Page 12 - Boca Club News - January '25

Page 12, Boca Club News

From The Professionals’ Desks
From The Professionals’ Desks

Healthy Answers – A Guide to Healthy Living:

“Your Weight Loss Doesn’t Have to Come...from a Syringe!

By Dale Brown, B.S., M.A., C.E.C. shedding unwanted weight? It might be “a long winding road,” keep track of calories, join a fitness class, walk 10,000 steps
Dale is a motivational speaker who but try to find an eating style that works for the long run! every day. Sounds like a plan, but six months later you find
has spent many years as a Certified One of the most popular methods is the concept of them still sitting on the couch, explaining that their busy
Life Coach and has written numerous intermittent fasting. Other diets outline what foods to eat, schedule got in the way.
articles and e-books relating to self- but in this case the word is when. Fasting has been found The Overachiever – These folks set goals way beyond
improvement and ways to build a to be effective for losing weight while protecting against what’s realistic. Have a class reunion coming up, a child’s
high-performance team. She is the muscle loss. There are several different ways fasting might wedding, or some other big occasion? Okay, you want to
author of the book, “Small Steps...Big be beneficial. Here are two of the most common. lose 50 lbs. by whatever the date may be. A healthy weight
Changes: The Personal Stories of a Life The first is the 16/8 method, which suggests you restrict loss is one to two lbs. per week, so if you have two months
Coach.” Her education and years of experience in physical eating to an 8-hour window. This can easily be done by not before the big day, the goal may be impossible to reach.
fitness and training of elite athletes has enabled her to sharpen eating anything after dinner and eating a late breakfast. This The Meal Skipper - “I haven’t eaten a thing all day so
her knowledge in many health-related areas. The following is not for everyone, but I for one find it easy to do because I can afford to chow down on chicken nachos and a couple
introduces a new approach to Ms. Brown’s series of columns I’m not a morning person. If I finish dinner by 8 p.m. and eat beers. It all evens out at the end of the day!” WRONG. Don’t
devoted to many topics that deal with the mind/body connection by 11:00 a.m. the next day I’ve easily met the requirement. skip meals unless you’re following a specific fasting program.
and the importance of living a healthy lifestyle. Dale, a Bocaire The second concept is the 5/2 diet, which involves Your body stores fat and holds out for the next meal, which
resident, can be reached at dalebrown@lovingmondays.com. breaking up the week between eating normally and eating is counterproductive to losing weight.
It’s that time of year when millions of Americans resolve fewer calories two days a week. For example, you may choose The Snacker – Snacking isn’t always a bad thing to do,
to make lifestyle changes. Whether it’s to lose weight, to eat small meals on Mondays and Thursdays (250 calories but it has to be nutritious. Eating several small meals a day
exercise more or eat healthier, the start of a new year sparks for women and 600 for men) and eat as usual the rest of the is more likely to control hunger and keep your metabolism
enthusiasm and motivates people to get going. You’ll likely time. This type of fasting seems to work better for those in high gear. Nuts are a good choice but consider apples, trail
hear familiar phrases such as, “I’m cutting back,” “No more whose main meal of the day is a hearty breakfast. mixes, carrots and celery, need I say more?
carbs,” “I’m on a new diet.” When coaching athletes and counseling them on proper The Low-Fat Expert – “I only buy low-fat items, which
Throughout my life I’ve seen diets come and go, each nutrition, my mantra was always and still is. “Calories in, helps keep my fat content down.” Whoops! Low-fat does
claiming to be the perfect solution to quickly shed unwanted calories out!” It’s as simple as that. If you eat more than your not translate to low-calorie. Check your carbs, fat, sugar and
pounds. Who would have thought that there would one day body burns it ends up as fat somewhere on your body. I hear calories on the nutrition label for a real eye opener.
be an injectable drug, such as Wagovy or Ozempic, that could people say, “Oh, I tried that diet but it didn’t work for me”. The Drinker – Did you know that some shakes, coffee
help control diabetes as well as obesity? For some these Some folks seem to always be on a diet, yet for some reason drinks and alcoholic beverages contain more than 500
medical miracles are heaven sent. But for others they can be they end up right back where they started. Why? calories? Watch out because you’ll still eat the same amount,
overkill. Outside of side effects from the drugs, they aren’t The answer is simple. Most diets do work if you make the but tack on those extra calories for the drink!
prescribed for a lifetime. There are endless stories of how commitment to practice the designated regimen. Diets don’t Dieting is hard; eating and drinking is easy. Don’t blame
individuals stopped their medication only to see the pounds work when you sabotage your own efforts to succeed and the diet on your inability to lose weight. For best results find
come pouring back on. blame it on the diet. In my coaching practice I have identified a healthy way of eating that you enjoy and can follow for
Many people aren’t usually looking to shed 50 lbs. or more; types of behavior that are responsible for failing to reach a life. Moderation and portion control are key along with daily
they might simply want to look and feel better in their clothes. desired weight loss goal. exercise. Once you find a diet that works best for you stick
Holiday eating and drinking has taken its toll and the time of The procrastinator – This person is good at telling you with it. And remember to always check in with your health
reckoning is here. So, what’s the best recommendation for what they’re going to do: load the Weight Watchers app to professional before starting any diet.
Medical Matters: Medicare Advantage Plans

