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7 reasons why you may be so tired

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*7 reasons why you may be so tired*

“If I’m so healthy, why am I tired all of the time?” asked my patient, a 47-year-old mother. I had examined her, reviewed her lab tests, and assured her that all was well. But her complaint is one I hear every day.

Surveys of primary care medical practices in the U.S. show that patients mention moderate to severe fatigue in about a third of all office visits. A study reported in the Archives of Internal Medicine screened 1,000 patients with complaints of severe fatigue. About two-thirds of the cases were associated with identifiable diseases (anemia, diabetes, heart disease, lung disease, or rheumatoid arthritis); a third of them, however, had no definable cause.

-Take notes on tiredness-

If you notice a similar problem, these questions might lead your doctor to an accurate diagnosis:

*1. Was the onset of fatigue sudden? *If it was, the cause is usually physical. A gradual onset may have an emotional component.

*2. Do you feel better after a good night’s sleep? *Sleep deprivation is rampant today. In a landmark 2006 report, the Institute of Medicine recommended 7 to 8 hours of sleep as optimal for adults. But in 2011, a survey in the journal Preventive Medicine found that more than one in three adults failed to get that amount (that number doubled for adolescents).

Even if one gets sufficient sleep, the quality might not be top-notch. REM sleep, characterized by rapid eye movement, is the most beneficial type, and its absence can contribute to fatigue. A clue to non-REM sleep is the lack of dreaming, but to be certain, a sleep study is necessary. Apnea, in which the sleeper’s breathing stops and starts repeatedly, is a common disorder that disrupts sleep. (It’s often accompanied by severe snoring.)

*Take our sleep habits quiz and find out the best sleeping pills to treat insomnia.*

*3. Are you confusing muscle weakness with fatigue? *Sometimes the loss of strength (trouble lifting a suitcase, for example) can be mistaken for tiredness. Early symptoms of neurological disorders such as Parkinson’s disease or multiple sclerosis may seem like fatigue.

*4. Are you experiencing menstrual irregularities? *Fatigue is common in early pregnancy, and the flushes and nocturnal sweating associated with menopause deprive many women of sleep.

*5. Do you have other symptoms? *They can indicate a specific condition, for example, weight loss (cancer, an overactive thyroid), decreased libido (hormone-deficiency disease), changes in bowel habits (celiac disease, colitis), and shortness of breath (anemia, heart failure, lung problems).

*6. Do you have an infection that’s not apparent? *Your doctor might suspect an underlying problem, such as toxoplasmosis if you touched cat litter, brucellosis if you’ve done farmwork, or a tick-borne illness such as Lyme disease if you spent time in the woods.

*7. Do you take drugs that might cause fatigue? *Almost all of them can, but some prime of­fenders are beta-blockers (atenolol, metoprolol), diu­ret­­ics (furosemide, hydrochlorothiazide), pain­killers (ga­b­apentin, opioids), antihistamines (chlor­­­­phen­ira­mine, diphenhydramine), antidepressants (citalopram, sertraline), and anti-anxiety drugs (diaze­pam, lorazepam). If you’re utterly exhausted, your doctor might lower your dosage or change the medication altogether.

As my patient pondered those questions, the cause of her fatigue became apparent. In addition to running a household and coping with two rebellious teenagers, she was hosting holiday parties and shopping for gifts. That stress was on top of holding down a part-time job as a paralegal. She had been making mistakes at work, and her relationships with her husband and children were in turmoil. After talking things over with her husband, she got household help and began seeing a therapist. A month later she was no longer tired and was actually able to enjoy the holiday season.

*Use our free app to explore your health insurance options*

Not sure where to begin with getting health insurance? Our free interactive tool, Health Law Helper, will point you in the right direction.

This article also appeared in the December 2014 issue of Consumer Reports on Health.*Consumer Reports has no relationship with any advertisers on this website. Copyright © 2006-2014 Consumers Union of U.S.*

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    Reported by Consumer Reports 10 hours ago.

Obamacare Fines Those Who Do Not Register Under the Affordable Care Act

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AUSTIN, Texas, Dec. 2, 2014 /PRNewswire/ -- The Affordable Care Act or Obamacare requires most Americans to obtain some kind of health insurance coverage starting in 2014. It is designed to protect consumers from insurance company worst-practices – like denying coverage based... Reported by PR Newswire 12 hours ago.

The New Organizational Structure for Estate Planning

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The New Organizational Structure for Estate Planning Filed under: Estate Planning

*Alamy*

Nobody wants to contemplate their own mortality, but just like taxes, death is an inevitability that we all have to face. Yet studies have shown that more than 50 percent of Americans don't have even the most basic estate planning documents needed to protect themselves and their heirs in case of an unexpected demise.

Those that do often have physical documents squirreled away in filing cabinets or safe deposit boxes with no mechanism in place to alert the appropriate people of their existence when needed.

A new company -- Estate Assist -- aims to change that by allowing customers to create a secure, cloud-based digital safe deposit box where they can upload, organize and automatically distribute all the critical information and documents related to their estate. Such as:

· *Financial assets.* Bank, brokerage and retirement accounts.
· *Digital assets.* Email, Facebook, Twitter and other social media accounts.
· *Life documents.* Wills, powers of attorney, life insurance policies, birth certificates and deeds.

