By Rozalynn Goodwin. My employer was asked for a statement acknowledging the second anniversary of federal health reform. Here was my suggestion.

“Happy Birthday to South Carolina’s mistress, the Affordable Care Act! We use and enjoy your goods in the dark, but despise and won’t claim you in the daylight.”

For the life of me, I can’t understand why our communications team didn’t see value in using it. No hard feelings though…

We South Carolinians don’t take too well to anybody telling us what to do. We are very proud to have been the first state to secede from the Union. Our relationship with federal health reform is no different.

“We will continue to push back against the federal takeover of our healthcare system. South Carolina does not want, and cannot afford, the President’s healthcare plan. Not now, and not ever,” South Carolina Governor Nikki Haley, January 2012

Yet, South Carolina has received over $101 million dollars from “Obamacare” for health care grants, demonstration projects and programs. Not the mention the $13 million in rebates our seniors received for Medicare prescription drug coverage, plus another $32 million in brand name prescription drug savings. And I haven’t even mentioned the 40 plus businesses (including Blue Cross Blue Shield of South Carolina) that have taken advantage of the Act’s Early Retiree Reinsurance Program, or the over 30,000 young adults who have received coverage as a result of the new law. But, remember, “We don’t want the President’s healthcare plan.”

Dear South Carolina and all other states talking out both sides of your mouths:

While Madam ACA has her flaws, I believe she has good intentions. She’s so young and vulnerable, and doesn’t deserve the verbal onslaught she’s received, especially during this presidential primary marathon. It’s time to come clean about your relationship with her. Take her home to meet the family. Heck. Once they meet her, they might even like some of her qualities, and help you two work out your differences for an open and honest relationship that benefits us all.

By Hope Ditto. Every three minutes, food allergies send an American to the emergency room. Activities that most of us take for granted — like sitting in a restaurant that uses peanut oil or indulging in a birthday cupcake from a bakery that uses nuts in some of its treats – could be harmful, if not fatal for the millions of people who suffer from food allergies. Families must take extra precautions to ensure children with food allergies do not face what could be life-threatening exposure to foods like milk, eggs, wheat, soy, shellfish, seeds and nuts. Sometimes a child doesn’t even have to eat the allergen to become ill and all it takes to cause a reaction is light physical contact, such as spilling a glass of milk on a child with a dairy allergy.  Not surprisingly, food-allergic children often feel a sense of isolation and embarrassment in social situations.

The prevalence of food allergies has been on the rise in recent years. According to a national study  of 38,480 families in 2011, one in 13 children has food allergies compared to one in 25 children with food allergies in 2008. That’s 5.9 million children in America suffering from at least one food allergy, or two children in every classroom, with more than a third of them considered severe or life-threatening.

Mary Jane receiving the award from former U.S. Representative Michael Castle

Mary Jane Marchisotto, the executive director of the Food Allergy Initiative (FAI), an organization dedicated to curing food allergies, and a Disruptive Woman, is on a mission to make life safer for those suffering from food allergies and is having some real success.

In honor of FAI’s many outstanding achievements, the organization, under Marchisotto’s leadership, was awarded the Paul G. Rogers Distinguished Organization Advocacy Award by Research!America at their annual Advocacy Awards Dinner last night – a commendation many consider to be the highest honor an organization can receive in medical and health research.  Past recipients have included the March of Dimes, Genetic Alliance and Juvenile Diabetes Research Foundation International. The award,  established in 2007, was named in honor of the late Paul Rogers, a former congressman known on the Hill as “Mr. Health” for his support of the National Institute of Health and other health care and health research measures, and had served as Research!America’s  board chairman, and its chairman emeritus.

To the health policy world, receiving the Paul G. Rogers award is a testament to all that FAI has accomplished and the remarkable progress they have made in advancing food allergy research, education and awareness. (more…)

The Disruptive Women in Health Care blog is looking for an editorial intern for the Fall 2011 Semester. The Editorial Intern will be responsible for assisting the Disruptive Women team in the day-to-day aspects of managing and maintaining what HealthTech recognized as “one of the top health policy blogs” in the country. This will include not only editing and monitoring content submissions, but also researching and writing posts as well. Ideal candidates for this position might be Journalism/Political Science/English/Public Policy majors with experience writing/reporting/editing (especially for the web) who want the opportunity to develop their blogging and social media repertoire. The Editorial Intern will have his or her own writing (with byline) published on a syndicated site, assist in the creation and implementation of special features, bolster social media communications efforts surrounding the blog and serve as an integral part of the editorial process from start to finish.

