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4 Tips To Be Healthy And Frugal In 2019

You may assume that a healthy lifestyle is also an expensive one, but it’s actually quite easy to nourish yourself well on a budget. It just takes planning.

So you’ve decided that 2019 is the year you finally behave like a grownup. No more living on ramen noodles and drive-thru. This year you’re going to eat real food that you prepare yourself. We’re talking fresh produce, whole grains, the works.

But, you’ve also made a commitment to gain control of your finances. Spending all your money on beer and pizza is fine when you’re in college. When you’re gainfully employed, it’s just sad. This year you’re going to budget like a boss.

Here’s your dilemma though. How are you going to be healthy and smart with your money. Isn’t it expensive to eat like an adult? Actually, no. Healthy and frugal can co-hab just fine, all you need are a few pointers to get started.

Frugal vs. Cheap

The first thing to understand is that there’s a difference between frugal and cheap. Frugal means you’re smart with your money. You prioritize saving over instant gratification. You’ll shop at second hand stores, buy off-brand food products and only drink alcohol at home.

Living within your means is a good thing, but being cheap doesn’t serve any purpose. If you never leave a tip when you eat out and calculate your part of a group bill down to the cent, you may be taking penny pinching too far.

Healthy on a Budget

People always assume that living a healthy lifestyle is an expensive exercise. Shopping at high-end health food stores will definitely break the bank, but you can just as easily be healthy on a budget. You just need a proper plan.

1. Get Smart About Grocery Shopping

frugal and healthy

The first thing you need to do is learn to shop smart. Helpfully, the guys at Nerdwallet have put together a comprehensive list of ways to save money on groceries. Their advice starts before you even set foot in the store.

Avoid doubling up on perishables by checking what’s in the fridge before you leave the house. This will ensure less wastage. Once at the store, opt for generic or store brands, as they’re invariably cheaper than well-known labels.

If you tend to frequent the same store, join their loyalty program, if they have one. Finally, pay attention to when things go on special. You’ll often find that fresh produce that’s still on the shelves will be marked down when they restock. These items are usually still within their expiration date and perfectly fine to eat.

2. Buy Organic, It’s Often Cheaper Than You Think

frugal and healthy

When we switched to organic produce recently, we discovered it to be much the same as conventionally grown fruit and veg, from a price standpoint. When we order the weekly pre-packed box selection, it’s often less expensive.

We live in South Africa, so I’m not sure how prices compare elsewhere in the world. It’s definitely worth checking out, though. You’re sure to find at least some more affordable produce at the farmer’s market.

The other thing to keep in mind is that the short-term expense of buying organic will offset the long-term health implications of eating food laden with pesticides. If you’re in a position to spend a little extra, this is an area to splurge.

3. Plan Your Meals Brown Bag Your Lunch

frugal and healthy

Throwing away food that’s gone off and buying lunch at work are two unnecessary expenses that you can easily avoid. Planning your meals ahead will save you money and time, and it’ll help you avoid decision fatigue.

Instead of wondering what to make for dinner, you just take a look at your meal plan and make that. These vegan meal prep ideas will make life even easier. Set aside a weekend morning or afternoon and make your lunch for the next week.

Preparing food in bulk means less chance of wastage and helps you avoid empty fridge syndrome, which we all know is an excuse for ordering expensive and unhealthy takeout. From a health perspective, making your own food from scratch means you have more control over what goes into it.

4. Grow Your Own Herbs and Veggies

frugal and healthy

Growing your own fresh herbs and vegetables is a great way to save money and be healthy. It’s also better for the environment, because you don’t need to use pesticides, and there’s no additional plastic packaging required, either.

Even if all you have available is a sunny windowsill in your apartment, you can still grow some herbs. A balcony opens your options even further. With the extra space for bigger pots or window boxes, you could try your hand at growing tomatoes and lettuce or even green beans.

