Health Savings Accounts

Most people with health insurance, especially employer paid health insurance, really don’t know what their health care costs are. Furthermore, in many cases, they are limited in which health providers (doctors, hospitals, pharmacies etc) they can use.

Most people are locked into a network of doctors. They know what the co-pay is, but have no idea what the doctor actually charges.

When insured consumers are hospitalized, they rarely see the bill. They don’t know if the insurance company was overcharged or not. There are firms that audit hospital bills for insurers and self insured companies. They get paid a percentage of what they save on the bill payer by finding overcharges, duplicate charges and the like. The last I heard these firms were still making lots of money.

Overcharging, whether deliberate or not, by doctors and hospitals drive up health care costs for all. (So do malpractice suits, but that’s another story.)

In order to give consumers more direct control not only over their health costs, but in the choice of which doctor they can see or which hospital they can enter, Congress enacted the Health Savings Account Availability Act. As of the beginning of 2004, individuals who are not otherwise insured can have Health Savings Accounts (HSA) , which carry with them some very attractive tax benefits.

An individual can set up an HSA for himself or his family. An employer can add an HSA option to the so-called cafeteria benefit plan it may already offer.

The money put into the plan is before taxes, including Social Security, if part of an employer plan. Otherwise it is a above-the-line deduction, meaning you don’t have to itemize your deductions to get the tax break and that the deduction is not subject to the phase-out rules that make many itemized deductions unavailable to high wage earners.

The plan is set up like an IRA. A trustee approved by the IRS must be used. Money put in the plan grows tax free and funds withdrawn for qualified medical expenses are also tax free. Unlike the older Flexible Savings Accounts offered in employer cafeteria plans, you don’t have to spend the money put into the account by year end or otherwise lose whatever’s left. Money can be rolled over from year to year. This can allow for a nice chunk of money to accumulate that can be withdraw tax free at age 65.

In order to qualify, the individual or family must purchase a high deducible health insurance policy. These are special policies that have a minimum deductible of $1000 to a maximum of $5000 for an individual and $2000 to $10,000 for a family. The higher the deductible, the lower the premium.

Individuals can deduct the lesser of $2250 or the deductible on the policy: for married couples or families it is double that. If over 55, the deduction is $600 higher for individual and $1200 higher for couples and will continue to rise at $100 a year until 2009, where it will be capped at $1000 for individuals and $2000 for families.

The money in the HSA cannot be used to pay the premiums for this policy except in certain circumstances (basically when you’re unemployed). It is meant to meet the deductible, co-pays, drug costs, eyeglasses or any other medical expense that could be itemized on an individual tax return as a medical expense.

Money withdrawn in excess of qualified medical expenses is taxed as income and subject to a 10% penalty, unless the owner is disabled or over 65. Any money in the account at death is added to the taxable estate.

There are no income limits on this plan. If started early, when you are still young and healthy a substantial amount of money could accumulate to either meet higher medical costs as you get older or to use to supplement your income.

It pays to compare the costs of this plan with whatever your insurance you have now. It might turn out that your employer’s plan is still cheaper and you might want to keep it. Or you might want to consider HSA’s for their portability (you carry it from job to job without cost or loss of any contributions) and the tax benefit of having another vehicle to shelter income and capital growthArticle Search, while giving you more control over the cost and quality of your health care.

A Life Giving Reminder Enroll Now

One of the main reasons that the mortality rate for African Americans remains disparately high for heart disease, cancer, stroke and diabetes is because we too often delay going to the doctor for symptoms or regular checkups. By the time we go, the health condition is sometimes worse.

Dr. Louis Sullivan, former U.S. Secretary for Health and Human Services and founder of the Morehouse School of Medicine, knows the negative health habits of many African Americans. He says sometimes we don’t go to the doctor because of fear, procrastination, financial problems or just hoping the symptoms will go away.

Visit AARP Health Law Facts »

Well, no more excuses. We now have another opportunity to sign up for health care coverage under the Affordable Care Act (ACA). If you’ve missed the sign-up in previous years, open enrollment for 2016 ends Jan. 31, 2016. For coverage to start Jan. 1, 2016, you must enroll by Dec. 15, 2015. If you purchase a plan after Dec. 15, your insurance will become effective Feb. 1.

