UnitedHealth Group / Pacificare: alleged that 30% of the medical claims it reviewed were improperly denied ... 133,000 alleged violations ...

Health Plan Faces Fines of $1.33 Billion | By Lisa Girion | The Los Angeles Times | Tuesday 29 January 2008

California regulators are expected to announce today that they are seeking as much as $1.33 billion in penalties from Cypress-based PacifiCare as a result of widespread problems stemming from its takeover two years ago by healthcare giant UnitedHealth Group Inc.

In an investigation prompted by widespread complaints, the state Department of Insurance uncovered 133,000 alleged violations of state laws and regulations regarding payments for medical care. Each violation carries a maximum penalty of $10,000 for a possible total of $1.33 billion.

Separately, the state Department of Managed Health Care alleged that 30% of the medical claims it reviewed were improperly denied. That agency is seeking an additional $3.5 million in fines.

"These were very serious violations," said Cindy Ehnes, executive director of the Department of Managed Health Care. "The most fundamental promise of insurance is that they will pay when you are sick, and they will pay those physicians and hospitals in a fair manner." ...
...
The potential fines are the latest black eye for UnitedHealth. Longtime Chief Executive William McGuire resigned in 2006. Last month, in the first settlement of its kind under post-Enron corporate reforms, he agreed to pay $468 million to avoid trial on charges that he secretly padded his paycheck by manipulating stock options. ...

Vitorin: found to work no better than lower priced Zocor ... $3 a pill compared with 3 cents a pill

Tuesday, January 29, 2008 by CommonDreams.org | Pay No Attention to That Clinical Data or Squandered Tax Payer Dollars for Medicaid Drugs | by Martha Rosenberg

“The American Heart Association is cautioning patients if they stop taking Vytorin abruptly, Schering-Plough and Merck’s stock price will fall.”

That’s how a cartoon showing a news anchor would read after revelations that the American Heart Association–which receives nearly $2 million a year from Vytorin makers Merck and Schering-Plough–and the American College of Cardiology told patients to stay on the drug despite a recent damning study.

Cholesterol drug, Vytorin was hyped as treating “cholesterol from two sources: food and family” but found to work no better than lower priced Zocor in the Enhance clinical study whose results were released in January.
...
The state of New York, for example, spent $21 million for Medicaid prescriptions for Vytorin in the last two years–it costs $3 a pill compared with 3 cents a pill for Zocor–prompting New York Attorney General Andrew Cuomo to also launch an investigation.

“Drug companies are on notice that concealing critical information about life-saving prescription drugs, profiting at the expense of patients’ health, and wasting taxpayer dollars, is simply unacceptable,” said Cuomo. ...

1 in 5 returning troops may have brain injury

1 in 5 returning troops may have brain injury | Many do not know symptoms can be treated, U.S. Army officials said | AP | Jan. 17, 2008

WASHINGTON - As many as 20 percent of U.S. combat troops who fought in Iraq or Afghanistan leave with signs they may have had a concussion, and some do not realize they need treatment, Army officials said Thursday.

Concussion is a common term for mild traumatic brain injury, or TBI. While the Army has a handle on treating more severe brain injuries, it is "challenged to understand, diagnose and treat military personnel who suffer with mild TBI," said Brig. Gen. Donald Bradshaw, chairman of a task force on traumatic brain injury created by the Army surgeon general. ...

Drug trails bias[ed] toward reporting positive results: 94 percent of the positive studies ... [only] 14 percent of disappointing results

Antidepressant Studies Unpublished | By BENEDICT CAREY | Published: January 17, 2008

The makers of antidepressants like Prozac and Paxil never published the results of about a third of the drug trials that they conducted to win government approval, misleading doctors and consumers about the drugs’ true effectiveness, a new analysis has found.

In published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the less positive, unpublished trials are included, the advantage shrinks: the drugs outperform placebos, but by a modest margin, concludes the new report, which appears Thursday in The New England Journal of Medicine.

Previous research had found a similar bias toward reporting positive results for a variety of medications; and many researchers have questioned the reported effectiveness of antidepressants. But the new analysis, reviewing data from 74 trials involving 12 drugs, is the most thorough to date. And it documents a large difference: while 94 percent of the positive studies found their way into print, just 14 percent of those with disappointing or uncertain results did.

The finding is likely to inflame a continuing debate about how drug trial data is reported. ...

Heart attack patients waited eight minutes in 1997 but 20 minutes in 2004

ER waits dangerously long in U.S.: study | Tue Jan 15, 2008 11:45am EST

WASHINGTON (Reuters) - Patients seeking urgent care in U.S. emergency rooms are waiting longer than in the 1990s, especially people with heart attacks, U.S. researchers reported on Tuesday.

