Tuesday, December 29, 2009

Nurses Say Senate Bill Entrenches Chokehold of Insurance Giants

Nurses Say Senate Bill Entrenches Chokehold of Insurance Giants

Ask a nurse.

"It is tragic to see the promise from Washington this year for genuine, comprehensive reform ground down to a seriously flawed bill that could actually exacerbate the health-care crisis and financial insecurity for American families, and that cedes far too much additional power to the tyranny of a callous insurance industry," says National Nurses Union co-president Karen Higgins, RN.

"Sadly," adds Higgins, "we have ended up with legislation that fails to meet the test of true health-care reform, guaranteeing high quality, cost effective care for all Americans, and instead are further locking into place a system that entrenches the choke-hold of the profit-making insurance giants on our health. If this bill passes, the industry will become more powerful and could be beyond the reach of reform for generations."

The 150,000-member NNU, the largest union and professional organization of registered nurses in the U.S., condemned Reid's bill -- which is expected to gain Senate approval this week -- as a deeply flawed measure that grants too much power to the nation's largest private and for-profit insurers.

Specifically, the union that takes in the powerful California Nurses Association, cited 10 fundamental flaws in the Senate bill:

1. The individual mandate forcing all those without coverage to buy private insurance, with insufficient cost controls on skyrocketing premiums and other insurance costs.

2. No challenge to insurance company monopolies, especially in the top 94 metropolitan areas where one or two companies dominate, severely limiting choice and competition.

3. An affordability mirage. Congressional Budget Office estimates say a family of four with a household income of $54,000 would be expected to pay 17 percent of their income, $9,000, on healthcare exposing too many families to grave financial risk.

4. The excise tax on comprehensive insurance plans which will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of high-deductible plans, and lead to more self-rationing of care and medical bankruptcies, especially as more plans are subject to the tax every year due to the lack of adequate price controls. A Towers-Perrin survey in September found 30 percent of employers said they would reduce employment if their health costs go up, 86 percent said they'd pass the higher costs to their employees.

5. Major loopholes in the insurance reforms that promise bans on exclusion for pre-existing conditions, and no cancellations for sickness. The loopholes include:

· Provisions permitting insurers and companies to more than double charges to employees who fail "wellness" programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.

...

6. Minimal oversight on insurance denials of care; a report by the California Nurses Association/NNOC in September found that six of California's largest insurers have rejected more than one-fifth of all claims since 2002.

7. Inadequate limits on drug prices, especially after Senate rejection of an amendment, to protect a White House deal with pharmaceutical giants, allowing pharmacies and wholesalers to import lower-cost drugs.

8. New burdens for our public safety net. With a shortage of primary care physicians and a continuing fiscal crisis at the state and local level, public hospitals and clinics will be a dumping ground for those the private system doesn't want.

9. Reduced reproductive rights for women.

10. No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay. Nothing changes in basic structure of the system; healthcare remains a privilege, not a right.

...

Global Health-Care Snapshot

Global Health-Care Snapshot

Three common measures of health-care quality show how well various countries stack up.
What health-care systems look like around the world
What health-care systems look like around the world
What health-care systems look like around the world

Here's how six major countries handle health and what their citizens think of their care.

About 57% of Canadians believe they are receiving high-quality health care, a percentage that's held relatively steady since 2002, according to a poll of more than 1,200 Canadians conducted in late 2007 by Pollara Research. About one in five cited wait times as the most important health issue facing the nation, with 19% saying a doctor shortage is most critical. Nearly half — 48% — said they thought access to timely, quality health care will improve over the next five years.
Some 83% of French citizens express satisfaction with their social security system, according to a 2007 study.
Germany: Surveys often show a mixed level of satisfaction among patients, according to the Ministry, which attributes the mixed feelings to high expectations and gripes that arise from concerns about rising costs in the German health-care system.
Satisfaction
Current data is scant on the national level. More than half of Japanese patients were generally satisfied with the quality of their health care, according to a 1995 survey from the Ministry of Health and Welfare. But private and local surveys conducted since then have shown dissatisfaction levels creeping up, mostly due to rising costs and long waiting times at some clinics.
Satisfaction
Britain: Nearly three out of four people were “completely” satisfied that their general practitioner or health center had dealt with the main reason for their visit, according to a 2008 survey from the Picker Institute.
Satisfaction
Americans are the least satisfied with their health-care system among 10 nations studied in 2008, according to the Commonwealth Fund. A third of Americans said they believe the U.S. system "has so much wrong with it that we need to completely rebuild it," and their feelings have remained stable over the last decade, with roughly twice as many saying they want a complete overhaul compared with other nations.

Monday, December 28, 2009

Child diabetes blamed on food sweetener - Times Online

Child diabetes blamed on food sweetener - Times Online

Scientists have proved for the first time that a cheap form of sugar used in thousands of food products and soft drinks can damage human metabolism and is fuelling the obesity crisis.

Fructose, a sweetener derived from corn, can cause dangerous growths of fat cells around vital organs and is able to trigger the early stages of diabetes and heart disease.

It has increasingly been used as a substitute for more expensive types of sugar in yoghurts, cakes, salad dressing and cereals. Even some fruit drinks that sound healthy contain fructose.

Experts believe that the sweetener — which is found naturally in small quantities in fruit — could be a factor in the emergence of diabetes among children. This week, a new report is expected to claim that about one in 10 children in England will be obese by 2015.

Previous studies of the potentially adverse impact of fructose have focused on rats, but the first experiment involving humans has now revealed serious health concerns.

