Paging Dr Willy Wonka: Chocolate Update

Over the years, we've touted the benefits of chocolate-based health care: whether you're pregnant, overweight, or just suffering from high blood pressure, chocolate seems to be the "go to" dietary hero (well, maybe next to tomatoes). It's not enough, apparently, for scientists merely to acknowledge cocoa's seminal role in the health care arena; now they want to map the delicious pod's genome:

"Government scientists are launching a five-year project Thursday aimed at safeguarding the world's chocolate supply by dissecting the genome of the cocoa bean."

It seems that there are a host of challenges that affect cocoa crops, from fungi to droughts, and researchers believe that they can learn more (and better) techniques for protecting the world cocoa bean supply by more completely understanding what makes it "tick."

It's actually a pretty interesting venture, with leading edge genetic research which promises to have positive, real-world impact.

Dr Wonka, I Presume?

We’ve discussed the health benefits of my favorite bean before. But a British physician has gone one better:

“Roger Corder, a professor of experimental therapeutics, is so convinced of the possible benefits of dark chocolate that he has asked for permission to test the theory as part of the treatment for 40 cardiovascular patients.”

According to the experts, the anti-oxidants in chocolate have the ability to dampen LDL (bad cholesterol) levels.

The downside – if there is one – is that the chocolate “doses” are relatively small (about 3 tenths of an ounce, or one M&M). The article also notes that “it is probably wrong to say that all dark chocolate is good for you.” And, they’re still trying to determine which brand works best.

Unfortunately for your intrepid correspondent, the study is being conducted across the pond. Still, I eagerly await the results.

Sir Willy Wonka to the rescue!

Recently, we discussed the terrific new "Twinkies Diet," which demonstrated that even those spongy treats hold promise. Now comes word that another perennial IB favorite, chocolate, has even greater health potential. Scientists working with candy giant Mars are even now busy deciphering the genome of cacao, from which chocolate is processed:

"Researchers ... are scouring the genome of the tree Theobroma cacao to find ways of enhancing the health benefits of cocoa beans ... They believe they can boost the levels of compounds known as flavonols in the beans. Flavonols have been found in recent research to improve blood pressure and have beneficial effects on the cardiovascular system."

So a chocolate covered Twinkie would be the perfect health food, right?

Red wine health news

Not that I'd have guessed this, but we've been blogging about the health benefits of the compound resveratrol for years. it can be found in blueberries and even peanut butter, but perhaps its most well-known source is red wine.

And therein may lie a problem:

"A new study published in JAMA Internal Medicine on the health effects of resveratrol – a compound found in red wine, dark chocolate and some fruits and vegetables – has generated a lot of sensational headlines"

This study claims that there are, in fact, "no health benefits from red wine and chocolate."

[ed: one wonders, then, about the anti-oxidant properties of dark chocolate - are these hype, as well?]

Sounds bleak, no?

Never fear, Dr Manny is here (Dr. Manny Alvarez is FOX News Channel's Senior Managing Editor for Health News; he is also a member of numerous professional societies). The good doctor has a number of qualms about the study:

"... there were many factors omitted in the study. We have limited knowledge of the lifestyle and family histories of these participants. Furthermore, surveys carry a certain degree of inaccuracy, because they rely on the honor system. And the researchers did not measure participants’ resveratrol levels at the end of the nine-year study period to see how these levels might have changed"

Seems like that last bit reflects a major fail on the researchers' part.

On the other hand, Dr Manny is also a bit leary of the purported benefits of resveratrol, and cautions us to be skeptical about some of the claims its proponents make:

"Many Americans may believe that taking a daily pill, like resveratrol, can prevent any number of diseases. That is not how diseases work."

So, is resveratrol a hero or a villain? Well, probably not the latter, but maybe not the former, either.

Food Pyramid Update...

In our never ending quest to ensure that we stay on the cutting edge of food health, we've had semi-regular updates to our famous food pyramid.

Today, we learn that "(w)hen it comes to lowering blood pressure, a piece of dark chocolate beats green tea, hands down."

That's correct: chocolate, and especially dark chocolate [ed: my favorite!] contains healthful flavenoids that can help reduce blood pressure, apparently even more effectively than the much-touted green tea beverages.

More food for thought.

More Healthful Food News...

