Primary Care, Medical School Debt, and US Health Needs: Analysis from the Graham Center

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Bob Phillips MD, Executive Director of the Robert Graham Center, the American Academy of Family Physicians’ (AAFP) DC-based policy center, gave one of the plenary speeches at the recent annual meeting of the Society of Teachers of Family Medicine (STFM). His talk, available at the Family Medicine Digital Resource Library (www.fmdrl.org) presented a great deal of data regarding the current, and anticipated future, state of the US primary care workforce. There are currently 222,308 primary care doctors (FPs, GPs, general internist, general pediatricians and geriatricians), or one for every 1358 people, and an additional 86,000+ NPs and PAs in primary care, for a total of about 308,000, or about 1 primary care provider for every 1000. This is not a bad ratio, looking at the nation as a whole, but geographic distribution is another matter, with the ratio of primary care providers (PCPs) to person ranging from 500:1 to 5,000:1 in various primary care service areas (PCSAs); the nearly 5000 PCSAs with a shortage have a deficit of over 54,000 PCPs, which is equal to the “surplus” in the 1,600 or so PCSAs who have higher ratios. And, of course, those underserved PCSAs comprise the vast majority of the US geographic area (see figure).

Phillips and colleagues estimate that we will need an additional 50,000-60,000 primary care physicians by 2025. The largest cause of the growth is, of course, the projected growth in the US population, but it is augmented by the aging of that population (older people require more health care services) and, significantly, the increase in the number of insured-and-thus-likely-to-access-health-care created by the new coverage provisions in the Affordable Care Act (ACA). This portion of the increase is smaller, but unlike the gradual growth resulting from the other two causes, will “hit” all at once in 2014, and our primary care workforce is in no way prepared to meet it. This lesson was emphasized by the experience that Massachusetts had when it introduced near-universal coverage; in addition to adding more people to the “insured pool”, the group that is added has pent-up health care needs. Moreover, the currently uninsured are largely clustered in areas with the lowest current PCP:population ratios, so that what will happen when they gain insurance is that they will end up seeking primary care in the emergency room. While the Graham Center estimates a need for an additional 8,500-10,000 primary care doctors, given what Dr. Phillips calls our “voodoo” workforce policy -- which not only does not incent students to enter primary care or locate in rural and underserved areas, but in fact does quite the opposite -- the actual increase in the number of providers would need to be many times higher. Much recent work has demonstrated the decrease in student interest in primary care, and in particular the phenomenal decrease in the percent of internal medicine graduates entering primary care (as opposed to entering subspecialties or hospitalist practice), as documented by Garibaldi[1] and Hauer[2] among others (see A Quality Health System Needs More Primary Care Physicians, Dec 11, 2008). More recent data collected by the American College of Physicians (ACP – the internists’ group) from residents taking required examinations in 2009 indicate that only 21% of these residents are planning careers in general internal medicine (65% subspecialties, 10% hospitalist) and the actual results tend to show that these plans tend to skew even more to the latter two groups when decisions are actually made.

I have pointed to money, specifically the anticipated income related to student debt, as a major determinant of specialty choice, and Dr. Phillips makes this quite graphic by comparing the ratio of primary care and family physician incomes to more highly paid specialties over time. Using Diagnostic Radiology and Orthopedic Surgery as comparators, primary care incomes, which were about 60% in 1979, dropped to barely 35% in 2003, a trend that has not decreased since. Other graphs show that the % of graduate training (residency) positions filled by US medical graduates tracks linearly with specialty income, and that the growth in new residency positions has been almost entirely in those high-income specialties with drops in primary care positions. (This is not only because of student interest; it is also because many of these new positions are funded by hospitals. The same specialists – radiologists, cardiologists, orthopedists, anesthesiologists – that make big incomes for themselves also make big profits for the hospitals, so that hospitals are more interested in increasing their capacity to do these functions by having more trainees, residents and fellows, in these specialties.)

This creates a problem. The Graham Center data support much other research that has been cited in this blog by Starfield and others indicating that a health system that is based on primary care, with 40-50% PCPs, creates the greatest benefit in health and lowers cost. We have currently about 32% PCPs. With an interest in primary care among medical students now at about 22%, the problem is going to grow, not shrink. And, as I have often written, if we are interested in increasing primary care specialty choice, we are largely taking the wrong students into medical schools (e.g., Primary care specialty choice: student characteristics, July 12, 2010). Given that these characteristics are in large part negatively associated with family income, the changes in funding for medical schools are also troubling. Phillips cites an interview with the founding dean of the University of Missouri-Kansas City (UMKC) medical school, E. Grey Dimond MD, in the Kansas City Star (April 25, 2011). Dr. Dimond is asked how UMKC, as the “public” medical school with the least state funding of any in the US, survives, and he answers that they have increased tuition to become the highest tuition school in the country. This, of course, does not bode well for low-income students, urban or rural, becoming physicians: “Farm kids in Missouri from little towns that need doctors can’t pay what we have to have.” And, for those low (and middle, and even upper-middle) income students who graduate with debts often exceeding $250,000, those income differences among specialties loom very large – and this does not bode well for primary care.

Phillips provides evidence that Medicare costs and avoidable hospitalizations and hospital readmissions drop dramatically when there are higher primary care ratios (ratios of 1 FP+NP+PA:1500-2000 people, or 1:1000 if all PCPs considered[3]). He cites a large number of studies demonstrating essentially the same thing.

Is there a bright side? Are there solutions? Well, the contributions of primary care are now being widely acknowledged, and there are lots of calls for increasing primary care physicians. The ACA bill provides some increased funding for primary care (about a 10% increase under Medicare) and major funding increases for the National Health Service Corps (NHSC), which pays for medical education by (some) scholarships or (mostly) loan repayment for physicians who enter primary care (and sometimes general surgery) and practice in an underserved area for a period of years. Unfortunately, these are not sufficient; a 10% increase sounds like a lot, but if it brings the primary care doctor’s income from 33% to 37% of that of a specialist (and this would be if the whole practice were Medicare), it is not going to do the trick. The loan repayment from NHSC is good, but it rarely covers the whole bill.

What would work? Medicare, taking the lead among all payers, needs to increase primary care physicians’ income dramatically. The Council on Graduate Medical Education (COGME) estimates in its very impressive 20^th Report, Advancing Primary Care, that a family physician must be able to anticipate earning 70% of what a subspecialist makes if the goal of having a 40% primary care workforce in 20 years is to happen., the level at which income expectations tend to wash out of the decision on specialty choice. The federal and state governments should learn from successful models and repay all of the loans of medical school graduates who enter primary care over 8-10 years (enough time to ensure they are actually practicing primary care) and do it twice as fast for those who practice in an underserved setting.

This is what it will take to bend the curve of specialty choice, and, as a result, to bend the cost curve of providing health care.

