Good to Go – by Christie Aschwanden

10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

Many of us may more often need to recover from a day of moving furniture than running a marathon, but the science of recovery can still teach us a lot. The author, herself an endurance athlete and much-decorated science journalist, sets out to do just that.

She explores a lot of recovery methods, and examines whether the science actually backs them up, and if so, to what degree. She also, in true science journalism style, talks to a lot of professionals ranging from fellow athletes to fellow scientists, to get their input too—she is nothing if not thorough, and this is certainly not a book of one person’s opinion with something to sell.

Indeed, on the contrary, her findings show that some of the best recovery methods are the cheapest, or even free. She also looks at the psychological aspect though, and why many people are likely to continue with things that objectively do not work better than placebo.

The style is very easy-reading jargon-free pop-science, while nevertheless being backed up with hundreds of studies cited in the bibliography—a perfect balance of readability and reliability.

Bottom line: for those who wish to be better informed about how to recover quickly and easily, this book is a treasure trove of information well-presented.

Click here to check out Good To Go, and always be good to go!

Don’t Forget…

Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

Recommended

  • Felt Time – by Dr. Marc Wittmann
  • Stuck in fight-or-flight mode? 5 ways to complete the ‘stress cycle’ and avoid burnout or depression
    Stress is inevitable, but chronic stress harms your health. Learn how exercise, cognitive therapy, and creative pursuits can help you complete the stress cycle and restore well-being.

Learn to Age Gracefully

Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Palliative care as a true art form

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    How do you ease the pain from an ailment amidst lost words? How can you serve the afflicted when lines start to blur? When the foundation of communication begins to crumble, what will be the pillar health-care professionals can lean on to support patients afflicted with dementia during their final days?

    The practice of medicine is both highly analytical and evidence based in nature. However, it is considered a “practice” because at the highest level, it resembles a musician navigating an instrument. It resembles art. Between lab values, imaging techniques and treatment options, the nuances for individualized patient care so often become threatened.

    Dementia, a non-malignant terminal illness, involves the progressive cognitive and social decline in those afflicted. Though there is no cure, dementia is commonly met in the setting of end-of-life care. During this final stage of life, the importance of comfort via symptomatic management and communication usually is a priority in patient care. But what about the care of a patient suffering from dementia? While communication serves as the vehicle to deliver care at a high level, medical professionals are suddenly met with a roadblock. And there … behind the pieces of shattered communication and a dampened map of ethical guidelines, health-care providers are at a standstill.

    It’s 4:37 a.m. You receive a text message from the overnight nurse at a care facility regarding a current seizure. After lorazepam is ordered and administered, Mr. H, a quick-witted 76-year-old, stabilizes. Phenobarbital 15mg SC qhs was also added to prevent future similar events. You exhale a sigh of relief.

    Mr. H. has been admitted to the floor 36 hours earlier after having a seizure while playing poker with colleagues. Since he became your patient, he’s shared many stories from professional and family life with you, along with as many jokes as he could fit in between. However, over the course of the next seven days, Mr. H. would develop aspiration pneumonia, progressing to ventilator dependency and, ultimately, multi-organ failure with rapid cognitive decline.

    What strategies and tools would you use to maximize the well-being of your patient during his decline? How would you bridge the gap of understanding between the patient’s family and health-care team to provide the standard of care that all patients are owed?

    To give Mr. H. the type of care he would have wanted, upon his hospital admission, he should have been questioned about his understanding of illness along with the goals of care of the medical team. The patient should have been informed that it is imperative to adhere to the medical regimen implemented by his team along with the risks of not doing so. In the event disease-related complications arose, advanced directives should have been documented to avoid any unnecessary measures.

    It is important to note, that with each change in status of the patient’s health status, the goal of treatment must be reassessed. The patient or surrogate decision-maker’s understanding of these goals is paramount in maintaining the patient’s autonomy. It is often said that effective communication is the bedrock of a healthy relationship. This is true regardless of type of relationship.

    This is why I and Megan Vierhout wrote Integrated End of Life Care in Dementia: A Comprehensive Guide, a book targeted at providing a much-needed road map to navigate the many challenges involved in end-of-life care for individuals with dementia. Ultimately, our aim is to provide a compass for both health-care professionals and the families of those affected by the progressive effects of dementia. We provide practical advice on optimizing communication with individuals with dementia while taking their cognitive limitations, preferences and needs into account.

