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well az THE ARIZONA REPUBLIC A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING IN THIS ISSUE: - HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY Vol. 3, 3 No. 12 December 2013 Weight-loss COVER/08: WEIGHT-LOSS SURGERY 02: AFFORDABLE CARE ACT 03: CYSTS, TUMORS, LUMPS AND GROWTHS 04: SMOKE ALARMS AND FIRE SAFETY 06: TESTING 1-2-3; FANTASTIC FIBER 06: TOP EVENTS/INFO ONLINE 07: CALENDAR OF EVENTS; SUPPORT GROUPS 09: PEDIATRIC AND ADULT CIRCUMCISION SURGERY Procedure can have a profound impact on health THINKSTOCK BY DEBRA GELBART Flexible Spending and Health Savings Accounts Tax-free accounts can make a big difference in your healthcare bottom line BY ELISE RILEY RICK D’ELIA There’s a lot of talk these days about the Affordable Care Act, but the reality is that most people with health insurance obtain it through their employer. And besides selecting coverage options, one of the biggest financial decisions most people face at this time is whether or not to participate in flexible spending and/or health savings accounts. The benefits and offerings vary by employer, but in general, these types of accounts offer tax-free savings on healthcare and dependent care expenses. “Nearly everybody would benefit from these types of arrangements because they’re going to provide some kind of shelter from income tax,” said John Barlament, a partner with the law firm of Quarles & Brady. Barlament specializes in employee benefits. Robin Blackstone, M.D., a bariatric surgeon and medical director of the Scottsdale Healthcare Bariatric Center, tells patients that weight-loss surgery will not solve all of their issues, but also said that this type of surgery has a profound impact on a patient’s well-being and can bring problems like diabetes, high cholesterol and sleep apnea under control. I f you or someone you love doesn’t need weight-loss surgery, why should you care about advancements in bariatrics, the field of medicine concerned with obesity? “Weight-loss surgery has such a profound impact on a patient’s well-being and can bring problems like diabetes, high cholesterol and sleep apnea under control,” explained Robin Blackstone, M.D., a bariatric surgeon and medical director of the Scottsdale Healthcare Bariatric Center. “We’re hopeful that these surgeries will show us the way to solutions other than surgery that can be accessed easily by people who are struggling with weight issues but aren’t necessarily obese.” Blackstsone, who is the immediate past-president of the American Society for Metabolic and Bariatric Surgery, considers herself an advocate of a “holistic approach to obesity,” she said. “I tell patients that surgery will not solve all of their issues. There’s still plenty of hard work ahead of them, in terms of changing their eating habits and lifestyle.” Overview of account types Here’s a brief overview of the most common types of these tax-free accounts. As always, individual circumstances will vary, so check with your personal financial advisor on which accounts might work best for you and your family. FLEXIBLE SPENDING ACCOUNT (FSA): There are two kinds of FSAs: a health spending account and a dependent care assistance account. If available from employers, these accounts allow employees to contribute pre-tax dollars to accounts they can use throughout the benefit plan year to pay for eligible healthcare and/or childcare expenses. It’s important to note that all eligible expenses are outlined by the IRS. Previously, participants had to spend all the funds in their account each year, a condition referred to as “use it or lose it.” However, the IRS has relaxed these restrictions for 2014 and — if an employer permits and adjusts its plan — up to $500 can be carried over from year to year. Depending on what the employer plan permits, the maximum allowable employee annual contribution for an individual’s healthcare FSA is $2,500 annually. There are parameters based on filing status and other issues, but generally, the maximum allowable annual contribution for a dependent care FSA is $5,000. By The Numbers <18.5: is considered underweight 18.5–24.9: healthy weight 25–29.9: overweight >30: obesity >40: extreme obesity There are many online calculators, however, the formula used is (weight in pounds X 703) divided by (height in inches X height in inches). Gastric band Blackstone, Podkameni and two other local bariatric surgeons interviewed for this article stated that they believe one of the most well-known bariatric surgery techniques is falling out of favor. Over time, they say, a patient’s gastric band — often referred to generically by its brand name “Lap-Band” — can slip, leave scarring and doesn’t prevent patients from regaining lost weight. Continued on page 8 WEIGHT-LOSS SURGERY TOY RECALLS It is important to make sure the latest holiday-craze gizmo or gadget hasn’t been deemed a safety hazard. Fortunately, the good news is the number of toy recalls has significantly decreased over the last few years: 2013: 31 2012: 38 2011: 34 2010: 46 2009: 50 2008: 172 THINKSTOCK HSA (HEALTH SAVINGS ACCOUNT): These accounts are not controlled by employers and are linked to insurance plans. Individuals can contribute pre- and post-tax, without any “use it or lose it” rule. Funds grow tax-free and medical expenses are non-taxed as well. HSAs are also portable from job to job, which means health savings can transfer throughout someone’s career for years. Annual contributions are capped at $3,300 for individuals and $6,550 for families and catch-up contributions — much like with 401(k) plans — are possible at age 55. BMI determines eligibility The National Heart, Lung and Blood Institute states that a normal-weight Body Mass Index (BMI) is between 18.5 and 24.9; someone who is considered overweight has a BMI between 25 and 29.9. Someone with a BMI of 30 or above is considered obese. David Podkameni, M.D., a bariatric surgeon at the Banner Gateway Weight Loss Institute in Gilbert, said recommendations from the National Institutes of Health identify candidates for bariatric surgery as those with a BMI of at least 35 who have at least one co-morbidity factor such as high blood pressure, sleep apnea or coronary artery disease. A patient with a BMI of 40 or more is considered eligible for weight-reduction surgery without any co-morbidity factors, Podkameni said. Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women. The majority of toy recalls last year involved ingestion hazards, including chemical and magnetic dangers. For more information on product recalls, visit the U.S. Consumer Product Safety Commission’s website at, or call 800-638-2772 (TTY 301-595-7054). —PAULA HUBBS COHEN

LivngWell AZ December 2013

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