HealthView Retirement Planning

New Findings About Women And Heart Disease

Women have historically been treated differently than men when it comes to heart because their risk has been considered to be lower. However, in the mid-nineties, The National Institutes of Health mandated that women be included in all clinical studies including those involving heart disease. Since that time, studies have shown that women are also at risk and more women die every year in the United States from heart disease than men.

A recent study in the journal Circulation revealed startling findings on how preconceptions of female heart disease affect women’s treatment. Doctors are “much less likely” to identify women who are at high-risk than men of who share the same risk profiles. As a result, women are not getting the preventative care they need to battle their disease. Women are also less likely to be referred for helpful procedures such as balloon angioplasty, stents and imaging tests.

Heart disease can present itself in many different ways. Women, more often than men, experience something other than the classic squeezing and crushing chest pain normally associated with a heart attack. Women’s symptoms are often fatigue, nausea, back pain, and dizziness which they confuse for heartburn or acid reflux. In the United States, sixty-four percent of women who die of heart disease have had previous symptoms.

It is important to know the risk factors for heart disease and work to reduce the ones you have control over. Obesity, high cholesterol, hypertension, tobacco use, diabetes, family history, and age can all contribute to your heart health. However, certain factors pose a higher risk for women. Diabetes, for instance, raises heart disease risk twice as much for woman than as it does for men. Tobacco also poses a great danger to women.  Data has shown that a woman smoking a similar amount as a man is more likely to develop heart disease.  

Taking Aspirin May Increase Breast Cancer Survival Rate

A preliminary study unveiled a possible correlation between aspirin and breast cancer remission. Researchers found that aspirin may slow the growth and inhibit the invasiveness of breast cancer cells by acting as a stimulator for the immune system. The study indicated that women who took aspirin regularly during the initial two to five week remission period were 60% less likely to have a later recurrence and about 70% less likely to die from the disease. The findings are part of an ongoing Nurses’ Health Study published in the Journal of Clinical Oncology earlier this month.

The study, conducted by a group of physicians at Brigham and Women’s Hospital in Boston, used data from over 4,000 nurses that were diagnosed with breast cancer between 1976 and 2002. By 2006, there had been 400 recurrences and 341 deaths among the group. Data was collected on the women’s aspirin intake beginning one year after diagnosis, when treatment was completed. The results showed women who took 81 milligrams of aspirin per day two to five times a week had a significantly lower risk of recurrence and death. Researchers did not find similar benefits from taking acetaminophen, commonly known as Tylenol.

In the next year alone 200,000 American women will be diagnosed with breast cancer. It is predicted that over 40,000 of these women will die as a result. If these early findings prove to be true the breast cancer fatality rate could be reduced by more than half. However, doctors agree that women undergoing treatment for breast cancer should not take aspirin without consulting with their doctor as it may interfere with therapy and have severe side effects.

The study’s results are exciting but have not yet been confirmed. There are many other factors that may have contributed to the women’s recovery, such as a better diet or a pre-existing condition. Either way, the study has raised hopes that an effective means for battling breast cancer is within reach.

For more information and to read the report, Aspirin Intake and Survival After Breast Cancer, in the Journal of Oncology, click here. 

Health Reform And The Uninsured

Much of the ongoing health care debate has centered on providing coverage to the uninsured. In order to better understand this dilemma, it is important to understand who and how many people are uninsured in this country. It is clear that many Americans do not have health insurance and cannot afford the cost of healthcare. However, what is not clear is why.

The 2008 Census showed that more than 46 million Americans do not have health insurance. This number is expected to be greater now due to the recession. Low income is one of the leading contributing factors for those not insured. In fact, two thirds of Americans without coverage earn less than twice the poverty level; this is just over $22,000 for a family of four. Almost 25 percent of those without coverage are eligible for Medicaid but are not enrolled. Most of the uninsured are working and have a family, but not making enough income to afford health insurance. Nearly 80 percent of those without coverage are US citizens and around 15 are undocumented immigrants. People between the ages of 19 to 29 boast the highest uninsured rate of 30 percent. Income is often very low in this age group and insurance is too expensive.