    I invite you to explore the unpredictable terrain of end-of-life care for patients with dementia. Together, we can pave a smoother, sturdier path toward the practice of medicine as a true art form.

    This article is republished from healthydebate under a Creative Commons license. Read the original article.

    Share This Post

  • Zero Sugar / One Month – by Becky Gillaspy

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve reviewed books about the evils of sugar before, so what makes this one different?

    This one has a focus on helping the reader quit it. It assumes we already know the evils of sugar (though it does cover that too).

    It looks at the mechanisms of sugar addiction (habits-based and physiological), and how to safely and painlessly cut through those to come out the other side, free from sugar.

    The author gives a day-by-day plan, for not only eliminating sugar, but also adding and including things to fill the gap it leaves, keeping us sated, energized, and happy along the way.

    In the category of subjective criticism, it does also assume we want to lose weight, which may not be the case for many readers. But that’s a by-the-by and doesn’t detract from the useful guide to quitting sugar, whatever one’s reasons.

    Bottom line: if you would like to quit sugar but find it hard, this book thinks of everything and walks you by the hand, making it easy.

    Click here to check out Zero Sugar / One Month, and reap the health benefits!

    Share This Post

  • In This Oklahoma Town, Most Everyone Knows Someone Who’s Been Sued by the Hospital

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    McALESTER, Okla. — It took little more than an hour for Deborah Hackler to dispense with the tall stack of debt collection lawsuits that McAlester Regional Medical Center recently brought to small-claims court in this Oklahoma farm community.

    Hackler, a lawyer who sues patients on behalf of the hospital, buzzed through 51 cases, all but a handful uncontested, as is often the case. She bantered with the judge as she secured nearly $40,000 in judgments, plus 10% in fees for herself, according to court records.

    It’s a payday the hospital and Hackler have shared frequently over the past three decades, records show. The records indicate McAlester Regional Medical Center and an affiliated clinic have filed close to 5,000 debt collection cases since the early 1990s, most often represented by the father-daughter law firm of Hackler & Hackler.

    Some of McAlester’s 18,000 residents have been taken to court multiple times. A deputy at the county jail and her adult son were each sued recently, court records show. New mothers said they compare stories of their legal run-ins with the medical center.

    “There’s a lot that’s not right,” Sherry McKee, a dorm monitor at a tribal boarding school outside McAlester, said on the courthouse steps after the hearing. The hospital has sued her three times, most recently over a $3,375 bill for what she said turned out to be vertigo.

    In recent years, major health systems in Virginia, North Carolina, and elsewhere have stopped suing patients following news reports about lawsuits. And several states, such as Maryland and New York, have restricted the legal actions hospitals can take against patients.

    But with some 100 million people in the U.S. burdened by health care debt, medical collection cases still clog courtrooms across the country, researchers have found. In places like McAlester, a hospital’s debt collection machine can hum away quietly for years, helped along by powerful people in town. An effort to limit hospital lawsuits failed in the Oklahoma Legislature in 2021.

    In McAlester, the lawsuits have provided business for some, such as the Adjustment Bureau, a local collection agency run out of a squat concrete building down the street from the courthouse, and for Hackler, a former president of the McAlester Area Chamber of Commerce. But for many patients and their families, the lawsuits can take a devastating toll, sapping wages, emptying retirement accounts, and upending lives.

    McKee said she wasn’t sure how long it would take to pay off the recent judgment. Her $3,375 debt exceeds her monthly salary, she said.

    “This affects a large number of people in a small community,” said Janet Roloff, an attorney who has spent years assisting low-income clients with legal issues such as evictions in and around McAlester. “The impact is great.”

    Settled more than a century ago by fortune seekers who secured land from the Choctaw Nation to mine coal in the nearby hills, McAlester was once a boom town. Vestiges of that era remain, including a mammoth, 140-foot-tall Masonic temple that looms over the city.

    Recent times have been tougher for McAlester, now home by one count to 12 marijuana dispensaries and the state’s death row. The downtown is pockmarked by empty storefronts, including the OKLA theater, which has been dark for decades. Nearly 1 in 5 residents in McAlester and the surrounding county live below the federal poverty line.