Who says you can’t eat your cake and have it, too? In this case, of course, we must be referring to chocolate cake, perhaps made with Nestle’s brand chocolate:

“In a move that recognizes the modern world's twin obsessions — indulgence and guilt — chocolate maker Nestle said Monday it would purchase weight loss product maker Jenny Craig Inc. for $600 million.”

That’s right, the giant food conglomerate has us now, coming and going. We can indulge our sweet teeth, and then shed those unwanted pounds (and inches) when we’re sated.

If nothing else, one must applaud the company for its ingenious (if somewhat cynical) marketing synergy.

Just one more step toward the new food pyramid.

HumpDay LinkFest

■ Will they or won't they? Back in May, Patrick quoted Ron Pollack, Founding Board Chairman of Enroll America (EA), who told him that "Enroll America  has not filed to serve as navigators and has no intention of doing so."

Fast forward a bit, and we learn that EA is still a bit less than forthcoming about its role in the train wreck:

"Jessica Barba Brown, national communications director at Enroll America, says the exchange promotion team now has a staff of 130 and about 3,000 registered volunteers ... The campaign organizers said the Get Covered America campaign is a "metric-focused" organization but declined to discuss numerical goals for their outreach efforts."

So what, exactly, are those "tens of millions of dollars" doing? Inquiring minds want to know.

■ The Gem State, which had initially opted to design and run its own Exchange, has run into a spot of trouble:

"Idaho will be relying on the federal health insurance exchange for at least a year while it develops its own"

Turns out that they took a little too long in getting their Exchange planned out, let alone implemented.

■ Most folks love their chocolate, and now there's another reason to rejoice in the confection:

"In a study published [recently] in the journal Neurology, researchers reported that chocolate may help improve brain health and thinking skills in the elderly"

Some words of caution, though: the benefits appeared to accrue only to those who were already at higher risk of dementia, and it's not clear how long the affects actually last. But hey, it's a tasty way to potentially decrease one's risk of dementia.

■ FoIB Jeff M tips us to this news from the Tar Heel State:

"Triad Adult and Pediatric Medicine, Inc. will close its adult practice on S. Eugene St. in Greensboro on Aug. 30"

Now this might seem like a "local news story," but it's actually more significant: it affects some 20,000 patients, who will now have to find new health care providers. The bulk of these folks (70% or more) are currently uninsured. his means that, once they've bought their shiny new, government-mandated policies, they'll need to spend some quality time trying to find someone with whom to use them.

Good luck with that.

Game, Set...and Match?

While the "S" in USA doesn't stand for "svelte," our cousins across the pond are facing an even weightier dilemna:

"The growing problem of obesity risks bringing financial ruin to the National Health Service, a study has warned...Research commissioned by the Government in 2005 has warned that half the population will be obese within 25 years if current trends continue."

Seems that the increasing costs associated with a portly population threatens to bankrupt the English health care system (not that it's exactly helping ours any). Here in the States, the problem may start with our youngsters:

"Pushing diets probably won't help. Neither will teasing about weight. Instead parents should focus on having frequent family meals, creating a positive atmosphere at mealtimes, promoting physical activity and building self-esteem, the researchers recommend."

Given the reputation of English cooking, that may not offer much hope for our British cousins, though.

And this probably won't help, either:

"CONFECTIONERY giant Cadbury is to slash the cost of three of its top-selling chocolate bars by about 40 per cent in the run-up to Christmas, in a move which health experts have warned could contribute to the UK's obesity epidemic."

Now, we've touted the amazing health benefits of chocolate more than once here at IB, so this is sort of a "good news, bad news" kind of thing. But the key seems to be moderation, which may be more difficult as prices for the tasty treat plummet.

On the other hand, maybe it's time to switch to another healthy food group.

Tea and (Dark) Chocolates

We've been reporting for a while that chocolate (particularly dark chocolate) has some major health benefits. But have you ever wondered why that is?

Turns out, the sweet treat actually works with the microbes in our stomachs to promote specific health benefits. Specifically, "beneficial bacteria that reside toward the end of our digestive tract ferment both the antioxidants and the fiber in cocoa."

Neat!

Also neat?

Earl Grey tea may actually be better at reducing your cholesterol than oft-prescribed (and much more expensive) statins:

"Researchers from Italy’s University of Calabria explained that the tea contains extracts of a Mediterranean citrus fruit called bergamot, which is made of enzymes known as Hydroxy Methyl Glutaryl Flavonones (HGMF)."

