Health-Care Crisis Endangers Economy | By Jason Leopold, Consortium News. Posted July 6, 2008.
A new report urges policymakers to find a solution to the health-care crisis; long-term fiscal problems may develop if the issue is not addressed.
If the United States does not act soon to address health-care costs, federal and state governments as well as American businesses could face a cascading fiscal crisis with devastating long-term consequences, says a new report by the Government Accountability Office.
In the report entitled, "Long Term Federal Fiscal Challenge Driven Primarily by Health Care," the GAO, the investigative arm of Congress, said an immediate "multi-pronged solution" must be pursued before the "window of opportunity" to address the issue closes.
"Rapidly rising health-care costs are not simply a federal budget problem," said the report, prepared by Gene Dodaro, acting U.S. Comptroller General. "Growth in health-related spending is the primary driver of the fiscal challenges facing state and local governments as well.
"Unsustainable growth in health-care spending also threatens to erode the ability of employers to provide coverage to their workers and undercuts their ability to compete in a global marketplace." ...
Thursday, July 10, 2008
Monday, June 16, 2008
Walgreens Pill-Flipping Scheme Costs Taxpayers Millions
Walgreens Pill-Flipping Scheme Costs Taxpayers Millions
Thanks to an anonymous whistle-blower, a Walgreens pill-flipping scheme has been blown wide open, according to CBS. "Pill-flipping" refers the practice of pharmacies that purposefully switch Medicaid patients to more expensive versions of certain drugs for the sole reason of collecting more money from the government. Naturally, when this happens, taxpayers pick up the bill. Athough, Walgreen's officially denies any wrongdoing they have agreed to pay the government more than $35 million. Details, inside...
CBS explains the scheme,
To save taxpayer dollars, Medicaid limits how much it pays for popular forms of drugs. But it doesn't bother to set price-ceilings on rarely-used versions.
Take generic Zantac, or ranitidine, for example. The antacid is a huge seller in tablet form. Medicaid limits payment to 34 cents apiece.
The same drug as capsules has no price-ceiling because it was so rarely-prescribed. Medicaid pays $1.25 each. Walgreens figured it could pocket millions by switching patients from tablets to capsules.
...
And they're not the only ones. CVS and Omnicare quietly settled similar cases coughing up $86 million more. The whole pill-flipping episode proves just how imperfect some drugstore chains can be. ...
Thanks to an anonymous whistle-blower, a Walgreens pill-flipping scheme has been blown wide open, according to CBS. "Pill-flipping" refers the practice of pharmacies that purposefully switch Medicaid patients to more expensive versions of certain drugs for the sole reason of collecting more money from the government. Naturally, when this happens, taxpayers pick up the bill. Athough, Walgreen's officially denies any wrongdoing they have agreed to pay the government more than $35 million. Details, inside...
CBS explains the scheme,
To save taxpayer dollars, Medicaid limits how much it pays for popular forms of drugs. But it doesn't bother to set price-ceilings on rarely-used versions.
Take generic Zantac, or ranitidine, for example. The antacid is a huge seller in tablet form. Medicaid limits payment to 34 cents apiece.
The same drug as capsules has no price-ceiling because it was so rarely-prescribed. Medicaid pays $1.25 each. Walgreens figured it could pocket millions by switching patients from tablets to capsules.
...
And they're not the only ones. CVS and Omnicare quietly settled similar cases coughing up $86 million more. The whole pill-flipping episode proves just how imperfect some drugstore chains can be. ...
Friday, June 6, 2008
20-29 unisured up again: 30 percent of the uninsured: 53 percent of Hispanics uninsured in age range
Number of uninsured U.S. young adults grows | Fri May 30, 2008 | By Will Dunham
WASHINGTON (Reuters) - The number of uninsured U.S. young adults, who already represent a major chunk of the American population without health coverage, rose again in 2006, according to a study released on Friday.
Based on census data, 13.7 million people aged 19 to 29 had no health insurance, either public or private, in 2006, up from 13.3 million in 2005, according to a report by the Commonwealth Fund, a private foundation that researches health policy.
Men and women in this age group accounted for 17 percent of the under-65 U.S. population, but made up almost 30 percent of the uninsured, according to the report.
...
Hispanic and black young adults were at greater risk of being uninsured than whites, the report showed. While 23 percent of whites ages 19 to 29 lacked insurance, the figure was 36 percent of blacks and 53 percent of Hispanics. ...
WASHINGTON (Reuters) - The number of uninsured U.S. young adults, who already represent a major chunk of the American population without health coverage, rose again in 2006, according to a study released on Friday.
Based on census data, 13.7 million people aged 19 to 29 had no health insurance, either public or private, in 2006, up from 13.3 million in 2005, according to a report by the Commonwealth Fund, a private foundation that researches health policy.
Men and women in this age group accounted for 17 percent of the under-65 U.S. population, but made up almost 30 percent of the uninsured, according to the report.
...
Hispanic and black young adults were at greater risk of being uninsured than whites, the report showed. While 23 percent of whites ages 19 to 29 lacked insurance, the figure was 36 percent of blacks and 53 percent of Hispanics. ...
An immigrant women from Honduras - with legal documentation - faces deportation because her insurance does not cover long-term care
Hospital Attempts Deportation of Woman With Inadequate Insurance | Posted by Cara , Feministe at 3:23 PM on May 19, 2008.
An immigrant woman from Honduras who has very recently awakened from a coma is being threatened with what can effectively be called deportation, because she does not have the insurance needed to cover her medical bills. (Don’t read the comments in these articles unless you want to lose your lunch.) But here is the real kicker: while it would be repulsive and incredibly inhumane to deport an uninsured/under-insured person with a serious medical condition because of their undocumented status, despite the lack of adequate facilities for their care in their nations of citizenship, it isn’t even the case here. Sonia del Cid Iscoa has a current visa and in the U.S. legally. (All emphasis in quoted text is mine.)
A gravely ill woman at risk of being removed from the country for lack of adequate insurance coverage awoke from a coma Tuesday.
The hospital has been seeking to return her to her native Honduras; her family took the hospital to court.
[. . .]
Iscoa, 34, has a valid visa and has lived in the United States for more than 17 years. She has no family in Honduras.
But St. Joseph’s Hospital and Medical Center sought to have her sent to Honduras when she went into a coma April 20 after giving birth to a daughter about 8 weeks premature. Iscoa has an amended version of Arizona Health Care Cost Containment System coverage that does not cover long-term care, Curtin said. But her family worried that the move would seriously harm her, or, at the very least, prevent her from ever returning to the United States.
Iscoa’s mother, Joaquina del Cid Plasecea, obtained a temporary restraining order to keep her from being moved. Maricopa County Superior Court Judge Carey Hyatt also ordered that the family post a $20,000 bond by Tuesday to cover St. Joseph’s costs of postponing the transfer. ...
Stressed Moms May Give Birth to Asthmatic or Allergic Kids
Stressed Moms May Give Birth to Asthmatic or Allergic KidsBy Anna Boyd | 16:46, May 19th 2008
Women should avoid being stressed during pregnancy, as recent research warns that stress may raise the risk of their child developing asthma or other allergies.
The findings by researchers from Harvard Medical School were presented Sunday at the American Thoracic Society’s 2008 International Conference in Toronto. They were based on the study of 387 babies enrolled in the Asthma Coalition on Community, Environment and Social project in Boston.
According to the study, mothers who were the most distressed during pregnancy were most likely to give birth to infants with higher levels of Immunoglobulin E or IgE, an immune system chemical linked to allergic responses. For example, a mom having three or more negative events would have a 12 percent increased risk of having a baby with elevated cord blood IgE.
“While predisposition to asthma may be, in part, set at birth, the factors that may determine this are not strictly genetic. This research supports the notion that stress can be thought of as a social pollutant that, when ‘breathed’ into the body, may influence the immune response, similar to the effects of physical pollutants like allergens,” Dr. Rosalind Wright, of Brigham & Women's Hospital and Harvard Medical School, said in a news release, according to Reuters. ...
Women should avoid being stressed during pregnancy, as recent research warns that stress may raise the risk of their child developing asthma or other allergies.
The findings by researchers from Harvard Medical School were presented Sunday at the American Thoracic Society’s 2008 International Conference in Toronto. They were based on the study of 387 babies enrolled in the Asthma Coalition on Community, Environment and Social project in Boston.
According to the study, mothers who were the most distressed during pregnancy were most likely to give birth to infants with higher levels of Immunoglobulin E or IgE, an immune system chemical linked to allergic responses. For example, a mom having three or more negative events would have a 12 percent increased risk of having a baby with elevated cord blood IgE.
“While predisposition to asthma may be, in part, set at birth, the factors that may determine this are not strictly genetic. This research supports the notion that stress can be thought of as a social pollutant that, when ‘breathed’ into the body, may influence the immune response, similar to the effects of physical pollutants like allergens,” Dr. Rosalind Wright, of Brigham & Women's Hospital and Harvard Medical School, said in a news release, according to Reuters. ...
Wednesday, June 4, 2008
$200 billion in higher drug prices buys $25B in drug research ... huge markups created by patent monopolies are an invitation to corruption.
Firefighters and Prescription Drugs | Monday 02 June 2008 |
by: Dean Baker, t r u t h o u t | Perspective
...
The drugs we need for our health or our lives are almost invariably cheap to produce, just as the firefighters might be able to easily stage the rescue once they have arrived at the fire. But the drug companies, like the firefighters on the scene, have a virtual monopoly on their services at the critical moment. Therefore, they are quite likely to get their price.
...
The United States is currently spending almost $250 billion a year for prescription drugs. If drugs were sold in a competitive market, without government-imposed patent monopolies, we could save close to $200 billion a year. The $200 billion in higher drug prices buys a bit less than $25 billion a year in pharmaceutical research, according to the Congressional Budget Office. Paying $8 in higher drug prices for $1 in research does not seem like a very good deal.
Furthermore, as economists who don't work for the drug companies will tell you, the huge markups created by patent monopolies are an invitation to corruption. When a drug company can sell a drug for $500 that costs it $4 to manufacture and distribute, it has an enormous incentive to mislead doctors and the public about the safety and effectiveness of the drug. And, when the drug company performs the research on the drug, and controls the dissemination of research findings, they also have the ability to act on this incentive.
Under the current system, we should not be surprised to find drug companies conceal evidence that their drugs might be ineffective or even harmful. Given the structure of the incentives that the government has created, we should be surprised if drug companies are not dishonest.
There are many different alternatives to patent monopolies for financing drug research. In fact, the US government already spends $30 billion a year on biomedical research through the National Institutes of Health. Virtually everyone, including the drug companies, agrees this government-funded research has been extremely valuable.
Would it make sense to double the level of public funding to pay the full cost of developing drugs, and then let all drugs be sold at $4 a prescription in a competitive market? We could more than cover the cost to the government by the savings each year on drugs purchased through Medicare and Medicaid. If the drug companies did not own our politicians, we would be having this debate. ...
We should be having a serious national debate on the relative efficiency of the current patent system and various alternative mechanisms for financing drug research. Unfortunately, the drug companies are so powerful that few politicians are even willing to consider alternatives. In fact, the drug companies are so powerful that few media outlets would even print a column suggesting alternatives. In fact, the drug companies are so powerful that few economists would ever consider researching alternative mechanisms. ...
by: Dean Baker, t r u t h o u t | Perspective
...
The drugs we need for our health or our lives are almost invariably cheap to produce, just as the firefighters might be able to easily stage the rescue once they have arrived at the fire. But the drug companies, like the firefighters on the scene, have a virtual monopoly on their services at the critical moment. Therefore, they are quite likely to get their price.
...
The United States is currently spending almost $250 billion a year for prescription drugs. If drugs were sold in a competitive market, without government-imposed patent monopolies, we could save close to $200 billion a year. The $200 billion in higher drug prices buys a bit less than $25 billion a year in pharmaceutical research, according to the Congressional Budget Office. Paying $8 in higher drug prices for $1 in research does not seem like a very good deal.
Furthermore, as economists who don't work for the drug companies will tell you, the huge markups created by patent monopolies are an invitation to corruption. When a drug company can sell a drug for $500 that costs it $4 to manufacture and distribute, it has an enormous incentive to mislead doctors and the public about the safety and effectiveness of the drug. And, when the drug company performs the research on the drug, and controls the dissemination of research findings, they also have the ability to act on this incentive.
Under the current system, we should not be surprised to find drug companies conceal evidence that their drugs might be ineffective or even harmful. Given the structure of the incentives that the government has created, we should be surprised if drug companies are not dishonest.
There are many different alternatives to patent monopolies for financing drug research. In fact, the US government already spends $30 billion a year on biomedical research through the National Institutes of Health. Virtually everyone, including the drug companies, agrees this government-funded research has been extremely valuable.
Would it make sense to double the level of public funding to pay the full cost of developing drugs, and then let all drugs be sold at $4 a prescription in a competitive market? We could more than cover the cost to the government by the savings each year on drugs purchased through Medicare and Medicaid. If the drug companies did not own our politicians, we would be having this debate. ...
We should be having a serious national debate on the relative efficiency of the current patent system and various alternative mechanisms for financing drug research. Unfortunately, the drug companies are so powerful that few politicians are even willing to consider alternatives. In fact, the drug companies are so powerful that few media outlets would even print a column suggesting alternatives. In fact, the drug companies are so powerful that few economists would ever consider researching alternative mechanisms. ...
Depleted Uranium has Destroyed the Genetic Future of Iraq
Depleted Uranium has Destroyed the Genetic Future of Iraq | markthshark, Daily Kos | May 30, 2008
It’s not just the U.S. military, and it's not just Iraq. The U.K. has also used depleted uranium in both Iraq and Afghanistan; NATO forces have used it in Kosovo, and Israel allegedly used it in Lebanon and on the Palestinians.
It’s not just the U.S. military, and it's not just Iraq. The U.K. has also used depleted uranium in both Iraq and Afghanistan; NATO forces have used it in Kosovo, and Israel allegedly used it in Lebanon and on the Palestinians.
A waste product from the enrichment of uranium, DU, contains nearly one-third the radioactive isotopes of uranium that occurs naturally. DU is generally used in armor-piercing ammunition; despite its classification as a weapon of mass destruction, and subsequent banning by the United Nations.
Incidental inhalation or ingestion of DU particles is very toxic and can remain so forever. To give you an idea of just how toxic: at the end of the first Gulf War, the United Kingdom Atomic Energy Authority estimated that 50 tons remained in Iraq, and that amount could be responsible for 500,000 cancer deaths by the year 2000. Now, it’s not clear whether that prediction came true or not, but to date, an estimated 2,000 tons of DU dust have been generated in the Middle East in general. ...
...
Since George H.W. Bush’s first Gulf War, birth defects and childhood cancer rates have increased seven fold in Iraq. And, our troops have paid a heavy price as well. More than 35 percent (251,000) of U.S. Gulf War veterans are dead or on permanent medical disability, compared with only 400 who were killed during the conflict. ...
Survey of Medical Schools Is Critical of Perks - "sales reps in clinics with free lunches and marketing paraphernalia"
Survey of Medical Schools Is Critical of Perks - NYTimes.comBy GARDINER HARRIS | Published: June 3, 2008
Most medical schools in the United States fail to police adequately the money, gifts and free drug samples that pharmaceutical companies routinely shower on doctors and trainees, according to a ranking by the American Medical Student Association.
Only 7 of the 150 medical schools included in the rankings received a grade of A while 14 were given a B. Sixty got a failing grade, and the student association found that 28 schools, or nearly one in five, were in the midst of revising their conflict-of-interest policies.
...
Gabriel Silverman, a medical student at the University of Pittsburgh School of Medicine who oversaw the grading, said medical students were increasingly put off by school policies that allowed drug companies to market their products to doctors and faculty members.
