HIV Still Plagues the U.S.: Some Areas Have Higher Rates Than Africa - The Human Condition Blog - Newsweek.com

HIV Still Plagues the U.S.: Some Areas Have Higher Rates Than Africa - The Human Condition Blog - Newsweek.com

By Jaime Cunningham

In December, NEWSWEEK argued that new signs of life were showing in the AIDS activism movement. Let's hope so. Recent research published in The New England Journal of Medicine shows that within certain populations in America, the prevalence of HIV-infected people is higher than in certain parts of Africa:

More than 1 in 30 adults in Washington, D.C., are HIV-infected—a prevalence higher than that reported in Ethiopia, Nigeria, or Rwanda. Certain U.S. subpopulations are particularly hard hit. In New York City, 1 in 40 blacks, 1 in 10 men who have sex with men, and 1 in 8 injection-drug users are HIV-infected, as are 1 in 16 black men in Washington, D.C. In several U.S. urban areas, the HIV prevalence among men who have sex with men is as high as 30%—as compared with a general-population prevalence of 7.8% in Kenya and 16.9% in South Africa.

What’s interesting is that the research shows that a person’s sexual network, more than just his or her lifestyle choices, defines the risk of getting HIV in America. So, black and Hispanic women are at increased risk due to the instability of their sexual relationships —which is attributed to the high rate of incarceration of men in their networks—and their vulnerable or dependent economic situation, which may cause them to be fearful of suggesting safer-sex options to their companions. And black men who have sex with men are at high risk because of the likelihood of their choosing to engage in sexual activity with someone who is racially similar, and because of the prevalence of HIV within their sexual networks. ...

Race to Pin Blame for High Health Costs - WSJ.com

Race to Pin Blame for High Health Costs - WSJ.com

By AVERY JOHNSON

A battle over who to blame for rising health-care costs is escalating, as groups seek to pin the problem on each other and say none of the health-care legislation under consideration does enough to solve it.

U.S. spending on health care reached $2.5 trillion in 2009, according to federal estimates. It is expected to jump to $4.5 trillion in 10 years.

Insurers contend that they must pass on ever-higher bills from hospitals and doctors. Hospitals say they are struggling with more uninsured patients, demands by doctors for top salaries, and underpayments from Medicare and Medicaid.

And doctors say they are strong-armed by insurance monopolies and hampered by medical malpractice costs.

In the rush to point fingers, few solutions are emerging.

"It's always someone else's fault," said Robert Laszewski, president of health-care consulting firm Health Policy & Strategy Associates. "There is not an incentive for these people to cooperate because the game they are all playing is getting a bigger piece of the pie."

The issue has come into sharp relief as WellPoint Inc. has sought to defend its plan to raise some prices in California by up to 39%.

In a hearing Wednesday on Capitol Hill, WellPoint Chief Executive Angela Braly singled out dominant hospital systems for demanding 40% rate increases and drug companies for roughly 20% profit margins.

A WellPoint spokeswoman said that at least one hospital had asked for a 220% payment increase.

Many Democrats have cited lack of competition among insurers as a driver of higher prices. On Wednesday, the House of Representatives voted to repeal a longstanding insurance-industry exemption from federal antitrust laws. The bill now heads to the Senate, where its future is less certain.

Doctors complain of a lack of competition among insurers, as well.

A report by the American Medical Association this week argues that 500 insurance-company mergers in the past 12 years have led to markets dominated by one or two health plans.

This year, two insurers control 70% of the market in 24 states, up from 18 last year, the report said.

"There is no other company for doctors to go to" when an insurer comes to them with terms that they find unfavorable, said AMA President James Rohack ...

Medical scan makers to install radiation controls - latimes.com

Medical scan makers to install radiation controls - latimes.com

A medical imaging trade group said Thursday that manufacturers of CT scanners would begin installing safety controls to prevent patients from receiving excessive radiation.

The dosing checks, which will begin rolling out before the end of the year, will alert operators whenever the machine's settings exceed recommended levels. Hospitals and clinics also will be able to set maximum dosing levels for their machines.

...

Last year three California hospitals reported hundreds of acute radiation overdoses from CT scanners, with many patients reporting lost hair and skin redness.

The average American's total radiation exposure has nearly doubled in the last three decades, largely because of next-generation imaging tests, the FDA said.

When the agency announced its crackdown it also targeted other types of scanners, including nuclear imaging machines. The trade group said it was still working to implement changes with the manufacturers of those machines. ...

