European Stars and Stripes (Newspaper) - June 12, 1990, Darmstadt, Hesse                                Coyour health exercise for arthritic firms provide health care by Karen Ball associated press spiralling health care costs a labor and management s biggest sticking Point in collective bargaining a Are forcing companies throughout the United states to take such extraordinary Steps As setting up their own medical clinics or physician networks. Goodyear tire amp rubber co., for instance has three medical clinics at plants in Oklahoma Ohio and Alabama where workers can visit a physician Eye doctor or pharmacist for $15. Follow up visits Are $5. Quot there Are two ways to go a decrease benefits and Jack up premiums for workers or find a better and cheaper Way Quot says consultant Victor Williams. More than a dozen Fortune 500 companies have called Williams in the past year inquiring about Goodyear a experience in the medical business he said. Goodyear estimates it saves $1 million a year on its $163 million health care Bill. Quot it just scratches the surface but it helps a said spokesman Bob Mercer. Employees Benefit As Well said . Countryman of the United rubber workers which represents Goodyear workers in Alabama. Quot it sure has Cut Down on our costs Quot he said. But not All management efforts to trim health care costs Are being embraced by workers. In fact Union workers nationwide increasingly find themselves trying to fend off management efforts to shift health care costs to workers the Issue was at the heart of 78 percent of the strikes waged last year by unions according to one study. Most recently a two year Battle to resolve health care costs in the Railroad Industry proved unsuccessful a last month president Bush was forced to appoint an emergency Board to try and prevent a strike. In that dispute the major railroads a which for decades have provided workers with a solid Low Cost health care package a wanted the 235,000 brakeman engineers and other workers who keep the nation s freight system moving to pay higher deductibles and make payroll contributions. Quot then they have to think twice because it s not something someone else is going to pay for 100 percent Quot said Charles Hopkins chairman of the National railway labor conference which represents management in the dispute. Union officials contend shifting health care costs to workers does Little to solve a greater problem that merits Congress attention a How to rein in runaway medical costs. Quot to try to pin the blame on some poor worker worried about their kid in the Middle of the night is really outrageous Quot said Bob master of the communications workers of America which fought a health care Battle for Telephone workers in the Northeast last year. Hopkins said management has no Choice but to try to shift part of the Burden to workers because a we Are being consumed by the Cost of our so called fringe  besides trying to shift Premium costs to workers companies Are also moving to restrict a workers right to choose a doctor. Some also Are auditing patients Bills. Many companies Are now setting up Quot preferred provider arrangements Quot medical networks that provide services to workers at a negotiated Price. Often employers provide financial incentives for workers to use the pro rather than their own family doctor. Other companies such As Florida Power amp Light Are hiring nurses to visit hospitals to audit patients Bills to make sure Money Isnit being wasted. The Effort said spokesman Michael Millhorn is an attempt to save Money without hurting workers. Quot we done to want to mess with the level of benefits if we can avoid it Quot Millhorn said. Paul of Neill chairman of Alcoa the aluminium company of America told a House panel recently that he did no to feel comfortable intervening in workers medical care decisions. O Neill noted that employers do not have a say in what Type of car or food a worker buys Quot yet Here i am in the Middle of personal medical  by Ira Dreyfuss associated press arthritis hurts. Exercise can Hurt too. However experts say exercise can help Many arthritis to Hurt less and keep More Active. Most of the estimated 37 million americans with some form of arthritis Don t realize what a Well designed program could do for them said or. Arthur i. Grayzel senior vice president for medical affairs of the arthritis foundation in Atlanta. Quot my own personal experience is that most people with arthritis would Benefit from some exercise Quot he said. Only about 200,000 people take part in programs affiliated with the foundation he said. Exercise he said can help an arthritis sufferer retain a maximum Range of motion in his joints so that he moves less stiffly and with less pain. Quot the physician has to take the time to explain what s Safe to do and what Isnit Safe to do a Grayzel said. Quot in a not sure most people with arthritis really have the Opportunity to get that sort of  exercise experts say can keep an arthritis sufferer from a vicious downward Cycle of pain that restricts motion which keeps the victim from moving which leads to the joint Locking into position. There Are several types of potentially beneficial exercise