Sunday, February 28, 2010

phil heath Kai Greene Branch Warren after the 2009 Mr Olympia video phil heath met rx

phil heath

phil-heath

video of phil heath Kai Greene and Branch Warren after the 2009 Mr Olympia, phil heath was unlucky at the 2009 mr olympia due to some illness going into the mr olympia bodybuilding contest.

but aspect to see phil heath pushing for the 2010 mr olympia title and in much better condition then the 2009 mr olympia contest.

phil heath is wearing a met rx t-shirt in the video not sure if phil heath is still sponsored by met rx or not now.

Part Deux: Is The California Individual & Family Health Insurance Market In Critical Condition?

Having recently watched the "bi-partisan" meeting in Washington and many videos on youtube, I wonder if the problem is "un"-fixable.

Speaker Pelosi, in a recent youtube video answering questions on the meeting, pointed out two things which are absolutely of concern. 1, our health insurance system is employer-based in design and function. 2, there are many more people not covered under the employer-based system who choose to remain on the sideline than those who participate in the non-employer health insurance market.

I won't go through the numbers again since they are covered under part one of this topic below. Suffice to say, nearly two-thirds of those who should participate in the health insurance market in California for individual & family coverage do not. No employer-sponsored health plan, whether fully insured or self-funded, could operate at a participation level of 33% or less. Employer plans require 75% of all eligible employees to participate. I have worked in the past for employers who made it mandatory to buy a health plan through their fsa/cafeteria plan unless one had a valid waiver (so as not to mess up participation).

With rare exception, most every vlog I have seen, including the grilling of Anthem/Wellpoint CEO Braly in Washington, have had a nasty, negative tone. While it is without doubt that people are upset by the rate changes and popular press, there are implications to this notwithstanding the fact that my study below shows that even with the "massive" rate increase, Anthem prices below most of the other California carriers for like coverage (including 2 not-for-profits).

Now here's your "inside scoop" for the day, dear readers. I have it on good authority that a very large health insurance company in California (which shall remain anonymous), in the last six months, approached the state regulatory agency/ies to review the option of cancelling the individual & family market product and bailing out. To be clear as to what is at stake....

IN THE LAST SIX MONTHS, ONE OF THE LARGEST HEALTH INSURANCE COMPANIES IN CALIFORNIA ADDRESSED TO A STATE REGULATORY DEPARTMENT THE POSSIBILITY OF NO LONGER SELLING HEALTH INSURANCE TO INDIVIDUALS & FAMILIES IN CALIFORNIA.

The writing is on the wall across the spectrum of carriers. Sales of new plans are flat. HIPAA plans have been reformated to high deductibles and expensive HMO plans to stem the bleeding in that pool. Programs like Tonik for individuals and BeneFits for small group have experienced less-than-stellar sales.

The only two PPO programs (non-HIPAA) that are selling at all right now are SmartSense by Anthem and VitalShield by Blue Shield. Even in those cases, the sales of new plans is not keeping up with the cancellation of existing subscribers.

Anthem has launched three new product portfolios for IFP in the last six months--Core Guard, Clear Protection, and coming April 1, Premier. I will be curious to see whether or not new enrollments in these plans (lower cost) will overtake defections off of coverage as is the current trend.

Until and unless this trend shifts, the IFP market is going to be chaotic at best. Continuous premium increases will become the norm, and this in turn will drive more people off of coverage which will create a repetitive cycle.

So, Dave, you ask, what is your solution to the problem?

Well, I see two choices.

One, like Speaker Pelosi mentioned, mandate coverage and penalize those who do not participate. Increase participation to as close to 100% as possible, guarantee-issue health insurance coverage with no pre-existing conditions problems and create an incentive (tax or othewise) for people to participate in addition to a penalty.

Two, and this is one I may favor over the first one, kill off all non-employer coverage plans and go to a single payer exchange for coverage (with a mandate or incentive). The exchange could offer compliant private plans from carriers that wish to offer them and/or public plans like Medicare/FEHB or other plans designed under federal mandates. Allow carriers to sell private plans outside of the exchange to those who can qualify and wish to purchase outside of the exchange.

Make the exchange available to those who cannot obtain employer-sponsored coverage and do not wish to or cannot purchase a private plan outside of the exchange. Also, provide that any employer under 20 employees (2-19) who chooses the exchange over the group plan must pay a penalty per employee to the exchange, and any company over 20 employees must either provider group coverage or pay a payroll tax penalty per employee to the exchange.

