How to Treat Mental Health Naturally

By knowing how to treat mental health naturally, you may avoid an early grave. Mental health is the leading cause of death in Australians under 45. It’s probably the same the world over.

However, if you learn to use effective natural health care systems, this can be avoided.

Mental health covers many problems, not always considered important in mainstream medicine until now. However, there are health care systems which have always considered this area of the utmost importance. And probably the one which can be most effective in dealing with it is homeopathy.

Homeopathy is a very powerful form of natural treatment. It is also a very gentle form. It is a natural and complete form of health care. Professional homeopaths know that most ill health stems from a deep disturbance at a psychological level.

When these disturbances, which may not seem very important to an observer, are not resolved, then mental health can become affected. Any disturbance which has a profound effect on you is important, regardless of how others see it.

One of the most common causes, and perhaps one which most people can easily understand, is grief. The loss of a loved one, be-it a pet, grandparent or a closer family member, can have a profound effect on a person, especially a child, if it is not handled sympathetically by the parents.

Grief needs an outlet. Often the crying of a child is not allowed full expression. But grief needs full expression. If it has this, then the grief can be resolved fully.

Homeopathic treatment works by finding out your personal cause of your mental health disturbance, in a supportive way. The treatment stimulates your immune system so that you can cure you.

This caring, supportive, natural and effective ways of treating mental health has to be one of the best. And definitely one of the fastest.

Joint Health Natural Remedies

Many of us suffer from chronic joint pain. What you may not know is that there are some natural remedies for stiff, aching or inflamed joints.

The health of our joints impacts our quality of life and determines how active we can be as we age. Degeneration and inflammation of the joints (arthritis) is America’s number one crippling disease, affecting approximately one in three American adults, and is the leading cause of disability among persons over age 15. Luckily, research has shown that arthritis and joint degeneration can be safely and effectively addressed using natural healing methods.

In fact, many nutrients have been found to provide significant relief of osteoarthritis and rheumatoid arthritis pain and stiffness without the potential side effects of over-the-counter (OTC) or prescription medications. We will take a look at a few compounds that have been proven effective in clinical trials to help alleviate joint pain and often times, help repair degeneration in joints.

Glucosamine Sulfate

One of the most studied compounds for joint health is glucosamine sulfate. Glucosamine is a naturally occurring substance in the body, synthesized by special cells in the body (called chondrocytes) for the purpose of producing joint cartilage. When the joints degrade (as in osteoarthritis or after injury), this synthesis is often defective, so supplying the body with additional glucosamine through supplementation can provide the body the nutrients it needs to rebuild and repair the joint.

In addition, glucosamine sulfate has been shown to relieve most symptoms as effectively as the non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, Aleve, and aspirin. In one well-designed study of 178 patients with OA of the knee, one group was treated for 4 weeks with glucosamine sulfate (1500 mg daily) and the other group was treated with ibuprofen (1200 mg daily). Glucosamine relieved the symptoms as effectively as ibuprofen and was tolerated significantly better (i.e., fewer side effects) than ibuprofen. The safety and tolerability of glucosamine can easily be explained by the fact that it is a substance normally used by the body.

As with most natural remedies, the therapeutic effect of glucosamine is not immediate. It usually takes 1-8 weeks to appear. Once achieved, it tends to persist for a notable time even after discontinuing glucosamine supplementation. The probable reason for this is that glucosamine is incorporated into rebuilding the cartilage itself. In most studies, the dose has been 500 mg three times daily.

Chondroitin Sulfate

Chondroitin sulfate is a major component of cartilage. It is a very large molecule, composed of repeated units of glucosamine sulfate. Although the absorption of chondroitin sulfate is much lower than that of glucosamine (10-15% versus 90-98%), a few studies have shown very good results from long-term treatment with chondroitin sulfate, reducing pain and increasing range of motion.

Chondroitin sulfate has an excellent safety record, with no known toxicity. In repeated clinical studies, oral chondroitin sulfate (1200 mg/day) was consistently effective in reducing OA symptoms, and was very well tolerated (no side effects). In most studies, the dose has been 400 mg three times daily.

Studies indicate that glucosamine sulfate and chondroitin sulfate work synergistically to provide a greater benefit combined than either does separately. Glucosamine has been shown to increase the production of beneficial joint compounds and chondroitin sulfate has demonstrated ability to inhibit joint deterioration. Thus, used together they have shown a marked ability to improve joint health.

Purity and Labeling of Glucosamine and Chondroitin Sulfate Products

Glucosamine and chondroitin sulfate are both obtained from animal tissue sources, and purity can vary widely depending upon the extraction techniques and analysis technology. The studies of glucosamine and chondroitin sulfate referenced in this article were all conducted using carefully assayed, purified compounds. The purity of the compounds used can certainly be expected to effect the outcome.

Furthermore, glucosamine and chondroitin sulfate are considered dietary supplements, and are therefore not regulated by the Food and Drug Administration. Although many brands of chondroitin sulfate and glucosamine are available over the counter, independent laboratory analysis has shown that many products do not actually contain the amounts claimed on the label.

For instance, in a recently published study done at the Pharmacy School at the University of Maryland, 32 bottles of chondroitin sulfate were purchased at pharmacies and health food stores. Only 2 of the products met label claims while 14 of the 32 bottles purchased contained 10% or less of the label claim. What were the buyer’s chances of getting a good product when only 2 of 32 products met their label claim?

Other Factors in Joint Health

Diet plays a key role in joint health. Certain foods can aggravate joint pain and inflammation – including tomatoes, white potatoes, eggplants and bell peppers. In addition, you can also eat foods that can enhance the repair process and decrease inflammation!

In addition there are many therapies, nutrients and herbs and specific supplements that you can use to dramatically improve your joint health. Natural therapies can be very effective for those suffering from arthritis or other joint injury. Studies have proven that natural remedies, diet and certain forms of exercise can slow down the progression of joint disease and even reverse it in many cases.

Dr. Chad has studied, lectured and taught throughout the United States, Canada, Great Britain, Germany, Peru and southern Africa. He is very active in teaching natural healing techniques and has given presentations to thousands of people worldwide. He is a faculty member at the University of Natural Medicine where he teaches doctors and other health care practitioners the value of alternative testing techniques in the healing process.

The Natural Path Health Center is a complete naturopathic health care center that provides you the information and resources you need to help your body heal. We offer a large array of natural healing modalities, including diet and nutrition counseling, botanical medicines, nutritional supplementation, cleansing and detoxification, physical therapies such as massage, acupressure, craniosacral, Trager and numerous other hands-on bodywork techniques; hydrotherapy, including our entire therapy area, which is dedicated to helping relieve the toxic burden on the body by drawing toxins out through the skin; energy work, including the therapeutic use of Reiki, and counseling.

Isagenix “Greens,” An Exceptional Health Natural Product

The Isagenix health natural products are exceptional for ones health and are no compromise health natural products. The “Greens” are one of my favorites.

