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. ...
Monday, March 24, 2008
"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.
...
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. ...
...
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.
...
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.
...
"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.
...
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.
...
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.
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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. ...
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"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.
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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
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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.
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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?
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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. ...
...
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. ...
have to have about $102,000 per person ($206,000 per couple) set aside just for health care expenses when they retire
Health Highlights: Feb. 19, 2008 | Tuesday, February 19, 2008; 12:00 AM
Health Care Costs Threaten Retirement Lifestyle: U.S. Study
Skyrocketing health care costs are a major reason why many American baby boomers and Generation Xers won't be able to maintain their standard of living when they retire, according to a study released Tuesday by the Center for Retirement Research at Boston College.
..
Based on those costs, most baby boomers (born between 1946 and 1964) and Generation Xers (born between 1965 and 1974) would have to have about $102,000 per person ($206,000 per couple) set aside just for health care expenses when they retire. ...
Health Care Costs Threaten Retirement Lifestyle: U.S. Study
Skyrocketing health care costs are a major reason why many American baby boomers and Generation Xers won't be able to maintain their standard of living when they retire, according to a study released Tuesday by the Center for Retirement Research at Boston College.
..
Based on those costs, most baby boomers (born between 1946 and 1964) and Generation Xers (born between 1965 and 1974) would have to have about $102,000 per person ($206,000 per couple) set aside just for health care expenses when they retire. ...
Insurance Fears Lead Many to Shun DNA Tests : could face genetic discrimination from employers or insurers.
Insurance Fears Lead Many to Shun DNA Tests | By AMY HARMON | Published: February 24, 2008
...
Some, like Ms. Grove, try to manage their own care without confiding in medical professionals. And even doctors who recommend DNA testing to their patients warn them that they could face genetic discrimination from employers or insurers. ...
Victoria Grove wanted to find out if she was destined to develop the form of emphysema that ran in her family, but she did not want to ask her doctor for the DNA test that would tell her.
She worried that she might not be able to get health insurance, or even a job, if a genetic predisposition showed up in her medical records, especially since treatment for the condition, alpha-1 antitrypsin deficiency, could cost over $100,000 a year. Instead, Ms. Grove sought out a service that sent a test kit to her home and returned the results directly to her.
...
Some, like Ms. Grove, try to manage their own care without confiding in medical professionals. And even doctors who recommend DNA testing to their patients warn them that they could face genetic discrimination from employers or insurers. ...
Thursday, March 6, 2008
Las Vegas clinic was found to be reusing syringes and vials of medication for nearly four years
Vegas Clinic May Have Sickened Thousands | By KATHLEEN HENNESSEY – 4 hours ago
LAS VEGAS (AP) — Nearly 40,000 people learned this week that a trip to the doctor may have made them sick. In a type of scandal more often associated with Third World countries, a Las Vegas clinic was found to be reusing syringes and vials of medication for nearly four years. The shoddy practices may have led to an outbreak of the potentially fatal hepatitis C virus and exposed patients to HIV, too.
...
Health inspectors say they observed clinic staff using the same syringe twice to extract anesthesia from a single vial, which was then inappropriately used to treat more than one patient. The practice allows contaminated blood in a used syringe to taint the vial and infect the next patient.
...
His wife, Josephine, a registered nurse, wonders how any health care professional could be so reckless: "To maximize profit? For what? What are you going to save?"
LAS VEGAS (AP) — Nearly 40,000 people learned this week that a trip to the doctor may have made them sick. In a type of scandal more often associated with Third World countries, a Las Vegas clinic was found to be reusing syringes and vials of medication for nearly four years. The shoddy practices may have led to an outbreak of the potentially fatal hepatitis C virus and exposed patients to HIV, too.
...
Health inspectors say they observed clinic staff using the same syringe twice to extract anesthesia from a single vial, which was then inappropriately used to treat more than one patient. The practice allows contaminated blood in a used syringe to taint the vial and infect the next patient.
...
His wife, Josephine, a registered nurse, wonders how any health care professional could be so reckless: "To maximize profit? For what? What are you going to save?"
