Affordable Health Insurance

Health insurance bills need Senate scrutiny Will Blue Cross gain at public's expense?

Friday 28 December 2007 at 3:30 pm The Michigan Senate should throw up a stop sign on health insurance legislation that would significantly change and raise rates for people who pay for their own coverage. The House allowed the legislation to zoom through like a toboggan shoved down a Teflon hill.

Blue Cross/Blue Shield of Michigan - the state's largest health insurer - crafted the bills that rewrite rate-setting, oversight and coverage rules for individual health insurance plans. They conveniently also expand profit-making options for Blue Cross subsidiaries.

Those are significant changes and need to be thoroughly vetted to determine what's best for the public. Two weeks after being introduced, the package of four bills (5282-5285) breezed through the House in October with scant opposition or opportunity for public scrutiny. The first two bills passed by votes of 89-17 and 90-16, respectively; the second two by 84-22 votes. (more)

Healthcare for all in California?

Friday 28 December 2007 at 3:27 pm The issue of universal healthcare looks set to become a key topic in the run up to next year's US presidential election.
With Congress stalled on enacting a nationwide plan, individual states are starting to take matters into their own hands.

In California, Governor Arnold Schwarzenegger has just won approval from legislators for a major healthcare reform which will expand coverage to most of the state's uninsured.

It took nearly a year of sometimes fractious haggling, but legislators in America's most populous state have done what many predicted they could not

They have approved a bill to extend health insurance to virtually everyone in the nation's most populous state - all 36 million of them. (more)

Can Turning 65 Make You Healthier?

Friday 28 December 2007 at 3:23 pm (WebMD) Compared with those with health insurance, the uninsured get sicker and sicker as they age -- until they qualify for Medicare.

The finding comes from a huge survey of 5,006 Americans with health insurance and 2,227 Americans who were persistently or intermittently uninsured from ages 55 to 64.

J. Michael McWilliams, MD, of Brigham and Women's Hospital and Harvard University and colleagues rated participants' health in terms of general health, change in general health, mobility, agility, pain, and depressive symptoms. They also collected specific data on people with heart disease and on measures of blood-sugar control for people with diabetes . (more)

America's Best Health Plans

Thursday 27 December 2007 at 12:15 pm Desperate to control healthcare costs, employers are rolling out wellness programs with teeth
By Michelle Andrews
Posted October 25, 2007

Discounted gym memberships. Free cholesterol screening. Movie passes for completing a personal health Q&A. Traditionally, most corporate wellness programs have relied on a variety of small perks like these to nudge employees to pay better attention to their health.

Despite such efforts, healthcare costs continue to rise, and most employees are getting no healthier. Straining to contain costs and looking ahead to worse as the workforce ages, employers are beginning to introduce wellness programs with teeth. Feel-good corporate self-interest is taking a back seat to employee accountability, with heftier rewards for those who toe the line—or painful bites taken from paychecks of workers who don't. And instead of simply urging workers to exercise and engage in other health-promoting activities, companies are focusing on specific benchmarks for weight, blood pressure, and cholesterol, for example, that they expect employees to meet to get the lowest-priced healthcare coverage. (more)

Late Twist for Health Insurance Coverage

Thursday 27 December 2007 at 12:11 pm Late Twist for Health Insurance Coverage
By KEVIN FREKING – 2 days ago

WASHINGTON (AP) — The modest spending increase that Congress approved for a popular children's health insurance program will maintain coverage for those already enrolled. But many lacking insurance will have to look elsewhere.

Few expected such a result when 2007 began. Democrats proposed a huge spending increase on the federal-state partnership known as the State Children's Health Insurance Program. Many Republicans embraced the idea. Meanwhile, states all over the country were drawing up plans to expand health coverage. (more)

Finding A Common Language In Health Care Information Technology

Thursday 27 December 2007 at 12:05 pm I may say soda and you may say pop, but what if the hospital lab you go to today says BMP and the one you visit next week calls the same test SMA7? Your physician knows that these are the same tests, but the computer systems they use don't automatically know. How can we develop a national healthcare information network, or even regional healthcare information exchanges, if we don't have a lingua franca?

A study by researchers from the Regenstrief Institute, the Indiana University School of Medicine and the Indiana University School of Health and Rehabilitation Sciences, looked at hospital laboratories from five hospital systems in the Indiana Network for Patient Care and found that even in the same metropolitan area - Indianapolis and its suburbs - a variety of names were assigned to the same test - for example: complete blood count, hemogram and CBC. (more)

Exciting News from MultiNational Underwriters, LLC

Wednesday 26 December 2007 at 1:37 pm Today HCC Insurance Holdings, Inc. announced its intent to acquire MultiNational Underwriters, LLC (MNU). This acquisition offers strength to existing products and efforts and furthers the goal of expanding existing and new business opportunities for both companies.

Headquartered in Houston, Texas, HCC Insurance Holdings, Inc. (HCC) is a leading international specialty insurance group with offices across the United States and in Bermuda, Spain, Ireland and the United Kingdom. HCC has assets of more than $8.0 billion, shareholders’ equity in excess of $2.3 billion and is rated AA (Very Strong) by Standard & Poor’s, AA (Very Strong) by Fitch Ratings and A+ (Superior) by A.M. Best Company.

When MNU was launched in 1998, the mission was simple: provide the best international health insurance products and service in the marketplace. We started with a modest distribution network and a few products. Nearly ten years later, our product portfolio offers numerous options, and we strive to exceed the expectations of travelers and residents worldwide. (more)

Focus on an Issue: Health Insurance for the Uninsured

Wednesday 26 December 2007 at 11:49 am Tens of millions of Americans, whether single, married, or married with children, face each day without the protection of health insurance. If you're one of them, or know someone who is, the questions and answers below are for you.


Will my health care providers continue my care even if I owe them money? Will they require a deposit before providing care?
That depends on the provider. Many hospitals and medical groups can and will put you in touch with public and private payment assistance programs, even if you owe them money. On the other hand, some could deny you care until your older bills are paid, at least in part.