The “Greens” have over 30 of the most nutritiously dense veggies in just one serving. For me, this is outstanding because I have a struggle many days to get all the veggies I need into my body. When I am traveling the Greens come with me, I put them in my water bottle or in my Isaleans shake each morning.

The health natural products of Isagenix “Greens” have been carefully processed to keep all the nutrition in them. I find that quite remarkable, it is leading edge technology for sure. When I do my shopping at my local market, I know that many of the veggies have been picked before they are ripened. This is necessary because they have to travel long distances often and they would be rotten already if they had been picked ripe. When veggies are picked before ripening the mineral content has been compromised. As well, if your veggies have been sprayed with chemicals as most have, then for sure the minerals have been destabilized.

Isagenix is remarkable in their creation of the “Greens” because all of the minerals are intact. Minerals are KEY to optimum health and wellness. Most of our soils are devoid of minerals which is why there are so many people with so many illnesses now. There are no artificial flavours or ingredients in the health natural product, Isagenix “Greens.”

Some of the health benefits are antioxidant, mental focus and clarity, improved digestion, support of health bacteria, digestive fiber to boost cleansing and stronger immune system.

The veggies included in the “Greens” are Pineapple juice (Ananas comosus), Alfalfa sprout (Medicago sativa), Carrot root (Daucus carota), Spirulina (Spirulina platensis), Chia seed (Salvia hispanica), Barley grass & juice (Hordeum vulgare), Ionic Alfalfa(TM), Wheat grass (Triticum aestivum), Chlorella (Chlorellavulgaris), Cinnamon bark (Cinnamomum verum), Parsley (Petroselinum crispum), Green Tea leaf (Camellia sinensis),Red Clover flower (Trifolium pretense), astaxanthin, Astragalus root (Astragalus membranaceus), Suma root (Pfaffi a paniculata), Papaya fruit (Carica papaya), Ginkgo biloba leaf, Dulse (Palmaria palmate), Eleutherococcus senticosus root, Dandelion root (Taraxacum offi cinale), Maitake (Grifola frondosa), Shiitake (Lentinula edodes), Cordyceps (Cordyceps sinensis), Grape seed extract (Vitis vinifera), flower pollen, Milk Thistle seed extract (Silybum marianum), Tomato fruit (Solanum lycopersicum), Cilantro (Coriandrum sativum), Red Beet root (Beta vulgaris), Bilberry berry extract (Vaccinium myrtillus), Turnip root (Brassica rapa), Bamboo shoot (Bambusa vulgaris), alpha lipoic acid, chlorophyll (Sodium chlorophyllin), Coenzyme Q-10, Brussels sprout (Brassica oleracea), Broccoli floret (B. oleracea) and Kale leaf (B. oleracea).

Amazing, to have all of these vegetables in one scoop. For me, being a very busy person, this is a time saver and a relief from worry about my nutrient content each day. I just know I am getting all of the nutrients that I need.

The cost is about $1.00 per/day for all these veggies. I always put my scoop in my Isalean Shake. This health natural product is outstanding, remarkable value for what we receive.

Isagenix International also has a natural health college as part of its commitment to education of people. You can access information on the website that is given to you, once you order any products and they have gatherings in a meeting style for people to come together to learn of new products. Nutrition is a relatively new field of learning and Isagenix has made it mark in the evolution of this industry in a powerful way.

The renowned scientist, John Anderson, heads the formulation of the Isagenix product line. John is one of the top leaders in this industry. He is lovingly known as “the mineral man” because he understands the importance of minerals being added to nutritional health natural products.

Joanie McMahon is President of Investment In Serenity Inc. She is a teacher/counselor/life coach/psychologist/writer and business woman.

Her passion is understanding fully how to use The Law of Attraction to her and her clients benefit. She has an understanding of achieving overall health either physically through nutrition, exercise and stress release; emotionally through Journey work and understanding our Emotional Guidance System; Financially; and Spiritually.

How To Achieve Optimal Thyroid Health Naturally

Many people with hypothyroidism and hyperthyroidism are sick and tired of taking thyroid medication, and would like to do what is necessary to achieve optimal thyroid health naturally, without having to take any drugs. Of course some people with thyroid conditions do need to take thyroid medication on a continuous basis. On the other hand, many people can restore their health back to normal by following a natural thyroid treatment protocol.

If you have a hypothyroid or hyperthyroid condition, or even an autoimmune thyroid disorder such as Graves’ Disease or Hashimoto’s Thyroiditis, the following represent six things you can do in order to help you achieve optimal thyroid health:

Optimal Thyroid Health Tip #1: Whole foods are the best. Eating well is definitely important to achieve optimal thyroid health. Many people wonder what the perfect “thyroid diet” is, but it really comes down to using common sense. Eating a diet consisting mostly of whole foods and minimizing the refined foods and sugars is the ideal diet.

Is the quality of the whole foods you eat important? In other words, should you be eating organic foods? Well, obviously eating organic foods is ideal, but is also more costly. I would definitely recommend that you try to eat organic meats whenever possible. As for fruits and vegetables, some of these are higher in pesticides than others (spinach, strawberries, grapes, etc.), and therefore you definitely should try to avoid eating these foods if they’re non-organic. Of course it’s impossible to avoid all of the toxins, and nobody expects you to eat a perfect diet 100% of the time. However, if you follow the advice I just gave then this will definitely help you to achieve optimal thyroid health.

Optimal Thyroid Health Tip #2: Effectively manage your stress. Most people deal with chronic stress on a daily basis. No matter how hard you try you won’t be able to eliminate the stress from your life. But most people can do a much better job of managing their stress. One of the things I ask on my patient health questionnaires is for people to rate the amount of stress they have on a scale of 1-10, as well as their stress handling skills. And while many people give themselves high ratings when it comes to stress handling, I find that most people don’t do as good of a job of managing stress as they think. It’s definitely a challenge to do this, but is essential for anyone looking to achieve optimal thyroid health.

Optimal Thyroid Health Tip #3: Obtaining quality sleep is essential. We all know the importance of obtaining quality sleep each night, yet there still are many people who try to get away with less than seven hours sleep on a regular basis. Of course some people do attempt to get quality sleep, but have difficulty falling asleep and/or wake up in the middle of the night and can’t get back to sleep. If this is the case then you might need to modify some of the other lifestyle factors I have discussed in this article. On the other hand, if you intentionally neglect your sleep then eventually this will catch up to you, and will most likely affect your ability to achieve optimal thyroid health.

Optimal Thyroid Health Tip #4: Certain nutritional supplements and herbs can help. Some people with thyroid conditions can benefit by taking certain supplements and herbs. Which ones depends on your specific condition, as many people with hypothyroidism can benefit from herbs such as Bladderwrack and Ashwagandha, while many people with hyperthyroidism can obtain natural relief from their symptoms by using Bugelweed and/or Motherwort. Other important supplements and herbs include Vitamin D, iodine, selenium, Magnesium, and Eleuthero. Of course the long-term goal shouldn’t be to rely on taking herbs and supplements, but they usually are necessary to restore the health of someone who currently has a thyroid condition.

