Tag: benefits

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Benefits and burdens of a high deductible health plan

Benefits and burdens of a high deductible health plan
Benefits and burdens of a high deductible health plan

The put exactly where I get the job done included a significant deductible overall health prepare (HDHP) to its fringe benefit bundle. Can you dedicate a column to the HDHP and explain its components?

— M.S., e-mail

HDHPs have turn into a well-liked substitute as a healthcare choice for businesses and workforce. The important reason is that these designs provide the employee reduced premiums. As long as the personnel enjoys good health and fitness, they acquire! Nevertheless, as one’s health care support needs grow, out-of-pocket expenses will likely be appreciably larger than a regular health system. 

Tax Chat:The EITC: Just one of the most generous tax credits and the most intricate to compute

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China’s health insurance reform won’t cut benefits, unrelated to COVID: experts

China’s health insurance reform won’t cut benefits, unrelated to COVID: experts
A medical worker talks with the relatives of a patient at the emergency department of the Second Affiliated Hospital of Anhui Medical University in Hefei, east China's Anhui Province, Jan. 21, 2023. Medical staff stick to their posts during the Spring Festival holiday. (Xinhua/Zhou Mu)

A professional medical employee talks with the kinfolk of a individual at the emergency section of the Second Affiliated Hospital of Anhui Clinical College in Hefei, east China’s Anhui Province, Jan. 21, 2023. Health-related employees adhere to their posts throughout the Spring Festival holiday getaway. (Xinhua/Zhou Mu)

A amount of Chinese localities, which include Central China’s Hubei, Southwest China’s Sichuan and Northeast China’s Heilongjiang, are employing a reform of wellness insurance policies for urban personnel and retirees, drawing widespread interest.

Industry observers said the reform, which lessens the volume deposited every month into private accounts, will not mean the reduction or reduction of well being insurance plan gains, nor is it a transfer to address COVID-19-connected expenses, as some Western media asserted.

The health insurance policy reform is a decision that has been created after decades of dialogue, scheduling and prudent thing to consider and sites Chinese family members in a greater posture to cope with medical hazards, and elderly individuals who are more vulnerable to health issues and incur better health care expenditures will benefit the most from the reform, observers mentioned. 

Wang Chaoqun, affiliate professor from Section of Labor and Social Stability at Central China Ordinary College, instructed the International Situations on Sunday that under the new plan, the reform can reimburse outpatient bills and alleviate the economic burdens of the insured, primarily elderly persons or people who often take a look at medical practitioners and find it is not enough to pay back for their fees. 

Formerly, the funds inside of particular accounts was significantly from sufficient in covering health-related expenditures in hospitals and pharmacies. Data confirmed that in a metropolis where by about 5 million people had joined the health care coverage system, much less than 5 percent of personal accounts had balances of extra than 10,000 yuan ($1456), and less than 1 {08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} experienced balances of more than 20,000 yuan, Wang pointed out. 

The threshold for the reimbursement percentage of outpatient health care expenses is 50 p.c, and in some towns these as Xiamen, a city in East China’s Fujian Province, the stage can reach as large as 98 {08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f}, according to Wang. 

For people who rarely see medical professionals and have tens of countless numbers of yuan sleeping in their accounts, the reform will really feel like a decline in the shorter phrase, but when they get more mature or if they come to be ill and want to see doctors commonly, they will eventually find that they profit from the reform, Wang reported. 

China’s wellbeing insurance policy process for urban staff and retirees is made up of two elements: necessary private accounts with contributions from both equally staff members and their employers that largely pay out for regular outpatient companies and a pooled fund contributed by businesses that is utilized to reimburse hospitalization charges, outpatient costs for severe diseases, and bills for some continual health conditions, according to the Xinhua News Company.

After the reform, revenue deposited by businesses into employees’ personalized accounts will be instantly paid out to the pooled fund in buy to guidance the reimbursement of regular outpatient clinical expenses. The reform was officially rolled out by the Condition Council in April 2021.

Some Western media have intentionally connected the reform of the health insurance to COVID-19 and asserted that the reform is attempting to allocate income from private accounts to make up the deficit of the health-related insurance coverage fund.

Their statements are designed only to smear China and absence basis, gurus claimed. The pooled fund has built ends fulfill in excess of the years, Jin Weigang, a professor at Zhejiang College, informed the World wide Occasions.

The overall income of China’s standard healthcare insurance policies resources in 2021 reached 2.8 trillion yuan (close to $439.7 billion) and the expenditure was 2.4 trillion yuan, according to the National Healthcare Security Administration (NHSA).

The reform is a selection that was manufactured soon after years of dialogue and in 2010, the Social Protection Law laid a lawful ground for the wellness reform, Wang famous, refuting any website link among COVID-19 and the reform.

Throughout the COVID-19 epidemic, expenses for vaccines and nucleic acid tests had been financed by the state, and some COVID-19 treatment options and medicine ended up lined by the health and fitness insurance coverage fund because it fit the reimbursement policy, Wang pointed out. 

