5th News Special Report: Feeling Good

four seven eight 81 good evening I'm Rick Roberts if you've been in the hospital or visited the doctor's office recently you know the cost of getting sick is expensive back in April Governor Ray put together an 11 member Commission to find ways to hold down rising healthcare costs the governor noted that the average cost of a hospital bed went from $118 a day in 1976 to $179 a day in 1980 an increase of 50% he says the Commission will study the rising costs and make suggestions as to what the state can do to bring them in line valid statistical information on which good judgment can be formed and decisions can be made along with that is you've noted I'm sure we've asked them for what recommendations they might have the Commission is examining such things as the high use of hospitals how government regulations affect costs the availability of healthcare professionals and the health of poor persons the Commission is working with a budget of $300,000 80,000 coming from the state and the rest from private industry D Eugene cyber e president of Blue Cross Blue Shield of Iowa is a member of the governor's Commission we talked with cyber E about rising healthcare costs and some possible solutions of care costs in Iowa continued escalators they have elsewhere in the country we certainly are seeing an increase in hospital per diems cost for a patient day in the hospital in dr. dental other type professional services the increase in Iowa has not been as remarkable as elsewhere in the country but it still has been on the incline and upward and we are concerned about it as most people has it been rising faster than the rate of inflation is there something else in there that's making it go up higher yes honestly in Iowa we have a problem of high utilization which is unique to Iowa and comparison elsewhere in the country we are in the fourth highest state in terms of in hospital inpatient utilization this means that even though on the average when you go to an Iowa hospital you get a real bargain because the per unit area per day costs are lower than the national average when we buy so many units of care it means that our overall health care costs are higher than elsewhere in the country and that makes it a very pronounced problem we're trying to do something about it but it is the high utilization that primarily is the problem in Iowa the governor has a commission looking into what can be done with the rising healthcare cost you see government playing a very big role state government playing a very big role in trying to contain those costs I think there has to be a partnership repointed private and public sectors I think in recent years government may have been playing a more active role in a larger role than might be necessary yes I think that the governor's Commission is evidence that the government's the governmental sector and the private sectors can work together that is a private nonprofit corporation appointed by the governor to look at health care issues in the state of Iowa I don't think the private sector can do it alone I don't think the public sector can do it alone I think it does require a partnership there must be some regulation to bring about necessary results and I hope that by initiatives within the private sector we can keep the governmental roles with minimum you talk about high utilization of hospital services in Iowa are we sicker or are we in the hospital maybe more or longer than we need to be we aren't in the hospital longer than we need to be the average stay and I was below the national average our admission rate is much higher than the national average 1980 data would indicate that the Iowans go to the hospital for those under age 65 which is for comparative purposes the best group to compare because of age differences but when you take that group of under age 65 Iowans are admitted approximately 40 percent more often than elsewhere in the country on the average do we know why we don't know why and that in part is why the governor's Commission on health care was formed it is also why Blue Cross of Iowa started mandating private utilization review working through the Iowa Foundation for medical care on Holland Isis to the hospitals occurring after January 1 of 1981 frankly I think there's a good environment in which to live in Iowa I do not think Iowans are sicker than elsewhere I think several factors contribute to this one insurance mechanisms or prepayment such as Blue Cross have been guilty because we have emphasized in hospital benefits rather than paying for care on an ambulatory basis we're doing something about that now also I think the way medicine is practiced in Iowa much more conservative in Iowa in comparison to the east coast or the west coast and possessions admit many patients for inpatient surgical procedures that in other parts of the country are being done routinely on an ambulatory basis while efforts are being made to determine why healthcare costs are rising and what can be done about it we all can take steps to reduce the cost of our own healthcare one example of this is the so-called wellness program instead of waiting until we're sick to be concerned about our health we could take steps to reduce the likelihood of illness Blue Cross and Blue Shield of Iowa initiated a wellness program for its employees a few years ago and is now helping other corporations do the same dr. Wayne Severson vice president of medical affairs for Blue Cross Blue Shield is in charge of the wellness program basically what we want to do is screen every employee of ours detecting high risk factors that may affect their life in the future or at present now there are many silent things going on in our bodies that were not aware of now we should of course be aware of those alarm systems that are built up in our body it says something is going wrong there's pain as distressed there's something where we don't feel well and let's take care of that problem right now by saying be aware of that alarm system on our body is very delicate and it's there to tell us that something is wrong don't be one of these persons who say nothing can happen to me I'm okay I'll never die nothing will ever happen to me so let's take care of that problem by saying go to your physician if you have warning signs of illness okay now let's go to the well person who says he's well he knows he is well and probably as well but there are many things that can be going on again it's Bonnie that is not well and we can detect those with many different methods and when we do so then we can direct that person to become involved in improving his health now we do many other things too the second most important thing I think is the risk factors we have various risk factors involved in being able to predict what may happen to us now one of the risk factors is your genetics what is your bloodline die-offs so if your father and uncles died early of a heart attack or of a stroke that puts you on notice that you have a problem and you need to do whatever you can do in helping your body prevent arteriosclerosis or hardening