Archive for April, 2011

Aetna To Scale Back Health Insurance Rate Hikes

April 29th, 2011

Policyholders in California will see an average increase to their health insurance premiums by about 12.2% starting in July.  Aetna originally was going to raise health insurance premiums by 17.9%, but the California insurance commissioner put pressure on the large insurance carrier.  Also, Aetna postponed the rate hike 60 days so consumers can get more of a break then they first intended.  The decision by Aetna to scale back the rate hikes will effect about 65,000 policyholders in California.

This will also account for a lot of savings for consumers – about $6.7 million in premiums.  Additionally, the 60 day delay will save another $1 million.  The news came shortly after large insurance carriers, Anthem Blue Cross and Blue Shield, also decided to scale back rate hikes.  The insurance commissioner has been very busy trying to get control of the rising health insurance costs for individual policyholders.  Aetna also mentioned that another 31,000 members might see rate decreases by September as well.  As the economy tries to get out of its current misery, cutting the costs, or at least decreasing the rate hikes, could not have come at a better time.

Top Sources Of Illness Related To Foods

April 28th, 2011

A study conducted by the University of Florida Emerging Pathogens Institute identified the 10 riskiest combinations of foods and disease-causing microorganisms in the United States.  Poultry contaminated with Campylobacter bacteria is the food-pathogen combination that causes the most illness in the United States.  This combination causes more than 600,000 illnesses per year and costs over $1.3 billion per year. 

The report named Salmonella as the leading disease-causing microorganism in the US.  Moreover, foods containing Salmonella such as produce, poultry, and eggs contain the most risk.  The top five illness-causing pathogens are Campylobacter, Salmonella, Listeria monocytogenes, Toxoplasma gondii and norovirus.  To read more about these health related issues, click here.

Health Reform Makes Insurance More Affordable

April 27th, 2011

The health care reform laws that passed over a year ago by President Obama will reportedly make health insurance more affordable for Americans.  For more than 40 million people who are currently uninsured, this is obviously a big concern.  Health insurance premiums have been rising for years now and their has been no end in sight.  The new laws will hopefully increase competition with the health insurance markets and drive down costs.  The health insurance exchanges are required to be up and running by each state by 2013.  These exchanges will make affordable plans easily accessible to Americans. 

A new Commenwealth Fund reports that 90% of Americans above the poverty line should be able to afford health insurance, largely in result from the Affordable Care Act passed last year.  Although the exchanges are required to be up by 2013, Americans are not required to have health insurance until 2014.  Small businesses may also qualify to purchase through these exchanges.

Some Health Exchanges In Danger

April 26th, 2011

A $48 million grant from the federal government could be in danger for Oregon.  Oregon was one of the few states that were given grants to help create insurance exchanges before the other states.  It was meant for them to be a model state so other states could emulate them.  Some of the Democrats say it is because of the Republican opposition of the entire health care reform overhaul.  The budget for the grant was supposed to be completed by Tuesday, but Republicans and Democrats could not agree by the deadline. 

The health insurance exchange would be established for individuals and small businesses to get subsidized health insurance through the federal government.  Not all individuals and small businesses would qualify for the federal subsidy but the purpose of the exchange was to create that opportunity for consumers.  Now, Oregon might have to go at it alone and without government help.

Republicans say that they are hesitant to approve a budget before they see a detailed plan of the project.  Historically, Republicans say that the state has had a poor record of managing similar types of projects and that this would be a huge undertaking.  This project has been criticized as over budget and already mismanaged.

Supreme Court Refuses To Skip Lower Courts

April 25th, 2011

In Monday, the Supreme Court refused to bypass the lower courts and take up an immediate challenge of the constitutionality of the national healthcare reform law.  By 2014, the healthcare reform law is requiring everyone in the US to have health insurance, either through their employer or out in the private market.  This decision not to bypass the lower court system is only an announcement, their is not a final decision on what the Supreme Court will finally do.