Are free or reduced-cost health care programs available in my area? (more)

Dental Health Insurance

Wednesday 26 December 2007 at 11:44 am Dental health benefit plans vary widely. You should know how your plan is designed, since this can significantly affect the plan's coverage and your out-of-pocket expense.

Although the individual features of plans may differ, the most common designs can be grouped into the following categories:

Direct reimbursement programs reimburse patients a predetermined percentage of the total dollar amount spent on dental care, regardless of treatment category. This method typically does not exclude coverage based on the type of treatment needed, allows patients to go to the dentist of their choice, and provides incentive for the patient to work with the dentist toward healthy and economically sound solutions. (more)

Uninsured Who Then Get Medicare Coverage Have Improved Health

Wednesday 26 December 2007 at 11:40 am People who were previously uninsured and then got Medicare coverage enjoyed better health, particularly people with diabetes and cardiovascular disease, says an article in the Journal of the American Medical Association (JAMA), December 26th issue.

The authors explain "Uninsured near-elderly adults, particularly those with cardiovascular disease or diabetes, experience worse health outcomes and use more health services as Medicare beneficiaries after age 65 years than insured near-elderly adults. Because chronic diseases are prevalent and insurance coverage is often unaffordable for older uninsured adults, the impact of near-universal Medicare coverage at age 65 years on the health of previously uninsured adults may be substantial." (more)

Democratic Presidential Candidate Obama Talks With New Hampshire Voters About Problems With Health Care Costs, Other Issues

Monday 24 December 2007 at 5:22 pm Presidential candidate Sen. Barack Obama (D-Ill.) on Wednesday at The Common Man restaurant in Concord, N.H., assembled six New Hampshire voters who told their stories about problems with health care costs and other issues, The Politico reports (Budoff Brown, The Politico, 12/20).

At the event, Sandra Burt, who last summer turned 65 and lost her manufacturing job, told Obama that she and her husband cannot afford their monthly prescription drug costs of $2,900 or heat for their home. Obama called her situation "outrageous" and criticized health insurers, pharmaceutical companies and other special interests for the problems with the health care system (Helman, Boston Globe, 12/20).

He said, "Nobody expects government to do everything for them. What people do expect is if you are working hard and doing the right thing, then you should be able to retire with dignity and respect and have some basic health care." In addition, he said, "I know I can fix it if I've got the American people understanding that it needs to be fixed." (more)

Gov. Schwarzenegger Says Health Care Reforms Will Help Businesses

Monday 24 December 2007 at 4:25 pm California's health premiums have risen faster than anywhere else in the United States. The spiraling health care costs, according to Schwarzenegger, undermine Californian companies' competitive advantage.

Gov. Schwarzenegger said "Currently, businesses pay $15 billion in hidden taxes to cover the uninsured. Everyone pays more in premiums, co-pays, deductibles and other out-of-pocket expenses. Our plan contains costs by eliminating the hidden tax. It requires insurers to cover everyone so workers don't have to live in fear of losing coverage if they leave their job. It also protects small business with a sliding scale so some pay only 1% of payroll."

He added that the Health Care Security and Cost Reduction act raises affordability for all and manages rising medical costs by widening coverage, improving access to preventive cases and bringing down expensive, and needless emergency room visits. (more)

Congress Should Pass Bill To Allow U.S. Residents To Purchase Health Insurance In Any State, Opinion Piece States

Monday 24 December 2007 at 4:20 pm The Health Care Choice Act, which Rep. John Shadegg (R-Ariz.) plans to reintroduce on Wednesday, would allow U.S. residents to purchase health insurance in any state to "create a competitive, 50-state market for health insurance, likely making it cheaper," Merrill Mathews, executive director of the Council for Affordable Health Insurance and a resident scholar with the Institute for Policy Innovation, writes in a Wall Street Journal opinion piece.

Mathews writes that the passage of the legislation "should be a no-brainer for Congress," but Democrats in the past have opposed the bill over concerns that "it would limit the ability of states to protect their residents." He adds, "If states are worried about losing regulatory control over health insurances, they might try making their regulations competitive with other states." (more)

Majority Of California Voters Supports Health Care Overhaul Legislation

Monday 24 December 2007 at 4:11 pm Sixty-four percent of California registered voters support health care legislation proposed by Gov. Arnold Schwarzenegger (R) and Assembly Speaker Fabian Nunez (D), according to a Field Poll released Thursday, the San Jose Mercury News reports (Zapler, San Jose Mercury News, 12/21).

The proposal, which was approved by the California General Assembly on Monday, would require most state residents to obtain health coverage. Under the bill, residents with incomes up to 250% of the federal poverty level would receive state subsidies for coverage, and residents with incomes up to 400% of the poverty level would receive tax credits to ensure that health care premium costs do not exceed 5.5% of their incomes. Low-income residents would be exempt from the coverage mandate if they would be required to spend more than 5% of their income on minimal coverage and do not qualify for public programs. In addition, insurers would be prohibited from denying coverage to residents because of pre-existing medical conditions and required to spend at least 85% of premiums received on medical care. (more)

Health Insurance Industry To Propose Steps To Make It Easier For Individuals To Obtain Coverage, Including Those With Pre-Existing Medical Conditions

Thursday 20 December 2007 at 01:38 am America's Health Insurance Plans on Wednesday will present a proposal that is intended to increase access for people seeking to purchase health insurance on the individual market, including those who previously have been denied coverage because of health issues, the New York Times reports. The proposal was drafted by a group of insurance executives.

The proposal "signals a willingness by insurers to abandon practices that have seemed aimed at excluding all but the healthiest individuals," the Times reports. Under the plan, strict guidelines would be enforced to make it more difficult for insurers to withdraw or deny coverage to individuals with pre-existing health problems. It also would limit the cost of premiums that such people could be charged. (more)

Talking With Your Teenager About Sex

Thursday 20 December 2007 at 12:00 am Topic Overview
As adolescents enter their late teen years, they begin to date more regularly, and many become sexually intimate with a partner. For many, sexual drive is at its strongest during adolescence. More than half of teenagers will have had sexual intercourse by the age of 17. By the age of 18, 65% of girls and 68% of boys have had sexual intercourse. 1

Talking to your son or daughter about sex
Whether they are sexually active or not, teenagers need help to make responsible choices about sex. Talking about sex does not encourage sexual activity in teens; in fact, some studies show that talking frankly and honestly about sex can prevent teenage pregnancy and delay intercourse. Having an open, honest relationship with your teen will largely depend on the quality of the relationship you have built to this point. (more)

Uninsured Americans Have Poorer Cancer Survival, Report

Thursday 20 December 2007 at 12:00 am A new report by a major US cancer charity has found that uninsured Americans are less likely to survive cancer, less likely to be screened for it, and more likely to have an advanced stage of the disease once they are diagnosed, compared with Americans on health insurance.

