Sunday, August 16, 2009

US economic myths bite the dust | not small business leader, poor income mobility, no vacations, broken healthcare ...

US economic myths bite the dust | Mark Weisbrot | guardian.co.uk

The Great Recession is allowing some widely held beliefs about the US economy – which were the source of much evangelism over the last few decades – to run up against a reality check. This is to be expected, since the United States has been theepicentre of the storm of policy blunders that caused the world recession.

This month my CEPR colleagues John Schmitt and Nathan Lane showed that the United States is not the nation of small businesses that it is regularly dressed up to be for electoral campaign speeches and editorials. If we look at what percentage of our overall labour force is self-employed, or what percentage of manufacturing workers or high-tech workers are employed in small businesses – well, the US ranks at or near the bottom among high-income countries.

As economist Paul Krugman noted after reading the study: "One more American myth bites the dust." Indeed it has. And as both the authors of the paper and Krugman note, there is a plausible explanation for the US's low score in the small business contest: our lack of national health insurance. There are enough risks associated with choosing to start a business over being an employee, but the Europeans don't have to worry that they will go bankrupt for lack of health insurance.

A number of other alleged advantages of America's "economic dynamism" are also mythical. Most people think that there is more economic mobility in America than in Europe. Guess again. We're also near the bottom of rich countries in this category, for example as measured by the percentage of low-income households that escape from this status each year.

The idea that the US is more "internationally competitive" has been without economic foundation for decades, as measured by the most obvious indicator: our trade deficit, which peaked at 6% of GDP in 2006. (It has fallen sharply from its peak during this recession but will rebound strongly when the economy recovers).

And of course the idea that our less regulated, more "market-friendly" financial system was more innovative and efficient – widely held by our leading experts and policy-makers such as Alan Greenspan, until recently – collapsed along with our $8tn housing bubble.

On the other hand, most Americans pay a high price for the institutional arrangements that bring us these mythical successes. We have the dubious honour of being the only "no-vacation nation", ie no legally required paid time off and of course some weeks fewer actual days off per year than our European counterparts enjoy. We have a broken healthcare system that costs about twice as much per capita as that of our peer nations and delivers worse outcomes, as measured by life expectancy and infant mortality. We are near the top in terms of inequality among high-income countries and at the bottom for parental leave policies and paid sick days. The list is a long one.

...

The major media in both Europe and the United States have played an important role, for decades, in helping politicians capitalise on economic mythology to push policy in economic and socially destructive directions on both sides of the Atlantic. It remains to be seen how much the Great Recession will influence the thinking and reporting of these influential institutions.

...

Saturday, August 15, 2009

A Public Health Insurance Plan Option Is Centrist Reform | OurFuture.org

A Public Health Insurance Plan Option Is Centrist Reform | OurFuture.org
...

The problem is the for-profit insurance company takeover of our health care. Handing the private insurance companies 50 million more lives to cover with no benchmark on cost or quality, no ability to stop them from wrongly delaying and denying care, in short, giving them a monopoly over our health insurance coverage for working people is not reform.

Only giving people the choice of a robust national public health insurance option provides a tenable solution to our health care crisis.

...

Without a public health insurance option there is no cost or quality benchmark.

Because public and private are competing side-by-side people with Medicare have a guaranteed back-up plan when their private insurance company decides to pull out of the program or merge with another company or their doctor drops out of their plan’s network.

Without a public health insurance option there is no guaranteed backup.

Because Medicare has such a large membership, it has leverage over large provider conglomerates to get better rates.

Without a public health insurance option there is no negotiating with the large provider conglomerates. ...

Thank heaven for the NHS | Michele Hanson | Comment is free | guardian.co.uk

Thank heaven for the NHS | Michele Hanson | | guardian.co.uk

The American Republicans opposed to Barack Obama's introduction of healthcare reforms have been bad-mouthing our NHS. How dare they? The NHS is one of my main reasons for thanking heaven I was born here, where I know that whatever my income, our free health system will look after me.

It's not perfect, no organisation of that size could be, it's bound to make some mistakes, but I don't know where I'd be without it. Probably dead. I have a thyroid condition, and every day for the last 30 years I've had free medication, like thousands of others with ongoing conditions: diabetes, epilepsy, cancer and many others. What happens to the 43 million people in the US who can't afford to pay for such things? Must they live a miserable, painful, debilitated life and die early?

My mother was cared for until 98, free, through pneumonia, stroke, angina, arthritis and a broken back. All but one of the dozens of doctors, nurses and medical staff who treated her were kind, patient and verging on saintly. She was even fitted with new false teeth at 97 by a lovely young dentist who came to our house to treat her, even though we all knew that the Grim Reaper was nearly at the door.