As opposed with other nations around the world, the gains of China’s wellness system are noticeable. China has crafted a nationwide standard clinical insurance policies procedure covering in excess of 1.36 billion people, accounting for over 95 {08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} of the total populace. It is a mission hardly imagined for a establishing place.
  
But in the US, just before Obamacare, as a great deal as about 30 or 40 million People in america were uninsured and various reports have demonstrated that the very first lead to for people to go bankrupt in the US is the excessive higher cost of professional medical treatment, observers famous. 

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Mayor Adams plows ahead with plan to privatize health benefits for 250,000 NYC municipal retirees

Mayor Adams plows ahead with plan to privatize health benefits for 250,000 NYC municipal retirees

New York City Mayor Eric Adams is showing no signs of stopping an already-delayed plan to switch 250,000 retired municipal workers from traditional Medicare to a private Medicare Advantage plan – with or without the cooperation of the City Council or the support of retirees themselves.

The city has proposed allowing retirees to keep their current benefits for a large fee ($191 per month), but the way things are going, that may not end up being an option. This proposed switch was supposed to take effect a year ago in January 2022 — but has faced stiff opposition. Meanwhile, some of those critics are urging the city to establish a panel of stakeholders to come up with alternative ways to achieve the $600 million savings that this Medicare Advantage switch is supposed to deliver.

Medicare Advantage plans, which shift seniors’ benefits to health plans administered by private insurance companies, have become increasingly popular in recent years – but have also faced criticism for having smaller networks of health care providers than traditional Medicare, and for improperly denying patients’ medical claims.

Municipal retirees don’t pay a monthly premium for their current health plan, known as SeniorCare. The new Medicare Advantage plan would also be premium-free – and would come with federal subsidies that will offset the cost to the city. Officials have been working to convince seniors that this particular Medicare Advantage plan would not have those problems, and would even represent an improvement over their current benefits.

A judge ruled last year that the city could not charge the $191 monthly premium for people to keep their SeniorCare. Adams responded by urging the City Council to change the city’s administrative code so the fee would be allowed. Believing that was the only way to grant seniors a modicum of choice in their health benefits, Councilmember Carmen de la Rosa introduced the bill the mayor requested.

But after an epic 10-hour City Council hearing on the proposal earlier this month, during which retirees clashed with union leaders and city officials, de la Rosa said her effort to fast-track the bill was put on hold.

After the hearing, it was clear that there were way more questions and concerns from councilmembers.

Carmen de la Rosa, New York City Councilmember

“After the hearing, it was clear that there were way more questions and concerns from councilmembers,” de la Rosa told Gothamist last Wednesday. “It doesn’t seem like there’s an appetite to move this bill at this moment and the bill was laid aside.”

Asked last week whether the administration is still moving forward with its efforts to switch retirees to a Medicare Advantage plan, City Hall spokesperson Jonah Allon didn’t deny it and said that at the hearing, “we presented a clear case that the city’s Medicare Advantage plan would offer myriad improvements over the current SeniorCare plan, while still encouraging the Council to preserve retiree choice by amending the administrative code.”

The change in benefits, intended to save the city $600 million on health coverage annually, was first set in motion by former Mayor Bill de Blasio and is being implemented in cooperation with the Municipal Labor Committee, a group of unions representing city workers. Implementation has been delayed for years, in part, by litigation brought by retirees who oppose the shift.

Some retirees who spoke at the Jan. 9 hearing urged the City Council not to be complicit in the switch and asked the lawmakers to explore other ways to save money on health benefits for city workers. Others, accepting the fact that the Medicare Advantage shift was moving forward, said the City Council should take action to preserve seniors’ options.

In the latter camp was Ellen Gentilviso, a retired public school teacher who said she was recently diagnosed with breast cancer and wanted the option to retain her current plan. Like others, she expressed concerns that her doctors would not accept the new insurance plan.

“Having a cancer diagnosis is devastating, but the threat of losing access to the trusted doctors treating you due to the elimination of choice of insurance coverage is even more stressful,” Gentilviso said.

A page from the 2019 U.S. Medicare Handbook in Washington.

Pablo Martinez Monsivais/AP/Shutterstock

The Adams administration and the Municipal Labor Committee are currently designing a new Medicare Advantage plan with Aetna, after the insurance companies previously selected to administer the plan backed out. About 85{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} of the doctors who currently accept SeniorCare would also be in Aetna’s network, and another 10{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} have indicated they would accept an Aetna Medicare Advantage plan even if they are not in-network, according to testimony from the Mayor’s Office of Labor Relations deputy commissioner Claire Levitt.

She also addressed fears about whether a Medicare Advantage plan would have a more burdensome process of assessing whether a procedure should be covered — sometimes referred to as prior authorization.

“We understand the concerns about prior authorization and want to assure retirees that this is not an issue they need to be concerned about,” she said, eliciting laughter from skeptical audience members. She said there would be a way to appeal coverage denials and that the city would maintain oversight over the plan.

The issue of prior authorization has emerged as a sticking point in negotiations over the new health plan, Crain’s New York Business reported this month.

United Federation of Teachers President Michael Mulgrew has been a supporter of the city’s proposed Medicare Advantage switch, but recently started expressing doubts about the particulars being developed with Aetna.