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[1] Garibaldi, RA, Popkave C, Bylsma W, “Career plans for trainees in internal medicine residency programs”, Acad Med 2005 May;80(5):507-12

[2] Hauer KE, Durning SJ, Kernan WN et al., “Factors associated with medical students’ career choices regarding internal medicine”. JAMA 2008;300(10):1154-64

[3] The benefit on cost of hospitalization, avoidable hospitalizations, and readmissions is more difficult to assess for general internists than for family physicians; this would be unsurprising given that their training in almost all in the hospital rather than in the ambulatory setting.

6 Healthy Habits for Great Sex

Want your sex life better? Try changing your habits to live a healthier life.

As quoted from medicinenet, experts agree that there is a critical link between health, lifestyle with sexual satisfaction. By having a healthier life, passion or you can increase libido. Not only that, problems like erectile dysfunction in both men and women can be cured with a healthy life.


These six healthy habits you can do to sex is more intense:
1. Stop Smoking or No
Launched goodinbeds, smoking can interfere with blood flow to the genitals. With the disruption of blood flow can make a passionate women and men declined.

Not only that, as reported by quitsmoking, nicotine contained in cigarettes can also cause decrease in blood testosterone levels in men. Though these hormones affect the ability of men to erection.

In women, smoking can make them difficult to reach orgasm. Nicotine contained in cigarettes damage the ovaries, causing menstrual abnormalities and reduced production of the hormone estrogen. All the things that ultimately make quicker menopausal women.

2. Sports
Regular exercise in both men and women can improve the quality of their sex life and add excitement. Routine exercise can nourish the blood vessels. It is important to the ability of male erection.

According to urologist Jennifer Berman, MD, exercise can also increase endorphins, hormones that make you feel happy, and makes women more confident.

3. Reduce Stress
To reduce stress, you can try to do it with some techniques such as meditation and yoga. Both the technique was shown to improve the quality of sex life.

"Stress can also be secretly killed, even worse than heart disease or cancer," said Dr. Berman, as reported from everydayhealth.

To cope with this stress, Berman suggests, at least you have adequate rest periods. Rest can increase libido.

4. Reduce or Stop Alcohol Consumption
Alcoholic beverages has long been recognized as one cause of decreased libido in person. It turned out that alcoholic beverages can also be damaging to eliminate sexual arousal. Although maybe when you're drunk do not lose sexual desire, but not necessarily with your partner.

5. Reduce Caffeine Consumption
Caffeine has been shown to be a vasoconstrictor, which has adverse effects to blood flow. Blood flow, in men associated with erectile ability. Although until now there has been no research that could prove the influence of coffee on erectile dysfunction, experts still recommend you should drink coffee in a reasonable amount only.

6. Eating Healthy Foods
Eat vegetables rich in color and fruit that contain many antioxidants such as strawberry, orange and red wine. These foods are proven to increase libido.

"Mediterranean diet, diet by eating fruits and vegetables and foods containing omega-3 fatty acids, very good for sexual health," said Dr. Berman again.

Healthy Digestion, Endurance Body Strength

New Qoute:

In a healthy body, there is a healthy bowel. :p

Similarly, the father of modern medicine, Hippocrates, said. The development of science to prove it because a healthy digestive system will strengthen the body's immune system which ultimately protects the body from various diseases.


One key to maintaining healthy intestinal flora is to balance in the gut. "There are about 100 trillion inhabitants of the intestine that functions for the metabolism of substances in the intestines of healthy for us. The imbalance of intestinal flora can cause health problems," explained Prof.dr.Aziz Rani, Sp.PD-KGEH, chairman of the division of gastroenterology department of internal medicine Faculty of Medicine, Indonesia.

When born, the human gastrointestinal tract in a sterile condition. First prize is given a mother to her baby is the good bacteria, through the birth canal if it were born normally. When you are born via cesarean section, then the bacteria residing in the operating room immediately reside in the gastrointestinal tract.

Likewise, babies who get breastmilk, channels cernanya more dominated by Bifidobacteria as in breast milk contained a variety of compounds supporting the growth of good bacteria that are known as prebiotics.

Family Medicine in the Era of Health Reform - 3

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In the last post in this series taken from the 21st G. Gayle Stephens lecture (Family Medicine in the era of health reform - 2, May 11, 2011), I discussed medical student interest in entering family medicine, and in particular a medical student named Kate Dewar featured in a NY Times article (More Physicians Say No to Endless Workdays). Her father and grandfather are primary care physicians but she is entering emergency medicine residency. In this final post, I continue the discussion, looking at changes in primary care practice and its implications for health and health care in the US.
The entire talk, "Family Medicine in the Era of Health Reform", is available at https://docs.google.com/document/d/1bmKCAUljtVgYjyJdStg96IpmajZPTkjCVG1lWtVTxo4/edit?hl=en_US#, in both GoogleDocs (for Chrome or Firefox) and Word (for IE) formats.


Of course, there are changes to primary care practice, but in my opinion, they are not all good. According the NY Times article, for Kate’s father, William Dewar III, “…the burden of trying to be all things to all of his patients became unmanageable. In 2006, after Wayne Memorial Hospital hired hospitalists — doctors who specialize in taking care of hospitalized patients — Dr. Dewar finally gave up hospital rounds. For his hospitalized patients, the change meant putting their trust in a doctor who knew them less intimately but was more available and more adept at hospital care. ‘My patients are getting better care now in the hospital,’ Dr. Dewar said. And the change saved him hours of work each week. ‘It meant getting off the hamster wheel,’ he said.”

Maybe they are getting better care, or maybe he just hopes that they are. And better in what way? It may be that hospitalists, who I call the “4-day ED docs”, are great at technical management but not so good (because of their role; I am not impugning their skill sets) at continuity. When your patient has a cold, or needs a BP check, they may be happy to see your partner, or even go to an urgent care center. But when they are sick enough to need to be in the hospital, when they need someone who knows them, they are not getting it. Yes, maybe they are getting someone who can balance their electrolytes, or operate on them in a skilful manner. Maybe, especially if they are lucky enough to be admitted on a Monday and not a Thursday they will even have a consistent management plan from their hospitalist (if not, perhaps, their nocturnist!) But where is the doctor who knows about them?

The surgeon may operate on your cancer, the oncologist and radiation oncologist may prescribe their treatments, the nephrologist may come in to manage the renal failure from the chemotherapy – but you still need the doctor who knows you. This is not a “social rounds” visit; this is caring for the patient, managing the various specialists. My sister was admitted to a hospitalist service in California some years ago (she is OK now) and after a few days the second (or maybe third) hospitalist told her that she looked a lot better. He’d known her for two days. My other sister, visiting from out of town, said “She may look better to you but she is NOTHING like she was last week! She is in no way back to normal!” Good for sisters who come in from out of town, but what if you don’t have one?

