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Reframing Healthcare in the Minds of Younger Americans

August 27, 2013 in fitness, health care costs, health care quality, Health Insurance, lifestyle, mental health, nutrition

The clock is ticking towards October 1, 2013 when public insurance exchanges are set to go live and begin offering health plan benefits to an estimated 30 million previously uninsured Americans. And as that day draws closer, all parties involved—plans, providers, employers, and patients—are scrambling to figure out just what it will mean to them from a cost and quality of care perspective. Yet, perhaps one of the biggest conundrums associated with the health insurance marketplace is how to deal with the potential sticker shock facing younger Americans and the ripple effect it could have on everyone. Specifically, with an age band as narrow as 3:1, there is a possibility that premiums for younger people (who tend to be lighter users of service) will be considerably higher in order to compensate for older Americans, who typically utilize more health care services. When combined with a relatively low penalty for not getting coverage, there is a very real fear that many of these ‘young invincibles’ will forgo coverage and simply choose to pay the penalty.

So, the question becomes, ‘how do we articulate the value of health coverage to this younger generation?’ or, in other words, convince them that coverage is relevant (and worth it) to them?

We need to help this younger population understand and believe that healthcare is not solely about supporting the sick – support is also critical for the well. For example: a recent college grad that is just starting out in his/her career and may have issues dealing with the stress of that new job; the twenty-something who runs marathons but wants to improve their nutrition; the new mother who wants to start a workout program to shed some of the baby weight; or the avid skier who suffers a knee injury on the slopes and wants to understand what treatment options are available to them.

These scenarios play out each day across the U.S. and could happen to just about anyone between the ages of 18-35, not solely older people or those with chronic conditions. And there are programs, resources and tools focused on shared decision making and wellness that are critical components of modern healthcare that young people can take advantage of. So at the core, the solution for this current dilemma needs to be about making the younger population aware of these resources because they support behaviors that contribute to better health and wellbeing. Specifically, we need to create a  culture that encourages all people—including the younger population—to think differently about their health, make more informed choices, and understand not only the resources at their disposal but also the value they provide.  If we can do that, we will go a long way in positively impacting the health and wellness of these younger generations and controlling spiraling healthcare costs.

Robert Mandel, MD, MBA, is the CEO of Health Dialog and has more than 15 years’ experience in senior leadership positions in health systems and health plan management. 

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Is caffeine withdrawal a mental health issue?

August 11, 2013 in lifestyle, mental health

Brietta’s graphic begs the question, are the effects of too much caffeine and the withdrawal messing with our mental health?

The American Psychiatric Association says it’s time for some rigorous research and has included caffeine withdrawal in its latest Bible, the DSM-5.  Here’s why:

Picture 10 Click here to play the video

Exercises to ease back pain

May 15, 2013 in fitness, health care costs, lifestyle, Member Stories

I’ve always been a money-saver  When I was younger, my mom looked in wonder as I handed her my birthday money and asked her to put it in the bank for me. I might not have had a Razor scooter like all of the other kids, but hey, I was able to pay off a third of my college loans before I even graduated. This frugal attitude has lead me to believe that I can save money in any situation, even when it comes to my health.

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I still go to the doctor when I have to (broken bone, the flu, etc.), but if I ever see a chance to avoid a trip to the doctor, I’ll take it. A couple of years ago I hurt my upper back when I was playing in a rugby match (poor choice of sport), and now I have a tight muscle that flares up every now and then. When the injury initially occurred, an athletic trainer told me that I could get an MRI, but that it wouldn’t do much for me. In a nutshell, the MRI could possibly reveal what was wrong with my back, but even if it did, the doctor would probably recommend the same thing that I could have come up with on my own: exercise.

According to an article on, Read the rest of this entry →

Do Not Covet Thy Neighbor’s Medicine

May 8, 2013 in lifestyle, Member Stories

Back in the day, sugar sprinkled with a spoonful of gossip was the typical commodity to share over the fence between neighbors and friends.  Perhaps if cooking or scandal was not your forte, then an innocent request for a snow blower may be on par.  Yet today, what is freely passing over neighborly coffees and talk of petunias is prescription medications whereby turning innocent backyards into outdoor pill dispensaries.

