Wednesday, June 3, 2009

Health insurance needs PROPER DIAGNOSIS

The author is fellow at ICRIER, New Delhi

IN ORDER TO ENSURE UNIVERSAL access to quality healthcare, the government has been making efforts for increasing health insurance penetration. The Insurance Regulatory and Development Authority (IRDA) recently relaxed norms for health insurance companies and reduced the reserve requirements. The IRDA has already licensed many third party administrators (TPAs) for faster and easier claim settlements and for providing cashless hospitalisation facility. Further, the FDI cap in the insurance sector is also set to be increased from 26% to 49% through the second insurance bill.
    Insurers are looking forward to tap the vast and fast-growing Indian healthcare market. In fact, many insurance companies have begun to offer health insurance. However, the path ahead is not so smooth for health insurers in a country like India. The health insurance industry in India at present is a loss-making one. Though the private sector health insurance is growing at 40% annually, the level of coverage is still very low and has not penetrated rural and semi-urban areas significantly.
    One of the biggest challenges — and an opportunity too — for insurance companies is to convert the huge out-of-pocket health spending (72% of the total health expenditure and 98% of the total private health expenditure) into a formal risk pooling mechanism which people have never been exposed to before. Such a conversion process is constrained due to several factors, among them the absence of reliable morbidity and health expenditure data. Also important, from a demand-side perspective, is the low level of insurance awareness, poor trust in insurance companies over reimbursement, and absence of regular and adequate income to make regular premium payment.
    The process also involves tackling two important forms of market failures that are making insurers reluctant to sell health insurance — overutilisation of healthcare due to insurance coverage, and mostly the relatively unhealthy people buying insurance. One may wonder if these are not the common problems faced by insurers all over the world. However, the magnitude of these problems may be severe in India.
    Perhaps, both the insured clients and healthcare providers have an incentive for over-utilisation and overprovision of healthcare, adding to the bill of insurance company. Further, at present, the healthcare insurance schemes in India are mainly limited to hospitalisation, forcing the insured persons to be admitted to hospitals even for those illness requiring only out-patient care. One solution can be including the out-patient treatment as well in the insurance package, but the resulting premium will not be affordable for majority of the Indians.
    On the supply side, there are hardly any pricing criteria for healthcare services and no benchmark as to how much care is required by patients for each category of illness. Further, healthcare cost inflation is sure to rise further, All these will force insurance company to increase the premium, thus making health insurance a costlier proposition.
    One possible way of controlling the over-utilisation of healthcare due to insurance coverage could be the use of co-insurance and deductibles so that insured clients also have to bear a part of his total incurred health expenditure. But this will be very hard to introduce as already the present insurance schemes cover only a part of the health expenditure and, therefore, any attempt to increase the out-of-pocket healthcare burden of insured clients would make health insurance a less attractive health-financing strategy.
    In India, a majority of those buying insurance do it for investment purposes and not as an insurance product. But the health insurance schemes are without the saving component (being purely of risk pooling). This could dissuade many from getting insured. In such a situation, it is obvious that only those likely to require healthcare are interested in buying health insurance.
    It is time insurance companies applied appropriate and innovative marketing strategies to overcome all these hurdles by taking the Indian reality into account.




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Tuesday, June 2, 2009

WORKOUT W I T H N A M I TA


I am a 50-year-old housewife. I am slightly overweight and have gained five kilos in the last two years due to sedentary habits. I have mild arthritis in my knees and hence, avoid exercising. My doctor suggests that I start exercising. Will it help my joints? What kind of exercises would you recommend? Please suggest ones that I can do at home.
    — Usha Bajoria
Dear Usha,
The right exercise regime can strengthen your joints, increase flexibility and improve cardiovascular fitness. Exercise is also important for weight reduction and overall well-being. Don't get into a vicious cycle of inactivity. This in time leads to more stiffness, reduced strength and cardiovascular fitness.
CONTROLLING ARTHRITIS

• Improve joint care through rest and exercise.

• Maintain an acceptable body weight.

• Achieve a healthy lifestyle.
EXERCISE CHANGES

• Begin slowly and progress gradually.

