In Hospice Care, Longer Lives Mean Money Lost | By KEVIN SACK | Published: November 27, 2007
...
Over the last eight years, the refusal of patients to die according to actuarial schedules has led the federal government to demand that hospices exceeding reimbursement limits repay hundreds of millions of dollars to Medicare.
The charges are assessed retrospectively, so in most cases the money has long since been spent on salaries, medicine and supplies. After absorbing huge assessments for several years, often by borrowing at high rates, a number of hospice providers are bracing for a new round that they fear may shut their doors.
One is Hometown Hospice, which has been providing care here since 2003 to some of the most destitute residents of Wilcox County, the poorest place in Alabama.
The locally owned, for-profit agency, which serves about 60 patients, mostly in their homes, had to repay the government $900,000, or 27 percent of its revenues, from its first two years of operation, said Tanya O. Walker-Butts, a co-owner. Its profits were wiped out in the time it took to open the demand letters, Ms. Walker-Butts said. ...
In the early days of the Medicare hospice benefit, which was designed for those with less than six months to live, nearly all patients were cancer victims, who tended to die relatively quickly and predictably once curative efforts were abandoned.
But in the last five years, hospice use has skyrocketed among patients with less predictable trajectories, like those with Alzheimer’s disease and dementia. Those patients now form a majority of hospice consumers, and their average stays are far longer — 86 days for Alzheimer’s patients, for instance, compared with 44 for those with lung cancer, according to the Medicare Payment Advisory Commission. ..
Tuesday, November 27, 2007
This is unsurprising when you consider the surge in interest in health policy among young people, one-third of whom are uninsured.
Young and uninsured turn to ... Facebook | By: Ben Adler | Nov 26, 2007 07:01 PM EST
In the year between his graduation from college and his first year in law school, Jeff Traylor, 25, worked in a restaurant and was similar to approximately 44 million Americans in this respect: He had no health insurance.
As a waiter, Traylor worked fewer than 30 hours a week and thus did not qualify for insurance as a full-time employee.
“I had to go to low-income clinics,” said Traylor, now a second-year student at Lewis & Clark Law School in Portland, Ore.
“That’s $130 for a visit to get antibiotics for a sinus infection, plus the cost of the drug. I could afford it. But some people cannot.” ...
...
Spurred by his own experience and by his concern for the uninsured, Traylor created a group on the social networking site Facebook to promote universal health care.
His is one of more than 20 groups on Facebook dedicated to advocating expanded government health coverage, and many of them have hundreds of members.
...
This is unsurprising when you consider the surge in interest in health policy among young people, one-third of whom are uninsured. ...
...
And the Kaiser Family Foundation, a nonpartisan institution that researches health care in the U.S., found that 42 percent of young people are very worried about being able to afford the health services they think they need. ....
In the year between his graduation from college and his first year in law school, Jeff Traylor, 25, worked in a restaurant and was similar to approximately 44 million Americans in this respect: He had no health insurance.
As a waiter, Traylor worked fewer than 30 hours a week and thus did not qualify for insurance as a full-time employee.
“I had to go to low-income clinics,” said Traylor, now a second-year student at Lewis & Clark Law School in Portland, Ore.
“That’s $130 for a visit to get antibiotics for a sinus infection, plus the cost of the drug. I could afford it. But some people cannot.” ...
...
Spurred by his own experience and by his concern for the uninsured, Traylor created a group on the social networking site Facebook to promote universal health care.
His is one of more than 20 groups on Facebook dedicated to advocating expanded government health coverage, and many of them have hundreds of members.
...
This is unsurprising when you consider the surge in interest in health policy among young people, one-third of whom are uninsured. ...
...
And the Kaiser Family Foundation, a nonpartisan institution that researches health care in the U.S., found that 42 percent of young people are very worried about being able to afford the health services they think they need. ....
Monday, November 26, 2007
we pay hospitals and doctors more than most other countries do ... minor roles to drug costs, malpractice and aging of baby boom ...
The High Cost of Health Care | Published: November 25, 2007
The relentless, decades-long rise in the cost of health care has left many Americans struggling to pay their medical bills. Workers complain that they cannot afford high premiums for health insurance. Patients forgo recommended care rather than pay the out-of-pocket costs. Employers are cutting back or eliminating health benefits, forcing millions more people into the ranks of the uninsured. And state and federal governments strain to meet the expanding costs of public programs like Medicaid and Medicare.
Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster than the overall economy or personal incomes for more than 40 years, a trend that cannot continue forever.
It is the worst long-term fiscal crisis facing the nation, ...
...
Varied and Deep-Rooted. Contrary to popular beliefs, this is not a problem driven mainly by the aging of the baby boom generation, or the high cost of prescription drugs, or medical malpractice litigation that spawns defensive medicine. Those issues often dominate political discourse, but they have played relatively minor roles in driving up medical spending in this country and abroad ...
...
This is mostly because we pay hospitals and doctors more than most other countries do. We rely more on costly specialists, who overuse advanced technologies, like CT scans and M.R.I. machines, and who resort to costly surgical or medical procedures a lot more than doctors in other countries do. Perverse insurance incentives entice doctors and patients to use expensive medical services more than is warranted. And our fragmented array of insurers and providers eats up a lot of money in administrative costs, marketing expenses and profits that do not afflict government-run systems abroad. ...
...
Stick to What Works. The sad truth is that less than half of all medical care in the United States is supported by good evidence that it works, ...
Managed Care. ...
Information Technologies. The American health care system lags well behind other sectors of the economy — and behind foreign medical systems — in adopting computers, electronic health records and information-sharing technologies that can greatly boost productivity. There is little doubt that widespread computerization could greatly reduce the paperwork burden on doctors and hospitals, head off medication errors, and reduce the costly repetition of diagnostic tests as patients move from one doctor to another. ...
Prevention. ... Preventive medicine actually costs money ... and it is not clear how soon, or even whether, substantial savings will show up. ...
Disease Management. ... In some initial trials it has cut costs, in others not.
