MATURE MARKET HEADLINES POSTED 06/25/98
- Tomatoes Play Catch-Up With Cancer Cure
- New Medicare+Choice Health Options
- Retirees Wrestle Wrongs of Retirement Rites
- Nursing Homes Ignore Many Elders in Pain
- Too Few Doctors Specialize in Geriatric Care
Tomatoes Play Catch-Up With Cancer Cure
Pass the ketchup, please. The latest research strongly suggests that Americans should consume more products processed from the tomato. (Yes, the spelling is "tomato", not "tomatoe". I have Dan Quayle's word on it.) . Why are tomatoes so valuable to the diet? Lycopene, a potent antioxidant found in tomatoes appears to offer a reduced risk of cancer. Lycopene is what gives tomatoes their red color.
You may already know about earlier research linking lycopene with reduced risk to heart attack and prostate cancer in men. The beneficial link between reduced cancer risk and processed tomatoes is reported in a series of published articles appearing in the June 1998 "Proceedings of the Society for Experimental Biology and Medicine".
"We now know that many thousands of cancer cases could be prevented through diet," explains Dr. John Weisburger, Senior Member of the American Health Foundation, which hosted the "International Symposium on the Role of Lycopene and Tomato Products in Disease Prevention," where the published studies were first reviewed. "Tomatoes, and especially processed tomato products, represent a good way for us to help reduce our risk for chronic diseases."
Studies show that lycopene is better absorbed by the body from processed tomato products than from fresh tomatoes. Processed tomatoes include ketchup, tomato sauce, tomato paste, and tomato soup. Now, I know what you're thinking, "What about fresh tomatoes?" Yes, fresh is okay. But the processed products have between 3 to 5 times more potency than fresh tomatoes. And, by the way, an equal portion of watermelon has the same potency as a fresh tomato ... just in case you aren't a tomato fan.
A number of other studies, according to the Tomato Council, demonstrate that lycopene helps reduce more than just cancer. For example, Carlo La Vecchia at the Mario Negri Institute for Pharmacological Research in Milan, Italy reported additional benefits in his study titled "Mediterranean Epidemiological Evidence on Tomatoes and the Prevention of Digestive-Tract Cancers". (Hmmm, do you think the guy who came up with that title, maybe has too much time on his hands? My suggestion would have been something like "Tomatoes and You". On second thought, I don't think I'm going to get a call from the "title creation" committee anytime soon.)
At any rate, La Vecchia's study found that Mediterranean diets featuring tomato products were linked with lower risk of cancer and heart disease for people living AND EATING in that region of the world. Here's the point. A little lycopene can't hurt. And, because your body doesn't produce it, you have to consume the tomato products. So let's all go out tonight to our favorite Italian bistro and just say "Ciao" to chow. Hope I got those last two words spelled correctly. Maybe I better put in a phone call to Dan ... just to be sure.
AgeVenture News Service, www.demko.com
BACK TO TOP
New Medicare+Choice Health Options
Currently, 17 percent of Medicare beneficiaries are enrolled in managed care plans. But that's all set to change. Soon. And in a big way. Starting in January 1999, in addition to original fee-for-service Medicare and health maintenance organizations, a broader array of health plans will be added to the menu of Medicare health options. These expanded health plan options are known as Medicare+Choice.
Government officials expect these options to have a major impact on how seniors receive health care. For example, by the year 2005, about 30 percent of all Medicare beneficiaries are expected to be enrolled in the new Medicare+Choice plans. In order to make that happen, seniors will need to be well-informed on both the range and types of options.
"More choice" sounds like a good idea, but you can get a mental hernia trying to compare all the options. So, the federal government will try to clear up some of the confusion by mounting a major consumer education effort between October 1998 and October 1999. Hmmm. What a coincidence.
The campaign begins one month before this year's November election, and ends one month before the November 1999 election. At any rate, beneficiaries will get consumer information on these options from a variety of sources, including government, employers, unions, and advocacy organizations for seniors. While many Medicare beneficiaries will have a larger number of health plan options to choose from, no beneficiary is required to change the way they currently receive their care.
Access to Medicare+Choice options will depend on where the beneficiary lives and what types of plans are available in that community. Here's the menu of health options that will soon be presented under the new Medicare+Choice initiative.
- Health Maintenance Organizations (HMOs).
In HMOs, beneficiaries must obtain
services from a designated network of doctors, hospitals, and other health care providers
who have agreed to serve plan enrollees, usually with little or no out-of-pocket payments.
- Health Maintenance Organizations with a Point of Service (POS) Option.
When
combined with a basic HMO package, the POS permits beneficiaries to selectively go out of
network to receive services, with higher out-of-pocket payment requirements.
- Preferred Provider Organizations (PPOs).
Beneficiaries in PPOs obtain services
from a network of health care providers that has been set up by the health plan. Unlike an
HMO, beneficiaries can choose to go to providers who are not in the network and the plan
will pay a percentage of the costs while the beneficiary is responsible for the rest.