By Richard Nagler, M.D., a member a specialist. They are covered when travelling. Preventive care doctors which presents a very difficult situation in having
of Broken Sound Club and retired medical care is included. any doctor available at all for these subscribers.
physician. After graduating from the During the yearly enrollment periods we are all deluged Many doctors and hospitals have opted out of Medicare
University of Pennsylvania and New by TV and other media advertisements advising us to switch Advantage plans because of the need for prior authorization
York University’s School of Medicine, from traditional Medicare to a bewildering array of Medicare and denials resulting in time-consuming hassles with the
Dr. Nagler served his internship and Advantage plans. There is considerable confusion when insurance company and long delays in reimbursement. It is
residency at Baltimore City Hospital considering these plans. They are privately administered and estimated that 50% of subscribers switched out of Medicare
and Johns Hopkins. He followed that are designed to make a profit for the insurers. Advantage plans over a five-year period, usually to another
with a Fellowship in Gastroenterology There are three major downsides to these plans. First is plan with only a few back to traditional Medicare.
at Yale University School of Medicine, and was then Chief denial of claims. While traditional Medicare rarely if ever While 46% of doctors accept Medicare Advantage
of Gastroenterology at Fitzsimons General Army Hospital denies claims, Medical Advantage plans have a 7.5 % denial plans it is now estimated that 20% of doctors and hospitals
in Denver. He returned to the Yale Medical School for one rate. They challenge the patient and the doctors as to whether have stopped accepting Medicare Advantage plans leaving
year as an Assistant Professor of Medicine before opening the treatment or procedures are necessary. millions of patients in jeopardy. The reasons given are delayed
his own successful private practice in Internal Medicine and Approximately 10% are appealed, mostly successfully, reimbursements, cumbersome prior authorization requirements
Gastroenterology. During that time, he also served for ten years but the patient must go through a long-drawn-out frustrating and high rates of denials. It has become a game of delay, delay
as Chief of Medicine at Huntington Hospital in Huntington, N.Y. process which can be maddening. The second negative is the and do not pay. People who wish to switch back to Traditional
There are approximately 64 million seniors enrolled in requirement of prior authorization for almost all medical costs Medicare must wait to do so during the annual three-month
Medicare. Over the years more than half of them have opted except for an emergency. This results in high rates of denial enrollment period.
to transition to a Medicare Advantage plan. and delays in both care and reimbursements to the doctors In this column I have focused on the essential factors that
Traditional Medicare is operated by the federal government and hospitals. people should consider when, and if, choosing to switch from
while Medicare Advantage plans are run by private institutions. The third problem is that subscribers do not have a free traditional Medicare to a Medicare Advantage plan. There are
Traditional Medicare consists of “A” for hospitalization and choice of a doctor. They must use a doctor on a list provided many less important considerations that would only serve to
“B” for doctors and other services. There is no premium by the insurance company and require a referral to a specialist add confusion in making such an important decision.
for “A” but premiums are charged for “B” and are usually on a similar list. Especially in rural areas, the list may be very One thing we must not forget is that you don’t get
automatically deducted monthly from Social Security. small where there is already a significant shortage of primary something for nothing.
Because Medicare does not pay 20% of costs most people
privately for coverage. In addition, there is available plan “D” Legal: Settlement Issues in Housing
opt for a supplemental Medigap policy which they pay
for prescription drug coverage at additional cost, which most
people arrange with a private insurance company. By Michael J Posner, Esq., a despite my verifying with a structural engineer that these
With traditional Medicare denials are very rare. partner in Lippes Mathias LLP, a were ordinary settlement cracks and not a sign of structural
Deductibles and copays are usually covered with national real estate and business- problems in the foundation.
supplemental insurance. With a Medicare Advantage plan oriented law firm with sixteen A buyer of a 1946 house contacted me after their
there is no need for supplemental or medigap insurance nor locations nation-wide. Michael inspection revealed settlement cracks. They had a
for a plan “D” as they are included along with both “A” and specializes in real estate and foundation repair contractor inspect who gave them an
“B” coverage. In addition, these plans often include limited association law. He can be reached $8,100 estimate. After another structural engineer inspected
dental care, hearing tests and certain hearing aids, as well at 561.594.1452 or at mjposner@ the property it was determined that the cracks were only due
as prescription eyeglasses. lippes.com to minor settlement and not a significant structural problem.
However, there is a deductible that must be reached after As the former owner of a brick house built in 1937 I In the news recently was fears of excessive sinking of a
which all costs are covered 100%. Combining all these features was quite aware of some settlement cracks in the exterior. large condominium in Miami. The headline screamed, “The
can result in cost savings for subscribers. Importantly, though, However, when I tried to sell the house, the buyer’s Porsche Design Luxury Skyscraper in Miami Is Sinking
all seniors are eligible for Medicare with no restrictions for inspection report stated, “STRUCTURAL CRACKING: Much Faster Than Expected. A twelve-story residential
preexisting conditions. All participating hospitals and doctors Cracking that appears to be of a structural nature is present. building nearby collapsed in 2021.” The article then detailed
must accept Medicare fee schedules. Patients can see any Suggest further evaluation by a structural engineer.” This
doctor of their choice, and do not require referrals to see was enough to cause the buyer to walk from the purchase Legal on page 13