Winter Health Focus

Monday, 11 January 2010 Gayle Eversole

After the New Year the focus seems to be on cleansing. While cleansing is very important for health, especially at the cellular level, winter is the time to direct your efforts to cleansing the kidneys and bladder. Over 19 million people have some form of kidney disease and it is prevalent in people with diabetes.

Some of the foods that promote kidney health include citrus fruit, cranberries, pomegranate, onion, beans, barley, poultry, sunflower seeds and pecans (Visit Leaf Lady for a complete list).

A simple, easy to prepare kidney cleanse is to drink 2 ounces of unsweetened, pure, organic cranberry juice each morning before breakfast. Although the juice will be tart, it supplies special enzymes and fights infection.

During the winter months remember that vitamin A is very important to health and specifically for the lungs.  Historically, using vitamin A in high doses over a short time can help you recover from pneumonia. It's a good idea to add this fat-soluble vitamin to your daily regimen.  Look for a product that includes both fish oil and beta-carotene – at about 25,000 IU.

Don' t forget vitamin D. Current research shows an epidemic of deficient vitamin D levels and the connection to many health problems.  You can get your health provider to order a 25 OH Test to check vitamin D levels. If you don't get enough sun daily or you are a person of color then you should consider taking 6000 IU daily during low light months of the year. Make sure you also include vitamin D3.

And last but not least, make sure you stay adequately hydrated.  During winter the air is dry, especially indoors. You' re more likely to get a cold or flu if you aren't drinking enough water.  Most well informed health providers encourage you to drink 8 – 8 ounce glasses (1.9 liters) of water each day. If you are exercising or trying to lose weight you'll need to consume more water.  There's more about water at Liquids for Life.

Let’s hope these tips get you off to a good start on your road to health...

Gayle Eversole, DHom, PhD, MH, NP, ND, is a natural health educator and advocate. Celebrating 50+ years blending science and the natural healing arts. Sign up for her herbalYoda newsletter.

This article is for educational and informational purposes only and does not take the place of a consultation with a qualified health care professional. Always consult a physician or other qualified health care professional before taking any herbs or applying any therapies. The reader must assume full responsibility for verifying any information or therapies with a qualified physician or health care professional.

 

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BioCrossroads drops dreams for hospital innovation

Sorry, IU Health.

There’s almost no chance of you becoming the next Cleveland Clinic, according to a report released last week by BioCrossroads, the Indianapolis-based life sciences business development group.
That’s because of the new demands for cost-cutting in health care, which are coming from Congress’ budget battles, the influx of baby boomers into the Medicare program and now Obamacare.
There simply isn’t the money available anymore for a hospital to replicate the 65-person staff and dedicated investment funding that Cleveland Clinic uses to turn medical innovations into high-growth companies.
This is not what IU Health or BioCrossroads wanted to hear. The leaders of both organizations had thought that IU Health individually or Indianapolis-area hospitals collectively could become engines of innovation to produce new life sciences companies.
BioCrossroads CEO David Johnson first mentioned the idea to me in early 2008, when I wrote a story about a researcher at Franciscan St. Francis Health who had stumbled on a way to diagnosis and potentially reverse autoimmune diseases.
That research did turn into a company, Redox Reactive Reagents LLC, which is trying to commercialize the technology as a diagnosis for Alzheimer’s disease. But Franciscan decided it wasn’t going to be in the startup game. It sold its stake in the company to the other owners and walked away.
About a year earlier, IU Health CEO Dan Evans had tapped his longtime friend Matt Neff to launch a venture capital arm, CHV Capital Inc., funded by some of IU Health's large endowment.
The firm has backed several Indiana life sciences companies, including Endocyte Inc., Nico Corp. and Perfinity Biosciences Inc. But it’s one attempt to commercialize research from within the IU Health system—a 2008 investment in CS-Keys Inc.—went nowhere.
The BioCrossroads report concludes that “classic innovation models such as the one resident at the Cleveland Clinic are too capital intensive to replicate.”
But BioCrossroads still sees opportunities for local hospital systems to play a major role in health care innovation, not so much by launching companies themselves, but rather by helping entrepreneurs understand the challenges that need to be fixed and then helping them test, refine and scale up their proposed solutions.
The Infuse Accelerator for digital health startups, which is being launched in Indianapolis, is trying to do exactly that. And so is the Hoosier Healthcare Innovation Challenge, an annual event where health care organizations present problems they have to IT entrepreneurs, who try to invent a solution.
A good example is Indianapolis-based Diagnotes Inc. It won the 2012 Healthcare Innovation Challenge and then worked with Community Health Network to pilot its mobile app, which allows doctors and patients to swap key medical records and images over mobile phones—yet without violating federal medical privacy laws.
Community has now signed a contract to use Diagnotes among some of its physicians.
BioCrossroads also thinks Indianapolis’ hospitals can replicate the kind of collaboration that led to the 2004 launch of the Indiana Health Information Exchange Inc., which allows hospitals to swap electronic patient records as needed from one health system to another.
Indianapolis’ hospitals could collective pitch themselves to drug and device companies to attract more of the clinical trials those companies fund, the BioCrossroads report suggested.
The hospitals could also consider forming a joint clinic that would conduct research, clinical trials and education, such as the Orthopedic Capital Clinic being launched by OrthoWorx, a BioCrossroads offshoot, in Warsaw, Ind.
None of those would have the impact of a Cleveland Clinic. But, as I’ve written elsewhere, in this age of austerity, the nature of health care innovation is going to be different than before.