Drug Prices. Compared with the residents of other countries, Americans pay much more for brand-name prescription drugs, less for generic and over-the-counter drugs, and roughly the same prices for biologics. ...
Who Picks Up the Tab?
Pay Providers Less. ... many experts believe it should be possible to tap into the vast flow of money sluicing through hospitals, nursing homes and other health care facilities to find savings.
Emphasize Primary Care. ... could get better health results, possibly for less cost, if we changed reimbursement formulas and medical education programs to reward and produce more primary care doctors and fewer specialists inclined to proliferate high-cost services. ...
Skin in the Game. The solution favored by many conservatives is to force consumers to shell out more money when they seek medical care so that they will think harder about whether it is really necessary. ... Most health care spending is racked up by a small percentage of individuals whose bills are so high they are no longer subject to cost sharing; they will hardly be deterred from expensive care they desperately need. Moreover, few consumers have the competence or knowledge to second-guess a doctor’s recommendations.
Single Payer. ... Such a system would let the government offset the price-setting strength of the medical and pharmaceutical industries, eliminate much of the waste due to a multiplicity of private insurance plans, and greatly cut administrative costs. ... But a single-payer system is no panacea for the cost problem — witness Medicare’s own cost troubles — and the approach has limited political support. ...
The relentless, decades-long rise in the cost of health care has left many Americans struggling to pay their medical bills. Workers complain that they cannot afford high premiums for health insurance. Patients forgo recommended care rather than pay the out-of-pocket costs. Employers are cutting back or eliminating health benefits, forcing millions more people into the ranks of the uninsured. And state and federal governments strain to meet the expanding costs of public programs like Medicaid and Medicare.
Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster than the overall economy or personal incomes for more than 40 years, a trend that cannot continue forever.
It is the worst long-term fiscal crisis facing the nation, ...
...
Varied and Deep-Rooted. Contrary to popular beliefs, this is not a problem driven mainly by the aging of the baby boom generation, or the high cost of prescription drugs, or medical malpractice litigation that spawns defensive medicine. Those issues often dominate political discourse, but they have played relatively minor roles in driving up medical spending in this country and abroad ...
...
This is mostly because we pay hospitals and doctors more than most other countries do. We rely more on costly specialists, who overuse advanced technologies, like CT scans and M.R.I. machines, and who resort to costly surgical or medical procedures a lot more than doctors in other countries do. Perverse insurance incentives entice doctors and patients to use expensive medical services more than is warranted. And our fragmented array of insurers and providers eats up a lot of money in administrative costs, marketing expenses and profits that do not afflict government-run systems abroad. ...
...
The Solutions
Geography. Pioneering studies by researchers at Dartmouth have shown enormous disparities in expenditures on health care from one region to another with no discernible difference in health outcomes. Doctors in high-cost areas use hospitals, costly technology and platoons of consulting physicians a lot more often than doctors in low-cost areas, yet their patients, on average, fare no better.Stick to What Works. The sad truth is that less than half of all medical care in the United States is supported by good evidence that it works, ...
Managed Care. ...
Information Technologies. The American health care system lags well behind other sectors of the economy — and behind foreign medical systems — in adopting computers, electronic health records and information-sharing technologies that can greatly boost productivity. There is little doubt that widespread computerization could greatly reduce the paperwork burden on doctors and hospitals, head off medication errors, and reduce the costly repetition of diagnostic tests as patients move from one doctor to another. ...
Prevention. ... Preventive medicine actually costs money ... and it is not clear how soon, or even whether, substantial savings will show up. ...
Disease Management. ... In some initial trials it has cut costs, in others not.
Drug Prices. Compared with the residents of other countries, Americans pay much more for brand-name prescription drugs, less for generic and over-the-counter drugs, and roughly the same prices for biologics. ...
Who Picks Up the Tab?
Pay Providers Less. ... many experts believe it should be possible to tap into the vast flow of money sluicing through hospitals, nursing homes and other health care facilities to find savings.
Emphasize Primary Care. ... could get better health results, possibly for less cost, if we changed reimbursement formulas and medical education programs to reward and produce more primary care doctors and fewer specialists inclined to proliferate high-cost services. ...
Skin in the Game. The solution favored by many conservatives is to force consumers to shell out more money when they seek medical care so that they will think harder about whether it is really necessary. ... Most health care spending is racked up by a small percentage of individuals whose bills are so high they are no longer subject to cost sharing; they will hardly be deterred from expensive care they desperately need. Moreover, few consumers have the competence or knowledge to second-guess a doctor’s recommendations.
Single Payer. ... Such a system would let the government offset the price-setting strength of the medical and pharmaceutical industries, eliminate much of the waste due to a multiplicity of private insurance plans, and greatly cut administrative costs. ... But a single-payer system is no panacea for the cost problem — witness Medicare’s own cost troubles — and the approach has limited political support. ...
[Kidney Dialysis firms] want to make patients wait longer before they can get access to the program ... charge 3x for that year ....
That’ll Cost a Kidney: How a Little-Noticed Vote in Congress Could Raise Workers’ Healthcare Costs Even Higher | By Juan Basile, AlterNet. Posted November 17, 2007.
Congress is on the verge of letting corporate lobbyists change how a critical treatment is delivered, reducing access to affordable care just so two corporations can boost their bottom line.
...
Usually, patients need to be 65 years old before they qualify for Medicare. But in 1972, because the high cost of dialysis put care out of reach for all but the wealthiest patients, Congress made the historic decision to extend Medicare coverage to dialysis patients of all ages. But patients who need dialysis have to stay on private insurance for 30 months before they are eligible for Medicare. DaVita and Fresenius want to make patients wait longer-another year-before they can get access to the program.
...
It's estimated that dialysis providers like DaVita and Fresenius would cash in a $2 billion windfall over the next decade if they succeed in persuading Congress to make patients wait longer for affordable care. ...
It's not hard to figure out why DaVita and Fresenius want to keep kidney patients out of Medicare. These companies can typically charge private insurers-and ultimately employers and workers-nearly three times more than they can charge Medicare for the same services. ...