Under the ACA, multiple plans are available for people on fixed incomes and even plans for people with no income. Since President Obama signed it into law on March 23, 2010, the ACA, which some call Obamacare, has provided coverage for more than 16.4 million people. But there are millions of others who could have otherwise been denied or faced discrimination now have access to coverage, according to the White House.

So take heed to this life-giving reminder. To start your application, hear about plans or just ask a question, call 800-318-2596, open 24 hours a day, 7 days a week, except Memorial Day, Independence Day and Labor Day.

What Does Caregiving Have to Do with Food Allergies

Who is a caregiver?  By definition, a caregiver is “someone who is a family member or paid helper who regularly takes care of a child or a sick, elderly, or disabled person”.  Well, if that’s the definition, then that’s me.

I have three small children: Catherine 4, Nora 2, and Mary 13 months.  I haven’t really thought of myself as a caregiver – I’m just a mom taking care of my children.  Most caregivers are just like me.  They don’t think about it, they just do what they have to do to help their loved one(s). Like most caregivers, I have a set of challenges I face.  I have a child with special needs. My daughter, Catherine has life-threatening food allergies.

Four years ago I learned the hard way about food allergies.  My beautiful newborn daughter began developing red marks on her face after she drank her bottle.  Then she began throwing up while drinking her bottle.  It wasn’t long before she was diagnosed with food allergies: milk, eggs, wheat, and beef. Quite a life changer for two new parents! About a year ago, my husband Jim was diagnosed with food allergies as well; milk, eggs, and lettuce (yes – lettuce). He was deemed a medical mystery for about seven months while enduring massive stomach pains and spent many days and nights in the hospital before he was finally diagnosed with his allergies.

Living with food allergies has been a transition. Some days it feels manageable and other days it’s cruel.  I’ve made a lot of changes in our daily living. I now cook with different ingredients; scour food labels with a fine-toothed comb; label shelves with safe foods; and, just in case, carry life-saving medications everywhere we go. I can tell you that we live in a world where food is all around us.  There is the obvious – food on a plate, in a cafeteria, and at restaurants.  But there is also so much hidden food that we are unaware of – on our hands, our face, our lips, and even our clothes.  And sometimes just minimal contact can severely harm someone with food allergies.

I have become an advocate for my daughter, my husband, and all individuals with food allergies.  I’ve noticed how insensitive people are when it comes to food allergies (and I educate them).  I’ve noticed how accepting some people are when it comes to food allergies (and I thank them).  I’ve noticed that too many restaurants don’t know what ingredients are in their food (and I’m working to change that too). We live in a world where research and education will drive the change I’m dreaming of for Catherine and Jim.  But for now, I’m working on improving the education in our community and making this world a safer place for them.  Isn’t that what every caregiver would do? Absolutely.

Allergy is the price we pay for our immunity to parasites

New findings, published in PLOS Computational Biology, help demonstrate the evolutionary basis for allergy. Molecular similarities in food and environmental proteins that cause allergy (such as pollen), and multicellular parasites (such as parasitic worms), have been identified systematically for the first time.

A study led by Dr Nicholas Furnham (London School of Hygiene & Tropical Medicine), supports the hypothesis that allergic reactions are a flawed antibody response towards harmless environmental allergens.

It is thought that part of our immune system has evolved to combat and provide immunity against infection by parasitic worms. However, in the absence of parasitic infection, this same arm of the immune system can become hyper-responsive and mistakenly target allergenic proteins in food or the environment. This results in an unregulated allergic response, which can sometimes be lethal.

The researchers used computational techniques to predict which proteins in parasitic worms would cause an immune response similar to an allergic reaction in humans. Their experimental studies supported these predictions and, for the first time, they identified a protein in a parasitic worm that is similar to a protein that was previously thought to be encoded only in the genomes of plants. This protein is one of the most common proteins in pollen that causes allergy in humans.

The study provides tools that will make it easier for scientists to predict proteins in food and the environment that are likely to cause allergy, and to design protein molecules for treating allergy.

Dr Furnham said: “Our findings address an outstanding question: what makes an allergen an allergen? We’ve shown that the off-target effects of the immune system in allergy are due to the significant molecular similarities we have identified between environmental allergens and parasitic worm proteins. The findings demonstrate that allergy is the price we pay for having immunity to parasites.”

