Strange Therapies: Proceed with Caution

Amidst today’s modern medical treatments and physical and mental therapies, there are some ancient ones such as acupuncture, ear candling, touch and sound therapies that have some scientific evidence of their effectiveness. Yet, while some may consider those unusual, there truly are some weird therapies that exist worldwide – with claims that they actually work. Here are a few that I felt were the strangest.

Snake Massage Therapy. Yes, just as the word implies, this involves piling a heap of non-venomous snakes onto the bare body. Apparently, the slithering action against the body’s bare skin provides relief to your aching muscles. While no formal research exists on its effectiveness, one spa in the Middle East has become popular because of its use of snakes. The Israeli spa, owned by Ara Barak, actually uses California and Florida king snakes, corn snakes, and milk snakes for treatment. Barak said she discovered the act of just holding her pet snakes relaxed her and her friends. That discovered prompted a new idea for Barak’s spa. However, for those who can’t handle snakes, she offers a rodent massage where mice and rats are placed on the bottom of people’s feet for relaxation. (Ah, yeah, right)

Virtual Dolphin Therapy. You don’t need a beach for this one! Your imaginary dolphin can simply relax and rejuvenate you! Apparently, the act of watching dolphins swimming and frolicking in the water offers a state of relaxation. There is no scientific evidence that this actually works. But wait…it can also include the sounds. Now, that brings in the element of music/sound therapy, for which there are numerous scientific studies that prove its effectiveness. I suspect it’s the sound therapy that has more of an impact than the virtual dolphin watching itself. (The jury is still out on that one)

Psychic Surgery. For those who believe in this type of phenomenon, this therapy might just be for you. But you can’t get it here. Medical ethics and other legal considerations prohibit such practices in the United States.  It involves a psychic surgeon simply pressing on and touching the diseased area of the body in order to heal it. The technique is common in Brazil and the Philippines, but has its roots in ancient Philippine history. Academic research has confirmed that this technique does have some value, but cannot scientifically explain it. One skeptic researcher, Harvey Martin, who spent some time investigating this phenomenon in the 1990s, noted, “I saw overwhelming evidence that psychic surgery was a very effective method of healing.” This “evidence” was only his witnessing people being cured of their alleged diseases.  A 1990 study published in Medical Anthropology Quarterly found that the psychic surgeon is more like a magician, using sleight of hand and trickery. The alleged “sick” were apparently never sick to begin with, yet claimed remarkable healing following their “surgeries.” However, anthropologists believe that psychic surgery is largely intertwined within the Philippine culture. As many studies have shown, a strong will and mind can be a powerful healer. (You can make the call on this technique)

Urine Therapy. While some pathogens exist in human urine, it has been proven through scientific research to have medicinal purposes. But, its uses extend far beyond topical. Many of us already know that it can assist in healing wounds as well as easing the sting from painful skin burns, cuts, etc. But, it has been reported that when ingested, urine can help treat diabetes, sickle cell anemia, and possibly cancer. In China, urine is used as a baby face wash in an effort to protect the skin. In India, the country’s Prime Minister attributes his good health to drinking a pint of the substance every day. However, there are significant dangers to urine therapy. Researchers have confirmed that ingesting urine can actually increase the production of multiple antibiotic resistant bacterial pathogens in the body, making it even more difficult to fight off disease. (I have no plans to start a urine regimen anytime soon)

Ho’oponopono. It’s a long word but its meaning is short. Basically, healing begins after saying “I’m sorry.” Ho’oponopono is an ancient practice of forgiveness. Of all of the alternative therapies out there, this one might actually have some validity without scientific research. It is a Hawaiian method of problem solving created by Mornah Nalamaku Simeona, a Hawaiian Kahuna Lapa’au. Of interest, scientific studies have shown that Ho’oponopono carries strong implications of reducing negativity within groups as well as promoting healing, mental, spiritual, and physical. It very well may be the best alternative therapy that everyone should try – at least once!

References

Benor, D. (2008). The Hawaiian practice of Ho’oponopono: healing the collective consciousness and the planet. Positive Health, 152, 1.

Boyd-Brewer, C. and McCaffrey, R. (2004). Vibroacoustic sound therapy improves pain management and more. Holistic Nursing Practice, 18(3), 111-119.

The Foundation of I, Inc. Freedom of the Cosmos. (2013). Website. Retrieved from http://www.hooponopono.org/.