    The hospital, operated by a public trust under the city’s authority, faces its own struggles. Paint is peeling off the front portico, and weeds poke up through the parking lots. The hospital has operated in the red for years, according to independent audit reports available on the state auditor’s website.

    “I’m trying to find ways to get the entire community better care and more care,” said Shawn Howard, the hospital’s chief executive. Howard grew up in McAlester and proudly noted he started his career as a receptionist in the hospital’s physical therapy department. “This is my hometown,” he said. “I am not trying to keep people out of getting care.”

    The hospital operates a clinic for low-income patients, whose webpage notes it has “limited appointments” at no cost for patients who are approved for aid. But data from the audits shows the hospital offers very little financial assistance, despite its purported mission to serve the community.

    In the 2022 fiscal year, it provided just $114,000 in charity care, out of a total operating budget of more than $100 million, hospital records show. Charity care totaling $2 million or $3 million out of a $100 million budget would be more in line with other U.S. hospitals.

    While audits show few McAlester patients get financial aid, many get taken to court.

    Renee Montgomery, the city treasurer in an adjoining town and mother of a local police officer, said she dipped into savings she’d reserved for her children and grandchildren after the hospital sued her last year for more than $5,500. She’d gone to the emergency room for chest pain.

    Dusty Powell, a truck driver, said he lost his pickup and motorcycle when his wages were garnished after the hospital sued him for almost $9,000. He’d gone to the emergency department for what turned out to be gastritis and didn’t have insurance, he said.

    “Everyone in this town probably has a story about McAlester Regional,” said another former patient who spoke on the condition she not be named, fearful to publicly criticize the hospital in such a small city. “It’s not even a secret.”

    The woman, who works at an Army munitions plant outside town, was sued twice over bills she incurred giving birth. Her sister-in-law has been sued as well.

    “It’s a good-old-boy system,” said the woman, who lowered her voice when the mayor walked into the coffee shop where she was meeting with KFF Health News. Now, she said, she avoids the hospital if her children need care.

    Nationwide, most people sued in debt collection cases never challenge them, a response experts say reflects widespread misunderstanding of the legal process and anxiety about coming to court.

    At the center of the McAlester hospital’s collection efforts for decades has been Hackler & Hackler.

    Donald Hackler was city attorney in McAlester for 13 years in the ’70s and ’80s and a longtime member of the local Lions Club and the Scottish Rite Freemasons.

    Daughter Deborah Hackler, who joined the family firm 30 years ago, has been a deacon at the First Presbyterian Church of McAlester and served on the board of the local Girl Scouts chapter, according to the McAlester News-Capital newspaper, which named her “Woman of the Year” in 2007. Since 2001, she also has been a municipal judge in McAlester, hearing traffic cases, including some involving people she has sued on behalf of the hospital, municipal and county court records show.

    For years, the Hacklers’ debt collection cases were often heard by Judge James Bland, who has retired from the bench and now sits on the hospital board. Bland didn’t respond to an inquiry for interview.

    Hackler declined to speak with KFF Health News after her recent court appearance. “I’m not going to visit with you about a current client,” she said before leaving the courthouse.

    Howard, the hospital CEO, said he couldn’t discuss the lawsuits either. He said he didn’t know the hospital took its patients to court. “I had to call and ask if we sue people,” he said.

    Howard also said he didn’t know Deborah Hackler. “I never heard her name before,” he said.

    Despite repeated public records requests from KFF Health News since September, the hospital did not provide detailed information about its financial arrangement with Hackler.

    McAlester Mayor John Browne, who appoints the hospital’s board of trustees, said he, too, didn’t know about the lawsuits. “I hadn’t heard anything about them suing,” he said.

    At the century-old courthouse in downtown McAlester, it’s not hard to find the lawsuits, though. Every month or two, another batch fills the docket in the small-claims court, now presided over by Judge Brian McLaughlin.

    After court recently, McLaughlin, who is not from McAlester, shook his head at the stream of cases and patients who almost never show up to defend themselves, leaving him to issue judgment after judgment in the hospital’s favor.

    “All I can do is follow the law,” said McLaughlin. “It doesn’t mean I like it.”