Sprouting is even easier. Sprouted seeds, grains and legumes are packed full of nutrients and don’t require much in the way of equipment. Even if you’re not blessed with green thumbs, you’ll still be able to grow some delicious sandwich fillers and salad toppings.

As you get better at it, you’ll find that frugal, healthy eating is more of a fun adventure than a challenge. Junk food will quickly lose its appeal as your culinary repertoire grows along with your bank balance. Best of all, you’ll feel amazing.

Photo Credit: Getty Images

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HEALTHY LIVING: Heal Yourself with Delicious Foods

In this episode of Healthy Living, Danielle Walker, author of  Eat What You Love, tells CBN News Medical Correspondent Lorie Johnson how she used food to reverse her autoimmune disease.  

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Heart health guidelines may also reduce diabetes risk: Study


Washington DC: According to a new study published in Diabetologia, a journal of the European Association for the Study of Diabetes, researchers from The Ohio State University College of Medicine say that lifestyle and health factors that are good for the heart can also prevent diabetes.

According to the Centers for Disease Control diabetes is a growing problem in the United States, with nearly a third of the population living with diabetes or prediabetes. Dr. Joshua J. Joseph’s latest work looked at how cardiovascular health can impact diabetes risk.

Dr Joseph is an endocrinologist and assistant professor at The Ohio State University Wexner Medical Center. Speaking about the study, Dr. K. Craig Kent, dean of the College of Medicine said, “This research adds to our collective understanding about how physicians can help their patients prevent a number of serious diseases, including heart disease, cancer and now diabetes.”

The research team, led by Joseph assessed diabetes among 7,758 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study and used the American Heart Association’s Life’s Simple 7 as a guide for measuring heart health among the group.

The Life’s Simple 7 health factors and lifestyle behaviours that are associated with cardiovascular health are physical activity, diet, weight, cholesterol, blood pressure, blood glucose and tobacco use.

The study found that participants who were in the ideal ranges for at least four of the seven factors had a 70 per cent lower risk of developing diabetes over the next 10 years.

Joseph said that when they compared people who had normal blood glucose and those who already had impaired blood glucose they found, “Those in normal levels who attained four or more guideline factors had an 80 per cent lower risk of developing diabetes. Those who were already diabetic or prediabetic and met four of the factors had no change in lowering their risk for diabetes.”

Joseph said this research proves using prevention strategies from the very beginning is key to help avoid diabetes.

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Greenwich Health Dept. Offers Tips For Dealing With Cold Weather

From The Town of Greenwich:With below freezing temperatures and below zero wind chills forecasted for this Sunday night into Monday January 21, 2019, the Greenwich Department of Health is reminding residents to take precautions against hypothermia and frostbite and when using alternative heating sources in their home. Heating systems during cold weather normally work “overtime” and sometimes become faulty without warning. When this situation occurs, space heaters and fire places get used to stay warm; however, their use increases the risk of household fires and carbon monoxide poisoning.

Extreme weather conditions are classified as near freezing or below freezing temperatures. Exposure to these weather conditions, whether indoors or outside, can cause serious or life threatening health emergencies. Although anyone can be affected by the cold, infants, children, the elderly and those with medical conditions are particularly at risk. The following information should be considered when dealing with extreme cold weather conditions.


Frostbite: a medical condition caused by the cold freezing of body tissue. Frostbite most often affects the nose, ears, cheeks, chin, fingers or toes. Frostbite can also occur at temperatures above freezing, due to wind chill.

First signs of frostbite include redness or pain in any skin area, followed by a white, waxy or grayish-yellow look to the skin. A person who is experiencing frostbite may experience numbness, tingling or stinging to the body part exposed. Person with this condition must be moved indoors immediately. Do not rub or massage parts of the body that appear to be frostbitten. Do not use a heating pad, fireplace or radiator for warming; however, affected frostbitten areas of the body can be warmed with body heat. This condition is serious and requires immediate medical attention.