The study, which examines the link between health insurance status and cancer treatment and survival, will appear in the January-February edition of the journal CA: A Cancer Journal for Clinicians and is the work of researchers from the American Cancer Society (ACS), led by Dr Elizabeth Ward, managing director, surveillance research at the ACS.

Other studies have already suggested that Medicaid and uninsured patients are more likely to be diagnosed with cancers that are more advanced, mostly because they can't afford to buy preventative services such as cancer screening. (more)

Los Angeles Times Publishes Articles About Partners In Health, Gates Foundation

Wednesday 19 December 2007 at 12:00 am The Los Angeles Times on Sunday published two articles on global health, one about Partners in Health and the other about the work of the Bill & Melinda Gates Foundation. Summaries appear below.

"Treating the Sick Without Bias": PIH, which "rejects narrowly targeted approaches" to address HIV/AIDS, has partnered with governments in Africa, Haiti, South America and Russia to improve health systems, the Times reports. PIH programs link medical care with nutrition, work and self-reliance for low-income people. In addition, PIH hires "accompagnateurs," or lay health guides, in communities to encourage people to seek medical care; take medication; monitor vaccinations; and look for health problems that require follow-up from a physician, nurse or social worker. The group also is training accompagnateurs to conduct home visits with pregnant women, encourage pregnant women to receive HIV tests and ensure that they give birth at a clinic. PIH next year plans to expand its program in Rwanda, which is funded in part by the Global Fund To Fight AIDS, Tuberculosis and Malaria and the Clinton Foundation. According to the (more)

Teens and smoking: What parents can do

Wednesday 19 December 2007 at 12:00 am Nearly 90 percent of adult smokers took up the habit before they turned 19 — in other words, before they were old enough to realize they might not live forever. By middle age, they've learned otherwise, often in the hardest way possible. One out of every three smokers can expect to die of a disease caused by cigarettes.

If you can help your teenager resist taking that first puff, you will dramatically improve his or her odds for a longer and healthier life.

What's the attraction?

Adolescents turn to tobacco for a variety of reasons. Perhaps it's a form of rebellion, or maybe they just want to fit in with a particular group of friends. They may believe cigarettes will improve their concentration or help them lose weight. (more)

Medicare Bill Is A Disappointment To Seniors, Victory For Insurers - Senior Advocates Will Continue The Fight Against Wasteful Industry Overpayments

Wednesday 19 December 2007 at 12:00 am "The debate over Medicare legislation has been a true disappointment to millions of seniors tired of paying more in premiums so that insurers offering private Medicare Advantage plans can keep their billions in government subsidies. While everyone in Washington talks about fiscal discipline, the President's veto threat with support from his allies in Congress, shows the influence of the insurance lobby once again ruled the day.

This legislation offers only a band-aid fix to the doctor's fee cut and clearly puts insurers' profits ahead of Medicare's solvency and seniors' needs. The National Committee will continue to work with the House and Senate members next year on legislation to eliminate these outrageous and wasteful subsidies to Medicare Advantage insurers, strengthen aid for low income beneficiaries and improve Medicare's long-term solvency."...Barbara B. Kennelly, President/CEO. (more)

Medicaid Health Insurance Information

Tuesday 18 December 2007 at 12:00 am Although the names are similar, Medicaid and Medicare are very different programs.

• Regardless of your income or assets, Medicare is available to every U.S. citizen over 65 and some younger people with disabilities or specific diseases.

• Medicaid is only available to people with low incomes, limited resources, or certain diseases or disabilities.

Although the federal government sets up some general guidelines, each state runs its own Medicaid program. States establish what services get covered and what groups of people get coverage. As a result, Medicaid programs vary a great deal from state to state. (more)

New York Times Examines Efforts To Stop Deceptive Marketing Practices For Medicare Advantage Plans

Tuesday 18 December 2007 at 12:00 am The New York Times on Monday examined deceptive or fraudulent practices used by insurance agents to enroll older U.S. residents in Medicare Advantage plans. In an effort to stop deceptive practices, the Bush administration has instructed insurers to "monitor their agents more closely, several companies have been fined, and the government sends 'secret shoppers' to some advertised sales events to check the accuracy of agents' statements," according to the Times. Acting CMS Administrator Kerry Weems said, "There are substantially fewer violations, and those violations are of substantially lower severity than in previous marketing periods."

However, insurance experts say that the "extent of the problem almost surely exceeds official data because many victims never file complaints or report their experiences," the Times reports. "Compounding the problem, many agents sell Medicare Advantage plans for two or more insurance companies, and some work for independent marketing organizations, so the lines of responsibilities may be blurred," according to the Times. (more)

Well-baby exams: What to expect

Monday 17 December 2007 at 12:00 am Most babies have their first checkup within the first few weeks after birth. Even when things are going well, frequent checkups during the first year are an important way to monitor your baby's growth and development. Here's what's on the agenda.

Measurements

Most well-baby checkups begin with measurements of your baby's length, weight and head circumference. You'll need to undress your baby, so keep a blanket handy.

The measurements will be plotted on a growth chart. You'll see how your baby's size compares with that of other babies the same age — but don't fixate on the percentages. A baby who's in the 95th percentile for height and weight isn't necessarily healthier than a baby who's in the 5th percentile. What's most important is steady growth from one visit to the next. (more)

Baby safety: How to baby-proof your home

Monday 17 December 2007 at 12:00 am As your baby becomes more mobile, exploration becomes the name of the game. Rocking, rolling and sitting soon give way to crawling, climbing and cruising along the furniture. But your baby's budding curiosity and inexperience can be a dangerous mix. As you marvel at each milestone, make baby safety a priority.