The final decision by the court system will not likely come until late next year.  Each state has continued to have their own opinion on the new laws and each has taken their own actions as well.  Some states have already had an exchange up and running, while others have refused to even put a health insurance committee together.  If states do not have an exchange up by 2013, then the federal government will be in charge of starting and running a health insurance exchange on behalf of the state.  People are not required to purchase health insurance until 2014 though.  Today, their are still roughly 40 million people uninsured.

California Regulator Questions Blue Shield Rate Hike

April 22nd, 2011

For the second time this year, Blue Shield of California has been under scrutiny because of a second consecutive rate hike in the double digits.  The rate hike affects over 70,000 policy holders who are facing an average rate hike of about 37.5%.  These rates increases are for individual policyholders in California.

Last month, Blue Shield of California was asked by the Department of Insurance to explain three different rates hike that totaled over 86% increase to 200,000 policy holders.  Blue Shield is one of the biggest insurance carriers in California and their rate increases lately have been closely watched and questioned.  With the added pressure from the state commissioner and Department of Insurance, Blue Shield of California withdrew some of the planned rate hikes earlier this year and last year. 

A spokeswoman for the Department of Managed Health Care wants to make sure that Blue Shield is overcharging its customers this year.  With health insurance prices still increasing after the passing of the health care reform law, regulators are keeping a close watch on the largest carriers to make certain they keep prices increases under control.

Calcium Might Be Tied To Heart Attack Risk

April 21st, 2011

According to doctors at the University of Auckland, calcium supplements may raise the risk of heart attack.  However, the date which was taken from postmenopausal women over the last seven years, is far from conclusive.  The reason that the results has been inconsistent is because of the participants and the control measures during the study. 

The purpose of the study was to isolate the effects of calcium supplements and the association to heart attack.  One group was supposed to take the supplement while others were supposed to take a placebo.  It was found that both groups of women were taking calcium supplements on the side.

This new study done by the University of Auckland says they took the extra dosage of calcium supplements into consideration.  During the seven year study, 16,178 women were studied and researchers found a 15% increase in the risk of heart attack.  However, since both groups still did take supplements on the side, there are many critics of the study.

America’s Most Popular Drugs

April 20th, 2011

The most popular drugs in America in 2010 were generic drugs.  This trend from brand name to generic drugs has a lot to do with the current state of the economy.  As unemployment remains at high levels and consumers are spending less in general, cheaper alternatives in medical care is desired by the marketplace.  Their is still a high demand for prescription drugs though.  People are very stressed as of late and this is a driver of drug purchases. 

The top ten most frequently prescribed drugs in the US include painkillers, anti-diabetes, pills, statins for high cholesterol, and blood pressure drugs.  The best selling drug last year was Vicodin.  This painkiller drug was prescribed 131 million times in 2010 as the generic form, hydrocodone.  This is the first time that all top ten drugs in one year were generic drugs.  Last year, 78% of drugs dispensed were generic.

Today, too many Americans are taking prescription drugs.  Given the current state of the economy and jobless claims, the stress has taken its toll on Americans.  In the US last year, 61% of adults used at least one drug to treat a chronic health problem.  That is a staggering number and something that needs to be monitored closely.  Moreover, seniors are taking more drugs than ever.  Last year, 1 in 4 seniors take at least five medications daily.

Drug Spending Slows In US

April 19th, 2011

Spending growth on prescription drugs slowed to 2.3 percent in 2010.  That is the second lowest level in the last 55 years.  According to IMS Health, spending on prescription drugs reached $307.4 billion in the US last year.  Even with the slower growth, that still puts US as one of the largest markets in the world.  In 2009, spending growth rate for prescription drugs was 5.9%, a big drop off in percentage compared to 2010.

Big patent expirations, including Pfizer’s top-selling drug Lipitor, will likely lead to even slower growth next year.  The lower trend is showing signs that large drug manufacturers are either taking drugs off the shelves or switching to less expensive generic drug alternatives.  The market to produce drugs on a consistent basis has changed over the years.  With the health care system in chaos, it is getting more and more expensive for all types of health care companies to compete.

