Research from the UK. 

http://aetrex.curatasite.com/articles/share/62956/

One in five women 'ashamed by their feet'

By Peter Russell
WebMD UK Health News

Medically Reviewed by Dr Farah Ahmed

6th June 2013 - Nine out of 10 women have experienced problems with their feet, while one in five are embarrassed by them, according to new research.

As a result, more than one in 10 women (12%) have resorted to covering up their feet in front of people because they are ashamed by their appearance, says The College of Podiatry - the professional body for registered chiropodists and podiatrists.

Blisters and cracked heels

The findings are based on an online survey of 2,000 men and women carried out by One Poll last month. It found the top 10 foot problems experienced by women are:

1. Blisters (55%)
2. Cracked heels (45%)
3. Veruccas (28%)
4. Corns (24%)
5. Ingrown toe nails (20%)
6. Athletes foot (20%)
7. Bunions (13%)
8. Joint problems (11%)
9. Excessive foot odour (9%)
10. Arthritis (8.8%)

Despite these problems, 19% of women have not sought help because they did not think their foot complaint was important, The College of Podiatry says.

High heels

The biggest cause of foot problems is choice of footwear, according to a separate survey of 60 registered podiatrists in the UK, with a lack of awareness of common foot complaints also contributing to the problem.

It is predominantly women, not men, who are more likely to put up with discomfort and pain in the name of fashion. Nearly half (43%) of women admit they have continued to wear uncomfortable shoes even though they hurt their feet - twice as many as the men in the survey.

A third (36%) of women have worn shoes they knew did not fit them because they looked nice; with just 12% of men reporting to have done the same.

The younger the woman, the higher the heel worn, with 20% of women aged 18-24 owning a pair of six inch high heeled shoes compared to 10% of those aged 25-42 and just 3% of 35-44 year olds.

Our hard working feet

Lorraine Jones, a podiatrist from The College of Podiatry says in a statement: "It’s shocking how little regard we show for our feet. Feet are one of the hardest working parts of the body and in a lifetime you will walk in excess of 150,000 miles.

"As a result of general wear and tear, most of us will suffer with some sort of foot complaint at some point in our lives but we are seeing a lot of cases which could have been prevented - particularly amongst women.

"Conditions like blisters and cracked heels may sound like minor ailments, but they can cause a lot of discomfort and embarrassment. Many people don’t seek treatment early enough which means they suffer unnecessarily and their problems get worse."

She advises a common sense approach when it comes to choice of footwear. "High heels and flip flops are fine to wear occasionally but not all the time. For day to day wear you should opt for a well-fitting round toed shoe with a heel height of around 3cm." (1.2 inches)

Promoting healthy feet

The survey has been released to coincide with June's national Feet for Life month, which aims to raise awareness of the importance of good foot health.

There are a number of simple self-help techniques for reducing foot problems and keeping your feet healthy, according to the Institute of Chiropodists and Podiatrists. It recommends:

• Practicing good hygiene by keeping your feet clean
• Applying lanolin or olive oil to dry skin
• Avoiding using hot water and strong soaps
• Drying skin carefully and not rubbing hard with a towel
• Using a mild fungicidal powder to reduce the chances of athlete’s foot infection
• Not cutting corns, callouses or ingrown toe nails
• Avoiding bruises, burns, cuts, cracks and frostbite - and seeking professional help if any of these injuries occur
• Avoiding the use of harsh or strong medications such as antiseptics containing iodine or carbolic acid, including corn cures, or chemical compounds and ointments for athlete’s foot
• Avoiding exposure to cold and dampness
• Seeking immediate professional care for any ulcer or sore on the foot or leg.

An interesting blog on the effect of Jobs after the implementation of Obamacare! Believe it or not we can learn from France. 

http://reason.com/blog/2013/02/19/will-obamacare-discourage-small-firms-fr

Will ObamaCare Discourage Small Firms From Growing Past 50 Employees?