“We see all these pharma sales reps in clinics with free lunches and marketing paraphernalia giving us the hard sell,” Mr. Silverman said. ...
Most medical schools in the United States fail to police adequately the money, gifts and free drug samples that pharmaceutical companies routinely shower on doctors and trainees, according to a ranking by the American Medical Student Association.
Only 7 of the 150 medical schools included in the rankings received a grade of A while 14 were given a B. Sixty got a failing grade, and the student association found that 28 schools, or nearly one in five, were in the midst of revising their conflict-of-interest policies.
...
Gabriel Silverman, a medical student at the University of Pittsburgh School of Medicine who oversaw the grading, said medical students were increasingly put off by school policies that allowed drug companies to market their products to doctors and faculty members.
“We see all these pharma sales reps in clinics with free lunches and marketing paraphernalia giving us the hard sell,” Mr. Silverman said. ...
Thursday, May 29, 2008
Pharmaceutical Payola — complemented by a host of tactics that in other circumstances might be called bribes.
Pharmaceutical Payola — Drug Marketing to Doctors - CommonDreams.orgSaturday, May 17, 2008 by Robert Weissman
...
Among industrialized countries, only the United States and New Zealand permit drug companies to market directly to consumers. It’s a bad idea, it drives bad medicine, and it should be banned.
...
Among industrialized countries, only the United States and New Zealand permit drug companies to market directly to consumers. It’s a bad idea, it drives bad medicine, and it should be banned.
But although it has the highest profile, direct-to-consumer advertising is a small part of Pharma’s marketing machine. Researchers Marc-André Gagnon and Joel Lexchin conclude in a recent issue of the journal PLOS Medicine that direct-to-consumer ads make up less than a tenth of industry marketing expenditures ($4 billion of $57.5 billion in 2004). And Gagnon and Lexchin’s estimate of $57.5 billion on marketing excludes many industry expenditures that are really driven by marketing, including clinical trials conducted for marketing purposes.
The bulk of the industry marketing effort — more than 70 percent by Gagnon and Lexchin’s calculation — is directed at doctors.
Why?
Because it works.
The companies spend huge amounts paying firms that carefully track what doctors prescribe, and then they use the information to tailor messages to doctors, distribute samples and develop continuing medical education programs.
Gagnon and Lexchin report that Pharma spends more than $20 billion a year on “detailers” — the pharma reps that knock on doctor doors, ply the staff with free coffee and lunches, distribute samples ($16 billion worth), and prod docs to prescribe their drugs.
This is complemented by a host of tactics that in other circumstances might be called bribes.
“Virtually all physicians in America take cash or gifts from the drug companies,” says Melody Petersen, author of Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs, and a former New York Times reporter. “A recent survey said 94 percent of physicians took something of value from the drug companies. Some doctors take hundreds of thousands of dollars a year from these companies, and there’s no law that says they can’t.”
...
The drug companies weave these diverse strategems into an elaborate tapestry — not infrequently to push drugs for inappropriate purposes. One eye-opening case that Petersen details in Our Daily Meds concerns Neurontin, a mediocre drug for epilepsy that Warner-Lambert illegally peddled as an unapproved treatment for bipolar disorder, migraines, attention deficit disorder in children and other conditions. The drug does not work for most of these conditions. Many persons were injured by taking excessive doses of Neurontin, and many others wasted money and emotional energy on hopeless Neurontin treatment strategies. Warner-Lambert ultimately paid $430 million to settle criminal and civil charges related to Neurontin marketing, but Petersen says that, even so, the illegal marketing scheme was clearly profitable for Warner-Lambert (and Pfizer, which acquired Warner-Lambert in 2000). ...
Tuesday, May 27, 2008
Post-Traumatic Stress Soars in US Troops ... Longer, Multiple Combat Tours
Post-Traumatic Stress Soars in US Troops | Tuesday 27 May 2008 | by: David Morgan, Reuters
Washington - Newly diagnosed cases of post-traumatic stress disorder among U.S. troops sent to Iraq and Afghanistan surged 46.4 percent in 2007, bringing the five-year total to nearly 40,000, according to U.S. military data released on Tuesday.
...
Army officials said the larger number of PTSD diagnoses in recent years partly reflects greater awareness and tracking of the disorder by the U.S. military.
Longer, Multiple Combat Tours
"But we're also exposing more people to combat," Lt. Gen. Eric Schoomaker, the Army surgeon general, told reporters.
Experts also say PTSD symptoms increase as soldiers return to combat for multiple tours of duty. ...
Washington - Newly diagnosed cases of post-traumatic stress disorder among U.S. troops sent to Iraq and Afghanistan surged 46.4 percent in 2007, bringing the five-year total to nearly 40,000, according to U.S. military data released on Tuesday.
...
Army officials said the larger number of PTSD diagnoses in recent years partly reflects greater awareness and tracking of the disorder by the U.S. military.
Longer, Multiple Combat Tours
"But we're also exposing more people to combat," Lt. Gen. Eric Schoomaker, the Army surgeon general, told reporters.
Experts also say PTSD symptoms increase as soldiers return to combat for multiple tours of duty. ...
Wednesday, May 14, 2008
deductibles and co-payments are growing so big that insured patients also have trouble paying hospitals
Ralph Nader: America's Pay-or-Die Health Care SystemMay 6, 2008 | The Story of Lisa Kelly
...
Advised by her physician to go to M.D. Anderson for urgent treatment of her leukemia, Mrs. Lisa Kelly was told she had to pay $105,000 up front before being admitted. The hospital declared her limited insurance unacceptable.
Sitting in the business office with seriously advanced cancer, she asked herself – “Are they going to send me home?” “Am I going to die?”
Time out from her torment for a moment. M.D. Anderson started this upfront payment demand in 2005 because of a spike in its bad debt load.
The Wall Street Journal explains – “The bad debt is driven by a larger number of Americans who are uninsured or who don’t have enough insurance to cover costs if catastrophe strikes. Even among those with adequate insurance, deductibles and co-payments are growing so big that insured patients also have trouble paying hospitals.”
It isn’t as if non-profit hospitals like M.D. Anderson are hurting. Look at this finding in an Ohio State University study: net income per bed at non-profit hospitals tripled to $146,273 in 2005 from $50,669 in 2000. And you also may have noticed the huge pay packages awarded hospital executives.
M.D. Anderson, exempt from taxation, recipient of funds from large government programs and research grants has cash, investments and endowment totaling $1.9 billion, with net income of $310 million last year, the Journal reports.
Back to the 52 year old, Lisa Kelly. She and her husband returned with a check for $45,000. After a blood test and biopsy, the hospital oncologist urged admittance quickly. Then the hospital demanded an additional $60,000-$45,000 just for the lab tests and $15,000 for part of the cost of the treatment.
To shorten the story, she received chemotherapy for over a year. Often her appointment was “blocked” until she made another payment.
In a particularly grotesque incident, she was hooked up to a chemotherapy pump, but the nurses were not allowed to change the chemo bag until Mr. Kelly made another payment. ...
...
Advised by her physician to go to M.D. Anderson for urgent treatment of her leukemia, Mrs. Lisa Kelly was told she had to pay $105,000 up front before being admitted. The hospital declared her limited insurance unacceptable.
Sitting in the business office with seriously advanced cancer, she asked herself – “Are they going to send me home?” “Am I going to die?”
Time out from her torment for a moment. M.D. Anderson started this upfront payment demand in 2005 because of a spike in its bad debt load.
The Wall Street Journal explains – “The bad debt is driven by a larger number of Americans who are uninsured or who don’t have enough insurance to cover costs if catastrophe strikes. Even among those with adequate insurance, deductibles and co-payments are growing so big that insured patients also have trouble paying hospitals.”
It isn’t as if non-profit hospitals like M.D. Anderson are hurting. Look at this finding in an Ohio State University study: net income per bed at non-profit hospitals tripled to $146,273 in 2005 from $50,669 in 2000. And you also may have noticed the huge pay packages awarded hospital executives.
M.D. Anderson, exempt from taxation, recipient of funds from large government programs and research grants has cash, investments and endowment totaling $1.9 billion, with net income of $310 million last year, the Journal reports.
Back to the 52 year old, Lisa Kelly. She and her husband returned with a check for $45,000. After a blood test and biopsy, the hospital oncologist urged admittance quickly. Then the hospital demanded an additional $60,000-$45,000 just for the lab tests and $15,000 for part of the cost of the treatment.
To shorten the story, she received chemotherapy for over a year. Often her appointment was “blocked” until she made another payment.
In a particularly grotesque incident, she was hooked up to a chemotherapy pump, but the nurses were not allowed to change the chemo bag until Mr. Kelly made another payment. ...
Tuesday, May 13, 2008
Health care workers sue state over pay-cut plan - San Jose Mercury News
Health care workers sue state over pay-cut plan - San Jose Mercury NewsBy Shaya Tayefe Mohajer | Associated Press | Article Launched: 05/06/2008 01:37:48 AM PDT
LOS ANGELES - A coalition of health care groups sued the state Monday to prevent pay cuts to doctors, dentists, pharmacists and others who treat the poor, elderly and disabled.
The lawsuit filed in Los Angeles County Superior Court on behalf of California health care providers seeks an injunction to halt 10 percent cuts to Medi-Cal and Denti-Cal reimbursements scheduled to take effect July 1. ...
LOS ANGELES - A coalition of health care groups sued the state Monday to prevent pay cuts to doctors, dentists, pharmacists and others who treat the poor, elderly and disabled.
The lawsuit filed in Los Angeles County Superior Court on behalf of California health care providers seeks an injunction to halt 10 percent cuts to Medi-Cal and Denti-Cal reimbursements scheduled to take effect July 1. ...
Monday, May 5, 2008
Getting married for health insurance - 25% keep or change jobs for health insurance ...
Getting married for health insurance - Los Angeles Times
| By Ricardo Alonso-Zaldivar, Los Angeles Times Staff Writer | April 29, 2008
Seven percent of Americans say they or someone in their household decided to tie the knot in the last year so they could receive healthcare benefits, a poll finds.
...
"It's a small number but a powerful result, because it shows how paying for healthcare is reflected not only in family budgets but in life decisions," said Drew E. Altman, president of the Kaiser Family Foundation, which commissioned the survey as part of its regular polling on healthcare.
...
On a broader scale, the survey found that healthcare costs outranked housing costs, rising food prices and credit card bills as a source of concern. ...
...
But with employer-based health insurance averaging $12,000 for family coverage and $4,500 for individuals, the public concern with costs is understandable. Nearly a fourth of Americans said they had decided to keep or change jobs in the last year because of health insurance. ...
| By Ricardo Alonso-Zaldivar, Los Angeles Times Staff Writer | April 29, 2008
Seven percent of Americans say they or someone in their household decided to tie the knot in the last year so they could receive healthcare benefits, a poll finds.
...
"It's a small number but a powerful result, because it shows how paying for healthcare is reflected not only in family budgets but in life decisions," said Drew E. Altman, president of the Kaiser Family Foundation, which commissioned the survey as part of its regular polling on healthcare.
...
On a broader scale, the survey found that healthcare costs outranked housing costs, rising food prices and credit card bills as a source of concern. ...
...
But with employer-based health insurance averaging $12,000 for family coverage and $4,500 for individuals, the public concern with costs is understandable. Nearly a fourth of Americans said they had decided to keep or change jobs in the last year because of health insurance. ...
(28 percent) report that the recent economic downturn has caused "serious problems" paying for medical care and insurance ...
April 29, 2008 | Ouch! Health costs rise as the economy falters | Chicago Tribune
...
Slightly more than 1 in 4 Americans (28 percent) report that the recent economic downturn has caused "serious problems" paying for medical care and insurance, according to a new survey by the Kaiser Family Foundation, a California policy group.
It’s the third most frequent type of problem people are encountering, behind problems paying for gas (44 percent) and getting a raise or a good paying job (29 percent).
Research shows what happens when people get caught in this kind of economic squeeze – they stop writing checks for insurance premiums or they stop taking medications (even $10 per prescription can add up) or going to the doctor (avoiding those $10 or $15 co-pays for each visit).
The new survey confirms this is happening: 29 percent of people said they or a family member have postponed getting needed care; 24 percent went without a recommended medical test or treatment; 23 percent didn’t fill a prescription; and another 19 percent cut pills in half or skipped medication doses. ...
...
Slightly more than 1 in 4 Americans (28 percent) report that the recent economic downturn has caused "serious problems" paying for medical care and insurance, according to a new survey by the Kaiser Family Foundation, a California policy group.
It’s the third most frequent type of problem people are encountering, behind problems paying for gas (44 percent) and getting a raise or a good paying job (29 percent).
Research shows what happens when people get caught in this kind of economic squeeze – they stop writing checks for insurance premiums or they stop taking medications (even $10 per prescription can add up) or going to the doctor (avoiding those $10 or $15 co-pays for each visit).
The new survey confirms this is happening: 29 percent of people said they or a family member have postponed getting needed care; 24 percent went without a recommended medical test or treatment; 23 percent didn’t fill a prescription; and another 19 percent cut pills in half or skipped medication doses. ...
median income flat ... but family portion of health insurance jumps 25%
April 29, 2008 | 660,000 Illinois jobs lose medical benefits | Chicago Tribune
...
Here’s the latest data: the number of jobs in Illinois with medical benefits plunged by 660,000 between 2001 and 2005, according to a study released today by the Robert Wood Johnson Foundation.
...
Driving the trend are soaring medical costs – a consequence of more medical services and more expensive technologies -- that make health insurance ever more expensive for workers and employers.
...
While median income for Illinois families was essentially flat between 2001 and 2005, the portion that they paid for health insurance provided by employers jumped 25 percent this five-year period. ...
...
Here’s the latest data: the number of jobs in Illinois with medical benefits plunged by 660,000 between 2001 and 2005, according to a study released today by the Robert Wood Johnson Foundation.
...
Driving the trend are soaring medical costs – a consequence of more medical services and more expensive technologies -- that make health insurance ever more expensive for workers and employers.
...
While median income for Illinois families was essentially flat between 2001 and 2005, the portion that they paid for health insurance provided by employers jumped 25 percent this five-year period. ...
“We have a deficit and a war.” ... NIH loses 2 per cent of funding every year for 7 years ....
Too few funds to fight cancer in U.S. | By Robert Weiner and Patricia Berg | April 18, 2008
With more than 500,000 cancer deaths in the United States each year, the underlying buzz all around the just concluded San Diego meeting of the American Association for Cancer Research, with 17,000 scientists from throughout the nation and the world, was, “Where is the federal government?"
...
Despite fear of the torturous physical slide of cancer – people's No. 1 health fear – federal funds for research into early diagnosis, treatment and cures are plummeting. The National Institutes of Health has lost 2 percent of its budget to inflation in real dollars every year for the last seven years, a 14 percent decline, points out leukemia researcher Michael Sheard of Childrens Hospital Los Angeles. Ellen Sigal, chairwoman of Friends of Cancer Research in Arlington, Va., and the chair of a forum at AACR on alternative funding mechanisms, confirmed Sheard's numbers.
When we asked Sigal why there is the drop in federal funds, she responded, “We have a deficit and a war.” If funding potential disease cures is part of the price of Iraq, it is no wonder that 70 percent of Americans oppose the war and want its cost to end in the scheme of priorities. ...
...
NCI now funds fewer than 10 percent of requested research projects, down from 25 percent a decade ago. President Clinton had doubled NIH's budget – explaining many of the amazing recent breakthroughs – but now, with the budget dropping, private organizations are desperately trying to pick up the pieces so that innovative science can continue. ...
...
The bar is now impossibly high for many new discoveries. At NCI, researchers “must show real leads, not discovery,” says Barker. ...