Get on your hands and knees

From the floor, your baby's view may be different from yours. Crawl from room to room, picking up small or fragile objects that may fit in your baby's mouth and pose a choking hazard — including nuts, grapes, buttons, pen caps and other stray items that may have fallen on the floor. (more)

Los Angeles Times Examines Government's Role In Helping U.S. Residents Obtain Health Coverage

Monday 17 December 2007 at 12:00 am Many observers when the year began expected the new Democratic-controlled Congress and President Bush to "make some headway on the problem many voters placed at the top of the nation's domestic agenda -- health care for the uninsured and rising medical costs that are squeezing the middle class" -- but lawmakers "fell back into the old pattern of harsh partisan rhetoric and stalemate," the Los Angeles Times reports.

The Times cites the failure of Congress and Bush to reach an agreement on legislation that would have reauthorized and expanded SCHIP. According to the Times, their "failure to act underscores how hard the health care problem is to deal with, and it puts the issue squarely in the laps of the presidential candidates in both parties." (more)

How to compile your family medical history

Sunday 16 December 2007 at 12:00 am Family gatherings are an ideal time to catch up on family news and information. They also provide a good opportunity to learn about your family's health history. Mapping your family medical history can help you identify some health risks you may face in the years ahead and help you take measures to avoid or plan for them.


What is a family medical history?

A family medical history or medical family tree is a record of illnesses among family members. It resembles the family tree you might have drawn in school, with the addition of health information. A medical family tree visually depicts the relationships between each member of your family. Depending on how much information you're able to obtain for each relative, your medical family tree can be very detailed and include health issues each family member faced. (more)

Complementary and alternative medicine: What is it?

Sunday 16 December 2007 at 12:00 am When you were a child and sprained an ankle or came down with the flu, you probably visited a pediatrician to soothe your symptoms. As an adult, you most likely visit your primary care physician for everything that ails you. But now your friends are suggesting complementary and alternative medicine treatments that you've never heard of — things like homeopathy, ayurveda, acupuncture and herbs.

What are these complementary and alternative medicine therapies? Are they safe? Will they work? Educate yourself before starting any new complementary and alternative medicine therapy, and always tell your doctor which ones you're trying.


What is complementary and alternative medicine? (more)

Finding a new doctor: A guide for older adults

Sunday 16 December 2007 at 12:00 am Your kids want you to move close to them. Or your doctor has reached retirement age. Or maybe you've got a new health insurance plan. Whatever the reason, after all these years with the same family doctor, you might discover that you have to find a new physician.

It might seem overwhelming at first — especially if you've come to trust your doctor and he or she understands you and your health history. Follow these steps and give yourself time to search for a new doctor who's best for you.


Step 1: Make a list of what you expect from your new doctor (more)

House Democrats Stall Medicare Vote; Republicans Propose Bare-Bones Bill, Including SCHIP Extension

Friday 14 December 2007 at 12:00 am The House on Wednesday decided to delay until next week a vote on a Medicare package that would delay the scheduled 10% reduction to Medicare physician fees, CongressDaily reports. According to CongressDaily, "Democrats are hoping to win support in the Senate for more than the 'bare-bones' fix being proposed by House Republicans, but it is unclear if that will be possible" (Johnson/Bourge, CongressDaily, 12/13). Aides from both parties said that the bare-bones package released on Wednesday could become law if Democrats fail to pass a broader bill before Congress adjourns.

The Republican package would halt the physician fee cut, but it does not include any fee increase. The proposal also would extend for one year several Medicare programs that are about to expire, including a program that gives higher reimbursement to rural health care providers, transitional Medicaid assistance and exemptions to caps on occupational therapy benefits. The physician fee fix would be paid for using money from a Medicare Advantage "stabilization fund" and by reducing MA payments to hospitals with teaching programs (Armstrong [1], CQ Today, 12/12). Republicans say the proposal is the only one that could pass both chambers and be signed into law by President Bush (CongressDaily, 12/13). (more)

Democrats Agree To Fiscal Year 2008 Spending Levels Requested By President Bush, Plan To Shift Funds To Health Care, Other Priorities

Friday 14 December 2007 at 12:00 am Congressional Democrats on Wednesday said that they would agree to fiscal year 2008 spending levels similar to those requested by President Bush in an omnibus budget package, although they would shift funds to health care and other programs that they consider priorities, the New York Times reports (Hulse, New York Times, 12/13).

The package, which remains in negotiations, would include the FY 2008 Labor-HHS-Education appropriations bill (HR 3043) and the 10 other unapproved FY 2008 appropriations bills. In addition, the package would limit, but not eliminate, earmarks for funds inserted by lawmakers. FY 2008 discretionary spending under the package, when combined with the Defense appropriations bill approved earlier this year, would total about $936.5 billion, $3.7 billion more than Bush requested, according to House Appropriations Committee staff members. (more)

Kaiser Daily Health Policy Report Highlights Recent Children's Health Coverage Developments In Two States

Friday 14 December 2007 at 12:00 am Summaries of news about children's health coverage in Montana and Pennsylvania appear below.
Montana: A proposed state ballot measure that would extend government-sponsored health coverage to thousands of uninsured children will not include a mandate that could require some parents to purchase private health insurance, state Auditor and Insurance Commissioner John Morrison said on Monday, the Billings Gazette reports. Morrison submitted the ballot measure to state officials in October, and he and Gov. Brian Schweitzer (D) are discussing changes to the initiative. According to the Gazette, the debate between Morrison's office and the Schweitzer administration mostly focuses on the proposal's cost. Morrison estimates the measure would cost about $20 million annually, while the Schweitzer administration estimates the cost at $30 million to $35 million. Possible changes to the measure include increasing the SCHIP income eligibility limit from 175% of the federal poverty level to 250% of the poverty level; possible tax credits to help families with incomes between 225% and 300% of the poverty level add their children to private health plans that already cover the parents; and expanding Medicaid eligibility for children (Dennison, Billings Gazette, 12/11). (more)

ABC News Survey Examines Presidential Candidates' Approaches To Health Care Reform

Thursday 13 December 2007 at 12:00 am In the second part of a series on health care in the 2008 presidential election, ABC's "World News" on Tuesday examined results of an ABC News survey of presidential candidates' positions on health care-related issues. The segment included a discussion with Drew Altman, president and CEO of the Kaiser Family Foundation; Karen Davis, president of the Commonwealth Fund; and Gail Wilensky, a senior fellow at Project HOPE.