Drug Tied to China Had Contaminant, F.D.A. Says
Drug Tied to China Had Contaminant, F.D.A. Says | By GARDINER HARRIS and WALT BOGDANICH | Published: March 6, 2008
WASHINGTON — Federal drug regulators said Wednesday that a critical blood thinner that had been linked to at least 19 deaths and whose raw components were produced in China contained a possibly counterfeit ingredient that mimicked the real drug.
Routine tests failed to distinguish the contaminant from the drug, heparin. Only sophisticated magnetic resonance imaging tests uncovered that as much as 20 percent of the product’s active ingredient was a heparin mimic blended in with the real thing. Federal officials said they did not know what the contaminant was.
“At this point, we do not know whether the introduction was accidental or whether it was deliberate,” said the Food and Drug Administration’s deputy commissioner, Dr. Janet Woodcock. ...
...
The F.D.A. has now received 785 reports of serious injuries associated with the drug’s use. Forty-six deaths have also been reported to the agency, but Dr. Woodcock said that just 19 of these appeared related to the suspect heparin. Baxter executives said that the total death toll was actually four.
APP Pharmaceuticals, which previously split the heparin market with Baxter, has been ramping up production to meet demand. So far, APP’s products show no signs of similar contamination, Dr. Woodcock said, although some of APP’s production is also based in China.
Most of the world’s heparin supply originates in China, according to Baxter. The F.D.A. will soon make public the test used to distinguish between real heparin and its mimic in hopes that regulatory bodies around the world will adopt the test. “We don’t know if any of the heparin products worldwide might contain this contaminant, and that is something we are going to be looking into,” Dr. Woodcock said.
The F.D.A. has yet to prove that the heparin contaminant is the cause of the deaths and illnesses now associated with the use of Baxter’s product. But heparin batches associated with illnesses, all of which were produced with ingredients made in China, were found to contain the contaminant while batches not linked to illnesses proved to be untainted. In a written statement, Scientific Protein said that “it is premature to conclude that the heparin active pharmaceutical ingredient sourced from China and provided by S.P.L. to Baxter is responsible for these adverse events.” ...
WASHINGTON — Federal drug regulators said Wednesday that a critical blood thinner that had been linked to at least 19 deaths and whose raw components were produced in China contained a possibly counterfeit ingredient that mimicked the real drug.
Routine tests failed to distinguish the contaminant from the drug, heparin. Only sophisticated magnetic resonance imaging tests uncovered that as much as 20 percent of the product’s active ingredient was a heparin mimic blended in with the real thing. Federal officials said they did not know what the contaminant was.
“At this point, we do not know whether the introduction was accidental or whether it was deliberate,” said the Food and Drug Administration’s deputy commissioner, Dr. Janet Woodcock. ...
...
The F.D.A. has now received 785 reports of serious injuries associated with the drug’s use. Forty-six deaths have also been reported to the agency, but Dr. Woodcock said that just 19 of these appeared related to the suspect heparin. Baxter executives said that the total death toll was actually four.
APP Pharmaceuticals, which previously split the heparin market with Baxter, has been ramping up production to meet demand. So far, APP’s products show no signs of similar contamination, Dr. Woodcock said, although some of APP’s production is also based in China.
Most of the world’s heparin supply originates in China, according to Baxter. The F.D.A. will soon make public the test used to distinguish between real heparin and its mimic in hopes that regulatory bodies around the world will adopt the test. “We don’t know if any of the heparin products worldwide might contain this contaminant, and that is something we are going to be looking into,” Dr. Woodcock said.
The F.D.A. has yet to prove that the heparin contaminant is the cause of the deaths and illnesses now associated with the use of Baxter’s product. But heparin batches associated with illnesses, all of which were produced with ingredients made in China, were found to contain the contaminant while batches not linked to illnesses proved to be untainted. In a written statement, Scientific Protein said that “it is premature to conclude that the heparin active pharmaceutical ingredient sourced from China and provided by S.P.L. to Baxter is responsible for these adverse events.” ...
