Where Tourism Brings Pricey Health Care, Locals Fight Back

Where Tourism Brings Pricey Health Care, Locals Fight Back

Julie Appleby, Kaiser Health News

Colorado’s ski resort areas in Summit County have a high cost of living, among the highest in the country. The people who visit these places — Keystone, Breckenridge and Copper Mountain ­— can afford it.

Many of those who live and work there can’t, especially when they get sick.

In addition to expensive rent, they pay some of the steepest health insurance premiums in the nation. Hospital costs are also pricey, with most business generated by tourists, skiers and outdoors enthusiasts.

But locals may soon get a break after a group, fed up with the costs, negotiated a deal with the hospital system. The group, which came to be known as the Peak Health Alliance, expects to be able to offer its members premiums next year that are at least 20% less than current rates.

About 6,000 people, among them individuals as well as employees of local businesses and the county government, can buy coverage through the alliance, which cut a deal for a discount of about one-third off the local hospital’s list prices (although at least one expert thinks they could have done a lot better).

“It wasn’t for the faint of heart,” said Tamara Drangstveit, who ran a county social services organization before becoming Peak’s executive director and, effectively, one of the lead negotiators.

Fed up with high hospital prices even after insurers’ negotiated discount, more employers are cutting out insurance middlemen and engaging in what is known as “direct contracting” with medical providers. They cut their own deals.

Direct contracting is a hot topic among employers because they are “up in arms about insurers not keeping prices in check,” said Chapin White, a Rand Corp. researcher who studies the tremendous variation in hospital prices. The citizens here in Colorado are taking the approach to the grassroots level.

What Peak did — starting with painstakingly gathering data about exactly what hospitals in the region were being paid by insurers, employers and consumers — might be an answer for some.

Such efforts may be helped by Congress, which is considering barring secrecy clauses in hospital and insurance contracts that can prevent employers from learning exactly how much insurers pay. The Trump administration is also considering proposals to require more public disclosure of negotiated hospital prices.

And, according to press reports, the experience with Peak may go statewide. Colorado’s insurance commissioner and Gov. Jared Polis say they are considering an alliance that could bring together state employees, individuals and private employers in a similar health care purchasing network.

“It feels like the curtain is going up on health care costs and prices,” said Cheryl DeMars, CEO of The Alliance, a group of 240 self-insured private sector employers that directly contracts with hospitals in Wisconsin, northern Illinois and eastern Iowa.

While interest is growing, experts caution that direct contracting won’t work in many places.

“It won’t have impact in urban areas where no one has significant market share, but it could work in rural areas where there is a dominant employer or some other large group,” said Gerard Anderson, a professor at Johns Hopkins University in Baltimore who researches health care costs.

First Step: Get Price Information

It takes a great deal of effort — and some luck — to peer behind the curtain.

“The people buying the plans, employers and workers, are often barred from viewing the contracts insurers have negotiated on their behalf … so they don’t know if they are reasonable,” said White at Rand.

The Peak Health Alliance in Colorado was lucky that the state is one of at least 18 that have made public some medical care price information from insurers. It also gathered similar information from local self-insured employers’ insurance plans.

Peak was able to compare the payments made to Centura Health, which owns the local hospital and others in the state, to what Medicare would pay.

“We found the average emergency room claim was 842% of what Medicare would pay — and our outpatient rates were 505% higher than Medicare,” Drangstveit said.

That helps drive up premium costs. It isn’t unusual, Drangstveit said, for families who don’t qualify for a federal subsidy through the Affordable Care Act to face $2,500 monthly premiums with an $8,000 annual deductible. Many area residents go uninsured or are forced to make hard financial choices.

“The stories we hear are heartbreaking,” said Drangstveit.

Second Step: Negotiate With The Hospital

Lee Boyles, CEO of Centura Health’s St. Anthony Summit Medical Center in Frisco, said he wasn’t surprised by the findings of Peak’s analysis.

Charges are high, he said, reflecting the cost of living, as well as the need to maintain round-the-clock trauma coverage, emergency helicopter service and physicians who specialize in the kind of head and limb injuries that can result from mountain sports.

Plus it’s the only hospital in town. Others are a 70-mile drive down the mountain in Denver.

Unlike some hospitals elsewhere with similar exclusivity, Centura was willing to bargain.

“We were going to do what’s right for our community,” said Boyles.

It also helped that granting discounts to locals wouldn’t affect the bottom line much.

Residents account for only about 15% of the hospital’s business, Boyles said, which is a far smaller portion than at a typical hospital.

Tourists and sports enthusiasts — many well-heeled, with good insurance — make up the largest share of the hospital’s business. Thus, any new prices negotiated with Peak would not apply to most of the hospital’s business.

The deal reached with Peak, Boyles said, represents a discount of about one-third off the hospital’s “list prices.”

Third Step: Keep Pushing

Anderson at Johns Hopkins said shaving this amount from already high charges isn’t much of a break. A discount pegged to Medicare rates, plus a bit for overhead and profit, would be better, he said.