Over 10 weeks, 16 volunteers on a strictly controlled diet, including high levels of fructose, produced new fat cells around their heart, liver and other digestive organs. They also showed signs of food-processing abnormalities linked to diabetes and heart disease. Another group of volunteers on the same diet, but with glucose sugar replacing fructose, did not have these problems. ...

...

“This is the first evidence we have that fructose increases diabetes and heart disease independently from causing simple weight gain,” said Kimber Stanhope, a molecular biologist who led the study. “We didn’t see any of these changes in the people eating glucose.”

Natural fructose represents 5%-10% of the weight of any fruit. Its use in processed foods stems from a discovery in 1971 that synthesised a 55% fructose and 45% glucose syrup from maize, creating an ingredient cheaper and six times sweeter than cane sugar. ...

Reposting Mari333's OP with graph shown: - Democratic Underground

Reposting Mari333's OP with graph shown: - Democratic Underground

Thank's to Mari333 for drawing attention to this chart.
original op: http://www.democraticunderground.com/discuss/duboard.ph...


International Health Care Spending Comparison Graph:



http://andrewsullivan.theatlantic.com/.a/6a00d83451c456...

Saturday, December 26, 2009

GOP lawmakers change tune on costly health plans - Yahoo! News

GOP lawmakers change tune on costly health plans - Yahoo! News

WASHINGTON – Democrats are troubled by the inconsistency of Republican lawmakers who approved a major Medicare expansion six years ago that has added tens of billions of dollars to federal deficits, but oppose current health overhaul plans.

All current GOP senators, including the 24 who voted for the 2003 Medicare expansion, oppose the health care bill that's backed by President Barack Obama and most congressional Democrats.

The Democrats claim that their plan moving through Congress now will pay for itself with higher taxes and spending cuts and they cite the nonpartisan Congressional Budget Office for support.

By contrast, when Republicans controlled the House, Senate and White House in 2003, they overcame Democratic opposition to add a deficit-financed prescription drug benefit to Medicare. The program will cost a half-trillion dollars over 10 years, or more by some estimates.

With no new taxes or spending offsets accompanying the Medicare drug program, the cost has been added to the federal debt. ...

Monday, December 21, 2009

Seeing Public Subsidy (Not Public Option) Investors Flock to Health Insurers

Seeing Public Subsidy (Not Public Option) Investors Flock to Health Insurers

Investors are seeing the Senate's version of health care reform as a massive public subsidy for insurance companies -- and as a result, are sending the sector's stock prices shooting up, up, up. Stripped of a government-run insurance plan, the bill would give tens of millions of Americans no option but to start paying hefty premiums to private companies.

The rise in stock prices has been particularly striking in the period since Sen. Joe Lieberman (I-Conn.) said on October 27 that he would filibuster a Senate health care reform bill if it included a public option - a threat that caused Senate leaders to cave without much of a fight.

Here's a quick breakdown of major health insurance company stock performance from Oct. 27 to Friday's market close:

  • Coventry Health Care, Inc. is up 31.6 percent;
  • CIGNA Corp. is up 29.1 percent;
  • Aetna Inc. is up 27.1 percent;
  • WellPoint, Inc. is up 26.6 percent;
  • UnitedHealth Group Inc. is up 20.5 percent;
  • And Humana Inc. is up 13.6 percent. ..

Sunday, December 20, 2009

Agent Orange: U.S., Vietnam Struggle Over Dioxin Legacy - TIME

Agent Orange: U.S., Vietnam Struggle Over Dioxin Legacy - TIME

This lonely section of the abandoned Danang air base was once crawling with U.S. airmen and machines. It was here where giant orange drums were stored and the herbicides they contained were mixed and loaded onto waiting planes. Whatever sloshed out soaked into the soil and eventually seeped into the water supply. Thirty years later, the rare visitor to the former U.S. air base is provided with rubber boots and protective clothing. Residue from Agent Orange, which was sprayed to deny enemy troops jungle cover, remains so toxic that this patch of land is considered one of the most contaminated pieces of real estate in the country. A recent study indicates that even three decades after the war ended, the cancer-causing dioxins are at levels 300 to 400 times higher than what is deemed to be safe.

After years of meetings, signings and photo ops, the U.S. held another ceremony in Vietnam on Dec. 16 to sign yet another memorandum of understanding as part of the continuing effort to manage Agent Orange's dark legacy. Yet there are grumblings that little — if anything — has been done to clean up the most contaminated sites. Since 2007, Congress has allocated a total of $6 million to help address Agent Orange issues in Vietnam. Not only does the amount not begin to scratch the surface of the problem or get rid of the tons of toxic soil around the nation, but there are questions about how the money is being spent. And several parties have noted with growing frustration that the money is primarily going to study the issue and hire consultants rather than implementing measures to prevent new generations from being exposed.

Responding to complaints that America is dragging its feet, U.S. ambassador to Vietnam Michael Michalak said the $1.7 million most recently allocated to conduct an environmental assessment of the Danang air base is being done to comply with both U.S. and Vietnamese law and is a necessary step toward cleanup. "We're investigating many promising techniques," Michalak said following the signing ceremony in Hanoi. Careful study is required if the job is to be done right, he added. "We know there is dioxin in the soil," he said. "But what method do we use to remove it? Where do we tell the diggers to dig? It's just another step on the road."

But critics believe the U.S. is playing a grim waiting game: waiting for people to die in order to avoid potentially costly lawsuits. For a country currently engaged in two wars, accepting comprehensive responsibility for wartime damages could set an expensive precedent. "They know what the problem is and where it is," says Chuck Searcy, country representative of the Vietnam Veterans Memorial Fund. "Why do they now need an environmental impact assessment? They are studying this to death."

