Archive by Month - January, 2010

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State of the Healthcare Reform Union

Wednesday, January 27th, 2010

President Barack Obama is giving his first State of the Union address tonight, airing on all major networks. Will he talk about healthcare reform?

It seems unlikely. His administration has been dropping hints that the speech will focus more directly on the economy, specifically job creation. Expanding individual health insurance coverage has been a slog, as well as a drain on his popularity ratings. While Obama recently said that he would rather be a great one-term President as opposed to a mediocre two-term one, he is nevertheless refocusing on issues that the middle-class believes is more important.

Most Americans receive affordable health insurance through their employers. 10% of Americans are unemployed. What happens to this slice of the population? COBRA health insurance is helpful, but most people without jobs don’t have the money to pay for the entire health insurance premium without an employer covering some of the cost. Obama has not managed to collect the dots in the minds of the public.

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Fewer Americans Receiving Needed Care

Wednesday, January 27th, 2010

With all the talk about healthcare reform, many people on all sides of the issue can forget about who it is intended to help. There is healthy disagreement on the best method of solving the predicament of the uninsured. Some people want a public option, while others desire more regulation of health insurance companies. Still others believe that chucking existing regulations and letting the market do its work unfettered is ideal.

The recession has resulted in many people losing their jobs, along with their health insurance. The National Center for Health Statistics has found that about 15% of the United States population lacks medical insurance. Even after excluding undocumented immigrants (who wouldn’t be covered by healthcare reform anyway), there are still millions of Americans left uninsured.

In 2009, a rapidly increasing number of respondents claimed that cost prevented them from seeking needed health care. Those without health insurance are often also without a regular health care provider. Access to a primary care physician is a key indicator of good health.

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Being Grateful For Healthcare After Haiti

Tuesday, January 26th, 2010

Emergency medical response team members struggle to keep up in Haiti

Now that U.S. armed forces have mobilized, set up tent hospitals in open fields and turned aircraft carriers into floating intensive care units, some U.S. Marines and their families are relieved to be out of harm’s way in the battle fields of Iraq and Afghanistan.

Some 100,000 displaced Haitians are among those receiving medical care, food and shelter from about 3,000 Marines; many of whom are between tours of duty in the Middle East. Although the Pentagon has a strict policy against soldiers speaking directly with the news media, Marines who have completed Middle Eastern missions are feeling conflicted about their current humanitarian effort in the devastated Haitian terrain. On the one hand, they are saddened to see so much loss. On the other, they’re fortunate that they’re not being shot at.

“This is great for us,” said one Marine in an interview with National Public Radio. “We’re guaranteed to go home and it doesn’t get any better than that.”

The Haitians whose lives they are literally holding in their hands, however, have nowhere to go once they are treated and released from one of the M*A*S*H-like compounds that surround the rubble around them. Marines and officials with the Pentagon say they expect these temporary medical facilities to stay up and running through the rainy season in April, when reconstruction is likely to begin.

One of the challenges facing U.S. and United Nations Peacekeepers is how to proceed with new medical infrastructure. The 22 hospitals in the capital city of Port-Au-Prince have been completely full of the sick, injured and the mortally wounded, in spite of the fact that most of them were either heavily damaged in the earthquake or are without even the most basic supplies needed to treat their growing patient loads.

U.S. Secretary of State Hillary Clinton recently told reporters she and the Haitian government had been working to improve the already impoverished health care conditions in the country before the quake. So the reconstruction has a ready-made blueprint, said Clinton. If sorting out the who, what and when of rebuilding will be hard, remember there are no such things as health insurance plans in Haiti; neither on paper nor available from Blue Cross, United Health, or others.

So while the World Health Organization (WHO) and emergency aid groups continue their pilgrimage to Haiti, keep in mind that once rebuilding of the country begins that we should all be grateful that we at least have a health insurance system here in the United States. To some, it may not be perfect. But knowing it’s there is a true blessing.

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If Democrats Dump Reform, Will GOP Back Off?

Tuesday, January 26th, 2010

Democratic political adviser David Plouffe is encouraging his party to move ahead on healthcare reform. Right now, doing so seems like the last thing any political strategist would recommend. Why would a man largely responsible for getting President Barack Obama elected suggest doing so, especially after the bruising loss in staunchly blue Massachusetts?