By that age, my mother often longed to be allowed to fade away, but our hospital seemed to pull out all the stops to keep her going. So those Republican claims that our elderly cannot receive certain treatments are fibs, or at least grossly exaggerated. The over-59s are not refused heart surgery. One of my friends, aged 70, has recently had a stent fitted; another, also 70, is about to have a valve replacement. And last year, aged 66, I had two cataracts removed.

Friday, August 14, 2009

LobbyBlog

LobbyBlog
...

August 14, 2009

Six lobbyists for every lawmaker

No fewer 3,300 lobbyists have signed up to influence health care reform, Bloomberg reports.

That's six lobbyists for each of the 535 members of the House and Senate, according to Senate records, and three times the number of people registered to lobby on defense. More than 1,500 organizations have health-care lobbyists, and about three more are signing up each day. Every one of the 10 biggest lobbying firms by revenue is involved in an effort that could affect 17 percent of the U.S. economy.

"The sheer quantity of money that's sloshed around Washington is drowning out the voices of citizens and the groups that speak up for them," said Larry McNeely of U.S. Public Interest Research Group.

Thursday, August 13, 2009

Health-Reform Rhetoric Gets Personal for Britons - "jaw-droppingly untruthful attacks" by some American critics.

Health-Reform Rhetoric Gets Personal for Britons - washingtonpost.com

Hamish Meldrum, the chairman of the British Medical Association, said in a statement Wednesday that he has been dismayed by the "jaw-droppingly untruthful attacks" by some American critics.

One of the most surprising of these was the rumor -- given an airing by Senate Finance Committee Chairman Charles E. Grassley (R-Iowa) -- that Kennedy, 77, would not receive treatment for his brain tumor if he were in England because he is too old.

"That's just wrong," a British Health Department spokesman said. "The NHS in England provides health services on the basis of clinical need, irrespective of age or ability to pay."

Zack Cooper, a researcher in health policy at the London School of Economics, agreed that the Kennedy claim was "nonsense," ...

Sunday, August 9, 2009

And You Thought a Prescription Was Private - NYTimes.com

And You Thought a Prescription Was Private - NYTimes.com
...
Like many other people, Ms. Krinsk thought that her prescription information was private. But in fact, prescriptions, and all the information on them — including not only the name and dosage of the drug and the name and address of the doctor, but also the patient’s address and Social Security number — are a commodity bought and sold in a murky marketplace, often without the patients’ knowledge or permission.

That may change if some little-noted protections from the Obama administration are strictly enforced. The federal stimulus law enacted in February prohibits in most cases the sale of personal health information, with a few exceptions for research and public health measures like tracking flu epidemics. It also tightens rules for telling patients when hackers or health care workers have stolen their Social Security numbers or medical information, as happened to Britney Spears, Maria Shriver and Farrah Fawcett before she died in June.

“The new rules will plug some gaping holes in our federal health privacy laws,” said Deven McGraw, a health privacy expert at the nonprofit Center for Democracy and Technology in Washington. “For the first time, pharmacy benefit managers that handle most prescriptions and banks and contractors that process millions of medical claims will be held accountable for complying with federal privacy and security rules.”

The law won’t shut down the medical data mining industry, but there will be more restrictions on using private information without patients’ consent and penalties for civil violations will be increased. Government agencies are still writing new regulations called for in the law. ...

Saturday, August 8, 2009

Drug from Japan -- costs $500 / year in UK ... $2,314 in US [preliminary investigation ... ed.]

The Gout Dugout. Issue #016.Febuxostat available in the U.S., but expensive; vitamin C for gout.: "

Taking a longer view, if you need febuxostat for just about a year (4 purchases of Uloric 90 tablets, 80 mg daily for 360 days supply) that will set you back US$2134.56."

http://www.nice.org.uk/guidance/index.jsp?action=article&o=40696
2.3 The proposed recommended dose of febuxostat is 80 mg once daily. If the serum uric acid concentration is above 6 mg/100 ml (360 µmol/l) after 2-4 weeks, febuxostat 120 mg once daily may be considered. The price for febuxostat 80 mg and 120 mg is £0.87. Annual treatment costs will be approximately £318. Costs may vary in different settings because of negotiated procurement discounts.

South Florida doctors paid thousands by Eli Lilly - South Florida - MiamiHerald.com

South Florida doctors paid thousands by Eli Lilly - South Florida - MiamiHerald.com

While policymakers question whether drug makers are hurting healthcare reform by paying doctors fees, Eli Lilly revealed that it paid 10 South Florida providers more than $10,000 each during the first quarter.