They found a quarter of heart attack victims waited 50 minutes or more before seeing a doctor in 2004. Waits for all types of emergency department visits became 36 percent longer between 1997 and 2004, the team at Harvard Medical School reported.

Especially unsettling, people who had seen a triage nurse and been designated as needing immediate attention waited 40 percent longer -- from an average of 10 minutes in 1997 to an average 14 minutes in 2004, the researchers report in the journal Health Affairs.

Heart attack patients waited eight minutes in 1997 but 20 minutes in 2004, Dr. Andrew Wilper and colleagues found. ...
...
"Emergency physicians have said for years that crowding and long wait times are hurting our patients -- insured and uninsured equally," ACEP president Dr. Linda Lawrence said in a statement.

"Ever-lengthening waits are a frightening trend because any delays in care can make the difference between life and death for some patients. The number of emergency patients is increasing while the number of hospital beds continues to drop. It is a recipe for disaster." ...

France best, US worst in preventable death ranking

France best, US worst in preventable death ranking | Tue Jan 8, 2008 12:15am EST | By Will Dunham

WASHINGTON, Jan 8 (Reuters) - France, Japan and Australia rated best and the United States worst in new rankings focusing on preventable deaths due to treatable conditions in 19 leading industrialized nations, researchers said on Tuesday.

If the U.S. health care system performed as well as those of those top three countries, there would be 101,000 fewer deaths in the United States per year, according to researchers writing in the journal Health Affairs.
...
Nolte said the large number of Americans who lack any type of health insurance -- about 47 million people in a country of about 300 million, according to U.S. government estimates -- probably was a key factor in the poor showing of the United States compared to other industrialized nations in the study. ...
...
France did best -- with 64.8 deaths deemed preventable by timely and effective health care per 100,000 people, in the study period of 2002 and 2003. Japan had 71.2 and Australia had 71.3 such deaths per 100,000 people. The United States had 109.7 such deaths per 100,000 people, the researchers said.

After the top three, Spain was fourth best, followed in order by Italy, Canada, Norway, the Netherlands, Sweden, Greece, Austria, Germany, Finland, New Zealand, Denmark, Britain, Ireland and Portugal, with the United States last.
...
The researchers compared these rankings with rankings for the same 19 countries covering the period of 1997 and 1998. France and Japan also were first and second in those rankings, while the United States was 15th, meaning it fell four places in the latest rankings. ...

Death by Profit Margin: Let's start with a fundamental truth: Insurance companies are in the business of not paying claims.

Death by Profit Margin | Posted by Christy Hardin Smith, Firedoglake at 11:10 AM on December 25, 2007.

This is not an isolated incident. The next one could be you or someone you love...

Let's start with a fundamental truth: Insurance companies are in the business of not paying claims.

By not paying your claim, they get to keep all those premiums you pay. Maximizing their benefit by minimizing their risk, by finding loopholes and other reason to deny claims unless and until they are either cornered into paying them or a claim is so clear-cut they can't avoid it under risk of bad faith. Welcome to the wonderful world of profit and to hell with the consequences.

From AP via the Insurance Times:

Many successful companies are known for taking risks. Cigna Corp. isn't one of them....

The lack of risky business, Wall Street analysts say, has helped Cigna avoid many problems associated with rising health costs, an issue plaguing competing health plans. And the company's low profile has made it less of a target for class action suits filed in recent years accusing HMOs of putting profits ahead of patient care. Cigna has been named in only two of six lawsuits, most of which are either pending or that have ended with rulings in the industry's favor. But Cigna officials say their quiet stance means the company's accomplishments aren't well known....

Insurance companies make money by finding ways to not pay claims. That's the truth of it. This past week, we sadly saw the result of this in the death of Nataline Sarkisyan. From the CA Nurses Association:

On Dec. 11, four leading physicians, including the surgical director of the Pediatric Liver Transplant Program at UCLA, wrote to CIGNA urging the company to reverse its denial. The physicians said that Nataline "currently meets criteria to be listed as Status 1A" for a transplant. They also challenged CIGNA's denial which the company said occurred because their benefit plan "does not cover experimental, investigational and unproven services," to which the doctors replied, "Nataline's case is in fact none of the above." ...

Healthcare: The insurance companies have been "taxing" you for half a century and you take it in stride.

Get real, Americans! | You have been ripped off! | By Mary Pitt

12/27/07 "ICH" -- -- At long last, the age-old problem of health care for the poor and near-poor is being discussed in open forum. The problem has existed since the ethos of class differentiation was begun with the invention of wampum. In this modern age, it is only through the acivities of individual greed that it continues, despite the glaring fact that one solution is the only alternative.