Responsibilities include, but are not limited to:
-  Serving as a member of the Disruptive Women editorial team
- Assisting in the day-to-day operations of one of the country’s top-rated health policy blogs
- Reporting and writing for the blog – conducting interviews, covering events, writing posts for publish (with byline), etc.
- Assisting the blog editors in overseeing the editorial content of the blog – copy editing, fact checking, etc.
- Maintaining the blog’s resource sections – including the calendar, multimedia and about tabs
- Assisting in the blog’s social media outreach/communications efforts
- Promoting and providing logistical support for blog-sponsored events

Schedule and Compensation:
- 10-15 hours/week (7 in office, 3-8 remotely)
- Flexible hours
- This is an unpaid internship
- Class credit available on a conditional basis
Note: The office is located in downtown DC. Applications are limited to those in the DC metro area. We regret that we are unable to provide compensation for travel expenses to and from the office.

Qualifications:
- Competency in Microsoft applications, including Word, Excel and Powerpoint
- Exceptional organizational and communication skills
- Familiarity with blogging/online reporting
- Experience using wide array of social media platforms, including but not limited to: Twitter, Facebook Pages, LinkedIn, YouTube, etc.
- Must be able to work effectively and independently as an editorial team member
- Must be precise, alert and attentive to details

Interested? Email a cover letter (detailing availability), resume and relevant writing sample to hditto (at) amplifypublicaffairs (dot) net.

With summer break right around the corner, more kids unsupervised at home, and prescription drug abuse on the rise, the National Family Partnership’s Lock Your Meds campaign offers tips for parents.

Studies show that more teens start using drugs during the summer months – while unsupervised and with more free time.

• 70% of teens who abuse Rx drugs get them from family and friends.
• 68% of households do not properly secure their Rx medications.
• Studies show that unmonitored kids are four times more likely to engage in substance abuse.
• The distressed employment market makes it harder for teens to find summer jobs, leading to more boredom, restlessness and free time. 
• A new study surveyed 2,500 high schoolers and reported that one in four admitted to abusing Rx drugs.

TIPS FOR PARENTS:

• Safeguard all medicines by monitoring quantities and controlling access. Remove drugs from your medicine cabinet and lock them up.  
• Warn your youngsters that prescription drugs can be just as dangerous, addictive, and lethal as street drugs.  Studies show that teens dangerously view prescription drugs as “safer” to abuse than illicit drugs.
• Properly dispose of old or expired medicines in the trash. Hide or mix them with cat litter or coffee grounds before throwing them away.
• Don’t have kids at home? What about your grandchildren, nieces and nephews, and your friends’ kids that visit your house? (more…)

The following is a guest post by Jenni Sunde. Jenni is a freelance fashion writer and pop culture junkie. She specializes in all things lifestyle-related. From home and design to health and beauty. With her love of art and all things beautiful, she delights in sharing her sense of style from her life to your computer monitor. Her title pegs her as an editor at a website that specializes in providing people with car insurance quotes, but her passion leads her into writing with a little more substance and a lot more heart.

By Jenni Sunde. The benefits of a sound mind and body can be traced all the way back to ancient Greco-Roman cultures.  Despite how long the concepts behind mind and body connection have been around, they are frequently overlooked in our modern society.  The connection between mind and body is particularly impactful for adolescents; studies have shown that happier youths are indeed, healthier youths.

Emily Shaffer Hudkins and her team of researchers at the University of South Florida conducted a study that focused on the impact that positive emotions, moods and overall satisfaction with life has on the health of teens.  Her research shows that these positive feelings, also known as subjective well-being are more significant than depression and anxiety when it comes to physical health.  Psychopathology has long been where the emphasis is placed when it comes to determining how the mind and body are connected. 

Hudkins conducted an experiment with 401 students, grades 6-8 from a suburban southeastern middle school in the US.  She monitored both their subjective well-being and psychopathological tendencies.  The study asked questions about the teens’ satisfaction with life; whether they were strong, proud and excited, and whether they felt lonely, guilty, or sad.  What Hudkins founds is that good mental health most often is linked to good physical health.  Mental health indicators explain roughly 30 percent of the difference in physical health ratings.  The findings show that subjective well-being has a significant, unique and primary affect on predicting important physical health outcomes in youth.  In other words, subjective well-being is more strongly associated with physical functioning than psychopathology.