Hypothermia: a medical emergency that is caused by prolonged exposure to cold temperatures. Hyperthermia develops when a person’s body temperature falls below normal. Early symptoms of persons affected by hypothermia are shivering uncontrollably, fatigue, confusion, disorientation and loss of coordination. Late symptoms of hypothermia include puffiness of the face, blue skin, memory loss, slurred speech, slow pulse and breathing, extreme exhaustion and loss of consciousness. If someone is hypothermic, call 911 immediately. Persons experiencing hypothermia must be taken to a warm location, with wet clothing removed and wrapped in warm dry clothing until medical assistance arrives. A warm non-alcoholic beverage can be given to a person who is conscious. Call 911 for medical assistance immediately.

 Wear layers of loose clothing with hat, gloves, scarf and insulated shoes
 Limit outdoor exposure including daily exercise routines
 Know outdoor temperature and the effect of wind chill factors on the body
 Keep walkways free of ice and snow to prevent falls
 Avoid the use of alcohol
 Notify someone of your whereabouts when you go out
 Avoid prolonged time outdoors of infants, children, the elderly, those with medical conditions and pets


Carbon Monoxide (CO) is an invisible, odorless gas that can be fatal. The following safety tips will prevent CO poisoning:
 NEVER use portable generators or gasoline-powered equipment inside your home or garage, car port, etc.
 Never use gas or charcoal grills in the house, garage, etc.
 Purchase a carbon monoxide detector for your home
 Make sure inlets and outlets for your furnace are free of snow
 Make sure your car’s exhaust pipe is clear. Never heat your car up in the garage, even if the garage door is open

Symptoms of CO poisoning include headache, fatigue, dizziness, nausea or vomiting or loss of consciousness. Take everyone, including pets out of the house and call 911 from outside the house if you think there is a CO exposure.


 Listen to weather forecasts
 Conduct annual chimney cleaning and inspection
 Install smoke and carbon monoxide detectors (battery operated) and test them regularly
 Install an indoor thermometer and outdoor thermometer, if possible
 Insulate water lines to prevent freezing
 Keep small children, pets, the elderly and those with health conditions indoors
 Have reliable transportation and a mobile phone if possible
 Do not use candles
 Never use charcoal/gas grills, camp stoves or generators indoors or in the garage
 Do not store gasoline indoors
 Use space heaters safely and ensure proper ventilation if they are needed
 Avoid using extension cords for space heaters and other portable equipment
 Never warm up your car in the garage, even if the garage door is open

Image via Shuttershock

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Neuroscientists Pinpoint Cells In The Amygdala Where Pain Hurts : Shots – Health News

Researchers studying mouse brains identified the cells that encode pain’s unpleasantness.

Sally Anscombe/Getty Images

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Sally Anscombe/Getty Images

Researchers studying mouse brains identified the cells that encode pain’s unpleasantness.

Sally Anscombe/Getty Images

Pain is a complicated experience. Our skin and muscles sense it, just like they sense softness or warmth. But unlike other sensations, the experience of pain is distinctly unpleasant.

Pain has to hurt for us to pay attention to it, and avoid hurting ourselves further.

But for people in chronic pain, the pain has largely lost its purpose. It just hurts.

While it has long been understood how nerves signal pain to the brain, scientists haven’t known how the brain adds a layer of unpleasantness.

Findings of a study published Thursday in Science offer an answer. A research team from Stanford University pinpointed the neurons in mouse brains that make pain hurt and were able to alter these neurons in a way that reduced the unpleasantness of pain without eliminating the sensation. The study lays the groundwork for future research into more targeted pain treatments.

“This study is a major advance,” says Irene Tracey, a pain neuroscientist at Oxford University who wasn’t involved in the study. “It was a tour de force and a welcome addition to understanding this complex and major problem.”

Stanford neuroscientist Grégory Scherrer, who co-led the study, started the search for pain neurons in the amygdala — the slim, almond-shaped region scientists know regulates many emotions. The challenge for Scherrer was to sift through the tangle of neurons there and identify the ones associated with pain.