Congress is on the verge of letting corporate lobbyists change how a critical treatment is delivered, reducing access to affordable care just so two corporations can boost their bottom line.
...
Usually, patients need to be 65 years old before they qualify for Medicare. But in 1972, because the high cost of dialysis put care out of reach for all but the wealthiest patients, Congress made the historic decision to extend Medicare coverage to dialysis patients of all ages. But patients who need dialysis have to stay on private insurance for 30 months before they are eligible for Medicare. DaVita and Fresenius want to make patients wait longer-another year-before they can get access to the program.
...
It's estimated that dialysis providers like DaVita and Fresenius would cash in a $2 billion windfall over the next decade if they succeed in persuading Congress to make patients wait longer for affordable care. ...
It's not hard to figure out why DaVita and Fresenius want to keep kidney patients out of Medicare. These companies can typically charge private insurers-and ultimately employers and workers-nearly three times more than they can charge Medicare for the same services. ...
Friday, November 23, 2007
insurers are unnecessary middlemen that drain nearly one third of our healthcare costs without ever laying hands on the patient ...
November 22, 2007 at 10:42:31 | Health care and the free market | by Jack Lohman | http://www.opednews.com
...
...
First, politicians prefer “the free market” even though it is the free market that took over in 1994 that has gotten us into today’s mess. They favor “privatization” because, they argue, it “adds competition and controls costs.”
That’s pure hogwash. It doesn’t.
Politicians prefer privatization for one and only one reason: private companies can give campaign contributions and public entities cannot. Just ask those who pocket the money from the insurance and healthcare industries but never get a penny from Medicare.
Politicians know why they prefer privatization, and you should too. The free market makes them money and Medicare doesn’t.
...
But in the healthcare market, insurers are unnecessary middlemen that drain nearly one third of our healthcare costs without ever laying hands on the patient. And they are protected by the politicians whose campaigns they help fund.
We don’t need mandated insurance — as Massachusetts has done and some politicians support – we need mandated health care. We must totally eliminate the 31% industry waste that is blocking this reform.
...
Medicare isn’t perfect, and it clearly must reign in abuse and overuse. But the private system has even more abuse and overuse because the penalties are far less than those at the federal level. ..
Wednesday, November 21, 2007
Depleted Uranium: Basra, Iraq report a sevenfold increase in childhood cancer and a sevenfold increase in gross congenital abnormalities ...
Radioactive Ammunition Fired in Middle East May Claim More Lives Than Hiroshima and Nagasaki | Sherwood Ross | November 19, 2007
By firing radioactive ammunition, the U.S., U.K., and Israel may have triggered a nuclear holocaust in the Middle East that, over time, will prove deadlier than the U.S. atomic bombing of Japan.
So much ammunition containing depleted uranium(DU) has been fired, asserts nuclear authority Leuren Moret, "The genetic future of the Iraqi people for the most part, is destroyed."
"More than ten times the amount of radiation released during atmospheric testing (of nuclear bombs) has been released from depleted uranium weaponry since 1991," Moret writes, including radioactive ammunition fired by Israeli troops in Palestine.
...
Moret, a Berkeley, Calif., Environmental Commissioner and past president of the Association for Women Geoscientists, says, "For every genetic defect that we can see now, in future generations there are thousands more that will be expressed."
She adds, "the (Iraq) environment now is completely radioactive."
Dr. Helen Caldicott, the prominent anti-nuclear crusader, has written: "Much of the DU is in cities such as Baghdad, where half the population of 5 million people are children who played in the burned-out tanks and on the sandy, dusty ground."
"Children are 10 to 20 times more susceptible to the carcinogenic effects of radiation than adults," Caldicott wrote. "My pediatric colleagues in Basra, where this ordnance was used in 1991, report a sevenfold increase in childhood cancer and a sevenfold increase in gross congenital abnormalities," she wrote in her book, "Nuclear Power is not the Answer"(The New Press). ...
By firing radioactive ammunition, the U.S., U.K., and Israel may have triggered a nuclear holocaust in the Middle East that, over time, will prove deadlier than the U.S. atomic bombing of Japan.
So much ammunition containing depleted uranium(DU) has been fired, asserts nuclear authority Leuren Moret, "The genetic future of the Iraqi people for the most part, is destroyed."
"More than ten times the amount of radiation released during atmospheric testing (of nuclear bombs) has been released from depleted uranium weaponry since 1991," Moret writes, including radioactive ammunition fired by Israeli troops in Palestine.
...
Moret, a Berkeley, Calif., Environmental Commissioner and past president of the Association for Women Geoscientists, says, "For every genetic defect that we can see now, in future generations there are thousands more that will be expressed."
She adds, "the (Iraq) environment now is completely radioactive."
Dr. Helen Caldicott, the prominent anti-nuclear crusader, has written: "Much of the DU is in cities such as Baghdad, where half the population of 5 million people are children who played in the burned-out tanks and on the sandy, dusty ground."
"Children are 10 to 20 times more susceptible to the carcinogenic effects of radiation than adults," Caldicott wrote. "My pediatric colleagues in Basra, where this ordnance was used in 1991, report a sevenfold increase in childhood cancer and a sevenfold increase in gross congenital abnormalities," she wrote in her book, "Nuclear Power is not the Answer"(The New Press). ...
same company kicked out all the Medicaid patients from their Oregon last year ... now Oregon has law that prohibits such practices
Kicking out old people because they’re on Medicaid? | By: bluegal on Monday, November 19th, 2007 at 2:09 PM - PST
The company has the Orwellian name of “Assisted Living Concepts” and their motto is “Life Just Got Easier”. No, really. And this is a deliberate business decision on the part of a company that says they are committed to eldercare. ...Eleven residents of Victoria House in Port Townsend, Washington State, (some in their 90s) are being evicted from the assisted living facility with 90 days notice. Why? Because the Victoria House management company, has decided to stop accepting Medicaid, and there is no law in Washington that makes them have to stick with their agreements with tenants.
Yup. They can just kick ‘em out.
