Arthritis Foundation Forum / Arthritis Today / Arthritis Today Stories

DRUG ADS: Waste of Money?

Joy125 — Tue, 02 Sep 2008 12:10:40 GMT

Drug ads may be a waste of cash

ASSOCIATED PRESS - September 2, 2008

PARIS (AFP) — Big Pharma may be throwing away billions of dollars on ad campaigns in the United States, according to a probe into the effectiveness of media blitzes to promote a drug directly with the public.

In 1997, the United States lifted a ban on prescription-drug ads that are pitched directly at the public rather than at doctors or other health professionals.

The change prompted pharmaceutical companies to invest heavily in retail advertising, and annual spending in this sector now averages more than five billion dollars (four billion euros).

Advocates of direct-to-public drug advertising say it raises awareness and encourages the treatment of neglected conditions.

Critics counter that it artificially drives up demand for expensive novel drugs that have not been tested over the long haul.

Both sides, though, have assumed that the marketing technique works -- but the new study suggests they have got it flat wrong.

"People tend to think that if direct-to-consumer advertising wasn't effective, Pharma wouldn't be doing it," said Harvard Medical School professor Stephen Soumerai, who led the investigation.

"But as it turns out, decisions to market directly to consumers are based on scant data."

Even when sales increase, it has been nearly impossible to isolate the impact of targeting consumers from, say, marketing campaigns directed at doctors and health professionals.

Ideally, one would want to compare two otherwise identical populations before and after one of them is exposed to direct-to-consumer ads for certain drugs in order to measure the difference.

In the United States that is not possible, so Soumerai came up with a clever idea: Canada.

Direct-to-consumer ads for prescription drugs are illegal north of the US border, but English-speaking Canadians are still massively exposed to pharma advertising on American television and radio, and in US magazines.

Their French-speaking neighbours in the Canadian province of Quebec, however, are not, which provided the investigators with a useful group for making a comparison.

The study focused on three drugs: Enbrel, for arthritis; Nasonex, for allergies; and Zelnorm, for irritable bowel syndrome.

To read rest of article see:

http://afp.google.com/article/ALeqM5hk1KJuuKiRymcrOpr4ygdSh8XbZw

ATTN: Send stories

Pippa Smith — Mon, 28 Sep 2009 12:48:21 GMT

ATTENTION: People with impairments/disABILITIES, here is a chance to talk about your stories for a book. EX: ARTHRITIS, BIPOLAR, CP, DEPRESSION, DIABETES, HEART, MIGRAINE, OVERWEIGHT/OBESE…see facebook page for Pippa Smith or contact pippa@mchsi.com

Free prescriptions, free insurance, free food, free transportation etc...for disabled

Michael Marki — Fri, 22 May 2009 14:10:02 GMT

Free Government programs to help the disabled, seniors and those on low income

www.maxpages.com/helpbenefits :)

Natural relief ..........that actually works!!

Lynne Costelloe — Fri, 22 May 2009 06:21:09 GMT

As a 12-year sufferer of RA, I have to share with you my amazing discovery that has eradicated my joint swelling, restored my mobility and energy, and most importantly eliminated my pain.

On a holiday to Singapore I came across a herbal remedy promoted to provide relief for joint and arthritis pain within 48 hours!! Sceptical but in my 10th year of suffering on a daily diet of ibuprofen that only takes the edge off the pain, I decided to give it a go and bought my first 10 pills. Recommendation was 4 the first day as a “starter boost” and then 2 a day after that.

I did my boost day (4 pills) on the Sunday; 2 pills on Monday; on Tuesday morning I found I could get out of bed without that delayed "stand" while my knees decided if they could bend or not. Wednesday morning I still had no pain getting out of bed, but tucked the ibuprofens in my bag (just in case). Throughout the day I realised that my wrists were flexing when I took change from a cashier. Thursday I walked and stood for 8 hours of the day at the Australian Grand Prix and was still able to get up from the dinner table without using the table as a crutch. My scepticism was starting to fade - but Thursday night I took the last pill of my "trial" pack. Friday and Saturday continued to be pain and ibuprofen-free days – could this stuff be real?? Then, just when I was getting used to my new quality-of-life, Sunday morning I woke up with throbbing wrists, and knees that didn’t want to bend when I finally got out of bed!

So it was back on the ibuprofen for Sunday and Monday, until I headed back to Singapore and stocked up on the full 30-tablet packs, and the details of the company distributing them in the UK and Europe. AND for those of you still suffering …. there is a no-risk money-back guarantee from the UK guys.

So that’s my story and I wanted to share it with every arthritis sufferer - as I know how life-consuming that “pain & drain” can be. You have absolutely nothing to loose by trying these capsules – totally natural, safe for children from the age of 5, and if they don’t work for you in the first 4 days … you can get your money back.

Don’t take my word for it --- try them for yourself:

www.belinecapsules.co.uk

p.s. my 74 year old mother tried them, after seeing the difference in me, and is now free of the pain of bursitis for the first time in 15 years.

HEALTH REFORM: The Cost of Failure

Joy125 — Thu, 21 May 2009 13:54:06 GMT

[size=2]PRESS RELEASE FROM THE ROBERT WOOD JOHNSON FOUNDATION WEBSITE:

Report Projects Up To 66 Million Americans Could be Uninsured by 2019 Unless Health Reform Is Enacted

Businesses Could See Their Health Care Costs Double Within 10 Years; Study Uses Simulation Model To Illustrate Future Trends In Health Care Costs And Coverage

May 21, 2009

As key congressional committees prepare to introduce landmark health reform legislation, a Robert Wood Johnson Foundation (RWJF) report projects that—if federal reform efforts are not enacted—within 10 years the cost of health care for businesses could double, and the number of uninsured Americans could reach 65.7 million—with middle-income families hardest hit.