With more than 500,000 cancer deaths in the United States each year, the underlying buzz all around the just concluded San Diego meeting of the American Association for Cancer Research, with 17,000 scientists from throughout the nation and the world, was, “Where is the federal government?"
...
Despite fear of the torturous physical slide of cancer – people's No. 1 health fear – federal funds for research into early diagnosis, treatment and cures are plummeting. The National Institutes of Health has lost 2 percent of its budget to inflation in real dollars every year for the last seven years, a 14 percent decline, points out leukemia researcher Michael Sheard of Childrens Hospital Los Angeles. Ellen Sigal, chairwoman of Friends of Cancer Research in Arlington, Va., and the chair of a forum at AACR on alternative funding mechanisms, confirmed Sheard's numbers.
When we asked Sigal why there is the drop in federal funds, she responded, “We have a deficit and a war.” If funding potential disease cures is part of the price of Iraq, it is no wonder that 70 percent of Americans oppose the war and want its cost to end in the scheme of priorities. ...
...
NCI now funds fewer than 10 percent of requested research projects, down from 25 percent a decade ago. President Clinton had doubled NIH's budget – explaining many of the amazing recent breakthroughs – but now, with the budget dropping, private organizations are desperately trying to pick up the pieces so that innovative science can continue. ...
...
The bar is now impossibly high for many new discoveries. At NCI, researchers “must show real leads, not discovery,” says Barker. ...
Heparin Contamination Reveals Dirty Secret: Their Pills are Made in China! ... [but] FDA warned Americans not to buy drugs from Canada
Heparin Contamination Fiasco Reveals Dirty Secret of Drug Industry: Their Pills are Made in China!Thursday, May 01, 2008 by: Mike Adams
(NaturalNews) Remember a couple of years ago how the FDA warned Americans not to buy prescription drugs from Canada because they might be "contaminated by terrorists?" I'm not making that up: That was the official announcement of an FDA spokesperson, and it was part of their fear strategy for enforcing a monopoly on U.S. consumers so that Big Pharma could continue engaging in rampant price fixing.
The implication in that warning is that drugs purchased in the United States are therefore safer, correct? What the FDA didn't tell anyone, however, is that most pharmaceuticals purchased in the United States are manufactured outside the U.S.; many from China or Puerto Rico. So they're not even made in the U.S. anyway, and drug companies are simply importing them from other countries just like a consumer might do if she drove across the border and bought her medications in Canada or Mexico.
...
Enter the blood-thinning drug Heparin. This blood-thinning drug, made by Baxter International, was recently discovered by consumers to have been manufactured in China. Worse yet, the quality controls in China were so low that this FDA approved, brand-name prescription drug was apparently deliberately contaminated with an adulterated chemical that has now resulted in the death of dozens of consumers in the United States. Sound familiar? It's precisely the scenario dreamed up by the FDA to warn consumers away from pharmaceuticals purchased in Canada, Mexico or elsewhere. But guess what? It turns out that brand-name, FDA-approved prescription drugs sold at monopoly prices right here in the United States are adulterated too!
Fact #1: Most U.S. prescription drugs aren't even made in the U.S.
Fact #2: Many U.S. prescription drugs are made in China, a country widely known to have the lowest quality control standards in the world.
Fact #3: U.S. drug companies don't even run quality control checks on the drugs they import from China!
That third fact should send a chill up your spine. What it means is that U.S. drug companies contract with cheap, low-end Chinese chemical factories to manufacture their drugs at something like two cents a pill (which they can mark up to $20 a pill or more...), and then they import these Chinese-made pills and don't even test them before selling them to U.S. consumers!
If it wasn't for the fact that so many Americans have now died from this, the whole thing would be quite hilarious. Why? Because the FDA and Big Pharma are always running around touting how "safe" their products are while screaming about how dangerous herbs and supplements are. And yet nutritional supplement companies test their ingredients for contaminants with far greater frequency than drug companies. ...
(NaturalNews) Remember a couple of years ago how the FDA warned Americans not to buy prescription drugs from Canada because they might be "contaminated by terrorists?" I'm not making that up: That was the official announcement of an FDA spokesperson, and it was part of their fear strategy for enforcing a monopoly on U.S. consumers so that Big Pharma could continue engaging in rampant price fixing.
The implication in that warning is that drugs purchased in the United States are therefore safer, correct? What the FDA didn't tell anyone, however, is that most pharmaceuticals purchased in the United States are manufactured outside the U.S.; many from China or Puerto Rico. So they're not even made in the U.S. anyway, and drug companies are simply importing them from other countries just like a consumer might do if she drove across the border and bought her medications in Canada or Mexico.
...
Enter the blood-thinning drug Heparin. This blood-thinning drug, made by Baxter International, was recently discovered by consumers to have been manufactured in China. Worse yet, the quality controls in China were so low that this FDA approved, brand-name prescription drug was apparently deliberately contaminated with an adulterated chemical that has now resulted in the death of dozens of consumers in the United States. Sound familiar? It's precisely the scenario dreamed up by the FDA to warn consumers away from pharmaceuticals purchased in Canada, Mexico or elsewhere. But guess what? It turns out that brand-name, FDA-approved prescription drugs sold at monopoly prices right here in the United States are adulterated too!
Three astonishing facts about brand-name pharmaceuticals
So far, then, there are three astonishing facts that have come out of this recent news about Heparin:Fact #1: Most U.S. prescription drugs aren't even made in the U.S.
Fact #2: Many U.S. prescription drugs are made in China, a country widely known to have the lowest quality control standards in the world.
Fact #3: U.S. drug companies don't even run quality control checks on the drugs they import from China!
That third fact should send a chill up your spine. What it means is that U.S. drug companies contract with cheap, low-end Chinese chemical factories to manufacture their drugs at something like two cents a pill (which they can mark up to $20 a pill or more...), and then they import these Chinese-made pills and don't even test them before selling them to U.S. consumers!
If it wasn't for the fact that so many Americans have now died from this, the whole thing would be quite hilarious. Why? Because the FDA and Big Pharma are always running around touting how "safe" their products are while screaming about how dangerous herbs and supplements are. And yet nutritional supplement companies test their ingredients for contaminants with far greater frequency than drug companies. ...
Friday, May 2, 2008
Merck - Vioxx Is Accused of Deception ... moving slowly to warn of possible hazards .. dressnig up studies
Maker of Vioxx Is Accused of Deception | By David Brown | Washington Post Staff Writer | Wednesday, April 16, 2008; Page A01
Two teams of researchers with access to thousands of documents gathered for lawsuits over the painkiller Vioxx allege that Merck waged a campaign of deception to promote its drug, moving slowly to warn of possible hazards while at the same time dressing up in-house studies as the work of independent academic researchers.
The reports in today's Journal of the American Medical Association in effect accuse one of the world's biggest pharmaceutical makers of various forms of scientific fraud.
One study alleges that Merck gave the Food and Drug Administration an incomplete accounting of deaths in a clinical trial of Vioxx in people with mild dementia. Federal regulators eventually received the data, which added to growing evidence that Vioxx increased the risk of heart attacks and strokes.
Simultaneously, Merck was using what the JAMA authors call "guest authorship and ghostwriting" to make it appear that research done by its employees or contractors was the work of scientists at medical schools and universities. That presumably gave the findings more credibility when they were published, in medical journals, boosting Vioxx's profile in the crowded painkiller market.
...
Since then, Merck has been named in 26,500 lawsuits by people who say the drug harmed them. Last fall, the company created a $4.85 billion fund to settle the claims while not admitting that Vioxx caused heart attacks, strokes or deaths.
The two JAMA papers -- which were based on access to company documents made public through the lawsuits -- say they provide a look at widespread practices in the pharmaceutical industry. This view was endorsed in an editorial signed by Catherine D. DeAngelis, the journal's editor, who wrote: "But make no mistake -- the manipulation of study results, authors, editors, and reviewers is not the sole purview of one company." ...
Two teams of researchers with access to thousands of documents gathered for lawsuits over the painkiller Vioxx allege that Merck waged a campaign of deception to promote its drug, moving slowly to warn of possible hazards while at the same time dressing up in-house studies as the work of independent academic researchers.
The reports in today's Journal of the American Medical Association in effect accuse one of the world's biggest pharmaceutical makers of various forms of scientific fraud.
One study alleges that Merck gave the Food and Drug Administration an incomplete accounting of deaths in a clinical trial of Vioxx in people with mild dementia. Federal regulators eventually received the data, which added to growing evidence that Vioxx increased the risk of heart attacks and strokes.
Simultaneously, Merck was using what the JAMA authors call "guest authorship and ghostwriting" to make it appear that research done by its employees or contractors was the work of scientists at medical schools and universities. That presumably gave the findings more credibility when they were published, in medical journals, boosting Vioxx's profile in the crowded painkiller market.
...
Since then, Merck has been named in 26,500 lawsuits by people who say the drug harmed them. Last fall, the company created a $4.85 billion fund to settle the claims while not admitting that Vioxx caused heart attacks, strokes or deaths.
The two JAMA papers -- which were based on access to company documents made public through the lawsuits -- say they provide a look at widespread practices in the pharmaceutical industry. This view was endorsed in an editorial signed by Catherine D. DeAngelis, the journal's editor, who wrote: "But make no mistake -- the manipulation of study results, authors, editors, and reviewers is not the sole purview of one company." ...
FDA Raises Estimate of Deaths Linked to Blood Thinner - ingredients from China
FDA Raises Estimate of Deaths Linked to Blood Thinner - washingtonpost.comBy Marc Kaufman | Washington Post | Staff Writer | Wednesday, April 9, 2008; Page A03
The Food and Drug Administration yesterday raised from 19 to 62 its estimate of the number of people who may have died after having allergic reactions to contaminated Chinese-produced batches of the blood thinner heparin.
...
In previous statements, the agency said it did not know whether the cheaper contaminant -- which may have come from pig cartilage -- was deliberately added to the crude heparin or was the result of a production problem.
China is now the world's largest producer of the raw ingredients in heparin. The contaminated batches of the drug have increased concerns among lawmakers and the public about the globalization of drug-manufacturing in lightly regulated nations. ...
The Food and Drug Administration yesterday raised from 19 to 62 its estimate of the number of people who may have died after having allergic reactions to contaminated Chinese-produced batches of the blood thinner heparin.
...
In previous statements, the agency said it did not know whether the cheaper contaminant -- which may have come from pig cartilage -- was deliberately added to the crude heparin or was the result of a production problem.
China is now the world's largest producer of the raw ingredients in heparin. The contaminated batches of the drug have increased concerns among lawmakers and the public about the globalization of drug-manufacturing in lightly regulated nations. ...
creating jobs and managing the nation's finances, Democratic presidents demonstrate success while Republican presidents show failure
David Fiderer: The Simple Arithmetic of Republican Failure - Business on The Huffington PostApril 20, 2008 | David Fiderer
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When it comes to creating jobs and managing the nation's finances, Democratic presidents demonstrate success while Republican presidents show failure.
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When it comes to creating jobs and managing the nation's finances, Democratic presidents demonstrate success while Republican presidents show failure.
Job Creation
Jimmy Carter, 1977-1980: 10.5 million new jobs
Bill Clinton, 1993-1996: 11.6 million new jobs
Bill Clinton, 1997-2000: 12.4 million new jobs
Total: 33.6 million jobs created over 12 years, or 2.8 million jobs per year
Ronald Reagan 1981-1984: 5.2 million new jobs
Ronald Reagan 1985-1988: 10.8 million new jobs
George H.W. Bush 1989-1992: 2.6 million new jobs
George W. Bush 2001-2004: 0.2 million fewer jobs
George W. Bush 2005-2007: 5.5 million new jobs
Total: 24 million jobs created over 19 years, or 1.3 million jobs per year
Government Spending
How much did the government spend for every dollar of revenue?
Jimmy Carter, 1977-1980: $ 1.16
Bill Clinton, 1993-1996: $1.25
Bill Clinton, 1997-2000: $1.01
Democratic Average: $1.16
Ronald Reagan 1981-1984: $1.31
Ronald Reagan 1985-1988: $1.38
George H.W. Bush 1989-1992: $1.34
George W. Bush 2001-2004: $1.27
George W. Bush 2005-2007: $1.24
Republican Average: $1.29
The difference between $1.16 and $1.29 may not seem like a lot, but the impact on the national debt is huge, especially when you consider that $1.29 applies to 19 years, and the budgets under this president are so much larger.
Increases in Government Debt
Growth In Debt Held By the Public [$US trillions]
Jimmy Carter, 1977-1980: 0.2
Bill Clinton, 1993-1996: 0.7
Bill Clinton, 1997-2000: -0.3
Democratic Total: 0.6
Ronald Reagan 1981-1984: 0.6
Ronald Reagan 1985-1988: 0.7
George H.W. Bush 1989-1992: 0.9
George W. Bush 2001-2004: 0.9
George W. Bush 2005-2007: 1.1
Republican Total: 4.3 ...
reventable diseases and lagging public health care ...Life Expectancy Slips in Poor Parts of America
Life Expectancy Slips in Poor Parts of America | April 22, 2008
New Study Shows Drop in Life Expectancy in Deep South, Parts of Midwest, Texas and Appalachia, Particularly for Women
"One out of five American women have had their health either getting worse or at best not getting better," said Dr. Majid Ezzati of the Harvard School of Public Health.
The joint Harvard School of Public Health and the University of Washington study found that 4 percent of the male population and 19 percent of the female population experienced either decline or stagnation in mortality beginning in the 1980s.
Researchers say it comes down to preventable diseases and lagging public health care. The downward trend of life expectancy was most pronounced in just a few parts of the country, including the deep South, the southern portion of the Midwest, parts of Texas and Appalachia.
In these parts of the country, doctors say they're finding alarming increases in cancer, diabetes, heart and lung disease.
...
New Study Shows Drop in Life Expectancy in Deep South, Parts of Midwest, Texas and Appalachia, Particularly for Women
"One out of five American women have had their health either getting worse or at best not getting better," said Dr. Majid Ezzati of the Harvard School of Public Health.
The joint Harvard School of Public Health and the University of Washington study found that 4 percent of the male population and 19 percent of the female population experienced either decline or stagnation in mortality beginning in the 1980s.
Researchers say it comes down to preventable diseases and lagging public health care. The downward trend of life expectancy was most pronounced in just a few parts of the country, including the deep South, the southern portion of the Midwest, parts of Texas and Appalachia.
In these parts of the country, doctors say they're finding alarming increases in cancer, diabetes, heart and lung disease.
...
Thursday, May 1, 2008
Merck Wrote Drug Studies for Doctors ... raised broad questions about the validity of much of the drug industry’s published research
Merck Wrote Drug Studies for Doctors | By STEPHANIE SAUL | Published: April 16, 2008
The drug maker Merck drafted dozens of research studies for a best-selling drug, then lined up prestigious doctors to put their names on the reports before publication, according to an article to be published Wednesday in a leading medical journal.
The article, based on documents unearthed in lawsuits over the pain drug Vioxx, provides a rare, detailed look in the industry practice of ghostwriting medical research studies that are then published in academic journals.
The lead author of Wednesday’s article, Dr. Joseph S. Ross of the Mount Sinai School of Medicine in New York, said a close look at the Merck documents raised broad questions about the validity of much of the drug industry’s published research, because the ghostwriting practice appears to be widespread.
...
The drug maker Merck drafted dozens of research studies for a best-selling drug, then lined up prestigious doctors to put their names on the reports before publication, according to an article to be published Wednesday in a leading medical journal.
The article, based on documents unearthed in lawsuits over the pain drug Vioxx, provides a rare, detailed look in the industry practice of ghostwriting medical research studies that are then published in academic journals.
