Nov
10
Rationing US Healthcare – Are you Ready?
Filed Under Expat Insurance, Health Insurance, Healthcare, International Healthcare, Medical Insurance, USA Health Insurance | 1 Comment
U.S. President Barack Obama made a major address to Congress in early September 2009, in which he outlined
his plan to fix the country’s US$ 2.5 trillion healthcare system. The healthcare reform plan must pass by the two chambers, the House of Representatives and Senate, before Obama can sign it into law. The current cost estimate for healthcare reform is US$ 1 trillion over the next 10 years by no means a meager price tag; and one which has borne the brunt of the Republican ire. On Saturday night (7th November 2009), after a 12-hour debate with 220-215 vote, the House of Representatives narrowly passed a healthcare reform bill, which clears the way for the Senate to begin to consider the passage of the legislation. The House vote was a vital victory for Obama, who staked much of his political capital on the healthcare battle. With the vote now going to the Senate, the fate of healthcare reform and the Obama’s presidency hangs in the balance.
Senate Democrats will require 60 out of 100 votes to end the debate and bring the legislation to the final vote. Currently, there are a number of moderate Democratic senators whom still have reservations. If the Senate does pass the bill it would need to be reconciled with the House version by a panel of lawmakers, from both chambers, before legislation is presented for final approval. On the other hand, if the Senate does not pass the bill, the House and Senate would have to reconcile their differences and agree on one bill to be passed again, and sent to Obama for his signature.
The President and his officials have repeatedly said that the healthcare bill would be signed into law by the end of 2009. It is their target to get health insurance reform done in 2009, and they are determined to achieve that. The White House has pushed hard to get a bill passed this year; the primary aim was always to establish momentum and call a vote prior to the beginning of the Congressional campaign season, because passing major legislation in a Congressional election year is considered more difficult. The calendar is not looking friendly, it is just less than one month away till end of 2009, and the self-imposed deadline by President Obama means that it will be tough to get approval from the Senate to pass the healthcare reform bill, yet there is still time to see whether the President can adhere to the target.
Healthcare reform involves a permanent change to the entire healthcare system in the USA and it has a, potentially, far greater and longer effect on the US nation than any single other piece of legislation. As mentioned in our 7th August, 2009 post, we have outlined the goals of the Obama administration reforms. In this month’s update, we would like to review some concerns and reasons not to support the healthcare reform bills.
Before we review the concerns or reasons not to support healthcare reform, let us look at why healthcare reform is being considered. Unlike in other countries, under the current healthcare system in the USA, an individual will never be refused admission to a hospital or left on the street by an ambulance just because one cannot produce a credit card or proof of insurance. It is however essential that you are insured for medical expenses because medical costs are highly inflated in the USA. There are currently more than 46 million Americans without health insurance of any kind, approximately another 25 million people are underinsured, meaning their coverage is inadequate for their needs. With the recent economic downturn, there are additional hundreds of thousands of people sent into the category of uninsured as unemployment rates increase. This comes down to the basic economic principle of supply and demand. Another contributing factor to the underinsured and uninsured is that medical costs continue to rise. It has been reported that US$2.2 trillion was spent on US healthcare in 2007, accounting for 16% of GDP, about twice the average of other OECD countries. The rising healthcare costs in turn means that more and more people in America are unable to afford healthcare and rising costs also mean that the Government is spending more and more on Medicare and Medicaid.
There are ongoing debates as to whether to approve the healthcare reform bills. While Americans are concerned about what will happen to their own healthcare if reform passes, they are also concerned about what will happen if reform does not pass. Some of the concerns and reasons not to support the healthcare reform bills are outlined below.
It seems that it is the wrong time for the United States to pursue healthcare reform right now. After all, the US has been in the middle of two wars and a recession. President Obama mentioned that the cost of the healthcare system remaining in its present state is much higher than the cost of healthcare reform. The United States spends more than US$ 2 trillion on healthcare each year, in which about US$700 billion is spent on unnecessary treatments. President Obama has promised that he will only sign a healthcare reform bill that is deficit neutral, meaning that it will not incur one extra cent to the deficit in 10 years. The current estimate is that if healthcare reform passes, it will costs US$1 trillion over the next 10 years. President Obama believes that it can be funded with the removal of waste in the system, in which, some of these savings may not be recognized by the Congressional Budget Office. A few key financing options that are currently on the table include squeezing savings out of Medicare and Medicaid, Taxation on the wealthy, Taxation on employee health insurance benefits, limit the itemized deductions of the wealthy, impose or raise taxes on sugary soft drinks and alcohol, penalize employers who do not offer health insurance and lower the insurance subsidy threshold. Types of funding is however yet to be finalized. If funding is not considered properly, it will add to the burden of an already unstable system.
The fundamental question on healthcare reform is that who will pay for all of these government healthcare costs? The answer is of course the taxpayers across America. The difference between the healthcare system that is in place now and President Obama’s healthcare reform is that under the current system, citizens have a choice to buy insurance. Should this healthcare reform bill pass, an individual will no longer have that option. It is compulsory for everyone to pay for healthcare whether you like it or not. The Government will be in charge of the citizen’s healthcare, the taxation to support it as well as the co-payments associated.
For those people who are struggling to receive healthcare under the current system, it might be great news to them with the passage of the healthcare reform bill in the House. Any individual will be able to enter hospitals in any city in the US and receive healthcare despite whether or not they are covered by insurance. However, questions will likely arise with the Government controlling healthcare; will treatments be provided to all people on an equal basis? Currently in US, many people with disabilities may already be enrolled on the Social Security Disability Income (SSDI) program and obtain cash benefits to support their living, with the passage of the healthcare reform bill, will these people receive the same medical treatment as any other US citizens? Moreover, the current Government is already running many programs like SSDI, Medicare and Medicaid, even more recently,the Cash-for-Clunkers program (a tiny program compared to the budget projected for healthcare), which the United States Government is struggling with running adequately. There are funding and management issues with these few Government programs. With the passage of the healthcare reform bill, the competency of Government Management is surely in question. Will the same Government be able to proficiently run and manage the national healthcare program as well as all the other programs that are already in place?