Scientists have been raising the alarm about dioxins since the 1960s. After TCDD, the dioxin in Agent Orange, was found to cause cancer and birth defects, the U.S. Environmental Protection Agency (EPA) slapped an emergency ban on the herbicide in 1979. Dow and Monsanto, the chemical's largest manufacturers, eventually shelled out millions in damages to U.S. troops who were exposed to it while it was being used as a wartime defoliant from 1961 to 1971. The U.S. government still spends billions every year on disability payments to those who served in Vietnam — including their children, many of whom are suffering from dioxin-associated cancers and birth defects. In October, the Department of Veterans Affairs added leukemia, Parkinson's and a rare heart disease to the list of health problems associated with Agent Orange. Yet U.S. official policy maintains that there is no conclusive evidence that the defoliant caused any health problems among the millions of exposed Vietnamese or their children.

...

Groups caring for children born with horrific deformities from Agent Orange — such as malformed limbs and no eyes — are wondering why they haven't seen any of that money. Bedridden and unable to feed themselves, many patients need round-the-clock care. As they age, and parents die, who is going to look after them? asks Nguyen Thi Hien, director of the Danang Association of Victims of Agent Orange. She says donations to her group, which cares for 300 children, are down 50% because there is a belief that local charities are flush with cash thanks to the U.S.'s latest allocation. "The $1 million [being spent by the Americans] is not for care but mainly for conferences and training," said Hien. "This money should go to caring for the victims."


Read more: http://www.time.com/time/world/article/0,8599,1948084,00.html#ixzz0aEvU15Qj

Read more: http://www.time.com/time/world/article/0,8599,1948084,00.html#ixzz0aEv9rW0Q

National Organization for Women opposes Senate health bill - The Hill's Blog Briefing Room

National Organization for Women opposes Senate health bill - The Hill's Blog Briefing Room

A leading women's group called on senators on Saturday to defeat its healthcare reform bill.

The leader of the National Organization for Women (NOW) excoriated the language in the health bill curtailing federal support for insurance plan covering abortions, which was inserted to win the 60th vote of Sen. Ben Nelson (D-Neb.).

"The so-called health care reform bill now before the Senate, with the addition of Majority Leader Harry Reid's Manager's Amendment, amounts to a health insurance bill for half the population and a sweeping anti-abortion law for the rest of us," NOW President Terry O'Neill said in a statement.

"We call on all senators who consider themselves friends of women's rights to reject the Manager's Amendment, and if it remains, to defeat this cruelly over-compromised legislation," O'Neill added. ...

...

The compromise to win Nelson's vote was included in the manager's amendment to the Senate bill, which was released by Majority Leader Harry Reid (D-Nev.) this morning. The compromise measure seeks to segregate federal funds from going to subsidize plans covering abortion. ...

Eschaton

Eschaton

Saturday, December 19, 2009

Just a reminder....

Total spending on health care, per person, 2007:
United States: $7290
Switzerland: $4417
France: $3601
United Kingdom: $2992
Average of OECD developed nations: $2964
Italy: $2686
Japan: $2581

Friday, December 18, 2009

Think Progress � Blue Shield of California threatens to revoke the coverage of customers who miss a single payment.

Think Progress � Blue Shield of California threatens to revoke the coverage of customers who miss a single payment.

One of the worst abuses of the private insurance industry is known as recission, where insurers decide to revoke the coverage of their customers for frivolous reasons. The Los Angeles Times reports today that one of the nation’s largest insurers, Blue Shield of California, has “notified [its] policyholders” that their coverage could be “immediately dropped” if they miss even a single payment:

Amid a national debate on how to make the healthcare system friendlier and more accessible, and as millions of people grapple with the loss of jobs and homes, what does insurance heavyweight Blue Shield of California do? It decides to take a key benefit away.

The company has notified individual policyholders that their coverage could be immediately dropped if they miss a single payment — or so it seems. Blue Shield says in a letter to customers that they can reapply for insurance, but with potentially higher premiums and stricter conditions.

Thankfully, a California law that mandates minimum grace periods and a decision by the company that will allow for a 28-day grace period will keep Blue Shield from immediately dropping people from coverage, as their letter threatens. The LA Times goes on to note that the the company’s pronouncement comes “after last year’s announcement that Blue Shield and Anthem Blue Cross agreed to pay a total of $13 million in fines after cancelling the policies of more than 2,000 Californians after they became ill.” ...

Jeffrey Feldman: Health Care Without Bankruptcy, Please

Jeffrey Feldman: Health Care Without Bankruptcy, Please

What kind of an America would we suddenly create if the President were to sign into law a health care bill with a mandate to buy private insurance? An America where millions would be covered, but bankrupt, broke, financially kaput. And unhealthy, too.

Wait--what?

You guessed it. All the fever-pitched, media-amplified ranting about "death" that has dominated the health care debate has likely done little more than obscure the ultimate sticking point for many Americans: a bill that would mandate--require by law--all Americans to buy private health insurance.

Make no mistake: the health insurance mandate would not be like the mandate to drive the speed limit. It would not just be a clever idea that nobody really followed. It would be law. There would be fines for not heeding it--and steeper penalties for shirking the fines.

And here is the kicker: a mandate for health insurance would, if signed into law by President Obama, would take the already flawed business model of health insurance and turn it into a perfect storm of financial and then physical ruin.

Right now we have a system that requires the government to cover those who are indigent and those who are elderly--Medicaid and Medicare--thanks to the legacy of the New Deal and the Great Society. There is a selfish bunch of Americans who are opposed to Medicaid and Medicare, but most see their value through their flaws. Despite the horror stories about "death panels" and "killing granny" (none of which are true), if the current health care bill were signed into law, poor and retired Americans will still be covered in the same way as they are today.

