- Why You Can Get Slapped With a Surprise Medical Bill
- 8 Ways Eating Can Improve Your Mental Health
- Surgeon General Says Addiction Crisis a ‘Moral Test for America’
- Donald Trump’s Obamacare Conundrum
- Inside the Halting Fight Against AIDS
- This IVF Calculator Helps Couples Predict Their Chances of Having a Baby
- The Case Against Energy Drinks Is Getting Stronger
- Marijuana Appears to Benefit Mental Health: Study
Posted: 17 Nov 2016 08:39 AM PST
When you land in the emergency room, navigating your complicated health insurance is often the last thing on your mind. But even if you have to foresight to go to a hospital covered by your plan, not every doctor who interacts with you may be in that same network, potentially leaving you with a surprise bill later on.
In new research published in the New England Journal of Medicine, a pair of Yale University economists wanted to find out the scope of surprise emergency room billing in the U.S. They looked at 2014-2015 claims data from an unidentified large commercial insurer, capturing 2.2 million visits to ERs across the country for people under age 65, totaling about $7 billion in emergency care.
They found that while the vast majority of patients visited hospitals within their coverage network, 22% were treated by an out-of-network doctor. Many incurred sizable surprise expenses as a result, the researchers say.
“It turns out to be something that’s happening way more frequently than I would ever have guessed,” says Zack Cooper, one of the authors of the study and assistant professor of public health and economics at the Yale School of Public Health. “These bills can be hundreds, thousands or even tens of thousands of dollars.”
Assuming that the insurer would only pay the in-network rate, Cooper and his co-author calculated that those treated by an out-of-network doctor might receive a bill averaging $622.
Not everyone agrees that coverage discrepancies between doctors and hospitals are to blame. In a statement, the American College of Emergency Physicians (ACEP) took issue with the study, saying that people often don’t realize how little coverage they have until a big medical event like an ER visit. “Most emergency physicians prefer to be ‘in-network,’ as long as insurance companies pay fairly,” says Dr. Rebecca Parker, president of ACEP. “The study does not discuss that insurance companies are misleading patients by selling so-called ‘affordable’ policies that cover very little until large deductibles are met—then blaming physicians for charges.”
The problem is worse in some parts of the country than in others, the authors of the new study found; in certain geographic areas, like parts of Florida and Texas, so-called “surprise billing” was rampant, but in some parts of Colorado and Indiana, it was nearly non-existent. “If there are places where this just isn’t occurring, it means that this is something that doesn’t need to be occurring anywhere,” Cooper says. “We need to do more research to figure out where and why this is happening.”
Posted: 17 Nov 2016 06:56 AM PST
Although French fries and ice cream often make it on the list of grub to dig into when we’re down, true comfort food comes from a healthier crowd. What you eat actually plays an important role in how you feel mentally; Spanish researchers who followed 15,000 young adults over the course of nine years found that those who ate more nuts, fruit, vegetables and fish had a 30 percent lower incidence of depression than those who gorged on sweets or processed foods. That’s not all. The UK-based Mental Health Foundation reports that fewer than half of patients who suffer from mental health problems eat fresh fruit and vegetables. Nearly two-thirds of those free from daily mental health problems eat fresh produce regularly.
Ensuring your diet is full of adequate amounts of healthy nutrients can enhance your mental clarity, provide a more balanced mood, and protect your mind from early mental decline. Discover all the ways that eating better can help improve your mental health.
1. You’ll save money
Think about all that cash you blow on soda, grabbing takeout at restaurants, picking out a snack every couple of hours and ordering dessert after every meal. But it’s not just food you’ll save money on when you start to eat better. Those who clock in at a healthy weight spend an astounding 42 percent less cash on medical bills and health expenses than their overweight peers, according to a Health Affairs report. And get this: you’ll not only be less stressed financially, but a study published in The Journals of Gerontology: Psychological Sciences and Social Sciences says that financial strain is a strong risk factor for and predictor of worsening mental health.
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2. Fueling up properly means you won’t get hangry as much
Whether you’re constantly muttering under your breath about coworkers’ minute errors or snapping at drivers during rush hour, you go about life with a short fuse. Rather than looking to poor anger management or mood disorders, look to your rumbling stomach. You could actually be hangry! One of the reasons why you’re always hungry, and thus, always hangry, is perhaps because of an inefficient diet that subsists on empty carbs. This food burns up in your body quickly, which causes your body to crave substance more quickly.