The came to Estate Assist founder and CEO Woody Levin on the heels of a family tragedy. "I watched my father struggling to find paperwork after my grandmother passed away," said Levin. "I decided there had to be a better way for all of us to organize our assets. Then it occurred to me that it's not just end-of-life critical to have fast access to key information -- it's day-to-day critical for all of us, at any age, to have one safe place to store our assets and important documents."

*Smart Planning*

To be sure, other companies offer secure online safe deposit boxes, but they generally provide only "dumb" storage, where the customer essentially dumps their documents without any structure or action plan.

By contrast, Estate Assist provides simple onboarding tutorials that prompt users as to what types of documents they may want to secure, who they want to designate to receive those documents and the time and circumstances in which those designees will gain access. The cost is $4.95 a month.

This process has been made even easier by a partnership with Intuit. Estate Assist users can input their main bank account information into their dashboard, and Intuit's powerful API will search and locate other financial accounts to be added to the digital safe.

One question that immediately comes up is security. How can you trust that all your important information is safe after being uploaded into the cloud? The company has gone to great lengths to ensure that the private details of their users stays private. All data transfers to and from the site are protected by 256-bit encryption technology, the same type used among financial institutions. Once in the cloud, documents are stored according to Health Insurance Portability and Accountability Act compliance standards developed by the government to safeguard individual's health and medical records.

*Organizing and Documenting as It Happens*

Levin says that users can also upload videos, photos and personal communications that can only be accessed after they pass. This gives Estate Assist an added dimension that goes beyond just storing financial documents, allowing users to create a virtual time-capsule of memories and messages.

The most obvious demographic for the product are baby boomers who have already entered the life stage where estate planning is one of the foremost financial considerations. But Levin also thinks that the product will have an appeal to millennials who have grown up with technology and are comfortable using it in all aspects of their lives.

In either case, the company hopes that users will also adopt Estate Assist for organizing and documenting significant life events in real time. "Whether it's marriage, a new baby, retirement, a work transfer overseas or military deployment," said Levine, "the most important thing each one of us can do is to keep our financial assets, digital assets, and important documents safe and secure -- and when we want, make those documents easily accessible to our loved ones."

The Lund Loop is a free once-weekly curated slice of what I am writing, reading and hearing about in finance, tech, music, pop culture, humor and the good life. But not sports or knitting ... ever!

 

Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 12 hours ago.

The Bawmann Group Acquires Ubiquity Group, a Leading Denver-Based Biotech and Medical Technology Marketing Firm

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The Bawmann Group Acquires Ubiquity Group

Denver (PRWEB) December 02, 2014

The Bawmann Group (TBG) – an integrated marketing communication agency with diverse experience in the health care, education, social services, entertainment, agriculture and nonprofit fields – has expanded its services with the acquisition of Denver-based Ubiquity Group, which specializes in biotech and medical technology marketing. The acquisition is effective immediately.

The combined TBG-Ubiquity team will continue to serve a wide range of clients, maintaining its high-quality work for premier biotech and medical technology companies as well as nonprofit organizations, private businesses and other industry innovators.

The acquisition will enhance TBG’s already expansive list of services, which run from branding, advertising and web development to media relations and issues management.

“Ubiquity’s founder, Lisa Stemmer, has done a phenomenal job building a world-class creative firm,” said Brad Bawmann, TBG president and CEO. “We are blessed to be able to grow our team with the addition of Ubiquity’s talented professionals and significant international client base. Our existing clients will benefit from Ubiquity’s creative team, and Ubiquity’s clients will have access to a broader range of integrated marketing expertise, including public relations, crisis communication and social media services.”

For nearly 20 years, TBG has helped organizations around the world achieve their marketing objectives across a variety of audiences. The agency has worked in virtually all segments of the health care system, serving governmental agencies, insurance companies, health care providers, hospital systems, foundations, medical researchers, biotechnology and pharmaceutical companies, private businesses and other key health care stakeholders to execute impactful, efficient and effective marketing initiatives.

“What impresses me about TBG is its ability to adapt very quickly,” said Stemmer, who founded Ubiquity in 2000. “I truly believe Ubiquity’s clients will thrive with more communication options, and TBG’s clients will benefit greatly from our creative team.”

Stemmer will stay on with TBG as a senior advisor and focus her work on cultivating the agency’s client base in Europe.

Ubiquity has helped health care and biotech clients achieve and surpass their marketing goals for 14 years. It has worked with prominent national and international companies as well as businesses based in Colorado’s health care, biotech and medical device sectors.

Ubiquity’s work includes marketing strategy, websites, mobile apps, interactive presentations, video, print collateral and email campaigns.

The new, more robust TBG will now expand its business even further into the health care, medical technology and biotech fields while continuing to grow its lively practices in a wide array of other industries.

# # #

About The Bawmann Group:
The Bawmann Group (TBG) is a leading integrated marketing communication agency based in Denver. During the last 17 years, TBG has helped to build and communicate brands for organizations in diverse industries spanning the country – from education and health care to finance and social services. In doing so, the firm has placed hundreds of thousands of news stories, generated millions of website visits and brought clients millions of dollars in added-value advertising, helping thousands further their education, obtain health insurance, pay their energy bills and register as organ donors. Strategic, quick and creative, the TBG team of more than 30 marketing professionals is known for making things happen on time and on budget. For more information, please visit the TBG website at http://www.morethanpr.com.

About Ubiquity Group:
Ubiquity Group specializes in biotech and medical technology marketing. By focusing on customer value and differentiation, we help companies change what people believe about their products, services and therapies. For more information, please visit http://www.ubiquitygroup.com. Reported by PRWeb 11 hours ago.