Man with Brain Disorder Can’t Recognize His Reflection

A man who thought he saw a “stranger” in the bathroom mirror, when he was actually looking at his own reflection, turned out to have a rare neurological condition, a new case report finds.

The 78-year-old man in France, identified in the report as Mr. B, noticed a stranger in his house. Mr. B said that the stranger looked just him, but stayed in the bathroom mirror, according to the authors of the report published online Aug. 25 in the journal Neurocase.

“The stranger was a double of himself: he was the same size, had the same hair, body shape, and features, wore the same clothes and acted the same way,” the researchers wrote in the report. “Mr. B. talked with this stranger and was puzzled because he knew much about him. Mr. B. even brought food to the mirror with cutlery for two persons.” [Senses and Non-Sense: 7 Odd Hallucinations]

“Eventually, the patient told his daughter that the stranger [had] became aggressive, and she decided to drive her father to the hospital,” said Dr. Capucine Diard-Detoeuf, a neurologist at the University Hospital of Tours in France, who treated the man and is one of the co-authors of the report.

After a checkup, doctors diagnosed Mr. B with a condition called atypical Capgras syndrome. In a regular case of Capgras syndrome (named after French psychiatrist Joseph Capgras, who first published a report on the disorder in 1923), a person thinks that a friend or family member has been replaced with an identical imposter.

Mr. B’s case was atypical because his delusion did concern another person, but himself, Diard-Detoeuf told Live Science in an email.

Doctors prescribed Mr. B an antipsychotic medication for his delusions. They also gave him anti-anxiety medication because he felt anxious and nervous about living with an “aggressive stranger” in his home, Diard-Detoeuf said.

After taking the medications for three months, Mr. B recovered, and reported that the stranger had disappeared.

Man in the mirror

Two similar cases of Capgras have been reported in the literature. According to a 1968 report, a 61-year-old woman in New Zealand became frightened by a double of herself who only appeared when she looked into the mirror, the authors said.

The other case involved a 77-year-old woman. That woman actually imagined that she talked with her “double” in the mirror — a woman just so happened to be identical to her in appearance, age, background and education, according to a 1989 case report.

It’s not clear why people develop Capgras syndrome, but one idea is that it’s similar to a condition called prosopagnosia, in which people become unable to recognize familiar people’s faces. (Prosopagnosia is also known as face blindness, and has been diagnosed in people such as the late neurologist Oliver Sacks and primatologist Jane Goodall.)

But the authors of the new case report, who are all neurologists and psychiatrists at the University Hospital of Tours, said that atypical Capgras is likely more complicated. They speculated in their report that people with the condition have impairments in two different brain pathways, not just one.

People with face blindness might not be able to recognize familiar faces, but tests of their skin conductance, which reveal the body’s physiological reaction to a stimulus, show that they still react to these faces emotionally. It is likely that people with face blindness, the “overt,” or direct pathway, that sustains face recognition is impaired, Diard-Detoeuf said.

In contrast, patients with regular Capgras syndrome can identify familiar faces, but don’t show any emotional reaction to them in skin conductance tests, Diard-Detoeuf said. It’s likely people with regular Capgras have brain damage to a different pathway, called the covert pathway, which sustains familiarity. If they see a familiar face but don’t feel a sense of familiarity, a subsequent feeling of strangeness will ensue, Diard-Detoeuf said. [10 Things You Didn’t Know About the Brain]

However, Mr. B and the other patients who didn’t recognize themselves likely had problems with both their covert and overt pathways, the authors said.

“The case reports describe a very rare and fascinating condition, where the patient recognized himself [or herself] as a stranger,” said Dr. Paul Wright, the chairman of neurology at North Shore University Hospital and Long Island Jewish Medical Center in New York, who was not involved with the report.

Even though the syndrome appears similar to face blindness, the study’s authors urged doctors to be careful not to misdiagnose it.

“This clinical condition could be interpreted as an atypical Capgras syndrome… and should be distinguished from prosopagnosia,” Diard-Detoeuf said.

People with any condition that falls into the category researchers call “misidentification syndromes,” such as atypical and typical Capgras, may be helped by taking antipsychotic medications, although more research is needed to know for sure, he said.