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Consumer Driven Health Care

Defined narrowly, consumer driven health care refers to health insurance plans that allow members to use personal Health Savings Accounts, Health Reimbursement Arrangements, or similar medical payment products to pay routine health care expenses directly, while a high-deductible health insurance policy protects them from catastrophic medical expenses. High-deductible policies cost less, but the user pays routine medical claims using a pre-funded spending account, often with a special debit card provided by a bank or insurance plan. If the balance on this account runs out, the user then pays claims just like under a regular deductible. Users keep any unused balance or "rollover" at the end of the year to increase future balances, or to invest for future expenses. This system of health care is consumer driven health care because of routine claims using a consumer-controlled account versus a fixed health insurance benefit. That gives patients greater control over their own health budgets. In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care they receive. Consumer driven health care received a boost in the U.S. in 2003, with passage of federal legislation providing tax incentives to those who choose such plans. Proponents argue that most Americans will pay less for health care in the long haul under consumer drive not only because their monthly premiums will be lower, but also because it increases free-market variables in the health care system, fostering competition, which in turn lowers prices and stimulates improvements in service.The Medicare Prescription Drug Improvement and Modernization Act includes provisions to stimulate the popularity of these plans. The law expanded medical savings accounts, renaming them Health Savings Accounts and created tax incentives to encourage adoption of high-deductible health plans. Banks were empowered to create accounts, which deliver tax-free interest to the holders, who can then withdraw money tax free to pay for qualified health care expenditures. To qualify for an HSA, the purchaser must also have a qualifying high-deductible health insurance plan. Participants contribute more to the savings account than would be required to fulfill their annual deductible, and any unused portions of the account accrue without tax penalty so long as the funds are only for qualified medical expenses.

Fake v. Real

The question of the difference between real vs. fake breasts has become common in celebrity media. The quality of the surgery results in much of the difference between real looking and fake looking breasts. A poor boob job can introduce an unnatural looks. Breast implants are silicone rubber sacs filled with either saline solution or silicone, which increase the size of the breasts. Saline implants are the most commonly used form of implants in the United States. Implants come in different sizes, shapes and textures and a surgeon may place them under or over the chest muscles. Breast implants often sit higher on the chest than real breasts, and they appear fuller and rounder on top than real breasts. Breast implants often have a noticeable gap between the breasts, while real breasts tend to be closer together. Real breasts also fill out more at the bottom and not at the top. When in motion, breast implants often do not move much and will appear to keep their round shape, whereas real breasts will jiggle, bounce or shift depending on movement. There is mostly fat in real breast tissues and is therefore soft, whereas breast implants are more firm and less pliable. Silicone breast implants are generally softer than saline implants because they are made of a thick, gel-like substance that feels similar to fat. Saline implants feel more like muscle instead of fat. When women with breast implants do not wear bras, their breasts tend to stay firm and round. Natural breasts will hang lower and will not jut out much without a bra. Real breasts are mostly fat, which gives them a jiggle quality, if breasts look more like solid muscle, they may fake. One often can identify if breasts are fake by comparing them to the rest of the body. Although there is the rare woman who has a hot body and unusually large natural breasts, more than a few women make the mistake of going too large and getting very big fake breasts. Fortunately, these women are easy to spot: if she has the body of a dancer and breasts like a porn star. Check breast shape and alignment with her movement. Fake breast do not follow body movements as well. Many people associate breast implants with a large cup size, such as a D or DD. However, many women who opt for breast implants choose more natural-looking sizes such as a C or B cup. It can be harder to determine whether a woman has natural or implants at these sizes. In addition, padded bras create a similar effect to breast implants by lifting the breasts and making them appear larger. It can be hard to tell the difference between real breasts and implants when a woman wears a bra.

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Helping Overweight Children

Healthy Eating and Physical Activity

Healthy eating and physical activity habits are important to the well being of every child. Eating too much and exercising too little may lead to being overweight and related health problems that may follow children into adult years. Parents can take active roles to help kids and the whole family, learn healthy eating and physical activity habits that last a lifetime.
Children grow at different rates at different times, so it is not always easy to tell if a child is overweight. If a child is overweight, talk to a health care provider. The doctor can determine if the weight and height of the child are in a healthy range.
Involve the whole family in building healthy eating and physical activity habits. This benefits everyone and does not single out the overweight child.
Do not put a child on a weight loss diet unless a health care provider advises it. If children do not eat enough, they may not grow and learn as well as they should.
Remind the child that he or she is special. The feelings children have about themselves are a result of how they think their parents feel about them. Accept a child no matter what his or her weight. Children are more likely to accept and feel good about themselves when parents accept them. Listen concerns the child may have about his or her weight. Overweight children probably know better than anyone that they have a weight problem. Children need support, understanding and encouragement from parents.

