Thursday, February 28, 2013

Nintendo Wii Helped Budding Surgeons Move To Head Of The Class

More From Shots - Health News HealthChange In Law May Spur Campus Action On Sexual AssaultsHealthStrategy To Prevent HIV In Newborns Sparks Enthusiasm And SkepticismHealthNintendo Wii Helped Budding Surgeons Move To Head Of The ClassHealthNew York Medical School Widens Nontraditional Path For Admissions

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Medicaid Fight Reinvigorated With Political Light On Health Care

More From Shots - Health News HealthChange In Law May Spur Campus Action On Sexual AssaultsHealthStrategy To Prevent HIV In Newborns Sparks Enthusiasm And SkepticismHealthNintendo Wii Helped Budding Surgeons Move To Head Of The ClassHealthNew York Medical School Widens Nontraditional Path For Admissions

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Massachusetts Voters Say YES to Single-Payer Healthcare, and NO to Mandates

From MassCare.org:

Dear Single Payer Supporters –

In an election that has brought out the highest voter turnout in Massachusetts probably since 1928, local ballot initiatives supporting single payer and opposing individual mandates passed by landslide margins in all ten legislative districts where they appeared. With almost all precincts tallied, roughly 73 percent of 181,000 voters in the ten districts voted YES to the following:

“Should the representative from this district be instructed to support legislation creating a cost-effective single payer health insurance system that is available to all residents, and oppose laws penalizing those who fail to obtain health insurance?”

The measure passed with margins ranging from 65 percent in the Fifth Middlesex to 82 percent in the Third Hampshire. A table of results, along with other local non-binding referendum outcomes, is available at the Boston Globe website.

Thanks to everyone in these ten districts for your hard work, and congratulations!

Tuesday, February 26, 2013

Mass Single Payer Action at Blumenauer’s Office

About 75 to 100 single payer activists surrounded Congressman Earl Blumenauer�s Portland, Oregon office this afternoon.

The activists insisted that the Congressman from Oregon�s third district join 77 of his colleagues in the House and sign on to HR 676 � single payer legislation in the House of Representatives.

The protest was organized by Single Payer Action and included doctors, nurses and activists from Physicians for a National Health Program, Portland Jobs With Justice Healthcare Committee, and local unions.

Twenty of the protesters entered the Congressman�s office, delivering a letter signed by over sixty citizens asking again that he co-sponsor HR 676.

The twenty activists then laid inert in his office for twenty-two minutes � in memory of the 22,000 who, according to the Institute of Medicine, die every year due to lack of health insurance.

Those who couldn�t fit in the Congressman�s office were strewn across the hall outside and scattered on the sidewalks in front of his office.

Portland police were present, but the protesters were allowed the entire twenty-two minutes of the �die-in� without anyone being asked to move.

The event ended peacefully with a call to those present to mobilize for a town hall meeting on healthcare to be held by Congressman Blumenauer and Howard Dean on June 5 at 3:00PM at Portland Community College�s Cascade Campus.

�Sixty Americans die every day due to lack of health insurance,� said Single Payer Action�s Philip Kauffman. �Sooner or later, we will get single payer in this country. To save lives, it�s better that we have it sooner rather than later. Congressman Blumenauer needs to get with the single payer program and put the lives of innocent Americans above profits for the health insurance industry.�

Silica Rule Changes Delayed While Workers Face Health Risks

More From Shots - Health News HealthU.S. Doctors Head Overseas To Train, Not Just TreatHealthMost People Can Skip Calcium Supplements, Prevention Panel SaysHealthGovernors' D.C. Summit Dominated By Medicaid And The SequesterHealthTo Spot Kids Who Will Overcome Poverty, Look At Babies

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Monday, February 25, 2013

Arizona Seeks To Balance Patients And Profits With Home Care

More From Shots - Health News HealthPediatricians Urged To Treat Ear Infections More CautiouslyHealthHow 'Crunch Time' Between School And Sleep Shapes Kids' HealthHealthAncient Chompers Were Healthier Than OursHealthContagion On The Couch: CDC App Poses Fun Disease Puzzles

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Sunday, February 24, 2013

Health Insurers Raise Some Rates by Double Digits

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration�s health care law was to stem the rapid rise in insurance costs for consumers.

Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers� filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.

In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.

The proposed increases compare with about 4 percent for families with employer-based policies.

Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site, healthcare.gov, along with regulators� evaluations.

The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.

New York, for example, recently used its sweeping powers to hold rate increases for 2013 in the individual and small group markets to under 10 percent. California can review rate requests for technical errors but cannot deny rate increases.

The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy. PricewaterhouseCoopers estimates that costs may increase just 7.5 percent next year, well below the rate increases being sought by some insurers. But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

�This is business as usual,� Mr. Jones said. �It�s a huge loophole in the Affordable Care Act,� he said.

While Mr. Jones has not yet weighed in on the insurers� most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.

The California insurers say they have no choice but to raise premiums if their underlying medical costs have increased. �We need these rates to even come reasonably close to covering the expenses of this population,� said Tom Epstein, a spokesman for Blue Shield of California. The insurer is requesting a range of increases, which average about 12 percent for 2013.

Although rates paid by employers are more closely tracked than rates for individuals and small businesses, policy experts say the law has probably kept at least some rates lower than they otherwise would have been.

