Today Kyle and Jeff talk about how to keep our teeth healthy and useful. We also visit with Dr. Macey Buker about the state of health care and some potential ideas on how to fix it. Interesting listen. Check it out at The Huntsman World Senior Games

 

Kyle Case:
[music] Hello and welcome to the Huntsman World Senior Games Active Life. My name is Kyle Case and I'll be your host on this amazing journey as we attempt to help you get the most of your life. Joining me in the studio today is my co-pilot, Jeff Harding. Jeff, how are you doing today?

Jeff Harding:
You know Kyle, I'm doing better than a wrestler holding his opponent in a Half Nelson.

Kyle Case:
Better than that?

Jeff Harding:
Better than that maybe a Full Nelson.

Kyle Case:
I honestly, I'm not sure it gets better than that.

Jeff Harding:
But as a wrestler, you would know.

Kyle Case:
Yeah well, that is pretty good. I'm doing good too. I'm doing good.

Jeff Harding:
Great.

Kyle Case:
So today Jeff, we're going to start off talking about something that we haven't really talked a lot about in the past. But I think, once again, it's an important subject. And that is our dental care.

Jeff Harding:
That is a big deal.

Kyle Case:
It's a big one right?

Jeff Harding:
Yup

Kyle Case:
So, unlike sharks, unfortunately, we don't have the whole bunch of teeth that just-

Jeff Harding:
Grow back in-

Kyle Case:
Move up into place once some of them get knocked out. So, we got to take care of them.

Jeff Harding:
We do.

Kyle Case:
We want to make sure that those pearly whites are healthy and useful and I found some information in Reader's Digest and I think a lot of these suggestions are just common sense. But, I thought it'd be worth touching on-

Jeff Harding:
Well, I think you need-

Kyle Case:
Yeah, the overall health and wellness concept we try to address here. So, the first one, this won't be a surprise to you. But, the first one that the doctors, the experts recommend is that we use fluoride toothpaste. You've heard that before, right?

Jeff Harding:
Yes.

Kyle Case:
Experts do recommend giving your toothpaste label a read just to make sure that it does contain fluoride. Fluoride toothpaste protects from demineralization which is when bacteria in the mouth combine with sugars and that produces acid, and this acid can erode tooth enamel and damage our teeth. We've heard that before; that's not new. So, toothpaste with fluoride. That's the first one.

Jeff Harding:
Is the second one to use the toothpaste?

Kyle Case:
It is. Brush twice daily.

Jeff Harding:
There you go.

Kyle Case:
You got it. And they even recommend an electric toothbrush.

Jeff Harding:
I'm not that high-tech [crosstalk 00:02:01]

Kyle Case:
Yeah, same and I've got one that I use depending on if I have a headache or not. It's not overly aggressive but just sometimes I don't want to have my brain shaken like that, you know? But keeping your teeth clean does ward off nasty bacteria. Studies have proven that electric toothbrushes can clean teeth significantly better than regular ones. So, maybe it's worth looking in to.

Jeff Harding:
And faster.

Kyle Case:
Most electric toothbrushes have features that prevent you from brushing too hard which in turn prevents accidentally damaging your teeth and gums and causing gum recession. They say that as gums recede the roots of the teeth become exposed and that results in hot and cold sensitivity, bone loss and an increased risk of dental cares. So, an electric toothbrush seems like the way to go.

Jeff Harding:
It does.

Kyle Case:
Number three is to see your dentist at least once a year. Now, Jeff are you afraid to go to the dentist if something bothers you?

Jeff Harding:
Not since I can't afford him.

Kyle Case:
Different kind of fear, right?

Jeff Harding:
Yeah.

Kyle Case:
Well, many people are afraid to got to the dentist. One study estimated that up to 15% of Americans hesitate to schedule their regular checkups because they have a phobia of going to the dentists. If you do fall into this category, you should talk to your dentist about that or maybe even find a new one. But, going to the dentist regularly can help them find small or new cavities and even offer treatments that can prevent cavities from getting bigger. So, it's worth it - we gotta go.

Jeff Harding:
I grew up with a dentist that used Nitrous Oxide so [crosstalk 00:03:33] I have happy memories of my dentist, yes.

Kyle Case:
Did you enjoy it? Mom, can we go to the dentist? Yeah, right?

