The Internet can be a great source of medical knowledge. But knowing where to look, and who you can trust, is critical when trying to diagnose symptoms or learn more about a disease. Former law professor Toni Bernhard offers some tips for your online health information search (read her complete comments on theKevinMD.com blog):
We’re just a few days from the battle of the century – President Obama vs. 26 states challenging his Affordable Care Act, going mano a mano in the Supreme Court, with the future of healh care reform hanging in the balance.
The outcome of the three-day hearing likely won’t be known until summer, but that hasn’t stopped HealthDay News from asking legal experts to predict the outcome. And just about everyone is giving the President a win by technical knockout:
Gregory Magarian, professor at Washington University Law School: “The folks [26 states] who are challenging the act have somewhat of an uphill battle. It’s been some time since the court has struck down a major piece of federal legislation on the theory that it exceeds Congress’ constitutional authority.”
Neil Siegel, professor of law and political science at Duke University School of Law: “The court has held that in issues of economic activity, Congress can act as if we have an integrated national economy. Here you have economic conduct [health care] with massive interstate effects.”
Robert Field, professor of law at Drexel University’s School of Public Health: “I think it’s unlikely the court wants to create a major public or policy upheaval, which is what it would be doing if it overturned the law.”
Stephen Presser, professor of legal history at Northwestern University School of Law: “I think [Justices] Scalia, Thomas, Alito and Roberts will all have to view this as Congress going much too far and virtually ignoring the 10th Amendment. Justices Breyer and Ginsburg have always been strong voices for expanded Congressional power, and Justices Kagan and Sotomayor are not going to embarrass the man [Obama] who appointed them, so there are four sure votes to uphold the legislation as well. That leaves only Kennedy as the swing vote, as most commentators, I think, understand.” Presser believes Kennedy will vote with the conservative justices, which means the ACA will be ruled unconstitutional.
Sometimes, expensive health care is just that – expensive health care, no matter where you get it. And lower-cost caregivers can deliver high quality regardless of geography.
According to Medical Xpress, a new study conducted by physicians in San Francisco found no solid evidence to support the theory that regions of the United States that spend more on health care and have higher rates of health care use deliver more unnecessary care to patients. Conversely, low-cost areas don’t necessarily deliver more efficient care – they simply don’t charge as much for care that’s just as good.
MedBen’s own experience has demonstrated degrees of cost-effective care at hospitals of all sizes, in regions large, small and in-between. But one important lesson we’ve learned is that many smaller facilities do indeed offer care that’s of comparable quality to their larger colleagues, and frequently charge less for it.
Partners Community Health Plan, now available in multiple Southeast Ohio and Southwest Kentucky regions, rewards members who choose local hospitals and doctors. Under the plan – a partnership between MedBen and leading area providers – members can obtain lower-cost care from smaller regional hospitals, at the same outcome levels found at facilities in major metropolitan areas.
Partners plans are available to both fully-insured and self-funded groups. To learn more, visit the Partners website or contact MedBen Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.
Not only is aspirin lauded for its ability to limit heart attack damage, it is believed that the painkiller can reduce the long-term risk of dying from cancer. Now, new research shows that there may be a short-term advantage as well.
Bloomberg reports that men and women who took a daily dose of aspirin had a 24% lower rate of developing cancer after three years and were 37% less likely to die from the disease after five years than those who didn’t, according to a study in The Lancet medical journal. Previous research had concluded that it took at least eight years to realize the benefits.
Based on the research findings, it’s also possible that the faster-acting qualities of aspirin may help to prevent tumors from spreading.
“We still need to do trials of aspirin in treatment of cancer to show that the benefit is definitely there if you start taking it after the cancer’s been diagnosed,” said Peter Rothwell, a professor at the University of Oxford who led the research. “But potentially it would be a highly cost-effective way of preventing the spread of cancers.”
As we noted on this blog last July, 2012 looks to be a big year for generic rollouts of popular brand name drugs. WebMD recently reported on two such introductions:
The Food and Drug Administration has ruled that three generic drugmakers may now sell their own versions of the drug Boniva, a once-a-month pill prescribed to prevent or to treat bone loss from osteoporosis.
Boniva, known by the generic name ibandronate, has been officially approved only for treatment of postmenopausal women, as the clinical studies that led to approval mostly involved women. However, doctors often prescribe the drug to men.