Additionally, high unemployment rates and lower incomes has also been an important factor to the decrease in the drug market.  People are forced to make decisions on which drugs are absolutely necessary to take and which ones that can just cut-off or delay in taking.  This is forced drug makers to scale back on production.  Getting back to full scale will depend largely on the economy and more importantly, confidence from the consumers.

Weight Loss Improves Memory

April 18th, 2011

New research indicates that losing weight does more than just improve your physical health, it may also improve your memory.  According to a study conducted by Kent State University, weight loss may improve concentration and overall cognitive ability.  Obesity is a big risk factor for heart related diseases and stroke.  Moreover, obese people, it has been proved, have more difficulty concentrating for longer periods of time as well as have memory problems.  Researchers wanted to investigate if the reverse would be true, lose weight so memory can be increased. 

The study tested the memory and attention of 150 overweight people.  Then, some of the participants went through weight loss surgery.  Those who lost weight showed improvements in memory about 12 weeks after surgery.

Before the surgery, 23.9 percent of the participants showed impaired learning.  After the gastric bypass surgery was completed, in about 12 weeks those who previously had impaired learning tested at least average on all cognitive levels.  The major question that needs to be answered is what is it in the brain that improved after surgery.  Once researchers firmly figure that out, it will help tremendously.

An Apple A Day Keeps The Cholesterol Away

April 15th, 2011

According to a new study from researchers at Florida State University, apples are a healthier fruit then people might think as it shows to have positive test results for people with high cholesterol.  Their findings show that having an apple a day not only keeps the doctor away, but also results in dramatic decreases in bad cholesterol. 

Researchers said that apples are full of key nutrients that the body really needs, such as antioxidants and fiber.  Moreover, having a daily dose of fiber and antioxidants is very good for heart health and to bring down inflammation in the body, which is a leading cause of chronic diseases. 

For the study, researchers studied a group of 160 women ages between 45 and 65 who either ate a dried apple or comparable amount of dried prunes and studied their results. 

Can You Save With A Health Exchange?

April 14th, 2011

In less than 3 years, Americans will be mandated to obtain health insurance, many for the very first time, through the state run health insurance exchanges.  Mandated by the Patient Protection and Affordable Care Act, the states must have a health insurance exchange up and running by Jan. 1st, 2013.  This is one year before consumers are required to have health insurance starting in 2014.  Many people are wondering if you can truly save money in these new health insurance exchanges.  Moreover, how will it operate and will it be easy to navigate.  If the states are not ready by 2013, the federal government reserves the right to operate the exchange for that particular state. 

As of today, only 2 states have functional health insurance exchanges – Massachusetts and Utah.  The two states have very different exchanges, both from an insurance carrier and consumer standpoint. 

States can choose to run their exchanges in three different structural options – state agency under the governor, public agency governed by a board, or state-established nonprofit.  California has chosen to run their exchange through the public agency route that will be managed and governed by a board appointed by the governor. 

Most people agree that creating an exchange will create a competitive market and hopefully lower the costs of having health insurance.  Some say though, that insurance carriers will have a tough time keeping costs low when the product offerings and the management of them increase.  Each state will have their own challenges running and operating the exchanges, and making plans affordable will be the only “important” element in the consumers’ mind.

Kids Lack Exercise, Healthy Foods

April 13th, 2011

A study conducted by the YMCA shows that kids are not getting the right amount of exercise and healthy nutrition on a daily basis.  In fact, of the 1,630 parents surveyed, 62% of the kids ages between 5 to 10 eat junk food on a regular basis.  Only 14% say their kids eat at least 5 fruits and vegetables a day. 

These stats illustrate very directly the problem the US has with obesity.  Today, about a third of the children in the US are considered obese.  And these kids that are obese have a higher chance of developing heart disease, diabetes or other heart related problems down the line.

Federal guidelines recommend that children get at least one hour of good exercise per day.  However, distractions like TV and computers do not promote an active lifestyle within the households.  From the parents surveyed, only 16% say that their kids are getting more than a hour of exercise per day.