If healthcare is universal for all Americans, it is likely that there will be a long waiting lists for people to obtain standard healthcare. Individuals who do not have healthcare coverage would however be happy, since there is at least a line that they could wait on. For these people, a waiting line is much better than the alternative of having no medical care. The Government will need to address the issue on resources such as the number of primary care providers available in the US to manage the number of new patients who will be able to access healthcare once the healthcare reform is passed. If there is a shortage of healthcare providers to provide adequate care to patients, then the poor and elderly will likely be put last in line to receive treatment, which brings back to the point stated above on whether treatment will be given to all citizens equally.
Previous American Presidents have tried to bring US into the community of nations that provide healthcare to all citizens. They have attempted seven times but encountered a number of roadblocks and the efforts all failed. Whether the healthcare reform will follow the same path as previous administrations have tried or there will be changes in the whole American healthcare system, it is yet to be seen. After all, rationing a nation’s healthcare system involves plenty of changes. With the pass of the healthcare reform by the House of Representatives, this already signified a historical moment in the history of the nation. Now, we shall wait and see what the Senate brings in and whether Obama can be the last President that can take up the cause on healthcare reform.
Whether the healthcare reform is to the better or worse of the USA, in the midst of all changes, if you do not want to be one of the “victims”, it is best to put in place a private healthcare insurance plan in order to give full protection to yourself and your family.
Oct
2
Good News for People Who like Bad News: Swine Flu Still Here
Filed Under Expat Insurance, Health Insurance, Healthcare, International Healthcare, Medical Insurance, Swine Flu, Uncategorized | 2 Comments
Now that the summer is winding to a close, we can all start getting ready for flu season. Only problem is, it’s come early this year.
Influenza-like illnesses are on the rise in both Britain and the United States. The American Centers for Disease Control and Prevention (CDC) are reporting that influenza-like illnesses have been on the rise in the U.S. for the last six weeks and while the numbers of influenza hospitalizations are similar or below regular flu season levels, it’s still higher than expected for this time of year. Currently, 26 U.S. states are reporting widespread influenza activity. Across the pond in England, numbers of estimated cases are at 14,000 people, which is 5,000 more cases than the previous week.
Swine flu continues to affect every age group, with 79 reported outbreaks in English schools since the start of the fall term with 39 of those occurring in two areas and 49 pediatric deaths in America (pediatric medicine covers infants to adolescents). Swine flu also remains is a major concern for people with severe underlying medical conditions, such as leukemia, and expectant mothers.
Swine flu vaccines are of course being prepared to be rolled out later this year, with the WHO estimating production capacity at 3 billion doses per year. Thankfully, clinical trails indicate that only one dose is necessary to give immunity to older children and adults, but 3 billion doses per year still doesn’t cover the 6.8 billion people walking the earth right now. Given that many countries are reliant upon vaccine donations, Australia, New Zealand, Brazil, France, Italy, the United Kingdom, Norway and the United States have pledged vaccine donations for developing countries. Understandably, the WHO is open to similar contributions and support from other countries.
On a sadder note, a telephone survey carried out by Consumer Reports found that only 34% of U.S. Adults would definitely get vaccinated. Furthermore, only 35% said they plan to have their child vaccinated, with 14% decidedly against the idea of vaccinating their child. Of all the people who are currently undecided or opposed to getting vaccinations 63% said they wanted to build ‘natural immunities’. This is, unfortunately, a tragic misunderstanding with potentially fatal consequences, according to Dr. John Santa, the director of health ratings for Consumer Reports, “[y]our body produces exactly the same antibodies, whether it’s from a ‘natural’ infection or from a vaccine[.]”
While the vaccine is still in the mail, let’s take a quick moment to reflect on what we can all do to help us, and those around us, not get infected. Wash your hands! With Soap! Let’s be clear now, running half a second’s worth of water over your hands and not even glancing at the soap dispenser accomplishes absolutely nothing. Given that influenza is communicable either by direct person-to-person transmission (the genius next to you on the bus is coughing and sneezing on you), or through surface contact (someone sneezes on an object, then you touch the object and then your face), it’s always a good time to wash your hands.
It is also important that if you’re going to cough or sneeze that you cover your mouth. While this may seem like a simple enough thing to do, most people just don’t do it. If you’re going to use a tissue to cover your face when coughing or sneezing, cover your face with it and then make sure to throw the tissue away. Carrying around a tissue filled with germs isn’t good for anyone and it sort of makes you a disease vector. Should you not have a tissue at hand, cough or sneeze into the inside of your elbow. Given that the influenza virus can survive on the surface of objects, if have the flu and you cough all over your hands and don’t wash them immediately, you’re basically spreading the virus to every object you touch after that. Trust me, that’s a bad thing.
Please take care as we come closer to the regular flu season, especially now that children have gone back to school. It is important that we all make an effort to stay clean and not get sick, please, for the sake of us all, make sure that you know how to wash your hands and cover your face properly. More importantly, put your knowledge into practice. Stay safe, I’m off to wash my hands.
