For health insurance executives, there is no scarier word than disintermediation. It's a fancy word that means eliminating the middleman, and those executives know that to many folks, they are the middlemen who all too often stand between patients and their doctors.
Three of the biggest health insurers have announced quarterly earnings in the past few days. If Americans were able to eavesdrop on what executives from those firms tell their Wall Street masters every three months, they would have a better understanding of why premiums keep going up while the number of people with medical coverage keeps going down.
It only takes three words, when you get right down to it, to describe the real of those folks: profits over people.
CIGNA and Humana are scheduled to report earnings this week. The three companies that have already spoken -- UnitedHealth, WellPoint and Aetna -- earned a combined $2.51 billion from April through the end of June, more than analysts expected. On a per share basis, their earnings were up more than 17 percent on average compared with the second quarter of 2010.
Submitted by Anne Landman on
Pharmaceutical companies are carrying out fake, pseudo-studies on humans as a marketing devices to get doctors familiar with new drugs. In such studies, called "seeding trials," drug companies invite hundreds of doctors to take part in a research study by asking them to recruit patients to serve as subjects. The companies then pay the doctors for every subject they recruit. These "studies" look like clinical trials, but are not designed to contribute to knowledge in any way. Their purpose is solely to make doctors more familiar with the new drugs being "tested," and make doctors more likely to prescribe the drugs in the future. Seeding trials are conducted privately and managed by the pharmaceutical companies' marketing departments, not their research departments. The results of such trials do not appear in medical journals, but in pharmaceutical marketing documents. The drugs in such tests already have FDA approval, but the investigators may be inexperience and untrained, and patients involved in such fake studies have even died. How do these studies avoid scrutiny by ethics boards? Institutional review boards (IRBs), which determine whether human studies are ethically sound, don't pass judgement on whether a study is being carried out simply as a marketing tool or not. Some IRBs are even run as for-profit businesses, and get paid by the same pharmaceutical companies that put on the studies. If a for-profit IRB fails to approve too many studies, the entities funding such studies will just go elsewhere for reviews.
If opponents of health care reform could view the grant money in the Affordable Care Act as an investment in our children rather than wasteful spending, I believe at least some of them would eventually accept that we're better off with the law than without it.
I'd be especially confident if they took the time to visit some of the community facilities that will be able to meet the health care needs of thousands more Americans as a result of those grants.
Earlier this month, the Obama administration announced awards of $95 million to 278 school-based health center programs across the country. The grants -- the first of $200 million worth of awards between now and 2013 -- will help clinics expand and provide more medical services at schools nationwide.
The American Legislative Exchange Council (ALEC) is an influential, under-the-radar organization that facilitates collaboration between many of the most powerful corporations in America and state-level legislative representatives. Elected officials then introduce legislation approved by corporations in state houses across the U.S., without disclosing that the bills were pre-approved by corporations on ALEC task forces.
ALEC has had a long relationship with the tobacco industry. To explore this relationship, we studied publicly-available tobacco industry documents found in the Legacy Tobacco Documents Library (LTDL), an electronic archive created by the University of California San Francisco that contains 70+ million pages of previously-secret, internal tobacco industry documents obtained in the discovery phases of the 46 state attorneys general lawsuits against the tobacco industry. Those lawsuits were resolved in 1998. The documents were made public as a term of the 1998 Master Settlement Agreement between the states and the tobacco industry. Before now, ALEC documents in this database have not been a major focal point.
The insurance industry made it abundantly clear this week that it is in the driver's seat -- in both Washington and state capitols -- of one of the most important vehicles created by Congress to reform the U.S. health care system.
The Affordable Care Act requires the states to create new marketplaces -- "exchanges" -- where individuals and small businesses can shop for health insurance. In the 15 months since the law took effect, insurers have lobbied the Obama administration relentlessly to give states the broadest possible latitude in setting up their exchanges. And those insurance companies have been equally relentless at the state level in making sure governors and legislators follow their orders in determining how the exchanges will be operated.
Days after President Obama signed the Affordable Care Act into law, I arrived at the spring 2010 meeting of the National Association of Insurance Commissioners (NAIC) in Denver, where a fellow consumer representative introduced me to one of the hundreds of industry lobbyists swarming the convention center.
Submitted by Anne Landman on
Internet users can't avoid those obnoxious, animated ads showing a cartoon woman with a flabby belly that shrinks, and then gets flabby again, over and over. The ad urges people to click to get "1 weird old tip" to help lose weight. The Federal Trade Commission (FTC) says the ads are really a three-part scam: First, people click on the ads and get taken to websites with names like "ConsumerOnlineTips.com" or "WeeklyHealthNews.com," that appear to be about dieting or health news. Next, those sites show an attractive TV reporter discussing the benefits of incorporating specific products made from berries, fruits or hormones, into the diet. The sites carry positive information about the products, supposedly from credible news sources like CNN, USA Today or ABC, and include brief "reader comments" extolling the virtues of the product. Those sites link to another site where people can order a "trial sample" of the featured product. But people who order the free sample find out later that they have actually agreed to pay $79.99 for an additional shipment of the product two weeks later, and another $79.99 for a shipment six weeks later, and so on until they cancel -- which apparently isn't easy. According to the FTC, the sites are a scheme to grab consumers' credit card information and pile on additional, unapproved charges. The ads have led to thousands of complaints of unauthorized charges. The FTC has filed multiple lawsuits against the people and companies behind the ads.
Want to be an entrepreneur but also be certain you'll have health insurance?
On behalf of Grigor and Hilda Sarkisyan, I would like to invite Republican Rep. Phil Gingrey of Georgia to attend the 21st birthday celebration of the Sarkisyans' only daughter, Nataline, this coming Saturday, July 9, in Calabasas, California.
Gingrey could consider it a legitimate, reimbursable fact-finding mission. He clearly needs to have more facts about the U.S. health care system before he starts talking about death panels again.
Gingrey seems determined to keep alive the lie that the Affordable Care Act (a.k.a., Obamacare) will create government-run death panels in the Medicare program.
Sarah Palin started the death panel fabrication when she claimed during the health care reform debate that a proposal to allow Medicare to reimburse doctors for talking to their patients about advance directives would be tantamount to establishing death panels deep in the federal bureaucracy. So many people believed her lie that Democrats felt they had no choice but to strip that provision from the final bill.
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