The big change will be for the rest of the country that would suddenly be faced with an unprecedented and up-to-that-point not understood requirement.

Everyone would be required to buy an annual health insurance policy for ourselves and our family members--dictated by government to purchase a private product.

Now, advocates for a mandate assure us that it would lower costs because it would plug the "leaks" in the insurance "pool." They also claim that there is already a mandate in the auto insurance market, and it has not caused anybody any harm.

In reality, there is no such thing as a coverage "pool" that does not leak. ...
...

The private insurance industry--probably the most sophisticated industry in history--will have no trouble developing precisely the kind of products that will feed off the short term concerns of middle class families. Families of four that earn enough money to feel like they are doing well, but not enough to pay $10,000 for a health care policy, will be enticed to buy policies that help them "save money," "control their costs," "take control," "get rich." It does not take much imagination to see how well these kinds of late-night-TV products would succeed. They would be the junk bonds of health insurance, the sub-prime mortgages of health care, the "Rich Dad" videos of the mandate era. They would fuel a health care bubble, and then, inevitably: a health care bust.

Five, maybe ten years, after the system started, we would be faced with our first financial crisis brought on by the mandate. ...

...

Think about it: What would be the one way to guarantee that your insurance premiums would not rise--a common method that millions of Americans use every day? Carry insurance, but avoid any situation where it would come into play.

So, even though these Americans at risk had insurance, millions would have figured out that the best way to avoid a personal financial crisis would be to avoid the doctor and hospitals altogether.

It would be a strange new world, indeed: a world of unhealthy people with health insurance--people whose solution to the financial dangers imposed on them by the mandate and an unregulated private insurance market would be to shift the risk from their household balance sheets to their medical files.

A mandate would mean health insurance, but bankruptcy--coverage, but bad health. ...

Health-care bill wouldn't bring real reform - washingtonpost.com

Health-care bill wouldn't bring real reform - washingtonpost.com

If I were a senator, I would not vote for the current health-care bill. Any measure that expands private insurers' monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform. Real reform would insert competition into insurance markets, force insurers to cut unnecessary administrative expenses and spend health-care dollars caring for people. Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these.
...
Real health-care reform is supposed to eliminate discrimination based on preexisting conditions. But the legislation allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage. The bill was supposed to give Americans choices about what kind of system they wanted to enroll in. Instead, it fines Americans if they do not sign up with an insurance company, which may take up to 30 percent of your premium dollars and spend it on CEO salaries -- in the range of $20 million a year -- and on return on equity for the company's shareholders. Few Americans will see any benefit until 2014, by which time premiums are likely to have doubled. In short, the winners in this bill are insurance companies; the American taxpayer is about to be fleeced with a bailout in a situation that dwarfs even what happened at AIG.
...
To be clear, I'm not giving up on health-care reform. The legislation does have some good points, such as expanding Medicaid and permanently increasing the federal government's contribution to it. It invests critical dollars in public health, wellness and prevention programs; extends the life of the Medicare trust fund; and allows young Americans to stay on their parents' health-care plans until they turn 27. Small businesses struggling with rising health-care costs will receive a tax credit, and primary-care physicians will see increases in their Medicare and Medicaid reimbursement rates.
...
... I know health reform when I see it, and there isn't much left in the Senate bill. I reluctantly conclude that, as it stands, this bill would do more harm than good to the future of America.

The writer is a former chairman of the Democratic National Committee and was governor of Vermont from 1991 to 2002.

thesquanderer's Journal - Obama campaigned AGAINST two major provisions in this health care bill

thesquanderer's Journal - Obama campaigned AGAINST two major provisions in this health care bill
...
As David Zephyr pointed out in this thread, the current heath care bill has a provision allowing people to buy insurance across state lines (as described in the LA Times article here). The problem is that, once insurance can be sold across state lines, insurance companies will gravitate to the states that most favor them and least favor the consumer.

In fact, before the election, this is exactly what McCain wanted, and Obama opposed.

From the second Obama-McCain debate ( transcript here):

MCCAIN:
Don't we go across state lines when we purchase other things in America? Of course it's OK to go across state lines because in Arizona they may offer a better plan that suits you best than it does here in Tennessee.


Obama's response?

OBAMA:
And the reason that it's a problem to go shopping state by state, you know what insurance companies will do? They will find a state -- maybe Arizona, maybe another state -- where there are no requirements for you to get cancer screenings, where there are no requirements for you to have to get pre-existing conditions, and they will all set up shop there.

That's how in banking it works. Everybody goes to Delaware, because they've got very -- pretty loose laws when it comes to things like credit cards.

And in that situation, what happens is, is that the protections you have, the consumer protections that you need, you're not going to have available to you.

That is a fundamental difference that I have with Sen. McCain. He believes in deregulation in every circumstance. That's what we've been going through for the last eight years. It hasn't worked, and we need fundamental change.


(As an aside... it was kind of funny that he kind of stumbled in the middle of the Delaware credit card analogy, apt as it may have been, probably because he knew to instantly water down the criticism there lest it backfire on his VP candidate!)
...
And of course, earlier in the campaign, Obama debated Hillary Clinton, who wanted a mandate requiring everyone to buy insurance. Obama's response then?

OBAMA:
Number one, understand that when Senator Clinton says a mandate, it's not a mandate on government to provide health insurance, it's a mandate on individuals to purchase it. And Senator Clinton is right; we have to find out what works. Now, Massachusetts has a mandate right now. They have exempted 20 percent of the uninsured because they have concluded that that 20 percent can't afford it. In some cases, there are people who are paying fines and still can't afford it, so now they're worse off than they were. They don't have health insurance and they're paying a fine. In order for you to force people to get health insurance, you've got to have a very harsh penalty,

(full transcript here)

Yeah, everyone's talked about change we can believe in, but the real question is, what does Obama really believe in? ...