Researchers from the Urban Institute prepared the analysis using the Institute's Health Insurance Policy Simulation Model, estimating how coverage and cost trends would change between now and 2019. The study examined three alternative scenarios:

1. Worst case—slow growth in incomes and continuing high growth rates for health care costs;
2. Intermediate case—somewhat faster growth in incomes, but a lower growth rate for health care costs;
3. Best case—full employment, faster income growth and even slower growth in health care costs.

Under any economic scenario, the analysis shows a tremendous strain on business owners and their employees over the next decade if reform is not enacted. There would be a dramatic decline in the percentage of people insured through their employers, and millions more would become uninsured. There would be large growth in public programs, and major increases in health care spending and levels of uncompensated care. While all income levels would be affected, middle-class working families would be hardest hit.

“This report makes clear that as battered as our health system has been in recent years, unless we take action, the worst is far from over,” said Risa Lavizzo-Mourey, M.D., M.B.A., RWJF's president and CEO. “Without comprehensive health care reform, costs will continue to skyrocket, millions more will lose insurance, and the health of Americans will suffer. Congress must act quickly and decisively to make quality health care more affordable and accessible for all Americans.”

Using national survey and other economic data, the Urban model examines three scenarios that each assume varying levels of income growth and increases in health care costs. The report shows that if health care reform is not enacted:

* Individuals and families would see health care costs dramatically increase. Total individual and family spending on premiums and out-of-pocket costs could increase 68 percent by 2019 in the worst-case scenario. Even under the best case scenario, health care costs would likely increase at least 46 percent.

* Businesses could see their health care costs double within 10 years. The model shows that employer spending on premiums would more than double – from $429.8 billion in 2009 to $885.1 billion in 2019. Even under best-case economic conditions, employer spending on health insurance premiums would increase 72 percent. The result would likely be far fewer Americans being offered or accepting employer-sponsored health insurance (ESI). Estimates suggest a drop from 56.1 percent of Americans being covered by ESI in 2009, to as few as 49.2 percent by 2019.

* Spending on government insurance programs could double. In the worst case scenario, spending on Medicaid and the Children’s Health Insurance Program could increase from $251.2 billion this year to $519.7 billion in 2019, as more people are priced out of private insurance and become eligible for government programs. Enrollment in these programs could increase to 20.3 percent in 2019 in the worst case, or one in every five Americans. That’s an increase of 13.3 million people from current figures.

* Millions more people would be uninsured. The model projects that without reform, 65.7 million people could be uninsured by 2019, compared to 62.2 million in the intermediate case and 53.1 million under the best case.

* The amount of uncompensated care in the health system would increase. In the worst case scenario, totals for uncompensated care could more than double, from $62.1 billion in 2009 to $141.4 billion in 2019 in the worst case, and even $106.6 billion in the best case—putting a tremendous strain on health systems, hospitals, providers of clinical care and local municipalities.

The report makes clear that the biggest effects of not having health reform would be felt by families with moderate incomes, who have less access to public coverage. Under the model, the number of middle-income earners without insurance would increase sharply from 12.5 million in 2009 to as many as 18.2 million in 2019.

By using a wealth of economic data on the behavior of individuals and firms, the model allows us to analyze what delaying or failing on reform means for working families,” said lead author John Holahan, Ph.D., director of the Health Policy Research Center at the Urban Institute. “Increases in premiums cause fewer employers to offer—and fewer employees to accept—health insurance coverage. If federal action is not taken, many Americans would lose their employer-sponsored insurance over the next decade and move to Medicaid and other government programs. Middle-income families would truly be stuck—too well off to be eligible for public programs, but too poor to afford their own health insurance.”

About the Urban Institute

The Urban Institute gathers data, conducts research, evaluates programs, offers technical assistance overseas, and educates Americans on social and economic issues — to foster sound public policy and effective government.

About the Robert Wood Johnson Foundation

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years, the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves.

[url]http://www.rwjf.org/coverage/product.jsp?id=42968[/url]

[/size]

"Health Care - A Lesson in Pain"

Joy125 — Wed, 13 May 2009 01:50:26 GMT

[size=2]By DAVID LEONHARDT
Published: May 12, 2009

The events of the last few weeks have raised the odds that a health care overhaul will really happen this year.

Democrats have suggested that they are willing to play hardball and pass a bill without Republican support. Arlen Specter, the senior Pennsylvania senator, became a Democrat, potentially adding one more vote. At the White House on Monday, lobbyists for doctors, insurers and other industry groups pledged to reduce the growth of medical spending.

Yet none of these developments has removed the main hurdle to health care reform: the matter of the missing $90 billion.

Providing health insurance to the roughly 50 million people without it will cost something like $120 billion a year. President Obama has proposed $60 billion or so in new revenue for this purpose — a “down payment,” his advisers say. But Congress seems set to reject about half of the down payment (a plan to limit high-income families’ tax deductions for charitable giving and other such things). That makes for the $90 billion health care hole.

And no one is quite sure how to fill it.

Because Mr. Obama has made it clear that health care is his top legislative priority, the $90 billion hole has become one of the biggest political issues of 2009. . .