�There�s no question that review of rates makes a difference, that it results in lower rates paid by consumers and small businesses,� said Larry Levitt, an executive at the Kaiser Family Foundation, which estimated in an October report that rate review was responsible for lowering premiums for one out of every five filings.

Federal officials say the law has resulted in significant savings. �The health care law includes new tools to hold insurers accountable for premium hikes and give rebates to consumers,� said Brian Cook, a spokesman for Medicare, which is helping to oversee the insurance reforms.

�Insurers have already paid $1.1 billion in rebates, and rate review programs have helped save consumers an additional $1 billion in lower premiums,� he said. If insurers collect premiums and do not spend at least 80 cents out of every dollar on care for their customers, the law requires them to refund the excess.

As a result of the review process, federal officials say, rates were reduced, on average, by nearly three percentage points, according to a report issued last September.

In New York, for example, state regulators recently approved increases that were much lower than insurers initially requested for 2013, taking into account the insurers� medical costs, how much money went to administrative expenses and profit and how exactly the companies were allocating costs among offerings. �This is critical to holding down health care costs and holding insurance companies accountable,� Gov. Andrew M. Cuomo said.

While insurers in New York, on average, requested a 9.5 percent increase for individual policies, they were granted an increase of just 4.5 percent, according to the latest state averages, which have not yet been made public. In the small group market, insurers asked for an increase of 15.8 percent but received approvals averaging only 9.6 percent.

But many people elsewhere have experienced significant jumps in the premiums they pay. According to the federal analysis, 36 percent of the requests to raise rates by 10 percent or more were found to be reasonable. Insurers withdrew 12 percent of those requests, 26 percent were modified and another 26 percent were found to be unreasonable.

And, in some cases, consumer advocates say insurers have gone ahead and charged what regulators described as unreasonable rates because the state had no ability to deny the increases.

Two insurers cited by federal officials last year for raising rates excessively in nine states appear to have proceeded with their plans, said Carmen Balber, the Washington director for Consumer Watchdog, an advocacy group. While the publicity surrounding the rate requests may have drawn more attention to what the insurers were doing, regulators �weren�t getting any results by doing that,� she said.

Some consumer advocates and policy experts say the insurers may be increasing rates for fear of charging too little, and they may be less afraid of having to refund some of the money than risk losing money.

Many insurance regulators say the high rates are caused by rising health care costs. In Iowa, for example, Wellmark Blue Cross Blue Shield, a nonprofit insurer, has requested a 12 to 13 percent increase for some customers. Susan E. Voss, the state�s insurance commissioner, said there might not be any reason for regulators to deny the increase as unjustified. Last year, after looking at actuarial reviews, Ms. Voss approved a 9 percent increase requested by the same insurer.

�There�s a four-letter word called math,� Ms. Voss said, referring to the underlying medical costs that help determine what an insurer should charge in premiums. Health costs are rising, especially in Iowa, she said, where hospital mergers allow the larger systems to use their size to negotiate higher prices. �It�s justified.�

Some consumer advocates say the continued double-digit increases are a sign that the insurance industry needs to operate under new rules. Often, rates soar because insurers are operating plans that are closed to new customers, creating a pool of people with expensive medical conditions that become increasingly costly to insure.

While employers may be able to raise deductibles or co-payments as a way of reducing the cost of premiums, the insurer typically does not have that flexibility. And because insurers now take into account someone�s health, age and sex in deciding how much to charge, and whether to offer coverage at all, people with existing medical conditions are frequently unable to shop for better policies.

In many of these cases, the costs are increasing significantly, and the rates therefore cannot be determined to be unreasonable. �When you�re allowed medical underwriting and to close blocks of business, rate review will not affect this,� said Lynn Quincy, senior health policy analyst for Consumers Union.

The practice of medical underwriting � being able to consider the health of a prospective policy holder before deciding whether to offer coverage and what rate to charge � will no longer be permitted after 2014 under the health care law.

Nixoncare Finally Wins

“The time is at hand this year to bring comprehensive, high-quality health care within the reach of every American. I shall propose a sweeping new program that will assure comprehensive health insurance protection to millions of Americans who cannot now obtain it or afford it.” – Richard Nixon

The Supreme Court decision to uphold the constitutionality of Barack Obama�s Affordable Care Act has caused a rejoicing among liberals not seen since the 2008 presidential election. The threat of repeal of the legislation now known by friend and foe alike as Obamacare, has united democrats and republicans too. The inability of any president to successfully provide universal health care to Americans made the passage and survival of Obamacare seem like a greater victory than it actually was. Republicans are united in thwarting the initiatives of any democratic president, especially a black one whose very presence causes them to react like one of Pavlov�s dogs.

Barack Obama�s health care plan is very much like a health care plan first presented by another president in 1971. Then president Richard Nixon presented a plan that was very similar to the over hyped Obamacare. Nixon proposed forcing private insurance companies to cover everyone regardless of prior health condition, and the government subsidizing those unable to pay.

The elation created by the Obama court victory is symptomatic of many things that are very wrong in the American body politic. Once again we see proof that the democrats of the 21st century are akin to the republicans of forty years ago. There is no other way to explain their bizarre rejoicing because a bandaid has been placed over a gunshot wound.