When you deprive yourself of food while your body screams at you to eat, your body goes into a state of distress. The result is low dopamine levels, which means less control over your emotions and more irritability, anxiety, mental confusion and slowness in thought. If you choose to fuel up with slow-burning sources of energy like complex carbs, protein, and healthy fats, you’ll start to see your anger subside in no time.
3. Combatting nutritional deficiencies can improve your mood
Studies show that a number of nutrients are associated with brain health, and deficiencies of these nutrients have countlessly been linked to depression. It should be no surprise that many of these micronutrients are abundant in “healthy” foods and M.I.A. in junk foods. Some of which include omega-3s (salmon, flax and chia seeds, walnuts), folate (asparagus, chickpeas, lentils), vitamin B12 (tuna, shrimp, milk), choline (egg yolks, broccoli, brussels sprouts), magnesium (spinach, yogurt, black beans), vitamin D (fatty fish, eggs). Always check with your doctor before going off any anti-depressants, but you may want to get blood work done to see if the reason your mood has tanked is because you’re experiencing some nutritional deficiencies.
4. Eating antioxidants can help you feel more optimistic about the future
Whether you’re a recent college grad or just attended your last child’s college graduation, the future can certainly seem daunting at times—and that can cause some serious anxiety. That’s even more so the case if you’re not eating enough carrots. Why? A study published in the journal Psychosomatic Medicine found that individuals with higher levels of carotenoids (a type of antioxidant) tended to be more optimistic about the future, an indicator of positive health. Unless you’re always ordering sweet potato fries when you eat out, you’re likely missing out on these beneficial antioxidants. On the other hand, a healthy diet easily incorporates many of its top sources: carrots, tomatoes, sweet potatoes, and kale.
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5. Chemicals in fast food block mood-boosting nutrient absorption
Phthalates are a group of endocrine-disrupting chemical toxins that, like BPA, are used in plastic food and beverage wrappers notorious in fast food places. But those toxins don’t just stay on the wrappers. A study recently made headlines that connected people who ate fast food with dose-dependent higher levels of phthalate metabolites than infrequent eaters. And that’s bad news for all-day-breakfast lovers, since a separate study published in the Journal of Clinical Endocrinology & Metabolism found that exposure to BPA and phthalates may reduce adults’ vitamin D levels—a vitamin whose low levels in the blood have been connected to mental decline in older adults and chronic migraines in young people. Bottom line: lay off the fast food and not only will the scale tip in your favor, but you may also have more mental clarity,
6. You’ll kick the junky foods that exacerbate stress
Foods that worsen stress are also the ones connected to weight gain. Worst of all, they’re often our go-to snacks when we’re feeling anxious (think: chips and ice cream), which just throws our bodies into a worsened cycle of stress. On the other hand, numerous options have been scientifically proven to alter both your brain chemistry and hormones to help your body deal with stress more easily. And you guessed it: they’re all good-for-you foods.
7. Your medicine may work better
A study published in the American Journal of Psychiatry found that supplementing your diet with certain nutrients found in healthy foods—omega-3 fatty acids, folate, and vitamin D—can be effective in boosting the positive effects of antidepressant medication.
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8. You’ll sleep better
When you eat a poor diet centered on foods that digest quickly and leave you hungry often, you can disrupt your sleep cycle by making yourself hungry in the middle of the night. When you improve your diet and lose weight, you’ll likely be able to put sleeping problems such as sleep apnea to bed.
You’ll also improve your mental health. Countless studies have found that sleep problems often precede mental illnesses such as anxiety disorders and depression. In a study of 1,000 adults, researchers found that those who reported a history of insomnia during an interview were four times as likely to develop major depression by the time of a second interview three years later.
Posted: 17 Nov 2016 06:00 AM PST
U.S. Surgeon General Vivek Murthy called addiction to drugs and alcohol “a moral test for America,” given the more than 20 million people in the country with substance abuse problems in a new report released Thursday.
The report is the first from his office to address substance abuse and Murthy hopes that it will influence how the public treats the issue much like the Surgeon General’s report on tobacco began a move away from the product 50 years ago.
“We can never forget that the faces of substance use disorders are real people,” Murthy wrote in a letter accompanying the report. “Are we able to live up to that most fundamental obligation we have as human beings: to care for one another?”
The report attempts to erode some of the stigma surrounding substance abuse by highlighting the growing evidence that substance abuse has roots in neurobiology. Repeated use of drugs changes the brain so that it demands more to function.
Only 10% of people with a substance abuse receive treatment, according to an editorial by Murthy, and the report looks at ways to help the millions who go untreated. Recommended initiatives include expansion of community-based programs, increased investment in training for health workers and policy reforms.