Killalea, D. (2008). Welcome to reptile therapy – the slithery snake massage designed to help you relax. Retrieved from http://www.dailymail.co.uk/news/article-1079623/Welcome-reptile-therapy--slithery-snake-massage-designed-help-relax.html.

Lee, E.-J., Bhattacharya, J., Christof, S., and Verres, R. (2012). Monochord sounds and progressive muscle relaxation reduce anxiety and improve relaxation during chemotherapy: A pilot EEG study. Complementary Therapies in Medicine, 20(6), 409-416.

Martin III, H. J. (1999). Unraveling the enigma of psychic surgery. Journal of Religion & Psychical Research, 22(3), 168-174.

Ogunshe, A. A. O. Fawole, A. O., and Ajayi, V. A. (2010). Microbial evaluation and public health implications of urine as alternative therapy in clinical pediatric cases: health implications of urine therapy. Pan African Medical Journal, 5(12), Published online.

Singer, P. (1990). “Psychic Surgery”: Close observation of a popular healing practice. Medical Anthropology Quarterly, 4(4), 443-451.

TopTenz.net. (2013). Top 10 weird health therapies. Retrieved from http://www.toptenz.net/top-10-weird-health-therapies.php.

Tracey, B. (2008). Spa unleashes snakes for your pains. Retrieved from http://www.nbcnews.com/id/16812096/ns/business-small_business/t/spa-unleashes-snakes-your-pains/.

Vaccines for “The Common Cold”

Vaccines are common protective agents against many diseases, some of which could be fatal such as smallpox, Hepatitis A and B, Lyme disease, and tuberculosis, just to name a few. While it’s rare that epidemics of these diseases occur today in industrialized nations, we still struggle with one particularly stubborn illness: Nasopharyngitis, better known as “The Common Cold.”

Researchers have discovered that annual costs associated with the common cold are near $40 billion, which includes doctor visits, emergency room appearances, and over-the-counter remedies and supplies for treatment. As a nation, we purchase piles of cold pills, aspirins, and alternatives such as Echinacea and Vitamin C tablets just to help beat the common cold. In many cases, the immunization system of the recipient oftentimes renders these remedies ineffective.

So, why not create a vaccine? We have one for influenza, which is a virus as well; so it stands to reason that a common cold vaccine is possible. It actually is, but it hasn’t yet been perfected.

According to a July 2 journal review of vaccines for the common cold, Ecuadorian researchers found that any common cold vaccine currently in development has been largely ineffective for humans. With such a ubiquitous illness, why can’t we eradicate it?

Unfortunately, the common cold virus is ever mutating, making it almost impossible to fight against it through vaccinations. In fact, scientists have been working for more than 40 years to perfect a vaccine for the common cold and have failed. We came close in a 1966 when a particular strain of the common cold was actually halted by a manmade vaccine. Yet, when the virus mutated, the immunization was no longer reliable. 

We are close again, according to a study released in 2011. Massachusetts Institute of Technology Scientist Todd Rider has developed an antiviral drug known as Draco (Double-stranded RNA Activated Caspase Oligomerizer), which has so far proven effective against several common cold strains in laboratory trials with human tissue. It has not been given to an actual human being yet. Designed to rapidly kill virus-infected cells while not harming uninfected ones, DRACO is still in test phases with animals.

Until we actually have a safe and effective vaccine, we’re basically stuck with our old methods of dealing with the common cold. The “Dummies” Series of books published by Wiley & Sons provides seven tried and true methods that can shorten the duration of your summer cold (or at least make you feel better while you have the cold):

1.      Wash your hands often. Germs readily spread by your hands touching infected objects or other people (as in a handshake). Keep them clean!

2.      Use hand sanitizers. If you do not have ready access to soap and water, make sure you use antibacterial hand sanitizers that kill germs. But, don’t use this as a substitute for hand washing. Use the sanitizer as a temporary solution until you can get to soap and water.

3.      Drink plenty of fluids. Water is the best liquid for you to not only hydrate your body but flush out the cold. Orange juice is another option as it can also provide Vitamin C, which has some efficacy in shortening your cold symptoms.

4.      Rest and sleep. While it’s hard to stay indoors when the weather is so nice, but making sure you rest your body can help it fight the virus faster. That could mean heading to bed an hour or so early…or perhaps sleeping in!

5.      Spend time in the sun (limiting your activities). Studies have shown that colds are more often caught while trapped indoors with recycled air or limited air circulation. Even air conditioned spaces can still harbor the virus. Perhaps combine your rest by napping outside (wear sunscreen!).

