Welcome new citizens to Life, Liberty and the Pursuit of Health Care

Recently I attended a Naturalization Ceremony, my first ever. Forty people from 15 different countries met all the requirements to become citizens of the United States.In honor of my new fellow citizens, I’m sharing a post I wrote about the American healthcare system-not perfect, but one we can “support and defend” with pride. 

Recently I attended a Naturalization Ceremony, my first ever. Forty people from 15 different countries met all the requirements to become citizens of the United States.

The ceremony was solemn but joyful with a local high school choir singing “Music to My Soul” as the whole audience clapped along. The Oath of Allegiance that I’m sharing with you here is sobering . Judge Michael said that we natural born citizens should take it to heart also.

Naturalization Ceremony
front page of the program
Oath of Allegiance
the oath of allegiance

In honor of my new fellow citizens, I’m sharing a post I wrote about the American healthcare system-not perfect, but one we can “support and defend” with pride.

Every year on July 4th we celebrate Independence Day- the day the original 13 American colonies established an independent country.

They subsequently established a government, military, educational system, highway system, public works, and a healthcare system.

We Americans may pride ourselves on not having “socialized” medicine or “national healthcare”, but we do have  a health care system that is a combination of public and private funding and administration. And even private healthcare must comply with a myriad of local, state, and federal laws and regulations.

I believe we have one of the best healthcare systems in the world  because of the people who work in healthcare- the people who devote years to education and training and who work tirelessly 365 days a year, 24 hours a day to make and keep us well.  Their commitment, compassion, dedication and competence benefits all of us and deserves our gratitude.

Statue of Liberty
Lady Liberty lifting her torch in New York harbor, from my vacation there 

According to recent statistics, the United States government accounts for-

40% of healthcare  spending

$1.3 trillion /year

Covering 100 million individuals

Through 4 federal agencies

Department of Health and Human Services 

Department of Defense

Veterans Administration

Department  of Homeland Security

(JAMA (Journal of the American Medical Association), June 21, 2016)

Healthcare for active duty military and veterans

During the American Revolution the fledgling government extended health care benefits to the soldiers and veterans of that war; that system evolved into the current military health care system which covers service members and the Veterans’ Administration system for veterans.

a Veterans Administration clinic
American soldiers serving in Afghanistan

Healthcare for civilians

Under President Barack Obama, Congress passed the Patient Protection and Affordable Care Act (ACA) in 2010 to guarantee basic health insurance to all citizens. Newly elected President Donald Trump vowed to “repeal and replace” this law while some changes have been made, it is still in force.

Two other government healthcare programs- Medicare and Medicaid are over 50 years old.

Medicaid provides insurance coverage for adults and children who are unemployed or low income.

Medicare covers disabled children and adults  and persons 65 years and older.

The numbers are rather staggering.

  • Together these programs cover at least 30% of Americans.
  • Together they comprise 25% of all federal spending.
  • Together they pay 40% of total U.S. health care spending.

An infographic from the Kaiser Family Foundation and JAMA explains this further.

(Cubanski J, Lyons B, Neuman T, et al. Medicaid and Medicare at 50. JAMA. 2015;314(4):328. doi:10.1001/jama.2015.8129)

You may not be eligible for either of these programs now, but chances are eventually you or someone close to you will.

  • Anyone can become disabled from a serious illness or freak accident.
  • You or your spouse may lose your job and your employer sponsored health insurance.
  • Your child may have a disability that will prevent them from working when they grow up.
  • We may all live long enough to qualify for Medicare on the basis of age alone.  Your parents or grandparents are near or already at Medicare age.
ELDERLY COUPLE -189282_1280
Senior adults age 65 and older use Medicare.

It’s important to understand how Medicare works, since it’s not automatic; even if you qualify, you need to sign up to be covered (with a few exceptions). The rules are summarized here. Or consider an  easy to understand book.  

Government healthcare administration –The United States Department of Health and Human Services (HHS)

Several government agencies regulate, monitor,  promote and/or support both public and private healthcare (most but not all of these are under HHS.) 

Food and Drug Administration- FDA

Centers for Disease Control and Prevention- CDC

National Institutes of Health- NIH

Occupational Safety and Health administration-OSHA

Drug Enforcement Agency-DEA

medication capsules
The FDA regulates the development and sale of medications and medical devices and the DEA regulates dangerous and controlled drugs.