The same company kicked out all the Medicaid patients from their Oregon facilities last year. Community action got together, and now Oregon has a law, like the one in Illinois, that prohibits such practices.
Tuesday, November 20, 2007
"These kids don't walk in with colds and scrapes anymore," ... "They walk in with pneumonia and other communicable diseases.
Children without health insurance lose out on learning at school | By Tony Pugh | McClatchy Newspapers | Sunday, November 18, 2007
WASHINGTON — While Congress and President Bush squabble over health insurance for low-income children, school officials nationwide are scrambling each day to find affordable medical care so that sick and needy students can continue to learn.
Growing numbers of uninsured children have made it harder for educators to focus on classroom achievement without first addressing the medical needs of their students who lack health insurance or dental coverage.
...
... The boy had become a behavioral problem and missed more than 50 days of school when he could no longer get the drug after his mother's insurance expired. ...
In New Prairie, Wis., school social workers got the local Lions Club to provide corrective eyewear for a nearsighted fifth-grader whose parents had no insurance. ...
And in West Palm Beach, Fla., high school principal Nathan Collins persuaded the local school board to help fund a full-time, school-based health clinic because so many of his uninsured students were missing school because they couldn't get medical care.
...
Wells, who's now a school health supervisor for the Department of Health in Manchester, N.H., said she'd like Bush and lawmakers who oppose the bill to visit a school health clinic themselves.
"These kids don't walk in with colds and scrapes anymore," Wells said. "They walk in with pneumonia and other communicable diseases. It's hard to realize how difficult it is for them not to have the appropriate care. You have to see sick kids to understand what it's like." ...
WASHINGTON — While Congress and President Bush squabble over health insurance for low-income children, school officials nationwide are scrambling each day to find affordable medical care so that sick and needy students can continue to learn.
Growing numbers of uninsured children have made it harder for educators to focus on classroom achievement without first addressing the medical needs of their students who lack health insurance or dental coverage.
...
... The boy had become a behavioral problem and missed more than 50 days of school when he could no longer get the drug after his mother's insurance expired. ...
In New Prairie, Wis., school social workers got the local Lions Club to provide corrective eyewear for a nearsighted fifth-grader whose parents had no insurance. ...
And in West Palm Beach, Fla., high school principal Nathan Collins persuaded the local school board to help fund a full-time, school-based health clinic because so many of his uninsured students were missing school because they couldn't get medical care.
...
Wells, who's now a school health supervisor for the Department of Health in Manchester, N.H., said she'd like Bush and lawmakers who oppose the bill to visit a school health clinic themselves.
"These kids don't walk in with colds and scrapes anymore," Wells said. "They walk in with pneumonia and other communicable diseases. It's hard to realize how difficult it is for them not to have the appropriate care. You have to see sick kids to understand what it's like." ...
Cannabis compound 'halts cancer'
Monday, 19 November 2007 | Cannabis compound 'halts cancer'
A compound found in cannabis may stop breast cancer spreading throughout the body, US scientists believe.
A compound found in cannabis may stop breast cancer spreading throughout the body, US scientists believe.
The California Pacific Medical Center Research Institute team are hopeful that cannabidiol or CBD could be a non-toxic alternative to chemotherapy.
...
Dr Joanna Owens of Cancer Research UK said: "This research is at a very early stage.
"The findings will need to be followed up with clinical trials in humans to see if the CBD is safe, and whether the beneficial effects can be replicated.
"Several cancer drugs based on plant chemicals are already used widely, such as vincristine - which is derived from a type of flower called Madagascar Periwinkle and is used to treat breast and lung cancer. It will be interesting to see whether CBD will join them." ...
‘Safe’ Uranium That Left a Town Contaminated ... use of [DU- Depleted Uranium] weapons may be a war crime.
November 18, 2007 by The Observer (UK) | ‘Safe’ Uranium That Left a Town Contaminated | by David Rose in Colonie, New York
[NOTE: THOUSANDS OF TONS were used in tank shells in IRAQ ... ed.]
They were told depleted uranium was not hazardous. Now, 23 years after a US arms plant closed, workers and residents have cancer - and experts say their suffering shows the use of such weapons may be a war crime.
...
The US federal government and the firm that ran the factory, National Lead (NL) Industries, have been assuring former workers and residents around the 18-acre site for decades that, although it is true that the plant used to produce unacceptable levels of radioactive pollution, it was not a serious health hazard.
Now, in a development with potentially devastating implications not only for Colonie but also for the future use of some of the West’s most powerful weapon systems, that claim is being challenged. In a paper to be published in the next issue of the scientific journal Science of the Total Environment, a team led by Professor Randall Parrish of Leicester University reports the results of a three-year study of Colonie, funded by Britain’s Ministry of Defense.
Parrish’s team has found that DU contamination, which remains radioactive for millions of years, is in effect impossible to eradicate, not only from the environment but also from the bodies of humans. Twenty-three years after production ceased they tested the urine of five former workers. All are still contaminated with DU. So were 20 per cent of people tested who had spent at least 10 years living near the factory when it was still working, including Ciarfello.
The small sample size precludes the drawing of statistical conclusions, the journal paper says. But to find DU at all after so long a period is ’significant, since no previous study has documented evidence of DU exposure more than 20 years prior… [this] indicates that the body burden of uranium must still be significant, whether retained in lungs, lymphatic system, kidneys or bone’. The team is now testing more individuals. ...
...
TV footage shot in Baghdad in 2003 shows children playing in the remains of tanks coated with thick, black DU oxide, while there have long been claims that the DU shells that destroyed Saddam Hussein’s tanks in the 1991 Gulf war were responsible for high rates of cancer in places such as Basra. ...
[NOTE: THOUSANDS OF TONS were used in tank shells in IRAQ ... ed.]
They were told depleted uranium was not hazardous. Now, 23 years after a US arms plant closed, workers and residents have cancer - and experts say their suffering shows the use of such weapons may be a war crime.
...
