Obama Wins: What It Means for Health Care info

Today i read article about election of Democrat Barack Obama ushers in a new administration that is all but certain to include some level of health care reform. Less clear is how extensive that reform will be and when it will come.

The Illinois senator has proposed sweeping changes in the health care system designed to provide health coverage to millions of uninsured Americans.

But experts tell WebMD that the current financial crisis makes sweeping change unlikely any time soon.

"I have no inside track, but I would bet that in this economic climate it is far more likely that changes will be phased in over time," says Karen Davis, president of the health policy and research group Commonwealth Fund.

University of Michigan health economist Thomas Buckmueller, PhD, agrees that the economic climate is likely to slow reform. "I am not extremely optimistic that major reform will happen, but this seems to be the best chance we have had in a long time."

Obama's Health Plan

Obama spoke often during the campaign about his mother's battle with ovarian cancer to illustrate his commitment to changing the health care system.

He told of her final days, spent battling insurance company bureaucrats who did not want to pay for her cancer treatments. "I know what it's like to see a loved one suffer, not just because they are sick, but because of a broken health care system," he said at a rally last week and at countless campaign stops before that.

His plan would extend health coverage by expanding existing private and public programs with the help of federal subsidies and mandates.

He has repeatedly claimed the reforms will lower the average family's health insurance premiums by about $2,500 a year.

These reforms include:

• Requiring employers, except small businesses, to provide health insurance to their employees or contribute to the cost.
• Requiring that all children have health insurance.
• Expanding Medicaid and the State Children's Health Insurance Program (SCHIP).
• Creating a National Health Insurance Exchange to pool risk and give people the choice of competing private or public health plans.

According to the Tax Policy Center, a nonpartisan tax analysis group, the president-elect's plan, if fully implemented, would reduce the number of uninsured Americans from a projected 67 million to 33 million over the next decade at a cost of $1.6 trillion.

Obama has said he would pay for his plan by rolling back President Bush's tax cuts on people making more than $250,000 a year and keeping the estate tax at 2009 levels, but he has not been more specific. He has not provided a timetable for seeking his proposed reforms and has not said if he would present a comprehensive health care reform package or try for incremental change.

Expansion Likely for State Children's Health Insurance Program

Experts interviewed by WebMD agreed that expansion of the children's insurance program SCHIP is likely to be the first of the proposed reforms to be considered.

Last December, Democrats in Congress lost a yearlong fight to boost federal spending that would have expanded the program after two separate vetoes by Bush.

The program will be up for congressional review next March, and experts say it will probably be the Obama administration's first chance to make good on a health care promise.

"SCHIP is one of the big success stories in health policy over the last 20 years," Buckmueller says. "It has succeeded in getting kids the preventive care they need to keep them out of the ERs."

Medicare Reform More Problematic

Many of Obama's other proposals -- from the expansion of Medicare to his National Health Insurance Exchange -- will be much harder to win support for, even with a largely friendly Congress behind him.

Buckmueller believes the best chance for major reform lies in seeking bipartisan support for his proposals.

He says a key reason for the failure of President Clinton's 1993 health care reform effort is that his administration did not reach across the isle. "Assuming that Obama has learned from the Clinton debacle, I think he would be wise to say, 'Here are the basic principles of my plan. You work out the details, get bipartisan support, and I'll sign it.'"

Health Spending 'Not Sustainable'

While sweeping reform may not come soon, experts contacted by WebMD agreed that the nation's broken health care system must be addressed and that this must happen sooner rather than later.

The statistics bear this out:

• 45 million Americans have no health insurance.
• 25 million more have health plans but are considered underinsured because their policies offer only minimal coverage, according to the Commonwealth Fund.
• 42% of U.S. adults under age 65 are uninsured or underinsured, up from 33% in 2003.

Total spending on health care represented around 16% of the gross domestic product in 2007, and the Congressional Budget Office says spending will rise to a quarter of gross domestic product by 2025.

"We are not going to reduce health care spending," says former Congressional Budget Office Director Alice Rivlin, PhD, who is now a scholar with the Brookings Institution. "The best we can do is reduce the rate of health care spending growth. That should be the No. 1 priority of any health care reform."

If jobs are the next thing to go in the current economic crisis, as many economists are predicting, the number of American's without health insurance will quickly increase beyond projections.

"Something has to happen over the next few years, because the cost of doing nothing is too great," Rivlin says.

Davis echoes the thought. "We can't afford to stay on the path we are on with regard to total health spending," she says. "Employers can't afford it, the government can't afford it, and individuals can't afford it. It is just not sustainable."

