From Health and Fitness

Weeklong Strike Set To Start For 4,000 Kaiser Permanente Mental Health Professionals In California

“This strike is a clear message to Kaiser that its mental health clinicians won’t stand by silently while their patients can’t get the care they need,” union leader Sal Rosselli said in a statement. Kaiser Permanente claims the union is most interested in raising wages that are already among the best in the nation.

Weeklong Strike Set To Start For 4,000 Kaiser Mental Health Professionals In California

“This strike is a clear message to Kaiser that its mental health clinicians won’t stand by silently while their patients can’t get the care they need,” union leader Sal Rosselli said in a statement. Kaiser claims the union is most interested in raising wages that are already among the best in the nation.

Doctors Who Treat Gunshot Victims Tell NRA Why Gun Safety Is Their ‘Highway’

After the NRA said “anti-gun” physicians should stay in their lane, a growing number of doctors join the social media campaign with the hashtag “#ThisIsOurLane,” gaining support from the U.S. Surgeon General Jerome Adams. Other gun violence news looks at a lack of CDC gun studies, a faulty high school active shooter drill and disturbing writings from the Sandy Hook shooter.

Doctors Who Treat Gunshot Victims Tell NRA Why Gun Safety Is Their ‘Highway’

After the NRA said “anti-gun” physicians should stay in their own lane, a growing number of doctors have mounted a social media campaign with the hashtag “ThisIsOurLane” and gained support from the U.S. Surgeon General Jerome Adams. Other gun violence news looks at a lack of CDC gun studies, a faulty high school active shooter drill and disturbing writings from the Sandy Hook shooter.

Hospital-Acquired Infections Dip, But Experts Say That There’s Still More Work To Do

Experts say there are certain infection types–such as pneumonia or C. diff–that aren’t showing any progress. Meanwhile, health care executives weigh in on what a politically divided Congress will mean to the hospital industry. And other hospital news comes out of Illinois, Florida, Massachusetts, and Texas.

Hospital-Acquired Infections Dip, But Experts Say That There’s Still More Work To Do

Experts say there are certain infection types–such as pneumonia or C. diff–that aren’t showing any progress. Meanwhile, health care executives weigh in on what a politically divided Congress will mean to the hospital industry. And other hospital news comes out of Illinois, Florida, Massachusetts, and Texas.

Young Pa. Mayor’s Fatal Fentanyl Overdose A Snapshot Of Epidemic That Is Still Gripping Nation

Brandon Wentz was only 24 when he had to resign as mayor from a small Pennsylvania town because his family was moving. The day after he wrote his resignation letter, he died of an overdose. Other news on the national drug crisis is reported from Michigan, Wisconsin, Massachusetts, Texas and California.

Young Pa. Mayor’s Fatal Fentanyl Overdose A Snapshot Of Epidemic That Is Still Gripping Nation

Brandon Wentz was only 24 when he had to resign as mayor from a small Pennsylvania town because his family was moving. The day after he wrote his resignation letter, he died of an overdose. Other news on the national drug crisis is reported from Michigan, Wisconsin, Massachusetts, Texas and California.

Need Health Insurance? The Deadline Is Dec. 15

The woman arrived at the University of South Florida’s navigator office in Tampa a few weeks ago with a 40-page document describing a short-term health insurance plan she was considering. She was uncomfortable with what the broker had said about the coverage, she told Jodi Ray, a health insurance navigator who helps people enroll in coverage, and she wanted help understanding it.

The document was confusing, according to Ray, who oversees Covering Florida, the state’s navigator program. It was hard to decipher which services would be covered.

“It was like a bunch of puzzle pieces,” she said.

Encouraged by her wife, the woman eventually opted instead for a marketplace plan with comprehensive benefits.

The annual open-enrollment period for people who buy their own insurance on the Affordable Care Act’s marketplaces ends Dec. 15 in most states. Enrollment in states that use the federal healthcare.gov platform has been sluggish this year compared to last. From Nov. 1 through Dec. 1, about 3.2 million people had chosen plans for 2019. Compared with the previous year, that’s about 400,000 fewer, or a drop of just over 11 percent.

The wider availability of short-term plans is one big change that has set this year’s apart from past sign-up periods.