The US federal government and the firm that ran the factory, National Lead (NL) Industries, have been assuring former workers and residents around the 18-acre site for decades that, although it is true that the plant used to produce unacceptable levels of radioactive pollution, it was not a serious health hazard.
Now, in a development with potentially devastating implications not only for Colonie but also for the future use of some of the West’s most powerful weapon systems, that claim is being challenged. In a paper to be published in the next issue of the scientific journal Science of the Total Environment, a team led by Professor Randall Parrish of Leicester University reports the results of a three-year study of Colonie, funded by Britain’s Ministry of Defense.
Parrish’s team has found that DU contamination, which remains radioactive for millions of years, is in effect impossible to eradicate, not only from the environment but also from the bodies of humans. Twenty-three years after production ceased they tested the urine of five former workers. All are still contaminated with DU. So were 20 per cent of people tested who had spent at least 10 years living near the factory when it was still working, including Ciarfello.
The small sample size precludes the drawing of statistical conclusions, the journal paper says. But to find DU at all after so long a period is ’significant, since no previous study has documented evidence of DU exposure more than 20 years prior… [this] indicates that the body burden of uranium must still be significant, whether retained in lungs, lymphatic system, kidneys or bone’. The team is now testing more individuals. ...
...
TV footage shot in Baghdad in 2003 shows children playing in the remains of tanks coated with thick, black DU oxide, while there have long been claims that the DU shells that destroyed Saddam Hussein’s tanks in the 1991 Gulf war were responsible for high rates of cancer in places such as Basra. ...
Wednesday, November 14, 2007
Democrat John Edwards: call to end health benefits for top politicians who don't approve a universal health care plan within six months of election
Edwards has new commercial in Iowa | Tue Nov 13, 7:35 AM ET
DES MOINES, Iowa - Democrat John Edwards will begin airing new campaign advertisements Tuesday focusing on his call to end health benefits for top politicians who don't approve a universal health care plan within six months of the next president taking office.
"When I'm president I'm going to say to members of Congress and members of my administration, including my Cabinet: I'm glad that you have health care coverage and your family has health care coverage," Edwards says in the new spot airing in Iowa. "But if you don't pass universal health care by July of 2009 — in six months — I'm going to use my power as president to take your health care away from you." ...
DES MOINES, Iowa - Democrat John Edwards will begin airing new campaign advertisements Tuesday focusing on his call to end health benefits for top politicians who don't approve a universal health care plan within six months of the next president taking office.
"When I'm president I'm going to say to members of Congress and members of my administration, including my Cabinet: I'm glad that you have health care coverage and your family has health care coverage," Edwards says in the new spot airing in Iowa. "But if you don't pass universal health care by July of 2009 — in six months — I'm going to use my power as president to take your health care away from you." ...
Tuesday, November 13, 2007
One of the state's largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped, money saved
Health insurer tied bonuses to dropping sick policyholders | By Lisa Girion, Los Angeles Times Staff Writer | November 9, 2007
One of the state's largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped and how much money was saved.
Woodland Hills-based Health Net Inc. avoided paying $35.5 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006. During that period, it paid its senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies, documents disclosed Thursday showed.
The revelation that the health plan had cancellation goals and bonuses comes amid a storm of controversy over the industry-wide but long-hidden practice of rescinding coverage after expensive medical treatments have been authorized.
These cancellations have been the recent focus of intense scrutiny by lawmakers, state regulators and consumer advocates. Although these "rescissions" are only a small portion of the companies' overall business, they typically leave sick patients with crushing medical bills and no way to obtain needed treatment. ...
...
The documents show that in 2002, the company's goal for Barbara Fowler, Health Net's senior analyst in charge of rescission reviews, was 15 cancellations a month. She exceeded that, rescinding 275 policies that year -- a monthly average of 22.9.
More recently, her goals were expressed in financial terms. Her supervisor described 2003 as a "banner year" for Fowler because the company avoided about "$6 million in unnecessary health care expenses" through her rescission of 301 policies -- one more than her performance goal. ...
One of the state's largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped and how much money was saved.
Woodland Hills-based Health Net Inc. avoided paying $35.5 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006. During that period, it paid its senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies, documents disclosed Thursday showed.
The revelation that the health plan had cancellation goals and bonuses comes amid a storm of controversy over the industry-wide but long-hidden practice of rescinding coverage after expensive medical treatments have been authorized.
These cancellations have been the recent focus of intense scrutiny by lawmakers, state regulators and consumer advocates. Although these "rescissions" are only a small portion of the companies' overall business, they typically leave sick patients with crushing medical bills and no way to obtain needed treatment. ...
...
The documents show that in 2002, the company's goal for Barbara Fowler, Health Net's senior analyst in charge of rescission reviews, was 15 cancellations a month. She exceeded that, rescinding 275 policies that year -- a monthly average of 22.9.
More recently, her goals were expressed in financial terms. Her supervisor described 2003 as a "banner year" for Fowler because the company avoided about "$6 million in unnecessary health care expenses" through her rescission of 301 policies -- one more than her performance goal. ...
Monday, November 12, 2007
Healthcare: apologists for the status quo offer a barrage of excuses for our system’s miserable performance
Health Care Excuses | By PAUL KRUGMAN | Published: November 9, 2007
The United States spends far more on health care per person than any other nation. Yet we have lower life expectancy than most other rich countries. Furthermore, every other advanced country provides all its citizens with health insurance; only in America is a large fraction of the population uninsured or underinsured.
You might think that these facts would make the case for major reform of America’s health care system — reform that would involve, among other things, learning from other countries’ experience — irrefutable. Instead, however, apologists for the status quo offer a barrage of excuses for our system’s miserable performance. ...
Excuse No. 1: No insurance, no problem. ... “After all, you just go to an emergency room.” ...
Excuse No. 2: It’s the cheeseburgers. ... Overeating and teenage sex, not the huge overhead of America’s private health insurance companies — the United States spends almost six times as much on health care administration as other advanced countries — are the source of our problems. ... those of the McKinsey Global Institute, say that diseases that are associated with obesity and other lifestyle-related problems play, at most, a minor role in high U.S. health care costs
Excuse No. 3: 2007 is better than 1950. ... It’s as if you went to a store to buy a DVD player, and the salesman told you not to worry about the fact that his prices are twice those of his competitors — after all, the machines on offer at his store are a lot better than they were five years ago. ...