The lead author of Wednesday’s article, Dr. Joseph S. Ross of the Mount Sinai School of Medicine in New York, said a close look at the Merck documents raised broad questions about the validity of much of the drug industry’s published research, because the ghostwriting practice appears to be widespread.
...
Combing through the documents, Dr. Ross and his colleagues unearthed internal Merck e-mail messages and documents about 96 journal publications, which included review articles and reports of clinical studies. While the Ross team said it was not necessarily raising questions about all 96 articles, it said that in many cases there was scant evidence that the recruited authors made substantive contributions.
One paper involved a study of Vioxx as a possible deterrent to Alzheimer’s progression.
The draft of the paper, dated August 2003, identified the lead writer as “External author?” But when it was published in 2005 in the journal Neuropsychopharmacology, the lead author was listed as Dr. Leon J. Thal, a well-known Alzheimer’s researcher at the University of California, San Diego. Dr. Thal was killed in an airplane crash last year.
The second author listed on the published Alzheimer’s paper, whose name had not been on the draft, was Dr. Ferris, the New York University professor. Dr. Ferris, reached by telephone Tuesday, said he had played an active role in the research and he was substantially involved in helping shape the final draft.
“It’s simply false that we didn’t contribute to the final publication,” Dr. Ferris said. ...
Trade Debt: service amounts to $2000 for each working American per year ... [Econmy smaller] This comes to about $10,000 per worker
Peter Morici: The Corrosive Consequences of the Trade Deficit March 17, 2008 | The Damage Worsens Each Month | By PETER MORICI
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In the 2007, the United States had a $106.9 surplus on trade in services and a $106.9 billion surplus on income payments. This was hardly enough to offset the massive $815.9 billion deficit on trade in goods, and net unilateral transfers to foreigners equal to $104.4 billion.
...
U.S. investments abroad were $ 1,206.3 billion, while foreigners invested $1,863.7 billion in the United States. Of that latter total, only $204 billion or 11 percent was direct investment in U.S. productive assets. The remaining net capital inflows were foreign purchases of Treasury securities, corporate bonds, bank accounts, currency, and other paper assets. Essentially, Americans borrowed or sold off real estate and other assets of about $600 billion to consume about 5.3 percent more than they produced.
Foreign governments loaned Americans $412.7 billion or 3 percent of GDP. The Chinese and other governments are essentially bankrolling U.S. consumers, who in turn are mortgaging their children's income.
The cumulative effects of this borrowing are frightening. The total external debt now is about $6.5 trillion. The debt service at 5 percent interest, amounts to $2000 for each working American.
...
Lost growth is cumulative. Thanks to the record trade deficits accumulated over the last 10 years, the U.S. economy is about $1.5 trillion smaller. This comes to about $10,000 per worker.
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Peter Morici is a professor at the University of Maryland School of Business and former Chief Economist at the U.S. International Trade Commission.
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In the 2007, the United States had a $106.9 surplus on trade in services and a $106.9 billion surplus on income payments. This was hardly enough to offset the massive $815.9 billion deficit on trade in goods, and net unilateral transfers to foreigners equal to $104.4 billion.
...
U.S. investments abroad were $ 1,206.3 billion, while foreigners invested $1,863.7 billion in the United States. Of that latter total, only $204 billion or 11 percent was direct investment in U.S. productive assets. The remaining net capital inflows were foreign purchases of Treasury securities, corporate bonds, bank accounts, currency, and other paper assets. Essentially, Americans borrowed or sold off real estate and other assets of about $600 billion to consume about 5.3 percent more than they produced.
Foreign governments loaned Americans $412.7 billion or 3 percent of GDP. The Chinese and other governments are essentially bankrolling U.S. consumers, who in turn are mortgaging their children's income.
The cumulative effects of this borrowing are frightening. The total external debt now is about $6.5 trillion. The debt service at 5 percent interest, amounts to $2000 for each working American.
...
Lost growth is cumulative. Thanks to the record trade deficits accumulated over the last 10 years, the U.S. economy is about $1.5 trillion smaller. This comes to about $10,000 per worker.
...
Peter Morici is a professor at the University of Maryland School of Business and former Chief Economist at the U.S. International Trade Commission.
In the name of free markets, we made ourselves and our economy vulnerable to the worst impulses of a greedy, remorseless few.
Truthdig - Reports - Slap Down ‘Free Market’ PiratesPosted on Mar 26, 2008 | By Joe Conason
For many years, Robert Morgenthau has warned America that the nexus of capitalism and criminality poses a serious threat to our prosperity, security and growth. Now in the wake of the collapse of Bear Stearns, which pushed global markets closer to the brink, perhaps the nation will listen to the Manhattan district attorney, whose scrutinizing gaze is fixed on targets well beyond New York.
As a legendary prosecutor of international financial crime, Morgenthau has long kept a watchful eye on the buccaneering crew at Bear, the firm that now symbolizes the worst in amoral capital. Its executives were notorious for testing the limits of the law by sheltering shady stock promoters and bucket-shop brokerages, and by swelling the assets of its hedge funds with dubious mortgage-backed assets.
...
But as Morgenthau insists, we cannot sustain an economy of universal bailouts. A son of FDR’s treasury secretary, he understands how the New Deal saved democratic capitalism from mindless greed 75 years ago, and he knows that the undoing of those reforms during the past 25 years has led to our present troubles. More and more of our capital (including public pension funds) has moved into offshore havens, where banking and corporate secrecy laws allow hedge fund operators to avoid regulation and taxes. This escape from transparency will continue as long as it is permitted by law and rewarded by the tax code.
All that will soon have to end, or we will find ourselves again at the edge of disaster.
...
As we mark the end of a long era of conservative excess, we could do much worse than heed Morgenthau’s advice. In the name of free markets, we made ourselves and our economy vulnerable to the worst impulses of a greedy, remorseless few. He saw that on the horizon and tried to tell us. Now, perhaps we will listen.
For many years, Robert Morgenthau has warned America that the nexus of capitalism and criminality poses a serious threat to our prosperity, security and growth. Now in the wake of the collapse of Bear Stearns, which pushed global markets closer to the brink, perhaps the nation will listen to the Manhattan district attorney, whose scrutinizing gaze is fixed on targets well beyond New York.
As a legendary prosecutor of international financial crime, Morgenthau has long kept a watchful eye on the buccaneering crew at Bear, the firm that now symbolizes the worst in amoral capital. Its executives were notorious for testing the limits of the law by sheltering shady stock promoters and bucket-shop brokerages, and by swelling the assets of its hedge funds with dubious mortgage-backed assets.
...
But as Morgenthau insists, we cannot sustain an economy of universal bailouts. A son of FDR’s treasury secretary, he understands how the New Deal saved democratic capitalism from mindless greed 75 years ago, and he knows that the undoing of those reforms during the past 25 years has led to our present troubles. More and more of our capital (including public pension funds) has moved into offshore havens, where banking and corporate secrecy laws allow hedge fund operators to avoid regulation and taxes. This escape from transparency will continue as long as it is permitted by law and rewarded by the tax code.
All that will soon have to end, or we will find ourselves again at the edge of disaster.
...
As we mark the end of a long era of conservative excess, we could do much worse than heed Morgenthau’s advice. In the name of free markets, we made ourselves and our economy vulnerable to the worst impulses of a greedy, remorseless few. He saw that on the horizon and tried to tell us. Now, perhaps we will listen.
ACE Inhibitor as Effective as More Expensive Blood Pressure Drug
ACE Inhibitor as Effective as More Expensive Blood Pressure DrugStudy focused on more than 17,000 people with coronary artery disease or diabetes | By Ed Edelson |
Posted 3/31/08
MONDAY, March 31 (HealthDay News) -- Treatment with an ACE inhibitor drug was as effective in reducing deaths, heart attacks and stroke in a high-risk group of patients as a newer and more expensive angiotensin-receptor blocker (ARB) drug, a large international study has found.
The study of more than 17,000 people with coronary artery disease or diabetes found no major differences between those treated with the widely used ACE inhibitor ramipril (Altace) and those given the ARB telmisartan (Micardis).
"This is the first study in such a population that shows ACE inhibitors are as effective as ARBs," said study leader Dr. Salim Yusuf, a professor of medicine at McMaster University, in Hamilton, Ontario, Canada. ...
Posted 3/31/08
MONDAY, March 31 (HealthDay News) -- Treatment with an ACE inhibitor drug was as effective in reducing deaths, heart attacks and stroke in a high-risk group of patients as a newer and more expensive angiotensin-receptor blocker (ARB) drug, a large international study has found.
The study of more than 17,000 people with coronary artery disease or diabetes found no major differences between those treated with the widely used ACE inhibitor ramipril (Altace) and those given the ARB telmisartan (Micardis).
"This is the first study in such a population that shows ACE inhibitors are as effective as ARBs," said study leader Dr. Salim Yusuf, a professor of medicine at McMaster University, in Hamilton, Ontario, Canada. ...
Sunday, April 27, 2008
Study: Health Insurers Are Near-Monopolies ... 95 percent of the 294 HMO/PPO metropolitan markets studied were above 1,800
Study: Health Insurers Are Near-Monopolies | Tuesday, April 18, 2006 by the Associated Press
Consolidation among health insurers is creating near-monopolies in virtually all reaches of the United States, according to a study released Monday.
Data from the American Medical Association show that in each of 43 states, a handful of top insurers have gained such a stronghold that their markets are considered "highly concentrated" under U.S. Department of Justice guidelines, often far exceeding the thresholds that trigger antitrust concerns.
Consolidation among health insurers is creating near-monopolies in virtually all reaches of the United States, according to a study released Monday.
Data from the American Medical Association show that in each of 43 states, a handful of top insurers have gained such a stronghold that their markets are considered "highly concentrated" under U.S. Department of Justice guidelines, often far exceeding the thresholds that trigger antitrust concerns.
The study also shows that in 166 of 294 metropolitan areas, or 56 percent, a single insurer controls more than half the business in health maintenance organization and preferred provider networks underwriting.
"This problem is widespread across the country, and it needs to be looked at," said Jim Rohack, an AMA trustee and physician in Temple, Texas. "The choices that patients have now are more difficult."
The AMA study cited a Justice Department benchmark in citing antitrust concerns, the Herfindahl-Hirschman Index, or HHI. A score above 1,000 shows "moderate" concentration. Those scoring above 1,800 yield a "high" concentration.
Figures show that 95 percent of the 294 HMO/PPO metropolitan markets studied were above 1,800. Raise that HHI bar even higher to 3,000, and 67 percent rise above it.
The AMA study is the latest piece of evidence — and most comprehensive to date — showing the market power of a few companies, and a large number of regional nonprofit Blue Cross operations, is formidable and growing. And it comes as premiums continue to grow at near double-digit percentage rates.
Critics say that carriers are not only creating monopolies and oligopolies in many regions, they also control the other side of the equation in what is known as monopsony power. That means in addition to having the most enrollees, they're also the biggest purchasers of health care and can dictate prices and coverage terms. ...
Co-Payments for Expensive Drugs Soar - [Is this health insurance or just a drug discount program?]
Co-Payments for Expensive Drugs Soar - New York TimesBy GINA KOLATA | Published: April 14, 2008
Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.
Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.
With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug’s actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.
The system means that the burden of expensive health care can now affect insured people, too.
No one knows how many patients are affected, but hundreds of drugs are priced this new way. They are used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without. ...
...
The system, often called Tier 4, began in earnest with Medicare drug plans and spread rapidly. It is now incorporated into 86 percent of those plans. Some have even higher co-payments for certain drugs, a Tier 5.
Now Tier 4 is also showing up in insurance that people buy on their own or acquire through employers, said Dan Mendelson of Avalere Health, a research organization in Washington. It is the fastest-growing segment in private insurance, Mr. Mendelson said. Five years ago it was virtually nonexistent in private plans, he said. Now 10 percent of them have Tier 4 drug categories.
Thursday, April 17, 2008
California insurers ordered to reinstate policies - San Jose Mercury News
California insurers ordered to reinstate policies - San Jose Mercury NewsBy SHAYA TAYEFE MOHAJER Associated Press Writer | Article Launched: 04/17/2008 06:03:45 PM PDT
LOS ANGELES—Three of the state's largest health insurance companies have been ordered to reinstate the policies of 26 customers who had their coverage dropped.
A state regulatory agency also warned insurers Thursday that an independent review had been ordered on policies canceled in the past four years, meaning thousands more could be ordered reinstated.
Department of Managed Health Care Director Cindy Ehnes says the practice of dropping coverage, known as rescission, is particularly harsh because it's often done when a consumer is vulnerable. ...
LOS ANGELES—Three of the state's largest health insurance companies have been ordered to reinstate the policies of 26 customers who had their coverage dropped.
A state regulatory agency also warned insurers Thursday that an independent review had been ordered on policies canceled in the past four years, meaning thousands more could be ordered reinstated.
Department of Managed Health Care Director Cindy Ehnes says the practice of dropping coverage, known as rescission, is particularly harsh because it's often done when a consumer is vulnerable. ...
Thursday, April 10, 2008
100 studies have been published documenting the harmful effects of racial discrimination on a variety of health measures in African-Americans
The Toxic Power of Racism | Posted March 26, 2008
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However, a growing body of research during the past few years indicates that one of the most glaring inequalities experienced by African-Americans is the disparity in health care that they receive. This week, for example, the New York Times reported that the Department of Veterans Affairs found that black patients "tend to receive less aggressive medical care than whites" at its hospitals and clinics, in part because doctors provide them with less information and see them as "less appropriate candidates" for some types of surgery.
Statistics tell the story. A new government report found the difference in life expectancy between poor black men and affluent white women to be more than 14 years (66.9 vs. 81.1 years)! African-Americans have a higher risk of dying from chronic ailments such as coronary heart disease and high blood pressure than any other ethnic group. Only part of this disparity is explained by differences in income and access to adequate medical care. On average, the most affluent African-Americans suffer more health problems than the least affluent whites.
In the past decade more than 100 studies have been published documenting the harmful effects of racial discrimination on a variety of health measures in African-American men and women. For example, a recent study that followed nearly 60,000 African-American women for six years found that women who reported on-the-job racial discrimination had a 32 percent higher risk of breast cancer than others who did not. Women who said they faced racial discrimination on the job, in housing and from the police were 48 percent more likely to develop breast cancer than those who reported no incidents of major discrimination. Another study of African-American women found that those who reported chronic emotional stress due to their experience of racism had more severely blocked carotid arteries (which supply blood to the brain) than those who did not. In yet another study perceived racism was associated with a significantly increased risk of uterine fibroids in black women, and this was unrelated to differences in health care utilization. ...
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However, a growing body of research during the past few years indicates that one of the most glaring inequalities experienced by African-Americans is the disparity in health care that they receive. This week, for example, the New York Times reported that the Department of Veterans Affairs found that black patients "tend to receive less aggressive medical care than whites" at its hospitals and clinics, in part because doctors provide them with less information and see them as "less appropriate candidates" for some types of surgery.
Statistics tell the story. A new government report found the difference in life expectancy between poor black men and affluent white women to be more than 14 years (66.9 vs. 81.1 years)! African-Americans have a higher risk of dying from chronic ailments such as coronary heart disease and high blood pressure than any other ethnic group. Only part of this disparity is explained by differences in income and access to adequate medical care. On average, the most affluent African-Americans suffer more health problems than the least affluent whites.
In the past decade more than 100 studies have been published documenting the harmful effects of racial discrimination on a variety of health measures in African-American men and women. For example, a recent study that followed nearly 60,000 African-American women for six years found that women who reported on-the-job racial discrimination had a 32 percent higher risk of breast cancer than others who did not. Women who said they faced racial discrimination on the job, in housing and from the police were 48 percent more likely to develop breast cancer than those who reported no incidents of major discrimination. Another study of African-American women found that those who reported chronic emotional stress due to their experience of racism had more severely blocked carotid arteries (which supply blood to the brain) than those who did not. In yet another study perceived racism was associated with a significantly increased risk of uterine fibroids in black women, and this was unrelated to differences in health care utilization. ...
