Sunday, November 29, 2009

Social Status Has Measurable Effect on Health | CommonDreams.org

Social Status Has Measurable Effect on Health | CommonDreams.org

In recent years, a growing body of scientific research indicates that human health and longevity aren't just matters of genes and habits. Rather, they seem to have a lot to do with our relative status or position in society.

The wonky term for this kind of thing is "the social determinants of health," which was recently the topic of a presentation to the West Virginia Legislature by epidemiologist and physician Dr. Camara Jones of the U.S. Centers for Disease Control. While the focus of Dr. Jones' presentation was on racial disparities, she said that inequalities and inequities affect the health of all people, regardless of racial or ethnic backgrounds.

A pioneer in this field of research is the British epidemiologist Michael Marmot, who among other things studied English civil servants over a period of decades. Here's the short version of his findings: people higher up the ladder lived longer and were less sick than those lower down, even when we take individual behavior into account.

This was true despite the fact that England has universal health care. Without it, the differences would no doubt have been even worse.

...

It seems that jobs and situations that give people low levels of control and impose high demands and low rewards are particularly toxic for health. Outside of the workplace, such situations might include living in bad housing or in unsafe or toxic neighborhoods or in violent family situations.

These kinds of situations seem to activate the body's stress response, which was designed to deal with short-term threats and dangers but can lead to higher risks of various kinds of diseases when the stress is prolonged or chronic. This can lead to a great susceptibility to such illnesses as diabetes and heart disease as well as greater risk of infectious disease.

A startling finding of this kind of research is that relative deprivation in early life can have lasting impacts on health years later. In one experiment, healthy adults were exposed to two kinds of rhinoviruses, which cause common colds. They were asked a series of questions about their socio-economic status. It turned out that people whose parents owned their homes when they were children were significantly less likely to get sick than those whose parents didn't.

The findings of Marmot and other researchers is pretty sobering in the context of the current recession. Based on solid research, it's sadly safe to say that some people are going to die sooner than they otherwise would have because of it. Marmot's research on jobless workers in Britain found that "people who became unemployed had 20 percent higher mortality than those who remained employed at the same social class level." ...

Senator Ben Nelson and His Connections to the Health Care Industry | Public Campaign Action Fund

Senator Ben Nelson and His Connections to the Health Care Industry | Public Campaign Action Fund

On May 1, 2009 Nebraska Senator Ben Nelson came out against including a public health insurance plan option as part of this year’s health care reform legislation. Sen. Nelson called the inclusion of a public plan a “deal-breaker,” according to Congressional Quarterly.1
...

Before entering politics, Ben Nelson spent his career as an insurance executive, insurance company lawyer and, early in his career, Nebraska’s state insurance regulator. He was chief executive officer of an insurance company and has sided with and received political support from business groups opposed to a public health plan as part of health reform.

  • “Nelson enjoyed a successful career in insurance law,” says his Senate website. “He has served as CEO of the Central National Insurance Group, as chief of staff and executive vice president of the National Association of Insurance Commissioners, and as director of the Nebraska Department of Insurance.”3

  • In his 2006 re-election campaign, Nelson received endorsements from the National Federation of Independent Business, the Business-Industry Political Action Committee, and the U.S. Chamber of Commerce. According to the Lincoln Journal Star, “NFIB jointed BIPAC (Business-Industry Political Action Committee) and the U.S. Chamber of Commerce in handing the Democratic senator strong business support.”4 These lobbies are either publicly opposed to a public insurance option, or are expected to be.

CAMPAIGN CONTRIBUTIONS

Sen. Nelson has depended on the insurance and health care industries to pay for his campaigns for public office.5

  • According to the nonpartisan Center for Responsive Politics, Sen. Nelson has raised more than $2 million from insurance and health care interests in his three campaigns for federal office.

  • Sen. Nelson has received $1,195,299 from insurance interests, $399,345 from health professionals, $258,483 from the pharmaceutical industry, and $195,138 from hospital and nursing home interests.

  • Of Sen. Nelson’s campaign contributions from the insurance and health care industries, 83.4% have come from out of state sources, according to our analysis of data downloaded from the Center for Responsive Politics.

MIT analysis backs Obama - Mike Allen - POLITICO.com

MIT analysis backs Obama - Mike Allen - POLITICO.com
...

The new document arms Democrats with a response to the contention of Senate Minority Leader Mitch McConnell (R-Ky.) that the bill would mean “higher premiums, higher taxes, and massive cuts to Medicare.”

The “microsimulation” analysis is by Jonathan Gruber, an economist at the Massachusetts Institute of Technology and a Treasury Department official under President Bill Clinton. Gruber used data from the Congressional Budget Office.

Gruber concludes that people purchasing individual insurance would save an annual $200 (singles) to $500 (families) in 2009 dollars. And people with low incomes would receive premium tax credits that would reduce the price that they pay for health insurance by as much as $2,500 to $7,500.

The report will be circulated to Capitol Hill this week. Read the four-page report here.

Gruber’s conclusion: “[F]or those facing purchase in the non-group market, the … bill will deliver savings ranging from $200 for singles to $500 for families in today’s dollars – even without subsidies. The savings are much larger for lower income populations that receive premium credits.

“This is in addition to the higher quality benefits that those in the exchange will receive, with actuarial values for low income populations well above what is typical in the non-group market today. It is also in addition to all the other benefits that this legislation will deliver to those consumers – in particular the guarantee, unavailable in most states, that prices would not be raised or the policy revoked if they became ill.”

Gruber was among the 23 Ph.D. economists who sent a letter to Obama on Nov. 17 endorsing his approach to health-care reform. Read the economists’ four-page letter here.

Tuesday, November 24, 2009

Insurance Industry Antitrust Fight Headed To Conference Committee

Insurance Industry Antitrust Fight Headed To Conference Committee
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Senate Majority Leader Harry Reid (D-Nev.)responded by saying the industry should lose its cherished antitrust exemption -- implemented some 60 years ago by the McCarran-Ferguson Act -- and be forced to compete under the same rules as any other enterprise.

"Insurance companies have become so large they dominate entire regions of the country," he said. "They have become so powerful they block start-up businesses from entering the market, and they put smaller companies out of business. They have become so dominant that they dictate business practices. They are so influential that they exert tremendous influence over public policy."

House Speaker Nancy Pelosi (D-Calif.) seconded Reid the next day, twisting the knife and adding that "it is well known to the public that the health insurance companies are the problem." The following day Judiciary Committee Chairman John Conyers announced a hearing and a committee vote on revoking the exemption. It passed and was included in the House health care bill that passed two weeks ago.

...

Nelson argues that repealing the exemption wouldn't hurt the big insurers because they're already so big they don't need to collude with each other. Repealing it, he argues, would only hurt the little guys.

But there are very few little guys left: one or two big insurers are dominant in almost every region of the country.

Nelson, now that he has voted to move the bill forward, is still threatening to filibuster a final bill if he finds it objectionable. Nelson and others want the public health insurance option stripped from the Senate bill, but if it goes to conference too friendly to the industry, the antitrust repeal is likely to be in the bill that comes back. For the industry, it's pick your poison.

