Dear Howard:
>
> Thank you for your advocacy – it made a difference!
>
> Last night, the Massachusetts Senate approved a health care cost containment bill with key provisions that may help to keep prescription drug costs down by limiting the marketing practices of the pharmaceutical industry.
>
> Did you know that the pharmaceutical industry spends over $7 billion annually marketing to physicians, and that 94% of physicians receive meals and other payments from pharmaceutical companies? The cost of that marketing is passed along to consumers and other purchasers in the price of prescription drugs.
>
> Today, pharmaceutical industry salespeople are the primary source of providers’ information about medications. The Senate bill includes a program in which medical professionals will provide physicians with unbiased data they need to make appropriate prescribing decisions, unlike pharmaceutical sales representatives who provide promotional information.
>
> There are several additional steps in the legislative process before this becomes law but now is the time to thank the Senate for their leadership.
Tuesday, April 22, 2008
Sunday, April 20, 2008
CVS PHARMACY
has asked Massachusetts health officials for approval to open the first of 20 to 30 planned "MinuteClinics" in Boston-area stores that executives said will offer patients fast, inexpensive care in a region struggling with packed emergency rooms and closed doctors' practices.
RETAIL CLINICS Show how the lure of profits creates opportunities for competition and quality care at an affordable price.
In a world where consumers are able to control more of their own routine health care spending.
The presciption for the clinics success;
Strict protocols to ensure high-quality care
Low prices that are clearly posted
Convenience
RETAIL CLINICS Show how the lure of profits creates opportunities for competition and quality care at an affordable price.
In a world where consumers are able to control more of their own routine health care spending.
The presciption for the clinics success;
Strict protocols to ensure high-quality care
Low prices that are clearly posted
Convenience
Competition won't ail you
The convenient-care clinic model arose from the mitmatch between what consumers need and what the Health care System was offering them.
QuickMedx runs stripped-down medical clinics in Cub Foods stores in the Twin Cities. Patients pay a flat $35 fee, and the clinics try to get people in and out in 15 minutes.
The clinics can charge lower fees than other clinics because they use nurse practitioners who diagnose and prescribe medications for about a dozen common ailments. They refer more complicated problems elsewhere.
This year marks the first time since opening in May 2000 that the company is taking its kiosk outside of a grocery store. Whitman said a local corporation — yet to be announced — has invited QuickMedx to open a clinic on its campus
Sunday, April 13, 2008
Senior Long Term Care
Baby boomers beware: The safety net you might be relying on to take care of you when you're old and sick is full of holes, a new study warns.
Many are relying on Medicaid, the government's health-care program for the needy, to pick up the tab for their nursing home and other long-term care expenses one day.
But there's a catch: Medicaid won't cover long-term care until your own resources are exhausted, warns Jeffrey Brown, director of the Center on Business and Public Policy at the University of Illinois College of Business and a co-author of the study.
"Medicaid basically forces you to impoverish yourself before it will pay for long-term care," he said. "Then you come out of care, and you've got nothing left."
What's more, the study contends, the government is encouraging people to rely on Medicaid by loading the program with disincentives to buy private long-term care insurance – which would be a better option because it protects assets and provides broader coverage.
Brown said economists have been puzzled about why so many Americans spurn long-term care insurance when they typically insure themselves against other financially damaging events and they face about a 40 percent chance of needing care in a nursing home one day.
"And if they need it, it can be financially devastating for many families, because a nursing home can cost $60,000 or $70,000 a year," he said.
As it turns out, the study found, Medicaid is choking the demand for private insurance because people prefer bad benefits at no charge to good benefits they'd have to buy.
And even for those who want private insurance, Medicaid makes it "not a good deal" for many, Brown said.
Once the benefits Medicaid picks up for free are factored in, the net benefits of long-term care insurance are just 20 cents to 40 cents on every dollar spent on private coverage premiums, the study found.
Another disincentive: Medicaid is a secondary payer, meaning it pays only after a private policy has paid first. So even when people do invest in private coverage, they might still end up exhausting all their resources.
"It will just take them longer to do so," Brown said.
Why not just rely on Medicaid, then?
Because it's not free. Taxpayers are footing $135 billion worth of long-term care expenses a year through Medicaid, and the burden can only grow as more baby boomers age, the study points out.
If there's a good way out of this conundrum, Brown said he hasn't found one yet.
The country could eliminate Medicaid coverage and let taxpayers spend their money on their own long-term care coverage, but there will always be people who won't have coverage and won't be able to afford nursing home care, Brown said.
"Are we as a society prepared to tell these people, 'You didn't insure, you didn't save enough, you're on your own?' I don't think this country is prepared to do that," he said.
Should Medicare, the government's health program for the elderly, take over long-term care expenses?
Talk about really breaking the federal budget, Brown said.
"We've already got under-funded (Medicare) benefits," he added.
Should the government require people to purchase long-term care insurance?
How could that be enforced? Brown said.
"One of the difficult things about this study is we've identified a very difficult public policy problem for which there is not an obvious solution," he said.
The nation's long-term care insurance industry is a bit more optimistic that more Americans will buy policies.