Sep
21
Dirty water, clean to drink
Filed Under Health Insurance, Healthcare, Medical Insurance, USA Health Insurance | 3 Comments
Many nations around the world are faced with a wide range of water problems. This is especially true in many developing countries such as the Republic of Congo, Mauritania, Bangladesh and India. These countries are facing severe shortages in drinking water and the technology to improve water quality. There is no equipment or facilities available to make the water safe to drink. The leaders of these countries cannot provide quality clean water required by their residents. Citizens have no choice other than to consume water that is in the form readily available to them, even knowing that the water is unclean and may contain a number of hazardous diseases, including ailments such as Diarrhea, Cholera, and Malaria. The lack of clean and safe water has caused deaths to millions of people all over the world.
If you think that failure to provide safe drinking water to all people only happens in third world countries, well then think again. While unclean water is a problem in many developing countries, it is shocking to learn that tap water in many parts of the USA has been contaminated with pollutants such as heavy metals, chemicals and inorganic toxins. These constituents in the water are highly harmful to human bodies and they are mainly released from chemical factories, manufacturing plants and coal mines.
The USA has the largest and most technologically powerful economy in the world, with a per capita GDP of US$ 47,000.The country is full of technological pioneers especially in computers, medical, aerospace, and military equipment. The nation is supposed to have one of the safest public drinking water supplies in the world. Most Americans get their tap water from a community water system. The US Environmental Protection Agency (EPA) regulates drinking water quality in public water systems and sets maximum concentration levels for water chemicals and pollutants.
Despite this attempt at instituting a fully formed regulatory system, contaminants have been identified in water systems throughout the United States, raising major concerns about the safety of “supposedly” potable water in America. Tap water in West Virginia was found contaminated with arsenic, barium, lead and manganese. Pesticides (Atrazine) were found in drinking water in Chicago and across a number of states in the Mid-West US. In addition to this, chemical contaminants were shown in drinking water wells near natural gas drilling rigs in Philadelphia and Wyoming. Failure to provide even the most basic water services for billions of people in the USA and the devastating human health problems associated with this failure are at the heart of the country’s water problems, and perhaps contribute to the current poor health of the American populace as a whole.
Recently, in Charleston West Virginia, heavy metals runoff from the coal industry have been poisoning the whole community. Analysis of the potable water supply has shown the existence of contaminants like arsenic, barium, lead and manganese at concentrations that could lead to cancer, and cause damage to an individual’s kidneys and nervous system. Some immediate effects were already found on residents that have had contact with the contaminated water, and whom developed symptoms such as rashes on the body and tooth enamel being dissolved. Residents are complaining of increasing health problems such as gall bladder diseases, fertility problems, miscarriages and kidney and thyroid problems. Some of the symptoms may take longer to detect as heavy metals accumulate in the body, and may link industrial contamination of municipal water supplies to cancer, birth defects and neurological disorders.
One of the contributing factors, which leads to the occurrence of these incidents is primarily due to companies that are violating the Clean Water Act by discharging excessive amounts of toxic waste into the environment. It was reported that the largest U.S. industrial, municipal and federal facilities discharging dangerous chemicals were in serious violation of the Clean Water Act, and had disposed over 500,000 times more industrial waste into the water system in 2009 than in the last five years. Most of the violations have gone unpunished, with state regulators taking significant action in just 3% of all cases.
Another reported case on contaminated water takes place in Chicago where pesticides (Atrazine) have contaminated watersheds and drinking water throughout most of the central United States. The states with the most severe contamination of drinking water included Missouri, Illinois, Indiana, Nebraska, and Iowa. Atrazine is the most commonly detected pesticide in the U.S. water system and is a known endocrine disruptor, which means that it affects human and animal hormones. Atrazine is actually one of the chemicals regulated by the U.S. Environmental Protection Agency (EPA). Under the Safe Drinking Water Act (SDWA), it was determined that if an annual average of no more than 3 parts per billion (ppb) of atrazine is present in drinking water, it is “safe” to drink. Atrazine concentrations in the water system in Versailles, Indiana and Mt. Olive, Illinois were found to be at 4.6 ppb and 3.79 ppb respectively.
However, there are possible flaws when setting the maximum contamination limit. Setting acceptable standards based on the annual averages means that there is a serious risk of running on faulty assumptions; Atrazine contamination levels will fluctuate throughout a reporting period, peaking at extremely high levels which may go unrecorded. Long term exposure to Atrazine could have a considerable impact on an individual’s reproductive system. Moreover, the regulations are set based on a safe level of consumption for an average weighted adult with presence of one chemical; they do not, however, take into account the combined toxicity effect of two or more chemicals. The strength of combining two or more chemicals may not increase in a linear manner proportion to the number of chemicals present in the water, it can be an exponential increase in a magnitude of 1,000 times. In addition to this, the terrible health effects of consuming these highly toxic chemicals are magnified many times over for small children, since their systems are more sensitive and are less developed; their bodies are unable to detoxify certain harmful chemicals. Small children also tend to consume a much larger volume of fluids per unit of their body weight, and as such children absorb a much higher dose of these toxic chemicals into their body. Unfortunately, EPA has not taken into account any of these factors when setting the maximum contaminant levels.
While there is no doubt that the big manufacturing companies have contributed to the water contamination problems, we as individuals are also the ones to blame. The majority of the contaminants found in our drinking water can be traced to improper or excessive use of ordinary compounds like lawn chemicals, gasoline, cleaning products and even prescription drugs. Once we realise that whatever goes down to the drain eventually winds up in our water supplies, we need to be extra cautious in what we flush down the drain.
US Government scientists have found contaminants in drinking water wells near natural gas drilling rigs during August, 2009 in Philadelphia. The gas drilling companies involved repeatedly told the public that the gas drilling technique that they were using were safe. The drilling technique involves injecting water and other fluids into the well and have the potential to create cross-contamination. Residents who live close to the drilling vicinity are still highly concerned over the gas-extraction technique used, which may possibly have adverse impacts to their health. One can understand the worries of the local residents as some said that their well water had become discolored, foul-smelling or tasted bad, in some cases water was black and oily. Up to date, there is still no conclusion on the cause of contamination but the gas drilling technique is a highly suspect cause of contamination.