We need more primary care doctors, more family physicians, more doctors who can provide continuity for the health-related portions of our journeys through life. But when we get these doctors, what is their life like? I recently met a very smart and committed young family doctor who works at a Federally Qualified Health Center (FQHC) in one of our more “desirable” cities. Even though she doesn’t deliver babies, and doesn’t take care of patients in the hospital, she still felt she was on a hamster wheel, often giving less-than-the-best-care-she-knew-she-could-give to the patients hustled through so that the FQHC could “make its numbers”. She wanted to know what could be done to support the family doctors who are out there working as hard as they can for relatively little money and in danger of burning out. Apparently, just expanding FQHCs to see more patients is not going to do it.

There has to be a solution that provides the benefits of a primary-care based health system to our people without balancing it on the backs of the primary care doctors, who don’t have enough time with their families and don’t have enough time with their patients. Who have to give up even the satisfactions that come from the happy moments of primary care, like delivering babies, and the times when your patients, admitted to the hospital, really need you. And doing it for a salary that, even if it far exceeds that of the average American, is a fraction of what your medical school classmates are getting for working less hard, and makes it difficult to pay off your loans.

If the US is going to benefit from a primary-care-based health system, it is going to have to address the input and process variables of medical education, that is who is admitted and what their experiences are in medical school, the things that lead them to choose specialties, and also the output variables, what the practice life experience is, and make sure that it is tolerable and sustainable.

We know what the characteristics of medical school applicants who are more likely to enter primary care and rural practice are; dozens of pilot programs have demonstrated them. They are students who are from rural areas, from under-represented minority groups; students who are older, and students who are from lower-income families. They also, on the whole, have lower Medical College Admissions Test (MCAT) scores. For those students who do come from higher-income, white, suburban families (who have always been and continue to be the vast majority of those admitted to medical school), the characteristics are a demonstrated history of service (e.g., Peace Corps, VISTA, Teach for America, carrying the rape crisis pager in college, volunteering in a free clinic).

And we are not, not in large enough numbers, not high enough percents. Demonstration projects are of little use if that is where they stay, if we don’t learn the lessons and implement them for the vast majority of medical school admissions.

The 2010 “Top 25” Family Medicine schools as rated (entirely by survey reputation) by US News vary widely in their percentage and number of students entering primary care. Over the 5 year period 2004-08, they ranged from the University of Minnesota with an average of 17.36% of their class, or 37.8 students, entering FM, to Duke with an average of 2.8% or 3.45 students. Of course, US News’ top 25 are not the same as the actual top 25 in students entering family medicine; my school, the University of Kansas (which is not in the US News’ top 25) averaged 20.3%, or 33.4 students, over that period. Since the national average over that period was 8.71%, or 10.8 students, apparently you can be a top FM school, at least according to US News’, and be well below the national average of students entering FM.

More important, even the actual top schools in producing family doctors have pretty low percentages, ranging from 13% to 20%. We are never going to get to the 40-50% primary care work force we need by producing less than 20% family doctors in the best schools. The worst schools – like Duke, Johns Hopkins and Harvard should be at 20%; KU and Minnesota should be much higher.



And when students are in medical school, we need to be sure both that there is adequate exposure to longitudinal continuity and interdisciplinary and inter-professional primary care, and that those experiences are positive. While I have said that Family Physicians need to be involved in caring for their patients in the hospital, students should not be able to go through medical school, as they do now, thinking that the hospital is the main venue for real health care.

And when those students we have carefully selected and nurtured graduate, and do enter primary care, they need to be able to expect to have reasonable lives. It seems obvious, but a lot of this is about money. Primary care doctors need to make more money, if not in absolute dollars, at least in terms of the percent of subspecialist income. Income does not have to be equal; work from the Robert Graham Center demonstrates that the effect of debt income disappears when primary care doctors make 70% of what specialists make. Medical school debt should be gradually forgiven for students who enter primary care, and forgiven at a much faster rate if they work in a rural area or HPSA.
Where will this money come from? There is no reason to expect that, in a country that already spends twice as much per capita as most other industrialized countries, all of which have better health outcomes, that there will be more money coming into the system. It is going to have to come from other parts of the health sector; the parts being collected now by hospitals and other specialists, in particular. It will also have to come from the profit being taken out of the system by those hospitals and even more by for-profit insurance companies and drug companies. There can be no room for so many “health dollars” going to investor profits, nor can there be perverse financial incentives that make it more desirable to treat sick people than to keep them from getting that sick. There must be a comprehensive approach, for otherwise there will always be “gaming of the system”, and this is where the big failing of ACA is.

We need continue to need specialists, so it is good that Kate Dewar gets her satisfaction from emergency medicine, or that others like to put people to sleep, read slides or x-rays, perform surgery, or see the same diagnoses over and over again in subspecialty practices. But we need a lot more primary care doctors – and nurse practitioners – more family doctors.

We need policies at every level, at those of the medical school and the LCME, and the ACGME, and the state and federal governments, that encourage us to take students who are more likely to enter primary care, to nurture them through their training so that they actually do enter primary care, and to provide a practice setting in which they can feel satisfied that they are providing excellent, patient centered – and population-conscious – care without giving up all of their personal lives.
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Menu Avocado for Baby Health

Avocado benefits can be an excellent alternative food, as the first solids that you introduce to your baby. Why is that? Besides having a high nutrient content, soft texture also makes it easy to be digested by your baby.

In fact, we often hear that avocados are also given the title as one of the world's most perfect, because it contains all the nutrients our body needs to survive.


Therefore, rather than giving your baby cereal instant you try to give avocado consider him as a "good fats" that are useful for brain and physical development of your baby!

According to nutrition experts, avocado Sodium and cholesterol free, and contains many beneficial nutrients, including 8% of total folate per day is recommended for consumption; 4% fiber and potassium, 4% 2% vitamin E and iron. One avocado contains about 81 micrograms of carotenoids Lutein, 19 micrograms of beta-caroten and 3.5 gram Unsaturated fats are known to play a role in the formation of the central nervous system and brain.

6 Best Nutrition for Pregnant Women

For pregnant women to consume foods that must be considered is because vitamins and minerals essential for health herself and the fetus. Nutritional needs during pregnancy, among others:

1. Protein, a big role in producing blood cells.
2. Carbohydrates, the body needs for daily energy.
3. Calcium, during pregnancy, calcium is important to help the growth of the baby.
4. Iron is very important in helping the process of production of red blood cells, primarily to prevent anemia.
5. Folic acid, based on several findings of health experts, pregnant women who lack folic acid greater the risk to have a miscarriage or damage to the fetus.
6. Fat, for pregnant women, fat immense benefits to the body's energy reserves, for intermittent body does not feel tired.