Optimal Thyroid Health Tip #5: Minimize your exposure to environmental toxins. Environmental toxins can also exacerbate, and in some cases directly cause a thyroid condition to develop. Just as is the case with chronic stress, one can’t completely eliminate their exposure to environmental toxins. But most people can do a much better job with this, especially with regards to the foods, cosmetics, and other household products they purchase and bring into their home. So simply being more health-conscious with regards to the foods and products you buy can make a big difference here.

Optimal Thyroid Health Tip #6: Consult with an expert. While most of what I described above you can do on your own, if you’re really looking to achieve optimal thyroid health then it’s a good idea to speak with a holistic doctor who focuses on endocrine disorders. This type of doctor will do what is necessary to evaluate your condition, and can put you on a natural thyroid treatment protocol to help restore your thyroid health back to normal, assuming this is possible of course.

In summary, whether you have hypothyroidism or hyperthyroidism, if you follow these six tips you are likely to achieve optimal thyroid health. While it can be challenging to follow some of these tips, most people who are willing to take responsibility for their health are happy they made such a commitment.

What’s The Definition Of Physical Health and Does Good Health Naturally Mean All Natural Is Good?

Let’s begin with a good health definition in general. The WHO health definition (World Health Organization), albeit from 1948: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. Assuming that’s true, what’s the definition of physical health and does good health naturally mean that “all natural” is good, especially as it applies to food?

What’s the definition of physical health?

Is there one?

Based on the WHO health definition as it applies to physical health, is it safe to say that simply because everything is working as it should in the absence of disease or infirmity (weakness or ailment), that we’re not necessarily in good physical health?

What do you think?

I personally believe there is more to being healthy in the moment. On the other hand, I also believe that because we are only guaranteed the present, if you’re healthy, don’t take it for granted. Enjoy it while you can.

I also believe the state of our physical health depends largely on our personal health plan. In other words, it depends on how well we take care of ourselves on a regular basis. That includes:

Eating habits
Exercise habits or lack thereof
Sleep habits
Spiritual habits
General living habits
Without seeming as though I am a pundit, expert or zealot about any of the aforementioned, that I am personally the definition of physical health, the definition of spiritual health, or anything that resembles the definition of good health, in a nutshell, what I’m saying is all the bullet points have a bearing on our physical health.

What do you think?

It’s about good health

One dictionary provides this definition of health:

“The general condition of the body or mind with reference to soundness and vigor: good health; poor health.”

The ancient Roman poet Virgil said, “The greatest wealth is health”.

I couldn’t agree more but I am a bit troubled by the amount of over-emphasis placed on physical health, as if it is mutually exclusive from the other aspects of health.

I believe health is about:

Physical
Mental
Emotional
Spiritual
Financial
The “soundness and vigor” in which we pursue and maintain these factors has a direct and indirect effect on each and every one of the factors.

Furthermore, I find it troubling that the word wealth is so overly associated with money and financial wealth.

It’s not to say that I don’t see the importance of physical health and financial wealth. They are both key components of overall health but they are not stand-alone concepts.

What are your thoughts?

All Natural

The “all natural” phenomenon, especially as it applies to food, is one of the biggest marketing ploys ever. If it’s not a scam, it’s a joke.

It means nothing!

There is a HUGE difference between organic and all natural. Don’t confuse the two and by all means don’t fall for the propaganda that leads you to believe they are one and the same. They’re not.

Organic, at least as it applies to food, is highly regulated. It actually means something. However, keep in mind that just because it’s organic doesn’t necessarily mean it’s healthy.

All natural can mean pretty much anything. As far as the food we eat is concerned, it is not regulated. It is a highly misleading tag.

Don’t be fooled.

I’m not saying don’t enjoy it. I’m not saying all natural is bad. I’m simply saying it’s about as superfluous term as there ever was. There is no depth to it.

My formula

For me, it all boils down to a few simple concepts and principles beginning with:

Honesty
Respect
Best Effort
These are indispensable. They cost nothing and should be applied at all times.

Next are the 5 F’s:

Food – Not just what we eat but includes anything we consume physically, mentally, emotionally, and spiritually. If we are what we eat, this says it all.
Fitness – Includes all the 5 bullet points mentioned above
Finances – Affected by the previous two and affects the previous and next two
Fulfillment – It’s about completion and includes all the bullet points mentioned
Fun – The importance of how it affects health and is affected by it is often overlooked
I have tagged the 5 F’s as the components of a bulletproof life.

To sum it up, all the above is important but the proper balance is the key. I believe too many of us are simply out of balance. Furthermore, there is not a one-size-fits-all balancing act.

Last but not least, from the late, great Redd Foxx:

“Health nuts are going to feel stupid someday, lying in hospitals dying of nothing.”

Agree? Disagree?

Leave comments.

Bob is a retirement planning and safe money professional who specializes in life insurance products and who has more than 20 years experience.

His company, A Bulletproof Life is the 5 F’s: Food, fitness, finances, fulfillment, fun. and is based on his motto: Honesty, respect, best effort

Plan Your Dream or Prepare for a Nightmare.

No one has EVER lost one cent doing business with A Bulletproof Life.

Order FREE 6 Page Report: “Insurance Companies and Products Overview 100–Life Insurance Products 101.

All About Affordable Health Insurance Plans

While consumers search for affordable health insurance, they have price in their mind as the top priority. A general conception among the consumers is that cheap health plans should not be costly-the cheapest health plan available in the market is their target. However, this approach is not good. Sometimes, paying for a cheap health insurance plan but still not getting the required level of coverage results only in wastage of money.

With the implementation of the affordable care act, the reach of affordable health plans is set to increase. Or at least, this is what is believed to be the objective of healthcare reforms. However, lots of consumers are still in confusion about how things would work. In this article, we will discuss some detailed options that consumers can try while looking to buy affordable health plans.

To get a hand on affordable health insurance plans, consumers need to take of certain things. First among them is about knowing the options in the particular state of the residence. There are lots of state and federal government-run programs that could be suitable for consumers. Knowing the options is pretty important. Next would be to understand the terms and conditions of all the programs and check the eligibility criteria for each one of them. Further, consumers should know their rights after the implementation of healthcare reforms, and something within a few days, they may qualify for a particular program or could be allowed to avail a particular health insurance plan. If consumers take care of these steps, there is no reason why consumers can’t land on an affordable health plan that could cater to the medical care needs.

Let’s discuss some options related to affordable health insurance plans state-wise:

State-run affordable health insurance programs in California

While considering California, there are three affordable health insurance plans that are run by the state government. Consumers can surely get benefitted by these if they are eligible for the benefits.

• Major Risk Medical Insurance Program (MRMIP)

This program is a very handy one offering limited health benefits to California residents. If consumers are unable to purchase health plans due to a preexisting medical condition, they can see if they qualify for this program and get benefits.