Peter Suderman|Feb. 19, 2013 10:49 am

ObamaCare imposes a fine on employers who do not provide qualifying health insurance for their employees. This is supposed to encourage employers to offer health insurance and keep too many from dumping workers onto the law’s new health insurance exchanges. But there’s a significant exemption: Small businesses, defined as those with fewer than 50 employees, don’t have to pay the fine.

That provides some relief for small businesses. But it also provides an obvious incentive for them to stay small by penalizing companies that pass the 49-employee threshold. Growing companies will likely think long and hard about pushing past that mark, perhaps delaying hiring or declining it altogether in order to avoid the law’s fines. Many will probably choose to grow to 49 employees and then stop, at least temporarily.

We can see this effect at work in France, which regulates companies with 50 or more workers far more heavily than those with 49 or less. A December 2012 paper by Boston University economist Francois Gourio and University of Wisconsin economist Nicolas A. Roys for the National Bureau of Economic Research notes that, as a result of the regulatory cliff, the size distribution of firms in France “is visibly distorted: there are many firms with exactly 49 employees.” And they’ve got the graphs to prove it.

Here’s their graph showing the distribution of firms with between 1 and 100 employees:
Credit: National Bureau of Economic Research

And here’s a zoomed-in detail of the same graph showing the number of firms with between 40 and 60 employees:  

Credit: National Bureau of Economic Research
Not only do you see pretty big dropoff at the 50 employee mark, you also see an oversized cluster of firms with exactly 49 employees. This is exactly what you'd expect given that there's a penalty for growing larger.

Gourio and Roys conclude that the regulatory threshold as “a sunk cost that must be paid the first time the firm reaches 50 employees.” The stark dividing line, they say, “clearly distorts the firm size distribution, leading to an obvious misallocation of labor,” and removing it could lead to a 0.3 percent productivity improvement if the number of firms stays the same.

It’s hard to predict exactly how U.S. businesses will react to ObamaCare’s dividing line. But I’d be surprised if we didn’t see some measurable effect, and a noticeable increase in the number of firms with exactly 49 employees coinciding with a decrease in the number who employ 50 or a little more. In other words, it’s yet another way that ObamaCare discourages some employers from hiring and probably makes it harder to create new jobs.

Amputations reduced by nearly 50% with podiatry care! http://www.mcknights.com/efforts-to-prevent-care-for-diabetic-foot-ulcers-cut-amputation-rate-in-half-study-finds/article/304016/

Efforts to prevent, care for diabetic foot ulcers cut amputation rate in half, study finds

Better ulcer care contributed to a nearly 50% decrease in diabetes-related leg amputations between 2000-2010, according to a study in the current issue of Foot & Ankle International.
University of Iowa researchers analyzed Medicare Part B claims for amputations and diabetic foot ulcer treatments. In the 10 years studied, the rate of upper and lower leg amputations decreased 47%, they discovered. Orthopedic treatments for foot ulcers increased more than 140%, and care teams are also doing a better job of preventing ulcers from developing in the first place, according to senior author Phinit Phisitkul, M.D. 
Recently introduced legislation could further contribute to this progress. The “Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians Act” was introduced in the U.S. Senate last week, after being introduced in the House of Representatives in the spring. 
Under the bill, podiatrists would be recognized as physicians by Medicaid. The legislation also would help providers better coordinate care under the Medicare Therapeutic Shoe program.
The HELLPP Act was introduced in the House by Rep. Lee Terry (R-NE) and in the Senate by Sens. Charles Schumer (D-NY) and Charles Grassley (R-IA).

Thanks To Obamacare, Doctor Shortages Set To Quintuple

My two cents: Sadly patients will think they have coverage to see a Doctor but will realize that no one accepts their insurance. The patients will end up flooding Emergency Rooms and Urgent Care Centers. The expenses of running a practice are great and require adequate reimbursement. This article was linked from: http://news.heartland.org/print/138595

Obamacare is set to provide some 16 million people with health insurance through Medicaid or the new exchanges next year. Unfortunately, their policies may not be worth much, because they may not be able to actually get care.