Mitt Romney's Massachusetts experiment has already been exposed as a failure as will be any other program for "mandatory insurance". As with the assistance that is provided to the elderly holders of policies for Medicare Part D, recipients of the plan must be totally destitute in order to be free of the required "deductible and co-payment" muddle. Even if they have "insurance coverage" they still cannot afford the cash outlay that is necessary in order to obtain the necessary treatment.
..
Half a century ago, a good businessman named Henry Kaiser joined other automobile and equipment manufacturers in ceasing the making of their former product in order to make the needed equipment that the country needed in order to effectively engage in World War II. He built huge shipyards on the West Coast and people poured in from all over the beleaguered nation to work in them. Soon it was apparent that these folks were physically devastated by the medical neglect, malnutrition, and other maladies inflicted by the Great Depression. The absenteeism troubled him until he reached one infallible conclusion: "It is less costly to keep people healthy than to get them well once they become ill."
...
There are many arguments from those who oppose the Universal Health Care plans as proposed by Dennis Kucinich and others. One is that it would raise taxes. Horrors! Have you computed the amount that you pay in insurance premiums each year? The insurance companies have been "taxing" you for half a century and you take it in stride. The added taxes to cover your health care would not be likely to be more than you are paying now to the insurance company and the coverage would be better.

Another is that it would "destroy an industry". Perhaps an unfeeling industry should be brought to account for the exhorbitant profits that they have amassed as the result of denying care, requiring co-payments and deductibles to deter people from fully utilizing their benefits, and refusing coverage to "high-risk individuals". Let them go back to insuring lives and property, cars, houses, and business liabilities.

The third argument against free universal health care is that it would cost too much. This argument is the least effective when viewed in the light of realism. The insurance companies declare an annual profit of some Ten Billion Dollars! How many of the 40% of Americans without adequate health care could be kept healthy by the addition of that amount to be paid to physicians, hospitals, and pharmacists?
...
... As they "cream the market", insuring only the healthy and discontinuing coverage for those with serious illnesses, those left uninsured must liquidate their homes and other assets to pay for their own medical care until they are destitute and qualify for Medicaid and welfare.

That is why our nation, which spends more for health care than any other can only rank 45th in the quality of care. Those who can afford it have access to the most modern technology and life-saving procedures where those who cannot are left with medical care that is reminiscent of the nineteenth century. This is the great shame of our vaunted democracy where we expound that "all men are created equal". The big lie is exposed when you learn that the rich get the best while the poor are shunted aside to die of neglect. When a plan is suggested that would care for the poor while costing the rich no more, we owe it to ourselves to give it serious consideration.

2002: combined profits of top 10 drug companies EXCEEDED combined profits of other 490 Fortune 500 companies

How Scientific Is Modern Medicine? | By Dana Ullman, North Atlantic Books | Posted on December 3, 2007, Printed on December 30, 2007 | http://www.alternet.org/story/68065/

The following is an excerpt from The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy, by Dana Ullman.
...
In 2002, the combined profits ($35.9 billion) of the ten largest drug companies in the Fortune 500 were more than the combined profits ($33.7 billion) of the remaining 490 companies together (Angell, 2004, 11).1 The only reason these drug companies did not maintain this shocking financial advantage is that the oil companies' profits have increased considerably with the Iraq War, thus raising the 490 non-drug companies' profits slightly higher. But then again, one would assume that the profits of 490 of the largest companies in the world would be substantially more than just ten companies in one commercial field. This economic information is important, even essential, because learning how to separate the "science" of medicine from the business of medicine has never been more difficult. The combined efforts of the drug companies and the medical profession, which together may be called the "medicalindustrial complex," have been wonderfully effective in convincing consumers worldwide that modern medicine is the most scientific discipline that has ever existed. Before discussing homeopathy, it is important, if not necessary, to raise basic questions about what "scientific"medicine is -- and is not.

Physicians today rarely run drug companies. Instead, businessmen run them. It is, therefore, not surprising that Marcia Angell,MD, a Harvard professor of medicine and former editor of the famed New England Journal of Medicine , wrote:

Over the past two decades the pharmaceutical industry has moved very far from its original high purpose of discovering and producing useful new drugs. ... Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the U.S. Congress, the FDA, academic medical centers, and the medical profession itself. (Levi, 2006)

There is big big money to be made in drug sales, and brilliant marketing has led too many of us to ignore or excuse this bully side of medicine.
...
Sadly and strangely, physicians do not see that there is something fundamentally wrong with the present medical model. Instead, once an old drug is found to be ineffective or dangerous, doctors and drug companies simply assert the "scientifically proven" efficacy of a new drug. Despite this recurrent pattern, doctors are prescribing drugs at record-breaking rates:

• In 2005 the volume of prescription drugs sold in the U.S. was equal to 12.3 drugs for every man, woman, and child in that year alone (compared to 1994, when 7.9 prescription drugs per year were on average purchased by every American). (Kaiser Family Foundation, 2006)
• According to a 2005 study, 44 percent of all Americans take at least one prescription drug and 17 percent take three or more prescription drugs (This number increased 40 percent between 1994 and 2000). ( Medscape , 2005)

The extremely high numbers listed above are considerably higher if one adds in the over-the-counter drugs that doctors recommend or that patients take on their own.
...

nation’s second-largest physician group - endorsed a single-payer health-care system yesterday

Tuesday, December 4, 2007 by The Philadelphia Inquirer | American College of Physicians Endorse Single-Payer | by Stacey Burling

The Philadelphia-based American College of Physicians - the nation’s second-largest physician group - endorsed a single-payer health-care system yesterday.

But the organization stopped short of saying that a single-payer system like Medicare, in which the government would get and pay most bills, is the best way to achieve universal health coverage.
..
After analyzing health care in the United States and 12 other industrialized countries, the group concluded that universal coverage had been successfully achieved elsewhere through single-payer and pluralistic systems.

Either could work here, the report said. The pluralistic system gives consumers more choice, but also leads to higher administrative costs and inequalities. Because it is what the United States already has, it is less of a political challenge. “It’s like remodeling your house to make it better for your whole family,” Dale said.

Single-payer has lower administrative costs, but is not politically popular, he said. “I’m not a political analyst. I’m just a doctor,” Dale said. “But I think there will probably be resistance to that. That’s why we don’t have it now.” He said his group added it to its proposal to “heighten the debate.” ...

FDA so underfunded, consumers are put at risk

Report: FDA so underfunded, consumers are put at risk | Updated 21h 11m ago | By Julie Schmit, USA TODAY

The Food and Drug Administration is so underfunded and understaffed that it's putting U.S. consumers at risk in terms of food and drug safety, an advisory panel to the FDA says in a report to be discussed Monday.

The report — developed in the past year by experts from academia, industry and other government agencies — delivers a scathing review of the state of the FDA, which regulates 80% of the nation's food, its drugs, vaccines and medical devices.

The report details a "plethora of inadequacies" in the agency, including:

•Inadequate inspections of manufacturers, noting that foodmakers, for example, are inspected about once every 10 years.

•A "badly broken" food-import system and food supply "that grows riskier each year." In the past 35 years, FDA inspections of the food supply have dropped 78% due to soaring numbers of products and inadequate FDA funding.
..
William Hubbard, a former FDA associate commissioner who supports the Coalition for a Stronger FDA, says the report stands out because of the "intensity of the feelings" expressed by the subcommittee.

"These people were horrified by what they found," he says. While the subcommittee was supposed to look ahead to where the FDA needs to be, Hubbard says it came away concluding that "it cannot even do its job now."

healthy people could choose not to buy insurance — then sign up for it if they developed health problems later

Mandates and Mudslinging | By PAUL KRUGMAN | Published: November 30, 2007

From the beginning, advocates of universal health care were troubled by the incompleteness of Barack Obama’s plan, which unlike those of his Democratic rivals wouldn’t cover everyone. But they were willing to cut Mr. Obama slack on the issue, assuming that in the end he would do the right thing.
...
The central question is whether there should be a health insurance “mandate” — a requirement that everyone sign up for health insurance, even if they don’t think they need it. The Edwards and Clinton plans have mandates; the Obama plan has one for children, but not for adults.

Why have a mandate? The whole point of a universal health insurance system is that everyone pays in, even if they’re currently healthy, and in return everyone has insurance coverage if and when they need it.

And it’s not just a matter of principle. As a practical matter, letting people opt out if they don’t feel like buying insurance would make insurance substantially more expensive for everyone else.

Here’s why: under the Obama plan, as it now stands, healthy people could choose not to buy insurance — then sign up for it if they developed health problems later. Insurance companies couldn’t turn them away, because Mr. Obama’s plan, like those of his rivals, requires that insurers offer the same policy to everyone. ...

Trimming the salt content in processed and restaurant foods by half could save up to 150,000 lives a year ...

UPDATE 1-US FDA mulls stricter regulation of salt in food | Thu Nov 29, 2007 6:18pm EST | By Kim Dixon

COLLEGE PARK, Md., Nov 29 (Reuters) - Public health advocates on Thursday called for tighter restrictions on salt content in food, arguing that cutting the nutrient's overuse by most Americans could save thousands of lives annually.
...
Trimming the salt content in processed and restaurant foods by half could save up to 150,000 lives a year by reducing heart-related disease, according to the consumer group, whose petition to the FDA prompted the public hearing.