Important Federal Healthcare Laws

The Affordable Care Act- ACA

Health Insurance Portability and Accountability Act-HIPPA

Emergency Medical Treatment and Labor Act- EMTALA

Health Information Technology  for Economic and Clinical Health- HITECH

Americans with Disabilities Act-ADA

Family Medical Leave Act-FMLA

Liberty Bell -replica
replica of the Liberty Bell at Disney World, Florida, photographed when I visited with my grandchildren

The origin of United States healthcare

In the Declaration of Independence, the founders of the United States created a nation based on the “self-evident truths”  of  “Life ,Liberty, and the Pursuit of Happiness” and to promote “Safety and Happiness” . 

In the Constitution they vowed to “promote the general Welfare” .

I wonder if they envisioned their new government would spend so much time and money providing and regulating health care –

most of which was not available or even imagined at that time? 

Let’s celebrate!

woman holding a sprakler
Let’s celebrate ! This photo and featured image from stock photo site- Lightstock.com (affiliate)

Dr. Aletha 

a woman in a red, white, and blue shirt
Me, a few years ago, showing my patriotic spirit by posing in red, white, and blue
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Let’s celebrate Life, Liberty and the Pursuit of Health Care

We Americans may pride ourselves on not having “socialized” medicine or “national healthcare”, but we do have a health care system that is a combination of public and private funding and administration. And even private healthcare must comply with a myriad of local, state, and federal laws and regulations.

Every year on July 4th we celebrate Independence Day- the day the original 13 American colonies established an independent country.

They subsequently established a government, military, educational system, highway system, public works, and a healthcare system.

We Americans may pride ourselves on not having “socialized” medicine or “national healthcare”, but we do have  a health care system that is a combination of public and private funding and administration. And even private healthcare must comply with a myriad of local, state, and federal laws and regulations.

Celebrate healthcare professionals

I believe we have one of the best healthcare systems in the world  because of the people who work in healthcare- the people who devote years to education and training and who work tirelessly 365 days a year, 24 hours a day to make and keep us well.  Their commitment, compassion, dedication and competence benefits all of us and deserves our gratitude.

Statue of Liberty
Lady Liberty lifting her torch in New York harbor

According to recent statistics, the United States government accounts for-

40% of healthcare  spending , totalling $1.3 trillion yearly

United States government healthcare covers 100 million individuals through 4 federal agencies

  • Department of Health and Human Services
  • Department of Defense
  • Veterans Administration
  • Department of Homeland Security

(JAMA (Journal of the American Medical Association), June 21, 2016)

Government sponsored health care programs

The Affordable Care Act, aka Obamacare

The  United States Congress passed the Patient Protection and Affordable Care Act (ACA) in 2010 to guarantee basic health insurance to all citizens.  During the last presidential campaign, President Trump vowed to “repeal and replace” this law but although it has been modified, it is still active

Healthcare for military service member, veterans ,and their families

During the American Revolution the fledgling government extended health care benefits to the soldiers and veterans of that war; that system evolved into the current military health care system which covers service members and the Veterans’ Administration system for veterans.

a Veterans Administration clinic
a Veterans Administration clinic (photo by Dr. Aletha)
American soldiers serving in Afghanistan
American soldiers serving in Afghanistan

Medicare and Medicaid

Two other government healthcare programs- Medicare and Medicaid are over 50 years old. 

Medicaid provides insurance coverage for adults and children who are unemployed or low income.  

Medicare covers disabled children and adults  and persons 65 years and older.

  • Together these programs cover at least 30% of Americans.
  • Together they comprise 25% of all federal spending.
  • Together they pay 40% of total U.S. health care spending.

An infographic from the Kaiser Family Foundation and JAMA explains this further.

You may not be eligible for either of these programs now, but chances are eventually you or someone close to you will.

  • Anyone can become disabled from a serious illness or freak accident.
  • You or your spouse may lose your job and your employer sponsored health insurance.
  • Your child may have a disability that will prevent them from working when they grow up.
  • We may all live long enough to qualify for Medicare on the basis of age alone.  Your parents or grandparents are near or already at Medicare age.
ELDERLY COUPLE -189282_1280
Senior adults age 65 and older use Medicare.