Obamacare's Impossible Challenge: Why You Can't Make A Smart Choice Among Dozens Of Health Insurance Plans

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Obamacare's Impossible Challenge: Why You Can't Make A Smart Choice Among Dozens Of Health Insurance Plans Reported by ajc.com 8 hours ago.

Corporate Wellness Services in the US Industry Market Research Report from IBISWorld Has Been Updated

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Many businesses have grappled with illness-related costs, such as a loss of productivity due to employee absenteeism, bolstering industry demand. For this reason, industry research firm IBISWorld has updated a report on the Corporate Wellness Services industry in its growing industry report collection.

New York, NY (PRWEB) December 02, 2014

The Corporate Wellness Services industry has experienced robust growth over the past five years, due to many businesses' purchasing wellness programs to help lower healthcare costs. Many businesses have grappled with illness-related costs, such as a loss of productivity due to employee absenteeism, bolstering industry demand. In particular, according to the research corporation RAND, 72.0% of employers purchased screening services (e.g. services that identify employees' health risks) and intervention services (e.g. services that reduce health risks by promoting healthy lifestyle choices), thus stimulating industry revenue growth. According to IBISWorld Industry Analyst Sarah Turk, “In response to the burgeoning obese and overweight population, which may increase employer-mandated health insurance costs, many businesses have implemented biometric screening services.”

For example, corporate wellness services may include collecting employees' biometric data (e.g. height, weight, blood pressure and blood glucose levels), which helps industry operators target high-risk employees for intervention programs. Among businesses that offered lifestyle management programs, 79.0% of businesses had nutrition and weight counseling, followed by smoking cessation (77.0%), fitness (72.0%), alcohol and drug abuse (52.0%), stress management (52.0%) and health education (36.0%) programs, according a RAND study in 2013. Further exacerbating demand for industry services, businesses are expected to have a high return on investment (ROI) for disease management services, with each dollar allocated toward these programs resulting in a $3.80 ROI. During the five years to 2014, industry revenue is expected to increase markedly, including a substantial rise in 2014. Profit is also expected to grow, driven by businesses increasingly demanding comprehensive wellness programs.

The Corporate Wellness Services industry is characterized by a low level of market share concentration. In 2014, the top four companies are expected to make up a small amount of industry revenue. Overall, the industry is highly fragmented, which can be attributed to many corporate wellness companies solely catering to market niches. In particular, some companies may offer wellness services to nonprofit businesses or some public sector businesses. For instance, ValueOptions benefits from robust demand for behavioral health and wellness services from active duty members, retirees and their families via the Department of Defense's TRICARE program.

As a result, if corporate wellness companies can secure contracts to exclusively provide wellness services (e.g. health assessments, screenings and nutrition education) to a particular client, this trend adds to the industry's fragmentation. “Further adding to the industry's level of fragmentation, corporate wellness services may encompass a multitude of products,” says Turk. For example, while health risk screenings have been a common industry service over the past five years, more corporate wellness companies have included additional services, such as disease management services, fitness benefits and access to healthcare providers (e.g. nurses).

During the five years to 2019, industry revenue is forecast to grow substantially. According to a 2012-2013 Health Care Reform study by Willis, 50.0% of businesses surveyed reported that they planned on expanding the scope of their wellness program, which will provide opportunities for the industry over the next five years. Furthermore, 65.0% of businesses with 50 to 100 employees reported that wellness programs are a key differentiator for employee recruitment, inciting some businesses to purchase wellness services to bolster employee retention rates.

For more information, visit IBISWorld’s Corporate Wellness Services in the US industry report page.

Follow IBISWorld on Twitter: https://twitter.com/#!/IBISWorld
Friend IBISWorld on Facebook: http://www.facebook.com/pages/IBISWorld/121347533189

IBISWorld industry Report Key Topics

This industry includes companies that primarily provide workplace programs that offer a combination of educational, organizational and environmental activities designed to support behavior that is conducive to the health of employees and their families. This does not include programs designed internally by existing human resources personnel.

Industry Performance
Executive Summary
Key External Drivers
Current Performance
Industry Outlook
Industry Life Cycle
Products & Markets
Supply Chain
Products & Services
Major Markets
Globalization & Trade
Business Locations
Competitive Landscape
Market Share Concentration
Key Success Factors
Cost Structure Benchmarks
Barriers to Entry
Major Companies
Operating Conditions
Capital Intensity
Key Statistics
Industry Data
Annual Change
Key Ratios

About IBISWorld Inc.
Recognized as the nation’s most trusted independent source of industry and market research, IBISWorld offers a comprehensive database of unique information and analysis on every US industry. With an extensive online portfolio, valued for its depth and scope, the company equips clients with the insight necessary to make better business decisions. Headquartered in Los Angeles, IBISWorld serves a range of business, professional service and government organizations through more than 10 locations worldwide. For more information, visit http://www.ibisworld.com or call 1-800-330-3772. Reported by PRWeb 8 hours ago.

Health Insurers Need Doctors To Hold Onto Medicaid Pay Raise

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A pay raise of more than 70 percent for doctors who treat Medicaid patients is in jeopardy come Jan. 1, 2015, which could have a negative impact on provider networks for health plans contracting with the federal-state health insurance program for poor Americans. Reported by Motley Fool 8 hours ago.