Jeff Harding:
Can I just borrow his NO's thing? Whatever it's called -

Kyle Case:
- the little oxygen delivery system, right? Another thing that they say is to consider a sealant if you've had more than a few fillings or even more than one root canal, you might consider a sealant which protects your teeth from bacteria, another thing that they say is to be mindful of your medications. This one was a new one to me, but they say that a lot of prescriptions have some unexpected side effects and it could be harmful to your teeth. Experts recommend paying extra attention to your dental health when you get a new prescription, many medications cause dry mouth and a dry mouth makes you more prone to cavities =, if you're taking medications that dry your mouth practical thorough oral hygiene is important to get those teeth brushed, use your mouthwash, even multiple times a day including after you eat, they say you should drink plenty of water and talk to your doctor about your medications. So I thought that was an interesting one.

Jeff Harding:
Yep.

Kyle Case:
The next one is an obvious one, eat healthy food that's low on sugar we know that the sugar kinda creates that acid that eats away at the teeth.

Jeff Harding:
Which includes coke - Coca Cola or Pepsi

Kyle Case:
Yeah, yeah those sodas those have plenty of sugar in them. Speaking of food they also recommend that you get more calcium in your diet, so we all know that calcium helps with the bones, we know that it helps with teeth as well, so drink your milk, get your yogurt. Leafy greens like broccoli, bok choy, that has calcium in it. Almonds also have calcium, brazil nuts several sources of calcium. The last one I thought was interesting, I also was unaware of this one, but they say that fiber is vital to your digestion, which I knew, and it's also good for your heart, I also knew that, but I didn't know that fiber would help fight tooth decay. You can get fiber from supplements, but as always the best way to get fiber is with your diet and eating high fiber foods, a good source of fiber includes dry fruits, such as dates, raisins and figs, fresh fruits like bananas, apples, oranges - other options include vegetables like beans, Brussels sprouts, peas, along with peanuts, almonds and of course bran and all those foods are high in fiber there are lots of benefits. Not the least of which is it can help you avoid tooth decay.

Jeff Harding:
There you go.

Kyle Case:
So we're going to shift gears pretty dramatically here-

Jeff Harding:
-Yes we are, don't get whiplash

Kyle Case:
We're going to introduce our guest, today's guest is Dr. Macey Buker he's a CPA and a professor of population health at Dixie State University. Dr. Buker has more than twenty years of finance and accounting work in a variety of industries including the healthcare industry and Dr. Buker welcome to the show.

Dr. Macey Buker:
Thank you, thank you for having me.

Kyle Case:
Thanks for joining us I'm going to say, this is interesting to me now, we're going to have an accountant talk to us about health and wellness and the overall health and wellness industry help us make that jump, how did we get there?

Dr. Macey Buker:
So, as I look at my background was public accounting as I started my career, started doing a lot of work with healthcare organizations and it's been about ten years ago I actually transitioned into the healthcare industry with a couple of businesses and then had some opportunities to teach full time. As I was working on a couple of other projects and this has blossomed into a long term stint in higher education now, so, I enjoy it, it's a great diversion but that initial background of accounting and finance becomes very helpful as we're looking at some of the things that are going on in the healthcare industry.

Kyle Case:
So let's jump into that, shall we? Let's talk a little about public health just as an overall view and why are they teaching courses in public health and what does that mean? How important is that to us?

Dr. Macey Buker:
Well there's a number of things that are happening, first of all as we look at the healthcare industry in general we've really been focused on a reactive care of individual's diseases, injuries that happen and we take care of people after they have those problems and issues come about, in doing so we have now exceeded twenty percent of our GDP. So one out of every five dollars you earn is going back into healthcare.

Jeff Harding:
For some of us, it's even higher.

Kyle Case:
For individuals yeah, with emergencies or anything like that, boy those bills can really add up. I mean I just want to emphasize how huge the spending in healthcare is as a nation

Dr. Macey Buker:
It is.

Kyle Case:
Individuals, those are tragedies that we deal with as families, as individuals, but nationally one in five dollars!

Dr. Macey Buker:
It is, it's the largest industry in the country we're spending about three point two trillion dollars last year in healthcare spending alone.

Jeff Harding:
Is it skewed by the fact we have an aging baby boomer population?

Dr. Macey Buker:
No, it's just increasing our costs as we move forward because that's a group as we start addressing some of their issues their ailments, diseases, conditions that they have we're adding dollars to it. The more interesting component of that is that we're about two and a half times the next highest country as far as spending per capita, if you look at dollars we're more than triple, so we have a couple of European countries that are spending about thirty-five hundred per person, here in the US we're spending about twelve thousand dollars a year right now.

