Thinking Required

Yes, Globalization is a Factor in Health Reform -

Please carefully consider the points raised in this article, make a point to read it.

New Health Law Brings More From Big Insurance Lobbyists

If you haven't quite figured out that Big Insurance is acting to protect Big Insurance under alleged "health reform" then you should refer to other posts on Natural Health News that explain how there were numerous back office deals with Obama and this industry prior to bill passage.

Most of what has changed will do very little to improve health care quality of service, and you should be watching at every step.

Health Insurance Companies Try to Shape Rules
By ROBERT PEAR

WASHINGTON — Health insurance companies are lobbying federal and state officials in an effort to ward off strict regulation of premiums and profits under the new health care law.

The effort is, in some ways, a continuation of the battle over health care that consumed Congress last year.

Insurance lobbyists are trying to shape regulations that will define “unreasonable” premium increases and require them to pay rebates to consumers if the companies do not spend enough on patient care.
For their part, consumer groups say they worry that their legislative victories could be undone or undercut by the rules being written by the federal government and the states.

The health care overhaul provides a classic example of how the impact of a law depends on regulations needed to interpret it. The rules deal with relatively technical questions but go to the heart of the law, pushed through Congress by President Obama and Democratic leaders with no Republican support.
More than 40 provisions of the law require or permit agencies to issue rules. Lobbyists are focusing on two whose stated purpose is to ensure that consumers “get value for their dollars.”

One bars insurers from carrying out an “unreasonable premium increase” unless they first submit justifications to federal and state officials. Congress did not say what is unreasonable, leaving that to rule writers.

Another provision, effective Jan. 1, requires that a minimum percentage of premium dollars be spent on true medical costs related to patient care — not retained by insurers as profit or used to cover administrative expenses. Insurers must refund money to consumers if they do not meet the standards, known as minimum loss ratios.

Michael W. Fedyna, vice president and chief actuary of Aetna, underlined the importance of this issue, saying no other aspect of the law would be so “influential in shaping the future of the health care marketplace in the United States.”

The definition of medical loss ratio will “determine the willingness of health plans to enter new markets and remain in existing markets,” he said.

Senator John D. Rockefeller IV, Democrat of West Virginia, said the definition would be just as important for consumers and small businesses.

“The health insurance industry has shifted its focus from opposing health care reform to influencing how the new law will be implemented,” he said.

The law requires insurers to spend a minimum percentage of premiums on health care services and “activities that improve health care quality” for patients.

Insurers are eager to classify as many expenses as possible in these categories, so they can meet the new test and avoid paying rebates to policyholders.

Thus, insurers are lobbying for a broad definition of quality improvement activities that would allow them to count spending on health information technology, nurse hot lines and efforts to prevent fraud. They also want to include the cost of reviewing care by doctors and hospitals, to determine if it was appropriate and followed clinical protocols.
Some consumer advocates, like Carmen L. Balber of Consumer Watchdog, favor a strict, narrow definition of quality improvement activities, limited to those that produce measurable benefits to individual patients.

Alissa Fox, a senior vice president of the Blue Cross and Blue Shield Association, said that if the definition is too narrow, “health plans will come under enormous pressure to cut back quality improvement activities, including highly effective programs to reduce hospital infection rates.”

But Charles N. Kahn III, president of the Federation of American Hospitals, a trade group, said he feared that the quality improvement category would become a “catchall for a wide variety of expenses not directly related to patient care.”

Under the new law, insurers in the large group market are generally supposed to spend 85 percent of customers’ premiums on “clinical services” and quality-enhancing activities. The minimum is 80 percent for coverage sold to individuals and small groups.

Insurers and insurance regulators say that some companies will be unable or unwilling to meet the new standards. http://www.nytimes.com/2010/05/16/health/policy/16health.html?ref=health

Another Health Reform Bill Conundrum

As I understand it, hidden deep inside the 2700 or more pages of the recently passed health bill is a small detail I think my readers should know.

As you may know the issue of pre-existing conditions was a major PR focus in the efforts to ram this bill through Congress, and get the citizenry to think they were really getting something.

What's missing is this tiny detail I fell upon in the past day or so about exactly what happens to one of the Big Insurance carriers that will be allowed in the "pool" to sell you something that will continue to give their CEO at least $13 million a year in salary without perks.

And you might end up not getting your claims paid if you happen to have one of these items, obscure and otherwise, deemed "pre-existing" by insurance profiteers.

It just so happens that whomever has been writing this bill, and of late it always seems that industry is writing the legislation, they sure seem to favor industry over Joe or Jane Citizen.

The slap on the hand for denying coverage for "pre-existing" is a paltry $100 a day. To Big Insurance the $100 a day fine doesn't even measure up to pocket change.

In the interim, you or a loved one could die.

Don't you think it might be a good idea to start taking back responsibility for your health?

See also "health care problem is far from solved"

United Steel Workers Blog and Health Reform

USW Blog

Healthcare law full of unknowns

Thom Hartmann did a good explanation of some of the points in the new mega bill that give you some clues into how the dark forces are at work in this bill.

Another point to consider is that Medicaid usually pays about 60% of costs and Medicare pays about 80%. With these figures in mind, is it a wonder that doctors aren't accepting or are cutting back on providing care to these people.