Earlier in March and May this year (2009), the EPA also found contaminants in 11 out of 39 wells tested around the Wyoming town of Pavillion. Chemicals found may cause illnesses such as cancer, kidney failure, anemia and fertility problems. Among the contaminants found in some of the wells was a solvent used in natural gas extraction, 2-butoyethanol (or 2-BE), which may cause breakdown of red blood cells, leading to blood in the urine and feces, and can damage the kidneys, liver, spleen and bone marrow.
Since 1999, the number of violations of the Clean Water Act has increased, while the number of inspections carried out by EPA remained roughly the same. There seems to be a shortage of resources to perform the work effectively. The EPA seems to be failing in its task of ensuring that companies comply with the regulations and at the same time carrying out the enforcement activity for those companies breaking the law; ultimately to ensure no polluters escape from any punishment. People put a lot of effort in establishing their lives, families and businesses in these cities. What is it all worth when a simple necessity of clean water supply cannot be fulfilled, especially in a developed country like the USA.
Globally, there are about 2.3 billion people suffering from diseases linked to dirty water each year. Among this number, approximately 3.6 million people die from water-related diseases, it is estimated that about 98% of water-related deaths occur in the developing countries and about 43% of water-related deaths are due to diarrhea. In the USA, roughly 19.5 million Americans fall ill per year from drinking contaminated water with parasites, bacteria or viruses. This figure is excluding water-related illnesses caused by toxins and chemicals. Given that the USA is a more developed country, people suffer from water related diseases in the country is about 1% of the total, which is deemed high.
It is a good intention that President Obama has committed to ratify healthcare reform to provide healthcare stability and security for all Americans. However, it is not going to help when fulfilling the basic needs of safe water is not even available. If contaminants are continuously found in water leading to adverse health problems in US residents, there is no point in carrying out health reform. US citizens all deserve the right to know what polluters are dumping into the communities. While the former Bush Administration severely limited the information disclosed to the public about toxic pollution released into the communities, we hope that the new Obama Administration will keep his word and will be able to make a change as he had promised. After all, president Obama does not want to be interrupted by people like Joe Wilson yet again, telling him that “You lie!”.
Aug
7
Medical Cash for Clunkers: Rejuvination on the way?
Filed Under Healthcare, Medical Insurance, USA Health Insurance, Uncategorized | 1 Comment
The hot topic currently dominating American news headlines is President Obama’s proposed healthcare reforms, and with both Congress and the Senate on their August recess until September 8th speculation is running rampant as to what actions, if any, will be implemented by the proposed House Healthcare Bill titled “America’s Affordable Health Choices Act of 2009”. There has been much argument on both sides of the political arena as to the need of such an act, and the need for reform. However, with so much spin flying left and right it is understandable that the average American might be slightly confused about the facts. As promised in our last post, we are here to try and dig through the deluge of misinformation and try to enlighten you as to the truth of healthcare reform in modern
By now it should come as no surprise that the
Step forward President Obama.
It is not news that even as a Senator, Obama was keen to implement changes to a necrotic, decrepit, and rapidly deteriorating medical system. As we mentioned in our June 18, 2008 post however, he planned to accomplish a rejuvenation of the system primarily by forcing the extinction of paper as a medium to convey patient information and medical records. The paperless healthcare system is still a primary goal for the now president, but a wider range of initiatives are potentially on the books. The goals of the Obama administration reforms include, among other things:
Reduce long-term growth of health care costs for businesses and government
Protect families from bankruptcy or debt because of health care costs
Guarantee choice of doctors and health plans
Invest in prevention and wellness
Improve patient safety and quality of care
Assure affordable, quality health coverage for all Americans
Maintain coverage when you change or lose your job
End barriers to coverage for people with pre-existing medical conditions
It would seem that these objectives are relatively straight forwards, full of common sense, and indeed necessary to revitalize the system and ensure that American citizens are no longer beholden to the insurance organizations “protecting their health”. However, as always in the 
Let’s be quite clear on one thing, the reforms are not meant to establish a universal healthcare system. Yes, there has been debate on the subject, but the reality is that, due to the very makeup of the US political system any Bill or Legislation that aims to create an NHS style healthcare network would fail miserably (remember that both the Senate and Congress must pass a bill in order for it to become law). The Republicans would scream bloody murder at the merest hint of such reform, and the more fiscally conservative Democrats would be none too pleased either.
No, Obama’s current objective is to create an equal playing field for all Americans to receive comprehensive healthcare coverage (whether received by a private health insurance company or through a government run program like Medicare or Medicaid), and ensure that should they loose their job, or suffer a major illness, the coverage will not cease. In addition to this, the President has placed a large emphasis on the ability of the American consumer to choose their healthcare plan. If the goal was to institute a universal healthcare system, it would be a case of “one plan fits all”, by clearly stating that his aim is to give the consumer freedom of choice when it comes to their medical protection, the President has given us a great deal of insight to his driving force – let the market be free and active, but also competitive and fair. The idea here being that the insurance companies offering the best coverage conditions will thrive, while those that impose hefty exclusions, automatically large deductibles or excesses, and engage in the dubious practice of recision will fail.
However, as part of the usual everyday politicization that occurs in the
Town hall meetings across the
The objective of reforming the healthcare system in the
In addition to this, the American health insurance industry stands to learn a thing or two from current “best practice” as it exists in the international marketplace. Current international health insurance plans will automatically allow a policyholder to visit the hospital or doctor of their choice, anywhere in the world – which is quite a big step up from freedom of choice in your home town. Guaranteed renewals, self selected deductibles, very high coverage limits, and a range of other standard benefits make global health insurance a radically different product to the insurance options currently available in the USA, and at the end of the day President Obama’s reforms really only emulate that which is standard in the international community.