White paper discussing investment opportunities related to the U.S. healthcare reform released

White paper discussing investment opportunities related to the U.S. healthcare reform released

According to the white paper, as emerging societies continue to become wealthier, they will likely spend more money on medical care as their populations seek to live longer and healthier lives. Moreover, as the storm cloud of healthcare-reform uncertainty hovers over Washington, short-sighted investors are missing an opportunity to participate in a sector that is expected to grow in excess of global GDP for the foreseeable future.

Other key highlights of Rockefeller and Company's healthcare white paper include:

  • Healthcare stock valuations are trading at or near multi-year lows, coinciding with the uncertainty of healthcare reform; healthcare stocks are trading currently at a 44% discount to the general market, a far larger discount than even during the Clinton administration's effort to reform healthcare.
  • Balancing all the political considerations, the most likely legislation to be enacted will essentially insure well more than 30 million currently uninsured individuals, without doing much in the way of restraining costs.
  • Investors also have some potential upside in the sector even if no healthcare reform bill is signed.
  • Regardless of the outcome of healthcare reform, compelling secular trends in the healthcare sector remain fully intact:
  1. Rising prosperity in emerging markets should drive the demand for healthcare.
  2. Even though governments in developed countries are concerned with rising healthcare costs, the pace of healthcare spending in developed markets is expected to continue above GDP growth, given aging populations and the increasing prevalence of chronic conditions such as obesity, diabetes and neurodegenerative disorders.
  3. Continued technological advances in the life sciences are key drivers for the sector. Importantly, continued incentives for medical technology in developed countries and strengthening intellectual property laws in emerging markets only help to fuel already robust innovation.
SOURCE Rockefeller & Co., Inc.

Overuse of CT scans will lead to new cancer deaths, a study shows -- latimes.com

Overuse of CT scans will lead to new cancer deaths, a study shows -- latimes.com

Widespread overuse of CT scans and variations in radiation doses caused by different machines -- operated by technicians following an array of procedures -- are subjecting patients to high radiation doses that will ultimately lead to tens of thousands of new cancer cases and deaths, researchers reported today.

Several recent studies have suggested that patients have been unnecessarily exposed to radiation from CTs or have received excessive amounts, but two new studies published Tuesday in the Archives of Internal Medicine are the first to quantify the extent of exposure and the related risks.

Each year that current scanners are used, researchers reported, 14,500 deaths could result.

In one study, researchers from UC San Francisco found that the same imaging procedure performed at different institutions -- or even on different machines at the same hospital -- can yield a 13-fold difference in radiation dose, potentially exposing some patients to inordinately high risk.

While a normal CT scan of the chest is the equivalent of about 100 chest X-rays, the team found that some scanners were giving the equivalent of 440 conventional X-rays. The absolute risk may be small for any single patient, but the sheer number of CT scans -- more than 70 million per year, 23 times the number in 1980 -- will produce a sharp increase in cancers and deaths, experts said.

"The articles in this issue make clear that there is far more radiation from medical CT scans than has been recognized previously," Dr. Rita F. Redberg of UC San Francisco, editor of the journal, wrote in an editorial accompanying the reports. Even many otherwise healthy patients are being subjected to the radiation, she said, because emergency rooms are often sending patients to the CT scanner before they see a doctor. ...

The five biggest myths about health reform Vital Signs - MarketWatch

The five biggest myths about health reform Vital Signs - MarketWatch
...

Here's how three experts who follow health-care policy weighed in on five of the biggest myths and half-truths about the proposed overhaul.

Assertion: It would lead to a government takeover of health care

That's hardly what the reform effort is designed to do, said Henry Aaron, senior fellow at the Brookings Institution in Washington.

"Here's a plan, the primary purpose of which is to extend private health insurance, and it's called a government takeover. It's just bizarre. It's false," he said. "Even the tiny glimmer of possible validity in that argument, which a public option would provide, is not going to be part of any final bill."
...

But the gap is still wide: About 29% of people had some form of government health insurance in 2008 compared with 58.5% of Americans who had private, job-based coverage, according to the U.S. Census Bureau. About 15%, or 46 million Americans, had no coverage.

"The distinction between who's delivering health care and who's paying for health care is routinely confused and distorted," said Stephen Zuckerman, a health economist at the Urban Institute's Health Policy Center in Washington. Medicare, for example, is a government-financed program, but private doctors make the clinical decisions and deliver the care.

"Government-run health care is like the Veterans Administration, where the government owns the hospital, employs the physicians and finances the care," Zuckerman said.

...

Assertion: An overhaul would lead to rationing, where more people face denials or delays in health care

"This is the big red herring of the current debate," Aaron said. "The United States is so far from having an institutional framework from which rationing could occur that it's not a discussion that has much relevance to the reality of our current system or of the system that would emerge if the bill would pass."

Americans don't support what he called hard rationing, when a person has the money to be treated but is prevented from getting care.

"The American public is quite accepting of rationing in the softer sense, that if you can't afford it you can't have it," he said. "Pushing back that frontier is part of the objective of [the legislation.] The main thrust is to reduce rationing in terms of price rationing."

...

Assertion: An overhaul would lead to rationing, where more people face denials or delays in health care

"This is the big red herring of the current debate," Aaron said. "The United States is so far from having an institutional framework from which rationing could occur that it's not a discussion that has much relevance to the reality of our current system or of the system that would emerge if the bill would pass."

Americans don't support what he called hard rationing, when a person has the money to be treated but is prevented from getting care.