People without coverage normally fall into one of three categories. Some employers do not offer health benefits and individual plans are not affordable. For others, medical conditions and prior illness limit their coverage options. Others choose to opt out of buying health insurance because they believe they are in good health and do not need it. However, the uninsured are less healthy when compared to the insured. The Centers for Disease Control and Prevention’s most recent National Health Interview Survey revealed that 7.2 percent of Americans delayed needed medical care because they were uninsured. The untreated illness becomes more severe and ultimately more expensive to treat.

The 2008 Study in the journal, Health Affairs, estimated that the uninsured received $86 billion in medical care during 2008. Of that amount, only $30 billion came out of the patient’s pocket, leaving around $56 billion in uncompensated medical costs. The uncompensated costs are distributed over hospitals, private physicians and other healthcare providers. Some of these costs can be recovered through government programs meant to fund medical care for the poor. The remainder of the burden is placed on insurers and their customers, ultimately creating higher charges for coverage. The Health Affairs journal study showed that this burden pushed back on the insured totaled $14.1 billion.

So how do we correct this unfair burden that is placed on the insured? The health over haul proposals would require most everyone to buy coverage. The exceptions would be those earning less than the poverty level, members of Indian tribes and those with religious objections. The House bill would require most employers to offer health benefits, while the Senate version would actually penalize large employers that do not. The bill would expand Medicaid coverage and provide financial help for people, some already earning up to four times the poverty level, to buy insurance.

Both proposals, the House and the Senate, would establish exchanges with standardized benefits and enable individuals and businesses to compare and purchase plans. Illegal immigrants would not be allowed to buy insurance through the exchanges. In another effort to greatly decrease the number of people without coverage, the both bills would stop private insurers from denying people coverage on the basis of pre-existing conditions. 

Quality Of US Nursing Homes Called Into Question After Recent Study

A recently released government survey shows that one in five nursing homes received low scores on a five star rating system. Out of the 15,700 facilities surveyed, 3,140 received a one or two star and approximately 250,000 people are currently enrolled in these lower end nursing homes. This data has raised concerns over the quality of care being provided to our elderly citizens while simultaneously calling the validity of this relatively new system into account. 

The five-star rating system is based on three sets of criteria; health inspections, staffing and quality measures. Health inspections are conducted annually onsite by government officials over a three-year period. Infractions are weighted differently according to their prevalence and potential or real harm to people. During the most recent survey, over 200,000 onsite reviews were taken into account when allotting scores.

Staffing data ratings are based upon the average number of hours of care given to each patient during the course of a day. The rating is adjusted to reflect the special needs of patients based on the severity of their condition. Nursing homes with patients who require more attention therefore need to have a higher average number of hours. 

Quality measures are rated on the basis of a list of ten conditions that indicate the health status of a patient and are collected during the three most recent quarters. Items on this list include changes in mobility, the use of physical restraints, incidents of high-risk pressures ulcers and number of long-term catheters. This information is provided by the nursing homes rather than being gathered by government agents. 

In the recent survey, the lowest fifth of care facilities received and average of 14 infractions. Proponents of the rating system hope that the findings will urge these nursing homes to improve the quality of their care but do not expect a drastic change in the near future. “We want to see improvements, but we don't expect a nursing home will jump to a five-star rating within a one-year time period," explains Medicare's Thomas Hamilton. However, they also note the number of one star nursing homes has decreased, a trend that could continues if people opt for high scoring facilities. This may provide the financial incentive for the lower end homes to improve their services and facilities.

To find out the rating of nursing homes near you,  Medicare provides a free online service that allows you to f facilities near you. Visit http://tinyurl.com/yzebapp. 

A more in depth version of this article can be found in the current edition of Retirement Weekly, a MarketWatch publication. 

STATE OF THE UNION OUTLINES A NEW AGENDA

This past Wednesday, President Obama delivered the State of the Union amid growing concerns over the direction of his administration and his waning popularity. The President however appeared unapologetic and confident in the course of his presidency and hopeful for the future. He claimed the worst was over and now it was time to rebuild by enacting broad and sweeping changes. 