Yes, that's a mouthful, but it seems that this HGMF helped to increase "good" cholesterol and reduce the "bad."

Now about those scones....

Food Pyramid Alert: Cocoa No-No

Last Spring, Bob touted chocolate's many benefits for expectant mothers, and a year earlier I reported on its ability to lower blood pressure. There's a fine line though, between low BP and no BP:

"A Cadbury spokesman says preliminary tests show melamine in its Chinese-made chocolates."

Turns out, some of the "milk" in Cadbury's "milk chocolate" came from China, and has been found to be tainted with melamine, "which is used to make plastics and fertilizer," but doesn't seem to have a place in candy-making.

The British sweets giant isn't alone in its concern: "(T)wo U.S. food makers were investigating Indonesian claims that high traces of melamine were found in Chinese-made Oreos, M&Ms and Snickers."

Cookies and candy bars? I may have to switch to 'Nilla Wafers and Marshmallow Fluff.

Health & Chocolate Down Under

"[R]esearchers at Monash University have discovered that eating a 100g [about 3.5 oz] bar of dark chocolate a day (yes, the whole seductive, delicious, mouthwatering brown slab, from each melting cube to the last sticky crumb) is one way to avoid cardiovascular disease."

This magic elixir apparently reduces both blood pressure and cholesterol. Obviously, one must avoid over-consumption, but it sounds like a great way to eat healthy.

Cavalcade of Risk #15...

When we started the CoR a little over 6 months ago, it seemed a calculated risk that we'd last this long. We've got hosts scheduled up through mid-February now (hey, that reminds me, how would you like to host an upcoming edition?), which seems to mean that that risk paid off.

So, take a break from that last minute shopping, sit back, and enjoy the show. And a great big Thank You to everyone who submitted, and a few who didn't (but got included anyway):

■ You’ve heard of soft water, but how about Hard Money? Joshua Dorkin, blogging at Real Estate Investing For Real, explains how some lenders use an imaginative technique to help folks secure loans.

■ Joe Kristan, of Roth & Company, explains some of the “useful changes to the HSA rules." Using them can help reduce your risk of spending too much on health care.

■ The PC-Doctor prescribes a dose of common sense: reusing passwords can be dangerous to your (computer's) health!

■ Think you’re paying too much to insure your car? Chuck Russell has 15 ways to help you lower your car insurance.

■ The folks at VitaBeat warn that young men face a greater risk of high blood pressure than their female counterparts. As a former teen-age boy myself (a LOOONG time ago!), I'm tempted to say "dunh!"

■ Klik Money reports that something as simple as a health risk assessment can help lower your medical bills. Good advice!

■ The unfortunate plight of CNET editor James Kim has some lessons for the rest of us. Pro Bargain Hunter’s Yan has some helpful tips on preparing for the worst.

■ Think your identity is safe? Do you get credit card offers in the mail? Wenchypoo warns that if the answer to both of those are “yes,” you may have a problem.

■ Last week, she hosted the Health Wonk Review; this week, Rita Schwab has some pointed questions about the redundancy of the current physician credentialing system in the US. Don’t miss the comments.

■ Great news! If visions of (chocolate covered) sugarplums are dancing in your head, Mombian reports that chocolate may reduce the risk of miscarriage.

■ What’s a modern day Jack the Ripper got to do with risk (other than the obvious, if you’re in a certain line of work)? Renthusiast wonders why the ubiquitous London surveillance cameras weren't a show-stopper.

■ Hedge Funds are mysterious, and potentially risky, vehicles. Find out why Mister Juggles loves ‘em.

■ Since it's such a hot topic these days, here's one more on identity theft. The Identity Theft Fixes blog has a cautionary tale about a simple printing error that could have dire consequences.

■ No need to grab a shovel: Paul’s Tips has some advice about cutting your losses.

■ Jon Coppelman at Workers Comp Insider has a great post on navigating the hazards of the ADA (no, not that ADA!)

■ And finally, Yours Truly responds to a commenter’s puzzlement over the difference between luck and risk.

Our next host will be Jason Shafrin, the Healthcare Economist, on January 3rd. You can find the new Winter Schedule (and any changes) at the Cavalcade homepage.

Medical Tourism: A New Twist

I must confess to being a bit apprehensive about this post. We've touched on IVF in the past, as it relates (or not) to risk. And we've discussed medical tourism, as well.