Some 400,000 long-term care policies were purchased last year, says Jesse Slome, executive director of the American Association for Long Term Care Insurance.
"It's growing slowly and steadily," he contends.
Last year, long-term care insurers paid out $3.5 billion in claims, about $200 million more than 2006, Slome said. As more people have positive experiences with this kind of coverage, he predicts more will want to buy it.
But it's going to take time. Before the baby boomer generation, the elderly lived closer to their children and didn't need to rely so heavily on nursing home care. People didn't live quite so long, either, Slome said.
"Prior generations didn't have to think about long-term care," he added.
Slome thinks the real impediment to buying long-term care insurance is human nature: Many folks just aren't good planners, and they procrastinate.
"The fact of the matter is, first of all, people don't live their lives planning to go on welfare. They live their lives without planning, but nobody who's 65 looks and says, 'Gee, I've worked my whole life. I was independent. I saved. I had a retirement plan. I did everything I was supposed to, and in my last years, I want to go on welfare to see what it's really like,'" he said.
The long-term care industry's challenge is to convince more people to start thinking about the costs of nursing home care before they become so old, or their health deteriorates so much, that insurance is going to be prohibitively expensive, he said.
Nearly 45 percent of people applying for long-term care coverage in their 50s qualify for good health discounts, but only about 19 percent of those who wait to apply in their 70s qualify for these discounts, a 2006 report done by Slome's association found.
Another challenge may be today's economy.
Slome said a single person at age 55 can buy decent long-term care coverage for about $1,000 a year, and a married couple at that age can buy decent coverage for both people at about $1,300 a year.
But with the rising cost of health care, many people are finding it difficult enough to pay for insurance they need right now, let alone pay for coverage they may need in their golden years.
Slome's advice for getting the best deal: Work with a professional who can find you the best long-term care insurance coverage for your needs and lock in the rates. The price of coverage varies widely, and every company has its own premium rate sweet spot depending on the client's age, marital status and health status, he said.
"Medicare and Medicaid are already strapped, and it's only going to get worse," Slome warned. "The government can only tax so much."
Should you buy long-term coverage?
It depends on what you've got to lose, says Paul McNamara, a professor and Extension specialist at the University of Illinois Department of Agricultural and Consumer Economics.
His advice:
— Consider buying coverage if you can afford it and want to have assets to leave your heirs or a surviving spouse.
— Know the premiums are more reasonable before you become elderly and fall into poor health. But keep in mind when you buy coverage younger that you're going to have to keep up the premium payments for a long time.
— Don't neglect the bigger picture: Consider long-term care insurance as part of your overall retirement planning. It wouldn't make sense to pay for a long-term care policy if you can't afford to fund your retirement savings.
— When it's not a good deal: If your income is anywhere near Medicaid eligibility level, you don't have a lot of assets now and likely won't have enough assets at retirement to protect.
Find this article at: http://www.news-gazette.com/news/2008/04/13/seniors_warned_about_longterm_care
Comments
Many are relying on Medicaid, the government's health-care program for the needy, to pick up the tab for their nursing home and other long-term care expenses one day.
But there's a catch: Medicaid won't cover long-term care until your own resources are exhausted, warns Jeffrey Brown, director of the Center on Business and Public Policy at the University of Illinois College of Business and a co-author of the study.
"Medicaid basically forces you to impoverish yourself before it will pay for long-term care," he said. "Then you come out of care, and you've got nothing left."
What's more, the study contends, the government is encouraging people to rely on Medicaid by loading the program with disincentives to buy private long-term care insurance – which would be a better option because it protects assets and provides broader coverage.
Brown said economists have been puzzled about why so many Americans spurn long-term care insurance when they typically insure themselves against other financially damaging events and they face about a 40 percent chance of needing care in a nursing home one day.
"And if they need it, it can be financially devastating for many families, because a nursing home can cost $60,000 or $70,000 a year," he said.
As it turns out, the study found, Medicaid is choking the demand for private insurance because people prefer bad benefits at no charge to good benefits they'd have to buy.
And even for those who want private insurance, Medicaid makes it "not a good deal" for many, Brown said.
Once the benefits Medicaid picks up for free are factored in, the net benefits of long-term care insurance are just 20 cents to 40 cents on every dollar spent on private coverage premiums, the study found.
Another disincentive: Medicaid is a secondary payer, meaning it pays only after a private policy has paid first. So even when people do invest in private coverage, they might still end up exhausting all their resources.
"It will just take them longer to do so," Brown said.
Why not just rely on Medicaid, then?
Because it's not free. Taxpayers are footing $135 billion worth of long-term care expenses a year through Medicaid, and the burden can only grow as more baby boomers age, the study points out.
If there's a good way out of this conundrum, Brown said he hasn't found one yet.
The country could eliminate Medicaid coverage and let taxpayers spend their money on their own long-term care coverage, but there will always be people who won't have coverage and won't be able to afford nursing home care, Brown said.
"Are we as a society prepared to tell these people, 'You didn't insure, you didn't save enough, you're on your own?' I don't think this country is prepared to do that," he said.