To do this he teamed up with his Stanford colleague Mark Schnitzer, a neuroscientist who developed a miniature microscope, or miniscope, that can be attached to the head of a freely behaving mouse.

“The miniscope allows you to track neurons over time while the mouse is behaving normally,” says Schnitzer.

Biafra Ahanonu, a postdoctoral researcher at Stanford University, holds the miniature microscope he used to peer into the brains of mice.

Biafra Ahanonu/Courtesy of the Schnitzer laboratory

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Biafra Ahanonu/Courtesy of the Schnitzer laboratory

Biafra Ahanonu, a postdoctoral researcher at Stanford University, holds the miniature microscope he used to peer into the brains of mice.

Biafra Ahanonu/Courtesy of the Schnitzer laboratory

To see neural activity, researchers first introduce a fluorescent protein into the amygdala that releases a tiny burst of light when neurons fire. Then, the team guides this slender scope deep into the brain to see which neurons flash as the mouse reacts to painful stimuli, like needle pricks.

When a mouse is in pain it reflexively withdraws, just as our hand does when we touch a hot stove. Scherrer says that these reflexive behaviors indicate the sensation of pain, but aren’t unpleasant. Other behaviors, like avoiding the painful stimulus, or licking the paw that touched it, indicate that the pain is unpleasant.

The researchers exposed the mice to a variety of painful and benign stimuli, and identified a constellation of about 150 neurons in a region called the basolateral amygdala that were active only when the mice appeared to be in pain. Further, it seemed that the more pain the mouse experienced, the brighter this constellation in the BLA glowed.

“At this point we could only see that these BLA neurons were correlated with pain,” explains Scherrer, “but not if they encoded the unpleasantness of pain.”

To answer that question, the research team needed to somehow turn off the pain neurons while the animal was in pain, and see whether the mouse behaves differently.

Scherrer and his team created chemical switches to control these pain neurons. They could then switch these pain neurons off, and see if a mouse behaved differently when pricked.

Getting these switches on pain neurons, and only the pain neurons, required some genetic trickery. “This paper really combines a lot of the most advanced techniques in neuroscience,” says Jordan McCall, a neuroscientist at Washington University in St. Louis who wasn’t involved in the study.

With the switches in place, the researchers turned off the BLA pain neurons, and found that the mice still sensed pain, but they didn’t behave as though it were unpleasant.

“They essentially didn’t care about pain anymore,” explains Scherrer.

This result held up when the researchers looked at mice who had developed chronic pain. Their BLA pain neurons had become so sensitive that they fired at the lightest touch. When Scherrer turned off their BLA pain neurons, the mice still experienced the light touch, but didn’t seem to experience it as unpleasant.

“This result got us really excited,” says Scherrer, explaining that their results suggest that the unpleasantness of both acute and chronic pain stem from these BLA pain neurons, making them a target for treating pain.

Opioids can be effective in relieving pain, but they are a blunt tool and affect brain areas associated with behaviors as varied as addiction and breathing, for example. “Now that we know what neurons give pain its unpleasantness, we can look for receptors present only in those neurons, and not in other areas of the brain,” says Scherrer.

If there are receptors unique to these neurons, researchers could try to design drugs that turn down their activity. If the approach worked, it could lead to a drug that makes pain more bearable, but doesn’t dull sensation, according to Schnitzer.

A treatment like that is a long way off, even under the best of circumstances. While this research confirms the BLA neurons play a critical role in making pain hurt, they could be working in concert with other brain areas that would need to be understood. Scherrer and his colleagues are working to trace those connections for a fuller picture.

The research team is already looking for receptors unique to BLA pain neurons. “It’s an open question whether we’ll find them,” says Scherrer. “But I’m hopeful that out of 30,000 genes there will be a couple that encode receptors we can target for treatment.”

