditions, you're not disciplined about saving money in your HSA, or if having such a high deductible makes you uneasy.<br />
<br />
3. Join a Discount Club<br />
If you don't have dental insurance, look into plans like AmeriPlan (ameriplanusa.com), Careington International (careington.com), or HealthInsurance.com's dental-discount cards. Participants in these plans agree to give members up to a 60 percent discount. You'll pay a monthly membership fee (ranging from about $12 to $30), and you'll probably need to pay cash at the time of service. Check each plan's coverage in your area -- some regions have fewer participating providers than others.<br />
<br />
4. Join the Farm Bureau<br />
Believe it or not, you don't need to be a farmer to join your state's farm bureau. Simply by paying an annual membership fee (usually less than $50) you're eligible for all sorts of benefits -- including discounted group health insurance in some states. If you or your spouse are self-employed, this might work for you. For more information, type &quot;farm bureau&quot; and your state's name into your Internet search engine.<br />
<br />
5. Always Have a Safety Net<br />
If you or your spouse are switching jobs and have to wait for your new health insurance to kick in, ask whether you can extend your policy from your old employer. (The COBRA law requires some, but not all, companies to let you.) If it's not possible to keep your old plan, buy a short-term family insurance plan so you're never without coverage. These policies are relatively inexpensive and can usually be activated within a day or two. Compare plans online at ehealthinsurance.com.<br />
<br />
<br />
<strong>Know Your Coverage</strong><br />
<br />
6. Take Advantage of Extras<br />
Your health plan may offer valuable services you don't hear much about, so poke around its Web site to learn what's available, says reader Kimberly Hoody, of Phoenix. Some carriers, for example, have nurses on call 24/7. They can tell you how to safely remove a splinter or whether or not your child's cold symptoms warrant an immediate doctor visit (and another co-pay, ka-ching!). Some plans also offer discounts on acupuncture, gym memberships, massage treatments, and weight-loss programs.<br />
<br />
7. Get Regular Checkups<br />
Don't skimp on well-child checkups just to save money, says Jessica Banthin, a healthcare expert at the U.S. Department of Health and Human Services. These exams are usually inexpensive or are fully covered by insurance, and they help your doctor detect health problems early. Routine vaccines will also lower your child's risk of illness -- and your risk of facing high medical bills.<br />
<br />
8. Look for Special Services<br />
Many health plans have programs for patients with ongoing conditions like asthma or allergies, including discounts on preventive care, helpful newsletters, and more. Reader Jaimee Starr's son Austin, 8, has asthma and gets chronic bronchitis in the winter months. After talking with her health-plan representatives, the Springfield, Ohio, mom learned she could buy a home nebulizer from them for just $55 instead of renting one from her pharmacy for $180. Health-plan reps also steered her to a drugstore that offered lower prices on her son's asthma medication.<br />
<br />
9. Flex Your Spending<br />
If your employer offers a flexible spending account (FSA), you'd be nuts not to use it. FSAs are tax-sheltered accounts that you can use to pay for out-of-pocket medical costs such as office and prescription co-pays. Reader Lisa Chavez-Melo, a human-resources professional in Albuquerque, New Mexico, suggests &quot;guesstimating&quot; what you'll spend on medical expenses each year and putting about 20 percent less into your account so you don't have to worry about scrambling to find last-minute ways to spend it before it disappears. (FSAs are a &quot;use it or lose it&quot; plan and the money must be used within the year.) Some good ways to spend that last bit of FSA money: replacement glasses or contacts, dental cleanings, and even certain over-the-counter items like bandages, infant pain reliever, and contact-lens solutions.<br />
<br />
10. Read Bills Carefully<br />
Up to 50 percent of your doctor or hospital bills may contain mistakes that end up costing you money, says Jane Cooper, president of Patient Care, a consumer-advocacy group in Milwaukee. Something as simple as an incorrect billing code could prompt your insurance to pay less than expected or even reject your claim. Other common errors: mistakes in an account number, claims with incomplete information -- even claims sent to the wrong insurance-company address by a doctor. Read your benefits booklet carefully to make sure your plan is paying all it should. If you catch an error, send a certified letter to your insurer. Follow up in a few weeks to make sure the mistake is corrected.<br />
<br />
11. Don't Accept &quot;No&quot;<br />
If your insurance company won't pay for a service you think you deserve, don't just give up. Appeal the decision. If you're denied again, contact your state insurance commission. That agency can mediate a dispute between you and your insurance company. If you win, you could save yourself hundreds, or even thousands, of dollars.<br />
<br />
12. Remember to Network<br />
When making an appointment, always double-check that the doctor is still in your insurance plan's network. (Many come and go.) And ask to see in-network providers when you go to the hospital or an urgent-care center. Just because a facility participates in your plan doesn't mean every professional (the nurse-practitioner or radiologist, for instance) does. Also, if you need to see a doctor when you're out of town, call your insurance provider's toll-free phone number to find out the best way to get services that will be covered.<br />
<br />
13. Split the Cost<br />
If you need extensive dental services, ask your dentist about starting the work in December and finishing it in January. Depending on your dental-plan benefits, you may get better coverage by splitting the cost between the two plan years.<br />
<br />
<br />
<strong>Discuss Options with Your Doctor</strong><br />
<br />
14. Bring a List<br />
Get a copy of your insurance company's list of covered prescription medications (a &quot;formulary&quot;) and share it with your doctor. Many insurers separate drugs into several pricing &quot;tiers,&quot; so some medicines cost you more than others. If your doctor knows what's on your insurer's list, he can select the best medication for you at the lowest price. Also, if your plan requires you to get a referral to a specialist, take your insurance plan's preferred-provider list to your primary-care appointment. Your doctor can easily pick out the best specialist who participates in your plan.<br />
<br />
15. Be Upfront About Finances<br />
Are you short on cash? Do you have a high insurance deductible? Don't be embarrassed to tell your doctor or dentist. He may be able to suggest less-costly treatment options or even agree to lower fees. In fact, a Wall Street Journal/Harris Interactive poll found that three out of five people who negotiated with their doctors received discounts.<br />
<br />
16. Slice Your Pills<br />
Believe it or not, many high-dose prescription pills, from allergy meds to antidepressants, require exactly the same co-pay as their lower-dose counterparts. Ask your doctor whether you can safely split a higher-dosage pill in half, and cut your costs too. (You can't do this with controlled-release medications.)<br />