Another is the elimination of the penalty for not having health insurance starting next year. The Congressional Budget Office has estimated that as many as 3 million people who buy their own coverage may give it up when they don’t face a tax penalty.  But experts who have studied health insurance enrollment say that surveys so far indicate that the penalty hasn’t typically been the pivotal factor in people’s decision on whether to buy insurance.

They also caution against reading too much into the preliminary enrollment totals.

“There typically is a surge in enrollment at the end,” said Sabrina Corlette, research professor at Georgetown University’s Center on Health Insurance Reforms. “It’s hard to know whether it will make up for the shortfall.”

If they don’t pick a new plan, people who are enrolled in a 2018 marketplace plan may be automatically re-enrolled in their current plan or another one that is similar when the open-enrollment period ends. About a quarter of people who have marketplace plans are reassigned in this way.

Another factor that may be affecting enrollment is tighter federal funding for the health insurance navigators, like Jodi Ray in Tampa, who guide consumers through the complicated process. With fewer experts available to answer questions and help fill out the enrollment forms, consumers may fall through the cracks.

Across the country, funding for navigators dropped from $36 million in 2017 to $10 million this year. In Florida, federal funding for the Covering Florida navigator program was slashed to $1.25 million this year from $4.9 million last year, Ray said. The program was the only one to receive federal funding in the state this year.

The Covering Florida program reduced the number of open-enrollment navigators to 59 this year, a nearly 61 percent drop, Ray said. Navigators this year are available in only half of Florida counties; the organization is offering telephone assistance and virtual visits to people in counties where they can’t offer in-person help.

“It’s all we can do,” Ray said. So far, the group’s navigators have enrolled about half the number of people this year as they had last year.

It’s unclear the extent to which the Trump administration’s efforts to reduce health care costs by expanding access to short-term plans is affecting marketplace plan enrollment.

These plans, originally designed to cover people who expected to be out of an insurance plan for a short time, such as when they change jobs, can be less expensive. Unlike marketplace plans, short-term plans don’t have to provide comprehensive benefits or guarantee coverage for people who have preexisting medical conditions.

The Obama administration limited short-term plans to a three-month term. But in August, the federal government issued a rule that allowed their sale with initial terms of up to a year, and the option of renewal for up to three years.

Ten states either ban short-term plans or restrict them to terms of less than three months, said Sarah Lueck, a senior policy analyst at the Center on Budget and Policy Priorities.

Many people are seemingly not focused on their options this open-enrollment season, however. According to a recent survey, about half of adults under age 65 who were uninsured or who buy their own coverage said they planned to buy a plan for 2019. But only 24 percent of people in that age group said they knew what the deadline was to enroll in health insurance, according to the Kaiser Family Foundation’s November health tracking poll.

The Life Motto Hannah Bronfman Lives By

There’s no shortage of talk about mindfulness. In fact, a growing amount of research is exploring the connection between our brains and our bodies. Whether or not Hannah Bronfman knows it, the catchphrase that the HBFIT founder lives by is at the core of this way of thinking.

“My personal mantra would be, ‘Mind right, body tight,’” Bronfman tells Health. “And that is because I think a lot of people lose sight of why they work out, and for me it is more of a mind-body connection. So that kind of reminds me that it’s not just about the physical, it’s about the mental as well.”

Clearly Bronfman’s brain is in alignment with her frame because her workouts—from one-legged deadlifts while balancing on a slam ball to prowler pushes to yoga—have been yielding some pretty awesome results. But she wasn’t always as dialed in as she is now. It was a tragedy in her life that may have launched the change in her perspective.

RELATED: 5 Fitness Influencers Share the Words They Live By

“My grandmother actually became very sick when I was 19 and it was actually because she had battled with anorexia her whole life, and so she basically got to a point in her life where her body could no longer support her,” Bronfman told us at a launch event for her book Do What Feels Good, which hits bookshelves in January. “When she passed away, that was a huge eye-opening experience for me to not only lead my happiest and healthiest version of myself.”

She also hopes that other women “realize that these types of issues that I had seen as a little girl—if you don’t get that under control and change that conversation with yourself—these are thoughts and feelings that will stay with you your whole life, and, ultimately, could lead to your demise, like my grandmother.”

Intimate and personal stories like this—along with recipes, DIY beauty, and healthy-living advice—are all things that have helped Bronfman on her overall wellness journey, and she includes them in her book. She also wants to get one more point across. 