Here at International Insurance News we believe in giving the consumer all the information that they need to make an informed decision. Any reforms which would see coverage improved and extended cannot help but make for a better product, at the end of the day it will encourage healthy competition and eliminate bad business practices. But it is the American consumer who will need to be vocal on the issue and see beyond politicized fabrication by special interest groups.
All this huffing and puffing and there hasn’t even been a vote yet. It will be interesting to see what happens in the coming weeks, and as always, we will keep you updated.
Jul
31
Genetic Changes Could Pose More Problems: The Global Flu Situation
Filed Under Medical Insurance, Uncategorized | 5 Comments
The word is out on Swine Flu. The international community has recognized the threat that the virus poses and has moved rapidly to deal with the situation, mainly by producing mass stocks of TamiFlu and making loud noises about ensuring the right population segments receive the vaccine. This is all well and good, not to mention exactly what we expect from our world leaders, but the question could be posed that, perhaps, we are focusing on the H1N1 strain of flu a little too extensively?
On the 30th of June 2009, a report was released by the South China Morning Post (subscription required) outlining the details relating to a wide spread infection of H3N2 flu throughout
At the issuing of the afore mentioned report Swine Flu accounted for 49% of all flu infections in Hong Kong, while the H3N2 strain accounted for 43%. However, without knowing what the genetic changes in the virus actually mean, these figures are not terrible in and of themselves. What is concerning is the fact that the genetic mutation observed in Hong Kong has also been noted by public health officials in
H3N2 Flu viruses are not new to science, in fact, none of the “A” type influenzas are unknown – they all tend to occur seasonally in populations around the world. Swine Flu, for instance, is a relation to the Spanish Flu of 1918 – 1919 (one of the main reasons for inflated levels of caution when dealing with this strain), and reappeared in North America during 1976 – leading to one confirmed fatality and a Presidential decision for national vaccination across the
The first identification of an H3N2 influenza strain occurred in 
All of the A Type Influenzas (H1N1, H2N2, H3N2, H5N1, etc) are naturally carried by wild Fowl, and have been demonstrated to be transmitted between wild fowl and humans or pigs. These viruses can then be transmitted from Humans to Pigs or Humans to Domestic poultry. The 2009 incidence of H1N1, or Mexican Swine Flu, is thought to be based in a transmission from pigs to humans at pig farms in rural
This transmission vector means that in certain parts of the world, those where humans, swine, and poultry live in close proximity to each other, it is relatively easy for new flu strains to occur. This fact is evidenced by the recent global outbreak of Mexican Swine Flu which is believed to have jumped from pigs in massive industrial farms to humans. A similar situation is with regards to the H5N1 strain of Avian Influenza (Bird Flu), which continues to have periodic outbreaks in areas with large numbers of migratory birds. Avian Influenza is believed to have jumped from domestic fowl and poultry populations in southern
All of this information means that while healthcare professionals and scientists may have a general understanding of the way that global pandemics may progress, we cannot be 100% certain of any given outcome. Which is why, when the mutation of the H3N2 virus was noted in
The fact that Swine Flu has been relegated to a “second tier” of news rather than dominating headlines around the world should raise some serious alarms. While most major governments have assured their populations that the resources are in place to fight the pandemic, the question of whether those resources will continue to work going into the northern hemisphere’s winter months remains unanswered. If the genetic changes in the H3N2 virus prove to be worse than we currently imagine, and if those changes – as currently thought – have the potential to render current anti-viral drug stocks irrelevant, how are we prepared to deal with the fallout?
In places like the USA, where the headlines are currently being dominated by a debate on Obama’s Healthcare Reform Proposal (a topic on which we will expand in a later post), it is understandable that Swine Flu, perceived in the USA as a relatively mild seasonal flu, is not receiving the full attention that it deserves. However, with the H3N2 mutation being observed in populations where the Swine Flu infection is spiraling out of control (as in Britain, where the number of confirmed cases has exceeded 55,000 people and is rising) something must be done sooner rather than later.
Who knows what the end result could be.
Jun
29
Market Competition: American and International insurance
Filed Under Health Insurance, Healthcare, Income Protection, International Healthcare, Medical Insurance, USA Health Insurance | Leave a Comment
Despite the fact that recent polls show approximately 72% of the American populace are in favor of a government-sponsored health insurance plan and the common sense idea that sooner would be better than later, the legislative leaders of the country seem to have instead let the discussion drift into politics.
Various Democrats have proposed plans either involving a public plan, an individual mandate to force people to buy insurance (probably with some form of government subsidy), or some kind of reform with a “trigger”, whereby if the market for health insurance does not rectify itself within a period of time then a public plan would be introduced. On the flipside, Republicans leaders have put forward a plan for health insurance reform which, to be fair, is somewhat less than substantive as it does not include any numbers or data.
While most of Washington has been consumed by the bickering, not all have been sitting on their hands. After an investigation by the New York attorney general’s office as well as a congressional investigation, it came to light that American insurance companies have been using a database run by Ingenix, a subsidiary of managed health care company UnitedHealth Group, that allowed many American insurers to routinely underpay U.S. doctors and hospitals for out-of-network care administered to American patients, ultimately saddling average Americans with the remainder of the costs. A separate congressional hearing has landed some insurers in hot water over the practice known as recission, where they have revoked some individuals’ coverage based on medical history after the individuals’ had already paid their premiums.
