Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Prevent 2/5 Cancers

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About 40% of cancers could be prevented were people to stop smoking and overeating, limit alcohol intake, exercise regularly and get vaccines that target cancer-causing infections (e.g., HPV, Hepatitis B).  For more information on this, pleaase explore: the International Union Against Cancer's, "UICC Population Survey of Cancer-related Beliefs and Behaviours" (PDF), the World Cancer Campaign, “Today’s children, tomorrow’s world” or contact directly.


Genes can be affected by exercise, “especially in the cells of the interval trainers, [which, in turn] are believed to influence the ability of mitochondria to produce energy for muscle cells; [i.e.,] subjects who did .... interval workouts showed increases in the number and health of their mitochondria — an impact that was particularly pronounced among the older cyclists.

It seems as if the decline in the cellular health of muscles associated with aging was ‘corrected’ with exercise, especially if it was intense, says Dr. Sreekumaran Nair, a professor of medicine and an endocrinologist at the Mayo Clinic and the study’s senior author. In fact, older people’s cells responded in some ways more robustly to intense exercise than the cells of the young did — suggesting, he says, that it is never too late to benefit from exercise.”

The Best Exercise for Aging Muscles.” by Gretchen Reynolds NY Times, March 23, 2017

According to Employee Benefit News [last accessed 2/4/10], the "National Business Group on Health and Fidelity Investments" employer survey states that regardless of the outcome of health care reform, 91% of employers will continue to invest in their health management programs. Among survey findings:

  • More than half (57%) of companies report that they use incentives with cash value for their wellness programs. The most common incentives were reducing the employee’s health care premium and offering cash and contributions to a health reimbursement arrangement or a health savings account.
  • One out of five companies (20%) spends more than $400 per employee a year on incentives, while 29% spend less than $100 per employee.
  • Companies are spending almost the same amount of money on programs aimed at prevention and lifestyle wellness (45%) as on programs that manage conditions after the onset of disease or illness (43%).
  • The most prevalent programs in the prevention and lifestyle categories are on-site flu shots (90% of companies offer them), preventive-care reminders related to screenings or annual exams (68%), employee assistance programs (92%), stress management (68%) and smoking cessation* (66%).
  • The top condition-management programs in use are nurse hotlines where nurses are available to answer questions via telephone (79%), diabetes disease management** (74%), coronary artery disease, congestive heart failure and asthma disease management (69%).

* Stop Smoking–an effective slideshow by Dr. Jonn Oyston, MB, FRCA that speaks clearly to the risks of Smoking and having surgery (or living for that matter) [Resources, including, "Stop Smoking for Safer Surgery," a Canadian doctor's health promotion efforts such as "How to Quit–general Advice"]. 

PowerPoint (PPT) Presentations


**  The prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years. Adding modest lifestyle change (even if poorly attended) to metformin may enhance the drug’s effect. However, what remains to be seen is whether lifestyle or metformin intervention reduces the debilitating (and costly) microvascular and macrovascular complications associated with diabetes.

Nichols GA, Hillier TA, Brown JB. Progression from newly acquired impaired fasting glucose to type 2 diabetes. Diabetes Care. 2007;30:228-233. Abstract