A reminder to MedBen plan members who get pharmacy benefits management services through Pharmacy Data Management (PDMI): You can get information about generic alternatives and compare prices through MedBen Access. By clicking on your name under “My Rx Claims” in the sidebar menu, you will be taken directly to the RxEOB service.
To access MedBen Access, simply go to MedBen.com, select “Online Client Services", and click on “MedBen Access".
The Affordable Care Act turns two years old on March 23, and to mark the occasion, Politico has compiled a list of five things to watch for in year three. Below we offer a “teaser” – you can find the complete answers at Politico website.
1) How many states won’t set up their own exchanges? So far[…] a lot of states are not moving ahead. The federal exchange could end up covering as many as 15 to 25 states[.]
2) What’s next on essential benefits? So far, [Health and Human Services] has put out a “bulletin” – less formal than an actual rule – that said states will be able to choose from a selection of benchmark plans. But who in the states, exactly, gets to make that call? And how can states fill in the gaps for benefits not typically offered by their insurers?
3) Who’s forming accountable care organizations? [July 1 is] the deadline for providers to apply to become accountable care organizations – the new networks of hospitals and physicians that will work together to deliver medical care more efficiently under new payment rules, incentives and quality measures. It’ll be too soon to tell whether these ACOs can actually save money without skimping on patients’ care, which is the point of the program. But the sign-up deadline will give everyone a better read on whether providers believe the model is viable in the long run.
4) Will there be more scares about the costs? Each study of how employers may react to the health care law invites potentially damaging answers that speak to people’s worst fears about employers dropping coverage. The studies get widely quoted, and new ones could make the public sour on the law even more.
5) Will there be a replacement plan? Congressional Republicans insist the Affordable Care Act is not the only way to fix the health care system — but they haven’t yet delivered the promised plan to “replace” the law with a more market-driven, state-centered alternative.
Only about 1 in 100 Americans meets seven heart-healthy targets recommended by the American Heart Association. according to WebMD.
The seven behaviors include:
A study conducted in 2005-2010 found that just 1.2% of Americans followed all the heart health habits, a drop from 2% in 1988-1994. Researchers noted that the number of people eating a healthy diet has declined, while the prevalence of obesity and abnormal fasting blood-glucose levels has risen.
There is some positive news, though. Smoking is down from from 28% to 23%, and more people met the ideal heart-healthy level of physical activity (45%, up from 41%). But the percentage of people classified as inactive doubled from 16% to 32%.
The study also demonstrated that heart disease and death risk decreases as more heart-healthy goals are met. People who met six of the seven goals had a 76% lower risk of heart-related death and a 51% lower risk of death from any cause, compared with those who met one or fewer.
More proof that we can learn a lot just by looking in someone’s eyes – especially if you look really close. WebMD reports people who have eye damage involving the blood vessels of the retina have a higher risk for memory decline, according to a new study.
Researchers say that retinopathy – damage to blood vessels in the eyes, caused by vascular disease – may indicate that blood vessels in the brain are likewise not operating properly. Retinopathy is also a common complication of diabetes and uncontrolled high blood pressure, which have also been linked to a higher risk for memory and thinking declines.
If the study is correct, it demonstrates how regular eye exams can identify problems that go well beyond impaired vision – in this case, potentially helping identify people at risk for dementia.
MedBen VisionPlus is a perfect match to your health care plan. Detecting eye disease and other potential ailments early reduces the risk of major medical costs down the road. To learn more about the benefits of group vision coverage, contact MedBen Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.
From John Goodman’s Health Policy Blog: In his new book American Health Economy Illustrated, Christopher Conover of the American Enterprise Institute debunks some widely-held health care myths.
Myth: Relative to other countries, the U.S. spends “too much” on health care.
Differences in income explain 85% of variations in health spending. The U.S. is spending what it should in GDP per capita, while France spends 1/5 too much, and Canada and the U.K. spend too little. Blue states are spending too much due to overregulation (Massachusetts, New York, New Jersey). After RomneyCare, Massachusetts has the highest level of health care spending.
Myth: The U.S. has an abysmal infant mortality rate.
It does rate 43rd, but there is no standard for reporting infant mortality. The U.S. is one of eight countries that count extremely premature infants as live births despite low chances of survival. If we categorize births by length of gestations the U.S. ranks 2nd, 3rd, or 4th (depending on type of rank) to European countries.
Myth: The U.S. lags behind its competitors in life expectancy.