In a report released in May, Rand used claims data from employers in 25 states to show a huge variation in prices paid to specific hospitals and show a huge variation between the prices paid by employers to those facilities and how much Medicare would allow for the same services.

To be sure, hospitals have long argued that Medicare doesn’t cover their costs. The Rand study found that employers paid an average of 241% of Medicare rates in 2017, but some saw rates three times those paid by the federal program or more.

Gloria Sachdev, CEO of the Employers’ Forum of Indiana, a group working to lower health care spending there, cautioned that price transparency alone is not a panacea.

Her organization, which commissioned the study, is pressing for more quality and cost data as well as tougher negotiations by its insurers.

“We need to take the driver’s seat,” said Sachdev.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

Simple Exercise To Naturally Drain Your Lymph System, Boost Immune Function & Remove Toxins

Simple Exercise To Naturally Drain Your Lymph System, Boost Immune Function & Remove Toxins

By Dr Maxwell 

http://www.askdrmaxwell.com/2013/07/rebounding-how-to-bounce-your-way-to-better-health/

When you think of a mini trampoline, you probably picture something your kids might like to play with, but mini trampolines aren’t just for fun.Rebounding, a type of exercise that uses a mini trampoline, has been touted by NASA as “the most efficient, effective form of exercise yet devised by man.”

Rebounding burns approximately 15% more calories than walking or jogging and takes all of your major muscle groups through their full range of motion. Rebounding is the only form of exercise that strengthens, tones, and detoxifies every single cell in your body.

It also encourages lymphatic drainage, which strengthens your immune system and prevents the development of disease.

The Importance of Your Lymphatic System

The lymphatic system is a subset of your circulatory system and is responsible for transporting a clear, colorless fluid that flushes toxins from your body. This fluid is called lymph and its proper flow is critical to proper immune system function.

You may not be aware of this but your tonsils and adenoids are a part of your lymphatic system and they are your first line of defense against harmful germs and contaminants.

Unfortunately, with tonsillectomies and adenoidectomies accounting for more than half a million US surgeries, many have lost this defense, even though these two common operations have been found to be largely ineffective.

The spleen is your largest lymphatic organ, which produces the lymphocytes that create antibodies that fight off foreign invaders. Part of your spleen also acts a filtration system, which is responsible for removing old and damaged red blood cells from your body.

The thymus gland stores the lymphocytes created by the spleen, giving them a place to mature into active T-cells. T-cells are your immune system’s soldiers, responsible for protecting you from infection and malignancy.

When your lymphatic system is working well, your immune system functions properly and disease is kept at bay. However, a sedentary lifestyle, poor diet, and exposure to toxins can slow your lymphatic drainage down to a crawl. When this happens, you are much more vulnerable to colds and flu as well as more serious diseases like lymphedema and breast cancer.

Pain in stomach - girl in painSymptoms of a sluggish lymphatic system include:

Frequent colds and infections

Chronic fatigue

Poor circulation

Cellulite

Itching skin (not related to skin conditions)

Heavy sweating

Chronic allergies and sinusitis

The Powerful Lymphatic Benefits of Rebounding

Normally, your lymphatic system drains very slowly at about one to two fifths of a teaspoon per minute. When you are rebounding, this drainage ramps up to an impressive four teaspoons per minute. Rebounding creates a powerful change in the gravitational pull on your body, which opens your lymphatic valves and encourages lymphatic circulation.

The upward bounce on a rebounder closes your lymphatic valves while the downward plummet opens them. The increased G-force with which you land causes a surge of lymphatic drainage, improving circulation and detoxifying your entire system.

More Health Benefits of Rebounding

In addition to detoxifying your body and improving overall immune functioning, rebounding also has some other amazing health benefits.

Rebounding improves:

Bone density

Rebounding offers a low-impact workout that provides muscle and bone-strengthening benefits without the strain associated with some cardiovascular and weight-bearing exercises.

Balance and coordination

Rebounding improves your brain’s responsiveness to the vestibular apparatus in your inner ear, which improves both balance and coordination.

Cellular strengthiStock_000001840189XSmall

Rebounding improves the strength and vitality of every cell in your body.

Metabolism

Rebounding increases your metabolic rate, which helps improve the number of calories burned at rest as well as during exercise.

Lung capacity and respiration

Rebounding improves respiratory function through deep, rhythmic breathing and increased cellular oxygenation.

Sleep

Excessive toxic build-up in the body can interfere with proper sleep. Rebounding releases toxins while decreasing stress hormones, leading to a more peaceful, relaxed slumber.

Digestion

Rebounding regulates peristalsis (intestinal muscle movement), which improves digestion and elimination.

Thyroid function

Rebounding tones the endocrine system. This improves thyroid output and may reduce the symptoms of hypothyroidism.

Learning

Rebounding improves circulation, oxygenation of organs and cells, and detoxifies the entire system. This helps improve overall brain function, including memory and retention.

