How federal health care reform will impact Wisconsin

Health care. It is one of the most basic needs for all citizens, yet there are citizens who do not have access to quality care for various reasons.

In response to this need, the federal government enacted the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act last month to help those vulnerable citizens get coverage.

There have been many who criticize the merits - and the legality - of this set of bills. In particular, Wisconsin Attorney General J. B. Van Hollen requested permission from state leaders to join with other state attorney generals to file suit contesting the constitutionality of the bills.

However, most agree these bills will make sweeping changes across the nation with effects varying depending on each state.

For example, while Wisconsin has always been a leader in health care, Department of Health Services spokesperson Seth Boffeli said the state will still need to make adjustments to meet the new national health care standards.

The bills

The House of Representatives first passed the Affordable Health Care for America Act in November 2009 as a means of reforming the U.S. health care system, but this bill did not make it past the Senate. Instead, the Senate crafted the PPACA, which the House then passed, along with the HCERA to amend parts of the PPACA.

The PPACA prohibits insurance companies from rating customers based on preexisting health conditions or current health status, and it set up a national "health insurance exchange" where qualifying insurance companies can be listed on a marketplace for consumers to browse the best coverage option.

This bill also forms a public health insurance option to ensure competition, allow for unmarried older children to stay on their parents’ insurance up to age 26 and offer small businesses and low-income residents tax credits to help them afford coverage.

The HCERA also makes such amendments to the PPACA as increasing tax credits to buy insurance, closing the Medicare Part D coverage gap, giving seniors a $250 rebate and having the government pay the total costs of Medicaid expansion from 2014 until 2016, when the percentage will decrease incrementally to 90 percent after 2019.

"As I looked across the well of the House, I saw so many of my colleagues tearing up because I think like me they sense the … history of this vote, the history of this moment," U.S. Rep. Tammy Baldwin, D-Wis. said in a video statement following the PPACA floor vote.

However, U.S. Rep. Paul Ryan, R-Wis. did not share Baldwin's opinion of the bills and criticized the government's "power grab" during the March 21 floor debate.

"Health care affects each and every one of us. It is the most personal thing there is. And yet, here we are debating whether the government should have a bigger role in making those decisions," Ryan said.

For more information please visit: http://badgerherald.com/news/2010/04/28/how_federal_health_c.php

Weight loss sites target men living large

Do men really need their own weight-loss programs?

The leaders in the industry, Jenny Craig and Weight Watchers, have targeted men. Working under the premise that “men approach weight loss differently,” Weight Watchers for Men offers a “customized online system built for men, just men,” the program’s Web site says. Jenny Craig has enlisted actor Jason Alexander as a spokesman and promises guys that they can occasionally splurge on beer and fries.

But do men lose weight differently than women do? Or are these “for men” programs gimmicks?

A bit of both. Arizona-based weight-loss doctor Craig Primack, speaking for the American Society of Bariatric Physicians, says there are a few ways in which men diverge from women in approaches to losing weight. But he suggests the differences aren’t big enough to require separate programs: “I think (the companies) are looking for subtypes of people to market to.”

That’s probably a smart business move, as the market is, well, huge. The Centers for Disease Control and Prevention reports that about one-third of all men are obese.

Men, Primack says, “tend to underestimate how much weight they have to lose, and they won’t start until they have 50 pounds” to shed. Plus, he says, “In society now, it’s not frowned upon when a man is mildly overweight.” The same doesn’t hold true for women.

Men also are generally taller and carry more lean muscle mass, which helps in losing weight, Primack says. “For women, baby weight often puts them behind the eight ball, and they get a second hit around menopause, when they gain weight around the middle.”

“When you have more muscle, you burn more calories at rest. We tend to see the men lose weight at a quicker rate than women,” agrees Misti Evans, a clinical dietitian and director of weight management and diabetes education at Lutheran Hospital in Fort Wayne.

Plus, women tend to carry extra weight in the hips, thighs and stomach, which is often is more difficult to lose than the typical male “apple shape,” where weight is concentrated in the stomach, she says.

Although 80 percent of its patients are female, the center’s programs don’t separate support groups by gender, because the behavioral therapists believe everyone can benefit from discussing their experiences together, she says.

The programs are individualized to tackle each patient’s issues, but she’s noticed a trend among new female patients: self-doubt.

“Typically, women deal with this more than men and have tried a number of things (before joining the program), and have that little voice in the back of their head telling them they’re going to fail,” Evans says.

Primack notes that while women are generally “slow and persistent” in their approach to weight loss, men tend to “initially lose faster, 15 or more pounds in three or four months. But then they get a little complacent” and their progress slows.

For more information please visit: http://www.journalgazette.net/article/20100422/FEAT/304229919/1162

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