Following the Script: How Drug Reps Make Friends and Influence Doctors
Following the Script: How Drug Reps Make Friends and Influence Doctors | Adriane Fugh-Berman*, Shahram Ahari | Published: April 24, 2007
Funding: This work was supported by a grant from the Attorney General Prescriber and Consumer Education Grant Program, created as part of a 2004 settlement between Warner-Lambert, a division of Pfizer, and the Attorneys General of 50 States and the District of Columbia, to settle allegations that Warner-Lambert conducted an unlawful marketing campaign for the drug Neurontin (gabapentin) that violated state consumer protection laws.
...
Funding: This work was supported by a grant from the Attorney General Prescriber and Consumer Education Grant Program, created as part of a 2004 settlement between Warner-Lambert, a division of Pfizer, and the Attorneys General of 50 States and the District of Columbia, to settle allegations that Warner-Lambert conducted an unlawful marketing campaign for the drug Neurontin (gabapentin) that violated state consumer protection laws.
...
It's my job to figure out what a physician's price is. For some it's dinner at the finest restaurants, for others it's enough convincing data to let them prescribe confidently and for others it's my attention and friendship...but at the most basic level, everything is for sale and everything is an exchange.
—Shahram Ahari
You are absolutely buying love.
—James Reidy [1]
In 2000, pharmaceutical companies spent more than 15.7 billion dollars on promoting prescription drugs in the United States [2]. More than 4.8 billion dollars was spent on detailing, the one-on-one promotion of drugs to doctors by pharmaceutical sales representatives, commonly called drug reps. The average sales force expenditure for pharmaceutical companies is $875 million annually [3].
Unlike the door-to-door vendors of cosmetics and vacuum cleaners, drug reps do not sell their product directly to buyers. Consumers pay for prescription drugs, but physicians control access. Drug reps increase drug sales by influencing physicians, and they do so with finely titrated doses of friendship. This article, which grew out of conversations between a former drug rep (SA) and a physician who researches pharmaceutical marketing (AFB), reveals the strategies used by reps to manipulate physician prescribing.
...
During training, I was told, when you're out to dinner with a doctor, “The physician is eating with a friend. You are eating with a client.”
—Shahram Ahari
Script Tracking
An official job description for a pharmaceutical sales rep would read: Provide health-care professionals with product information, answer their questions on the use of products, and deliver product samples. An unofficial, and more accurate, description would have been: Change the prescribing habits of physicians.
—James Reidy [4]
...
The Value of Samples
The purpose of supplying drug samples is to gain entry into doctors' offices, and to habituate physicians to prescribing targeted drugs. Physicians appreciate samples, which can be used to start therapy immediately, test tolerance to a new drug, or reduce the total cost of a prescription. Even physicians who refuse to see drug reps usually want samples (these docs are denigrated as “sample-grabbers”). Patients like samples too; it's nice to get a little present from the doctor. Samples also double as unacknowledged gifts to physicians and their staff. The convenience of an in-house pharmacy increases loyalty to both the reps and the drugs they represent.
...
Funding Friendship
While it's the doctors' job to treat patients and not to justify their actions, it's my job to constantly sway the doctors. It's a job I'm paid and trained to do. Doctors are neither trained nor paid to negotiate. Most of the time they don't even realize that's what they're doing‥
—Shahram Ahari
Four makers of artificial hips and knees paid doctors more than $800 million in royalties and fees in four years to influence their choice of implants
Orthopedic-Device Makers Accused of Paying Doctors | Congress Told Practice Is Deep-Seated | By Avram Goldstein | Bloomberg News | Thursday, February 28, 2008; Page D08
Four makers of artificial hips and knees paid doctors more than $800 million in royalties and fees in four years to influence their choice of implants, a U.S. investigator told Congress.
Four makers of artificial hips and knees paid doctors more than $800 million in royalties and fees in four years to influence their choice of implants, a U.S. investigator told Congress.
The unidentified companies control about three-quarters of the $9.4 billion worldwide market for hips and knees, said Gregory E. Demske, an assistant inspector general at the Health and Human Services Department, at a hearing yesterday of the Senate Special Committee on Aging.
"Illegitimate" payments, the extent of which is unknown, influence orthopedic surgeons' medical judgment and are so common that it will be difficult to eliminate the practice, Demske and other witnesses said. The fees have enriched doctors and distorted the market by bolstering sales of lower-quality devices, they said.
