Health Plans

As the Obama administration continues its top secret effort to build federal insurance exchanges in about 34 states while 16 states are doing it on their own, that continues to be the big question.

HHS is using IT consulting firm CGI for much of the work on the exchanges and the federal data hub. CGI has their plate full since they are not only working on the federal exchange but also doing work for the state exchanges in at least Colorado, Vermont, and Hawaii.

Earlier this month, the Senate Finance Committee held an oversight hearing. The Obama guy in charge of exchange development testified before them. I thought it was notable that it was the Democrats who expressed the greatest concern, and frustration, over senators not getting a clear idea for just where the administration is toward the goal of launching the new health insurance exchanges on October 1.

So far California has received $910 million in federal grants to launch its new health insurance exchange under the Affordable Care Act (“Obamacare”).

The California exchange, “Covered California,” has so far awarded a $183 million contract to Accenture to build the website, enrollment, and eligibility system and another $174 million to operate the exchange for four years.

The state will also spend $250 million on a two-year marketing campaign. By comparison California Senator Barbara Boxer spent $28 million on her 2010 statewide reelection campaign while her challenger spent another $22 million.

The most recent installment of the $910 million in federal money was a $674 million grant. The exchange’s executive director noted that was less than the $706 million he had asked for. “The feds reduced the 2014 potential payment for outreach and enrollment by about $30 million,” he said. “But we think we have enough resources on hand to do the biggest outreach that I have ever seen.”

Healthy living

Healthy living
"I'm confident in her," she said "She seems excited about the moment that she gets to hit the gym and get her body back, and she obviously trusts that I know how to do it, and I do. And as long as she shows up, she will do it."

New celebrity moms seem to re-emerge gorgeous, stylish and incredibly in-shape just months after giving birth. While it's nearly impossible to get those bodacious Hollywood bodies without personal chefs, trainers and stylists, it hasn't stopped many regular moms from trying. It's part of a recent trend to lose pregnancy weight faster than ever.

SoulCycle, an intense, indoor cycling studio with locations in New York City and Los Angeles, where riders can burn hundreds of calories in a single class, has become a favorite workout for many new moms.

Ali Carlin is a stay-at-home mom with two kids, 2-year-old Adrianna and 1-year-old Brooks, living in New York. She had her kids back-to-back and said she wanted to get back in shape and finally focus on herself.

SoulCycle instructor Nick Oram said moms trying to lose baby weight are among his biggest clients.

And they aren't just doing one class a week. They are working out even before their babies are big enough to crawl. In fact, an entire industry has sprung up around mothers who want to look hot pushing a stroller, and even while they are still pregnant. There is maternity athletic gear, pregnancy workout DVDs and apps, all to keep Mom in shape before she even has the baby.

Celebrity trainer Tracy Anderson has built her brand around transforming women's bodies after childbirth. She has trained some of the biggest A-list celebrities around, from Jennifer Lopez to Victoria Beckham, and she went into business with her client and friend Gwyneth Paltrow.

It's never too late to change your habits, and by establishing a healthy lifestyle now, you'll continue to reap the rewards in the future. Discover the facts behind nutrition so you can make informed choices, understand how BMI, or body mass index, affects you, or take part in our six-week diet and exercise programme."Everybody's life is unique," Anderson said. "As soon as your doctor releases you to work out, you have to start reconnecting to your body. What's hard is that you know what it's like to start working out again after being pregnant, it's the worst thing ever. "

PHOTOS: Celebrity Baby Bumps

Most medical experts agree it is healthy to work out during pregnancy. But being obsessed with your weight while pregnant and immediately after giving birth is another story.

In fact, a recent study by the University College London of 700 pregnant women found that 1 in 14 had an eating disorder during the first part of their pregnancy, roughly the same as the general population.

"Comparing a normal post pregnancy body to a celeb's is like expecting one's face to look like an airbrushed and photoshopped magazine ad," said Vivian Diller, a psychologist in New York. "It's just not realistic and leaves many moms falling short of expectations. Bodies change for real women throughout real life."

Unlike most people, celebrities have armies of people to help them get their post-baby body back, from personal trainers at the gym to plastic surgeons who can perform tummy tucks and liposuction.