The Ingenix database worked by taking claims data submitted by its customers, the insurers, and developing payment rates for out-of-network medical services. Here’s the rub, the insurers were found to have been cleaning up their claims data before sending it to the database by removing many high costing data points. Ingenix itself would then use highly suspect statistical analysis to arrive at rate estimates for how much insurers should pay for medical services provided by medical facilities not in their insurance networks. The end result being that the reduced cost of the initial data, along with statistical tweaking, forcibly and falsely pushes down the amount they have to pay on a claim and also increasing the amount the patient has to pay out of pocket.
On top of all this, Americans are paying more than ever for health insurance and health care. A report from the U.S. Department of Health & Human Services shows that not only are rising premiums a concern, but deductibles, the amount of money you must pay for medical expenses before insurance covers the rest, and copayments, the amount of money you pay each time you see a doctor, have also risen steeply over the years. Average deductibles for families have risen in price by 30% over two years and the number of people with employer-based insurance and copayments over US$25 rose from 1 in 5 to 1 in 3 between 2004 and 2008. So what exactly is wrong with local American insurance policies that are causing such problems?
One reason is because of the way the U.S. health insurance market is set up to begin with. Because each state is entitled to a large amount of self-governance, there are, in effect, 50 different markets, each one is its own particular mishmash of state and federal rules, and each one quite distinct from the others. In and of itself this isn’t a problem, however, it does make it easier to gain a majority of market share. A recent report shows that there have been 400 mergers involving health insurance companies in the last thirteen years. The result of this has been that 94% of American statewide health insurance markets are now considered “Highly concentrated” by U.S. Department of Justice guidelines. By the aforementioned guidelines, a market can be considered as “highly concentrated” if more than 42% of the market’s share is controlled by one company. Experts have noted that healthy competition in the market place is a key way of keeping costs and premiums down.
Thankfully, this is not a problem for companies providing international insurance policies. As we saw earlier, local American policies, much like local health insurance policies everywhere, are restricted in their choice of medical facilities and doctors based upon the insurer they have and the network of medical facilities that will accept their coverage. Most international health insurance plans do have two areas of coverage, one being worldwide, and the other being worldwide excluding the U.S., due to the fact that the cost of health care in America is so high. Still, international health and medical insurance plans will generally afford you access to any hospital or doctor of your choice and pay your claim up to the limits of your policy. Even a policy excluding coverage in the U.S. will often provide emergency coverage if you are traveling through the country.
The fact that the vast majority of international health and medical insurance plans’ give you access to global network of participating medical facilities means that insurers have access to similar networks and must work for market share through offering products that compete through benefits and costs. This keeps down the price of premiums as well as out of pocket costs like deductibles and coinsurance.
The constant competition for customers in the international health insurance marketplace means that customers are as important to insurers as the insurance is to the customer. In order to provide products that are attractive to customers over the long term, international health and medical insurance plans are community rated and guaranteed renewable for life. Being community rated means that each age groups’ premium is based upon the average cost to insure the most average of people. Basically, should you develop a costly or chronic condition, you are guaranteed to be able to renew your insurance for the rest of your life if you wish, without having your premiums raised significantly every year due to your claims history.
While local health insurance plans in America and elsewhere may initially appear cheaper, often times they end up being cumulatively more expensive as people age or if they fall seriously ill causing their premiums and out of pocket costs to rise. Because of a more fluid, open market in the international health insurance industry, the inflation of insurance costs to consumers is kept down and plans have become more competitive over a longer period of time.
May
5
Spanish Flu vs. Swine Flu. Are we prepared this time round?
Filed Under Health Insurance, Healthcare, Medical Insurance, Swine Flu | 1 Comment
In the modern day and age we as a human race have not experienced a major pandemic outbreak since the days of the Spanish flu, where it is estimated that 50 million people of the worlds population was wiped out. Prompting the question, are we prepared this time round? Do we have adequate methods in place now to deal with an outbreak of such scale? Can we prevent a pandemic with the possible power to kill a substantial percentage of the world’s population?
After less than a week of the worlds attention been drawn on the outbreak of the suspected next major pandemic, swine flu, the World Health Organization (WHO) has raised the global health alert from 3 to 4 to 5. Level 5 being a pandemic is imminent and level 6 being there is a pandemic and all humanity is at risk of catching the virus. This alertness shown today is in stark contrast to that shown during the Spanish Flu. Because of strange symptoms and lack of early dialogue between health officials of different countries, the Spanish flu initially was misdiagnosed as dengue, cholera or typhoid. This lack of early diagnosis and of Spanish flu was only exacerbated by the fact there was no global coordinated effort or central health body, thus allowing for no uniformed coordinated resistance against the pandemic, like those in place today in the form of the World Health Organization. Another significant factor contributing to the lack of early awareness during the Spanish Flu was the ignorance towards the matter shown by politicians during the pandemics infancy. This however is quite different from today where governments and politicians alike acknowledge the high risk of Swine Flu becoming a global pandemic and have begun planning for the worst case scenario. Such as in Hong Kong where a whole hotel guest list has been quarantined by the
Current antiviral stockpiles suggest that if there was a major outbreak of swine flu in the world, even the most powerful affluent nations such as U.S.A, the
With the widespread economic downturn facing the world it may seem that we are financially unstable and unprepared for a pandemic outbreak. However this may be the case but we are structurally and financially more prepared than in 1918 during the Spanish flu outbreak.1918, post war depression and war weariness rocked
Apr
28
Towards the Edge: Recession Presses Need for Change
Filed Under Health Insurance, Healthcare, Income Protection, Medical Insurance, USA Health Insurance | Leave a Comment
America has been in need of healthcare reform for some time now with government health services slated to become an ever larger part of the budget in the future, while the increasing cost of private health insurance has outstripped growth in income by about 3 to 1 over the previous years. While the government debates reform, the recession is having an increasing impact on people and may be a driving force in the widest ranging healthcare reforms in the United States in years.