"The American public is quite accepting of rationing in the softer sense, that if you can't afford it you can't have it," he said. "Pushing back that frontier is part of the objective of [the legislation.] The main thrust is to reduce rationing in terms of price rationing."

...

Assertion: If you like your health insurance you can keep it

President Obama touted this idea early and often as he campaigned to overhaul the system, but can he deliver on that promise?

Many experts speculate that it would work out that way but caution that it's not guaranteed, especially since the two bills assess the potential problem differently. While people wouldn't be forced to change what they have, employers may decide for them if they wager they'd be better served to drop coverage and let their workers shop for policies in the new insurance marketplaces the bills envision.

"There are penalties for employers that don't provide coverage so there is this pay-or-play notion, but depending on the penalties it still might be financially beneficial to employers not to play," Zuckerman said. "In the House bill the penalties are much more severe on employers than they are in the Senate bill."

...

Assertion: The bills are too big, and changes should be tackled one by one instead of all at the same time

It's been 15 years since the U.S. came even remotely close to passing comprehensive health reform. While this year's attempt is ambitious, people who decry the scope of the bills underestimate how many moving parts need to work in unison to achieve the desired results, Nichols said.

"It's got to be done as a package," he said.

For example, health insurers would be newly required to accept all comers regardless of their preexisting conditions in exchange for a new requirement that individuals have coverage or face financial penalties.

Addressing cost control without extending health insurance at the same time wouldn't work either, Nichols said. "You cannot get to serious cost containment without the salve of coverage."

"The status quo is not sustainable," he added. "The people who argue that having somebody pay a dollar more or lose their extra glasses in their Medicare Advantage plan is somehow equivalent to leaving 50 million uninsured and doing nothing to contain the cost growth that's eating our economy alive, that's just folly. That's what opponents are trying to get Americans to accept yet one more time."


Economic Scene - Congress May Be Finding the Nerve to Cut Health Costs - NYTimes.com

Economic Scene - Congress May Be Finding the Nerve to Cut Health Costs - NYTimes.com

Over the next several weeks, members of Congress will be confronted with one scary story after another about what will happen if they try to cut health care costs.

Tax the costliest health insurance plans? Workers will be denied medical care. Reduce the growth of spending on home health care agencies? Elderly patients living alone will be left to fend for themselves. Set up a commission to reduce Medicare waste? Again, the elderly will suffer. Impose a tax on plastic surgery? That’s unfair to unemployed women looking to enhance their appearance. (Seriously, the plastic surgeons are making that case.)

But here’s the thing: It is abundantly clear that our medical system wastes enormous amounts of money on health care that doesn’t make people healthier. Hospitals that practice more intensive medicine, to take one example, get no better results than more conservative hospitals, research shows. And while the insured receive better care and are healthier than the uninsured, the lavishly insured — those households with so-called Cadillac plans — are not better off than households with merely good insurance.

Yet every time Congress comes up with an idea for cutting spending, the cry goes out: Patients will suffer! You’re cutting bone, not fat!

How can this be? How can there be billions of dollars of general waste and no specific waste? There can’t, of course.

The only way to cut health care costs is to cut health care costs and, in the process, invite politically potent scare stories.

I’m as skeptical as anyone of the ability of the United States Congress to formulate good policy, but the last few days have offered reason to hope that its members may be summoning the political courage to endure the scare stories.

That would be a big deal. Health costs, through Medicare, are the main source of the huge long-term budget deficit. In recent years, they have also caused insurance premiums to rise so quickly that employers haven’t had the money to give workers a decent raise. David Cutler, a Harvard health economist, estimates that the measures already in the health bills will increase the typical family’s income $2,500 a year by the end of the decade. ...

Thursday, December 17, 2009

Poor Women Turned Away From Free Cancer Screenings

Poor Women Turned Away From Free Cancer Screenings

As the economy falters and more people go without health insurance, low-income women in at least 20 states are being turned away or put on long waiting lists for free cancer screenings, according to the American Cancer Society's Cancer Action Network.

In the unofficial survey of programs for July 2008 through April 2009, the organization found that state budget strains are forcing some programs to reject people who would otherwise qualify for free mammograms and Pap smears. Just how many are turned away isn't known; in some cases, the women are screened through other programs or referred to different providers.

"I cried and I panicked," said Erin LaBarge, 47. This would have been her third straight year receiving a free mammogram through the screening program in St. Lawrence County. But the Norwood, N.Y., resident was told she couldn't get her free mammogram this year because there isn't enough money and she's not old enough.

New York used to screen women of all ages, but this year the budget crunch has forced them to focus on those considered at highest risk and exclude women under 50.

"It's a scary thought. It really is," said LaBarge, who fears she's at a higher risk because her grandmother died of breast cancer. ...

...

"This is rationing of health care by offering (screenings) only in the first half of the fiscal year, or by cutting back on those programs," Brawley said. "It's rationing that is leading to people dying." ...

Catholics face moral crisis between healthcare reform and abortion / The Christian Science Monitor - CSMonitor.com

Catholics face moral crisis between healthcare reform and abortion / The Christian Science Monitor - CSMonitor.com

The healthcare reform debate could soon bring many Roman Catholics to a wrenching moral dilemma: Should they support a bill that expands healthcare to the poor, even if it involves so many uncertainties surrounding access to abortion?

For months, bishops have made their guidance plain: If the final bill weakens a ban on public funding for abortion, then Catholics should oppose it. But they are finding many of their antiabortion adherents willing to embrace what they see as a greater good – improving access to healthcare – even if it undercuts the church’s stand against abortion.
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During the past decade, Catholics have overwhelmingly supported a government guarantee of healthcare access for all citizens – regardless of cost. More than 70 percent of US Catholics supported such a guarantee in 2002 and again in 2006, according to the Center for Applied Research in the Apostolate (CARA) at Georgetown University in Washington. ...