“This book is not a how-to, it’s not a diet book, it’s not a manual on how to be like me… This is all the information that has gotten me through. It has changed the way I thought about myself, changed the way I have conversations about myself, and taught me a lot about how I feel, and so this knowledge is to help everyone on their journey of self-discovery.”

Bravo Bronfman. Bravo.

Must-Reads Of The Week On Health Care

Your regular Breeze correspondent, and its creator, Brianna Labuskes, is taking a break, but we didn’t want you to be without some semblance of a report today of things you don’t want to miss in health care.

So I’ll do my best at filling in. Be kind, and check back next week for the really good stuff.

One of the biggest bits of news this week was a coughed-up blot clot from the lung. Not sure why that seemed to fascinate people. We can skip that, but feel free to look.

The Atlantic: Doctors Aren’t Sure How This Even Came Out of a Patient

A more authentic bit of news was the report that health care spending slowed in 2017. It’s still growing, mind you, but growing more slowly. That’s not terribly surprising, because it has been slowing for a number of years. What Dan Diamond over at Politico calls “slowth.” It increased 3.9 percent to $3.5 trillion, while the year before it had grown 4.8 percent. Another way to look at it: Americans spend $10,739 per person on health care. HuffPost had a nice analysis:

HuffPost: America’s Health Care Spending Keeps Rising Really Slowly. Seriously.

Read the full report here.

The New York Times attempts to explain why enrollment in Obamacare is down. Any number of things could factor in, like higher employment at places that offer health insurance, no mandate forcing people to enroll or people signing up for Medicaid. Further study may present an answer.

The New York Times: Why Is Obamacare Enrollment Down?

This week, the Annals of Internal Medicine retracted a 2009 paper by Brian Wasinick, the now-discredited Cornell University researcher. The half-baked paper had claimed that the recipes in the more modern editions of the classic “Joy of Cooking” cookbook had more calories than the original. The always enlightening Retraction Watch website, which tracks medical and scientific research that has been undermined, has the whole story of the delightful sleuthing that led to the debunking. (And while you are on the site, peruse all the other Wasinick papers on food research that have been rescinded.)

Retraction Watch: The Joy of Cooking, Vindicated: Journal Retracts Two More Brian Wansink Papers

One of my favorite writers on health care makes an often overlooked point about health insurance: Its goal ought to be the same as other insurance, that is, to safeguard the financial health of beneficiaries. And Aaron Carroll, who is also a professor of pediatrics at Indiana University School of Medicine, says that several studies show it does exactly that.

Read the whole piece for yourself:

JAMA Forum: Medicaid as a Safeguard for Financial Health

As a bonus on this topic, here is an academic paper surfacing this week on the effects of the Affordable Care Act on mortgage delinquencies. Spoiler: The value of fewer evictions and foreclosures is substantial compared to the cost of the ACA subsidies.

The Effect of Health Insurance on Home Payment Delinquency: Evidence from ACA Marketplace Subsidies

The Commonwealth Fund, a foundation that seeks to improve health care,  wanted to know how the Affordable Care Act affected the uninsured and the insured. As its chart that summarizes its findings issued this week shows, there was considerable movement. The main finding was the number of young adults who switched from Medicaid to individual insurance — and the other direction as well.

The Commonwealth Fund: Who Entered and Exited the Individual Health Insurance Market Before and After the Affordable Care Act?

Commonwealth also conducted a forum on “Being Seriously Ill in America,” which dealt with the financial consequences.

Forbes likes to compile those “30 under 30” lists. (I’ve long wished someone would go back and look at one of those lists from 20 or 25 years ago to see how the luminaries are doing now.) Anyway, it put together a list of people in the health care industry. Most are on the cusp of 30, which might tell you something about how hard it is to get a fast start in the industry. But one person on the honor roll is only 18. In case you were wondering, because I was, Elizabeth Holmes, the founder of the ill-fated Theranos, was on a different “40 under 40” Forbes list in 2014. We hope these folks fare better.

Forbes: 30 Under 30 in Healthcare

This article ran a while back, but I got a kick out of it and just had to mention it. It looked at prehistoric health care. Researchers will never know how much Stone Age dwellers bored their hut mates with discussions of a paleo diet, but they are learning how they performed medical procedures that appeared to have worked.

The Atlantic: Neanderthals Suffered a Lot of Traumatic Injuries. So How Did They Live So Long?

May you survive another whirlwind week of health care news, until next Friday’s breezy recap.