<br />
17. Ask to Sample It<br />
Your doctor's cupboards are full of free drug samples, courtesy of the pharmaceutical industry. If your child is getting shots, ask for a trial-size pain reliever in case he needs it later. If you're trying a new antibiotic or rash cream, your physician may even have enough samples to cover your course of treatment. Also, check out the drug company's Web site, which sometimes offers coupons or free samples.<br />
<br />
<br />
<strong>Take Preventative Measures</strong><br />
<br />
18. Watch Your Head<br />
Make sure you and your kids wear helmets when you ride a bike, a scooter, or a skateboard, since most serious injuries are the result of falls.<br />
<br />
19. Get in a Lather<br />
Americans plunk down big bucks every year on cold remedies and flu treatments when the best preventive medicine is plain old soap and water. Teach everyone in the family to scrub their hands for about 20 seconds before eating, after playing outside, or after being in contact with someone who's already sick.<br />
<br />
20. Prevent Tooth Traumas<br />
Starting around their first birthday, kids should get twice-yearly checkups from the dentist, says Keith Morley, DMD, president of the American Academy of Pediatric Dentistry. Preventive care nips problems in the bud before they become more costly. You should also talk to your dentist about getting sealants for your child's molars. (Sealants are a liquid plastic material applied to your child's back teeth to prevent them from decaying.) Many insurance companies cover the cost, but even if they don't, get them anyway: They'll probably save you money in the long run.<br />
<br />
21. Steer Clear of the ER<br />
Never use the emergency room as a substitute for your regular doctor. You'll pay much more, and you'll probably wait longer to be seen, says Parents advisor Alice Domar, PhD. If your child feels lousy on a Friday morning, make an appointment with the doctor for that day so you don't end up in the ER over the weekend.<br />
<br />
22. Save on Supplements<br />
Don't spend your hard-earned money on vitamins, mineral supplements, and herbs since there's not enough data to support their effectiveness, says Dr. Domar. Most vitamins and supplements will pass right through you, which means money down the toilet -- literally! The notable exceptions: calcium and vitamin D supplements, which have been proven effective.<br />
<br />
<br />
<strong>Shop Around</strong><br />
<br />
23. Pay Less for Prescriptions<br />
Go generic, for starters. In almost every case, generics are just as good as name brands and are much cheaper, says Catherine Tom-Revzon, a pharmacist at The Children's Hospital at Montefiore, in New York City. Second, compare costs since prices vary significantly from store to store. Your best bet may be a warehouse club like Costco or Sam's Club. (You don't even need to be a member.) Another option: If your plan has a mail-order pharmacy, you might be able to get 90 days' worth of prescriptions mailed to you for two co-pays.<br />
<br />
24. Keep an Eye on Discounts<br />
Remember that you don't have to buy glasses or contact lenses from your optometrist or ophthalmologist. Federal law requires them to give you a copy of your prescription so you can buy lenses anywhere you like. Even if you don't have vision coverage, insurance providers may offer discounts on glasses or contact lenses. If not, look elsewhere: Some Automobile Association of America policies include eyewear discounts. Warehouse clubs and online retailers also offer deals.<br />
<br />
25. Go to Dental School<br />
If you need expensive dental care, consider a clinic at a local dental school. Well-supervised students staff these clinics and charge between 20 and 50 percent less than what you'd pay at a professional dental office -- big bucks if you need a costly crown or implant. Search for dental-school programs in your area at ada.org.<br />
--------------------------------------------------------------------------------<br />
<a href="http://www.parents.com">www.parents.com</a> <br />
<br />
<br />
<br />
<a target="_blank" href="http://www.streetwisehsa.com/site/blog.php">www.streetwisehsa.com/site/blog.php</a><br />
<a target="_blank" href="http://www.azuba.com">www.azuba.com</a><br />]]></full> 
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                <item> 
             <title><![CDATA[After Surgery to Slim Down, the Bills Can Pile Up]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=79</link> 
             <description><![CDATA[After Surgery to Slim Down, the Bills Can Pile Up - LESLEY ALDERMAN - NY&nbsp;Times

AFTER dieting unsuccessfully her entire life, Barbara Warnock-Morgan, 46, decided she needed to do something radical.]]></description> 
             <pubDate>Sun, 03 Jan 2010 12:00:00 -0500</pubDate> 
             <guid>http://www.streetwisehealth.com/assets/lib/files/Articles/After%20Surgery%20to%20Slim%20Down,%20the%20Bills%20Can%20Pile%20Up.pdf</guid>
             <author><![CDATA[By LESLEY ALDERMAN]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.nytimes.com/2011/01/01/health/policy/01patient.html"><strong>After Surgery to Slim Down, the Bills Can Pile Up</strong> </a>- LESLEY ALDERMAN - NY&nbsp;Times<br />
<br />
AFTER dieting unsuccessfully her entire life, Barbara Warnock-Morgan, 46, decided she needed to do something radical. <br />
<br />
&ldquo;I was the fat kid,&rdquo; she said. &ldquo;Over the years I yo-yo dieted my way up the scale. I&rsquo;d lose 20 pounds, then gain back 30.&rdquo; <br />
<br />
The cycle was so insidious that by her early 40s, Ms. Warnock-Morgan, who lives in Brooklyn with her husband and daughter and works for a music company, was obese, with a body mass index over 40. (A B.M.I. of 18.5 to 24.9 is normal; over 30 is considered obese.) <br />
<br />
In November 2009, she decided to have adjustable gastric banding, a form of bariatric surgery in which a silicone band is placed around the top portion of the stomach, restricting the amount of food a person can comfortably consume. <br />
<br />
Bariatric surgery costs $15,000 to $30,000, depending on the procedure and the area of the country in which the patient lives. Ms. Warnock-Morgan was fortunate in many ways. Not only was her surgery successful (she has lost 127 pounds), but her insurance covered all the costs. <br />
<br />
Even so, she&rsquo;s facing new bills. Once she loses all her excess weight, she said she would need to spend thousands of dollars on cosmetic surgery to &ldquo;rebuild my body&rdquo; &mdash; which she will have to pay for herself. <br />
<br />
Indeed, many bariatric patients like her discover that there are unexpected expenses associated with weight loss surgery. High co-payments, nutritional and behavioral counseling and cosmetic surgery, for example, can easily add up to thousands of dollars, mostly out of patients&rsquo; pockets. <br />
<br />
Despite the cost, more and more people are signing up. <br />
<br />
The number of bariatric surgeries performed in the United States rose 804 percent from 1998 to 2004, to 121,055 from 13,386, according to a study by the Agency for Healthcare Research and Quality. The number of annual surgeries now is closer to 200,000 or 250,000, according to Dr. Robin Blackstone, president-elect of the American Society for Metabolic and Bariatric Surgery. <br />
<br />