Six Democratic and two Republican candidates responded to the survey, which included questions on five issues:

Coverage for the uninsured; (more)

Growing Health Care Costs Must Be Addressed Before Social Security, According To Op-Ed

Thursday 13 December 2007 at 12:00 am The "rate at which health care costs grow will be the primary determinant of the nation's long-term budget picture," Congressional Budget Office Director Peter Orszag writes in a Wall Street Journal opinion piece. According to Orszag, CBO projections show that "under current law, federal spending on Medicare and Medicaid measured as a percentage of gross domestic product will rise to 12% in 2050 and almost 20% around 2080 from 4% today." He adds that a significant part "of that projected increase arises from steadily growing health care costs per beneficiary." In addition, the "aging of the population, although a less important factor, will exacerbate the fiscal pressures created by rising health care costs," Orszag writes.

He continues, "Such increases in spending associated with both aging and increased health care costs -- unless matched by significant reductions in other spending or increases in revenues -- would ultimately create outsized budget deficits that would raise government debt to unprecedented levels." According to Orszag, "The bottom line is that while we need to address the effects of the coming retirement of the baby boomers and the projected imbalance in Social Security, we have to pay even more attention to the health care costs that exert the dominant influence on our fiscal future." (more)

Kaiser Daily Health Policy Report Features Recent Health Care-Related Developments In Presidential Campaign

Thursday 13 December 2007 at 12:00 am Summaries of recent developments in the presidential campaign related to health care appear below.

Sen. Hillary Rodham Clinton (D-N.Y.): Clinton on Tuesday criticized rival Sen. Barack Obama (D-Ill.) for a 1996 questionnaire in which he indicated support for a single-payer health care system, Long Island Newsday reports. In 1996, during his campaign for the Illinois state Senate, Obama completed a questionnaire distributed by the Independent Voters of Illinois Independent Precinct Organization. His response to the questionnaire indicated support for a single-payer health care system, although he has proposed a system based on private health insurance during his presidential campaign. In an e-mail titled "Obama Forced to Defend Electability in Face ... of New Questionnaire," the Clinton campaign reprinted excerpts from an online article that claims Obama has received criticism for "abandoning" his position on the health care system as he "rose through the ranks." An aide to Obama said that "Obama never saw or approved" the response to the questionnaire and did not support a single-payer health care system. "It was filled out by an aide who has conceded she never got Obama's sign off," the (more)

Blackberries, Broccoli Sprouts Battle Cancer

Wednesday 12 December 2007 at 12:00 am THURSDAY, Dec. 6 (HealthDay News) -- Your local farmer's market might hold the key to cancer prevention, since new research shows that black raspberries, broccoli sprouts and some raw vegetables reduce the risk of esophageal and bladder cancers.

Data from three studies on the subject was presented Thursday at the American Association for Cancer Research's Sixth Annual International Conference on Frontiers in Cancer Prevention, in Philadelphia.

Fruits and vegetables have long been known to help reduce the risk of certain cancers. Based on prior research, the American Cancer Society recommends eating five servings of fruits and vegetables daily. (more)

Smoking Linked to Type 2 Diabetes

Wednesday 12 December 2007 at 12:00 am Smokers May Be More Likely Than Nonsmokers to Develop Type 2 Diabetes
By Miranda Hitti
WebMD Medical NewsReviewed by Louise Chang, MDDec. 11, 2007 -- Smokers may be more likely than nonsmokers to develop type 2 diabetes, according to a new research review.

The review included 25 studies of smoking and diabetes among a million people ages 16 and older in the U.S., U.K., Europe, Japan, and Israel.

None of those people had type 2 diabetes when the studies started. But more than 45,000 participants developed type 2 diabetes during the studies, which lasted for five to 30 years. (more)

Students Drawn To Health Care Policy Challenges

Wednesday 12 December 2007 at 12:00 am Reuters/Boston Globe on Sunday examined how "hordes of idealistic young people" are "pouring into health policy classes in economics, political science, history and public health departments" in colleges and universities. The popularity of public health schools, health economics, health law and health business programs is rising, while political science and history departments are offering numerous courses focusing on health care and medical issues.

According to Reuters/Globe, "Students are drawn by the political debate over how to cover 47 million uninsured Americans, the challenge of containing runaway costs and the growing awareness that quality of care is often tragically uneven." Harvard University economist David Cutler said, "There are fascinating economic issues, fascinating politics, fascinating cultural and social issues."

Other observers note that young people learn of "quality gaps" through family members' experiences within the U.S. health care system, Reuters/Globe reports. (more)

Few Medicare Plans In 2008 Will Offer Brand-Name Coverage In Doughnut Hole Gap

Tuesday 11 December 2007 at 12:00 am Few Medicare plans in 2008 will offer brand-name prescription drug coverage in the so-called "doughnut hole" gap because of cost, meaning that Medicare beneficiaries will have fewer options when choosing a plan during the open enrollment period that ends Dec. 31, the San Francisco Chronicle reports. The doughnut hole gap in 2008 begins when drug costs for an individual and his or her insurer reach $2,510 and ends when spending reaches $5,726. Only one plan, located in Florida, will provide coverage for brand-name prescription drugs in the gap in 2008.

According to the Chronicle, the lack of brand-name coverage in the coverage gap "is a big change for beneficiaries who opted to spend more for higher-level coverage that offered them some protection when they reached" the doughnut hole. Brand-name coverage within the gap is available to some individuals through Medicare Advantage plans, but "that means giving up traditional Medicare in exchange for a health plan managed by a private company," according to the Chronicle. (more)

Meat raises lung cancer risk, too, study finds

Tuesday 11 December 2007 at 12:00 am WASHINGTON (Reuters) - People who eat a lot of red meat and processed meats have a higher risk of several types of cancer, including lung cancer and colorectal cancer, U.S. researchers reported on Monday.