Madfloridian's Journal - The arrogance of allowing "annual limits" on health care....

Madfloridian's Journal - The arrogance of allowing "annual limits" on health care....
...
They dare because they can, because they know they will get away with it.

Annual limits allowed in Senate health care plan

WASHINGTON — A loophole in the Senate health care bill would let insurance companies place annual dollar limits on medical care for people struggling with costly illnesses such as cancer.

Adding to the confusion, the language is tucked away in a clause of the bill captioned "No lifetime or annual limits." Advocates for patients say it fails to deliver on that promise.

..."The legislation that originally passed the Senate health committee last summer would have banned dollar limits on medical coverage, but a second panel — the Finance Committee — disagreed. Finance Chairman Max Baucus, D-Mont., and others feared that an outright ban could drive insurance premiums higher for everyone, and sought to strike a balance.

As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not "unreasonable." The bill does not define what level of limits would be allowable, delegating that task to administration officials.

A spokesman for Senate Majority Leader Harry Reid, D-Nev., said that banning all limits could have have unintended consequences, leading to higher costs. "We continue to work with experts on how best to accomplish our goals of preventing insurance companies from imposing arbitrary coverage limits while providing the premium relief American families need and deserve," said Jim Manley.

The last few days I have read posts about how nearly all Democrats support Obama, how only a pathetic little few dare not. ...

Robert Reich's Blog: How a Few Private Health Insurers Are on the Way to Controlling Health Care

Robert Reich's Blog: How a Few Private Health Insurers Are on the Way to Controlling Health Care

The public option is dead, killed by a handful of senators from small states who are mostly bought off by Big Insurance and Big Pharma or intimidated by these industries' deep pockets and power to run political ads against them. Some might say it's no great loss at this point because the Senate bill Harry Reid came up with contained a public option available only to 4 million people, which would have been far too small to exert any competitive pressure on private insurers anyway.
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But we still end up with a system that's based on private insurers that have no incentive whatsoever to control their costs or the costs of pharmaceutical companies and medical providers. If you think the federal employee benefit plan is an answer to this, think again. Its premiums increased nearly 9 percent this year. And if you think an expanded Medicare is the answer, you're smoking medical marijuana. The Senate bill allows an independent commission to hold back Medicare costs only if Medicare spending is rising faster than total health spending. So if health spending is soaring because private insurers have no incentive to control it, we're all out of luck. Medicare explodes as well.

A system based on private insurers won't control costs because private insurers barely compete against each other. According to data from the American Medical Association, only a handful of insurers dominate most states. In 9 states, 2 insurance companies control 85 percent or more of the market. In Arkansas, home to Senator Blanche Lincoln, who doesn't dare cross Big Insurance, the Blue Cross plan controls almost 70 percent of the market; most of the rest is United Healthcare. These data, by the way, are from 2005 and 2006. Since then, private insurers have been consolidating like mad across the country. At this rate by 2014, when the new health bill kicks in and 30 million more Americans buy health insurance, Big Insurance will be really Big.

In light of all this, you'd think the insurance industry would be subject to the antitrust laws, so the Justice Department and the Federal Trade Commission could prevent it from combining into one or two national behemoths that suck every health dollar out of our pockets (as well as the pockets of companies paying part of the cost of their employees' health insurance). But no. Remarkably, the Senate bill still keeps Big Insurance safe from competition by preserving its privileged exemption from the antitrust laws. ...

Big Pharma's Bitter Pill | OurFuture.org

Big Pharma's Bitter Pill | OurFuture.org

Every morning I swallow a bitter pill. Actually, the medicine itself isn't all that bitter. It's no different from any of the other medicines I take that make it possible for me to function at home and at work by controlling things like allergies and gastro esophageal reflux disease. It didn't actually taste any differently this morning than it does any other morning. At least not in the literal sense.

I've been reluctant to sit down and figure out how exactly much my medicines cost me every month, but my co-pays add up to somewhere between $150 to $200 per month, after insurance. That's not a whole lot compared to what many other people pay, I admit. Still, anytime there's a chance of reducing a monthly expense, I'm happy.

So, I was happy to hear it when my husband (a doctor) told me earlier a few years ago that the medicine in question — the most expensive of my prescriptions, was set to go generic in 2010. It would mean lower prescription costs for me and my insurer. (Actually, it would have meant bigger savings for my insurer, though my co-pay for that prescription would go down by about half.)

Well, late last week, my husband gave me the bad news. After perusing the latest medical news, he informed me that the prescription won't go generic for at least another three years. Why, because the big pharmaceutical company paid off the generic manufacturer.

...

The vehicle for these deals is patent litigation. When a generic drug is approved to come to market, the maker of the more expensive name-brand drug sues the generic for patent infringement. But instead of a conventional settlement, in which the generic pays the patent-holder to settle the claim that it infringed the patent, the payment goes the other way: the patent-holder pays the maker of the generic, in exchange for a pledge to delay bringing the generic to market. That suggests the patent-holder fears its patent wouldn't hold up in court, as many don't. And it runs counter to the intent of the Hatch-Waxman Act of 1984, which sought to speed the path of generics to market, and to provide a legal framework for these cases.

So common have these deals become lately that they've been given a name: pay-for-delay. The approach — a textbook anti-competitive tactic — is worth billions to drug-makers, because it essentially allows them to buy more protection than their patent confers.

Tell me again, about the wonders of the free-market. Talk about "profits over people." To hear Big Pharma tell it, this is supposed to be a "win-win" situation.