Natural Food For Healthy Brain

The most important organ in our body is the brain. A healthy brain will contribute to support activities, helping us to better focus and increase concentration in performing daily activities.

Less healthy brain will result in a decreased concentration, ability to remember the weak and often out of focus. This can happen if the brain does not get 'food' or adequate nutrition.


For that we really need to pay attention to our brain needs a way to consume food that can enhance the brain works. Here are a natural food that can nourish the brain:
1. Fish
Fish is a source of animal protein is the highest. Fish species of salmon and tuna contain omega-3 fatty acids are essential for the growth process and protects the developing brain. Omega-3 fatty acids also lower the risk of dementia and mental decline. Eat lots of fish since childhood mengurangiresiko dementia in old age.

2. Caffeine
It is not always bad to drink coffee or tea for the body. As long as the amount consumed in moderation of course will bring benefits to your body. Caffeine contained in coffee or tea can make you concentrate and
focus. Your brain will be in a position of 'awake' after drinking it.

3. Breakfast as Brain Fuel
Often skip breakfast? Start fox habit. Breakfast can improve short-term memory and also keep you in a state of focus. Make sure your child does not ever skip breakfast even if only a stack of bread and a glass
milk. So that the little focus when studying at school. Breakfast does not need much but should contain enough protein.

4. Increase Sugar Alert
Sugar is not the usual sugar you add to the beverage or food, but glucose you get from food. Sugar derived from carbohydrates or fruits. Inibisa sweet foods trigger short-term memory and thought processes you spontaneously.

5. Nuts and Chocolate
Consumption of little chocolate and nuts every day is recommended. Because it can meet the requirement of vitamin E and antioxidants yangdiperlukan by the body. Sufficient vitamin E can prevent cognitive decline associated with age.

6. Blueberry
As already reported by webMD, blueberries can protect the brain from oxidative stress and reduce the effects of the condition yangberkaitan by age diseases like Alzheimer's and dementia.

5 Causes of Failure to Lose Weight

Do you include people who are facing weight problems? Indeed for some people who are obese or overweight tersa difficult to menurunkanya. Sometimes even to despair and let this situation happen to them.

Generally most people have a lot of willingness to lose weight, but to no avail. To increase the chances of success of behavior change necessary 1-2.


Some of the habits that made a person could unwittingly create difficult weight is reduced so that it remains to be fat. For that to know what things that can make a person difficult to become thin, as quoted from Menshealth.com, Tuesday (17/05/2011), namely:

Frequent snacking on salty foods
Sodium contained in salt can make a person continue to eat without realizing that he will be snacking in big portions. Gradually reducing salt intake can make a person slightly reduce ketagihannya.

Eating in front of the television
This is because someone is eating but do not burn calories, and studies show that eating in front of the television will make it consume more calories and menjadikanya increasingly inactive. And do not sleep after eating a heavy meal, but wait until several hours later.

Skipping meals
Do not have a regular meal times can make the body difficult to control appetite and become more of a meal. If someone spent the time eating the brain has no power and will send a signal to eat more.

Eating quickly
If someone ate quickly will make it feel full faster and will move to other foods. For that try to enjoy it and slow it down so the body more able to recognize the full signal and makes the brain issued an order to stop eating.

Doing a party at the end of the week
Party at the end of the week will cause problems later. Study finds saturated fatty acids from food will affect the palmitic acid and leptin (a hormone that helps regulate appetite), so that makes it will overeat on Monday.

Insurance company profits up and patient care down

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The third post in the series "Family medicine in the era of health reform" will appear at a later date. I  wanted to cover another topical issue.

Almost a year after the passage of the Affordable Care Act (ACA), amidst the dire predictions from the right about everything from death panels to socialism and their bloviating about overturning it, it turns out that the fears of the “left” are more accurate; that is, that it is insurance companies, not the American people, who are receiving the greatest benefits. There have indeed been benefits to consumers; notably the ability of young people to stay on their parents’ insurance until 26 and the elimination of restrictions on pre-existing conditions, and there will be more later on as 2014 rolls around. But the biggest impact of the bill so far has been inflating the coffers of health insurers.

The lead article in the New York Times, May 14, 2011, by Reed Abelson, is Health Insurers Making Record Profits as Many Postpone Care. In his wonderful daily commentary on health news, Quote of the Day, Dr. Don McCanne simply observes “The headline says it all.” That’s the gist of it, but it does deserve a little more discussion. For one thing, the health insurance companies, despite record profits over the last two years, are continuing to raise their premiums very significantly, justifying this by saying that they expect that, as the economy improves, people who have been delaying getting health care will begin to do so and create a great demand.

“Yet the companies continue to press for higher premiums, even though their reserve coffers are flush with profits and shareholders have been rewarded with new dividends. Many defend proposed double-digit increases in the rates they charge, citing a need for protection against any sudden uptick in demand once people have more money to spend on their health, as well as the rising price of care.”

Excuse me? This is a justification for raising rates now? That people, insured people, find the co-pays and deductibles currently in place to be so high that they are denying themselves needed care, so maybe later they’ll want to get it, so then it will finally cost the insurers money, so let’s pre-emptively raise premiums to cover it? Meanwhile, what it actually does is to ensure that even fewer people access care because the higher rates mean that they opt for policies with even greater co-pays and deductibles or even drop their insurance altogether.

The article quotes a number people, including physicians, describing how they or their patients have gone without or put off obtaining health care.
“’I am noticing my patients with insurance are more interested in costs,’ said Dr. Jim King, a family practice physician in rural Tennessee. ‘Gas prices are going up, food prices are going up. They are deciding to put some of their health care off.’ A patient might decide not to drive the 50 miles necessary to see a specialist because of the cost of gas...”
While the insurance companies are using the opportunity to stash away even more money for the flood that may, or may not, come: the Times quotes an industry analyst as saying about demand for health care services “The big question is whether it is going to stay weak or bounce back…Nobody knows.” They are raising their rates by double digits (for example, an Oregon Blue Cross/Blue Shield raised them by 22%), while having big profits (“…big insurance companies have reported first-quarter earnings that beat analysts expectations by an average of 30 percent.”)

Some of the reports suggest that people seem less interested in getting medically unnecessary services which they wanted when someone else was paying; according to Dr. King ”Fewer [people] are asking for an MRI as soon as they have a bad headache. “People are realizing that this is my money, even if I’m not writing a check.”  But others, such as the woman who has been putting off paying $350 for dental crowns she has needed for a year, are avoiding needed care. The effect on the health of the consumer may not be all bad; a doctor says more patients are “…asking for the generic alternatives to brand-name medicines, because of hefty co-payments. ‘Now, all of a sudden, they want the generic, when for years, they said they couldn’t take it.’” Let me be clear: in general, choosing generic drugs is a good thing; it is very uncommon that a patient is intolerant or allergic to a generic medication, or that it works less effectively than a brand-name one. Why, then, have this doctor’s patients heretofore been asking for them and saying that they “couldn’t take” the generics?