TO READ COMPLETE ARTICLE SEE:

[url]http://www.nytimes.com/2009/05/13/business/economy/13leonhardt.html?ref=global-home[/url]

[/size]

A Conversation: US Health Care

Joy125 — Thu, 30 Oct 2008 16:17:44 GMT

A conversation was started over on the RA forum but I'm starting a thread here so as not to disrupt the RA forum which is primarily a place for RAers to come for support.

Clara you posted: "I have friends from Canada and Australia who say that government run health care is far ,far below what we have here in the U.S. I don't think the expensive meds needed for RA would even be an option. They said that patients that need surgery have to wait many months to get it. Why....... Doctors are placed on a salary and it gives them no incentive to work hard and prosper. If their salaries are mandated, they will do the bare minimum. We could forget about our Dr.'s calling us back in a timely manner or even getting the labs we need. They said that people over a cetain age would not be able to get dialysis, ventilators or other life saving options. This is scary to me."

I understand your concerns. But I have also heard from people in Canada, New Zealand, Australia and the Uk, and they are satisfied with their system and think we have an inferior health care system. I have asked some of them to post here, and hope they have the time to do so.

I believe biologics are available in these countries, they are not available here to people w/out insurance or people whose insurance do not have these drugs on their formulary, or those that simply cannot afford them.

In regards to doctors, here in the US we are facing a shortage of primary care physicians. Many primary care physicians will not accept Medicare or Medicaid patients because of the low physician reimbursement rates. Specialists are reimbursed at higher rates, so medical students go into these specialties. Our government needs to revisit this issue, and set reasonable rates.

Insurance premiums are increasing. In the case of a poster over on the RA forum, she pays $800 for insurance through COBRA, her husband pays $300 for Medigap insurance. That's $1100 for insurance, to be paid out of a retirement income.

There are many complex issues when its come to health care. I hope people will take the time to comment here, about their concerns and thoughts about health care reform.

Supreme Court to Hear Drug Liability Case Monday

Joy125 — Fri, 31 Oct 2008 17:18:00 GMT

The US Supreme Court hears arguments on Monday, November 3, in a closely watched case that could limit liability claims against drugmakers if one of their medicines causes harm.

From Kaiser Network:

Plaintiff attorneys in Wyeth v. Levine, a U.S. Supreme Court case that could determine whether patients have the ability to file product liability lawsuits against pharmaceutical companies in state courts, on Thursday requested that the court add to the case record documents from FDA officials who expressed opposition to pre-emption, Dow Jones reports. Supporters of pre-emption, a legal principle under which federal laws supersede state laws, maintain that FDA approval of medication labels pre-empts the ability of consumers to file lawsuits against pharmaceutical companies under state product liability laws.

For rest of article see:

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=55309

For background on Wyeth vs. Levine see Bloomberg article:

Oct. 29 (Bloomberg) -- Children's musician Diana Levine watched her right hand gradually turn black in the six weeks after she was injected with a Wyeth anti-nausea drug. The pain, so powerful even morphine couldn't mask it, subsided only when doctors amputated the arm just below the elbow.

``It was totally shocking to wake up to this,'' said Levine, motioning toward her sleeve-covered stump as she sat in the kitchen of her Marshfield, Vermont, farmhouse. ``I just didn't think it would be that short. It took me quite a while to be able to look at it, to unwrap the bandage.''

Levine's story -- and the $7 million judgment she won from a Vermont state jury -- comes before the U.S. Supreme Court next week. Wyeth and other drugmakers are asking the court to put new limits on patient lawsuits over medications approved by the Food and Drug Administration.

For rest of article see:

http://www.bloomberg.com/apps/news?pid=20601109&sid=agDNyswitQ88&refer=home

Indvidual health insurance policies

Joy125 — Thu, 30 Oct 2008 20:25:56 GMT

NEW YORK TIMES

Women Buying Health Policies Pay a Penalty

Robert Pear

October 29, 2008

WASHINGTON — Striking new evidence has emerged of a widespread gap in the cost of health insurance, as women pay much more than men of the same age for individual insurance policies providing identical coverage, according to new data from insurance companies and online brokers.

Some insurance executives expressed surprise at the size and prevalence of the disparities, which can make a woman’s insurance cost hundreds of dollars a year more than a man’s. Women’s advocacy groups have raised concerns about the differences, and members of Congress have begun to question the justification for them.

The new findings, which are not easily explained away, come amid anxiety about the declining economy. More and more people are shopping for individual health insurance policies because they have lost jobs that provided coverage. Politicians of both parties have offered proposals that would expand the role of the individual market, giving people tax credits or other assistance to buy coverage on their own.

For rest of article see:

http://www.nytimes.com/2008/10/30/us/30insure.html?pagewanted=1&_r=1&em

PREMIUMS VS. PAYCHECKS: Growing Burden for Wkers

Joy125 — Fri, 24 Oct 2008 13:32:42 GMT

FROM FAMILIES USA REPORT

PREMIUMS VS. PAYCHECKS: A Growing Burden for Workers, September 2008

Throughout the first eight years of the new millennium, health care costs have skyrocketed, while working families’ wages have stood still. Other factors have also threatened families’ economic well-being, including rising gasoline prices and the downturn in the housing market, but the confluence of stagnant wages and rising health care costs has become a significant strain on family budgets. Numerous national studies have documented this damage.

As important as these studies are, they do not reflect the varying burdens experienced by families in different states. Just as labor markets, health systems, and economic circumstances vary from one state to another, the impact caused by rising health care costs and stagnant earnings differs considerably among the 50 states.

