Oakland, U.S.A. — Ask.com, an online brand for questions and answers, announced on November 15, the results of its job benefits study, conducted online by Harris Interactive among U.S. adults during the month of October. The 2012 State of the Workplace: Benefits and Perksstudy reveals that 95 percent of Americans weigh job benefits and perks before deciding to either stay put or take a new position. Benefits such as health insurance, 401K matching, paid time off and life insurance are so critical, more than half of U.S. workers (60 percent) would rather spend a night in jail than go without.

“Our goal here was to get a national view of what potential recruits value most, while pinpointing how job seekers in the West might differ,” said Lisa Ross, vice president of human resources at Ask.com. “While it’s clear that perks like free massages resonate with Westerners in particular, they pale in comparison to the value all Americans put on benefits like paid life insurance and tuition assistance.”

Healthcare: Worth Sleeping in the Slammer? 
Benefits and perks are so coveted, Americans say they’re worth a night behind bars. Men (64 percent) are more likely to indicate this than women (56 percent).

• U.S. adults (77 percent) list health insurance as the benefit that most factors into their employment decision.
  • Surprisingly, those without children (80 percent) are more likely to choose health insurance than those with children in the household (70 percent).
• Other benefits that topped the list for Americans include:
  • Retirement/401K matching (69 percent)
  • Paid time off (66 percent)
  • Life insurance (54 percent)
  • Ease of commute/proximity to transportation (49 percent)
  • Stock options (39 percent)
  • Tuition assistance (35 percent)

More Me Time, Please!
Americans are also protective of personal time, actively seeking employers invested in their health and well-being.

• More than a third said unlimited paid time off (PTO), telecommuter flexibility, and access to a free on-site gym/fitness center would encourage them to take or keep a job (34 percent each).
• American workers despise time wasted in gridlock. Half of respondents base their decision on a job on how close it is to public transportation, or the ease of the commute (49 percent).

Unlimited Vacation…For Real? 
Unlimited PTO is gaining traction with companies such as Netflix, Zynga and Ask.com embracing the concept. But how do Americans feel?

• Sixty-nine percent said they would be swayed to take a new job if the company offered unlimited PTO.
• Unlimited PTO matters more to single people (42 percent) than those who are married (30 percent) or divorced (27 percent).
• Is it really unlimited? Nearly half of U.S. adults (48 percent) worry about how much personal time they can actually take from their job.

Surprise…What Else They Want

• Western adults (21 percent) are more likely to be encouraged to take or keep a job with an on-site masseuse than those in the Northeast and South (14 percent and 12 percent, respectively).
• A job that comes with a clothing allowance is a big draw for many (26 percent), more so than a childcare subsidy or onsite childcare (22 percent).
• Younger adults (18-34 -year-olds) are more likely to want a nap room (24 percent), free dry cleaning (19 percent), and a personal shopper (16 percent) than adults 35 and older.
• Offering weekend trips planned for employees and their families on anniversaries and birthdays can also sway job seekers (18 percent).

“Silicon Valley companies are known for offering unusual perks like onsite haircuts and laundry service, which are nice-to-haves,” said Ross. “But at the end of the day, what American workers value most are employers committed to their health and well-being and those who are actively invested in their overall quality of life.”

Ask.com also released an infographic here detailing the benefits of adopting an unlimited PTO policy, a benefit the company offers.

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In parts one through four of our series on the Affordable Care Act, we have examined a few of the benefits that are seen as the most desirable provisions of the law, things like no pre-existing condition, no-cost birth control, and the ability for children to remain on their parents’ plans. There are other benefits, like cash subsidies to assist in the purchase of the ACA health care plans that will be examined later in the series. For part five, we will skip ahead and discuss the law as it relates to small business and corporate America.

Who Must Comply with Obamacare?

Under the ACA law, any business with more than 50 full-time employees must offer health insurance to its employees. This health insurance plan must be compliant, meaning the benefits of the plan must meet or exceed the minimum benefit thresholds in the ACA law. If a company does not offer a plan or has a plan that does not meet the minimum standards, then the employer will be assessed a tax fine of $2,000 per employee. This provision is not quite as straightforward, however, because technically the company is only supposed to pay the fine for employees who are eligible to receive subsidized health care costs.

Since everyone is mandated to have coverage, that means the fine would apply to all employees, not just the ones receiving government subsidies. In addition, the first 30 employees are exempted from the fine. For example, a company of 51 workers would pay a $2,000 fine on 21 workers (51-30=21) or $42,000. A good guide for explaining different scenarios can be found at the National Federation of Independent Business website.

If you have fewer than 50 employees, you are not required to provide health insurance. However, if you have up to 25 employees, the government will provide a tax credit if you have employees earning at least $50,000 per year and offer health insurance. In 2013, the tax credit amount is 35% of your annual cost for health insurance premiums and goes up to 50% after 2014.

However, that is only if your average employee salary is $20,000 or less. If the average salary is higher than $20,000, then the tax credit will be reduced by a factor determined by how much the average salary is above $20,000. In addition, if the company has more than 10 employees, regardless of salary average, the tax credit will be reduced. Lastly, there are no tax credits allowed for employees considered “highly compensated.”

For the ACA law, highly compensated is considered anyone making over $80,000 a year. If you noticed how the first sentence in this paragraph contradicts with the numbers in the third sentence, that is not a typo. It is contradictory, but that is what is written in the ACA law. You can find this information at the healthcare.gov and on page 319 of the ACA law.

Implications

The number one implication of the small business and employer provision is the flooding of potential ACA recipients into the system, resulting from employers dropping coverage. Most proponents of the ACA law have dismissed this idea as conservative scaremongering at best and corporate greed at worst. That, however, is because they are not the ones writing the checks. This is a simple math equation. The increase in required ACA benefits increases the costs of the health insurance premiums, because more items are covered.

At current levels, the Kaiser Family Foundation puts the average cost of employee health insurance at $15,073. Only $4,129 of that is paid by the employee, meaning close to 11,000 of the costs is paid by the employer. The ACA coverage mandates will increase those premiums, but even at current levels, paying a $2,000 per person fine is better than $11,000. This is simple math, and as you move into companies that have 5,000 or more employees, you are now talking about saving hundreds of millions of annual costs. Make no mistake, many companies will take this option.

For the companies that bite the bullet and provide health insurance, their costs will increase. This will be because of higher premiums charged by the insurance companies for having to cover more health care benefits and for costs related to keeping up with the regulations that come with the law. There is no definitive way to determine the costs accurately ahead of time, but the Congressional Budget Office projects the costs of ACA to be double what they originally projected.

To be fair, the CBO estimates were for the first 10 years. New projections that go out 11 years have the cost down 0.64%. Why the CBO would go out just one year on their projections is a little strange, especially given the paltry reduction in costs it would show. More telling is that the projection is based on additional revenue provisions that would pay for the law. This is always the problem with the CBO; it only answers questions based on the paper and assumptions put in front of them.

If any of those figures are wrong, if something is left out (like payments to doctors left out by Democrats when the bill was originally submitted), or the revenue gathered is less then projected, then the whole analysis is thrown off. Garbage in, garbage out is the old saying. The primary common sense question to this is simple: When has any government program ever cost less than promised? The answer is never.

The other implication is that the country may see an increase in temporary agency usage. Companies on the cusp of going past 50 employees and either wish to expand or have no choice to can avoid that employee threshold by going through temp agencies. This will alleviate some added costs to them, but only marginally as the temp agencies will also be charging a higher fee per employee supplied.

Lastly, small businesses will not get near the benefit from the tax credit. As discussed above, employers cannot have more than a $20,000 in average salary to receive the full tax credit. If you have higher salaries, the tax credit percentage goes down. Any company that can only afford to pay an average salary of $20,000 or less, in all likelihood, cannot afford to pay for health insurance regardless. Look at the numbers: With an average employer cost of $11,000, an employer could get a $5,500 tax credit, and they pay the other half.