“New York City can create a unique Medicare Advantage plan, provided we find the right partner,” Mulgrew said in a statement to Gothamist. “At the moment, for a variety of reasons, it is an open question whether Aetna could be that partner.”

According to UFT spokesperson Alison Gendar, the union wants an independent entity to be able to review any potential denials of coverage for patient care by the insurer.

Asked about these concerns, Rick Frommeyer, senior vice president of Aetna Group Retiree Solutions, said, “Our prior authorization process is aligned with federal regulations that govern our Medicare business.”

He added that the company is continuously working to streamline the process and make it more efficient to avoid unnecessarily delaying patient care.

Is the Medicare Advantage shift really necessary?

Part of the controversy around the Medicare Advantage switch comes from the fact that the annual savings generated would largely go toward benefiting active city workers, rather than retirees.

The $600 million would be funneled into the Health Insurance Premium Stabilization Fund. The city’s Independent Budget Office, which has criticized the plan, has explained that the fund was initially established in the 1980s to balance the costs of the health plans available to current city workers. It has since helped pay for a growing list of supplemental benefits including prescription drugs and telehealth services.

Thanks, in part, to rising health care costs, the Stabilization Fund has been depleted, union leaders said at the City Council hearing. Henry Garrido, executive director of DC 37, said union members have sacrificed raises to preserve their benefits and said unions have sought out many other ways to keep health care costs down. Now, he said, it was necessary to cut the cost of retiree health benefits.

What kind of choice are we preserving if retirees and their dependents are charged $200 a month to keep SeniorCare?

James Davis, PSC-CUNY president

“We have to take responsible actions,” Garrido told city councilmembers. “They may not be popular but they are responsible actions.”

Meanwhile, some critics of the plan have presented alternatives. CUNY’s union, the Professional Staff Congress, has suggested temporarily bolstering the Stabilization Fund by taking money from a different source, the Retiree Health Benefits Trust. This trust serves as a reserve that can help pay for retiree benefits when city coffers are low, and currently has a surplus. The union also advocated for convening a panel of stakeholders to come up with more long-term savings.

“What kind of choice are we preserving if retirees and their dependents are charged $200 a month to keep SeniorCare?” James Davis, president of the PSC-CUNY, asked councilmembers at the hearing.

De la Rosa said councilmembers will have a chance to put their own solutions forth during the city’s budget negotiation process. But it’s unclear how much time they will have to push alternatives to Medicare Advantage.

Last month, an arbitrator overseeing the negotiations gave the city until Jan. 9 to finalize a plan with Aetna, and directed the Municipal Labor Committee to vote on it immediately after.

Now that that deadline has passed, City Hall has declined to say exactly when a plan can be expected.

This story was corrected to show that the medicare advantage switch was supposed to take effect in January 2022.

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Diabetes and the benefits, risks of personal health on the internet

Diabetes and the benefits, risks of personal health on the internet

A blood glucose manage process with the support of a smartphone and a meter that is fixed to the pores and skin.

Ute Grabowsky | Photothek | Getty Pictures

The world-wide-web of items to distant keep an eye on and deal with prevalent wellness issues has been growing steadily, led by diabetic issues people.

About one out of every 10 Us residents, or 37 million individuals, are living with diabetic issues. Products these kinds of as insulin pumps, which go back again many years, and constant glucose displays, which monitor blood sugar ranges 24/7, are significantly related to smartphones via Bluetooth. The increased connectivity arrives with a lot of added benefits. Men and women with style 1 diabetes can have considerably tighter management about their blood sugar levels simply because they’re in a position to review weeks of blood sugar and insulin dosing facts, making it easier to location tendencies and wonderful-tune dosing. In recent several years, diabetes patient grew to become so adept at remote checking that a Do it yourself community of affected person-hackers manipulated products to improved handle their health care requires, and the health care gadget market has acquired from them.

But the capacity to monitor professional medical problems about the world-wide-web comes with pitfalls, which includes nefarious hacking. While clinical units, which ought to go as a result of Food and drug administration acceptance, meet up with a higher normal than physical fitness devices, there are even now pitfalls to shielding individual data and accessibility to the machine by itself. The Fda has issued periodic warnings about the vulnerability of health-related products these kinds of as insulin pumps to hackers, and merchandise makers have issued recollects relevant to vulnerabilities. In September, that transpired with Medtronic‘s MiniMed 600 Series insulin pump, which the corporation and Fda warned experienced a probable challenge that could enable unauthorized accessibility, creating a danger that the pump could deliver as well a lot or not enough insulin.

Slumber apnea, Sort 2 diabetes and remote wellbeing treatment

It is really not just diabetic issues where the health-related unit market place is offering sufferers new added benefits from remote checking. For snooze apnea, which is believed to have an impact on as numerous as 30 million People in america (and just one billion people today globally) C-PAP equipment can now retailer and deliver information to health-treatment providers without having needing an workplace pay a visit to. 