Thursday, April 3, 2008
Medicines approved right on deadline by the Food and Drug Administration are more likely to cause safety problems
FDA Deadlines May Impact Drug Safety | By LAURAN NEERGAARD – 20 hours ago
WASHINGTON (AP) — Vioxx, Bextra, Rezulin, Baycol. Looking at drugs yanked off the market, Harvard researchers found a disturbing pattern: Medicines approved right on deadline by the Food and Drug Administration are more likely to cause safety problems later than those cleared with more time to spare.
Congress set strict deadlines for FDA to speed the arrival of new medications, but critics have long complained that the ticking clock spurred a dangerous rush to judgment.
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"The article is a wake-up call," said Dr. Steven Nissen, the Cleveland Clinic's influential cardiology chief who helped sound the alarm on the risks of some of those ultimately doomed drugs
"It puts the FDA in a very difficult situation when they're trying to make complex decisions under these very, very tight deadlines," he added. "We've got to reevaluate now whether that's good public policy."
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"FDA staffers by their own admission feel very much under the gun as these deadlines loom," added Dr. Jerry Avorn of Brigham and Women's Hospital in Boston, who co-authored the study. "If they're forced to make decisions prematurely, they may not make the right decisions. That needs to be debated openly." ...
WASHINGTON (AP) — Vioxx, Bextra, Rezulin, Baycol. Looking at drugs yanked off the market, Harvard researchers found a disturbing pattern: Medicines approved right on deadline by the Food and Drug Administration are more likely to cause safety problems later than those cleared with more time to spare.
Congress set strict deadlines for FDA to speed the arrival of new medications, but critics have long complained that the ticking clock spurred a dangerous rush to judgment.
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"The article is a wake-up call," said Dr. Steven Nissen, the Cleveland Clinic's influential cardiology chief who helped sound the alarm on the risks of some of those ultimately doomed drugs
"It puts the FDA in a very difficult situation when they're trying to make complex decisions under these very, very tight deadlines," he added. "We've got to reevaluate now whether that's good public policy."
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"FDA staffers by their own admission feel very much under the gun as these deadlines loom," added Dr. Jerry Avorn of Brigham and Women's Hospital in Boston, who co-authored the study. "If they're forced to make decisions prematurely, they may not make the right decisions. That needs to be debated openly." ...
59 percent of US doctors support universal health care ... up from 49% in 2002 ...
US doctors support universal health care - survey | Mon Mar 31, 2008 5:00pm EDT
WASHINGTON, March 31 (Reuters) - More than half of U.S. doctors now favor switching to a national health care plan and fewer than a third oppose the idea, according to a survey published on Monday.
The survey suggests that opinions have changed substantially since the last survey in 2002 and as the country debates serious changes to the health care system.
Of more than 2,000 doctors surveyed, 59 percent said they support legislation to establish a national health insurance program, while 32 percent said they opposed it, researchers reported in the journal Annals of Internal Medicine.
The 2002 survey found that 49 percent of physicians supported national health insurance and 40 percent opposed it. ...
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"Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy," Ackermann said in a statement.
The Indiana survey found that 83 percent of psychiatrists, 69 percent of emergency medicine specialists, 65 percent of pediatricians, 64 percent of internists, 60 percent of family physicians and 55 percent of general surgeons favor a national health insurance plan. ...
WASHINGTON, March 31 (Reuters) - More than half of U.S. doctors now favor switching to a national health care plan and fewer than a third oppose the idea, according to a survey published on Monday.
The survey suggests that opinions have changed substantially since the last survey in 2002 and as the country debates serious changes to the health care system.
Of more than 2,000 doctors surveyed, 59 percent said they support legislation to establish a national health insurance program, while 32 percent said they opposed it, researchers reported in the journal Annals of Internal Medicine.
The 2002 survey found that 49 percent of physicians supported national health insurance and 40 percent opposed it. ...
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"Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy," Ackermann said in a statement.
The Indiana survey found that 83 percent of psychiatrists, 69 percent of emergency medicine specialists, 65 percent of pediatricians, 64 percent of internists, 60 percent of family physicians and 55 percent of general surgeons favor a national health insurance plan. ...
Infants born early are more likely to die during childhood and, if they survive, less likely to have children
Premature birth has lasting effects, study finds | By Thomas H. Maugh II, Los Angeles Times Staff Writer
4:26 PM PDT, March 25, 2008 Infants born early are more likely to die during childhood and, if they survive, less likely to have children of their own, researchers report.
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The study, conducted using Norwegian birth data, suggests that, as the percentage of premature infants who make it through their first year continues to grow because of advances in neonatology, the number of troubled infants and adults will also rise.
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Experts said the situation is probably worse in the United States.
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One in eight American infants is now born prematurely, a total of more than half a million per year, despite the best efforts of physicians to bring more pregnancies to full term -- defined as 38 weeks or longer.
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A total of 5.2% of the births were premature, less than half the percentage in the U.S.
For boys born the most prematurely, between 22 and 27 weeks, their risk of death was 5.3 times normal between the ages of 1 and 6 and seven times normal between 7 and 13. For boys born between 28 and 32 weeks, the risk of death was 2.5 time normal in early childhood and 2.3 times normal in late childhood.
The most premature girls had 9.7 times the normal risk of death between ages 1 and 6, but no increased risk between 7 and 13. Girls born between 28 and 32 weeks did not have a significantly increased risk of death.
The investigators are not sure what accounts for the increased risk, but some of it is due to cancer and congenital abnormalities, Swamy said.
In adulthood, boys born the most prematurely were 76% less likely to reproduce, with only about one in seven having children. Women were 67% less likely to reproduce, with one in four having children.
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4:26 PM PDT, March 25, 2008 Infants born early are more likely to die during childhood and, if they survive, less likely to have children of their own, researchers report.
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The study, conducted using Norwegian birth data, suggests that, as the percentage of premature infants who make it through their first year continues to grow because of advances in neonatology, the number of troubled infants and adults will also rise.
...
Experts said the situation is probably worse in the United States.
...
One in eight American infants is now born prematurely, a total of more than half a million per year, despite the best efforts of physicians to bring more pregnancies to full term -- defined as 38 weeks or longer.
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A total of 5.2% of the births were premature, less than half the percentage in the U.S.
For boys born the most prematurely, between 22 and 27 weeks, their risk of death was 5.3 times normal between the ages of 1 and 6 and seven times normal between 7 and 13. For boys born between 28 and 32 weeks, the risk of death was 2.5 time normal in early childhood and 2.3 times normal in late childhood.
The most premature girls had 9.7 times the normal risk of death between ages 1 and 6, but no increased risk between 7 and 13. Girls born between 28 and 32 weeks did not have a significantly increased risk of death.
The investigators are not sure what accounts for the increased risk, but some of it is due to cancer and congenital abnormalities, Swamy said.
In adulthood, boys born the most prematurely were 76% less likely to reproduce, with only about one in seven having children. Women were 67% less likely to reproduce, with one in four having children.
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Accident -- brain damage -- $1m award --- $417,000 after attorneys ... then Wal-Mart's health plan sued for remainder !
Brain-damaged woman at center of Wal-Mart suit | By Randi Kaye | CNN
JACKSON, Missouri (CNN) -- Debbie Shank breaks down in tears every time she's told that her 18-year-old son, Jeremy, was killed in Iraq.
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Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.
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Two years after the accident, Shank and her husband, Jim, were awarded about $1 million in a lawsuit against the trucking company involved in the crash. After legal fees were paid, $417,000 was placed in a trust to pay for Debbie Shank's long-term care.
Wal-Mart had paid out about $470,000 for Shank's medical expenses, but in 2005, Wal-Mart's health plan sued the Shanks for the same amount.
The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit. ...
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Wal-Mart spokesman John Simley, who called Debbie Shank's case "unbelievably sad," replied in a statement: "Wal-Mart's plan is bound by very specific rules. ... We wish it could be more flexible in Mrs. Shank's case since her circumstances are clearly extraordinary, but this is done out of fairness to all associates who contribute to, and benefit from, the plan." ...
JACKSON, Missouri (CNN) -- Debbie Shank breaks down in tears every time she's told that her 18-year-old son, Jeremy, was killed in Iraq.
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Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.
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Two years after the accident, Shank and her husband, Jim, were awarded about $1 million in a lawsuit against the trucking company involved in the crash. After legal fees were paid, $417,000 was placed in a trust to pay for Debbie Shank's long-term care.
Wal-Mart had paid out about $470,000 for Shank's medical expenses, but in 2005, Wal-Mart's health plan sued the Shanks for the same amount.
The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit. ...
...
Wal-Mart spokesman John Simley, who called Debbie Shank's case "unbelievably sad," replied in a statement: "Wal-Mart's plan is bound by very specific rules. ... We wish it could be more flexible in Mrs. Shank's case since her circumstances are clearly extraordinary, but this is done out of fairness to all associates who contribute to, and benefit from, the plan." ...
"In this invasion we used even more DU bullets. ... "We are living through another Hiroshima," Iraqi doctor says
"We are living through another Hiroshima," Iraqi doctor says | Sherwood Ross | March 24, 2008 - 8:41am
The U.S., Great Britain and Israel are turning portions of the Middle East into a slice of radioactive hell. They are achieving this by firing what they call "depleted uranium" (DU) ammunition but which is, in fact, radioactive ammunition and it is perhaps the deadliest kind of tactical ammo ever devised in the warped mind of man.
There's a ton of data about this on the Internet for the skeptics: from sources such as the 1999 report of the International Atomic Energy Commission to oncologist members of England's Royal Society of Physicians to U.S. Veterans Administration hospital nuclear medicine doctors to officials at the Basra maternity and pediatric hospital to reporter Scott Peterson of the Christian Science Monitor. Peterson used a Geiger counter in August, 2003 to find radiation readings between 1,000 and 1,900 times normal where bunker buster bombs and munitions had exploded near Baghdad. After all, a typical bunker bomb is said to contain more than a ton of depleted uranium.
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And from U.S. veterans: Tom Cassidy, of the 1st Cavalry Division who saw service in Iraq in 2003-05: "After the first gulf war, the level of radiation was 300 times what is considered normal. In this invasion we used even more DU bullets. The effects there are horrible," he told the UCSC paper. Added Dennis Kyne, from the U.S. Army's 18th Airborne division and Desert Storm veteran and who suffers from an "undiagnosed illness": "The scientists call it cell disruption, and they don't know why it's happening to veterans, but it's really radiation sickness, and it's because the DU is all over."
The U.S., Great Britain and Israel are turning portions of the Middle East into a slice of radioactive hell. They are achieving this by firing what they call "depleted uranium" (DU) ammunition but which is, in fact, radioactive ammunition and it is perhaps the deadliest kind of tactical ammo ever devised in the warped mind of man.
There's a ton of data about this on the Internet for the skeptics: from sources such as the 1999 report of the International Atomic Energy Commission to oncologist members of England's Royal Society of Physicians to U.S. Veterans Administration hospital nuclear medicine doctors to officials at the Basra maternity and pediatric hospital to reporter Scott Peterson of the Christian Science Monitor. Peterson used a Geiger counter in August, 2003 to find radiation readings between 1,000 and 1,900 times normal where bunker buster bombs and munitions had exploded near Baghdad. After all, a typical bunker bomb is said to contain more than a ton of depleted uranium.
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And from U.S. veterans: Tom Cassidy, of the 1st Cavalry Division who saw service in Iraq in 2003-05: "After the first gulf war, the level of radiation was 300 times what is considered normal. In this invasion we used even more DU bullets. The effects there are horrible," he told the UCSC paper. Added Dennis Kyne, from the U.S. Army's 18th Airborne division and Desert Storm veteran and who suffers from an "undiagnosed illness": "The scientists call it cell disruption, and they don't know why it's happening to veterans, but it's really radiation sickness, and it's because the DU is all over."
[Depleted Uranium] worms in the Dumfries testing ground had significant traces of poisonous uranium isotopes in their bodies.
Depleted uranium turns earthworms into glowworms | By Jasper Hamill | Mar 25, 2008, 18:38 | Fears that radioactive material has tainted ecosystem.
EARTHWORMS WERE pushed into the firing line last week after a resumption of the testing of depleted uranium shells at Dundrennan.
Significant levels of radioactive uranium isotopes were found in the flesh of worms at the Ministry of Defence's Dumfries weapons range last year. Despite concerns from environmentalists and the international community, the MoD last week started a series of tests of depleted uranium (DU) shells, supposed "safety checks".
A report published in the Journal of Environmental Monitoring found that worms in the Dumfries testing ground had significant traces of poisonous uranium isotopes in their bodies.
Worms are a crucial part of the ecosystem, aerating the soil and aiding the nutrient uptake of plants. If they are contaminated, it suggests the wider environment is tainted. ...
EARTHWORMS WERE pushed into the firing line last week after a resumption of the testing of depleted uranium shells at Dundrennan.
Significant levels of radioactive uranium isotopes were found in the flesh of worms at the Ministry of Defence's Dumfries weapons range last year. Despite concerns from environmentalists and the international community, the MoD last week started a series of tests of depleted uranium (DU) shells, supposed "safety checks".
A report published in the Journal of Environmental Monitoring found that worms in the Dumfries testing ground had significant traces of poisonous uranium isotopes in their bodies.
Worms are a crucial part of the ecosystem, aerating the soil and aiding the nutrient uptake of plants. If they are contaminated, it suggests the wider environment is tainted. ...
Monday, March 24, 2008
"There is a definite concern that in-office imaging could lead to scanning for dollars,"
Health Insurers Limit Advanced Scans | Sunday, March 23, 2008
TRENTON, N.J. - Insurance companies are taking a harder look at advanced medical scans like CT scans, citing spiraling costs and safety concerns. And some doctors agree there's emerging evidence that these scans are being over-prescribed.
"Costs are soaring in this area, quality concerns are mounting and safety concerns are mounting," said Karen Ignagni, chief executive officer of the trade group America's Health Insurance Plan.
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Doctors, too, are concerned about patients getting excessive radiation exposure when they receive scans that aren't needed or are ordered as "defensive medicine" to protect against possible lawsuits. There also is concern that a small number of unscrupulous doctors without adequate expertise are referring patients for tests in their own offices or imaging facilities in which they have a financial interest.
"There is a definite concern that in-office imaging could lead to scanning for dollars," said Dr. Robert Hendel, a heart specialist who sits on American College of Cardiology panels focused on quality and appropriateness of imaging. ...
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The two doctor specialist groups are fighting improper use of scans by supporting accreditation of the machines and doctors using them and by publicizing criteria for quality and appropriateness of various imaging tests.
"There is substantial evidence that these types of techniques, when used appropriately - and I want to emphasize the word 'appropriately' - can keep the lid on expenses and improve outcomes," such as by catching cardiac problems early enough to prevent a heart attack, Hendel said. ...
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The insurer restrictions seem to be working: After one health plan that was seeing 20 percent annual jumps in advanced imaging use began requiring preauthorization, its growth rate plunged. Yet the insurer said only 1.5 percent of requests were being denied, indicating doctors were ordering fewer tests, according to the report. ...
TRENTON, N.J. - Insurance companies are taking a harder look at advanced medical scans like CT scans, citing spiraling costs and safety concerns. And some doctors agree there's emerging evidence that these scans are being over-prescribed.
"Costs are soaring in this area, quality concerns are mounting and safety concerns are mounting," said Karen Ignagni, chief executive officer of the trade group America's Health Insurance Plan.
