Top cities for healthy strolls ranked

With the thermometer hovering at 22, and the wind ripping off a frozen Lake Mendota, Rink DaVee and his brother Jim decided to take a stroll.And why not? After all, according to a recent top 10 list, there's no better place in the country for walking than the capital city of a state known more for cheese and beer than exercising."It makes you feel better," DaVee said during a break in his walk Wednesday, standing on the icy, snow-covered trail that extends out over the lake. "It gets you through a cold month of March."Prevention magazine named Madison -- 1,300 miles north of sunny Miami -- as the most walkable of the country's 100 most populated cities. The list was commissioned by the American Podiatric Medical Association based on certain criteria. It ran in editions of the magazine released this week.Madison beat out the likes of Austin, Texas (No. 2), San Francisco (No. 3) and Miami, which barely cracked the list at No. 98.Factors contributing to the ranking were air quality, the percentage of people who walk to work, access to parks, number of athletic shoes sold, and (believe it or not) weather.Number of beaches versus frozen lakes apparently was not a factor. Crime rate, unfortunately for Miami, was.Adopting a walker-friendly plan 10 years ago was a major plus for Madison, said Prevention magazine's deputy editor Karyn Repinski. That plan focused on maintaining and improving the city's walkability and requires that when roads are redeveloped, they should accommodate not just cars, but bikes and pedestrians, too.But don't be fooled by all the signs of fitness around town. Madisonians also love their beer, bratwurst and Wisconsin cheese. The city of 250,000 plays host to a four-day extravaganza dubbed "The World's Largest Brat Fest," where nearly 200,000 brats are consumed over four days.Madison was the only city in the walking top 10 in a state that's not in the South or the West, a point of pride for people like Kathy Andrusz, coordinator of the Fit City initiative. Started in 2003 by Mayor Dave Cieslewicz, the program is a collaboration between Madison city officials and more than 30 other groups to combat obesity and get people moving."We're definitely touting it," Andrusz said of the walking rating. "We're definitely proud of it and will be able to use it as a sense of pride, if nothing else."Madison is no stranger to No. 1 rankings. People still talk about Money Magazine naming it the best place to live in 1998, although that ranking dropped to 53rd last year. Outside Magazine named it the best road biking city in August, and other high rankings have come for its being vegetarian-friendly, gay-friendly, environmentally friendly, and, well, according to Midwest Living in 2003, the overall friendliest city in the Midwest.Even with all that love going around, who wants to break out the walking shoes in the middle of winter? Especially this winter, with snow on the ground every day since January 14, and an average high temperature in February of just 21.7 degrees and an average low of 7.2 degrees. It also snowed 22 inches last month."Winter weather is only a barrier if you let it be," Andrusz said. "It's a matter of attitude."Repinski, the magazine editor who spoke from New York City, which ranked 39th, said only a cynic would let a little winter weather get in the way of walking."I walked a mile this morning and I was walking in an inch of snow," she said. "The conditions don't have to be perfect for walking, that's what's nice about it."Downtown Madison lies on an isthmus with Lake Mendota to the north and Lake Monona to the south. Stretching to the west from the state Capitol is State Street, which is crammed full of bars, restaurants and boutiques, but no cars. It's perfect for, you guessed it, walking.At the west end of State Street rests the University of Wisconsin, where students are known to complain about the steep climb up Bascom Hill to the administration building, which offers a stunning view of the city and the Capitol dome.Even with 40,000 students mostly walking to and from class -- and bars at night -- Madison has a remarkable bike trail system, with more than 30 miles of trails and 110 miles of bike lanes even on the busiest of streets. Not to mention the 6,000 acres of parkland.Zac Stencil, 23, a senior at the university, said he walks about two miles every day to and from classes."You can meet cool groups of people who are walking beside you," Stencil said. "Plus, when the lakes are frozen you can walk right across."

Community Health trumps private bid for Triad Hospitals

Community Health Systems Inc. said Monday it has agreed to buy Triad Hospitals Inc. for about $5.1 billion plus $1.7 billion in debt, topping a previous bid by private-equity buyers.

Community Health said the deal would make it the nation's largest publicly traded hospital company. It would own or operate about 130 hospitals in 28 states and control more than 18,700 beds.

Franklin, Tenn.-based Community Health agreed to pay $54 per share, the companies said.

Triad, based in the Dallas suburb of Plano, had previously agreed to be taken private in a $4.7 billion sale, or $50.25 per share, to an affiliate of Goldman Sachs and a JPMorgan Chase & Co. spinoff.

Shares of Triad rose $2.60, or 5.3 percent, to $51.96 in afternoon trading on the New York Stock Exchange after hitting a 52-week high of $52.20. Community Health shares fell $1.13, or 3.1 percent, to $35.67.

The Triad transaction comes after hospital giant HCA Inc. was sold to private owners for $21.3 billion.

Hospitals are struggling with flat volumes and more unpaid bills from uninsured patients.

Triad signaled last fall that a sale was likely. The stock has slumped since mid-2005, and its largest shareholder, hedge fund TPG-Axon Capital Management LP, has accused Triad of "remarkably poor financial analysis" and failing to say how it would fix the company.

Triad said it paid a breakup fee to cancel its earlier deal with GS Capital Partners and CCMP Capital Advisors but didn't disclose the amount. If Triad was negotiating with Community by Friday, the fee could be up to $40 million; otherwise; it could be $120 million, according to a Triad regulatory filing.

Community Health is smaller than Triad by many measures, including beds and annual revenue — $4.37 billion at Community in 2006, versus $5.54 billion for Triad. Both favor small towns where there is less competition.

Triad has 53 hospitals in the West and South and another under construction. The company also provides hospital management and consulting services.