The number of world wide web-related professional medical gadgets grew during the pandemic, as lockdowns made a huge press to address people today at home. As virtual care visits rose, “it opened everybody’s eyes to house-based medical units for distant affected individual checking,” stated Gregg Pessin, a senior director of analysis at Gartner.

Continual revenue of ongoing glucose displays and insulin pumps have buoyed providers this kind of as Dexcom, Insulet, Medtronic and Abbott Laboratories, and diabetes tech unit income are predicted to develop. According to the Centers for Disorder Management and Prevention, further than the 37 million individuals in the U.S. that have diabetic issues, there are 96 million older people are approximated to be pre-diabetic. Manufacturers of continuous glucose displays and insulin pumps, which have been the normal of treatment for type 1 diabetes for many years, are more and more concentrating on kind 2 diabetes people as perfectly.

Multiple kinds of health-related cybersecurity hazard

Sector safety gurus categorize cybersecurity threats of health care gadgets into 3 buckets.

Initial, you will find the possibility to affected individual knowledge. Numerous clinical devices this kind of as insulin pumps have to have people to build on the internet accounts to download info to a personal computer or smartphone. These accounts could incorporate sensitive information, not just delicate overall health facts but personal aspects these types of as Social Safety numbers.

A different possibility is to the clinical system itself, as evidenced by the headlines about the possibility of hackers having into a health care product like Medtronic’s pump and switching dosage settings, with perhaps fatal results. A report by Device 42, a cybersecurity company that is element of Palo Alto Networks, located that 75{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} of infusion pumps — which incorporate insulin pumps — had “recognized protection gaps” that place them at possibility of currently being compromised by attackers. May perhaps Wang, chief technological innovation officer of world-wide-web of matters security at Palo Alto Networks, mentioned that in a lab experiment hackers acquired access to infusion pumps, changing treatment dosages. “So now cybersecurity is not just about privateness, not just about facts leakage. It is a lot more about daily life or death,” she mentioned.

But Gartner’s Pessin claimed that these types of risk is slight in the genuine planet. In the managed situations in a laboratory, “it can be just a make a difference of time in advance of you will be ready to do it,” but in the real planet, “it’d be a lot a lot more complicated,” he reported.

Why insulin pumps are finally getting smarter

A Medtronic spokeswoman reported the firm layouts and producers professional medical systems to be as safe and sound and secure as achievable, and that its worldwide merchandise safety business consistently displays the protection goods during their lifecycle. The organization also screens the cybersecurity landscape to handle vulnerabilities and to “get motion to defend sufferers through a coordinated disclosure method and protection bulletins.”

In September, Medtronic’s notice to users walked them via how to eradicate the hazard of unintended insulin supply by turning off the capability to dose remotely as a result of a separate device.

The third cybersecurity threat is the link between the clinical system and community, no matter whether it is really WiFi or 5G. As medical products come to be much more connected, they occur with amplified danger of malware, a risk perfectly-acknowledged in other industries that could soon be in wellbeing care. Wong pointed to a situation in 2014 in which Concentrate on leaked sensitive client information right after setting up an HVAC system that was contaminated with malware.

Although there aren’t any recognized incidents but of this going on by medical products used at home, it could be a issue of time, and more mature devices that are not current consistently more at risk. In hospitals, old operating systems have left some healthcare products susceptible to assault. Some health-related imaging programs, which can have a lifecycle of about 20 several years, are even now operating on Windows 98 with out any stability patches and there have been incidents where by the MRI scanners or X-ray devices have been hacked to run crypto mining functions, unbeknownst to wellbeing-care providers.

Regulation of equipment

Lawmakers and health and fitness-care leaders have been pushing for extra direction and regulations about healthcare gadget protection. 

In April of last 12 months, senators launched the PATCH Act to require health-related unit makers that are applying for Food and drug administration acceptance to meet sure cybersecurity demands and maintain updates and protection patches. Extra a short while ago, the $1.65 trillion omnibus appropriations invoice passed at the finish of 2022 involved new medical machine cybersecurity requirements. Specialists claimed the law’s provisions did not go as significantly as the PATCH Act prerequisites, but are nonetheless significant.

An Food and drug administration spokesperson advised CNBC that the new cybersecurity provisions in the omnibus invoice stand for a substantial action forward in FDA’s oversight of cybersecurity as portion of a professional medical device’s security and success. Among the provisions, manufacturers will have to place ideas and processes in put to disclose vulnerabilities. Product suppliers will also have to present updates and stability patches to gadgets and related units for “important vulnerabilities that current uncontrolled threat,” in a well timed fashion.

How to retain handle as a buyer

As doctors are ever more prescribing glucose monitors and insulin pumps for not just sort 1 diabetes but the substantially more typical style 2 diabetic issues as properly, individuals weighing whether or not or not to use these a unit can start off by seeking on the manufacturer’s site for statements about cybersecurity and HIPAA compliance for protection of their private wellness-care information. They can also question their medical doctors about stability, while cybersecurity experts say there is nevertheless function to be finished to enhance education about these hazards among health and fitness-care companies.