A Stacked Deck : Quiat on Claims

A Stacked Deck : Quiat on Claims

Some recent case reports made us wonder once again why IMEs are called Independent Medical Examinations. They are hardly “independent”.

These “examinations” are the evidentiary foundation upon which disability insurance companies rely to deny disability income claims so that these denials can withstand subsequent scrutiny from the courts.

How do you “fix” a game so that it favors you? When you are the manager, you pick the players who you think will win the game for you. Medical “experts” who can be counted on to deny a disability are key to getting the outcome the carrier is looking for. That part is obvious. What is not obvious is that Congress and the courts have permitted this corrupt practice to flourish, making this already one-sided affair a knockout blow for disabled claimants.

ERISA, supposedly passed by Congress to make it easier for employees to level the playing field, gives the insurer, which is also an administrator of a plan, discretion to determine whether a disability claim is covered by a disability policy. It doesn’t take a great brain to figure that if a claim is denied, the money that would have been paid to the claimant goes right to the insurance company’s bottom line.

Ever since the Supreme Court ruled in Firestone v. Bruch, 489 US 101 (1989) that courts must give deference under ERISA to the finding of the plan administrator as to whether a claim is covered, insurance companies have been having a field day denying claims that should have been paid and having the courts, with their hands tied by Firestone, back them up.

What does the IME have to do with this? Insurers have gathered to themselves a coterie of doctors who know only one thing – which side of the bread their butter is on. These “experts” make all or most of their income year after year from insurance company examinations (some in excess of $1 million per). They know that if they were actually impartial in their work, their source of income would dry up fast. So, these “independents” lean heavily in favor of their meal ticket. The result? Disabled policyholders, who may have been paying premiums for years, suffer.

On top of this, courts have had their hands tied since 1989, and have to give these slanted medical reports not only credence, but deference. If any of these so-called “independent” medical reports supports the denial of benefits by the administrator, the court has to uphold the denial even if the court may feel, on the basis of the evidence it has heard, that the denial is flat wrong. ...

Quiat on Claims : New York Disability Insurance Lawyer & Attorney : Michael Quiat : Uscher Quiat Uscher & Russo Law Firm : ERISA, Denied Claims

Quiat on Claims : New York Disability Insurance Lawyer & Attorney : Michael Quiat : Uscher Quiat Uscher & Russo Law Firm : ERISA, Denied Claims

How About Paying Us Back?

Drug companies have been raising their prices in anticipation of a government health reform program which may try to rein in uncontrolled drug price rises the companies have grown used to pocketing over the years. So, what’s new?

As reported in the NY Times, the wholesale price of drugs has gone up about 9% in the last year while the Consumer Price Index fell by about 1.3% during the same period. The drug industry claims the prices have risen at this rate, a rate unprecedented for the last
15 years, for good and valid business reasons. Realists say the industry is preparing for health reform, one of the cornerstones of which is trying to curb drug spending.

Whichever it is, the consumer gets caught in the middle again. While the drug industry trumpets its agreement to cooperate in lowering the nation’s drug bill by $8 billion a year in support of national health reform, it has already increased the nation’s health bill by more than $8 billion even before the health legislation gets its legs under it.

The excuse they use is the old saw that they have to charge more to generate monies for research and development of new products. Drug manufacturers have been using this excuse for raising prices for decades although the real reason is to keep their shareholders happy.. But, nobody seems to give a darn about the end user, the person who desperately needs the drug to stay alive or functional. Whether or not these afflicted people can afford the price, they have to find some way to pay.

Speaking of new product research and development, how about the billions and billions taxpayers spend on basic research at universities which lead to the development of many of these drugs and medications? Why doesn’t the taxpayer get a cut of the profits just as shareholders do? Why does all of the good stuff (profits) go to the company owners, while the taxpayer whose funds started the research and development, gets zilch? ...

The Problem is ERISA

The Problem is ERISA

I have clients cheated by their insurers. "It's fraud!" they say. "It sure is," I tell them. "What can we do about it?" they ask. "Not much," I say, "the problem is ERISA."

ERISA is the federal law governing employee benefits, like your health insurance. If you get your insurance through your employment, and if you think "insurance" is an enforceable contract that the insurer will cover what it says it will, then you don't have insurance at all -- you only think you do.

Wednesday, November 18, 2009

“Independent” medical exams and “reasonable” grounds for denying your claim

As we’ve seen when an insurance company has managed to grant itself “discretion” it gets the benefit of the most absurd judicial deference known to the law. The courts make no bones about it: a decision to deny benefits, even if the court agrees it is wrong, will nonetheless be upheld so long as the court concludes it was “reasonable” (not reasonable, “reasonable”).

So what does it take for a wrong decision to be “reasonable”? One way is for the insurance company to say hey, it wasn’t our decision, we hired an independent doctor to review all the files and we just abided by this fine fellow’s impartial and fair opinion. And the judge says, well, they did have someone with “M.D.” after his name say the claim was bogus, and who am I, a mere federal district court judge, to disagree with such a learned and considered opinion? (and the champagne and caviar doesn't affect my decision at all!).

Of course, as in all things ERISA, the books are cooked here. These so-called “independent” medical examiners are very, very frequently beholden to the insurance companies who hire them and pay the freight. These doctors are very handsomely contemplated for their time, and that gravy train stops abruptly if the insurance company sees they are issuing too many opinions which don't allow the insurer to deny a claim. So to all too many of these “independent” doctors, no one is ever disabled, and no medical treatment ever qualifies as “medically necessary.”

My colleague Michael Quiat, on his excellent disability law blawg, addressed this issue recently. You should read the whole thing, but here’s a taste:

To construct the façade of “impartiality”, insurance companies hire doctor “agencies” which hire physicians to do what are facetiously called Independent Medical Examinations, purportedly because the insurance company wants to catch malingerers. These doctor agencies scout out MDs, many of whom do not practice medicine as a vocation, but stick strictly to IME exams. These exams provide most, if not all of their income.

These physicians are paid to be highly skeptical of disability claim and claimants. Most of their exams are based on the written reports of claimants’ doctors, but yet they are supposedly able to determine that a claimant is not in pain or restricted in movement or otherwise afflicted, even though they never see the claimant! ...

Monday, November 23, 2009

debbierlus's Journal - Health Insurance Reform: The Enslavement of American Citizens to Corporate Rule

debbierlus's Journal - Health Insurance Reform: The Enslavement of American Citizens to Corporate Rule

After months of silent, closed door negotiations between the holy trinity (the executive branch, the congress, & the health care industry), we stand on the brink of health insurance reform.

Health insurance reform. Do not confuse this with health care reform as that was never the intent of this legislation. This is not a minor point. Health care reform would have addressed the central problem of our current health care system and confronted the reality that in order to provide universal, affordable health care for all citizens, we would need to stop treating human health as a commodity. It would have taken a moral imperative to place human life over profit. But, right from the very beginning, the central GOAL in creating this legislation was just the opposite, the development of a plan that not only maintained, but expanded the ability of the health care industry (private insurers, big pharm, large hospitals) to profit off human illness.