If you guessed “drug company advertising”, congratulations! It may seem obvious but it is also true; direct-to-consumer advertising, particularly on television, has major impact in creating demand from people on their doctors. The advertising is, of course, all for brand name drugs that are currently under patent and not available generically. Like other advertising for brand-name products it creates the (usually incorrect) impression that, somehow, this drug is better than the “no-name” drug. Why should this be surprise when it is clear that people prefer brand names in clothes, food, and other consumer items even when there is no demonstrated quality difference? [Amazingly (to me), people  -- even people over 14 years old! --pay good money to walk around with a designer’s name scrawled across their T-shirt and believe that this has cachet!]

The simple goal of drug manufacturers is to get people to switch to their drug when it comes out, develop brand loyalty when it is under patent, and stay with the brand even when generic competitors come out. The actual best thing for people’s health is to rarely adopt a new drug that “seems like it might be” better (unless all the old drugs are not working or have serious side effects or allergies), but rather wait until there is convincing evidence, usually after several years of use, that it is both more effective and has fewer dangerous side effects than the old drug it was replacing, especially if it is not cheaper. So, to the extent that higher co-pays and deductibles might counteract the impact of drug-company advertising, it can have a positive impact, and fulfills the expectations of many health care economists.

But it is not, after all, a very good way to do it. Raising health insurance premiums and co-pays and deductibles may make people more cautious with their health care dollar, but as indicated in this article, and shown years ago in the RAND Health Insurance Experiment (as cited in Freedom abroad, health at home: experiments in preventive health care, February 13, 2011; the study was published in the New England Journal of Medicine in 1983[1]; and it is summarized in an article by Joseph P. Newhouse, "Free for all?:  lessons from the RAND Health Insurance Experiment", RAND 1993), people are at least as likely to skimp on  necessary care and preventive care that may have a negative impact on their health, as well as be more likely to create high costs, in the future, as they are to forego elective or unnecessary care. They may not demand an MRI for a headache, but also may not want to pay for it when it is medically indicated. They may be more likely to ask for generic drugs, but may also skip filling the prescriptions altogether.

Dr. McCanne continued his brief comment by saying “Under the Affordable Car Act we're getting more of the same, except worse (higher costs, skimpier coverage). It doesn't have to be this way.” He is completely correct.  There is a better way to control costs, and to ensure quality health care. It is to make sure that everyone has coverage, such as through the single-payer plans recently introduced in the Senate by Bernie Sanders and the House by Jim McDermott, to have central pro-active control of costs by regulation of premiums and profit, using the power of bulk purchasing by federal agencies such as CMS to drive down drug prices, and to use the incredible power of an increased primary care workforce to increase quality and “bend the cost curve”. More on that in an upcoming blog.

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[1] Brook RH, et al., “Does Free Care Improve Adults' Health? — Results from a Randomized Controlled Trial”, N Engl J Med 1983; 309:1426-1434

Broccoli Good For Ulcer Prevention

Recent research shows that broccoli has the ability to suppress a variety of digestive disorders such as intestinal infections, ulcers and possibly stomach cancer. This means complement variety of previous studies that mention broccoli contain antioxidants that can reduce the risk of cancer.

In a study in Japan, the experts found that eating 70 grams of fresh broccoli every day for two months to protect the human body from bacteria-related stomach ulcer disease, gastric infections, and even stomach cancer.


The content of sulforaphane present in broccoli may trigger enzymes in the stomach so as to provide protection against radical compounds that can damage DNA and cause inflammation.

Sulforaphane in broccoli are also known to increase the production of phase II enzymes in the liver. These enzymes play a role together with the materials produced from the compound carcinogens prokarsinogen and out of cells. Please note, the content of sulforaphane in broccoli sprouts fresh higher than broccoli that has been boiled too ripe.

Tip: Choose the dark green broccoli. In addition to directly eaten as vegetables, broccoli can also be mixed with other fruits and vegetables for salads. Or another option, you can eat broccoli in the form of juice. -DechaCare-

Cures And Overcoming Chapped Lips

Problem of chapped lips often underrated many people, this fact if left unchecked will cause irritation and pain when eating. In fact, can also cause inflammation and bleeding on the lips.

It certainly will be able to interfere tesebut our activities. For that you need to know how where how to prevent and if you already have you should know also how menyembuhkanya.

Here are tips to prevent and treat the problem of chapped lips:


Prevention
When his lips began to dry up, usually the first thing you might do is try to lick it melembabkannya manner. This will alleviate the problem of dry lips for a while. but, once the saliva dries up, your lips will be even drier than before. Cause, licking her lips would remove natural protective oils of your lips. In addition, chemical substances in saliva which serves to digest the food instead will try to "digest" the lips. Therefore, one way to prevent dry lips so chapped is to try not to lick it.

It is better to keep moisture from the body throughout the day with emphasis on drinking water. In addition, when outside the room, do not forget to protect the skin of your lips with lip balm that contains sunscreen to your sensitive lips. If you are a smoker, then quit. Smoking will dry out the lips and leave oil on the dry lips so easily cracked.

Handling
If prevention efforts fail and keep your lips were chapped and bloody, immediately to treatment. The first way, choose a lip balm that is designed specifically for chapped lips. This prevents the addition bjbir chapped. And to remove dry skin cells from lips, apply a small amount of vaseline to brush your teeth (which is still new and only single-use) and then rub it gently into the area to dry out the lips. This will remove all dead skin cells and dry skin from your lips. However, avoid this if in a state of bloody lip. If lips are inflamed, apply hydrocortisone cream to reduce inflammation.

Also, make sure to maintain moisture of the body with emphasis on drinking water and avoiding caffeinated drinks each day. And if your room was dry and hot, turn on the moisturizer to keep the room air humidity. Dry air can also aggravate the condition of your lips.

You know, Skin of Apple Fruit Contain High Nutritious

Did you know the apple skin was saving a lot of vitamins. Therefore, if you do not need to eat peeled apples, because apples have the highest nutrient in skin.

Concerns about pesticide residues left on the skin of the fruit makes a lot of people are afraid of eating fruits directly. In fact, some types of fruit such as apple store essential nutrients just under the skin.

"If the skin is peeled, of course vitamins can go wasted. Indeed there are nutrients in meat, but usually a little fruit," said Dr. Inge Permadhi, a nutritionist from the Department of Nutritional Sciences Faculty of Medicine, University of Indonesia. Therefore, he recommends eating fruits directly to the skin.


To minimize pesticide residues, Dr Inge offers tips for washing fruit with warm water and soap and then rinsed with running water. Currently also available a special soap to wash the fruit that can be used. If you're still worried, could also eat organic fruits.