The work is the first big study to show a link between meat and lung cancer. It also shows that people who eat a lot of meat have a higher risk of liver and esophageal cancer and that men raise their risk of pancreatic cancer by eating red meat.

"A decrease in the consumption of red and processed meat could reduce the incidence of cancer at multiple sites," Dr. Amanda Cross and colleagues at the U.S. National Cancer Institute wrote in their report, published in the Public Library of Science journal PLoS Medicine. (more)

Republican Presidential Candidates Discuss Health Care, Other Issues Related To Hispanics During Debate

Tuesday 11 December 2007 at 12:00 am Seven Republican presidential candidates on Sunday at the University of Miami in Coral Gables, Fla., discussed health care during a Spanish-language debate co-sponsored by the university and Univision that focused on issues related to Hispanics, the Wall Street Journal reports (Meckler [1], Wall Street Journal, 12/10). The debate in large part focused on immigration, but some of the candidates discussed health care. Former

Arkansas Gov. Mike Huckabee criticized filmmaker Michael Moore for claims in his documentary "Sicko" that Cuba has a higher-quality health care system than the U.S. "I don't mind shipping him down there, but the rest of us I'd like to get health care right here," he said (Dinan, Washington Times, 12/10).

Former Massachusetts Gov. Mitt Romney cited the need to expand health insurance to more U.S. residents to improve access to care. He said, "The best kind of prevention you can have in health care is to have a doctor. And if someone doesn't have a doctor, doesn't have a clinic they can go to, doesn't have health
insurance to be able to provide the prescription drugs they need, you can't be healthy." In addition, Romney discussed a recently implemented Massachusetts health insurance law that requires all residents to obtain coverage and provides subsidies for lower-income residents. According to Romney, "It cost us no more money to help people buy insurance policies that they could afford than it was costing us before, handing out free care." (more)

UAW Opposes Bills Touted By Blue Cross Blue Shield Of Michigan

Tuesday 11 December 2007 at 12:00 am The United Auto Workers on Thursday joined the Michigan chapter of AARP and the Consumer's Union in opposing four bills promoted by Blue Cross Blue Shield of Michigan that would alter rates for Michigan's individual health insurance market, the Detroit Free Press reports.

The bills would change how Blue Cross determines rates for about 130,000 people who purchase individual insurance policies. Under the legislation, Blue Cross would be able to delay from six months to 12 months the time it has to provide coverage for people with pre-existing medical conditions; eliminate challenges to proposed rate hikes by consumers and the state attorney general; and allow the Accident Fund, a for-profit Blue Cross subsidiary, to sell more than workers compensation insurance. According to Blue Cross, the changes are necessary to offset losses from individual policies. (more)

Buying Health Insurance on Your Own

Monday 10 December 2007 at 12:00 am Report: Most People Either Can't Get It or Can't Afford It
By Salynn Boyles
WebMD Medical NewsReviewed by Louise Chang, MDDec. 3, 2007 -- Most people who try to buy health insurance on their own find that they either can't get it or can't afford it, even if they are relatively healthy, a yearlong investigation by Consumer Reports shows.

Of the roughly one in seven people surveyed who had no health insurance, 76% said they could not afford to buy it.

Only about 7% of those surveyed had purchased health insurance on their own, and 71% of these people were unhappy with their policies. (more)

Three States Consider Proposals To Expand Health Care Coverage

Monday 10 December 2007 at 12:00 am Summaries of news articles about health care proposals in New Mexico, New York and Vermont appear below.
New Mexico
A universal health coverage proposal by New Mexico Gov. Bill Richardson (D) would cost the state an additional $333 million over five years, but the state would generate enough new revenue under the proposal to cover the costs, state Human Services Secretary Pam Hyde said on Tuesday, the AP/Santa Fe New Mexican reports. Hyde on Tuesday outlined the preliminary cost estimates to the state Legislative Finance Committee.

The cost analysis, prepared by the Mathematica Policy Research Group, projects state health care expenses over a period of five years under the current health care system, as well as expenditures if Richardson's plan was fully implemented beginning in fiscal year 2010. According to the analysis, under the current system, the state would spend about $6.9 billion on health care in 2010 and about $9.2 billion in FY 2014. Under Richardson's proposal, health care spending in 2010 would increase by about $75 million and by $333 million over five years. (more)

Presidential Candidate Clinton Most Trusted On Health Care Among Likely New Hampshire Democratic Primary Voters, Poll Finds

Monday 10 December 2007 at 12:00 am Democratic voters in New Hampshire trust Sen. Hillary Rodham Clinton (D-N.Y.) the most among Democratic presidential candidates to address health care, according to a recent Washington Post/ABC News poll, the Post reports. For the poll, researchers conducted telephone interviews of a random sample of 592 New Hampshire residents likely to vote in the Democratic primary. The poll has a margin of error of plus or minus four percentage points, with higher margins of error for subgroups of respondents.

According to the poll, Clinton has a 23% lead over other Democratic candidates as the most trusted to address health care. About half of respondents cited health care as either their most or second-most important issue of the presidential election, the poll found.

Overall, 35% of respondents indicated that they would vote for Clinton, compared with 29% for Sen. Barack Obama (Ill.), 17% for former Sen. John Edwards (N.C.), 10% for New Mexico Gov. Bill Richardson and 3% or less for other Democratic candidates, according to the poll (Balz/Cohen, Washington Post, 12/6). (more)

Health Care Debate Should Focus On Spending, Opinion Piece States

Friday 07 December 2007 at 12:00 am "We need to have a candid debate about health care in 2008, but the odds are against it," as presidential candidates have focused on the issue of the uninsured, rather than "runaway health spending" because "expanding benefits is so much more politically rewarding than trying to control them," Washington Post columnist Robert Samuelson writes. Health care spending, which totals more than $2 trillion annually, accounts for 16% of gross domestic product and could account for more than 25% of GDP by 2030, Samuelson writes.