In the first revelation about how much drug makers are paying doctors, Eli Lilly has created an online registry detailing payments to 3,400 healthcare providers -- including more than two dozen in South Florida in the first three months of this year.

Top on the South Florida list -- and No. 3 in the nation -- was internist Manuel Suarez-Barcelo, who told The Miami Herald that he earned $65,000 by traveling through 11 states, making 41 presentations, mostly to nursing home staff, about the advantages of the Lilly drug Forteo, used to treat osteoporosis.

Seven others in South Florida pulled in more than $10,000 each, including Broward obstetrician-gynecologist Jay S. Cohen, who received $38,000.

The payments are not illegal, but Washington policymakers question whether they raise the potential for conflicts of interest. ... [what the average layman calls BRIBERY. ed.]

Unions Receive Increasingly Scary Threats Of Violence For Town Hall Participation - Democratic Underground

Unions Receive Increasingly Scary Threats Of Violence For Town Hall Participation - Democratic Underground:

"Union officials continued to receive a barrage of threats on Friday evening and into Saturday punctuated by warnings that if organizers were sent to counter-demonstrate at health care town halls they would be met with violence.

An official with the AFL-CIO, a federation of labor organizations, passed on what he described as a 'pretty direct threat' to those union hands who were showing up to balance out anti-Obama demonstrations being waged at local Democratic forums.

'I will be going to a local town hall this weekend, all you union members BEWARE!' an emailer wrote at 9:40 Saturday morning. 'We will be waiting for you. better make sure you have arrangements with your local ER. today is the day when the goon meets the gun. see you there.'"

Drug Industry to Run Ads Favoring White House Plan - [Deal with the devil?? ed.]

Drug Industry to Run Ads Favoring White House Plan - NYTimes.com

WASHINGTON — The drug industry has authorized its lobbyists to spend as much as $150 million on television commercials supporting President Obama’s health care overhaul, beginning over the August Congressional recess, people briefed on the plans said Saturday.

The unusually large scale of the industry’s commitment to the cause helps explain some of a contentious back-and-forth playing out in recent days between the odd-couple allies over a deal that the White House struck with the industry in June to secure its support. The terms of the deal were not fully disclosed. Both sides had announced that the drug industry would contribute $80 billion over 10 years to the cost of the health care overhaul without spelling out the details. ...

Johann Hari: The hidden truth behind drug company profits - Johann Hari, Commentators - The Independent

Johann Hari: The hidden truth behind drug company profits - Johann Hari, Commentators - The Independent

This is the story of one of the great unspoken scandals of our times. Today, the people across the world who most need life-saving medicine are being prevented from producing it. Here's the latest example: factories across the poor world are desperate to start producing their own cheaper Tamiflu to protect their populations – but they are being sternly told not to. Why? So rich drug companies can protect their patents – and profits. There is an alternative to this sick system, but we are choosing to ignore it.
...

Our governments have chosen, over decades, to allow a strange system for developing medicines to build up. Most of the work carried out by scientists to bring a drug to your local pharmacist – and into your lungs, or stomach, or bowels – is done in government-funded university labs, paid for by your taxes.

Drug companies usually come in late in the process of development, and pay for part of the expensive, but largely uncreative final stages, like buying some of the chemicals and trials that are needed. In return, then they own the exclusive rights to manufacture and profit from the resulting medicine for years. Nobody else can make it.

The argument in defence of this system offered by Big Pharma is simple, and sounds reasonable at first: we need to charge large sums for "our" drugs so we can develop more life-saving medicines. We want to develop as many treatments as we can, and we can only do that if we have revenue. A lot of the research we back doesn't result in a marketable drug, so it's an expensive process.

But a detailed study by Dr Marcia Angell, the former editor of the prestigious New England Journal of Medicine, says that only 14 per cent of their budgets go on developing drugs – usually at the uncreative final part of the drug-trail. The rest goes on marketing and profits. And even with that puny 14 per cent, drug companies squander a fortune developing "me-too" drugs – medicines that do exactly the same job as a drug that already exists, but has one molecule different, so they can take out a new patent, and receive another avalanche of profits.

As a result, the US Government Accountability Office says that far from being a font of innovation, the drug market has become "stagnant". They spend virtually nothing on the diseases that kill the most human beings, like malaria, because the victims are poor, so there's hardly any profit to be sucked out.

We all suffer as a result of this patent dysfunction. The European Union's competition commissioner, Neelie Kroes, recently concluded that Europeans pay 40 per cent more for their medicines than they should because of this "rotten" system – money that could be saving many lives if it was redirected towards real health care.

