Tuesday, February 1, 2022

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No Longer a Hypothetical Concern

Eakinomics: No Longer a Hypothetical Concern

Student loan forgiveness is a policy that seems to have a life of its own. The Obama Administration – which, as a reminder, has been gone since 2017 – originated modern student loan forgiveness, which has continued to morph and expand in the years since. (The most recent efforts on this front took place last fall.) Campaigns (named the silly season for a reason) brought forth a slew of expansive (and expensive) loan forgiveness proposals, especially during the bidding war that was the 2019-20 Democratic primary. And, don’t forget, the declaration of a national health emergency became a sufficient reason to simply stop payments – not forgive, but defer payments and freeze interest rates – on student loans.

All of this occurred despite the fact that loan forgiveness is a policy in search of a problem. It doesn’t rectify the inequality bemoaned by the left because the more affluent disproportionately benefit from forgiveness. So much for a distributional argument. It also does not improve educational attainment or access to higher education. These issues are in the past and “sunk” from the perspective of a forgiveness policy. So, no argument based on improving educational attainment. And it does not improve the functioning of financial markets; there is no case to be made on financial market efficiency.

Indeed, the argument has always been the opposite: Student loan forgiveness sets up the expectation of forgiveness for future borrowers. This is an incentive for future borrowers to borrow too much, get into financial trouble, and harm their individual welfare and reduce overall market functioning. It is the kind of argument that soulless economics types (e.g., me) make. And the typical response is something like, “Yeah, right. Why don’t you go back to your Eakinomics and find a real problem?”

So I am pleased (sort of) to report that CNBC has a story that says: “Americans believe it’s more likely that some, or all, of student debt gets forgiven than that bills will resume in three months, according to a CNBC + Acorns Invest In You Student Loan Survey.” Specifically: “Just 29% of respondents ranked student loans resuming in the spring as the most probable outcome. More than a quarter think the likelier situation is that the pause is prolonged beyond May, while 14% of people anticipate full loan forgiveness and another 28% expect some cancellation.”

That is stunning, especially that over 40 percent expect at least some cancellation/forgiveness, while just over a quarter expect people to pay at all. Far from being a hypothetical problem, the expectation of future forgiveness is spreading like, well, a pandemic.

Student loan forgiveness is a pointless policy that people expect a lot more of. Terrific.

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Seven Key Questions to Check for Plausibility in Mental Health Claims

Seven Key Questions to Check for Plausibility in Mental Health Claims

By Johannes Schmidt, Tuesday, February 1, 2022 3:00 AM

This article summarizes important aspects for claims professionals to keep in mind when assessing mental health claims and which represent the scientific standard in the context of assessment.

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Living With Multiple Myeloma

Posted on October 14, 2021
Medically reviewed by
Todd Gersten, M.D.
Article written by
Anastasia Climan

Multiple myeloma is a cancer of plasma cells. This disease can present a variety of challenges, but people with multiple myeloma can experience productive and fulfilling lives by proactively managing their condition. Although no two journeys are the same, there are many ways to make navigating life with multiple myeloma easier.

Exercise

Regular physical activity has been shown to benefit people with myeloma in many ways. Exercise can help reduce fatigue and sleep problems. However, fractures are more common for people with multiple myeloma, so you may not be able to participate in the same types of exercise you once enjoyed. In addition, staying hydrated is crucial when you exercise.

Members of MyMyelomaTeam often share tips and resources for staying active. “I do Silver Sneakers online,” one member wrote. “It has helped me so much. I do it three days a week. You can do it standing up or in your chair. It’s live-streamed through Facebook. I think it has helped with the pains in my legs. At any rate, I feel better mentally, as well.”

Another member explained how they approached exercise safely: “My oncologist gave me a referral for physical therapy. My physical therapy was personally set up to match my physical capabilities. Everyone, please remember to try and not worry about someone pushing you too hard. My therapist was very understanding and compassionate. She worked on my balance, leg strength, and arm strength after an interview and review of my multiple myeloma and background.”

Managing Stress

Multiple myeloma complicates the already demanding areas of daily life. The stress of high medical costs combined with pressure to keep up at work and home can feel like too much to cope with by yourself. Fortunately, support groups are available in person and online to offer advice from others dealing with similar challenges.

Self-care is crucial before, during, and after myeloma treatments, such as radiation therapy or chemotherapy. Prioritize essential elements like healthy eating, restful sleep, and counseling as needed to preserve your well-being and quality of life.

Smoking

Myeloma can be a stressful diagnosis, and smoking is a tough coping mechanism to quit. Several members on MyMyelomaTeam are working on quitting. Hearing the struggles that others face will show you that you’re not alone.

“I’m trying. I really want to stop,” one member wrote. “The thing is, I didn’t start again until after I got cancer. I feel so bad. I’m hurting my kids and myself. Why can’t I stop? Why is the urge so bad? I just don’t get it. I’m not weak, but I feel that I am with this.”