The U.S. ranks 39th, but this is misleading. This distortion is due to a high rate of deaths resulting from violence. When adjusted for deaths related to violence and suicide the U.S. ranks first in OECD countries.
Myth: The U.S. has worse health outcomes than its peers.
Cancer is the second leading cause of death in the U.S., but cancer patients live longer in the U.S.; cancer survival rates are better. The U.S. has far higher screening rates.
Conclusion: The U.S. health system has many problems, but other countries do not offer a magic bullet.
In an effort to address the ongoing contraceptive coverage controversy, the Obama administration has announced how religious organizations than insure themselves can remain exempt from paying for birth control, yet still provide free coverage for female employees and students.
According to The New York Times, the administration said that in such cases, contraceptive coverage will be provided by “third party administrators” or by “some other independent entity.”
As to whom will provide the money to pay the claims for contraceptive drugs and devices, Health and Human Services Secretary Kathleen Sebelius suggested that pharmaceutical companies could provide drug rebates to help cover the cost. Alternatively, the federal government could encourage or require one or more private insurers to provide contraceptive coverage for people in a religious organization’s health plan.
Sebelius said these proposals would guarantee women access to contraceptives “while accommodating religious liberty interests.” Republican in Congress had a different take on it.
“It’s a Washington accounting gimmick,” Representative Jeff Fortenberry, Republican of Nebraska, said Friday in an interview. “The administration is twisting itself in all directions to expand the ‘accommodation’ for faith-based institutions. Why is it the government’s role to decide who gets an accommodation? The White House is creating an unnecessary political firestorm.”
The early onset of Spring weather has certainly been a pleasant surprise. But for allergy sufferers, dealing with sneezing and sniffling sooner than usual means the warm temperatures are a mixed blessing.
However, allergy sufferers need not just accept their plight, advises Dr. Myron Zitt, former president of the American College of Allergy, Asthma and Immunology. “People with spring allergies often don’t realize how many things can aggravate their allergy symptoms, so they just muddle along and hope for an early end to the season. But there’s no reason to suffer. A few simple adjustments in habits and treatment can make springtime much more enjoyable,” says Zitt in a college news release.
According to HealthDay, allergists recommend allergy-sufferers keep their house and car windows closed so pollen can’t drift in from outdoors. Using the proper air filter is also essential.
People with seasonal allergies to grass, birch trees or alder trees may also have cross-reactions to closely related fruits, vegetables and nuts. As a result, grass allergy sufferers may experience tingling, itching and swelling around the mouth when they eat tomatoes, potatoes or peaches. Likewise, those with tree allergies sometimes find celery, cherries or apples risky as well.
Allergists also encourage people to take their medicine even before their symptoms flare, and to see an allergist who can suggest the best course of treatment.
A recent Towers Watson survey of over 500 businesses reveals the wide range of difficulties employers face when trying to keep health care costs in check. As listed on the MedCity News website, the top ten challenges include:
At MedBen, we have the people and the technology to help employers face these challenges – and any other obstacles that may arise along the way. From innovative wellness programs that promote better health habits, to prescription plans that offer superior discount rates on brand name and generic drugs alike, we help businesses of all sizes save money.
Among the many resources we employ to control employer health care expenses is an advanced claims surveillance system. Going beyond traditional cost control measures, the system – working in conjunction with highly trained health care professionals – screens every claim, searching for that “small” claim that may very well have large claim potential. On average, this physician-driven process saves 45.1% per selected claim.
To learn more about MedBen’s array of cost containment tools, please contact Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.
Could 20 million people lose their employer-sponsored insurance in 2019? Highly unlikely, says a new report from new report from the Congressional Budget Office – but not totally out of the question, either.
The 20 million number is a worst-case scenario based on a CBO analysis of the Affordable Care Act. More probable, the agency says, 3 million to 5 million fewer people between 2019 and 2022 will have health care coverage from their employer due to the health reform law. It’s even possible – and here we’re talking best-case outcome – that an increase of 3 million workers with employer insurance could happen.
According to Politico, whether the loss of employer coverage be 2 million people or 20 million, the federal government would subsidize coverage for many of these workers through the new health insurance exchanges or cover them through Medicaid. And CBO estimates that because their coverage would be more than offset by employer penalties and higher income taxes, it would actually reduce the law’s cost.
