The official government statistics claims that 33 million people, every year siide below poverty line owing to Healthcare expenditure. This clearly indicates the intensity of the problem and the huge implication on the nation. Provision of quality health care is high on government's agenda through the provision of various schemes. Provision of Health insurance ensures the provision of quality Healthcare minus the additional burden on the consumer.

magine the anguish of a family with income to merely take care of their essential needs when faced with life threatening ailment in his family. Overnight this person needs to divert his income for medical purposes and there is good chance that he ends up selling all his assets accumulated over years. There is a good chance of some such families slipping into BPL category. If you think that this is a story, hold your breadth, this happens in reality in India. 33 million people slide below poverty line every year owing to Healthcare expenditure and this is the official government

statistics. This clearly implies the magnitude of the problem and the huge implication on the nation if timely corrective action is not taken. It is the possible genesis of social unrest.

Given the emphasis of the Government on Social and Financial Inclusion, provision of quality health care is high on government's agenda. Through schemes like National Rural Health Mission (NRHM) and Rashtriya Swasthya Bima Yojana (RSBY), Arogyashree, etc a change is certainly being felt. The speed of change however needs to be accelerated in view of the magnitude of the problem.

Provision of Health insuran is a key financing mechanis in ensuring the provision quality healthcare without putt additional burden on consur pocket. Government, Regi and Private sector are all invc in creating right environr and products for development vibrant health insurance marke India and a lot has been achiey too. A lot however, yet rema to be done before we can assume that consumer is a kir this space.

Both Health providers Insurers have their proble especially in terms of claim,settlements, ever rising medical cost, lack of transparency and standardization of various parameters et al. Both the sides also have their ways of ensuring viability of their business model through various means.

It is ultimately the consumer who suffers as result of information gap between the payer and the provider. Most of the times, consumer is bogged down with issues like difficulty in getting claims., uncertainty about benefits, insurance being more beneficial to hospitals than patients, important ailments not covered, meant for rich, educated and those in business etc.The change in consumer mindset is possible only if these issues are taken care of.

How is this possible? 

FICCI in its quest to provide "justice to the consumer" embarked on the exercise of identifying the causes of friction between the health providers and insurers and work on developing ways and means of plugging the differences between the two sides in a manner that the consumer interest is upheld. FICCI was supported in this activity by the Insurance regulator i.e. Insurance Regulatory and Development Authority (IRDA), numerous clinical experts and health providers, life insurance council, general insurance counc)), a large number of insurance Companies, TPAs et al.

A group comprising of all the above mentioned stakeholders was constituted to enable FICCI in conducting the pioneering work in creating standards for the key areas in the health ecosystem:

Development of Standard Treatment Guidelines (STGs) for common reasons of hospitalization. The aim of these treatment guidelines are to reduce claim disputes substantially by providing a reference framework for payers to process medical claims for these conditions and thus reducing the needs for queries moving back and forth between payers and providers. This could enable increased automation of claims handling resulting in faster claim processing and reduction of TATs (turn around time) for a significant proportion of claims. Further, these cou\d help in setting appropriate grades/ levels of payout for different types of surgeries in fixed benefit plans and setting scientific and reasonable sub-limits for different procedures in reimbursement plans while providing a framework for development of appropriate price range for these conditions in different situations. Above all this would also ensure that consumer is provided the essential medical attention while avoiding over diagnosis and under treatment.

Standardization of definitions of Critical Illnesses for Indian Insurance Industry - This, we believe, will help resolve the confusion in the minds of the consumer arising out of varying definitions adopted by different companies and give them clear parameters for selection of right product. It would thus help enhance consumer satisfaction significantly.

Standardization of list of expenses of expenses generally excluded ('non medical expenses" in hospitalization indemnity Policy - The aim is to minimize the ambiguity and subjectivity in deductions from hospital bills, which will improve the understanding for such expenses amongst patients, providers and insurers/Third party Administrators (TPAs). The consumer would be aware of the excluded items from the inception and will not get caught in the crossfire between the payer and the provider.

How does this work benefit all the stakeholders?

This transparency will help reduce the acrimony between the payer and the provider thus helping the consumer to have realistic expectation from the Insurance product. Also, this exercise would lead to more innovation in product creation, awareness and enhancement of health Insurance market at large.

The FICCI initiative has enabled a constructive dialogue between the Health provider, insurer and TPA which has hitherto been missing. So far all the stakeholders have been focusing on individual growth that was hindering the collective growth of the sector.

The consensus exercise created under FICCI banner would have multiplier impact on the growth of Health Insurance market in India catering to a huge lower and middle income group comprising 61.9 per cent of the total Indian population hitherto unattended, apart from supporting the Government initiatives focused towards BPL category.

Courtesy. FICCI Health Services & Financial Services Divisions

Medical Tips & Information

When buying peanut butter, remember that peanut butter products which
have separated oils are more natural and healthier for you! Beware of
products where the oil doesn't separate: That's accomplished with
partially-hydrogenated oils which promote chronic disease.

Eating blueberries really does improve memory and brain function, but
beware of dried blueberries because many of them are sweetened with
sugar. Check the labels to be sure, or choose organic frozen
blueberries, which typically have no added sugar.

When you buy a new computer or some other electronics, be sure to hold
your breath when opening the box for the first time. Why? Because the
air inside the box is full of VOCs (toxic chemicals) that have
off-gassed from the styrofoam, plastics and other packing materials.
If you inhale while opening the box, you'll inject some of those
chemicals right into your bloodstream (via your lungs).

Pan masala contains a mixture of areca nut (80%), catechu (10%), lime
(1%), flavouring agents and spices (9%). According to the Indian
National Science Academy, pan masala surveys and tests have "revealed
a direct relationship between chewing pan masala and oral submucous
fibrosis (OSF)", a condition that is a precursor to oral cancer.

(Compiled from Internet by J@K Amenities Research Team)

Note: This information is only educative, not prescriptive. Always
consult your doctor before treatment.

Common Fatigue Syndrome

  Nomenclature

There are a number of different terms which have been at various times identified with this organic neuroimmune disorder.Myalgic encephalomyelitis (ME, "inflammation of the brain and spinal cord with muscle pain") as a disease entity has been recognized and described in the medical literature since 1938, with the seminal paper being that by Wallis in 1957; Sir Donald Acheson's (a former Chief Medical Officer) major review of ME was published in 1959; in 1962 the distinguished neurologist Lord Brain included ME in his textbook of neurology, and in 1978 the Royal Society of Medicine accepted ME as a distinct clinical entity.

In 1988 both the UK Department of Health and Social Services and the British Medical Association officially recognized it as a legitimate and potentially distressing disorder. Opponents to the term ME maintain there is no inflammation and that not all patients report muscle pain. United Kingdom and Canadian researchers and patients generally use this term in preference to CFS.

Chronic fatigue syndrome (CFS); this name was introduced in 1988 by a group of United States researchers based at the Centers for Disease Control and Prevention, and is used increasingly over other designations, particularly in the United States.

Chronic fatigue immune dysfunction syndrome (CFIDS); many people, especially patients in the United States, use the term CFIDS (pronounced [See-Fids]), which was originally an acronym for the above or "Chronic Fatigue & Immune Dysregulation Syndrome". This term was introduced by patients current with the biomedical research in an attempt to reduce the psychiatric stigma attached to "chronic fatigue", as well as the public perception of CFS as a psychiatric syndrome.

Post-viral [fatigue] syndrome (PVS or PVFS); this is a related disorder. According to original ME researcher Dr. Melvin Ramsay, "The crucial differentiation between ME and other forms of post-viral fatigue syndrome lies in the striking variability of the symptoms not only in the course of a day but often within the hour. This variability of the intensity of the symptoms is not found in post-viral fatigue states" (Ramsay 1989).

Chronic Epstein-Barr virus (CEBV) or Chronic Mononucleosis; the term CEBV was introduced by virologists Dr. Stephen Straus and Dr. Jim Jones in the United States. The Epstein-Barr virus, a neurotropic virus that more commonly causes infectious mononucleosis, was thought by Straus and Jones to be the cause of CFS. Subsequent discovery of the closely related human herpesvirus 6 shifted the direction of biomedical studies, although a vastly expanded and substantial body of published research continues to show active viral infection or reinfection of ME/CFS patients by these two viruses. As these viruses are also found in healthy controls, however, it is uncertain what role they play in CFS.

Low Natural Killer cell disease; this name is used widely in Japan. It reflects research showing a reduction in the number of natural killer cells in many CFS patients.

Yuppie Flu; this was a factually inaccurate nickname for CFS, first published in a November 1990 Newsweek article. It reflects the belief that CFS mainly affects the affluent ("yuppies"), and implies that it is a form of malingering or burnout. CFS, however, affects people of all races, genders, and social standings, and this nickname is inaccurate and considered offensive by patients. It is likely that this article contributed to the damaging public (and even medical) perception of CFS as a psychiatric or even psychosomatic condition.

Uncommonly used terms include Akureyri Disease, Iceland disease (in Iceland), Royal Free disease (after the location of an outbreak), raphe nucleus encephalopathy, and Tapanui flu (after the New Zealand town Tapanui where the first doctor in the country to investigate the disease, Dr Peter Snow, lived).

Symptoms

According to the 1994 Fukuda definition there are eight main categories of symptoms in CFS:

Fatigue: People with CFS experience profound, overwhelming exhaustion, both mental and physical, which is worsened by exertion, and is not relieved (or not completely relieved) by rest. To receive a diagnosis of CFS, this fatigue state must last for six months.

Pain: Pain in CFS may include muscle pain, joint pain (without joint swelling or redness, and may be transitory), headaches (particularly of a new type, severity, or duration), lymph node pain, sore throats, and abdominal pain (as a symptom of irritable bowel syndrome). Patients also report; bone, eye and testicular pain, neuralgia and painful skin sensitivity. Chest pain has been attributed variously to microvascular disease or cardiomyopathy by researchers.

Cognitive problems: people with CFS may experience forgetfulness, confusion, difficulty thinking, concentration difficulties, and "mental fatigue" or "brain fog". Additional signs may be experienced; in the 2003 Canadian Definition these include aphasia, agnosia, loss of cognitive body map.

Hypersensitivity: people with CFS are often sensitive to light, sound, and some chemicals and foods. Many CFS patients report an increase in allergic-type sensitivity to foods, scents, and products, and many also report a sensitivity to medications, which can complicate treatment. Patients with pre-existing allergies, asthma, and similar conditions often report a worsening of symptoms. A remarkable feature of "classically defined" ME are "sensory storms", typified by sudden catastrophic incapacitation to noise, light, smell, which feels overwhelming; more pronounced as discrete earlier on in the illness.

Poor temperature control: people with CFS often report either running too hot or too cold, possibly due to involvement of the hypothalamus, which regulates body temperature. Many CFS patients frequently run a low fever, or report fever-like symptoms (sweating, feeling too hot or cold, etc.) without measurable fever temperature.

Sleep problems: "Unrefreshing sleep" and rest is a hallmark of CFS, and in one of the syndrome's greatest ironies, insomnia is also common, especially in the chronic phase. Maintaining a sleep schedule is extremely difficult for many patients. Vivid, "feverish" dreams are a symptom in many people with CFS, exacerbating disturbed sleep patterns. A hallmark sign of neurological disease is that exercise worsens the insomnia, i.e. the opposite to that found in well people.

Psychological/Psychiatric symptoms: emotional lability, anxiety, depression, irritability, sometimes a curious emotional "flattening", may manifest in CFS patients. It is undetermined whether any of these are directly caused by the CFS mechanism, or may be secondary symptoms created by the syndrome, as many chronic pain or illness patients also show similar psychiatric issues. However the exaggerated and sometimes random nature of emotional expression is consistent with some brain disease.

Disturbances in the autonomic nervous system and hormones:

People with CFS often have abnormalities in the autonomic nervous system such as low blood volume, orthostatic intolerance, dizziness and light-headedness, especially when standing up quickly. Hormonal abnormalities may include abnormal vasopressin metabolism and a blunted ACTH response leading to hypothyroidism and/or low cortisol and reduced ability to respond to physiological and emotional stress. Patients sometimes show abnormally low levels of testosterone, growth hormone and other important hormones. It should be noted that lists of diagnostic criteria (such as the Oxford and Fukuda lists) were designed for selection and exclusion of participants for research studies and, as such, are quite narrow in scope. Some patients have CFS despite the fact that their symptoms do not match the strict research diagnostic criteria.

Onset

Some cases of CFS start gradually, but the majority start suddenly, often triggered by a 'flu-like viral or similar illness. People with CFS may improve or recover completely after a few or many years, or not at all. It is not known whether any CFS sufferer has truly recovered to pre-illness levels, or whether their symptoms have merely subsided enough for them to live a more normal life. Some sufferers have a remission for months or years only to later relapse, often more

Sudden onset cases

Many people with CFS report a sudden, drastic start to their illness. Some people can remember a specific day or even hour when they first became ill.

Often CFS starts with, or is triggered by, another illness. Many people report getting a case of the 'flu', exposure to an allergen (a cough or sniffle caused by paint, a new pet, or construction dust), or a severe infection such as bronchitis, from which they seem never to fully recover and which slowly evolves into CFS. Other patients begin with Lyme disease, which despite adequate Lyme treatment, may 'evolve' from the clinical symptoms and definition of Lyme to those of CFS (this is permitted by the Fukuda definition). Other triggers can include car accidents, moving house, and stressful life situations. Some patients say they felt unusual or uneasy for a short period (days or weeks) before the onset.

Gradual onset

Other cases have a very slow, gradual onset, sometimes spread over years. People with gradual onsets may not realize there is anything wrong for quite some time. Patients may believe they have a minor illness, or ascribe their weakened condition to stress, and assume they will improve with time. It is only when the patient realized that their condition is truly debilitating, or the stress is removed and the symptoms remain, that the patient will begin to seek treatment.

There is no standard course for CFS. For a patient to be officially diagnosed with chronic fatigue syndrome, the symptoms must have persisted for at least six months. It is possible that not all cases of CFS are chronic: some people may have CFS for four months, recover, and never get diagnosed, some claim. However, the Fukuda paper also contains a definition of "chronic fatigue" which is reserved for those who do not meet the full criteria for CFS. Since the 50% rule of Holmes et al was dropped, it is possible that there are people with CFS whose level of disability is so low that they never seek treatment, or receive an accurate diagnosis, though this is not permitted by the Canadian definition.

Activity levels

Activity levels vary widely among CFS patients. While some are able to lead a relatively normal and active life, others are totally bed-bound and unable to care for themselves. Almost all patients find they must drastically reduce their activity from pre-illness levels, regardless of their previous level of athleticism, and must severely modify or give up physical hobbies and exercise. Many patients find themselves unable to work full-time, or at all. A considerable number of CFS cases in many countries are on disability benefits or private insurance, or have made claims and been denied.

One notable CFS sufferer is soccer legend Michelle Akers, who reported struggling with the illness for many of the later years of her career. However, more severe sufferers felt that an active professional athlete "poster child" like Akers helped to trivialize the syndrome in the eyes of the public, and made it much more difficult for highly incapacitated patients to be taken seriously. It is worth noting that the condition can strike persons of all activity levels, however.

Post-exertion symptom exacerbation

One of the most common and recognizable aspects of CFS is what is called "post-exertional malaise". When people with CFS exert themselves beyond their limits (and their limits may change daily), their symptoms worsen. The harder the exertion and the longer it lasts, the worse the symptoms will be afterward with greater recovery time. Some contend from this that prognoses such as deterioration or relapse-remission must be due to sufferers' activity patterns, however this is far from proven, since in many sufferers at least, fluctuations are not solely related to exertion but can include responses to infection, changes in temperature (e.g. hot or cold weather), physical or emotional stressors, and unknown disease process, but they maintain:

The cyclical pattern occurs when patients work harder because they "feel better" or are having a "good day", leading them to think they can exert themselves more than usual. However, the excess exertion leads to worse symptoms on the following day. Thus it is difficult for patients to maintain an even level of activity, or to tell if they are improving.

In sufferers without a diagnosis of CFS, or a proper understanding of how CFS affects exertion, this can lead to a "downward spiral", where a sufferer will try to work harder to make up for the previous day's lack instead of resting. This exhausts them further, and often can trigger a relapse or worsening of their condition.

However, many sufferers who are severely affected particularly find this "behaviourist" hypothesis simplistic and offensive as it leads to the blaming of patients and denial of social support and medical care since the condition can be seen as supposedly self-controllable and self-limiting and already scarce services may be withdrawn if the sufferer is unfortunate enough to deteriorate.

Duration

People with CFS may improve after a few months, or after many years, or never at all. They may reach a plateau at some constant level of health, or may progressively decline, although CFS does not appear to be directly fatal or damagingly progressive. Often, the symptoms change over time, or cycle through time. Relapses are common, especially after stressful life events or additional illness. Exertion can cause not merely a relapse, but a worsening of overall health. Un-diagnosed cases of CFS often worsen as the sufferer attempts to return to a 'normal' level of activity, only to make their condition worse through exertion.

Diagnosis

At this time, there is no accepted conclusive test or series of tests of chronic fatigue syndrome. CFS is therefore largely an exclusionary diagnosis. If a doctor suspects a patient may have CFS they should begin the diagnostic process by eliminating other potential causes of the patient's symptoms. "Chronic fatigue" and similar symptoms can be caused by a wide variety of conditions which should be investigated, although treatment of the patient's symptoms can begin before a complete diagnosis is made. In a patient displaying CFS symptoms, fatigue and new migraines, for example, it is safe and reasonable to treat the migraines while attempting to rule out other possible causes of the patient's fatigue.

Additional symptoms

The fatigue must be accompanied by a minimum of 4 of the following
eight symptoms:

1) Impairment of short-term memory and concentration

2) Sore throat

3) Tender lymph nodes

4) Muscle pain

5) Multi-joint pain

6) Headaches of a new type, pattern, or severity

7) Unrefreshing sleep

8) Post-exertional malaise (fatigue lasting more than 24 hours after exertion)

Treatment

Immune enhancers: These are generally "food supplements" of various types that are claimed to enhance the immune system, although they can include various antiviral drugs. They are often proposed either to treat some presumed viral infection or to treat a presumed general immune deficiency.

Notable sufferers

Some notable persons with CFS are:

Michelle Akers, soccer player

Brian Aldiss, author

Susan Blackmore, parapsychologist, author

Howard Bloom, evolutionary psychologist, author

Cher, pop singer, actress

Neil Codling, formerly of Suede

Blake Edwards, writer and director of such movies as Breakfast at
Tiffany's, 10, and The Pink Panther

John Fahey, folk guitarist

Flea, musician

Kelly Holmes, athlete

(Compiled from Internet by J4K Amenities Research Team)

Rye bread may help