Another member stated, “I’m having a rough time trying not to get cigarettes. Even though I have not had any for a couple of months, my desire seems to have gotten stronger. It’s bad when you dream of smoking. I’ve been really depressed lately, and my mind is going different places and won’t stop spinning. I know I’ve talked about this. I’m sorry, I just don’t have anyone else to talk to. I need some help with this.”

Quitting is a challenge, but it’s important to keep in mind that every bit of progress is a win. “So, this is my second day without smoking, and I’m proud of myself,” one member wrote. “Treatment has my myeloma down over 50 percent.”

How To Talk About Myeloma With Friends, Family, and Co-Workers

Hiding the side effects of myeloma treatment from people you regularly spend time with can be difficult. You may experience appearance changes, extreme fatigue, moodiness, and gastrointestinal problems. If you have a suppressed immune system, you might need to avoid high-risk environments and large groups. Openly communicating with others may help set you free, but only when you feel ready to do so.

Navigating Family Life With Myeloma

The roles and responsibilities you have at home may need to change depending on your current stage of myeloma treatment. Don’t be afraid to reach out for help from relatives and friends for tasks such as grocery shopping, meal prep, cleaning, lawn care, driving kids to activities, or even helping out with homework after school. There may be times when your partner will need to step into the role of caregiver. If your family is having trouble adjusting to the changes, meeting with a family or relationship counselor can help you work through the logistics and emotions involved with keeping your household running smoothly.

Working With Myeloma

A myeloma diagnosis is a significant life change that may affect your occupation and career path. A flexible work environment that includes a part-time schedule, available time off, and remote work can be ideal as you go through the ups and downs of treatment. If your current workload becomes unmanageable, but you don’t want to find a different job, start by speaking with your manager to determine if reasonable accommodations can be made. The Americans with Disabilities Act National Network has resources that can explain your rights.

Parenting With Myeloma

Multiple myeloma rarely occurs in people under age 45. Therefore, it’s not unusual to have had children before you learn about your diagnosis. Finding opportunities to discuss cancer with loved ones can be hard. However, speaking to your kids about your diagnosis sooner rather than later will open up the conversation, giving them time to adjust, ask questions, and express their concerns. You’ll also be able to make sure they hear the news from you rather than from another relative or a friend.

If you have multiple children of different ages, you may choose to share more or less information individually, depending on their maturity level. There are circumstances when it also makes sense to share your diagnosis with your child’s school. Their teachers can help keep an eye out for signs of stress, and guidance counselors may be able to provide extra support.

Financial Burden

Cancer treatment can feel like a whirlwind of unexpected costs. Meeting with specialists, having a variety of tests, and being prescribed a range of medications can make it hard to keep track of your medical bills. Health insurance may help, but it doesn’t usually cover everything. If you have a high-deductible plan, you may end up paying quite a bit out of pocket before any assistance kicks in.

Although financial stress seems unavoidable, the problem is, unfortunately, widespread. Ask your oncology health care team to speak with someone in your hospital’s billing department. You may be able to apply for financial assistance or a payment plan to ease the burden. Be sure to communicate with your insurance carrier to help anticipate the costs of different treatment options before they come through. There are several avenues you can explore for help with medical bills. Never allow the cost of treatment to deter you from getting the cancer care you need.

Costs for your myeloma treatment will be much more affordable if you have some form of public or private health insurance, including the following:

If you do not have health insurance, or if you have insurance but need further support, you may find resources within your state to help cover medication costs. Some of the programs available include:

You may want to talk with a Medicare advisor or social worker about programs you may be eligible for that can help offset the costs of myeloma treatments.

Disability Benefits for Myeloma

Social Security Disability Insurance and Supplemental Security Income are two federal programs that may offer assistance for people with myeloma who are unable to work. Ask your health care team for a referral to a social worker to find out whether you qualify for one of these programs and how to apply.

Tips for Traveling With Myeloma

Many people with myeloma (especially those with low white blood cell counts) are on heightened alert about the potential spread of germs on airplanes.

One member of MyMyelomaTeam described their concerns. “It’s especially easy during this holiday season to catch a cold. My wife and I decided not to travel by airplane for the holidays. In addition to catching a cold from all the travelers, the security lines are horrendous. I’m constantly washing my hands, wearing gloves when I’m outdoors, and carrying extra tissues.”

If you choose to take a long trip by car, giving yourself enough time to stop and stretch can be a big help. “I took a seven-hour trip by car and had to stop about every couple of hours just to get out and walk,” another member wrote. “I have had many fractures, including a hip replacement and peripheral neuropathy. We would stop at rest stops, gas stations, restaurants, lookout points, and anywhere you can walk. I am sure that I looked funny walking circles around gas stations and restaurants, but I didn’t care. Just be safe when you walk.”

Talk With Others Who Understand

MyMyelomaTeam is the social network for people with myeloma and their loved ones. More than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with myeloma.