The surgery is also becoming safer; the rate of complications is down, and so are the number of deaths. &ldquo;It&rsquo;s the only good treatment for severe obesity,&rdquo; said Dr. James Mitchell, a professor of clinical neuroscience at the University of North Dakota School of Medicine. <br />
<br />
Ms. Warnock-Morgan has no regrets: &ldquo;I feel better, and I look better. I&rsquo;m happier than I have been in 25 years.&rdquo; <br />
<br />
The National Institutes of Health recommends bariatric surgery for people with a B.M.I. over 40 (or 35 to 40 if they also have related medical condition, like diabetes). A Food and Drug Administration panel recently recommended that the B.M.I. base for lap-band surgery (a form of adjustable-band surgery) be lowered to 35 and higher (30 to 35 if they have a related disease). <br />
<br />
Adjustable gastric banding is the second most popular form of bariatric surgery. The most common is laparoscopic gastric bypass, which decreases the size of the patient&rsquo;s stomach and also the body&rsquo;s ability to fully absorb food and thereby calories. <br />
<br />
Gastric bypass is more expensive but typically results in greater weight loss than gastric banding. <br />
<br />
If you&rsquo;ve been considering bariatric surgery, tally up all your expenses upfront so you&rsquo;ll know your liability down the line. Here&rsquo;s what you need to know, along with tips on how to minimize the costs. <br />
<br />
INSURANCE COVERAGE Just half of large employer health plans cover bariatric surgery, while small employers rarely cover it at all, Dr. Blackstone said. Medicare pays for weight loss surgery, but the majority of people who have the procedure are under age 55. <br />
<br />
Even if your insurer covers bariatric surgery, make inquiries about the fees involved. Co-payments tend to be much higher than for other operations, sometimes as much $5,000, Dr. Blackstone said. <br />
<br />
Ask, too, how your insurer typically responds if there are complications and you need to spend a month or so at a skilled nursing facility. And what is your insurer&rsquo;s policy if the first surgery doesn&rsquo;t work and you need a second operation? <br />
<br />
FOREIGN OPTIONS Some people without insurance coverage choose to have bariatric surgery in Latin America or Asia, where the cost is 40 percent to 70 percent less than in the United States, according to Joseph Woodman, author of &ldquo;Patients Beyond Borders,&rdquo; a consumer guide to medical tourism. He estimates that 20,000 Americans went abroad for weight loss surgery last year. <br />
<br />
But choose the doctor and hospital carefully. Look for a facility that has been accredited by Joint Commission International, a United States-based nonprofit that accredits hospitals abroad. <br />
<br />
&ldquo;Spend some time online reading about bariatrics abroad,&rdquo; said Vicky Gould, 48, who had adjustable-band surgery in Monterrey, Mexico, in 2007. &ldquo;If a hospital is not doing good work, people will write about it.&rdquo; <br />
<br />
Be sure you have found a doctor to care for you once you return home, said Dr. David Flum, a professor of surgery and public health at the University of Washington. &ldquo;It&rsquo;s not necessarily a bad idea to go abroad for surgery, but it&rsquo;s a bad idea to go there and not have established a method for follow-up care at home,&rdquo; he said. <br />
<br />
ADDITIONAL EXPENSES Gastric bypass patients normally lose significant amounts of weight. But about 25 percent of gastric banding patients have not lost weight two years after surgery, Dr. Blackstone said. That&rsquo;s in part because those patients fail to revamp their diet and exercise patterns. <br />
<br />
&ldquo;When it comes to adjustable banding procedures, the surgery is not the intervention,&rdquo; Dr. Flum said. &ldquo;It&rsquo;s the lifestyle changes and the adjustments that come after it.&rdquo; <br />
<br />
No matter what type of procedure you undergo, be prepared to pay for services like a nutritional counselor and personal trainer, as well as a gym membership, all of which can help keep you motivated over the long haul. <br />
<br />
Some insurers will also stipulate that you join a care-management program, which could cost $1,500 or more out of pocket, Dr. Flum said. Most doctors will insist that you quit smoking before you have surgery. <br />
<br />
Once you lose the excess weight, you&rsquo;ll have excess skin, and this may require another unforeseen expense: cosmetic surgery. Most insurers don&rsquo;t cover surgery to remove sagging and excess skin after weight loss, unless it is considered medically necessary &mdash; if the skin is causing rashes, for instance, or infections. <br />
<br />
Some patients need more than one procedure to remove skin from the abdomen, thighs and upper arms. The bills can reach $20,000, Dr. Flum said. <br />
<br />
Ms. Warnock-Morgan worries that her cosmetic surgery bills could go still higher, perhaps to $30,000. &ldquo;I might have to tap my 401k or work out some kind of payment plan with a surgeon,&rdquo; she said. &ldquo;I would go on a reality show if they would pick up the cost of the surgery.&rdquo; <br />
<br />
Another cost that many bariatric patients do not consider: a new wardrobe, or several new wardrobes, as weight falls off. <br />
<br />
But the expense that most frequently blindsides patients is, oddly, perhaps the most obvious. &ldquo;The most expensive thing is if the surgery is unsuccessful,&rdquo; Dr. Blackstone said. <br />
<br />
If you are not prepared to make the necessary lifestyle changes as well, then surgery is likely to be a waste of your time and money. <br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Health Savings Account Updates for 2010]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=9</link> 
             <description><![CDATA[Health Savings Account Updates for 2010

A Health Savings Account, or HSA, is a type of health insurance plan that allows individuals and families to reduce their annual incomes while, simultaneously,]]></description> 
             <pubDate>Wed, 23 Dec 2009 12:00:00 -0500</pubDate> 
             <guid>http://www.amazines.com/Finance_and_Investment/article_detail.cfm/1239670?articleid=1239670</guid>
             <author><![CDATA[Health Insurance]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.amazines.com/Finance_and_Investment/article_detail.cfm/1239670?articleid=1239670">Health Savings Account Updates for 2010</a><br />
<br />
A Health Savings Account, or HSA, is a type of health insurance plan that allows individuals and families to reduce their annual incomes while, simultaneously, storing money away that they can use to pay for qualifying medical expenses. Much like an IRA, the money that an individual saves in a HSA can be invested into high-interest investments, including stocks, bonds, money market accounts, CDs, and more. These investments are either tax-deductible or tax-deferred, depending upon how an individual chooses to use the money from his or her savings account. <br />
There are annual fees and requirements that must be met in order for an individual or family to have a Health Savings Account. These include minimum deductibles, maximum contributions, and maximum out-of-pocket expenses. However, in order to have a HSA in the first place, an individual needs to have a qualifying health insurance plan, which is a health insurance plan that has a high deductible. These health insurance plans can be obtained from a wide variety of health insurance providers. <br />