In 2006, Families USA undertook the first state-by-state analysis of growing health care premiums versus stagnant earnings in the new millennium. Since then, state economies have weakened, while health insurance premiums have continued their upward trend. Health care costs are now an even greater burden on American families. These reports, which are based on data from the U.S. Census Bureau, the Department of Labor, and the Department of Health and Human Services, examine what these trends mean for working families.

To see report for your state see:

http://www.familiesusa.org/resources/publications/reports/premiums-vs-paychecks-2008.html

HEALTH CARE SPIN

Joy125 — Fri, 17 Oct 2008 12:27:13 GMT

FROM FACTCHECK.ORG

Health Care Spin

October 14, 2008

McCain and Obama each make false claims about the other's health care plan. We sort through the misinformation.

Summary

McCain and Obama have sharply different health care plans, and each has made sharply worded attacks that are either false or misleading. McCain proposes a market-based system that relies on tax incentives, which one Obama ad falsely characterizes as the "largest middle-class tax increase in history." Obama proposes new subsidies to expand private insurance coverage and some expansion of government insurance, which McCain falsely claims "will rob 50 million employees of their health coverage."

Neither candidate has offered enough specifics about his plan to allow experts to assess the cost or impact without making various assumptions. Studies agree generally, however, that Obama’s plan would cover more of the uninsured than McCain’s would.

Here we lay out a brief explanation of both plans, what the experts are saying about them, and some of the ways each campaign is trying to fool the voters about the other.

FOR ANALYSIS SEE:

http://www.factcheck.org/elections-2008/health_care_spin.html

UNIVERSAL HEALTH CARE IN GERMANY

Joy125 — Fri, 03 Oct 2008 23:21:50 GMT

NATIONAL PUBLIC RADIO

Germany has the world's oldest universal care system and is arguably the most successful. Like Americans, most Germans get their health coverage through their employers. But Germany's rich pay higher premiums to subsidize insurance for the poor — a principle the Germans call "solidarity."

For rest of article see:

http://www.npr.org/templates/story/story.php?storyId=91971170

Mention European health care to an American, and it probably conjures up a negative stereotype — high taxes, long waiting lines, rationed care.

It's not that way in Germany. Very little tax money goes into the system. The lion's share comes, as in America, from premiums paid by workers and employers to insurance companies.

German health benefits are very generous. And there's usually little or no wait to get elective surgery or diagnostic tests, such as MRIs. It's one of the world's best health care systems, visible in little ways that most Germans take for granted.

http://www.npr.org/templates/story/story.php?storyId=91971406

UNIVERSAL HEALTH CARE IN THE NETHERLANDS

Joy125 — Fri, 03 Oct 2008 23:18:46 GMT

NATIONAL PUBLIC RADIO

Many U.S. policy analysts say that if America adopts universal coverage, this should be the model to follow. The brand new Netherlands system is like a giant HMO, except the government sets the rules. Citizens must buy health insurance, and insurers must sell affordable, comprehensive policies.

For complete article see:

http://www.npr.org/templates/story/story.php?storyId=91973552

UNIVERSAL HEALTH CARE IN SWITZERLAND

Joy125 — Fri, 03 Oct 2008 23:15:33 GMT

NATIONAL PUBLIC RADIO

Republican policymakers are abuzz over Swiss-style, universal health care; it comes closest to what they could imagine emerging in the United States. Everyone in Switzerland is required to buy government-regulated health insurance, with subsidies for the poor.

For rest of article see:

http://www.npr.org/templates/story/story.php?storyId=91974014

UNIVERSAL HEALTH CARE IN FRANCE

Joy125 — Fri, 03 Oct 2008 23:01:59 GMT

NATIONAL PUBLIC RADIO

France is known as a country that surrounds new mothers and their babies with care. All this coverage costs a lot. France spends more on health than just about any other country, but not as much as the United States. And yet, French mothers seem to get more for their money.

For rest of article see:

http://www.npr.org/templates/story/story.php?storyId=91970968

UNIVERSAL HEALTH CARE IN JAPAN

Joy125 — Fri, 03 Oct 2008 22:48:51 GMT

NATIONAL PUBLIC RADIO

T. Reid

April 14, 2008 · Japan produces cars, color TVs and computers, but it also produces the world's healthiest people. It has the longest healthy life expectancy on Earth and spends half as much on health care as the United States.

That long life expectancy is partly due to diet and lifestyle, but the country's universal health care system plays a key role, too.

Everyone in Japan is required to get a health insurance policy, either at work or through a community-based insurer. The government picks up the tab for those who are too poor.

It's a model of social insurance that is used in many wealthy countries. But it's definitely not "socialized medicine." Eighty percent of Japan's hospitals are privately owned — more than in the United States — and almost every doctor's office is a private business.

For rest of article see:

http://www.npr.org/templates/story/story.php?storyId=89626309

UNIVERSAL HEALTH CARE IN TAIWAN

Joy125 — Fri, 03 Oct 2008 22:42:58 GMT

NATIONAL PUBLIC RADIO

Taiwan Takes Fast Track to Universal Health Care

T. Reid

April 15, 2008 · At the end of the 20th century, Taiwan became a rich country, almost overnight. But it still had a poor country's health care — about half the population had no coverage at all. So Taiwan set out to design a national health care system from scratch. What makes Taiwan unique is the way the country figured out how to cover everyone.