Nixon�s proposal ultimately failed because the late senator Ted Kennedy opposed it. Kennedy was the democratic point person on health care and he saw the obvious flaws in a plan which maintained a dependence on the rule of private health insurers. He assumed that an eventual democratic presidential victory would bring true health care reform, and torpedoed the Nixon initiative which is now being celebrated by democrats as a progressive triumph.

The Obama plan does address some of the major problems inherent in the current system, such as allowing parents to continue covering young adult children and preventing pre-existing conditions from barring access to coverage. These are certainly worthy goals, but a true single payer, medicare for all plan would address those problems too, and would also address the biggest obstruction to true health care reform, the reliance on private health insurance companies to provide care for every person.

Private health insurance companies are the problem, and the Affordable Care Act presents a huge windfall for them. When Obama�s plan goes into full effect in 2014, there will still be nothing to prevent health insurance companies from manipulating the market place and giving Americans access to inferior coverage with high deductibles. Medical care bankruptcies will not disappear, and the true death panel, privately run health care, will continue with the help of government dollars. Nixon�s plan was in some ways superior to Obama�s because it called for strict federal oversight of the insurance companies. Greater regulation would have prevented what will now be an inferior and overly expensive system from dictating health care outcomes.

As Vice President Biden famously said, the Obama plan is a �big f*ing deal.� It is a tremendous political victory for Obama but once again we must ask if political victories and also victories for the people. We now have a deeply flawed health care system which is more entrenched than ever. The argument that this plan will eventually lead to a single payer system is highly problematic. Big pharma and health insurance companies were at the negotiating table every step of the way while single payer advocates were locked out.
This act solidifies their control over our lives and shows once again the degree to which corporations drive American public policy.

A victory for Obama is not necessarily a victory for the people, even if that political victory causes insanity among republicans. Scorn from Sarah Palin, Glenn Beck and Rush Limbaugh are not necessarily justifications for rejoicing. Republicans can�t strike a blow against Obama in part because he accepted and promoted so many of their policies. From making war around the world, to bailing out the banks, to bailing out health care, Obama and the democrats act like the republicans they say are their political enemies.

We are told that Ted Kennedy must be smiling in his grave because his long held dream came true. After living to see only backward steps in the health care system he acknowledged regret at not accepting the Nixon plan The president who resigned in disgrace ended up winning in the end. Nixon may also be happy in the great beyond. It took a black man and the democratic party to give him his final political victory.

Saturday, February 23, 2013

Thousands Of Hospitals Face Penalties For High Readmission Rates

More From Shots - Health News HealthContagion On The Couch: CDC App Poses Fun Disease PuzzlesHealthParents, Just Say No To Sharing Tales Of Drug Use With KidsHealthTreating HIV Patients Protects Whole CommunityHealthFeds Set New Rules For Controversial Bird Flu Research

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Countdown to Affordable Health Insurance

January is the perfect month for looking forward to new and great things around the corner.

I�m feeling that way about the new Health Insurance Marketplace. Anticipation is building, and this month we start an important countdown, first to October 1, 2013, when open enrollment begins, and continuing on to January 1, 2014, the start of new health insurance coverage for millions of Americans. In October, many of you�ll be able to shop for health insurance that meets your needs at the new Marketplace at HealthCare.gov.

This is an historic time for those Americans who never had health insurance, who had to go without insurance after losing a job or becoming sick, or who had been turned down because of a pre-existing condition. Because of these new marketplaces established under the Affordable Care Act, millions of Americans will have new access to affordable health insurance coverage.

Over the last two years we�ve worked closely with states to begin building their health insurance marketplaces, also known as Exchanges, so that families and small-business owners will be able to get accurate information to make apples-to-apples comparisons of private insurance plans and, get financial help to make coverage more affordable if they�re eligible.

That is why we are so excited about launching the newly rebuilt HealthCare.gov website, where you�ll be able to buy insurance from qualified private health plans and check if you are eligible for financial assistance � all in one place, with a single application. Many individuals and families will be eligible for a new kind of tax credit to help lower their premium costs.�If your state is running its own Marketplace, HealthCare.gov will make sure you get to the right place.

The Marketplace will offer much more than any health insurance website you�ve used before. Insurers will compete for your business on a level playing field, with no hidden costs or misleading fine print.

It�s not too soon to check out HealthCare.gov for new information about the Marketplace and tips for things you can do now to prepare for enrollment.� And, make sure to sign up for emails or text message updates, so you don�t miss a thing when it�s time to enroll.

There is still work to be done to make sure the insurance market works for families and small businesses. But, for millions of Americans, the time for having the affordable, quality health care coverage, security, and peace of mind they need and deserve is finally within sight.

Vermont Single-Payer Financing Plan Released

The Shumlin administration released two financing plans Thursday evening: one for funding a publicly financed health care system and another to pay for portions of the state�s new health benefit exchange.

The much-anticipated single-payer financing plan provides more of a map of the state�s health care finance landscape than it does a course of action through it. The document itself alludes to the need for a plan with substantive revenue-generating measures.

�A future financing plan will likely feature a substantial and regular individual and employer contribution, similar to current law, albeit one paid through a public system,� the plan says.