• Healthy Families Program

Healthy Families Program offers Californians with low cost health, dental, and vision coverage. This is mainly geared to children whose parents earn too much to qualify for public assistance. This program is administered by MRMIP.

• Access for Infants and Mothers Program (AIM)

Access for Infants and Mothers Program provides prenatal and preventive care for pregnant women having low income in California. It is administered by a five-person board that has established a comprehensive benefits package that includes both inpatient and outpatient care for program enrollees.

Some facts about affordable health insurance in Florida

While talking about affordable health insurance options in Florida, consumers can think about below mentioned options:

• Floridians who lost employer’s group health insurance may qualify for COBRA continuation coverage in Florida. At the same time, Floridians, who lost group health insurance due to involuntary termination of employment occurring between September 1, 2008 and December 31, 2009 may qualify for a federal tax credit. This credit helps in paying COBRA or state continuation coverage premiums for up to nine months.

• Floridians who had been uninsured for 6 months may be eligible to buy a limited health benefit plan through Cover Florida.

• Florida Medicaid program can be tried by Floridians having low or modest household income. Through this program, pregnant women, families with children, medically needy, elderly, and disabled individuals may get help.

• Florida KidCare program can help the Floridian children under the age of 19 years and not eligible for Medicaid and currently uninsured or underinsured.

• A federal tax credit to help pay for new health coverage to Floridians who lost their health coverage but are receiving benefits from the Trade Adjustment Assistance (TAA) Program. This credit is called the Health Coverage Tax Credit (HCTC). At the same time, Floridians who are retirees and are aged 55-65 and are receiving pension benefits from Pension Benefit Guarantee Corporation (PBGC), may qualify for the HCTC.

Some facts about affordable health insurance in Virginia

While talking about affordable health insurance options in Virginia, consumers need to consider their rights:

• Virginians who lost their employer’s group health insurance may apply for COBRA or state continuation coverage in Virginia.

• Virginians must note that they have the right to buy individual health plans from either Anthem Blue Cross Blue Shield or CareFirst Blue Cross Blue Shield.

• Virginia Medicaid program helps Virginians having low or modest household income may qualify for free or subsidized health coverage. Through this program, pregnant women, families with children, and elderly and disabled individuals are helped.

• Family Access to Medical Insurance Security (FAMIS) helps Virginian children under the age of 18 years having no health insurance.

• In Virginia, the Every Woman’s Life Program offers free breast and cervical cancer screening. Through this program, if women are diagnosed with cancer, they may be eligible for treatment through the Virginia Medicaid Program.

Some facts about affordable health insurance in Texas

While talking about affordable health insurance options in Texas, consumers need to consider their rights:

• Texans who have group insurance in Texas cannot be denied or limited in terms of coverage, nor can be required to pay more, because of the health status. Further, Texans having group health insurance can’t have exclusion of pre-existing conditions.

• In Texas, insurers cannot drop Texans off coverage when they get sick. At the same time, Texans who lost their group health insurance but are HIPAA eligible may apply for COBRA or state continuation coverage in Texas.

• Texas Medicaid program helps Texans having low or modest household income may qualify for free or subsidized health coverage. Through this program, pregnant women, families with children, elderly and disabled individuals are helped. At the same time, if a woman is diagnosed with breast or cervical cancer, she may be eligible for medical care through Medicaid.

• The Texas Children’s Health Insurance Program (CHIP) offers subsidized health coverage for certain uninsured children. Further children in Texas can stay in their parent’s health insurance policy as dependents till the age of 26 years. This clause has been implemented by the healthcare reforms.

• The Texas Breast and Cervical Cancer Control program offers free cancer screening for qualified residents. If a woman is diagnosed with breast or cervical cancer through this program, she may qualify for medical care through Medicaid.

Like this, consumers need to consider state-wise options when they search for affordable health coverage. It goes without saying that shopping around and getting oneself well-equipped with necessary information is pretty much important to make sure consumers have the right kind of health plans.

A Prescription For the Health Care Crisis

With all the shouting going on about America’s health care crisis, many are probably finding it difficult to concentrate, much less understand the cause of the problems confronting us. I find myself dismayed at the tone of the discussion (though I understand it—people are scared) as well as bemused that anyone would presume themselves sufficiently qualified to know how to best improve our health care system simply because they’ve encountered it, when people who’ve spent entire careers studying it (and I don’t mean politicians) aren’t sure what to do themselves.

Albert Einstein is reputed to have said that if he had an hour to save the world he’d spend 55 minutes defining the problem and only 5 minutes solving it. Our health care system is far more complex than most who are offering solutions admit or recognize, and unless we focus most of our efforts on defining its problems and thoroughly understanding their causes, any changes we make are just likely to make them worse as they are better.

Though I’ve worked in the American health care system as a physician since 1992 and have seven year’s worth of experience as an administrative director of primary care, I don’t consider myself qualified to thoroughly evaluate the viability of most of the suggestions I’ve heard for improving our health care system. I do think, however, I can at least contribute to the discussion by describing some of its troubles, taking reasonable guesses at their causes, and outlining some general principles that should be applied in attempting to solve them.

THE PROBLEM OF COST

No one disputes that health care spending in the U.S. has been rising dramatically. According to the Centers for Medicare and Medicaid Services (CMS), health care spending is projected to reach $8,160 per person per year by the end of 2009 compared to the $356 per person per year it was in 1970. This increase occurred roughly 2.4% faster than the increase in GDP over the same period. Though GDP varies from year-to-year and is therefore an imperfect way to assess a rise in health care costs in comparison to other expenditures from one year to the next, we can still conclude from this data that over the last 40 years the percentage of our national income (personal, business, and governmental) we’ve spent on health care has been rising.

Despite what most assume, this may or may not be bad. It all depends on two things: the reasons why spending on health care has been increasing relative to our GDP and how much value we’ve been getting for each dollar we spend.

WHY HAS HEALTH CARE BECOME SO COSTLY?

This is a harder question to answer than many would believe. The rise in the cost of health care (on average 8.1% per year from 1970 to 2009, calculated from the data above) has exceeded the rise in inflation (4.4% on average over that same period), so we can’t attribute the increased cost to inflation alone. Health care expenditures are known to be closely associated with a country’s GDP (the wealthier the nation, the more it spends on health care), yet even in this the United States remains an outlier (figure 3).

Is it because of spending on health care for people over the age of 75 (five times what we spend on people between the ages of 25 and 34)? In a word, no. Studies show this demographic trend explains only a small percentage of health expenditure growth.

Is it because of monstrous profits the health insurance companies are raking in? Probably not. It’s admittedly difficult to know for certain as not all insurance companies are publicly traded and therefore have balance sheets available for public review. But Aetna, one of the largest publicly traded health insurance companies in North America, reported a 2009 second quarter profit of $346.7 million, which, if projected out, predicts a yearly profit of around $1.3 billion from the approximately 19 million people they insure. If we assume their profit margin is average for their industry (even if untrue, it’s unlikely to be orders of magnitude different from the average), the total profit for all private health insurance companies in America, which insured 202 million people (2nd bullet point) in 2007, would come to approximately $13 billion per year. Total health care expenditures in 2007 were $2.2 trillion (see Table 1, page 3), which yields a private health care industry profit approximately 0.6% of total health care costs (though this analysis mixes data from different years, it can perhaps be permitted as the numbers aren’t likely different by any order of magnitude).