- Provider-Sponsored Organizations (PSOs).
PSOs are a relatively new form of
managed care that work much like an HMO, except that they are formed by a group of
hospitals and doctors who directly take on the financial risk of providing comprehensive
health benefits for Medicare beneficiaries.
- Private Fee-For-Service Plans (PFFS plans).
The Medicare beneficiary elects a
private indemnity type insurance plan. The insurance plan, rather than the Medicare
program, decides how much to reimburse for services provided. Medicare pays the private
plan a premium to cover traditional Medicare benefits. Providers are allowed to bill
beyond what the plan pays (up to a limit), and the beneficiary is responsible for paying
whatever the plan doesn't cover. The beneficiary may also be responsible for
additional premiums.
- Medical Savings Accounts (MSAs).
Congress has authorized up to 390,000
Medicare beneficiaries to participate in a MSA demonstration. The beneficiary chooses a
Medicare MSA Plan -- a health insurance policy with a high deductible. Medicare pays the
premium for the MSA Plan and makes a deposit into the Medicare MSA that is established by
the beneficiary. The beneficiary uses the money in the Medicare MSA to pay for services
provided before the deductible is met and for other services not covered by the MSA Plan.
Unlike other Medicare plans, there are no limits on what providers can charge above the
amount paid by the Medicare MSA Plan. Unlike other Medicare+Choice options, individuals
who enroll in MSAs are locked in for the entire year, with a one-time option of
withdrawing by December 15 of the year in which they enrolled.
There you have it. All the proposed options. Hopefully, this summary will answer many preliminary questions that seniors have about the differences between all those health options on the Medicare+Choice menu.
Source: Department of Health and Human Services.
AgeVenture News Service, www.demko.com
BACK TO TOP
Retirees Wrestle Wrongs of Retirement Rites
Retirement is part of the new reality in American Society. It is not wrong, or right, to retire. Retirement is beyond value judgements of right and wrong. Retirement is "truth", unquestioned truth, a rite of passage from the world of work to the world of, .... well, that's what I want to talk about.
Maybe it's time to question the unquestioned truth because the so-called American Retirement Rite isn't always a rewarding experience. Like vacationers who discover that they've fallen into a tourist trap, retirees are starting to say, "This doesn't look anything like the brochure". In fact, the American way of retirement sometimes reads like a bad novel titled "Time and Punishment".
These are the thoughts that led me to write a recent column, "Retirement Doesn't Work". My advice ... "don't do it". At least, don't retire until you have something (plan, goal) to retire to. Something that keeps you looking forward to life. As I've often said, "Those who don't long to live, don't live too long".
At any rate, after writing the column, I received a number of responses from readers across the country. Responses that can best be described as "all over the scale". Some saw my advice as genius, a real "head" for retirement. Others agreed that I did indeed have "a head", but speculated it was stuck some where ... in a position that was ... anatomically incorrect. I'll start by sharing the letter I received from one of the retirees who agreed with me, and conclude with two notes from retirees who have their own thoughts on retirement.
READER B.G.R. wrote, DEAR DAVE:
"How right you are!!! I opted to take early retirement after 29 years of working for the State. I turned 50 on December 23 and that was the last day I worked. Oh, I had a GREAT plan. I've always loved animals. I thought I'd get a job with a vet (just as a kennel attendant) or at a kennel -- almost anything to work with animals. It didn't happen. No one would hire me. So after being out of work for 2 months I started looking into anything I could. We have a local grocery story here that is among the best 16 places to work in the country so I put in an application. I was given a job to begin February 16. I was on my way February 12 to do the final paper work when I was involved in a very serious car accident. My car was demolished (thankfully,not my fault, but that doesn't make it hurt less!) Needless to say I lost the job. So since February my life has entailed doctors, medications, and sitting alone in my apartment missing my job and my friends from work and the structure it provided. Fortunately, I get a good pension from the State as well as good health benefits. But I really liked my job. The only reason I left was to pursue my life-long dream of working with animals. Also financially, with my pension and a part time job I would have been making more than I made working. So it seemed like the right choice. How was I to know that no one would hire me in the animal world or that
I would be in such a bad accident and stuck home alone day after day getting more and more depressed. Sorry for the life story. I just wanted you to know how very RIGHT you were!"
READER S.M. wrote, DEAR DAVE: (Okay, okay. They didn't EXACTLY say "Dear" Dave)
"We are young retirees...middle 50's.....the greatest part of retirement is we are living by OUR rules....probably, the 1st time in our life! We can do anything we want, anytime we want...within our budget....and it is fun being creative when our budget does not allow it...I think that we are being brainwashed to think that a "job" is the only valuable and worthwhile position in life. I feel sad for those who cannot retire...we ALL deserve it!"