For rest of article see:

http://www.npr.org/templates/story/story.php?storyId=89651916

Fewer Med Students Choosing Primary Care

Joy125 — Tue, 09 Sep 2008 21:15:07 GMT

ASSOCIATED PRESS

Fewer US Med Students Choosing Primary Care

By CARLA K. JOHNSON – September 9, 2008

CHICAGO (AP) — Only 2 percent of graduating medical students say they plan to work in primary care internal medicine, raising worries about a looming shortage of the first-stop doctors who used to be the backbone of the American medical system.

The results of a new survey being published Wednesday suggest more medical students, many of them saddled with debt, are opting for more lucrative specialties.

Just 2 percent of nearly 1,200 fourth-year students surveyed planned to work in primary care internal medicine, according to results published in the Journal of the American Medical Association. In a similar survey in 1990, the figure was 9 percent.

Paperwork, the demands of the chronically sick and the need to bring work home are among the factors pushing young doctors away from careers in primary care, the survey found.

"I didn't want to fight the insurance companies," said Dr. Jason Shipman, 36, a radiology resident at Vanderbilt University Medical Center in Nashville, Tenn., who is carrying $150,000 in student debt.

Primary care doctors he met as a student had to "speed to see enough patients to make a reasonable living," Shipman said.

Dr. Karen Hauer of the University of California, San Francisco, the study's lead author, said it's hard work taking care of the chronically ill, the elderly and people with complex diseases — "especially when you're doing it with time pressures and inadequate resources."

The salary gap may be another reason. More pay in a particular specialty tends to mean more U.S. medical school graduates fill residencies in those fields at teaching hospitals, Dr. Mark Ebell of the University of Georgia found in a separate study.

Family medicine had the lowest average salary last year, $186,000, and the lowest share of residency slots filled by U.S. students, 42 percent. Orthopedic surgery paid $436,000, and 94 percent of residency slots were filled by U.S students.

Meanwhile, medical school is getting more expensive. The average graduate last year had $140,000 in student debt, up nearly 8 percent from the previous year, according to the Association of American Medical Colleges.

Another likely factor: Medicare's fee schedule pays less for office visits than for simple procedures, according to the American College of Physicians, which reported in 2006 that the nation's primary care system is "at grave risk of collapse."

For rest of article see:

http://ap.google.com/article/ALeqM5j9vQmR7AZDkCnUDJH6TMpybABTIAD933GH8O0

Store-based clinics fill a need

Joy125 — Thu, 11 Sep 2008 10:36:01 GMT

LOS ANGELES TIMES - September 11, 2008

The emergence of healthcare clinics in grocery, drug and big box stores has generated a fair bit of controversy in the medical world. Some people praise clinics for their convenience and affordability while others -- namely, the American Medical Assn. -- say they worry that the clinics provide inferior care and discourage a regular doctor-patient relationship.

Several studies in the current issue of Health Affairs throw some sorely needed light on this topic. One report, by Rand Corp. researchers, is the first examination of the types of patients who use retail clinics and what kinds of services patients seek. The study found that most of these consumers do not have a regular healthcare provider and use the clinics for simple conditions or preventive care. The clinics attract insured and uninsured patients. Researchers found that 43% of the patients were ages 18 to 44 and just 39% said they had a regular doctor.

For complete article see:

http://latimesblogs.latimes.com/booster_shots/2008/09/store-based-cli.html

Knee pain not helped by surgery

Joy125 — Thu, 11 Sep 2008 02:22:59 GMT

Keep in mind that orthopaedic surgeons make $436,000 a year (see article in thread on fewer med students)

NEW YORK TIMES

KNEE PAIN NOT HELPED BY SURGERY, STUDY SHOWS

By GINA KOLATA

Published: September 10, 2008

A study has found that surgery is no better than more conservative treatment to relieve knee pain caused by arthritis.

In the study, being published Thursday in The New England Journal of Medicine, 86 patients who had the operation fared no better over two years than 86 who had physical therapy and took medications to dampen inflammation.

The results of the study are in line with those from a study published in 2002. But experts are divided about what effects the two studies will have.

Some say the new study just confirms what they already knew. Others say they hope that doctors who did not believe the 2002 study will be persuaded by this one to stop doing the operations.

The 2002 study, by the Department of Veterans Affairs, had a different design: instead of assigning patients to surgery or medical treatment, it assigned them to real surgery or a sham operation. The real surgery was found to be no better than the sham one.

That study was denounced by many orthopedic surgeons, but Medicare decided in 2003 to stop paying for the operation. Still, because doctors can be reimbursed for the procedure by modifying what they say is the patient’s problem, it is not clear whether most doctors stopped doing the operation, or how many such operations are being done. There is no national system for keeping track.

For rest of article see:

http://www.nytimes.com/2008/09/11/health/research/11knee.html?em

Political Ads-Fact Check

Joy125 — Sun, 24 Aug 2008 13:48:42 GMT

I found this website www.factcheck.org helpful in discerning the accuracy of political ads, especially those that deal w/health care reform.

The following is their mission statement from their "about us" page from their website:

"We are a nonpartisan, nonprofit, "consumer advocate" for voters that aims to reduce the level of deception and confusion in U.S. politics. We monitor the factual accuracy of what is said by major U.S. political players in the form of TV ads, debates, speeches, interviews, and news releases. Our goal is to apply the best practices of both journalism and scholarship, and to increase public knowledge and understanding.

The Annenberg Political Fact Check is a project of the Annenberg Public Policy Center of the University of Pennsylvania. The APPC was established by publisher and philanthropist Walter Annenberg in 1994 to create a community of scholars within the University of Pennsylvania that would address public policy issues at the local, state, and federal levels.