According to Plouffe, recent polls show that the majority of Americans still agree with the overall objective of the Obama administration: to expand medical insurance coverage while simultaneously lowering costs. While the public is very skeptical of the Democrats’ specific proposals, scaling back or abandoning the legislation may not help that. After all, the party and its members are already associated with the issue. Even Congressional Democrats turn against it, Plouffe believes that Republicans will continue to attack them for having the audacity to put forth such comprehensive reforms in the first place. If the legislation is actually passed, he thinks that the public will have the opportunity to eventually measure its positive aspects; whereas failure would not stop the attacks.

Do you believe that the heat would come off of Democrats if they let their comprehensive health insurance bill die, or would it just humiliate them further?

(Image: David Ortez under CC 2.0)

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HIV/AIDS

Monday, January 25th, 2010

HIV/AIDS
HIV
stands for human immunodeficiency virus. This is the virus that causes AIDS. HIV is different from most other viruses because it attacks the immune system. The immune system gives our bodies the ability to fight infections. HIV finds and destroys a type of white blood cell (T cells or CD4 cells) that the immune system must have to fight disease.

AIDS stands for acquired immunodeficiency syndrome. AIDS is the final stage of HIV infection. It can take years for a person infected with HIV, even without treatment, to reach this stage. Having AIDS means that the virus has weakened the immune system to the point at which the body has a difficult time fighting infection. When someone has one or more specific infections, certain cancers, or a very low number of T cells, he or she is considered to have AIDS.

Living with HIV/AIDS
The most difficult part of living with HIV/AIDS depends on whether you have, at a minimum, a good individual health insurance plan. If you have one before symptoms start, you are most likely going to have more positive attempt at stabilizing your symptoms. The earliest disease symptoms occur while  your body begins to form antibodies to the virus (known as seroconversion) between six weeks and three months after infection with the HIV virus. Those who do show early HIV symptoms will develop flu-like symptoms. This can include: fever, rash, muscles aches and swollen lymph nodes and glands. However, for most people, the first symptoms of HIV will not be apparent.

As the infection progresses, people with HIV grow increasingly susceptible to illnesses and infection that don’t normally affect the healthy population. Even though many of these illnesses can easily be treated, those with HIV often have such weakened immune systems that typical cures fail.

Without treatment, people infected with the illness can expect to develop AIDS eight to ten years after HIV infection. Taking HIV medications, however, can slow down this progression. With treatment, it can take ten to 15 years or more before you develop AIDS. In the later stages of HIV, before it progresses to full blown AIDS, signs of HIV infection can involve more severe symptoms. These include:

The only way to know whether you are infected is to be tested for HIV. You cannot rely on symptoms alone because many people who are infected with HIV do not have symptoms for many years. Someone can look and feel healthy but can still be infected. In fact, one quarter of the HIV-infected persons in the United States do not know that they are infected.

Treatment for HIV/AIDS
It is important to remember that HIV is not a death sentence. However you will need good healthcare which can become costly. You will need to consider various affordable health insurance companies and speak with a health insurance agent to find what works best for you.

HIV treatment has made significant progress from what it was even a few years back. Important new medications and older, proven medications can now be taken less frequently with reduced side effects.

HIV medications and determining when to begin treatment are important decisions. Fortunately, newly infected people not on treatment typically can go several years without a single symptom. This means that when you test positive for HIV, depending on when you were infected and what your CD4 count and viral load are, it’s usually OK to wait to make an informed decision about using HIV medications.

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Obama Compares Healthcare Reform to Buzz Saw, Races Into Blade

Monday, January 25th, 2010

When a tree trunk faces a buzz saw, the result is usually negative for the tree. The only way for the tree to avoid being cut in half is to stop the conveyor belt drawing it closer. Right now, Democrats are like that tree. President Obama recently admitted as much during a recent town hall meeting.

Obama said that healthcare reform had reached “a bit of a buzz saw” with the Democratic loss of a filibuster-proof majority in the Senate. He is encouraging Democrats to press on with regulating the health insurance industry regardless. This is in contrast to senators such as Chris Dodd, who suggest that they press the pause button on the issue before their heads are cut off. Unlike the President, most members of Congress are up for re-election this year.