Excuse No. 4: Socialized medicine! Socialized medicine! ... Rudy Giuliani’s fake numbers on prostate cancer — which, by the way, he still refuses to admit were wrong — were the latest entry in a long, dishonorable tradition of peddling scare stories about the evils of “government run” health care. ... The reality is that the best foreign health care systems, especially those of France and Germany, do as well or better than the U.S. system on every dimension, while costing far less money. ..
The United States spends far more on health care per person than any other nation. Yet we have lower life expectancy than most other rich countries. Furthermore, every other advanced country provides all its citizens with health insurance; only in America is a large fraction of the population uninsured or underinsured.
You might think that these facts would make the case for major reform of America’s health care system — reform that would involve, among other things, learning from other countries’ experience — irrefutable. Instead, however, apologists for the status quo offer a barrage of excuses for our system’s miserable performance. ...
Excuse No. 1: No insurance, no problem. ... “After all, you just go to an emergency room.” ...
Excuse No. 2: It’s the cheeseburgers. ... Overeating and teenage sex, not the huge overhead of America’s private health insurance companies — the United States spends almost six times as much on health care administration as other advanced countries — are the source of our problems. ... those of the McKinsey Global Institute, say that diseases that are associated with obesity and other lifestyle-related problems play, at most, a minor role in high U.S. health care costs
Excuse No. 3: 2007 is better than 1950. ... It’s as if you went to a store to buy a DVD player, and the salesman told you not to worry about the fact that his prices are twice those of his competitors — after all, the machines on offer at his store are a lot better than they were five years ago. ...
Excuse No. 4: Socialized medicine! Socialized medicine! ... Rudy Giuliani’s fake numbers on prostate cancer — which, by the way, he still refuses to admit were wrong — were the latest entry in a long, dishonorable tradition of peddling scare stories about the evils of “government run” health care. ... The reality is that the best foreign health care systems, especially those of France and Germany, do as well or better than the U.S. system on every dimension, while costing far less money. ..
Tuesday, November 6, 2007
As patients and businesses realize they can save up to 80 percent on pricey medical procedures, the medical travel industry is booming.
A Cut Below: Americans Look Abroad for Health Care | By MARK REPASKY | Aug. 29, 2006
As U.S. Health Care Costs Rise, More Americans Head Abroad for Treatment
...
More and more Americans are looking across the border and overseas to get their medicine. Jeff Schult, author of "Beauty from Afar," a guide to medical tourism, estimates that more than 100,000 Americans a year travel beyond the boarder for cosmetic procedures alone.
In 2005, for example, Bumrungrad Hospital in Thailand served more than 50,000 American patients, a 30 percent increase from the previous year. Thailand is just one of the countries where foreign patients have flocked. India, Brazil, Costa Rica and Mexico all market themselves as medical destinations, according to Schult.
...
Traveling abroad for medical procedures isn't new. For years, people have voyaged to exotic locals for aesthetic procedures -- a little nip and tuck between some rest and relaxation. But now the number of Americans leaving the country for medically necessary procedures has taken off too.
"The medical tourism model has really been turned around as the health care crisis looms larger and larger," said Dr. Matt Fontana, the chief medical officer for GlobalChoice Healthcare, a medical tourism booking company in Albuquerque, N.M. "People are saying, 'I'll pick the procedure and then I'll pick the destination.'"
As patients and businesses realize they can save up to 80 percent on pricey medical procedures, the medical travel industry is booming. ...
As U.S. Health Care Costs Rise, More Americans Head Abroad for Treatment
...
More and more Americans are looking across the border and overseas to get their medicine. Jeff Schult, author of "Beauty from Afar," a guide to medical tourism, estimates that more than 100,000 Americans a year travel beyond the boarder for cosmetic procedures alone.
In 2005, for example, Bumrungrad Hospital in Thailand served more than 50,000 American patients, a 30 percent increase from the previous year. Thailand is just one of the countries where foreign patients have flocked. India, Brazil, Costa Rica and Mexico all market themselves as medical destinations, according to Schult.
...
Traveling abroad for medical procedures isn't new. For years, people have voyaged to exotic locals for aesthetic procedures -- a little nip and tuck between some rest and relaxation. But now the number of Americans leaving the country for medically necessary procedures has taken off too.
"The medical tourism model has really been turned around as the health care crisis looms larger and larger," said Dr. Matt Fontana, the chief medical officer for GlobalChoice Healthcare, a medical tourism booking company in Albuquerque, N.M. "People are saying, 'I'll pick the procedure and then I'll pick the destination.'"
As patients and businesses realize they can save up to 80 percent on pricey medical procedures, the medical travel industry is booming. ...
lobbying juggernaut that helped kill Clinton's health plan, plans to announce today that [it is] promoting access to affordable healthcare for all
Unlikely alliance forming on healthcare | By Ricardo Alonso-Zaldivar, Los Angeles Times Staff Writer | November 1, 2007
The top small business group, which helped doom a 1990s overhaul, is joining a diverse coalition in trying to forestall polarization.
WASHINGTON -- The leading small-business organization, a lobbying juggernaut that helped kill President Clinton's health plan in the 1990s, plans to announce today that it is signing up with a diverse political coalition promoting access to affordable healthcare for all.
The National Federation of Independent Business will join AARP, the Service Employees International Union and the Business Roundtable -- which represents chief executives of major companies -- in an umbrella group called Divided We Fail. The effort is aimed at ensuring that healthcare and retirement security are at the top of the presidential candidates' domestic agendas next year.
...
"Access to affordable health insurance is the No. 1, No. 2 and No. 3 issue for small business across the United States," said Todd Stottlemyer, president of the National Federation of Independent Business. "For us not to be at the table in any serious conversations makes no sense. There really can't be a national debate about healthcare unless small business has a seat at the table."