People with a medical gadget connected to the online ought to register with the company to assure they are notified about safety updates. Following simple cyber cleanliness at property is also key, given that a lot of devices now join to WiFi. Make absolutely sure the WiFi community is protected with a powerful password and also use a robust username and password for the firm’s website if sharing or downloading knowledge. Additional consumers are now also opting to use a password manager to hold all of their web login information and facts. For the reason that devices can interact with other units more than WiFi, make guaranteed house laptops and phones are safe as effectively.

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Shas secures billions for welfare, healthcare, religious benefits in coalition deal

Shas secures billions for welfare, healthcare, religious benefits in coalition deal

In its coalition agreement with incoming prime minister Benjamin Netanyahu’s Likud, the ultra-Orthodox Shas party secured billions of shekels in promises to advance its core agendas, including supporting disadvantaged Israelis, benefits to the religious community and its institutions, and improving healthcare services, especially in the so-called periphery.

Laser-focus on its socioeconomic and religious priorities has been a longtime winning strategy for Shas. The party did not make any independent security or foreign policy demands, and largely acceded to Likud requests beyond its core interests.

In addition to the policy points, Shas secured six ministerial portfolios to be handed out to five of its 12 lawmakers. Party leader Aryeh Deri will take two of the portfolios, returning to lead the Interior Ministry once again and the Health Ministry. He will also be a deputy prime minister for the entirety of the government’s term.

The religious services and welfare portfolios will also go to Shas, as well as two additional ministers within — but not leading — the welfare and education ministries.

To take on his ministries alongside the other members of Israel’s 37th government when they swear in on Thursday, Deri pressed for a change to one of the fundamental laws undergirding the structure of Israel’s government. Convicted of tax offenses in January and given a suspended sentence, Deri would have had to go to the Central Elections Committee for a decision on whether he was fit to become a minister, turning on the question of whether his crime carried moral turpitude.

To eliminate the need, on Tuesday the incoming coalition passed a law that limited the test only to custodial — rather than suspended — sentences. Netanyahu rallied his Likud party to fast-track the legislative promise.

Head of the Likud party Benjamin Netanyahu, right, with Shas chair Aryeh Deri at a conference in Jerusalem on September 12, 2022. (Yonatan Sindel/Flash90)

Deri is also slated to rotate his interior and health ministries jobs for the finance ministry, mid-way through the government’s term. In the interim, he secured separate budgetary authority over the Interior Ministry, without Finance Ministry involvement. He also cleared NIS 5.85 billion ($1.65 billion) for improvements to the healthcare system, with a special focus on improving services in disadvantaged and far-flung communities outside central Israel.

Shas routinely refers to itself as a “social” party and its election slogan was “hungry for change,” a double entendre that nodded to poor families especially challenged by Israel’s rising cost of living. The party delivered on one of its core election promises, securing “at least” NIS 1 billion ($280 million) to renew a pre-loaded card program to provide food aid to needy families. The program will operate out of Deri’s Interior Ministry.

The following are key promises from Shas’s coalition deal with Likud, signed Wednesday. These coalition deals are not legally binding, and their clauses are not always implemented.

Expanding welfare benefits and fighting the rising cost of living

In addition to securing another NIS 1 billion for its food card program, Shas both demanded and signed on to a range of policies to support ultra-Orthodox socio-economic development, increase workforce participation, reduce costs associated with government bureaucracy, and generally combat sharply rising living costs.

The party secured a promise for the government to develop a five-year plan for ultra-Orthodox social-economic development, touching on areas that include housing, transportation, healthcare, education, strengthening local authorities, infrastructure, employment, and closing socioeconomic gaps.

Israel’s ultra-Orthodox population is disproportionately close to the poverty line, with a large percentage of its men choosing full-time religious study over workforce participation. And, due to education in a parallel system that does not always include core curricular subjects like English and math, combined with the challenges of respecting an ultra-Orthodox lifestyle in a secular work environment, many community members find it challenging to obtain lucrative mainstream jobs.

Ultra-Orthodox entrepreneurs saying afternoon prayers at Ampersand, the co-working space set up by KamaTech; July 4, 2019 (Shoshanna Solomon/Times of Israel)

To encourage workforce participation, the Shas deal also includes a negative income tax and tax credits for working families, the latter in the form of partial credit points for each additional child.

The party also signed on to initiatives to reduce bureaucracy for self-employed Israelis, as well as a licensing reform to enable new immigrants to work in professions for which they received certifications in their countries of origin.

Shas also pushed to recognize religious degrees as equivalent to higher education degrees, for the purpose of competing for government tenders, which often list out education requirements for positions.

To encourage the building of approximately 300,000 new dwellings to address Israel’s housing crisis, the party also wants to reduce bureaucratic barriers to building. Bureaucracy also will be further slashed for imported products to adopt European standards in lieu of idiosyncratic Israeli ones for even more goods and products, reducing both cost and barriers to importation.

In line with promises made by Likud, Shas signed onto a commitment to freeze utilities and municipal property tax rates, as well as to look into freezing fuel and price-controlled good prices.

Removing a particular source of ire in the ultra-Orthodox community, both Shas and fellow ultra-Orthodox party United Torah Judaism obtained commitments to cancel taxes passed by the outgoing government to make single-use cutlery and sugared drinks more expensive.