    About This Project

    “Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.

    The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country. 

    Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.

    The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability. 

    KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.

    Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

    Share This Post

Related Posts

  • Felt Time – by Dr. Marc Wittmann
  • Parenting a perfectionist? Here’s how you can respond

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Some children show signs of perfectionism from early on. Young children might become frustrated and rip up their drawing if it’s not quite right. Older children might avoid or refuse to do homework because they’re afraid to make a mistake.

    Perfectionism can lead to children feeling overwhelmed, angry and frustrated, or sad and withdrawn.

    And yet perfectionism isn’t considered all bad in our society. Being called a “perfectionist” can be a compliment – code for being a great worker or student, someone who strives to do their best and makes sure all jobs are done well.

    These seemingly polarised views reflect the complex nature of perfectionism.

    Annie Spratt/Unsplash

    What is perfectionism?

    Researchers often separate perfectionism into two parts:

    1. perfectionistic strivings: being determined to meet goals and achieve highly
    2. perfectionistic concerns: worry about being able to meet high standards, and self-criticism about performance.

    While perfectionistic strivings can be positive and lead to high achievement, perfectionistic concerns can lead to a higher chance of children developing eating disorders or anxiety and depression, and having lower academic achievement.

    Children doing maths homework
    Perfectionistic concerns can result in lower academic achievement. Jessica Lewis/Unsplash

    Children and adolescents may experience perfectionism in relation to school work, sport, performance in art or music, or in relation to their own body.

    Signs of perfectionistic concerns in children and adolescents may include:

    A range of genetic, biological and environmental factors influence perfectionism in children. And as a parent, our role is important. While research evidence suggests we can’t successfully increase positive perfectionistic strivings in our children, harsh or controlling parenting can increase negative perfectionistic concerns in children.

    Parents who are perfectionistic themselves can also model this to their children.

    So, how can we walk the line between supporting our child’s interests and helping them to achieve their potential, without pressuring them and increasing the risk of negative outcomes?

    Give them space to grow

    A great metaphor is the gardener versus the carpenter described by psychology professor Alison Gopnik.

    Instead of trying to build and shape our children by controlling them and their environment (like a carpenter), parents can embrace the spirit of the gardener – providing lots of space for children to grow in their own direction, and nourishing them with love, respect and trust.

    Girl runs up a hill in winter
    Parents don’t need to control their child and their environment. Noah Silliman/Unsplash

    We can’t control who they become, so it’s better to sit back, enjoy the ride, and look forward to watching the person they grow into.

    However, there is still plenty we can do as parents if our child is showing signs of perfectionism. We can role model to our children how to set realistic goals and be flexible when things change or go wrong, help our children manage stress and negative emotions, and create healthy balance in our family daily routine.

    Set realistic goals

    People with perfectionistic tendencies will often set unattainable goals. We can support the development of flexibility and realistic goal setting by asking curious questions, for example, “what would you need to do to get one small step closer to this goal?” Identifying upper and lower limits for goals is also helpful.

    If your child is fixed on a high score at school, for example, set that as the “upper limit” and then support them to identify a “lower limit” they would find acceptable, even if they are less happy with the outcome.

    This strategy may take time and practice to widen the gap between the two, but is useful to create flexibility over time.

    If a goal is performance-based and the outcome cannot be guaranteed (for example, a sporting competition), encourage your child to set a personal goal they have more control over.

    Child rides bike up ramp
    Parents can help children set goals they can achieve. liz99/Unsplash

    We can also have conversations about perfectionism from early on, and explain that everyone makes mistakes. In fact, it’s great to model this to our children – talking about our own mistakes and feelings, to show them that we ourselves are not perfect.

    Talk aloud practices can help children to see that we “walk the walk”. For example, if you burn dinner you could reflect:

    I’m disappointed because I put time and effort into that and it didn’t turn out as I expected. But we all make mistakes. I don’t get things right every time.

    Manage stress and negative emotions

    Some children and adolescents have a natural tendency towards perfectionism. Rather than trying to control their behaviour, we can provide gentle, loving support.

    When our child or adolescent becomes frustrated, angry, sad or overwhelmed, we support them best by helping them to name, express and validate all of their emotions.

    Parents may fear that acknowledging their child’s negative emotions will make the emotions worse, but the opposite is true.