Perhaps the omen is that we need to do a better job of taking care of our selves and our health needs, just like it used to be.

And you can do it!

About the only thing Dr. Philip Schwarzman can be sure of under the national healthcare overhaul is that he is adding his daughters, ages 23 and 25, to his health plan immediately.

Much less clear to Schwarzman is how the sweeping law will affect the emergency department at Providence St. Joseph Medical Center in Burbank, where he is medical director.

"It's incredibly complicated," said the white-haired physician, whose department sees 50,000 patients a year. "It's hard to predict what's going to happen."

That pretty well sums up the Patient Protection and Affordable Care Act. Potential effects of the law, passed last month, can be described as profound and prosaic, obvious and unknowable.

Some of its most complex and far-reaching changes won't take effect for years, including the requirement that, by 2014, all Americans have health insurance. But the law also contains immediate changes, such as the one allowing parents to add or keep dependent children up to age 26 on their health insurance policies.

Over the next decade, many of its consequences will play out at places like St. Joe's, a 431-bed nonprofit hospital founded by the Sisters of Providence in 1943, and in surrounding community clinics.

Article continues here -

Related article here on the state of Social Security

Kiplinger reports as well...

More to consider re: Health Reform

A time to consider taking responsibility for your health.  You can do it!

Seniors wary of health overhaul impact on Medicare

N.Y. Times columnist: Death panels will save 'a lot of money'

Health Care Battle Ends; War on Social Security Begins 

Refer to this article for more information.

Why Insurance Reform Doesn't Get You Better Health

Senator Lieberman who is holding positive movement on insurance reform in limbo may have reason to be concerned, especially where women's health is concerned.

It seems as if the controversy over Hadassah Lieberman, the Senator's wife, is on the payroll of the Komen Foundation to the tune of about $300K a year.  Gary Locke's wife is on their payroll too, most likely lobbying while she's living in DC.

The problem with this is that Komen has no interest in CHANGE. For them it is PhRMA all the way, along with cancer promoting mammogram.

It might be why there is no effort to do more for prevention or more for research into the known environmental causes of cancer.

Nancy Brinkerman, CEO and sister of Susan Komen, is also suspect because she is on some PhRMA director's boards.

Do you wonder why the so-called health reform effort and the "race for the cure" keep circling the wagons and make deeper ruts?

Health Lobby Fights Against Progress with $$$

If you aren't aware that the health insurance reform bills aren't being bought, here's an update on how the battle is moving from Congress payoffs to the state level -

" Insurance companies, hospitals and other health care interests have been positioning themselves in statehouses around the country to influence the outcome of the proposed health care overhaul. Around the 2008 election, the groups that provide health care contributed about $102 million to state political campaigns across the country, surpassing the $89 million the same donors spent at the federal level, according to the institute. " Health Lobby Takes Fight to the States

Medicare: Coming Accessibility Crisis

In 1995 I started teaching a series of health education programs for Elders known and well-respected as "Healthy Options".  The program originally were sponsored by Secure Horizons and later were offered at community colleges, for business and government, as well as community organizations. One of the most popular versions was "Healthy Options for Seniors".  I even had 'groupies' that would go from place to place to hear me speak.  Of course this is what I have been advocating for decades, learn what you can do for your health, and please learn it from the best resources!   Learn more about "Healthy Options"

Access to medicine in question for future Medicare patients who suffer from disabling hip and knee arthritis

ScienceDaily (2010-06-01) -- Healthcare reform -- and the many options for fixing a broken system -- have appeared in the news headlines for months. According to a new article, Medicare patients -- many who suffer from disabling arthritis of the hip and knee, among other age-related ailments -- may end up facing an accessibility crisis to medical care. ... > read full article

Affordable Health Care

As we listen to the progaganda on health reform today remember that a worker in New Hampshire pays $8000 more than their Member of Congress for health insurance.  They also have to pay a tax on it.

If you don't inderstand that this so-called "health reform" activity is more about payoffs to Big PhRMA and Big Insurance then you aren't on track with what is actually happening.

There is no change and there is no health reform.

Make sure you let your representatives know what you think!

Taxol Boosts Odds of Chronic Pain

More drugs needed to deal with pain following Taxol?  I guess no one is questioning the impact of these drugs, just another source of higher health cost.

Breast cancer patients getting the chemo drug may suffer long-term neuropathic discomfort, study finds
MONDAY, Nov. 30 (HealthDay News) -- The chemotherapy drug paclitaxel (Taxol) increases the risk of chronic neuropathic pain in breast cancer survivors, a new study shows.

It included 240 women who took part in clinical trials of Taxol between 1994 and 2001. Those who experienced chemotherapy-induced peripheral neuropathy during their treatment with Taxol were three times more likely to eventually be diagnosed with chronic neuropathic pain.

The study is published in the November issue of the Journal of Pain.

The findings indicate that patients treated with Taxol should be regularly monitored for neuropathic pain after their chemotherapy ends, said the researchers from the University of Texas M.D. Anderson Cancer Center.

In certain cases, patients and doctors should review the risks and benefits for continuing treatment with Taxol if a patient is likely to experience worsening neuropathy, the study authors added.

They noted that the same cellular mechanism that's altered by Taxol to kill tumors can be toxic to normal tissue.

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