Regardless, CBO still thinks that “most employers will continue to have an economic incentive to offer health insurance to their employees.” The agency expects changes will stick close to its earliest estimate that 3 million people could lose their workplace coverage.
Cancer experts are advising that women get screened for cervical cancer less frequently than doctors currently recommend, NPR reports.
Guidelines released by the American Cancer Society and two other medical groups now recommend that women wait until they turn 21 to get their first Pap smear, and then only get tested every three years thereafter if everything looks okay. This goes against the long-standing recommendation that screening should begin either at age 21 or three years after the onset of sexual activity.
Debbie Saslow of the ACS says that cervical cancer is rare in young women, so there’s no reason to start earlier than age 21. And the cancer grows very slowly, so there’s no danger in waiting longer between tests. “If you compare the benefit of annual screening to screening every three years with the Pap test it’s almost nothing,” she said.
Also factoring into the recommendation is that Pap tests often produce false alarms, so more frequent testing can result in unnecessary procedures to ensure there’s no cancer, Saslow added.
The new guidelines also advise women to cease Pap smears at age 65, provided there’s no evidence of cervical cancer risk in earlier screenings.
Kaiser Health News offers a handy overview of the legal challenges to the Affordable Care Act, which the Supreme Court will hear over a three-day span later this month. All told, the justices have scheduled six hours of arguments – the most time given to any case since 1966.
At the core of the case is the constitutionality of the individual mandate – the provision of health care reform that would require most Americans to purchase health coverage or pay penalties. The Obama administration will defend the law, while 26 states (along with a business group and four individuals) will challenge it.
The proceedings will begin on March 26, when the justices will hear arguments as to whether the penalty provision of the individual mandate is a “tax", and thus subject to the Anti-Injunction Act. If so, the case could potentially be deferred until 2015, as tax laws can’t be ruled before payments are due.
On March 27, the parties will argue whether or not Congress has the authority to require that people buy insurance under its interstate commerce powers. Defenders say that the individual mandate will end “discriminatory insurance practices that have excluded millions of people from coverage based on medical history,” while critics counter that “the power to compel individuals to engage in commerce in order more effectively to regulate commerce” doesn’t exist.
Finally, March 28 will tackle “severability” – namely, if the individual mandate is struck down, what happens to the rest of the health reform law? Should that happen, the government argues that the ACA could stand, save for “guaranteed-issue” and “community-rating” provisions. The 26 states counter that the mandate was deemed by Congress to be “necessary to make the other provisions work as intended,” and that the court should strike down the whole law.
Studies that confirm the potential hazards of red meat and sugary drinks hardly qualify as front page news nowadays – but the occasional reminder about their risks doesn’t hurt, either. So with that in mind:
Even a small amount of red meat in your diet can significantly increase the chances of premature death, according to a long-range Harvard study. The Los Angeles Times reports that research conducted over 20 years found that that a single daily 3-ounce serving of unprocessed red meat – say, a steak the size of a deck of cards – was associated with a 13% greater chance of dying. And a daily serving of unprocessed red meat, such as a hot dog, increased the risk to 20%.
On the other hand, substituting a serving of nuts for beef or pork was linked to a 19% reduction in the reisk of dearth during the study. Choosing poultry or whole grains also proved beneficial, lowering mortality risk by 14%, while low-fat dairy or legumes decreased risk by 10%, and fish by 7%.
According to Harvard research published by the American Heart Association, men who drank a 12-ounce sugar-sweetened beverage a day had a 20% higher risk of heart disease compared to men who didn’t drink any sugar-sweetened drinks.
Medical News Today reports that the study of over 42,000 men determined that the increase persisted even after controlling for other risk factors, including smoking, physical inactivity, alcohol use and family history of heart disease. However, less frequent consumption – twice weekly and twice monthly – didn’t increase risk.
Beginning in 2013, the Affordable Care Act will change the maximum amount an employee may contribute to a Health FSA plan on a calendar year basis. But if your Health FSA plan happens to run on a plan year basis, it’s critical to be aware of this change and take appropriate measures this year, not next.
Effective January 1, 2013, Health FSA plans may not permit employee salary contributions to exceed $2,500 in a calendar year. For “plan year” groups, this affects your FSA elections in 2012, as the payroll deductions that occur in January 2013 can affect the 2013 Health FSA payroll deductions. Because the maximum deduction for calendar year 2013 cannot exceed $2,500, if a participant elects a greater amount in the 2012-2013 plan year, the amount withdrawn from their 2013 pay could potentially be greater than $2,500.