• Avoid rapid or repetitive movements of affected joints.

• Adapt activities to suit your needs.
EXERCISES
STRETCH
Stretching exercises preserve range of motion and flexibility around each joint. Even inflamed joints can be put through a gentle stretch routine.
STRENGTH TRAIN
Strength training exercises using lightweights builds bone strength. Isometric strength exercises are often used to strengthen joints. Do these exercises only when pain and joint inflammation are under control.
LOW IMPACT CARDIO EXERCISE
In the past, treatment of arthritis excluded aerobic exercise for fear of increasing joint pain. Aerobic exercise is however, safe and effective when the joint inflammation is not acute. Low impact cardiovascular exercises such as swimming, cycling and walking are great too. Note: Always consult your physician for exercise guidelines.
STRETCHING EXERCISES LEG STRETCH
Lie on a mat or carpet. Extend the right leg up and place a bath towel around your right foot. Hold the ends of the towel and straighten your leg. Hold for 10-30 seconds and then switch legs.
SEATED KNEE TO
CHEST STRETCH
Raise one leg up onto the chair, resting your heel on the edge of the chair. Slowly bring the knee closer to you chest. Repeat with the other leg.
WAIST STRETCH
With your feet shoulder-width apart, knees slightly bent and toes pointing straight ahead, place your right hand on your hip while you extend your left arm over your head. Slowly bend at the waist to the side and hold. Repeat on the other side.
UPPER BACK STRETCH
Clasp your hands in front of you so that you feel the stretch in your upper back. Lower your head during the stretch so that your chin is close to your chest.
CHEST STRETCH
Clasp your hands behind your back and slowly lift your hands up until you feel a stretch.
SHOULDER STRETCH
Cross the right arm horizontally over your chest, placing your left hand or forearm just above the elbow joint, pull the right arm closer towards your chest.






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Dr Rajeev Warrier prescribes easy-to-do ayurvedic recipes for complete well-being

Diet, according to Ayurveda, defines the nature of a person, his response to circumstances, mindset and moods. Ayurveda classifies food materials into several groups such as like grains, grams (dhaanya varga), types of milk and milk products (ksheera varga), vegetables and fruits (saaka varga), types of meat (maamsa varga) etc.
    The solid diet consumed should take up half the capacity of the stomach, the liquids should take a quarter and the fourth quarter should be left free to aid digestion. The order of the intake of food is important too — sweet and heavy food first, sour and salty tastes next and the meal should end with astringent and bitter food substances. This aids digestion and absorption.
BROCCOLI AND
MOONG BEAN BAKE
Ingredients: 1/2 cup moong dal, 1 cup broccoli florets (chopped), 4 cups water, 1 tbsp lime juice, 1/2 tsp ginger (minced), 1 tbsp fresh cilantro (chopped), 2 tbsps ghee, salt and black pepper to taste
Method: Wash moong dal and add water to it. Cook it in a pressure cooker until tender. Mix it with broccoli, lime juice, ginger, salt and black pepper. Grease a shallow baking dish with ghee. Scoop the mixture into the dish and drizzle more ghee on top. Bake at 350-375 degrees for 10 minutes. Garnish with cilantro.
SAUTÉED ASPARAGUS
Ingredients: 2 cups asparagus stems (diced), 2 tbs water, 1 tsp lemon juice, 1 tsp cumin seed, ¼ tsp turmeric, ¼ sweet paprika, ½ cup almonds (sliced), 2 tbs ghee Method: Heat ghee until it looks clear. Add cumin seed and stir briefly and add turmeric and paprika. Now add the asparagus stems and sauté for 2-3 minutes more. Now cover the pan and stir occasionally. Add water to prevent sticking. Add in the almonds and cook for two more minutes. Serve hot.
MIXED VEGETABLE SAUTÉ
Ingredients: 1 small white radish (peeled), 1 medium zucchini, 1 medium carrot (peeled), 1 fennel bulb, 6-8 almonds (soaked and slivered), 2 tbs ghee, 1-2 tbs water, salt and pepper to taste
Method: Wash and slice all the vegetables finely. Heat ghee in a large flat pan. Sauté the almonds and add all the vegetables. Stir for a couple of minutes and cover the pan. Cook the vegetables on medium flame until tender. Season with salt and pepper and serve hot.
SWEET AND SOUR
CARROTS
Ingredients: 1 cup carrot (sliced), 1 tbsp raisins, rock salt and black pepper to taste, 1/2 tsp minced ginger root, 1 tsp fresh parsley, 1/2 tsp fresh lemon juice, 1/8 tsp fresh lemon peel, 1/8 tsp crushed cardamom, 1 tbsp ghee
Method: Steam the carrot for 5-6 minutes until tender. Heat ghee in a pan and sauté the raisins. Now add carrots, ginger cardamom, salt and pepper. Stir for three to four minutes. Drizzle lemon juice, the peel and parsley. Serve hot.
(Dr Rajeev Warrier is xyz of Arogya Ayurvedic Spa & Clinic)
    —COORDINATED BY SONAL VED