It is common to hear that we have become desensitized.  Typically desensitization refers to such offensive stuff such as violent carjacking video games, bad manners and daily mentions of ill at large.  Yet, we have also become immune to the dangers that lurk deep in the bowels of our own medicine cabinet and the quick impulse to dole out said medicine.  Perhaps in a neighborly gesture gone array, friends teeming with good intentions, offer their prescription meds to others in need of a pill.

Sharing we are taught is a good thing.  From days long before we can even remember, our mothers were reminding us and scolding us to share, share, share.  Share your favorite toy, share that half eaten cracker, share the remote with your brother.  Thus, it may only be succumbing to a natural instinct that to see a friend in need illicits a helpful response.  Urinary tract infection? Oh here are some unused antibiotics.  Stress at work or a big presentation coming up?  Here is some Adderall or Ritalin.  Wisdom teeth bothering you?  Here’s some Oxycontin.  Bad breakup?  Here’s a Valium. That’s what friends are for after all.

According to a Center for Disease Control and Prevention study, women 18 to 44 lead the trend.  Over 36% polled in this group, admitted that they have either lent or borrowed a prescription drug from a friend or family member. Read the rest of this entry →

Value of yoga

May 6, 2013 in fitness, lifestyle, Member Stories, News

I’ve never been one for yoga. My roommate has been trying to get me to go to a class with her for months, but I always tell her that I’m more of a cardio kickboxing type of girl. What can I say? I’d rather de-stress by punching and kicking the air than pose like a tree. However, I might now consider going to yoga after a recent study was released that claims yoga does much more than relax the body and mind; it can actually change the expression of genes.

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According to a new study from the Benson-Henry Institute for Mind/Body Medicine at Massachusetts General Hospital (MGH)  and Beth Israel Deaconess Medical Center, “elicitation of the relaxation response – a physiologic state of deep rest induced by practices such as meditation, yoga, deep breathing and prayer – produces immediate changes in the expression of genes involved in immune function, energy metabolism and insulin secretion.”

The study consisted of blood samples from 26 healthy adults who had never participated in relaxation response practices. The samples were taken before and after they completed an Read the rest of this entry →

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Avoiding the sugar/fat blahs

December 24, 2012 in lifestyle, nutrition

Cookies, candy, cheese rolls, eggnog…the temptations of the holidays are everywhere you turn.  So we put together a list of our favorite tips for avoiding the sugar/fat blahs and the extra pounds.  Please add yours!

Drink a big glass of water before you eat or drink anything else at a party.

Use a napkin, not a plate – it can’t hold as much.

Go for color: carrots, peppers, broccoli, celery.

Give yourself a pedometer and challenge someone to beat your step count every day.

From Kathleeen Zelman at WebMD:

Wear snug clothes and keep one hand busy. When you wear snug-fitting attire, chances are you’ll be too busy holding in your stomach to overeat. While you stand around looking posh in your holiday finery, hold a drink in your dominant hand so it won’t be so easy to grab food.

Chew gum. When you don’t want to eat, pop a piece of sugarless gum into your mouth. This works well when you’re cooking or when you’re trying not to dive into the buffet.  Breath mints work too.

Be a food snob. If you don’t love it, don’t eat it. Read the rest of this entry →

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How healthy is your state?

December 17, 2012 in health care costs, lifestyle, News

Vermont is no. 1, again, in the annual health ranking of states from the United Health Foundation. Here’s more from the foundation’s summary:

Hawaii is ranked second this year. New Hampshire is third, followed by Massachusetts and Minnesota. Mississippi and Louisiana tie for 49th as the least healthy states. Arkansas, West Virginia, and South Carolina complete the bottom 5 states.

My state, Massachusetts, is 4th overall, but 40th when it comes to binge drinking (is that because we have so many universities?) and we have a high rate of preventable hospitalizations (is this a case of supply driving demand?).

Plan Ahead for International Travel Medical Bills

November 2, 2012 in health care costs, Health Insurance, Insurance Bills, lifestyle, Medical Care, Medicare, Member Stories

You may be closing out 2011 with a holiday trip, domestically or internationally. If you plan to leave the country, you may want to consider the following when it comes to your health:

  • You may not have health insurance coverage for illnesses or injuries that are treated abroad, even if you have US based medical coverage. Confirm with your benefits administrator.
  • Generally, Medicare does not provide coverage for hospital or medical costs incurred abroad, however, rare circumstances may be covered.
  • AARP can assist with obtaining foreign medical coverage and offers valuable travel tips.
  • US consulate personnel will help you locate health care providers and facilities and even contact family members, if necessary.
  • You can purchase travel insurance that covers health care needs and pays for medical evacuation if you need to be transported back to the US for treatment.

