The American Diabetes Association (ADA) recommends that people with pre-diabetes take these steps:

• Lose a modest amount of weight (5 to 10 percent of current weight) through diet and exercise.
• Engage in moderate physical activity, such as brisk walking, for 30 minutes daily.

According to the ADA, these simple lifestyle measures can turn back the clock, and even return a person’s blood sugar to normal.

1. A failure of employers to agree to “narrow networks” of providers and thus be able to drive down prices
2. The end of the oversupply of hospital beds
3. Provider clout due to name recognition (only for the “have” hospitals, not the have nots.

Further industry consolidation has taken three main forms over the last few years:

1. Multi-hospital chains are buying more hospitals,
2. Hospitals are employing more physicians directly, and
3. Physicians are consolidating into groups.

Physician consolidation is particularly interesting.  Physicians consolidate not only to gain negotiating leverage, but a larger practice allows for physicians to start performing ancillary services such as labs and imaging.

The first task is to understand what we are taking about.  Gluten is a core protein in wheat and to a lesser extent in barley and rye and possibly oats.  It gives baked products structure and pliability.  The mushy carbohydrate fraction of these grains causes no problems in people whose intestines do not tolerate gluten, but since the carbohydrates in grains are hard to separate from the proteins, the easiest way to avoid gluten is to avoid most grains and the products made from them.

Though grains have been dietary staples for thousands of years, some people have a genetic pattern that makes their intestines see gluten as an alien worthy of attack.  Many people, perhaps 30 to 40 percent of the Western population, have this genetic makeup, but most have no trouble eating grain products that contain gluten.  This means that other, non-genetic factors, as yet unknown, are setting off the immune response to gluten.

In people who do react negatively to dietary grains, gluten fragments act like bacterial or viral invaders, stimulating immune cells in the small intestine’s lining to attack them.  In the process, inflammation damages the villi, which are little fingerlike projections in the lining.  Normally, millions of villi make the surface area of the small intestine hundreds of times larger than it would be if the lining cells were smooth and flat.  This huge surface area increases the ability of the intestine to absorb food.

Early detection, patient education and support are the keys to getting the cost under control, improving outcomes and ultimately improving the quality of life for these patients. Patients can obtain and maintain optimal health by using principles of healthcare education and behavior modification. Attending physicians will need to have available patient specific information and data on nationally recognized standards. This will ensure that all of the patient’s treatments are aligned with an intervention plan that is designed to improve financial and clinical outcomes.

The corporate in-house medical care is geared to cut absenteeism while reducing employee medical bills, which in turn yields healthier employees that make for a greater workforce. Large companies such as Disney, American Express, and NBC Universal have invested in centers where employees are offered medical care at small costs. The benefits for patients are clear:

• Cost/Time efficient
• Convenient
• Family friendly
• Reduced stress levels

The innovative medical centers do it all- from orthopedics to orthodontics in the same place. Skeptics wonder if quality of care is sacrificed, yet there seems to be a high level of satisfaction in the companies and employees alike. Praveen Samudrala is a software engineer and patient who spoke to LA Times: “It saves me a lot of time,” he said of the health center. “I don’t go to outside doctors anymore.”

Critical illness insurance pays a set amount to insured people when they’re diagnosed with or suffer heart attacks, cancer, strokes, coronary artery bypass surgery, major organ failure, transplants or other specified major medical conditions.           

According to recent statistics, heart attacks, stroke and coronary artery bypass surgery together made up 58% of critical illness claims in 2010.  Cancer accounted for another 35%.  Other condition, including kidney failure and transplants, were responsible for the remaining claims. 

Not only can these illnesses be extremely expensive to treat, there are often significant nonmedical expenses, so even employees with good major medical coverage may be left with large bills unpaid. Voluntary critical illness plans pay benefits directly to the insured individuals, unless they specify otherwise. They can then use the money for nonmedical expenses – such as mortgages, groceries, electric bills, child care, or travel to and from a treatment center – or for uncovered medical expenses, including deductibles, treatment bills, rehabilitation or home health care expenses.           

Without adequate protection, people who suffer a heart attack or stroke, or undergo coronary artery bypass surgery, might have to use their savings or rely on the financial aid of family members to cover their expenses.  In fact, nearly a third of Americans report their family had had problems paying medical bills, with 18% reporting bills in excess of $1,000.  (Kaiser Tracking Poll, 2008) 

A critical illness plan is for survivors. Some people may never be able to return to their old lifestyle, go back to the same jobs or return to work at all.  Instead, they’ll face a new way of life focused on recuperation, recovery and rehabilitation.  Benefits from a critical illness plan can help ease financial worries so they can focus on getting well instead of paying the bills.

This applies to Washington too!!

On the other hand, numerous patients simply do not mean to ‘skip a day’. Forgetfulness may play a large role in patient noncompliance, whether it be forgetting to run to the pharmacy or forgetting to take the medicine at specific times day to day. Unfortunately, the doctor’s job is not to hold the patients’ hand and remind them about their medication, so there is little they can do to enforce prescription adherence.

Doctors simply cannot treat diabetes or heart disease in the office. It requires work from both parties, and patients who don’t take their medication cannot be treated. In turn, patients who can’t be treated may be subject to:

• Dangerous health issues
• More hospital time (and costs)
• Hospital re-admittance (and re-admittance fees)
• Lower mortality rates

Before going to bed at night and skipping out on medicine or further postponing trips to the pharmacy may seem harmless to patients now, but they may not feel the same way when they suffer dramatic consequences to their health and wallets later on.

According to the 12th annual survey from the Transamerica Center for Retirement Studies, thirty-nine percent of American workers plan to retire after age 70 or don’t plan to retire at all. For the sixty-one percent whose plans are to retire before 70, a solid retirement plan is going to be high up on the list of necessary benefits in an employer. For those who plan on retiring later or not at all, a good retirement plan may not mean much; given circumstances don’t change and things remain the same.

Unexpected changes may force some into retirement though, which is less stressful when the employee knows they can rely on their benefits to protect them in changing and potentially rough times.

In spite of the fact that workers say they might know how to get in good physical shape, many are not taking action to do so. Most (84%) think making wise decisions in everyday life leads to excellent overall health, and about three-quarters (72%) think good health is a consequence of getting regular preventive care. Only 46% of the workers surveyed reported doing a “great” or “good job” of regular exercising and only about half of the workers think they do a “great” or good job” of eating healthy. 

While satisfaction is by and large high in health programs, participation is low. Participation in a lot of employer provided health programs is not as high as many businesses would like to see, even though employees and their dependents report that they know what they need to do to get and stay healthy.

Biometric screenings are the most popular programs with online health information tools and health risk questionnaires following closely. Stress management programs and employee assistance programs (EAPs) were the least popular, with just nine percent participation in each.

Financial motivation is a strong factor in participation but non monetary, internal motivators can be just as effective. Many businesses presume that offering cash incentives in exchange for involvement will generate the best results and incent employees to participate in health care programs. Nearly half of the surveyed employees would complete a health-risk questionnaire (HRQ) without any incentive because it is “the right thing to do”. About 30% of the individuals would complete a survey if there was a penalty for not doing so and an additional 30% would do it if there was a monetary incentive involved. In addition, 44% of the workers surveyed said they would be willing to take part in a wellness program furnished by their employer because “it’s the right thing to do”.