The Cycle of Republican Radicalization

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Yesterday, the Washington Post reported on a Quinnipiac poll from a week ago showing a striking change in public opinion on immigration. The question was whether undocumented immigrants should be deported or should be able to get on a path to citizenship. Clear majorities of the public have long favored a path to citizenship (especially if you provide details of what that path would entail, which this poll didn't). But that has changed, because Republicans have changed. As the Post described the Quinnipiac results, "Although [Republicans] supported citizenship over deportation 43 to 38 percent in November 2013, today they support deportation/involuntary departure over citizenship, 54 to 27 percent."

That's an enormous shift, and it provides an object lesson in a dynamic that has repeated itself many times during the Obama presidency. We've talked a lot about how the GOP in Congress has moved steadily to the right in recent years, but we haven't paid as much attention to the movement of Republican voters. But the two feed off each other in a cycle.

Immigration is a perfect example. Before this latest immigration controversy, Republican voters were at least favorably inclined toward a path to citizenship. But then Barack Obama moves to grant temporary legal status to some undocumented people (and by the way, nothing he's doing creates a path to citizenship for anyone, but that's another story). It becomes a huge, headline-dominating story, in which every single prominent Republican denounces the move as one of the most vile offenses to which the Constitution has ever been subjected. Conservative media light up with condemnations. And because voters take cues from the elites on their own side, Republicans are naturally going to think the order was wrong while Democrats are going to think it was right.

But what the Quinnipiac poll suggests — and granted, this is only one poll and we won't know for sure until we get more evidence — this process also ends up shifting people's underlying beliefs about the issue. In this case, the controversy makes Republicans more conservative.

Let's take another example. People like me have mocked Republican officeholders for the way they shifted on the wisdom of health insurance reform that involves establishing a marketplace where people can buy private insurance, providing subsidies so those with modest incomes can afford it, and imposing an individual mandate to ensure a wide risk pool. When Mitt Romney passed a plan on that model in 2006, Republicans thought it was an innovative, market-based solution to the problem of health insecurity and the uninsured, but when Barack Obama passed a similar plan in 2010, they decided it was a freedom-murdering socialist nightmare.

But it's safe to say that the average Republican voter didn't have much of an opinion on that particular kind of health care reform prior to Barack Obama becoming president. They did, however, have opinions on the underlying question of whether it's the responsibility of the government to make sure that everyone has health coverage. You'd expect most Republicans to say no, since they believe in the free market and aren't favorably inclined toward the safety net. And most did — in Gallup polls, the number of Republicans answering no to this question has consistently been over 50 percent. In 2006, for instance, it was 57 percent. But since then the rejection of government having this responsibility has gone from a majority position among Republicans to near-unanimity. In 2013, it reached 86 percent.

So it isn't just that Republican voters were convinced that the Affordable Care Act is a bad thing. As a group they moved to the right, with the minority of them who believed in a government responsibility for health care either changing their minds or changing their party affiliation.

This movement hasn't happened on every issue; for instance, you might be surprised to learn that substantial numbers of Republican voters appreciate the reality of global warming and favor taking steps to address it; in some cases, even a majority of them do, depending on what specific question is being asked (see here for some examples). My guess is that there are two reasons we haven't seen a similar movement to the right on climate. First, there is some diversity of opinion within the GOP elite, from outright climate denialism on one end to acknowledgement of reality on the other (without, it should be said, accepting that anything ought to be done about it). Second, and perhaps more important, the issue has never been at the top of the news agenda for an extended period in recent years, particularly in a conflict that pits all Republicans against Barack Obama.

But when an issue like immigration or health care does meet those criteria, you get a particular cycle. Elite Republicans take their place in the fight against Obama; then rank-and-file Republicans follow along; then pushed by their constituencies, the officeholders harden their positions, which in turn pulls their voters farther to the right, and on it goes. The particularly intense loathing Republicans at all levels have for Obama feeds the cycle, pushing them toward not just disagreeing with him on particular courses of policy but rejecting the underlying principles he holds.

Is this cycle going to continue after Obama leaves office? If Hillary Clinton wins in 2016, it probably will. Reported by The American Prospect 6 hours ago.

MNsure targeting last 5 percent of people without insurance

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The state-run health insurance exchange is aiming to sign up the last 5 percent of Minnesota residents without insurance through a multimillion dollar effort. Reported by TwinCities.com 7 hours ago.

Black Friday Revealed How Poor Americans Really Are

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Black Friday Revealed How Poor Americans Really Are Black Friday sales plummeted this year, leaving retailers completely stumped. 

After weeks of declining gas prices, many analysts predicted the biggest holiday season ever. Industry groups like the National Retail Federation reasoned that Americans would use their fuel savings on gifts. 

Despite encouraging forecasts, Black Friday weekend sales were down 11%. Cyber Monday sales rose 8%, falling short of many predictions.

So where are the customers?  

They're probably broke, according to some analysts and executives. 

Brad Anderson, former CEO of Best Buy, told CNBC that customers "are still feeling constrained," which could lead to a lackluster holiday season. 

Macy's CFO Karen Hoguet told analysts that consumers today have priorities other than clothing and housewares. 

"Shoppers are spending more of their disposable dollars on categories we don’t sell, like cars, healthcare, electronics and home improvement," Hoguet said in a call with investors.

The stores that did remarkably well on Black Friday, such as Family Dollar and Kohl's, are all deep discounters, according to a recent Deutsche Bank report. 