Jonathan Lambert is an intern on NPR’s Science Desk. You can follow him on Twitter: @evolambert.‏

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Could bone broth boost heart health?

Recently, bone broth has enjoyed a boost in popularity. To add to its new-found fame, a recent study concludes that it could have benefits for heart health, too.

Bone broth may be fashionable, but is it good for your heart?

Bone broth is a soup containing brewed bones and connective tissue.

Slowly cooking the bones in vinegar releases some of the nutrients that a person might otherwise discard with the rest of the carcass.

According to some quarters, drinking bone broth carries a multitude of benefits.

From reducing inflammation to improving sleep, bone broth can seemingly do no wrong.

Although some are hailing bone broths as “the new coffee,” there is little evidence to support its benefits.

It is true that bone broth delivers nutrients, including amino acids and minerals, but not in any higher quantities than might be found in many other foods.

Bone broth contains collagen, leading some supporters to claim that bone broth improves skin health and joint function. However, collagen that we consume never reaches the skin or joints because it is broken down into amino acids by the digestive system.

The authors of the most recent study into bone broth published their findings in the Journal of Agricultural and Food Chemistry. They focused on the amino acids and peptides that the bone and connective tissue produce as they break down.

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Bone broth and cardiovascular health

In particular, the researchers were interested in how cooked bones might release proteins which, during digestion, are broken down further into smaller chains of amino acids, referred to as peptides.

Once broken down in this way, peptides can have very different properties from the original proteins.

The scientists, led by Leticia Mora, wanted to understand whether Spanish dry-cured ham bones could be a source of heart-beneficial peptides. To investigate, they simulated both cooking and human digestion.

Once they had the final product, they tested the resulting peptides to see if they might block particular enzymes known to be involved in heart disease.

The enzymes of interest included angiotensin 1-converting enzyme (ACE-1), endothelin-converting enzyme, dipeptidyl peptidase-4, and platelet-activating factor acetylhydrolase.

All of the enzymes above regulate aspects of the cardiovascular system. ACE-1 inhibitors, for instance, are used to treat high blood pressure and inflammation-based heart disease. If scientists could source these peptides from foods, this might be beneficial for people who have an elevated risk of developing these conditions.

According to the authors, “their inhibition can result in the reduction of high blood pressure and alleviation of disorders, including type 2 diabetes, obesity, atherosclerosis, and inflammatory diseases.”

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Potential heart benefits

The scientists found that peptides — predominantly derived from hemoglobin and collagen — could block the enzymes related to heart disease, even after cooking and digestion.

Additionally, they measured the presence of other peptides; many of these were chains of just two or three amino acids, making them more likely to be able to travel through the intestinal wall and be active in the body. The authors conclude:

These results suggest that dry-cured ham bones [used in] stews and broths could have a positive impact on cardiovascular health and a possible reduction of high blood pressure for consumers.”

However, as the authors note, measuring these peptides under artificial conditions is not the same as assessing their impact on living organisms. Scientists will need to do much more work before they can confirm the heart benefits of bone broth.

Understanding the chemistry of foods is only one small step toward realizing their impact on health. These findings might further boost bone broth’s popularity, but the trend will probably be over before conclusive evidence rolls in.

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Government Shutdown Brings Higher Health Bills To Some Families : Shots – Health News

Demonstrators affiliated with the National Air Traffic Controllers Association protested the federal shutdown at a Capitol Hill rally earlier this month in Washington, D.C.

Alex Wroblewski/Bloomberg/Getty Images

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Demonstrators affiliated with the National Air Traffic Controllers Association protested the federal shutdown at a Capitol Hill rally earlier this month in Washington, D.C.

Alex Wroblewski/Bloomberg/Getty Images

Joseph Daskalakis’ son Oliver was born on New Year’s Eve, a little over a week into the current government shutdown, and about 10 weeks before he was expected.

The prematurely born baby ended up in a specialized neonatal intensive care unit, the only one near the family’s home in Lakeville, Minn., that could care for him.