"Industry and physicians are equally culpable," said Sen. Herb Kohl (D-Wis.), chairman of the panel. "Some physicians make it known to the companies that they will be loyal to the highest bidder. Where does the patient's well-being fit into the equation?"
The hearing followed a probe of the orthopedic-device industry by U.S. prosecutors that was settled in September for $311 million. The government said the companies handed out excessive consulting agreements, lavish trips and other perks to reward surgeons who used their products. ...
Massachusetts May Ban Drug Industry Freebies for Docs
March 4, 2008, 8:29 am | Massachusetts May Ban Drug Industry Freebies for Docs | Posted by Jacob Goldstein
We’ve been wondering when we’d see our first swag-free doctor’s office. A trip to Massachusetts may soon do the trick. The president of the state’s senate is proposing a ban on all drug industry freebies for docs — from travel to pens, the Boston Globe reports.
A bill filed yesterday by Democrat Therese Murray would also require the state’s doctors to adopt electronic medical records by 2015, to be funded at least in part by cigarette taxes. The bill would also force public reviews of any insurance company that wanted to raise premiums by more than 7%. Drug reps would still be allowed to give doctors free drug samples for use by patients.
We’ve been wondering when we’d see our first swag-free doctor’s office. A trip to Massachusetts may soon do the trick. The president of the state’s senate is proposing a ban on all drug industry freebies for docs — from travel to pens, the Boston Globe reports.
A bill filed yesterday by Democrat Therese Murray would also require the state’s doctors to adopt electronic medical records by 2015, to be funded at least in part by cigarette taxes. The bill would also force public reviews of any insurance company that wanted to raise premiums by more than 7%. Drug reps would still be allowed to give doctors free drug samples for use by patients.
Murray argues that drug industry gifts drive up health care costs by persuading some docs to prescribe more expensive, branded drugs. An official with the industry group PhRMA, which opposes the ban, told the Globe that she was “not aware of any kind of evidence or studies that link promotional or marketing materials with the cost of healthcare.”
Skepticism of drug industry promotion has been rising lately. Some medical centers have banned drug rep trinkets. Minnesota has capped drug industry gifts at $50. But if Murray’s bill goes through, Massachusetts would be the first state to ban the gifts outright, the Globe reports. ...
When considering tax fairness, we should ask: What exactly is a tax?
Mon, Mar. 03, 2008 10:15 PM | 'Individual mandate' in health-care proposals might as well be called a tax | By JON HALL | Guest columnist
When considering tax fairness, we should ask: What exactly is a tax?
Government mandates businesses to pay for their employees’ unemployment insurance, workers’ compensation and other benefits. These payments burden businesses just as surely as if the payments were made directly to the government — a tax by another name. And if businesses fail to comply with government mandates, they can be dealt with like any tax scofflaw. ...
When considering tax fairness, we should ask: What exactly is a tax?
Government mandates businesses to pay for their employees’ unemployment insurance, workers’ compensation and other benefits. These payments burden businesses just as surely as if the payments were made directly to the government — a tax by another name. And if businesses fail to comply with government mandates, they can be dealt with like any tax scofflaw. ...
Nearly 50 million Americans chronically suffer from sleep problems and disorders that affect their careers ... relationships, safety ...
Long work hours leave Americans drowsy, off sex | AFP | Published: Monday March 3, 2008
One in five Americans has lost interest in sex -- and not because they have a headache, a study released Monday showed.
The culprit for the loss of libido is lack of sleep due to excessively long work hours and too much overtime, according to a study by the National Sleep Foundation (NSF).
"Longer work days and more access to the workplace through the Internet and other technology appear to be causing Americans to get less sleep," said Darrel Drobnich, head of the NSF, in a statement.
"Nearly 50 million Americans chronically suffer from sleep problems and disorders that affect their careers, their personal relationships and safety on the roads," Drobnich said.
The study showed that more than one-third of Americans -- 36 percent -- have fallen asleep at the wheel, and nearly two-thirds report having sleep problems, such as waking at night or difficulty falling asleep.