Know that the highest nutrient found in fruit skin? Yes. The experts also say some kinds of fruit leather is the main source of antioxidants that are useful to prevent cancer, maintain healthy skin and delay the arrival of wrinkles on our face. So, revert intention peel fruits and enjoy the following properties for our body.

Benefits Of Shark Fins Can Found on Chicken Leg

Shark fins are very nutritious, so the sharks are always hunted. Many people who do not know the benefits of chicken legs. Though chicken leg is very easy to get a nutrient content similar to shark fin.

One of the useful content in shark fin is cartilage or cartilage, which is believed capable of improving immunity and preventing cancer. Just as shark fins, legs, aka chicken feet also contain a lot of cartilage to coat joints.

As reported previously detikHealth, the American Cancer Society has developed a cancer drug made ​​from cartilage. Drugs made ​​from shark fin was quite effective, but difficult to obtain raw materials in large quantities without disturbing the balance of marine life.


In this case if the shark to be protected, then the chicken foot can be an alternative because both contain a lot of cartilage. chicken leg is clearly more easily obtained because these birds are grown so it is not possible extinction although consumed continuously.

Other Ingredients can be found in shark's fin and chicken legs are glucosamine and chondroitin, two compounds are efficacious as a natural anti-inflammatory. A study in 1995 proved, two compounds that could alleviate the symptoms of rheumatoid arthritis or osteoarthritis.

Another advantage of the chicken feet than shark fin is a very high content of kolagennya. Collagen is a type of protein and is widely used in beauty products are widely available on the bones, joints, and the hardened skin on chicken legs.

5 Drinks For Stress Relief

There is always busy with daily routines, or the pressure of work makes you stressed? Do not assume that all trivial, because if not quickly treated can cause depression.

To eliminate or reduce stress, not hurt you to try to enjoy the following five drinks as reported CAIRO.

1. Warm milk
We're feeling too late or saturated, drink a glass of warm milk. The content of tryptophan in milk will undergo a process of metabolism into serotonin functioning improve mood. Then, the content of calcium, magnesium and potassium can reduce blood pressure increased because of stress.


2. Hot chocolate
Warm drinks will increase your body temperature and can lead to comfort. Content of substances in chocolate can also make your mood more stable.

3. Black tea
Change the habit of drinking coffee during stress, replace it with black tea. Research by a team from University College London, UK, showed that drinking black tea four times a day for six weeks reduces stress triggers the hormone cortisol.

4. Green tea
Green tea contains theanin, which enhances relaxation in the brain. Namely, increases alpha waves which cause a calming effect and reduce the wave betha that create a feeling depressed.

5. Cold water
Cold water also can you make drugs stress. But, after drinking make sure you walk outdoors and breathe fresh air. Water will move the blood and fresh air stimulates the production of endorphins, relieving stress hormones.

Tips For Removing the Hair Leg

All women would want to look beautiful, attractive, fresh and clean. Obviously a very important body treatments, including maintaining cleanliness of the feet of the hairs that can interfere with the beauty of the foot.

Tips removing the hair leg is simple. For those of you who are troubled by the growth of hair on your legs do not worry, the following simple tips for removing the hair leg, especially in women.


Take a little pepper, camphor and a few drops of kerosene. Mix and beat until smooth, then wipe the fur-covered feet. Do it once a day until all the hair fall out by itself.

Eliminate Stress With Fresh Grass Aroma

Remember when you are in the middle of green pastures, plus the fresh mountain breeze and the warm of morning sunshine, Breathe in deeply the fresh air mixed with the natural scent of fragrant green grass. And we will feel fresh and soothing.

This prompted Dr Menoreh Lavidis, Euroscientist an expert from the University of Queensland to research links between the scent of fresh grass, its effect on comfort, ease tension in the head due to stress, and happy feelings generated.

No kidding, this research may take up to seven years. The results showed that the aroma of fresh grass was able to work directly on the brain, which is a special section called the amygdala and hippocampus. Sections were directly related to control emotion and memory. The same section was also responsible for the release of hormones that can cause stress.

Be happy if you live in an area that still leaves a grassy area, lay there in the morning will awaken your spirit. What if not? Not to worry, it's been a lot of manufacturers that provide perfumes and aromatherapy scent of fresh grass. The effects of perfume and aromatherapy is just as good as fresh grass that grows in the field.

Two Human Organs Free from Cancer attack

Cancer is one disease belonging to the deadly disease. Almost all the organs of the human body ranging from bones, blood, breast, skin, heart and others can be affected by cancer. But actually there are two organs of human body which will not attacked by cancer, do you know?

"The hair and nails can not get cancer because it is dead tissue, so it can be cut," said Dr. Joni Fauzi, Deputy Director of the Ethical PT Kalbe Farma in talking with the media at the Penang Bistro, Menteng, Jakarta, Tuesday (05/04/2011 .)


According to Dr. Joni, in both parts of the body other than the cancer can strike any part of the human body. The lungs, including the body part most widely attacked by cancer, with the highest death rate in 2008 that 1.4 million people around the world.

Data World Health Organization WHO in 2008 put the stomach in the second rank at most parts of the body attacked the cancer, with mortality rates 740 000 inhabitants. Row below it is the liver (700,000 deaths), colorectal (610,000 deaths) and breast (460,000 deaths).

Benefits from Grapes can Prevent Cancer

Grapes is a kind of fruit plants in the form of creeping shrubs belonging to the family Vitaceae. In addition to edible directly, Grapes can also be processed to drink wine, jely, juice, raisins and others.

Resveratol and polyphenol compounds contained in wine contribute substantially to the body's metabolism, and can prevent the formation of cancer cells. Antiosidan in Grapes can ward off free radicals. Grapes contain:

• Carotenoids and lycopene
• Manganese
• Vitamin C, B6, C and B1
• Resveratrol (probably to prevent cancer)

Benefits:

• Maintain stable blood sugar
• Overcoming fatigue
• Overcoming influenza
• Helps overcome polio and herpes.

Toothache Can Really Infectious to Others?

A study conducted shows that a toothache can indeed spread. During this candy and sweet foods are often blamed as the culprit causing the hole in the tooth, but the actual cavities (caries) is caused by bacteria attached to the teeth and particles that come from food. The bacteria convert sugar and carbohydrates you eat into acid. Bacteria and acid deposition become sticky, called tooth plaque.


Like the flu viruses that may infect other people, as well as with the bacteria that cause dental caries. One of these is Streptococcus mutants. Toddlers and children are the most vulnerable of contracting.

Research shows children are often infected with mutant bacteria Streotococcus it from parents or caregivers, such as food tasting children to know whether too hot or not. Transmission of the bacteria are also often occur in pairs.