6.      Treat the symptoms. While there is no cure for the common cold, there are treatments to ease your symptoms. While Naturopaths and some medical practitioners recommend letting the cold run its course, there are over-the-counter remedies to alleviate the runny nose and coughing. The U.S. Food and Drug Administration highly encourages those who opt to use over-the-counter medicines to follow the recommended doses. The FDA notes that more health problems and complications occur with the common cold when these drugs are used in excess.

7.      Eat fruits and vegetables. With summer in full swing, we now have access to local produce. Eating fruits and vegetables that are rich in nutrients will boost your immune system and help rid your body of that nasty cold virus.

One common mistake that people often make in regards to the common cold is reach for an antibiotic. This is never a good idea. Public health professionals have noted that an antibiotic may appear to eliminate the cold faster; it really does nothing to stop the virus. All it does is reduce the effectiveness of the antibiotic when you really need it. This is how our bodies have become resistant to some new diseases (such as MRSA) because of the overuse of antibiotics.

If your cold symptoms persist after the traditional 7-10 day cycle, you may have more than a cold. This is when a check-up with your primary care physician is warranted.

References:

Hegarty, S. (2011). Is a cure for the common cold on the way? Retrieved from http://www.bbc.co.uk/news/magazine-16165605.

Jawad, M., Schoop, R., Suter, A., Klein, P., and Eccles, R. (2012). Safety and efficacy profile of Echinacea purpurea to prevent common cold episodes: A randomized double-blind, placebo-controlled trial. Evidence-Based Complementary and Alternative Medicine, 1-7.

Olszewska, W., Zambon, M., and Openshaw, P. J. M. (2002). Development of vaccines against common colds. British Medical Bulletin, 62(1), 99-111.

Rider, T. H., Zook, C. E., Boettcher, T. L., Wick, S. T., Pancoast, J. S., and Zusman, B. D. (2011). Broad-spectrum antiviral therapeutics. PLoS One, 6(7), 1-15.

Simancas-Racines, D., Guerra, C. V., and Hidalgo, R. (2013). Vaccines for the common cold. Cochrane Database Systematic Reviews, 6.

Stewart, D. (2013). Draco, the new virus killer, coming to a store near you soon. Retrieved from http://deekstewart10.wordpress.com/2013/02/12/draco-the-new-virus-killer-coming-to-a-store-near-you-soon/.

Wiley, J. & Sons. (2013). How to treat summer colds. Retrieved from http://www.dummies.com/how-to/content/how-to-treat-summer-colds.html.

Professional Athletes after 100?

Who says you can’t play professional sports after that “magical” old age number? Most people understand that a professional athlete's career may last into his or her 30s, but rarely beyond. Well, several people across the world have challenged the fact that even after 100, you can still be a professional competitor.

Let’s look a few amazing senior citizens:

Herman Smith-Johannsen (1875-1987) – At 104, Johannsen, more commonly known as “The Fabulous Jack Rabbit, competed in his final professional cross-country ski event. He was known as a pioneer of the skiing world and earned his nickname for his uncanny ability to hop around in the deepest snow in the thickest of forests. He settled in Cleveland and helped to popularize the sport of cross-country skiing in both Canada and the United States. After competing in hundreds of ski events, including several Olympic competitions, he was finally inducted into the Canadian Sports Hall of Fame at age 107. He was 111 when he died.

John Whittemore (1899-2005) – At age 104, only six weeks prior to his 105^th birthday, he competed in the Master’s Track meet in Santa Barbara, California. He was a javelin and discus thrower and set a new world record for the oldest professional Track and Field athlete.

Buddy Helms (1915-2003) – At age 87, he was a professional race car driver, his first racing being the first-ever NASCAR sanctioned race in 1949. Helms was actually still working at the time of his death as he was working on his vintage Chevrolet marine engine when gasoline ignited severely burning him.

Fred Davis (1913-1998) – At age 78, he was one of England’s more famous professional snooker and billiards player. He won both snooker and billiards. His professional career spanned from 1929 to 1993.

Jerry Barber (1916-1994) – At age 77, he was still a professional golfer playing on the PGA Tour. His biggest claim to fame was unseating Arnold Palmer in 1961 as Player of the Year on the PGA tour. That would have been at age 45 at the time. He played his last professional golf game at the Buick Invitational the same year he died.