READER O.R.E. wrote:
Dear David: "Sounds great. Except, how do you overcome age discrimination, the most massive, pervasive, subtle and difficult to prove form of job discrimination? To deny that this is so, is almost as bad as insisting that the Earth is really flat."
This last reader made an interesting point. Age discrimination can push an employee out of the workplace, then once he's out, it can keep him from re-entering the world of work, especially when he finds retirement sometimes doesn't look anything like the brochure.
See related article in the AgeVenture archives.
Aging? Boomers say "Hell no, we won't go"
AgeVenture News Service, www.demko.com
BACK TO TOP
Nursing Homes Ignore Many Elders in Pain
Living with cancer is worrisome. Living with cancer in a nursing home is troubling. Living with cancer in a nursing home as a member of a minority group is tragic. At least that's what a recent nursing home study seems to suggest. Here's why.
40 percent of nursing home patients with cancer have daily pain, and one-in-four of these patients receive no painkillers, according to a study of nursing homes in five states. The research study, reported in the Journal of the American Medical Association (JAMA), was undertaken by Roberto Bernabei, M.D., of the Universita Cattolica del Sacro Cuore in Rome, Italy, Giovanni Gambassi, M.D., of Brown University in Providence, R.I., and colleagues.
The researchers studied the adequacy of pain management in elderly and minority cancer patients admitted to nursing homes. 13,625 cancer patients aged 65 and older and living in Medicare and Medicaid-certified nursing homes participated in the study. Twenty-five to 40 percent of these elderly cancer patients experienced daily pain. Of those who experienced daily pain, the older and minority cancer patients were less likely to be medicated for their pain. Regarding the administration of pain medication, here's what the study found.
- 16 percent of those in daily pain received non-narcotic drugs (over-the-counter)
- 33 percent of those in daily pain received weak opiates
- 26 percent of those in daily pain received morphine or similar substances
- 25 percent of those in daily pain did not receive any pain-killing agent
The researchers also found a strong relationship between pain and belonging to a minority group.
In particular, the pain of minority patients was under-reported, and minorities were less likely to receive medication. Here's what the study found.
- racial or ethnic minority groups were less likely to have pain recorded relative to whites
- minority patients were more likely to receive no analgesia (pain-killer)
- minority patients were less likely than whites to have pain recorded
Why didn't the nursing home administer the pain medication? Was cost a factor? Apparently not.
Researchers believe that financial issues were unlikely to play a role in whether pain medications were provided because all the patients, regardless of their own health insurance, had Medicare coverage extended to include all medication costs.
Reduced use of medication appeared to result from under-reporting of pain by the cancer patients. "Elderly may experience more pain than younger people, although they may be less likely to complain about it." Under-reporting of pain, say the researchers, may result from multiple medical problems, cognitive and sensory impairment, and the presence of depression.
The researchers seemed to find some irony in the situation because the World Health Organization has widely disseminated pain management guidelines that have produced pain relief in over 90 percent of similar cases. So why is pain management in such a poor state in such a rich nation? The Greeks may have invented "tragedy", but it's American eldercare that's kept the torch burning. Source: Journal of the American Medical Association
See related articles in the AgeVenture archives.
Market Watch: Nursing Home Trends
Nursing Home Therapy Declared Excessive
AGS Launches Pain Management Guidelines
AgeVenture News Service, www.demko.com
BACK TO TOP
Too Few Doctors Specialize in Geriatric Care
If the physician workforce remains unchanged, chances are that the physician who takes care of
you in your golden years won’t know enough about the physiology of aging, late life depression, or
Alzheimer’s disease to provide you with quality health care.
That is why, as the population continues to age at an unprecedented pace, the Senate Special Committee on Aging is examining the realities of a workforce shortage of properly trained geriatricians and geriatric psychiatrists to care for our aging population now and into the next century.
With more than 33 million Americans currently over the age of 65, we should have 24,000 geriatricians and geriatric psychiatrists. Instead we have about 8,000. It's not that the government isn't trying. Medicare paid nearly $7 billion in graduate medical education costs in FY98. But only a fraction of those dollars were directed toward the clinical education of physicians who focus on the healthcare needs of older adults.
Of almost 100,000 medical residency and fellowship programs that Medicare helped support nationwide, only 324 were in geriatric medicine and geriatric psychiatry. The Congressional Bipartisan Commission on the Future of Medicare is trying to develop a strategy on how best to develop systems of training and health care delivery which ensure that physicians who treat older patients understand how both physical and mental illness might appear differently in older versus younger patients.
Such discussion is imperative as the current inadequate training and under-staffing of the geriatric medicine workforce comes with a tremendous cost in excess disability, unnecessary hospitalizations and treatments, and lives lost.Sources: Senate Special Committee on Aging, American Association for Geriatric Psychiatry, American Geriatrics Society.
See related article in the AgeVenture archives.
Demographics Demonstrate Doctor Debacle
AgeVenture News Service, www.demko.com
BACK TO TOP
View More Headlines
|
