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HEALTH

Heavier is now healthier: Danish study

Being on the heavier side may not be as dangerous as it was in the 1970s, at least when it comes to the risk of dying, according to a Danish study released on Tuesday.

Heavier is now healthier: Danish study
Being overweight might actually decrease the risk of death. Photo: Colourbox
The optimum ratio of weight and height — known as body mass index or BMI — is now on the upper side of the healthy range, according to the report in the Journal of the American Medical Association (JAMA).
 
“Compared to the 1970s, today's overweight individuals have lower mortality than so-called normal weight individuals,” said Børge Nordestgaard, clinical professor at the University of Copenhagen and Copenhagen University Hospital. “The reason for this change is unknown.”
 
The report was based on more than 100,000 people in Denmark. The study spanned three groups, or cohorts, whose risk of dying for any reason was examined in 1976-78, 1991-1994, and in 2003-2013.
 
Currently, doctors define the normal range for BMI — calculated by weight in kilograms divided by height in meters squared — as between 18.5 and 24.9.
 
A BMI of 25-29.9 is considered overweight, while 30 or higher is obese.
 
In the 1970s, the optimal BMI for the lowest risk of death was 23.7.
 
This would be the equivalent of a 1.83 meter (six-foot) tall man who weighs 77 kilograms (170 pounds), or a 1.65 meter (five-foot-five) woman who weighs 65 kilograms (143 pounds).
 
By 1991-94, the optimal BMI had risen to 24.6. And in 2003-2013, it reached 27.
 
Compared to four decades ago, that would mean adding 14kg (30 pounds) to the frame of the a person who stands six-feet tall, or nine kg (19 pounds) to the frame of someone 1.65 metres tall.
 
Researchers also found that obese people in the 1970s were more likely to die than normal weight people, but this association disappeared in the 2000s.
 
“The increased risk of all-cause mortality associated with obesity compared to normal weight decreased from 30 percent 1976-78 to 0 percent in 2003-13,” said principal investigator Shoaib Afzal, of Copenhagen University Hospital in Denmark.
 
Health authorities have long warned of the risks of being overweight, including diabetes and cardiovascular disease.
 
Nordestgaard said the current findings suggest “a need to revise the categories presently used to define overweight, which are based on data from before the 1990s.”
 
However, experts cautioned that the biological mechanism behind the new findings remains poorly understood, and the results should not be interpreted to mean that people can cease caring about what they eat.
 
According to Naveed Sattar, professor of metabolic medicine at the University of Glasgow, the study is “of interest” but dos not merit changing advice on obesity and preventing extra pounds.
 
“In recent years, as populations become more obese and with wider availability of cheap preventative medications many more such individuals are likely to be better treated for abnormal blood pressure, abnormal cholesterol and, if also present, type 2 diabetes, leading in turn to lower death risks,” said Sattar, who was not involved in the study.
 
“In other words, the current findings do not mean that being overweight is protecting you from death, far from it — rather, many confounding factors may give the current result and we know from many other studies that being overweight or obese does increase mortality risks, in the same way that it
increases risk for many other conditions.”

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HEALTH INSURANCE

Acupuncture to rolfing: What your Swiss health insurance gets you (if you pay more)

If you pay for supplementary health insurance in Switzerland you can benefit from access to complementary therapies. We look at what's available and how the system works.

Acupuncture to rolfing: What your Swiss health insurance gets you (if you pay more)

Like numerous countries in Europe, health insurance in Switzerland is a compulsory coverage that all people must have.

Most Swiss insurance providers offer several options for their customers, which are separated into two categories: basic and supplementary.

Basic health insurance (KVG / LaMal) must be purchased, because it is compulsory. Supplementary insurance comes with extra benefits for healthcare but also of course an extra fee.

The franchise (or deductible) will need to be met, but thereafter, even basic insurance has you covered. It pays for medical care, prescriptions, and specialist care like eye doctors, sometimes even without  referrals from your primary care physician. Supplementary health coverage, however, gives you access to complementary therapies that can differ substantially from what basic coverage allows. 

CLICK HERE for more on health insurance in Switzerland

You have to fill out a form the insurance carrier provides and sometimes might have to undergo a health check and discuss preexisting conditions in order to see how much insurance coverage can be offered — if any at all. 

Unlike the KVG / LaMal, which must be provided to all residents regardless of their health status, insurers can deny supplementary coverage if they deem you too much of a risk.