One fact about the American healthcare system that is fast becoming apparent is that it doesn’t function very smoothly. America has the highest medical costs in the world and the price tag does not always guarantee the highest quality care. Private insurance is prohibitively expensive unless purchased through an employer-based plan, while government run insurance manages to be under funded with an enormous budget at the same time. One thing is for certain, the current mix of public and private insurance have not excelled over time.
A recent survey carried out by David Cutler of Harvard University and Alexander Gelber of the Wharton School show that over the last two decades, a larger number of Americans are losing health insurance coverage at some point during the year. Using data from the US Census Bureau, the authors compared statistics from 1983-1986 and 2001-2004, finding that the percentage of the population that lost their insurance coverage during a 12 month period increased from 19.8% to 21.8% during the two decades or so in between the data sets. The percentage of people losing insurance as you look at the poor and those not in perfect health increases alarmingly.
There is good news though, in that for most of those losing their private insurance, many of them seek coverage under various government healthcare programs. The most recent Census Bureau figures for 2006-2007 show a minor dip in private insurance from 67.9% to 67.5% of the population, but the number of uninsured people in the country went down from 47 million to 45.7 million people. Government health insurance seems to have absorbed most of these people, growing from 80.3 million people covered to 83 million in the 2006-2007 period.
While it’s nice to see that government programs are stepping in to fill the gap, the problem is that its old news. It does not even begin to take into account the massive shifts brought on by the recent recession. The consequences are beginning to take a heavy toll on the health of the country in a myriad of ways. Since the start of the downturn in December 2007, employers have cut 5.1 million jobs. The number of people currently on continuing unemployment benefits is at 6.13 million, bringing the national unemployment rate to 8.5%. Because many people in the US receive their medical insurance through their employers, lost jobs means lost insurance. The Kaiser Family Foundation says that a 1% increase in the unemployment rate means an increase of 1 million enrollments in Medicaid and the Child Health Insurance Program (CHIP), and also a 1.1 million increase in uninsured people.
This high rate of lost jobs, estimated to be as high as 14,000 jobs per day, is pushing people out of their employer-based insurance and either into a government health insurance program or, if they are too young for Medicare or simply not poor enough to qualify for Medicaid, are forced to purchase private individual health insurance plans if they would like to have health insurance at all. An investigation by Consumer Reports has found this trend to carry problems of its own.
The investigation showed that personal health insurance is regularly more expensive than the equivalent cover would be through an employer-based plan. It is often extremely expensive or completely out of reach for people of meager income and less than stellar health. Consumer protection in this area is also an issue where, once again, America demonstrates the importance of appropriate regulation by not having it. Consumer Reports found that most state insurance regulators are not charged with evaluating the coverage these products offer and most disclosure requirements are decidedly limp-wristed at best. So, trying to compare plans, figure out prior to purchase what is and is not covered, or approximately calculating the out-of-pocket liability for any serious medical procedure is nigh impossible. While affordable, these low-end personal plans often come with extensive exclusions and loopholes which often leave people in serious medical debt if they suffer a medical catastrophe.
As everyday American consumers are continuing to feel financial pressure, recent polls have shown an increasing trend to put off medical care. A poll released by Thomson Reuters this month showed that over the past year, 20% of American households have either delayed or cancelled receiving medical care. Out of those who did cancel or delay care, 24.1 attributed it to the cost. The last time this poll was administered in 2006, the number of people delaying or canceling care was at 15.9% and the main reason for delays and cancellations was lack of time. Another chilling figure from the poll was that 21% of American adults were anticipating they would have difficulties paying for either health insurance or healthcare services within the next three months.
As the financial implications on healthcare snowball for the consumers, so too does it snowball for medical practitioners. One instance of this is in North Carolina, which has the fourth highest unemployment rate in the country at 10.7%. The increasing numbers of unemployed and uninsured people have led to a remarkable increase in traffic in free or discounted clinics and also emergency rooms, where hospitals are obliged to administer treatment to everyone, insurance or no. This often means hospitals are performing millions of dollars worth of healthcare services and not seeing any money from it. On top of this, people who do have insurance and actually pay the hospitals for their services are shying away from optional procedures and surgeries which would usually help generate income to keep the hospital running. At the moment, hospitals under financial pressure from both the shrinkage of revenue generating procedures and the amount of “uncompensated care” hospitals are offering to those in need, in some cases only staying functional through infusions of federal monies from the stimulus package.
The picture of American healthcare is looking increasingly bleak. Record numbers of Americans are losing their livelihoods and insurance, forcing the federal government to widen enrollment to more people and ratchet up spending on government programs which receive regular sniping from conservatives for being too expensive already. Not only that, but the health and finances of the people may suffer in the long run as they either cannot get the healthcare they need, or go into medical debt receiving it. One thing is for certain, the current hodge-podge of public and private in the healthcare system is a mess that is only getting worse with the limping economy. It can no longer be fixed by piecemeal measures and requires an alteration at the fundamental level of which the system operates.
Apr
3
Tuberculosis: The Disease That Keeps On Giving
Filed Under China insurance, Health Insurance, Healthcare, International Healthcare, Medical Insurance | 2 Comments
World Tuberculosis Day was marked on March 24th with a forum in Rio de Janeiro this year and despite this disease having a history dating back to antiquity may be becoming more of a problem today than ever.
Tuberculosis is caused by the bacteria Mycobacterium tuberculosis and is the most deadly bacterial disease in the world. The World Health Organization alongside other partners is on a drive to bring mortality and prevalence rates of tuberculosis down to half the levels they were in 1990 by 2015.