The success of discount retailers shows that Americans are more concerned about spending money than ever. 

Wal-Mart provided few details about results from the weekend, a possible sign of bad news, the Deutsche Bank analysts wrote.

Many Americans are watching their spending despite lower gas prices, writes Lindsey Piegza, chief economist at Sterne Agee. 

"Consumers are increasingly familiar with energy price reprieve from summer gas prices and no longer adjust their long-term spending habits as much, or at all, based on short-term price fluctuations," Piegza writes. 

And while gas prices are lower, the benefit is offset by higher housing and utility costs, according to Piegza. 

Health insurance premiums have increased between 39 and 56% since early 2013, meaning additional costs of $230 per month for the average family. 

The lackluster job market is also contributing to poor holiday sales, Piegza writes. 

"With uncertainty lingering and patience wearing thin after 5+ years of still lackluster wage growth, consumers are increasing saving for the future, hedging against a continuation of 'more of the same,'" according to Piegza. "Thus, for many, extra savings at the pump as a result of lower gas prices are simply being stored away to help supplement spending needs in the future, ramping up savings, not spending."

*SEE ALSO: 3 Retailers Who Won Black Friday*

*Follow Us: On Twitter*

Join the conversation about this story » Reported by Business Insider 6 hours ago.

How to get a great-looking pair of cheap glasses

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*How to get a great-looking pair of cheap glasses*

A new pair of glasses can leave you seeing double over the price. Fancy frames, special lenses, and protective coatings can add $500 or more, even with insurance. But with our tips, you can chop the overall cost significantly.

And if you have a flexible spending account, you can buy glasses with those extra use-them-or-lose-them dollars. Glasses and prescription sunglasses qualify as medical expenses. If you haven't bought new frames in a while, here's what you need to know to find good quality cheap glasses that you can trust to correct your vision.

-Don't focus on brands-

One reason glasses cost a lot is that they have become a hot fashion accessory. You can spend hundreds on frames from Chanel, Prada, Versace, and other big names. But those frames are often designed and manufactured by companies that license the names—not the designers.

And they may not be sturdier than store-brand frames. Most are made by a handful of companies that also make high-quality nondesigner frames, some of which look similar to the name brands, minus the logo, at a fraction of the cost. Luxottica, for example, makes frames for the designers above and for LensCrafters, Pearle Vision, Sears Optical, and Target Optical.

*Check our eyeglass store buying guide and Ratings for more tips and for buying eyewear.*

-Shop discount stores-

Just 38 percent of Americans buy their glasses from an eye doctor or optometrist, according to Mintel, a market-­research firm. Instead, they are turning to inexpensive places such as Walmart Vision Center and Costco Optical.

In our survey of 19,500 Consumer Reports readers published in 2013, Costco topped the Ratings for overall satisfaction, beating out retailers such as LensCrafters and Pearle Vision. But you might have to wait a week or more for your glasses.

-Look online-

Sales of glasses online are growing stead­i­ly. Warby Parker entered the market in 2010 as an independent online shop. (It now also has more than a dozen stores nationwide.) To keep prices low, generally $95 for single-vision glasses and $295 for progressive glasses, the frames are designed in-house. Shoppers can request up to five pairs to try on at home for five days.

There are other online sources, often with huge selections and low prices. Zenni Optical, which also offers single-vision specs for less than $100, was the most widely used online source of glasses among Consumer Reports readers. And most Web shoppers told us they would buy glasses online again. We found a women’s Vogue frame for $160 at LensCrafters that was just $96 at SimplyEyeglasses.com and $80 at LensesRx.com. Similarly, a men’s Polo frame was $199 at LensCrafters but $100 at LensesRx.com. With single-­vision poly­carbonate lenses and an antireflective coating, it came to $180, ­cheaper than LensCrafters by more than $300.

To get lenses online, ask your doctor for a copy of your eyeglass prescription, plus your pupillary distance number (the distance, measured in millimeters, between the centers of the pupils in each eye).

But buying online isn’t for everybody. “If you have a complex prescription requiring additional measurements, it’s not the best choice,” Linsy Farris, M.D., professor of clinical ophthalmology at Columbia University, said. Plus, online retailers can’t adjust frames or provide other in-person services. One option is to buy frames online and lenses locally. Walmart fills prescriptions for frames purchased elsewhere for $10 plus the cost of the lenses; Costco charges $18.

-Check on quality-

If you want wire frames, look for titanium, which is strong, doesn’t corrode, and is lightweight, says Avi Vizel, an optician and owner of optical shops in New York City. Spring hinges are more likely to break than regular ones. And “if you’re on a budget, invest in lenses, not frames,” he said. Also ask about warranties and return policies. Some give you just 14 days to return glasses; others offer a full year.

-Ask about insurance-

If you’re covered by insurance, find out whether the eyeglass store accepts your plan. About half of our survey respondents who shopped in stores used it to cover part of their bill. Insurance would cover up to $140 of the cost, on average, for our readers. Those with little or no insurance had to pay an average of $244 out of pocket.

If you have vision coverage but are shopping at a retailer that doesn't accept your plan (and many online vendors don't), you might be able to get reimbursed for at least part of your out-of-pocket costs.  

-Get two pairs-

Eyeglass stores often have coupons and special half-price deals. If you find one, consider buying a backup pair in case your primary pair is lost or broken. That way you won't have to run to an expensive shop to have a replacement made right away. Or just ask for a discount if you buy two pairs. Eye doctors and independent shops may be more willing than chains to negotiate on price.  