<br />
Changes coming in 2010 <br />
<br />
There are several increases to prices for Health Savings Accounts for 2010, including increases in the minimum deductible, maximum deductible and maximum out-of-pocket expenses. These changes are as follows: <br />
<br />
The minimum deductible will increase in 2010 to $1,200 for individuals and $2,400 for families. This is the minimum deductible allowable for the high deductible health insurance plan. The 2009 rates were $1,250 for individuals and $2,300 for families. <br />
<br />
The maximum contribution that individuals and families can make each year towards the HSA will be $3,050 for individuals and $6,150 for families. Individuals and families are not required to make the maximum annual contribution towards their HSA, but the amount of their contributions will be reduced from their annual income tax burdens. HSA participants can also make contributions to their Health Savings Accounts to cover a specific medical expense that they wish to be tax deductible by reimbursing themselves for their own medical expenses from the funds in their Health Savings Accounts. The 2009 maximum contributions were $3,000 for individuals and $5,950 for families. <br />
<br />
Catch-up contributions will stay the same for 2010. These amounts are $1,000 for both individuals and families for 2009 and 2010. A catch-up contribution is an additional contribution that individuals can make towards their Health Savings Accounts if they are between the ages of 55 and 65. <br />
<br />
Maximum out-of-pocket expenses will increase in 2010 as well. For individuals, the maximum out-of-pocket expenses will increase to $5,950. For families, the maximum out-of-pocket expenses will increase to $11,900. The 2009 maximum expenses were $5,800 for individuals and $11,600 for families. <br />
<br />
Individuals and families who are considering opening a Health Savings Account can benefit not only by being able to reduce their annual income tax burdens, but they will also be able to grow their savings accounts. The growth on their accounts is tax-deductible if they use the money from their Health Savings Accounts to pay for qualifying medical expenses. However, if they choose to use the money for other expenses, they will simply have to pay taxes only when they make their withdrawals. <br />
<br />
Many individuals and families can save a significant amount of money each year by enrolling in Health Savings Accounts. To find out how much they can save, individuals and families can speak with a Health Savings Account consultant or check rates with different health insurance companies that offer Health Savings Account plans. <br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[Research: HSAs showing benefits to employees, employers]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=13</link> 
             <description><![CDATA[Research: HSAs showing benefits to employees, employers

Employers and employees using Health Savings Accounts (HSAs) and HSA-qualified health plans say they are satisfied with their coverage, spend less and are more]]></description> 
             <pubDate>Sat, 12 Dec 2009 12:47:14 -0500</pubDate> 
             <guid>http://ifawebnews.com/2009/10/12/research-hsas-showing-benefits-to-employees-employers/</guid>
             <author><![CDATA[Bob Graham]]></author> 
             <full><![CDATA[<a target="_blank" href="http://ifawebnews.com/2009/10/12/research-hsas-showing-benefits-to-employees-employers/"><strong>Research: HSAs showing benefits to employees, employers</strong></a><br />
<br />
Employers and employees using Health Savings Accounts (HSAs) and HSA-qualified health plans say they are satisfied with their coverage, spend less and are more engaged in managing health benefits, separate surveys indicate.<br />
<br />
The tax-favored health care savings accounts are designed to help individuals pay for current qualified health care expenses and save for future medical and retiree health care expenses.<br />
<br />
&ldquo;With the vigorous debate over health care reform, and more specifically health insurance reform, the survey results indicate that employers and account holders more effectively control costs and are satisfied with their coverage by utilizing HSAs,&rdquo; said Tom Hricik, national director for Dallas, Texas-based ACS Solution, an administrator of HSA plans. &ldquo;The survey results also indicate that HSAs are being used by account holders as an important vehicle to save for future medical expenses.&rdquo;<br />
<br />
Employers found benefits to HSAs, as well. Exactly 86% of those offering the option for more than three years indicated that plan costs were the same or less than the previous year. Almost all employers surveyed (96%) said HSAs allow the company to continue offering group-sponsored health insurance.<br />
<br />
The surveys were completed in the spring by Buck Consultants, an independent arm of ACS.<br />
<br />
The surveys found that 84% of account holders said their HSA-qualified plans are affordable, and 72% said they pay the same or less than with a traditional type of health plan.<br />
<br />
After moving to an HSA, more than half of account holders said they more closely monitor their health care costs, a finding that supports one of the key claims for how HSAs ultimately save money.<br />
<br />
Exactly 48% said they read their medical bills more closely, 46% have a better understanding of where their money goes, and about 40% more closely evaluate costs before electing medical services, according to the surveys.<br />
<br />
A majority of HSA holders (81%) said the ability to personally control health care costs is an important factor that caused them to select an HSA.<br />
<br />]]></full> 
          </item>
                <item> 
             <title><![CDATA[5 Less Known Facts About HSA Plans]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=16</link> 
             <description><![CDATA[In the article they talk about 5 misconceptions about HSA&nbsp;health plans.&nbsp;&nbsp;The article touches on how HSA&nbsp;plans can be a good option for&nbsp;those who are 

    uninsured
 ]]></description> 
             <pubDate>Thu, 10 Dec 2009 12:00:00 -0500</pubDate> 
             <guid>http://www.visualeconomics.com/5-less-known-facts-about-hsa-plans/</guid>
             <author><![CDATA[visualeconomics.com]]></author> 
             <full><![CDATA[In the article they talk about <strong><a target="_blank" href="http://www.visualeconomics.com/5-less-known-facts-about-hsa-plans/">5 misconceptions about HSA&nbsp;health plans</a></strong>.&nbsp;&nbsp;The article touches on how HSA&nbsp;plans can be a good option for&nbsp;those who are <br />
<ul>
    <li>uninsured</li>
    <li>low income &amp;</li>
    <li>high risk</li>
</ul>
<br />
The article also argues that many HSA health plans are quite comprehensive and that they are easy to set-up!!&nbsp; Check it out <a target="_blank" href="http://www.visualeconomics.com/5-less-known-facts-about-hsa-plans/"><strong>here</strong></a>!]]></full> 
          </item>
                <item> 
             <title><![CDATA[Health Savings Accounts winning battle among employers CDHP options]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=11</link> 
             <description><![CDATA[Health Savings Accounts winning battle among employers&rsquo; CDHP options

Health Savings Accounts rule among employers who offer a consumer-driven health plan, a new survey finds.