The WHO currently estimates that one third of the world’s population is infected with the tuberculosis bacteria. Out of everyone infected with the Mycobacterium tuberculosis bacteria only 5-10% of those people will develop active tuberculosis of the lungs, which is the only way to become infectious and transmit the disease. While this may seem like a statistically low number, it is estimated that every second someone new is infected with tuberculosis bacteria.
In spite of the fact that tuberculosis is not only millennia old but also treatable, the goals that the World Health Organization set out to achieve are becoming increasingly hard to attain. While the agency has said that the percentage of the global population becoming ill with tuberculosis has continued the decline first noticed in 2004, they have also said that both Europe and Africa will not meet the intended reductions in either mortality or prevalence rates. So if the percentage of people suffering from tuberculosis is, as a percentage of the world’s population, going down, why is there increased concern over the issue?
There are two major reasons that are making tuberculosis an even larger health issue than it has ever been before. The first is that there is an incredible increase in the number of people with active tuberculosis that are also HIV positive, leading to increased complications in treatment and prevention. The second reason is that the disease has evolved into both multidrug-resistant tuberculosis (MRD-TB) and extensively drug-resistant tuberculosis (XDR-TB), which has made some standard treatments ineffective in combating the disease.
Because HIV attacks the body’s immune system, it is leading not only to increased rates of infection but also increased mortality rates in people infected with both HIV and tuberculosis. The co-infection of HIV/TB is a seriously threat as the diseases piggy back on each other, each speeding the progress of the other. The WHO’s 2009 global TB control report indicates that about one out of four TB deaths are HIV related, which is more than twice as many as was previously indicated. Regions with high levels of HIV infections like Africa are being hit the hardest, with some places like South Africa where numbers of tuberculosis infections almost tripled. In 2007 alone it is estimated that there were 1.37 million new cases of tuberculosis in people infected with HIV as well as 456,000 deaths.
There is, however, somewhat good news arising from the intense scrutiny of data over the years. Having realized the increased threat that HIV/TB co-infection poses, there has been a raised effort to test for HIV in people who are receiving treatment for TB. The WHO report shows that in Africa in 2004, only 4% of patients being treated for tuberculosis were tested for HIV. By 2007 the number of TB patients in the African region getting HIV tests has risen to 37%, with some individual countries testing as many as 75% of their TB patients for the immunodeficiency disease.
The other issue of drug-resistant tuberculosis is beginning to attract increased attention because of concerns about the possibility of a virtually untreatable tuberculosis epidemic. The driving force behind the rise in drug-resistant strains of tuberculosis is that in the places with the highest rates of TB infections, such as Africa, Eastern Europe and Asia often have poor healthcare systems.
One of the gravest problems is that the systems will lose track of tuberculosis patients who do not finish their course of treatment for TB, allowing the disease to morph into a drug-resistant form of the disease. Some places such as India or Russia have poor healthcare where there is either a shortage of doctors and appropriate medication, or little control over the sale and usage of TB drugs.
As health ministers from some of the most direly affected countries, along with the leader of the WHO and Bill Gates gathered in Beijing on April 1st to formulate plans to prevent the spread of drug-resistant tuberculosis, one story has illustrated the need for quality medical insurance networks. A migrant worker named Wang Chong was in the Beijing Chest Hospital for his tuberculosis treatment which has been continuing for over five months. But because he has no insurance of his own and no national healthcare safety net to support him, he must decide whether to continue the treatment which has already cost him more than $5000 dollars, no small amount of money for a migrant worker in China, or to stop treatment and risk his disease evolving into a drug-resistant variety which could kill him.
There are estimated to be more than half a million people in the world with drug-resistant tuberculosis across the globe, with more than a quarter of them in China. Some health advocacy groups say that less than five percent of the people carrying drug-resistant strains of the disease are being treated properly, meaning that they are often out and about spreading the increasingly resilient disease to others.
At the moment, treatment of regular tuberculosis requires taking four different antibiotics and lasts for up to six months. Treatment for extensively drug-resistant tuberculosis is toxic to the patient and may last up to two years, often leading to the confinement of the patient. There are ongoing efforts to find a two drug combination that will work in combating both regular tuberculosis and extensively drug-resistant tuberculosis, with one phase of clinical trials scheduled to be completed by the end of 2009 in South Korea. The recent forums and meetings of the worlds’ healthcare leaders in highlights the need for awareness on the topic and the need to make sure you are protected, so that you can be assured a full treatment without having to make the same decisions that Wang Chong is having to make this very moment.
Feb
20
The Young Invincibles
Filed Under Health Insurance, Healthcare, Income Protection, Medical Insurance, Students, USA Health Insurance | 1 Comment
The New York Times is running an interesting story on young under-insured Americans during the current economic crisis. Regulars to this blog will be aware that this is a favorite topic of ours, and really only serves to illustrate that serious changes need to occur in the USA’s domestic healthcare and insurance industries.
From the article:
“My first reaction was to start laughing — I just kept saying, ‘No way, no way,’ ” Alanna Boyd, a 28-year-old receptionist, recalled of the $17,398 — including $13 for the use of a television — that she was charged after spending 46 hours in October at Beth Israel Medical Center in Manhattan with diverticulitis, a digestive illness. “I could have gone to a major university for a year. Instead, I went to the hospital for two days.”
“Most family insurance policies cut off dependents when they turn 19 or finish college, and many young adults start out in New York cobbling together part-time or freelance work with no benefits. To qualify for Medicaid, a single adult can earn no more than $706 a month — less than what a full-time minimum-wage earner makes. Yet the average insurance premium for a single adult is $900 a month, according to a spokesman for the State Insurance Department.”
Read more of the article, entitled For Uninsured Young Adults, Do-It-Yourself Healthcare, by visiting the New York Times website.
Its an interesting topic and one that bears further watching.