It’s important to understand how Medicare works, since it’s not automatic; even if you qualify, you need to sign up to be covered (with a few exceptions). The rules are summarized here. Or consider an easy to understand book here. 

Several government agencies regulate, monitor,  promote and/or support both public and private healthcare including-

Food and Drug Administration- FDA

Centers for Disease Control and Prevention- CDC

National Institutes of Health- NIH

Occupational Safety and Health administration-OSHA

Drug Enforcement Agency-DEA

medication capsules
The FDA regulates the development and sale of medications and medical devices and the DEA regulates dangerous and controlled drugs.

LIFE, LIBERTY AND THE PURSUIT OF HEALTHCARE

Congress enacted several important laws that administer and regulate both private and public healthcare.

The Affordable Care Act- ACA

Health Insurance Portability and Accountability Act-HIPPA

Emergency Medical Treatment and Labor Act- EMTALA

Health Information Technology  for Economic and Clinical Health- HITECH

Americans with Disabilities Act-ADA

Family Medical Leave Act-FMLA

Liberty Bell -replica
replica of the Liberty Bell at Disney World, Florida

Let Freedom Ring

In the Declaration of Independence, the founders of the United States created a nation based on the “self-evident truths”  of  “Life ,Liberty, and the pursuit of Happiness” and to promote “Safety and Happiness” . 

In the Constitution they vowed to “promote the general Welfare” .

I wonder if they envisioned their new government would spend so much time and money providing and regulating health care –

most of which was not available or even imagined at that time? 

Let’s celebrate!

woman holding a sprakler
Let’s celebrate ! This photo and featured image from stock photo site- Lightstock.com (affiliate)

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

Dr. Aletha 

a woman in a red, white, and blue shirt
Me, a few years ago, showing my patriotic spirit by posing in red, white, and blue

These are affiliate links you may find helpful and which help fund this blog with a commission when a purchase is made using them.

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Update on weight management options

 

(An update to this blog post is in progress. Check back soon.)

This blog has looked at several approaches to weight loss.

First and always are lifestyle changes involving food choices, and eating habits.

Along with that, one needs to start or increase physical activity.

There are many different ways to achieve these, from books, videos, group activities, online programs, counselling and many combinations of these.

For those folks who still can’t reach goal, the next options are weight loss medications, and surgery.

someone standing on a scale
New weight loss options are good news.

 

 

 

Now there are FDA approved options which do not involve drugs or invasive surgery. These medical devices aid weight loss by affecting the amount of food that gets eaten and/or absorbed into the body.

 

The ReShape Integrated Dual Balloon System was approved by the U.S. Food and Drug Administration in July 2015. . Candidates for the device are

  • Adults
  • BMI 30-40
  • At least one obesity-related condition- hypertension, diabetes, elevated cholesterol

It is a device placed into the stomach by going through the mouth and down through the esophagus through a tube called an endoscope. It takes about 30 minutes and requires on a mild sedative, not general anesthesia. Once in the stomach the “balloons” are inflated; by taking up space in the stomach it can trigger a feeling of fullness.

Patients still continue to follow their eating and exercise plan and the device is removed in 6 months.

Like any medical procedure, there are potential adverse effects including headache, muscle pain, and nausea from the sedation and procedure; in rare cases, severe allergic reaction, heart attack, esophageal tear, infection, and breathing difficulties can occur. Once the device is placed in the stomach, patients may experience vomiting, nausea, abdominal pain, gastric (stomach) ulcers, and feelings of indigestion.

The Orbera Gastric Balloon works in a similar way, with a single silicone balloon. Potential adverse effects are similar to the ReShape.

The Maestro Rechargeable System is implanted under the skin; an intermittent pulse generator delivers an electrical signal to the vagus nerve in the abdomen. The vagus nerve controls stomach action; when slowed down, one feels full sooner and theoretically will eat less.

 

Another interesting device is AspireAssist.

This is a tube inserted into the stomach, from which a portion of the stomach contents can be “aspirated” (removed) after eating.

This device helped 10 out of 11 people loss 18% of total body weight in one year.

An application has been submitted to the FDA but it has not been approved for use in the United States.