Remember the old Reese's Cup commercials? "You got chocolate in my peanut butter! "No, you got peanut butter in my chocolate!"

Well, this post is like that. According to the (English) Times on Line, "(t)he Vikings are coming. As sperm donations in Britain slow to a trickle, Denmark has become the sperm powerhouse of Europe."

That's right, English lasses are trading in their scones for "a Danish." (Or maybe, a Dane). Turns out, the Brits have all but outlawed anonymous sperm donations, which has caused their supply to, um, dry up. Stoking the flames is the fact that a sample of less than half a milliliter (less than a teaspoon) can fetch as much as $32.

Different strokes, I guess.

Tuesday Health Tip...

Here at InsureBlog, we agree with the central tenet of Consumer Driven Health Care: that each of us is, ultimately, responsible for our health and well-being.

One way we can all accomplish at least part of this goal is with a healthy, and healthful, diet. Fortunately, this just got a whole lot easier, thanks to our friends, the Dutch:

"A study of older men in The Netherlands, known for its luscious chocolate, indicated those who ate the equivalent of one-third of a chocolate bar every day had lower blood pressure and a reduced risk of death."

As for me, I'm off to the health food store right now.

Healthy Food News

It's been almost a year since our last Food Pyramid update, and there's some great news to share:

"Chocolate and red wine can help stave off diabetes: High levels of antioxidants can regulate blood glucose levels"

Turns out, the candy, booze and fruit diet provides a boatload of "flavenoids" - antioxidant compounds - that may help to regulate one's glucose levels.

Eat, drink and be healthy!

Health Wonk Review: Spring Renewal edition

[UPDATE: HWR now back up - Thanks to Roy Poses for the heads' up!]

Spring is traditionally a time to air out the house, clean out the garage, and generally spruce up the homestead. One important task in this process is reducing the clutter. To that end, this week's HWR is simple in design, sparing in verbiage, and focused on the beauty of my fellow wonkers' efforts. As advertised, it's first in, first up:

■ David Williams

HBB's David Williams notes the irony (and arrogance) of Nature magazine's efforts to promote more patient advocacy - behind a $32 firewall.

■ Jaan Siderov

Speaking of social media, Jaan offers his Ten Commandments, er, Rules for health care organizations that want to tap into the power of Twitter, FaceBook and the like.

■ Glenn Laffel

Of course, Nature, Twitter amd FaceBook aren't the only new tech available to Health Wonkers: over at Pizaazz, Glen Laffel discusses how cloud computing is already impacting health care organizations. Glenn offers a case study of how one start-up was recently knocked for quite a loop.

■ Jason Shafrin

Do Medicare patients really have to wait longer to see their doc than those with commercial insurance? Our favorite health care economist, Jason Shafrin, has the (perhaps not surprising) answer to that question, and a handful more.

■ Roy Poses

Roy wonders why physicians are so reluctant to seek legal counsel before signing potentially career-ending contracts.

■ Peggy Salvatore

So here's the question: is it really necessary for providers to fully implement EMR? To which Peggy has a simple answer ("Only If You Want To Get Paid") as well as some interesting alternative financing ideas.

■ John Goodman

As usual, John's not afraid to tackle the big issues. In this post, he looks under the hood of Congressman Ryan's plan to reshape Medicare (with a special cameo from Diana Ross and the Supremes!).

■ Louise Norris

Another longtime HWR contributor, Louise reports on the underwhelming decrease in the number of covered lives in Colorado's small group health insurance market.

■ Anthony Wright

Looks like Anthem Blue Cross is playing chicken with California's Insurance Department by raising rates even after being told not to.

■ Tim Jost

As ObamaCare© wends its way through the judicial system, Tim outlines the arguments in the 4th Circuit, focusing on whether the Act is even Constitutional.

■ Avik Roy

Known primarily for fine cheese and chocolate (and watches, of course), Switzerland may be an unlikely holder of the title "World’s Best Health Care System," but Avik effectively pleads the case.

■ Jared Rhoads

If Switzerland is the Best Health Care system (see above), then Massachusetts may be a leading contender for the opposite appellation. Jared points out that, in the Bay State, fewer doc's are accepting new patients, and existing ones are facing much longer wait times.

■ Bob Vineyard

Our own entry comes from co-blogger Bob Vineyard, channeling Cato's Mike Tanner and Dr Jane Orient, on why ObamaCare© spells big trouble if you actually need care.