But Daskalakis, who works as an air traffic controller outside Minneapolis, has an additional worry: The hospital where his newborn son is being treated is not part of his current insurer’s network and the partial government shutdown prevents Daskalakis from filing the paperwork necessary to switch insurers, as he would otherwise be allowed to do.

As a result, he could be on the hook for a hefty bill — all the while not receiving pay. Daskalakis is just one example of federal employees for whom being unable to make changes to their health plans really matters.

Shutdown Will Be Worse For Economy Than First Thought, White House Says

Although the estimated 800,000 government workers affected by the shutdown won’t lose their health insurance, an unknown number are in limbo like Daskalakis — unable to add family members such as spouses, newborns or adopted children to an existing health plan; unable to change insurers because of unforeseen circumstances; or unable deal with other issues that might arise.

“With 800,000 employees out there, I imagine that this is not a one-off event,” says Dan Blair, who served as both acting director and deputy director of the federal Office of Personnel Management during the early 2000s and is now senior counselor at the Bipartisan Policy Center. “The longer this goes on, the more we will see these types of occurrences.”

While little Oliver Daskalakis is getting stronger every day — he’s now out of the ICU, according to his father’s local air traffic union representative — it’s unclear how the situation will affect his family’s finances.

That’s because out-of-network charges are generally far higher than being in-network, and NICU care is enormously expensive,no matter what. Those bills could add up, especially as the family’s current insurance plan has an out-of-pocket maximum of $12,000 annually. Because Oliver was born before the new year, the family could face that amount twice — for 2018 and for 2019.

And Daskalakis still isn’t getting paid.

“I don’t know when I’ll be able to change my insurance, or when I’ll get paid again,” Daskalakis wrote to Sen. Tina Smith, D-Minn., who shared the letter on Facebook and before her Senate colleagues last week.

Federal Workers Struggle To Stretch Their Money As Shutdown Lingers

Other families are also worried about paperwork delays, and the financial and medical effects a prolonged shutdown could cause.

Dania Palanker, a health policy researcher at Georgetown’s Center on Health Insurance Reforms, studies what happens when families face insurance difficulties. Now she’s also living it.

After arranging to reduce her work hours because of health problems, Palanker knew her family would not qualify for coverage through her university job. No problem, she thought, as she began the process in December of enrolling her family in coverage offered by her husband’s job with the federal government.

But there was a hitch.

“We could not get the paperwork in time to apply for special enrollment through the government and get it processed before the shutdown,” Palanker says.

Georgetown allowed her to boost her work hours this month to keep the family insured through January, but Georgetown’s share of her coverage will end in February.

Palanker’s treatments are expensive, so she is likely to hit or exceed her annual $2,000 deductible in January — then start over with another annual deductible once the family secures new health coverage.

“I’m postponing treatment in hopes that it is just a month and I’m back on the federal plan in February,” says Palanker, who has an autoimmune disease that causes nerve damage. “But I can’t postpone indefinitely, as my condition will get worse.”

Most Federal Workers' Health Coverage To Continue During Shutdown, Even If Pay Stops

Overseeing federal health benefits programs is within the purview of the Office of Personnel Management, whose data hub is operational, according to a spokeswoman. But getting information to that data hub to make the kind of changes Daskalakis, Palanker and others need depends on the individual agencies that employ government workers.

The OPM has told government agencies “that they should have [human resources] staff available during the lapse, specifically to process” such requests, which are called “qualifying life events,” the spokeswoman says.

In a written statement Wednesday, Smith said: “Oliver’s story is a powerful reminder that hundreds of thousands of real families have had their financial and personal lives turned upside down by this unnecessary shutdown.” The Minnesota senator called on the president to come back to the negotiating table.

For Daskalakis, there’s been some recent good news.