Is it because of health care fraud? Estimates of losses due to fraud range as high as 10% of all health care expenditures, but it’s hard to find hard data to back this up. Though some percentage of fraud almost certainly goes undetected, perhaps the best way to estimate how much money is lost due to fraud is by looking at how much the government actually recovers. In 2006, this was $2.2 billion, only 0.1% of $2.1 trillion (see Table 1, page 3) in total health care expenditures for that year.

Is it due to pharmaceutical costs? In 2006, total expenditures on prescription drugs was approximately $216 billion (see Table 2, page 4). Though this amounted to 10% of the $2.1 trillion (see Table 1, page 3) in total health care expenditures for that year and must therefore be considered significant, it still remains only a small percentage of total health care costs.

Is it from administrative costs? In 1999, total administrative costs were estimated to be $294 billion, a full 25% of the $1.2 trillion (Table 1) in total health care expenditures that year. This was a significant percentage in 1999 and it’s hard to imagine it’s shrunk to any significant degree since then.

In the end, though, what probably has contributed the greatest amount to the increase in health care spending in the U.S. are two things:

1. Technological innovation.

2. Overutilization of health care resources by both patients and health care providers themselves.

Technological innovation. Data that proves increasing health care costs are due mostly to technological innovation is surprisingly difficult to obtain, but estimates of the contribution to the rise in health care costs due to technological innovation range anywhere from 40% to 65% (Table 2, page 8). Though we mostly only have empirical data for this, several examples illustrate the principle. Heart attacks used to be treated with aspirin and prayer. Now they’re treated with drugs to control shock, pulmonary edema, and arrhythmias as well as thrombolytic therapy, cardiac catheterization with angioplasty or stenting, and coronary artery bypass grafting. You don’t have to be an economist to figure out which scenario ends up being more expensive. We may learn to perform these same procedures more cheaply over time (the same way we’ve figured out how to make computers cheaper) but as the cost per procedure decreases, the total amount spent on each procedure goes up because the number of procedures performed goes up. Laparoscopic cholecystectomy is 25% less than the price of an open cholecystectomy, but the rates of both have increased by 60%. As technological advances become more widely available they become more widely used, and one thing we’re great at doing in the United States is making technology available.

Overutilization of health care resources by both patients and health care providers themselves. We can easily define overutilization as the unnecessary consumption of health care resources. What’s not so easy is recognizing it. Every year from October through February the majority of patients who come into the Urgent Care Clinic at my hospital are, in my view, doing so unnecessarily. What are they coming in for? Colds. I can offer support, reassurance that nothing is seriously wrong, and advice about over-the-counter remedies—but none of these things will make them better faster (though I often am able to reduce their level of concern). Further, patients have a hard time believing the key to arriving at a correct diagnosis lies in history gathering and careful physical examination rather than technologically-based testing (not that the latter isn’t important—just less so than most patients believe). Just how much patient-driven overutilization costs the health care system is hard to pin down as we have mostly only anecdotal evidence as above.

Further, doctors often disagree among themselves about what constitutes unnecessary health care consumption. In his excellent article, “The Cost Conundrum,” Atul Gawande argues that regional variation in overutilization of health care resources by doctors best accounts for the regional variation in Medicare spending per person. He goes on to argue that if doctors could be motivated to rein in their overutilization in high-cost areas of the country, it would save Medicare enough money to keep it solvent for 50 years.

A reasonable approach. To get that to happen, however, we need to understand why doctors are overutilizing health care resources in the first place:

1. Judgment varies in cases where the medical literature is vague or unhelpful. When faced with diagnostic dilemmas or diseases for which standard treatments haven’t been established, a variation in practice invariably occurs. If a primary care doctor suspects her patient has an ulcer, does she treat herself empirically or refer to a gastroenterologist for an endoscopy? If certain “red flag” symptoms are present, most doctors would refer. If not, some would and some wouldn’t depending on their training and the intangible exercise of judgment.

2. Inexperience or poor judgment. More experienced physicians tend to rely on histories and physicals more than less experienced physicians and consequently order fewer and less expensive tests. Studies suggest primary care physicians spend less money on tests and procedures than their sub-specialty colleagues but obtain similar and sometimes even better outcomes.

3. Fear of being sued. This is especially common in Emergency Room settings, but extends to almost every area of medicine.

4. Patients tend to demand more testing rather than less. As noted above. And physicians often have difficulty refusing patient requests for many reasons (eg, wanting to please them, fear of missing a diagnosis and being sued, etc).

5. In many settings, overutilization makes doctors more money. There exists no reliable incentive for doctors to limit their spending unless their pay is capitated or they’re receiving a straight salary.

Gawande’s article implies there exists some level of utilization of health care resources that’s optimal: use too little and you get mistakes and missed diagnoses; use too much and excess money gets spent without improving outcomes, paradoxically sometimes resulting in outcomes that are actually worse (likely as a result of complications from all the extra testing and treatments).

How then can we get doctors to employ uniformly good judgment to order the right number of tests and treatments for each patient—the “sweet spot”—in order to yield the best outcomes with the lowest risk of complications? Not easily. There is, fortunately or unfortunately, an art to good health care resource utilization. Some doctors are more gifted at it than others. Some are more diligent about keeping current. Some care more about their patients. An explosion of studies of medical tests and treatments has occurred in the last several decades to help guide doctors in choosing the most effective, safest, and even cheapest ways to practice medicine, but the diffusion of this evidence-based medicine is a tricky business. Just because beta blockers, for example, have been shown to improve survival after heart attacks doesn’t mean every physician knows it or provides them. Data clearly show many don’t. How information spreads from the medical literature into medical practice is a subject worthy of an entire post unto itself. Getting it to happen uniformly has proven extremely difficult.

In summary, then, most of the increase in spending on health care seems to have come from technological innovation coupled with its overuse by doctors working in systems that motivate them to practice more medicine rather than better medicine, as well as patients who demand the former thinking it yields the latter.

But even if we could snap our fingers and magically eliminate all overutilization today, health care in the U.S. would still remain among the most expensive in the world, requiring us to ask next—

WHAT VALUE ARE WE GETTING FOR THE DOLLARS WE SPEND?

According to an article in the New England Journal of Medicine titled The Burden of Health Care Costs for Working Families—Implications for Reform, growth in health care spending “can be defined as affordable as long as the rising percentage of income devoted to health care does not reduce standards of living. When absolute increases in income cannot keep up with absolute increases in health care spending, health care growth can be paid for only by sacrificing consumption of goods and services not related to health care.” When would this ever be an acceptable state of affairs? Only when the incremental cost of health care buys equal or greater incremental value. If, for example, you were told that in the near future you’d be spending 60% of your income on health care but that as a result you’d enjoy, say, a 30% chance of living to the age of 250, perhaps you’d judge that 60% a small price to pay.