Illustrative. A grocery shopper in the northern town of Katzrin, in the Golan Heights, on July 1, 2022. (Michael Giladi/Flash90)

Among other cost-of-living initiatives, the party committed to supporting the privatization of the Ashdod port, looking into options for cheapening or subsidizing gluten-free food, backing a Likud promise to provide free education from birth to age 3, and building a new ultra-Orthodox city.

However, the party would roll back the current, and contentious, agriculture reforms passed by the outgoing government, meant to lower protectionist barriers against food imports. Instead, Shas said it would look for a “balance” between reducing prices and strengthening domestic agriculture.

Increasing socio-economic benefits to soldiers, while slipping service

Shas, along with UTJ, is pushing for two big laws that will help exempt ultra-Orthodox men from service.

First, the parties continue to push for an amendment to the current conscription law that will further lower ultra-Orthodox military conscription quotas, letting men study in religious institutions instead. Second, the parties are pushing for a new Basic Law: Torah Study, which will raise the legal standing of Torah study and may give a firmer basis for continued religious study exemptions to service.

Alongside this move, Shas is supporting Likud-initiated policies to financially bolster soldiers.

The proposals would raise enlisted soldiers’ salaries by 20{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} for their period of compulsory service, and bump up combat soldiers’ pay to a level akin to minimum wage. Eligible veterans would see their scholarship funding bump up to 100{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} under the From Uniform to Studies program, in line with a promise Likud made while trying to torpedo the legislation in an effort to topple the outgoing government.

IDF soldiers carry out raids in the West Bank on September 8, 2022. (Israel Defense Forces)

The plan would also give every soldier a free study year for each year of service and create an affirmative action plan for veterans applying to study medicine, law, computer science, accounting, or engineering. It would also increase resources and support for soldiers suffering from post-traumatic stress disorder.

Pumping in funds to improve healthcare access and services

Shas party sources have said that Deri wanted the health portfolio in line with the party’s focus on helping underserved communities. Healthcare access and resources vary greatly across Israel, and communities disconnected from Israel’s central regions are especially disadvantaged in this regard.

In preparation to move into the Health Ministry, Deri secured a NIS 5.85 billion budget addition to improve access and services. Among other uses, the money is earmarked to reduce the cost of health services to patients, improve hospital technology, increase the number of hospital beds, improve infant care, and reduce appointment wait time.

Accompanied by a number of policy priorities and authorities accompanying Deri into the Health Ministry, Deri secured a promise to receive this funding without Finance Ministry weigh-in.

Connecting the periphery to the mainstream

Shas has for years focused on supporting, and building support in, communities beyond Israel’s main cities and urban sprawl.

The party has inked commitments to better connect these peripheral regions to the rest of the country, as well as reduce the costs of moving between the periphery and the center.

Shas has signed on to supporting a bullet train to run from Kiryat Shmona in the north to Eilat in Israel’s south, increasing public transport to the periphery, canceling recent transportation reform and returning public transport price subsidies for peripheral communities, canceling a planned congestion tax on highways, and supporting a law to enable a Tel Aviv metro, after joining a politically-motivated block against a metro bill pushed by the outgoing government.

Construction on the Tel Aviv Red Line light rail at Allenby station, as part of a planned mass transit system for the Tel Aviv metropolitan area some of which runs underground. September 13, 2021. (Moshe Shai/FLASH90)

It would also support creating another international airport, as well as privatizing and expanding the Haifa airport.

The party also wants to increase student discounts for public transportation, and give yeshiva and kollel religious school students a similar 50{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} discount.

To encourage economic development in the southern Negev and northern Galilee, Shas wants to support the regions turning into biotech and advanced agritech centers.

Keeping the religious ‘status quo’?

Like all parties, Shas has language in its agreement committed to preserving Israel’s “status quo” between religion and state. To Shas, this means rolling back hated reforms made by the outgoing government, as well as pushing a few new ones.

In addition to the tax on single-use utensils and sugared drinks — pitched as environmental and health matters, but seen as disproportionately affecting ultra-Orthodox communities — Shas wants to roll back reforms made by former religious services minister Matan Kahana.

Kahana pushed through a reform to liberalize the kosher certification market, by both letting establishments and manufacturers choose any municipal rabbinate to supervise, and in a piece to go into effect in January 2023, to open the market to other Orthodox supervision providers.

A strawberry-topped croissant from venerated bakery Kadosh, which defended their decision to switch kosher supervision to Tzohar from the chief rabbinate (Courtesy Kadosh)

Shas and UTJ want to cancel this reform, but Shas separately wants to unify kashrut standards across the rabbinate.

It also wants to cancel a Kahana directive that changed the appointment process for municipal rabbis, as does UTJ.

Other policy points shared with UTJ include: preserving gender-segregated prayer at the Western Wall, tightening eligibility to immigrate to Israel under the Law of Return, backing a partial rollback of Israel’s anti-discrimination law to allow gender-segregated events and private companies to deny service based on religious belief, and a law to enable hospitals to bar unleavened food during the Passover holiday. They also agree on the need to form a committee to investigate the ability to provide land burials, include a Chief Rabbinate representative on committees approving Shabbat work permits, and allow rabbinical courts to expand their reach into civil affairs.