The survey, released by Aon Consulting and]]></description> 
             <pubDate>Wed, 09 Dec 2009 12:41:40 -0500</pubDate> 
             <guid>http://ifawebnews.com/2009/12/01/health-savings-accounts-winning-battle-among-employers-cdhp-options/</guid>
             <author><![CDATA[Bob Graham]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://ifawebnews.com/2009/12/01/health-savings-accounts-winning-battle-among-employers-cdhp-options/">Health Savings Accounts winning battle among employers&rsquo; CDHP options</a></strong><br />
<br />
Health Savings Accounts rule among employers who offer a consumer-driven health plan, a new survey finds.<br />
<br />
The survey, released by Aon Consulting and the International Society of Certified Employee Benefit Specialists, found that 44% of survey participants offer CDHPs, up from 28% in 2006.<br />
<br />
Of those offering CDH plans this year, 56% are using the HSA model, while 35% of organizations are using the Health Reimbursement Arrangements model, and 9% are using both.<br />
<br />
HSA use has risen from 48% to 56% in the last three years, while HRA use has fallen from 43% to 35% over the time period, the survey found.<br />
<br />
&ldquo;HSAs have grown in popularity relative to HRAs since HSAs are considered more advantageous to the employee than an HRA,&rdquo; said John Zern, U.S. health and benefits practice director with Aon Consulting.<br />
<br />
Zern said HSAs appeal to employees because they can contribute their own money and own the plan, giving them portability. HSAs also have tax advantages, he said.<br />
<br />
Additionally, the survey found the majority of employers (83%) offer the HSA or HRA as an optional plan, while the remaining 17% have implemented a total replacement CDH program where the only plan choices offered to employees are CDHPs.<br />
<br />
&ldquo;Although only 17% of employers offer a total replacement CDH program, we expect that number to increase next year,&rdquo; said Bill Sharon, national consumer -driven health care practice leader with Aon Consulting. &ldquo;In response to the economic downturn and double digit health care cost increases, employers are becoming more aggressive in managing their health care costs. Implementing a total replacement CDH program is one of the leading health care strategies available to employers.&rdquo;<br />
<br />
The survey, based on 370 organizations who responded, also found that more employers who offer the HSA plan are contributing money to the plan (66%, up from 60% last year).<br />
<br />
Employers offering an HRA plan make a wide variety of contributions to the account for a single employee: 4% provide less than $300; 11% provide between $300 and $499; 49% provide between $500 and $799; 1% provide between $800 and $999; and 34% provide $1,000 or more.<br />
<br />
Similar to last year, employers currently offering a CDHP are mainly seeking to control health-plan costs (38%) or to introduce &ldquo;consumer engagement&rdquo; into the purchasing of health care for long-term change (35%). Other reasons include: expanding employee choices (14%), encouraging better use of health care services (9%), and providing a vehicle for retiree medical savings (3%).<br />
<br />
The survey found 63% of employers have more than 10% of their employees participating in a CDHP, which is similar to last year, but higher than three years ago when 53% had more than one-in-10 in a CDHP.<br />
<br />
While 56% of all employers surveyed are not currently offering a CDH plan, 37% of respondents say they plan to offer one in the near future. Of this group, 6% are planning to offer one this year or next; 31% are undecided on an effective date; and 62% are not seriously considering a CDHP as a future plan offering.<br />
<br />]]></full> 
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                <item> 
             <title><![CDATA[Findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=15</link> 
             <description><![CDATA[Below is the executive summary from EBRI's December report!!&nbsp; For the full report, click here to visit EBRI's website!&nbsp;

Findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey

FIFTH ANNUAL]]></description> 
             <pubDate>Thu, 03 Dec 2009 12:08:09 -0500</pubDate> 
             <guid>http://www.ebri.com/publications/ib/index.cfm?fa=ibDisp&amp;content_id=4418</guid>
             <author><![CDATA[Employee Benefit Research Institute]]></author> 
             <full><![CDATA[<p>Below is the executive summary from EBRI's December report!!&nbsp; For the full report, <a target="_blank" href="http://www.ebri.com/publications/ib/index.cfm?fa=ibDisp&amp;content_id=4418"><strong>click here</strong></a> to visit EBRI's website!&nbsp;<br />
<br />
<strong><a target="_blank" href="http://www.ebri.com/publications/ib/index.cfm?fa=ibDisp&amp;content_id=4418">Findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey</a><br />
</strong><br />
FIFTH ANNUAL SURVEY: This Issue Brief presents findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey, which provides nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with four earlier annual surveys. <br />
<br />
ENROLLMENT LOW BUT GROWING: In 2009, 4 percent of the population was enrolled in a CDHP, up from 3 percent in 2008. Enrollment in HDHPs increased from 11 percent in 2008 to 13 percent in 2009. The 4 percent of the population with a CDHP represents 5 million adults ages 21&ndash;64 with private insurance, while the 13 percent with a HDHP represents 16.2 million people. Among the 16.2 million individuals with an HDHP, 38 percent (or 6.2 million) reported that they were eligible for a health savings account (HSA) but did not have such an account. Overall, 11.2 million adults ages 21&ndash;64 with private insurance, representing 8.9 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA, but had not opened the account. <br />
<br />
MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors. They were more likely to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about prescription drug options, other treatments, and costs; asked their doctor to recommend a less costly prescription drug; developed a budget to manage health care expenses; checked prices before getting care; and used an online cost-tracking tool. <br />
<br />
CDHP MORE ENGAGED IN WELLNESS PROGRAMS: CDHP enrollees were more likely than traditional plan enrollees to report that they had the opportunity to fill out a health risk assessment, whereas they were equally likely to report that they had access to a health promotion program. CDHP enrollees were more likely than traditional plan enrollees to participate when a program was offered. Among those not participating, they did not participate because they could make changes on their own; they lacked time; and they were already healthy. <br />
<br />
FINANCIAL INCENTIVES MATTER: Financial incentives for healthy behavior mattered more to CDHP enrollees than traditional plan enrollees. Financial incentives were a larger factor for CDHP enrollees than for traditional plan enrollees when it came to participating in wellness programs, choice of doctor, and the use of health information technology, as well as patient engagement using e-mail and the Web. <br />