During his one hour and ten minute speech, the President restated and outlined his agenda and covered a broad range of topics. However, his primary focus was tackling unemployment and a floundering economy. Obama stated that creating jobs would be his top priority in 2010 and that efforts to create a new job bill would begin immediately. To this end, he proposed a number of initiatives including giving $30 billion in repaid bailout money to community banks for small business loans and not charging capital gains tax to small businesses.

The President acknowledged that the primary stimulus will always come from the business sector but that government can create an environment that fosters economic growth. However, he also reiterated his criticism of the banking industry and suggested instituting stricter regulation on the industry and creating a commission to oversee changes.

The State of the Union represented a shift in focus from healthcare reform to job creation. The President did not broach the topic of healthcare until he was thirty minutes into his speech and did not elaborate on the topic. He did affirm his commitment to passing a comprehensive healthcare bill saying, “Do not walk away from reform. Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people." Obama also assured the American people that the bill would lower premiums, ensure accessible healthcare and would ultimately reduce the budget by $1 trillion over the next 20 years. What he did not discuss was how he was planning on furthering the bills passage or what its final form might be.

Obama’s reluctance to address the healthcare bill is not surprising in light of increasing public disapproval. This dissension was made apparent during the recent senatorial race in Massachusetts in which Scott Brown won on a platform that opposed the bill. During his speech, Obama admitted the public no longer backed healthcare reform and took some of the blame, stating, “The longer it was debated, the more skeptical people became. I take my share of the blame for not explaining it more clearly to the American people.” 

Browns’ election marked the end the Democrats supermajority in the Senate and jeopardizes the bills passage. The GOP remains staunch in its opposition, which was clear last in Virginia Gov. Bob McDonnell response to the Presidents’ speech. McDonnell said, "Most Americans do not want to turn over the best medical care system in the world to the federal government." The Governor also stated his disbelief in the affordability of the President’s plans and questioned how they could be funded.

In the face of Republican opposition, Obama simultaneously called for an end to bipartisanship but also told his Democratic constituency to unite behind this agenda. The President said he was open to new ideas and plans on having monthly meetings with members from both parties to help alleviate hostility. He also conceded several issues to the GOP such as nuclear power and a proposed freeze on government spending in the coming year. However, he also called upon Democrats to rally behind him in order to pass reformative measure. The President said, “To Democrats, I would remind you that we still have the largest majority in decades, and the people expect us to solve some problems, not run for the hills.” How this will affect party relations has yet to be seen.

The State of the Union seems to alleviate the public’s agitation over the state of the nation. According to a CNN poll, 71% of Americans now think that the Presidents’ policies are going in the right direction whereas only 53% thought so before the speech. A CBS poll indicated that almost 60 percent believe he had outlined a clear plan for creating jobs, which is up from 40%. Whether or not public opinion or the speech will sway Congress members will be determined in the coming months

Democrats Reach A Deal On Proposed Cadillac Tax

Last week, The White House and Congress appeared to have reached a deal on the hotly contested excise tax on high value insurance plans. The proposed 40% tax on Cadillac plans has been a major sticking point between various Democratic party factions and organized labor groups. In order to pass a health care bill on schedule, a deal was brokered on several important details of the proposed legislation in order to make it more palatable to the opposition.

According to reports, the qualifying minimum premium was raised from $23,000 to $24,000 per family but would continue to be $8,500 for singles. These tax floors may vary by an estimated $3,000 depending on an individual’s state of residence, profession, age, and gender, as these all affect premiums. Furthermore, dental and vision will be excluded when tabulating the final cost.

State, local and Union members would be exempt from paying the tax until 2017, four years after it will come into affect if passed. This has assuaged Union leaders opposition, as 1 and 4 Union members would qualify for the tax. Unions tend to provide their members with better health benefits rather than raising their wages. Not surprisingly, Union members tend to be higher value plans than the average American. According to the Kaiser Family Foundation, the average total cost of a family policy offered by employers was $13,375. This measure therefore will take away a substantial amount of the tax’s’ revenue base.