Medicare Premium Increase: Private Plans Jump 14% In 2010

Medicare Premium Increase: Private Plans Jump 14% In 2010

WASHINGTON — Millions of seniors who signed up for popular private health plans through Medicare are facing sharp premium increases this year – another sign that spiraling costs are a problem even for those with solid insurance.

A study released Friday by a major consulting firm found that premiums for Medicare Advantage plans offering medical and prescription drug coverage jumped 14.2 percent on average in 2010, after an increase of only 5.2 percent the previous year. Some 8.5 million elderly and disabled Americans are in the plans, which provide more comprehensive coverage than traditional Medicare, often at lower cost.

...

At a town hall meeting Friday outside Las Vegas, Obama said the Medicare Advantage plans are getting a "sweet deal" from the government – overpayments averaging 13 percent. "All we've been saying is 'Let's make sure that there's a competitive bidding process, and that we are getting the absolute best bargain,'" the president said.

The Avalere study found that, for consumers, Medicare Advantage is becoming less of a bargain. The premium for 2010 is $39.61, representing an increase of nearly $5 a month from the previous year. That compares with a rise of less than $1.75 a month in 2009. The averages are adjusted based on enrollment levels in particular plans that offer medical and prescription coverage, reflecting the choices that seniors make. ...

Op-Ed Columnist - California Death Spiral - NYTimes.com

Op-Ed Columnist - California Death Spiral - NYTimes.com

By PAUL KRUGMAN

Published: February 18, 2010

Health insurance premiums are surging — and conservatives fear that the spectacle will reinvigorate the push for reform. On the Fox Business Network, a host chided a vice president of WellPoint, which has told California customers to expect huge rate increases: “You handed the politicians red meat at a time when health care is being discussed. You gave it to them!”

Here’s the story: About 800,000 people in California who buy insurance on the individual market — as opposed to getting it through their employers — are covered by Anthem Blue Cross, a WellPoint subsidiary. These are the people who were recently told to expect dramatic rate increases, in some cases as high as 39 percent.

Why the huge increase? It’s not profiteering, says WellPoint, which claims instead (without using the term) that it’s facing a classic insurance death spiral.

Bear in mind that private health insurance only works if insurers can sell policies to both sick and healthy customers. If too many healthy people decide that they’d rather take their chances and remain uninsured, the risk pool deteriorates, forcing insurers to raise premiums. This, in turn, leads more healthy people to drop coverage, worsening the risk pool even further, and so on.

Now, what WellPoint claims is that it has been forced to raise premiums because of “challenging economic times”: cash-strapped Californians have been dropping their policies or shifting into less-comprehensive plans. Those retaining coverage tend to be people with high current medical expenses. And the result, says the company, is a drastically worsening risk pool: in effect, a death spiral.

So the rate increases, WellPoint insists, aren’t its fault: “Other individual market insurers are facing the same dynamics and are being forced to take similar actions.” Indeed, a report released Thursday by the department of Health and Human Services shows that there have been steep actual or proposed increases in rates by a number of insurers.

But here’s the thing: suppose that we posit, provisionally, that the insurers aren’t the main villains in this story. Even so, California’s death spiral makes nonsense of all the main arguments against comprehensive health reform.

For example, some claim that health costs would fall dramatically if only insurance companies were allowed to sell policies across state lines. But California is already a huge market, with much more insurance competition than in other states; unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most. And competition hasn’t averted a death spiral. So why would creating a national market make things better?

More broadly, conservatives would have you believe that health insurance suffers from too much government interference. In fact, the real point of the push to allow interstate sales is that it would set off a race to the bottom, effectively eliminating state regulation. But California’s individual insurance market is already notable for its lack of regulation, certainly as compared with states like New York — yet the market is collapsing anyway.

Finally, there have been calls for minimalist health reform that would ban discrimination on the basis of pre-existing conditions and stop there. It’s a popular idea, but as every health economist knows, it’s also nonsense. For a ban on medical discrimination would lead to higher premiums for the healthy, and would, therefore, cause more and bigger death spirals.

So California’s woes show that conservative prescriptions for health reform just won’t work. ...

County Health Rankings

County Health Rankings

The Associated Press: HHS warns of double-digit spike in health premiums

The Associated Press: HHS warns of double-digit spike in health premiums

By RICARDO ALONSO-ZALDIVAR (AP) – 1 hour ago

WASHINGTON — Eye-popping health insurance premium increases of up to 39 percent are a worrisome sign of the times, the Obama administration said in a report Thursday as it tried to tap public frustration with high costs to revive the stalemated effort to overhaul health care.