of the arteries we then evaluate their risk factors and there's about ten different risk factors it involves age and gender what your parents died of whether you have diabetes which our lifestyle is long Inc how much exercise you get when you smoke very important what your blood cholesterol ZAR all these are factors that we measure for every employee and we say you're a high risk factor because you've got too many positives in these areas and then we do something about them or we say you're a low risk factor you're lucky now your father and mother and grandmother and great-grandmother died when they were 90 years old of natural causes and that doesn't mean they can discontinue thinking about their health but at least they're in good grounds if you're a high risk I would like these three things I'd like you to keep trimmed keep fit and keep happy because stress is a very important part of how it affects the target organs of our blood vessels sometimes we take life too seriously we all have stress and that's a normal part of living but if we have stress that's every day and every day and it's unfulfilled it's like a full-court press him like all the time and they can do nothing but cause disease in us exercise very important thing to do we live in a sedentary life we sit behind desks like I do and our cholesterol goes up our blood pressures go up and exercise certainly impacts them significantly what we eat and how much we also has a lot to do with how we feel we went to ISU Extension Nutrition is Betty Schaefer to find out if Americans are becoming more aware of proper nutrition some of us are very concerned about what we eat and many people many Americans are changing their diets for health reasons other people just couldn't care less all of the nutrition advice that we give based on two principles variety and moderation and the fall of your food selections follow those two principles you will have a healthful diet we name four different food groups and if your eating foods four molecules groups you are getting a varied diet and that is helpful what are those groups now virtually absolutes and vegetables there's one group the second group is breads and cereals and third group is milk and milk products this would include cheese yogurt all kinds of things made of milk and the fourth group is meat and other protein rich foods such as poultry beans eggs what about food attitudes we've read a lot about the pros and cons of food attitudes lately of what should we watch out for we would not have the foods that we're used to if we did not have attitudes in most of the additives are there to add nutritive value many vitamins are added to foods and leading food additives also many of the additives are preservatives now all of these are reviewed constantly by the Food and Drug Administration to guarantee their safety is some where ever found to be unsafe they are immediately removed from the marketplace another hot topic is salt in our diet apparently we're consuming much too much salt we certainly are ten times more salt and we actually need it is an essential nutrient sodium is but not in the quantities that were used to consuming and we can easily cut that down processed foods are very rich in and we can use fresh food more often prepare foods from scratch we can stop adding salt ourselves at the table kissing other some foods that contain a lot of salt that might surprise us you might not be aware of oh I'm sure there are ketchup is full of salt cheese hot dogs all processed foods canned soups are very high in salt we'll have more about feeling good in just a moment joining us now is Michael pace AG from Iowa State University in his area of expertise is health education Michael how do you regard the whole area of wellness programs well wellness is very important wellness is a relatively new phenomena wellness wellness is Health Promotion it's an effort that provides an opportunity for individuals to make decisions concerning their health wellness is considered in many ways the opposite of a sickness system that doctors are working in as has been said already it deals with risk factors it deals with preventing disease it deals with well people it's an effort that tries to get people to take self-responsibility of their lives their lifestyles changing behaviors and making healthful decisions and and with the goal being to move towards optimal health do you feel the government and the medical professions are pushing this hard enough in some ways yes the government sponsors monies to help promote health maintenance organizations HMOs Iowa is in the process of looking into that that particular approach the health maintenance organization is insurance it's a third-party payment kind of program where individuals are health educated and are provided with health maintenance versus sickness care on the other hand the sickness system more has to be done more work is being done on the industrial level and at the government level presently let's get into a few specifics I know you have a lot of experience with heart attacks and heart attack prevention what can be done to prevent a heart attack first off who is a candidate for a heart attack anyone's a candidate for a heart attack it boils down to lifestyles lifestyle behaviors and as has been said again the risk factors the risk factors in one's life styles for example smoking serum cholesterol levels and high blood pressure top three risk factors for having a heart attack and anyone can have those risk factors college students young people old people age is a significant risk factor it does increase your risk as you get older those the combined risk factors become more substantial anybody can have a heart attack men and women equally says the men have a greater risk of having a heart attack at this time it's changing though as women go get into the workforce and as women change their lifestyles they are increasing the risk of having heart attacks it's really what it boils down to how we behave how we feel about ourselves it boils down to interrelationship of physical health mental health spiritual health and that's those are the kind of things that integral like to increase our risk or decrease our risk of having a heart attack so if we are going to decrease our risk of having a heart attack you think we would have to not just focus on one particular area like blood pressure although it may be important we have to look at the our whole concept our whole self our whole health we have to look at our lifestyle again that critical word in a wellness program is lifestyle or analyzing our life lifestyles and we can do that by looking at our behaviors how we behave what we do the dynamics of our lifestyle what happens to us and how we feel about all those things yes it's going to require a whole variety of changing changes that we have to make if we want to reduce our risk or increase our our wellness towards the optimal health end of the continuum for example dealing with smoking it's not just dealing with the the smoking it's why do we smoke when do we smell calorie smoke and how do we feel