Kyle Case:
Per person?

Dr. Macey Buker:
Per person, that includes insurance all of your copays, your medications.

Jeff Harding:
That's just the net? The gross, the gross.

Dr. Macey Buker:
You as an individual are spending that much money. I mean thinking about it every time, let's say you have an injury - fall down break an arm you go to the emergency room, average emergency room visit was about twenty-seven hundred dollars last year. So I mean it adds up, and it adds up quickly.

Kyle Case:
Especially as you said the emergency room visits, the specialized care, intensive care, wow that can go so so fast, and then you look at chronic problems and long term cancer and all the thing that we deal with. WOW! There's a lot of money that's being spent there.

Dr. Macey Buker:
There is. So we're spending the most of any country in the world and yet if you look at our measure of care, for example, or quality-adjusted life years we rank about thirty-fourth as a country. So even though we're spending the most we aren't getting the outcomes. Well it's a challenge, our healthcare system is really evolved and as it's evolved it's really grown into a very unique business model because it would bring in a third party payer, our insurance companies that are actually establishing the contracts with the providers and so we don't have a lot of say in what those contractual amounts are. We're directed as far as where we're going to receive our care, what conditions we're going to meet and now all of a sudden we're looking at what the spending is, what continues to grow, we had the Affordable Care Act that passes in 2010 to try to help with some of this, it slowed the growth, but the growth has still been there.

Kyle Case:
Wow, I have a theory, it's just a theory I don't have anything to back it up to other than just the way I feel about it. I remember watching Little House on the Prairie, many of us watched that and the doc would just get in his wagon and he would make the rounds to all these little farmhouses and somebody needed help they would saddle up the horse and run over to the doctors house in the middle of the night and bring him over but when that was the model it felt like you were looking the doctor in the eye and he was providing care and he was also making a living, which, granted in Pinter days it was maybe a chicken that he got or some potatoes or something but it felt like as soon as you said as soon as the third party entered the picture it just feels like that's where things started to turn into a different direction, you no longer had control as a consumer, and as a doctor you don't really have to look someone in the eyes and say 'Hey you owe me thirty-two thousand dollars for this three hour stay in the ICU because that's all done with someone else.

Kyle Case:
You remove that personal aspect of it and don't get me wrong, I'm not knocking the insurance or anything, I've got health insurance I'm grateful for it, but it just feels like they've created a disconnect on both sides of the equation that created some of the challenges that we're dealing with.

Dr. Macey Buker:
Well, what it did more than anything is it added some layers of complexity. It used to be when you were dealing with that doctor and that doctor was coming to your home you were paying that doctor when he finished providing those services. Now, because of the layers of complexity that we've built into the system it becomes very very difficult in many cases your provider, your clinicians that are practicing won't know the cost of a procedure, they're there trying to provide the best care possible and it's interesting there was a documentary it's called 'Money in medicine' in 2012 that compared [inaudible 00:12:57] here in Utah to UCLA medical system. It was talking about some of the differences that are there and in that documentary Brent James talks about almost sixty percent of our healthcare costs being waste at various levels.

Kyle Case:
Wow, how does that happen in the industry, right?

Dr. Macey Buker:
Yeah, exactly, so as you look at it you have all these different layers of complexity, you have physicians and clinicians trying to make the best decisions for their patients and yet they're being bound by best practices by risk management. We have all these other components that are going in to the point where, hey, they're going to do the best job that they can to practice medicine provide you with the best care possible and we're going to have to try to work through these other challenges and complexities, so it is, it's very very unique -

Kyle Case:
And complicated and difficult

Dr. Macey Buker:
- Yeah, very very different than what happens around the world.

Kyle Case:
You mentioned that the most difficult complexities of the whole this is is that when you're in pain or when you're in sick really the last thing you're worried about is how much it costs. If you're shopping for a new shirt, you can take the time to compare and look around, and go online and all that kind of stuff but if you're in the emergency room you just want the very best that's available -

Dr. Macey Buker:
Correct.

Kyle Case:
- and doctors, to their credit, are trying to provide that and then after it's all over and the aftermath is done that's when you start putting the pencil to the paper to see how much all of this is going cost, it's a very complicated situation-

Dr. Macey Buker:
-It is

Kyle Case:
-You're listening to the Huntsman World Senior Games Active Life and we're visiting with Dr. Macey Buker and we're talking about population health and the healthcare system as it is here in the United States it's a very complicated situation, I think we've done a reasonable job of explaining some of the challenges, what are some of the solutions - how do we get through this mess?