Obtaining medical treatment in another country can be expensive and a medical evacuation can cost over $50,000. Plus, you may encounter challenges with deciphering charges while abroad. Be vigilant, prepared, and follow the same self-advocacy steps you would while receiving medical care in your home state.

If you choose to purchase medical expense coverage while travelling abroad, double check you’ve carefully researched the following:

What am I supposed to give my kids to drink?

September 24, 2012 in diabetes, lifestyle, nutrition

Water is the short answer, I know.  But my three teenagers hurl accusations of child abuse when I suggest a “water only” policy at home.

So we drink lots of juice. I don’t buy soda, although the kids do with their own money.  Last week one of my sons started comparing the sugar content in soda with some of the juice in our fridge. Call me stunned.  OK, I’ve been watering down juice (I aim to dilute by half) for years (which the kids also hate) because it’s too sweet.  Still, I had no idea that they were drinking 8 teaspoons of sugar or more in a cup of juice if they got to the bottle before I watered it down.

FYI – sugar on most nutrition labels is measured in grams.  Four grams are roughly equal to one teaspoon.  There are some good visuals here:

Several studies posted online by the New England Journal of Medicine last week compared sugary and non-caloric beverages.  The sugar free or diet stuff is out for me, too many chemicals. And, as I said, water is a tough sell.

So what am I supposed to buy?

A colleague suggests lots of seltzer and persuading my kids to mix a spritzer – that’s worth a try.  Any other suggestions?

Six tips for the running enthusiast

August 21, 2012 in fitness, lifestyle, Member Stories

Boston Esplanade Runner by mcritz/Flickr

Running is my favorite way to exercise, especially in the summer. After completing my first half-marathon, I learned that running can also take a toll on your body once you start increasing your mile-time and distance. To learn more about things every runner should know, I spoke with Dr. Pierre d’Hemecourt at Children’s Hospital’s Running Clinic. Here are a few take-aways from our conversation that could be re-affirming- and possibly enlightening- for the running enthusiast:

Fueling up- The carbs that help:  Holding off on breakfast till after your morning run isn’t the best idea. “You want to get some carbs in [before] the run, preferably 2-3 hours prior,” says Dr. d’Hemecourt. Simple carbs, like pancakes or cereal, will give you the most available fuel.  He also recommends re-fueling on carbs with protein after every run. And yes, chocolate milk counts! Dr. d’Hemecourt says this is a great way to restore your energy reserves after your run because it gets “glycogen back in [the] muscles.”

Hydration- Don’t overdo it: When I was preparing for my race, I remembered reading about avoiding over-hydration. I didn’t really think it was possible, but apparently it happens a lot, especially during temperature extremes. Common symptoms include headache, feeling confused and bloating. “People take in too much fluid and are not getting rid of it,” says Dr. d’Hemecourt. To determine if you’re drinking too much water, you should weigh yourself, without clothes, before and after running to see if there’s a difference in weight. If you’re running between one and one and one half hours, you should expect to lose 2% of your body weight, according to Dr. d’Hemecourt. If your weight is the same (or greater) after your run, then you’re drinking too much water.  

Proper footware and over-striding- The case for minimalist shoes: When Vibrams and other “minimalist” sport shoes came out on the market, there was a lot of talk on whether or not running in your traditional sneaker was the smart thing to do. Read the rest of this entry →

Using mobile apps to manage your weight loss goals

July 30, 2012 in lifestyle, Member Stories

One of these could be your next weigh loss coach- Group of Smartphones- By gillyberlin (Flickr: Motorola Milestone Test) via Wikimedia Commons

My smartphone earned its place at the top of my list of favorite things when I used it to keep a food diary during a month-long weight loss challenge with a few of my friends in the Spring. Normally, I would be turned off at the idea of jotting down everything I ate, but research has shown that keeping track of what you eat leads to greater weight loss. And during the challenge I found that using my phone was really helpful in tracking the calories I ate and the calories I burned, which is half the battle of weight loss- burning more calories than you consume.