And, that has what has been created. A bill that enshrines private health care companies as the government mandated model for health care administration. A bill that will provide 70 billion dollars in subsidies to private insurance companies, at the expense of universal, affordable coverage for every American citizen. A bill that negotiated away the government's ability to stop big pharm price gouging, in exchange for a phony bargain where the pharmaceutical companies would cut up to 8 billion dollars in costs over the next ten years while they elevated prices 10 billion this year alone. A bill that does not allow reimportation of drugs from Canada and holds the American people hostage to a mob type system of pay or die. Under this bill, millions will not be able to afford their prescriptions. Millions more will be forced to choose medication, food, or heat.

Under this bill, denial of care will be allowed for a thousand other reasons then the sole prohibited exception of a preexisting condition.

Under this bill, health care coverage will remain a game of chance.

Under this system, class difference may still determine whether you live or die.
...
This legislation was written to save the health insurance system from the collapse which was soon to come. A collapse which very well could have precipitated the transition to single payer.

Why are we reviving the beast?

News Analysis - Medical Science and Practice in Conflict - NYTimes.com

News Analysis - Medical Science and Practice in Conflict - NYTimes.com

This week, the science of medicine bumped up against the foundations of American medical consumerism: that more is better, that saving a life is worth any sacrifice, that health care is a birthright.

Two new recommendations, calling for delaying the start and reducing the frequency of screening for breast and cervical cancer, have been met with anger and confusion from some corners, not to mention a measure of political posturing.

The backers of science-driven medicine, with its dual focus on risks and benefits, have cheered the elevation of data in the setting of standards. But many patients — and organizations of doctors and disease specialists — find themselves unready to accept the counterintuitive notion that more testing can be bad for your health.

“People are being asked to think differently about risk,” said Sheila M. Rothman, a professor of public health at Columbia University. “The public state of mind right now is that they’re frightened that evidence-based medicine is going to be equated with rationing. They don’t see it in a scientific perspective.”

For decades, the medical establishment, the government and the news media have preached the mantra of early detection, spending untold millions of dollars to spread the word. Now, the hypothesis that screening is vital to health and longevity is being turned on its head, with researchers asserting that mammograms and Pap smears can cause more harm than good for women of certain ages.

...

“A review of the evidence to date shows that screening at less frequent intervals prevents cervical cancer just as well, has decreased costs and avoids unnecessary interventions that could be harmful,” said Dr. Alan G. Waxman, a professor at the University of New Mexico who directed the process. ...

Wednesday, November 18, 2009

OpEdNews - Article: Afghan Escalation Would Make One-Year Pentagon Budget Almost As Big as Entire 10-Year Health Bill

OpEdNews - Article: Afghan Escalation Would Make One-Year Pentagon Budget Almost As Big as Entire 10-Year Health Bill

In pitting the 10-year cost of Democrats' health care bill against the 10-year projected cost of the bloated Pentagon budget, my newspaper column last weekmade a simple comparison rarely ever made in politics today - a comparison that might provide citizens with much needed context, but a comparison that is ignored.

Is the comparison's omission deliberate? It's hard to say, but when you read this typical New York Times piece, it's hard to argue that it isn't being irresponsibly ignored:

...

Even if fewer troops are sent, or their mission is modified, the rough formula used by the White House, of about $1 million per soldier a year, appears almost constant.

So even if Mr. Obama opts for a lower troop commitment, Afghanistan's new costs could wash out the projected $26 billion expected to be saved in 2010 from withdrawing troops from Iraq. And the overall military budget could rise to as much as $734 billion, or 10 percent more than the peak of $667 billion under the Bush administration.

Kudos, of course, to the Times for even reporting on the unfathomably large costs of intensifying militarism and adventurism. But as you'll see in the story, there's no attempt to put the costs into any context - specifically, there's no mention that an escalation in Afghanistan would mean outlays for the one-year Pentagon budget is approaching the total outlays of the entire 10-year health care bill.

Of course, the Times does offer up one fleeting contextual message indicating that increased defense spending from an Afghanistan escalation "would be a politically volatile issue for Mr. Obama at a time when the government budget deficit is soaring, the economy is weak and he is trying to pass a costly health care plan." But even that brief mention is dishonest.

On what basis does the Times call the health care plan "costly?" As I said in my column, while the Congressional Budget Office (ie. the nonpartisan institution that reporters/politicians use to price bills) says the health legislation would mandate about $890 billion, CBO also makes painfully clear its tax and budget-cutting provisions would recover a net of $109 billion over 10 years, meaning the bill is as "costly" to the public treasury as the purchase of a stock that produces a net 10% return on investment. I mean, seriously - if you invested $1,000 into a stock and got $1,100 back, would you lament to a friend about how "costly" the investment was to your bank account? No - because your friend would look at you like you were insane....

Drug Makers Raising Prices Before Reform - NYTimes.com

Drug Makers Raising Prices Before Reform - NYTimes.com

Even as drug makers promise to support Washington’s health care overhaul by shaving $8 billion a year off the nation’s drug costs after the legislation takes effect, the industry has been raising its prices at the fastest rate in years.

In the last year, the industry has raised the wholesale prices of brand-name prescription drugs by about 9 percent, according to industry analysts. That will add more than $10 billion to the nation’s drug bill, which is on track to exceed $300 billion this year. By at least one analysis, it is the highest annual rate of inflation for drug prices since 1992.

The drug trend is distinctly at odds with the direction of the Consumer Price Index, which has fallen by 1.3 percent in the last year.

Drug makers say they have valid business reasons for the price increases. Critics say the industry is trying to establish a higher price base before Congress passes legislation that tries to curb drug spending in coming years.

“When we have major legislation anticipated, we see a run-up in price increases,” says Stephen W. Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota. He has analyzed drug pricing for AARP, the advocacy group for seniors that supports the House health care legislation that the drug industry opposes.

A Harvard health economist, Joseph P. Newhouse, said he found a similar pattern of unusual price increases after Congress added drug benefits to Medicare a few years ago, giving tens of millions of older Americans federally subsidized drug insurance. Just as the program was taking effect in 2006, the drug industry raised prices by the widest margin in a half-dozen years.

“They try to maximize their profits,” Mr. Newhouse said.

But drug companies say they are having to raise prices to maintain the profits necessary to invest in research and development of new drugs as the patents on many of their most popular drugs are set to expire over the next few years. ...

Tuesday, November 17, 2009

Insurance Runs Out For 12-Year-Old Boy Without Arm

Insurance Runs Out For 12-Year-Old Boy Without Arm

Benjamin French was born with his right arm missing below the elbow. In his 12 years, he has been fitted with seven prostheses. His most recent replacement will cost nearly $30,000 and his doctor says he will soon grow out of it.

But, according to his insurance company, the boy is ineligible for further coverage of prosthetic devices because he has already spent his lifetime maximum benefit.