Raja Maharaj Singh (1878-1959) – At age 72, he was still part of the professional Cricket team in Bombay. In fact, he was the captain of the team.

Albert Beckles (1930 – ) – At age 61, he won the Niagara Falls Pro Invitational bodybuilding competition in 1991. He was 5’7” and 218 pounds of pure muscle. Currently residing in Los Angeles, Becklees holds multiple international titles over his lifetime of bodybuilding.

Jeannie Longo (1958 – ) – At age 54, Jeannie Longo is still active in the professional cycling circles and is considered one of the greatest female cyclists of all time. She is a 59-time French champion and 13-time world champion cyclist. She may be most remembered for her Olympic competition in 1984. She also competed in the women’s road race in the 2008 summer Olympics, her 7^th Olympic appearance.

 Gordon Howe (1928 – ) – At age 52, he goes down as the oldest ice hockey player having been a professional with the Detroit Red Wings. He is a four-time Stanley Cup holder, and is currently retired living in Canada.

How do these people do it? Activity. In reviewing these individual’s biographies, it is adamantly clear that staying active in whatever interests you can keep both your mind and body alive and well.  Studies have long shown that staying fit and active will not only keep you living longer but will keep you living healthier.

I’m in awe over Johannsen’s cross-country skiing activities. From what I have read, the man has skied enough mileage in his lifetime that he has probably covered the distance around the earth several times! His energy comes from remaining active…active for life!

Regardless of your age or existing health, anything that you can do to improve your fitness will improve your health. Remember, you should talk with your primary care physician or health care provider before trying anything crazy. Who knows, you could be the next centurion competing in the Sochi Olympics!

References

The Auto Channel. (2013). Buddy Helms oldest NASCAR drive died from burns at age 87. Retrieved from http://www.theautochannel.com/news/2003/12/02/173688.html.

Farfan, M. (2013). Herman “Jackrabbit” Smith-Johannsen (1875-1987). Retrieved from http://laurentian.quebecheritageweb.com/article/herman-jackrabbit-smith-johannsen-1875-1987.

Wikipedia. (2013). List of oldest professional athletes by sport. Retrieved from http://en.wikipedia.org/wiki/List_of_oldest_professional_athletes_by_sport.

Caution: Manis and Pedis may be harmful to your health

Your next manicure or pedicure could actually do you more harm than good. Fingernail polish and its obvious cousin, nail polish remover, contain a plethora of toxic chemicals that are known to cause or associated with cancer, reproductive disabilities, asthma, and other harmful health consequences.

The focus today is on nail polish. Most commercial nail polishes contain what has been coined the “toxic trio” more commonly known by chemists as dibutyl phthalate (DBP), formaldehyde, and toluene.

DBP is an agent that adds the shine to your nail polish and basically makes your fingernails (or toes) sparkle. But, DBP is a toxin that has been linked reproductive disorders in males. A 2005 study found that males exposed to DBP while in their mother’s womb can adversely affect the male reproductive organs. Basically, the study found that DBP exposure impairs testicular function.

A more recent study conducted in 2010 connected DBP exposure to attention deficit hyperactivity disorder and low intelligence of school-age children. Furthermore, a study published in January’s issue of PLoS One, a biology-focused academic journal, discovered a strong connection between DBP and the inheritance of obesity.

We’re only one-third done defining the dangers of the toxic trio. Moving onto formaldehyde, this carcinogen has been linked to cancer, particularly when inhaled. In fact, recent studies have found that formaldehyde exposure may be a causal factor for nasopharyngeal cancer and leukemia. Because of this most recent research, the EPA has posed new rules for formaldehyde emissions, reducing the amount of the toxic chemical permitted into the atmosphere. Nail polish contains the chemical because of its hardening effect. Your polish would be rather pliable without the hardener. The agent is found in more products than just nail polish; however, no matter what the form, the danger still exists.

Toluene is used to produce a smooth finish over the finger/toe nails. It also is harmful to the human nervous and reproductive systems. The Centers for Disease Control and Prevention noted that exposures can cause extreme fatigue, mental confusion, nausea, headaches, and dizziness. Furthermore, extreme exposures have been linked to depression of the central nervous system as well as the bone marrow – both of which could be fatal.

While most people who receive manicures and pedicures do so with limited exposure to the toxic trio, the biggest risk is aimed at salon workers. These are the people who are exposed to the chemicals for at least 8 hours or more.