The report assesses addiction and substance abuse across a wide range of drugs, but opioids have received the most attention given the scale of the opioid crisis in the U.S. Nearly 30,000 people die from heroin or prescription opioid misuse every year, according to the report.
Nearly a dozen U.S. cities have pledged to drastically reduce new infections and deaths from HIV/AIDS. Progress has been uneven at best.
Posted: 16 Nov 2016 03:30 PM PST
For couples who turn to IVF, the biggest question on their minds is how successful the treatment will be. That can vary widely, from 20% to around 50%, depending on what the issues are. Even so, most IVF experts won’t make those estimates until after the first cycle, when they have more information on the quality of the eggs, sperm and embryos involved.
But now, researchers led by David McLernon at University of Aberdeen report in the BMJ that there is a way to help couples get a better idea of their IVF success before they start their first cycle.
McLernon and his colleagues analyzed data from the Human Fertilization and Embryology Authority (HFEA), which collects data from all licensed IVF clinics in the U.K. The dataset, involving 113,873 women, provides complete information on more than 118,000 cycles performed at these clinics, including the number of eggs produced, number of eggs fertilized, number of embryos transferred, and number of live births. Based on this data, they isolated certain characteristics that were linked with higher success for a live birth.
After IVF began, factors that affected success included the woman’s age, as well as the number of eggs retrieved from the cycle, whether the eggs used were frozen, and the stage at which the embryos were transferred. The more eggs produced from each IVF cycle, the better the chances of a live birth, but only up to about 13 eggs; after that, over stimulation may result in lower-quality eggs that are less likely to become fertilized and result in healthy embryos.
The calculator, available here, can be a useful tool for couples considering and undergoing IVF, says McLernon. “It can really shape couples’ expectations and their chances over the complete journey of IVF, rather than just a single cycle,” he says. He notes that it’s not perfect — no model for estimating IVF success is — since it doesn’t take into account things like BMI and lifestyle factors. But it could help people get a more individualized estimate of their chances of having a baby. Current models focus on success rates involving fresh embryos only, but since more people are taking advantage of new technology that allows embryos to be frozen and transferred later, this model takes that option into account as well.
His group is working with IVF experts in the U.S. to test the model on the largest database of IVF information, overseen by the CDC and the Society for Assisted Reproductive Technology (to which member clinics voluntarily provide data), to see if the model applies to U.S. IVF cycles as well. There are some differences in IVF practices between the U.S. and the U.K., the most notable one being that in the U.S. clinics may still transfer more embryos per cycle than those in the U.K. “If it doesn’t predict well, we will make adjustments to recalibrate the model to make sure it does, and also add further predictors that might be available in the U.S. dataset that weren’t available in the HFEA dataset,” he says. “The model works so well in the U.K. I don’t see a reason why it can’t be used to counsel fertility patients in the U.S. as well.”
It may also help as a planning tool. “It can prepare them financially and emotionally,” says McLernon. “It can give them an idea that if their chances [of a live birth] are small, they may need to fund three to four cycles of treatment.” It may also help doctors to give their patients a more realistic and personalized perspective on their IVF experience, one that is based on real data from other couples like them.
Posted: 16 Nov 2016 01:01 PM PST
Energy drinks are popular among young teens and adults, but studies continue to show they may have unintended and potentially serious side effects, including high blood pressure, hyperactivity and more.
In a new report published in Pediatric Emergency Care, researchers conducted a questionnaire at two emergency departments from June 2011 to June 2013 that surveyed adolescents between ages 12 and 18. Of the 612 young people who responded, 33% said they frequently drank energy drinks. Among those teens, 76% said they experienced a headache in the last six months, 47% said they experienced anger and 22% reported difficulty breathing.
It’s impossible to say whether any of those behaviors were due to energy drinks, but young people who consumed them were much more likely to report the symptoms than those who didn’t. Overall, kids who consumed energy drinks often were more likely to say the drinks helped them do better in school or in sports, helped them focus and helped them stay up at night.
“Moderation is key,” says Dr. Vikas Khullar, a University of Florida fellow in Gastroenterology and Hepatology.
In a recent case study published in the journal BMJ Case Reports, Khullar and his colleagues wrote about a 50-year-old man who came to the hospital with an inflamed liver. He was in pain, vomiting and had dark urine. After running several tests for possible infections and coming up short, the doctors learned that the man drank four to five energy drinks every day for three weeks before his health issues appeared. The doctors concluded energy drinks caused his liver problems, citing another similar case that supports their suspicions. “We cannot speculate on the safety of energy drinks, however anyone with liver or heart disease should consume energy drinks with caution,” says Khullar.