Contrary to his previous statements about scaling back, Obama is now calling for the revival of attempts to pass comprehensive healthcare reform. Many are advising him to turn his focus towards the economy, but Obama attempted to connect the dots: his belief is that the soaring cost of individual health insurance has the potential to bankrupt many Americans.

(Image: Let Ideas Compete under CC 2.0)

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Do Wellness Incentives Make Health Insurance Cheaper?

Monday, January 25th, 2010

An increasing number of employers have launched company wellness initiatives. These programs are promoted as relatively low-cost ways to promote the good health of employees. They also promise to lower group health insurance costs. The logic is simple: a healthier workforce costs less to insure. Usually, employees can opt in the wellness program: if they do, they are then tested on health-related measures including cholesterol, weight, and high blood pressure. Then, the employee has a certain amount of time (often one year) to improve those health measures if they are currently unacceptable. If he or she lowers their cholesterol level or decreases their weight to a healthy body mass index, his or her health insurance premium goes down. Conversely, if he or she continues to have a high BMI, for example, health insurance rates will increase.

Supporters of wellness incentives claim that it gives employees more reponsibility over their health care and encourages them to engage in preventative care, as opposed to relying on their medical insurance to treat them after the fact. However, such incentives do not appear to have lowered health care costs. Grocery store chain Safeway, whose CEO has heavily promoted such reforms in Congress, did not keep health insurance costs flat after enacting the policy. Rather, the percentage of revenue spent on employee health insurance continued to rise; in 2009, Safeway’s costs actually increased more than the national average!

Republican and Democratic politicians alike have pointed to Safeway as a model for healthcare reform. In fact, the Senate’s legislation would double the penalties and rewards that could be tied to the results of wellness tests (as opposed to the act of simply participating in wellness programs). The wellness test portion of the program was under a year old when its so-called reduction in health care spending was praised. It seems that praise may have been premature.

(Image: Pink Sherbet Photography under CC 2.0)

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How Pharmacists Can Lead To Affordable Health Insurance

Monday, January 25th, 2010

One of the best ways to remain in good health is to have a closer relationship with your health care provider. He or she can help you get past medical misunderstandings, which could have a negative impact on your health if not corrected. Obviously, health insurance is less expensive when you are healthy.

Unfortunately, that kind of personalized attention has become less common. Co-payments and co-insurance percentages may mean that you don’t see your primary care physician as often as you should. Your local pharmacist can help fill in the gap. For the price of your prescription, you can speak with him or her about it. Ask any questions you have about your medication! Although pharmacists aren’t medical doctors, they nevertheless have education and a body of knowledge about the topic.

Studies have shown that one of the causes of wasted healthcare expenses is the accidental misuse of medication. If you have a chronic condition that must be managed with prescriptions, a lack of clarity regarding the instructions could land you in the hospital. Patients with athsma, high blood pressure, and Type-2 diabetes are among those who could benefit. Walgreens is launching a program of “medication coaches” with the latter. The program could make a dent in the $290 billion medical insurance companies and patients spend each year on illnesses that are preventable with proper medication management.

(Image: quinn.anya under CC 2.0)

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Virtual Fitness: Employers Creating Online Workout ‘Buddy’ Networks

Sunday, January 24th, 2010

Health insurance providers are offering their own versions of a virtual fitness system for the Web junkie set. Following a successful internal beta test with its own employees, “Aetna Health Connections Get Active!” is a group / team oriented fitness and nutrition program tailored to Aetna’s commercial employer health plan customers.

The company reports that more than 57 percent of its 35,000 employees in the United States participated in the “Get Active Aetna” program. One Aetna official from Arlington, TX reports the program helped him to lose 120 pounds. Other employees say the social networking component of the program has helped them connect with others who they otherwise wouldn’t have considered shaping up with. The program is a private-label product of Providence, RI-based Shape Up The Nation.

Even before the current Twitter and Facebook fanatics flocked to the Internet, Med School buddies Brad Weinberg and Rajiv Kumar learned from their early clinical days that patients who were the most successful at losing weight, increasing their exercise, quitting smoking and sticking to their goals all had one thing in common: they had social networking profiles and used their online friends to push them forward.