<br />
HEALTH STATUS IS BETTER, INCOME HIGHER: Adults in CDHPs were significantly less likely to have a health problem than were adults in HDHPs or traditional plans. Adults in CDHPs and HDHPs were significantly less likely to smoke than were adults in traditional plans, and were significantly more likely to exercise. People in CDHPs were also less likely to be obese compared with adults enrolled in a traditional health plan. Adults in CDHPs were significantly more likely than those with traditional health coverage to have a high household income. CDHP and HDHP enrollees were also more likely than traditional plan enrollees to be highly educated. <br />
&nbsp;</p>]]></full> 
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             <title><![CDATA[More Consumers Turn to Internet To Compare Health Care Prices]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=10</link> 
             <description><![CDATA[More Consumers Turn to Internet To Compare Health Care Prices&nbsp;- iHealthBeat
The increasing number of uninsured residents, the rise in high-deductible health insurance plans and large increases in copayments are leading]]></description> 
             <pubDate>Wed, 02 Dec 2009 11:29:45 -0500</pubDate> 
             <guid>http://www.ihealthbeat.org/articles/2009/11/30/more-consumers-turn-to-internet-to-compare-health-care-prices.aspx</guid>
             <author><![CDATA[iHealthBeat]]></author> 
             <full><![CDATA[<a target="_blank" href="http://www.ihealthbeat.org/articles/2009/11/30/more-consumers-turn-to-internet-to-compare-health-care-prices.aspx"><strong>More Consumers Turn to Internet To Compare Health Care Prices</strong></a>&nbsp;- iHealthBeat<br />
The increasing number of uninsured residents, the rise in high-deductible health insurance plans and large increases in copayments are leading more consumers to compare medical prices online, the New York Times reports.<br />
<br />
<strong>Insurer-Based Resources</strong><br />
<br />
Many health plans have begun posting health provider price information on their Web sites for members. <br />
<br />
The online health plan tools let consumers compare prices among network physicians and find the price of diagnostic tests and other treatments.<br />
<br />
<strong>Independent Web Sites</strong><br />
<br />
Several companies have launched Web sites aimed at providing consumers with better medical price information.<br />
<br />
PriceDoc.com lets consumers enter their ZIP codes to find health care providers in their area who have posted their prices online. In addition, consumers can enter a price they are willing to pay for a medical service, and health providers will respond if they are willing to accept that price. <br />
<br />
HealthcareBlueBook.com collects prices paid for specific treatments and procedures in areas throughout the country and then identifies what it determines to be a range of fair prices. <br />
<br />
OutOfPocket.com uses price information that consumers provide to determine a going rate for specific health care services throughout the U.S. <br />
<br />
<strong>Online State Data</strong><br />
<br />
Meanwhile, at least 33 states require hospitals to publicly disclose their prices. <br />
<br />
However, most of the state sites listed the most expensive, non-discounted prices. In addition, most of the Web sites do not include bundled costs meaning that the sites might list the price of a general surgery but not include the surgeon's or anesthesiologist's fees (Konrad, New York Times, 11/28). <br />
<br />]]></full> 
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             <title><![CDATA[Online Shopping Site Dedicated to Over-the Counter Medications Approved for FSA/HSA Claims]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=8</link> 
             <description><![CDATA[eHealthSource.com Launches Online Shopping Site Dedicated to Over-the Counter Medications Approved for FSA/HSA Claims

eHealthSource.com launched the first online shopping site dedicated exclusively to products approved for Flexible Spending Account or]]></description> 
             <pubDate>Wed, 02 Dec 2009 11:18:00 -0500</pubDate> 
             <guid>http://www.prnewswire.com/news-releases/ehealthsourcecom-launches-online-shopping-site-dedicated-to-over-the-counter-medications-approved-for-fsahsa-claims-78135602.html</guid>
             <author><![CDATA[eHealthSource.com]]></author> 
             <full><![CDATA[<p><strong>eHealthSource.com Launches <a target="_blank" href="http://www.prnewswire.com/news-releases/ehealthsourcecom-launches-online-shopping-site-dedicated-to-over-the-counter-medications-approved-for-fsahsa-claims-78135602.html">Online Shopping Site Dedicated to Over-the Counter Medications Approved for FSA/HSA Claims</a></strong><br />
<br />
eHealthSource.com launched the first online shopping site dedicated exclusively to products approved for Flexible Spending Account or Health Savings Account (FSA/HSA) claims. The site is also the first to exclusively carry value-brand, over-the-counter medications, saving shoppers up to 75 percent on everyday healthcare needs. <br />
<br />
&quot;eHealthSource helps cure two common healthcare headaches - high costs and complexity,&quot; says eHealthSource.com President, Roger Henkin. &quot;For customers, we offer the convenience of one-stop shopping with unbeatable savings on over-the-counter needs. For employers, we provide the tools to help your employees take full advantage of their FSA/HSA programs.&quot; <br />
<br />
Consumers can save in three ways:</p>
<ul>
    <li>
    <p>With more than 400 healthcare products, shoppers will save an average of 40 percent over national-brand products. Shoppers can search by category (such as &quot;allergies&quot;) or by national-brand equivalents (such as &quot;Zyrtec&quot;). For national-brand comparisons, eHealthSource.com provides active ingredients, dosage strength and quantity, and suggested retail price.</p>
    </li>
    <li>
    <p>eHealthSource.com is currently the only online independent retailer with Inventory Information Approval System (IIAS) certification, allowing shoppers to pay for their purchases using FSA/HSA debit cards.</p>
    </li>
    <li>
    <p>Shoppers can also save an additional 10 percent off of their total purchase if their company is a member of the Employer Discount Program. Companies that enroll for the free program receive a discount code that employees can use at checkout.</p>
    </li>
</ul>
<p><br />
For employers, eHealthSource.com offers a no-cost extension of their healthcare benefits. <br />
<br />