These concessions have raised speculation as to how the health care bill will be financially supported. The proposed bill will likely cost $1 trillion over a ten-year period. The Cadillac tax was the biggest revenue raiser in the Senate bill and was endorsed by the White House as such. According to Richard Trumka, president of the AFL-CIO, the original tax would have raised $150 billion whereas the revised version will only garner $90 billion, a $60 billion decrease in revenue. How this difference will be made up is unclear. 

One potential funding solution lies in how the tax has been indexed. Rather than being indexed to the rate of inflation, the Cadillac tax has been indexed to the consumer price index plus 1%. The rate of inflation traditionally rises faster on an annual basis than the cost of health care spending. This means that more people will qualify for the tax as time goes on, creating an ever-growing revenue pool. Though this will help alleviate the loss of revenue it may not completely fill the void. 

Ron Mastrogiovanni Appointed to RIIA Board

Ron Mastrogiovanni, President and Chief Executive Officer of HealthView Services, has recently been appointed to the board of Retirement Income Industry Association (RIIA). RIAA was founded in 2006 as a non-profit organization that seeks to define the future of retirement income planning. They bring the latest developments, research, education, and practices in retirement management to members of the financial industry. The company unites often disparate industry factions in order to share information and codify the products, processes and advisory services of the field. To this end, members include leading academics, banks, insurers, fund companies, financial advisors, brokerage houses, researchers, technology companies, marketing firms, consulting firms and media. 

The retirement income industry is a relatively new development and is growing rapidly. RIIA has developed unique method of financial planning for this specific market that is different in its practice and objective. “The retirement income industry is emerging in its own right as something related but yet different from the traditional investment industry” explains Francois Gadenne, Chairman and Executive Director of RIIA, in a recent interview with Annuity Digest, “Its goal is not the management of expectations but rather involves the creation of outcomes.”

As more people are entering their retirement years, the need for expert knowledge and advice is becoming an increasingly valuable commodity. Mastrogiovanni brings more than 25 years of experience in management consulting, financial services, technology, and retirement planning industry. As a founder of HealthView Services, he brings a unique set of skills and insight into the retirement field and an expertise in product development to RIIA.

For more information on RIIA, please visit http://www.riia-usa.org/.

What To Consider When Looking For Long Term Care Insurance

More people are living longer and many will likely need long term care in their latter years. Currently, Medicare and Medicaid do not cover a majority of these services. Instead, individuals are responsible for acquiring and paying for them. One solution is to purchase a long term care (LTC) insurance (LTCI) policy. Ideally, your LTCI would cover all of your services for as long as you need them. However, policies vary widely in regards to coverage, costs and accessibility. As the cost and demand for these services continues to grow, planning for cost of care requires an informed and strategic approach.

Determining the cost of your LTC is dependent upon several variables. Important factors include the age at which you buy your policy, life expectancy, where you plan on retiring, what services you may need, how long you will need care, and the rate of inflation. Systematically finding this information on your own can be overwhelming. Fortunately, HealthView Services offers a free LTC calculator that gives you an estimation of what your costs would be now and later based on your personal criteria. In one scenario, a 65 year old male who can likely expect to live to 80 wants to retire in Raleigh, North Carolina in an assisted living community. His LTC costs for 2 years in 2010 would be $80,819 whereas in 2030 they would be $318,641. This estimate can then be used as a starting point in choosing a policy.

When looking at individual policies there are several key items that will affect your benefits. Pay attention to whether the daily benefit is a fixed dollar amount or is adjusted to take the rate of inflation into account. The daily benefit is the amount you policy pays out on a daily basis. If you take a policy with a set dollar amount it will likely not be able to cover the cost of your services in the future and you will have to pay the difference out of pocket. You should also find out what the elimination period is. Also called the waiting period or the deductible period, this is the length of time that must elapse from the time a service is requested to the time at which your policy begins payment. This interim period can last from 0 to over 100 days, during which time you must pay for the service out of pocket. Another important policy feature is the benefit period. This is the length of time you can receive your benefits and it can last anywhere from 2 years to the rest of your life. Lastly, find out if a policy covers nursing homes, assisted living and/or home care. Some plans may only cover nursing homes or some combination of the three. Make sure your policy facilitates the type of lifestyle you envision for yourself.