And that, dear readers, is that.

Please join us in a fortnight at the Health Affairs Blog, where Chris Fleming will host the next Health Wonk review.

Cavalcade of Risk: 1st Anniversary Edition

As our good friend Julie pointed out a few weeks ago, the 26th bi-weekly edition could have been considered our anniversary issue, as well. But I tend to look at these things in terms of time passing, and it was a year ago this week that we published the first Cav.

We've come a long way since then, with lots of great hosts, and I want to thank each of you for your help and support, and your willingness to help out. I'm really looking forward to this coming year, as well, as more folks jump on our mailing and hosting lists.

As CoR hosts know, I spend the weekend before each Cav "hunting" for interesting/unusual risk-related posts from around the blogosphere. These are often included along with those submitted by our "regulars." Since this is our anniversary edition, though, I'm sticking exclusively with posts submitted by you.

Thank you for a great year!

And now, the 1st Anniversary Cavalcade of Risk:

■ The title of this post alone earned it top billing here. My Wealth Builder's "Super Saver" explains how asset allocation techniques can help take some of the risk out of retirement planning.

■ Over at the New York Personal Injury Law Blog, Eric Turkewitz tells the tale of an insurance company that wants to settle, and a doctor that doesn’t. The insurer settles anyway. The doctor sues.

■ Hurricane Katrina continues to cause risky ripples. Dr J C, at GNIF Brain Blogger, explores a unique and unusual case involving the failure to evacuate a patient. Was it malpractice, or good medicine?

■ Leon Gettler, blogging at Sox First, says that cross-border fraud is now one of the top 10 business risks, but according to a new study, most companies are not prepared to deal with it.

■ With a subject close to my own heart, Charles H. Green (Trust Matters) avers that systemic insurance fraud won't stop until we make it stop.

■ Bryan Moore, The Financial Whiz, writes about a risk-management approach to investing, using "Hedge Fund" Mutual Funds that are currently available to the small retail investor.

■ Over at the Boston Erisa blog, Stephen Rosenberg examines the roles of risk, liability, and (of all things) climate change. You'd be surprised.

■ HWR regular Jason Shafrin asks "How does insurance company physician reimbursement restrictions affect the cost of influenza vaccinations?" He calls on Adam Smith and Jonas Salk for answers.

■ The Health Business Blog's David Williams has a question, too: Did you know that collaborating with a cardiologist can be like collaborating with a rattlesnake? That's what some radiologists seem to think.

■ Chocolate or vanilla? Ginger or MaryAnne? Stockmarket or Real Estate? In his favorite risk post from the past year, our friend The Silicon Valley Blogger attempts to discern which investment strategy is the better risk. Click to find out.

■ The Cato Institute's always provocative, always interesting, Michael Cannon shares his thoughts on how HSA's (Health Savings Accounts) can be used to help reduce folks' health risks.

■ Julie Ferguson of Workers' Comp Insider takes the industry's pulse to see what lies ahead for employers and insurers. In her post, Julie observes that the worker’s comp market continues to be robust, but there’s still some risky waters ahead.

■ Meanwhile, in her favorite risk post since we started the Cav, Susan Mangiero of Pension Risk Matters highlights a survey indicating that risk still worries some institutional investors.

■ And Jay Norris, over at Colorado Health Insurance Insider, discusses the recent passage of (CO) House Bill 1330, the "second parent adoption bill", the steps Colorado is making to rise above bigotry in the health insurance industry, and what still needs to be done.

■ And finally, here at IB, our own Bob Vineyard has some thoughts on Atlanta’s least favorite lawyer, Andrew Speaker, the erstwhile globe-trotting TB carrier. Bob explores some of the risks Mr S took, as well as those he forced on his fellow passengers.

That about wraps up our First Anniversary Edition. Please join Julie, at Workers Comp Insider, on the 20th for the next star-studded issue.

Southern Belle Tolls

True story: a few years back, my better half and I were watching Paula's Kitchen on the Food Network, when we heard a distinct - and unmistakeable - sound. We turned to each other and asked, "did they just bleep Paula Deen?!"

Indeed they had. First, last and only time we'd ever heard a bleep on Food Network.

I was reminded of that experience when this appeared on the radar:

"Drug giant Novo Nordisk has nabbed Paula Deen ... as a new spokeswoman to help raise awareness about type 2 diabetes – which she has."

