Deepak Mendiratta, MD, HII

The New Delhi-based Health & Insurance Integrated (HII) has crafted a unique health insurance plan for Private Healthcare Group of New Delhi called — Private Health Plans (PHP), which was launched recently at the capital. Through PHP, the consumer is benefited by lowering the barrier to usage of medical facilities due to the availability of unlimited access to a doctor, diagnostics, pharmacy and a regular health check-up. The cost of the scheme is designed to suit all sections of people. The price range for outpatients ranges from Rs 1,050 for an individual per year to Rs 9,000 per annum for a family package.

When asked why have a new health insurance plan, Deepak Mendiratta, MD, HII, replied, “I had a long-standing dream to design a product that will truly be an end-to-end cover for the customer with the promise of low cost coverage. Why provide treatment to people only when they are sick? Why not promise them a healthy life instead?” He further added, “PHP took me almost one and a half years to bring it up in its current state and I made sure it provides advantage to every stake holder,” says Mendiratta. Privat Healthcare is a part of Asia Medical Assistance, a company having offices in India and Thailand and representative offices in Middle East and Japan. The marketing, advertising and promotion of PHP is entirely handled by HII.

Through this scheme, hospitals get a constant flow of patients due to increased customer usage and the insurance company gets to reduce its claim ratios by having increased percentage of its insured healthy and keeping them away from falling sick. “The most attractive feature of this plan is the unlimited access to a doctor as well as unlimited pharmacy usage, if recommended by the patient’s GP,” informs Mendiratta. However, variations of this plan provide limited access to a specialist. This cover also has the option for taking an evacuation membership in case the patient is traveling outside his/her home city. In this case, the benefits will ensure that, if required, the insured will be evacuated through road or air to the nearest place of medical excellence in a matter of hours. “This feature is extremely useful in medical emergencies, which are currently lacking in India,” adds Mendiratta.

The introduction of any product or scheme involves a lot of research work and market feasibility studies. And PHP is no different. Before designing the product, HII did a comprehensive study of international health benefits and the various models that are used in health insurance markets worldwide. In India, they conducted a study of the consumers’ perception of such a product and their expectations, the barriers to adoption and HII’s options in distribution. “We then came up with critical factors that will ensure the success of this scheme,” states Mendiratta.

According to him, the insurance market is excited about this product since it gets to use the capitation model to transfer the risk on the outpatient benefit. This is important as insurance companies do not have much data or capability for effectively controlling claim costs. “They appreciate that this is the next wave of health insurance benefits and by promoting PHP they will be better able to manage their claim ratios on the inpatient claims,” says Mendiratta. In addition, the availability of comprehensive outpatient benefits will substantially reduce the morbidity leading to hospitalization.

Resource : http://www.expresshealthcaremgmt.com/200611/innews01.shtml

Today the obesity rates are rapidly rising and now it has been proven that it can shave almost ten years off of your life. It is more important now than ever to take care of ourselves so we will have one less health issue to worry about while we are living our lives.

Gary Whitlock, a researcher from the Clinical Trial Unit at the University of Oxford in the United Kingdom, said that by being moderately obese it can shave about three years off your life. By definition, moderate obesity means weighing about a third more than what is ideal, which for most people would mean being about 50 to 60 pounds overweight.

More than one in three Americans that are middle-aged now fall into this category, Whitlock stated. “By contrast, weighing twice your ideal weight—say an extra 150 pounds—shortens life span by about 10 years,” he added.

This level of obesity is still not considered common, but it equals then known ten year reduction life span caused by smoking. So, smoking is considered to be just about as dangerous as being severely obese, and approximately three times as dangerous as being moderately obese. This report is published in the March 18th online issue of The Lancet.

For this study, Whitlock and some other members of the Prospective Studies Collaboration collected data on approximately 894,576 women and men who participated in 57 studies. The participants in these studies came primarily from North America and Western Europe. On average their body-mass index or BMI was 25.

Body-mass index is a calculation that expresses a relationship between weight and height. People are considered to be underweight if their BMI is below 18.5, normal weight is when the BMI is between 18.5 and 24.9, overweight is when the BMI is between 25 and 29.9, and being obese is when the BMI is 30 or more, according to the U.S. National Heart, Lung, and Blood Institute.

The researchers found that the women and men whose BMI was between 22.5 and 25 lived the longest amount of time. They noted that for a person that is 5 feet 7 inches tall, his or her optimum weight would be around 154 pounds.

For those people that have a BMI over 25, every 10 to 12 pound increase could translate to about a 30 percent increased risk of death. In addition, there was approximately a 40 percent increase in the risk for stroke, heart disease, and other vascular disease, a 60 percent to 120 percent chance of developing an increased risk for diabetes, kidney disease, liver disease, a 10 percent increased risk for cancer, and a 20 percent increased risk for developing lung disease, the researchers stated.

Whitlock said, “Obesity causes kidney disease, liver disease and several types of cancer, but the most common way it kills is by causing stroke and, most importantly, heart disease. Obesity causes heart disease by pushing up blood pressure, by interfering with blood cholesterol levels, and by bringing on diabetes.”

People who are considered to be moderately obese with a BMI in the 30 to 35 range can reduce their lifespan by two to four years. For those people that are considered severely obese with BMIs between 40 and 45, their lifespan was reduce by eight to then years. This is considered comparable to the effects of smoking.

In fact, the people whose weight was considered below normal also died earlier, which is due mainly to smoking-related diseases, the researchers noted.

“If you are obese and smoke, then, above all else, quit smoking,” Whitlock stated. “If you are obese and don’t smoke, then don’t start, and do what you can to avoid further weight gain. By avoided further weight gain, you may well live a few years longer than you otherwise would do. By quitting smoking, a smoker can expect to gain several extra years of life — about as many as a severely obese person might gain by shedding half of his or her body weight.”