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Saturday, May 30, 2009

A cool nut to beat the heat

This nut packs in quite a punch. And if the scorching summer is making you feel the heat, here is the secret you needed to crack! Including almonds, one of the world's oldest cultivated fruit, in your daily diet is one of the best ways to beat the heat. A rare fruit that is available through the year and can be eaten at all times, the sheer variety in which almonds can be consumed and used, makes it a fruit for all seasons.
The summer fruit
Over the years, almonds have proved their nutritional attributes, and socio-cultural importance. The nut's healthy properties won it a following for not just its delicate taste, but in various countries and regions of
the world,
for being auspicious and lucky. From Rome to Sweden and the US to India, almonds have been referred
to as symbol of fortune, happiness and health. Since the time when the Mughals popularised the fruit in India, almonds have been part of every Indian home's staple diet.
    From a simple snack that can be munched anytime, to being the essential ingredient of many a delicacy, the almond has been the classic choice of food lovers for a good reason. For one, it enhances any dish it is added to. But more importantly, almonds by themselves can be an healthy option for the fitness conscious.
    In fact, almond provides the body with many essential nutrients and can really help in summers when a lot of people cut back on heavy eating and so often fail to get the essential nutrients.
How can you use almonds?
Not surprising then, that this cool nut is a hit with most health conscious people in all seasons. Almonds are one of those rare fruits that are available through the year. For years now, almonds have been part of cool recipes and delicacies just right for the season. Simply toss in a handful of almonds into your every
day food and you add
crunch, great taste and natural nutrients.
    According to Researchers at Tufts University in the United States, a 28 gram serving of almonds packs the same level of flavonoid antioxidants as a serving of cooked broccoli or a serving of brewed green or black tea. Just a handful or about 23 almonds can provide an individual with heart-healthy monounsaturated fat, vitamin E, protein, fibre, potassium, magnesium, and iron. That too, all in just 160 calories!
    There is nothing like a
    g o o d
    breakfast to kickstart the day. And yet, as calorie count gains prominence, the biggest challenge before most working Indians is perhaps finding the right option to start their day. Paranthas can be too filling and a glass of juice too light. So what do you do?
    Grab of glass of fresh badam sheera or sharbat, which is healthy and provides you with just the right amount of calories required. Almond shakes are, of course, the perfect bet for people who prefer a cool shake or smoothie to a heavy meal. A handful of almonds thrown into your fruit shake – be it strawberry, mango or for that matter chocolate, can make the beginning to your day just right.
    Summers are often the season when many people prefer to go the salad way. This is specially so for the increasingly weight watching generation that would rather have a large bowl of greens as against heavy paranthas.
    To the left is a simple recipe for tasty almonds that you can add to your salads anytime, or just pop them as a healthy snack, all spiced up just for the Indian taste buds!
    TNN
SWEET N SPICY ROASTED ALMONDS
Ingredients
One egg white; 15 ml water; 690 grams whole blanched almonds; 57 grams sugar; 10 grams ground cumin; five grams ground coriander; 10 grams coarse salt; seven grams ground red pepper
Directions
Preheat oven to 135 o Celsius. Line a sided sheet pan with parchment paper. Whisk egg white and water together until foamy. Add almonds and toss to coat. Transfer almonds to a sieve, toss gently and let drain. Stir together sugar, cumin, coriander, salt and red pepper. Add almonds and toss to coat thoroughly. Spread almonds on the sheet pan in a single layer; bake for 30 minutes. Gently stir almonds. Reduce the oven temperature to 93 o Celsius and continue to bake for another 30 minutes, until almonds are dry and nicely toasted. Set aside to cool completely, about 15 minutes. Serve immediately or store airtight for up to one week.