"I am sure no one would tolerate so many deaths from airline crashes, so why tolerate it from food?" Dr. Stephen Havas, vice president for science and public health at the American Medical Association, said.

The CSPI, backed by several public health groups, wants the FDA to beef up labeling, require manufacturers to cut salt in packaged foods, and revoke salt's "generally recognized as safe" status, subjecting it to stricter regulations as a food additive. ...

27% interest on the portion of your medical bill not covered by insurance? That's what some Americans are facing ...

Medical Bills On SteroidsDECEMBER 3, 2007 | The Business Week -- News You Need to Know | Harry Mauer & Cristina Linblad

How would you like to pay 27% interest on the portion of your medical bill not covered by insurance? That's what some Americans are facing. Hospitals and other health-care providers are converting bills of uninsured and underinsured patients into consumer debts in a bid to boost payment. Finance outfits, including big banks and credit-card companies, acquire the debts for a discount, then charge double-digit rates on past due bills. Hospitals get paid quickly, but the practice can leave lower-income patients in a worse financial bind.

hardly an anomaly: Medicare pays more than double for oxygen equipment ... $8,280 vs. $3,500

Golden Opportunities | Oxygen Suppliers Fight to Keep a Medicare Boon | By CHARLES DUHIGG | Published: November 30, 2007

Millions of people with respiratory diseases have relied on oxygen equipment, delivered to their homes, to help them breathe. A basic setup, including three years of deliveries of small oxygen tanks, can be bought from pharmacies and other retailers for as little as $3,500, or about $100 a month.

Unless, that is, the buyer is Medicare, the government health care program for older Americans.

Despite enormous buying power, Medicare pays far more. Rather than buy oxygen equipment outright, Medicare rents it for 36 months before patients take ownership, and pays for a variety of services that critics say are often unnecessary.

The total cost to taxpayers and patients is as much as $8,280, or more than double what somebody might spend at a drugstore.

The high expense of oxygen equipment — which cost Medicare over $1.8 billion last year — is hardly an anomaly.

Medicare spends billions of dollars each year on products and services that are available at far lower prices from retail pharmacies and online stores, according to an analysis of federal data by The New York Times. The government agency has paid above-market costs for dozens of items, a comparison of Medicare figures with retail catalogs finds.

For example, last year Medicare spent more than $21 million on pumps to help older and disabled men attain erections, paying about $450 for the same device that is available online for as little as $108. Even for a simple walking cane, which can be purchased online for about $11, the government pays $20, according to government data.

These widespread price discrepancies, including those for oxygen services, have been noted in dozens of regulatory reports.

But when officials and politicians have tried to cut these costs, they have often encountered a powerful foe: the companies that sell these devices, who ask their elderly customers to serve, in effect, as unpaid lobbyists, calling and writing to their representatives in Congress, protesting at rallies, and even participating in political attacks against individual lawmakers who take on the issue.

the refusal of patients to die according to actuarial schedules has led the federal government to demand that hospices ... repay hundreds of millions

In Hospice Care, Longer Lives Mean Money Lost | By KEVIN SACK | Published: November 27, 2007
...
Over the last eight years, the refusal of patients to die according to actuarial schedules has led the federal government to demand that hospices exceeding reimbursement limits repay hundreds of millions of dollars to Medicare.

The charges are assessed retrospectively, so in most cases the money has long since been spent on salaries, medicine and supplies. After absorbing huge assessments for several years, often by borrowing at high rates, a number of hospice providers are bracing for a new round that they fear may shut their doors.

One is Hometown Hospice, which has been providing care here since 2003 to some of the most destitute residents of Wilcox County, the poorest place in Alabama.

The locally owned, for-profit agency, which serves about 60 patients, mostly in their homes, had to repay the government $900,000, or 27 percent of its revenues, from its first two years of operation, said Tanya O. Walker-Butts, a co-owner. Its profits were wiped out in the time it took to open the demand letters, Ms. Walker-Butts said. ...
In the early days of the Medicare hospice benefit, which was designed for those with less than six months to live, nearly all patients were cancer victims, who tended to die relatively quickly and predictably once curative efforts were abandoned.

But in the last five years, hospice use has skyrocketed among patients with less predictable trajectories, like those with Alzheimer’s disease and dementia. Those patients now form a majority of hospice consumers, and their average stays are far longer — 86 days for Alzheimer’s patients, for instance, compared with 44 for those with lung cancer, according to the Medicare Payment Advisory Commission. ..

This is unsurprising when you consider the surge in interest in health policy among young people, one-third of whom are uninsured.