Energy drinks contain multiple stimulating ingredients, beyond caffeine. “Often energy drinks contain a energy blend which is a combination of herbal supplements as well as vitamins in often greater levels than the recommended daily intake,” he says. “Further research may be needed to determine appropriate use and dosages.”
Groups like the U.S. Center for Disease Control and Prevention (CDC) warn against mixing energy drinks and alcohol, arguing energy drinks mask the depressant effects of alcohol. Still, in a 2016 survey of 1,000 young adults, 57% said they consumed energy drinks in the past year, and 71% of those students drank energy drinks with alcohol.
As TIME has previously reported, energy drink companies insist their products are safe and that a link between their beverages and side effects can’t be confirmed. The companies also appear to be making their drinks bigger and with more sugar; Monster’s new Mutant beverages, describe as a “super soda” on the label, have now hit shelves. The 20-ounce drinks have about 70 grams of sugar (more than twice of what’s in some candy bars) and 115 milligrams of caffeine.
Groups like the Center for Science in the Public Interest have called on the U.S. Food and Drug Administration to add safety warnings to energy drinks, and American Academy of Pediatrics researchers have argued the stimulants in energy drinks have “no place in the diet of children and adolescents.”
“While more research is needed, accumulating evidence exists to suggest that energy drink consumption is linked to adverse cardiovascular events, sleep disturbances, and other substance use among adolescents,” says Amelia Arria, director of the University of Maryland School of Public Health’s Center for Young Adult Health and Development and co-author of the recent energy drink and alcohol study.
Though definitive links between the beverages and health problems are not proven, many health professionals agree: the emerging data is not encouraging.
Posted: 16 Nov 2016 12:37 PM PST
Legal access to marijuana, medicinal or otherwise, is growing. In 2016, four states approved recreational use of the drug and four states passed laws related to medical-cannabis access, bringing the total number of states that allow some form of legal marijuana use to 28.
Scientists know that marijuana contains more than 100 compounds, called cannabinoids, that have biological effects on the body. Mdically, cannabis can be prescribed for physical ailments like arthritis and cancer symptoms as well as mental health issues like PTSD, depression and anxiety. Still, the role marijuana can play in medicine remains murky. The dearth of research is in large part due to the fact that most studies have focused on illicit use of marijuana rather than its therapeutic potential, and because it’s classified as a schedule 1 drug, making it nearly impossible to study.
Looking for answers about marijuana’s potential mental health benefits, a team of researchers in Canada and the U.S. recently conducted a review of the science. In their report, published in the journal Clinical Psychology Review, researchers found evidence that cannabis can likely benefit people dealing with depression, social anxiety and PTSD, though it may not be ideal for people with bipolar disorder, for instance, for which there appears to be more negative side effects than positive ones. “This is a substance that has potential use for mental health,” says Zach Walsh, an associate professor of psychology at the University of British Columbia. “We should be looking at it in the same way [as other drugs] and be holding it up to the same standard.”
Though more research is needed, studies also suggested that cannabis may have a place in dealing with addiction. “We are really excited about the potential substitution effect,” says study author Zach Walsh, an associate professor of psychology at the University of British Columbia. “If people use cannabis as a replacement for opioid medications, or to get off of opioids or cut back, we could see some pretty dramatic public health benefits. The level of opioid overdoses is so high right now.”
There’s evidence to support that potential. Another unrelated study suggested that pot may even have a place in curbing the opioid epidemic. And yet marijuana can be notoriously hard to study in the U.S. because it’s classified as a Schedule 1 drug, which means it has a high potential for abuse. Many scientists and medical professionals think the classification hampers research, and that marijuana’s medical potential merits further exploration. More studies, research advocates argue, would also help eliminate stigma associated with the drug, paving the way for more and better studies.
“I think people will derive more benefit if they can speak more openly with providers about whether they are using cannabis and why,” says Walsh.
Walsh is a lead investigator on a clinical trial of cannabis that is being funded by a medical cannabis producer called Tilray. Another researcher on the study has been a consultant for other medical cannabis producers. When asked if this represents a conflict of interest, Walsh points out that funding for marijuana-related research is hard to come by. “I think we are entering a different world,” he says, “but for now a lot of the research, at least in Canada, is funded by the producers.”
Like any drug, pot can have side effects, and Walsh and other researchers argue that for now, all aspects of cannabis need to be further explored, both benefits and potential harms.
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