The APPC accepts NO funding from business corporations, labor unions, political parties, lobbying organizations or individuals. It is funded primarily by the Annenberg Foundation."

http://www.factcheck.org/

HEALTH CARE FRAUD

Joy125 — Thu, 04 Sep 2008 01:21:41 GMT

ASSOCIATED PRESS

WHISTLE BLOWERS HELP US RECOUP $9.3 BILLION

By KEVIN FREKING, September 1, 2008

WASHINGTON (AP) — Whistle-blowers helped authorities recover at least $9.3 billion from health care providers accused of defrauding states and the federal government, according to an analysis of Justice Department records.

The department ramped up efforts in the 1990s to combat health care fraud by using private citizens with inside knowledge of wrongdoing. They now initiate more than 90 percent of the department's lawsuits focusing on health care fraud.

Whistle-blowers start cases by filing a sealed complaint in federal court. The department investigates the allegation and can intervene, assuming the lead role in the lawsuit. Whistle-blowers then get between 15 percent and 25 percent of the amount recovered.

Of the $9.3 billion recovered between 1996 and 2005, whistle-blowers got more than $1 billion, say analysts, writing for the Annals of Internal Medicine.

The analysts' findings are conservative.

Information was only available for about three-quarters of the 379 cases reviewed. Second, some of the largest recoveries have taken place after the period reviewed.

For example, the study doesn't include the single largest settlement, worth $920 million, which came against Tenet Healthcare Corp., one of the nation's largest hospital chains, in 2006.

Still, the study highlights some important trends in health care fraud.

While the number of claims pursued has dropped in recent years, recovery amounts have soared because of a late addition to the cast of defendants — pharmaceutical manufacturers. Recoveries jumped from about $10 million a case in 2002 to $50 million by 2005.

Drug makers are required to sell products to state Medicaid programs at the "best price" offered in the private marketplace. But the companies may artificially inflate the price, according to the report.

Another common scheme is to market drugs for uses not approved by the Food and Drug Administration.

For rest of article see:

http://ap.google.com/article/ALeqM5ihvX2KcsVV_Im_C5AmAEmiseWpcAD92U5R1G3

FROM KAISER DAILY HEALTH REPORT - July 2, 2008

Whistle-blower lawsuits alleging that pharmaceutical companies and government contractors defrauded the federal government have created a backlog of more than 900 cases at the Department of Justice, the Washington Post reports. According to the Post, more than 500 of the cases involve the health care and pharmaceutical industries, as well as Medicare and Medicaid.

Lawyers involved in the backlogged disputes say DOJ "cannot keep pace with the surge in charges brought by whistle-blowers," the Post reports. Since 2001, 300 to 400 civil cases have been filed each year; however, the 75-lawyer unit that reviews the allegations investigates about 100 cases annually. Whistle-blowers routinely wait 14 or more months to find out whether DOJ will get involved in the case, during which time whistle-blowers are not allowed to discuss or disclose the existence of such disputes. The government rejects about three-quarters of the cases it receives, saying the majority lack merit.

Some of largest the false-claims cases include a $650 million settlement reached this year with Merck in connection with an alleged failure to repay Medicaid rebates and a $515 million deal with Bristol-Myers Squibb to cover illegal drug pricing and marketing. The Post reports, "Even bigger lawsuits containing potentially explosive allegations are waiting in the wings."

Deputy Assistant Attorney General Michael Hertz last month told Congress that "the number and increased complexity of the fraud schemes presented to the department, combined with the volume of cases now under review, certainly present challenges." Patrick Burns, a spokesperson for Taxpayers Against Fraud, said, "Even if no new cases are filed, it might take 10 years for the Department of Justice to clear its desk. Cases in the backlog represent a lot of money being left on the table." Advocates of federal intervention to address the backlog note that verdicts and settlements in whistle-blower lawsuits have returned nearly $13 billion to the U.S. government in recent years (Johnson, Washington Post, 7/2).

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=53086

Number of Uninsured Declines in 2007

Joy125 — Wed, 27 Aug 2008 17:21:42 GMT

NEW YORK TIMES

A Decline in Uninsured is Reported for 2007

By IAN URBINA

Published: August 26, 2008

WASHINGTON — After climbing steadily for six years, the number of Americans without health insurance dropped by more than a million in 2007, to 45.7 million, the Census Bureau reported Tuesday.

The drop was the result of growth in government-sponsored health insurance programs, officials said, most of them focused on children. At the same time, the number of people covered by private insurance continued to decline.

Experts cautioned that the report, which also included data on income and poverty, did not take into account the economic downturn that began late last year, and therefore it probably presents a rosier picture than the current economic reality.

For rest of article see:

http://www.nytimes.com/2008/08/27/washington/27census.html?ref=us

NEW YORK TIMES EDITORIAL - "Where's the Prosperity?"

Published: August 26, 2008

There is so little good economic news these days that we were cheered on Tuesday after the Census Bureau reported that in 2007 the income of the typical American household rose for the third year in a row. We weren’t cheered for long.

A closer look confirms what Americans already know: most families reaped none of the benefits of the previous six years of solid economic growth. Median household income last year was still 0.6 percent less than it was in 2000, when the last economic expansion peaked. Households led by someone 65 or under made an average of $56,545 last year — 3.4 percent less than in 2000.

The census offers the same mirage when it comes to health insurance. While the overall number of uninsured dropped — from 47 million in 2006 to 45.7 million last year — that still left the number of uninsured Americans 7.2 million higher than in 2000. The improvements were entirely attributable to an increase in the number of people enrolled in Medicaid and other public programs.