Young and uninsured turn to ... Facebook | By: Ben Adler | Nov 26, 2007 07:01 PM EST

In the year between his graduation from college and his first year in law school, Jeff Traylor, 25, worked in a restaurant and was similar to approximately 44 million Americans in this respect: He had no health insurance.

As a waiter, Traylor worked fewer than 30 hours a week and thus did not qualify for insurance as a full-time employee.

“I had to go to low-income clinics,” said Traylor, now a second-year student at Lewis & Clark Law School in Portland, Ore.

“That’s $130 for a visit to get antibiotics for a sinus infection, plus the cost of the drug. I could afford it. But some people cannot.” ...
...
Spurred by his own experience and by his concern for the uninsured, Traylor created a group on the social networking site Facebook to promote universal health care.

His is one of more than 20 groups on Facebook dedicated to advocating expanded government health coverage, and many of them have hundreds of members.
...
This is unsurprising when you consider the surge in interest in health policy among young people, one-third of whom are uninsured. ...
...
And the Kaiser Family Foundation, a nonpartisan institution that researches health care in the U.S., found that 42 percent of young people are very worried about being able to afford the health services they think they need. ....

we pay hospitals and doctors more than most other countries do ... minor roles to drug costs, malpractice and aging of baby boom ...

The High Cost of Health Care | Published: November 25, 2007

The relentless, decades-long rise in the cost of health care has left many Americans struggling to pay their medical bills. Workers complain that they cannot afford high premiums for health insurance. Patients forgo recommended care rather than pay the out-of-pocket costs. Employers are cutting back or eliminating health benefits, forcing millions more people into the ranks of the uninsured. And state and federal governments strain to meet the expanding costs of public programs like Medicaid and Medicare.

Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster than the overall economy or personal incomes for more than 40 years, a trend that cannot continue forever.

It is the worst long-term fiscal crisis facing the nation, ...
...
Varied and Deep-Rooted. Contrary to popular beliefs, this is not a problem driven mainly by the aging of the baby boom generation, or the high cost of prescription drugs, or medical malpractice litigation that spawns defensive medicine. Those issues often dominate political discourse, but they have played relatively minor roles in driving up medical spending in this country and abroad ...
...
This is mostly because we pay hospitals and doctors more than most other countries do. We rely more on costly specialists, who overuse advanced technologies, like CT scans and M.R.I. machines, and who resort to costly surgical or medical procedures a lot more than doctors in other countries do. Perverse insurance incentives entice doctors and patients to use expensive medical services more than is warranted. And our fragmented array of insurers and providers eats up a lot of money in administrative costs, marketing expenses and profits that do not afflict government-run systems abroad. ...
...

The Solutions

Geography. Pioneering studies by researchers at Dartmouth have shown enormous disparities in expenditures on health care from one region to another with no discernible difference in health outcomes. Doctors in high-cost areas use hospitals, costly technology and platoons of consulting physicians a lot more often than doctors in low-cost areas, yet their patients, on average, fare no better.

Stick to What Works. The sad truth is that less than half of all medical care in the United States is supported by good evidence that it works, ...

Managed Care. ...

Information Technologies. The American health care system lags well behind other sectors of the economy — and behind foreign medical systems — in adopting computers, electronic health records and information-sharing technologies that can greatly boost productivity. There is little doubt that widespread computerization could greatly reduce the paperwork burden on doctors and hospitals, head off medication errors, and reduce the costly repetition of diagnostic tests as patients move from one doctor to another. ...

Prevention. ... Preventive medicine actually costs money ... and it is not clear how soon, or even whether, substantial savings will show up. ...

Disease Management. ... In some initial trials it has cut costs, in others not.

Drug Prices. Compared with the residents of other countries, Americans pay much more for brand-name prescription drugs, less for generic and over-the-counter drugs, and roughly the same prices for biologics. ...

Who Picks Up the Tab?

Pay Providers Less. ... many experts believe it should be possible to tap into the vast flow of money sluicing through hospitals, nursing homes and other health care facilities to find savings.

Emphasize Primary Care. ... could get better health results, possibly for less cost, if we changed reimbursement formulas and medical education programs to reward and produce more primary care doctors and fewer specialists inclined to proliferate high-cost services. ...

Skin in the Game. The solution favored by many conservatives is to force consumers to shell out more money when they seek medical care so that they will think harder about whether it is really necessary. ... Most health care spending is racked up by a small percentage of individuals whose bills are so high they are no longer subject to cost sharing; they will hardly be deterred from expensive care they desperately need. Moreover, few consumers have the competence or knowledge to second-guess a doctor’s recommendations.

Single Payer. ... Such a system would let the government offset the price-setting strength of the medical and pharmaceutical industries, eliminate much of the waste due to a multiplicity of private insurance plans, and greatly cut administrative costs. ... But a single-payer system is no panacea for the cost problem — witness Medicare’s own cost troubles — and the approach has limited political support. ...