Example: ABC Company’s plan year runs July to June. Their Health FSA has a maximum contribution of $4,000.
John elects $4,000 in his Health FSA for the July 2012 to June 2013 plan year. He has 24 pay cycles per year (2 per month) and has a total of $333.32 per month deducted from his salary. In July 2013 he elects $2,500 in his Health FSA plan for the July 2013 to June 2014 plan year and has $208.33 per month deducted.
From January 2013 to June 2013, $1,999.92 was deducted on a pre-tax basis ($333.32 x 6 months), and from July 2013 to Dec 2013, $1,249.98 was deducted on a pre-tax basis ($208.33 x 6 months). The total of the two plan year deductions equals $3,249.90, which is greater than the $2,500 permitted by the IRS for the calendar year 2013. This could cause tax consequences for the participants as well the plan for permitted the deductions.
MedBen strongly recommends that groups change their 2012 Health FSA maximum to $2,500 to avoid potential tax issues for plan participants in 2013. Our Health FSA clients with questions regarding this change are welcome to call Sharon A. Mills, Director of Administrative Services, at (800) 423-3151, Ext. 438.
More evidence that newer metal-on-metal (MOM) hip replacements may not be as effective as traditional implants: A British study found that all-metal implants require maintenance at a much higher rate than other types, the Associated Press reports.
Experts analyzed data for more than 400,000 hip replacements – 31,000 of them MOM devices – from the National Joint Registry of England and Wales between 2003 and 2011. After five years, MOMs failed in about 6% of the people studied, requiring repair or replacement. In contrast. the failure rate for people who had ceramic or plastic joints ranged from 1.7% to 2.3%.
Ashley Blom, head of orthopedic research at the University of Bristol and one of the study authors, noted that while over 9 out of 10 MOM implants work fine, the fact that safer alternatives are available means that people need not take the risk. “If I were a patient, I would not choose a metal-on-metal hip,” he said.
Last November, the Food and Drug Administration sponsored a report that uncovered similar failure problems with all-metal hip replacements, and requested that makers conduct safety studies on them.
According to AP, doctors usually expect hip joints to last at least a decade.
March is National Colorectal Cancer Awareness Month – and as such, a perfect time to remind adults between the ages of 50 and 75 about the benefits of getting a colonoscopy.
According to HealthDay, about 1 in 3 U.S. adults who should get screened for colorectal cancer have not yet done so.
“Colorectal cancer is one of the most preventable cancers because the majority of colorectal cancers arise from precancerous growths in the colon called polyps, which can be found during a colonoscopy screening exam and removed before they turn into cancer,” Dr. Gregory Ginsberg, president of the American Society for Gastrointestinal Endoscopy (ASGE), said in a society news release.
Ginsberg also stressed the importance of following pre-colonoscopy instructions carefully to ensure the colon is thoroughly cleaned so no polyps or cancers are missed during the procedure.
MedBen encourages its clients to follow standard guidelines for colonoscopies, mammograms, PSAs and other screenings, as well as an annual wellness exam. MedBen Worksite Wellness members can check their compliance with critical wellness examinations by visiting the MedBen Access website and clicking on the Wellness Plan link under “My Plan”.
A program designed to help people who can’t afford prescription medications has recently come under government scrutiny, Pharmalot reports.
Created in 1992, the 340B Drug Pricing Program offers discounts to public and non-profit health care facilities that provide outpatient drugs. Through the program, participating hospitals and clinics can realize savings of 20-50% off the cost of drugs – and potentially generate additional revenue if government reimbusements exceed prices paid.
But a 2011 report by the US Government Accountability Office found that oversight of the program is inadequate to ensure that participating facilities administer the discounted drugs only to eligible patients, and that drugs are sold to those facilities at or below agreed upon prices. And last week, four Republican members of Congress wrote to several pharmaceutical organizations, including Pharmaceutical Research and Manufacturers of America (PhRMA) and the Biotechnology Organization (BIO), to request detailed information about 340B pricing and audits, and address possible incidents of hoarding.
“With the reliance on self-policing among participating manufacturers and covered entities and the increase in the number of new settings in which the program is offered, the risk of improper purchases or diversion of 340B drugs has significantly increased,” wrote US Senators Orrin Hatch, Chuck Grassley and Mike Enzi, as well as Congressman Joe Pitts.