"The average new mom needs to keep in mind that most celebs view working out as a part of their job," Diller said. "Prior to pregnancy, they are often in very good shape. Getting back to it as soon as possible is, in part, what they are paid to do."

Some famous moms can't even live up to the perfect image that's demanded of them. Kim Kardashian has been skewered in the tabloids for gaining weight during her pregnancy.

"It's like adult bullying," Anderson said. "It's the most ridiculous thing I've ever heard."

Even though Kardashian is working out with Anderson, every pound she has gained during her pregnancy has been plastered across magazine covers.

"I feel badly for her because anybody who has to do that under the pressure of being photographed all the time ... sometimes when you're pregnant, it's like the last thing you want to do," Anderson said. "You want to be in sweats."

But Anderson is confident that like all of her celebrity mom clients, Kardashian too will be back and better than ever.

"I'm confident in her," she said "She seems excited about the moment that she gets to hit the gym and get her body back, and she obviously trusts that I know how to do it, and I do. And as long as she shows up, she will do it."

But for real moms, just feeling good and looking good, for themselves and their kids is what really matters.

Healthy Families

Healthy Families

Today I would like to introduce a guest writer. Carolyn is a 20-something year old with a passion for life, fitness and overall well-being. She is an avid cycler, golfer and has been known to bust some serious moves on the dance floor. 

Carolyn wrote to me (not too long ago) about her passion for getting healthy- starting at home. As a mother, I am constantly trying to better my own health- and that of my family. I honestly believe that mothers are the most influential factors in raising healthy children. After all, we do the majority of the grocery shopping and activity planning. So, I thought Carolyn would be a wonderful addition to Diapers & Daisies today and help to expand our knowledge on leading healthy lives.

Thanks Carolyn.

With no further ado...

  

When the calendar flips to the new year, people around the world get to work on their New Year’s resolutions. For my family, changes in habits had to be addressed in November of last year, which was when my young cousin was diagnosed with Type 2 Diabetes. I couldn’t believe that someone who is only 13 years old could develop this disease…but after talking with her doctors and doing my own research, I found that it has become quite common among young children to develop Type 2.

What was even scarier to me than the sheer number of kids affected by this disease, are all of the possible consequences that can come from it. Information provided by St. Joseph’s Hospital Cardiac Center describes how, if left untreated, Diabetes can lead to things such as eye problems and blindness, heart disease, and even neurological problems. Seeing as how this disease can frequently be treated and prevented with adjustments to diet and exercise, I took it upon myself to work with my family to make healthy adjustments to diet and exercise so that none of my other cousins will run the risk of developing this disease. Seeing that we are in the New Year, it’s a perfect time for other families to make this their resolution for 2013 as well!

Inactivity and obesity are two contributing factors to the rise in Type 2 Diabetes in youngsters under the age of 20. The best tools against it, of course, are exercise and a healthy diet. It is always a good idea to check with a doctor concerning best dietary options and exercise regimes, but here are a few tips to get you and your children started on the right track for the New Year.

Get Active to Get Healthy! 

First, take advantage of the weather to enjoy exercising outdoors with the kids. Those who live in cold climates will find winter sports a great way to stay fit. Take the kids tubing, sledding or skiing. Spend an afternoon building snow forts and having a snowball fight.

If snow doesn’t fall where you live, take the kids on a family bike ride or go rollerblading together. If weather is bad enough that going outside isn’t an option, turn on some music and have a family dance contest or pick up some exercise DVDs from the library and enjoy the workout together! The key is to get moving every day, and it makes it easier and way more fun if everyone does it together! 

Eat Right to Get Healthy! 

To improve your children’s diet, make some moderate changes to start (changing everything at once can be a major shock, and they are much more likely to resist each change). Replace sugary drinks with water. If the kids don’t like the taste, offer purified drinking water or add a squeeze of lemon, lime, or cucumber to the drink.

At snack time, offer fresh or dried fruit with no added sugar, almonds or crunchy vegetables. Hummus and guacamole are great, healthy sides that are both delicious, healthy, and great with veggies or whole grain pita chips!

At mealtime, use proper portion control and replace processed food and red meat with options such as fish, brown rice, poultry and legumes. For a balanced plate, ½ the plate should be filled with fruits and/or non-starchy vegetables, ¼ should be lean protein, and the last ¼ should be whole grains/healthy carbs. 