For rest of article see:

http://www.nytimes.com/2008/08/27/opinion/27weds2.html?partner=rssnyt&emc=rss

FOR THOSE THAT DON'T READ THE NYT, THE SAME SUBJECT COVERED BY THE KAISER FOUNDATION

Coverage & Access | Number, Percentage of Uninsured U.S. Residents Decreased in 2007, According to U.S. Census Bureau

[Aug 27, 2008]

The number and percentage of uninsured U.S. residents declined in 2007 to 45.7 million people, or 15.3% of the population, according to an annual U.S. Census Bureau report released Tuesday, USA Today reports (Cauchon/Appleby, USA Today, 8/27). In 2006, 47 million people were uninsured, or 15.8% of the population (Alonso-Zaldivar, AP/Kansas City Star, 8/26). For the report, researchers analyzed data from the Current Population Survey of the 50 states and Washington, D.C. (U.S. Census Bureau release, 8/26).

For rest of article see:

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=54175

They're Back - Harry & Louise Ads

Joy125 — Mon, 25 Aug 2008 01:34:06 GMT

They're back: Harry and Louise on health insurance

By KEVIN FREKING – 6 days ago

WASHINGTON (AP) — Harry and Louise are back for an encore.

A series of political ads starring the fictional couple back in 1994 helped sour the public's view of President Clinton's plan for universal health coverage.

Now, the two are back asking the presidential contenders to make health care their top domestic priority.

The latest Harry and Louise ads, starring the same actors as the earlier ads, will run during the Democratic and Republican Party conventions. While the kitchen table scene will look familiar, the concerns they raise will differ. Previously, Louise spoke of rationing — "you know, long waits for health care and some services not even available."

This time, she complains that someone the couple knows has cancer but no health insurance.

Harry, shaking his head in sympathy, complains "too many people are falling through the cracks."

Louise concludes: "Whoever the next president is, health care should be at the top of his agenda, bring everyone to the table and make it happen."

The groups sponsoring the new ad include one group that aggressively fought the Clinton efforts back in 1994 — the National Federation of Independent Business. There's also a major supporter of the Clinton plan — the advocacy group Families USA. The American Cancer Society Cancer Action Network and trade groups for hospitals are also sponsors.

Health insurers paid for the previous Harry and Louise ads.

In some respects, the ad shows a shifting political landscape for overhauling the nation's health care system. Business groups and consumer groups are working together to stress that changes have to be made to deal with rising costs and the growing number of uninsured. Yet, the coalitions could prove fragile once candidates get beyond their campaign blueprints.

For rest of article see:

http://ap.google.com/article/ALeqM5hOjZUPINY9Oi-A0GAeXmtF74WiSAD92L1P6O2

Right to Sue-Product (drugs) Liability

Joy125 — Fri, 15 Aug 2008 12:08:20 GMT

WALL STREET JOURNAL

PLAINTIFFS LAWYERS FIGHT RESTRICTIONS ON PRODUCT LIABILITY SUITS

ALICIA MUNDY
August 13, 2008; Page A3
WASHINGTON -- Since 2001, the Bush administration has steadily whittled away the ability of consumers and other groups to sue corporations for damages related to their products.
Now plaintiffs' lawyers are fighting back by raising money to battle a Supreme Court case and to support candidates seen as sympathetic to their cause in the November congressional elections.
At stake are billions of dollars in potential product-liability lawsuits. Some corporations are already getting tough in settlement talks. Judges have put on hold some cases, including three involving GlaxoSmithKline PLC's antidepressant Paxil, pending a Supreme Court ruling.
"It is a war," said Houston attorney Ed Blizzard, a member of the plaintiffs' lawyers task force to fight regulations that pre-empt plaintiffs' right to sue.
The Supreme Court case, Wyeth v. Levine, which is to be heard Nov. 3, could affect lawsuits involving products such as cars, toys and flammable mattresses.
For rest of article see:
http://online.wsj.com/article/SB121858968255135401.html?mod=googlenews_wsj

Single Payer System for Health Care Reform

Joy125 — Thu, 14 Aug 2008 12:50:10 GMT

The presidential candidates' health care reform proposals would either build on the existing private and public system of health insurance with shared responsibility for financing coverage by government, employers, and households (Obama) or move away from employer based coverage to the individual health insurance market with tax incentives to subsidize purchase (McCain). But is there another option -- single payer insurance?

The following article by by Drs. Edward P. Ehlinger and Susanne L. King which appears in the Physicians for National Health Program (PNHP) website answers the following questions:

1) What is single-payer health care?

2) Is single payer socialized medicine?

3) Doesn’t Medicare have big problems?

4) Can we afford single payer, if that means covering 47 million uninsured people?

5) Won’t there be waiting lines or rationing with single payer?

6) Won’t our aging population break the bank in a single-payer system?

7) Some people believe that their insurance is meeting their needs; why should they change?
8) How would single payer be financed?
9) Who would run a single-payer plan?
10) Won’t doctors dislike a single-payer system?
11) How would we get to a single-payer system?
http://www.pnhp.org/news/2008/august/what_about_single_pa.php

Health care in 5 Democratic, Capitalist Countries

Joy125 — Tue, 12 Aug 2008 16:32:00 GMT

From the April 2008 PBS program Frontline, the link below is to an online video and transcript of "Sick Around the World" and its website that discusses the health care systems of 5 other capitalist democracies. How do they provide health care to all their citizens and pay less than the US that leaves over 47 million uninsured and millions others underinsured?

