Thursday, April 16, 2009

Ironman Lottery results

April 15 is the day that the Ironman race in Kona releases the lottery results, which makes it a "fork in the road" day for my calendar. This year, they showed the results on the Florida 70.3 show, but I was driving back from visiting my sister in DC and wasn't watching. We did get to drive near a Saab with an IM sticker and a tri-bike on top for a while.

My wife was talking to her friend on the trip. Her friend's husband is a bit of a jokester (and a friend) and he told me to go "cry in my gluten-free beer" because I hadn't been selected for Kona. I was annoyed, because I knew that the results wouldn't be online for a couple of days, so how could he know? And he said that he was watching the Florida show. Knowing his viewing habits, there really must have been nothing else on or he was yanking my chain. I told him there was no way he watched it, and he told me I was in denial.

It turns out he did watch, and I was in denial. I've been doing the lottery for years and have not been selected. Bit of a bummer.

There are basically three ways to get into the Kona Ironman race:
  1. Be fast
  2. Be lucky << my default option
  3. Be rich
One of the the things that surprised me this year was my level of annoyance. It went beyond the usual annoyance at being at the wrong end of a joke, and for the first time there was a bit of disappointment. Upon reflection, it had nothing to do with my friend (who simply spoke truth, right?), but was about a change in my attitude. I'm not sure when it happened, but I'm pretty sure I "wanted it more" this year. I think it indicates to me that maybe I need to really sharpen the focus of my strategy on the other two options as well.

Wednesday, April 1, 2009

Managed care insurers now have an economic reason to diagnose Celiac Disease

One of the barriers to awareness and diagnosis of Celiac disease has been the lack of enthusiasm on the part of health insurers. Now things have changed, and it is about time.

The Journal of Insurance Medicine has published a Celiac economic study by the Celiac Disease Center in Columbia that shows a decreasing cost after diagnosis.

"Researchers led by Dr. Peter Green, a professor of clinical medicine, said their study of a large managed-care database revealed cost reductions after diagnosis of celiac disease were attributable to decreasing trends in utilization of office visits, laboratory tests, diagnostic imaging and endoscopy procedures. "

This study is years overdue (see this two year old post including insurers), and it finally gives managed care insurers an economic reason to make sure all Celiac disease sufferers in their populations are diagnosed.

As a next step, I hope to see data-driven suggestions from these insurers soon. For example, it would be cheap and effective for them to send an email to segments of their population saying something like, "You have chronic iron-deficiency anemia. The differential diagnosis for that condition includes Celiac disease. Have you discussed it with your doctor?"