Why would we keep this system, if it is so bad? The drug companies have spent more than $3bn on lobbyists and political "contributions" over the past decade in the US alone. They have paid politicians to make the system work in their interests. If you doubt how deeply this influence goes, listen to a Republican congressman, Walter Burton, who admitted of the last big health care legislation passed in the US in 2003: "The pharmaceutical lobbyists wrote the bill."

There is a far better way to develop medicines, if only we will take it. It was first proposed by Joseph Stiglitz, the recent Nobel Prize winner for economics. He says: "Research needs money, but the current system results in limited funds being spent in the wrong way."

Stiglitz's plan is simple. The governments of the Western world should establish a multi-billion dollar prize fund that will give payments to scientists who develop cures or vaccines for diseases. The highest prizes would go to cures for diseases that kill millions of people, like malaria. Once the pay-out is made, the rights to use the treatment will be in the public domain. Anybody, anywhere in the world, could manufacture the drug and use it to save lives.

The financial incentive in this system for scientists remains exactly the same – but all humanity reaps the benefits, not a tiny private monopoly and those lucky few who can afford to pay their bloated prices. The irrationalities of the current system – spending a fortune on me-too drugs, and preventing sick people from making the medicines that would save them – would end.

It isn't cheap – it would cost 0.6 per cent of GDP – but in the medium-term it would save us all a fortune because our health care systems would no longer have to pay huge premiums to drug companies. Meanwhile, the cost of medicine would come crashing down for the poor – and tens of millions would be able to afford it for the first time. ...

...

The idea of ring-fencing life-saving medical knowledge so a few people can profit from it is one of the great grotesqueries of our age. We have to tear down this sick system – so the sick can live. Only then we can globalise the spirit of Jonas Salk, the great scientist who invented the polio vaccine, but refused to patent it, saying simply: "It would be like patenting the sun."

Op-Ed Columnist - The Town Hall Mob - NYTimes.com

Op-Ed Columnist - The Town Hall Mob - NYTimes.com
...

Some commentators have tried to play down the mob aspect of these scenes, likening the campaign against health reform to the campaign against Social Security privatization back in 2005. But there’s no comparison. I’ve gone through many news reports from 2005, and while anti-privatization activists were sometimes raucous and rude, I can’t find any examples of congressmen shouted down, congressmen hanged in effigy, congressmen surrounded and followed by taunting crowds.

And I can’t find any counterpart to the death threats at least one congressman has received.

...

There was a telling incident at a town hall held by Representative Gene Green, D-Tex. An activist turned to his fellow attendees and asked if they “oppose any form of socialized or government-run health care.” Nearly all did. Then Representative Green asked how many of those present were on Medicare. Almost half raised their hands. ...

Healthcare Efficiency: Business Roundtable

Healthcare Efficiency: Business Roundtable
...
In discussing this study, John Iglehart, at Health Affairs blog, cites another study by McKinsey Global Institute that reaches many of the same conclusions. Interesting tidbits from this latter study:
  1. We spend twice as much on healthcare as we do on food.
  2. We spend more on healthcare than the Chinese spend on everything.
  3. We spend more than could be expected, based on per capita GDP.
  4. Healthcare spending has grown faster than the GDP almost forever.
  5. Outpatient care is the fastest growing component. (7.5% vs 6.0% for inpatient care.)
  6. Specialists comprise 64% of U.S. physicians vs 66% in OECD countries.
  7. U.S. specialists earn 6.5 time per capita GDP vs the 3.9 % OECD average.
  8. Healthcare spending in Japan may double in the next two decades, driven by technology, wealth, and demographics.

The bottom line picture you come away with is that healthcare expenses in the U.S. are higher than any other country, and the reasons are everywhere. We get more healthcare, pay more for every aspect of care, and lack any control on costs--either from a top down government ownership or market competition. And this situation may well sink our economy unless we correct it soon.

Spinal Fracture: Cement No Better Than Sham

Spinal Fracture: Cement No Better Than Sham
By Salynn Boyles | WebMD Health News | Reviewed by Louise Chang, MD

Aug. 5, 2009 -- A popular treatment for painful spinal compression fractures works no better than sham therapy in patients with osteoporosis, according to two new studies published today in the New England Journal of Medicine.

... “It is possible that there was a treatment effect (with the cement treatment) that we were just unable to measure,” Kallmes says. “I don’t think we should give up on this procedure. I think it needs to be studied in more detail.”