Govt. Announces Plan To Reduce Health Disparities

April 12th, 2011

Their is a big disparity between the quality of care the rich and poor receive on a daily basis.  Minority populations especially tend to get poorer quality health care in the US.  The government has proposed to change the way health care is delivered and also the quality of care for all minority communities.  The plan illustrates the important elements of a successful program.  Everything from Spanish speaking guides called “promotoras”, to improving dental care for poorer children. 

The government does acknowledge that it takes a lot more than just improving the way care is delivered, it also has to start at the community level.  People in the minority communities will have to want to make a change for the better and they will have to educate themselves on health care in general so over usage and improper usage does not take place.  Many people still go to the emergency room for non-emergency related issues, take prescription drugs when its not necessary, etc.  These unnecessary uses of health care drive up the cost of delivering it.  The local guides will help make the transition easier once the program is launched.  They will help answer questions when people have them and help point them in the right direction when they need it. 

A large number of people are part of this proposed plan, which makes it more of a challenge.  Minorities make up more than half of the 50 million uninsured in the US.  A report by Health and Human Services outlined some interesting points that will be crucial to the success of this plan.

Budget Deal Will Take Away Patient Choice

April 11th, 2011

Last Friday, Democrats and Republicans finally agreed on a huge budget deal to fund the government through September, 2011.  The plan will give about $39 billion in spending cuts but very little is forecasted to reduce the federal budget or national debt.  Two of the major provisions in the plan are intended to reverse the Affordable Care Act.  This is one of the important provisions of the health care reform and also very close to Obama’s heart.  Republicans have been trying to get rid of the health care reform all together and this is a good start in their eyes. 

The Affordable Care Act would give low income workers a choice between employer provided health insurance and private health insurance.  In 2014, the Act would allow people to take the money that an employer would of given them for group insurance and a put it towards a cheaper health insurance plan through a health insurance exchange.  These new exchanges are required to be set up by each state starting in 2014.

The new proposals might unfortunately raise the cost of health insurance.  The purpose of these provisions in the health care laws was to increase competition and to eventually lower the cost of health insurance.  Getting rid of the Affordable Care Act might not help out consumers in the log run.

GOP Proposals On Medicare

April 8th, 2011

Entitlement programs take up a big portion of the budget and each party has their own opinions on how to spend the money, specifically for Medicare.  Most politicians do agree that entitlement spending is out of control and taming spending on entitlements is crucial.  Republicans leaders have called for a major overhaul on Medicare spending and want a new program in place.  This overhaul will cost about $520 billion and will affect 47 million older and disabled Americans

Some GOP members want to raise the eligibility age from 65 to 67, which is similar to social security requirements by 2027.  Currently, social security benefits start at 66 and many members of the GOP feel Medicare should be the same.  Also, Republicans want consumers to be more responsible for health care expenses when they are on Medicare.  They claim that if people have “more skin the game”, they will be less likely to overuse the benefits and drive up costs. 

Another proposal is providing vouchers for consumers to purchase private insurance.  Currently, participants get a specific package of benefits which sometimes drives the wrong behaviors.  Giving consumers a simple discount, Republicans claim, will drive the right spending behaviors and not promote abuse of the health care system.

Federal Insurance Program Covers Pre-Existing Conditions

April 7th, 2011

The federal agency Centers For Medicare & Medicaid Services is aiming to boost enrollment in a new public insurance program for people that have been denied health insurance because of pre-existing conditions.  CMMS estimates that over 250,000 people in Texas have been denied at some point for health insurance and that they would be eligible for its Pre-Existing Condition Insurance Plan.  The CMMS also says that about 7 million people in the US may be qualified to participate in the federal program. 

Applicants for the federal program will have to provide a denial letter from the insurance company to prove their eligibility.  Or, an offer letter that states individual coverage will be granted only if the illness or disability will not be covered.  Applicants can also submit a letter from the agent or broker stating that the individual will not qualify for private health insurance because of their pre-existing condition. 

This federal program is crucial in providing coverage for those “high risk” consumers.  It’s a step in the right direction for the Obama administration’s goal of having everyone insured in the US.  In 2014, this federal program will go away as each insurance carrier will be mandated not to deny applicants with pre-existing conditions.