Benjamin's family happens to live in Michigan, one of 33 states where insurance companies are allowed to set annual and lifetime caps on prosthetic coverage. The family's policy with Blue Cross Blue Shield of Michigan covers a maximum of $30,000 per lifetime for prosthetics, plus $1,000 per year for repairs. In states such as Colorado and Maryland, the law says there can be no such cap on prosthetics.

...

Within this decade, 17 states have passed laws requiring that insurers pay for prosthetics on par with federal programs such as Medicaid, but in the other 33 states, insurers do not have to offer coverage for prosthetic devices and also can set annual or lifetime caps on coverage. These caps on prosthetics are similar to the caps on mental health coverage that were recently made illegal by a federal mental-health parity law, scheduled to go into effect in January.

"These rules are illogical and arbitrary," said Kimberly Hoyt, a specialist in Denver, Colo., who designs and fits prosthetic limbs. "You have to be an investigative reporter to figure out which states have parity laws and which states don't." Since Colorado became the first state to pass prosthetic parity legislation in 2001, Hoyt said, she has seen fewer denials overall for prosthetic limbs, but gets frustrated when she sees patients, such as college students, who cannot get coverage because they are insured in states with looser rules. ...

Sunday, November 15, 2009

Study questions Vytorin and Zetia in heart disease treatment - washingtonpost.com

Study questions Vytorin and Zetia in heart disease treatment - washingtonpost.com

A widely prescribed and expensive cholesterol drug does not unclog arteries as effectively as a modified version of Vitamin B3, a cheap alternative used to treat heart disease for decades, according to a new study.

The research, which appears Monday in the New England Journal of Medicine, is sending rumbles through the medical community because it is the third recent study to raise questions about the effectiveness of Zetia and its sister drug, Vytorin, highly profitable pharmaceuticals made by Merck & Co.

"This is the third strike," said Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic in Ohio. "The studies are telling us that it doesn't appear to produce benefits. This is a drug used by millions of Americans, a very big seller, in a health-care system where costs are a major issue. And the question has to be, is this the right approach?"

Vytorin and Zetia are among the most popular of prescription drugs. Last year, physicians in the United States wrote more than 29 million prescriptions for both drugs combined, and worldwide sales totaled $4.56 billion, according to Merck.

...

Introduced in 2002 and 2004 amid heavy direct-to-consumer marketing, Zetia and Vytorin became blockbusters for Merck and Schering-Plough, which had collaborated on their development. The companies recently merged.
...
Taken as a whole, the new research is unnerving, said Harlan Krumholz, a Yale University cardiologist. "The accumulating evidence isn't giving you any confidence," he said. "This is a very expensive drug being used without any strong evidence that it's benefiting patients . . ." Zetia and Vytorin should be "drugs of last resort, if used at all," Krumholz said. "And anyone who uses it should make sure patients are informed that they're taking a gamble."
...
The patients who took Niaspan (Vitamin B3 Niacin) had less plaque in their arteries and also had higher levels of high-density lipoprotein or HDL. Known as "good" cholesterol, HDL is believed to remove cholesterol from the arteries and carry it back to the liver, where it is passes from the body.

The patients who took Zetia had more plaque in their arteries but lower levels of LDL. They also had more heart attacks, strokes and other cardiovascular problems than the patients taking niacin. Merck President Peter Kim said the fact that Zetia lowers LDL cholesterol makes it valuable. "It's very well established that lowering LDL saves lives," he said.

Roger S. Blumenthal, a cardiologist at Johns Hopkins, criticized the new study in an editorial also published Monday in the New England Journal of Medicine. Blumenthal, who has been a paid speaker for Merck, noted that the new study was halted early, which meant results from 40 percent of the participants were not included in the final analysis. ...

Swine flu: Without paid sick leave, workers won't stay home | csmonitor.com

Swine flu: Without paid sick leave, workers won't stay home | csmonitor.com

Nearly half of all American workers do not have paid sick leave, and half of these are more likely to go to work feeling unwell – or send an ill child to school – rather than take an unpaid day off.

These findings threaten to undermine President Obama's effort to have anyone exhibiting swine-flu-like symptoms stay at home for as many as four days. The emphasis on prevention and individual responsibility is a welcome departure from the punitive government actions – such as quarantines and forced vaccinations – called for under previous pandemic-response plans, some health experts say.

But for the 48 percent of Americans without paid sick leave, the policy presents a choice between two equally undesirable options: stay at home and lose money or go to work despite government exhortations not to. Businesses, too, say the situation leads to so-called "presenteeism," or the act of going to work while unwell, costing the economy $180 million a year, by one estimate.

Sen. Chris Dodd (D) of Connecticut announced Tuesday that he is preparing emergency legislation that would guarantee paid sick days for those diagnosed with the H1N1 virus.

"Families shouldn't have to choose between staying healthy and making ends meet," Senator Dodd said in a statement.

Dodd had also championed the Healthy Families Act, which sought to mandate an hour of sick time for every 30 hours worked. But that bill is stalled in Congress.

In addition, 15 states have proposed mandatory sick-leave laws, and New York City is following the lead of San Francisco, Milwaukee, and Washington, D.C., which have passed some form of mandatory sick-leave measures. ...

How to Control Rising Health Care Costs - Room for Debate Blog - NYTimes.com

How to Control Rising Health Care Costs - Room for Debate Blog - NYTimes.com

With the House’s passage of a health care bill and the Senate legislation possibly moving to the floor for debate next week, many analysts are saying that neither bill goes far enough to slow rising health care costs — an issue that President Obama has made central to his reform agenda.

We asked some experts what are one or two provisions not in the bills that could help contain health care costs going forward?


Jacob S. Hacker is a professor of political science at Yale and the author of “The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream.”

Many critics of the Democratic reform bills are concerned that the bills don’t do enough to slow the rise of health spending. Oddly, many of these critics are also against one of the most important immediate steps needed to create real spending restraint: a strong public insurance plan with the authority to bargain for lower prices for medical goods and services, including prescription drugs.

Health policy experts have shown — and some revealing new evidence drives home — that American insurers pay much more, on average, for goods and services than do insurers in other rich nations. There is also a huge disparity in the prices and the administration of payments that insurers pay.

Close

To bring real cost restraint to American health care, not only should the public plan be strengthened to have greater bargaining authority, but private insurers should also be allowed to piggyback on it in setting their own rates.

Most observers of health care know that the insurance market has become increasingly consolidated, with one or a small handful of insurers enrolling most of the privately insured. Less well known is that providers, too, have grown increasingly consolidated. Many insurers admit they cannot negotiate fair rates in local markets because of provider oligopolies.
...

Len M. Nichols is director of the Health Policy Program at the New America Foundation.

The Medicare payment reforms in both the House and the Senate bills will help to slow the growth of costs by rewarding value over volume, as will the proposed Medicare commission and the tax on insurers who offer high-cost health plans, which are in the Senate Finance Committee bill. And both House and Senate legislation also include “innovation centers” which will allow us to test different payment models and health care processes.

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Daniel Callahan is the co-founder of the Hastings Center, a nonpartisan research institution dedicated to bioethics and public policy. He is author of “Taming the Beloved Beast: How Medical Technology Costs Are Destroying our Health Care System.”