White House Confirms: Deal With Big Pharma Bars Price Negotiations

White House Confirms: Deal With Big Pharma Bars Price Negotiations

In closed-door negotiations with President Obama and his top aides throughout the spring, Big Pharma offered its support for comprehensive health care reform and pledged to cut $80 billion in costs over the next ten years. Just exactly what Obama promised in return wasn't made public and was the subject of intense debate on Capitol Hill Thursday, as senators wondered aloud if the White House had tied their legislative hands.

Earlier in the week, there were reports that Obama had promised to oppose any congressional attempt to exact further money from the massive pharmaceutical industry, which would include allowing Medicare to negotiate for lower prices or import cheaper drugs from Canada -- two major priorities for congressional Democrats.

In a Thursday meeting with Senate Democrats, some of those present thought the White House backed off that deal. The administration has now stepped in to clear up its position: Congress can vote to do those things -- just not as part of the health-care overhaul legislation. ...

Health-Care Firms Have Supported Lawmakers Debating Reform

Health-Care Firms Have Supported Lawmakers Debating Reform - washingtonpost.com
By Dan Eggen | Tuesday, July 21, 2009 | Washington Post Staff Writer

As liberal protesters marched outside, Sen. Max Baucus sat down inside a San Francisco mansion for a dinner of chicken cordon bleu and a discussion of landmark health-care legislation under consideration by his Senate Finance Committee.

At the table on May 26 were about 20 donors willing to fork over $10,000 or more to the Democratic Senatorial Campaign Committee, including executives of major insurance companies, hospitals and other health-care firms. ...

Key GOP Senators Soak Up Thousands At Health-Specific Fundraiser

Key GOP Senators Soak Up Thousands At Health-Specific Fundraiser

Top Republican senators involved in crafting health care reform legislation participated in a health care-specific fundraiser Monday evening. Guests were asked for a $2,000 contribution to the National Republican Senatorial Committee to attend a "Roundtable on Healthcare Issues" -- and $5,000 for both the roundtable and dinner with Sen. Chuck Grassley (R-Iowa), Sen. Mike Enzi (R-Wyo.) and Sen. Richard Burr (R-N.C.).

The nonpartisan Sunlight Foundation cited the event for its upfront offer of special-interest access. All three senators sit on key health committees. Grassley is the ranking member of the Senate Finance Committee, currently embroiled in negotiations with Committee Chairman Max Baucus (D-Mont.) over the pending reform bill. Enzi sits on the Finance Committee and serves as ranking member of the Health, Education, Labor and Pensions Committee, of which Burr is a member as well. ...

The Truth about Socialized Medicine���� : Information Clearing House - ICH

The Truth about Socialized Medicine���� : Information Clearing House - ICH
By Audrey Mayer

July 28, 2009 "
Commondreams" -- I have been hearing a lot of pundits and politicians bemoan “socialized medicine” and its supposed inefficiencies and inequities. These horror stories are never accompanied by data, just hearsay and anecdotes from “a friend of a friend” in Canada or the United Kingdom. Rarely have I heard from people who have themselves experienced a universal public health care system. As one of those people, I thought I should speak up.

While living in Finland for three years, I experienced socialized medicine up close and personal. I gave birth to my son there.

...
I never had to wait to see a medical professional, nor was any necessary procedure delayed or denied. Every nurse and doctor I saw was caring and knowledgeable, and spent whatever time was necessary to make sure that I received the care I needed.

I have now been living and working back in the US for 6 months, and already I have had problems with my health insurance plan through my employer. I found out the hard way (that is, at the doctor’s office after my son’s vaccination visit) that my son had been arbitrarily dropped from my plan months before, even though I had been paying the premiums for the family plan all along. It took almost a week of phone calls to get him reinstated. All the while, I privately wondered if the two ear infections he had had in the spring had prompted some computer at the health insurance company to calculate that he was “overusing” the system, and automatically drop his coverage.

That may seem like paranoid thinking, but I have seen it all before. In 2001, my mother was diagnosed with aggressive breast cancer. Instead of focusing her strength and attention on recovering from a double mastectomy, chemotherapy, and radiation, she spent much of her time arguing with the health insurance company and the hospital over bills she had already paid, and routine treatments that should have been covered by her insurance plan. Ultimately she lost her insurance altogether when she lost her job, and she has since been living in remission, uninsured.

When these pundits and politicians go onto national television and spew all sorts of false rhetoric about the evils of socialized medicine, it makes my blood boil. They are doing an incredible disservice to their fellow Americans, both those with and without health insurance. For every anecdote they have about a Canadian waiting six months for necessary open heart surgery, I can find twenty Americans for whom that equally necessary surgery is completely out of reach. Now is the time for an honest assessment about what (if anything) can be salvaged from our current system, and to put a system in place that does what it is supposed to do: provide health care. ...