What Emily proposes is that we change our wellness models to ones that are more holistic, so as to incorporate the entire spectrum.  With current standards, the subjective well-being is often overlooked in terms of its impact on physical health when it actually is more prominent than poor mental health in terms of how much it can affect the body.

By Meryl Bloomrosen. “They” say that being a teenager is NOT easy.  Well, being the parent of a teenager is certainly isn’t easy either.  And it is usually the case that all of us will experience some bumps along the way.  

Yet, to some such concerns and crises seem insignificant or trite in comparison to recent headlines such as those about the Tsunami, earthquake and nuclear reactor explosions in Japan; Haitian elections; social unrest and justice in Egypt and elsewhere; and attacks in Libya. Or the ongoing headlines about the economic meltdowns on Wall Street; bank, savings and loans failures; or the continuing high unemployment statistics; and plummeting real estate values.  Or even NCAA March madness.

Although, there has been periodic news and media attention on teen and school bullying and some new efforts are in process to take a look at this growing challenge.  It  has been in the past several weeks, months and years, that I have learned about adolescent mental health services along with a bit about the legal/justice and educational systems.  Having worked in the health care “system” for almost 35 years, I thought that I was fairly well informed…I was wrong.

Maybe it was the early morning phone call stating that the teen was being taken to the county emergency crisis unit.  Or how about the parent who called 911 and was (thankfully) coached to “say the right thing” because the teen was standing in the house with two huge kitchen knives pointed at himself? Or the parents who got the phone call asking them to come down to the police station because of their teen’s arrests at an underage drinking party. Or the parents who came home one night and found their teen unconscious suffering from what turned out to be alcohol poisoning.   Or maybe it was the parents whose teen jumped out of the window at her therapeutic boarding school in spite of the promise of 24/7 supervision?   Or maybe it was the crisis center stating that given the history the teen needed to be evaluated at an emergency department because the teen posed a safety threat to self? Only the crisis center did not seem to know any local “teen-appropriate EDs”. (more…)

By Hope Ditto. It’s the morning after the Academy Awards, barely twelve hours after the last little golden Oscar statue was presented, and your eyes are still burning with images of what our society conventionally considers “beauty” . The Oscars are essentially a parade of broadly accepted beautiful people with beautiful hair and beautiful figures in beautiful clothing adorned with beautiful accessories and beautiful shoes. Between last night’s red carpet glam-fest, that certain day of the year devoted solely to love and beauty two weeks ago and the annual release of the Sports Illustrated swimsuit issue last week, you’re probably feeling like February’s dished out all the beauty you can handle in a measly 28 days. In reality, it isn’t beauty you’re fed up with — rather it’s the media’s perception of what should constitute beauty that has got you so fed up. So if you’re at your wit’s end with the notion that a toned bikini bod and/or a pair of really expensive shoes are the be all and end all when it comes to appearances, keep reading, because our February Man of the Month – photographer Rick Guidotti – has devoted his career to capturing beauty of a different sort. And we could find no better way to celebrate our favorite February holiday (my apologies to GW and Abe) – Rare Disease Day – than by honoring Rick’s work.

Rick Guidotti

Rick Guidotti began his career focusing, like most fashion and portraiture photographers, on capturing traditional beauty. Educated at New York’s School of Visual Arts and based in Manhattan, Guidotti enjoyed the glamorous life of a successful high fashion photographer – snapping shots of conventional beauties for clients like Yves Saint Laurent, Elle and Harper’s Bazaar in traditionally beautiful places like Milan, Paris and London.

But all of that changed in 1997, when Guidotti was drawn to focus his work on a different type of beauty – the “beauty of genetic diversity.” Seeking to gain attention for this beauty he had discovered, Guidotti joined forces with Diane McLean, MD, PhD, MPH and together, the pair founded Positive Exposure (PE) – “a nonprofit organization that challenges stigma associated with difference by pioneering a new vision of the beauty and richness of genetic diversity.” The organization “utilizes the visual arts to significantly impact the fields of genetics, mental health and human rights” by forging “cross-sector partnerships with health advocacy organizations, governmental agencies and educational institutions.” 

PE does not just display Rick’s photos, though. They sponsor a number of initiatives and programs aimed at concurrently capturing the beauty of those suffering from genetic conditions and educating the broader public about them.