[Kidney Dialysis firms] want to make patients wait longer before they can get access to the program ... charge 3x for that year ....

That’ll Cost a Kidney: How a Little-Noticed Vote in Congress Could Raise Workers’ Healthcare Costs Even Higher | By Juan Basile, AlterNet. Posted November 17, 2007.

Congress is on the verge of letting corporate lobbyists change how a critical treatment is delivered, reducing access to affordable care just so two corporations can boost their bottom line.
...
Usually, patients need to be 65 years old before they qualify for Medicare. But in 1972, because the high cost of dialysis put care out of reach for all but the wealthiest patients, Congress made the historic decision to extend Medicare coverage to dialysis patients of all ages. But patients who need dialysis have to stay on private insurance for 30 months before they are eligible for Medicare. DaVita and Fresenius want to make patients wait longer-another year-before they can get access to the program.
...
It's estimated that dialysis providers like DaVita and Fresenius would cash in a $2 billion windfall over the next decade if they succeed in persuading Congress to make patients wait longer for affordable care. ...
It's not hard to figure out why DaVita and Fresenius want to keep kidney patients out of Medicare. These companies can typically charge private insurers-and ultimately employers and workers-nearly three times more than they can charge Medicare for the same services. ...

insurers are unnecessary middlemen that drain nearly one third of our healthcare costs without ever laying hands on the patient ...

November 22, 2007 at 10:42:31 | Health care and the free market | by Jack Lohman | http://www.opednews.com
...

First, politicians prefer “the free market” even though it is the free market that took over in 1994 that has gotten us into today’s mess. They favor “privatization” because, they argue, it “adds competition and controls costs.”

That’s pure hogwash. It doesn’t.

Politicians prefer privatization for one and only one reason: private companies can give campaign contributions and public entities cannot. Just ask those who pocket the money from the insurance and healthcare industries but never get a penny from Medicare.

Politicians know why they prefer privatization, and you should too. The free market makes them money and Medicare doesn’t.
...

But in the healthcare market, insurers are unnecessary middlemen that drain nearly one third of our healthcare costs without ever laying hands on the patient. And they are protected by the politicians whose campaigns they help fund.

We don’t need mandated insurance — as Massachusetts has done and some politicians support – we need mandated health care. We must totally eliminate the 31% industry waste that is blocking this reform.
...
Medicare isn’t perfect, and it clearly must reign in abuse and overuse. But the private system has even more abuse and overuse because the penalties are far less than those at the federal level. ..

Depleted Uranium: Basra, Iraq report a sevenfold increase in childhood cancer and a sevenfold increase in gross congenital abnormalities ...

Radioactive Ammunition Fired in Middle East May Claim More Lives Than Hiroshima and Nagasaki | Sherwood Ross | November 19, 2007

By firing radioactive ammunition, the U.S., U.K., and Israel may have triggered a nuclear holocaust in the Middle East that, over time, will prove deadlier than the U.S. atomic bombing of Japan.

So much ammunition containing depleted uranium(DU) has been fired, asserts nuclear authority Leuren Moret, "The genetic future of the Iraqi people for the most part, is destroyed."

"More than ten times the amount of radiation released during atmospheric testing (of nuclear bombs) has been released from depleted uranium weaponry since 1991," Moret writes, including radioactive ammunition fired by Israeli troops in Palestine.
...
Moret, a Berkeley, Calif., Environmental Commissioner and past president of the Association for Women Geoscientists, says, "For every genetic defect that we can see now, in future generations there are thousands more that will be expressed."

She adds, "the (Iraq) environment now is completely radioactive."

Dr. Helen Caldicott, the prominent anti-nuclear crusader, has written: "Much of the DU is in cities such as Baghdad, where half the population of 5 million people are children who played in the burned-out tanks and on the sandy, dusty ground."

"Children are 10 to 20 times more susceptible to the carcinogenic effects of radiation than adults," Caldicott wrote. "My pediatric colleagues in Basra, where this ordnance was used in 1991, report a sevenfold increase in childhood cancer and a sevenfold increase in gross congenital abnormalities," she wrote in her book, "Nuclear Power is not the Answer"(The New Press). ...

same company kicked out all the Medicaid patients from their Oregon last year ... now Oregon has law that prohibits such practices

Kicking out old people because they’re on Medicaid? | By: bluegal on Monday, November 19th, 2007 at 2:09 PM - PST

Eleven residents of Victoria House in Port Townsend, Washington State, (some in their 90s) are being evicted from the assisted living facility with 90 days notice. Why? Because the Victoria House management company, has decided to stop accepting Medicaid, and there is no law in Washington that makes them have to stick with their agreements with tenants.