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Doctors, too, are concerned about patients getting excessive radiation exposure when they receive scans that aren't needed or are ordered as "defensive medicine" to protect against possible lawsuits. There also is concern that a small number of unscrupulous doctors without adequate expertise are referring patients for tests in their own offices or imaging facilities in which they have a financial interest.
"There is a definite concern that in-office imaging could lead to scanning for dollars," said Dr. Robert Hendel, a heart specialist who sits on American College of Cardiology panels focused on quality and appropriateness of imaging. ...
...
The two doctor specialist groups are fighting improper use of scans by supporting accreditation of the machines and doctors using them and by publicizing criteria for quality and appropriateness of various imaging tests.
"There is substantial evidence that these types of techniques, when used appropriately - and I want to emphasize the word 'appropriately' - can keep the lid on expenses and improve outcomes," such as by catching cardiac problems early enough to prevent a heart attack, Hendel said. ...
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The insurer restrictions seem to be working: After one health plan that was seeing 20 percent annual jumps in advanced imaging use began requiring preauthorization, its growth rate plunged. Yet the insurer said only 1.5 percent of requests were being denied, indicating doctors were ordering fewer tests, according to the report. ...
"workers and households pay for health insurance through lower wages and higher prices,"
Rising Health Costs Cut Into Wages | Higher Fees Squeeze Employers, Workers | By Michael A. Fletcher | Washington Post Staff Writer | Monday, March 24, 2008; Page A01
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The main reason: spiraling health-care costs have been whacking away at their wages. Even though workers are producing more, inflation-adjusted median family income has dipped 2.6 percent -- or nearly $1,000 annually since 2000.
Employees and employers are getting squeezed by the price of health care. The struggle to control health costs is viewed as crucial to improving wages and living standards for working Americans. Employers are paying more for health care and other benefits, leaving less money for pay increases. Benefits now devour 30.2 percent of employers' compensation costs, with the remaining money going to wages, the Labor Department reported this month. That is up from 27.4 percent in 2000.
"The way health-care costs have soared is unbelievable," said Katherine Taylor, a vice president for Local 1199 of the Service Employees International Union. "There are people out here making decisions about whether to keep their lights on or buy a prescription."
Since 2001, premiums for family health coverage have increased 78 percent, according to a 2007 report by the Kaiser Family Foundation. Premiums averaged $12,106, of which workers paid $3,281, according to the report.
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Researchers Ezekiel J. Emanuel and Victor R. Fuchs say that employer-sponsored health-care plans create the "myth" that workers are getting their health benefits for little or nothing. But, in fact, "workers and households pay for health insurance through lower wages and higher prices," they wrote in the March 5 issue of the Journal of the American Medical Association. ...
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The main reason: spiraling health-care costs have been whacking away at their wages. Even though workers are producing more, inflation-adjusted median family income has dipped 2.6 percent -- or nearly $1,000 annually since 2000.
Employees and employers are getting squeezed by the price of health care. The struggle to control health costs is viewed as crucial to improving wages and living standards for working Americans. Employers are paying more for health care and other benefits, leaving less money for pay increases. Benefits now devour 30.2 percent of employers' compensation costs, with the remaining money going to wages, the Labor Department reported this month. That is up from 27.4 percent in 2000.
"The way health-care costs have soared is unbelievable," said Katherine Taylor, a vice president for Local 1199 of the Service Employees International Union. "There are people out here making decisions about whether to keep their lights on or buy a prescription."
Since 2001, premiums for family health coverage have increased 78 percent, according to a 2007 report by the Kaiser Family Foundation. Premiums averaged $12,106, of which workers paid $3,281, according to the report.
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Researchers Ezekiel J. Emanuel and Victor R. Fuchs say that employer-sponsored health-care plans create the "myth" that workers are getting their health benefits for little or nothing. But, in fact, "workers and households pay for health insurance through lower wages and higher prices," they wrote in the March 5 issue of the Journal of the American Medical Association. ...
Wednesday, March 19, 2008
Doctors Take Kidney, Leave Cancerous One
Doctors Take Kidney, Leave Cancerous One | Pathologist Notices Healthy Kidney Next Day | POSTED: 12:05 pm CDT March 19, 2008
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Officials at a Minnesota hospital said a tragic error led doctors to remove the healthy kidney from a patient with cancer. ...
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Officials at a Minnesota hospital said a tragic error led doctors to remove the healthy kidney from a patient with cancer. ...
Saturday, March 15, 2008
Uninsured: 36% of Hispanics, 22% of African Americans, 17% of Asians, 13% of whites
Lack of Insurance Hits Us All | By Michelle Singletary | Sunday, March 16, 2008; Page F01
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"I feel bad because I can't afford health care, but I can't afford health insurance, either," said Gomez, whose newborn son, Edward, is covered by Medicaid. "What am I going to do?"
The fact that 47 million people -- 9 million children -- in this country are uninsured has been one of the top issues in the presidential campaign. Equally troubling is this statistic: The lack of health-care coverage is most acute among Hispanics and African Americans, many of whom work in low-wage jobs without benefits or are employed by small businesses that don't offer coverage.
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Thirty-six percent of Hispanics are uninsured, compared with 22 percent of African Americans, 17 percent of Asian/Pacific Islanders and 13 percent of whites, according to the Kaiser Family Foundation's most recent analysis of census data.
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Lavizzo-Mourey said minorities, who disproportionately suffer from chronic illnesses, often avoid getting critical screening or skip treatment because they lack health insurance. She shared the story of Ruth, a diabetic African American in her 50s who came into a clinic with an ulcer on her foot. By the time she sought help, she needed more care than the clinic could offer.
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"I feel bad because I can't afford health care, but I can't afford health insurance, either," said Gomez, whose newborn son, Edward, is covered by Medicaid. "What am I going to do?"
The fact that 47 million people -- 9 million children -- in this country are uninsured has been one of the top issues in the presidential campaign. Equally troubling is this statistic: The lack of health-care coverage is most acute among Hispanics and African Americans, many of whom work in low-wage jobs without benefits or are employed by small businesses that don't offer coverage.
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Thirty-six percent of Hispanics are uninsured, compared with 22 percent of African Americans, 17 percent of Asian/Pacific Islanders and 13 percent of whites, according to the Kaiser Family Foundation's most recent analysis of census data.
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Lavizzo-Mourey said minorities, who disproportionately suffer from chronic illnesses, often avoid getting critical screening or skip treatment because they lack health insurance. She shared the story of Ruth, a diabetic African American in her 50s who came into a clinic with an ulcer on her foot. By the time she sought help, she needed more care than the clinic could offer.
“through a complex series of illegal rackets and lies, Eli Lilly built a multi-billion dollar drug enterprise at the expense of taxpayers
Lilly accused of "sick marketing mindset" in new Zyprexa lawsuit | 12 March 2008
Connecticut has become the latest US state to sue Eli Lilly after claiming that the firm marketed the antipsychotic Zyprexa for unapproved off-label uses,and hid side effects such as weight gain and diabetes.
nnouncing the lawsuit, the state’s Attorney General Richard Blumenthal issued a scathing statement saying that Lilly “allegedly corrupted physicians, pharmacies and administrators at nursing homes and youth detention centres as part of a massive illegal marketing campaign” to promote Zyprexa (olanzapine), notably among children, for anxiety, depression and attention-deficit hyperactivity disorder. He adds that the firm also “dangerously concealed risks associated with Zyprexa”, which was only approved for schizophrenia, including diabetes, cardiovascular problems and significant weight gain.
Mr Blumenthal goes on to claim that “through a complex series of illegal rackets and lies, Eli Lilly built a multi-billion dollar drug enterprise at the expense of taxpayers, consumers and patient lives”. He then says that he is seeking to “recover millions of taxpayer and consumer dollars”, around $190 million, that was “improperly spent” on Zyprexa. ...
Connecticut has become the latest US state to sue Eli Lilly after claiming that the firm marketed the antipsychotic Zyprexa for unapproved off-label uses,and hid side effects such as weight gain and diabetes.
nnouncing the lawsuit, the state’s Attorney General Richard Blumenthal issued a scathing statement saying that Lilly “allegedly corrupted physicians, pharmacies and administrators at nursing homes and youth detention centres as part of a massive illegal marketing campaign” to promote Zyprexa (olanzapine), notably among children, for anxiety, depression and attention-deficit hyperactivity disorder. He adds that the firm also “dangerously concealed risks associated with Zyprexa”, which was only approved for schizophrenia, including diabetes, cardiovascular problems and significant weight gain.
Mr Blumenthal goes on to claim that “through a complex series of illegal rackets and lies, Eli Lilly built a multi-billion dollar drug enterprise at the expense of taxpayers, consumers and patient lives”. He then says that he is seeking to “recover millions of taxpayer and consumer dollars”, around $190 million, that was “improperly spent” on Zyprexa. ...
influx of reports describing allergic reactions, including four fatalities, which may be linked to contaminated product.
Heparin Stopped at the Border | By MedHeadlines • Mar 15th, 2008 • Category: Drugs, FDA, Poisoning, Prevention, Recalls
On Friday, the US Food and Drug Administration (FDA) announced that it is taking action against shipments of heparin coming into the country from China after an influx of reports describing allergic reactions, including four fatalities, which may be linked to contaminated product. All shipments reaching the US border will now be tested for contamination before further distribution.
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FDA officials announced last week that they discovered a significant amount of a suspicious substance, thought to be a contaminant, in samples of some recalled heparin and in the active ingredient used to manufacture it. The substance is said to be “heparin-like” but it has yet to be identified exactly. Baxter issued a recall of most of its heparin products last month after receiving reports of adverse allergic reactions.
A heparin manufacturer in Germany issued reports of contaminated heparin last week and ordered a recall of all its products. Rotexmedica GmbH also purchases heparin ingredients from China ...
On Friday, the US Food and Drug Administration (FDA) announced that it is taking action against shipments of heparin coming into the country from China after an influx of reports describing allergic reactions, including four fatalities, which may be linked to contaminated product. All shipments reaching the US border will now be tested for contamination before further distribution.
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FDA officials announced last week that they discovered a significant amount of a suspicious substance, thought to be a contaminant, in samples of some recalled heparin and in the active ingredient used to manufacture it. The substance is said to be “heparin-like” but it has yet to be identified exactly. Baxter issued a recall of most of its heparin products last month after receiving reports of adverse allergic reactions.
A heparin manufacturer in Germany issued reports of contaminated heparin last week and ordered a recall of all its products. Rotexmedica GmbH also purchases heparin ingredients from China ...
the U.S. healthcare system is killing people. It is especially killing non-white women and children
March 13th, 2008 | Discriminatory Health Care In The U.S.
Meanwhile here in the U.S… RH Reality Check has some appalling statistics about the inequities of health care in this country:
* African-American women are nearly four times more likely to die in childbirth than white women, 23 times more likely to be infected with HIV/AIDS and 14 times more likely to die from the disease.
* American-Indian/Alaskan Native women are over 5 times more likely than white women to have chlamydia and over 7 times more likely to contract syphilis.
* The unplanned pregnancy rate among Latinas is twice the national average; and Latinas are much more likely to contract human papillomavirus, the infection that leads to cervical cancer.
and:
* More young African-American females and Latinas than white women are given abstinence-only instruction in school, instead of comprehensive sex education. This means they aren’t taught about contraceptive use to prevent pregnancy or protect against HIV and other sexually transmitted infections (STIs). Abstinence-only programs have proven ineffective, and in some cases counter-productive, but every year the government has increased their funding dramatically, now totaling $176 million annually.
* Although the U.S. has the resources to reduce maternal deaths and has acknowledged the importance of prenatal care to prevent them, it has adopted policies which force women to delay pregnancy-related care or forego it altogether. Unreasonable requirements for Medicaid like the 5-year bar on benefits for legal residents prevent many immigrant women from receiving even basic services.
Just to be clear–the U.S. healthcare system is killing people. It is especially killing non-white women and children. ...
Meanwhile here in the U.S… RH Reality Check has some appalling statistics about the inequities of health care in this country:
* African-American women are nearly four times more likely to die in childbirth than white women, 23 times more likely to be infected with HIV/AIDS and 14 times more likely to die from the disease.
* American-Indian/Alaskan Native women are over 5 times more likely than white women to have chlamydia and over 7 times more likely to contract syphilis.
* The unplanned pregnancy rate among Latinas is twice the national average; and Latinas are much more likely to contract human papillomavirus, the infection that leads to cervical cancer.
and:
* More young African-American females and Latinas than white women are given abstinence-only instruction in school, instead of comprehensive sex education. This means they aren’t taught about contraceptive use to prevent pregnancy or protect against HIV and other sexually transmitted infections (STIs). Abstinence-only programs have proven ineffective, and in some cases counter-productive, but every year the government has increased their funding dramatically, now totaling $176 million annually.
* Although the U.S. has the resources to reduce maternal deaths and has acknowledged the importance of prenatal care to prevent them, it has adopted policies which force women to delay pregnancy-related care or forego it altogether. Unreasonable requirements for Medicaid like the 5-year bar on benefits for legal residents prevent many immigrant women from receiving even basic services.
Just to be clear–the U.S. healthcare system is killing people. It is especially killing non-white women and children. ...
Friday, March 14, 2008
millions of veterans and their dependents have no access to care in veterans' hospitals and clinics and no health insurance
Veterans Without Health Care | The New York Times | Editorial | Friday 09 November 2007
Although many Americans believe that the nation's veterans have ready access to health care, that is far from the case. A new study by researchers at the Harvard Medical School has found that millions of veterans and their dependents have no access to care in veterans' hospitals and clinics and no health insurance to pay for care elsewhere. Their plight represents yet another failure of our disjointed health care system to provide coverage for all Americans.
The new study, published in the American Journal of Public Health, estimated that in 2004 nearly 1.8 million veterans were uninsured and unable to get care in veterans' facilities. An additional 3.8 million members of their households faced the same predicament. All told, this group made up roughly 12 percent of the huge population of uninsured Americans. ...
Although many Americans believe that the nation's veterans have ready access to health care, that is far from the case. A new study by researchers at the Harvard Medical School has found that millions of veterans and their dependents have no access to care in veterans' hospitals and clinics and no health insurance to pay for care elsewhere. Their plight represents yet another failure of our disjointed health care system to provide coverage for all Americans.
The new study, published in the American Journal of Public Health, estimated that in 2004 nearly 1.8 million veterans were uninsured and unable to get care in veterans' facilities. An additional 3.8 million members of their households faced the same predicament. All told, this group made up roughly 12 percent of the huge population of uninsured Americans. ...
Sugar Substitutes May Contribute to Weight Gain
Sugar Substitutes May Contribute to Weight Gain | By Randy Dotinga | HealthDay Reporter | Monday, February 11, 2008; 12:00 AM
MONDAY, Feb. 11 (HealthDay News) -- Surprising research suggests a popular artificial sweetener has the unexpected and unwelcome effect of packing on the pounds.
...
To test this theory, the researchers fed two different types of plain Dannon yogurt to male rats. Some received yogurt sweetened with glucose, a form of sugar, while others ate saccharin-sweetened yogurt. All also ate unsweetened yogurt.
The rats who ate artificially sweetened yogurt consumed more food overall and gained more weight. The body temperatures of those rats also didn't rise as high as the others. "That might be a kind of measure of energy expenditure, suggesting not only are the animals eating more calories, they may be expending or burning up fewer calories," Swithers said. ...
MONDAY, Feb. 11 (HealthDay News) -- Surprising research suggests a popular artificial sweetener has the unexpected and unwelcome effect of packing on the pounds.
...
To test this theory, the researchers fed two different types of plain Dannon yogurt to male rats. Some received yogurt sweetened with glucose, a form of sugar, while others ate saccharin-sweetened yogurt. All also ate unsweetened yogurt.