according to the foundation. Range of motion exercises such As stretching help the body stay Limber. Muscle building such As resistance work with Light weights develops strength around the arthritic joint to control the joint s movement. Activities of daily living a anything from walking to opening jars a also Are forms of exercise. And aerobic exercises help you to stay generally fit. The foundation recommends aquatics a workouts in the water. Floating will let you take the stress of Gravity off your joints and the Effort of moving through the water can provide a whole body resistance workout. Grayzel recommends that a doctor or a therapist devise an exercise program with an Eye to keeping stress from damaging an already fragile joint. Getting started is not necessarily easy for healthy people and it can be even harder for arthritis. If you Haven t exercised before Start slowly the arthritis foundation recommends. Quot some in be worked with Start with three minutes Quot said Kathleen Haralson associate director of the Washington University regional arthritis Center in St. Louis. The physical therapist builds up endurance through interval training gradually increasing exercise periods while decreasing rest periods. In the end she said Many arthritis can work for 20 to 40 minutes three times a week a the same Standard recommended for people with healthy joints. Pain can Force arthritis victims to Stop exercising a but Haralson said they need to learn the difference Between the kind of pain that should Stop them and the kind that should t. The kind that should she said is the familiar joint aches that indicate another attack of arthritis. The kind that should to she said is the muscle soreness that Only Means you be had a Good workout and just need a rest. Haralson also said that for arthritis sufferers even More than healthy people a balanced program of strength and flexibility As Well As aerobics is important. Quot it would t make sense to have the strongest heart and lungs in the world and not be Able to Bend your fingers Quot she said. A passive health Hazard by Lawrence k. Altman new York times after years of questioning the potential health hazards of secondhand cigarette smoke a growing number of scientists and health officials Are becoming persuaded that the dangers Are real broader than once believed and parallel those of direct smoke. I it has Long been established that smoking harms the health of those who do the smoking. Now new epidemiological studies and reviews Are strengthening the evidence that it also harms the health of other people nearby who inhale the toxic fumes generated by the smoker particularly from the burning end of the cigarette. Such indirect or secondhand smoking causes death not Only by lung cancer but even More by heart attack the studies show. The studies on passive smoking As it is often called also strengthen the link Between parental smoking and respiratory damage in children. In reports and in interviews More than a dozen experts said there was Little question that passive smoking is an important health Hazard. What has swayed Many scientists is a remarkable consistency in findings from different types of studies in several countries with improved methods Over those used in the first such studies a few years ago. The new findings confirm and Advance two landmark reports in 1986 from the surgeon general who concluded that passive smoking caused lung cancer and from the National research Council which said passive smoking is associated with lung cancer. Quot the links Between passive smoking and health problems Are now As solid As any finding in epidemiology Quot said or. Cedric f. Garland an expert in the j epidemiology of smoking at the University of California at san Diego i the environmental Protection Agency has released a report i concluding that passive smoke j causes 3,800 lung cancer deaths f each year. The study Calls the statistical data firm j not a result of Chance and biologically plausible. J if the Epa s scientific advisory Board agrees with j the Agency a conclusions environmental tobacco smoke will be listed As a group a or very hazardous j Carcinogen. Although the Epa has no Power to \ regulate tobacco smoke As an indoor pollutant the \ Agency a recommendations will strongly influence j employers and state and local governments. A the newer understanding of the health hazards of a passive smoking were underscored in a report at a world conference on lung health in Boston. Or. Stanton a. Glantz of the University of j California at san Francisco estimated that passive smoke killed 50,000 americans a year two thirds of whom died of heart disease. I passive smoking ranks behind direct smoking and alcohol As the third leading preventable cause of death Glantz said in what experts called an unusually thorough review of All 11 epidemiological studies published on the subject. About 400,000 americans die from breathing their own smoke each year the surgeon general s 1989 report said. About 100,000 die from alcohol it according to a report in 1987 from the National Institute on alcohol abuse and alcoholism. A Page 16 a a a the stars and stripes tuesday june 12, 1990