When we started talking about the challenge, I initially felt one month wasn’t enough time. But my friends convinced me that it would be fun to do for the moral support, results aside. My friend suggested using the MyFitnessPal app as a way to monitor our progress. After putting in my weight, height, and goal weight, the app gave me a daily calorie count to meet that goal. It was pretty easy to keep a food diary, too, because my new Pal took care of the math for me. I just selected the foods I ate from the database of food items, with calorie, fat and carb totals pre-calculated, after each meal.

Adding in the calories I burned was pretty easy, too. For every time I went on a run, I just entered the length of the run and about how fast I was going to get a total of calories burned. Granted, all of these are estimates, but seeing these numbers helped me become more aware of how I should choose what I eat throughout the day. Read the rest of this entry →

Massachusetts 2012 Ballot

July 23, 2012 in lifestyle, News

Two of three measures on the Massachusetts statewide ballot for 2012 relate to healthcare.

One is the Medical Marijuana Initiative and the other is the Death with Dignity initiative.

On the face of it, I favor both for the reason of allowing people to control their own destinies when possible and when others are not being harmed.  In other words, In these cases, I support the Platinum Rule over the Golden Rule.  (For comparison, see or search online for Platinum Rule.)

Benefits of a vegetarian/pescetarian diet: My transition to a (mostly) meat-free lifestyle

July 6, 2012 in lifestyle, Member Stories

Lately, I’ve been considering cutting meat out of my diet. After a recent walk home from an indulgent dinner of General Tso’s chicken at a local Chinese restaurant, I realized just how sluggish I felt. Typically, I’m the girl that craves burgers and loves buffalo wings paired with a beer at the bar, but I’ve given up meat and poultry once before and saw real benefits from it. I lost a little weight and felt like I had more energy. So, now I’m ready to make the transition back to a mostly meat-free diet. Allow me to explain what I mean when I say “mostly meat-free.” I’m not opting for strict vegetarianism. I’m leaning toward taking on the pescetarian diet- avoiding red meat and poultry by opting for seafood alternatives instead. I also think placing a ban on all meat could be too tall of an order for me- more on that later.

Ever thought of trying out the vegetarian/pescetarian side of life? There are many benefits from taking the plunge. Cutting down on meat can lower your risk for heart disease by reducing calories, saturated fat and lowering the bad cholesterol in your diet, says the Mayo Clinic. And if you’re into eco-friendliness, you can feel extra good knowing that cutting back on meat can ultimately reduce your carbon footprint, another benefit touted by the Meatless Mondays movement.

I plan to do things a little differently in my second attempt to cut back on meat by actually cooking tasty, healthy vegetarian food instead of just opting for a tuna sandwich. I found a few websites that could be helpful to the vegetarian or pescetarian in the making: Read the rest of this entry →

Wellness- A Different Type of Savvy

June 19, 2012 in lifestyle, Member Stories

These days you’ll find the word “health” followed by the words “and wellness.” “But aren’t they the same thing?” you may ask.

Well, yes and no. To be precise, Merriam-Webster defines wellness as “the quality or state of being in good health, especially as an actively sought goal.”

Me hiking along the beach at Discovery Park with a view of Puget Sound- Seattle, WA

Health and wellness are intertwined. Wellness is the combination of your daily choices and activities that sustain your health now and for the future. And for those with chronic diseases, demanding jobs or families to care for, being well takes a little more work and creativity. So over the next couple of weeks, I’m going to bring you information on how you can make wellness fit into your day-to-day.

We’ll talk about how stress, exercise and good nutrition fit into the many facets of your health and where you can find information to fortify you on your journey to wellness.  And even better- we’ll focus on ways you can make wellness part of your life at little to no cost to you.

In the next part of this wellness series,  I’ll discuss finding community in your search for wellness. We’ll look at how social networks can help newly-diagnosed patients navigate treatments and manage symptoms through highlighting a few social networks  for diabetics.

Wellness starts with you- beyond the doctor’s office, referrals and co-pays. Feel free to let me know if there’s anything specific you’d like to learn more about.

With well wishes,