The rats who ate artificially sweetened yogurt consumed more food overall and gained more weight. The body temperatures of those rats also didn't rise as high as the others. "That might be a kind of measure of energy expenditure, suggesting not only are the animals eating more calories, they may be expending or burning up fewer calories," Swithers said. ...
Supreme Court on Wednesday made it harder for consumers to sue manufacturers of federally approved medical devices
Wed, Feb. 20, 2008 | Court limits suits over medical devices | By PETE YOST | Associated Press Writer
WASHINGTON -- The Supreme Court on Wednesday made it harder for consumers to sue manufacturers of federally approved medical devices.
In an 8-1 decision, the court ruled against the estate of a patient who suffered serious injuries when a catheter burst during a medical procedure.
The case has significant implications for the $75 billion-a-year health care technology industry, whose products range from heart valves to toothbrushes.
In a recent three-month span, federal regulators responded to over 100 safety problems regarding medical devices.
At issue before the Supreme Court was whether the estate of Charles Riegel could sue a company under state law over a device previously cleared for sale by federal regulators.
Under federal law, a company must substantiate the safety and effectiveness of a medical device before the U.S. Food and Drug Administration will approve it for the marketplace.
State lawsuits are barred to the extent they would impose requirements that are different from federal requirements, said the ruling by Justice Antonin Scalia.
In dissent, Justice Ruth Bader Ginsburg said that Congress never intended "a radical curtailment of state common-law lawsuits seeking compensation for injuries caused by defectively designed or labeled medical devices."
But Scalia, in response, said, "It is not our job to speculate upon congressional motives." ...
WASHINGTON -- The Supreme Court on Wednesday made it harder for consumers to sue manufacturers of federally approved medical devices.
In an 8-1 decision, the court ruled against the estate of a patient who suffered serious injuries when a catheter burst during a medical procedure.
The case has significant implications for the $75 billion-a-year health care technology industry, whose products range from heart valves to toothbrushes.
In a recent three-month span, federal regulators responded to over 100 safety problems regarding medical devices.
At issue before the Supreme Court was whether the estate of Charles Riegel could sue a company under state law over a device previously cleared for sale by federal regulators.
Under federal law, a company must substantiate the safety and effectiveness of a medical device before the U.S. Food and Drug Administration will approve it for the marketplace.
State lawsuits are barred to the extent they would impose requirements that are different from federal requirements, said the ruling by Justice Antonin Scalia.
In dissent, Justice Ruth Bader Ginsburg said that Congress never intended "a radical curtailment of state common-law lawsuits seeking compensation for injuries caused by defectively designed or labeled medical devices."
But Scalia, in response, said, "It is not our job to speculate upon congressional motives." ...
lives of 22,000 patients could have been saved if U.S. regulators had been quicker to remove a Bayer AG drug
22,000 died amid delayed Bayer drug recall: doctor | Reuters | Saturday February 16, 2008
The lives of 22,000 patients could have been saved if U.S. regulators had been quicker to remove a Bayer AG drug used to stem bleeding during open heart surgery, according to a medical researcher interviewed by CBS Television's 60 Minutes program. ...
The lives of 22,000 patients could have been saved if U.S. regulators had been quicker to remove a Bayer AG drug used to stem bleeding during open heart surgery, according to a medical researcher interviewed by CBS Television's 60 Minutes program. ...
NY AG Charges the Companies Used 'Rigged Data to Manipulate' Reimbursement Rates to Customers
N.Y. AG Prescribes Subpoenas to UnitedHealth Group, Others | Charges the Companies Used 'Rigged Data to Manipulate' Reimbursement Rates to Customers
The nation's largest health care insurer, four of its subsidiaries and a number of other large insurers are being served subpoenas -- 16 in all -- in a suit to be brought by New York Attorney General Andrew Cuomo that charges the companies used "rigged data to manipulate the reimbursement rate to their customers who filed claims."
At the center of the scheme, according to the attorney general, is Ingenix, Inc., "the nation's largest provider of health care billing information, which serves as a conduit for rigged data to the largest insurers in the country."
Cuomo notified Ingenix and its parent company, UnitedHealth Group, of his intent to file suit and subpoenaed 16 other companies, including Aetna, CIGNA, and Empire BlueCross BlueShield. The central allegation is that companies manipulated reimbursement rates. In addition to Ingenix, the suit is also encompassing three other UnitedHealth Group subsidiaries. ...
...
"Further, the investigation found that two subsidiaries of United (the "United insurers") dramatically under-reimbursed their members for out-of-network medical expenses by using data provided by Ingenix," Cuomo's office said.
"The Attorney General's investigation found that by distorting the 'reasonable and customary' rate, the United insurers were able to keep their reimbursements artificially low and force patients to absorb a higher share of the costs."
"When insurers like United create convoluted and dishonest systems for determining the rate of reimbursement, real people get stuck with excessive bills and are less likely to seek the care they need," ...
The nation's largest health care insurer, four of its subsidiaries and a number of other large insurers are being served subpoenas -- 16 in all -- in a suit to be brought by New York Attorney General Andrew Cuomo that charges the companies used "rigged data to manipulate the reimbursement rate to their customers who filed claims."
At the center of the scheme, according to the attorney general, is Ingenix, Inc., "the nation's largest provider of health care billing information, which serves as a conduit for rigged data to the largest insurers in the country."
Cuomo notified Ingenix and its parent company, UnitedHealth Group, of his intent to file suit and subpoenaed 16 other companies, including Aetna, CIGNA, and Empire BlueCross BlueShield. The central allegation is that companies manipulated reimbursement rates. In addition to Ingenix, the suit is also encompassing three other UnitedHealth Group subsidiaries. ...
...
"Further, the investigation found that two subsidiaries of United (the "United insurers") dramatically under-reimbursed their members for out-of-network medical expenses by using data provided by Ingenix," Cuomo's office said.
"The Attorney General's investigation found that by distorting the 'reasonable and customary' rate, the United insurers were able to keep their reimbursements artificially low and force patients to absorb a higher share of the costs."
"When insurers like United create convoluted and dishonest systems for determining the rate of reimbursement, real people get stuck with excessive bills and are less likely to seek the care they need," ...
Ccost for treatments of back and neck problems ... increase 65% ... not observe improvements in health outcomes commensurate with the increasing costs
Back and neck problems more costly now than ever | By Sue Mueller | Feb 13, 2008 - 12:01:04 PM
WEDNESDAY FEB 13, 2008 (foodconsumer.org) -- The medical cost for diagnosing and treating back and neck problems has jumped faster than the general medical expenditures during the past decade, but the increase apparently has not resulted in an health status that matches the magnitude of the increased cost, according to a study in The Journal of the American Medical Association.
The cost for treatments of back and neck problems in the United States reached $86 billion in 2005, a 65 percent increase from 1997 after adjusting the inflation, the New York Times reported. In the meantime, the proportion of people with impaired function due to back and neck problems increased drastically during the same period even after the aging factor was considered.
...
Among others, the cost for drugs has increased much faster than others. In 2005, US adults spent an estimated $20 billions on drugs for treating back and neck problems, an increase of 171 percent from 1997, according to the New York Times. The cost for some narcotic pain relievers such as OxyContin and others increased more than 400%. ...
Albeit the sharp increase in medical expenditures for treating back and neck problems, the rate of people with spine problems who reported to have physical function limitations due to the conditions increased to 24.7 percent in 2005 from 20.7 percent in 1997.
"These data suggest that spine problems are expensive, due both to large numbers of affected persons and to high costs per person. We did not observe improvements in health outcomes commensurate with the increasing costs over time. Spine problems may offer opportunities to reduce expenditures without associated worsening of clinical outcomes," the researchers conclude.
WEDNESDAY FEB 13, 2008 (foodconsumer.org) -- The medical cost for diagnosing and treating back and neck problems has jumped faster than the general medical expenditures during the past decade, but the increase apparently has not resulted in an health status that matches the magnitude of the increased cost, according to a study in The Journal of the American Medical Association.
The cost for treatments of back and neck problems in the United States reached $86 billion in 2005, a 65 percent increase from 1997 after adjusting the inflation, the New York Times reported. In the meantime, the proportion of people with impaired function due to back and neck problems increased drastically during the same period even after the aging factor was considered.
...
Among others, the cost for drugs has increased much faster than others. In 2005, US adults spent an estimated $20 billions on drugs for treating back and neck problems, an increase of 171 percent from 1997, according to the New York Times. The cost for some narcotic pain relievers such as OxyContin and others increased more than 400%. ...
Albeit the sharp increase in medical expenditures for treating back and neck problems, the rate of people with spine problems who reported to have physical function limitations due to the conditions increased to 24.7 percent in 2005 from 20.7 percent in 1997.
"These data suggest that spine problems are expensive, due both to large numbers of affected persons and to high costs per person. We did not observe improvements in health outcomes commensurate with the increasing costs over time. Spine problems may offer opportunities to reduce expenditures without associated worsening of clinical outcomes," the researchers conclude.
private audit companies will begin scouring mountains of medical records ... to find over and under payments
Mar 1, 8:07 AM EST | Audits Sting Hospitals, Physicians | By KEVIN FREKING | Associated Press Writer
WASHINGTON (AP) -- In coming weeks, private audit companies will begin scouring mountains of medical records. Their mission: Determine if health care providers erred when billing Medicare and require them to return any overpayments to the federal government. The auditors will keep a tidy percentage for their services.
The contractors have shown they're pretty good at their work. In just three years, they've returned more than $300 million to the federal government - and that's just from three states. That experiment is winding down. But a larger, national program will soon take its place. ....
WASHINGTON (AP) -- In coming weeks, private audit companies will begin scouring mountains of medical records. Their mission: Determine if health care providers erred when billing Medicare and require them to return any overpayments to the federal government. The auditors will keep a tidy percentage for their services.
The contractors have shown they're pretty good at their work. In just three years, they've returned more than $300 million to the federal government - and that's just from three states. That experiment is winding down. But a larger, national program will soon take its place. ....
VA: veterans only get "medical care secretary determines is needed, and only to the extent funds ... are available."
Veterans not entitled to mental health care, U.S. lawyers argue Published on Wednesday, February 06, 2008. | Source: San Francisco Chronicle
Veterans have no legal right to specific types of medical care, the Bush administration argues in a lawsuit accusing the government of illegally denying mental health treatment to some troops returning from Iraq and Afghanistan.
The arguments, filed Wednesday in federal court in San Francisco, strike at the heart of a lawsuit filed on behalf of veterans that claims the health care system for returning troops provides little recourse when the government rejects their medical claims.
The Department of Veterans Affairs is making progress in increasing its staffing and screening veterans for combat-related stress, Justice Department lawyers said. But their central argument is that Congress left decisions about who should get health care, and what type of care, to the VA and not to veterans or the courts.
A federal law providing five years of care for veterans from the date of their discharge establishes "veterans' eligibility for health care, but it does not create an entitlement to any particular medical service," government lawyers said.
They said the law entitles veterans only to "medical care which the secretary (of Veterans Affairs) determines is needed, and only to the extent funds ... are available." ...
Veterans have no legal right to specific types of medical care, the Bush administration argues in a lawsuit accusing the government of illegally denying mental health treatment to some troops returning from Iraq and Afghanistan.
The arguments, filed Wednesday in federal court in San Francisco, strike at the heart of a lawsuit filed on behalf of veterans that claims the health care system for returning troops provides little recourse when the government rejects their medical claims.
The Department of Veterans Affairs is making progress in increasing its staffing and screening veterans for combat-related stress, Justice Department lawyers said. But their central argument is that Congress left decisions about who should get health care, and what type of care, to the VA and not to veterans or the courts.
A federal law providing five years of care for veterans from the date of their discharge establishes "veterans' eligibility for health care, but it does not create an entitlement to any particular medical service," government lawyers said.
They said the law entitles veterans only to "medical care which the secretary (of Veterans Affairs) determines is needed, and only to the extent funds ... are available." ...
[Aging] citizenry plays only a minor role in the projected jump in costs ...
March 13, 2008 | Will Boomers Bankrupt Our Health Care System? Myths and Facts
...
This brings me to Princeton economist Uwe Reinhardt’s speech on the very first day of the conference. The only American to speak at WHCCE, Reinhardt focused on what he called “the folklore that people bring to the health care policy table." By nature an iconoclast, Reinhardt spent the next 20 minutes shattering some of the myths that have become part of the received wisdom among policy-makers.
Begin with the notion that an aging population is a major factor driving health care inflation. In the U.S. this is accepted as a justification for why the nation’s health care bill now equals more than $2 trillion dollars—and why we must expect it to climb ever higher.
...
Here, we see that the U.S. spends close to $7,000 per person on care—even though its population is younger than the citizens of most developed countries, including Germany, Italy and Japan. ... Meanwhile, Japan’s population has been graying for some time, yet it spends only $1,000 per person. Could eating fish really make that much difference?
...
It turns out that when you look at estimates of growth in health care spending from 1990 to 2030, a senescent citizenry plays only a minor role in the projected jump from $585 billion (what we laid out for health care in 1990) to $14,026 billion (what analysts say we’ll ante up in 2030, assuming we continue in our profligate ways).
What will be the biggest factor pushing the tab so much higher? Innovation. “The health care industry will continue developing new stuff for every age group,” Reinhardt explains. Will that “new stuff”—in the form of new drugs, devices, tests and procedures—be worth it? Some of it will be. Some won’t. Indeed as this article from Health Affairs reveals, over the past twelve years, rising spending on new medical technologies designed to address heart disease has not meant that more patients survived. In many areas, we seem to have reached a point of diminishing returns. This also is true in the drug industry, where most new entries are “me too drugs”—little different from products already on the market.
As I have often discussed on this blog, it is usually suppliers, not “patient demand,” that drives health care inflation. The big ticket items are not the ones patients ask for; they’re the ones companies advertise—or that doctors and hospitals tell us we need. Few chronically ill patients ask to be hospitalized; not many cry out for dialysis, or the chance to spend thousands on cancer drugs; it’s the rare person who asks if he can die in an ICU.
“In truth, the aging of the population is not a big problem,” ...
...
Finally, Sweden offers proof that an aging population doesn’t have to spell financial disaster. The second day of the conference I interviewed Mona Heurgren, an economist at Sweden’s National Board of Health and Welfare, and she pointed out that “while we have the oldest population in the EU, our health care costs haven’t been rising. Over the last 15 years or so, the share of our citizens who are older has been growing, yet health care spending has stayed level at about 9 percent of GDP.”
How has Sweden managed the buck the trend? For one, 95 percent of the country’s hospitals and doctors use electronic medical records which guarantee many fewer errors, and much greater efficiency. (As of three years ago, only 15 to 20 percent of U.S doctors’ offices and 20 to 25 percent of U.S. hospitals had implemented electronic medical records, and adoption continues to move slowly as we try to decide who should pay for health care IT).
Moreover, in Sweden, preventive care is free. So no one is tempted to skip a needed Pap Smear. Diabetics go for their eye check-ups. In the U.S., by contrast, many 50-something patients put off care that they can’t afford, waiting until they reach the magic age of 65, and qualify for Medicare. At that point, the catch-up care they need can be very expensive and in some cases, their health has been permanently damaged. ...
...
This brings me to Princeton economist Uwe Reinhardt’s speech on the very first day of the conference. The only American to speak at WHCCE, Reinhardt focused on what he called “the folklore that people bring to the health care policy table." By nature an iconoclast, Reinhardt spent the next 20 minutes shattering some of the myths that have become part of the received wisdom among policy-makers.
Begin with the notion that an aging population is a major factor driving health care inflation. In the U.S. this is accepted as a justification for why the nation’s health care bill now equals more than $2 trillion dollars—and why we must expect it to climb ever higher.