There are two important elements missing in the bills: permitting Medicare to consider costs in making its benefit coverage decisions, and a provision setting a “trigger point” to control insurance premiums if competition does not work to hold down cost increases.

The Medicare program has been forbidden since its inception in 1965 from allowing costs to be considered in its benefit coverage decisions. That ban makes no sense for a program facing insolvency in the next eight years or so, particularly since it now covers drugs and treatments that are far more costly than their health value. That limitation should be eliminated.

...

Leslie Greenwald is a principal scientist and division vice president at RTI International, a nonprofit research institute. She worked at the Health Care Financing Administration (now the Center for Medicare and Medicaid Services) on health care, among other issues, under Republican and Democratic administrations.

Identifying an effective method for controlling and reducing health care costs is the most difficult element of health care reform. Unfortunately, so far, the health care reform bills under consideration largely avoid the core problem of runaway health care spending: Americans consume too much expensive health care, driving up costs with little or no marginal improvement in their health status or longevity.

The current health care reform bills include some provisions that may have an impact on lowering health care prices. Inclusion of a public option is one way to lower health insurance pricing. Government sponsored health insurance options, like the Federal Medicare program, have a number of structural differences that make them inherently less expensive than private insurance.

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read more ...

Doctor visits get longer, but care quality poor | Health | Reuters

Doctor visits get longer, but care quality poor | Health | Reuters

NEW YORK (Reuters Health) - It may come as a surprise to many patients, but a new study shows that primary care visits have actually gotten a little longer since the late 1990s.

This is particularly remarkable, say the researchers, given the increased pressure on primary care doctors to be efficient in the face of rising numbers of patients and declining income.

Nevertheless, based on quality measurements like whether physicians counseled patients on diet and exercise, they found that "overall performance...was poor." Any improvements in care quality will likely require multi-pronged efforts, the researchers say, including paying doctors for spending more time to counsel and screen patients.

Primary care physicians were making about 10 percent less in 2003 than they were in 1995, after taking inflation into account, Dr. Lena M. Chen, who is now with the University of Michigan Health System in Ann Arbor, and her colleagues note in their report in the Archives of Internal Medicine.

"Given the reimbursement environment and the pressures to improve efficiency," they add, "one might worry that primary care physicians would respond by spending less time with each patient to see more patients, improve their efficiency, and boost their incomes."

...

Over the study period, the number of adult visits to primary care physicians rose from 273 million to 338 million, a 10 percent increase on a per person basis. The average visit lasted 18 minutes in 1997, while visit time had increased to nearly 21 minutes by 2005.

While older patients and new patients had longer visits, non-Hispanic black patients and Hispanic patients had significantly shorter visits than whites, the researchers found. They say they were "surprised" by this finding, which "may explain why patients of minority groups do not always receive care that is comparable to that provided to white patients."

During the study period, the quality of care doctors were providing showed "only modest improvements," Chen and her colleagues say, with patients no more likely to get counseling on diet and exercise in 2005 than they were in 1997, even though there's strong evidence that giving high-risk patients this advice is beneficial. ....

Pfizer Broke the Law by Promoting Drugs for Unapproved Uses - Bloomberg.com

Pfizer Broke the Law by Promoting Drugs for Unapproved Uses - Bloomberg.com

Nov. 9 (Bloomberg) -- Prosecutor Michael Loucks remembers clearly when lawyers for Pfizer Inc., the world’s largest drug company, looked across the table and promised it wouldn’t break the law again.

It was January 2004, and the attorneys were negotiating in a conference room on the ninth floor of the federal courthouse in Boston, where Loucks was head of the health-care fraud unit of the U.S. Attorney’s Office. One of Pfizer’s units had been pushing doctors to prescribe an epilepsy drug called Neurontin for uses the Food and Drug Administration had never approved.

In the agreement the lawyers eventually hammered out, the Pfizer unit, Warner-Lambert, pleaded guilty to two felony counts of marketing a drug for unapproved uses.

New York-based Pfizer agreed to pay $430 million in criminal fines and civil penalties, and the company’s lawyers assured Loucks and three other prosecutors that Pfizer and its units would stop promoting drugs for unauthorized purposes.

What Loucks, who’s now acting U.S. attorney in Boston, didn’t know until years later was that Pfizer managers were breaking that pledge not to practice so-called off-label marketing even before the ink was dry on their plea.

On the morning of Sept. 2, 2009, another Pfizer unit, Pharmacia & Upjohn, agreed to plead guilty to the same crime. This time, Pfizer executives had been instructing more than 100 salespeople to promote Bextra, a drug approved only for the relief of arthritis and menstrual discomfort, for treatment of acute pains of all kinds.

Record High Fine

For this new felony, Pfizer paid the largest criminal fine in U.S. history: $1.19 billion. On the same day, it paid $1 billion to settle civil cases involving the off-label promotion of Bextra and three other drugs with the U.S. and 49 states. ...

Michele Bachmann to protesters: 'Scare' Congress - Daniel Libit - POLITICO.com

Michele Bachmann to protesters: 'Scare' Congress - Daniel Libit - POLITICO.com

In a conference call Wednesday night with bloggers and activists for the advocacy group Americans for Prosperity, Rep. Michele Bachmann (R-Minn.) called on protesters to “scare” members of Congress into killing the proposed health care reform bill.

If the protesters succeed in scaring lawmakers, Bachmann said that it could cripple efforts to restructure health care for a decade.

...

“Don’t bring your pitchforks,” Bachmann said, “bring your video cameras.”

Bachmann expressed confidence that such efforts would stultify the Democrats’ efforts.

“I think that will absolutely scare these members of Congress so much that Pelosi will not get the votes and it will kill the bill. I think it could be dead for 10 years. Why won’t we? Why won’t we go for broke?” ...

�Shut Down This Murderous Racket: Change We Need and Crave����� : Information Clearing House -� ICH

�Shut Down This Murderous Racket: Change We Need and Crave : Information Clearing House -� ICH

Al Capone is awake in his grave in awe at the criminal racket promulgated by the health care industry: a murderous multi-billion dollar industry that keeps the world’s Superpower in the sociological Stone Age. A recent study upped the figure of Americans killed by this enterprise from 20,000 to about 45,000: that is fifteen 9-11’s a year of Americans facing a cruel, painful death at the hands of these prolific killers.

Some might say I sound like a demagogue. When you are used to insipid soundbytes and P.C.-fluff, the truth starts sounding like demagoguery. The fact of the matter is that the truth is extraordinarily painful in this country ruled by a peculiar Victorian fetish of the marketplace. Nowhere in the civilized world could one imagine civic leaders fear mongering the populace about the evils of “socialized medicine” without getting laughed out of the country. Unfortunately, these goons of capitalist oppression seem to have been collectively laughed out of the civilized world and into Land of the Free.