The plan � which was drawn up by the University of Massachusetts for a price tag of $300,000 � estimates that the total savings of reforming the system would be about $35 million in 2017. The total $5.91 billion cost of the system would place a burden of $1.61 billion on taxpayers, after federal funding, and a $332 million chunk would be placed on employers who continued to enroll their employees on their insurance plans after the system takes effect.

While the plan points to a slate of tax bases for raising such revenues, the architects of the plan acknowledge the lack of information they had to work with � and, therefore, the potential inadequacy of their findings.

�Many details regarding the structure of a single payer system in Vermont have not been determined,� they write. �These details may significantly affect the assumptions underlying our models and therefore the results of our models.�

When Gov. Peter Shumlin and the Legislature approved Act 48 in 2011, they set the state on a track towards a publicly financed health care system. Part of that legislation called for a financing plan to be submitted to the Legislature by Jan. 15, 2013, that �shall recommend the amounts and necessary mechanisms to finance Green Mountain Care and any systems improvements needed to achieve a public-private universal health care system.�

On Thursday, Director of Health Care Reform Robin Lunge said the plan met the statutory goal.

�It has amounts, and it has necessary mechanisms included; it just doesn�t have one,� she said. Furthermore, she added, the plan seeds the Statehouse for constructive debate over how to pursue and implement such a health care system.

Jeffrey Wennberg, who runs the anti-single payer group Vermonters for Health Care Freedom, panned the report for its lack of substance.

�The report � contains surprisingly little information within its 91 pages,� he said in a public statement. �There is no multi-year budget or projection, and the Act 48-required recommendation for a funding source is completely absent.�

Friday, February 22, 2013

Why Tea Party Gov. Rick Scott Flip-Flopped on Obamacare

Florida Gov. Rick Scott was elected in 2010 almost entirely thanks to his activism opposing the Affordable Care Act, better known as Obamacare. Scott spent $20 million of his own considerable fortune attacking the law, and the Republican backed the state’s lawsuit challenging its constitutionality all the way to the Supreme Court. Scott had declared last summer that Florida would implement the law basically over his dead body, including the optional part that would provide federal funding to expand Medicaid to people making up to 138 percent of the poverty line.

So it was a bit of a surprise Wednesday when he announced suddenly that he had changed his mind: Florida should embrace the Medicaid expansion. We’d like to think that this article might have had something to do with his decision; Scott himself claims that mother’s death inspired his change of heart. But it’s more likely that the decision was a direct result of the US Department of Health and Human Services agreeing to grant Florida a waiver that would allow it to move more Medicaid recipients into private managed-care plans�many of which are part of huge corporate insurance companies waiting to cash in on the latest installment of Obamacare. (The Medicaid expansion is expected to send $66 billion in federal funds to Florida in the next decade.)

Scott has been saying for months that if HHS approved Florida’s waiver request, he might be more willing to take the Medicaid expansion. He was in DC in January meeting with HHS Secretary Kathleen Sebelius over the issue. But HHS’s decision to grant the waiver was somewhat surprising, given that the state was asking to expand a very troubled pilot project going back to the Bush era. The pilot project, which also required a waiver from HHS, allowed the state to put Medicaid recipients in five counties into private, HMO-type health plans rather than the traditional government health plan for the poor and disabled. Scott has championed the pilot as an innovative way of keeping government spending in check. Health care advocates, though, saw the program as a major disaster.

A study by the Georgetown University Health Policy Institute backed up their claims, finding that the biggest problem with the “reform” was that insurance companies got into the program thinking they’d make a lot of money, only to discover that they actually had to care for people who were expensively sick. Nine plans dropped out of the pilot project in a year, leaving many patients without access to any primary health care. There were horror stories, too: the woman denied a kidney transplant, the man with a lifelong seizure disorder who suddenly found he couldn’t get the Botox injections that calmed his seizures. If the patients weren’t getting dropped by the managed-care plans, they were fleeing them for whatever other options they could find. There’s no evidence that the private plans saved the state any money.

“We’ve been raising hell for a couple of years saying this is a problem,” says Laura Goodhue, executive director of Florida CHAIN, a consumer advocacy group that works for the uninsured in Florida. “When you’re caring for an expensive population with multiple conditions, lots of mental-health issues, the only way to make a profit is to delay and deny services, and that�s what we saw in Florida.”

Some of the companies chosen to lead the Medicaid “reform” pilot project weren’t exactly stellar performers before they got there. Wellcare, one of the HMOs in the project (and a major donor to Florida’s GOP), paid out $80 million in 2009 to settle charges federal criminal charges that it had lied about how much it actually spent on health care for poor kids and other vulnerable clients. Last year it paid out another $137.5 million to settle False Claim Act lawsuits alleging schemes to wring extra money out of Medicaid programs, including those in Florida, as well as cherry-picking customers and other abuses.

Despite experiences like these, the Florida Legislature in 2011 voted to expand the pilot project, and big insurers have been jumping to get into this market, (The insurance giant WellPoint, for instance, recently bought Amerigroup, a large Medicaid managed care company, to get in on new business thanks to Obamacare.) But to fully implement its new privatization law, Florida needed the federal government, which pays for about half the program, to waive certain requirements designed to protect patients.

Consumer advocates had fought the law and have been lobbying the Obama administration against granting Florida a waiver. And they had some success. Recently, HHS refused to allow Florida to let HMOs charge Medicaid enrollees $10 co-pays for doctor visits or $100 for emergency room visits for non-emergency care, as the state law allows.