� Health Care Hypocrisy�� : Information Clearing House - ICH

Health Care Hypocrisy : Information Clearing House - ICH
...

His political opponents become bolder with each day as they see his party base in Congress weakening, his polls dropping, and a confused public being saturated with unrebutted propaganda by the insatiable profiteering, subsidized health care giants.

Their campaign-money-greased minions on Capitol Hill and the corporatist Think Tanks and columnists are seizing on President Obama's aversion to conflict and repeated willingness to water down what he will fight for.

The loud and cruel baying pack comes in the form of William Kristol ("This is not time to pull punches. Go for the kill."), Senator Jim DeMint (R-SC) ("If we're able to stop Obama on this, it will be his Waterloo. It will break him."), and Charles Krauthammer yammering wildly about medical malpractice and tort law. Krauthammer does not substantiate his claims or mention the many victims of malpractice as he gleefully predicts "Obamacare sinking."

All these critics have gold-plated health insurance, of course.

Hillary tried to appease the drug and hospital companies. Obama invites them to the White House, where they presumably pledged to give up nearly $300 billion dollars over ten years without any specifics about how this complex assurance can be policed.

No matter, in return Obama and his aides agreed not to press Congress to authorize the federal government to negotiate drug prices with the drug industry. Don't worry: the taxpayers will pay the bill.

At a meeting on July 7 at the White House between drug company executives, Obama's chief of staff, Rahm Emanuel, and Senate Finance Chairman Max Baucus (D-MT), the industry, according to The New York Times, was promised that the final legislative package would not allow the reimportation of cheaper medicines from Canada or other countries even if they meet our drug safety standards. ...

Steve Corrick: 50 Year Olds are Unemployable Without a Public Option | BuzzFlash.org

Steve Corrick: 50 Year Olds are Unemployable Without a Public Option | BuzzFlash.org
BUZZFLASH GUEST COMMENTARY | by Steve Corrick

I have a friend my age (56) with impeccable credentials: She has a Master's Degree; 18 years experience as a successful college administrator; glowing recommendations; she shows up for work every day and is hardly ever sick; she's a team player and works selflessly for whomever she's employed by.

She also has a pre-existing medical condition (as does virtually everyone by the time they reach 50).

Therefore, she is almost completely unemployable by American companies.

Well, not quite. Store clerk jobs, entry level temp jobs, manual data entry jobs, real estate and consulting jobs are all available to her -- as long as they don't offer benefits.

In this experience my friend is like virtually every other 50+ year old. Unless we make a company a couple hundred thousand a year, increased medical premiums make us too expensive to hire.

When a job offers benefits -- like, oh, say, every single job that her many years of successful service qualify her for -- by the end of the training period, employers find that she's just "not quite right for the job," that they were looking for a different kind of experience, and gosh darn it if every person who replaces her isn't about 25 years old with virtually no experience.

However, these 25-year-olds hold one credential my friend will never hold again. They have clean medical records and, at their age, they don't make insurance companies nervous and they don't increase a company's group rates.

I had a similar experience. After 4½ years with a national telecommunications company and the year after I was one of the regional sales leaders, I had a third two-day circulatory problem that landed me in the hospital. When I returned, instead of concern or some assistance in helping me get back on my feet, suddenly everything I'd been taught to do by my company was wrong, and I was suddenly being written up again and again for providing the same exceptional customer service I'd received awards for the previous year -- and, within five months, I was out of a job. ...

Wednesday, August 5, 2009

Industries Hurt Most by Soaring Health Costs - Rick Newman (usnews.com)

Industries Hurt Most by Soaring Health Costs - Rick Newman (usnews.com)
August 04, 2009 03:50 PM ET | Rick Newman | Permanent Link | Print

It started as a dull throb in the economy, with the pain growing sharper. Now there's finally a diagnosis: Runaway healthcare costs are directly harming businesses and their employees.

...

A new study, however, shows that some industries have become chronically hamstrung by rising healthcare costs, with lower growth and employment than they'd have if costs were lower—or somebody else paid them. Researchers Neeraj Sood, Arkadipta Ghosh, and José J. Escarce of the Rand Corp. analyzed the performance of 38 industries from 1987 to 2005 and found that sectors where a high proportion of workers have company-provided health insurance—such as manufacturing, utilities, communications, education, and finance—showed the lowest growth over the 19-year period. Industries where fewer workers get company-paid health insurance—such as agriculture, hotels, entertainment, retail, and construction—grew more.