Dr. Macey Buker:
Well, I think a lot of it is we're shifting our reimbursement model so rather than being reactive, we talked a little about waiting until somebody gets sick, having them show up at the hospital, the doctor's office, treating them for whatever ailment they have, we're changing the shift of our focus to preventative care, so rather than wait for you to get sick we're going to do something about it, and that's where really kind of focus of population health comes in is we're looking at measures of health within an entire group of individuals. So, for example, if we looked at all the individuals living here in Washington County we would be looking at measures of health for the entire county and then we start focusing programs and interventions based of what that community needs.

Dr. Macey Buker:
So, one of the biggest challenges we have in a cost become associated with chronic conditions, for example, diabetes. It's affecting almost one in five individuals within our community. So if we were able to focus on preventive care for diabetes we start talking about lifestyle changes, teaching people to eat the right foods, exercise, be active, goes into a lot of the things that happen here within our community locally as we're promoting healthy, active lifestyles, but we can focus our efforts on those individuals and with the shift in that reimbursement model rather than individual organizations being compensated based off when I go and visit the doctor they're going to be paid a set amount of funds. We refer to it as a Capitation model where I get so much per individual per month and then my goal as a provider now becomes not in treating those individuals but providing that preventive care that reduces my overall healthcare costs.

Jeff Harding:
And now you're speaking our language because we're right in the middle of that and big advocates of that active healthy lifestyle that I think we all want. I think we all want it, sometimes it's hard to achieve it, sometimes challenges come up and get in the way - whatever it is, but I love what you said that concept and that idea of preventative and trying to preempt it rather than being reactive to it and it feels like if there is any way forward that's productive and helpful it feels like that has to be the way.

Dr. Macey Buker:
It does, I mean we have to be able to hold individuals accountable for those lifestyle choices they're making and we do in some aspects when we talk about the third party payers and health insurance companies for example if you're a smoker, you're going to pay a higher premium for your health insurance.-

Jeff Harding:
Right - life insurance and other things.

Dr. Macey Buker:
-but if you're inactive you're obese which is a huge issue around the country there's no penalty for that. There's no way for health insurance companies to write that in a while, all of a sudden if we find that way of, to write in some of those incentives into our policies where, you know what, if you exceed this amount on your BMI then we're going to actually charge you a higher premium, now I have financial incentive to do it because quite honestly to live a healthy lifestyle, eat good quality, nutritional food it's not cheap, it's not the dollar menu. It's much more expensive, much more time consuming

Jeff Harding:
Yeah, as much as the money it's the time a lot of times, you know, how convenient is it to just hit that drive through on your way home and grab a burger and fries and eat it in the car because you're onto the soccer match or whatever it is, you know, we're very busy, so yeah there's a financial part of being active and eating healthy but there's the time part of that too where you've got to go shopping for groceries and you have to go home and prepare it. So yeah, there are some real significant cultural challenges that I think we need to deal with but as you said maybe tying that to some kind of financial incentive or penalty as the case may be depending on the situation that might be the direction we need to go to sort things out.

Dr. Macey Buker:
It is, and think about the drive through if consumers were demanding healthy foods when they went through the drive through they're there I mean, there are healthy options that are available to you. Again, they tend to be more expensive and it's difficult for us to get that information some of that's changing, we have a lot of things that are happening as far as transparency, not just in the food industry that helps but also within healthcare. On January first all the hospitals around the country now have to post their pricing on a website, so we're starting to see some changes and shifts so that we can play a larger role in what happens with our health. For example, related to costs of healthcare I know go on my insurance company's log in, they have a portal for it, I can track all my claims, within there I can actually pull up providers if I enter in and ask for a procedural code for my provider before it happens I can actually compare prices with providers here locally and go to the one that's going to be the best. The past it's been taboo because we acquaint lower price with less quality and it's not always the case.

Kyle Case:
So let's shift gears just a little bit, you are in public health and you talked about the ability to take a population and kind of analyze trends that are going on there and within that population try to create scenarios or incentives or education or information that can help change some of the challenges. What are some of the trends that you see nationwide that you see that we need to be dealing with and talking about and working towards?

