Posts by Author - Michael

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Wellpoint Warns Obama: Expect Higher Health Insurance Premiums

Thursday, January 28th, 2010

Wellpoint Inc., the nation’s largest health insurance company by membership, posted record earnings to Wall Street on the same day it sent a carefully-worded warning to the Obama Administration that it expects to book more profits if health insurers are forced to cover people with pre-existing conditions.

“The cost of premiums will rise if Democrats force plans to cover people with pre-existing conditions,” said Wellpoint CEO, Angela Braly. “Insurers went along with their practice of refusing coverage based on pre-existing conditions because the legislation also required 30 million more Americans to get coverage.”

Since debate about how to reform healthcare has simmered in Congress, the pre-existing element was among the last meaningful legislative changes to survive. But the House and Senate essentially concede that the mandate for all Americans to purchase individual health insurance is all but dead. Without the mandate, Wellpoint and other major health insurance companies wouldn’t have a built-in guarantee of new business coming to pay for those with pre-existing conditions.

“Without those added customers,” Braly added, “insurance companies will raise rates to cover the cost of the sicker people.”

Wellpoint posted a $536 million profit in the last quarter, after adjustments for the sale of its former NetRx pharmacy benefits unit to rival Express Scripts in December. Insurance industry analysts had been bracing for a flat earnings report amidst news that membership in some of the biggest health insurance companies continues to decline.

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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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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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Sitting is the Silent Killer

Friday, January 22nd, 2010

Image and video hosting by TinyPicSitting behind a desk for the workday in corporate America is just part of the job. So long as we’re supported by a comfy chair that helps us get our workday tasks done with relative ease and minimal strain on the back, it’s hard to imagine many occupational hazards to concern ourselves with until we leave the office. Not so say Swedish medical researchers. Turns out, sitting is the silent killer.

Aside from putting ourselves at a higher risk for obesity and diabetes, the longer we stay in sitting mode, say the Swedes, the worse off we are in the long run. Doctors at the Karolinska Institute and Swedish School of Sport and Health recently submitted the results of their study to Swedish health officials who quickly designed a series of elaborate exercise programs to keep working Swedes in tip-top shape.

Swedish guidelines now call for individuals to “take regular 5-minute breaks during a working day that is spent behind a desk,” and engage in “a minimum of 2.5 hours of physical activity off the clock to stay fit and healthy,” reads the recommendation.

Perhaps the most mind-warping concept for Americans to embrace in the study is our notion of “sedentary.” For years, U.S. health officials have forged such a strong bond between this relatively benign word and a visual of the mid-life couch potato husband who spends the majority of his off-hours on the couch at home. The Swedish sitting study makes the typical couch potato look like a blob of Play Dough in comparison.

“In the demanding and stressful society of the present, to prescribe these low and minimally time-consuming efforts may encourage many people with problems in maintaining a sufficient level of exercise,” the doctors wrote. “Encouragingly, research has shown that simple forms of individualized physical activity in clinical practice has had a beneficial impact on exercise level as well as sedentary time.”

If that wasn’t enough to get you outta your chair, consider the fact that our American counterparts in the healthcare and medical insurance industry have warned us against deep vein thrombosis — essentially a blood clot that forms and pools most often in the leg when we sit for long periods of time. If you sit in the same position without moving around much for as little as three hours, some people are susceptible to sudden blood clots that could launch quickly into the lungs and cause a fatal heart attack.

Considering the Swedish are amongst the healthiest people in the world, following their lead is probably a safe bet.

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