IPAB: What it Means for Medicare Patients
September 2, 2011
You may have been hearing a lot about the Independent Payment Advisory Board, or IPAB, in the media lately. Maybe you've been wanting to learn more about the Board and what it could mean for Medicare beneficiaries. The IPAB was established by the 2010 Affordable Care Act, and it is charged with making recommendations to reduce the growth in Medicare spending, if Medicare exceeds a certain growth rate. The Board consists of 15 members nominated by the President and confirmed by the Senate.
More needs to be done to ensure sustainable healthcare costs, but there are flaws with IPAB that patient advocates believe will ultimately limit seniors' access to quality healthcare. The way that IPAB is currently designed will give the Board the ability to dramatically cut payments to healthcare providers and physicians who provide services to Medicare beneficiaries. Great concern has been expressed that doing so may result in fewer providers being willing to accept Medicare patients, ultimately, limiting seniors' access to quality providers.
Advocates are concerned by the lack of oversight of IPAB. The Board has the power to change laws previously enacted by Congress. When IPAB puts forth proposals, the Secretary of the Department of Health and Human Services is required to implement the board's recommendations unless Congress passes a law with the same cost savings. If Congress fails to adopt a substitute proposal, IPAB's proposal must be implemented, meaning that IPAB's proposal does not need Congressional approval to go into effect.
Furthermore, the Secretary's implementation of IPAB's recommendations is exempt from judicial and administrative review. Patient advocates are also troubled that there is no patient representation on the Board and that IPAB is not required to hold public meetings where the voices of patients, caregivers and families can be heard. Important health care decisions that can dramatically impact patients will be made by an unelected Board without accountability to the public. Efforts are underway to explore repeal options within the United States Congress.
New Research around Adolescent and Teen Development
August 8, 2011
During adolescence, boys and girls often experience their peak of physical health, strength, and mental capacity, and yet, for some, this can be a hazardous age.
- Mortality rates jump between early and late adolescence.
- Rates of death by injury between ages 15 to 19 are about six times that of the rate between ages 10 and 14.
- Crime rates are highest among young males and rates of alcohol abuse are high relative to other ages.
Even though most adolescents come through this transitional relatively well, it's important to understand the risk factors for behavior that can have serious consequences. Genes, childhood experience, and the environment in which a young person reaches adolescence all shape behavior. Adding to this complex picture, research is revealing how all these factors act in the context of a brain that is changing, with its own impact on behavior.
Powerful new technologies have enabled researchers to track the growth of the brain and to investigate the connections between brain function, development, and behavior.
The research has turned up some surprises, among them the discovery of striking changes taking place during the teen years. These findings have altered long-held assumptions about the timing of brain maturation. In key ways, the brain doesn't look like that of an adult until the early 20s.
The more we learn, the better we may be able to understand the abilities and vulnerabilities of teens, and the significance of this stage for life-long mental health. The fact that so much change is taking place beneath the surface may be something for parents to keep in mind during the ups and downs of adolescence.
L-theanine and Sleep Quality
May 24, 2011
A study from Japan presented at the 17th European Sleep Research Society suggests that ingestion of an amino acid extract from tea, L-theanine, may improve sleep quality. About 30% of US adult men report insomnia in the course of any year and it is estimated that over 50 percent of US adults aged 65 and older report some sleep disruption, while about 20 percent suffer from chronic insomnia. As men age from 16 to 50, they lose about 80% of their deep sleep and after 44 years of age, REM and total sleep reduce and wakefulness increase. The US leads in the world in cases of insomnia, followed by Germany and England, and sleep problems add an estimated $15.9 billion to US national health care costs.
L-Theanine, a derivative of the major excitatory brain neurotransmitter L-glutamate, is an amino acid found in the tea plant Camellia sinensis. Studies have shown L-theanine to inhibit LDL oxidation, counteract the stimulatory effects of caffeine, and lower blood pressure. In its anti-stress capacities, L-theanine increases dopamine and serotonin production, decreases norepinephrine concentrations, and induces alpha-brain wave activity. It reduces cortisol levels and increases relaxation associated with recovery from a stressful task. L-theanine also directly provides neuroprotection against glutamate neurotoxicity through blockade of the N-methyl-d-aspartate (NMDA), and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors.
The Japanese study was a blind crossover design involving 22 healthy men (12 daytime workers with an average age of 28 years, and 10 students with an average age of 26 years). After a three-day acclimatization period, the subjects were given 200mg of L-theanine or a placebo, one hour before bedtime for six days and were then crossed over to the other treatment group. Sleep quality was assessed by interviews upon awakening, self reported questionnaires and a wrist actigraph, to record bodily movements during sleep. All subjects reported a significant absence of feeling exhausted and a reduced need for sleep when administered L-theanine, compared to placebo. Seven of the 10 students had improved sleep efficiency and these same subjects reported a superior mental state prior to sleep and a decreased occurrence of nightmares. Total sleeping time did not alter between the two groups.
L-theanine may be a safe, effective treatment for sleep disorders such as insomnia either alone or in combination with prescription medications. Additionally, L-theanine typically does not result in increased morning drowsiness or impaired concentration.
Reference: Shirakawa, S. Theanine supplementation and sleep quality. 17th European Sleep Research Society. 2004.
June is Men's Health Month… Are You Ready?
May 24, 2011
June is Men's Health Month and groups across the United States and around the globe are joining together in celebration of this awareness period. The purpose of Men's Health Month is to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. Men's Health Month is celebrated with health screenings, health fairs, media appearances, and other health education and outreach activities. These events help ensure a healthier future for men and their families.
The month is anchored by National Men's Health Week, June 13-19, the week ending on Father's Day, a special awareness period recognized by the United States Congress each year, which was signed into law by U.S. President Bill Clinton in 1994. Additional support comes from governors of U.S. States as they declare and recognize Men's Health Week.
On the global stage, representatives from six leading men's health organizations around the world met at the 2nd World Congress on Men's Health in Vienna, Austria in 2002 and resolved to work together to launch International Men's Health Week (IMHW). The goal being to increase awareness of male health issues on a global level and to encourage inter- and intra-national institutions to develop health policies and services that meet the specific needs of men, boys, and their families. For ideas, help with programs, or to have your initiative listed on the website visit: www.menshealthmonth.org/imhw/imhw.htm
The goal of Men's Health Month is to empower and equip men with actionable information and resources that can make a difference in their health and that of their families. An example program, Wear BLUE, is designed to raise awareness and educate men, women, and their families of the need to end the silent crisis in men's health. Workplaces, community groups, places of worship, and others are encouraged to host a Wear BLUE event in their community. Information, tools, and resources can be found at www.wearblueformen.com.
Health care providers, public policy makers, the media, and individuals can use Men's Health Month to encourage men and boys to seek regular medical advice. Awareness periods like this help make it OK for men and boys to talk and take action about their health
For resources, tools, and more information visit: www.menshealthmonth.com