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ArticlesFebruary 28th, 2010
It never hurts to start off with a few simple truths. If it was easy to lose weight by eating less, there would be no obesity. If exercise burns off unwanted pounds, everyone would get off their couches and lose those potatoes. But life is never straightforward when it comes to losing weight and, more importantly, preventing the pounds from sneaking back when we are not looking. So what’s the problem? The Jesuits have a saying, “Give me the boy until the age of seven, and I will give you the man.” Put another way, as we grow up, we are surrounded by role models and authority figures who show us and instruct us on how to fit in and live our lives successfully. This so-called socialization process is largely complete by the age of seven. We have absorbed all the social rules for fitting into our culture and it takes a major effort to unlearn all these habits later in life.
So what’s the problem? Well, here comes another simple truth. The portion sizes sold as suitable for children in the US are the same as the adult portions in Europe. The portion given to adults in the US would feed an entire family in many other parts of the world. But, by the time we are seven, our expectations have been set. The eyes see the amount everyone eats as normal. The stomach is trained to accept this quantity – anything less and hunger pangs make life uncomfortable. So, if as an adult, someone tells you to eat less, you are being advised to act in a way that strikes you as fundamentally abnormal. You will suddenly stand out in social activities as the person who asks for less food when visiting friends for a meal or when ordering food in a fast food outlet. Even if you accept the label of eccentric, then comes the hunger pangs and your morale crumbles. Your mind may be strong, but your body betrays you.
Weight loss surgery is increasingly seen as an option by health insurance companies. They recover the cost in between two and four years through avoiding the need to pay for the treatment of high blood pressure, diabetes, heart disease, and so on. The procedures physically limit the amount of food your stomach can hold. No matter what your expectations, you physically cannot eat the same amount of food. The average cost of full surgery is $26,000. Keyhole surgery costs about $17,000. But this is not cosmetic surgery. It is a drastic measure and most doctors refuse it unless you are genuinely overweight and have consistently failed to lose weight any other way. That means you should diet, exercise and use acomplia. In clinical trials, the participants lost an average 10% of their body weight over a 12 month period. This represents a significant reduction but it may still not bring you down to a low BMI. More importantly, maintaining the weight loss is a real challenge. So, if your medical insurance will cover the cost and your doctor agrees, you should consider surgery if your BMI is above 30. Otherwise, buy acomplia and use it as part of a consistent low-calorie diet. Either way, your weight will fall.
Adults, Burns, Couches, Fast Food, Food Outlet, Health Insurance, Health Insurance Companies, Hunger Pangs, Jesuits, Losing Weight, Obesity, Portion Sizes, Potatoes, Role Models, Simple Truth, Socialization Process, Stomach, Trea, Unwanted Pounds, Weight Loss Surgery
ArticlesJanuary 26th, 2010
Medicalization is a wonderful word. It means the process of taking a natural condition and convincing people that it’s a disease to be treated and cured by the medical profession. Once a condition is medicalized, the pharmaceutical industry can sell drugs, doctors and hospitals can charge fees. The cash registers just keep on ringing up the profits. Once this happens, there’s a kind of bandwagon effect. The condition suddenly becomes a lot more serious. It’s now a disorder or disease. For health insurance companies, it’s a pre-existing condition.
Now there’s a funny thing about health insurance companies. They are never shy about coming forward with new reasons for not paying out on their policies. One of their classic excuses is the “disclosure” rule. The law sounds quite reasonable. If you are sitting in your office and never get to meet the person applying for a health plan, you have to rely on the honesty of what the person says when you decide whether to write the policy. It’s a sad fact that some people are less than honest when they apply for policies. They forget the heart problem and declare themselves fit and healthy. Insurance companies therefore need the right to rescind the policy – to cancel it if the applicant failed to disclose information needed to assess the risk.