High Doses Of Painkillers Up Risk Of Death

April 6th, 2011

Prescription painkiller drugs are prescribed by doctors all the time to help heal pain associate.  However, it does not protect patients from taking too much and overdosing on the prescription drugs possibly leading to death.  A new study found that those on high or maximum doses of prescription opioid pain killers are at a significantly higher risk of accidental, lethal overdose. 

Alesandra Rain, 53, was prescribed pain killers that were meant to help her.  She did not have the results she expected from taking these medications.  These drugs are sometimes to strong for patients and do not help them in the long-run. 

From 2004 to 2008, trips to the emergency room associated with prescription drug overdose more than doubled.  Among adults between 45 and 54, overdoses are the second leading cause of accidental death, according to the Substance Abuse and Mental Health Services Administration.  With regards to opioids, the CDC now estimates that there are about 13,000 deaths per year related to overdose with this particular drug.

Health Care Expands For Ex-Offenders In California

April 5th, 2011

Many people leave the prison system every year with serious health problems and no money for treatment.  Local governments in California are set to gain tens of millions of dollars in federal funds to care for the indigent, including ex-offenders.  This is a crucial element to making the health care reform work in the coming years.  Many people are set to get health insurance, or at least required to, by 2014 or they will face a fine. 

State officials estimate that the federal funded program will help about 500,000 people currently without health insurance.  The program is set to start as early as June.

The major portion of the initiative will launch in 2014.  This is right about the time when Medicaid is ready to expand as well.  With the new programs set forth by the health care reform, the two programs will work together to bring affordable health insurance and health care to these targeted segments.  In California, referred to as Medi-Cal, the porgram is very well timed.  Most other programs are underfunded and consumers are paying the price of caring for the underinsured.

Less Stress, Better Sleep May Help You Lose Weight

April 4th, 2011

Recent studies done by Kaiser Permanente’s Center for Health Research suggest that lowering stress and getting the right amount of sleep can help you lose weight.  Most people historically only focus on diet and exercise, which of course is still an important part of any weight loss diet.  However, researchers are pointing out the mental aspect of losing weight.  Being in the right state of mind and not losing all your energy to stress can help assist people in their dietary strategies. 

During the research study, Kaiser found that people reporting between six to eight hours of sleep with lower stress levels loss the most amount of weight.  Doctors say that getting too much or too little sleep along with high stress levels will not allow you to focus on making behavioral changes that will ultimately lead to weight loss.

Their was a two-step trial that 472 obese adults participated in over a 26-week period.  In this study, sleep patterns and stress were monitored while they were also on a strict diet and exercise program.  Those who loss more than 10 pounds proceeded on to the next phase of the trial.  Researchers found that stress and sleep patterns were significant in the weight loss results.  Read more here.

Protecting California Women’s Access To Affordable Care

April 1st, 2011

California has remained committed to implementing the federal health care reform law.  California has positioned themselves well for the years to come, in an effort to make health care and health insurance more affordable for their residents.  Also, March 23rd marked the one year anniversary of the Patient Protection and Affordable Care Act (PPACA).  This is an important initiative in the new health care laws.  Several PPACA provisions benefit women especially, specifically for reproductive health care benefits. 

The PPACA makes important advances with women’s health care.  It gives women of all ages greater access to care and more affordable options.  As health care spending has reached an all-time high in California, the enactment of the PPACA is crucial now and into 2014.  Their are many steps and hurdles to get through though.  By 2014, the law could be repealed and that would severely diminish the quality and access of care for women.  If it does not get repealed, all health insurance plans for woman will have maternity coverage; historically a huge driver in health care expenses.  The PPACA’s main purpose is to reduce the inflated costs for women and the reproductive process. 

In California, an estimated 7 million people are uninsured, of that amount, 3 million are women (ages between 18-64).  Since the state is so big and the health care system is complex, access to care and the overall health care process varies greatly throughout the state.  Implementing a uniform process is essential to the future but will be a big challenge.  The new health care law and administration also agree that uniformity is the key to making affordable and quality care possible.