...

In other words, "pay-to-delay" settlements shorten lawsuits, thus theoretically lowering legal costs for the pharmaceutical companies, which then pass those savings on to consumers. Theoretically. But as Zach Roth points out above, the "pay-to-play" settlements strongly suggest that big pharmaceutical companies' patently claims would not stand up in court. And big pharma seems to be jacking up prices anyway, to get get ahead of health care reform. ...

Daily Wrap-Up and Poll: Do We Have Too Much Healthcare In This Country? | OurFuture.org

Daily Wrap-Up and Poll: Do We Have Too Much Healthcare In This Country? | OurFuture.org

We need to stop the excise tax on so-called "Cadillac" health plans - a tax that will affect an increasing number of middle-class workers over the next ten years. In the meantime, feel free to take a poll: "Do you think we have too much healthcare in this country?"

As I explained in The Huffington Post, I plan to devote a great deal of energy in the coming weeks to stopping the excise tax on so-called "Cadillac" health plans - a tax that will affect an increasing number of middle-class workers over the next ten years.

I've never gotten this deeply into direct advocacy before - but this is a bad idea. So there's now a web page at the Campaign For America's Future called "No Middle-Class Health Tax."

...

This tax would also represent at least two broken campaign promises: that health reform would not be paid for with new middle-class taxes, and that (in the President's words) "if you like the plan you have now, you can keep it." ...

Astounding Mercer Fact #1: Excise Tax Could Affect One Out of Every Five Employer Plans | OurFuture.org

Astounding Mercer Fact #1: Excise Tax Could Affect One Out of Every Five Employer Plans | OurFuture.org

Kaiser Health News has summarized some new findings from the Mercer consulting group that are quite compelling. We think they're so significant they should each be absorbed separately. The first impressive finding, from a study of 3,000 firms: "The excise tax ... could hit up to 19 percent of medical packages offered by employers in 2013, the first year it goes into effect." (Emphasis mine)

19 percent! As in one health plan in five - you know, that 19 percent. We don't have enough data to guess what percentage of people with employer health insurance would be affected, but we're predicting it will be more than 19 percent. Why? Because larger employers tend to offer more generous health coverage than smaller employers, and union health plans also tend to have larger memberships. So if one in every five plans will be affected, larger plans will be disproportionately taxed - with the effects of that tax being passed on to more than one American in five with employer-based insurance.

...

So the so-called "Cadillac tax" - sold as a tax on extravagant executive plans - is likely to affect one-fifth or even more of the American workforce and their families. That's a stunning number - and it's based on a large sampling of health plans. This tax is looking less like a Cadillac and more like a family station wagon every day.

Study: Medicaid Expansion, Lower Health Care Costs - WBOY-TV - WBOY.com

Study: Medicaid Expansion, Lower Health Care Costs - WBOY-TV - WBOY.com

Expanding Medicaid eligibility along with requiring individuals and businesses to carry health insurance could save West Virginians more than $2 billion a year in health care costs, according to a study released Dec. 7.

The actuarial study examined the potential costs and benefits of several proposed health care reforms using data donated by the state's largest health care providers. Several groups came together to fund the study, including the West Virginia Heath Care Authority and the West Virginia Chamber of Commerce.

The report's authors concluded that more government spending upfront would more than pay for itself through savings in the system. Health care providers in particular would see a substantial drop in amount of uncompensated charity care they provide, which is often blamed for driving up costs for all patients.

"It is an enormous benefit to our doctors and hospitals around the state because they are providing that care for nothing and now will get paid," said Perry Bryant, executive director of West Virginians for Affordable Health Care, one of the study's sponsors. ...

...

The firm was able to make its predictions thanks to three years of pharmaceutical and medical claims data voluntarily provided by the largest health care providers in the state, said Sonia Chambers, chairwoman of the authority. The data came from Mountain State Blue Cross Blue Shield, Medicaid, the Public Employees Insurance Agency, The Health Plan, Coventry and the state's Children's Health Insurance Program.

Currently, most adults do not qualify for Medicaid. Expanding the program to cover adults up to 100 percent the federal poverty level would cost the state $56.8 million and the federal government $162 million in 2014, but overall health care expenditures will decrease $611.5 million, according to CCRC.

More than 59,000 would become eligible for the program under the expansion, according to the report.

Adding mandates for individuals and for businesses with more than 10 employees dramatically increase cost for government, which would need to provide more than $1 billion in subsidies to help people pay for the mandates. However, overall health expenditures would decrease by $2.1 billion by 2014. Low-income residents would see the majority of savings, spending $2.2 billion less on health care. ...

Fix the Bill

Fix the Bill

A new report, Health Care Reform and Walmart: What the Senate Health Care Reform Bill Means to the Country’s Largest Employer, outlines how that the Senate Health Care Bill, as written, fails to hold Walmart responsible for the health care costs of its 1.4 million employees.

The report examines the Senate bill by looking at its impact on America’s largest and most irresponsible private employer. As written, the employer responsibility provision—“Free Rider”—would provide no overall health care cost savings because it would:

  • Provide little or no incentive for Walmart to provide insurance to more workers or provide better care to its workers;
  • Continue the dependence of tens of thousands of Walmart employees and their families on federal and state subsidies for Medicaid and SCHIP, and encourage Walmart to have even more workers and their families dependent on these taxpayer-funded programs;
  • Make few, if any, Walmart workers eligible for tax credits to purchase better insurance through the health insurance exchange;
  • Force low-income Walmart workers into high-deductible, company-provided insurance;
  • Incentivize the hiring of a largely part-time workforce, and encourage reducing workers’ hours as a way to reduce health care costs.