...

"This shocking increase isn't unique," said the report, being presented by Secretary Kathleen Sebelius at a news conference Thursday. "Across the country, families have seen their premiums skyrocket in recent years, and experts predict these increases will continue."

With his drive for health care overhaul bogged down, President Barack Obama has seized on the Anthem premium increases as Exhibit A to make his case for sweeping change before a bipartisan White House summit next week. California officials say 700,000 households face increases averaging 25 percent overall and as high as 39 percent for some.

...

The HHS report found that the Anthem numbers are in line with increases sought by insurers in other states — at a time of robust profit growth for the companies and a lack of competition in most states.

For example, Anthem in Maine was denied an 18.5 percent increase last year and is now requesting that state regulators approve a 23 percent rise. Maine is home to Sens. Olympia Snowe and Susan Collins, Republican moderates whose support Obama would like to have for his health care legislation.

Michigan's Blue Cross Blue Shield plan requested approval for premium increases of 56 percent in 2009. And in the state of Washington, rates for some individual health plans increased by up to 40 percent until regulators cracked down.

Other states cited in the report were Connecticut, Oregon and Rhode Island. ...

...

Insurers say the push for higher premiums reflects supply and demand. Medical costs keep going up, even in a weak economy. Many healthy people are dropping coverage or switching to bare-bones policies to keep their bills down. That leaves a higher proportion of people with health problems in the risk pool, forcing the steep rate increases. ...

Study Looks at Benefits of National Salt Reduction Program - WSJ.com

Study Looks at Benefits of National Salt Reduction Program - WSJ.com

By SHIRLEY S. WANG

A national program to reduce dietary salt could prevent tens of thousands of heart attacks, strokes and deaths and trim as much as $24 billion from the U.S. health-care tab, according to a study published Wednesday in the New England Journal of Medicine.

The study, a computer simulation, suggests the impact would be similar to prevention strategies such as quitting smoking, lowering cholesterol or modest weight-loss.

But significant cuts in salt from the diet could be challenging for individuals without action from food manufacturers. Some 75% of dietary salt intake comes from processed foods, according to the researchers.

Their findings add to a growing body of research suggesting that lowering dietary salt could be an effective weapon against high blood pressure and cardiovascular disease. "The time is right now to consider efforts to…achieve population wide reduction in salt" intake, says Kirsten Bibbins-Domingo, first author of the study and an associate professor of medicine and epidemiology at the University of California, San Francisco.

...

In the computer simulation, which included data from the U.S. Census, the Centers for Disease Control and Prevention and other national studies, Dr. Bibbins-Domingo and her colleagues estimated the effect of lowering salt in the daily American diet by a small amount—up to three grams a day—in adults age 35 and older.

Based on other research, they assumed a three-gram reduction in salt would lower systolic blood pressure by 3.6 to 5.6 millimeters of mercury; a one-gram reduction would reduce the level by 1.2 to 1.9 millimeters. (Systolic is the higher number in a blood-pressure reading. People whose level is 140/90 or more are considered to have high blood pressure.) Such modest blood-pressure reductions are associated, in other studies, with significant lowering of risk of death, heart attack and stroke.

In the current study, researchers found that lowering salt intake by three grams a day would cut new cases of heart disease annually by a third—an estimated 60,000 to 120,000 cases per year—heart attacks by 54,000 to 99,000 cases and strokes by 32,000 to 66,000 cases. It would reduce about 100,000 deaths a year in the U.S.

Based on a cost of $1 a person for salt-reduction strategies projected by the World Health Organization, researchers estimated a U.S. program could save from $10 billion to $24 billion in annual health costs. Such projections can be imprecise because they are based on assumptions that may differ from disease that would develop in real life.

But even if these numbers are off, the results still indicate that sodium reduction is important, said Clyde Yancy, president of the American Heart Association and medical director of the Baylor Heart and Vascular Institute in Dallas. "We can go beyond saying that too much salt is a bad thing," said Dr. Yancy. "We can say, yes, too much sodium is related to disease. By reducing sodium we can reduce disease."

California rule gives HMO patients timely health care access | McClatchy

California rule gives HMO patients timely health care access | McClatchy
...

The state's so-called timely access rules went into effect over the weekend after an eight-year delay during which doctors, health plans and consumer groups quibbled over details.
...

Under the new rules, HMO physicians must see a patient who requests an appointment within 10 days. Specialists have 15 days. Urgent-care patients must be seen within 48 hours.