However, any exposure can be harmful and perhaps fatal, so it might be good to check on your salon’s product brands before your next visit. There are some manufacturers that have eliminated the use of the toxic trio from their products. So far, OPI, a leading nail polish brand, no longer uses the toxic trio in any of its products. It appears that Orly and Sally Hansen has followed suit. More information on safe cosmetics can be found through the Safe Cosmetics Action Network at www.safecosmetics.org.

References

Campaign for Safe Cosmetics. (2011). Nail products and salons. Retrieved from http://safecosmetics.org/article.php?id=224.

Centers for Disease Control and Prevention. (2013). Documentations for immediately dangerous to life or health concentrations: Toluene. Retrieved from http://www.cdc.gov/niosh/idlh/108883.html.

Cho, S.-C., Bhang, S.-Y., Hong, Y.-C., Shin, M.-S., Kim, B.-N., Kim, J.-W., Yoo, H.-J., Cho, I. H., & Kim, H.-W. (2010). Relationship between environmental phthalate exposure and the intelligence of school-age children. Environmental Health Perspectives, 118(7), 1027-1032.

Frost, L. (2013). EPA proposes new rules for formaldehyde emissions. Chemical Week, 175(16), 13.

Manikkam, M., Tracey, R., Guerrero-Bosagna, C., and Skinner, M. K. (2013). Plastics derived endocrine disruptors (BPA, DEHP and DBP) induce epigenetic transgenerational inheritance of obesity, reproductive disease and sperm epimutations. PLoS ONE, 8(1), special section 1-18.

National Cancer Institute. (2013). Formaldehyde and cancer risk. Retrieved from http://www.cancer.gov/cancertopics/factsheet/Risk/formaldehyde.

Swan, S. H., Main, K. M., Liu, F., Stewart, S. L., Kruse, R. L., Calafat, A. M., Mao, C. S. …Teague, J. L. (2005). Decrease in anogenital distance among male infants with prenatal phthalate exposure. Environmental Health Perspectives, 113(8), 1056-1061.

Laundry Pods are NOT Candy

Those colorful pods of laundry detergent can actually do more harm than good. Recent reports from poison control centers across the country found that children are mistaking these colorful bite-sized casings for candy.

Last year, poison control centers reported 1,008 laundry detergent exposures in just one month. Of those cases, almost half were from ingesting the pods or having them burst into the eyes or cause skin irritations. The Centers for Disease Control and Prevention reported that almost 90% of those with detergent pods exposures were children age 5 or younger.

The National Poison Data System found that 180,493 exposures to household cleaning products were reported in 2010 with 8,685 resulting from laundry detergents (all types).  The laundry pod was just introduced to the United States in 2010, whereas they have been available in Europe for more than 10 years. Based on European data, laundry pod poisonings and exposures accounted for 96% of the reported annual cases involving children age 5 and under. Ingestions accounted for 80% of those cases. Since the pods have been introduced in the United States, there have been more than 9,000 accidental poisonings from the pods. That number continues to grow as more people use the convenient product.

Unfortunately, you can’t blame a child’s curiosity for his or her interest in the cute, quishy, fun-sized pods. They look like a new toy or a delicious piece of candy. Because of their packaging in clear plastic containers, they truly do give the impression that they are edible pieces of candy with a juicy center. Of course they appear tasty in the eyes of a child.

Despite that glorious appearance, they are considerably dangerous with some toddlers being hospitalized after ingesting the high-concentrate liquid inside.

What can be done about keeping the product from your child? While it may be convenient to leave the laundry detergent pods sit in plain view by the washing machine, they really should be placed out of a child’s reach. (Of course, this would be true of all household chemical products.) Several manufacturers, including Proctor and Gamble (makers of Tide), have indicated they plan to repackage the pods in opaque containers rather than clear ones to deter little eyes from spying them out. Proctor and Gamble has also noted they were putting a double-locking system on the pod’s storage bins. However, locking them in a cabinet and out of a child’s reach is the best way to avoid accidental poisoning.

If you child does ingest the product, the CDC urges the parents or guardians to rinse out the child’s mouth well to extract as much of the product as possible. The next step is to call your local poison control center. To go one step beyond the recommendations, parents should consider contacting the child’s pediatrician.

Health researchers as well as consumer products research have discovered that the pods are safe for use as long as they are used in accordance to package directions. Eating them is not a safe option.