...
From the beginning of the current “health reform” debacle, the game was rigged. Immediately, the only meaningful reform, “single payer,” was taken off the table, and progressives were told to rally behind a “strong public option” by Democratic front groups like Moveon.org and Health Care for America Now (HCAN). These two NGO’s organized numerous “rallies” in order to command a feeble subservience to the Democratic leadership ahead of their caving to corporate interests on the issue.
...
Democratic cheerleaders have been trumpeting the success at instituting a “public option” in both the House and Senate versions of the health reform bill. The proposed public option will cover about 3% of the population, while roughly 33% of Americans are un- or under-insured. Many progressive democrats inform me that this is the best we can realistically do given the conservative dynamics of the American populace. I don’t understand what American populace they are talking about. As someone who goes out to the bungalow belt of Chicago to knock on doors practically everyday, I can say with full confidence that only an insignificant wacko minority is repelled by the thought of “Medicare for all.” Perhaps we can figure out a way to leave those few people out when we finally do institute a single-payer system.

Progressive leaders have fallen to the right of the American people. Americans crave and need meaningful health care reform in line with the remainder of the civilized world. They crave and need leadership in Washington that stands for the interests of their constituents: leaders that aren’t fearful of lifting their heads above the fray, pounding their fists on the podium and declaring “It is time we shut this racket down. Let us throw the insurance companies into the dustbin of history once and for all, and end this domestic terrorism that kills 45,000 Americans a year!”

Unfortunately, to get to this point, we are going to have to purge the Congress of almost every last one of its members, and stop thinking that the Democrats or the NGO industrial complex will ever bring Americans their cherished Medicare-for-all.

Matt Reichel is a French teacher and the Green Party Candidate in Illinois's 5th Congressional District. He can be reached at: mereichel@gmail.com. Visit Matt's website.

The Swine Flu Vaccine Screw-up | government or big Pharma ?

The Swine Flu Vaccine Screw-up | CommonDreams.org

If you can't find any swine flu vaccine for your kids, it won't be for a lack of positive thinking. In fact, the whole flu snafu is being blamed on "undue optimism" on the part of both the Obama administration and Big Pharma.

Optimism is supposed to be good for our health. According to the academic "positive psychologists," as well as legions of unlicensed life coaches and inspirational speakers, optimism wards off common illnesses, contributes to recovery from cancer, and extends longevity. To its promoters, optimism is practically a miracle vaccine, so essential that we need to start inoculating Americans with it in the public schools -- in the form of "optimism training."

But optimism turns out to be less than salubrious when it comes to public health. In July, the federal government promised to have 160 million doses of H1N1 vaccine ready for distribution by the end of October. Instead, only 28 million doses are now ready to go, and optimism is the obvious culprit. "Road to Flu Vaccine Shortfall, Paved With Undue Optimism," was the headline of a front page article in the October 26th New York Times. In the conventional spin, the vaccine shortage is now "threatening to undermine public confidence in government." If the federal government couldn't get this right, the pundits are already asking, how can we trust it with health reform?

But let's stop a minute and also ask: Who really screwed up here -- the government or private pharmaceutical companies, including GlaxoSmithKline, Novartis, and three others that had agreed to manufacture and deliver the vaccine by late fall? Last spring and summer, those companies gleefully gobbled up $2 billion worth of government contracts for vaccine production, promising to have every American, or at least every American child and pregnant woman, supplied with vaccine before trick-or-treating season began.

According to Health and Human Services Secretary Kathleen Sebelius, the government was misled by these companies, which failed to report manufacturing delays as they arose. Her department, she says, was "relying on the manufacturers to give us their numbers, and as soon as we got numbers we put them out to the public. It does appear now that those numbers were overly rosy." ....

whatreallyhappened.com: FDA HID RESEARCH THAT DAMNED ASPARTAME

whatreallyhappened.com: FDA HID RESEARCH THAT DAMNED ASPARTAME

When the G.D. Searle Co. sought FDA approval for NutraSweet they submitted doctored, fraudulent “studies,” so corrupt that the Department of Justice appointed two prosecutors to Investigate Searle. Searle's lawyers hired the prosecutors and the case died with the statute of limitations.

Listen in on aspartame hearings in 1976 between Senator Ted Kennedy and FDA Commissioner Alexander Schmidt at the Senate Subcommittee on Labor and Public Health:

Commissioner Schmidt: ”Today I would like to report to you the final results of the Food and Drug Administration's detailed investigation of animal studies performed by Searle.”

Senator Kennedy: “Is this the first time, to your knowledge, that such a problem has been uncovered of this magnitude by the Food and Drug Administration?”

Dr. Schmidt: “It is certainly the first time that such an extensive and detailed examination of this kind has taken place. We have never before conducted such an examination as we did at Searle. From time to time, we have been aware of isolated problems, but we were not aware of the extent of the problem in one pharmaceutical house.”

Senator Kennedy : “The extensive nature of the almost unbelievable range of abuses discovered by the FDA on several major Searle products is profoundly disturbing.”

Yet a year later look what happened!

The 1977 Bressler Report, even without the concealed studies, clearly revealed fraud. Searle deleted what they didn't want FDA to see, even excised the brain tumors from rats, and put them back in the study. After death they resurrected them on paper.

Chief FDA Scientist, Dr. Thomas Xavier Collins, investigated two mice teratology (birth defects) studies. The incompetent Searle employee who reviewed studies had but a single year of experience: worked on rabbit populations for the Illinois Wildlife Service! The studies were a travesty, like all Searle's studies submitted to FDA . ...

Senate Pressing Insurers on the Amount of Premiums They Spend on Care - NYTimes.com

Senate Pressing Insurers on the Amount of Premiums They Spend on Care - NYTimes.com

The health insurance industry likes to cite figures showing that 87 cents of every dollar in premiums is spent on medical claims.

But a new Senate analysis suggests that for-profit insurance companies are spending much less than that, especially for policies sold to individuals and small businesses. Instead, as little as 66 cents of each dollar paid in premiums goes toward doctor and hospital bills, while the rest covers administrative expenses, marketing and company profits, according to the analysis.

The data come from an analysis of regulatory filings by the Senate Commerce Committee from the largest for-profit companies, including WellPoint, the UnitedHealth Group, Aetna and Cigna. They spent about 74 cents out of every dollar on medical care in the individual market, according to the information released by Senator John D. Rockefeller IV, the West Virginia Democrat, who is chairman of the commerce committee.

The insurers “need to tell us how they are spending their customers’ money,” Mr. Rockefeller said in a statement he released on Monday along with the committee’s analysis. “Are they spending it to make people well when they are sick and keep them healthy?” he asked. “Or is the money they charge going to profits, to executive salaries, and to figuring out how to deny care to people when they really need it?” ...

Daily Kos: Insurance Industry Expert Says Stupak Would Practically Mean No Abortion Coverage

Daily Kos: Insurance Industry Expert Says Stupak Would Practically Mean No Abortion Coverage

Like most anti-choice efforts we've seen come out of Congress and state legislatures in the past 30+ years since abortion was legalized, Stupak's Coathanger amendment is another attack on the practical side of the issue: on access. Rather than going for Roe and actually proposing something that could result in it's being overturned, he's going the practical route of making it more difficult to obtain by stretching the limits of the Hyde amendment beyond the breaking point.
...