His union representative, Tony Walsh, says both the OPM website and Daskalakis’ insurer now indicate that the family’s request to change to an insurance plan that classifies the hospital as “in-network” will be retroactive to Oliver’s birthday — so the out-of-network charges may not play a role.

Just to be safe, “Joe is currently working on an insurance appeal based on no in-network care [being available],” Walsh reports in an emailed statement.

Still, the family has already received an initial $6,000 bill from the hospital, Walsh notes. He says that $6,000 does not include costs associated with Oliver’s birth or his stay in the intensive care unit — those charges likely are still to come.

Walsh says the shutdown is affecting a broad swath of employees in ways many lawmakers never anticipated.

The workers “are essential to the system,” he says, “and it’s unfair they are being treated this way.”

Kaiser Health News, a nonprofit news service, is an editorially independent program of the Kaiser Family Foundation and not affiliated with Kaiser Permanente.

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3 ways Trump could disrupt health care for the better

(The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.)

Peter Hilsenrath, University of the Pacific and David Wyant, Belmont University

(THE CONVERSATION) Since his winning presidential campaign, Donald Trump has beenrepeatedly billed as a disrupter. From trade and foreign policy to immigration, Trump has consistently tried to shake up the status quo.

As experts in health care management and policy, we believe the president should now focus his talent for disruption in our sector.

And unlike the issue of immigration, there is widespreadbipartisan appreciation of the crisis in health care, with bloated costs and an industry that fiercely resists change.

Why health care needs disrupting

While the growth of health care costs has been relatively muted in recent years, they are still cripplingly high and pose a threat to the entire economy.

Health care now accounts for about 18 percent of the economy – up from about 13 percent two decades ago – and is expected to make up about a fifth of the U.S. gross domestic product by 2026. The United States spends more on health care than any other country.

Yet Americans have little to show for it. U.S. life expectancy at birth, for example, is lower than 11 other high-income countries including Japan, Germany and the U.K. At the same time, infant mortality is the highest.

In addition, despite the mitigating impact of the Affordable Care Act, 28.3 million remained uninsured in 2018.

Furthermore, rising health care costs crowd out other consumer spending, which has the potential to erode Americans’ standard of living.

Here are three ways Republicans and Democrats can come together to disrupt the health sector to reduce costs and improve efficiency.

1. Let nurses and pharmacists do more

One of the key drivers of rising health care spending is the high cost of labor.

And one reason for that is state laws and regulations control what medical professionals can and cannot do in a way that requires high-paid physicians to perform certain duties or make medical decisions that nurses, pharmacists and others with more modest salaries could easily do. While the intent may be to ensure quality, the end result of this ring fencing in our view is that it protects certain groups – including nurses and others – from competition. It also ties the hands of health care managers seeking to improve efficiency.

For example, state scope of practice rules generally restrict prescribing medications to physicians – even though others such as nurse practitioners and pharmacists are fully qualified to do this in most cases. Similarly, ophthalmologists rather than optometrists are primarily allowed to prescribe eye medication, while dental hygienists require the supervision of a dentist.

And as for the impact on quality, a 2013 study showed that the quality, safety and effectiveness of care is similar between less costly nurse practitioners and more costly physicians.

To change this, Trump could direct federal regulators to craft guidelines that greatly expand the scope of what nurses, pharmacists, hygienists and the like can do, and then have Medicare and Medicaid make payments to health plans, hospitals and states contingent on compliance with those guidelines.

Increasing competition and letting less well-paid health care professionals handle more of these duties and decisions should help contain and possibly even lower costs.

2. End the monopoly on drugs

Another major culprit behind out-of-control health care inflation is high prescription drug prices, especially for patented medicines. Most prescriptions are for generic products that are commonly inexpensive, but new drugs often command eye-popping prices.

Studies show Americans pay at least three times more for drugs than residents of other high-income countries. And a quarter of Americans who take a prescription drug say they skip doses or take fewer pills than they should because of the high cost.

Pharmaceutical firms can charge such high prices for new drugs because patents give them monopoly power for years. Moreover, insurers have been willing to pay.