References

Centers for Disease Control and Prevention. (2012). Health hazards associated with laundry detergent pods – United States, May-June 2012. Morbidity and Mortality Weekly Report, 61(41), 825-829.

Weiler, E. (2013). Contact 2: Laundry pods poisoning children. Retrieved from http://fox2now.com/2013/05/01/contact-2-laundry-pods-poisoning-children/

Proctor and Gamble. (2013). Thanks for helping us spread the word, for the safety of our little ones. Our response to recent reports of incidents involving single pack detergents. Retrieved from http://news.pg.com/blog/tide-pods/thanks-helping-us-spread-word-safety-our-little-ones.

Health Services Severely Affected by Sequestration

As most of us are aware, sequestration has had an impact on a variety of national resources that provide vital services to our country. The cap on spending affected defense and nondefense discretionary programs including many public health initiatives. Over the next 10 years, $1 trillion will be cut from such programs because Congress failed to pass a balanced deficit reduction plan in 2011.

In the world of public health, there are substantial cuts to every state’s public health initiatives. Here are the key facts when compared to funding levels from 12 years ago (note that the numbers are adjusted for inflation and population growth):

·         Health Resources and Services Administration: $2 billion reduction. This reduces the health workforce which exists to support training new health professionals.

·         National Institutes of Health: $1.2 billion reduction. This reduces the amount of funding for critical health research such as cancer and diabetes cures.

·         Substance Abuse & Mental Health Services Administration: $813 million reduction. This cut will affect successful smoking cessation programs as well as critical mental health services for low-income groups. This could mean that close to 373,000 seriously mentally ill adults and children will go untreated, leading to increased hospitalizations, criminal cases, and homelessness.

·         Head Start: $968 million reduction. According to the Education Subcommittee on Appropriations, the last decade has already struggled with a significant shortfall from this early childhood education program that eliminated thousands of enrollment slots across the nation. This addition cut will likely result in turning away children who could benefit from Head Start programming in the state.

·         Child Care & Development Block Grant: $592 million reduction. This means that only one in six children will be eligible for child care assistance when far more than that require help. According to the Education Subcommittee on Appropriations, child care remains one of the biggest challenges for working families.

·         Centers for Disease Control and Prevention: $122 million reduction. This affects a plethora of programs from environmental health and immunization to emergency response and preparedness to global health.

The most recent sequestration hit the CDC the hardest causing a $580 million reduction in the centers’ 2014 operating plan. No program went unscathed as the following areas will see reduced funding:

a.       Immunization and respiratory

b.      HIV/AIDS, Hepatitis, STI and TB prevention

c.       Emerging and Zoonotic (animal-transmitted) infectious diseases

d.      Chronic disease prevention and health promotion

e.      Cancer prevention and control program

f.        Birth defects, developmental disabilities, disability and health

g.       Environmental health

h.      Injury prevention and control

i.         Scientific services (surveillance, informatics, career development)

j.        Occupational safety and health

k.       Global health

l.         Emergency response and preparedness

One of the hardest hit areas was the childhood immunization program, which took more than $1 million in cuts from 2013 to 2014. This could essentially create issues with the start of the school year in 2014 when required immunizations will not be as easily accessible to low-income groups.

In addition, the cuts affect food safety programs and up to 2,100 fewer food inspections jobs could be lost, putting families at risk of foodborne illnesses. Furthermore this cut coupled with the reduction in emergency response and preparedness funding could open the door to easier bioterrorism attacks via the nation’s food supply.

The list of issues goes on and on because of the impasse and the exceptionally high national debt. The impact will be nationwide with both services and personnel being cut. The NDD United (with NDD meaning nondefense discretionary) created a video that explains the cuts. You can access it at www.nddunited.org.

There has been a solution on the table through The Prevention and Public Health Fund, created under the Affordable Care Act. This fund had the potential to sink billions of dollars into public health and prevention services. According to the ACA, the fund is to provide $18.75 billion from 2010 to 2022 and then $2 billion per year after that. Unfortunately, a February 2012 piece of legislation cut that $18.75 billion over 12 years to $6.25 billion over 9 years. Further reductions were made thanks to sequestration.

References

American Public Health Association. (2013). Get the Facts: Prevention and public health fund. Retrieved from http://www.apha.org/NR/rdonlyres/3060CA48-35E3-4F57-B1A5-CA1C1102090C/0/APHA_PPHF_factsheet_May2013.pdf.

