21. November 2012 · Comments Off · Categories: Health Law, Health Trends

Yesterday, November 20, the bell rang.  CMS issued its proposed rule on insurance exchanges and their requirements.  CMS essentially has reaffirmed what the ACA requires.  This is not unexpected, but it demonstrates how the “sturm and drang” of the dialogue pre-2012 election has now officially been replaced with a certain normality as the proposed rules are released, reviewed, and then made final.  Don’t expect these proposed rules to change much.

The quick take-aways are:

  • Whether state or federally run, or a mix, the all-important insurance exchanges will not be able to deny coverage and will not be able to charge certain types of patients (women, people with pre-existing conditions) more for coverage.  Remember – CMS just gave the states an additional four (4) weeks to consider to what extent they wish to have the federal government involved in running their individual state exchanges.
  • One of the “quid pro quos” of the ACA – that as the number of covered lives is increased, other types of payments to hospitals for caring for the uninsured (e.g. the DSH payments) fade away over time – remains unchanged and is now on track.
  • In the exchanges, insurers will have to cover 10 “basic” health care benefits – such as ER care, maternity care, prescriptions, and hospital stays.

It will be interesting to see in what direction states that have not yet made a choice as to their exchange model choose to go.



19. August 2012 · Comments Off · Categories: Health Trends, Living

The recent issue of Scientific American, which I heartily recommend, contains a short but interesting article on the two primary ways of achieving even greater longevity than we have now.  One, focus on the specific areas of the body that cause trouble and remove/regenerate/replace them.  Two, and alternatively, examine molecular development way down at the molecular level to adjust cellular development in order to “slow down” the aging process.  I am summarizing, of course, so read the article!  But what strikes me is that while living beyond 100 years may be desirable for some, as a society we truly need to address how such lives will be led, and under what conditions for the participants – mentally, socially, and physically.  Our medical and scientific knowledge, we should assume, will outpace our evolutionary and mental capacities for coping with this knowledge.


I’ve decided to spare readers yet another article and/or opinion about the argument before the U.S. Supreme Court on health care reform and the manner in which certain members of the Supreme Court addressed the issues.  I am digesting the arguments and the media’s handling of them.  For now, I have two points. 1. Whether the ACA survives constitutional scrutiny or not, payment reform is happening.  2.  Health care reform is not like forcing folks to eat broccoli.  Sheesh……

Speaking of broccoli, the Concord Monitor today featured an interview with Dr. Lorenzo Cohen, professor of integrative medicine at the University of Texas MD Anderson Cancer Center.  Dr. Lorenzo will give a free lecture this week on lowering “the risk of cancer and improving outcomes for those touched by cancer, through choices in diet, exercise and stress management.”

In the interview, Dr. Cohen, to his credit, spoke of the usual suspects  – diet and exercise.  I did not realize, however, that his research also focuses on stress and stress management.  His work as a research psychologist has led him from the psychological underpinnings of stress to its effects on the immune system.

As a layman, I find this interesting.  What is one way to get stress under control?  Breathing.  What is one way to become a better breather?  Being taught and taking the time to be taught.  What does that require?  Time away from other so-called productive pursuits.  Oh sure, I suppose you could rent a DVD on yoga or breathing techniques, but my sense is that participation in a full “classroom setting” with other motivated participants allows a more focused, and ultimately for those of you keeping count, efficient approach.

Dr. Lorenzo also spoke of the “western lifestyle” in the interview.  Decades ago, I doubt that a “western lifestyle” conjured images of – in Dr. Cohen’s words – “sedentary jobs, weight gain, and exposure to environmental toxins.”  But now in 2012 it does, at least in the international medical community.  In fact, the good doctor stated in the interview that an “anticancer lifestyle” has to with achieving a balance, and doing everything you can to decrease your exposure to the [Editor’s note: “now”] traditional western lifestyle.”

I hope that one take-away from his up-coming lecture will be how to allow us to re-engineer the western lifestyle so all in our society get to partake in the new benefits.