The NFIB and AARP were on opposite sides of the hard-fought healthcare reform debate of 1993-94. The small-business group, with about 350,000 members and representatives in practically every congressional district, proved to be one of the more formidable adversaries of the Clinton plan. Its members were particularly incensed over a proposal that would have required most employers to contribute to the cost of coverage. ...
The top small business group, which helped doom a 1990s overhaul, is joining a diverse coalition in trying to forestall polarization.
WASHINGTON -- The leading small-business organization, a lobbying juggernaut that helped kill President Clinton's health plan in the 1990s, plans to announce today that it is signing up with a diverse political coalition promoting access to affordable healthcare for all.
The National Federation of Independent Business will join AARP, the Service Employees International Union and the Business Roundtable -- which represents chief executives of major companies -- in an umbrella group called Divided We Fail. The effort is aimed at ensuring that healthcare and retirement security are at the top of the presidential candidates' domestic agendas next year.
...
"Access to affordable health insurance is the No. 1, No. 2 and No. 3 issue for small business across the United States," said Todd Stottlemyer, president of the National Federation of Independent Business. "For us not to be at the table in any serious conversations makes no sense. There really can't be a national debate about healthcare unless small business has a seat at the table."
The NFIB and AARP were on opposite sides of the hard-fought healthcare reform debate of 1993-94. The small-business group, with about 350,000 members and representatives in practically every congressional district, proved to be one of the more formidable adversaries of the Clinton plan. Its members were particularly incensed over a proposal that would have required most employers to contribute to the cost of coverage. ...
Outstanding healthcare: The report found that the United States stands out because of its expense and people's dissatisfaction.
US healthcare comes up short in survey of 7 nations | Thu Nov 1, 2007 | By Maggie Fox, Health and Science Editor
WASHINGTON, Nov 1 (Reuters) - Americans spend double what people in other industrialized countries do on health care, but have more trouble seeing doctors, are the victims of more errors and go without treatment more often, according to a report released on Thursday.
Patients in the Netherlands struggle the most with paperwork, while British and Canadian citizens wait the longest for elective surgery, the Commonwealth Fund reports in the journal Health Affairs.
The report, published on the Internet at http://content.healthaffairs.org/cgi/content/abstract/26/6/w717T, provides an annual comparison from the Commonwealth Fund, a private foundation that supports research on health systems.
...
The report said Americans spent $6,697 per capita on healthcare in 2005, or 16 percent of gross domestic product. All the other countries spent less than half of that -- $3,128 in Australia or 9.5 percent of GDP, $3,326 in Canada or 9.8 percent of GDP, down to a low of $2,343 in New Zealand or 9 percent of GDP.
...
The report found that the United States stands out because of its expense and people's dissatisfaction.
...
"As in previous surveys, U.S. adults were most likely to have gone without care because of cost and to have high out-of-pocket costs," the report reads.
"In the U.S., nearly two of five (37 percent) of all adults and 42 percent of those with chronic conditions had skipped medications, not seen a doctor when sick, or foregone recommended care in the past year because of costs -- rates well above all other countries," it adds.
"In contrast to the U.S., patients in Canada, the Netherlands, and the U.K. rarely report having to forgo needed medical care because of costs."
WASHINGTON, Nov 1 (Reuters) - Americans spend double what people in other industrialized countries do on health care, but have more trouble seeing doctors, are the victims of more errors and go without treatment more often, according to a report released on Thursday.
Patients in the Netherlands struggle the most with paperwork, while British and Canadian citizens wait the longest for elective surgery, the Commonwealth Fund reports in the journal Health Affairs.
The report, published on the Internet at http://content.healthaffairs.org/cgi/content/abstract/26/6/w717T, provides an annual comparison from the Commonwealth Fund, a private foundation that supports research on health systems.
...
The report said Americans spent $6,697 per capita on healthcare in 2005, or 16 percent of gross domestic product. All the other countries spent less than half of that -- $3,128 in Australia or 9.5 percent of GDP, $3,326 in Canada or 9.8 percent of GDP, down to a low of $2,343 in New Zealand or 9 percent of GDP.
...
The report found that the United States stands out because of its expense and people's dissatisfaction.
...
"As in previous surveys, U.S. adults were most likely to have gone without care because of cost and to have high out-of-pocket costs," the report reads.
"In the U.S., nearly two of five (37 percent) of all adults and 42 percent of those with chronic conditions had skipped medications, not seen a doctor when sick, or foregone recommended care in the past year because of costs -- rates well above all other countries," it adds.
"In contrast to the U.S., patients in Canada, the Netherlands, and the U.K. rarely report having to forgo needed medical care because of costs."
Medicare drug (Part D) boosted the business of drug makers and pharmacists by 158 million prescriptions in 2006 ... reduced patient paid by 5.6%
Medicare Part D Pushed Drug Prescriptions Up 158 Million, Gov Cost by $32 Billion | Oldest, poorest spending a much greater share of their own income on premiums and health services than others |
Nov. 1, 2007 – The Medicare drug program (Part D) boosted the business of drug makers and pharmacists by 158 million prescriptions in 2006 and Medicare paid the bill of $32 billion, but a new study says the drug use and cost decrease to senior citizens was "relatively minor."
Many senior citizens already had prescription drug coverage, so the new benefit reduced the average amount paid by seniors per day of therapy by 18.4% and increased threir prescription drug use by only 13%, say researchers in a study published today in the 25th anniversary issue of the journal Health Affairs.
...
Lichtenberg and coauthor Shawn Sun, a researcher at Walgreens Health Services, found that Medicare patients paid about 66 cents per day of medication therapy in September 2004.
By December 2006 - after implementation of Medicare Part D - they paid about 53 cents per day of therapy.
However, with the subsequent increase in utilization that came after Part D, researchers found that the program reduced the total amount paid by patients by only 5.6 percent.
The program increased the amount that private insurers paid by 22.3 percent.
...