By carrying more than 400 FSA/HSA eligible products, eHealthSource makes it easy for employees to take full advantage of their benefit plans. eHealthSource.com helps alleviate employees' &quot;use it or lose it&quot; fears by offering free account management tools such as printable receipts and automatic reminders alerting customers to check their balance before the plan cut-off.&nbsp;&nbsp; eHealthSource.com provides the materials to introduce the program to employees, including print collateral for annual enrollment packages and stand-alone electronic communications.<br />
&nbsp;</p>]]></full> 
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             <title><![CDATA[HDHP enrollees favor lower-cost care options, survey finds]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=14</link> 
             <description><![CDATA[HDHP enrollees favor lower-cost care options, survey finds

Consumers who choose high-deductible health plans (HDHPs) favor lower cost care options, including generic drugs over brand drugs and efforts to improve their]]></description> 
             <pubDate>Wed, 18 Nov 2009 12:49:53 -0500</pubDate> 
             <guid>http://ifawebnews.com/2009/04/21/hdhp-enrollees-favor-lower-cost-care-options-survey-finds/</guid>
             <author><![CDATA[Bob Graham]]></author> 
             <full><![CDATA[<strong><a target="_blank" href="http://ifawebnews.com/2009/04/21/hdhp-enrollees-favor-lower-cost-care-options-survey-finds/">HDHP enrollees favor lower-cost care options, survey finds</a></strong><br />
<br />
Consumers who choose high-deductible health plans (HDHPs) favor lower cost care options, including generic drugs over brand drugs and efforts to improve their wellness.<br />
<br />
&ldquo;Our research concludes that people are beginning to understand the importance of choosing healthier lifestyles, asking their physicians more questions about treatment options, and proactively making the right decisions for their wellness. The role of the health care consumer has become more and more prominent,&rdquo; said Dr. Esther Nash, senior medical director and co-chair for the Office of Consumerism at Philadelphia-based Independence Blue Cross, in a statement.<br />
<br />
Nash added that consumerism is &ldquo;rapidly changing the health care industry.&rdquo;<br />
<br />
The IBC researchers caution that consumers would do even better if they were better educated on the issues surrounding their health care.<br />
<br />
The research offers a glimpse at some of the benefits health insurers have been predicting would arise when people became better acquainted with the costs associated with their health care decisions.<br />
<br />
In 2008, about 6% of all new health enrollment in the large-group market came in HDHPs and Health Savings Accounts, according to America&rsquo;s Health Insurance Plans. Industry experts expect that number to continue to increase as employers fight the effects of the recession.<br />
<br />
IBC commissioned two studies to learn more about employer groups&rsquo; and consumers&rsquo; attitudes towards taking active roles in their health care and whether their behaviors back up their beliefs. Scott Post, IBC&rsquo;s vice president of marketing and co-chair of the office of consumerism, said the shift to consumerism forces everyone in the health care system to participate fully.<br />
<br />
&ldquo;Everyone plays a role in this transformation, from the broker who sells health care plans, to the employer who offers health coverage to his employees, to the physician who treats patients, to the end consumers who ultimately make the decisions that play a huge part in how healthy they are,&rdquo; Post said.<br />
<br />
Consumers in HDHPs, especially those dealing with chronic conditions, appear to be more engaged in making health care decisions than consumers in more traditional managed care plans such as HMOs or PPOs, according to IBC research. Exactly 57% of HDHP members with chronic conditions say they are actively involved in treatment decisions, compared to 37% of members who are in other managed care plans.<br />
<br />
With a key to HDHPs being consumer access to information, researchers found that consumers are not yet confident in their ability to make health care decisions and they continue to look for guidance from traditional sources such as friends, family and their physicians. However, consumers have now begun to regard their health plans as a viable source for information, particularly when exploring treatment options or the cost of care.<br />
<br />
In general, consumers remain unwilling to accept inconvenience to get a better price for health care. However, HDHP members are more likely to take actions for a better price such as using a primary care physician over a specialist or changing the location for taking a diagnostic test. When consumers do ask questions, they primarily pertain to the cost of prescription drugs, IBC researchers found.<br />
<br />
The top health care decision where consumers said they would make a choice to save money is opting for a generic over a brand name prescription drug.<br />
<br />
The IBC researchers also found that half of employers surveyed said they are likely to offer a wellness rewards program to their workforce and believe it will lead to healthier employees. Nearly 85% of the surveyed employers believe that the best way to control health care costs is for people to take better care of themselves.<br />
<br />
Nearly two-thirds of consumers surveyed would be likely to participate in incentive programs if it were available to them. Consumers also said if their employers offered incentive programs, it would show that they cared about their employees.<br />
<br />]]></full> 
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             <title><![CDATA[Lifting the Veil on Pricing for Health Care ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=7</link> 
             <description><![CDATA[This article will be important to consumers in High Deductible Plans. &nbsp;Anna Mathews tells the story of a gentleman in his 60s who, armed with the knowledge of what outpatient]]></description> 
             <pubDate>Wed, 28 Oct 2009 9:33:01 -0400</pubDate> 
             <guid>http://online.wsj.com/article/SB10001424052748704222704574499623333862720.html?mod=WSJ_hpp_RIGHTTopCarousel#printMode</guid>
             <author><![CDATA[ANNA WILDE MATHEWS]]></author> 
             <full><![CDATA[This article will be important to consumers in High Deductible Plans. &nbsp;Anna Mathews tells the story of a gentleman in his 60s who, armed with the knowledge of what outpatient gastrointestinal surgery should cost, was able to find a surgery center that charged him $900; rather than the $4200 he was originally quoted.&nbsp; <br />
<br />
Websites such as HealthcareBlueBook.com are providing consumers the ability to research what a reasonable cost should be.&nbsp;&nbsp; Although prices may not be exact, consumers can at least get an idea of what the typical price should be&nbsp;in their area.&nbsp; Hospitals and other providers generally don't publicize how much they're paid for services.&nbsp; (Often it depends on who is paying).&nbsp;Insurers don't often reveal the negotiated rates either.&nbsp; Also, with higher deductibles, co-insurance, and co-pays,&nbsp;consumers are finding they have &quot;more skin in the game.&quot;<br />