Telephone triage and screening services must be available 24 hours a day with a call back from a medical provider within 30 minutes. The new rules require that customers spend no more than 10 minutes on hold before they speak to an HMO customer-service representative.

...

Today, the average wait to see a general practitioner for a physical is 20 days in some of the state's large cities, according to a report last year by the market research firm Merritt Hawkins and Associates. In Los Angeles, the usual wait was 59 days.

To read the complete article, visit www.sacbee.com.

Single-Payer By Attrition - The Daily Dish | By Andrew Sullivan

Single-Payer By Attrition - The Daily Dish | By Andrew Sullivan

DiA's view of the current healthcare system:

Health spending is rising at 8% per year. PriceWaterhouseCooper says medical costs will grow 9% in 2010; health insurance premiums generally rise even faster than costs. Premiums now amount to 18% of the average household's income, up from 11% in 1999. As insurance costs rise far faster than wages, unsurprisingly, the number of uninsured keeps rising too, to 46.3m in 2008. And those who aren't uninsured are increasingly insured by the government.

Medicaid added 3m people to its rolls in 2008. The Children's Health Insurance Program (CHIP) picked up another 1.5m. As this process continues, federal spending on health insurance keeps climbing; it grew 10.4% in 2008. Sick people, poor people, and older people are increasingly unable to afford insurance, and many are winding up on the government's dime. As premiums rise, people at higher and higher income strata find they cannot afford them, drop out of private insurance, and end up being covered by the government or not covered at all....

Study shows how Medicare rewards MDs for overuse | Reuters

Study shows how Medicare rewards MDs for overuse | Reuters

CHICAGO (Reuters) - Medicare's move in 2005 to pay doctors to do bladder cancer surgery in their offices rather than in hospitals dramatically raised the number of procedures and overall health costs, U.S. researchers said on Monday.

The findings reflect the complexity of cutting health costs in the United States, showing how in some cases Medicare -- the insurance program for the elderly and disabled -- gives doctors incentives to provide too much care, they said.
...

"It's incredibly complicated," said Dr. Micah Hemani, a bladder cancer expert at the New York University Langone Medical Center, who studied changes in treatment patterns in his group practice before and after the pay hike.

"What we found based on our billing data was that the number of procedures dramatically increased without a decline in the number of hospital-based procedures," Hemani, whose study appears in the journal Cancer, said in a telephone interview.

"If you adjust for the growth of our practice and you are doing more of these procedures but your hospital-based ones don't decline, you are spending more money."

Bladder cancer is the most expensive of all cancers to treat, with an average cost from diagnosis to death ranging from $96,000 to $187,000, according to Hemani and colleagues.

In theory, the Centers for Medicare and Medicaid Services decision in 2005 to pay doctors extra to do the procedure in their offices would cost less than doing it in a hospital, he said.

Instead, the number of outpatient bladder cancer procedures in Hemani's group practice doubled after the Medicare pay hike and costs to Medicare rose 50 percent overall.

...

BBC News - Obesity 'often set before age of two'

BBC News - Obesity 'often set before age of two'

The "tipping point" that sets children on the way to a lifetime of obesity often occurs before the age of two, say US researchers.

A study of more than 100 obese children and teenagers found more than half were overweight by 24 months and 90% were overweight by the age of five.

A quarter were overweight before they were five months old, the researchers reported in Clinical Pediatrics.

In the UK, around 27% of children are now overweight.

The children in the study - who had an average age of 12 - were all overweight or obese by the age of 10. ...

OpEdNews - Article: Single Payer: Best for Small Business, Childrens' Health and a Healthy Economy

OpEdNews - Article: Single Payer: Best for Small Business, Childrens' Health and a Healthy Economy

Single Payer Health Care (along the lines of the German and French System) is the way to go.

It should be marketed to the US voters as best for small businesses, which it is. I have been a small business owner in the USA and in Germany for over 25 years. I can not afford the same medical benefits to my USA employees that my employees get in Germany. In the US as a small business owner I am always at a disadvantage when hiring employees vs a large company or hospital that can offer benefits. So I am forced to hire less qualified workers or pay more to get the same level of expertise

second those opposed should be clearly identified as MURDERERS! Those opposed for the main part are conservatives who support right to life and the unborn. It should be made very clear that opposition to universal health care has killed more unborn babies than abortions. Do they want to kill more unborn babies by not providing proper pre and post natal care for many of those babys?

Third is the reduction in cost. Single payer countries pay about half for health care and medicine than we do in the US. This would be the best way to reducing the Budget Deficits that voters care about.