So now we come to the case of Otto Raddatz who, courtesy of his sister, became a famous victim after his death. She testified to a Senate committee about what happened and the story, in suitably dramatic form, was later picked up by President Obama in support of his campaign for healthcare reform. The facts are easy to state. Here was a man lining up to get surgery for cancer. The hospital appointment was booked when, surprise, the insurance company decided to rescind the policy. Why? Because Otto had failed to disclose the fact he had acne as a teen! This was a serious pre-existing condition and likely an indicator he would get cancer later in his life. His failure to disclose it justified rescission. Well, fortunately, his sister was an attorney and she got the state attorney general on the job. Six weeks later, the insurer reinstated the policy and Otto got his operation. This gave him six more years of life.
It’s sometimes odd to see how the world works. The medical profession goes to great trouble to convince everyone that acne is a disease. The pharmaceutical industry sells us accutane which is an almost always effective treatment, clearing the skin and restoring beauty during the first period of treatment. And then insurance companies accept this medicalization and require people applying for policies to disclose acne as a pre-existing condition. This is a logical and predictable progression. If doctors say acne is a disease, it must be a pre-existing condition and everyone should disclose it when they apply for health insurance! Do not be deceived! The Illinois attorney general does not fight for everyone. Otto was lucky that his sister was an attorney with the right political connections. So never lie about having acne! The risk of rescission is real. And while you have acne, rely on accutane, the sure-fire way of solving the problem.
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Health insurance has become one of the largest monthly expenses for the vast majority of Americans. Not only has it become quite expensive, but for many, health insurance isn’t even available because they simply don’t make enough money to fit health insurance into the budget. This has left hundreds of thousands of Americans without adequate health coverage, including many children. For these reasons, health insurance has also become one of the biggest concerns for most people in the coming elections. So, why has health insurance become so expensive?
The first thing you need to understand about health insurance companies is that they are businesses whose sole interest is to make money by providing a service. In order to make money, these companies must turn a profit by bringing in more money than they spend. In today’s regulatory environment, along with the increased number of lawsuits related to health care, the cost of doing business in the health insurance industry has skyrocketed. These companies, in turn, have had to raise rates to accommodate those additional costs in order to keep making a profit.
That’s not to say that health insurance companies are completely honest with you about just how much health insurance is going to cost you. Most health insurance companies quote premiums based on age. You’ve seen the television ads that offer health insurance for a mere $129 per month for a 29 year old non-smoker. While that sounds like a very reasonable rate, there is more to this than meets the eye.
In order to get the rest of the story, so to speak, you’d need to look at the actual policy and the so-called “fine print.” In order to qualify for that low $129 rate, you’d have to be a perfectly healthy person whose never gotten sick in the past and have absolutely no reason to need health insurance in the first place. In short, they can offer this rate because there is little to no risk that the company will have to pay out any kind of benefit to this person.
Another thing you might not notice from just watching the advertisement is the size of the deductible. For the rate mentioned above, the deductible is likely to be somewhere around $1000. For other policies, the deductible can be as high as $5000.
So, what is a deductible, you might ask? The deductible in an insurance policy is the amount of money you must pay out of pocket before the insurance company will start paying out benefits. Usually, the deductible does not apply to all health care expenses, so you have to pay careful attention as to whether the policy is worthwhile in your particular situation. In some cases, you would spend less money just paying for health care services out-of-pocket than actually purchasing health insurance because of the deductible.
Another thing that might raise the price of insurance coverage is a pre-existing condition. This is any condition that existed before you purchase coverage with any specific health insurance company. In many cases, you may not be able to get coverage for that condition at all, unless you can prove that you have had continuous care for that condition during the time in which you had no insurance. Even if it is covered, you can be assured that it will cost you more money for it.
Because of all of these variables, most people wind up with far higher premiums than those low rates advertised on TV. In some cases, people may not even be able to get insurance at any price, due to the perceived risk to the insurance company. In many cases, the resultant premium is just simply too high to fit into an individual’s budget, and so they continue on without health coverage.
High insurance premiums are a fact of life in these times, and are likely to remain so for a long time to come. The only way to change this is to fundamentally change the approach to providing health care in this country, by socializing the health care system. This, however, comes with its own set of problems that can be worse than the current system in many respect. The bottom line is that there are no easy answers to solving the health care problems in this country. The only thing you can do is to be aware of all the issues surrounding the problem and make your decision based on facts, and not what the talking heads on television are trying to tell you.
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