As with any disease, it is easier to prevent Type 2 Diabetes that to treat it following onset. A few lifestyle changes will ensure better health for the entire family, and will build healthy habits for years to come!

Engaged Parents Have Healthier Adolescents
Students whose parents are engaged in their school lives are more likely to practice healthy behaviors and succeed academically.

Chickenpox Can Be Serious: Protect Your Child
Most children with chickenpox completely recover. But it can be serious, even fatal, for babies, adolescents, and adults. Be proactive. Get vaccinated if you are not protected against chickenpox.

Antibiotics Aren't Always the Answer
Antibiotics do not fight infections caused by viruses like colds, most sore throats and bronchitis, and some ear infections. Unneeded antibiotics may lead to future antibiotic-resistant infections. Symptom relief might be the best treatment option.

Traveling Overseas? Consider Getting Insurance
If you are planning an international trip, there are 3 types of insurance you should consider: trip cancellation insurance, travel health insurance, and medical evacuation insurance. These will cover different situations and may give you financial peace of mind, as well as allowing for safe and healthy travel.

Inspiration for a Healthy New Year
Make being healthy your resolution and find ways to get and stay healthy this year. Meet three people who changed their health habits—and their lives. Here are their stories and tips for making healthy living easier.

Inspiration for a Healthy New Year

Make being healthy your resolution and find ways to get and stay healthy this year. Meet three people who changed their health habits—and their lives. Here are their stories and tips for making healthy living easier.

Many popular New Year's resolutions focus on how to improve our health. That is good news, considering that being healthy provides us protection against disease and injury, as well as strength and energy to help us have a good quality of life.

5 Healthy Tips for 2013

Whatever your situation, see your health care provider and find out how you can live a safer and healthier life. Here are a few general tips for a safe and healthy life:

• Find health resources to help you achieve your New Year's goals.
• Protect yourself from injury or disease by wearing a helmet, sunscreen, or insect repellentwhen necessary.
• Make an appointment for a check-up, vaccination, or screening. Know where to go for care if you do not have health insurance.
• Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer.
• Learn health tips that take 5 minutes or less.

Need inspiration to get started? Meet three people who changed their health habits—and their lives. They lost weight, became active, gained energy, and grew in self-confidence. Here are their stories and tips for making healthy living easier. They say if they can do it, you can too!

Bill

Bill had stayed in shape playing football in high school, but then became inactive in college and started gaining weight.By the time he was in his mid-30s and the mid-300 pound range, he was diagnosed with type 2 diabetes and started giving himself insulin shots twice a day.

In his 50s, Bill weighed 515 pounds, had achy knees, used a cane, and rode a scooter to get around the store when he shopped. A friend's well-meaning comment about his weight and health got his attention. That night, Bill took stock of his life and developed a plan to change his habits.

At his doctor's suggestion, he took the plunge into exercise with water aerobics. To his surprise, Bill found he enjoyed the workout and could move easily in the water with little impact on his joints. He lost 35 pounds and the knee pain subsided. That encouraged him to keep going and make other changes in his life.

He dropped 140 pounds on his own before having surgery for help in taking off 145 more. He jokes that with 285 pounds gone, he lost the equivalent of an NFL linebacker. Not only that—Bill has been off diabetes medication for years.

"Obesity robbed me of a lot in life," says Bill. "I call it the O-beast." For example, when his son was 8, Bill was scared to go on a ride with him at an amusement park. However, when a slimmer Bill took the family to the same park years later, he asked his then 30-year-old son, "Will you ride with me?" They did, and as he says, "It was an emotional moment."

Strategies That Work For Me

• Make small changes, like sometimes eating other things instead of meat.
• Make a commitment to yourself. I don't care if it rains, sleets, or snows: I walk an hour five times a week.
• Get the professional help that you need, whether for emotional support or physical check-ups.
• Enjoy life! I didn't go to my high school prom, so I plan to have a prom this year, with a band and all the people I love. I will take a date and celebrate.

Becky

To look at Becky, a triathlete, marathoner, and ultramarathoner, you would never know she used to be a couch potato who spent nights watching TV and eating junk food. Fishing was her only real activity, and as she quips, she only exercised one arm.

She weighed close to 180 pounds and smoked two packs a day, but gave up cigarettes on her own. Then in 1995, her sister, who was training for a race, challenged her to run a mile.