Office of the Press Secretary. (2013). Fact sheet: Examples of how the sequester would impact middle class families, jobs, and economic security. Retrieved from http://www.whitehouse.gov/the-press-office/2013/02/08/fact-sheet-examples-how-sequester-would-impact-middle-class-families-job.

NDD United. (2013). Stop the Cuts! [video file]. Retrieved from http://www.youtube.com/watch?v=cu0YPgTlAtg&feature=player_embedded.

Workplace Wellness Incentives: For Better or for Worse?

For those who have been following the various elements enacted through the Affordable Care Act, you are now fully aware of the new rule that will actually benefit some health enthusiasts but upset many others.

The final rule (TD 9620; CMS-9979-F under Employee Benefits Security Administration) has upheld an increase in rewards and penalties for those participating (or not) in employee wellness programs. What that means is employers can now increase the financial incentives from 20 to 30 percent of health premiums starting in January 2014. Those participating in tobacco cessation programs can receive a 50 percent incentive. Basically, if you participate in an employee wellness program, you could qualify for hundreds or thousands of dollars in premium or deductible discounts.

That’s the good news, but here’s the not-so-great news. If you do not participate or use tobacco products, you could be eligible for a penalty of those same amounts – 30% more for not participating in wellness programs and/or 50% for using tobacco products.

Okay, so there’s good news and not-so-good news. Now, here’s the worst of it…If you are unable to participate in such a program because of valid medical problems or conditions, including pregnancy, you could actually be penalized with an increase in your premium.

I’m a huge proponent of higher premiums for those who knowingly and willingly partake of unhealthy behaviors such as smoking, illicit drug use, and sedentary lifestyles. It is those people who will eventually end up costing the system more money because they run up hospital bills from medical issues associated with those behaviors such as emphysema, lung cancer, diabetes, stroke, heart attack, and more. That “system” is actually the rest of society footing the bill to underwrite the costs of their unhealthy behaviors.

Yet, I am not in favor of penalizing those who truly cannot be part of a wellness program. According to the Kaiser Health, the theory behind the incentives is to encourage people to make healthier choices in an effort to reduce significant health care costs associated with obesity, high blood pressure, and diabetes. Some studies have shown that money can be a strong incentive for changing our behaviors.

But, how fair is it that a woman with a difficult pregnancy would be penalized because she was physically restricted? What about the man bound to a wheelchair from a car accident that wasn’t his fault several years earlier? There are so many valid reasons for not being able to participate in a wellness program that penalties should probably be determined on an individual basis – or not enacted at all.

Two types of wellness programs were outlined in the rules, one which provides the opportunity for all employees to participate – such as sitting through a wellness class/seminar. The other program focuses on meeting goals (such as weight loss, or reducing blood pressure) or participating in activities (such as walking programs or fitness classes). It is this second program type that has produced the controversy.

According to Kaiser Health, the rule, filed on May 29 with the Federal Register, gives employers leeway, saying the programs must simply have a ‘reasonable chance’ of improving health. What does that mean? It means that every individual is given the opportunity to improve their health status starting from where they are today (or rather, as of January 1, 2014).

I am truly in favor of projects like employee wellness programs that can not only improve the health of the employees but improve productivity and overall economic wellbeing for the community. In fact, employers that cover the costs for gym memberships are really making it easy for their employees to improve their health.

Considering that employers have the option of enacting these discounts and penalties, I strongly recommend leaning towards a rewards system. Give those discounts to those participating in wellness activities, whether on site or in the community. And, for cases where there is a valid medical reason for lack of participation, the discount should still be offered. Yet, for those who flat-out refuse, I wouldn’t penalize them; but I certainly wouldn’t offer the reward.

Positive rewards have proven to be more successful than negative reinforcement. Any parent can tell you that!

References

Appleby, J. (2013). Final rule upholds increased rewards, penalties for wellness participation. Retrieved from http://capsules.kaiserhealthnews.org/index.php/2013/05/final-rule-upholds-increased-rewards-penalties-for-wellness-participation/.

Internal Revenue Service, Department of the Treasury, Employee Benefits Security Administration, Department of Labor, Centers for Medicare & Medicaid Services, Department of Health and Human Services. (2013). Final Rule: Incentives for nondiscriminatory wellness programs in group health plans. Retrieved from http://www.ofr.gov/(S(ztwp1tthdztmqqh35iza2ek4))/OFRUpload/OFRData/2013-12916_PI.pdf.