1. It is good for small business
2. Those opposed are Murderers
3. This is the best way to reduce the deficit.

ask the Voters:
1. Do you support small businesses in the USA?
2. Are you opposed to killing the unborn babies?
4. do you want the government to reduce the deficit now?

The Seminal � Report: Insurers enjoy record-breaking profits as they cut 2.7 million people from their rolls

The Seminal � Report: Insurers enjoy record-breaking profits as they cut 2.7 million people from their rolls

Health Care for America Now has a new report out today on the insurance industry’s profits and customer base [pdf] and the statistics are shocking:

The five largest U.S. health insurance companies sailed through the worst economic downturn since the Great Depression to set new industry profit records in 2009, a feat accomplished by leaving behind 2.7 million americans who had been inprivate health plans. For customers who kept their benefits, the insurers raised rates and cost-sharing,and cut the share of premiums spent on medical care. Executives and shareholders of the five biggest for-profit health insurers, UnitedHealthGroup inc., WellPoint inc., Aetna Inc., Humana Inc., and Cigna Corp., enjoyed combined profit of $12.2 billion in 2009, up 56 percent from the previous year. It was the best year ever for Big Insurance.

…

The 2009 financial reports from the nation’s five largest insurance companies reveal that:

• The firms made $12.2 billion, an increase of $4.4 billion, or 56 percent, from 2008.
  • Four out of the five companies saw earnings increases, with CIGNA’s profits jumping 346 percent.
• The companies provided private insurance coverage to 2.7 million fewer people than the year before.
  • Four out of the five companies insured fewer people through private coverage. UnitedHealth alone insured 1.7 million fewer people through employer-based or individual coverage.
  • All but one of the five companies increased the number of people they covered through public insurance programs (Medicaid, CHIP and Medicare). UnitedHealth added 680,000 people in public plans.
• The proportion of premium dollars spent on health care expenses went down for three of the five firms, with higher proportions going to administrative expenses and profits.

The numbers may be shocking, but they shouldn’t be surprising. This is how the industry makes money, by charging people more and cutting the unprofitable people from their rolls. In fact, the one company who’s profit margin went down slightly this year – Aetna – was also the only company to add more customers to its rolls in 2009.

But the industry will go to any length to "justify" their profits and their policies of dropping their sick or expensive customers.

First, they’ll claim that the cost of medical care is going up, and so they need to raise prices, but it’s simply not true. As Congresswoman Rose DeLaura (D-CT) pointed out on a call with reporters announcing this report:

They’ll say the increases are justified because medical care is going up, and they’ll hide behind their actuaries to explain their rate increases. But this is coming from the same people who’ve been saying health insurance reform will increase costs. They can’t have it both ways.

She’s absolutely right. Insurance costs are skyrocketing now. Double-digit rate increases like those announced from Anthem in California have been common for years, and will continue to be "commonplace" if we don’t reform our health care system, according to Richard Kirsch, Health Care for America Now’s National Campaign Director. And yet, while raising their rates, insurers claim health reform will increase prices. It seems there’s only one way prices can go in according to the insurance industry – up. ...

Newt Gingrich and John Goodman: Ten GOP Health Ideas for Obama - WSJ.com

Newt Gingrich and John Goodman: Ten GOP Health Ideas for Obama - WSJ.com

Make insurance affordable. The current taxation of health insurance is arbitrary and unfair, giving lavish subsidies to some, ...

...

Make health insurance portable. The first step toward genuine portability—and the best way of solving the problems of pre-existing conditions—is to change federal policy. Employers should be encouraged to provide employees with insurance that travels with them from job to job and in and out of the labor market. ...

Meet the needs of the chronically ill. Most individuals with chronic diseases want to be in charge of their own care. ...

Allow doctors and patients to control costs. Doctors and patients are currently trapped by government-imposed payment rates. Under Medicare, doctors are not paid if they communicate with their patients by phone or e-mail. ...

Don't cut Medicare. The reform bills passed by the House and Senate cut Medicare by approximately $500 billion. This is wrong. ...

Protect early retirees. More than 80% of the 78 million baby boomers will likely retire before they become eligible for Medicare. This is often the most difficult time for individuals and families to find affordable insurance. ...

Inform consumers. Patients need to have clear, reliable data about cost and quality before they make decisions about their care. But finding such information is virtually impossible. ...