Once the dust settles on the legal issues of what this bill does, you have to look at the practical results. Even if insurers participating in the exchange can find the needle to thread to offer abortion coverage, would they? No, says one industry expert.

"I really think it would be impractical," says Robert Laszewski, a health insurance industry consultant....

Laszewski says the problem is that by all estimates, the vast majority of people who will be shopping in the new exchanges will be getting subsidies, so they won't be allowed to get abortion coverage. Thus, if a health insurer did offer a separate plan with abortion coverage, it would only be available to a small universe of buyers, and it simply wouldn't make much business sense.

...

Women could use their own money to buy a separate policy that just covers abortion. But that's not likely to happen, either, says Laurie Rubiner, vice president of public policy and advocacy for Planned Parenthood of America.

Rubiner bases her conclusion on real-world experience. Five states — Missouri, Idaho, Kentucky, Oklahoma and North Dakota — already ban private insurance from covering abortion.

Yet, she says, "we haven't been able to find any kind of separate abortion rider, and it doesn't surprise us because there's no market for it. Why is that? Because no woman plans to have a catastrophic pregnancy, or an unintended or unplanned pregnancy. Therefore, she doesn't think about buying coverage separately for abortion. And since there's no market for it, the product doesn't exist."

Wednesday, November 11, 2009

“Diagnosing” the U.S. health care system: in Soundings Magazine

“Diagnosing” the U.S. health care system: in Soundings Magazine
...
So why aren’t we getting better results?

Read the full article in Soundings Magazine, Fall 09 edition.

Key quotes from the article:
  • “Ironically, American’s collective unwillingness to pay for universal health care costs the country dearly. Without good preventive care, America’s 43.6 million uninsured must often resort to emergency and acute care — the most expensive types of medical treatment."
  • “It would be much cheaper to provide primary care rather than waiting until people present to emergency rooms,” David Jones says. “I think that if we provided care to everyone, costs would come down."
  • “Universal coverage in America is expected to cost $1 trillion over 10 years — not a small amount, but a figure equivalent to the amount health care costs rise each year, according to Jonathan Gruber, Professor of Economics. “Think about it, we could cover all the uninsured in America for the cost of one year’s growth in cost,” he says.
  • The current system of employer-sponsored health insurance also effectively locks people into their jobs, strangling entrepreneurship, Gruber observes.
  • Campbell, Gruber, and Jones all say they would like to see a public option included in any national health care reform legislation. “I think it would outperform private insurance,” Jones says.
  • Be that as it may, it’s clear the United States is not going to nationalize a $500 billion industry, Gruber says. “If you think about steps toward cost control in America, there are easy steps and there are harder steps,” he says. Starting with universal coverage will give everyone a stake in controlling costs going forward, he says.

Tuesday, November 10, 2009

Top 10 Ridiculous Quotes by Health Care Reform Opponents

Top 10 Ridiculous Quotes by Health Care Reform Opponents

10 most patently ridiculous quotes about health care reform from the likes of Sarah Palin, Rush Limbaugh, Glenn Beck, and Michele Bachmann. ...

1. "The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil." —Sarah Palin, in a message posted on Facebook about Obama's health care reform plan, Aug. 7, 2009 (Source)

2. "Obama's got a health care logo that's right out of Adolf Hitler's playbook … Adolf Hitler, like Barack Obama, also ruled by dictate." —Rush Limbaugh, Aug. 6, 2009 (Source)

3. "People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless." —a July 31 editorial in Investor's Business Daily warning about end-of-life counseling in health care reform. Hawking, in fact, lives in England and has been treated by their National Health Service, which, by his own account, saved his life (Source)

4. "What we have to do today is make a covenant, to slit our wrists, be blood brothers on this thing. This will not pass. We will do whatever it takes." –Rep. Michele Bachmann (R-MN), on what is needed to defeat health care reform, Aug. 31, 2009 (Source)

5. "You have three people in the White House that are in love with eugenics or whatever it is you would call it today. … Please dear God, read history. Please dear God read the truth of what these people have said in their own words, and ask yourself this one question: Do you trust these people enough to give them control over who lives and who dies? Because that's what health care is when you have no other choice but to go to the state." —Glenn Beck, comparing health care reform to Nazi eugenics (Source) ...

Conflicts of interest? Dr. Mehmet Oz owns 150,000 option shares in vaccine technology company

Conflicts of interest? Dr. Mehmet Oz owns 150,000 option shares in vaccine technology company

Dr. Mehmet Oz is a huge promoter of vaccines. He's been on television reinforcing fear about H1N1 swine flu and telling everyone to get vaccinated. But what he didn't tell his viewing audience is that he holds 150,000 option shares in a vaccine company that could earn him millions of dollars in profits as the stock price rises. It is in Dr. Oz's own financial interest, in other words, to hype up vaccines and get more people taking them so that his own financial investments rise in value.

Evidence describing these facts was delivered to NaturalNews by a private investigator named Joseph Culligan (http://webofdeception.com/oprah.html#oz). That evidence includes an SEC document detailing how Dr. Oz. bought options on stocks for SIGA Technologies in 2005, 2007, 2008 and 2009. SIGA Technologies (stock symbol SIGA) is a vaccine technology company with many advanced developments whose success depends on the widespread adoption of vaccines. According to SEC documents, Dr. Mehmet Oz. currently holds 150,000 option shares on SIGA Technologies, purchased for as little as $1.35 back in 2005. ...

2,266 Veterans Died In 2008 Because They Were Uninsured

2,266 Veterans Died In 2008 Because They Were Uninsured

According to a study released by the Harvard Medical School, 2,266 veterans under the age of 65 died last year as a result of not having health insurance. Researchers emphasize that "that figure is more than 14 times the number of deaths (155) suffered by U.S. troops in Afghanistan in 2008, and more than twice as many as have died (911 as of Oct. 31) since the war began in 2001."

The 1.46 million working-age veterans that did not have health insurance last year all experienced reduced access to care as a consequence, leading to "six preventable deaths a day."

Like other uninsured Americans, most uninsured vets are working people -- too poor to afford private coverage but not poor enough to qualify for Medicaid or means-tested VA care," said Dr. Steffie Woolhandler, a professor at Harvard Medical School. [...]


Dr. David Himmelstein, the co-author of the report and associate professor of medicine at Harvard, commented, "On this Veterans Day we should not only honor the nearly 500 soldiers who have died this year in Iraq and Afghanistan, but also the more than 2,200 veterans who were killed by our broken health insurance system. That's six preventable deaths a day."

Wednesday, November 4, 2009

Martha Rosenberg: Is Your Doctor's Continuing Ed Funded by Drug Makers?

Martha Rosenberg: Is Your Doctor's Continuing Ed Funded by Drug Makers?

Raise your hand if you've breathed a sigh of relief seeing your doctor had a CME (Continuing Medical Education) certificate next to the medical school diploma on the wall.

Did your doctor pass Bipolar Disorder: Individualizing Treatment to Improve Patient Outcomes, Part 2 "taught" by Trisha Suppes, MD, PhD and offered by CME Outfitters?