about smoking and is it a very important part of our life there's a whole bunch of dynamics that go along with smoking and a bunch of Dynamis to go along with serum cholesterol what we eat not just the eggs and the shellfish it's also the fat content of our foods why we eat that is it because our parents ate it is it because we're close we live next door to a fast food restaurant it's a whole bunch of dynamics that make up our lifestyle and increase our risk or lower our risk of diseases another word we hear very often these days is stress is all stress bad for us no now there's positive stress and negative stress exercise is a stress to get the effect of exercise to get the positive affective exercise you really have to stress your body and then again too much negative stress is not so good stress is interrelated with cholesterol you while you're on if you're under stress your cholesterol levels go up it's related of course the blood pressure we smoked on because of stress in some cases we overeat because of some stresses because of poor problem-solving techniques it's interrelated with a variety of factors it's a very important risk factor it's a very important thing in terms of the wellness revolution learning how to relax learning how to positively deal with stress is very very important learning how to breathe respiration which comes from the word spirit respiration is a very important phenomena that the Wellness movement is looking at very seriously if we learn how to breathe carefully and deeply and it reduces stress it makes us feel good and that's very important is there any way we can harness the stress and use it in a positive way or is it best just to deal with it and try to alleviate the stress I mean we mean negative with women harness ah okay do do we need do we need certain types of stress maybe an actor or a singer or something get a little bit of stress to make the performance a little bit better or in everyday situations maybe we're confronted with a crisis do we need some type of stress to get us through that a lot of people perform better on the stress you know if you're not nervous before you go on stage you're probably going to flub your lines as I've been told but too much it has to be dealt with in a positive way and that calls for understanding your body and getting in touch with breathing and breathing exercises etc getting back to exercise exercise is a stress we can harness and a stress that can result in positive effect benefits positive effects and you must stress yourself to get the positive effects so there's an example of positive stress that can be harnessed to benefit our body and our spirit and minds what about exercise as it relates to staying healthy and feeling good do we all have to run 10 20 miles a day or how do we know how much exercise that we need individually it depends on a variety of factors exercise is important and I am pretty a little leery using the word exercise I always like to say activity in keeping moving constantly not just sitting there and constantly watching TV and just moving your body one way or another whether it's dance whether it's running swimming bicycling anything that gets your heart on the stress and gets you get your blood flowing is the kind of activity and it's different for different individuals but it's very important it's very important for example many authority will authorities will agree that weight control programs will not succeed without some sort of activity program the idea that activity results in positive self-image it makes you feel good it also burns up calories and it's very it's a very important into a part of a weight control program as an example the two things we always hear about when we're talking about our health smoking and drinking bad for us well some studies show that moderate drinking is good for you a a couple of studies have shown that one to two drinks a day one and a half drinks a day reduces your risk of having a heart attack smoking definitely increases your risk of having a heart attack is the carbon monoxide not only the tars and a drug nicotine it's the carbon monoxide which increases your risk it strangles your circulate circulatory system it's a certain it also contributes to cholesterol levels increasing it also contributes to blood pressure increasing it's a significant factor I'm an ex-smoker and I know that a lot of smokers watching this program and the Saenger well it's easy for him to say he doesn't smoke now and it's a very difficult task and it requires again getting back to that that very important word lifestyle lifestyle person has to check out look at the way he behaves why he's doing what he's doing why he's smoking is it coffee is it the meal that's prompting you to smoke very important kinds of things to look at the dynamics of how we live what are some other silent signals that we should be aware of relating to our body I'm thinking of high blood pressure here a lot of people have it and don't know about it there really is no clear-cut symptom or sign and symptom of high blood pressure hypertension that is where the doctor becomes a very important part of the health team the doctor or the nurse can check out your blood pressure that really is the only way to discover the high blood pressure size of symptoms for example stress butterflies in your stomach heavy breathing you find yourself sweating cold clammy hands too much stress something to think about let me ask you something what are we doing with our kids and trying to bring them up to be healthy individuals what what can we do to promote a healthier attitude a better attitude toward health among our children it boils down to the way we behave boils down to modeling how we behave for example if we are drug users and many of us are in terms of just taking an aspirin when we have a headache or taking an aspirin every time we have a headache we'll teach our children how to behave when we're under stress or when we have a headache it also increases the chance of becoming drug users themselves maybe other drugs so modeling is a very very important concept in terms of teaching our children that's just one example I guess so if we would you agree that if we try to improve our lifestyles try to stay healthier that is one way to bring the cost of health care down and try to stay out of the doctor's office quite as much absolutely absolutely taking responsibility also shopping around and becoming an active consumer of that medical care system asking questions of your doctor asking questions at the clinic or the hospital also taking some responsibility for ourselves and understanding that for example there is no cure for the common cold going to the doctor may not result in a cure it may result in you know some help and in other ways patient heal thyself I carefully keep ourselves healthy it's partly the responsibility of the patients certainly ok Michael pace ak from Iowa State University thank you for joining us tonight thank you and that is our report for this special report thank you for joining 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