 

People lost weight with all of these devices largely due to the intensive counseling and support they received along with use of the device.

tape-403591_1280
Obesity is defined using BMI, body mass index, but waist circumference is also important and may be more accurate.

 

 

 

A success story

After gaining weight with her pregnancies, one woman , J.T. ,successfully lost weight with gastric bypass surgery.

Read about the lifestyle changes she made at this article from American Family Physician journal

 

IN THE NEWS- BIG LOSSES, BIG GAINS

Many news sources have reported  a recently published study about contestants in “The Biggest Loser” weight loss contest. In this contest, severely obese people have lost huge amounts of weight with strict diets and vigorous exercise.

Unfortunately, the study found that most of them gained most of the weight back over time, due to what the scientists called “metabolic adaptation”, popularly called slowed metabolism. This is discouraging news.

However, they also point out that even though the contestants regained a “substantial” amount of weight in 6 years post competition,

“they overall were quite successful at long term weight loss compared with other lifestyle interventions.”

Even though they regained weight, they still weighed less than when they started.

If you want to read the full report with all the graphs and statistical analysis, here is the link

Persistent metabolic adaptation 6 years after “The Biggest Loser” competition

 

statues of athletes jumping
Contestants in the Biggest Loser competition exercised several hours daily but did not continue this after it ended.

 

 

 

Review  my previous posts about weight management

at these links.

Obesity and BMI defined

How we should view excess weight 

How effective are weight management programs? 

A success story; how a doctor helped her patient lose weight

When diet alone doesn’t work

How my friend lost weight and inspired others with her example

 

Please share your experiences with weight management, good or bad. We’re here to encourage you in your efforts and celebrate with you in your success.

Good news- more weight management options

I have written about several approaches to weight loss. First and always is lifestyle changes involving food choices, and eating habits. Along with that, one needs to start or increase physical activity. There are many different ways to achieve these, from books, videos, group activities, online programs, counselling and many combinations of these. For those folks who still can’t reach goal, the next options are weight loss medications, which I have discussed previously, and surgery.

Now there is another option which does not involve drugs or invasive surgery. The ReShape Integrated Dual Balloon System was approved by the U.S. Food and Drug Administration in July 2015. . Candidates for the device are

  • Adults
  • BMI 30-40
  • At least one obesity-related condition- hypertension, diabetes, elevated cholesterol

It is a device placed into the stomach by going through the mouth and down through the esophagus through a tube called an endoscope. It takes about 30 minutes and requires on a mild sedative, not general anesthesia. Once in the stomach the “balloon” is inflated; by taking up space in the stomach it can trigger a feeling of fullness.

Patients still continue to follow their eating and exercise plan and the device is removed in 6 months.

Like any medical procedure, there are potential adverse effects including headache, muscle pain, and nausea from the sedation and procedure; in rare cases, severe allergic reaction, heart attack, esophageal tear, infection, and breathing difficulties can occur. Once the device is placed in the stomach, patients may experience vomiting, nausea, abdominal pain, gastric (stomach) ulcers, and feelings of indigestion.

Follow this link for more info.

After gaining weight with pregnancies, one woman successfully lost weight with gastric bypass surgery. Read about the lifestyle changes she made at this article from American Family Physician journal

 

You can review my previous posts which address weight management issues at these links.

Obesity and BMI defined

How we should view excess weight 

How effective are weight management programs? 

A success story; how a doctor helped her patient lose weight

When diet alone doesn’t work

How my friend lost weight and inspired others with her example

And again, please share your experiences with weight management, good or bad. We’re here to encourage you in your efforts and celebrate with you in your success.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

These are affiliate links you may find helpful and which help fund this blog with a commission when a purchase is made using them.

                              Dr. Aletha 

Listeria in the news again

Two major food companies are voluntarily recalling products that contain spinach that may have been contaminated with Listeria prior to reaching their facilities. The products are not definitely known to be contaminated and so far no illnesses have been linked to eating the products . Still, with even a suspicion, a recall is the safest action. Full details about the involved products  and how to return them are here at the FDA website.

via Recalls, Market Withdrawals, & Safety Alerts > Amy’s Kitchen Recalls Various Products Because of Possible Health Risk.

http://www.fda.gov/Safety/Recalls/ucm439439.htm

My post on March 16, 2015  talks about  symptoms and treatment of Listeriosis and another food recall