America is suffering from a doctor shortage. An influx of millions of new patients into the healthcare system will only exacerbate that shortage, driving up the demand for care without doing anything about its supply. Those who get their coverage through Medicaid or the exchanges may feel the effects of the shortage even more acutely, as many providers are opting not to accept their insurance.

Right now, the United States is short some 20,000 doctors, according to the Association of American Medical Colleges. The shortage could quintuple over the next decade, thanks to the aging of the American population and the aging and consequent retirement of many physicians. Nearly half of the 800,000-plus doctors in the United States are over the age of 50.

Obamacare is further thinning the doctor corps. A Physicians Foundation survey of 13,000 doctors found 60 percent of doctors would retire today if they could, up from 45 percent before the law passed.

Rejecting Medicaid Patients

Doctors are also becoming choosier about whom they’ll see.

They’ve long limited the number of Medicaid patients they’ll treat, because of the program’s low reimbursement rates. According to a study published in Health Affairs, only 69 percent of doctors accepted new Medicaid patients in 2011. In Florida, just 59 percent do so. A survey by the Texas Medical Association of doctors in the Lone Star State found 68 percent either limit or refuse to take new Medicaid patients.

Medicaid pays about 60 percent as much as private insurance. For many doctors, the costs of treating someone on Medicaid are higher than what the government will pay them.

These underpayments have grown worse over time, as cash-strapped states have struggled to rein in spending on Medicaid. Ohio hasn’t increased payments to doctors in three years; Kentucky hasn’t raised them in two decades. Colorado, Nebraska, South Carolina, Oregon, and Arizona all cut payments in 2011.

By throwing nine million more people into the program without fixing this fatal flaw, Obamacare will make it even harder for Medicaid patients to find doctors.

Restricting Access to Networks 

Healthcare providers are signaling they may turn away patients who purchase insurance through the exchanges, too.

In California, for example, people covered by Blue Shield’s exchange plan will have access to about a third of its physician network. The UCLA Medical Center and its doctors are available to customers of just one plan for sale through the state exchange, Covered California. And the prestigious Cedars-Sinai Medical Center is not taking anyone with exchange insurance.

Patients who live in central and southern Maine, meanwhile, stand to lose access to local doctors and hospitals if they buy coverage from the state’s largest health insurer through the exchange. In order to keep premiums down and comply with all the coverage mandates Obamacare imposes, Anthem Blue Cross Blue Shield is looking to contract with just one hospital network, MaineHealth. “This is critically important in offsetting premiums increases” driven by Obamacare, rhe insurer told regulators.

The partnership might not be a problem if Mainers had other choices through the exchange. But thus far, Anthem and a small, nonprofit start-up are the only two firms that have applied to sell coverage on the exchange.

Emergency Rooms Already Crowded 

If Medicaid patients and new exchange enrollees can’t actually see doctors, they’ll head to emergency rooms for care. But the nation’s ERs are already in crisis. More than half are over capacity, after some 650 shut down over the past two decades.

With Medicaid patients being twice as likely to use the ER as those with private insurance, Obamacare could lead to catastrophic overcrowding. Ryan Stanton, director of emergency medicine at a Kentucky hospital, called it “a perfect storm that will lead to decreased access.”

The evidence backs him up. Harvard researchers found emergency room utilization increased in all 11 Massachusetts hospitals they studied after the Bay State implemented a carbon copy of Obamacare back in 2006. To try to alleviate the doctor shortage, some lawmakers have proposed increasing federal funding for physician residencies. Others, particularly at the state level, have argued for relaxing “scope-of-practice” rules to allow nurse practitioners and physician assistants to assume many functions that have historically been the sole province of doctors.

But neither approach will have a sufficient impact on the supply of care to counterbalance the immense increase in demand Obamacare’s Medicaid expansion and new exchanges will engender. And no provider will be excited to accept the government’s cut-rate reimbursements, which the federal health care law does nothing to fix.

