Posts Tagged "diabetes"
January 24, 2023
Medicare to Cover 3 New Dental Procedures
“Is it medically necessary for a person to be able to chew?” Dr. Lisa Simon, a physician and dentist at the Harvard School of Dental Medicine, asks.
This is a serious question for older Americans in fragile health. I know a 93-year-old man whose teeth problems make it extremely difficult for him to eat meat and many other foods on the dinner table.
Two-thirds of retirees do not have dental insurance, which means they may decide to forgo getting expensive dental care. The importance of dental care to nutrition and health is also an equity issue for older Blacks and low-income retirees, who are more likely to be missing all of their teeth.
Medicare has historically paid for very few dental procedures. But the Centers for Medicare and Medicaid Services has expanded its existing, limited coverage to include treating patients who have oral infections prior to an organ transplant and patients who need a cardiac procedure or treatment of head and neck cancers.
Simon, who advocates for integrating dental care into overall medical care, argues in the journal Health Affairs that Medicare’s expansion of coverage for medically necessary procedures does not go far enough.
“These provisions are an overly narrow interpretation of what makes a health care service ‘necessary,’ ” Simon writes.
She lists several examples of medically necessary conditions that don’t seem to fit Medicare’s updated definition. They include cancer patients who have oral inflammation during chemotherapy, diabetes patients with periodontal disease, and elderly women being treated for osteoporosis with injections that put them at risk of painful jaw deterioration. …Learn More
December 1, 2022
COVID’s Small Impact on Future Mortality
The most COVID deaths were among Americans over age 60, who accounted for 300,000 of the 500,000 U.S. deaths from the disease in its first year.
A new study by the Center for Retirement Research finds, not surprisingly, that the oldest survivors of the early months of the pandemic were healthier than those who died from the virus. Taking this into account, the researchers estimated what mortality might look like in a “post-COVID” world in an analysis that was based on a big assumption – that COVID’s deaths were confined to a single year.
Factoring in the early impact of the virus, the researchers found that, despite COVID’s tragic toll in the over-60 population, their future mortality would decline only slightly because the number of COVID deaths was low relative to the group’s overall population.
Even a small drop in mortality might seem counterintuitive at a time the media were widely reporting that COVID was causing a dramatic increase in the annual death rate. But future mortality is different.
The researchers decided to test whether mortality would decline over the next decade because the older people who survived the pandemic were less likely to have the medical conditions like heart disease, high blood pressure, and cancer that made others in their age group vulnerable. COVID’s survivors are a healthier population, they explained, with lower mortality rates than those who entered the pandemic. …Learn More
March 31, 2022
Using Home Equity Improves Retiree Health
Retirees spend $1,500 more per year, on average, for medical care after a diagnosis of a serious condition like lung disease or diabetes.
Often, the solution for individuals who can’t afford such big bills is to scrimp on care or avoid the doctor altogether. But older homeowners can get access to extra cash if they withdraw some of the home equity they’ve built up over the years.
While the money clearly provides financial relief for retirees, a new study out of Ohio State University finds that it is also good for their health. Every $10,000 that Medicare beneficiaries extracted from their homes greatly improved their success in controlling a chronic or serious disease.
Among the retirees who had hypertension or heart disease, for example, one standard used to determine whether the condition was under control was whether blood pressure levels stayed below 140/90, which the medical profession deems an acceptable level. The people who tapped their home equity were more likely to stay below these levels than those who did not.
This is one of several studies in recent years to tie financial security to home equity, a resource many retirees are reluctant to tap. A study in 2020 found that older homeowners were less likely to skip medications due to cost after they had extracted equity through a refinancing, home equity loan, or reverse mortgage.
But this new research is the first attempt to connect the strategy to retirees’ actual health. The analysis followed the health of more than 4,000 homeowners for up to 15 years after they were diagnosed with one of four conditions – lung disease, diabetes, heart conditions, or cancer. …Learn More
June 16, 2020
Readers Lament Decline in Boomer Health
The share of people in their late 50s with the second most severe form of obesity has tripled since the early 1990s. This grim fact, featured in a recent Squared Away article, clarifies COVID-19’s danger to older Americans.
The article, “Our Parents Were Healthier at Ages 54-60,” summarized research establishing that baby boomers are less healthy than their parents’ generation due to several conditions related to obesity, including diabetes, pain levels, and difficulty performing daily activities. The poorest Americans’ health deteriorated the fastest – and COVID-19 is preying on them.
“This decline in markers of metabolic health seems to correlate with increased vulnerability to the pandemic,” wrote one reader, Dan O’Brien, who was among several who commented on recent health-related blogs.
That’s what happened during the H1N1 flu pandemic in 2009. Hospitalizations – and possibly death rates – were tied to obesity in adults with multiple health conditions, according to the National Institutes of Health.