Triad's board recommended that shareholders take the Community Health offer. Two inside directors abstained. If approved by Triad shareholders and regulators, the deal is expected to close in the third quarter.

There is no financing condition to the sale. Community Health said it has lined up financing commitments from Credit Suisse and Wachovia Capital Markets LLC.

Wayne T. Smith, chairman, president and chief executive of Community Health, said the acquisition would increase his company's size and geographic diversity.

"This acquisition complements our rural strategy by adding mid-size markets in great locations," Smith said.

Community Health said it was withdrawing previous comments about its financial performance for 2007. Last month, the company said it expected to earn $2.30 to $2.38 per share on revenue of about $5 billion in 2007. Company officials said they planned to acquire three or four hospitals this year.

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Hope For Comatose Patients

Science is far from omniscient – a woman’s miraculous temporary awakening from a persistent vegetative state stands as proof of this.

Christa Lilly suffered a cardiac arrest in November 2000, and has been in a coma-like state ever since. Her 73-year-old mother took care of her at home and reported to Christa’s doctor that during these years her daughter had awakened five times, sometimes for hours.

Last Sunday, mother Minnie Smith had the wonderful surprise of being answered to her “How are you, baby?” with a “Fine.” Christa then had three consecutive days of lucidity and activity.

She spent time with her family and friends and even went out to eat her favorite foods. Christa was happy to be with her four daughters, including a 12-year-old, and the three grandchildren she hadn’t met before.

"It's just got me dumbfounded," neurologist Dr. Randall Bjork told the Colorado Springs Gazette of Christa Lilly’s, a Colorado Springs resident, unexplainable, astounding revival.

"I'm just not able to explain this on the basis of what we know about persistent vegetative states. I've never seen this quality of awakening, and if this is true, it's going to change how we look at the persistent vegetative state," he told the newspaper.

Bjork confessed he hadn’t believed Christa was awake in the past.

“She was smiling and grinning and told my staff she wanted to go to a club, even doing a little chair dance in her wheelchair,” he mused.

After three miraculous days the 49-year-old woman relapsed in her mysterious state. Bjork considers it a “minimally conscious state” rather than a persistent vegetative state.

“We may have to rethink these people that have been called vegetative in nursing homes who may have some awareness of their horrible circumstances,” Dr. Bjork said. “It goes against the grain of what we thought.”

It seems though that love and caring endure through hopeless times and finally come through. Christa Lilly is a lucky lady to have such a devoted family.

Patrick unveils health plan

BOSTON — The average uninsured Massachusetts resident could obtain health care coverage for as little as $175 a month under the state's insurance law, Gov. Deval L. Patrick announced yesterday as he released the results of negotiations with the state's health insurers.

The lowest monthly premium is far lower than an earlier estimate of $380 a month suggested by some insurers.

"This is a big improvement from the first round of bids and a big step forward for health care reform," Patrick said. "The health security that was the point of health care reform will be delivered at an affordable price."

The minimum plan detailed by Patrick would cover the average uninsured Massachusetts resident, who is typically around 37 years old. It includes prescription drug coverage and covers basic medical care, such as emergency room visits and outpatient medical care.

Lower cost plans would be available to young adults. Prices would also rise and fall depending on the age of the person seeking insurance and where they live. If purchased on a pre-tax basis, the lowest cost plans drop to $109 a month for someone earning $50,000 a year.

The panel charged with overseeing the law — the Commonwealth Health Insurance Connector board — is expected to give its seal of approval to the seven health care plans that met the affordability goals at its meeting Wednesday.

One board member, Charles Joffe-Halpern, who runs North Adams' Ecu-Health Care, said he was "very encouraged" by the numbers and looking forward to examining the plans.

"We will be giving our seal of approval to the different plans. Then, on March 20, we will be making the significant decision of what is minimal credible coverage and deciding who will be mandated to purchase health insurance. This is very encouraging new and hopefully augurs success," Joffe-Halpern said.

On March 20, the board will also vote on whether the insurers will be able to offer lower cost versions without drug coverage. Health care advocates have said any minimum coverage must include prescription coverage. They said that without it, the state would be giving its blessing to inferior insurance plans.

The insurers include Blue Cross and Blue Shield of Massachusetts, ConnectiCare, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, Neighborhood Health Plan and Tufts Health Plan. Three plans were rejected because their premiums were too pricey.

The lowest bidder was Neighborhood Health Plan.

Deborah Enos, Neighborhood Health Plan President and CEO, said the insurer could hold down costs because many of their members rely on lower-cost community health centers for primary care. She also said the plan offset monthly premiums by requiring members to pay a little more.

All of the plans must include coverage for preventive doctor visits and an out-of-pocket limit, after which the plan would pay everything else to prevent individuals from facing bankruptcy, said Connector Authority Executive Director Jon Kingsdale. They must also include emergency, mental health, substance abuse, rehabilitation, hospice and vision care coverage.

The insurers will be able to offer different kinds of plans, from basic to premier coverage.

The announcement won applause from Senate President Robert Travaglini, and House Speaker Salvatore DiMasi called the initiative "a huge step toward making affordable health care a reality."

The lower-cost plans are a critical piece of the landmark insurance initiative, which requires all Massachusetts residents to have health coverage by July 1 or face tax penalties.

One of the toughest parts of the law has been trying to come up with relatively low cost private health plans for uninsured residents earning too much to qualify for subsidized care — about $29,400 annually for an individual. An estimated 160,000 to 200,000 people are uninsured and do not qualify for state-subsidized plans.

Patrick said he personally intervened, calling the chief executive officers of three of the state's largest insurers and encouraging them to do better.