Nov. 1, 2007 – The Medicare drug program (Part D) boosted the business of drug makers and pharmacists by 158 million prescriptions in 2006 and Medicare paid the bill of $32 billion, but a new study says the drug use and cost decrease to senior citizens was "relatively minor."
Many senior citizens already had prescription drug coverage, so the new benefit reduced the average amount paid by seniors per day of therapy by 18.4% and increased threir prescription drug use by only 13%, say researchers in a study published today in the 25th anniversary issue of the journal Health Affairs.
...
Lichtenberg and coauthor Shawn Sun, a researcher at Walgreens Health Services, found that Medicare patients paid about 66 cents per day of medication therapy in September 2004.
By December 2006 - after implementation of Medicare Part D - they paid about 53 cents per day of therapy.
However, with the subsequent increase in utilization that came after Part D, researchers found that the program reduced the total amount paid by patients by only 5.6 percent.
The program increased the amount that private insurers paid by 22.3 percent.
...
Medicare Beneficiaries at Highest Risk, Spending More Out Of Pocket On Health Care
A related study in the November/December issue shows that the oldest, frailest, and poorest Medicare beneficiaries are spending a much greater share of their own income on premiums and health services than others, and that out-of-pocket spending as a share of income has increased over time for the Medicare population.
Kaiser Family Foundation and University of California, Los Angeles, researchers found that median out-of-pocket spending on health care increased by 50 percent, from $1,667 to $2,501, between 1997 and 2003.
The oldest Medicare beneficiaries, those in poor health, beneficiaries with low incomes, and those living in nursing homes were more likely than other Medicare beneficiaries to spend a large share of their incomes on premiums and health care services, according to the study.
The top quarter of high-spending beneficiaries spent almost 30 percent of their income on health care. The top 10 percent spent nearly 60 percent of their income on health care. Four of 10 beneficiaries spent more than 20 percent of their income on health in 2003, researchers Patricia Neuman, Juliette Cubanski, Katherine Desmond, and Thomas Rice found.
The findings “raise important questions about how much of their incomes beneficiaries can reasonably be expected to spend on their health care and whether current out-of-pocket spending levels are affordable,” the researchers say.
They warn that the overall burden of paying for health care could continue to rise for beneficiaries, and, as a result, health care could become less affordable and accessible for all but the highest-income beneficiaries. ...
Friday, November 2, 2007
So Mr. Giuliani’s supposed killer statistic about the defects of “socialized medicine” is entirely false ... should be a major political scandal
November 2, 2007 by The New York Times | Prostates and Prejudices | by Paul Krugman
“My chance of surviving prostate cancer - and thank God I was cured of it - in the United States? Eighty-two percent,” says Rudy Giuliani in a new radio ad attacking Democratic plans for universal health care. “My chances of surviving prostate cancer in England? Only 44 percent, under socialized medicine.”
...
Let’s start with the facts: Mr. Giuliani’s claim is wrong on multiple levels - bogus numbers wrapped in an invalid comparison embedded in a smear.
Mr. Giuliani got his numbers from a recent article in City Journal, a publication of the conservative Manhattan Institute. The author gave no source for his numbers on five-year survival rates - the probability that someone diagnosed with prostate cancer would still be alive five years after the diagnosis. And they’re just wrong.
You see, the actual survival rate in Britain is 74.4 percent. That still looks a bit lower than the U.S. rate, but the difference turns out to be mainly a statistical illusion. The details are technical, but the bottom line is that a man’s chance of dying from prostate cancer is about the same in Britain as it is in America.
So Mr. Giuliani’s supposed killer statistic about the defects of “socialized medicine” is entirely false. In fact, there’s very little evidence that Americans get better health care than the British, which is amazing given the fact that Britain spends only 41 percent as much on health care per person as we do.
...
By rights, then, Mr. Giuliani’s false claims about prostate cancer - which he has, by the way, continued to repeat, along with some fresh false claims about breast cancer - should be a major political scandal. As far as I can tell, however, they aren’t being treated that way.
To be fair, there has been some news coverage of the prostate affair. But it’s only a tiny fraction of the coverage received by Hillary’s laugh and John Edwards’s haircut.
“My chance of surviving prostate cancer - and thank God I was cured of it - in the United States? Eighty-two percent,” says Rudy Giuliani in a new radio ad attacking Democratic plans for universal health care. “My chances of surviving prostate cancer in England? Only 44 percent, under socialized medicine.”
...
Let’s start with the facts: Mr. Giuliani’s claim is wrong on multiple levels - bogus numbers wrapped in an invalid comparison embedded in a smear.
Mr. Giuliani got his numbers from a recent article in City Journal, a publication of the conservative Manhattan Institute. The author gave no source for his numbers on five-year survival rates - the probability that someone diagnosed with prostate cancer would still be alive five years after the diagnosis. And they’re just wrong.
You see, the actual survival rate in Britain is 74.4 percent. That still looks a bit lower than the U.S. rate, but the difference turns out to be mainly a statistical illusion. The details are technical, but the bottom line is that a man’s chance of dying from prostate cancer is about the same in Britain as it is in America.
So Mr. Giuliani’s supposed killer statistic about the defects of “socialized medicine” is entirely false. In fact, there’s very little evidence that Americans get better health care than the British, which is amazing given the fact that Britain spends only 41 percent as much on health care per person as we do.
...
By rights, then, Mr. Giuliani’s false claims about prostate cancer - which he has, by the way, continued to repeat, along with some fresh false claims about breast cancer - should be a major political scandal. As far as I can tell, however, they aren’t being treated that way.
To be fair, there has been some news coverage of the prostate affair. But it’s only a tiny fraction of the coverage received by Hillary’s laugh and John Edwards’s haircut.
And much of the coverage seems weirdly diffident. Memo to editors: If a candidate says something completely false, it’s not “in dispute.” It’s not the case that “Democrats say” they’re not advocating British-style socialized medicine; they aren’t.
The fact is that the prostate affair is part of a pattern: Mr. Giuliani has a habit of saying things, on issues that range from health care to national security, that are demonstrably untrue. And the American people have a right to know that.
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