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Blue Cross reaches out over insurance law changes

Just down from the Target and Gander Mountain big-box stores and between a nail salon and dental office, North Carolina's largest health insurer opened its first retail store.

It has some exercise offerings — step aerobics classes and stationary bike workouts — but for now, its main product is providing in-person information about changes coming in October with the health insurance overhaul law.

Blue Cross and Blue Shield of North Carolina is opening half a dozen of these offices in strip malls statewide to first educate and then, starting in October, enroll consumers shopping for coverage because of the federal Affordable Care Act, also known as "Obamacare." Blue Cross affiliates in Florida and Pennsylvania have had similar stores open for years.

The North Carolina company also hauls an air-conditioned showroom trailer to fairs and farmers markets to reach out to the estimated 600,000 people who will be newly shopping for individual policies — some of them subsidized by the government for consumers who might have trouble affording a policy. Many of the individual policies will be sold on a statewide Internet marketplace designed to make buying coverage comparable to finding a hotel room or rental car.

North Carolina's Republican General Assembly and governor oppose the law and so the federal government is running the state marketplace where insurers will sell policies.

As people who have been uninsured or had their coverage provided by employers start shopping around, BCBSNC is reaching out like never before to expand on its 375,000 insurance policies for individuals, marketing director Bruce Allen said. The goal is explaining the federal law, which requires everyone to have coverage or pay a fine and subsidizes many middle-class consumers who might otherwise not be able to afford policies on their own. The law also prohibits insurers from rejecting customers who have pre-existing health conditions.

"There's a big segment of the population that really wants to talk to someone face to face about it," Allen said. "It's a new market that's entering that doesn't have health insurance, never had it, and really needs kind of that step-by-step walk-through to understand a really critical decision for them to make."

Across the country, Blue Cross companies are among the health insurers most aggressive in reaching out to build consumer trust and capture their spending on policies. Spots for a broad new print, television and online advertising campaign are multiplying. Meetings with civic organizations community groups, and religious institutions are taking place from Vermont to Texas. The North Carolina company has rented movie theaters and invited guests to watch first-run films, with the addition of a 15-minute ad explaining the Affordable Care Act and laptop-ready staffers in the lobby offering individual guidance on the law.

The Blue Cross and Blue Shield Association, the umbrella organization for the country's 38 Blue Cross companies, launched a campaign last month with the Walgreen Co. drugstore chain, with signs and brochures in about 8,000 stores.

Indianapolis-based WellPoint, the largest operator of Blue Cross Blue Shield health plans, is teaming up with Spanish-language TV and radio network Univision in California, New York, Colorado and Georgia for meetings, broadcast advertisements, and newscast segments describing what coverage means and how to buy insurance on an online exchange.

Blue Cross Blue Shield companies already are some of the country's biggest sellers of health insurance policies for individuals. Seven Blue Cross companies, including North Carolina's, were among the top 10 at the end of 2011, according to Atlantic Information Services Inc., which specializes in health industry data and news.

"For other insurers, the majority of their experience is in the employer-provided market, so they don't know the individual market as well and are unsure whether this will be profitable, so they're moving very carefully," said David Ridley, director of the health sector management program at Duke University's Fuqua business school. "In contrast, Blue Cross Blue Shield — with their experience in the individual market, its experience interacting with government as the insurer of last resort — is moving much more aggressively and creatively."