Still, they’re known best for their flagship undertaking – the Spirit of Difference gallery, which is a collection of images and video interviews of people, particularly children, living with various genetic conditions. PE has an online version of the Spirit of Difference gallery that you can check out here.

That’s not all PE does to impact and improve the lives of those living with these conditions, though. The organization sponsors and puts on “Self-Esteem/Self-Advocacy photographic and interview workshops” and “diversity workshops” and conducts “portable, sustainable educational and human rights programs and multi media exhibitions for physicians, nurses, genetic counselors, health care professionals-in-training, universities, elementary and secondary schools, legislators and the general public” around the country and the world. Using the photos and video interviews that Rick has taken, presenters (oftentimes Rick himself) shed light on not only the beauty but the unique spirit of his subjects, helping people to look past the differences created by their conditions and see that special, indescribable quality that so captivated Rick some 14 years ago.

But don’t just take my word for it. Check out one of Rick’s presentations, entitled “Redefining Beauty”.  I know I can’t think of a better way to celebrate the holiday than by checking it out! And, for more information about Positive Exposure and its undertakings, you can visit their website.

By Santi Bhagat. We all know how hard it is to advocate for ourselves, our spouses and our parents.  But can you imagine having to advocate for your child day in and day out for the rest of your life?  This is the harsh reality faced by many parents of children with childhood-onset health conditions and disabilities.  And believe me, it is hard!  When my perfectly healthy child became critically ill at the age of 8 years, I went from being a medical fellow to a life-long, full-time parent advocate. 

I learned everything I didn’t want to know about the health care system, but I eventually realized that the knowledge I acquired as an advocate is equally critical to health care practitioners if they are to provide quality health care, i.e., the right care the right way at the right time.  Adding the dimension of patient-centered care means care is delivered the way patients need and want it. 

Right now, we are still learning how to advocate for the right care the right way at the right time.  It looks like we’ll have to wait a while to get care the way we need and want it.   

As a parent and a physician, I had to be extra careful in the pediatric health care world.  If I came across as too demanding, I would have been dismissed as a neurotic or helicopter parent.  (I know a couple of physician-parents who were erroneously said to have Munchausen’s Syndrome by proxy.)  If I didn’t advocate, I risked danger.  In every situation, I had to find the fine line between objectivity and subjectivity, to assure myself that I truly was balanced in my approach. 

The problem is that even though most of us know what to advocate for, we are still dealing with human beings in the health care system.  They have pressures and barriers, they have egos, they have feelings – and they have the knowledge.  The art of advocacy is getting health care providers to do the following:

• Provide the best care so the patient achieves and maintains optimal health, and
• Empower patients with the knowledge needed to make informed decisions and self-manage their health and health care. 

The art of advocacy should empower health care providers to practice the art of medicine.

Parent advocates have another equally complex system to tackle: the education system.  After learning about all the various laws, e.g., American with Disabilities Act, Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act, parents have to learn about the culture of their child’s school as well as the county and state educational systems.  Then, parents have to advocate with human beings in the educational system to practice the art of education.

When our children grow up and enter adulthood, all the rules change and we are back at square one again.  The only consistency is that the systems are devoid of supports, and as parents, it is up to us to start over and learn from scratch on how to advocate for young adults with childhood-onset conditions and disabilities.

By Santi Bhagat, MD.  It seems that children with chronic medical conditions and disabilities (CMCD) just disappear into thin air when they grow up.  No-one tracks these young people, so we have no idea what happens to them.  We don’t know if they have insurance and doctors; are sick and in emergency rooms; go to school and have jobs; and/or live independently and have social lives. It is estimated that 600,000 young people with CMCD enter adulthood every year, into a system devoid of any supports and services, a system that is completely unprepared for them.  

To help improve things for children with CMCD as they transition into young adults , Physician-Parent Caregivers (PPC), is launching EMERGE–a new campaign  next week…stay tuned…I will be blogging more about that in the coming weeks.  

In the meantime, I would like to introduce a special PPC young adult leader, Amy Long.  Amy is one of America’s 8.2 million amazing young adults with CMCD who push through barrier after barrier and never give up on their dreams.  Amy gave me permission to share her first person account of what it is like to be a young adult with a chronic medical condition.  She calls it, the Google Circus.