This, it seems to me, is what the debate on health care spending really needs to be about. Certainly we should work on ways to eliminate overutilization. But the real question isn’t what absolute amount of money is too much to spend on health care. The real question is what are we getting for the money we spend and is it worth what we have to give up?

People alarmed by the notion that as health care costs increase policymakers may decide to ration health care don’t realize that we’re already rationing at least some of it. It just doesn’t appear as if we are because we’re rationing it on a first-come-first-serve basis—leaving it at least partially up to chance rather than to policy, which we’re uncomfortable defining and enforcing. Thus we don’t realize the reason our 90 year-old father in Illinois can’t have the liver he needs is because a 14 year-old girl in Alaska got in line first (or maybe our father was in line first and gets it while the 14 year-old girl doesn’t). Given that most of us remain uncomfortable with the notion of rationing health care based on criteria like age or utility to society, as technological innovation continues to drive up health care spending, we very well may at some point have to make critical judgments about which medical innovations are worth our entire society sacrificing access to other goods and services (unless we’re so foolish as to repeat the critical mistake of believing we can keep borrowing money forever without ever having to pay it back).

So what value are we getting? It varies. The risk of dying from a heart attack has declined by 66% since 1950 as a result of technological innovation. Because cardiovascular disease ranks as the number one cause of death in the U.S. this would seem to rank high on the scale of value as it benefits a huge proportion of the population in an important way. As a result of advances in pharmacology, we can now treat depression, anxiety, and even psychosis far better than anyone could have imagined even as recently as the mid-1980′s (when Prozac was first released). Clearly, then, some increases in health care costs have yielded enormous value we wouldn’t want to give up.

But how do we decide whether we’re getting good value from new innovations? Scientific studies must prove the innovation (whether a new test or treatment) actually provides clinically significant benefit (Aricept is a good example of a drug that works but doesn’t provide great clinical benefit—demented patients score higher on tests of cognitive ability while on it but probably aren’t significantly more functional or significantly better able to remember their children compared to when they’re not). But comparative effectiveness studies are extremely costly, take a long time to complete, and can never be perfectly applied to every individual patient, all of which means some health care provider always has to apply good medical judgment to every patient problem.

Who’s best positioned to judge the value to society of the benefit of an innovation—that is, to decide if an innovation’s benefit justifies its cost? I would argue the group that ultimately pays for it: the American public. How the public’s views could be reconciled and then effectively communicated to policy makers efficiently enough to affect actual policy, however, lies far beyond the scope of this post (and perhaps anyone’s imagination).

THE PROBLEM OF ACCESS

A significant proportion of the population is uninsured or underinsured, limiting or eliminating their access to health care. As a result, this group finds the path of least (and cheapest) resistance—emergency rooms—which has significantly impaired the ability of our nation’s ER physicians to actually render timely emergency care. In addition, surveys suggest a looming primary care physician shortage relative to the demand for their services. In my view, this imbalance between supply and demand explains most of the poor customer service patients face in our system every day: long wait times for doctors’ appointments, long wait times in doctors’ offices once their appointment day arrives, then short times spent with doctors inside exam rooms, followed by difficulty reaching their doctors in between office visits, and finally delays in getting test results. This imbalance would likely only partially be alleviated by less health care overutilization by patients.

GUIDELINES FOR SOLUTIONS

As Freaknomics authors Steven Levitt and Stephen Dubner state, “If morality represents how people would like the world to work, then economics represents how it actually does work.” Capitalism is based on the principle of enlightened self-interest, a system that creates incentives to yield behavior that benefits both suppliers and consumers and thus society as a whole. But when incentives get out of whack, people begin to behave in ways that continue to benefit them often at the expense of others or even at their own expense down the road. Whatever changes we make to our health care system (and there’s always more than one way to skin a cat), we must be sure to align incentives so that the behavior that results in each part of the system contributes to its sustainability rather than its ruin.

Here then is a summary of what I consider the best recommendations I’ve come across to address the problems I’ve outlined above:

1. Change the way insurance companies think about doing business. Insurance companies have the same goal as all other businesses: maximize profits. And if a health insurance company is publicly traded and in your 401k portfolio, you want them to maximize profits, too. Unfortunately, the best way for them to do this is to deny their services to the very customers who pay for them. It’s harder for them to spread risk (the function of any insurance company) relative to say, a car insurance company, because far more people make health insurance claims than car insurance claims. It would seem, therefore, from a consumer perspective, the private health insurance model is fundamentally flawed. We need to create a disincentive for health insurance companies to deny claims (or, conversely, an extra incentive for them to pay them). Allowing and encouraging aross-state insurance competition would at least partially engage free market forces to drive down insurance premiums as well as open up new markets to local insurance companies, benefiting both insurance consumers and providers. With their customers now armed with the all-important power to go elsewhere, health insurance companies might come to view the quality with which they actually provide service to their customers (ie, the paying out of claims) as a way to retain and grow their business. For this to work, monopolies or near-monopolies must be disbanded or at the very least discouraged. Even if it does work, however, government will probably still have to tighten regulation of the health insurance industry to ensure some of the heinous abuses that are going on now stop (for example, insurance companies shouldn’t be allowed to stratify consumers into sub-groups based on age and increase premiums based on an older group’s higher average risk of illness because healthy older consumers then end up being penalized for their age rather than their behaviors). Karl Denninger suggests some intriguing ideas in a post on his blog about requiring insurance companies to offer identical rates to businesses and individuals as well as creating a mandatory “open enrollment” period in which participants could only opt in or out of a plan on a yearly basis. This would prevent individuals from only buying insurance when they got sick, eliminating the adverse selection problem that’s driven insurance companies to deny payment for pre-existing conditions. I would add that, however reimbursement rates to health care providers are determined in the future (again, an entire post unto itself), all health insurance plans, whether private or public, must reimburse health care providers by an equal percentage to eliminate the existence of “good” and “bad” insurance that’s currently responsible for motivating hospitals and doctors to limit or even deny service to the poor and which may be responsible for the same thing occurring to the elderly in the future (Medicare reimburses only slightly better than Medicaid). Finally, regarding the idea of a “public option” insurance plan open to all, I worry that if it’s significantly cheaper than private options while providing near-equal benefits the entire country will rush to it en masse, driving private insurance companies out of business and forcing us all to subsidize one another’s health care with higher taxes and fewer choices; yet at the same time if the cost to the consumer of a “public option” remains comparable to private options, the very people it’s meant to help won’t be able to afford it.