Monday, February 22, 2010

Magnesium and Insulin Sensitivity

From a paper based on US NHANES nutrition and health survey data (1):
During 1999–2000, the diet of a large proportion of the U.S. population did not contain adequate magnesium... Furthermore, racial or ethnic differences in magnesium persist and may contribute to some health disparities.... Because magnesium intake is low among many people in the United States and inadequate magnesium status is associated with increased risk of acute and chronic conditions, an urgent need exists to perform a current survey to assess the physiologic status of magnesium in the U.S. population.
Magnesium is an essential mineral that's slowly disappearing from the modern diet, as industrial agriculture and industrial food processing increasingly dominate our food choices. One of the many things it's necessary for in mammals is proper insulin sensitivity and glucose control. A loss of glucose control due to insulin resistance can eventually lead to diabetes and all its complications.

Magnesium status is associated with insulin sensitivity (2, 3), and a low magnesium intake predicts the development of type II diabetes in most studies (4, 5) but not all (6). Magnesium supplements largely prevent diabetes in a rat model* (7). Interestingly, excess blood glucose and insulin themselves seem to reduce magnesium status, possibly creating a vicious cycle.

In a 1993 trial, a low-magnesium diet reduced insulin sensitivity in healthy volunteers by 25% in just four weeks (8). It also increased urinary thromboxane concentration, a potential concern for cardiovascular health**.

At least three trials have shown that magnesium supplementation increases insulin sensitivity in insulin-resistant diabetics and non-diabetics (9, 10, 11). In some cases, the results were remarkable. In type II diabetics, 16 weeks of magnesium supplementation improved fasting glucose, calculated insulin sensitivity and HbA1c*** (12). HbA1c dropped by 22 percent.

In insulin resistant volunteers with low blood magnesium, magnesium supplementation for four months reduced estimated insulin resistance by 43 percent and decreased fasting insulin by 32 percent (13). This suggests to me that magnesium deficiency was probably one of the main reasons they were insulin resistant in the first place. But the study had another very interesting finding: magnesium improved the subjects' blood lipid profile remarkably. Total cholesterol decreased, LDL decreased, HDL increased and triglycerides decreased by a whopping 39 percent. The same thing had been reported in the medical literature decades earlier when doctors used magnesium injections to treat heart disease, and also in animals treated with magnesium. Magnesium supplementation also suppresses atherosclerosis (thickening and hardening of the arteries) in animal models, a fact that I may discuss in more detail at some point (14, 15).

In the previous study, participants were given 2.5 g magnesium chloride (MgCl2) per day. That's a bit more than the USDA recommended daily allowance (MgCl2 is mostly chloride by weight), in addition to what they were already getting from their diet. Most of a person's magnesium is in their bones, so correcting a deficiency by eating a nutritious diet may take a while.

Speaking of nutritious diets, how does one get magnesium? Good sources include halibut, leafy greens, chocolate and nuts. Bone broths are also an excellent source of highly absorbable magnesium. Whole grains and beans are also fairly good sources, while refined grains lack most of the magnesium in the whole grain. Organic foods, particularly artisanally produced foods from a farmer's market, are richer in magnesium because they grow on better soil and often use older varieties that are more nutritious.

The problem with seeds such as grains, beans and nuts is that they also contain phytic acid which prevents the absorption of magnesium and other minerals (16). Healthy non-industrial societies that relied on grains took great care in their preparation: they soaked them, often fermented them, and also frequently removed a portion of the bran before cooking (17). These steps all served to reduce the level of phytic acid and other anti-nutrients. I've posted a method for effectively reducing the amount of phytic acid in brown rice (18). Beans should ideally be soaked for 24 hours before cooking, preferably in warm water.

Industrial agriculture has systematically depleted our soil of many minerals, due to high-yield crop varieties and the fact that synthetic fertilizers only replace a few minerals. The mineral content of foods in the US, including magnesium, has dropped sharply in the last 50 years. The reason we need to use fertilizers in the first place is that we've broken the natural nutrient cycle in which minerals always return to the soil in the same place they were removed. In 21st century America, minerals are removed from the soil, pass through our toilets, and end up in the landfill or in waste water. This will continue until we find an acceptable way to return human feces and urine to agricultural soil, as many cultures do to this day****.

I believe that an adequate magnesium intake is critical for proper insulin sensitivity and overall health.