Becky started out walking and tried running a little bit. Once she ran a full mile, she thought maybe she could do more. Exercise gave her an unexpected physical and mental boost. It relieved stress from taking care of her ill mother.

Soon Becky had built up to running a half-marathon. The next year, she tackled her first marathon. She never looked back, and has completed 29 marathons since 1996 and at age 50 completed a full Ironman triathlon.

Strategies That Work For Me

• Adapt to your body's needs. I now have arthritis in my knee, so have focused on finding what types of movement I can do instead of what I can't do. I do moderate running, walk, cycle, kayak, and work out with weights.
• Eat healthily. I cut out french fries and pizza, ate less sugar, and dropped 40 pounds.
• Get adequate sleep and rest. I teach meditation, which is all part of overall wellness. I'm working on the sleep and rest part.
• Move more at your desk. I try to make myself get up every 30 to 60 minutes, even if it's just to walk around for a minute or move around from my desk.

Sylvia

Sylvia was a stay-at-home mom whose life revolved around cooking, cleaning, watching soap operas, and eating unhealthy food. Her weight had climbed to 175. "I'd always been skinny," says the former farm girl, who ran track and played basketball in her youth. "But at that weight I was sluggish and tired."

Then she and her husband took in an ill friend who had undergone surgery. While helping the friend eat healthier and regain his strength, they began to change their eating habits too. Sylvia's energy skyrocketed. She began working out, doing an hour on the treadmill or elliptical machine. Next, she added weight training.

The mother of two toned up and slimmed down by more than 30 pounds. "I'm a witness that this change in lifestyle works. The same way I changed my life and made health a priority, you can too."

Strategies That Work For Me

• Buy your food fresh. Love yourself by cooking your own food. I make my own vegetarian pizza and pasta.
• Season with herbs instead of salt. I use curry, basil, cilantro, rosemary, parsley, and ginger.
• Steam vegetables like broccoli or string beans.
• Find the physical activity and training level that's right for you. I started with cardio workouts to raise my heart rate and build my aerobic capacity, then added weight training to become strong.

Below are more tips for creating a healthy you and healthy family in the new year.

Healthy You

• Make healthy food choices. Grab a healthy snack such as fruit, nuts, or low-fat cheese.
• Be active. Try simple things such as taking the stairs instead of the elevator. Be active for at least 2½ hours a week.
• Find out more about the benefits of regular physical activity. Sometimes getting startedis the hardest part. Learn what counts as aerobic exercise.
• Be smoke-free. If you are ready to quit, call 1-800-QUIT-NOW for free counseling. Need inspiration? Check out Tips from Former Smokers.
• Get enough sleep. Remember that sleep is a necessity, not a luxury.

Traveling Overseas? Consider Getting Insurance.

If you are planning an international trip, there are 3 types of insurance you should consider: trip cancellation insurance, travel health insurance, and medical evacuation insurance. These will cover different situations and may give you financial peace of mind, as well as allowing for safe and healthy travel.

Trip Cancellation Insurance

Trip cancellation insurance covers your financial investment in your trip, such as flights, cruises, or train tickets. Carefully examine the policy to make sure that it covers what you need it to cover, including cancellation if you or a close family member gets sick. Depending on the policy, trip cancellation insurance might not cover any medical care you need overseas, so you may need a separate travel health insurance policy.

Travel Health Insurance

If you need to go to a hospital or clinic overseas, you will probably be asked to pay out-of-pocket for any services, which could be very expensive. Even if a country has nationalized health care, it may not cover people who are not citizens. Before you go, you should consider your insurance options in case you need care while you’re abroad, especially if you have existing health conditions, will be away from home for a long time, or will be engaging in adventure activities such as scuba diving or hang gliding.

If you have health insurance in the United States, find out if it will cover emergencies that happen abroad. Ask if your policy has any exclusions, such as for preexisting conditions or adventure activities. If your health insurance coverage is not adequate, consider buying a short-term supplemental policy. Look for a policy that will make payments to hospitals directly.

Medical Evacuation Insurance

If you are traveling to a remote destination or to a place where care is not likely to be up to US standards, consider buying medical evacuation insurance. This can be purchased separately or as part of your travel health insurance policy. This insurance will pay for emergency transportation from a remote or poor area to a high-quality hospital. Make sure that the policy provides a 24-hour physician support center.