Americans sleep on average six hours and 40 minutes a night, or less than the seven hours, 18 minutes they said they needed, the study showed.
"Studies show that habitually getting inadequate sleep -- less than seven or eight hours each night -- creates long-lasting changes to one's ability to think and function well during the day," said Thomas Balkin, the deputy head of the NSF. ...
One in five Americans has lost interest in sex -- and not because they have a headache, a study released Monday showed.
The culprit for the loss of libido is lack of sleep due to excessively long work hours and too much overtime, according to a study by the National Sleep Foundation (NSF).
"Longer work days and more access to the workplace through the Internet and other technology appear to be causing Americans to get less sleep," said Darrel Drobnich, head of the NSF, in a statement.
"Nearly 50 million Americans chronically suffer from sleep problems and disorders that affect their careers, their personal relationships and safety on the roads," Drobnich said.
The study showed that more than one-third of Americans -- 36 percent -- have fallen asleep at the wheel, and nearly two-thirds report having sleep problems, such as waking at night or difficulty falling asleep.
Americans sleep on average six hours and 40 minutes a night, or less than the seven hours, 18 minutes they said they needed, the study showed.
"Studies show that habitually getting inadequate sleep -- less than seven or eight hours each night -- creates long-lasting changes to one's ability to think and function well during the day," said Thomas Balkin, the deputy head of the NSF. ...
Brand Name Drug Prices Gorw ... about 2.5 times overall inflation, continuing a long-standing trend
Mar 4, 7:14 PM EST | Brand-Name Drug Prices Continue to Grow | By KEVIN FREKING | Associated Press Writer
WASHINGTON (AP) -- Drug makers increased their prices last year by an average of 7.4 percent for brand-name medicines most commonly prescribed to the elderly, according to the advocacy group AARP.
The increase was about 2.5 times overall inflation, continuing a long-standing trend.
The advocacy group has tracked drug prices going back to 2002. Specifically, it looks at the prices charged to wholesalers. It noted that the price increases have been slightly greater since the Medicare drug benefit kicked in Jan. 1, 2006.
In the four years before the benefit's startup, wholesale prices rose between 5.3 percent and 6.6 percent a year, according to AARP's tracking.
...
All but four of the 220 brand-name prescriptions in the study had price increases during 2007. Nearly all exceeded the rate of general inflation. Among the top 25 drug products, the sleep aid Ambien had the largest price increase, 27.7 percent. Ambien is manufactured by Sanofi-Aventis. On the other end of the spectrum, Merck's cholesterol drug Zocor had no price change in 2007. Also, Bristol-Myers Squibb's blood thinner Plavix had a price increase of 0.5 percent.
WASHINGTON (AP) -- Drug makers increased their prices last year by an average of 7.4 percent for brand-name medicines most commonly prescribed to the elderly, according to the advocacy group AARP.
The increase was about 2.5 times overall inflation, continuing a long-standing trend.
The advocacy group has tracked drug prices going back to 2002. Specifically, it looks at the prices charged to wholesalers. It noted that the price increases have been slightly greater since the Medicare drug benefit kicked in Jan. 1, 2006.
In the four years before the benefit's startup, wholesale prices rose between 5.3 percent and 6.6 percent a year, according to AARP's tracking.
...
All but four of the 220 brand-name prescriptions in the study had price increases during 2007. Nearly all exceeded the rate of general inflation. Among the top 25 drug products, the sleep aid Ambien had the largest price increase, 27.7 percent. Ambien is manufactured by Sanofi-Aventis. On the other end of the spectrum, Merck's cholesterol drug Zocor had no price change in 2007. Also, Bristol-Myers Squibb's blood thinner Plavix had a price increase of 0.5 percent.
Saturday, March 1, 2008
Vietnamese victims of wartime “agent orange” were disappointed by a U.S. court’s dismissal of a lawsuit
February 23, 2008 by Reuters | US “Agent Orange” Ruling Disappoints Vietnamese; Pleases Monsanto, Dow Chemical | by Grant McCool and Nguyen Nhat Lam
HANOI — Vietnamese victims of wartime “agent orange” were disappointed by a U.S. court’s dismissal of a lawsuit against chemical companies but believe they have gathered more support for their cause, an official said on Saturday.