"There is a case of 40-year-old patient who previously never had a hole in the tooth two teeth suddenly began to suffer from cavities and gingivitis. It turned out that after investigation the woman is dating a new guy gingivitis pain and have for years had not been to the doctor, "Dr.Margaret said Mitchell, a dentist in Chicago.

To reduce the risk of cavities, she recommends to clean your teeth regularly. The habit of chewing sugarless gum are also encouraged to increase production of saliva so that the formation of plaque and bacteria can be inhibited.

7 Tips Avoid Flu And Cold

Unpredictable weather changes and cold temperatures, can cause colds or even flu. Factors other from weather, the flu and common colds can also be triggered by the immune system that does not fit.



For there is always fit and strengthens the immune system try some bleak lifestyle tips below:

1. Diligently hand washing to prevent the spread of germs and disease gathered
2. Drink at least 8 glasses a day, so the entire immune system and running well
3. Do not breathe snot back, but just throw it, so that the body is cleaned from a variety of toxins
4. Dress warmly. Quick change of clothes if rain
5. Many healthy foods on a regular basis and provide energy.
6. Expand to eat vegetables and fruits. Avoid touching / holding the eyes, nose and mouth
7. Drinking vitamin C to strengthen immunity to disease.

How To Cooking Not Eliminate Nutritional Content

Fry: The temperature of cooking oil smoke does not pass through the point (temperature at the time of cooking oil smoke) and do not get too dry or burnt, so that the protein is not damaged. fried maximum results will be used when the oil temperature of about 110-160 * C (depending on the type of oil).

Boiling vegetables: Just until half cooked so many vitamins or minerals are not soluble in water.

Steaming: Should green vegetables still seem somewhat fresh and if bitten and still feels crispy.


Baking: Better food (meat) was inserted into the microwave for two minutes for a little mature, so it does not take long to bake it. Because the grill too long is not good for health because it causes the emergence aminia heterosiklis-amine.

4 Leaf Green For Anemia Prevention

Anemia caused by deficiency of red blood cells, which causes the circulation of oxygen to brain and other organ not smoothly. Due to the perceived body is often a headache, difficulty concentrating, face looked pale and tired.

According to research, the content of iron in green vegetables can increase the production of red blood cells or hemoglobin (Hb). Of the many green vegetables, there are some that are traditionally used as a remedy to overcome the lack of blood.


The types of vegetables or herbs are as follows as quoted by the Nigerian Tribune, Monday (04/04/2011).

1. Guava Leaf
Guava guava or benefits not only lies in the fruit that can enhance platelet cells in patients with dengue fever beradarah. The leaves also influence the formation of blood cells, particularly hemoglobin in patients with less blood.

In the tradition of African people, guava leaf decoction drunk to overcome anemia. Research at the University of Calabar prove that the effect on hemoglobin increased significantly and no side effects on the kidney.

2. Sweet potato leaves
In a study published in the Journal of Medicine and Biomedical Research in 2007 revealed, sweet potato leaf extract could increase the activity of the organs involved in the formation of red blood cells, among others, liver and bone marrow.

3. Leaves grass goat
Babadotan (Ageratum Conyzoides) or also known as goat grass (Billy-goat weed) are easily found anywhere, including in the yard. Plant white flowering kind of grass is actually including weeds or plant pests for farmers.

Because it contains antibacterial compounds, residents often use it to treat wounds. In addition, a study in Nigerian Journal of Physiological Sciences, proving its leaves are rich in iron so that its extract can treat anemia.

4. Pumpkin leaves
Various studies have shown pumpkin leaf extract is effective to increase the regeneration of hemoglobin in a way to stabilize blood cell membranes. In limited clinical trials in 30 pregnant women in rural areas in Africa, tersbeut extract can significantly increase levels of iron when given together with eggs and milk 3 times / day for 7 days.

How To Get Pregnant Easier for Couples

Not a few couples do not have a descendant or child, though already married for years. Almost all couples who face this problem, be willing to do anything to get a pregnancy.

An expert and fertility specialist physician and founder of Southern California Reproduktive Center, named Dr. It Danzer, said there are a few tips on related positions Isti husband who can improve your chances to get pregnant, as quoted from Parents.com

1. Sex before you ovulate
Sperm can remain in the uterus and fallopian tubes to the uterus for 2 or 3 days. However, your egg will only last maybe 12-24 hours after release. So, having sex before you ovulate can encourage the possibility of sperm that will greet you as soon as the egg is released.

2. Position: "missionary"
Indeed, there is no scientific evidence that indicates that a particular position is more effective than others. However, the purpose of sexual relations that allow the occurrence of fertilization is to deliver the sperm as close as possible to the cervix. Thus, it would be better if the couple could put his penis as deep as possible, and this may happen if he was on top. On the other hand, doggy style is arguably the least effective way to make your egg is fertilized.

3. Lying on your back, and prop your hips
What makes this sex session worked, and what is just a myth, it is still debated. However, Dr. Christopher Williams, MD, a reproductive endocrinologist from Charlottesville, Virginia, and author of The Fastest Way to Get Pregnant Naturally, described what the facts fully. For example, prop your hips with a pillow.

4. Making love before bed tonight
Although some sources reported that sperm counts more in the morning, in fact there is no optimal time of day for sex. Besides, making love before you sleep at night be an easy way to make sure you lie down afterwards.

Excessive salt, Esophageal Stroke And Cardiovascular Risk

Salt is one of the essential ingredient for a dish, any dish will taste bland without salt spiked. But it turns out salt can also bring the threat to human health when consumed in excess.

According to research scientists in Australia, the excess salt in food risk of causing blood flow in major arteries blocked. Just within 30 minutes of blood vessels is estimated to be stiff. Then, this condition will affect the work system of the heart.


"This type of damage to the blood flow is considered as a very early sign of heart disease. Every time you eat salty foods you change the function of cells line your arteries, "said Professor Graham MacGregor, as quoted by the Daily Mail.

Besides an effect on the increased risk of heart attack, excess salt is also associated with risk of stroke, kidney disease, osteoporosis, and stomach cancer.

Ideal portion of salt consumption is safe for health, not more than 6 grams per day. However, the majority of people are estimated to consume more than 8 grams a day. In some developed countries, one of the two patients who died from disorders or heart attack, salt mengasup average 8-12 grams a day.

The portion of Healthy Sleep According to Age

Sleep time of each person is different, the portion of sleep depending on the age of each individual. especially for a baby will need more sleep than adults.

Reporting from Yahoo Shine, Describes how much sleep time for each person on the basis of age, complete with benefits:


Age 0-2 months
Infants who reach the age of two months, it generally takes 12 to 18 hours of sleep each day.

Age 3-11 months
At this age, babies need time to sleep 14 hours to 15 hours each day, including naps. The days were very important to their lives. Adequate sleep will make the body and the baby's brain develop well and normal.