From the programs intro:

"In Sick Around the World, FRONTLINE teams up with veteran Washington Post foreign correspondent T.R. Reid to find out how five other capitalist democracies -- the United Kingdom, Japan, Germany, Taiwan and Switzerland -- deliver health care, and what the United States might learn from their successes and their failures.

Reid's first stop is the U.K., where the government-run National Health Service (NHS) is funded through taxes. "Every single person who's born in the U.K. will use the NHS," says Whittington Hospital CEO David Sloman, "and none of them will be presented a bill at any point during that time." Often dismissed in America as "socialized medicine," the NHS is now trying some free-market tactics like "pay-for-performance," where doctors are paid more if they get good results controlling chronic diseases like diabetes. And now patients can choose where they go for medical procedures, forcing hospitals to compete head to head.

While such initiatives have helped reduce waiting times for elective surgeries, Times of London health editor Nigel Hawkes thinks the NHS hasn't made enough progress. "We're now in a world in which people are much more demanding, and I think that the NHS is not very effective at delivering in that modern, market-orientated world."

Reid reports next from Japan, which boasts the second largest economy and the best health statistics in the world. The Japanese go to the doctor three times as often as Americans, have more than twice as many MRI scans, use more drugs, and spend more days in the hospital. Yet Japan spends about half as much on health care per capita as the United States.

One secret to Japan's success? By law, everyone must buy health insurance -- either through an employer or a community plan -- and, unlike in the U.S., insurers cannot turn down a patient for a pre-existing illness, nor are they allowed to make a profit.

Reid's journey then takes him to Germany, the country that invented the concept of a national health care system. For its 80 million people, Germany offers universal health care, including medical, dental, mental health, homeopathy and spa treatment. Professor Karl Lauterbach, a member of the German parliament, describes it as "a system where the rich pay for the poor and where the ill are covered by the healthy." As they do in Japan, medical providers must charge standard prices. This keeps costs down, but it also means physicians in Germany earn between half and two-thirds as much as their U.S. counterparts.

In the 1990s, Taiwan researched many health care systems before settling on one where the government collects the money and pays providers. But the delivery of health care is left to the market. Every person in Taiwan has a "smart card" containing all of his or her relevant health information, and bills are paid automatically. But the Taiwanese are spending too little to sustain their health care system, according to Princeton's Tsung-mei Cheng, who advised the Taiwanese government. "As we speak, the government is borrowing from banks to pay what there isn't enough to pay the providers," she told FRONTLINE.

Reid's last stop is Switzerland, a country which, like Taiwan, set out to reform a system that did not cover all its citizens. In 1994, a national referendum approved a law called LAMal ("the sickness"), which set up a universal health care system that, among other things, restricted insurance companies from making a profit on basic medical care. The Swiss example shows health care reform is possible, even in a highly capitalist country with powerful insurance and pharmaceutical companies.

Today, Swiss politicians from the right and left enthusiastically support universal health care. "Everybody has a right to health care," says Pascal Couchepin, the current president of Switzerland. "It is a profound need for people to be sure that if they are struck by destiny ... they can have a good health system."

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

This website (see site map): discusses how each health care system in these countries work; compares US and 5 countries health stats; explains the 4 basic health care models; has interviews -- it's worth a look, and the online video narrated by T. Reid is interesting, not dull.

Comparing Candidates Health Proposals

Joy125 — Mon, 11 Aug 2008 12:44:57 GMT

The link below is to the National Public Radio (npr) website and a brief comparison of the presidential candidates health care proposals.

http://www.npr.org/templates/story/story.php?storyId=93445861

What health-care issues matter most to you?

Editors of Arthritis Today — Fri, 08 Aug 2008 15:12:36 GMT

How we vote at the polls this November will inevitably leave an indelible mark, not only on the future of health care and our quality of life, but also on history.

Arthritis Today magazine and the Arthritis Foundation want to know your opinions on health-care policy and politics. Use this forum to share your views with us and the 46 million others living with arthritis.

Visit [url=http://www.arthritis.org/politics-is-personal-forum.php]www.ArthritisToday.com[/url] to read what other voters with arthritis want the next president to do about health care.

Go to the [url=http://www.arthritis.org/advocacy.php]Arthritis Foundation's Advocacy center[/url] to learn how you can help shape the future of health care policy.

Survey says Americans want health care reform

Joy125 — Fri, 08 Aug 2008 13:14:21 GMT

By Emily P. Walker, Washington Correspondent, MedPage Today
Published: August 07, 2008
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

NEW YORK, Aug. 7 -- An overwhelming proportion of Americans believes the nation's healthcare system needs a fundamental change or a complete overhaul, according to the results of a survey released today.

And the next president is just the person to stimulate such reforms, said nine of every 10 respondents in the survey of a geographically representative sample of 1,004 adults, conducted on May 23 through May 27 by Harris Interactive for the Commonwealth Fund. Democrats support major changes more than Republicans do, the survey found.

"A majority of adults look to the next president to lead by proposing reforms that could improve the quality of healthcare, ensure affordable care, and decrease the number of uninsured," the survey report said. "Across income levels, region, and political affiliation, adults want presidential candidates to focus on health reforms in each of these areas.

"About nine of 10 adults say it is important for presidential candidates to have reform proposals that would improve the quality of care (90%), ensure care and insurance are affordable (93%), and decrease the number of uninsured (88%). In fact, a majority think these policy priorities are very important."

For rest of article see:

http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/tb/10475