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How to beat acidity

For instant relief from acidity, consuming fresh mint juice after meals is an effective remedy. Fruits and vegetables that are high in water content like watermelons and cucumbers have a cooling effect on the stomach and help in easing pain. Try chewing on tulsi leaves to reduce nausea and the burning sensation caused by acidity. Consuming raw garlic on a regular basic also helps. Suck on a piece of clove or jaggery. For heartburn symptoms, the best relief is a couple of almonds.




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Truth about obesity — the biggest health hazard

 Obesity is a condition of the body, in which there is a generalized accumulation of excess fat in adipose tissue in the body leading to more than 20 per cent of the desirable weight. Obesity has several adverse health effects and can even lead to premature death. It also leads to arthritis, joint pains, high blood pressure, high cholesterol, heart disease, diabetes, gall bladder stone and certain types of cancer. Over-eating, reduced physical activity, genetic or hormonal disorders can also lead to obesity.
Causes for Obesity
    Obesity is caused by a chronic imbalance between energy intake and energy expenditure or a high intake of dietary fat.
    Poor exercise, sedentary lifestyles, complex behavior or psychological factors are some other causes.
    Metabolic errors in energy utilization may favour fat accumulation.
    Obesity in childhood and adolescence can lead to adult obesity.
    Thyroid and hormonal disorders are other causes.
Ideal Body Weight
The most commonly used measure is Body Mass Index (BMI) and it is computed by dividing weight in kilograms by the square of the height in meters. BMI < 18.5 : Undernourished 18.5 - 24.5 : Normal > 25 : Overweight > 30 : Obese Former health minister, Anbumani Ramadoss, had issued a warning about the rising obesity problem in the 300 million middle and upper rich class, due to high intake of junk food. Ramadoss has warned that the wealthy middle classes are facing a galloping rise in obesity, heart disease and diabetes. It is estimated that at least 30 per cent of women and 20 per cent of men in urban areas are clinically obese, although some experts put the real figure at closer to two-thirds of women. A country-wide survey has indicated high prevalence of obesity, hypertension, diabetes and high cholesterol levels in women over the age of 35 in India. Abdominal obesity is a major risk factor.
How do we reduce weight?
    Eat less fried foods and include more of fruits, vegetables and fiber rich food items like whole grains, grams and sprouts in your diet. Use low-fat milk. Exercise regularly to keep body weight within normal limits.
    Slow and steady reduction in body weight is advised since severe fasting may lead to health hazards.
    Enjoy a variety of foods needed to balance your physical activity.
    Eat small meals regularly at frequent intervals and cut down sugar, fatty foods and alcohol.
    A weight reducing diet must be in rich in protein and low in carbohydrates and fat.
    At Gorgeous, we have a team comprising a surgeon, dietician, physician, physiotherapist and psychiatrist and have done hundreds of pinhole liposuction, with no stitches or cuts and reduced weights from 100 kgs to 70 kgs in three months. Non invasive liposuction by using Ultralipolysis along with Thermo C for skin tightening is the best in the world to reduce overall inches and weight. Gorgeous provides a permanent and healthy solution to obesity although it depends on a patient's body condition as well. In next 10 years obesity will effect almost 50 per cent or more of the urban population, which will be huge burden on our medical system, which is still trying to cope with the present medical scenario.
— Dr Purnima Mhatre, Medical Cosmetologist Bandra: 26049333 Peddar Road: 32653215 www.getgorgeous.co.in www.drpurnimaskinclinic.com 

Dr Purnima Mhatre
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