Mental Health

The combination of exercise, improved cellular oxygenation, and toxin elimination increase feelings of well-being and relaxation.

How to Select a Rebounder

When selecting a rebounder, it’s a good idea to avoid choosing the cheapest rebounder available. Cheap rebounders can easily break, resulting in injury and they don’t offer the same amount of joint support as their better-made counterparts.

There are certain things you want to pay attention to when selecting a rebounder. One, your rebounder should have at least 32 springs that taper at the end. This allows for better give and a more even bounce. Steel construction is best. Look for models that come with support bars if necessary and look for a Lifetime Guarantee or a strong refund policy. You should be able to try out your rebounder for 60-90 days before making a decision.

older man exercisingBefore selecting your rebounder, be sure to do thorough research and read reviews before making a commitment.

How to Use Your New Rebounder

Once you find the right rebounder for you, it’s time to get started using it. Rebounding is one of the most fun and versatile exercises you can do. It never gets boring and you can do it while listening to your favorite music or watching TV.

When you first get on your new rebounder, start slow with little jumps then increase to bigger jumps. Alternate your workout by adding jumping jacks, criss-crosses, and elliptical-style jumps. Max out with big jumps and cool down by going back to little jumps.

Alternatively, you can sit on your rebounder and use your feet to push your body up and down. You will still get the lymphatic drainage benefits even if you are unable to stand up to do your rebounding.

Rebounding is one of the best low-impact exercises you can do. It not only offers you a fun, effective way to work out, it also strengthens your organs while detoxifying your entire body. With rebounding, you can’t go wrong. Just 15 minutes a day is all you need to burn calories, boost your metabolism, and help stave off disease.

Water Fluoridation

Water Fluoridation

One Place, Many Possibilities, Your Truth

Water Fluoridation

Fluoride is the negative ion of the element fluorine which is involved in maintaining the good health of teeth and bones. Fluoridation of water was first started as a means to reduce the onset of dental cavities and other issues by ensuring adequate intake of fluorine.

However, excess fluoridation of water has its own consequences. In fact, dental issues need to be addressed at an individual level instead of incorporating a treatment at such a huge mass level by making the general public drink fluoridated water.

Which is why most European countries have altogether banned fluoridation of water in order to prevent its ill-consequences. But still, most countries in the Asian sub-continent and a majority of American states still resort to water fluoridation.

How does fluoridation of water adversely affect one’s health?

  • Dental Fluorosis:

True that fluoride is quite important to maintain the good health of the teeth, it does more harm than good when consumed in large quantities. Visual changes like spotting on teeth, brown stains, and yellowing are bound to occur.

Dental fluorosis is more common in kids under 2 years of age and results in weakening of the teeth in the long run.

  • Skeletal Fluorosis:

Being continuously exposed to large amounts of fluoride in the diet can cause a bone disorder called skeletal fluorosis. This condition is characterized by damage to bones and joints resulting in bouts of acute pain and discomfort.

This causes undue hardening of bones leading to brittleness. In severe cases, impaired joint mobility can also occur.

  • Neurological issues:

Taking in excess amounts of fluoride in the diet can lead to decreased cognitive abilities in children as they mature into adults. In fact, in 2010, fluoride was ruled at a hazardous neurotoxin for child development along the lines of arsenic, lead, and methyl mercury.

  • Impaired thyroid function:

In severe conditions, excess fluoride deposits can damage the thyroid gland which may result in the continuous secretion of the parathyroid hormone leading to hyperparathyroidism.

This, in turn, causes depletion of calcium deposits in bones and an abnormal increase in the concentration of blood calcium levels. Reduced calcium in bones makes them vulnerable and more prone to fractures.

Other health issues arising due to water fluoridation:

  • Brain developmental issues
  • Reproductive problems and low-fertility in men and women
  • Skin disorders and acne
  • Bone conditions like osteoarthritis and temporomandibular joint disorder (TMJ)
  • Cardiovascular disorders like arterial calcification, high blood pressure, and arteriosclerosis

How can you avoid excessive exposure to fluoride?

The first step is to avoid consuming fluoridated water. If you live in a country where fluoridated water is a norm, install water purifiers that get rid of excess the fluoride in the water before you drink it.

Don’t let your child swallow fluoridated toothpaste and follow suit yourself. Better still, resort to using organic toothpaste than fluoridated ones.

Ensure that you only consume un-fluoridated salt. This is also quite important if you’re looking to reduce fluoride exposure.

Summing it up:

Fluoridation of water is a harsh reality the consequences of which are being tackled by the general public. However, you can still make amends to keep yourself and your family safe. In due course of time, your body will have excreted the excess fluoride toxins rendering yourself hale and hearty.

References:

https://www.healthline.com/nutrition/fluoride-good-or-bad#section4

https://www.medicalnewstoday.com/articles/154164.php

Top Ten Reasons to Oppose Water Fluoridation

https://www.webmd.com/vitamins/ai/ingredientmono-1068/fluoride

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