2. Motivate the population to engage in healthier lifestyles that have been proven to prevent disease. Prevention of disease probably saves money, though some have argued that living longer increases the likelihood of developing diseases that wouldn’t have otherwise occurred, leading to the overall consumption of more health care dollars (though even if that’s true, those extra years of life would be judged by most valuable enough to justify the extra cost. After all, the whole purpose of health care is to improve the quality and quantity of life, not save society money. Let’s not put the cart before the horse). However, the idea of preventing a potentially bad outcome sometime in the future is only weakly motivating psychologically, explaining why so many people have so much trouble getting themselves to exercise, eat right, lose weight, stop smoking, etc. The idea of financially rewarding desirable behavior and/or financially punishing undesirable behavior is highly controversial. Though I worry this kind of strategy risks the enacting of policies that may impinge on basic freedoms if taken too far, I’m not against thinking creatively about how we could leverage stronger motivational forces to help people achieve health goals they themselves want to achieve. After all, most obese people want to lose weight. Most smokers want to quit. They might be more successful if they could find more powerful motivation.

3. Decrease overutilization of health care resources by doctors. I’m in agreement with Gawande that finding ways to get doctors to stop overutilizing health care resources is a worthy goal that will significantly rein in costs, that it will require a willingness to experiment, and that it will take time. Further, I agree that focusing only on who pays for our health care (whether the public or private sectors) will fail to address the issue adequately. But how exactly can we motivate doctors, whose pens are responsible for most of the money spent on health care in this country, to focus on what’s truly best for their patients? The idea that external bodies—whether insurance companies or government panels—could be used to set standards of care doctors must follow in order to control costs strikes me as ludicrous. Such bodies have neither the training nor overriding concern for patients’ welfare to be trusted to make those judgments. Why else do we have doctors if not to employ their expertise to apply nuanced approaches to complex situations? As long as they work in a system free of incentives that compete with their duty to their patients, they remain in the best position to make decisions about what tests and treatments are worth a given patient’s consideration, as long as they’re careful to avoid overconfident paternalism (refusing to obtain a head CT for a headache might be overconfidently paternalistic; refusing to offer chemotherapy for a cold isn’t). So perhaps we should eliminate any financial incentive doctors have to care about anything but their patients’ welfare, meaning doctors’ salaries should be disconnected from the number of surgeries they perform and the number of tests they order, and should instead be set by market forces. This model already exists in academic health care centers and hasn’t seemed to promote shoddy care when doctors feel they’re being paid fairly. Doctors need to earn a good living to compensate for the years of training and massive amounts of debt they amass, but no financial incentive for practicing more medicine should be allowed to attach itself to that good living.

4. Decrease overutilization of health care resources by patients. This, it seems to me, requires at least three interventions:

* Making available the right resources for the right problems (so that patients aren’t going to the ER for colds, for example, but rather to their primary care physicians). This would require hitting the “sweet spot” with respect to the number of primary care physicians, best at front-line gatekeeping, not of health care spending as in the old HMO model, but of triage and treatment. It would also require a recalculating of reimbursement levels for primary care services relative to specialty services to encourage more medical students to go into primary care (the reverse of the alarming trend we’ve been seeing for the last decade).

* A massive effort to increase the health literacy of the general public to improve its ability to triage its own complaints (so patients don’t actually go anywhere for colds or demand MRIs of their backs when their trusted physicians tells them it’s just a strain). This might be best accomplished through a series of educational programs (though given that no one in the private sector has an incentive to fund such programs, it might actually be one of the few things the government should—we’d just need to study and compare different educational programs and methods to see which, if any, reduce unnecessary patient utilization without worsening outcomes and result in more health care savings than they cost).

* Redesigning insurance plans to make patients in some way more financially liable for their health care choices. We can’t have people going bankrupt due to illness, nor do we want people to underutilize health care resources (avoiding the ER when they have chest pain, for example), but neither can we continue to support a system in which patients are actually motivated to overutilize resources, as the current “pre-pay for everything” model does.

Florida Health Insurance Rate Hikes and Quotes

Florida Health Insurance Rate Hike

Florida Health insurance premiums have touched new heights! Every Floridian has the common knowledge that most annual health insurance contracts will endure a rate increase at the end of the year. This trend is not new and should be expected. Every time this issue pops up it seems as though the blame game starts. Floridians blame Health insurance companies; Health insurance companies blame Hospitals, Doctors and other medical care providers, Medical care providers blame inflation and politicians, well, we really don’t know what they do to help the issue… No one seems to be interested in finding the real cause of the health insurance premium rate increase. Most individuals, self employed, and small business owners have taken Florida Health Insurance Rate Hikes as the inevitable evil.

Hard Facts

What are various reports telling us? Why do Health insurance premium have annual rate increases?

Rate of inflation and heath insurance premium rate increase.

America’s health expenditure in the year 2004 has increased dramatically, it has increased more than three time the inflation rate. In this year the inflation rate was around 2.5% while the national health expenses were around 7.9%. The employer health insurance or group health insurance premium had increased approximately 7.8% in the year 2006, which is almost double the rate of inflation. In short, last year in 2006, the annual premiums of group health plan sponsored by an employer was around $4,250 for a single premium plan, while the average family premium was around $ 11,250 per year. This indicates that in the year 2006 the employer sponsored health insurance premium increased 7.7 percent. Taking the biggest hit were small businesses that had 0-24 employees. There health insurance premiums increased by nearly 10.4%

Employees are also not spared, in the year 2006 the employee also had to pay around $ 3,000 more in their contribution to employer’s sponsored health insurance plan in comparison to the previous year, 2005. Rate hikes have been in existence since the “Florida Health Insurance” plan started. In covering an entire family of four, a person will experience an increase in premium rate at every annual renewal. If they would have kept the record of their health insurance premium payments they will find that they are now paying around $ 1,100 more than they paid in the year 2000 for the same coverage and with the same company. The same item was found by the Health Research Educational Trust and the Kaiser Family Foundation in their survey report of the year 2000. They found out that the premiums of health insurance that is sponsored by the employer increases by around 4 times than the employee’s salary. This report also stated that since 2000 the contribution of employees in group health insurance sponsored by employer was increased by more than 143 percent.

One business man predicts that if nothing is done and the Health insurance premiums keep increasing that in the year 2008, the amount of health premium contribution to employer will surpass their profit. Professionals within and outside the field of Florida health insurance, think that the reason for increase in Florida health insurance premium rates are due to many factors, such as high administration expenditure, inflation, poor or bad management, increase in the cost of medical care, waste etc.

Florida health insurance rate hikes affect whom?

Rising rates of Florida health insurance generally affects most of the Floridians who live in our beautiful state. The highest affected individudals are the minimum wage and low wage workers. Recent drops in the renewal of health insurance are mostly from this low income group. They just can’t afford the high premiums of Florida health insurance. They are in the situation where they can not afford the medical care and they can not afford the medical insurance premiums that are assosiated with adequate coverage. Almost half of all Americans are of the opinion that they are more worried about the high health insurance rate and high cost of health care, over any other bill they have on a monthly basis. A survey also finds that around 42% of Americans can not afford the high cost of health care services. There is one very interesting study conducted by Harvard University researchers. They found out that 68% of people who filed bankruptcy covered themselves and their family by health insurance. Average out-of-pocket deductibles for people filed bankruptcy were around $ 12,000 per year. They also found some co-relation between medical expenditure and bankruptcy. A national survey also reports that main reason for people not to take health insurance is the high premium rate of health insurance.