Finding the right LTCI policy can be arduous process. Fortunately, there are numerous sources that provide free information industry specific information. An informed decision is always the best one and the key to finding the best policy is doing your research.

A more in depth version of this article can be found in the current edition of Retirement Weekly, a MarketWatch publication.

Deal Making Secures Votes For The Health Care Bill

Just in time for Christmas, Harry Reid was able to keep his promise and obtain the votes needed to pass the health care bill by Christmas Eve day.  A seemingly insurmountable task has become a reality with all 60 members of the Democratic caucus voting in favor of the new bill. Reid, the Nevada Senator, is being given credit for making it happen and bringing everyone on board.

Reid had to compromise many times to get the health care bill passed and win over holdouts. Ben Nelson from Nebraska and Connecticut Senator Joe Lieberman were two of the last to cross over and vote in favor of the bill. Reid had to remove the public option that had been in earlier versions of the bill in order to win over Lieberman. The Connecticut senator believed that the public option was redundant in light of the subsidies included in the bill.  In order to get Nelson’s 60th  vote,  the bill was tailored to include stricter guidelines on abortion and legislation that will permanently expand Nebraska’s Medicaid. This means that federal taxpayers will have to pay an additional $45 million in the next decade alone to support Nebraska’s Medicaid program.

Furthermore, Nebraska and Michigan will be exempt from a large exercise tax for non-profit insurers. All other 48 states have to pay the tax, a deal that has angeredmany. In order to win the vote of Louisiana Senator Mary Landrieu, a $300 million dollar increase in Medicaid was made for the state. These are just a few of the many arrangements made.

These controversial deals have raised many questions and people are wondering if the bill should have been passed. Was the nature of the deal making unconstitutional? Should Senator Reid be criticized for being the backroom deal maker, or is he just doing his job?  One thing is for certain- getting your agenda met in Washington is a complex negotiation process in which the old adage “you can’t please all the people all the time” holds true.

You’re Never Too Old To Benefit From Exercise

By the year 2030, the number of people over the age of 65 in the United States will grow to 70 million and those over 85 will become the fastest growing demographic. As we age our bodies begin to lose their ability to maintain muscle mass on their own. Adults lose 3-5% of muscle mass per decade starting around the age of 40 and the rate of muscle loss increases by 1-2% per year after age 50. However, there is good news.  Not only can muscle loss be halted, but muscle mass can be increased at any age through exercise. Exercise enables older adult to build muscle while improving flexibility, balance, cognitive function, and mood.

Maintaining an active lifestyle is especially important for older adults who are more prone to lose mobility if they are inactive. A recent study conducted at a nursing home in Boston analyzed the impact of weight lifting in older adults from the ages of 72 to 98 years old. Participants in the study lifted leg weights three times a week for 10 weeks. On average, the residents had an increase of nearly 3% in leg muscle mass, a 12% increase in walking speed and leg strength increased by over 100%. Muscle patterning improved within just days of starting a weight lifting program. The study indicated that even a small amount of low impact weight lifting can dramatically improve your health. 

Cardiovascular exercise can similarly improve seniors’ health. The Honolulu Heart Program conducted a study that examined the correlation between walking and health. Participants were broken up into two groups. The first group walked less than a mile a day, while the other group walked two or more miles a day. The mortality rate in the first group was double that of the second group. This study indicated that walking for short distances on a regular basis is an easy way to maintain a healthy lifestyle.

Aging is a difficult process, especially when physical limitations become obvious and limiting. Exercise helps to decrease the effects of aging and allows older adults to stay independent for longer. If you have underlying health conditions, you should consult with your physician before beginning an exercise program. Start exercising today and feel better tomorrow!