Aetna isn’t the only group health plan provider to put exercise in the cloud. Cigna, UnitedHealth and other major insurance companies offering their own brands of virtual fitness tracking and exercise regimes, to their own employees and to their plan subscribers. These companies and other FORTUNE 500s regularly report substantial cuts in healthcare costs, employee morale and retention by offering wellness programs that are fully integrated into social networking sites.

Some online fitness program providers work with companies to generate customized reports that tell CEOs which employees are using the program and how often. Other companies fully-integrate the data into Human Resources systems to cross-reference it with group health insurance claim information. While privacy advocates have concerns about the usage of such data to discriminate against employees in some way, national statistics tend to favor the employer:

  • The Kaiser Family Foundation reports: Nationwide, employer-sponsored health coverage premiums for family coverage have increased by 97% since 2000, from $6,438 to $12,680 in 2008.
  • Many have experienced 16% increases during the last 3 years much due to the rising epidemic of obesity and overweight adults.
  • A study in the Journal of Health Affairs noted that per person health care spending for obese adults is 56 percent higher than for normal-weight adults. Over 15 years, the additional costs incurred by obese adults with private health insurance versus normal-weight adults increased from $272 to $1,244 per person per year. The International Journal of Obesity reports, weight gains of 20 pounds are associated with medical care cost increases of >$500 over the last three years.
  • Obese workers lose about 13 times more days per year of work from injury or illness. (In an organization of 10,000 employees, with 32% obesity, that equates to 334,880 hours or an estimated 161 full time employees. With an average national salary of $38,500, the total cost of lost days can be as much as: $6,198,500 per year.)

Online nutritionists, exercise coaches and member message boards are also growing in popularity outside the workplace since real-live trainers are finding work in other industries and more exercise enthusiasts are cutting their gym memberships to save money.

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Healthcare Reform Nor’easter and Party Politics Aside, We’re All Just Tired of it.

Sunday, January 24th, 2010

Last week’s Nor’easter in Massachusetts stunned the Democratic party and created widespread panic. One likely consequence is that healthcare reform – Barack Obama’s signature initiative – will go down to defeat. Some would say reform of some sort is decades overdue. But not all Americans are convinced the effort must be abandoned.

Democrats could press on if they chose. The loss of their super-majority in the Senate is not decisive, after all. The party still controls the House of Representatives. If the House simply passed the bill which the Senate has already approved, the measure for mandating individual health insurance could go directly to President Obama’s desk.

But many Democrats in the House do not like the Senate bill and Liberals find it too timid. Moderates in swing districts, worried about November’s midterm elections fear it will lose them votes. Democrats aren’t simply sweeping their health plans under the rug; out of lack of conviction, they are choosing to surrender.

Democrats are looking at other options now, but options are tough to come by. Knowing full well these are likely to yield little or nothing of meaningful reform, aside from a bit more regulation, the bill is killed. You cannot guarantee availability of insurance coverage, for example, without an individual mandate to buy insurance: this would cause premiums to soar. Then, in turn, such a mandate requires subsidies. Once you start to pick apart the Senate bill, it unravels completely.

The president and most Democrats are simply tired and seem ready to let it all go away like a bad dream…If only we could get some sleep.

In the coming days, expect the Democrats to show they are listening to voters. It would be wrong to pretend that the Massachusetts election didn’t happen, of course. But popular opposition to healthcare reform is easily misinterpreted. It will be a very tight rope they will walk with the American public. But it may help their stance with voters to reassure their constituents that affordable health insurance is still available on the open market.

Though they ended up with a huge and expensive proposal, President Obama and his Democratic allies made a remarkable hash of getting there. The process was gruesome and the public support was non-existent. Voters have reason to be confused and fearful, and this is driving the polls. But there is no solid opposition to change. President Obama, after all, was elected largely on of comprehensive healthcare reform.

Sadly, it now looks too late for the president to exercise the leadership that was missing last year – in guiding the effort, in uniting his own party around a plan, and above all in assuring the public that it all made sense. No matter where you side on healthcare reform or the political party you affiliate with most, this whole mess gave everyone undeniable and decisive double-take on the Obama administration.

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