GOOGLE Circus

Five years ago, I aged out of my pediatric skeletal dysplasia clinic (a place for kids with bone diseases).   I will never forget my first two adult medicine experiences….The first happened late one Fall evening. 

I was in college dorm my senior year and I woke up  from a late afternoon nap with a terrible headache, flashes of light and floating dots in my vision. I have a rare connective tissue disorder and form of arthritis called Kniest Syndrome that puts me at risk for a detached retina.  The flashes of light and floaters are common symptoms of retina disease.  Retina detachment is only fixable in the first 24 hours. I immediately called Student Health who told me they could get me into see an eye doctor next week.  I tried to explain that I couldn’t wait that long but no one seemed to take me seriously. All the doctors had left for the day. I called a friend and we drove the Emergency department.

We arrive. I spell Kniest no less than 3 times for the tirage nurses. They lead me back to the eye exam room and leave the door open with my chart hanging there. The doctor grabs my chart, starts to come in, looks at my file. His eyes widen and he backs out of the room. Through the open door I watch him try to Google Kiiest Syndrome.  He flips through the links and then finally after five minutes comes back in and sheepishly asks me, “So what exactly is going on?” I tell him, yeah I have a migraine-like headache, and I am seeing stars. I have a collagen disorder that causes high myopia and thus very fragile retinas. “Yes, yes, how exactly do you spell your condition?” I spell Kniest 2 more times.  I then watch him turn around and type Kniest Syndrome into Google. (more…)

By Sheryl Flynn.  Earlier this week, the American Heart Association (AHA) announced a new partnership with Nintendo of America.  According to their website (www.activeplaynow.com), the AHA and Nintendo are working together to promote physically active play as a part of a healthy lifestyle. This is the first time that the AHA has partnered with the video game industry to help consumers discover how video games that incorporate movement can be beneficial to health.  According to their “Healthy Lifestyle Tips” they encourage everyone in the house to enjoy active-play video games together and when the weather prevents outdoor activities- they encourage hosting an active-play video game tournament in your living room. 

 Today, according to AHA’s press release- They are not supporting playing all video games in an effort to promote a healthy lifestyle- only the Nintendo games such as WiiFit™ Plus and Wii Sports Resort™ software for the Wii are supported by the AHA.  The AHA’s logo will be found on these products beginning this summer. 

 The AHA is “trying to reach people where they are.”  They suggest that if you don’t move at all- move some.  If you move a little, move a little more.  In essence, if you go outside and play sports or are already active- they are not suggesting that you come inside and play video games- rather, they are trying to get those people who play video games (or are otherwise) mostly inactive- to start doing something active.  They figure, if you like playing video games and typically play video games with your thumbs while surfing the couch- perhaps you could get a little exercise by playing active video games. They are targeting the “no physical activity” group and trying to get them to move!

So, as one would expect- there is controversy over the two companies working together.  Some people believe that both Nintendo and the AHA see a significant return on their partnership investment.  But the AHA has suggested that this is not the case.  Nintendo has contributed $1.5million to AHA to fund a prevention platform aimed at informing Americans about heart disease and stroke prevention.  Another important consideration to keep in mind is that Nintendo is not the only “active-play” video game company out there.  Sony PlayStation released the “EyeToy” years before the Wii and it offers many hours of fun, active gaming as well.  The EyeToy is fun because you can see a video projection of yourself in the game, rather than controlling an avatar as with the Wii games. Microsoft plans to release Project Natal later this year- these games will also offer hours of active gaming fun! There are a number of other off-the-shelf gaming devices that promote active gaming- the consumer should be encouraged to seek the game that would be most fun for them. 

Perhaps most exciting, however, is the Innovation Summit that the AHA intends to host.  With $350,000 support from Nintendo, the AHA will bring together “Thought Leaders” in the area of health care, research, physical activity, fitness and video gaming to look at the synergies and potential benefits of active-play video games and physically active lifestyles.  Now that is exciting!  Finally!  The game industry, researchers and health care industry all together in one room to envision the future!  Wow!

To learn more about the disease and get information about the JDRF Capitol Chapter’s 2010 Walk to Cure Diabetes, visit www.jdrfcapitol.org. The Walks will be held in Washington, D.C. on Sunday, May 2 and in Leesburg, Virginia on Sunday, June 6.