Antibiotics Aren't Always the Answer

Antibiotics do not fight infections caused by viruses like colds, most sore throats and bronchitis, and some ear infections. Unneeded antibiotics may lead to future antibiotic-resistant infections. Symptom relief might be the best treatment option.

Dangers of Antibiotic Resistance

CDC efforts have resulted in fewer children receiving unnecessary antibiotics in recent years, but inappropriate use remains a problem. Widespread overuse and inappropriate use of antibiotics continues to fuel an increase in antibiotic-resistant bacteria.So the next time you or your child really needs an antibiotic for a bacterial infection, it may not work.Colds and many other upper respiratory infections, as well as some ear infections, are caused by viruses, not bacteria. If antibiotics are used too often for things they can't treat—like colds or other viral infections—they can stop working effectively against bacteria when you or your child really needs them. Antibiotic resistance—when antibiotics can no longer cure bacterial infections—has been a concern for years and is considered one of the world's most critical public health threats.

Antibiotic resistance is also an economic burden on the entire healthcare system. Resistant infections cost more to treat and can prolong healthcare use.

Video: Parents Want To Do What's Best

When your child is sick, antibiotics may not be the answer. Work with your child's doctor or nurse to learn how you can help your child feel better. CDC created a 30-second TV public service announcement to highlight this important information. 

If You or Your Child Has a Virus Like a Cold or Sore Throat

Taking antibiotics when you or your child has a virus may do more harm than good. In fact, in children, antibiotics are the most common cause of emergency department visits for adverse drug events. Rest, fluids, and over-the-counter products may be your or your child's best treatment option.

Get smart about when antibiotics are appropriate—to fight bacterial infections. Taking them for viral infections, such as a cold, most sore throats, acute bronchitis and many sinus or ear infections:

• Will not cure the infection
• Will not keep other people from getting sick
• Will not help you or your child feel better
• May cause unnecessary and harmful side effects

What Not to Do

• Do not demand antibiotics when a doctor says they are not needed.
• Do not take an antibiotic for a viral infection like a cold or most sore throats.
• Do not take antibiotics prescribed for someone else. The antibiotic may not be right for your or your child's illness. Taking the wrong medicine may delay correct treatment and allow bacteria to increase.

If your doctor prescribes an antibiotic for bacterial infection:

• Do not skip doses.
• Do not save any of the antibiotics for the next time you or your child gets sick.

Just because your doctor doesn't give you an antibiotic doesn't mean you aren't sick.What to Do

Talk with your doctor about the best treatment for your or your child's illness. To feel better when you or your child has an upper respiratory infection:

• Ask your doctor or pharmacist about over-the-counter treatment options that may help reduce symptoms
• Increase fluid intake
• Get plenty of rest
• Use a cool-mist vaporizer or saline nasal spray to relieve congestion
• Soothe a throat with ice chips, sore throat spray, or lozenges (do not give lozenges to young children)

Helping Parents Cope With Disaster

Anyone who is a parent knows how hard it can be to raise a child. Add a stressful situation, like a natural disaster or other emergencies, and a difficult job gets even harder. When disasters happen, it is important to remember the health and well-being of yourself and your children. If you are prepared for potential disasters, you can be more confident in your ability to keep your family safe, and your children are likely to handle the disaster better as well.

View, download or print Helping Parents Cope With Disaster

This study assessed effects of traumatic childhood death on parents. From July 1988 to September 1992, 48 of the 1,954 children admitted to our pediatric trauma center died. Interviews were requested with parents of children who died and were conducted by a chaplain in the homes of 29 parents (20 families). Interview assessments were based on Worden's ``Mourning Tasks'' and Demi and Miles's ``Parameters of Normal Grief.'' Grieving was uncomplicated in seven parents (five families). Common elements included use of multifaceted nonfamily support networks to aid grieving, and no parents blamed themselves or God for the child's death. Grieving was pathologic in 22 parents (15 families). Dominant features included: (1) lack of a support network beyond the extended family; (2) an avoidant stance to grieving; and (3) view of God as distant and punitive. We provide nine indices that will enable hospital caregivers to anticipate the outcome of parental grieving, and offer suggestions for the physician who desires to be involved in parents' acute and rehabilitative grief recovery.