* Zucker rats that lack leptin signaling

** Thromboxane A2 is an omega-6 derived eicosanoid that potently constricts blood vessels and promotes blood clotting. It's interesting that magnesium has such a strong effect on it. It indicates that fatty acid balance is not the only major influence on eicosanoid production.

*** Glycated hemoglobin. A measure of the average blood glucose level over the past few weeks.

**** Anyone interested in further reading on this should look up The Humanure Handbook

Tuesday, February 16, 2010

Dissolve Away those Pesky Bones with Corn Oil

I just read an interesting paper from Gabriel Fernandes's group at the University of Texas. It's titled "High fat diet-induced animal model of age-associated obesity and osteoporosis". I was expecting this to be the usual "we fed mice industrial lard for 60% of calories and they got sick" paper, but I was pleasantly surprised. From the introduction:
CO [corn oil] is known to promote bone loss, obesity, impaired glucose tolerance, insulin resistance and thus represents a useful model for studying the early stages in the development of obesity, hyperglycemia, Type 2 diabetes [23] and osteoporosis. We have used omega-6 fatty acids enriched diet as a fat source which is commonly observed in today's Western diets basically responsible for the pathogenesis of many diseases [24].
Just 10% of the diet as corn oil (roughly 20% of calories), with no added omega-3, on top of an otherwise poor laboratory diet, caused:
  • Obesity
  • Osteoporosis
  • The replacement of bone marrow with fat cells
  • Diabetes
  • Insulin resistance
  • Generalized inflammation
  • Elevated liver weight (possibly indicating fatty liver)
Hmm, some of these sound familiar... We can add them to the findings that omega-6 also promotes various types of cancer in rodents (1).

20% fat is less than the amount it typically takes to make a rodent this sick. This leads me to conclude that corn oil is particularly good at causing mouse versions of some of the most common facets of the "diseases of civilization". It's exceptionally high in omega-6 (linoleic acid) with virtually no omega-3.

Make sure to eat your heart-healthy corn oil! It's made in the USA, dirt cheap and it even lowers cholesterol!

Sunday, February 14, 2010

Anthem: The Tale of the Tape in California

I was curious about the impact of the now-delayed Anthem Blue Cross rate increase on premium levels. I could only think of one way to find out, so I ran quotes on myself in Gilroy for four comparative coverage plans from the four California health carriers. Kaiser and Blue Shield are not-for-profit, so they should win, right? The results may surprise you!

The rates below include the Anthem rate increase scheduled for March 1, 2010.

1500 Deductible HSA Plan (or closest match)

#1 Anthem Blue Cross Lumenos 1500 HSA...............$243.00
#2 Health Net CA 2500 HSA (closest).................$246.00
#3 Blue Shield CA 1800 HSA (closest)................$311.00
#4 Kaiser 1500 HSA..................................$349.00

3500 Deductible Traditional PPO (or closest)

#1 Health Net Value PPO 4000 (closest)..............$179.00
#2 Anthem Blue Cross 3500 PPO.......................$224.00
#3 Kaiser 3000 Plan (closest).......................$277.00
#4 Blue Shield CA Essentials 3000 (closest).........$352.00

$0 Deductible PPO/HMO RightPlan Clone with Comprehensive Rx (or closest)

#1 Anthem Blue Cross RightPlan 40 PPO...............$358.00
#2 Health Net NetFirst PPO..........................$383.00
#3 Kaiser HMO (closest match).......................$457.00
#4 Blue Shield CA Active Start 35...................$504.00

1500 Deductible HMO Plan

#1 Kaiser 30/1500...................................$365.00
#2 Anthem Blue Cross HMO (w/1500 deductible)........$654.00
#3 Health Net HMO 40................................$670.00
#4 Blue Shield CA Access+ HMO.......................$798.00



I have not included the SmartSense plans, nor the the Core Guard and Clear Protection plans offered by Anthem. However, those three portfolios all price even more favorably against the in-state competition.

Anthem Agrees To Delay Rate Increase in California

On Saturday (2/13) Anthem agreed to hold off on the March 1 rate increases until May 1 at the soonest. This will give time for independent actuaries and auditors to determine if the increase in rates is appropriate.

Anthem to delay insurance rate hike amid criticism

Thursday, February 11, 2010

Anthem Answers Sebelius

Anthem President and CEO of Consumer Business, Brian Sassi, addressed his response to Ms. Sebelius regarding her inquiry concerning Anthem rate increases in California.

Click here to read Mr. Sassi's letter