The Trump administration has already made an important if narrow move to remedy this by directing that Medicare Part B use international reference prices in some cases when reimbursing pharmaceutical companies. That is, the program would pay the average price of a drug in a basket of countries, which is usually lower than prices in the U.S. A recent government study of the impact estimated the program would have saved more than $8 billion had reference pricing been used in 2016.

But it could do more, particularly as there is significant bipartisan interest in the issue.

An even bolder approach would involve reforming the patent system underpinning biomedical research. Currently the patent system provides incentives for biomedical research, with the potential to reap enormous profits. A more efficient way to finance groundbreaking research in our view would be to put a tax on the sale of prescription drugs and use the proceeds to fund research on new ones.

Pharmaceutical and other biomedical companies would compete for those grants – making the decision over what types of drugs to develop a social decision rather than a private one – and any drug they develop with the money would be patent-free. Nobel Prize-winning economist Joseph Stiglitz, for one, has argued in favor of an approach similar to this.

In our view, this would drastically reduce prices.

3. Put consumers in the driver’s seat

A third problem that leads to high health care spending is the lack of consumer control.

Normally, when someone wants to buy something – be it groceries or a car – a consumer looks around in stores or online and compares prices to make an informed choice about what works best given her needs and budget.

Health care does not conform to this model. Information is asymmetric —- which means one side knows more than the other —- and consumers tend to defer to their providers. Moreover, insurance renders consumers insensitive to prices with little incentive to shop. Cost containment breaks down if shoppers cannot obtain prices.

Trump could empower consumers by aggressively pushing for greater standardization and use of technology in health care. This could include giving consumers more control of their health records in the cloud and requiring insurers and providers to give them more information about prices and the quality of competing options. And as with occupational control, the administration could condition Medicare and Medicaid payments on following its standards.

Knowledge that all providers have ready access to all your medical information will likely encourage switching to lower cost providers. And just as giving consumers more control led to significant innovations, competition and savings in retirement plans, the same thing would happen in health care.

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

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Invest in health for global security and growth, Gates urges donors

LONDON (Reuters) – Donating billions of dollars to global funds that fight poverty and disease is one of the best investments governments can make to boost security and economic growth, philanthropists Bill and Melinda Gates said on Thursday.

Ending epidemics of infectious diseases such as malaria, polio, HIV and malaria is proving tough, they said, but dramatic progress made by global aid mechanisms recent decades means the world’s people are now healthier and more productive.

“The data has been really striking,” Melinda Gates told reporters on a teleconference.

She cited figures from the World Health Organization and others showing that since 1990, under-five mortality rates have fallen by more than 50 percent, and deaths due to infectious diseases like HIV, malaria and measles have also halved.

“A child born today is half as likely to die before the age of five, compared to if she was born in 2000,” Melinda Gates said. “The human and economic benefits of this are enormous.”

The multi-billion dollar philanthropic Gates Foundation she co-chairs with her husband Bill, the co-founder of Microsoft, is one of the largest funders of global health program aimed at helping poor people escape disease, poverty and premature death.

The Foundation is seeking to encourage international donor governments such as the United States, Japan, Australia, Germany, Britain and many others to replenish four key global funds in the next 18 months so they can continue their work.

The funds include the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Global Polio Eradication Initiative (GPEI) and the GAVI vaccines alliance and the Global Financing Facility for child and maternal health.

Bill Gates said he was optimistic that wealthy donor governments remain committed to funding international aid for poor countries, but added: “We never want to take it for granted, because … just one (donor) country dropping back could cost hundreds of thousands of lives.”

He also said he was concerned that “distraction by domestic issues” may mean the still urgent need for global aid funding may not get the attention it deserves.

“People shouldn’t become complacent,” he said. “We still have a little less than six million children who die under the age of five.”

Reporting by Kate Kelland; Editing by Raissa Kasolowsky

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