-Can you spot the splurge?-

Eyeglasses that look identical are often sold at vastly different prices. Think you can tell which frames are the costly designer ones and which are the less pricey pairs? The top frame (A.) is the Oliver Peoples “Artie,” which costs $340 without lenses. Compare that with the lookalike Warby Parker “Sims“ frame and lenses (B.) for $95. The bottom frame is the Giorgio Armani 7005 (D.), which costs $280. Compare that with its lookalike, the Ray-Ban 7029 frame (C.), which costs $160.   

—Sue Byrne

Lenses are better than ever

New technologies are worth a look; just be aware that you’ll pay a lot more for the latest and greatest. Here are some examples that experts told us about.

*• High definition. *HD (digital) lenses can help you see even more clearly, experts say. They’re meant for people who want progressive lenses. The per-pair cost averages around $295, says Steve Kodey, senior director of industry research for The Vision Council.

*• High-index lenses. *These are lightweight and thin, and offer ultraviolet-radiation protection. They are especially good for people who have strong prescriptions.

*• Photochromic lenses. *The newest version of these, which darken in sunlight and offer ultraviolet-ray protection, is worth considering, Kodey says. “Consumers who didn’t like what they bought years ago would like them better today,” he said. “The tinting changes quickly, and they become remarkably clear when you’re back inside.” Average cost: $190.

*• Blue-light coatings. *That’s shorthand for high-energy visible-radiation-light lens coatings. People who spend a lot of time staring at computers and other screens that emit light can suffer headaches and blurred vision; a blue-light coating is designed to block that light. But it’s pricey, at $150 to $200 or so.

*• Antireflective coatings. *These make it easier to see in strong light and at night, and now they come with anti-smudge and anti-fogging technology. So if you’ve shied away from those coatings in the past because lenses were prone to smudges and hard to clean, you may want to consider them now. They’re not cheap, costing about $210, but are often included on high-index lenses.

Use our free app to explore your health insurance options

Not sure where to begin with getting health insurance? Our free interactive tool, Health Law Helper, will point you in the right direction.

A version of this article also appeared in the December 2014 issue of Consumer Reports on Health.*Consumer Reports has no relationship with any advertisers on this website. Copyright © 2006-2014 Consumers Union of U.S.*

*Subscribe now!*
Subscribe to *ConsumerReports.org* for expert Ratings, buying advice and reliability on hundreds of products.
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    Reported by Consumer Reports 5 hours ago.

Colorado health exchange site experiences enrollment glitches

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Technical glitches in the state's online health insurance exchange have stopped at least 88 prospective customers from completing their applications despite assurances the site was more Reported by Denver Post 6 hours ago.

How Can I Find Out If I Qualify for Discounted Health Insurance?

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How Can I Find Out If I Qualify for Discounted Health Insurance? Reported by ajc.com 5 hours ago.

Interview With a Henchman

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Rocky LeFebre, a professional henchman who has worked for several leading super-villains, talks with Mark Osler about his fascinating and often troubling career.

*You've worked for some fascinating personalities. Which were most memorable?* I was with the Joker from 1985 to 1989. Then I worked for Dr. Doom through, oh, the mid-90's, then this Italian guy no one has heard of, Fraudio. General Zod, briefly. In 2011 and 2012, I worked for Rick Perry. Those are the really memorable ones.

*Who was Fraudio? * Tall dark-haired guy, black cape, really sinister looking, paid well. He mostly did white-collar stuff, skimming off import-export fees. It got boring. No real action. That guy had a ton of dough, though. I think he felt bad that he never got much attention. He had some business dealings with Bruce Wayne, and I kept telling him to do something to piss him off, but he didn't get it. They're like that. They just focus on their own little silo.

*How do you get into this business? It's not like anyone goes to school thinking "I want to be a henchman."* It's different for everybody. Right now, it's a lot of guys who used to be mortgage brokers, but it's a mix. For me, it was the cars. I was working for UPS, driving a truck, and the Joker was outfitting people in these great rides -- Dodge Darts, tricked out--and I wanted in. It was great, too. That slant-6 engine never gave out, even if the rest of the car was incinerated. I'd love to have that car back, but it got buried under about 120 police cars down on 7th Avenue.

*It seems like a pretty risky job.* I guess, yeah. Most of the guys I worked with back in the '80s are gone now. Part of it is bad management. The Joker would just leave you with one assistant henchman and Batman, expecting you to finish him off in a giant percolator or something. That didn't work out so well for our side. You'd be waiting for the thing to finish, having a sandwich, and boom! A lot of times, you didn't have a real weapon, either, or something pretty useless like a tire iron or a metal ball on a chain. I got stuck a lot with a mace. Really? When everyone else in Texas has a gun, I'm standing there behind Perry like a medieval goon holding a weapon from the 1400's? But it wasn't my call.

*You've been at it a long time. What keeps you going? *Up until a few years ago, it was the health insurance. Obamacare changed things for freelancers like me. Loki is the best for that -- the guy pays for anything. I've got a pretty limited skill set, but I'm good at what I do. You need a guy to pound a baseball bat into his hand menacingly? I got that. Driving a car straight into a pile of other cars? Done. It gets routine, and that's ok. I do what I know.