According to Samuelson, the "unchecked rise in health spending" likely will "increase taxes, depress take-home pay and crowd out other government spending," but "our national policy toward these issues is: Don't ask, don't tell." The "politics of health care rests on a mass illusion," as most U.S. residents "think that someone else pays for their care," he writes, adding, "No one has an interest in controlling spending because everyone believes that it burdens someone else." Samuelson writes that U.S. residents "need to see and feel health costs." (more)

Too Much Sex a Problem?

Friday 07 December 2007 at 12:00 am If having little or no sexual desire is a problem, what about wanting too much sex? The term "sexual addiction" was coined a few years back to describe people with an obsessive sex drive. Yet psychologists have been slow to believe that wanting too much sex isn't a problem.

Even psychologists have a decidedly pro-sex bias. For proof, look no further than the "bible" of the psychological profession, the Diagnostic and Statistical Manual of Mental Disorders, or DSM. Psychologists use the definitions in the DSM as a means of diagnosing--and treating--mental health problems. The DSM provides a three-part clinical definition for hypoactive sexual desire:

Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. The judgment of deficiency or absence is made by the clinician, taking into account factors that affect sexual functioning, such as age and the context of the person's life. (more)

Rising Health Care Costs Threaten States' Economic Outlook, Report Says

Friday 07 December 2007 at 12:00 am Mounting fiscal pressures from rising health care costs, among other factors, could cause severe budget shortfalls for state governments nationwide, according to a report released Wednesday by the National Governors Association and the National Association of State Budget Officers, the AP/Asbury Park Press reports (Welsh-Huggins, AP/Asbury Park Press, 12/5). According to the report, Medicaid spending from all funding sources in fiscal year 2007 is estimated to increase by 7.3%, compared with a growth rate in FY 2006 of 1.7%.

A significant factor in the increase stems from the provision of prescription drug benefits to beneficiaries who are dually eligible for Medicare and Medicaid. Under the Medicare prescription drug benefit, dual-eligibles now receive their drug benefits through Medicare, and states finance those benefits through payments to the federal Medicare Trust Fund. Those payments are projected to amount to about 5% of state Medicaid expenditures, according to the report. (more)

Colorado Republican State Lawmakers Unveil Health Care Agenda

Thursday 06 December 2007 at 12:00 am Colorado Republican state lawmakers on Monday unveiled a series of bills that would take incremental steps toward increasing the affordability of health care without raising taxes, the Denver Rocky Mountain News reports. The measures would:

Create a low-cost benefit plan with basic health care coverage that would have a low monthly premium;

Allow individuals to purchase health insurance from other states;

Allow qualified nurse practitioners in rural areas to have greater authority in addressing basic patient health needs; (more)

Massachusetts Health Insurance Connector Asks Insurers To Limit Premium Increases To 5% In 2008

Thursday 06 December 2007 at 12:00 am The Massachusetts Commonwealth Health Insurance Connector on Tuesday voted to press insurers to hold premium increases to 5% in 2008 for unsubsidized health insurance plans sold in the state, the Boston Globe reports. According to the Globe, connector officials and health care analysts "agree that neither the state nor individuals will be able to afford coverage without aggressive price control." Connector staff estimated that without limits, premiums for Commonwealth Choice insurance would increase between 4% and 14% next year. Some connector board members said even a 5% premium increase might be too large.

The connector also instructed insurers to try to limit premium increases without shifting significant costs to plan members. The connector will ask insurers that cannot hold increases to 5% without changing benefits to submit an alternative plan detailing what benefit reductions or increases in copayments would be needed to meet the 5% limit. (more)

White House Threatens Veto Of Medicare Legislation

Thursday 06 December 2007 at 12:00 am HHS Secretary Mike Leavitt on Tuesday in a letter to the Senate Finance Committee wrote that White House advisers would recommend a veto of any Medicare legislation that includes cuts to Medicare Advantage plans or changes to the Medicare prescription drug benefit, CQ Today reports. The centerpiece of the Medicare legislation is the reversal of a 10% cut to physician fees, which is expected to cost several billion dollars. The Finance Committee has been drafting legislation that is expected "to rely heavily on the payments to private insurers" to stop the fee cut, according to CQ Today. A draft of the legislation has not been released.

Leavitt wrote that a veto would be recommended for any bill that "results in a loss of access to health care services, benefits or choices" in the MA program; "raises taxes ... to fund spending increases"; or alters Medicare's fiscal status by overturning administration regulatory decisions. Committee Chair Max Baucus (D-Mont.) said, "He knows there's no Medicare bill if there's no MA cuts. He knows there's no doctor fix if there's no MA cuts" (Armstrong, CQ Today, 12/4). (more)

Routine health care lags for children: study

Wednesday 05 December 2007 at 12:00 am BOSTON (Reuters) - U.S. children are receiving less than half the routine care they need, even if they are covered by health insurance, researchers said on Wednesday.

"We're talking about the basics of what we should be providing, and in many cases it's just not happening," said Dr. Rita Mangione-Smith of the University of Washington in Seattle, who led the study.

Shortfalls were seen in vaccinating children on time, providing recommended asthma care and even monitoring growth. Parents may need to read up on needed care and come in to checkups armed with checklists, Mangione-Smith said. (more)

Eight states support suit vs U.S. over kids' health

Wednesday 05 December 2007 at 12:00 am NEW YORK (Reuters) - Eight states will back a lawsuit to stop the federal government from imposing new rules which they fear will force them to cut children from a health insurance plan, five governors said in a statement on Monday.

The State Children's Health Insurance Program, which relies heavily on federal funding, initially focused on poor children but governors increasingly have sought to add children from more moderate income families who say they cannot afford to buy private insurance.