    Creating healthy balance

    The building blocks of healthy child development are strong loving family relationships, good nutrition, creative play and plenty of physical activity, sleep and rest.

    Perfectionism is associated with rigidity, and thinking that there is only one correct way to succeed. We can instead encourage flexibility and creativity in children.

    Children’s brains grow through play. There is strong research evidence showing that creative, child-led play is associated with higher emotion regulation skills, and a range of cognitive skills, including problem-solving, memory, planning, flexibility and decision-making.

    Girl runs while playing a game
    Play helps children’s brains grow. Mi Pham/Unsplash

    Play isn’t just for young children either – there’s evidence that explorative, creative play of any kind also benefits adolescents and adults.

    There is also evidence that getting active outdoors in nature can promote children’s coping skills, emotion regulation and cognitive development.

    Elizabeth Westrupp, Associate Professor in Psychology, Deakin University; Gabriella King, Associate Research Fellow, Deakin University, and Jade Sheen, Associate Professor, School of Psychology, Deakin University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Ouch. That ‘Free’ Annual Checkup Might Cost You. Here’s Why.

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When Kristy Uddin, 49, went in for her annual mammogram in Washington state last year, she assumed she would not incur a bill because the test is one of the many preventive measures guaranteed to be free to patients under the 2010 Affordable Care Act. The ACA’s provision made medical and economic sense, encouraging Americans to use screening tools that could nip medical problems in the bud and keep patients healthy.

    So when a bill for $236 arrived, Uddin — an occupational therapist familiar with the health care industry’s workings — complained to her insurer and the hospital. She even requested an independent review.

    “I’m like, ‘Tell me why am I getting this bill?’” Uddin recalled in an interview. The unsatisfying explanation: The mammogram itself was covered, per the ACA’s rules, but the fee for the equipment and the facility was not.

    That answer was particularly galling, she said, because, a year earlier, her “free” mammogram at the same health system had generated a bill of about $1,000 for the radiologist’s reading. Though she fought that charge (and won), this time she threw in the towel and wrote the $236 check. But then she dashed off a submission to the KFF Health News-NPR “Bill of the Month” project:

    “I was really mad — it’s ridiculous,” she later recalled. “This is not how the law is supposed to work.”

    The ACA’s designers might have assumed that they had spelled out with sufficient clarity that millions of Americans would no longer have to pay for certain types of preventive care, including mammograms, colonoscopies, and recommended vaccines, in addition to doctor visits to screen for disease. But the law’s authors didn’t reckon with America’s ever-creative medical billing juggernaut.

    Over the past several years, the medical industry has eroded the ACA’s guarantees, finding ways to bill patients in gray zones of the law. Patients going in for preventive care, expecting that it will be fully covered by insurance, are being blindsided by bills, big and small.

    The problem comes down to deciding exactly what components of a medical encounter are covered by the ACA guarantee. For example, when do conversations between doctor and patient during an annual visit for preventive services veer into the treatment sphere? What screenings are needed for a patient’s annual visit?

    A healthy 30-year-old visiting a primary care provider might get a few basic blood tests, while a 50-year-old who is overweight would merit additional screening for Type 2 diabetes.

    Making matters more confusing, the annual checkup itself is guaranteed to be “no cost” for women and people age 65 and older, but the guarantee doesn’t apply for men in the 18-64 age range — though many preventive services that require a medical visit (such as checks of blood pressure or cholesterol and screens for substance abuse) are covered.

    No wonder what’s covered under the umbrella of prevention can look very different to medical providers (trying to be thorough) and billers (intent on squeezing more dollars out of every medical encounter) than it does to insurers (who profit from narrower definitions).

    For patients, the gray zone has become a billing minefield. Here are a few more examples, gleaned from the Bill of the Month project in just the past six months:

    Peter Opaskar, 46, of Texas, went to his primary care doctor last year for his preventive care visit — as he’d done before, at no cost. This time, his insurer paid $130.81 for the visit, but he also received a perplexing bill for $111.81. Opaskar learned that he had incurred the additional charge because when his doctor asked if he had any health concerns, he mentioned that he was having digestive problems but had already made an appointment with his gastroenterologist. So, the office explained, his visit was billed as both a preventive physical and a consultation. “Next year,” Opasker said in an interview, if he’s asked about health concerns, “I’ll say ‘no,’ even if I have a gunshot wound.”