Shas also wants NIS 30 million ($8.48 million) to increase ultra-Orthodox youth participation in the popular Taglit Birthright program that brings Jewish young adults in the diaspora to Israel, as well the Masa internship program, which services a similar purpose.

The party also secured NIS 220 million ($62.17 million) for the construction and renovation of religious buildings, including synagogues, ritual baths, and cemeteries.

Increasing religious school funding, without core curricular demands

While maintaining the “independence” of religious education systems, Shas — along with other religious parties — secured promises to increase funding for exempted schools to 55{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} of public schools, and recognized unofficial schools to 75{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} of public school funding.

These largely religious exempted and unofficial schools will get the funding bumps, without having to integrate core curricular subjects like math, English, and science into their studies.

Alongside these promises, Shas signed on to a promise to improve public school education in Bible studies and core curricular subjects like math, English, and science. It also pushed for Zionist history and heritage classes for all faiths in public schools, including Christians and Muslims.

The party also signed on to support rolling back the outgoing government’s contentious matriculation exam reform.

The Hesder Yeshiva in the Itamar settlement in the West Bank, May 2, 2021. (Sraya Diamant/Flash90)

The Education Ministry will also work towards absorbing religious schools into its years-old New Horizons program, which funds work in small groups between teachers and pupils and bumps up teacher salaries, among other initiatives.

Yeshiva and kollel-based religious study institutions also received a funding bump. Kollel students are married and many have children; both Shas and UTJ would have to sign onto changes affecting daycare subsidies, which the outgoing government tried to pull from full-time religious scholars.

Programs for at-risk ultra-Orthodox children will have NIS 30 million in additional funding for technical schools, as well as the formation of at-risk youth villages.

A heritage center for its spiritual leader and not-so-smart phones

Among various other proposals, Shas has also secured a promise and state funding for a Sephardic Jewry heritage center to honor its late spiritual leader and rabbi Ovadia Yosef. Along with UTJ, it supports canceling the outgoing government’s kosher cell phone reform package that would have opened up the closely held market, as well as making internet-based government services and public transportation tickets available to users without the internet or smartphones, deliberately lacking in ultra-Orthodox circles.

File: An ultra-Orthodox Jewish man walks near a billboard with a picture of the late Shas spiritual leader Rabbi Ovadia Yosef, as part of a Shas election campaign, in the northern Israeli city of Safed, February 28, 2020. (David Cohen/Flash90)

The party has also signed on to pass a stalled climate bill, including a promise to reduce Israel’s greenhouse gas emissions by 50{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} of the 2015 levels by 2030, and to advance a “humanitarian solution” for connecting illegal West Bank outposts to electricity.

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6 Water Physical Therapy Benefits for Multiple Sclerosis

6 Water Physical Therapy Benefits for Multiple Sclerosis

While there is currently no cure, there may be some things you can do to manage your
multiple sclerosis (MS) symptoms. Water therapy can help deal with the pain, mobility issues, and mental health challenges that people with MS face.

This article discusses water physical therapy for MS, the benefits of aquatic therapy, and what to expect if you seek treatment.

Giselleflissak / Getty Images


What Happens During Water Physical Therapy?

Water physical therapy, or aquatic therapy, is one treatment people with MS can use to improve their health. For people with MS, the pools used for this exercise program must be carefully temperature controlled.

A physical therapist or other healthcare team member will design and assist you in an individualized program you complete in the pool, tub, or natural body of water. This type of therapy may help with your MS, including:

  • Buoyancy: Water helps support your body weight, so there is less stress on your joints, making it is easier to move (better flexibility).
  • Resistance: Moving through the water helps to strengthen muscles.
  • Hydrostatic pressure: The gentle pressure of the water helps decrease swelling and improve awareness of the position of your joints (proprioception).

At gentle warm temperatures, hydrotherapy (another name for water therapy) can improve blood flow to muscles and help relax tight muscles.

6 Benefits for MS

Exercise programs may be helpful for people living with MS by increasing strength, decreasing fatigue, slowing the progression of symptoms, and improving quality of life. Aquatic therapy can provide many benefits, according to research studies.

Mobility 

Up to 80{08cd930984ace14b54ef017cfb82c397b10f0f7d5e03e6413ad93bb8e636217f} of people with MS are expected to develop problems walking. Other common mobility issues are loss of balance, difficulty getting dressed, and trouble climbing stairs. Exercise, including aquatic therapy, can help slow or even reverse these challenges.

Water therapy is helpful for improving muscular strength in people with MS. Strength is an important part of overall mobility (the ability to complete functional movements).

One study found people with MS who participated in three aquatic therapy sessions per week improved mobility in several areas, including a six-minute walk test and Berg balance scale score (measuring balance).

Other studies have shown water therapy for people with MS can help improve balance and walking speed. However, more research is needed to understand how long the benefits continue to last.