SOURCES: Karen Davis, president, Commonwealth Fund. Thomas Buckmueller, PhD, professor of business economics and public policy, Ross School of Business, University of Michigan, Ann Arbor. Alice Rivlin, director, Greater Washington Research project, Brookings Institution. Tax Policy Center: "Presidential Candidates Tax Plans," Sept. 12, 2008. Congressional Budget Office, health care spending, 2007.

10 Lifestyle Tips for Cancer Prevention

Today i read article from medicinenet.com about Looking for ways to cut your risk of developing cancer? Here's a list of 10 diet and activity recommendations highlighted this week in Chicago at the annual meeting of the American Dietetic Association (ADA).

• Be as lean as possible without becoming underweight.
• Be physically active for at least 30 minutes every day.
• Avoid sugary drinks, and limit consumption of high-calorie foods, especially those low in fiber and rich in fat or added sugar.
• Eat more of a variety of vegetables, fruits, whole grains, and legumes (such as beans).
• Limit consumption of red meats (including beef, pork, and lamb) and avoid processed meats.
• If you drink alcohol, limit your daily intake to two drinks for men and one drink for women.
• Limit consumption of salty foods and food processed with salt (sodium).
• Don't use supplements to try to protect against cancer.
• It's best for mothers to exclusively breastfeed their babies for up to six months and then add other liquids and foods.
• After treatment, cancer survivors should follow the recommendations for cancer prevention.

Why These Cancer Recommendations?

Walter Willett, MD, DrPH, an epidemiology professor who leads the nutrition department the Harvard School of Public Health, was on the international team of scientists that wrote the recommendations.

At the ADA meeting, Willett said the first recommendation -- to be as lean as possible within the healthy weight range -- is "the most important, by far."

But there is one recommendation that Willett says may be a "mistake" -- the one about not taking supplements. Vitamin D supplements may lower risk of colorectal cancer and perhaps other cancers, notes Willett. He predicts that that recommendation will be a top priority for review.

How to Follow the Recommendations

Karen Collins, MS, RD, CDN, is the nutritional advisor for the American Institute for Cancer Research. She reviewed the recommendations before they were issued last year, and she joined Willett in talking to ADA members.

Collins provides these tips for each of the recommendations:

• Be as lean as possible without becoming underweight: Don't just look at the scale; check your waist measurement as a crude measurement of your abdominal fat, Collins says. She recommends that men's waists be no larger than 37 inches and women's waists be 31.5 inches or less.
• Be physically active for at least 30 minutes every day: You can break that into 10- to 15-minute blocks, and even more activity may be better, notes Collins.
• Avoid sugary drinks and limit consumption of energy-dense foods: It's not that those foods directly cause cancer, but they could blow your calorie budget if you often overindulge, notes Collins, who suggests filling up on fruits, vegetables, and whole grains.
• Eat more of a variety of vegetables, fruits, whole grains, and legumes such as beans: Go for a variety of colors (like deep greens of spinach, deep blues of blueberries, whites of onions and garlic, and so on). Most Americans, says Collins, are stuck in a rut of eating the same three vegetables over and over.
• If consumed at all, limit alcoholic drinks to two for men and one for women per day: Watch your portion size; drinks are often poured liberally, notes Collins. Willett adds that the pros and cons of moderate drinking is something that women may particularly need to consider, weighing the heart benefits and increased breast cancer risk from drinking.
• Limit red meats (beef, pork, lamb) and avoid processed meats: Limit red meats to 18 ounces per week, says Collins, who suggests using chicken, seafood, or legumes in place of red meat. Collins isn't saying to never eat red meat, just do so in moderation.
• Limit consumption of salty foods and foods processed with sodium: Don't go over 2,400 milligrams per day, and use herbs and spices instead, says Collins. She adds that processed foods account for most sodium intake nowadays -- not salt you add when cooking or eating.
• Don't use supplements to protect against cancer: It's not that supplements are bad -- they may be "valuable" apart from cancer prevention, but there isn't evidence that they protect against cancer, except for vitamin D, says Collins.
• It's best for mothers to breastfeed babies exclusively for up to six months and then add other foods and liquids: Hospitals could encourage this more, Collins says.
• After treatment, cancer survivors should follow the recommendations for cancer prevention. Survivors include people undergoing cancer treatment, as well as people who have finished their cancer treatment.

Making Cancer Prevention Simpler

Overwhelmed? Collins boiled the 10 recommendations down to these three:

• Choose mostly plant foods. Limit red meat and avoid processed meat.
• Be physically active every day in any way for 30 minutes or more.
• Aim to be a healthy weight throughout life.

Keep in mind that these tips are about reducing -- but not eliminating -- cancer risk. Many factors, including genes and environmental factors, affect cancer risk; diet and exercise aren't the whole story, but they're within your power to change.