“The vast majority of [COVID-19 patients] who reach the ICU suffer from comorbidities. My takeaway is that metabolic dysfunction is tied to immune-system failure in ways we don’t yet understand,” O’Brien said.
Another reader, Lorraine Porto, advocated a simple way for people to keep their weight in check: walk. An elderly woman she knows “walked miles every week.” Porto believes this healthy habit saved the woman’s life when she broke her hip in her 80s and was “walking around, sprightly as ever, less than two months later.” The woman lived into her 90s, Porto said.
A second health-related blog popular with readers looked at the unexpected costs of treating medical conditions that become more common in old age.
Older workers and retirees who try to anticipate their future medical expenses might feel a bit like they’re throwing a dart at a dartboard. The researchers did the work for them in a study described in the blog, “Unexpected Retirement Costs Can be Big.” …Learn More
April 30, 2020
Unexpected Retirement Costs Can be Big
Resourceful retirees usually weather the financial surprises that come their way. But a handful of unexpected health events can really hurt.
The death of a spouse is at the top of the list. Net worth drops by more than $30,000 over a couple of years as retirees pay for the extraordinary medical and other expenses surrounding a spouse’s death.
Two serious health conditions also deplete retirees’ assets: strokes and lung disease, which strike about one in five older Americans during their lifetimes, according to a National Bureau of Economic Research study funded by the U.S. Social Security Administration that tracked changes in the finances of people 65 and over.
Despite the presence of Medicare, a first-time stroke reduces a retired household’s average wealth by more than $25,000 – or 6 percent – and lung disease reduces it by about $29,000.
Net worth in this study includes financial assets and home equity minus debts.
These estimates of the cost of various events provide new information about a few of the many unknowns that go into retirement planning. Workers who may think they are saving enough to cover their routine retirement expenses don’t necessarily factor in medical and related costs that are difficult or impossible to predict.
Taken together, single and married retirees will use anywhere from 3 percent to 14 percent of their wealth to pay these unpredictable expenses. But wealthy retirees, who can afford first-rate care, spend much more than the average, while poor people, who have Medicaid to supplement their Medicare, spend very little. …Learn More
April 7, 2020
Our Parents Were Healthier at Ages 54-60
Baby boomers aren’t as healthy as their parents were at the same age.
This sobering finding comes out of a RAND study that took a series of snapshots over a 24-year period of the health status of Americans when they were between the ages of 54 and 60.
The researchers found that overall health has deteriorated in this age group, and they identified the specific conditions that are getting worse, including diabetes, pain levels, and difficulty performing routine daily activities.
Obesity is an overarching problem: the share of people in this age group with class II obesity, which puts them at very high risk of diabetes, tripled to 15 percent between 1992 and 2016.
In addition to declining health, the study for the Retirement and Disability Research Consortium uncovered strong evidence of growing health disparities among 54 to 60-year-olds: the poorest people are getting sicker faster than people with more wealth.
The increase in women’s pain levels has been starkest over the past 24 years. The wealthiest women have seen an increase of 6 percentage points in the share experiencing moderate to severe pain from conditions like joint or back pain. But the poorest women saw a 21-point leap. The disparity for men was also large: up 7 points for the wealthiest men versus 15 points for the poorest men.
The bottom line: today’s 54 to 60-year-olds are not as healthy as their parents were, and the study suggests that the disparities between rich and poor will continue to grow.
March 10, 2020
Hypertension, Arthritis? Keep Working!
The growing list of effective medications available for managing a variety of chronic conditions seem to be changing the way we work and retire.
For example, older workers at one company who suffer from arthritis and high blood pressure – two relatively easy conditions to treat – are able to keep working just like their healthier co-workers, according to a new study from a research consortium funded by the U.S. Social Security Administration.
In fact, the two specific groups in this study – employees with hypertension or a combination of arthritis and hypertension – actually worked an average of four to 10 months longer, respectively, than the healthy workers. This counterintuitive finding might owe to the fact that people with chronic conditions are motivated to work longer to maintain their employer health insurance. Another possibility is that, because of their condition, they pay closer attention to their overall health and take better care of themselves.
The researchers, who are from Stanford University’s Medical School and Princeton University, had the advantage of access to nearly 4,700 employees’ detailed medical records, which allowed them to track how their health progressed over an 18-year period, until they retired.
A limitation of the study is that the employees aren’t representative of the general working population. They were mainly white men employed in Alcoa smelters and fabrication plants around the country. And because it was very common for them to join the company in their 20s and qualify for a 30-year pension, their average retirement age was only 58.
But older workers in a wide variety of professions are reckoning with the need to work longer than they might have planned so they can afford to retire.
A chronic medical condition doesn’t have to be a barrier to working as long – or even longer – than everyone else. …Learn More