Is life with multiple myeloma putting a strain on your relationships? What advice do you have for others? Share your experience in the comments below, or start a conversation by posting on MyMyelomaTeam.


https://www.mymyelomateam.com/resources/living-with-multiple-myeloma?utm_campaign=notification&utm_medium=email&utm_source=sendgrid 

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The Most Important Vitamin You Can Take This Winter

By Rachel Meltzer Warren, MS, RDN\

As a dietitian, I try to take a "food first" approach when it comes to making sure our bodies are getting the nutrients they need.

But there's one vitamin that I'm consistently recommending my clients take in supplement form, particularly during the cold and dark months—vitamin D.

Chances are you've heard about this vitamin in the past few years. It's become a bit of a star in the nutrition world, as researchers have discovered it may play an important role in bone health, immunity, heart function, cancer prevention, and many other conditions. It's an unusual vitamin because your skin produces it when exposed to the sun's UVB rays, which is where much of our vitamin D comes from. Some foods do naturally contain vitamin D, but it can be hard to get an adequate amount through diet alone.

Are you vitamin D deficient? Here's how to tell

Some people, particularly older adults, may be at risk for vitamin D deficiency, an issue that can have health repercussions. There are various reasons why a person may have low vitamin D levels. Spending long periods of time indoors and covering up from the sun can reduce the amount of vitamin D our skin produces. Other risk factors are having darker skin and aging; not things we can change.

You may be curious if you would benefit from a vitamin D supplement. But how do you know for sure? You can ask your healthcare provider to test your vitamin D level through a blood test, and then make choices about supplementation.

What you need to know about vitamin D supplements

Here are some questions my clients frequently ask about vitamin D supplementation:

·        What form of vitamin D to take? Evidence suggests that vitamin D3 is a valuable form of the vitamin for your body; you can take it in any type of pill, liquid, or gelcap, as long as it's D3.

·        When to take vitamin D? The time of day that you take your vitamin D shouldn't matter, as long as you choose a time that you'll be most likely to remember to take it.

·        How much vitamin D to take? This is where getting your vitamin D level tested is important. Your healthcare provider can help you determine, based on your test results, how much you should be supplementing. For reference, the Dietary Reference Intake set by the Institute of Medicine is 600 international units (IUs) or 15 mcg for adults.

·        Can't I just get more vitamin D from food? Well, in theory, yes. But in reality it's pretty tough. Three ounces of cooked sockeye salmon has about 70% of your daily need; an egg has about 10% of your daily value in the yolk. Keep in mind that many of the other foods that contain vitamin D, like milk, yogurt, and certain orange juices and cereals, have been fortified—so it's similar to taking a supplement.

Rachel Meltzer Warren, MS, RDN, is a NYC-area based nutrition writer, educator and counselor, and the author of The Smart Girl's Guide to Going Vegetarian.

Clinically reviewed and updated November, 2021.

Sources:

“How to get more vitamin d from your food,” Cleveland Clinic. Web. November 2 2021. “Vitamin D,” National Institutes of Health. Web. November 2 2021. https://health.clevelandclinic.org/how-to-get-more-vitamin-d-from-your-food/

“Vitamin D,” National Institutes of Health. Web. November 2 2021. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

Forrest, K. Y., & Stuhldreher, W. L. (2011). Prevalence and correlates of vitamin D deficiency in US adults. Nutrition research (New York, N.Y.), 31(1), 48–54. https://doi.org/10.1016/j.nutres.2010.12.001

Michael F Holick, Tai C Chen, (2008) Vitamin D deficiency: a worldwide problem with health consequences, The American Journal of Clinical Nutrition. 87 (4) 1080S–1086S, https://doi.org/10.1093/ajcn/87.4.1080S

“Vitamin d deficiency,” Scientific American. Web. November 2 2021. https://www.scientificamerican.com/article/vitamin-d-deficiency-united-states/

Houghton, L. A., & Vieth, R. (2006). The case against ergocalciferol (vitamin D2) as a vitamin supplement. The American journal of clinical nutrition, 84(4), 694–697.https://doi.org/10.1093/ajcn/84.4.694

https://www.walgreens.com/health/p2/a/1800008/the-most-important-vitamin-you-can-take-this-winter/2198650?ec=hncx2036428_C4155_p02hero&mi_u=&mi_u=AOQNBD&%24web_only=true&~campaign=hncx2036428_C4155_p02hero&%243p=e_cheetahmail&_branch_match_id=697909966056831743&_branch_referrer=H4sIAAAAAAAAA42O3U7DMAyFn6bcpT9JW8qkCQ3GLkE8QWQiq4mWP6UuYW%2BPd8Utlm0dffI5siXK26HrKvi1IMathZxb7%2BK1U%2Fm5kaPKR9TGIhLYAM4%2FMEvFrS6C13vxR3tPaNSpkRfuWmv7l2VSYGYRPFkWWfICnmHpuRZWZFGEtJFwIadCEEl8O4LgorilXRiIguCKgqzbRHWRsLBLDk%2FLPPWNuqBp1NlG8yN7NY9y0a%2FjME0699JiSY2cg9M7n7Dixyt%2B6RT9jQGVHe%2Fw8c1AyODW%2BL%2Bg08fn%2B8v5F4Xk2Ck3AQAA

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