And while Scott has heralded this week’s news about the latest waiver approval as a victory, what HHS actually agreed to is less than the governor and the HMO companies lobbying for the changes were probably hoping for. Among other things, HHS said that the state still has a long way to go to protect consumers enrolled in private plans, and that the approval of the waiver was “conditional,” premised on Florida developing “robust” community input and data-driven goals and strategies.

Goodhue says the new waiver has many more consumer protections built into it than the one granted under the Bush administration, and that hopefully it will prevent some of the problems that occurred under the state’s pilot program. She still doesn’t think that managed care is the way to go to improve Medicaid. But in the end, she�s pleased that it’s not as bad as it could be, and if it means that a million Floridians will get new coverage, that’s something advocates can get behind.

Thursday, February 21, 2013

U.S. Health Worse Than Nearly All Other Industrialized Countries

U.S. citizens suffer from poorer health than nearly all other industrialized countries, according to the first comprehensive government analysis.

U.S. citizens suffer from poorer health than nearly all other industrialised countries, according to the first comprehensive government analysis on the subject, released Wednesday.

Of 17 high-income countries looked at by a committee of experts sponsored by the National Institutes of Health, the United States is at or near the bottom in at least nine indicators.

These include infant mortality, heart and lung disease, sexually transmitted infections, and adolescent pregnancies, as well as more systemic issues such as injuries, homicides, and rates of disability.

Together, such issues place U.S. males at the very bottom of the list, among those countries, for life expectancy; on average, a U.S. male can be expected to live almost four fewer years than those in the top-ranked country, Switzerland. U.S. females fare little better, ranked 16th out of the 17 high-income countries under review.

�We were stunned by the propensity of findings all on the negative side � the scope of the disadvantage covers all ages, from babies to seniors, both sexes, all classes of society,� Steven H. Woolf, a professor of family medicine at Virginia Commonwealth University and chair of the panel that wrote the report, told IPS.

�It�s unclear whether some of these patterns will be experienced by other countries in the years to come, but developing countries will undoubtedly begin facing some of these issues as they take on more habits similar to the United States. Currently, however, even countries in the developing world are outpacing the U.S. in certain outcomes.�

Although the new findings offer a uniquely comprehensive view of the problem, the fact is that U.S. citizens have for decades been dying at younger ages than those in nearly all other industrialised countries. The committee looked at data going back to the 1970s to note that such a trend has been worsening at least since then, with women particularly affected.

�A particular concern with these findings was about adolescents, about whom we document very serious issues that, again, stand out starkly from other counties,� Woolf says.

�Not only do they risk being killed in greater numbers, but they are also experiencing illness, and a variety of mental health concerns, at far higher rates than similar cohorts in other countries. These include significant implications for tomorrow�s adults.�

Beyond insurance

The unusually high levels of population who lack health insurance in the U.S. would certainly seem to be one factor at work here. In 2010, some 50 million people, around 16 percent of the population, were uninsured � a massive proportion compared with the rest of the world�s high-income countries.

Of course, after a rancorous debate and more than a decade of political infighting, in 2010 President Barack Obama did succeed in putting in place broad legislation that will bring the number of uninsured in the United States down significantly.

Further, Obama�s winning of a second term in office, coupled with a recent decision by the Supreme Court, will now undercut most attempts by critics to roll back Obama�s new health-care provisions.

And yet, according to the new findings, the insurance issue has relatively little impact on the overall state of poor health in the United States. (In fact, those 75 years old or more can expect to live longer than those in other countries, a clear indication of the tremendous money and effort that has gone into end-of-life care.)

�Even advantaged Americans � those who are white, insured, college-educated, or upper income � are in worse health than similar individuals in other countries,� the report states. Likewise, �Americans who do not smoke or are not overweight also appear to have higher rates of disease than similar groups in peer countries.�

Indeed, some of the few categories in which U.S. citizens are found to do better than their peers in other countries include smoking less tobacco and drinking less alcohol. They also appear to have gained greater control over their cholesterol levels and blood pressure.

At the same time, people in the United States have begun to suffer inordinately from a host of other problems that can contribute to a spectrum of additional health concerns.

Sky-high obesity rates, for instance, are undergirded by findings that people in the U.S. on average consume more calories per person than in other countries, as well as analysis that suggest that the U.S. physical environment in recent decades has been built around the automobile rather than the pedestrian.

Health disadvantage

Confusingly, people in the United States not only record far lower health indicators on average when compared to other high-income countries, but also score far lower on seemingly unrelated issues related to environmental safety � for instance, experiencing inordinate numbers of homicide and car accidents.

The committee clearly had trouble putting together these seemingly disparate datasets.

�No single factor can fully explain the U.S. health disadvantage,� the report states. �More likely, the U.S. health disadvantage has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions.�

According to Samuel Preston, a demographer and fellow committee member, �The bottom line is that we are not preventing damaging health behaviours. You can blame that on public health officials or on the health care system � But put it all together and it is creating a very negative portrait.�

Over the past decade, one of the most puzzling aspects of the opposition to greater insurance coverage in the United States was the belief espoused by many in the country that the U.S. health system, unique in its lack of state �interference�, was better than those in most other countries.