... They also compared U.S. industries with their counterparts in Canada—where the government, not business, pays for healthcare—to see if the entire industry was suppressed because of global trends or just the American slice. Their conclusion: Rising healthcare costs in the United States have directly curtailed growth and employment. And the industries with the most generous benefits tend to be penalized for it. "Industries which provide healthcare to a large fraction of workers didn't grow as fast as industries offering health insurance to a small fraction of workers," says Sood.

[See 8 industries that will sit out an economic recovery.]

... Only 59 percent of small firms offer health insurance to their employees, down from 68 percent in 2000. Many business owners say they limit hiring or try to get by with part-timers because the costs of full-time benefits are too high. ...

One startling outcome of the Rand projections is that every one of the 15 industries they analyzed stands to suffer lost jobs and output if healthcare expenses keep rising. Agriculture and forestry, where just 19 percent of workers have company-paid insurance, would shrink the least. Utilities, which cover 83 percent of their workers, would shrink the most. Here's how 15 major industries would fare if healthcare costs swell to 20 percent of GDP by 2017: ...

Tuesday, August 4, 2009

rescission: canceling coverage: 50% chance if you are in the top 1% most sick people ???!!!

Unconscionable Math � Taunter Media
July 28, 2009 by Taunter

The House hearings on rescission – the retroactive cancellation of individual health insurance policies – were over a month ago, but after its initial run through Daily Kos it seems to have waited a bit before popping up on Baselineand Slate. James Kwak at Baseline described the practice as rare, affecting only 0.5% of the population. The faint light bulb above my head began to flicker:could that be true…that’s not rare – that is amazingly common.

...

What tangled webs we weave…

To understand why 0.5% of the people Assurant covers is a lot of people – a jarring, terrifying, probably criminal lot – you need to understand a little bit of math. You need to understand just enough math to understand what Don and his legal team are not telling you. You need to understand conditional probability. And the folks at Assurant are counting on the fact that you don’t.

...

Here’s the health care nuance (2005 HHS report based on 2002 data):

Bar graph shows percent of total expenditure by percent of population: Top 1% (greater than or equal to $35,543), 22%; Top 5% (greater than or equal to $11,487), 49%; Top 10% (greater than or equal to $6,444), 64%; Top 20% (greater than or equal to $3,219), 80%; Top 50% (greater than or equal to $664), 97%; Bottom 50% (less than $664), 3%.

Half of the insured population uses virtually no health care at all. The 80th percentile uses only $3,000 (2002 dollars, adjust a bit up for today). You have to hit the 95th percentile to get anywhere interesting, and even there you have only $11,487 in costs. It’s the 99th percentile, the people with over $35,000 of medical costs, who represent fully 22% of the entire nation’s medical costs. These people have chronic, expensive conditions. They are, to use a technical term, sick.

...

It should be fairly clear that the people who do not file insurance claims do not face rescission. The insurance companies will happily deposit their checks. Indeed, even for someone in the 95th percentile, it doesn’t make a lot of sense for the insurance company to take the nuclear option of blowing up the policy. $11,487 in claims is less than two years’ premium; less than one if the individual has family coverage in the $12,000 price range. But that top one percent, the folks responsible for more than $35,000 of costs – sometimes far, far more – well there, ladies and gentlemen, is where the money comes in. Once an insurance company knows that Sally has breast cancer, it has already seen the goat; it knows it wants nothing to do with Sally.

If the top 5% is the absolute largest population for whom rescission would make sense, the probability of having your policy cancelled given that you have filed a claim is fully 10% (0.5% rescission/5.0% of the population). If you take the LA Times estimate that $300mm was saved by abrogating 20,000 policies in California ($15,000/policy), you are somewhere in the 15% zone, depending on the convexity of the top section of population. If, as I suspect, rescission istargeted toward the truly bankrupting cases – the top 1%, the folks with over $35,000 of annual claims who could never be profitable for the carrier – then the probability of having your policy torn up given a massively expensive conditionis pushing 50%. One in two. You have three times better odds playing Russian Roulette.

...

It is in the health insurer’s interest to have application fraud, not only because it saves time and expense on the front end, but also because it lets them get out of any policy that isn’t going well for them. If the health insurer had to verify the information – if, in essence the insurance company had to behave as an accredited investor with adequate expertise to make a decision without reliance – it wouldn’t have the opportunity to bail out. It would catch more genuine liars, but many of these liars would have turned out to be healthy, profitable customers, and what the carrier really wants is a population devoid of expensive claims, not devoid of liars. ...