Outside the Blue Cross Blue Shield world, Humana Inc. has signaled plans to station representatives in grocery stores and pharmacies in the 14 states where its policies will be sold on online insurance marketplaces. Pittsburgh-based UPMC Health Plan has set up kiosks in six western Pennsylvania malls to reach insurance consumers with questions, and it launched a computer application in an effort to offer a fun way to understand the details of the law and its polices.

Spokesmen for Assurant Health and Aetna described no novel marketing twists tied to the upcoming changes.

Government, too, is ramping up efforts to reach the working poor, young people and others with no health coverage. President Barack Obama's administration and many states are launching campaigns this summer to get the word out. Grassroots organizers are recruiting pastors, barbers and mothers to convey the message. In some neighborhoods, volunteers organized by a coalition of health companies and advocates hand out brochures.

But any company marketing efforts come as most Americans are confused or uninformed about what the new health insurance law means to them. Only about one in five had heard about the health insurance marketplaces as of June, according to a poll by the Kaiser Family Foundation.

"There is a lot of misinformation out there. One of the things that we hear often is that I have to go buy a government plan on the marketplace," Allen said. "We spend a lot of time explaining to people, 'You're going to buy a private insurance plan. There is no government plan.' "

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Board suggested busy Evans let go of AIT

Michael Evans was juggling two companies and two newborn twins when his board of directors suggested it was time for a new CEO of AIT Laboratories.

“I was shocked first of all,” said Evans, 69, a professor of toxicology who founded AIT 23 years ago and led it for all but six months of those years. “The entire board came to me and said, ‘Mike, we think Matt [Neff] should be the president.”

Neff, a local venture capitalist who has been chairman of AIT since October, became its CEO and president Monday, taking Evans’ place.

Between the board’s suggestion and the leadership handoff, Evans had many discussions with Neff. Over time, Evans said, he grew more comfortable with the idea.

“I said to myself, ‘Mike, you were a lab rat trying to run a business. And this is a business that has a lab,’” Evans said. “Matt, he’s a business guy.”

Evans also acknowledged Friday he has not been giving AIT Labs his full-time attention. Evans and his wife have four-month-old twin daughters, and he is also CEO of AIT Bioscience, a 26-person contract research laboratory that turned profitable this year as its revenue runs at double the pace of a year ago.

“AIT’s got a tremendous future. It just needs some good leadership at the top,” Evans said. “It needs a full-time leader and I can’t run it full-time.”

Evans will remain chairman emeritus. But he said he’s “trying” to stay out of Neff’s way, something that he ultimately could not do the last time he handed AIT’s reins to someone else.

In early 2012, Evans stepped down as CEO in place of Ron Thieme, who had been vice president of information technology.

At the time, AIT was just beginning to realize it was suffering a body blow from a reimbursement cut instituted by the federal Medicare program.

On Jan. 1, 2011, the federal Medicare program cut reimbursement 47 percent for basic drug screening tests. Over the following year, most private health insurance plans followed with similarly drastic cuts.

Those cuts affect the urine-drug-analysis tests that make up 90 percent of AIT's revenue. Doctors use such tests to make sure patients suffering from chronic pain are taking the narcotic painkillers at the prescribed dose—not taking too much of them and not diverting them to friends or for sale on the black market.

In late summer of 2012, Evans decided AIT was not turning around fast enough, so he returned as CEO and Thieme left the company.

Evans said he expects this succession to work better because he vetted the decision with many counselors.

“Last time, I made the decision in a vacuum,” Evans said, adding, “I don’t blame Ron, but the financials were not coming around.”

Around the same time as Evans’ return, AIT started forming its first independent board. Neff came on as chairman, along with Dr. Ben Park, CEO of American Health Network, and local venture capitalists David Mann and Carrie Bates.

AIT’s losses in 2011 forced it to restructure its debt with BMO Harris. The bank insisted that AIT bring on Bob Bosar, a local turnaround expert. Bosar led a round of layoffs and cost-cutting moves.

In January, Bosar said the company employed about 350 people, down from nearly 500 in 2011. The company had about $55 million in revenue last year, but has been predicting strong growth this year.

Neff, in a prepared statement, said ongoing reforms to the health insurance industry continue to present difficulties for AIT, but that he likes the base Evans has built.