“We anticipated this because it is not easy suing big and powerful U.S. companies on U.S. soil and under the U.S. court system,” said Nguyen Trong Nhan, vice chairman of the Vietnam Association for Victims of Agent Orange/Dioxin.
...
The lawsuit contended agent orange caused ailments, including birth defects and cancer.
Studies have shown the compound of dioxin, a component of “agent orange” herbicides sprayed during the war, is still present in so-called “hot spots” at levels hundreds of times higher than would be accepted elsewhere.
The United States has maintained there is no scientifically proved link between the wartime spraying and the claims of dioxin poisoning by more than 3 million people in Vietnam. ...
HANOI — Vietnamese victims of wartime “agent orange” were disappointed by a U.S. court’s dismissal of a lawsuit against chemical companies but believe they have gathered more support for their cause, an official said on Saturday.
“We anticipated this because it is not easy suing big and powerful U.S. companies on U.S. soil and under the U.S. court system,” said Nguyen Trong Nhan, vice chairman of the Vietnam Association for Victims of Agent Orange/Dioxin.
...
The lawsuit contended agent orange caused ailments, including birth defects and cancer.
Studies have shown the compound of dioxin, a component of “agent orange” herbicides sprayed during the war, is still present in so-called “hot spots” at levels hundreds of times higher than would be accepted elsewhere.
The United States has maintained there is no scientifically proved link between the wartime spraying and the claims of dioxin poisoning by more than 3 million people in Vietnam. ...
provide health care coverage for virtually every American while generating huge cost savings
Lewin Group: 'Health Care for America' Works | Study Finds Hacker Plan Covers All for Less
"Health Care for America," developed for the Economic Policy Institute by Yale University Political Science Professor Jacob Hacker, would provide health care coverage for virtually every American while generating huge cost savings — more than $1 trillion over 10 years, according to the Lewin Group, a nationally respected, nonpartisan consulting firm. (Read the full Lewin Group report. ) Their report offers the most detailed analysis of the reform proposal to date. ...
"Health Care for America," developed for the Economic Policy Institute by Yale University Political Science Professor Jacob Hacker, would provide health care coverage for virtually every American while generating huge cost savings — more than $1 trillion over 10 years, according to the Lewin Group, a nationally respected, nonpartisan consulting firm. (Read the full Lewin Group report. ) Their report offers the most detailed analysis of the reform proposal to date. ...
[Arbitrator] blasted the company for tying employee bonuses to the number of policies canceled and the amount of money saved.
Health Net ordered to pay $9 million after canceling cancer patient's policy | Fri Feb-22-08 | Source: Los Angeles Times | http://www.latimes.com/business/la-fi-insure23feb23,1,5...
A breast cancer patient whose medical coverage was canceled by her insurer was awarded more than $9 million today in a case against Health Net Inc., one of the state's largest for-profit insurers.
The award issued by an arbitration judge was the first of its kind and prompted Health Net to announce it was scrapping its cancellation practices that are under fire from state regulators, patients and the Los Angeles city attorney.
Arbitrator Sam Cianchetti, a retired Los Angeles County Superior Court judge, found that Health Net violated numerous state laws in canceling Patsy Bates' policy and declared the company's actions "despicable."
Cianchetti also blasted the company for tying employee bonuses to the number of policies canceled and the amount of money saved. ...
A breast cancer patient whose medical coverage was canceled by her insurer was awarded more than $9 million today in a case against Health Net Inc., one of the state's largest for-profit insurers.
The award issued by an arbitration judge was the first of its kind and prompted Health Net to announce it was scrapping its cancellation practices that are under fire from state regulators, patients and the Los Angeles city attorney.
Arbitrator Sam Cianchetti, a retired Los Angeles County Superior Court judge, found that Health Net violated numerous state laws in canceling Patsy Bates' policy and declared the company's actions "despicable."
Cianchetti also blasted the company for tying employee bonuses to the number of policies canceled and the amount of money saved. ...
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