Dr. David L. Katz, the director of the Prevention Research Center at Yale University School of Medicine, said that this study confirms that the obesity epidemic is considered to be the clear and present danger that many of us knew it would be.

The association between mortality and BMI has been challenged in the scientific community, partly due to the uncertainty about weight estimates and the debate about measurement methods. Katz said, “Here we have an emphatic reaffirmation of the fundamental issue: Overweight and obesity take years from life.”

We know that, in many ways, that the BMI is a crude measurement of the health risks that are associated with obesity, since not all excess body fat is created equal. The weight that is gained around the middle tends to be considered the most dangerous, so for those who are subject to this patter, risks may indeed be higher than this study is suggesting. For those that have lower body weight gain, the risks may be lower.

A study that was published in the November 13, 2008 issue of the New England Journal of Medicine also found that where the weight gain is centered is a risk factor. Men that have the largest waist circumference had more than double the risk of dying, and women that had the largest waist circumference increased their risk of dying by approximately 78 percent.

USPSTF has new recommendations for patients who have never suffered a stroke or heart attack in regards to a daily aspirin as a preventative measure. Men ranging in age from 45 to 79 should consider their risk of bleeding, making sure the benefits outweigh the risks. Women at risk of stroke and ranging in age of 55 to 79, who are at risk for a first schematic stroke, should consider the risk of a daily aspirin and make sure the benefits outweigh the risks of bleeding. The group doesn’t recommend men under 45 and women under 55, who have never suffered a heart attack or stroke, take a daily aspirin as a preventative measure. The task force was unable to find a recommendation for daily aspirin use for men and women over 80.

A baby aspirin a day, 81 mg, is a common recommendation by doctors to patients who are at risk for heart attack or stroke. However, the new task force recommendation doesn’t specify an optimum dosage. They do note that preventative trials have shown benefits from varying dosages and regimens, but USPSTF states that the risk of Gastrointestinal bleeding increases as the dosage of aspirin increases, and a lower dosage seems as effective as a high dosage.

Dr. Michael Pignone, a member of USPSTF and chief of general internal medicine at the University of North Carolina, said, “The updated USPSTF recommendation emphasizes the importance of considering the potential benefits and downsides of using aspirin for cardiovascular prevention. It’s clear that discussing aspirin use with patients in the targeted age groups should become standard practice for clinicians.” There are more risks to consider when prescribing an aspirin a day as a preventative measure such as, age, gender, diabetes, blood pressure, cholesterol levels, smoking and GI bleeding. Talk to your doctors in regards to benefits and potential risks before taking a daily aspirin. While the little white pill can be a life saver in some situations, it could potentially be deadly in others.

Researchers tested the therapy, known as spinal cord stimulation or dorsal column stimulation, on mice and rats with deficient degrees of dopamine—mimicking the biological features of individuals with Parkinson’s. They developed a prosthetic device that delivers electrical stimulation to the dorsal column in the spinal cord and attached it to the surface of the spinal cord in the rodents with small electrodes. Mere seconds after stimulation began the rodents became 26 times more active. The treatment was also effective when combined with dopamine replacement therapy; two doses of L-DOPA were needed compared to five doses when used alone. “We see an almost immediate and dramatic change in the animal’s ability to function when the device stimulates the spinal cord,” said senior study investigator Dr. Miguel Nicolelis, a professor of neuroscience at Duke University Medical Center in Durham, N.C. “If this technology could work in humans, it would provide a completely new option for treating Parkinson’s disease.”

Nicolelis had the idea for the device when he experienced a “sudden moment of insight” while analyzing the brain activity of mice with Parkinson’s, realizing it was similar to what he had seen while studying epilepsy a decade earlier. “The ideas began to flow from there,” he said. In people with normal brain function, the firing patterns of large circuits of neurons oscillate in harmony, but Parkinson’s patients have abnormal low-frequency oscillations in the regions of the brain that controls movement. Stimulation of the top layer of the spinal cord, which conveys touch sensations to the brain, could disrupt these abnormal oscillations and restore normal firing patterns across the brain structures involved in the control of voluntary movements, Nicolelis explains.

Spinal cord stimulation would also be a safer and less invasive alternative to direct stimulation, which requires invasive surgery to embed electrodes deep in the brain, and may benefit only one-third of Parkinson’s patients.

Dr. Rodolfo Llinas, chairman of neuroscience and physiology at the N.Y.U. School of Medicine, who was not involved in the research, said the treatment “makes good sense,” but added: “How successfully it will translate to humans is an important issue. The human spinal cord is much more complex than the rodent counterpart, and long-term stimulation might result in nasty secondary effects.”

However, Dr. Ali Rezai, a neurosurgeon and director of the Center for Neurological Restoration at the Cleveland Clinic, said spinal cord stimulation was “technically simple to do” and has been performed on tens of thousands of people to treat chronic pain, stroke, spasticity, and other medical problems with the main side effect being a sense of vibration, like pins and needles, that never goes away. He said the idea of using spinal cord stimulation to treat Parkinson’s disease is entirely new and called it both “provocative and fascinating,” though further research is needed on how it would work in practice.

The researchers are already working with a team from Brazil’s Edmond and Lily Safra International Institute of Neuroscience in Natal, to test the device in marmosets, a type of primate. If successful, they hope to begin human testing in about a year. “If we can demonstrate that the device is safe and effective over the long term in primates and then humans, virtually every patient could be eligible for this treatment in the near future,” Nicolelis said.

According to the National Parkinson Foundation, approximately 1.5 million Americans have Parkinson’s disease and another 60,000 are diagnosed each year.

The study appears in the March 20 issue of Science.