Saturday, August 1, 2009

Op-Ed Columnist - Health Care Realities - NYTimes.com

Op-Ed Columnist - Health Care Realities - NYTimes.com
...

The key thing you need to know about health care is that it depends crucially on insurance. You don’t know when or whether you’ll need treatment — but if you do, treatment can be extremely expensive, well beyond what most people can pay out of pocket. Triple coronary bypasses, not routine doctor’s visits, are where the real money is, so insurance is essential.

Yet private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Horror stories are legion: the insurance company that refused to pay for urgently needed cancer surgery because of questions about the patient’s acne treatment; the healthy young woman denied coverage because she briefly saw a psychologist after breaking up with her boyfriend.

And in their efforts to avoid “medical losses,” the industry term for paying medical bills, insurers spend much of the money taken in through premiums not on medical treatment, but on “underwriting” — screening out people likely to make insurance claims. In the individual insurance market, where people buy insurance directly rather than getting it through their employers, so much money goes into underwriting and other expenses that only around 70 cents of each premium dollar actually goes to care.

Still, most Americans do have health insurance, and are reasonably satisfied with it. How is that possible, when insurance markets work so badly? The answer is government intervention.

Most obviously, the government directly provides insurance via Medicare and other programs. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare — which is, by the way, one of those “single payer” systems conservatives love to demonize — covers everyone 65 and older. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance.

Still, most Americans under 65 do have some form of private insurance. The vast majority, however, don’t buy it directly: they get it through their employers. There’s a big tax advantage to doing it that way, since employer contributions to health care aren’t considered taxable income. But to get that tax advantage employers have to follow a number of rules; roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.

And it’s thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market.

So here’s the bottom line: if you currently have decent health insurance, thank the government. ...

Open Left:: Democrats Preparing Health Care "Plan B"

Open Left:: Democrats Preparing Health Care "Plan B"
...
... There were several problems with the Baucus "bi-partisan" plan:

  1. Over-representative of Republicans. The mini-committee of six included an even number of Democrats and Republicans (three on each side), even though Democrats control 60% of the seats in both the House and the Senate.

  2. Negotiating with the wrong Senators. Two of the three Republicans being negotiated with (Enzi and Grassley) weren't even the key swing votes to reach 60 Senators.

  3. Nothing in it for Republicans. Republicans have no political interest in passing health care legislation. they will be better off if it fails, electorally speaking.

  4. Republicans weren't negotiating in good faith This is demonstrated by Enzi's demand that, other than the gang of six, all other negotiations in Congress and with the Obama administration must be dropped until they three Republicans in the gang agree to anything. Demanding total power over all negotiations is not actual negotiation. It is just a power grab.

  5. Unrepresentative of the country. Those six Senators represented states that collectively formed only 3% of the national population.(Montana, North Dakota, Wyoming, Maine, New Mexico and Iowa)..
For the reasons outlined above, the Baucus bi-partisan plan was flawed in both concept and in execution. Further, whatever function it might have served as a public display to attempt bi-partisanship has already been accomplished.

At this point, if Democrats don't circumvent Baucus and Republicans, we are doing ourselves, and the country, far more harm than good. Abstract process concepts like bipartisanship won't reduce the percentage of GDP spent on health care, and certainly won't cover any more uninsured Americans.

Raw Story � Blue Dog opposition may be ‘underwritten’ by pharmaceutical giants

Raw Story � Blue Dog opposition may be ‘underwritten’ by pharmaceutical giants

Typical “Blue Dog” Democrats — moderate members of Congress who have been the most ardent among Obama’s own party in thwarting ongoing national healthcare legislation — receive 25 percent more campaign cash from the healthcare and insurance industry than other Democrats, an investigation has found.

In fact, a Blue Dog’s average receipts from the medical industry was just $3,625 lessthan that of the average Republican. Republicans have worked to block plans to enact universal health insurance legislation, saying that it would restrict individual choice and lead to the rationing of medical care.

Blue Dog Democrats say they’re for moderate fiscal policy and aim to reduce the overall cost of a health insurance measure. It appears, however, that their ideological opposition is underwritten by the industry most affected by proposed changes.

Notably, the Blue Dog Political Action Committee has received lavish financial support from pharmaceutical giants Pfizer and Novartis; insurers WellPoint and Northwestern Mutual and the trade group American’s Health Insurance Plans.

The average Blue Dog got more than half (54 percent) of total 2009 financial contributions from the medical care industry. Its PAC has more than doubled in size since 2005 — at a time when both national Republican and Democratic campaign committees reported double-digit drops in funding. ...