“I am pleased to be in a position to build upon the work of Dr. Evans, and to collaborate with him to continue the successful growth of AIT Laboratories,” Neff stated. “As health care reform takes hold, addressing the needs of the laboratory testing market will be a challenge.”

Evans had nothing but praise for Neff, who has led CHV Capital Inc. since the Indiana University Health hospital system formed it in 2007. Neff is a longtime friend of Dan Evans, the CEO of IU Health.

“He’s done a great job for Dan Evans at IU Health,” Mike Evans said of Neff. “He’s going to take AIT to the next level.”

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Baldwin & Lyons posts 21-percent boost in profit

Indianapolis-based Baldwin & Lyons Inc. on Thursday reported healthy jumps in second-quarter profit and revenue, spurred by record premiums from the company’s insurance subsidiaries.

The insurer of trucking and auto fleets recorded profit of $4.9 million, or 33 cents per share—a 21-percent jump from $4.05 million, or 27 cents per share, in the second quarter of 2012.

Profit was boosted by investment gains of $467,000. In the same quarter last year, investment losses of $3.5 million dragged down the bottom line.

Revenue jumped 13 percent to $66 million.

The company said premiums written by its insurance subsidiaries hit a record $92.8 million, an increase of 18 percent.

Baldwin & Lyons shares slipped nearly 2 percent in early trading Thursday, to $26.24.

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Already a wreck, the worst is yet to come with Obamacare

In this post on Obamacare in Indiana, I argue why the law will fail. You can read my argument for why Obamacare will succeed here. A third post, arguing why Obamacare will be a “non-event,” will be published on Aug. 8. No single post should be read as my personal view on Obamacare, but rather as my best attempt to analyze the available evidence for three potential outcomes of the law.

Obamacare is destined to fail for one key reason: it will make health insurance cost more and buy less.

Consider other sectors where prices rose sharply while the quality of the product sank. Suburban housing circa 2006. Your daily newspaper since 2006. How’d those work out—for both businesses and consumers?

Well, expect Obamacare to do the same thing for health insurance.

Obamacare has created millions of pages of new rules and billions of dollars in new taxes—all of which contribute to driving up the cost of health insurance.

That will be true of the 685,000 Hoosiers that are expected to buy insurance through the newly created insurance exchanges. More importantly, it will also be true for the 3.7 million Hoosiers that continue to get health insurance through an employer.

That’s about three-quarters of the population. Repeat the same story in all 50 states, and there will be a lot of angry people out there. Enough to spark a political backlash.

Employers should expect to see their health benefits costs rise at the same pace they have for the past half decade, plus an additional 20 percent as some Obamacare icing on the top.

Why? Because Obamacare taxes health insurers, who will likely pass that on to employers as a 2-percent to 3-percent premium increase. Because employers must pay new taxes to help the federal government pay for new kinds of medical research and for a “transitional reinsurance” fund to offset the liklihood that the exchanges will attract more sick people than healthy ones. And because penalties on individuals who don’t buy insurance will push more people into employer plans, also driving up overall costs.

The increasingly unaffordable insurance that Obamacare will produce will push numerous employers into Obamacare's “Cadillac" tax. In 2018, any employer or health insurer will be forced to pay a whopping 40 percent excise tax on the cost of their health plan that exceeds $ 10,200 for an individual and $ 27,500 for a family.

Companies such as Columbus-based Cummins Inc. have been raising their deductibles in order to keep their benefits from triggering the tax. Obamacare is also pressuring many union health plans to shift significantly more financial risk onto workers.

Indeed, one of the oddest sights this year has been the calls by several unions—some of Obama’s staunchest political supporters—for the outright repeal of Obamacare. Why? Because they know the rich health benefits they have negotiated for so diligently for the past 30 years will vanish.

That’s the future Obamacare will bring: pay more, get less.

The changes to employers are important because they affect more people. But it’s Hoosiers in the exchanges that have the most to worry about.

New rules in the exchanges will make health insurance more affordable for those with very expensive conditions, such as cancer, and will most likely make insurance cheaper for older patients, childbearing women and those making below-average wages.

But for everyone else, there will be rate shock, as Obamacare drives up the average cost of insurance in Indiana by 72 percent. And it could get far worse than that.

That’s because Obamacare requires health insurers offering plans in the exchanges to cover everyone, with no consideration of anyone's health status in the price of the product (other than factoring in tobacco use and age).