How to reduce Florida’s high health insurance cost? Nobody knows for sure. There are different opinions and experts are not agreeing with each other. Health professionals believe that if we can raise the number of healthy people by improving the lifestyle and regular exercise, good diets etc. than naturally they will need less medical care services which decreases the demands of health care and hence the cost.( This year in Florida the smoking rate has increased by 21.7 percent) One Floridian sarcastically suggested that there are ‘highs’ and ‘lows’ in health care that are needed to reversed. That the state of Florida is to ‘high’ in cost of medical care compare to other States and ‘low’ in the quality of health care.

Florida Health insurance rate hike has attracted many frauds. These frauds float many bogus insurance companies and offer cheap health insurance rate which attract many people to them. These companies usually through assosiations that are based in other states.

Meanwhile reputable Florida health insurance companies provide different types of health insurance like employer sponsored group health insurance, small business health insurance, individual health insurance etc. to vast number of employees and their families. Still there are many people in Florida that lack any health coverage. Today the employer also has found it challenging to decide how to offer employer sponsored group health insurance to their employees, so that both of them arrive at some point of agreement.

Community Needs Health Assessment

In 2012 the Internal Revenue Service mandated that all non-profit hospitals undertake a community health needs assessment (CHNA) that year and every three years thereafter. Further, these hospitals need to file a report every year thereafter detailing the progress that the community is making towards meeting the indicated needs. This type of assessment is a prime example of primary prevention strategy in population health management. Primary prevention strategies focus on preventing the occurrence of diseases or strengthen the resistance to diseases by focusing on environmental factors generally.

I believe that it is very fortunate that non-profit hospitals are carrying out this activity in their communities. By assessing the needs of the community and by working with community groups to improve the health of the community great strides can be made in improving public health, a key determinant of one’s overall health. As stated on the Institute for Healthcare Improvement’s Blue Shirt Blog (CHNAs and Beyond: Hospitals and Community Health Improvement), “There is growing recognition that the social determinants of health – where we live, work, and play, the food we eat, the opportunities we have to work and exercise and live in safety – drive health outcomes. Of course, there is a large role for health care to play in delivering health care services, but it is indisputable that the foundation of a healthy life lies within the community. To manage true population health – that is, the health of a community – hospitals and health systems must partner with a broad spectrum of stakeholders who share ownership for improving health in our communities.” I believe that these types of community involvement will become increasingly important as reimbursement is driven by value.

Historically, healthcare providers have managed the health of individuals and local health departments have managed the community environment to promote healthy lives. Now, with the IRS requirement, the work of the two are beginning to overlap. Added to the recent connection of the two are local coalitions and community organizations, such as religious organizations.

The community in which I live provides an excellent example of the new interconnections of various organizations to collectively improve the health of the community. In 2014 nine non-profits, including three hospitals, in Kent County, Michigan conducted a CHNA of the county to assess the strengths and weaknesses of health in the county and to assess the community’s perceptions of the pressing health needs. The assessment concluded that the key areas of focus for improving the health of the community are:

· Mental health issues

· Poor nutrition and obesity

· Substance abuse

· Violence and safety

At this time the Kent County Health Department has begun developing a strategic plan for the community to address these issues. A wide variety of community groups have begun meeting monthly to form this strategic plan. There are four work groups, one for each of the key areas of focus. I am involved in the Substance Abuse workgroup as a representative of one of my clients, Kent Intermediate School District. Other members include a substance abuse prevention coalition, a Federally qualified health center, a substance abuse treatment center and the local YMCA, among others. The local hospitals are involved in other workgroups. One of the treatment group representatives is a co-chair of our group. The health department wants to be sure that the strategic plan is community driven.

At the first meeting the health department leadership stated that the strategic plan must be community driven. This is so in order that the various agencies in the community will buy into the strategic plan and will work cooperatively to provide the most effective prevention and treatment services without overlap. The dollars spent on services will be more effective if the various agencies work to enhance each others’ work, to the extent possible.

At this time the Substance Abuse work group is examining relevant data from the 2014 CHNA survey and from other local resources. The epidemiologist at the health department is reviewing relevant data with the group so that any decisions about the goals of the strategic plan will be data driven. Using data to make decisions is one of the keystones of the group’s operating principles. All objectives in the strategic plan will be specific, measurable, achievable, realistic and time-bound (SMART).

Once the strategic plan is finished, the groups will continue with implementation of the plan, evaluating the outcomes of the implementation and adjusting the plan as needed in light of evaluation. As one can see, the workgroups of the CHNA are following the classic Plan-Do-Check-Act process. This process has been shown time and again in many settings-healthcare, business, manufacturing, et al-to produce excellent outcomes when properly followed.

As noted above I recommend that healthcare providers become involved with community groups to apply population level health management strategies to improve the overall health of the community. One good area of involvement is the Community Health Needs Assessment project being implemented through the local health department and non-profit hospitals.

Optimum Health Nutrition is the Pathway to a Healthy Life

Whether you are overweight or not, it is important to know about health nutrition. It is true that the problems resulting from overweight abound in the country and that these problems are connected in one way or other to nutritional deficiencies and improper diets. While obese people need to correct their diets, it is best even for those who are not overweight to follow the rules of optimum health nutrition to ensure that they are able to maintain the weight and remain healthy.

In this connection child health nutrition is also equally important. As they are in the growing phase, children need sufficient nutrition and it is also important that they understand the value of right nutrition early enough so that they will make it a habit all through their lives.

The primary rule of optimum health nutrition is that you should be aware of what you are eating. Sometimes the calories in what you eat may be high, sometimes your meal timings may be wrong, or sometimes there could be too much of harmful things like caffeine in what you take. This eating pattern has to be changed both in the case of adults and children, to manage the best possible child health nutrition. It may be a bit difficult in the beginning but will become a habit very soon.

The fundamentals of optimum health nutrition is having plenty of liquids in the diet, eating lots of fresh fruits and vegetables, and taking some dietary supplements to compensate for what could be lacking in the diet. The benefits of this balanced nutrition will be better immunity for the body, more energy, freedom from many common ailments, and an overall feeling of well being. Nutritional supplements are considered a part of this nutrition as well as child health nutrition because human body can often lack in minerals like iron or calcium and taking of supplements becomes mandatory to rectify the imbalance.

Consulting your personal doctor will help you to get some guidance on how to manage optimum health nutrition. He will be able to provide you with detailed information on the matter and will also give you tips and tricks to manage it on a day to day basis. Nutritionists and dietitians can also be helpful in giving advice on the matter. Once a person develops an interest in physical fitness, it is best for him to consult an expert in the field and get the necessary direction to move ahead fast in the chosen path.