One of the committee�s central recommendations is the need to �alert the American public about the U.S. health disadvantage and to stimulate a national discussion about its implications.�

Amidst widespread discussions of austerity, lawmakers here in Washington are continuing to debate new ways to impose steep cuts on government spending. In this, the new findings could offer some caution.

�Policymakers must recognise the potential implications of current decisions that have to be made about public health and social programmes that are currently in jeopardy because of fiscal concerns,� Woolf says.

�Understanding how cuts to those programmes might help balance budgets will probably exacerbate the country�s current health disadvantage � and make greater demands on the system later on. We need to help them understand the larger economic implications, if not the human toll.�

Wednesday, February 20, 2013

How The Sequester Could Affect Health Care

More From Shots - Health News HealthIn Reversal, Florida Gov. Scott Agrees To Medicaid ExpansionHealthPrint Me An Ear: 3-D Printing Tackles Human CartilageHealthFeds Outline What Insurers Must Cover, Down To Polyp RemovalHealthArizona Seeks To Balance Patients And Profits With Home Care

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

States Prepare for the Health Insurance Marketplace

When key parts of the health care law take effect in 2014, there will be a new way for individuals, families, and small business owners to get health coverage through the Health Insurance Marketplace, also known as the Affordable Insurance Exchange. Whether you�re uninsured or just want to explore new options, the Marketplace will offer you apples-to-apples comparisons of costs and coverage between health insurance plans.� You can compare all your insurance options based on price, benefits, quality, and other features that may be important to you, in plain language that makes sense.

Starting in October 2013, customers in every state will be able to shop in their Marketplace for coverage that would begin in January 2014.� Each state has the opportunity to choose to create its own State-based Marketplace, work in partnership with the Department of Health and Human Services (HHS), or have a Marketplace operated by HHS.� To date, 20 states and the District of Columbia (DC) have been conditionally approved to run either a State-based or Partnership Marketplace in 2014, and this number will grow by March 1.�

This past Friday, February 15, also marked a milestone for this progress � it was the deadline to submit an application to run a State-partnership Marketplace in 2014.�We received new applications from Iowa, Michigan, New Hampshire and West Virginia, bringing the total number of states that have applied to play a role in operating their Marketplace to 24 and DC.� In addition, several other states have suggested their own approaches to contributing toward plan management in their Marketplace in 2014.�

No matter where a qualified consumer lives, he or she will have access to coverage through a Marketplace.� And 2014 is the beginning, not the end.� States will have the option to apply to run their own Marketplace in future years.�

States will continue to be partners in implementing the health care law, and we are committed to providing them with the flexibility, resources, and time they need to deliver the benefits of the Affordable Care Act to the American people.� For example, 37 states plus the District of Columbia have received establishment grant awards�to help them modernize and develop the IT and business systems needed for their Marketplace. �For more information about Marketplace Establishment Grants visit:� http://cciio.cms.gov/Archive/Grants/exchanges-map.html

To see a complete list of states that have been conditionally approved to run either a State-based or Partnership Marketplace, visit: http://cciio.cms.gov/resources/factsheets/state-marketplaces.html

And to learn more about the Marketplace: http://www.HealthCare.gov/marketplace

Monday, February 18, 2013

Celebrating Healthier Patients and Stronger Communities

Today we are celebrating the work of the National Health Service Corps in communities across the country.� This year�s theme is �Healthier Patients, Stronger Communities,� and that theme is reflected in the work that our NHSC providers do every day.

The National Health Service Corps helps improve access to health care in communities that need it most. �It provides financial support for doctors, nurses and other health care providers as well as students training for a career in primary care.� This financial support in the form of loan repayment and scholarships allows clinicians who are passionate about serving in our communities the ability to pursue jobs in primary care disciplines without the burden of overwhelming debt.�

Now, thanks to investments made by the Obama Administration there are close to 10,000 National Health Service Corps �doctors, dentists, nurse practitioners, physician assistants, mental and behavioral health specialists, and other health providers treating more than 10.4 million people throughout the country.� In fact, the number of providers serving in the NHSC has nearly tripled from 3,600 since the start of the Obama Administration. �And, while Corps members commit to working for at least two years in high need areas, more than 82 percent decide to stay beyond their initial commitment, helping ensure more Americans get the care they need.

I am also excited to announce that this year, the health care law has invested almost $230 million in the NHSC through 4,600 loan repayment and scholarship awards to clinicians and students who are committed to working where they are needed most.

Today, we celebrate Corps Community Day to honor the important work of National Health Service Corps members who are bringing their talents to communities that need health care providers.� To those of you who are serving in the Corps or will serve, I want to say thank you. Thank you for the work you do each and every day to ensure that Americans get the primary care they need and deserve to lead healthy lives.