*Did you ever think of stepping it up to the next level?* Nah, that's not my thing. I'm from Newburgh, and I'm thinking about going back there and opening a coffee place. Don't even say it -- everyone does. "Will it be an evil coffee shop?" I get so sick of that. But yeah, a little bit. I don't recycle. Reported by Huffington Post 4 hours ago.

2014 Connance Consumer Impact Study Shows Link Between Business Office, Patient Payment Behaviors and Patient Satisfaction

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Fifth Annual Study Finds Patients Who are Unsatisfied with Hospital Billing Less Likely to Pay Their Bills in Full or Recommend the Hospital

Waltham, MA (PRWEB) December 02, 2014

Connance, Inc. (http://www.connance.com), healthcare’s premier source of predictive analytic technology solutions that optimize financial and clinical workflows, today announced that according to its fifth annual Connance Consumer Impact Study, a survey of Americans who received hospital services within the last year, 35% of patients gave their recent hospital billing experience a top satisfaction score, while 14% were less than satisfied. Satisfaction has been slowly increasing over the years and is now 15 points higher than it was in the first survey.

For business office teams responding to the rapid rise in patient payment revenue as a result of high deductible health plans and plans purchased through government exchanges, these findings confirm the criticality of their efforts. Delivering a better patient experience during the resolution of financial responsibilities is a component to building a positive relationship with patients. This financial relationship is often developed when the patient is off campus after treatment and complements the clinical relationship formed in the delivery of care. With increasing risk-based reimbursement, providers must take advantage of every touch to reinforce care plans and healthy living.

The 2014 Connance Consumer Impact Study is an online survey of 500 healthcare consumers from 46 states, 6% of whom were uninsured and 94% of whom were insured. This is the highest percentage of insured respondents in the five years of the survey. Executed in August 2014, highlights from the survey include:· Among respondents giving billing processes a top score:

o 82% would recommend the hospital,
o 95% would return to the same hospital for a future elective service, and
o 74% paid their bills in full.· Among respondents giving billing processes less than satisfied scores:

o 15% would recommend the hospital,
o 58% would return to the same hospital for a future elective service, and
o 33% paid their bills in full.· Among respondents, 35% gave billing processes a top score of “5” (on a 1-5 scale) and 51% rated the billing processes a “3” or less. These results are better than in previous years when top score percentages were 29% in 2013, 25% in 2012, 21% in 2011 and 20% in 2010.
· Satisfaction is higher among insured respondents without high deductible plans, 37% gave

billing processes a top score, while only 28% of those with high deductible plans ranked it
similarly.· Of consumers with balances due of greater than $100, those who gave business office processes

a top score, 66% paid their hospital bills in full. Among less than satisfied consumers, only 36%
paid their bills in full.

Business Offices have an Opportunity to Build Positive Patient Relationships

"The dynamics put in motion with high deductible health plans designed more than a decade ago and reinforced in the reimbursement model of health reform are starting to come into maturity. Healthcare is becoming a consumer product, where patients consider the full experience, clinical and financial,” said Steve Levin, Chief Executive Officer of Connance. "How clinical leadership embraces this new patient engagement model will have long-term implications. Those who see this transformation as an opportunity will find numerous ways to thrive in the new system. Those who shy away from the consumer as a decision maker will find tomorrow’s healthcare environment unfulfilling."

Revenue cycle and patient engagement around their financial responsibility is an area for strategic opportunity. Patients engage with the revenue cycle operations before treatment and after treatment, for weeks or months. These interactions are opportunities to better serve patients and forge virtuous relationships.

The 2014 Connance Consumer Impact Study survey data will be presented during a webinar on
Thursday, December 4 at 12:00 p.m. EST. Visit https://www3.gotomeeting.com/register/416329030 to register.

The Connance Consumer Impact Study focused on understanding patient behavior, satisfaction, attitudes and perceptions towards healthcare bills. The survey was conducted via an internet survey in August 2014 with 500 adults across the U.S. who had recently received hospital services. The survey sampling quotas were designed to be representative of U.S. adults ages 26 and above who do and do not have health insurance. The data has a tolerance of +/- 4.4%. This is the fifth consecutive year running the survey.

About Connance, Inc.
Connance is healthcare’s premier source of predictive analytic technology solutions that enable hospitals, clinicians and outsourcing organizations to optimize financial and clinical workflows for sustained performance improvement. Leveraging your data, our data and consumer data, Connance delivers revenue cycle and population health solutions that prioritize activity and tailor your workflows to improve net income, reduce costs, and enhance the patient experience. Connance is redefining workflow optimization in healthcare. For more information call (781) 577-5000 or visit http://www.connance.com.

### Reported by PRWeb 4 hours ago.

Colorado health exchange enrolls 9,719 in first two weeks

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Coloradans signing up for health insurance on the state exchange number 9,719 after two weeks of open enrollment for 2015, Connect for Health Colorado officials reported Tuesday. Reported by Denver Post 4 hours ago.

Blue Cross and Blue Shield of Texas Hosts Free Health Insurance Enrollment and Wellness Fair in Dallas

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RICHARDSON, Texas, Dec. 2, 2014 /PRNewswire-USNewswire/ -- Blue Cross and Blue Shield of Texas (BCBSTX) is hosting a free health insurance enrollment and wellness event in Dallas on December 13 from 9 a.m. – 3 p.m. at the Fair Park Embarcadero Building. At the Countdown to Coverage:... Reported by PR Newswire 3 hours ago.