Well, that last is no real surprise, but what is news here is that "Deen had profited from making herself and others diabetic, and that now she would make more money selling drugs to make those same people better."

Sort of a "Backdraft" moment, no?

So the question becomes: is this a conflict of interest? After all, one could argue that she encouraged eating behaviors that could easily lead to developing diabetes, a risk that could have been avoided by pushing healthier recipes.

I don't think it's that simple: for one thing, these kinds of shows are as much entertainment as educational. And let's face it, no one's forcing you to make deep-fried butter-balls topped with chocolate syrup and sprinkles.

(Although that sounds delicious!)

And certainly more than a few of her fellow diabetes patients see her "as a fellow traveler, different from the doctors and health nuts who are lecturing them about what they eat." In fact, she may actually have more credibility, given her own food proclivities and history.

Which brings us to this obesity-related item sent in by FoIB Holly R:

"As one of the many outgrowths of [ObamneyCare©], health insurers and employers must now pay the cost of screening children for obesity and providing them with appropriate counseling."

Of course, insurers and employers don't actually pay for any of this: their insureds and employees do, in the form of higher premiums.

On the one hand, it's in the bill we had to pass to learn what was in it. On the other hand, well, the Law of Unintended Consequences is a brutal mistress:

"Other than intensive hospital-based programs, few proven models exist for helping children and adolescents achieve and maintain a healthier weight, and researchers do not even fully understand the factors that contributed to the rapid rise in childhood obesity in recent years."

We don't know what causes this, but the answer is obvious: Quick, throw more money at it!

Why not just block Paula's Kitchen?

Friday Afternoon Linkfest

■ If you're a current or former Anthem insured (or employee), the beleaguered carrier is offering a series of Town Hall meetings to "[t]o review what we know and share with you what we're doing at this point."

On hand will be Chief Info Officer Stacia Grosso and Ken Goulet, Commercial and Specialty Market honcho.

Aside from these Town Halls, Anthem's also arranging for complimenatry credit monitoring for those affected by the cyber attack. Click here for more on that.

■ Speaking of commercial business, employers will be delighted to learn that the IRS [ed: ever notice how, of you take out that space, it becomes theIRS?] is about to ship out the new Form 1094-C, which "employers are supposed to use to tell the IRS whether they offered workers minimum essential coverage (MEC), and Form 1095-C, which is the form employers are supposed to use to tell the workers themselves whether they had or were offered MEC."

Oh goody.

■ And finally, just in time for Valentine's Day, this reminder from Dame Nancy McBotox Pelosi that, in lieu of flowers or chocolate, one should instead urge loved one's to sign up for an ObamaPlan.

See, romance isn't dead (it is, apparently, quite under the weather).

Vanilla is Vanilla

My kids love our favorite local ice cream joint. The soft serve isn't what draws them though. It is the fact that they have so many different choices of sundaes and toppings. From a "Mud Sundae" with crushed Oreos, hot fudge, and gummy worms to the quart sized "hot fudge cake" there is something for everyone.

All of that is about to change. Later this week legislation is being introduced on the Affordable Ice Cream Act (AICA). You see, the cost for these heavenly sundaes has been rising lately and the government feels that they need to step in and change the way people purchase the product and make it more affordable for everyone.

In order to make it affordable the government is setting standards for what is available. You will now only be able to choose from chocolate, vanilla, strawberry, and twist. If you are under the age of 12 you can get Neapolitan. The only variation of ingredients can be in the fat content of the dairy products you use. No longer will you be able to have any toppings and all serving sizes will be measured to the ounce. Because of this, every ice cream shop in town would now be the same. Prices will be close and the only difference will be in taste.

Everyone must purchase ice cream or they will pay a penalty. The only people who can qualify for an exemption are those who can prove that they are lactose sensitive (yes, there is a difference from lactose intolerant).

For the sake of "professional development" I told my boys about this crazy new law yesterday afternoon. The reaction from them was priceless. The older two didn't believe it and actually made fun of the thought that anyone would eliminate toppings. The four year old wasn't happy. He really believed that he wouldn't be able to get a twist with sprinkles and smiley face.

The next time you step up to order a Topsy Tervy - or my personal favorite the Buckeye Sundae - think about Obamacare. Because in the health insurance world pretty soon the most creative option left will be the basic cone with twist ice cream.