Eliminate junk lawsuits. Last year the president pledged to consider civil justice reform. We do not need to study or test medical malpractice any longer: The current system is broken. States across the country—Texas in particular—have already implemented key reforms including liability protection for using health information technology or following clinical standards of care; caps on non-economic damages; loser pays laws; and new alternative dispute resolution where patients get compensated for unexpected, adverse medical outcomes without lawyers, courtrooms, judges and juries.

Stop health-care fraud. Every year up to $120 billion is stolen by criminals who defraud public programs like Medicare and Medicaid, according to the National Health Care Anti-Fraud Association. ...

Make medical breakthroughs accessible to patients. Breakthrough drugs, innovative devices and new therapies to treat rare, complex diseases as well as chronic conditions should be sped to the market. ...

Anthem Blue Cross dramatically raising rates for Californians with individual health policies - latimes.com

Anthem Blue Cross dramatically raising rates for Californians with individual health policies - latimes.com

California's largest for-profit health insurer is moving to dramatically raise rates for customers with individual policies, setting off a furor among policyholders and prompting state insurance regulators to investigate.

Anthem Blue Cross is telling many of its approximately 800,000 customers who buy individual coverage -- people not covered by group rates -- that its prices will go up March 1 and may be adjusted "more frequently" than its typical yearly increases.

The insurer declined to say how high it is increasing rates. But brokers who sell these policies say they are fielding numerous calls from customers incensed over premium increases of 30% to 39%, saying they come on the heels of similar jumps last year.

Many policyholders say the rate hikes are the largest they can remember, and they fear that subsequent premium growth will narrow their options -- leaving them to buy policies with higher deductibles and less coverage or putting health insurance out of reach altogether.

"I've never seen anything like this," said Mark Weiss, 63, a Century City podiatrist whose Anthem policy for himself and his wife will rise 35%. The couple's annual insurance bill will jump to $27,336 from $20,184.

"I think it's just unconscionable," said Weiss, a member of Blue Cross for 30 years. ...

Health's GDP share makes biggest jump ever - MarketWatch

Health's GDP share makes biggest jump ever - MarketWatch

LOS ANGELES (MarketWatch) -- The economy may be struggling but spending on health care is showing no signs of slowing down, according to a study released early Thursday.

The Centers for Medicare and Medicaid Services is estimating that the sector's share of gross domestic product made its biggest one-year jump ever, going to 17.3% in 2009 from 16.2% in 2008.

CMS also figures that health-care spending rose 5.7% to $2.5 trillion last year, even though GDP dipped by 1.3%. And the agency says public insurers like Medicare and Medicaid will spend the majority of U.S. health-care dollars by 2012, about four years earlier than expected.

These findings were to publish in Thursday's editions of Health Affairs magazine. CMS officials say that while there seems to be a disconnect between GDP and what's happening with health-care spending, it is the struggling economy that is responsible for the estimates, said Christopher Truffer, a CMS actuary and one of the authors of the study.

...

Health-care spending is expected to grow by 6.1% on average this decade. By 2019, health-care spending is expected to double to $4.5 trillion, and it will comprise 19.3% of GDP, nearly one-fifth of the economy. The study's estimates are not final numbers, Truffer said.

...

Truffer said the most surprising finding in the study was that public spending will overtake private spending by 2012 and comprise the majority of health-care dollars. That wasn't expected to happen until 2016.

But it's also the by-product of a troubled economy, as fewer people are employed and thus getting insurance through their jobs, he said ...

Soaring cost of healthcare sets a record - latimes.com

Soaring cost of healthcare sets a record - latimes.com

Reporting from Washington - In a stark reminder of growing costs, the government has released a new estimate that healthcare spending grew to a record 17.3% of the U.S. economy last year, marking the largest one-year jump in its share of the economy since the government started keeping such records half a century ago.

The almost $2.5 trillion spent in 2009 was $134 billion more than the previous year, when healthcare consumed 16.2% of the gross domestic product, according to an annual report by independent actuaries at the federal Centers for Medicare and Medicaid Services, or CMS, scheduled for release Thursday.

The nonpartisan accounting agency also projected that as early as next year, the country could mark another milestone as government picks up more than half of the nation's total healthcare tab for the first time.

The rise in current costs, driven in part by surging spending in Medicare and Medicaid, and the bleak projections for the future do not take into account changes that may come if Democrats revive their healthcare overhaul legislation.

The report appears likely to fuel further debate about the health bills now stalled in Congress.

In the absence of change, the report raises a grim prospect for the country -- a healthcare system consuming an ever greater and potentially unsustainable share of the economy even as private health coverage lags.