Encourage Healthy Eating Habits

Buy and serve more fruits and vegetables fresh, frozen, canned or dried. Let the child choose them at the store. Buy fewer soft drinks and high fat or high calorie snack foods like chips, cookies and candy. These snacks may be okay occasionally, but always keep healthy snack foods on hand. Offer the healthy snacks more often at snack times. Make sure the child eats breakfast every day. Breakfast may provide the child with the energy he or she needs to listen and learn in school. Skipping breakfast can leave a child hungry, tired and looking for less healthy foods later in the day. Eat fast food less often. When visiting a fast food restaurant, encourage healthier options choices, such as salads with low-fat dressing or small sandwiches without cheese or mayonnaise. Offer a child water or low fat milk more often than fruit juice. Low fat milk and milk products are important for development of any child. One hundred percent fruit juice is a healthy choice but is high in calories. Limit the amount of saturated and trans fats in the family diet. Instead, most fat intake should come from sources such as fish, vegetable oils, nuts and seeds. Plan healthy meals and eat together as a family. Eating together at meal times helps children learn to enjoy a variety of foods. Do not get discouraged if a child will not eat a new food the first time. Some kids will need to have a new food served to them 10 times or more before they will eat it. Try not to use food as a reward when encouraging kids to eat. Promising dessert to a child for eating vegetables, for example, sends the message that vegetables are less valuable than dessert. Kids learn to dislike foods they think are less valuable.

Healthy Snack Ideas

A child might enjoy trying the following foods: fresh fruit; fruit canned in juice or light syrup; small amounts of dried fruits, such as raisins, apple rings or apricots; fresh vegetables, such as baby carrots, cucumber, zucchini or tomatoes; low sugar, whole grain cereal with low fat milk. Foods that are small, round, sticky or hard to chew, such as raisins, whole grapes, hard vegetables, hard chunks of cheese, nuts, seeds and popcorn, can cause choking in children under age 4. These foods are okay for young children with a little preparation, for example, by cutting grapes into small pieces and cooking and cutting up vegetables. Always watch a toddler during meals and snacks.

Serving Size

Start with small servings and let the child ask for more if he or she is still hungry. Children need adults to provide them with healthy meals and snacks, but a child should be allowed to choose how much food he or she will eat.
Be aware that some companies market some high fat or high sugar foods and beverages specifically to kids. Usually these products have cartoon characters, offer free toys and come in bright packages. Talk with kids about the importance of fruits, vegetables, whole grains and other healthy foods, even if TV and stores do not advertise these foods.

Encourage Daily Physical Activity

Like adults, kids need daily physical activity. Here are some ways to help kids move every day:
Set a good example. If a child sees an adult that is physically active and that it is fun while doing, he or she is more likely to be active throughout life.
Encourage children to join a sports team or class, such as soccer, dance, basketball or gymnastics at school or at a local community or recreation center.

Sensitive to Needs

Be sensitive to the needs of the child. If a child feels uncomfortable participating in activities like sports, help him or her find physical activities that are fun and not embarrassing, such as playing tag with friends or siblings, jumping rope or dancing to his or her favorite music.
Be active together as a family. Assign active chores such as making the beds, washing the car or vacuuming. Plan active outings such as a trip to the zoo, a family bike ride or a walk through a local park.
The body of a pre-adolescent child is not ready for adult physical activity. Do not encourage children to participate in activities such as long jogs, using an exercise bike or treadmill or lifting heavy weights. Kids should do fun physical activities.
Kids need about 60 minutes of physical activity a day, but this does not have to happen all at once. Several short 10- or even 5-minute periods of activity throughout the day are just as good. If children are not used to being active, encourage them to start with what they can do and build up to 60 minutes a day.

Discourage Inactive Pastimes

Set limits on the amount of time spent watching TV, playing video games and being on the computer.
Help kids find fun things to do besides watching TV, like acting out favorite books or stories or doing a family art project. A child may find that creative play is more interesting than TV.
Children are good learners and they often mimic what they see. Choose healthy foods and active pastimes. Children will learn to follow healthy habits that last a lifetime.

Childhood Weight-Control Program

Think about a treatment program if: A change in eating and physical activity habits has not impacted the health of the child or if a health care provider advised that the health or emotional well being of the child is at risk because of his or her weight.
The overall goal of a treatment program should be to help the whole family adopt healthy eating and physical activity habits that will last a lifetime. A weight-control program should also: include a variety of health care professionals on staff, including doctors, registered dietitians, psychiatrists or psychologists and exercise physiologists. Staff should evaluate the weight, growth and health of the child before enrolling him or her in the program. The program should also monitor these factors while the child participates in the program. The program should adapt to the specific age and abilities of the child. Programs for 4-year-olds should be different from those for 12-year-olds.

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