For stories from National Health Service Corps clinicians, please visit: http://nhsc.hrsa.gov/corpsexperience/memberstories/index.html� or http://nhsc.hrsa.gov/corpsexperience/40clinicians/index.html

Saturday, February 16, 2013

What Nuclear Bombs Tell Us About Our Tendons

More From Shots - Health News HealthWhat Nuclear Bombs Tell Us About Our TendonsHealthPopular Workout Booster Draws Safety ScrutinyHealthDon't Count On Extra Weight To Help You In Old AgeHealthDarkness Provides A Fix For Kittens With Bad Vision

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Friday, February 15, 2013

Epidemics Prefer Changing Planes In JFK Over ATL

More From Shots - Health News HealthWhat Nuclear Bombs Tell Us About Our TendonsHealthPopular Workout Booster Draws Safety ScrutinyHealthDon't Count On Extra Weight To Help You In Old AgeHealthDarkness Provides A Fix For Kittens With Bad Vision

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Presbyterians, TIAA-CREF hear call to divest from private health insurance firms

In the midst of a fierce debate on the national level around the Supreme Court�s decision to uphold the Affordable Care Act, the Divestment Campaign for Health Care made its official debut. Its stated mission: �to expose how the health insurance industry puts the need for profit above the needs of patients and to escalate public support for total removal of the private health insurance companies from our nation�s health care.�

Leading advocacy organizations dedicated to single-payer health care are committed to pursuing a divestment campaign from private health insurance companies in order to transform the treatment of health care as a commodity into a basic human right for all people in the U.S.

�We are responsible for our investments, and particularly as health care workers and patients, we see the immorality of the private health insurance companies as they deny payment for care in order to create huge profits for shareholders. Those who stand for a just and equitable health care system must recognize the corrupting force of the private health insurance industry on our political process that costs tens of thousands of lives every year in addition to being a huge financial drain,� states Dr. Rob Stone, M.D.

The Presbyterian Church (USA) became the first major institution to take steps towards divestment from private health insurance. On July 7th, the church�s national assembly unanimously passed a resolution stating they will �evaluate the variance between church principles of universal access and affordability on the one hand and corporate objectives on the other. It will also assess the likelihood of significant change in corporate behavior.�

The resolution passed after moving testimony was delivered by Rev. Dr. Johanna W.H. van Wijk-Bos, the widow of the original author of the resolution, Rev. A. David Bos who passed away from a sudden case of pneumonia last year, stating before the committee:

�As he lay in the hospital, struggling with the oxygen mask provided to give his lungs the air they needed, he spoke haltingly what would be his last words on this earth: �How much will this cost?� He died six days later. Three weeks after his death a representative from our health insurance company informed me in a telephone call that they rejected the claim to pay for my husband�s hospitalization and medical costs because of a �pre-existing condition.�”

Rev. Dr. van Wijk-Bos felt confident the work they had done would lead to full exposure of these corrupt companies because �corporate interests are incompatible with patient care.�

On the heels of this successful endorsement from the Presbyterian Church, activists gathered inside and outside the pension fund giant TIAA-CREF�s shareholder meeting in New York City to call attention to their holdings in private health insurance. Members of TIAA-CREF were shocked to learn that private health insurance companies are considered part of their socially responsible investment portfolio.

Sandy Fox, psychiatric social worker from Pittsburgh, PA, received applause from the other attendees when she asked President and CEO Roger Ferguson, Jr. about these holdings:

“How do you justify including health insurance companies–CIGNA, Humana, Aetna, Coventry, and WellPoint– in CREF-Social Choice? Private health insurance companies add enormous cost but no value to health care. Furthermore, these companies violate 3 of the 5 social criteria for inclusion in the fund including:

1) NOT �devoted to human rights;�

2) NOT �dedicated to producing high-quality and safe products;� and

3) NOT �managed in an exemplary and ethical manner.�

…We come to you today to demand that you immediately divest from these ruthless companies.�

Shortly before the meeting, the Campaign launched a petition to TIAA-CREF calling for them to move their money out of private health insurance receiving nearly 2000 signers in just a few days.

The Divestment Campaign for Health Care calls upon all people of conscience to shed light on the duplicitous practices that continue in the private health insurance industry. As the Campaign�s mission statement says �We have nothing to lose. Health insurance companies have everything to lose as their stock prices drop and their influence wanes. Go to your religious organization, your union, your pension plan, your 401k advisor, your university endowment, your city council, your friends and neighbors, and tell them it�s time to get the health insurers out!�

Thursday, February 14, 2013

In British Emergency Room, 'There's No Card To Show; There Are No Bills'

More From Shots - Health News HealthMore Women Turn To Morning-After PillHealthScientists Pass The Hat For Research FundingHealthReport: Action Needed To Wipe Out Fake And Substandard DrugsHealthSARS-Like Virus Spreads From One Person To Another

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Feds Reject Mississippi's Plan For Insurance Exchange

More From Shots - Health News HealthScientists Pass The Hat For Research FundingHealthReport: Action Needed To Wipe Out Fake And Substandard DrugsHealthSARS-Like Virus Spreads From One Person To AnotherHealthBorn First And Headed For Health Trouble?

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

The Affordable Care Act and Community Living

The Affordable Care Act is helping seniors and people with disabilities get the supports and services they need to live in their homes and fully participate in their communities, rather than in nursing homes or other institutions.

The new law is providing choices and options to support community living so seniors and people with disabilities don�t have to choose between living in their homes and getting the services and supports they need. Creative solutions are now rolling out in States across the country

As a new report highlights, thanks to the Affordable Care Act, 12 additional States have joined the Money Follows the Person Program to help older Americans and individuals with disabilities transition back to their communities from long-term care institutions.� Eight States are participating in the new Balancing Incentives Program, which gives States new incentives to make home and community-based services more accessible to older Americans and people with disabilities.� Forty- seven community-based organizations are partnering with hospitals around the country through the new Community-Based Care Transition Program to help Medicare beneficiaries as they leave the hospital so they can successfully transition back to their home or the setting that best suits their needs.� And, just last week, California became the first State Community First Choice State, a program which gives States an increase in their federal Medicaid matching rate for providing community-based attendant services and supports as an alternative to nursing home care.