Fatigue

Fatigue is a common MS symptom and can cause significant disability. Fatigue is more than just being tired; it includes a lack of energy and motivation to get started on tasks. Memory or thinking issues can also occur with fatigue.

Although it initially takes energy to complete water physical therapy, it has often been shown to decrease fatigue and improve activity levels for people with MS. One study found people with MS who participated in three aquatic therapy sessions per week improved their scores on the modified fatigue impact scale (MFIS), which measures the impact of fatigue.

Another study found that water exercise was the most effective intervention for improving fatigue.

Mental Health

People with MS may face mental health challenges. The loss of mobility can affect social interactions, their ability to work, and their quality of life. Hydrotherapy and exercise can decrease depression and improve mood in people with MS.

In one study, women in an aquatic exercise group improved their quality of life over eight weeks compared to a group without exercise interventions. More research is needed to learn the exact mechanism that improves mental health in people with MS during aquatic exercise. Still, reasonable levels of activity may be safe and even provide benefits.

Pain Management

Acute and chronic pain can be symptoms of MS. Research shows aquatic therapy may help reduce pain in people with MS. However, the way hydrotherapy works to decrease pain is not fully understood.

Exercises that improve flexibility help to reduce muscle spasms and keep joints mobile, which may help with pain. More research is needed to understand how to incorporate this into an aquatic therapy exercise program.

Cooling

Water therapy for people with MS is often provided in pools with temperatures between 80 and 88 degrees F. This temperature range helps keep the body cool and can reduce MS symptoms that often appear when the body gets too hot. Water pulls heat away from the body 25 times faster than in the air, promoting optimal body temperature for people with MS.

Increased Body Heat

Increased body heat can cause a relapse of MS symptoms (Uhthoff’s sign). Fever, exercise, increased environmental temperature, and hot beverages or foods can worsen symptoms. Check the temperature of the pool before entering to help prevent triggering a relapse.

Overall Health

Water therapy provides many of the benefits of other exercise programs, including:

  • Cardiovascular health
  • Activity tolerance
  • Weight maintenance/weight loss
  • Stress reduction

Finding a Water PT Specialist

Your healthcare team may be able to recommend a local physical therapist specializing in water therapy. Your provider and physical therapist may ask questions to confirm that water therapy is a safe and appropriate treatment option for you. Check with your insurance provider to discuss the coverage available for this treatment based on your policy.

High temperatures can worsen MS symptoms in many people. Check with your healthcare provider to see what pool temperatures are recommended for your health.

MS Water Therapy Exercises

A specialist will tailor physical therapy to your condition, including water therapy. PT begins with an evaluation of your symptoms.

Depending on your goals and current mobility, you will be prescribed a specific exercise program. You may perform exercises that focus on the following:

  • Strength (arm and leg exercises against the water or holding a floating dumbbell)
  • Walking (gait training)
  • Balance
  • Flexibility
  • Aerobic exercise
  • Cycling (on an underwater bike)

You may benefit from beginning with a specialist to learn MS-friendly exercises you can work on in a pool. After your training, speak with your provider to see if you can continue using the pool independently. Be sure you understand the risks and benefits of working out on your own.

Risks and Safety Tips

Your healthcare provider will discuss the risks and benefits of water therapy with you before you start. Be sure to share any concerns about being in a pool—especially if you cannot swim.

Pool therapy may not be appropriate for you if you have open wounds on your skin, are incontinent of bowel or bladder (have bathroom accidents), or have an active fever or infection. Also, aqua therapy is not recommended for people with heart disease or abnormal blood pressure.

Depending on your mobility limitations, you may want to inquire how you can enter and exit the pool (zero entry, lift chair, stairs). You and your physical therapist may choose to have you stay in a depth where you can fully stand and be near a wall or grab bar for safety.

Summary

Water physical therapy has multiple benefits for people with MS, such as improving balance, mobility, and mental health. However, it is not suitable for every person. Ask your provider for a referral to a physical therapist who specializes in aquatic therapy. You will receive an assessment and an individualized program focused on your goals.

A Word From Verywell

If you find water soothing and relaxing, you may benefit from water therapy for your MS symptoms. However, if you are unable to swim or afraid of the water, there are still many treatments to help you live with MS. Reach out to your healthcare team and share any questions or concerns about your condition.

Frequently Asked Questions

  • Are hot tubs safe for people with multiple sclerosis?

    Warm environments, like hot tubs, can rapidly worsen symptoms of MS for many people. Your healthcare provider may recommend avoiding warm temperatures like hot tubs, saunas, and the outdoors during the hot seasons of the year. Never enter the water alone; consider seeking a pool with a lifeguard.

  • What temperatures make MS worse?

    Even a slight (less than 1 degree) increase in your core body temperature can worsen MS symptoms. Exercise, fevers, hot tubs, being outdoors in warm temperatures, and other things that raise body temperature may affect you.

  • Is shallow water better for pool therapy?

    You may practice movements in different pool depths if you are working with a physical therapist for your pool therapy. Water levels between waist and chest height are common. Deeper water provides more support for your body weight.