Dr. Macey Buker:
I think one of the first things we need to do is look at chronic conditions, as we look at one's chronic conditions that are preventable, heart disease is a big one, diabetes is a big one, here locally -

Kyle Case:
And you're mostly talking about type two diabetes

Dr. Macey Buker:
- Yes, this primarily types two because it's completely, we can change the course of that-[crosstalk 00:20:56]

Kyle Case:
Right, type one, there's not much you can do about that, but type two

Dr. Macey Buker:
-So typically as we talk about chronic conditions we're talking about chronic conditions that we prevent or change as we adopt different behaviors.[crosstalk 00:21:09]

Kyle Case:
Different behaviors?

Dr. Macey Buker:
Correct. And so as we're looking at that, that really needs to be our focus the nice thing is here locally within the southwest Utah health department Dr. Blodgett is being very proactive in developing in rolling out a diabetes management program. So kudos to him for seeing the issue-

Jeff Harding:
The need.

Dr. Macey Buker:
-and need for it and being able to adopt a program that will go out and help, and part of it is education, part of it is actually showing people how to do things and then providing opportunities for affordable care, affordable food options is another big one, where we have areas, where what we refer to as a nutritional desert where we don't have access to good healthy food choices, trying to be able to change some of those, so that's I think where it needs to start, and then I think the other component of that is that we have to take a bigger role in our own health.

Jeff Harding:
More accountability for ourselves?

Dr. Macey Buker:
Absolutely. Some if I'm choosing to sit behind a desk all day and not get out and go for a walk, or ride my mountain bike or take advantage of the recreation opportunities we have here that burden shouldn't be passed on to everybody else on my health insurance plan, that should rest with me, and so I think that's the big thing that needs to happen, but that's hard for people to hear sometimes.

Kyle Case:
Well, it's hard to hear and behavior is so hard to change. It's just tough, it's just the nature of it, and I think we all struggle with goal setting or knowing, we know we're supposed to do these things, this isn't brand new information necessary to us, usually in most cases. It's just that digging down and finding out how to make it happen and we get it done. But I believe in us as a species like human beings, I think we'll figure it out. I think we will.

Dr. Macey Buker:
We will. I think we're making progress on it and fortunately here within our community, there's a very very encouraging environment and culture that's been created to help improve and be active and make good choices.

Kyle Case:
And I think that our community here is leading the way in a lot of ways but wherever you're from wherever you happen to be listening to this show there's good stuff going on in every community so we need-[crosstalk 00:23:29]

Dr. Macey Buker:
There is.

Kyle Case:
To take advantage of it. Well thank you very much, Dr. Buker, appreciate you being here and appreciate the information that you've shared.

Dr. Macey Buker:
Alright, great, thank you for having me.

Kyle Case:
So Jeff

Jeff Harding:
Yes

Kyle Case:
Just yesterday I went down to the Las Vegas and I wrestled in the US Open and got a black eye, I have some proof to show that I was actually there. A day later, which is today, I have incredibly sore muscles as you mentioned, I have a beat up face but I am more passionate now that ever about what we do with the Huntsmen World Senior Games, all the clichés that they say really are true, the thrill of victory the agony of defeat, competition is a great motivator, it really is and we need these things in our lives, while wrestling may not be for everyone, in fact, wrestling may not be anyone, I don't know, I think the jury is out on that but with thirty-two different sports to choose from in the Huntsmen World Senior Games maybe the games could be for everyone.

Jeff Harding:
I think so.

Kyle Case:
And the great thing is is that registration is open

Jeff Harding:
Ah, it is!

Kyle Case:
We already have almost thirty-nine hundred of the more than eleven thousand athletes that we expect to compete in October here in St George if you're interested in being a part of the Huntsmen World Senior Games this year and we hope that you're interested -

Jeff Harding:
We do, we do, come party with us.

Kyle Case:
-get registered, get it on your calendar, use that motivation to help you really live the active life throughout the next several months

Jeff Harding:
And avoid some of the health pitfalls

Kyle Case:
And avoid some of the problems that we've just talked about, it's very easy to do just visit Seniorgames.net click on register, the process is simple, it's fast, it's secure and before you know it you'll be ready to become one of the more than eleven thousand athletes who will compete in the games this year, the dates for the 2019 Huntsmen World Senior Games are October seventh through the nineteenth remember to tune in live next and every Thursday at five thirty PM mountain time on AM 1450 or FM93.1 for the Huntsmen World Senior Games Active Life. Our inspirational quote of the day from author Joshua Marine he says "Challenges are what make life interesting, and overcoming them is what makes life meaningful."

Jeff Harding:
There you go.

Kyle Case:
Until next Thursday, stay active.

Jeff Harding:
Bye, everyone.