...
Here, we see that the U.S. spends close to $7,000 per person on care—even though its population is younger than the citizens of most developed countries, including Germany, Italy and Japan. ... Meanwhile, Japan’s population has been graying for some time, yet it spends only $1,000 per person. Could eating fish really make that much difference?
...
It turns out that when you look at estimates of growth in health care spending from 1990 to 2030, a senescent citizenry plays only a minor role in the projected jump from $585 billion (what we laid out for health care in 1990) to $14,026 billion (what analysts say we’ll ante up in 2030, assuming we continue in our profligate ways).
What will be the biggest factor pushing the tab so much higher? Innovation. “The health care industry will continue developing new stuff for every age group,” Reinhardt explains. Will that “new stuff”—in the form of new drugs, devices, tests and procedures—be worth it? Some of it will be. Some won’t. Indeed as this article from Health Affairs reveals, over the past twelve years, rising spending on new medical technologies designed to address heart disease has not meant that more patients survived. In many areas, we seem to have reached a point of diminishing returns. This also is true in the drug industry, where most new entries are “me too drugs”—little different from products already on the market.
As I have often discussed on this blog, it is usually suppliers, not “patient demand,” that drives health care inflation. The big ticket items are not the ones patients ask for; they’re the ones companies advertise—or that doctors and hospitals tell us we need. Few chronically ill patients ask to be hospitalized; not many cry out for dialysis, or the chance to spend thousands on cancer drugs; it’s the rare person who asks if he can die in an ICU.
“In truth, the aging of the population is not a big problem,” ...
...
Finally, Sweden offers proof that an aging population doesn’t have to spell financial disaster. The second day of the conference I interviewed Mona Heurgren, an economist at Sweden’s National Board of Health and Welfare, and she pointed out that “while we have the oldest population in the EU, our health care costs haven’t been rising. Over the last 15 years or so, the share of our citizens who are older has been growing, yet health care spending has stayed level at about 9 percent of GDP.”
How has Sweden managed the buck the trend? For one, 95 percent of the country’s hospitals and doctors use electronic medical records which guarantee many fewer errors, and much greater efficiency. (As of three years ago, only 15 to 20 percent of U.S doctors’ offices and 20 to 25 percent of U.S. hospitals had implemented electronic medical records, and adoption continues to move slowly as we try to decide who should pay for health care IT).
Moreover, in Sweden, preventive care is free. So no one is tempted to skip a needed Pap Smear. Diabetics go for their eye check-ups. In the U.S., by contrast, many 50-something patients put off care that they can’t afford, waiting until they reach the magic age of 65, and qualify for Medicare. At that point, the catch-up care they need can be very expensive and in some cases, their health has been permanently damaged. ...
A system that perpetuates poor access to care for the have-nots will only drive that [uninsured patient] bill higher
February 12, 2008 | Will Consumer-Driven Medicine Really Cut Health Care Costs?
...
One of the most common justifications for consumer-driven medicine is reduced health care costs. The reasoning here is two-fold:
- Since they’re high-deductible and low premium, consumer-driven health plans require more out-of-pocket spending. Consumers are more cost-conscious when they have to actively shell out for purchases. As a result, they will user fewer health care services—and thus overall health care costs will fall.
- If consumers are in the driver’s seat, competition in an open market will drive prices down. For-profit providers will want to offer the best deal to get the most business. Consumers will also have better information thanks to the commoditization of medicine, which will translate medical jargon into universally comprehensible knowledge. Smarter consumers translate into less over-payment for services.
This is standard-issue free market orthodoxy at its finest. Unfortunately, this isn’t the whole story. In fact, there’s an even stronger argument to be made that consumer-driven health plans could lead to higher health care costs.
The Wrong Patients Forgo the Wrong Care
Research by the RAND Corporation’s health insurance experiment shows that when you shift costs to the consumer, patients forego both wasteful and effective care. And this is particularly true of the patients who cost us most in the long run—those suffering from chronic diseases.
A 2007 paper from the National Bureau of Economic Research looked at retired California public employees on Medicare, and its findings contradict some of the basic assumption of the consumerist movement.
The study’s authors--from Harvard, MIT, and the University of Oregon-- found that chronically patients who are asked to shoulder more of their health care costs deferred, neglected, or opted-out of doctor’s visits and drugs when the price got too high. This short-term cost reduction led to long-term catastrophe, as their hospitalization rates were significantly higher than other patients suffering from chronic diseases. Immediate savings ultimately led to a greater—and otherwise preventable—use of more expensive care. Oops.
...
Consumer-Driven Medicine Turns Healthcare into a Commodity
In a market-driven health care system, businesses try to maximize revenue and minimize cost. The quickest way to do that is to market what’s already out there, rather than waste time on true innovation.
Retail health clinics, for example, want to “cross-sell” by encouraging patients to pick up other products that the store sells on their way in or out of the clinic. Why? Because it’s a low-cost way to increase profits: shuttle patients from the clinic to the prescription counter, no muss no fuss.
A similar reasoning prevails in the prescription drug industry. A January study from York University found that the U.S. pharmaceutical industry spends almost twice as much on promotion as it does on research and development. Again, it’s easier to troll for new customers than to build a better product. ......
More Inequality
...
Consider health savings accounts, which favor high-income earners because they are tax-free (richer people save more by not paying taxes). More money in the savings account means more purchasing power. More purchasing power means more health care options—not to mention more providers falling at your feet to get your dollars.
... In a market-driven system, health care prospects improve as you move up the income ladder. But if those at the bottom don’t see a real boost, we have a problem—socioeconomic status is a major predictor of health. Ultimately it’s the poor who need access to health care that lies beyond their means.
... the disadvantaged suffer more when they consume less care than do the affluent. And when patients have asked to have “more skin in the game,” it is the poor who are most likely to forgo needed care. In 2003, the Center for Budget and Policy Priorities cited research from the RAND corporation that found “low-income adults and children reduced their use of effective medical care services by as much as 44 percent when they were forced to make co-payments, a much deeper reduction than occurred among those with higher incomes.”
... Currently, the price tag of health care for the uninsured is over $40 billion. A system that perpetuates poor access to care for the have-nots will only drive that bill higher.
GSK drug trials: "effectively manage the dissemination of these data in order to minimise any potential negative impact".
Drugs firms face new laws on test results | # Martin Hodgson and Nicholas Watt
# The Guardian, | # Thursday March 6 2008
...
The health minister Dawn Primarolo will tell MPs that new legislation will be introduced by the end of the year to ensure drugs companies pass on results of clinical trials as soon as the alarm is raised about one of their medicines.
The government is to intervene after a four-year investigation by the drug regulatory body into the way GSK withheld the full results of their trials of the antidepressant Seroxat on children.
The trial data, which was finally handed to the Medicines and Healthcare Regulatory Authority (MHRA) in May 2003, identified two problems of which the company had been aware as early as 1998:
· A higher risk of suicidal behaviour among under 18s using Seroxat rather than a placebo.
· Seroxat was ineffective in dealing with depressive illness among under 18s. ...
...
A leaked internal document from GSK, dated to 1998, said the company would have to "effectively manage the dissemination of these data in order to minimise any potential negative impact".
# The Guardian, | # Thursday March 6 2008
...
The health minister Dawn Primarolo will tell MPs that new legislation will be introduced by the end of the year to ensure drugs companies pass on results of clinical trials as soon as the alarm is raised about one of their medicines.
The government is to intervene after a four-year investigation by the drug regulatory body into the way GSK withheld the full results of their trials of the antidepressant Seroxat on children.
The trial data, which was finally handed to the Medicines and Healthcare Regulatory Authority (MHRA) in May 2003, identified two problems of which the company had been aware as early as 1998:
· A higher risk of suicidal behaviour among under 18s using Seroxat rather than a placebo.
· Seroxat was ineffective in dealing with depressive illness among under 18s. ...
...
A leaked internal document from GSK, dated to 1998, said the company would have to "effectively manage the dissemination of these data in order to minimise any potential negative impact".
In the United States, GSK was sued by the New York state attorney general, Eliot Spitzer, and settled for $2.5m (£1.25m) and an agreement to publish all its trial results - negative or positive - on a publicly available database. ...
Blue Cross Blue Shield Gets Ready to Game Universal Healthcare ...
Damaged Care 2008: Blue Cross Blue Shield Gets Ready to Game Universal Healthcare | Posted by McCamy Taylor in Health | Thu Mar 06th 2008, 02:10 AM
...
What we are seeing now is the industries major players---the plans that think that they will survive the shake up and emerge part of Hillarycare or Obamacare---test out methods for denying services under universal healthcare. And---no surprises here---since the problem (from the insurance companies’ point of view) is that they will be forced to insure the sick alongside the well, they are dusting off the underhanded methods they refined in the 1990s to use with HMOs.
...
At HMO, Member Services always lied . Their job was to get you to sign up, because they got paid per head. Once you were enrolled, you learned the truth. As long as you were a healthy person who only intended to use your HMO if you were in a car wreck, you and your HMO would get along just fine. But if you planned to get ongoing, state of the art, reliable medical care for a serious chronic medical condition, you were either going to have to learn to fight for your rights---or you would be better off on some other insurance.
The last is how HMOs made their money. They drove sick people off their plans. They required people to jump through hoops to get specialty care. They paid primary care doctors a flat fee out of which they had to pay the cost of medical care for sick patients so that the primary care doctors would have an incentive to find excuses to drive sick people away .
I will let you in on a secret. Remember the part in the Michael Moore film Sicko in which the insurance companies try to find reasons to cancel people’s policies after they have gotten sick or hard surgery? Doctors are way better than any insurance company at getting people to leave a practice—or an insurance plan—because they are sick and require medical care. “Your case is too complicated. “You do not need to see an oncologist to manage your lung cancer. I can do that for you.” “I don’t like the specialists you have been seeing. I am going to change your specialists to the ones I like.” “I only see HMO patients one afternoon a week, and you can only discuss one problem a visit.”
These are all real things said by real doctors to HMO patients the first and last time that the patients saw them, before they came to see me. Doctors on a capitated HMO plan can spot a money sink---a new patient who is going to accrue a lot of medical bills—the minute she or he walks in the door. An unscrupulous doctor knows just what to say to turn that patient around and send him back out to another doctor. ...
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II. Excluding Providers
Georgia Blues is being sued. Georgia, like many states has an Any Willing Provider Law which means that any doctor or hospital or other provider of medical services who is willing to accept an insurers terms must be offered a contract.
Well, Georgia Blues has an HMO product, and like all good HMOs it has found that one of the best ways to keep costs down is to make it absolutely impossible for anyone with an actual medical condition to get medical care. You do that by limiting the number of providers and making sure that their offices are all located in out of the way places (on top of mountains would be good) and that the specialists are swamped (booked up for months would be ideal) and that the only hospitals that do necessary services are six counties away and the only pharmacy that takes your card has two hour waits and the only primary care doctors who take your insurance also see a lot of workman’s comp and “diet” patients so you have to sign in and wait your turn.
This article is in the February 16 issue of AMA News and is called Ga. Blues Sued Under any-willing provider law and describes the plight of 100s of North Georgia cancer patients who now have to drive hours to see an oncologist, because Ga. Blues terminated its contract with their doctors.
The ability of an insurance plan to exclude or drop providers goes way beyond simply limiting costs. It is a tool that insurers can use to get rid of whole panels of unusually sick people under universal care—by dropping a few doctors. For example, some doctors tend to treat people with more severe illness. People with chronic disease have been shown in studies to be more drawn to female physicians. Insurance companies create profiles of their providers, so they know which doctor spends how much money. They also know whether that money is well spent—i.e. if the patients that doctor sees are really sick enough to warrant those expenditures. When I was in practice, a large local HMO complained to me regularly that I was spending too much money on my patients who just happened to have a much higher illness burden than most other family physicians. The amount of money spent was actually lowish compared to their illness burden, because I kept most of them out of the hospital, but the HMO still tried to terminate me, because they wanted to save money---and getting rid of me would have meant getting rid of a bunch of my chronically ill patients who would have changed insurance plans so that they could keep seeing me. ...
...
What we are seeing now is the industries major players---the plans that think that they will survive the shake up and emerge part of Hillarycare or Obamacare---test out methods for denying services under universal healthcare. And---no surprises here---since the problem (from the insurance companies’ point of view) is that they will be forced to insure the sick alongside the well, they are dusting off the underhanded methods they refined in the 1990s to use with HMOs.
...
At HMO, Member Services always lied . Their job was to get you to sign up, because they got paid per head. Once you were enrolled, you learned the truth. As long as you were a healthy person who only intended to use your HMO if you were in a car wreck, you and your HMO would get along just fine. But if you planned to get ongoing, state of the art, reliable medical care for a serious chronic medical condition, you were either going to have to learn to fight for your rights---or you would be better off on some other insurance.
The last is how HMOs made their money. They drove sick people off their plans. They required people to jump through hoops to get specialty care. They paid primary care doctors a flat fee out of which they had to pay the cost of medical care for sick patients so that the primary care doctors would have an incentive to find excuses to drive sick people away .
I will let you in on a secret. Remember the part in the Michael Moore film Sicko in which the insurance companies try to find reasons to cancel people’s policies after they have gotten sick or hard surgery? Doctors are way better than any insurance company at getting people to leave a practice—or an insurance plan—because they are sick and require medical care. “Your case is too complicated. “You do not need to see an oncologist to manage your lung cancer. I can do that for you.” “I don’t like the specialists you have been seeing. I am going to change your specialists to the ones I like.” “I only see HMO patients one afternoon a week, and you can only discuss one problem a visit.”
These are all real things said by real doctors to HMO patients the first and last time that the patients saw them, before they came to see me. Doctors on a capitated HMO plan can spot a money sink---a new patient who is going to accrue a lot of medical bills—the minute she or he walks in the door. An unscrupulous doctor knows just what to say to turn that patient around and send him back out to another doctor. ...
...
II. Excluding Providers
Georgia Blues is being sued. Georgia, like many states has an Any Willing Provider Law which means that any doctor or hospital or other provider of medical services who is willing to accept an insurers terms must be offered a contract.
Well, Georgia Blues has an HMO product, and like all good HMOs it has found that one of the best ways to keep costs down is to make it absolutely impossible for anyone with an actual medical condition to get medical care. You do that by limiting the number of providers and making sure that their offices are all located in out of the way places (on top of mountains would be good) and that the specialists are swamped (booked up for months would be ideal) and that the only hospitals that do necessary services are six counties away and the only pharmacy that takes your card has two hour waits and the only primary care doctors who take your insurance also see a lot of workman’s comp and “diet” patients so you have to sign in and wait your turn.
This article is in the February 16 issue of AMA News and is called Ga. Blues Sued Under any-willing provider law and describes the plight of 100s of North Georgia cancer patients who now have to drive hours to see an oncologist, because Ga. Blues terminated its contract with their doctors.
The ability of an insurance plan to exclude or drop providers goes way beyond simply limiting costs. It is a tool that insurers can use to get rid of whole panels of unusually sick people under universal care—by dropping a few doctors. For example, some doctors tend to treat people with more severe illness. People with chronic disease have been shown in studies to be more drawn to female physicians. Insurance companies create profiles of their providers, so they know which doctor spends how much money. They also know whether that money is well spent—i.e. if the patients that doctor sees are really sick enough to warrant those expenditures. When I was in practice, a large local HMO complained to me regularly that I was spending too much money on my patients who just happened to have a much higher illness burden than most other family physicians. The amount of money spent was actually lowish compared to their illness burden, because I kept most of them out of the hospital, but the HMO still tried to terminate me, because they wanted to save money---and getting rid of me would have meant getting rid of a bunch of my chronically ill patients who would have changed insurance plans so that they could keep seeing me. ...
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