Age 3-5 years
At the age children enter school before this, they need time to break sleep 11 hours to 13 hours, including naps. This is very important. Because, according to the study of children aged under five years of a lack of sleep, will affect the status of obesity in the future.

Age 5-10 years
School-age children will take time to sleep 10 hours to 11 hours. According to research, children who do not have adequate rest periods, can cause them to become hyperactive, not the concentration of study, and have behavioral problems at school. Research has shown.

Age 10-17
By the teens through adolescence, they need to sleep daily between 8 hours and 9 hours. Studies show that teenagers who sleep less, are more susceptible to depression, not focused, have bad grades, even car accidents.

Adult
Adults need time to sleep 7 hours to 9 hours each day. The doctors recommend for those who want to live healthy to apply these rules in life.

According to studies, people suffering from lack of sleep 1-2 hours every day or irregular sleep will increase heart rate, blood pressure, and inflammation in the body and increase the appetite so the risk of obesity.

Prevent Osteoporosis with Eating Fish

Fish is a food that contains nutrients and bad fats or cholesterol. In addition, research shows that people who often eat fish will have strong bones and much of the risk of osteoporosis.

From the results of a recent study showed that adults who regularly eat fish will have good bone density compared with those who rarely ate fish. The researchers also believe that the combination of fish oil may protect bones from osteoporosis risk.

"We think omega-3 fatty acids from fish may help prevent kekeroposan bones (osteoporosis)," said study leader Dr. Katherine Tucker, a professor at North-eastern University, as reported by Health24, Saturday (02/04/2011).


Dr Tucker said that did not prevent bone kekeroposan simple as imagined. In this study, Dr. Tucker just get the results after 4 years of study.

Participants who consumed three or more servings of fish a week dark, like salmon or mackerel, had a risk of bone loss smaller four years later, compared with women who rarely ate fish.

Really Chocolate And Candy Make You Fat?

Chocolate and candy make fat? not necessarily. Even those who like to eat chocolate and sweets that have a smaller waist circumference as long as the amount of sweet foods in / create in small portions.

Recent research has found that people who eat chocolate and sweets tend to have smaller waist and body mass index (BMI) is low. not only that, for those who like to consume the sweet 15 percent could reduce the risk of metabolic syndrome and reduce the risk of hypertension 14 percent lower.


Carol O'Neil, a researcher from Louisiana State University Agricultural Center, revealed the consumption of sweets and chocolate had no effect on body weight or illness if taken properly. From his research on average the study participants ate 1.3 ounces of candy per day.

In his research he analyzed the dietary data of more than 15,000 American adults who followed a survey on eating habits in the years 1999-2004. The respondents were asked what their food / create in the last 24 hours.

About 20 percent of respondents said they do not eat sweet foods like candy or chocolate at all.

Then the researchers measured weight and waist circumference of all respondents. Who dance, those who mengasup sweet foods on average had a lower BMI than those who do not eat candy.

"The important thing to remember is, the candy itself was not put on weight. What makes the growing body fat is excessive calorie intake," said Heather Mangieri, a spokeswoman for the American Dietetic Association.

Nevertheless, the experts evaluate the research method is considered less appropriate because the respondent could have forgotten to remember what they ate in the last 24 hours.

Traditional Herb Eliminate Mouth Odor

Mouth odor is a problem that is very disturbing one's self confidence. In fact there is someone who tends to be alone because he felt so bad mouth odor.

Bad breath can be caused by several factors, such as leftover food in the mouth that comes out through respiration, food debris in between teeth, the fermentation leftovers, inflammation of the gums and other.


Here are some traditional herb to eliminate mouth odor:

1. 10 pieces of betel leaves boiled with water to taste, and the water used to rinse his mouth.
2. 10 grains and 30 grams cardamom grip leaves boiled with water to taste, and the water is drunk while warm.
3. 1 handful of flowers starfruit wuluh boiled with 400 cc of water to the remaining 200 cc. Once cool, filtered, then used to rinse his mouth.
4. 15 grams beluntas leaf, cardamom 2 eggs, 1 teaspoon of fennel, and salt to taste boiled with 500 cc of water to the remaining 250 cc, then drink while warm.
5. 25 grams kencur boiled with 400 cc of water to the remaining 200 cc. Drink boiled water while warm. Or, it can also be chewed, swallowed water and waste disposal.

Herbal Remedy to Treat Child Colds

Cool temperatures and erratic weather, if not careful this is not good for the health of children, usually cold symptoms will be easy to attack. When you've got the flu, keep the child rest at home. To warm the child's body temperature, you can make their own herb.

This is often done Chef Rina Poerwadi when her daughter, Stephanie Alexandra Rich, got the flu. His profession as a practitioner Holistic Natural Health and cooking instructor in the community make Mom Can Cook Rina endless explore herbal remedy and healthy food for children. One of them, a prescription herbal drink which is also contained in his first book, Son of Favorite Cuisines.


Rina made ​​herbal concoction of ginger tea should be drunk three times a day when Stephanie flu. "Give your child in a small cup of ginger tea, three times a day while catching colds. Ginger tea will make the body warm and cold has spread to cough," he explained.

How to make it simple. Prepare 250 g of fresh ginger, peeled and crushed. Other materials, one liter of water, half a cup of hot water, one sliced ​​lemon and a teaspoon of honey. How to prepare:

1. Boil ginger with water to a boil, then lift as reddish ginger.
2. Let the water cool ginger, put into bottles, seal tightly. Keep refrigerated
3. Mix half a cup of ginger tea cold with hot water, lemon, and honey. Mix well and serve.

Debt Can Affect Your Health

Are you among those who like to owe? Be careful, because it turns out the problem has the effect of bad debt for private life, health and lower quality of work.

The Consumer Credit Counselling Service (CCCS) found nearly half of the respondents bear the adverse impact on health due to owe as suffering from a nervous breakdown, suffered hair loss, reduced ability to taste the taste and stopped menstruating, as quoted by the Guardian.co.uk, Friday (1 / 4 / 2011).


Unfortunately not many people realize the adverse effects of frequent debt. Adverse effects caused if often mengutang namely:

1. Emotional and mental health
Emotional and mental health can be easily influenced by the debt. Stress and pressure that comes when a person must fulfill its obligation to pay the debt can cause anxiety and depression.

2. Physical Health
Research has shown that feelings of anxiety and depression can cause side effects on physical health. The impact is a matter of heart and reduced immune response. In addition, the most immediate visible impact was the disturbing physical activity and poor diet can lead to other physical illnesses.

3. Cause a sense of shame and guilt
People who often mengutang also often feel a sense of shame and guilt, especially if this habit is known by many people. This also can affect one's social life.

4. Affect relations
Having debt also affect one's relationship with spouse and children. Surveys conducted of 372 people found the debt problems have affected its relationship with the partner by 37 percent and with children by 22 percent.