By Tamera Adams. “Can I do anything?” is the response 12-year-old Sara Jacob typically hears when she explains to new friends that she has diabetes and the device strapped to her waist is not a cell phone, but her “life support.” Those are the exact words Sara uses to describe the pump that automatically infuses insulin into her small body. It’s more critical than chemotherapy is to a cancer patient she explains.

Unlike a type 2 diabetic whose body doesn’t produce sufficient insulin, Sara’s body produces no insulin at all. She has type 1 diabetes, which is commonly referred to as juvenile diabetes and generally diagnosed in children, teens or young adults. It’s the most severe form of the disease, lasts a lifetime and its cause remains unknown. Most importantly, the complications that result from type 1 diabetes can be devastating.

Diagnosed at the age of four, Sara has no difficulty explaining what the disease is or how it has affected her life—neither does 12-year-old Jeremy Gross, also diagnosed at age four. Jeremy’s nine-year-old brother Benjamin, on the other hand, was diagnosed just two years ago and seems a little less vocal about his experience.

The stories they shared are common among children with diabetes—the difficulty of going on sleepovers at friends’ houses; teachers that make it difficult for them to leave the classroom to test blood sugar levels or take glucose tablets; and being instructed by gym teachers and coaches to remove medic alert jewelry to participate in sporting activities. Jeremy was especially grateful that he doesn’t have to contend with the latter of these challenges. Fortunately, his gym teacher is very understanding.

However, Benjamin once heard a teacher tell his class that exercise would prevent diabetes—a blanket statement about the disease that doesn’t apply to type 1 diabetics and made Benjamin slightly uncomfortable.

Although their parents are very involved and intervene without hesitation, diabetes is a difficult disease to manage, especially for a child.

That’s why the Gross family turned to the Juvenile Diabetes Research Foundation (JDRF) after Jeremy was diagnosed. JDRF immediately sent a Bag of Hope—which includes a glucose meter, books, DVDs and a myriad of materials to educate and lend support to diabetic children and their caregivers. (more…)

By Santi Bhagat, MD, MPH. Health Care Reform is off to a good start.  A couple of days ago, I blogged on the debate between the insurance industry and the administration about the interpretation of this new law.  Hats off to insurers for making the right choice, right away, to heed regulations that are forthcoming from Health and Human Services.   I first heard this through the grapevine at the Disruptive Women Breakfast Series this week from Stephanie Cohen, the expert panelist representing the insurance industry.

The law is intended to require insurers to issue policies that provide a full range of benefits for all children with pre-existing conditions starting in September 2010.  That means insurers can no longer refuse to cover children with pre-existing conditions under their parents’ plans, even if the children never had insurance.

This law has far-reaching ramifications.  A recent story about a newborn who was denied coverage at the age of a mere 9 days highlights how critical this law is.   Born with a congenital heart defect, Houston Tracy underwent lifesaving open heart surgery when he was just 4 days old.  His parents cannot afford insurance for themselves, being small business owners, and have individual policies for their older two sons.  After being charged and given the run-around by the insurance company, they resorted to enrolling their newborn in the state’s high-risk pool.

The big question now is how much will insurers charge for these policies.  If the price tag is too high, parents will not be able to afford to purchase policies, and in effect, coverage will be denied to these children.

It is not clear whether HHS regulations will speak to this issue.  The administration will be watching the insurance industry closely.   So will we.

Hygeia Note:  On March 30th, Disruptive Women in Health Care launches the first of its monthly in-person breakfasts.  Among our speakers will be Stephanie Cohen.  Her post appears below.

By Stephanie Cohen.  This month’s health insurance nightmare: Dad is still paying for his daughter’s insurance — and no one is happy.

The situation: I received a call last week from a client whose daughter recently told him she hates her insurance “because it does not cover anything.” He phoned me to see if she had a real gripe, and if I could help him find another policy with better coverage for her.

The problem: It turned out that her policy had a $5000 deductible, which did not include coverage for dental or vision doctor visits. Since she has an entry-level position and not a lot of extra spending money, I told her she had a choice.

She could choose to pay more per month to lower her out-of-pocket expenses, but her monthly premiums would be higher. Since her father was paying her premium, and was happy to do so, I decided the best policy for her was one with a higher premium and lower expenses.

The solution: The decision to pay for an adult child’s health care is a personal one that each family must make, of course. The reality is that once a child turns an age selected on the policy by the plan administrator based on the rules of the state and the size of the employer, they are no longer considered a dependent.