The first step in addressing the nation’s shortage of doctors is full repeal of Obamacare. The second is the installation of market-based reforms in its place. That’s the best way to ensure Americans can actually get care when they need it.

Sally Pipes (spipes@pacificresearch.org ) is president and CEO of the Pacific Research Institute, a California-based think tank, and the author of “The Pipes Plan: The Top Ten Ways to Dismantle Obamacare” (Regnery Publishing, 2012). http://news.heartland.org/print/138595

Options to Obamacare

My two cents: Although I do not agree with everything in this article, that was  printed on July 18th 2013, in the New Canaan News, I found some points interesting. I liked the idea of the lower medicare ages. This would allow patients to get medicare at a time when regular  insurance  may be out of reach due to cost and pre-existing conditions. 
Excerpts below- for the full article:
http://www.newcanaannewsonline.com/opinion/article/House-Calls-Dr-Michael-Schwartz-4672345.php

Patients and physicians are both finding the health care policies implemented under the recent Affordable Care Act (also known as "Obamacare") confusing and concerning. While patients are concerned about health care costs and access, the new rules and regulations are forcing many doctors to consider leaving the profession and many potential physicians to not enter the profession. Older Americans are anxious about losing their Medicare benefits and the uncertainty of the effect the Affordable Care Act is placing on the economy.
Ideally, health care coverage should be accessible to everyone. However, many doctors and patients are discouraged by the implementation of more regulations and many do not think the entire system needs an overhaul. As such, I asked physicians and patients across the country for their views on how to fix the system; below are some of their suggestions:
The government should provide free medical care for every child until the age of 18:
1. Eliminates the need for families to worry about coverage for their children;
2. Reduces health care costs for individuals as well as corporate employers.
3. Create competition by developing not-for-profit health care companies to compete with the current "for profit" model HMO/PPO:
1. Government should assist in the creation of "not-for-profit" medical insurance companies to compete with "for profit" companies;
2. Lower the premiums for individuals who choose "not for profit" companies for their health care;
3. Competition will decrease the amount currently charged by existing "for profit" insurance companies.
Lower the eligible Medicare age and add a co-pay, for example:
Age 62 -- Medicare pays 50 percent and patient pays 50 percent with a $30 co-pay
Age 65 -- Medicare pays 65 percent and patient pays 35 percent with a $20 co-pay
Age 67 -- Medicare pays 75 percent and patient pays 25 percent with a $10 co-pay
Age 70 -- Medicare pays 80 percent and patient pays 20 percent with a $5 co-pay
Age 75 and older -- Medicare pays 90 percent and patient pays 10 percent without a co-pay.
1. This will allow many Americans to enjoy the benefits of the Medicare program at an earlier age and will reduce costs for millions of Americans who will not have to pay for their health insurance for three extra years;
2. Preserves the Medicare program by reducing costs and discouraging unnecessary patient visits by adding a co-pay;
3. Will allow employers to save money by lowering or eliminating the need to cover insurance costs for many of their aging work force.
Limit malpractice awards:
1. Tort reform could lower malpractice premiums and lower patient costs;
2. Create "malpractice panels" made up of specially trained individuals to determine appropriateness of cases and awards.
Tax all malpractice awards 10 percent off the top and add ¼ percent federal sales tax to help fund these health programs:
1. Use these collections to fund lowering the Medicare age and covering all children until the age of 18.
2. Assures that these monetary awards will ultimately improve the health care for others.
Eliminate all direct to consumer advertising by pharmaceutical companies:
1. Use the savings to lower drug costs and support additional programs to supply free or discounted medicine;
2. Will encourage the use of generic products whenever possible.
With the confusion and uncertainty surrounding the effects of the Affordable Care Act, the number and quality of individuals eager to enter the medical profession has diminished. Over-regulation merely results in confusion and runaway medical costs. Creative ideas from doctors and patients may ultimately assist our legislators in ways to promote a better health care system for everyone.

Dr. Michael Schwartz is board- certified in internal medicine with a private practice in Darien. For comments or questions, visit his website at www.drmichaelbschwartz.com.