However, $5,500 dollars is a quarter of a $20,000 salaried employee’s pay. A business that small cannot afford to pay that. They cannot afford to risk going under just to satisfy some politician’s belief that paying for health insurance is the right thing to do–no matter the cost. Also, this tax credit does nothing for large employers because they are not eligible. If you have 51 or more employees, you cannot get a tax credit at all. Because of this, there is no incentive.

The primary problem is political and social philosophy intruding on policy and business. Things like health care, time off, vacations, etc., used to be called fringe benefits. They were there to create greater employee loyalty and a way to compete for better employees. They were, in short, extra benefits. Today, they are seen as items that are owed to employees.

The President and the Democrats have determined that health insurance is a right, and if the government cannot get a bill through for single payer, then employers are responsible for paying for that right. Whether this is true (health insurance as a right) is an argument for a different day. The point here is when you approach policy that way, then you end up with bills that have consequences far beyond what is written or intended. Businesses exist to provide a product or service, and make a profit. That is all. They are not smaller surrogates for government to be enlisted in the care and feeding of the population.

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New York, U.S.A. – As the Supreme Court readies for its ruling on the fate of the Affordable Care Act (ACA), sometimes referred to as “Obamacare,” Americans have different opinions on components of the law, depending on the type of health insurance they currently have. Specifically, over half of U.S. adults who have purchased health insurance individually (54%) think employers should not be required to provide employee health insurance compared to only 28% of Americans with employer-sponsored insurance who think this. Additionally, over half of those with individual health insurance (55%) think the government should play a role in assuring access to health insurance, compared to almost two-thirds of Americans with employer-sponsored coverage (64%).

These are some of the results of The Harris Poll of 2,208 U.S. adults (ages 18 and over) surveyed online between June 12 and 14, 2012 by Harris Interactive.

Two thirds of Americans (66%) agree that having health insurance should be a personal choice, so there may be some general disapproval of the ACA’s individual mandate. However, Americans do agree with some of the ACA’s other provisions. For example, over four in five U.S. adults agree that neither children nor adults should be denied health insurance if they have a pre-existing condition (83%) and nearly three-quarters of Americans agree that tax credits should be offered to individuals if they purchase their own health insurance (74%).

However, when looking at the data by the type of insurance respondents currently have, some distinct differences can be seen. Interestingly, among those that have individual coverage, almost half (46%) agree that all people do not need to be covered by health insurance, compared to 30% among those with employer-sponsored coverage and 36% among those that have no insurance at all. Those with individual insurance are also slightly less likely to agree (79%) that adults and children with pre-existing coverage should not be denied coverage, compared to those with employer-sponsored plans (86% adults; 85% children) and Medicare (82% adults; 83% children).

When asked to rate how important 11 different aspects of health insurance are, over nine in ten Americans say access to the doctors, hospitals and services they need is important (91%) while nine in ten say coverage for prescriptions (90%) and availability of insurance if they have a pre-existing condition (90%) are important. Those who have employer sponsored health insurance are more likely than those with insurance they have purchased themselves to say each of the 11 aspects is important when it comes to health insurance. Some of the larger differences are seen when looking at coverage for prescriptions (95% vs. 76%), coverage for preventative care (93% vs. 74%), and coverage for wellness programs (84% vs. 65%).

Additionally, when asked which two things are most important when it comes to health insurance, one aspect rises to the top – two in five Americans say one of the two most important aspects is access to the doctors, hospitals and services they need (39%). The next three are financial as about one-quarter of U.S. adults say financial protection from major health crises (27%), lower out of pocket costs (26%), and low premiums (24%) are most important.

“The importance of health insurance to the American consumer cannot be understated regardless of the opinion issued by the Supreme Court,” said Debra Richman, Senior Vice President of Healthcare Business Development & Strategy at Harris Interactive. “This is especially true for consumers who individually purchase health insurance plans, a market of growing significance to health insurers. It will be imperative for health insurers to increase their focus on how those in the individual market ‘consume’ health insurance, including what plan features they prefer, and what they will and conversely will not choose to buy. Financial protection from major health crises, access to providers, convenience, and quality will be key factors as individual health consumers make purchasing decisions, despite how the Supreme Court rules on the individual coverage mandate.”

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Colorado Springs, U.S.A. – In an effort to improve national health, reduce dramatic rises in healthcare costs, and reduce drowning tragedies, the non-profit, National Swimming Pool Foundation is launching the Step Into Swim Campaign. The 10-year campaign will initially partner with nine organizations that teach children, adults, and minority populations to swim. Beyond the personal pain caused by poor health, the financial burden of obesity is estimated to be $147 billion/year. In addition, the tragic incidences of drowning will cost society about $100 billion for the next 20 years.

Obesity trends are likely to continue based on increased childhood obesity rates and Census Bureau estimates that there will be about 24 million more 65+ year olds in the next 10 years. Aquatic activity is one of the best activity options available for aging and out-of-shape people. Unfortunately, about half of Americans are afraid of deep water or cannot swim. “Becoming a swimmer is the first step to opening a spectrum of fun and healthy activities for the entire family — grandparents, grandkids and everyone in between,” says John Puetz, President of the NSPF Board of Directors.

The Step Into Swim campaign asks private and public sectors to sponsor or donate to organizations that teach people to swim. The National Swimming Pool Foundation issued a White Paper to explain how teaching more people to swim is imperative to address skyrocketing healthcare costs and prevent troubling drowning rates.

“There is a lot of bad health, drowning, and economic news! Here is good news. One simple step will provide a primary prevention practice to improve public health, prevent drowning and help keep our country economically sound and competitive,” declares Thomas M. Lachocki, Ph.D., CEO with NSPF. “What’s better? People will have more year-round fun with friends and family.”

Public and private sector organizations can download the white paper, learn more about the partner organizations and donate to the cause at www.StepIntoSwim.org. The first major campaign event is theStep Into Swim Congress, scheduled for October 10, 2012 from 1:00-5:00 pm, in the Nauticus Museum, beside the Battleship Wisconsin in Norfolk, Virginia. “Today, we have rolled out www.StepIntoSwim.org, where potential donors and sponsors can learn more and make a tax deductible donation. We will also share more about the upcoming Step Into Swim Congress,” explains Dr. Lachocki.

Nine Step Into Swim partners will present proposals at the Congress describing their plan to teach more people to become swimmers. The proposals will focus on swim programs for children, adults who are fearful in the water, and minority populations.

The nine partners are: YMCA of the USA, Jewish Community Centers, U.S. Swim School Association, World’s Largest Swim Lesson, Miracle Swimming Institute, Strategies for Overcoming Aquatic Phobias, American Red Cross, Make a Splash Campaign, and Swim America. “We are thrilled to organize this event and align with and support these organizations,” adds Lachocki. “In addition to organizing the Step Into Swim Campaign and Congress, the National Swimming Pool Foundation also plans to donate on an annual basis,” reinforces Puetz.

“The problem is defined. The solution is clear. The better we work together, the more impact we will make,” summarizes Puetz. “I dream of the day we help a million MORE people take the step to become swimmers,” he adds. Dr. Lachocki agrees, urging public and private organizations, “Please, take the first step by making a donation.”

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Registered nurses at a Manhattan Veterans Affairs hospital failed to notice a patient had become disconnected from a cardiac monitor until after his heart had stopped and he could not be revived, according to a report Monday from the VA inspector general.

The incident from last June was the second such death at the hospital involving a patient connected to a monitor in a six-month period. The first, along with two earlier deaths at a Denver VA hospital, raised questions about nursing competency in the VA system, ProPublica reported last month.

The deaths also prompted a broader review of skills and training of VA nurses. Only half of 29 VA facilities surveyed by the inspector general in a recent report had adequately documented that their nurses had skills to perform their duties. Even though some nurses “did not demonstrate competency in one or more required skills,” the government report stated, there was no evidence of retraining.

Monday’s report documents the June 2011 death of patient in his 80s at the Manhattan campus of the VA’s New York Harbor Healthcare System. The man had undergone several heart procedures and needed to have his vital signs continuously monitored, the report said.

On his fifth day at the hospital, monitor records show that an alarm indicated a problem with the device or the patient. But there is no evidence nurses were aware of the alarm until the man was discovered unresponsive an hour and a half later. He was declared dead shortly afterward, the report said.

“The patient’s telemetry status was not effectively monitored at the time of his death due to a lack of awareness of the disconnected lead,” inspectors concluded.

Registered nurses assigned to telemetry units typically place cardiac leads, set parameters for the monitors tracking each patient, verify heart rhythms and take appropriate actions if there is an irregularity. They also enter progress notes and inform doctors of any changes.

Ironically, federal inspectors were in the hospital the same month to investigate the first death, which occurred in a different monitoring unit in January 2011.

During that investigation, the inspectors discovered nurses at the hospital didn’t understand how the monitors even worked. None of those interviewed could accurately explain what would happen if a patient became disconnected from a cardiac monitor.

Inspectors also found no evidence that the nurses’ competence had been checked. Records showed that one of the patient’s nurses had last received training on the monitors 13 years earlier, according the October 2011. The report recommended sweeping changes and retraining, which the hospital agreed to implement.

IG inspectors were not notified of the second death at the Manhattan facility until someone complained in November 2011, five months after the alarm was missed and the patient died.

The latest report does not recommend any additional changes or training at the hospital because “managers have made significant progress” after the first report.

In a response to the inspector general, the hospital acknowledged receipt of the report and said it concurred with the document. A spokeswoman for the VA in Washington didn’t immediately respond to our requests for comment.

by Charles Ornstein and Tracy Weber, ProPublica, May 15, 2012, 3:06 p.m.

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London, UK – Action on Bladder Cancer (ABC) releases findings from a new National survey^[1] exposing how little the general public knows about bladder cancer. Awareness around the main warning sign for bladder cancer – blood in the urine – is gradually increasing (50% in 2010 rising to 55% in 2012), but still only 5% of the public recognise that smoking is a main cause of bladder cancer.

Over 10,000 people are diagnosed every year in the UK^[2] and ABC, the only UK charity dedicated to bladder cancer, wants to encourage more people to understand how to recognise the warning signs and consult their doctor if they are concerned. Up to date information on the disease and advice on how people can help raise awareness is available through the ABC website (http://www.actiononbladdercancer.org).

The work of ABC supports the Be Clear on Cancer Campaign run by the Department of Health as well as Bladder Cancer Awareness Day which is organised out of the US (this year on May 5th).

Bladder cancer is the 4th most common cancer in men and the 11th most common in women^[2]. Across different areas of health, women are traditionally better informed. Yet, in the case of bladder cancer, one quarter (25%) of both men and women wouldn’t know what a sign of possible bladder cancer might be.

Over half of survey respondents have no idea what causes it. One in five people think it is caused by drinking too much alcohol rather than citing the most common cause of smoking. The main area where public awareness has increased over the last two years is around treatment options. More people recognise chemotherapy (32% in 2010 versus 38% in 2012) and radiotherapy (12% in 2010 versus 24% in 2012) as possible treatment approaches for bladder cancer.

Mr Colin Bunce, Chair of ABC and Consultant Urologist in Barnet says: “We don’t expect everyone to be an expert, but such a huge lack of understanding can lead to people being mis-diagnosed and/or diagnosed at a later stage in the disease which can narrow down the best treatment choices. Over the last 15-20 years bladder cancer has been in the shadows. Greater public attention is urgently needed to improve understanding about the disease so that people know when and where to go for help. We also need to help people take steps to reduce their risk of getting the cancer in the first place, such as giving up smoking.”

Dr Mary Archer, who has been affected by bladder cancer, supports the work of Action on Bladder Cancer: “If you notice blood in your urine, you should consult your GP as soon as possible. It may not be bladder cancer, but if it is, the earlier it is caught the better the chances of successful treatment”, comments Dr Archer. ”Blood in the urine is a sign that you need to be seen by a GP and a specialist urgently.”

ABC is working with healthcare professionals, patients, their carers and the general public, to help improve the treatment and prevention rates of bladder cancer through raising awareness, education and research.

Mr Tony Kirkbank, Trustee of ABC and a Service User, says: “The profile of bladder cancer and, as a result, the care of patients can be significantly improved by asking the public and healthcare professionals and providers to become involved in our dedicated advocacy group, ABC (http://www.actiononbladdercancer.org) – we want to work together”.

References:

http://info.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@sta/documents/generalcontent/crukmig_1000ast-2778.pdf

Survey Technical Details:

GfK NOP conducted a nationally representative face-to-face omnibus survey amongst 2055 adults aged 16+ in 2010.  In 2012 Gfk NOP commissioned TNS Research to conduct a face-to-face omnibus survey amongst 1015 adults aged 16+ in Great Britain.

Weighting was applied to the data in both surveys to ensure it matched known population profiles.

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Washington, U.S.A. – Following Wednesday’s hearing ‘Is Government Adequately Protecting Taxpayers from Medicaid Fraud?’, the Partnership for Quality Home Healthcare praised the House Committee on Oversight and Government Reform for calling attention to the impact Medicaid fraud is having on beneficiaries and taxpayers alike.

The home healthcare community supports tough measures that target and prevent fraud and abuse. In order to strengthen program integrity, home healthcare leaders have developed reform proposals that would prevent payment of aberrant claims and enhance conditions of participation and claims validation processes. Policy solutions that target fraud and abuse can strengthen state Medicaid programs to more effectively ensure that valuable taxpayer dollars are not falling into the hands of fraudulent individuals.

“Medicaid fraud that could amount to billions of dollars per year is a serious problem that must be remedied,” said Senator John Breaux, senior counsel to the Partnership for Quality Home Healthcare. “Wednesday’s hearing underscores the fact that we must do more to protect America’s 50 million Medicaid beneficiaries and the taxpayers who fund this essential healthcare benefit.”

Home healthcare plays a vital role in delivering clinically advanced healthcare services to Medicaid patients requiring treatment for illnesses related to acute, chronic or rehabilitative needs.  Highly trained healthcare professionals and clinicians are helping patients effectively manage chronic diseases with care that was once only available in more costly settings.

Home healthcare services today include cardiac and pulmonary care, physical therapy and rehabilitation, wound care, intravenous (IV) therapies and a myriad of other advanced care services, which are distinctly different from personal care services incorrectly associated with skilled home healthcare.

“Medicaid fraud and abuse must not be tolerated,” added Breaux. “Solutions are urgently needed to ensure we are taking all possible steps to protect beneficiaries and taxpayers alike, which means fighting Medicaid fraud with tough reforms like those crafted by the home healthcare community.”

The Partnership for Quality Home Healthcare was established in 2010 to assist government officials in ensuring access to quality home health services for all Americans. Representing more than 1,500 community- and hospital-based home health agencies nationwide, the Partnership is dedicated to developing innovative reforms to improve the program integrity, quality, and efficiency of home healthcare for our nation’s seniors.  To learn more, visit www.homehealth4america.org .

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President Obama told a packed audience of supporters in Vermont on Friday that America faces a stark choice between a society based on “shared responsibility” and a society “where you’re on your own.” He pledged to continue his efforts to equalize the tax burden and to push legislation which he believes will continue to create jobs and strengthen the economy.

Speaking of his rivals in the Republican presidential primary, Obama said, “Their philosophy is simple: in America, you’re on your own. If you’re out of work and can’t find a job, too bad; you’re on your own. If you get sick and don’t have healthcare, you’re own your own. If you’re born into poverty, you’re supposed to pull yourself up by your own bootstraps, even if you don’t have boots.” He continued, “They believe that’s how America advanced. That’s their cramped, narrow conception of liberty, and they are wrong.”

Obama said the Republican philosophy is reflected in their efforts to cut government programs such as Medicare, Medicaid, and Social Security, deregulate the banks, and create a tax structure that favors the wealthy. That is the same approach that caused the recession in 2008, he said.

“The recovery is happening,” said Obama. “In three years, we’ve created four million new jobs. We’ve rescued the American auto industry. American manufacturing is stronger than it’s been in years. I know there are still a lot of people out of work, and things haven’t gone as fast as we would like, but the last thing we can afford to do is go back to the same policies that caused this mess in the first place.”

Obama’s speech at the University of Vermont in Burlington was the first leg of a fundraising tour through New England. He drew laughs from the heavily partisan crowd when he pointed out that he was the first American president to visit the state in 17 years. President George W. Bush avoided Vermont, a perennial stronghold of the Democratic party and bastion of liberal politics, through all eight years of his presidency. President Bill Clinton visited the state during his first term.

“We’re going the reset the clock on that,” he said. “We love you,” shouted a woman in the audience. “Love you back,” Obama responded, drawing more laughs and cheers.

While avoiding the Supreme Court hearings on his healthcare reform bill, Obama touted the benefits of the law and said it has already had a positive impact. “Two and a half million more young people now have health insurance because they’re allowed to stay on their parents plans until they’re 26,” said Obama. “Seniors have already saved hundreds of millions on their Medicare prescription drug benefits. The healthcare reform we’ve passed will ensure that no one will go broke just because they got sick.”

He said the Republican party originally supported many of the ideas included in the healthcare reform law and that their uncooperative, anti-government attitude is something new. He said some of the country’s greatest achievements, such as the GI Bill, the space program, and the interstate highway system, were only possible with bipartisan support.

“There used to be a common spirit of cooperation, but not anymore, at least not in Washington D.C.,” said Obama. “But outside of Washington, most Americans understand that no matter who you are or where you’re from, we rise and fall as one people.”

Obama concluded by telling his supporters not to be discouraged by the opposition to the changes and improvements he promised when he ran for office in 2008.

“I told you change would not be easy,” said Obama. “I’m not a perfect man – Michelle will tell you that. But I promised I would keep fighting as hard as possible for positive change, and I have kept that promise. We’ll keep working until we’ve finished what we started in 2008. Press on with me. Press on, and we’ll remind the world what America is all about.”

Image Courtesy of    Ryan Rodrick Beiler / Shutterstock.com

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Dr. Gary A. Puckrein, President and CEO of the National Minority Quality Forum, on March 1 released the following statement of concern regarding the Independent Payment Advisory Board (IPAB):

“In our increasingly diverse society, it is important that we have an honest and open discussion about the investment required to enable an American healthcare research, delivery and financing system that will support the provision of the highest quality care to all Americans. Unfortunately IPAB, a cost-containment mechanism that is a provision of the Patient Protection and Affordable Care Act, will stymie that essential national conversation.

“The 15-member Independent Payment Advisory Board (IPAB) will develop specific proposals to contain the growth rate of Medicare spending if it is projected to exceed targets also established by the law. These proposals are transmitted to Congress in the form of legislative proposals that must be enacted or substituted on a legislatively mandated basis. Once it is in place, IPAB can be discontinued only by a joint resolution that must be introduced in January 2017.

Since IPAB is not a government agency, and is not promulgating regulations, it is subject neither to open meetings or public comment requirements. There are no options for appealing the IPAB recommendations. The provisions for judicial review appear to be limited to the recommendations issued by IPAB based upon deliberations that are not open to the public. Judicial or administrative review of the Secretary’s implementation of those recommendations is prohibited.

“The clear intent of the law is to insulate IPAB and its decisions from the full range of traditional democratic checks and balances. This is unwise and unwarranted. Instead of this draconian measure, we must pursue an integrated and practical approach to improving our nation’s healthcare system that will assure that the improved health status of the consumer of those services is the primary measure of success.

“The National Minority Quality Forum urges Congress to abolish the Independent Payment Advisory Board and to engage in the constructive deliberations that are necessary to protect the health of the people they were elected to serve.”

About the National Minority Quality Forum

The National Minority Quality Forum (The Forum) is a Washington, DC-based not-for-profit, non-partisan, independent research and education organization dedicated to improving the quality of health care that is available for and provided to all populations.

The Forum develops user-friendly, web-based disease indices that provide a unique two-dimensional view of the prevalence and impact of diseases by ZIP code, including diabetes, kidney disease, heart disease and HIV/AIDS. Visit the website at www.nmqf.org. Look for National Minority Forum on Facebook , and follow on Twitter (http://www.twitter.com/NMQF).

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The United States Conference of Catholic Bishops (USCCB) have issued the following statement: The Catholic bishops have long supported access to life-affirming healthcare for all, and the conscience rights of everyone involved in the complex process of providing that healthcare.

That is why we raised two serious objections to the “preventive services” regulation issued by the U.S. Department of Health and Human Services (HHS) in August 2011.

First, we objected to the rule forcing private health plans—nationwide, by the stroke of a bureaucrat’s pen—to cover sterilization and contraception, including drugs that may cause abortion. All the other mandated “preventive services” prevent disease, and pregnancy is not a disease.Moreover, forcing plans to cover abortifacients violates existing federal conscience laws. Therefore, we called for the rescission of the mandate altogether.

Second, we explained that the mandate would impose a burden of unprecedented reach and severity on the consciences of those who consider such “services” immoral: insurers forced to write policies including this coverage; employers and schools forced to sponsor and subsidize the coverage; and individual employees and students forced to pay premiums for the coverage.

We therefore urged HHS, if it insisted on keeping the mandate, to provide a conscience exemption for all of these stakeholders—not just the extremely small subset of “religious employers” that HHS proposed to exempt initially.

The President has done two things.

First, he has decided to retain HHS’s nationwide mandate of insurance coverage of sterilization and contraception, including some abortifacients. This is both unsupported in the law and remains a grave moral concern. We cannot fail to reiterate this, even as so many would focus exclusively on the question of religious liberty.

Second, the President has announced some changes in how that mandate will be administered, which is still unclear in its details. As far as we can tell at this point, the change appears to have the following basic contours:

• It would still mandate that all insurers must include coverage for the objectionable services in all the policies they would write. At this point, it would appear that self-insuring religious employers, and religious insurance companies, are not exempt from this mandate.
• It would allow non-profit, religious employers to declare that they do not offer such coverage. But the employee and insurer may separately agree to add that coverage. The employee would not have to pay any additional amount to obtain this coverage, and the coverage would be provided as a part of the employer’s policy, not as a separate rider.
• Finally, we are told that the one-year extension on the effective date (from August 1, 2012 to August 1, 2013) is available to any non-profit religious employer who desires it, without any government application or approval process.

These changes require careful moral analysis, and moreover, appear subject to some measure of change. But we note at the outset that the lack of clear protection for key stakeholders—for self-insured religious employers; for religious and secular for-profit employers; for secular non-profit employers; for religious insurers; and for individuals—is unacceptable and must be corrected.

And in the case where the employee and insurer agree to add the objectionable coverage, that coverage is still provided as a part of the objecting employer’s plan, financed in the same way as the rest of the coverage offered by the objecting employer. This, too, raises serious moral concerns.

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Kids treated more than 150 days after an Anterior Cruciate Ligament (ACL) injury have higher rates of other knee injuries, including medial meniscal tears, say researchers presenting at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day in San Francisco, CA.

“In our research, children who had delayed treatment of an ACL injury more than 150 days, tended to have an increased chance of also having a medial meniscus or chondral injury in their knee.

These additional injuries may increase recovery time, inhibit return to play, and worsen long term functional outcomes of the knee,” said lead researcher, Guillaume D. Dumont, MD of the University of Texas Southwestern Medical Center in Dallas, Texas. “This finding may also be relevant when counseling patients and their families regarding timing for injury treatment.”

The researchers analyzed records from 370 patients who underwent ACL reconstruction between January 2005 and January 2011 at Children’s Medical Center of Dallas. 200 patients were more than 15 years old and 170 patients were less than 15 years old. There were 208 male patients and 162 female patients involved in the study.

Patients were injured in a variety of athletic activities: football (29.7%), basketball (20.2%), soccer (17.6%), cheerleading/gymnastics (4.3%), and other (28.1%).

“Weight also appeared to be a factor associated with the rate of meniscal tears found at the time of surgery,” comments senior author, Philip Wilson, MD. “Our data demonstrates patient weight over 143 lbs (65 kg) to be associated with an increased rate of medial and lateral meniscal tears at the time of surgery. With recent significant increases in child and adolescent obesity rates, this finding may have significant public health implications.”

The study also demonstrated a relationship of age with children more than 15 years old having a higher rate of medial femoral chondral injury. Neither gender nor sport played during injury was found to be associated with an increased rate of injury in the study.

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Pointing to a study he delivered at a recent (Congressional Health Care Caucus), Phil Lebherz, Founder and Executive Director of the Foundation for Health Coverage Education (FHCE), has called upon Congress and the Obama administration to make 2012 a watershed year for adopting a “Point-of-Care” approach with Medicaid’s administrative program in an effort to save as much as $56 billion in administrative costs.

The costs being targeted are derived from complicated and duplicative steps that keep government administrative costs high and prevent qualified Medicaid recipients from seeking needed care.  Delayed treatment often results in higher overall costs, as patients are treated in hospital emergency rooms with higher incidence of requiring surgery and expensive intensive care services.

“If we continue to run government’s biggest program – Medicaid utilizing the program with 1980s technology, we will be out of money before we reach 2014,” said Lebherz.

In his testimony before the Congressional forum, Lebherz laid out the reasoning behind changing Medicaid from a complicated enrollment system to a “point-of-care” program by describing the current holes. The proposed (Point-of-Care Eligibility) system would target a large segment of the population who are eligible for Medicaid, yet are not enrolled, and access their care in hospitals’ Emergency Rooms. With these patients, the hospital is often left with unpaid bills that should be turned into Medicaid or another liable public entity.

The solution of moving to a Point-of-Care concept was created following (Onsite Study) conducted at four Emergency Rooms in San Diego, California in 2011. Over a period of a year, Sharp Healthcare asked 20,000 uninsured patients FHCE’s Eligibility Quiz, and 80.2% were found eligible for free or low-cost public health coverage.

A previous analysis of Medicaid numbers, detailed in this 2011 (Health Affairs article), demonstrates that a “point-of-care” system could solve the uninsured problem for an estimated 17 million Americans and trim billions of dollars from the government budget.

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By the end of 2011, over 10,000 New York State healthcare providers had enrolled into a federally subsidized program that will help them transition from paper to electronic medical records, continuing the effort to improve the quality and coordination of care for all patients across the state. Federal and state data has long shown that health information technologies measurably improve healthcare and reduce its cost.

Called Regional Extension Centers, the program instructs doctors and nurses how to implement EMRs and teaches them how to achieve the federally defined “Meaningful Use” of them, which qualifies them for reimbursements. The program supports mainly primary care providers and small practices, who often struggle with the transition.
New York has two entities that administer REC programs throughout the state. The New York City Health Department, through its NYC REACH program, covers the five boroughs. The New York eHealth Collaborative, a federally designated public private partnership, oversees the rest of the state including Long Island.

Both entities created individualized programs while working closely together on shared goals. By the end of 2011, the REC programs combined had enrolled well over 10,000 providers, with each REC meeting its goal (NYeC goal: 5,107; NYC REACH goal: 4,543).

“Ten thousand is a big number, and we’re proud to have worked closely with our partners at NYC REACH to achieve it.  Of course, enrollment is just the first step, and now we are focused on helping all of these providers reach the Meaningful Use of these technologies.  That’s what will really help providers and their patients,” said Paul Wilder, director of the NYeC REC.

“In New York City, we’ve seen how health IT can help doctors. EMRs let them see which patients are falling through gaps in our health system and help practices set priorities to improve population health,” said Jesse Singer, DO, Assistant Commissioner at the NYC Health Department. “We are excited to help more doctors understand how to use data to improve the lives of their patients.”

“As a physician in a small practice, I can say I greatly appreciate what the NYeC REC has done for us,” noted Eugene Heslin, MD, owner of Bridge Street Family Medicine in Saugerties, NY. Dr. Heslin is also on the NYeC board of directors. “I’m excited to say that all five physicians in our practice have just attested to Meaningful Use.”

“Our practice made the decision to become a member of the REC in 2010.  Although we had successfully integrated EMR in 2006, as a busy OB-GYN practice, we realized that any resource we could tap to expedite achieving Meaningful Use would be a wonderful time management tool and stress reducer,” said Louise West, Practice Administrator at Myrtle Street Obstetrics & Gynecology, PC in Saratoga Springs, NY.

“In March of 2011, our practice was among the first in New York State to achieve Meaningful Use.  I would recommend membership to any practice wishing to achieve Meaningful Use, regardless of their current EMR status.”

“I am proud to be working closely with the extension center,” said Sumir Sahgal, MD, of Essen Medical Associates in the South Bronx. The practice has been working with the NYC Health Department during every step of EMR adoption, and now delivers state-of-the-art care to patients in one of the most underserved areas in the state.

“With more and more organizations adopting EMRs, I am looking forward to even more connectivity and having a full picture of my patients’ health at my fingertips.”

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Hospice of the Western Reserve is kicking off a program to recognize “Hospice Heroes,” a community of individuals, families, and school, church or service groups across Northern Ohio who host fundraising activities that help the non-profit agency provide care to all who need it, regardless of their ability to pay.

Last year, the hospice covered unreimbursed expenses and charity care valued at nearly $5 million in the Northern Ohio region. According to Bill Sluzewski, development officer, fundraising events range from simple activities like selling candy bars, to larger events, like craft shows, benefit concerts and golf outings. “The organizers are often family members or friends of a patient who had been in our care,” he explained.

“Whether it’s a one-time activity or an annual event, it’s a legacy of love that honors their loved one and keeps their memory alive by giving back to other patients and families.” Such is the case for “Misty’s Wish,” created in 2010 by Sherri Viccarone, a resident of Cleveland’s West Park neighborhood, in loving memory of Misty, her teenaged daughter.

Misty, who was diagnosed with a fatal brain tumor, was cared for by Hospice of the Western Reserve during the final stage of her life.  The non-profit agency serving Ashtabula, Cuyahoga, Geauga, Lake, Lorain and Summit Counties, offers one of the few pediatric hospice and palliative programs in the country.

Hospice helped with Misty’s medical supplies, medicine, physical and psychological therapies, and also supported Sherri and the extended family by guiding them the complex healthcare maze and providing emotional and spiritual support throughout the illness.  They also gave Misty an unexpected gift.

One day, a hospice team member asked Misty if there was one wish she would like to have granted before she died. Her response was a surprise to everyone: “I want my Dad to adopt me.” (Her stepfather was the only father she had known as she was growing up.) Within just ten days, Hospice of the Western Reserve’s legal team worked with a Cleveland judge to grant Misty’s wish to be legally adopted.

When Misty died, her mother, Sherri, was determined to tell her story to help other families coping with their children’s terminal illnesses, and to keep her daughter’s memory alive.  She started out by organizing an event called the “Misty Viccarone Christmas Memorium,” which involved collecting teddy bears and donating them to the Cleveland Clinic’s Oncology Department for children undergoing cancer treatment.

In 2010, Mrs. Viccarone and a dedicated group of volunteers expanded upon initial efforts by hosting a commemorative fundraiser with bowling, raffles and prizes. They called the event “Misty’s Wish,” a reference to the final wish Hospice of the Western Reserve helped to fulfill.

The event raised more than$5,000 for the non-profit agency’s pediatric palliative care patients. It was so successful that the group decided to make it an annual event.  Last year’s event, held at Yorktown Lanes in Parma Hts., generated an incredible $8,600. Mrs. Viccarone acknowledges that having a child diagnosed with a terminal illness is something no parent can ever anticipate or be equipped to deal with emotionally or psychologically.

However, she is determined to create something positive from the tragic circumstances.  An important part of her mission is helping other parents and caregivers by expanding awareness of pediatric palliative care.

“When I first tell people about the mission of Misty’s Wish, they’re sometimes shocked and surprised,” she said. “There’s a misconception that hospice care is only for the elderly.  In fact, a co-worker who even knew Misty had died of a brain tumor asked me why there was a need for a pediatric hospice team.

My answer was simple: `Because children die.’” Misty died on July 27, 1996, but thanks to the love and dedication of her family and friends, her memory lives on to help others through Misty’s Wish.

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Individuals who have been homeless are staffing a “homeless hub” launched by two non-profit agencies (along with other health care and social service providers) with the support of the Philadelphia Department of Behavioral Health and Intellectual disability Services (DBHIDS). The Hub of Hope, in a Suburban Station concourse storefront, serves homeless individuals who have been reluctant to make use of services.

The Mental Health Association of Southeastern Pennsylvania (MHASP) worked with Project H.O.M.E. to create and staff the storefront office, which was launched on January 3 and will be open until April.

“We were approached by DBH to come up with creative ways to do better on behalf of the people who had been living in the concourse,” said Michael Brody, MHASP’s director of Service Operations. MHASP interviewed some 20 formerly homeless individuals and “one of the things that came out in these focus groups was people who were formerly homeless talking about how helpful it was to receive help from people who had had similar experiences,” Brody said.

The majority of MHASP staff members are in recovery from serious mental health conditions, including some staffers who have been homeless. “What we’re bringing to this project is employing three recovery coaches who are Certified Peer Specialists” – individuals in recovery who have been trained to help others work toward recovery – “to do outreach to and follow up with people who make use of the Hub of Hope,” Brody said.

The recovery coaches are working with the Student-Run Emergency Housing Unit of Philadelphia (SREHUP) and with the Project H.O.M.E. housing coordinator, and play a major role in ensuring that people who come to the Hub are welcomed, Brody said.

“Peer support staff are working to build trust and relationships with people entering the Hub, and ensuring they are getting connected,” said MHASP outreach advocate Johnathan Evans, himself formerly homeless, who supervises the recovery coaches. “They are helping to walk people through the process of having their medical and psychiatric needs met.”

“People are coming in on a daily basis and really making use of this added service,” Evans noted. At this writing, 95 individuals have already been served. “The certified peer specialist team has been welcoming people into the Hub and reaching out to them in the concourse.

They are introducing them to representatives of the Behavioral Health Special Initiative [which provides assessments, referrals and funding support for persons who are uninsured or underinsured with substance abuse problems] and walking them over to Mary Howard Health Center.”

The Hub is open from 7 a.m. to 9 a.m. and from 7 p.m. to 10 p.m. M-F. “People we encounter in the evening will be given an appointment to come in the morning to link with a recovery coach,” Brody continued. “The recovery coach will be doing outreach to find those folks to bring them back to get them linked with services.” MHASP will also offer psychiatric services one evening a week.

“It has been a wonderful collaboration with Project H.O.M.E. and a number of other homeless service providers,” Brody said, “and we appreciate the support of the Department of Behavioral Health.”

Marcella Maguire, Ph.D., director of DBH Homeless Services, said that DBH welcomes what MHASP brings to the table. “DBH is excited to have MHASP bring its peer outreach services to persons who have severe mental illnesses and are experiencing homelessness. The City has been successful in helping hundreds leave homelessness, but we know that a small group remains on the street despite our best efforts.

MHASP has always been committed to trying new models to assist those most in need, and we hope that this novel use of Certified Peer Specialists will assist many more in leaving homelessness and engaging more fully in their recovery.”

JustASC / Shutterstock.com

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The community contributions made by Minnesota nonprofit and government hospitals and health systems in 2010 totaled more than $3.4 billion, an increase of almost 6 percent compared to 2009, according to the latest Community Benefit Report released by the Minnesota Hospital Association.

The overall increase is largely due to double-digit growth in charity care, which jumped up dramatically by 27 percent from 2009 to 2010. The new data provide evidence that economic challenges bring greater pressure on health care providers, yet hospitals and health systems continue to face those challenges with a spirit of caring and a commitment to improving Minnesotans’ health.

“As nonprofits, hospitals and health systems go above and beyond to make numerous and powerful community contributions, and most of those contributions stay local,” said Lawrence Massa, President and CEO of the Minnesota Hospital Association. “One of the main ways hospitals contribute to their community is by providing high quality health care to our patients, regardless of their ability to pay, and by leading efforts to improve care and lower costs.”

About $1.17 billion of the total was spent on community and health services, education and healthcare workforce development, research, community building activities and cash, in-kind donations to other local nonprofits. In addition, a substantial and growing proportion of hospitals’ community contributions is from providing care without getting paid.

This uncompensated care includes “charity care,” for patients from whom there is no expectation of payment, and “bad debt,” the result of patients who cannot or did not pay their share of the hospital bill. Uncompensated care as a whole totaled $496.5 million in 2010, an increase of about 4 percent from 2009 to 2010.

Another significant driver of hospitals’ community contributions is the difference between the actual cost of providing care and the payments received from caring for Medicare and Medicaid patients. The report details that state and federal government payments to Minnesota hospitals and health systems for these programs were more than $1.3 billion below the actual costs of providing the care.

In all, such government underfunding accounts for nearly 7 percent of Minnesota hospitals’ total operating expenses. The 2011 Community Benefit Report reflects 2010 financial information – the most recent data available, self-reported by Minnesota hospitals and health care systems and supplemented with data reported to the Minnesota Department of Health.

The annual report comprises an analysis of categories of community contribution activities on a statewide and regional basis. Community contributions range from supporting the education and training of tomorrow’s healthcare workforce and medical research to public health activities and community outreach programs, such as health screenings and immunization clinics.

In addition, hospitals and health systems play a crucial role in the economic health of Minnesota’s communities. As the largest employers in most communities, Minnesota hospitals generated $27.2 billionin economic activity for the state and supported more than 214,000 jobs in 2009, according to a study conducted by the Minnesota Department of Employment and Economic Development.

“Minnesota’s hospitals are a tremendous asset for their communities, serving as nation-leading health care providers, community leaders and economic drivers,” added Massa. “It is important that Minnesotans continue to support their hospitals so together we can continue to advance our communities and improve Minnesotans’ health.”

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Two years after the Haiti earthquake, the American Red Cross is helping people rebuild their homes and their lives and improving communities with health, water and sanitation projects.

In a two-year update, the American Red Cross highlighted its emergency work after the 7.0 earthquake struck Haiti on January 12, 2010, as well as its recovery efforts over the past year. Recovery activities have included building homes, giving people opportunities to earn money, providing access to clean water and sanitation systems, supporting the delivery of health care, and teaching communities how to prevent the spread of diseases and be better prepared for future disasters.

“The money donated to the American Red Cross provided life-saving relief to millions of Haitians after the earthquake and is now being used for longer-term solutions such as helping people move from camps to permanent homes and communities,” said Gail McGovern, president and CEO of the American Red Cross.

“Although progress is not as fast as we would like, recovery is well underway,” McGovern said, adding “for example, the pace of home construction has increased rapidly, with the American Red Cross and the rest of the global Red Cross network providing housing to more than 100,000 people at the two-year mark.”

Other highlights of the past year include:

• Providing clean water and sanitation services to more than 369,000 people
• Providing health services and hygiene education to more than 2.4 million people
• Reaching more than 3 million people with cholera treatment and prevention
• Teaching more than 436,000 people how to better prepare for disasters
• Providing livelihoods assistance – grants, jobs and other help – to 114,000 people

The American Red Cross received about $486 million in donations following the earthquake, and has spent and signed agreements to spent $330 million on Haiti earthquake relief and recovery efforts in the first two years. The largest portion of spending has gone to food and emergency services, followed by housing, water and sanitation, health, livelihoods, disaster preparedness, and response to the cholera outbreak.

“In the coming year, the American Red Cross will focus on programs to renew communities, which include constructing and repairing homes, providing clean water and sanitation, health education, livelihood support and disaster preparedness programming,” McGovern said. “We also continue to support hospitals and clinics that are critical to providing access to needed medical treatment in Haiti, and we will maintain our efforts to combat cholera and teach people how to prevent diseases.”

Housing is a priority, and the American Red Cross is shifting its focus from providing transitional homes to building permanent homes and repairing damaged homes so people can return to their former neighborhoods.

Further information on Red Cross work in Haiti, including a copy of the two-year report, can be found at www.redcross.org/Haiti

Image Courtesy of    http://www.flickr.com/photos/expertinfantry/

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American DG Energy, a leading On‑Site Utility, offering clean electricity, heat, hot water and cooling solutions to hospitality, healthcare, housing and athletic facilities, has reached an agreement to supply clean energy to Governor Paterson Towers, a 225 unit, 30 story, residential high-rise, located in Paterson, New Jersey.

Under the terms of the agreement, Governor Paterson will soon receive a significant portion of its energy from a 75 kW combined heat and power (also called CHP or cogeneration) system, which will be owned and operated by American DG Energy. Governor Paterson will receive a discount on the energy produced by the CHP system and reduce its greenhouse gas emissions. The value of the agreement to the company is $1.9 million over the fifteen-year term.

Working with its partner, Peter Westerhoff, to develop this project, American DG Energy will produce clean energy in the form of electricity, space heat and domestic hot water at Governor Paterson Towers and sell it to the residential property at a price lower than the local energy utility rates. Having opted for the company’s On-Site Utility energy solution, Governor Paterson will pay only for the energy used by the property and will avoid all capital, installation and operating costs.

The energy will be produced with small-scale, combined heat and power equipment, located at the property site but owned and operated by American DG Energy. The company will also handle all service, maintenance and repair; therefore, Governor Paterson will not need to provide manpower to support the equipment.

CHP systems offer considerable environmental benefits when compared with purchased electricity and on-site-generated heat from a boiler. By capturing and utilizing heat that would otherwise be wasted from the production of electricity, CHP systems require less fuel than equivalent separate heat and power systems to produce the same amount of energy. Because less fuel is combusted, greenhouse gas emissions, such as carbon dioxide, as well as air pollutants like nitrogen oxides and sulfur dioxide, are reduced.

The CHP system planned for Governor Paterson Towers will be comprised of a CM-75 Ultra by Tecogen, which is equipped with a proprietary ultra-clean emissions technology and has recently been granted the new air emissions certification from the New Jersey Department of Environmental Protection (NJDEP).

This certification eliminates the process of applying for pre-construction operation certification and air permits prior to installation which will save time and money on implementation of this project. In addition, the CHP system is expected to reduce the residential property’s emissions by 252 tons of carbon dioxide annually, the equivalent of removing the carbon emissions of 42 cars each year.*

* Figures were calculated using the EPA CHP Partnership emissions calculator.

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One in three dollars spent on health care in Florida currently pays for unnecessary tests and treatments that physicians order to keep from being sued, according to a new Florida physician poll released by Patients for Fair Compensation. This spending equates to more than $40 billion dollars each year.

The poll, conducted by Oppenheim Research on behalf of Patients for Fair Compensation, showed that of physicians surveyed statewide, 88 percent said they practiced some form of “defensive medicine” in the past 12 months to protect themselves from frivolous lawsuits.

That means patients are paying more so doctors don’t get sued. ”Doctors order unnecessary medical care because they are in fear that one mistake could wipe out everything they’ve ever worked for,” said Richard L. Jackson, chairman of Patients for Fair Compensation, a new not-for-profit advocacy group.

Oppenheim Research, under the direction of Jay Rayburn, Ph.D., Florida State University School of Communications, conducted the statewide survey across a variety of physicians. Those doctors reported that 33 percent of overall healthcare costs can be attributed to the practice of defensive medicine.

According to 2009 data released by the Centers for Medicare and Medicaid Services, healthcare in Floridanow costs $132 billion annually. Based on its poll, Patients for Fair Compensation officials, estimate that more than $40 billion of Florida’s annual health care dollars are spent on unnecessary tests and treatments.

“That kind of money could certainly help pay for the healthcare of many uninsured Americans,” Jackson added. “If we eliminate defensive medicine, we can make healthcare more affordable for everyone.” In Florida’s current medical liability system, physicians risk personal financial exposure with every decision they make. They also abhor the litigation process. These factors force physicians to eliminate every potential threat of litigation, resulting in defensive medicine.

Patients for Fair Compensation was founded to educate and propose policy solutions that eliminate the incentives to practice defensive medicine by replacing the current medical liability system. For more information about Patients for Fair Compensation and the Patients’ Compensation System, visit www.patientsforfaircompensation.org.

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When 27-year-old Nina Sanchez was 13 weeks pregnant, doctors gave her the devastating news that she had kidney failure. At a time when most mothers are eagerly awaiting the journey of pregnancy, Sanchez was grappling with a distressing diagnosis. Her new priority was now, not only her own health, but keeping her baby alive and healthy.

During her seventh month of pregnancy, she went on dialysis. Shortly thereafter, she delivered a healthy baby girl, thankfully, although six weeks early.

Now that her daughter had safely arrived, it opened the realm of therapeutic options for Sanchez. Her team of transplant specialists at Northwestern Medicine determined she would need a kidney transplant or face dialysis for the rest of her life. The search for a living-donor match began.

Sanchez’s brother, Sam Vega, was tested and found to be an incompatible donor.  Just when it seemed she would never get the transplant she so desperately needed, Sanchez received a call from Northwestern’s transplant program with news that a match had been identified through what is known as a paired exchange transplant, which matches one incompatible donor-recipient pair to another, enabling an organ exchange.

“When my doctor told me he found a kidney for me, I was so relieved,” said Sanchez. “I was scared that I wasn’t going to be around to raise my daughter.”

“Patients are often able to find a willing donor,” explained Juan Carlos Caicedo, MD, director of the Hispanic transplant program at Northwestern Memorial Hospital and assistant professor of surgery in the Division of Organ Transplantation at Northwestern University Feinberg School of Medicine.

“But approximately one-third of the living donors are not a match for the loved ones they wish to donate to. Paired exchanges are becoming more common and give more patients the opportunity to find a compatible donor.” Unbeknownst to them at the time, Sanchez and her brother were matched to a father-daughter twosome.

Like Sanchez, Lino Martinez, a 69-year-old father of seven, suffered from kidney failure. His daughter, Maria Ortega, was his donor, but was not compatible. When doctors suggested they participate in a paired exchange, she said the choice was easy.  “I would do anything for my father,” said Ortega. “It was a small thing I could do to give him a second chance at life.”

And like Ortega, when Vega was offered an opportunity to give his kidney to a complete stranger so his sister could receive a kidney, he said he did not think twice. “I was honored to give life to someone else so my sister could have a chance too.”

Martinez received Vega’s kidney and Ortega donated to Sanchez. Following their much-awaited transplants, the two families say they have forged a bond that will last forever.

With paired exchange transplants, recipients’ and donors’ identities are always concealed leading up to and after the transplants occur. The opportunity to meet is always offered. However, unless all parties agree, identities are never revealed. In the case with the Vega-Sanchez and Martinez-Ortega pairs, all parties wanted to meet and by coincidence, all participants were of Hispanic descent.

Northwestern’s transplant team performed its first paired exchange in 2006. Since then, more than 80 paired exchange transplants have occurred. Caicedo says the fact that Northwestern’s transplant program makes a special emphasis on the Hispanic community is a long-overdue and a unique offering in Chicago’s healthcare landscape.

High incidences of obesity, hepatitis B, and hepatitis C among our nation’s Hispanic populations put these communities at higher risk and greater occurrences of needing transplants. The National Kidney Foundation estimates that among the 90,000 people on the wait list for kidney transplant, approximately 16,000 are Hispanic. Furthermore, data provided by the United Network for Organ Sharing rank Hispanics as the second-highest ethnic representation among individuals awaiting liver transplant.

Northwestern’s transplant program caters to the unique cultural needs of all patients. For Hispanic patients, it features unique offerings including, but not limited to, educational sessions for patients and families that are conducted in Spanish and Spanish-language Web-based information about offerings at the Chicago campus and transplant’s satellite clinics.

“We know as healthcare providers that customized patient care is important for everyone,” said Caicedo. “Cultural differences influence how patients respond to care—it’s just as simple as that. For many Spanish-speaking families, family elders make most important decisions. So we know that by involving the family and by making it easy to communicate and easy for them to get information, we have a much better situation such that we achieve successful experiences for patients and their donors.”

Martinez and Sanchez agreed that after years of being sick and on dialysis, they have a new outlook on life. “It has changed everything for me,” said Sanchez. “I can now live a healthy and fulfilling life and be the mother my daughter deserves.”

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It is easy to forget that some Americans, apparently Tea Party members, believe that uninsured people should actually die rather than the United States providing any form of help. That fact was startling clear on Monday night during the Republican debate.

Late in the debate, CNN moderator Wolf Blitzer posed a hypothetical question to Rep. Ron Paul from Texas. “What do you tell a guy who is sick, goes into a coma and doesn’t have health insurance? Who pays for his coverage? Are you saying society should just let him die?” Wolf Blitzer asked. The audience actually cheered at the idea of letting someone die because they don’t have health insurance.

This is the world we now live, allowing other humans to die rather than have some damn socialist system is preferable. Paul interrupted the cheering to offer an explanation for how this was, more-or-less, the root choice of a free society. He added that communities and non-government institutions can fill the void that the public sector is currently playing.

“We never turned anybody away from the hospital,” he said of his volunteer work for churches and his career as a doctor. “We have given up on this whole concept that we might take care of ourselves, assume responsibility for ourselves … that’s the reason the cost is so high.” There are countless examples of people dying because they don’t have health insurance.

This is not a novel idea. It is a reality in everyday America. We can pump out our chests and talk about how proud we are to be an American, but a country that allows 45,000 citizens to die each year because they don’t have the money it not a place I am proud of.

Just the other day, there was another heart-wrenching story about a young girl who died with a very treatable condition because she was uninsured. A ten-year old girl was sent home from the emergency room by two different doctors on two different days, even though during her second visit she was blue around her mouth and nose, had difficulty breathing and couldn’t pee.

She was diagnosed with the “worst kidney infection” this particular doctor had ever seen. The girl died the next day. Although Paul may have an idealistic idea of a free society, that is not what happens. Clearly. Maybe people are not turned away for not having insurance, but they aren’t given the best care either.

I don’t want to live in a society where it is celebrated that people die because they live in the wrong socioeconomic bracket.

Image Courtesy of  http://www.flickr.com/photos/eriklandru/

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I have waited a few days out of respect for 9/11 to say my piece. Although like everyone else, the images and memories of 9/11 are forever with me, I don’t have the same feeling about it as most others. Celebrating the ten year anniversary does not make me particular proud to be an American.

All over Facebook and in the media, people use the anniversary as a way to celebrate the fact that our country survived the worst terrorist attack on American soil. But, did we survive? To me, it seemed like our nation’s complete mentality changed on that day. Instead of hope and optimism, we became scared. No longer wanting to help others or welcome immigrants, we became paranoid.

Every day, it becomes increasingly difficult to find a reason to be proud to be an American. Yes, we like to say that phrase, especially on anniversaries of horrific tragedies and holidays, but are we really proud? The income gap continues to grow in our country, as we become a banana republic where only the wealthy one percent has any power.

More than 45,000 uninsured Americans are uninsured and with no healthcare, children die of treatable diseases. We execute poor men who have been railroaded because they cannot afford lawyers while letting rich men off scot-free even though their greed caused the worst economic crisis since the Great Depression.

We start two wars to fight against an idea and a small sect of radical fundamentalists. We are restricting voting rights to millions of Americans because suddenly Jim Crow laws are back in vogue. We hate a particular religious group because men who perverted their religion were responsible for 9/11 while our own “Christian” religion has become an instrument of hate.

In 2008, it almost seemed like maybe we were letting go of the 9/11 post apocalyptical period. Maybe we could have hope and change and move forward from that day. We elected our first black president, even though he is only 50 percent black. But, the last three years, things have become even worse.

Instead of focusing on the growing unemployment and recession, we worry about a pretend Mosque in New York City or where the President was born. Nothing is accomplished because the focus remains on the negative. The last decade has been bleak. My twenties were spent in a country that seemed comparable to communist Russia.

The media controls the message and the message has been on asinine stuff for ten years, so that the simpletons won’t become enraged at the direction of our country. Let’s focus on Angelina Jolie and Kim Kardishan so no one will notice how many rights we have lost. Pay attention to gay marriage, abortion and those damn welfare mothers who are taking your money so you don’t notice billionaires like the Koch Brothers who are controlling politics and court decisions while raping your mother.

I can only hope that the color will return to our country now that we have survived the first decade after the terrorists shot down our hope and dreams. However, I don’t really see it. Yes, we survived. But, we aren’t any better for it. We did not get any stronger after this tragedy.

We became scared little kids and I am not proud to be an American in 2011. Not even a little bit. I know our country can do so much better. We can help out neighbors and preach love instead of hate. I know we have the ability to do it, but we are so far away from that vision of America. I don’t know if I will see it in my lifetime.

 
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The first new drug to treat Lupus Erythematosus in more than 50 years was approved this month by the U.S. Food and Drug Association (FDA).  Lupus is a chronic, inflammatory, multi-system disorder of the immune system, which causes fibrous tissue and inflammation of internal organs, skin rashes and joint pain.  A facial rash that resembles a wolf bite often accompanies lupus and is what gave the disorder it’s name, lupus meaning “wolf” and erythematosus meaning “redness.”

The new drug, Belimumab (Benlysta), is an injectable drug that was designed to relieve flare-ups and pain.  Benlysta was created — after 15 years of development — by Human Genome Sciences Inc. and GlaxoSmithKline PLC.  The drug is a monoclonal antibody that targets the B-lymphocyte stimulator protein (BLyS).  According to the FDA, this is the first drug designed to target a protein that may reduce the number of abnormal B cells believed to be at the root of lupus.

“Benlysta, when used with existing therapies, may be an important new treatment approach for healthcare professionals and patients looking to help manage symptoms associated with this disease,” said Dr. Curtis Rosebraugh, director of the Office of Drug Evaluation II in the FDA’s Center for Drug Evaluation and Research.

The last drugs to be approved by the FDA for lupus was Plaquenil (hydroxychloroquine), a malaria drug, and corticosteroids in 1955.  Before that, aspirin was approved as a treatment.

Benlysta was approved by the FDA after an advisory committee of independent experts voted 13-to-2 in November to recommend its approval.  At that time, there was some reservations about the effectiveness of the drug.  Most of the drug’s benefit came from relieving muscle inflammation, not organ problems.

A clinical study showed that Benlysta, after one-year of monitoring response rates, was more effective than placebo.  In the study, to be credited with a response, patients had to have at least a four-point improvement in SELENA-SLEDAI score, have no increase in Physician Global Assessment scores of 0.3 points or more, and have no new flares meeting the British Isles Lupus Assessment (BILAG) 1A-2B standard.  That being said, a relatively small proportion of patients met the study’s criteria for a response after one year (43% with the drug vs. 32% with the placebo).

More clinical trials need to be conducted with Benlysta because thus far the drug has been shown to be less effective in African Americans — who are twice as likely as Caucasians to be diagnosed with lupus.  Studies to date were not extensive enough to make any conclusions about whether the drug will be ineffective for all African Americans or not.  Also, the new drug was not effective for any trial patients with the deadliest form of lupus.

Benlysta, even though only modestly effective, should provide encouragement that after more than 50 years of no new approved drugs, there is still a future for drug advancement for lupus.  The drug “will send out the message that it’s possible to conduct a successful clinical trial in lupus and that’s tremendously important to keep the pharmaceutical industry interested in this disease,” Dr. Betty Diamond, a researcher at the Feinstein Institute in New York said.

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