That is a sure-fire recipe for the exchanges becoming a magnet for sick people and a no-go zone for healthy people. In insurance speak, that’s called a death spiral.

The only thing standing between Obamacare and death spirals in all 50 states is a tax on individuals that tops out at $695 in 2016. That fine is expected to force young, healthy patients to buy expensive health insurance, so they can cover the costs of all the older, sick people who will flood into the exchanges.

Imagine you’re just out of college and you can only find part-time jobs paying $10-$12 an hour—an increasingly common reality since Obamacare, by requiring employers to look back 12 months to determine their number of full-time workers on Jan. 1, 2014, has already begun to discourage the hiring of full-time workers.

You’ll still have to pay $1,100 to $1,600 for health insurance—even after Obamacare’s subsidies. And that’s for a plan with a good-sized deductible—meaning you’ll pay out of pocket for the first $2,000 or so of your expenses.

If you were young, poor and healthy, would you spend $100 a month extra on something you don’t use or which, if you do use it occassionally, still makes you pay the doctor’s bill anyway? I don’t think so.

But let’s say, by some miracle, Obamacare avoids death spirals in the exchanges. Even so, the real-value of health insurance will actually go down. That’s because insurers believe that in order to have any chance of signing up healthy people, they need to keep the price as low as possible. So they are offsetting the increased costs created by Obamacare’s rules and taxes by sharply limiting the number of doctors and hospitals their policyholders can visit.

Oh, and the health plans are paying those doctors and hospitals less, too.

Indianapolis-based WellPoint Inc. expects the health plans it sells through the exchanges to pay health care providers at close to Medicare rates—which are typically about 30 percent less than what individual insurance policies pay now.

If exchange plans pay low rates, expect hospitals and doctors to find ways to avoid those patients. They have lots of options. Some doctors are simply leaving the third-party insurance system altogether, setting up concierge practices that run primarily on cash retainer payments. That’s a problem for anyone that wants to pay with health insurance.

Other doctors are splitting their practices into two sides—one that takes insurance and one that operates on cash. If you’re paying with insurance, expect the wait times to grow—and grow and grow. In Massachusetts, which enacted a law similar to Obamacare in 2006, it still takes about six weeks to see a doctor—and half of physicians aren’t accepting any new patients at all.

Hospitals, especially in Indianapolis, have been quite adept at following the migration patterns of customers with employer-sponsored insurance, making the best health care abundant in Hamilton County but non-existent in Haughville.

And I haven’t even talked about the access problems that patients with Medicaid—if Indiana even decides to expand the program, as Obamacare calls for—will have seeing a doctor or finding a convenient hospital facility.

Obamacare may expand the number of people with health insurance, but it will leave those people fighting to actually get care. And once Hoosiers and Americans realize that, they will turn on the law.

The only question is if the Obamacare train wreck happens in high speed or slow motion. Said another way, Obamacare is certain to tarnish the president’s legacy, but will it fail so hard and so fast that he is literally chased from the White House in 2016, sort of like George W. Bush was in 2008, by a candidate promising over and over again to reverse “the failed policies of Barack Obama”?

The answer lies in how bad things go with the nitty-gritty technical functions of Obamacare. So far, the Obama team has an awful track record on implementation. Almost no part of the law has been rolled out smoothly, if at all.

Obamacare’s long-term-care insurance program was scotched because its actuarial assumptions were so bogus (the entire thing was used to help the law get a better budget score from the Congressional Budget Office).

Obamacare’s high-risk pool got going but only helped a fraction of the people it was supposed—and, in a harbinger of things to come, incurred costs far higher than projected.

In May, the Obama team delayed a plan to offer a choice of health plans to workers at small businesses that buy through the Obamacare federal exchanges. And in June, Obama’s IRS simply decided to take a year’s break in enforcing the tax penalty against employers that don’t offer health insurance.

Not only that, but the Obama team is not actually going to check if your income qualifies you for one of exchanges’ tax credits. They’re just going to take your word for it initially, and then let you sort it out on your taxes. Which means you could end up having to write a multi-thousand-dollar check back to the government in 2015.

So with that inspiring record, the Obama team has promised—and promised and promised and promised again—to have exchanges up and running by Oct. 1 in 33 states—including Indiana. And God bless them, they just might do it—if they change the definition of the word “running.”

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Amid Obamacare's changes, WellPoint keeps old playbook

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