    Kevin Lin, a technology specialist in Virginia in his 30s, went to a new primary care provider to take advantage of the preventive care benefit when he got insurance; he had no physical complaints. He said he was assured at check-in that he wouldn’t be charged. His insurer paid $174 for the checkup, but he was billed an additional $132.29 for a “new patient visit.” He said he has made many calls to fight the bill, so far with no luck.

    Finally, there’s Yoori Lee, 46, of Minnesota, herself a colorectal surgeon, who was shocked when her first screening colonoscopy yielded a bill for $450 for a biopsy of a polyp — a bill she knew was illegal. Federal regulations issued in 2022 to clarify the matter are very clear that biopsies during screening colonoscopies are included in the no-cost promise. “I mean, the whole point of screening is to find things,” she said, stating, perhaps, the obvious.

    Though these patient bills defy common sense, room for creative exploitation has been provided by the complex regulatory language surrounding the ACA. Consider this from Ellen Montz, deputy administrator and director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare & Medicaid Services, in an emailed response to queries and an interview request on this subject: “If a preventive service is not billed separately or is not tracked as individual encounter data separately from an office visit and the primary purpose of the office visit is not the delivery of the preventive item or service, then the plan issuer may impose cost sharing for the office visit.”

    So, if the doctor decides that a patient’s mention of stomach pain does not fall under the umbrella of preventive care, then that aspect of the visit can be billed separately, and the patient must pay?

    And then there’s this, also from Montz: “Whether a facility fee is permitted to be charged to a consumer would depend on whether the facility usage is an integral part of performing the mammogram or an integral part of any other preventive service that is required to be covered without cost sharing under federal law.”

    But wait, how can you do a mammogram or colonoscopy without a facility?

    Unfortunately, there is no federal enforcement mechanism to catch individual billing abuses. And agencies’ remedies are weak — simply directing insurers to reprocess claims or notifying patients they can resubmit them.

    In the absence of stronger enforcement or remedies, CMS could likely curtail these practices and give patients the tools to fight back by offering the sort of clarity the agency provided a few years ago regarding polyp biopsies — spelling out more clearly what comes under the rubric of preventive care, what can be billed, and what cannot.

    The stories KFF Health News and NPR receive are likely just the tip of an iceberg. And while each bill might be relatively small compared with the stunning $10,000 hospital bills that have become all too familiar in the United States, the sorry consequences are manifold. Patients pay bills they do not owe, depriving them of cash they could use elsewhere. If they can’t pay, those bills might end up with debt-collection agencies and, ultimately, harm their credit score.

    Perhaps most disturbing: These unexpected bills might discourage people from seeking preventive screenings that could be lifesaving, which is why the ACA deemed them “essential health benefits” that should be free.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • The Obesity Code – by Dr. Jason Fung

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Firstly, if you have already read Dr. Fung’s other book, The Diabetes Code, which we reviewed a little while ago, you can probably skip this one. It has mostly the same information, presented with a different focus.

    While The Diabetes Code assumes you are diabetic, or prediabetic, or concerned about avoiding/reversing those conditions, The Obesity Code assumes you are obese, or heading in that direction, or otherwise are concerned about avoiding/reversing obesity.

    What it’s not, though, is a weight loss book. Will it help if you want to lose weight? Yes, absolutely. But there is no talk here of weight loss goals, nor any motivational coaching, nor week-by-week plans, etc.

    Instead, it’s more an informative textbook. With exactly the sort of philosophy we like here at 10almonds: putting information into people’s hands, so everyone can make the best decisions for themselves, rather than blindly following someone else’s program.

    Dr. Fung explains why various dieting approaches don’t work, and how we can work around such things as our genetics, as well as most external factors except for poverty. He also talks us through how to change our body’s insulin response, and get our body working more like a lean machine and less like a larder for hard times.

    Bottom line: this is a no-frills explanation of why your body does what it does when it comes to fat storage, and how to make it behave differently about that.

    Click here to check out The Obesity Code, and learn about your body’s relationship with the fat that it stores—and how to change that, if you so desire!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: