#red pill vs blue pill but these are the options instead

[spookberry]

if youre a doll the gender options are Yes Makeup or No Makeup

[honeysucklepink]

MISSISSIPPI VOTERS:

Look, I know. “It’s a red state, doesn’t matter if I vote, all our electors will go to Turnip anyway, blah blah blah.” I know it feels hopeless, depending on other states because we know we can’t depend on ours. But...look, I just have a feeling, okay? And besides, there are other things on the ballot!

First off, unless you have been living under a rock or completely avoiding all local television, Democrat Mike Espy is running to unseat completely useless Republican Senator Cindy Hyde-Smith. Seriously, this is the Confederacy-loving, “public hanging” lady from two years back (aren’t Senate terms six years? Yes, but that was to fill the last two years of the late Senator Thad Cochran’s term...this is for the whole six). Aside from being a lapdog for Trump, Cindy hasn’t done jack-shit...hasn’t written or sponsored a bill, doesn’t meet with constituents, votes against her state’s interests. Mike is running to bring better healthcare to us (we are dead last, pun intended, on many health markers). He has the experience, the goods, and he would be the first black senator from the state since Reconstruction.

Then, all our congressional representatives are up for re-election, as they are every two years. Look up your district here (first one listed is the incumbent):

First: Trent Kelly (Rep) vs. Antonia Eliason (Dem)

Second: Bennie Thompson (Dem) vs. Brian Flowers (Rep)

Third: Michael Guest (Rep) vs. Dorothy “Dot” Benford (Dem)

Fourth: Steven Palazzo (Rep) vs. no one, I’m so sorry Coasters...

There are also races for justices on the Mississippi Supreme Court; again, these races will depend on if you are in the North, Central, or Southern District, and these are “nonpartisan”:

Central District Place 1: Kenny Griffis vs. Latrice Westbrooks

Central District Place 2: Leslie D. King (unopposed)

Southern District Place 3: Michael Randolph (unopposed)

Northern District Place 3: Josiah Coleman vs. Percy Lynchard

In addition to all of that, there are three ballot initiatives. The first two are pretty easy; the third is a bit more complicated (and is in two parts!):

Sorry for the big flag, couldn’t get it between the bullet points.

Removing the House Electoral Provision: this gets rid of a Jim Crow rule that a candidate for statewide office has to win the majority of the popular vote AND the majority of state house districts (and in the case of a tie on both, the House votes). Instead, the top two vote getters (in the case neither get 50% + 1) go to a runoff. Vote “yes” on this one.

The State Flag. Look, I don’t like that it says “In God We Trust” anymore than you do but it sure as hell beats a FUCKING CONFEDERATE FLAG (and who says it has to be GOD-God? If you want that “God” to be Thor or Wonder Woman or the inventor of Toaster Strudels, go ahead). I like it...who doesn’t like magnolias, and the diamond star in honor of the First Nations is a nice touch. Definitely better than the 2001 option (which was ugly but still would have been better than what we just got rid of). Vote “yes” on this!

Finally, the medical marijuana question. This would have been cut and dry but the legislature just HAD to go and put a “poison pill” in there. Here’s the lowdown,,,there are TWO questions:

Do you want medical marijuana in Mississippi, yes or no? Vote yes.

Do you prefer Amendment 65, or 65A? 

Amendment 65 is the citizen’s initiative that all the petition signatures got on the ballot. IT IS A GOOD PLAN, with a strict list of conditions, size and potency regulations, administered by the Department of Health, 

Amendment 65A was added by the legislature to muddy the waters. It only allows it for “terminally ill” patients, and otherwise...it just says “the legislature will make the plan.” It’s not a plan, it’s a roadblock. 

VOTE AMENDMENT 65.

This page has a full voter guide with more details on the candidates and ballot measures. Do your homework, and vote blue no matter who (I mean, you 4th district folks, um... there is a campaign apparently to write in the former Dem Gene Taylor?).  

Finally, as you may know, Governor Tater Tot let the mask mandate expire last month. So it’s a crap shoot as to whether your polling place will be safe or not. A lot will depend on where you live; if your county is one of those few under a governor-mandate (he is doing them county-by-county based on case rates), or you are in a town that still has their own, like Oxford or Starkville or Jackson. My county isn’t under a rule, BUT the old ladies that are poll workers at our polling place insisted on a) still working and b) being protected, so we have the whole enchilada. BUT YOU MAY NOT. Call your clerk’s office, check your polling place, and come prepared...photo ID, masks, sanitizer, shield if you want, comfy shoes. 

Oh, one other thing! Q-TIPS WORK ON THE TOUCH SCREENS! Some polling places have them, but just in case, bring some so you can vote touch-free!

Stay safe, protect your health AND our democracy!

[megamoses]

Backblog #12 - Dr. Mario (NES)

Finally, I’m back to the game that led me down this puzzle gauntlet in the first place: Dr. Mario.  Dr. Mario is a falling block puzzle game developed by Nintendo R&D1 for the Famicom and published by Nintendo in Japan on July 27, 1990.  It was released for the NES in other regions and ported to many other Nintendo systems (such as the Nintendo Vs. and PlayChoice-10 arcade systems, the Game Boy, and even as part of an SNES compilation with the Nintendo version of Tetris) soon after.  I ended up playing the original NES version, although I did consider the SNES compilation, since it would’ve been fun to briefly revisit Tetris, since I did essentially play all of those Tetris versions because of this game being on my list.

Like most games of this type, it is a very simple game.  In it you play as Mario assuming the role of a doctor.  Dr. Mario continually throws bicolored pills called megavitamins into the pill bottle shaped playing field.  The field also contains three different colored viruses (blue, red, and yellow which were named Chill, Fever, and Weird respectively in a Nintendo comic) up to a certain height, depending on what level you select, similar to the height option found in other games like this.  The objective of each level is to completely eliminate all of the viruses using the megavitamins by lining up four of the same color in a row horizontally or vertically (no diagonals).  If a megavitamin ends up blocking the opening of the bottle then it’s game over.  Like Columns and Klax, combos are possible, but, amusingly, clearing too many blocks at once causes the game to crash.

When the game starts, you are given the option to select a 1 player or 2 player game.  Both modes begin with an options screen where the player(s) can select from 21 virus levels (from 0 to 20) which determines how many viruses there are in the field, the game speed from low to high (though the speed does gradually increase as you play no matter what starting speed you select), and the music selection.  Although on two player mode, both players can select virus levels and speed independently of one another, in case one player requires a handicap or something like that.

In single player mode, completing each level allows you to proceed to the next one, with every fifth level cleared showing a short cutscene of the three viruses sitting in a tree and some kind of object flying by.  After the final cutscene that plays after level 20, the game does continue but only goes up to level 24 and loops that level from there.  Two player is a head-to-head versus mode seen in other games like this where the objective is to either clear your screen of viruses first or to just outlast the other player.  Getting combos causes garbage blocks to drop on the opposing player’s field (although the system doesn’t always place the garbage intelligently and it is possible for these blocks to clear something for the other player).  The versus matches are best of five so they can run a little long and the number of rounds unfortunately cannot be adjusted in the options.

The game is pretty appealing visually.  As mentioned above, the playing field is supposed to be a pill bottle, though I always thought it was supposed to be the inside of whatever person you’re trying to cure (in fact, beta versions of the game, known as Virus, seem to support this by showing a sick animal that you’re supposed to be curing).  In the top right, you can see Dr. Mario himself in a typical doctor getup actually throwing the pills into the field.  And in the bottom left you can see the viruses themselves, which have very cute classic alien or monster designs, dancing around and taunting you (until you gradually get rid of all of the viruses of a certain color, which removes them from this view).  The viruses are seen under a magnifying glass instead of something like a microscope, implying that they’re enormous.  I guess this is true, since they can be seen from the naked eye in a tree in the endings.  Also, in the level 20 ending, the thing which flies by the tree is a UFO, which picks the viruses up.  So, I guess they actually are aliens.  Maybe Tatanga did Dr. Mario.

Of the two selectable songs in the game that play during actual gameplay, “Fever”, with its upbeat and extremely catchy tune, is by far the more recognizable song and is generally thought of as being the Dr. Mario theme.  “Chill” is a much more downtempo theme and, although I don’t think it exactly works for something that gets as fast paced as this game often does, I think it’s a fine song in its own right.  And the verses of it where the tempo picks up sound pretty, uh... cool.  Both songs have moments where they sound sort of deliberately chaotic or off-key, which works since they’re supposed to be the theme songs of these weird alien viruses that I guess are causing havoc on some dogs or something if the aforementioned beta version is anything to go by.  Unfortunately, there isn’t a third song called “Weird” for the yellow virus.  It’s a shame, because I really would’ve liked to hear a song like that.

Overall, this is a very good game, though simple like all games of this type.  Not that its simplicity is a bad thing in the least.  That’s actually the greatest strength of games like this.  Anyone can pick them up and instantly understand the rules.  It’s easy to learn but hard to master, which is pretty much exactly where you want a game to be, especially if it has a multiplayer versus mode like this one does.  Though this game, being height based, is very easy in the early levels when there are barely any viruses.  Even in later levels where there are quite a few more, it gets much easier as soon as you are able to break through the first layer or so of viruses.  But level 19 is about where I fall apart completely and am barely able to progress in eliminating viruses at all, so it’s definitely no cakewalk, it just feels a little easier than similar games.  Next time, I’ll finally be moving past puzzle games and to one that I’ve been looking forward to for a while now: StarTropics.

[benbenmedia]

Tuesday, March 19th, members of the Menifee community and surrounding areas gathered together at Merna's Cafe to engage in discussion about newly created business startups in the local area and region, with a specific focus on technology startups. Of course, you may have already guessed that this was a group of individuals focused on technology from the name alone – Menifee Matrix (a play on the 1999 movie The Matrix ). The goal is to help support those businesses already in the sphere and to encourage the growth of new technology-based businesses right here in Menifee , instead of allowing them to be lured away by already established technology centers like Silicon Valley. The group is bringing together business-minded owners, entrepreneurs, and city personnel and forging an active community for the improvement of the economic environment necessary for success. Clockwise: Gina Gonzalez (Menifee EconDev) , Jimmy Fu (JimmyFu-tography) , George Mills (MVCC) , Tony LoPiccolo (MVCC) . Gina Gonzalez is the Economic Development Director for the City of Menifee. When I asked her, she explained that the City is focused on job creation, and especially with young growth-oriented businesses. "To have a room of over 30 in attendance was fabulous!" "Anytime we have businesses, entrepreneurs or start-ups supporting the development of each other, the faster we can all grow business in our region and create jobs. As the City looks to provide and support resources for our business community, we meet with our start-up community so we can begin to identify their needs and find ways we can provide for those needs to see them blossom and become successful!" "Yes, if someone is thinking about an idea, or has an idea for a business, this is a great avenue to get feedback, support resources, and information on how to develop the idea. This is really a thinktank for tech industries and innovation." While I was talking with Gina, a thought came to me that it is vital that our region aggressively pursue the cultivation of an identity as a leader in technology-based businesses. This came from a very personal place. When our children grow up and attend University and think about starting a business, they most likely believe that they will have to move out of the area. Silicon Valley is known worldwide for being the center of technological development. Why shouldn't we seek to become a destination for technology companies? Wouldn't it be great if our children could get their education and establish their businesses right here? RED PILL vs BLUE PILL Left to Right: Philip McAndrew (Heartcup.com) , George Benjamin (BenBen Media) , Chris Hernandez (Appcore Labs) . Upon arrival at the event, every attendee received a wristband with a blue bead (aka the blue pill). If you've seen the movie, you'll get the reference. While everyone who decided to come to the meeting had already made a conscious effort to connect and improve the community, the evening's presenter, Philip McAndrew, founder of Heartcup.com , received a red bead as a thank you for presenting to the group. The Heartcup.com social media network, is a website designed to empower people to impact their communities by monetizing social sharing in the form of donations to nonprofits. "We are changing the giving experience and making it possible for people with just $10 to support 100 nonprofits. Our technology makes giving fun. Our time in social media can now be meaningful instead of feeling like a waste." "Menifee Matrix was an important event for me because it represents the uprising of entrepreneurial energy in our region. The daily hustle for people starting and running businesses is real, and we need to support one another and share the experience along the way." "I got further insight into the chief concerns that my users will care about. I was able to get a better understanding of the trust factor and some more ideas on how best to increase transparency in the nonprofit space." "The energy in the room was very positive, and it was nice that every person had a chance to introduce themselves. It made connecting with people after my presentation easier and more exciting." The creator of the Menifee Matrix Meetup is George Benjamin, Founder of BenBen Media, a Menifee based web design and digital marketing firm. "I'm thankful that I was given the opportunity by Gina and her team to partner with the city and do this for our community. The community and it's people are what's important, along with the connections we make. Our mission statement has always been to 'bring technology to humanity and humanity to technology'. A lot of times as techies we forget that it's all about the human connection. " I can't end this article without saying something about Merna's Cafe & Grill . I had to try the food to find out why this eatery has received such surprisingly high ratings on all the review sites: Yelp Reviews, Facebook reviews, Google Reviews and Grubhub. I was absolutely blown away by the flavors I experienced and the quality and quantity of food on the plate was top notch. The service was outstanding and Merna herself spent considerable time with the guests. While I initially experienced a little trouble finding the location, it is truly worth the effort. I now know where it is, and I will definitely be back. Review: "Well done Merna!! Today was the first time I stepped into the restaurant. Excellent food and atmosphere. Kudos and I will be back with others !!!" Left to Right: Chris Courtney (Courtney Enterprises), Jeannette LeHoullier (DJ's Virtual Management) , Gary Hawthorne (SCCC) , Shawn Brown (S.E.B Sounds) , George Benjamin (BenBen Media) , Nellie Hathorne (Accipiter Marketing). ENTER THE MATRIX Join us at our next event.#MenifeeMatrix is held every third Tuesday of the month. You can find more information at www.menifeematrix.com Signing off, Gerry Michaels Freelance Writer BenBen Media BenBenMedia.com

[nicholemhearn]

Healthcare Spending vs. Health System Performance: What are the Realistic Options for Reform?

We often hear that we, in United States, spend more on healthcare than other high-income countries, but get less for our money. A report from the Commonweath Fund, “Mirror, Mirror 2017”, is among many pieces of research to reach that conclusion.  Just why is U.S. healthcare spending so high and performance so low? What are the realistic options for reformers? One of the report’s key charts provides an excellent framework for discussing what it calls “flaws and opportunities for better U.S. healthcare.”

Why is U.S. healthcare spending so high?

To understand why U.S. healthcare spending is so high, we can begin by asking, , “High relative to what?” After all, as one of the wealthiest countries in the world, we spend more than others on a lot of things. The question is whether U.S. healthcare spending is higher than we would expect it to be even when we take our generally high standard of living into account.

Consider, for example, the following scatterplot of healthcare expenditures (HEX) per capita against GDP per capita. The eleven countries covered in the Commonwealth report are shown in red and other OECD countries in blue.* The United States is the furthest outlier in the chart, falling more than four standard errors above the trend line. That puts it well outside an interval of plus or minus two standard errors, which would be expected to contain 95 percent of countries.

However, GDP may not be the appropriate basis of comparison. According to the anonymous author of the blog Random Critical Analysis (whom I identify hereafter as RCA), it makes more sense to compare healthcare spending, not to GDP, but to a less familiar measure of living standards known as actual individual consumption (AIC).

AIC is the sum of household final consumption expenditure, final consumption expenditure of non-profit institutions serving households, and government expenditure on individually consumed goods and services. Government spending on healthcare, education, housing, and other goods and services is included in AIC because those items are consumed individually by consumers. However, spending that serves the public in general, such as national defense and police protection, is not included. As a measure of a country’s average standard of living, AIC is thus not sensitive to differences among countries in the way healthcare funding is divided between public and private sources.

The share of AIC in GDP varies widely within the OECD, ranging from 59 percent in Norway to 78 percent in Greece. At 73 percent, the U.S. ratio of AIC to GDP is near the top of that range. One reason that AIC varies is that households in some countries consume more of their personal income and save less. Trade deficits and surpluses are another reason. Since countries with deficits import more than they export, they can use the extra imports to support higher levels of both private and government consumption expenditures per dollar of GDP. Both low saving and persistent trade deficits tend to raise the share of AIC in GDP for the United States. It has the highest standard of living in the OECD as measured by AIC, even though it does not have the highest GDP per capita.

Not surprisingly, healthcare spending tends to increase as AIC increases.  Not only that, but healthcare is a superior good, meaning that its share of total spending increases as AIC grows. My estimate for OECD countries is that each 1 percent increase in AIC is associated with approximately a 1.6 percent increase in HEX. RCA gets similar results both across countries and over time within individual countries. In the following chart, which uses log scales on both axes, about 80 percent of the variability in health expenditure is statistically explained by variations in AIC.**

Comparing this chart with the previous one shows that the United States, although still an outlier in healthcare spending relative to its OECD peers, is much less of one. When compared to AIC rather than GDP, U.S. healthcare spending lies just 1.5 standard errors above its predicted level, instead of 4 standard errors. That puts it well inside a 95 percent prediction interval.

For completeness, it is worth noting that the preceding chart says nothing about whether prices or quantities of healthcare are more important in producing higher-than-expected U.S. healthcare spending. That remains a matter of ongoing debate among healthcare economists.

One line of thought is reflected in a widely-cited paper with the provocative title, “It’s the Prices, Stupid.” Anecdotal evidence, such as $100 saline bags and million-dollar cancer pills, reinforces the idea that excess healthcare spending stems from unreasonably high healthcare prices.

However, there is also evidence pointing the other way. For example, in another post, RCA argues that high U.S. healthcare prices are partly explained by the so-called Baumol effect, according to which productivity increases faster in goods-producing sectors than in services as GDP rises. That causes wages and prices in service sectors, including healthcare, to rise relative to the average price level as an economy’s general standard of living increases. Corrected for the Baumol effect, U.S. healthcare prices are not as far out of line with average OECD prices as they would otherwise appear. RCA also cites direct evidence that quantities have increased, along with total spending. (For anecdotal evidence to that effect, see my own recent notes on dermatology clinics and urine drug testing.)

Whichever point of view one takes on the relative role of prices vs. quantities, however, the point stands that high spending can only in part be viewed as a “flaw” in our healthcare system. Yes, lack of competition, perverse incentives, and misguided or ineffective regulations undoubtedly are sources of inefficiency, but there are also more fundamental forces at work. On the demand side, there is strong evidence, over time and across a wide variety of national systems, that people are willing to devote an increasing share of their total consumption spending to healthcare as their standard of living rises. At the same time, the Baumol effect makes it inevitable that the price of personal services, including healthcare services, will rise as standards of living rise. Perhaps the real question, then, is not why we spend so much, but why we get such poor performance in return.

Why is U.S. healthcare performance so poor?

Health system performance, in the Commonwealth report, represents a weighted average of scores on many individual variables. These are grouped in into five categories: The care process, access, equity, healthcare outcomes, and administrative efficiency. The following is a brief summary of the findings in each category. A set of appendixes to the report provide full data on each of the underlying variables for each of the eleven countries.

It turns out that the United States does rather well, ranking fifth overall, in terms of the first category, “care process.” The rankings are based on data covering preventative care, safety, coordination, and engagement with patient preferences. Certainly, there are places where there is room for improvement, but this is not the area of the rankings where U.S. reformers should look for dramatic gains.

Instead, low U.S. performance scores can, to a much larger degree, be traced to last-place rankings for healthcare access and equity. Americans who lack insurance or face high out-of-pocket costs are far more likely than citizens of the other countries to report skipped checkups and serious problems paying medical bills, and are less likely to have a regular doctor or clinic. What is more, the gap between access to healthcare by those with below-average and above-average incomes is wider for the United States than for any other country in the Commonwealth study.

The United States also ranks last among the eleven countries in terms of healthcare outcomes. Broad measures of population health, including infant mortality, life expectancy, and the prevalence of chronic diseases in working-age adults are all worse in the United States than in any of the ten other countries in the Commonwealth study. U.S. amenable mortality rates are also much higher, and have been declining more slowly than elsewhere. (Amenable mortality is defined as premature deaths that could potentially be avoided given timely treatment.)

The difference in healthcare outcomes appears to be linked, at least in part, to problems in access and equity. That is suggested by the fact that on variables that measure outcomes for people who actually receive treatment for conditions like stroke, heart attacks, and cancer, U.S. performance is well above average. Not everyone has access to the best treatment, however, nor do people without insurance or with high out-of-pocket costs always follow through on treatment that is offered.

Still, it would be wrong to attribute poor U.S. health outcomes entirely to flaws in policy. Socioeconomic factors, such as obesity and lack of exercise, also contribute. One study found that traffic accidents, gun violence, and drug use account for as much as two-thirds of the mortality gap between the United States and countries such as Austria, Denmark, Finland, and Germany.

Administrative costs are the final performance category in the Commonwealth report. This is an area in which many American advocates of a single-payer system have high hopes for improving performance. They are right to point out that the U.S. ranks poorly in this area compared to the median for the Commonwealth study. However, even some European healthcare systems that have higher overall performance scores struggle with some aspects of administrative costs. In France (which is the worst-performing of the eleven in terms of administrative costs), and also in Switzerland, Germany, and the Netherlands (all with below-average scores), complaints about excessive time spent on insurance, paperwork, and reporting are common. The United States is perhaps less of an outlier in this area than one might think.

Implications for reformers

Our review of the reasons for high U.S. healthcare spending and low health system performance has clear implications for reformers, as suggested by the following modification of the Commonwealth chart:

      There are limits on what U.S. healthcare reformers can reasonably expect to achieve in terms of spending and performance. Those limits are represented here as a “policy option envelope,” which is pushed to the right, relative to other countries, by high U.S. levels of actual individual consumption, and downward by socioeconomic factors. As a result, it cuts to the right and below the positions occupied by other countries in the sample.

      It is wishful thinking to hope that simply copying one of the various systems used in Australia, the UK, the Netherlands, or elsewhere would automatically produce similar results in terms of cost and performance. There is no easy path—probably no path at all—by which the U.S. could leap into the central cluster of low-cost, high-performing countries in the chart. That does not mean we have nothing to learn from others. It simply means that what works well elsewhere is likely to cost more here, or produce less favorable results, or both.

      Although we could certainly improve overall healthcare performance by prioritizing greater access to the system we now have, doing so would, other things being equal, mean an increase in spending.

      We could, instead, prioritize spending cuts to Medicaid, Medicare, ACA subsides, and other programs, but doing so would worsen performance. That is especially true when performance is measured as it is by the Commonwealth study, where large weights assigned to access and equity.

In listing these implications, I do not mean in any way to pour cold water on reform efforts. Rather, I think that greater realism makes it more important, and perhaps also easier, for reformers of all political persuasions to work together.

In particular, I would emphasize that we are far from being tight up against the performance-vs.-spending tradeoff represented by the policy option envelope in the chart. There are many potential efficiency-enhancing initiatives, for which it ought to be possible to get broad consensus, that would move us closer to the curve. Those include measures to mitigate perverse incentives that encourage patients to seek and providers to offer care that is neither clinically nor economically effective. They would also include reforms designed to increase competition, improve price transparency, better educate consumers, and push back against socioeconomic factors that undermine public health.

None of these should be controversial in principle, although many of them will meet resistance from special interests who profit from existing inefficiencies. As Uwe Reinhardt once put it, “Every dollar of health spending is someone else’s healthcare income, including waste, fraud, and abuse.”

Still, even with maximum efforts to enhance efficiency, we need to accept that healthcare will continue to consume a large share of both personal and government spending. In the end, the prospect of continued high healthcare spending is not a reason to resist reform, but rather, to do our best to make sure that we get a good return on what we do spend.

*The chart covers 34 OECD countries, excluding Luxembourg. Luxembourg is unusual in that nearly half of its labor force commutes daily from neighboring EU countries. The commuters contribute to Luxembourg’s measured GDP, but are not counted in its population. Moreover, most of them get their healthcare where they live, not where they work. For that reason, data on GDP per capita and health expenditures per capita for Luxembourg are not comparable to those of other OECD countries. In our chart, Luxembourg would be an extreme outlier in the lower-right hand corner. Including it would pull the trend line down and exaggerate the degree to which the United States is an outlier in the upward direction.

**One technical detail: Healthcare itself accounts for a substantial share of all consumption spending, so as a matter of simple arithmetic, HEX would increase as AIC increased even if healthcare spending were completely uncorrelated with consumption spending on other goods and services. To avoid bias, then, the scatterplot puts non-healthcare consumption spending (AIC minus HEX) on the horizontal axis, rather than total AIC. For a regression of HEX on AIC-HEX, the coefficient of determination (R2) is 0.80. As expected, that is a little less than the R2 of 0.87 obtained when total AIC is used as the independent variable.

  The post Healthcare Spending vs. Health System Performance: What are the Realistic Options for Reform? appeared first on Niskanen Center.

from nicholemhearn digest https://niskanencenter.org/blog/healthcare-spending-performance-reform-options/

[ourhealthyfoodblog-blog]

New Post has been published on Healthy Food and Remedies

New Post has been published on http://healthyfoodandremedies.com/2017/05/01/100-tips-lose-weight-fast/

100 Tips on How to Lose Weight Fast

If you need to lose weight fast, you’ve come to the right place. You’ll find 100 proven free tips below to help you lose weight quickly and to keep you inspired along the way.

Cutting calories has an upside. A study recently that showed that cutting just 15 percent of your caloric intake can substantially increase your lifespan! Implement these diet and exercise tips gradually. If you try to jump in full force, you can become overwhelmed. Take it a few tips at a time. It might be slower, but your chance for success and losing weight will increase if you incorporate these tips at a comfortable rate. If you are looking for a full diet and exercise plan, learn how to lose weight the smart way with our book.

100 Tips on How to Lose Weight Fast

1. Set Realistic Goals – Write down short-term and long-term goals, and keep them where you can see them. If you see your goals every day, you are more likely to reach them. Keep your goals realistically achievable. It feels great to cross off a goal when you reach it!

2. Visualize – Imagine yourself reaching your next short-term goal and your long-term goal and crossing each goal off your list as you reach it. Imagine your life when you reach your BIG goal. Imagine how you will look and how it will feel. See yourself in a new outfit at your healthy weight.

3. Pick Your “Diet” – Whether you adopt one of today’s popular diets or you create your own, have something to use as a game plan—a roadmap to keep you on track. By selecting one of “today’s” diets, you can get support on the Internet from other dieters. Just stay away from fad diets, because they don’t work for the long term, and they can damage your health.

4. Steer Clear of Diet Pills – Remember Fen-phen? Some diet pills can cause serious illness. Most are not natural and are not needed at all, so why take the risk?

5. Replace – Make a list of all the current foods you like to eat. Cross off the ones that you know are not going to help you reach your goal, and find new healthy recipes for weight loss to replace them. Print out at least 10 recipes for breakfast, lunch, dinner and snacks for future use.

6. Clear Out – Gut your fridge and pantry! Remove all unhealthy foods you might be tempted to eat that you listed above. Then, head to the store, and make sure to keep your fridge and pantry stocked full of healthy food at all times.

7. To Tell or Not to Tell – Some dieters tell others about their journey. Others keep it to themselves. Tell only those who will support you in your efforts. There is no point in sharing your objectives with negative people.

8. Incorporate Tips Slowly – Don’t try to incorporate all of these tips at once. That’s a sure-fire way to disappointment. Start slowly incorporating the easy tips first, then move on to the ones you find more difficult. While your short-term goal is to lose weight fast, it’s the long-term goal of health of fitness that matter most—this is a marathon, not a sprint.

9. Persistence Pays – Few people reach any goal without persistence. View each setback as a learning opportunity, and you’re on your way to eliminating unhealthy behavior.

10. Shop on a Full Stomach – Shopping on a full stomach will help to ensure that you don’t buy unhealthy comfort foods.

11. Make a List – Make a shopping list and stick to it. If you find another fruit or vegetable on sale, you can substitute, but as a general rule, stick to the list and get out of the grocery store as quickly as possible. Studies show that the more you dawdle, the more junk food you place in your cart and the more money you spend in the grocery.

12. Swear off Processed Foods – Replace processed foods with foods that you cook from scratch. Yes, fresh, healthy foods cost money, but they cost no more than expensive, fat- and sugar-laden processed Frankenfoods. Have you read the ingredients on those boxes lately?

13. Shop the Perimeter – Healthy foods live on the perimeter of the grocery store—produce, meat and dairy. The aisles are your danger zone, except for a few condiments and spices and herbs, you’ll want to steer clear of the aisles. Also avoid the endcaps.

14. Pick up Healthy Snacks – Pick up nuts, fruit, cheese—whatever your diet allows—for treats to replace candy bars and sugar-filled snacks. Keep health snacks on hand at all times.

15. Buy Large Meat Packages – You can make chicken stir-fry one day, sesame chicken the next day and grill some chicken for the freezer. You can also add leftover chicken to salads—you get the idea. Use the same strategy with meat, and you’ll never have an excuse to eat fast foods.

16. Don’t Fall for Low-Fat – You’ll find all kinds of low-fat cookies, pastries and other treats. When you remove most of the fat, you’re removing flavor, and you have to replace the fat with something. In this case, they replace it with sugar!

17. Don’t Fall for Veggie Chips – They’re veggie, but the vegetable is more often than not potatoes and some kind of other vegetable derivative. In essence, they’re just potato chips by another name.

18. Don’t Fall for Substitutes – You must read the label on all products you buy, because often enough, when a product says its “free” of something considered unhealthy the replacements used to achieve the same taste can be just as unhealthy!

19. Sugar Substitutes – Avoid Aspartame, Splenda and all the other new-fangled sweeteners.

20. Approach Mealtime as an Adventure – Keep your healthy eating dynamic by trying new things and mixing up what you eat. This will help you develop a rich diet that you can stick to forever instead of a short time. The more healthy options you have, the less your chances will be of running for fast food or take out.

21. Eat More Fruits and Vegetables – Vegetables represent dense calories, that is, calories packed with nutrients and antioxidants. Five to nine servings of fruits and vegetables are recommended daily. If you eat your vegetables first, you’re bound to lose weight. Fruits supply extra fiber and water and can provide a quick and easy snack.

22. Incorporate Color and Texture – Buy mixing green, yellow, orange, red and purple vegetables, you’ll get a wide array of nutrients. Adding texture gives you something to chew on.

23. Add Raw Foods – Raw foods pack a bigger punch nutritionally. Nutrients are always loss in the cooking process. If you can start by adding 20 percent raw foods and work up from there, you’ll quickly replace empty calories with dense calories and fiber.

24. Undercook Vegetables – There’s nothing worse than limp broccoli or asparagus. YUK! Not only are overcooked vegetables unappetizing, but they can have less nutrition. The more nutrition you get from your food, the less likely you are to overeat.

25. Add Fiber – The typical American diet contains only about half the amount of recommended fiber. By adding vegetables, nuts, whole grains and beans to your diet, you’ll automatically increase the fiber content of your diet, helping you to feel full and aiding in cancer prevention.

26. Season Food – Fresh ground sea salt and pepper, garlic, herbs, chiles and lemon juice add tons of flavor with few calories, and all that flavor excites the taste buds and helps to satisfy your hunger.

27. Cut Down on Salt – A little salt goes a long way. Replace some salt with lemon juice and herb mixtures.

28. Replace Table Salt – Throw out that blue box of table salt and replace it with sea salt, which is full of trace minerals.

29. Eat Seasonally – People are moving toward supporting local farmers and eating local food. That means that they’re eating seasonally. When you eat seasonally, you’re guaranteed the freshest produce, the produce that contains the most nutrients, and nutritionally dense food keeps your appetite at bay better than sugary empty calories.

30. Capsaicin Burns Fat – Incorporate hot peppers that contain Capsaicin into your diet to raise your metabolism. Add raw peppers to salads, omelets, etc. 31. Spice up Your Metabolism – Some spices and condiments aid in thermogenesis, the production of heat, which helps to burns fat. Adding ginger, peppers, allspice, cinnamon, coriander, cumin, turmeric, etc., can keep the fat burning engine in top form. Try a side of wasabi, chutney or salsa—all on the spicy side—and use garlic and onions liberally in your cooking.

32. Don’t Forget the Protein – Try to work some protein into each meal. It’s satisfying, fills you up, and it will hold you until your next meal.

33. Plan a Cook-a-Thon – When you cook healthy meals, make enough for multiple servings and save or freeze individual portions. You can have leftovers or defrost one or more frozen portions when you don’t want to cook.

34. Use Healthy Fats – Fats keep the skin supple, and used in moderation, they can enhance mealtime. Stay away from trans-fats, and stick to olive oil, coconut oil (yes, that’s right) and even butter when cooking (a little goes a long way)—those are the only fats you should use when cooking, because heat does not transform them into trans-fats. Use olive oil, safflower or sunflower oil sparingly on salads. Never, ever use margarine. 35. Eat More Small Meals – Instead of eating three large meals a day, eat five or six small meals a day.

36. Drink Water – Drink at least eight glasses of non-carbonated, purified water—half your weight in ounces each day. Water keeps the metabolism engine running, and drinking enough water ensures that you burn more calories each day. There is no substitute for water. If you really hate the taste of water, add a little lemon or lime juice or brew a weak green tea.

37. Dehydration vs. Hunger – When the first hunger pang strikes, drink a tall glass of water before eating. Dehydration often mimics hunger, and once you’ve killed your thirst, you may find that you’re not hungry.

38. Eliminate Stress – Stress is one of the biggest causes of overeating.

39. Uncover Food Addictions – Any food that you must have and that you cannot stop eating is most likely an addiction. If you feel bad or sleepy after eating a certain food, it’s a good bet that you’re addicted to that food. Avoid it and find a suitable substitute. Soon, you’ll lack the desire for the addicting food.

40. Always Eat Breakfast – Not only will eating breakfast get you off to a good start and stave off the mid-morning slump, but studies show that it improves learning and memory.

41. No Time for Breakfast? – Make a superfoods smoothie with one of the green drink mixes. Add a scoop of protein powder, a scoop of superfoods greens powder and mix with ice, water and fruit for a delicious breakfast drink that will keep you satisfied for hours.

42. Add Raw Veggies to Fruit Smoothies – Adding spinach, celery, etc. to your morning smoothie, supercharges it, adds fiber, and the fruits overpower the taste of the vegetables.

43. Avoid Commercial “Smoothies” – Don’t confuse a superfoods smoothie with a commercial smoothie—commercial smoothies are mostly sugar suspended in ice cream or yogurt in drinkable form. Most contain little, if any, actual fruit. 44. Eat Before You Get Hungry – This tip requires practice, because sometimes we get busy, and by the time we realize we’re hungry, we starving. That’s why snacks are important when you’re on a diet. You never want to go more than a few hours without food. Eating before you get hungry helps you to eat sensible portions.

45. Eating at Work – Pack your lunch and plenty of snacks for work each night. Stock the refrigerator at work with healthy snacks and make sure that you don’t run out. 46. Replace Commercial Luncheon Meats – Luncheon meats contain lots of nasty fillers. Buy whole turkey breasts, chicken breasts and lean cuts of meat. Roast them and slice thinly for use as luncheon meats. Freeze in small portions and defrost as needed.

47. Fake Fried Foods – Almost anything that you can fry, you can “oven-fry.” You’ll find plenty of oven-fried recipes on the Internet.

48. Avoid Liquor – Did you know that alcohol is sugar? If you must raise a (a, as in one) glass, have some red wine and tell yourself that you’re getting lots of age-defying antioxidants. The resveratrol in red wine also can help you to keep from gaining abdominal fat.

49. Replace Commercial Fruit Juice – Commercial fruit juice contains a high concentration of sugar. If you can’t stand the thought of giving up fruit juice, eat whole fruit instead so that you receive the benefit of the fiber.

50. Replace Soda – One can of soda contains a ton of sugar! Most commercial diet sodas also contain Aspertame. Squeeze one orange, including the pulp, and top it off with club soda for a refreshing treat. That way, you’re getting whole fruit and minimal sugar.

51. Replace Sports Drinks after Exercise – Drink an “electrolyte” water such as SmartWater to receive the same benefits you would from a sugary sports drink—without the added sugar.

52. Water First – Drink a large glass of water 10 minutes before meals. You will feel satisfied with less food.

53. Sleight of Hand – Trick your mind. Use smaller plates when you eat and you will be reducing portion sizes and calories. Your stomach is about the size of your fist, so it takes a very small plate of food to fill your stomach. Restaurant and fast-food meals are sized for an army, and that amount of food is neither healthy nor normal.

54. Slow Down – Eat slower. Put your fork down in between bites. Enjoy conversation with family and friends.

55. Chew Well – Digestion starts in the mouth, and if you don’t fully digest your food, you miss out on some of the nutritional value.

56. Leave Behind the Multitasking – When it’s time to eat, sit at the table and eat. Don’t stand at the counter, watch TV, pay bills, talk on the phone or work while eating. You will eat less if you concentrate your energy on eating slowly and purposefully.

57. Not So Fast – After you eat, wait at least 10 minutes before thinking about second helpings. It takes time for your stomach to signal your brain that it is full enough, which translates into not hungry. Routinely waiting 10 minutes will help you differentiate between not hungry and full.

58. Closed for the Night – Close the kitchen early so that you aren’t tempted to snack in the evenings. Wash the dishes, clean the sink and stove top, and put everything away for the night. Often, evening snacking is habitual. If you must snack, try a few nuts or a half cup of homemade, sugar-free ice cream.

59. Treats and Cheats – When the urge strikes to cheat and nothing else will do, make your cheat-treat from scratch. Yes, you’ll have to go to the store to buy the ingredients, mess up the kitchen, clean up after yourself and it could take hours. Do you still want to cheat?

60. Healthy Cheats – According to Dr. Andrew Weil, plain dark chocolate, used sparingly is the only healthy sweet. Note: sparingly is the operative word. Save for a treat when you’ve been especially good for a week or when you’ve had a terrific workout.

61. Stock up on Gum – Keep sugar-free, Aspartame-free gum around. Sometimes the act of chewing is all you really need to keep hunger at bay.

62. Supplements – Even though you’re eating healthier, it’s next to impossible to get enough nutrients from today’s food supply. At a minimum, supplement with a good multi-vitamin and extra C.

63. Maintain a Healthy Gut – According to Dr. Mercola, a healthy gut environment can aid in weight loss.

64. Stay Low – Familiarize yourself with the Glycemic Index and substitute low GI foods such as multigrain bread, apples and sweet potatoes for white bread, melon and French fries. High GI foods wreak havoc with insulin levels, while low GI foods result in stable insulin levels, which helps with weight loss.

65. Don’t Fall for the Myth of Negative Calorie Foods – Negative calorie foods use more calories for digestion than they provide—or so they say. This myth has been fully debunked. Sorry, but you’ll have to take responsibility for every morsel that passes your lips.

66. Brush Your Teeth – Brush your teeth after a meal. The mint flavor simulates the after-dinner mint, signaling the end of eating.

67. Eat Out Infrequently – Stay away from restaurants whenever possible. When eating out, check out the heart-healthy choices or stick with grilled or broiled chicken or fish. Watch out for the salad entrées, because some can have up to 2,000 calories! Pass on appetizers, dessert and liquor. Plan a “restaurant meal” at home one night each week. That way, you control the ingredients and the portion.

68. Fill up at Home – If you are going to a restaurant you know has unhealthy, tempting foods, eat something healthy before you leave so you are already full when you go. You will keep temptation under control and eat less at the restaurant.

69. To Go, Please – Ask your server to pack up half your meal before bringing your order t the table.

70. Share the Wealth – Split a large meal at a restaurant with your dining companion.

71. Control Restaurant Selection – When eating out with family or friends, try to steer them toward a restaurant with healthy food.

72. Why Exercise? – By adding regular exercise to your health and fitness routine, your diet doesn’t have to do all the heavy lifting alone. You’ll feel better once you begin to exercise regularly, and you’ll sleep better as well. In short order, you’ll look forward to your exercise routine.

73. Total Fitness – You MUST have a solid workout program for maximum weight loss and fitness—a combination of cardio, weight-bearing and stretching exercises.

74. Early Bird Gets the Worm – Work out in the morning, if possible. It will energize you for hours to come and make you feel good for the rest of the day.

75. Shake it UP – Vary your exercise routine so that you don’t get bored and so that you are constantly challenging different muscles. This is especially important when you reach a plateau in weight and body mass loss.

76. Stretch – Always begin your workouts with stretching to warm up muscles and avoid injury. End with stretching to cool down. Bursting into a full-blown workout without warming up can be stressful on your heart.

77. Walking for Fitness – Add walking to your exercise program. Start walking one to two miles a day—or whatever you can. A simple two-mile walk can help you lose lots of weight over a few months when combined with a good diet. Thirty minutes of brisk walking burns off 300 calories. An hour of brisk walking can absolve a multitude of sins when you’ve been bad.

78. Power Walking – When you do your two-mile walk, start working in a 30-second power walk every two minutes to keep your heart rate up. This will help you build up your endurance, burn more calories. Studies show that by adding 30-second bursts, you increase the effectiveness and receive the maximum benefit from your walk.

79. Hot Fun in the Summer Time – Take advantage of the nice weather. Play tennis, swim, hike, garden, go horseback riding—sneak in all kinds of summertime outdoor activities in addition to your normal exercise routine. This is also the perfect time to park your car as far as possible from the entrance to a building.

80. Winter Blues – During the winter, replace outdoor activities with an exercise bike, treadmill or elliptical machine.

81. Double Up – Find a workout partner. You’ll keep each other motivated and help drag each other out of bed on those tough mornings!

82. Get Personal – If you can afford a personal trainer a few times a week (at least when you start your workout program), this will give your workout an extra edge and ensure that you are performing the exercises properly.

83. Frequency Counts – Frequency is even more important than duration when it comes to exercise. Even short exercise periods elevate metabolism for several hours. If you (legitimately) don’t have time for a full workout, settle for an abbreviated workout rather than skipping a day.

84. Step Away from the Couch – Make your TV time count by incorporating exercise with TV viewing. Try this aerobic coordination exercise the next time you’re tempted to veg out on the couch. Raise your right knee up to your left elbow, and then alternate with your left knee to your right elbow. Start with 20 reps and work up to 100 or more reps.

85. Dance, Dance, Dance – Dancing is not only fun, but it’s aerobic and a terrific caloric burner.

86. You Snooze, You Lose – Make sure you get at least seven to eight hours of sound sleep each night to help keep you energized. One of the major causes of weight gain, other than overeating, is inadequate sleep. Sometimes evening exercise can keep you awake at night. That’s one more good reason to exercise first thing in the morning.

87. Prepare Ahead of Time – If you work out at the gym, get your bag ready the night before, and place it by the door. In fact, repack your bag when you return home from the gym and have it ready to go on a moment’s notice.

88. Ask Yourself – Every time you contemplate taking an action that you know is bad for you, take a minute to ask yourself, “Is this action taking me toward my goal or away from goal?” Make it a habit, and choosing wisely becomes easier with practice.

89. Buy an Accurate Digital Scale – There’s a big difference between 130.0 and 130.8 pounds, especially when you begin to reach a plateau.

90. Weight Once a Week – Daily weight fluctuations are normal, but they can set you up for unnecessary disappointment. You’re more likely to see real progress by weighing once a week. 91. Take Progress Photos – Take a photo when you begin your diet and exercise program. Once a month, take a progress photo. Wear the same outfit (or lack thereof) so that you can compare against your baseline photo. Now, you have visible progress—your eyes don’t lie.

92. Measure This – Take your measurements when you start your fitness program and once each month thereafter. Tape measures don’t lie either. 93. Calculate BMI – Measure your Body Mass Index once a month. The BMI measures the amount of body fat based on your weight and height. It’s a better indicator of fitness than weight alone.

94. Post-it – Place inspirational post-it notes all over the house—on your bathroom mirror, on your refrigerator, on the edge of your computer monitor, etc.—to help keep you motivated.

95. Healthy Before You Know It – You begin reaping healthy benefits by the time you’ve lost just five to 10 percent of your weight. That’s motivation to stick with your program until you reach your goal.

96. Journal Your Progress – Record your daily intake and exercise in a journal. Studies show that those who keep a journal reach their fitness goals quicker. You’ll be able to look back over your path to fitness and relish your success. Better yet, why not start a blog and lend encouragement to your readers.

97. Celebrate Success – When you reach an interim goal, pull out all the stops and celebrate. Find a nonfood celebration—indulge in a facial or a mani/pedi. Go to a concert or museum. Take a weekend getaway. Throw a barbecue with friends.

98. If You Fall off the Wagon – Pick yourself up and get back on board. Today is a brand new day toward your ultimate goal. Look at your written goals, note how far you’ve come and visualize the final outcome. Get out of the house and go for a walk. Do whatever you have to do to stop beating yourself up and get back on track.

99. Fit for Life – Don’t think of your diet and exercise program as temporary. These changes are LIFESTYLE changes to incorporate into your daily routines and habits.

100. Stay Connected – Check in regularly with diet blogs like this one, online forums and chat rooms for dieters. Helping others stay inspired is a sure route to firing up your motivation.

Zig Ziglar used to say, “Whether you think you can or think you can’t, you’re right in both cases.” Once you set your mind to something and believe that you can accomplish it, you can move mountains. Set your mind to getting healthy and go for it. Your quality of life depends on it.