Last year, CMS estimated that government spending on healthcare would not overtake private spending until 2016, compared with 2011 or 2012 in the current report.

"The health system is hurting, and we are seeing that in these numbers," said Karen Davis, president of the Commonwealth Fund, a leading authority on healthcare policy. ...

Phoebe Loosinhouse's Journal - J'accuse! Pharma is trying to kill off the generic drug industry & getting lots of help

Phoebe Loosinhouse's Journal - J'accuse! Pharma is trying to kill off the generic drug industry & getting lots of help

http://www.reuters.com/article/idUSTRE5BN3...
Generics chafe under big pharma's reform shadow
Susan Heavey
Sun Dec 27, 2009 4:04pm Wed, Dec 23 2009
WASHINGTON (Reuters) -
The massive Senate healthcare reform measure passed on Thursday with support from the multibillion drug industry, but makers of cheaper generic rivals are feeling left out in the cold.

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"The bill passed by the Senate unfortunately amounts to a treasure trove to brand drug companies," said Generic Pharmaceutical Association President Kathleen Jaeger, whose group represents Mylan, Watson Pharmaceuticals and Teva Pharmaceutical Industries, among other companies.

President Barack Obama has often pointed to generics as a key way to cut costs, but big pharmaceutical makers such as Pfizer and Merck came to lawmakers and the White House with an $80 billion, 10-year pact to cut prices and pay additional taxes to help fund the expansion of health insurance coverage.

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Most notable is the setback for generic versions of biotech drugs, also known as biogenerics or follow-on biologics.

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http://www.latimes.com/business/la-fi-hilt...

Biotech bonanza lurks in healthcare reform bills

A proposal by Rep. Anna Eshoo would give developers of innovative biomedical drugs 12 years of statutory protection from generic competition, significantly extending their patent rights.

By Michael Hiltzik
December 17, 2009
The debate over healthcare reform is focused on such a small number of hot issues -- should there be a public option, Medicare buy-in, government-paid mental health counseling for Sen. Lieberman? -- that dozens of other questions are cruising under the radar.

Here's one worth a lot more attention than it has been getting: Is Congress poised to make a big payoff to biotech firms and their venture backers by hindering the entry of a new class of generic drugs into the marketplace?

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http://maplight.org/dems_senate_pharma_pre...

Dems Voting No on Prescription Drug Imports Receive More Pharma Money

December 16, 2009

Yesterday, the Senate voted against the importation of prescription drugs, 51-48. Offered by Sen Byron Dorgan (D-ND) as an amendment to the health care reform bill, the provision would pave the way for market access to cheaper prescription drugs, by relaxing restrictions on imports from Canada and other highly-developed countries. In a bipartisan effort rarely seen in recent votes on health care reform, 30 Democrats sided with 17 Republicans and one Independent to kill the bill.

MAPLight.org found that Senate Democrats who voted to block imports, siding with drug companies, received an average of $73,678 each from drug companies over the past six years—76% more than Democrats who voted in favor of imports.

Among all Senators, those voting to block imports received an average of $85,779 each from drug companies, 69% more than those who voted in favor of imports.
...
http://www.washingtonpost.com/wp-dyn/conte...
The not-so-sweet side of closing 'doughnut hole'
By Amy Goldstein
Washington Post Staff Writer
Monday, December 28, 2009

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Under the health-care bill the House passed in November, people who reach the doughnut hole would be $500 better off next year than they would otherwise. But the impact over the next few years would be subtler than it appears at first for two reasons: The gap -- without any change -- is scheduled to expand each year, and the bill would fill it gradually. As a result, patients would face a larger coverage hole in 2011 and 2012 than this year, according to Ways and Means Committee data. After that, it would shrink more rapidly and disappear in 2019.

The just-passed Senate measure would narrow the gap halfway. Even before the bill was approved, Reid and the chairman of the two Senate committees that handle health-care issues said they would, as part of negotiations to resolve differences between the two bills, accept the House's goal of closing the hole completely. ...

BBC News - Why do people often vote against their own interests?

BBC News - Why do people often vote against their own interests?

... This makes it even harder for the Obama administration to get healthcare reform passed in the US.

Political scientist Dr David Runciman looks at why is there often such deep opposition to reforms that appear to be of obvious benefit to voters.

Last year, in a series of "town-hall meetings" across the country, Americans got the chance to debate President Obama's proposed healthcare reforms.

What happened was an explosion of rage and barely suppressed violence.

Polling evidence suggests that the numbers who think the reforms go too far are nearly matched by those who think they do not go far enough.