To continue to build on this important work, today, Secretary Sebelius announced $12.5 million in awards to Aging and Disability Resource Centers across the country. These Centers provide expert counselors to help older Americans and people with disabilities and their family members understand the services and supports that are available to them in their communities, and help them sign up and access those critical services and remain independent.

These grants are just a part of our efforts to help people get the services they need and remain independent. You can learn more about our work by reading Affordable Care Act Supports Community Living.

Tuesday, February 12, 2013

Hospital Observation Units Fill Gaps, But Patients May Foot The Bill

More From Shots - Health News HealthWorld's Most Popular Painkiller Raises Heart Attack RiskHealthFolic Acid For Pregnant Mothers Cuts Kids' Autism RiskHealthHospital Observation Units Fill Gaps, But Patients May Foot The BillHealthAttacks On Health Workers Put Fight To End Polio Under Fire

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Treating Everybody With HIV Is The Goal, But Who Will Pay?

More From Shots - Health News HealthHospital Observation Units Fill Gaps, But Patients May Foot The BillHealthAttacks On Health Workers Put Fight To End Polio Under FireHealthNeed A Price For A Hip Operation? Good Luck With ThatHealthU.S. Fertility Rates Fall To All-Time Low

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Thursday, February 7, 2013

Lesson Learned: A Curb On Drugmakers' Gifts To Medical Students

More From Shots - Health News HealthCatholic Bishops Reject Compromise On ContraceptivesHealthBotulism From 'Pruno' Hits Arizona PrisonHealthDespite Rocky Economy, Money For Global Health Remains SolidHealthSilica Rule Changes Delayed While Workers Face Health Risks

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Wednesday, February 6, 2013

Cost Of Treatment Still A Challenge For HIV Patients In U.S.

More From Shots - Health News HealthDefying Expectations, GOP Governors Embrace Medicaid ExpansionHealthDebate Rages On Even As Research Ban On Gun Violence EndsHealthWith Elbows, Cortisone Shots May Hurt More Than HelpHealthNigeria Moves To Clean Up Lead Pollution From Gold Mines

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Saturday, February 2, 2013

Amid An AIDS Epidemic, South Africa Battles Another Foe: Tuberculosis

More From Shots - Health News HealthQuick TB Test Builds Up Arsenal Against Drug-Resistant BacteriaHealthNovartis Recalls Triaminic And Theraflu Cough SyrupsHealthWhite House Tries Again To Find Compromise On ContraceptionHealthAre NFL Football Hits Getting Harder And More Dangerous?

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Friday, February 1, 2013

Jill-Care: Pre-Existing Condition Insurance Plan Keeps Her Running

Jill from North Carolina is a writer and a tutor, but she�s also a runner. A few years ago, she was even training for the Olympic trials in the marathon. But one day, she suddenly passed out in a parking lot. She was diagnosed with a heart condition, atrioventricular nodal reentrant tachycardia (AVNRT).

The good news was that the condition could be remedied with a surgical procedure.

The bad news was that Jill could not afford the surgery.

For years following her diagnosis, she lived within reach of a cell phone just in case she had to call 911. Her condition worsened. �I did stop running; I stopped exercising completely because any kind of exertion would trigger an episode. So I went from running marathons competitively to doing nothing,� Jill says.

She applied for insurance that might cover her surgery, but was turned down due to her pre-existing condition. Her appeal was denied.

There didn�t seem to be a place in the health care system for her situation.

In 2011, Jill heard about the Pre-Existing Condition Insurance Plan (PCIP). PCIP is a program created by the health care law. It is designed to provide affordable health coverage for people who were otherwise locked out of the private system. It also serves as a bridge to 2014, when insurance companies are prohibited from refusing to sell coverage based on someone�s pre-existing condition.�

Jill applied for PCIP. �It took about about 10 minutes to fill out the online application. I received a [approval] letter two weeks later,� Jill says. �In another two weeks, she had her surgery. It�s been over a year since her surgery and Jill hasn�t had another episode. She�s running every single day again.

�The Affordable Care Act---and PCIP program in particular--allows me to pursue what I love to do and have medical coverage and have the comfort of having that medical coverage,� Jill says. �So I don�t have to worry if I have an injury, or an illness, or an accident, that I�m going to go bankrupt; I�m going to lose everything.�

Jill-Care in Action: Coverage for Pre-Existing ConditionsVisit PCIP.gov to learn more about this programSee Myrna's story about trying to find insurance with a pre-existing conditionSee all MyCare stories ?

Could The Health Law End Up Back In Court? Opponents Think So

More From Shots - Health News HealthSalmonella Undermines Hedgehogs' Cuteness OverloadScienceHow Owls Spin Their Heads Without Tearing ArteriesHealthShould Medicare Pay For Alzheimer's Scans?HealthWhy Some Families Won't Qualify For Subsidized Health Insurance

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.