This can happen if you have chronic illnesses or pre-existing health problems, in which case you could be either turned down or offered a policy with wavers for your specific conditions.

Each insurance company decides what coverage they will offer and what percentage they pay, depending on both your overall health at the time of enrolment, and which plan you choose. You’ll be able to read what’s included in your plan in the paperwork you receive from your health insurance and, as always, the fine print is important to read. 

People who only have basic KVG / LaMal insurance still have thorough coverage for many things, from standard doctor visits to in-patient care and hospital stays.

READ ALSO: What is not covered by compulsory basic health insurance in Switzerland?

What complementary treatments are available?

In Switzerland, homeopathy is included in all health insurance plans, as healthcare isn’t merely approached with classical treatments; instead, a holistic approach is applied to healthcare throughout the country. The complementary therapies available through the supplementary insurance give individuals the opportunity to play an important part in their own wellness. 

Having a supplementary insurance not only increases the financial coverage you’ll have for some of your standard medical needs, but it also brings expanded access to numerous forms of wellness therapies. The Swiss are very focused on health and wellness and it is clear through the various types of insurance available, that a primary focus is getting the population healthy and keeping it that way. This additional insurance creates a way for people to access treatments and care for their well-being which, in turn, creates a healthier population. 

Complementary therapies can include various styles of massage including, classic, manual lymph drainage, therapeutic, connective tissue, acupressure, and medical massage, among others.

There are additional treatments and therapies such as foot reflexology, osteopathy, and Rolfing (massage/treatment of connective tissues) that are included in the coverage, plus there is also access to traditional Chinese medicine including cupping (suction cups applied to your body), acupuncture, and herbal medicine. Some practitioners also offer consultations in naturopathic health, including detoxification (guided cleansing of your digestion and body), nutrition, and hydrotherapy (using the element of water as therapy).

READ ALSO: How people in Switzerland can save money on healthcare

Your insurance provider will be able to better detail what is covered for you.

Another thing to take into consideration is that some insurance plans will even reimburse a portion of the costs of other health-related things, such as a part of the annual cost of a gym membership. Some plans will refund about 800 Francs per year for a gym membership that costs about 1,400 Francs. Granted, you will pay more each month for some of these extra options, but having access to them– and utilising them– can make the pricier monthly cost worth it. 

How do you go about getting complementary therapy?

Once you’ve signed up for supplementary insurance, you’re able to view a list of complementary therapies on the website of your insurance provider. Getting connected with a masseuse, osteopath, or other care provider is as simple as calling them up and scheduling an appointment. Once you have the supplementary insurance, there is no need to go to your primary physician and get a referral. 

In Switzerland, the reimbursement process for these therapies is also a little different. While some practitioners will still have you pay direct and out of pocket for the treatment (with a reimbursement coming later, after you’ve submitted the receipt to your insurance company), others will send you a bill in the mail. This creates a unique way that you can receive the receipt from the treatment, file it with the insurance, and often times have the reimbursement from the insurance deposited directly into your bank account before you even pay for the initial treatment. This makes it so that people who also don’t have a lot of access to cash can still receive quality care.

READ ALSO: Which Swiss cantons see the biggest hikes in health insurance premiums?

Be aware though you can’t just go for as much cupping, acupuncture or “rolfing” as you’d like because most insurers will put a limit on how much treatment you can get in a certain period. Some insurers might not cover the full cost meaning the patient might have to pay 10 to 20 percent of the fee.

This focus on providing access to things that augment an individual’s overall wellness makes Swiss healthcare among some of the best in the world. If you can see beyond the price tag (and let’s admit, it is expensive: sometimes 400-500 Francs or more each month), there are myriad ways to source treatments and therapies that will benefit your overall health and well-being, making for a healthier and ultimately happier person. 

When you first move to Switzerland, you can either select an insurance on your own, or sit down with an insurance consultant who will not only go over what each insurance offers, but can help you find the best coverage for you, your family, and your situation. When you need to make a change with your health insurance, you can get in touch with the consultant and they will procure the papers needed to make the changes. Although there is a cost associated with this sort of service, it can make selecting and signing up for health insurance in Switzerland an easy and smooth process. 

To find out more and compare rates for health insurance in Switzerland, information can be found here: https://en.comparis.ch/krankenkassen/default

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