Suppes is a Professor in Stanford's Department of Psychiatry and Behavioral Science and funded by Abbott, AstraZeneca; GlaxoSmithKline, Janssen, Novartis, Pfizer, Wyeth, Bristol-Myers Squibb, Eli Lilly, Shire and four more drug companies.

Maybe your doctor passed Quadrivalent HPV Vaccine May Be Effective in Women 24 to 45 Years Old -- which sounds like a sales pitch for Gardasil because it is -- which "studies" a Lancet article written by Nubia Munoz, MD, two Merck employees and other authors.

Sample question: "What was the main conclusion of the current study by Munoz and colleagues of HPV vaccine among women between the ages of 24 and 45 years?" (Italics CME's) Hint: the answer is in the title.

Upon "completion on this activity" offered by CME giant Medscape, part of the WebMD monolith -- still available for credit if you hurry -- "participants will be able to: "Specify the currently recommended age range for the administration of the quadrivalent human papillomavirus vaccine" and "Describe the effects of the quadrivalent human papillomavirus vaccine among women between the ages of 24 and 45 years."

Maybe your doctor passed Medscape's Innovative Approaches to Vaccination Challenges: Overcoming Barriers for Adult Patients sponsored by -- surprise! -- vaccine makers Novartis, GSK and Merck and meaning sales barriers. ...

...

Last year Bernard Carroll, MD a former chairman of psychiatry at Duke, challenged the objectivity of a CME Outfitters course called Atypical Antipsychotics in Major Depressive Disorder: When Current Treatments Are Not Enough (what are they trying to say?) funded by Seroquel maker AstraZeneca and taught by disgraced Emory University psychiatrist Charles Nemeroff, MD who lost his department chairmanship from unreported drug industry income.

Two doses of Seroquel were tested but only the results of one were "statistically significant," writes Carroll on a blog called Health Care Renewal. "One of the junior presenters stated very clearly that there was 'significant improvement in both response and remission with both doses' of Seroquel. That is a falsification of the scientific record."

In October AstraZeneca agreed to pay $520 million to settle Seroquel suits and investigations of "physicians who participated in clinical trials involving Seroquel," presumably on which safety was established, and a JAMA article red flags Seroquel's metabolic proclivities in which studied children gained a pound a week and more. Yet AstraZeneca still seeks FDA approval to market Seroquel to kids. ..

Daily Kos: Boehner Cooks Up Excuses for a Really Bad Bill

Daily Kos: Boehner Cooks Up Excuses for a Really Bad Bill |
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Wed Nov 04, 2009 at 10:30:08 AM PST

Yesterday, hours after the House Republicans healthcare "reform" plan was released and universally mocked, Rep. Boehner cried foul, insisting that this unauthorized leak was of a draft bill that wasn't finalized and hadn't been seen by members.

Just a quick reminder of the reaction in the media to Boehner's bill. Here's what the original WSJ article reported:

A House Republican health-care bill wouldn't seek to prevent health-insurance companies from denying sick people insurance, Minority Leader John Boehner said Monday.

And here's Roll Call:

Under the GOP plan, insurance companies would still be allowed to exclude anyone with a pre-existing medical condition from coverage, there would be no national insurance exchange and businesses would not face any mandate to provide insurance nor individuals to buy it. Boehner also left out tax credits to help the poor and middle class buy insurance — a central pillar of most GOP reform proposals and a key feature of a four-page outline Republican leaders released in June.

But that bill, says Boehner and Pence, wasn't the real bill, as reported by The Hill:

Minority Leader John Boehner (R-Ohio) was "hot" when news broke that a premature copy of his much-awaited healthcare bill had been published on the Internet, aides and GOP lawmakers told The Hill....

"It was a very unauthorized leak," the member told The Hill, noting that the GOP aides were still in discussions with staffers at the Congressional Budget Office (CBO).

On Tuesday afternoon, GOP Conference Chairman Mike Pence (Ind.) had to tell reporters that the document was not, in fact, the final text of their bill.

"The Republican alternative is still a work in progress, and we’re putting the finishing touches on our legislation as we speak," Pence said hours after media outlets, including The Hill, posted copies of the document online.

As the article points out, this fury didn't emerge until "hours after media outlets" posted the draft, and hours after it was universally derided as a massive gift to the insurance industry. It took them a full day to come up with the story that it was a leaked draft. ...

GOP health bill would allow insurers to ignore consumer protection laws | Raw Story

GOP health bill would allow insurers to ignore consumer protection laws | Raw Story

A new Republican health reform proposal would allow insurers to bypass consumer protection laws and remove restrictions on rate hikes, according to published reports.

In the GOP's 230-page draft of an alternative health care bill is the following passage:

This policy may be less expensive than others because it is not subject to all of the insurance laws and regulations of the state ... including coverage of some services or benefits mandated by the law of the state ... Additionally, this policy is not subject to all of the consumer protection laws or restrictions on rate changes ...

The bill, which caps medical malpractice awards, additionally seeks to increase the use of health savings accounts and would create insurance pools for high-risk individuals. ...

Processed food link to depression: research - Yahoo! News

Processed food link to depression: research - Yahoo! News

LONDON (AFP) – A diet heavy in processed and fatty foods increases the risk of depression, according to British research published on Monday.

Researchers at University College London also found that a diet including plenty of fresh veget

... Taking into account other indicators of a healthy lifestyle such as not smoking and taking physical exercise, those who ate the whole foodshad a 26 percent lower risk of depression than those who ate mainly processed foods.

People with a diet heavy in processed food had a 58 percent higher risk of depression. ...

Lack of Health Insurance Tied to Child Deaths - ABC News

Lack of Health Insurance Tied to Child Deaths - ABC News

NEW YORK (Reuters Health) - Hospitalized children who lack health insurance are more likely to die than those who have coverage, a large U.S. study finds.

Using data on more than 23 million child hospitalizations between 1988 and 2005, researchers found that children without insurance were 60 percent more likely to die than those with either private or government insurance coverage.

They estimate that lack of insurance directly contributed to nearly 17,000 children's deaths over 18 years.

The findings, reported in the Journal of Public Health, do not prove cause-and-effect. But the increased risk was there even after the researchers accounted for demographics like race and neighborhood income levels, as well as the child's diagnosis and any co-existing health problems.

The results also suggest that "pre-hospital factors," at least some of which could be related to lack of insurance, account for the higher risk of death, explained lead researcher Dr. Fizan Abdullah, an assistant professor of pediatric surgery at Johns Hopkins Children's Center in Baltimore.

...

On average, insured children's charges totaled roughly $21,000, while uninsured children averaged $8,000. And while uninsured children were typically in the hospital less than one day, those with insurance were there for a full day.

But this is not, Abdullah said, because hospitals were refusing to treat the uninsured children.

...

Instead, uninsured children who died likely got to the hospital later than their insured counterparts, after their condition had deteriorated significantly. "These kids died before the hospitals could provide medical care," Abdullah said. "They literally never had a chance to treat them."