Many times, the insurance company does not notify the parent or the plan administrator that the student has been dropped. The student typically finds out when filling a prescription or when receiving services. 

Keep in mind that it is the parents’ responsibility to notify the carrier that the student is or is not a full-time student and is eligible for coverage. The student is responsible for having a student certification form completed and signed by the bursars office proving they are in school fulltime with 12 plus credits.

If I were the Health Insurance Ambassadors: All students would have to prove they had coverage or they could not attend school.

Although with the recent health reform legislation there is now a new Federal mandate to allow children to be on their parents health plan until 26, it still may be less expensive to insure that child unto themselves rather than remain on the parents plan.  Obviously, the rates will be much lower for someone who is much younger.

The painful truth: Parents can analyze the cost of coverage through the school or an individual policy versus the cost of keeping the child on his/her plan. If the parent has other children on the plan, it rarely saves to pull one child off the plan.

 I encourage you to share your insurance nightmares with me.

By Santi Bhagat, MD, MPH.  Policymakers and insurance industry are battling over a key feature of health care reform.  As the president proclaims the bill will cover and protect all children with pre-existing conditions this year, the insurance industry is contending that the law reads differently.   

Congressional leaders are outraged that insurers are trying to wriggle out of their legal responsibility to insure new children who have pre-existing conditions. 

1. Insurers are interpreting bill language to mandate coverage of pre-existing conditions of children only if they are currently enrolled in plans, but not for new, uninsured child customers with pre-existing conditions. 
2.  The administration vows to fix this by having Health and Human Services (HHS) issue regulations next month to clarify the law’s intent to both provide access to insurance and a full range of benefits for all children with chronic conditions this year. 
3. Insurers plan to act on legislation language.  They will not say how they will respond to regulations and forecast that the courts will be the final arbiters.
4.  HHS spokesman and chairmen of Congressional health policy committees in the House of Representatives assert that the administration’s solution adequately addresses this problem.  
5. Citing experiences in other states, insurers are saying that covering children with chronic conditions now will lead to higher rates that may be unaffordable.  They believe that it is better to wait until 2014, when the risk can be spread since most Americans will have to be covered that year.
6. Regardless, insurers are free to charge what they want until 2014, when health status can no longer be used to calculate premiums. 

This is no small matter, for one in five American households, 8.8 million, has at least one child with a pre-existing condition.  Contrary to popular thought, most of these children are covered by private insurance.  The economic and job crises have impacted the ability of parents to maintain employer-based health insurance, forcing them to turn to the exorbitant individual market.  Children with individual coverage and who go without insurance for two months are at the greatest risk of being denied access.  From September 2010, the health care bill is supposed to prohibit insurers from denying individual and group coverage to children based on health status.

Health care reform does provide for a $5 billion dollar insurance pool of last resort that these families can turn to.   Hopefully, this mechanism will help families until this problem is straightened out.

Parents cannot wait to obtain coverage for their children who are in urgent of need of health care now.   Children are not simply little adults:  denying access and care to chronically ill children denies them the ability to grow, develop, play and learn.  As we watch the deliberations and wait for implementation of this piece of law, our children and families are losing precious time that can never be recovered.

First Lady Michelle Obama recently launched a nationwide campaign to lower childhood obesity, citing that one-third of U.S. children are overweight. NHMA is proud to be invited to partner with the First Lady and the White House in this effort.

The Let’s Move campaign will combat childhood obesity by focusing on four main strategies: helping parents make health family choices, providing healthier food options in schools, promoting physical activity and ensuring that low-income urban and rural areas have access to healthy and affordable food.

One in four Latino youth is overweight, and the result has been an alarming increase in Type 2 diabetes and high blood pressure among children. The causes are numerous and range from a lack of supermarkets in Hispanic neighborhoods to disparities in access to health services. But regardless of the barriers, this growing trend must end.

The mission of Let’s Move is to solve the childhood obesity epidemic within a generation. That’s an ambitious goal, and one that is going to require cooperation between governments, organizations, companies, schools and families at every level. NHMA is committed to doing our part to fight childhood obesity and will be working with the White House and our other partners to educate Latino communities on healthy lifestyles for children – everything from learning how to make smart grocery purchases to finding safe outdoor options for physical activity.

I’d love to hear your ideas for lowering childhood obesity too. What healthy lifestyle measures have worked in your family or community? Let me know!