Mitch McConnell Says SCOTUS Could Take Down Obamacare, Progressives Go Wild

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Today's progressive nontroversy has arrived. When Mitch McConnell stated that the future of Obamacare was in the hands of the Supreme Court and could "take it down," he probably thought this was common knowledge by now. But some on the left are now suggesting this statement, "confirms here that the litigation is politics by other means."

In order to see what a stretch the progressive freak out over stating the obvious is, you only need to read McConnell's full statement. In an interview with the Wall Street Journal, McConnell was asked "How do you approach the Affordable Care Act now?" He replied at length:



I think it's the single worst piece of legislation we've passed in at least the last half century and the biggest step to European-ize American health care.

Having said that, it bears the president’s name. The chances of his signing a full repeal are pretty limited. There are parts of it that are extremely toxic with the American people. The elimination of the 40 hour work week. The individual mandate. The medical device tax. The health insurance tax. I think you could anticipate those kinds of things being voted on in the Senate. They've not...Such votes have not been allowed in the past.

Who may ultimately take it down is the Supreme Court of the United States. I mean there’s a very significant case that will be decided before June on the question of whether the language of the law means what the language of the law said, which is that subsidies are only available for states that set up state exchanges. Many states have not. If that were to be the case, I would assume that you could have a mulligan here, a major do-over of the whole thing, presented-- that opportunity presented to us by the Supreme Court, as opposed to actually getting the president to sign a full repeal, which is not likely to happen.



Somehow, McConnell's tentative assessment combining what we all know (Obama would veto repeal, and the ACA is in SCOTUS' hands) and what we all know could happen next (they could take it down) is being transmogrified into an admission the case is "politics by other means."

Writing at the Washington Post, Greg Sargent seems eager to make a mountain out of a molehill but does eventually admit there's not much here. "Even if McConnell is simply describing this as the objective outcome that will result from a SCOTUS decision against the law, it represents a noteworthy level of candor," he writes. I'm not so sure it's even that. Is it "candor" for Mitch McConnell to state something we all know to be the case? Isn't that just sort of just keeping up with current events?

In a quote given to Greg Sargent at the Post, law professor Nicolas Bagley--who has been one of the loudest voices opposing the court case--goes even further saying, "McConnell confirms here that the litigation is politics by other means. It sounds like McConnell is treating the Supreme Court as another political institution."

This claim is not remotely substantiated by McConnell's statement. McConnell said nothing at all about the intent of the litigation. He only speculated about what might eventually happen given that the Supreme Court has taken on the case. To be fair, Bagley did allow that the word "confirm" may have been ill-chosen, though he didn't back away from the statement:



@ThePlumLineGS @verumserum Perhaps I should have said "suggests," but I think either way the point stands.

— Nicholas Bagley (@nicholas_bagley) December 2, 2014


I don't see how McConnell's statement even suggests such a thing to anyone who wasn't already convinced this was the case beforehand.

Meanwhile, the usual suspects are running with this latest nontroversy. Think Progress has a similar story up claiming McConnell "admitted on Monday that Republicans are banking on the Supreme Court to invalidate a key portion of the Affordable Care Act." Again, McConnell made no admission and said nothing about banking on the court. At best, he stated it was a possibility which of course it is.

The question and McConnell's full answer can be viewed in the following clip:

So Reported by Breitbart 2 hours ago.

Utah man says finding affordable health insurance saved his life

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West Valley City, Utah- (ABC 4 Utah) – Some say the Affordable Care Act needs to be repaired or even repealed, others say it changed their life. Reported by abc4 39 minutes ago.

Kathleen Sebelius: 'Americans Have No Idea What Insurance Is About'

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Kathleen Sebelius: 'Americans Have No Idea What Insurance Is About' Former Health and Human Services (HHS) Secretary Kathleen Sebelius said on Tuesday that passage of the highly unpopular Obamacare program has revealed Americans' ignorance about health insurance. 

"One of the things that we have learned with the passage of the law [Obamacare], and certainly with open enrollment in 2014--and I think this will be true again in 2015--is that a lot of Americans have no idea what insurance is about, and have no idea, even if they have coverage, what it means, you know, what a deductible is, what a copay is, how to choose a network. Those are complicated terms," Sebelius told USA Today's Susan Page. 

Sebelius added that Americans' inability to understand health insurance was a "stunning revelation."

"I think the financial literacy of a lot of people, particularly people who did not have insurance coverage, or whose employers choose their coverage and kind of present it to them, is very low," said Sebelius. "That has been a stunning revelation."

Asked about controversial remarks by Obamacare architect Jonathan Gruber that Obamacare passed because of the "stupidity of the American people," Sebelius downplayed Gruber's role and said she never met with him personally before backtracking and suggesting she may or may not have been on phone calls or group meetings with Gruber. As the nonpartisan Government Accountability Institute (GAI) revealed in Politico Magazine, Sebelius only had a single one-on-one meeting with President Obama since the passage of Obamacare until its unveiling. 

After making her comment about the "stunning revelation" about how ignorant most Americans are about health insurance, Sebelius went on to criticize Gruber's comments about how ignorant most Americans are about Obamacare. 

"Clearly he is not very articulate with the phrasing he uses," said Sebelius. "He is making some headlines, which is unfortunate because I think he's harming the very product that he helped to push forward." 

Jonathan Gruber testifies before Congress next week.  Reported by Breitbart 39 seconds ago.
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