"Hard-working families are caught in a no-win situation -- they earn too much to qualify for Medicaid, their employers do not offer coverage, and they cannot afford private coverage," said New Hampshire Democratic Governor John Lynch. (more)

Health Coverage for Kids: It's Completely Unfair

Wednesday 05 December 2007 at 12:00 am The big man in front of me was holding back. He was trying not to swear. "It's completely unfair," he roared, "I work my whole life. I get a little raise, and now they tell me I make too much for my kid to get health insurance! I can't afford health insurance for him. It's hard enough to pay the rent. Other people come in here, they don't work at all, and their kids are covered!"
His son, who had ADHD, was doing well on a long-acting pill. But that pill cost nearly a hundred dollars a month, money his father didn't have. So Johnny (whose real name isn't Johnny) would have to take one pill in the morning, and another at noon. He would have to go to the school nurse to get his medication. The other kids in school would know.

But even if I prescribed the cheaper drug, I couldn't see Johnny often enough to monitor and adjust his medication. The visits cost too much. Our hospital has a sliding fee plan, which would help somewhat, but not enough. I wouldn't be able to give Johnny the quality of care he deserved and needed. (more)

Can Honey Help a Cough?

Tuesday 04 December 2007 at 12:00 am Study: Honey May Be an Alternative to Over-the-Counter Cough Medicines
By Miranda Hitti
WebMD Medical NewsReviewed by Louise Chang, MDDec. 3, 2007 -- A little bit of honey, taken before bedtime, may ease coughing in children.

Pennsylvania State University researchers reported that news today, based on 130 children with coughs.

On average, the kids were 5 years old (age range: 2 to 18) and had had a cough from colds for about four days.

When the kids saw a doctor about their cough, the parents rated the severity of the kids' cough symptoms, including frequency of coughing and effects on sleep. (more)

Uninsured, Others Less Likely To Receive Breast Cancer Test

Tuesday 04 December 2007 at 12:00 am An American Cancer Society study finds breast cancer patients who lack insurance, who come from areas with lower education levels, who are African American, or who are older are less likely to get a key diagnostic test to make appropriate treatment decisions. The study finds those groups are ten percent to three times more likely not to receive tests to determine if the breast cancer has spread to axillary (underarm) lymph nodes. An abstract of the study was presented at the American Association for Cancer Research conference on the health disparities, held in Atlanta.

In axillary lymph node dissection, lymph nodes near the tumor are removed and looked at under the microscope. When the lymph nodes show signs of the tumor, there is an increased likelihood that cancer cells have spread through the bloodstream to other parts of the body. This information is an important part of staging and also helps to help guide breast cancer treatment decisions. (more)

Clinton, Obama Continue To Spar Over Health Care Plans

Tuesday 04 December 2007 at 12:00 am Leading Democratic presidential candidates continued to focus on health care issues and "the question of how 'universal' a coverage plan must be," the Los Angeles Times reports. Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.) have proposed plans that would require all individuals to obtain health insurance, while Sen. Barack Obama (D-Ill.) has proposed such a requirement only for children (Wallsten/Zaldivar, Los Angeles Times, 12/1).

On Saturday at two forums held in Des Moines, Iowa, Clinton said of her health care proposal, "We have to have more cost-effective and higher-quality health care for everyone; I don't want to leave anyone uncovered." In response to a question about the participation of private health insurers under her proposal, Clinton said, "My plan also regulates insurance companies," adding, "They can no longer do business unless they were willing to drastically change the way they treat people." She also criticized Obama for his claims that his health care proposal would provide "universal" health insurance despite the lack of requirement that all residents obtain coverage (Glover, AP/Minneapolis Star-Tribune, 12/2). (more)

Medicare Spends Billions Annually On Products Available At Lower Prices From Retail Pharmacies, Online Stores, New York Times Analysis Finds

Monday 03 December 2007 at 12:00 am "Despite enormous buying power, Medicare pays far more" than individuals for equipment and services that are "available at far lower prices from retail pharmacies and online stores," the New York Times reports. As a result of "fierce patient and corporate lobbying," Medicare in many cases pays prices for products and services based on rates established in the 1980s, "when devices were often much more expensive than they are now," according to the Times.

The "widespread price discrepancies ... have been noted in dozens of regulatory reports," but, when lawmakers "have tried to cut these costs, they have often encountered a powerful foe: the companies that sell these devices, who ask their elderly customers to serve, in effect, as unpaid lobbyists, calling and writing to their representatives in Congress, protesting at rallies, and even participating in political attacks against individual lawmakers who take on the issue," the Times reports. Former Sen. Alan Simpson (R-Wyo.) said, "These industries rely on a basic threat: If you mess with us, we can turn the seniors against you," adding, "Angering seniors is the quickest route to political suicide." (more)

UAW Gains Clout To Affect Health Care System Through VEBA Deals

Monday 03 December 2007 at 12:00 am When the United Auto Workers in 2010 assumes responsibility for the health care benefits of 540,000 Big Three automaker retirees and spouses through a voluntary employees' beneficiary association, experts say the union will have enough clout and bulk purchasing power to affect health care costs, the AP/Philadelphia Inquirer reports. UAW in its contract negotiations with General Motors, Ford Motor and Chrysler Group agreed to take responsibility for health care liabilities through the establishment of a VEBA in exchange for funding levels of between 56% and 62% of liabilities. Other funding sources include wage contributions from active employees and increased payments from retirees.

The contracts turn UAW "into one of the largest health care consumers in the nation," according to the AP/Inquirer. Experts say that UAW must make smart choices when investing the funding provided by the Big Three to see returns higher than the average annual health care inflation, which rises 6% to 8% each year. In addition, UAW "must control costs with bulk buying, perhaps negotiating directly with health care providers," the AP/Inquirer reports. The union also (more)

Night Shift Work May Cause Cancer

Monday 03 December 2007 at 12:00 am Studies Suggest Link Between Circadian Rhythm Disruption and Cancer
By Miranda Hitti
WebMD Medical NewsReviewed by Louise Chang, MDNov. 30, 2007 -- Working the night shift may cause cancer, according to a report published in The Lancet.

The report comes from a team of 44 scientists in 10 countries commissioned by the World Health Organization's International Agency on Cancer Research.

They report "limited" evidence of a connection between cancer and night shift work in people. That evidence included a higher rate of breast cancer in female nurses who work night shifts. (more)