<p>To read the full article and learn how it can help you, click here:&nbsp;&nbsp;&nbsp;<a target="_blank" href="http://online.wsj.com/article/SB10001424052748704222704574499623333862720.html?mod=WSJ_hpp_RIGHTTopCarousel#printMode"><strong>Lifting the Veil on Pricing for Health Care </strong></a></p>]]></full> 
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             <title><![CDATA[Health Plan Members Pleased with Their HSAs ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=4</link> 
             <description><![CDATA[
Health Plan Members Pleased with Their HSAs 
John Commins, for HealthLeaders Media, September 25, 2009

Most employers and account holders using health savings accounts and HSA-qualified health plans are satisfied with]]></description> 
             <pubDate>Fri, 25 Sep 2009 12:00:00 -0400</pubDate> 
             <guid>http://healthplans.hcpro.com/print/content/239539/topic/WS_HLM2_HEP/Health-Plan-Members-Pleased-with-Their-HSAs.html</guid>
             <author><![CDATA[John Commins, HealthLeaders Media]]></author> 
             <full><![CDATA[<br />
<a target="_blank" href="http://healthplans.hcpro.com/print/content/239539/topic/WS_HLM2_HEP/Health-Plan-Members-Pleased-with-Their-HSAs.html"><strong>Health Plan Members Pleased with Their HSAs </strong></a><br />
<em>John Commins, for HealthLeaders Media, September 25, 2009</em><br />
<br />
Most employers and account holders using health savings accounts and HSA-qualified health plans are satisfied with their coverage, spend less, and are more engaged in managing health benefits, two HSA industry-sponsored surveys indicate.<br />
<br />
The surveys, conducted last spring, examined employer and account holder selection and use of HSAs as well as health plan participation, behaviors related to plan usage, and satisfaction with product features.<br />
<br />
The surveys, sponsored by HSA administrators ACS and subsidiary Buck Consultants, found that:<br />
<ul>
    <li>84% of account holders say their HSA-qualified plans are affordable.</li>
    <li>72% of account holders say they pay the same or less than a traditional type of health plan.</li>
    <li>After moving to an HSA, more than half of account holders say they more closely monitor their healthcare costs, while 48% read their medical bills more closely than when they did not have an HSA, 46% have a better understanding of where their money goes, and 40% more closely evaluate costs before electing medical services.</li>
    <li>81% of account holders said the ability to personally control healthcare costs is an important factor that caused them to select an HSA.</li>
    <li>Of the employers offering HSAs for more than three years, 86% indicated that plan costs were the same or less than the previous year.</li>
    <li>96% of employers claimed that HSAs allow the company to continue offering group-sponsored health insurance.</li>
</ul>]]></full> 
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             <title><![CDATA[How Store Credit Cards Trap You]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=93</link> 
             <description><![CDATA[Store specific credit cards can often be a debt trap to consumers.  They are relatively easy to obtain but are often accompanied by high interest rates.  This article]]></description> 
             <pubDate>Tue, 30 Nov 1999 12:00:00 -0500</pubDate> 
             <guid>http://money.msn.com/credit-cards/how-store-credit-cards-trap-you-investopedia.aspx</guid>
             <author><![CDATA[Rachel Brown ]]></author> 
             <full><![CDATA[Store specific credit cards can often be a debt trap to consumers.  They are relatively easy to obtain but are often accompanied by high interest rates.  This article addresses some of the pitfalls of store credit cards and offers some tips on how to use them wisely.<br />]]></full> 
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             <title><![CDATA[New College Grads Value Health Insurance More than Parents May Realize]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=94</link> 
             <description><![CDATA[Health insurance is important, and an increasing number of recent college graduates are realizing that.  A recent survey revealed that nearly half of college grads would be willing to]]></description> 
             <pubDate>Tue, 30 Nov 1999 12:00:00 -0500</pubDate> 
             <guid>http://www.dailyfinance.com/2011/06/01/new-college-grads-value-health-insurance-more-than-parents-may-r/</guid>
             <author><![CDATA[Dawn Kawamoto]]></author> 
             <full><![CDATA[Health insurance is important, and an increasing number of recent college graduates are realizing that.  A recent survey revealed that nearly half of college grads would be willing to take a job they didn&rsquo;t like if it meant they&rsquo;d have health insurance.  This article also discusses rules for keeping adult children on their parents&rsquo; health plans and alternative insurance options.<br />]]></full> 
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             <title><![CDATA[5 Characteristics of a Good 401(k) Plan  ]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=95</link> 
             <description><![CDATA[What separates a good 401(k) plan from the rest?  There are a few key features you should know about, which can impact the success of your retirement.  Make]]></description> 
             <pubDate>Tue, 30 Nov 1999 12:00:00 -0500</pubDate> 
             <guid>http://money.usnews.com/money/blogs/the-smarter-mutual-fund-investor/2011/05/09/5-characteristics-of-a-good-401k-plan</guid>
             <author><![CDATA[Roger Wohlner]]></author> 
             <full><![CDATA[What separates a good 401(k) plan from the rest?  There are a few key features you should know about, which can impact the success of your retirement.  Make sure you know what characteristics to look for in your plan.<br />
<br />
<br />]]></full> 
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             <title><![CDATA[I’m 70.  Should I put more money into annuities?]]></title> 
             <link>http://streetwisehealth.com/?v=news&amp;id=96</link> 
             <description><![CDATA[When deciding whether to increase your annuities stake, you may wish to consider how much retirement income you&rsquo;ll need overall.  It&rsquo;s also important to think about what percentage of]]></description> 
             <pubDate>Tue, 30 Nov 1999 12:00:00 -0500</pubDate> 
             <guid>http://money.cnn.com/2011/06/03/pf/expert/retirement_saving_annuities.moneymag/?section=money_latest </guid>
             <author><![CDATA[Walter Updegrave]]></author> 
             <full><![CDATA[When deciding whether to increase your annuities stake, you may wish to consider how much retirement income you&rsquo;ll need overall.  It&rsquo;s also important to think about what percentage of your income you want from assured sources or from diversified portfolios of stocks, bonds, and cash.<br />]]></full> 
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