Yup. They can just kick ‘em out.

The same company kicked out all the Medicaid patients from their Oregon facilities last year. Community action got together, and now Oregon has a law, like the one in Illinois, that prohibits such practices.

The company has the Orwellian name of “Assisted Living Concepts” and their motto is “Life Just Got Easier”. No, really. And this is a deliberate business decision on the part of a company that says they are committed to eldercare. ...

"These kids don't walk in with colds and scrapes anymore," ... "They walk in with pneumonia and other communicable diseases.

Children without health insurance lose out on learning at school | By Tony Pugh | McClatchy Newspapers | Sunday, November 18, 2007

WASHINGTON — While Congress and President Bush squabble over health insurance for low-income children, school officials nationwide are scrambling each day to find affordable medical care so that sick and needy students can continue to learn.

Growing numbers of uninsured children have made it harder for educators to focus on classroom achievement without first addressing the medical needs of their students who lack health insurance or dental coverage.
...
... The boy had become a behavioral problem and missed more than 50 days of school when he could no longer get the drug after his mother's insurance expired. ...

In New Prairie, Wis., school social workers got the local Lions Club to provide corrective eyewear for a nearsighted fifth-grader whose parents had no insurance. ...

And in West Palm Beach, Fla., high school principal Nathan Collins persuaded the local school board to help fund a full-time, school-based health clinic because so many of his uninsured students were missing school because they couldn't get medical care.
...
Wells, who's now a school health supervisor for the Department of Health in Manchester, N.H., said she'd like Bush and lawmakers who oppose the bill to visit a school health clinic themselves.

"These kids don't walk in with colds and scrapes anymore," Wells said. "They walk in with pneumonia and other communicable diseases. It's hard to realize how difficult it is for them not to have the appropriate care. You have to see sick kids to understand what it's like." ...

Cannabis compound 'halts cancer'

Monday, 19 November 2007 | Cannabis compound 'halts cancer'

A compound found in cannabis may stop breast cancer spreading throughout the body, US scientists believe.

The California Pacific Medical Center Research Institute team are hopeful that cannabidiol or CBD could be a non-toxic alternative to chemotherapy.
...
Dr Joanna Owens of Cancer Research UK said: "This research is at a very early stage.

"The findings will need to be followed up with clinical trials in humans to see if the CBD is safe, and whether the beneficial effects can be replicated.

"Several cancer drugs based on plant chemicals are already used widely, such as vincristine - which is derived from a type of flower called Madagascar Periwinkle and is used to treat breast and lung cancer. It will be interesting to see whether CBD will join them." ...

‘Safe’ Uranium That Left a Town Contaminated ... use of [DU- Depleted Uranium] weapons may be a war crime.

November 18, 2007 by The Observer (UK) | ‘Safe’ Uranium That Left a Town Contaminated | by David Rose in Colonie, New York

[NOTE: THOUSANDS OF TONS were used in tank shells in IRAQ ... ed.]

They were told depleted uranium was not hazardous. Now, 23 years after a US arms plant closed, workers and residents have cancer - and experts say their suffering shows the use of such weapons may be a war crime.
...
The US federal government and the firm that ran the factory, National Lead (NL) Industries, have been assuring former workers and residents around the 18-acre site for decades that, although it is true that the plant used to produce unacceptable levels of radioactive pollution, it was not a serious health hazard.

Now, in a development with potentially devastating implications not only for Colonie but also for the future use of some of the West’s most powerful weapon systems, that claim is being challenged. In a paper to be published in the next issue of the scientific journal Science of the Total Environment, a team led by Professor Randall Parrish of Leicester University reports the results of a three-year study of Colonie, funded by Britain’s Ministry of Defense.

Parrish’s team has found that DU contamination, which remains radioactive for millions of years, is in effect impossible to eradicate, not only from the environment but also from the bodies of humans. Twenty-three years after production ceased they tested the urine of five former workers. All are still contaminated with DU. So were 20 per cent of people tested who had spent at least 10 years living near the factory when it was still working, including Ciarfello.

The small sample size precludes the drawing of statistical conclusions, the journal paper says. But to find DU at all after so long a period is ’significant, since no previous study has documented evidence of DU exposure more than 20 years prior… [this] indicates that the body burden of uranium must still be significant, whether retained in lungs, lymphatic system, kidneys or bone’. The team is now testing more individuals. ...
...
TV footage shot in Baghdad in 2003 shows children playing in the remains of tanks coated with thick, black DU oxide, while there have long been claims that the DU shells that destroyed Saddam Hussein’s tanks in the 1991 Gulf war were responsible for high rates of cancer in places such as Basra. ...