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.

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.

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. ...
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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.

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. ...

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. ...

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." ...

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. ...

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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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." ...

"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."

[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. ...