But it is striking that the people who most dislike the whole idea of healthcare reform - the ones who think it is socialist, godless, a step on the road to a police state - are often the ones it seems designed to help.

In Texas, where barely two-thirds of the population have full health insurance and over a fifth of all children have no cover at all, opposition to the legislation is currently running at 87%.

...

In his book The Political Brain, psychologist Drew Westen, an exasperated Democrat, tried to show why the Right often wins the argument even when the Left is confident that it has the facts on its side.

He uses the following exchange from the first presidential debate between Al Gore and George Bush in 2000 to illustrate the perils of trying to explain to voters what will make them better off:

Gore: "Under the governor's plan, if you kept the same fee for service that you have now under Medicare, your premiums would go up by between 18% and 47%, and that is the study of the Congressional plan that he's modelled his proposal on by the Medicare actuaries."

Bush: "Look, this is a man who has great numbers. He talks about numbers.

"I'm beginning to think not only did he invent the internet, but he invented the calculator. It's fuzzy math. It's trying to scare people in the voting booth."

Mr Gore was talking sense and Mr Bush nonsense - but Mr Bush won the debate. With statistics, the voters just hear a patronising policy wonk, and switch off.

For Mr Westen, stories always trump statistics, which means the politician with the best stories is going to win: "One of the fallacies that politicians often have on the Left is that things are obvious, when they are not obvious. ...

Daily Kos: Surprise! Income Inequality Bad for Your Health. And the Nation's

Daily Kos: Surprise! Income Inequality Bad for Your Health. And the Nation's

Fri Jan 29, 2010 at 09:29:33 PM PST

We all know what inequality in wealth and income means when it comes to political clout. And for weathering economic adversity. And for the kind of lifelong head start or hold back that can be given to offspring. The effects are gigantic and extend everywhere. In more economically equal societies, as British epidemiologists Richard Wilkinson and Kate Pickett point out in their new book, The Spirit Level: Why Greater Equality Makes Societies Stronger, people do better on every metric, much better, whether it’s drug addiction, teen pregnancies, homicide or life-span.

What possible good can come from epidemiologists poking around in economics, and in the United States, well outside their usual scholarly arenas? Quite a lot, writes Sam Pizzigati, a senior fellow at the Institute for Policy Studies and proprietor of the on-line web-site Too Much:

"If you want to know why one country does better or worse than another," as Wilkinson and Pickett note simply, "the first thing to look at is the extent of inequality."

The United States, the developed world’s most unequal major nation, ranks at or near the bottom on every quality-of-life indicator that Wilkinson and Pickett examine. Portugal and the UK, nations with levels of inequality that rival the United States, rank near that same bottom.

...

^{Click for a larger image.}

According to economist Emmanuel Saez, who has made a career of studying the impact of income inequality, in 2007, the most recent year for which we have full data, the ratio of CEO pay to the average paycheck was 344 to one. Because of the recession, it’s estimated that the ratio will decrease to 317 to one in 2010. In the 1960s, ‘70s and ‘80s, the average ratio fluctuated between 30 and 40 to one.

...

And that won’t be easy given the brainwashing visited on America by right-wing think-tanks that have propagandized us for three decades with soothing talk about the benefits of deregulation, privatization and what Pizzigati so aptly calls "wealth worship."

Just how bad the trend has been over the past 30 years can be seen by comparing with an earlier era:

• In 1955, tax records showed that the 400 richest people in the U.S. were worth an average $12.6 million (adjusted for inflation). In 2006, the 400 richest were worth $263 million.

• In 1955, the richest Americans paid an average of 51.2% of their income in taxes under a system with a top rate of 90%, but with lots of loopholes. By 2006, the top tier paid 17.2% of their incomes.

• At the same time, wages for most Americans stagnated from 1979 to 1998, and by 2000 the median male wage was below the 1979 level, despite productivity increases of 44.5 percent. Between 2002-2004, two years of the "jobless recovery," the inflation-adjusted median household income declined $1669 a year.

• To cover this loss, households in the aggregate boosted their credit-card debt 315% between 1989 and 2006.

"Over the past 30 years, the income of the top 1%, adjusted for inflation, doubled: the top one-tenth of 1% tripled, and the one-one-hundredth quadrupled," says Pizzigati. "Meanwhile, the average income of the bottom 90% has gone down slightly. This is a stunning transformation."

Inevitably, any attempt to curb executive compensation will be decried as class warfare, that all-purpose charge never invoked by the powers-that-be when we’re talking about the destruction of poor and middle-class Americans. ...