Should Medicare, the government's health program for the elderly, take over long-term care expenses?
Talk about really breaking the federal budget, Brown said.
"We've already got under-funded (Medicare) benefits," he added.
Should the government require people to purchase long-term care insurance?
How could that be enforced? Brown said.
"One of the difficult things about this study is we've identified a very difficult public policy problem for which there is not an obvious solution," he said.
The nation's long-term care insurance industry is a bit more optimistic that more Americans will buy policies.
Some 400,000 long-term care policies were purchased last year, says Jesse Slome, executive director of the American Association for Long Term Care Insurance.
"It's growing slowly and steadily," he contends.
Last year, long-term care insurers paid out $3.5 billion in claims, about $200 million more than 2006, Slome said. As more people have positive experiences with this kind of coverage, he predicts more will want to buy it.
But it's going to take time. Before the baby boomer generation, the elderly lived closer to their children and didn't need to rely so heavily on nursing home care. People didn't live quite so long, either, Slome said.
"Prior generations didn't have to think about long-term care," he added.
Slome thinks the real impediment to buying long-term care insurance is human nature: Many folks just aren't good planners, and they procrastinate.
"The fact of the matter is, first of all, people don't live their lives planning to go on welfare. They live their lives without planning, but nobody who's 65 looks and says, 'Gee, I've worked my whole life. I was independent. I saved. I had a retirement plan. I did everything I was supposed to, and in my last years, I want to go on welfare to see what it's really like,'" he said.
The long-term care industry's challenge is to convince more people to start thinking about the costs of nursing home care before they become so old, or their health deteriorates so much, that insurance is going to be prohibitively expensive, he said.
Nearly 45 percent of people applying for long-term care coverage in their 50s qualify for good health discounts, but only about 19 percent of those who wait to apply in their 70s qualify for these discounts, a 2006 report done by Slome's association found.
Another challenge may be today's economy.
Slome said a single person at age 55 can buy decent long-term care coverage for about $1,000 a year, and a married couple at that age can buy decent coverage for both people at about $1,300 a year.
But with the rising cost of health care, many people are finding it difficult enough to pay for insurance they need right now, let alone pay for coverage they may need in their golden years.
Slome's advice for getting the best deal: Work with a professional who can find you the best long-term care insurance coverage for your needs and lock in the rates. The price of coverage varies widely, and every company has its own premium rate sweet spot depending on the client's age, marital status and health status, he said.
"Medicare and Medicaid are already strapped, and it's only going to get worse," Slome warned. "The government can only tax so much."
Should you buy long-term coverage?
It depends on what you've got to lose, says Paul McNamara, a professor and Extension specialist at the University of Illinois Department of Agricultural and Consumer Economics.
His advice:
— Consider buying coverage if you can afford it and want to have assets to leave your heirs or a surviving spouse.
— Know the premiums are more reasonable before you become elderly and fall into poor health. But keep in mind when you buy coverage younger that you're going to have to keep up the premium payments for a long time.
— Don't neglect the bigger picture: Consider long-term care insurance as part of your overall retirement planning. It wouldn't make sense to pay for a long-term care policy if you can't afford to fund your retirement savings.
— When it's not a good deal: If your income is anywhere near Medicaid eligibility level, you don't have a lot of assets now and likely won't have enough assets at retirement to protect.
Find this article at: http://www.news-gazette.com/news/2008/04/13/seniors_warned_about_longterm_care
Comments
Saturday, April 12, 2008
Fix Health Care Problems
Brody prescribes fix for health care problems
By: Marie Cushing
Posted: 4/10/08When it comes to fixing the American health care system, politicians are failing. That was the message University President William Brody delivered during a lecture Monday on the major issues facing the health care system in America. The soon-to-retire president says the major problems with the health care system are not being discussed - and that college students will be the ones to suffer. "This is your future we're describing. I turn 65 next year. I'll go on Medicare, and you'll have to pay for it. And guess what? I can spend as much as I want and you will foot the bill," he said. With the cost of the health care system near two trillion dollars, polls show that health care is among the leading domestic issues for Americans today. But for Brody, politicians have not been taking a strong stand on the issues. He cited the lack of involvement by high-profile presidential candidates in the Hopkins-sponsored series of health care forums as an example. "Other than Mitt Romney, we struck out. They didn't want to talk about the issue ... people running for office are scared to have to commit themselves to a policy," Brody said. Assistant to the President Michael Field, who has helped organize the forums and helped Brody draft his remarks, said coordinators have not given up on attracting the top candidates. "We have been trying and we're continuing to try. It has something to do with this being such a topsy-turvy campaign cycle. Nothing went according to people's plans. And I think it has something to do with the fact that some politicians prefer not to talk," Field said. Although New York Senator and Democratic presidential hopeful Hillary Clinton agreed to film a forum earlier in the year, a date has not been set. Field attributed the delay to the hectic campaign schedule. "Sens. Obama and Clinton, who do want to talk, are so frenetically tied up that it's difficult to get on their schedules. We'll see if this changes after the party conventions," he said. No agreement has been made with Arizona Sen. John McCain, the likely Republican presidential nominee. "John McCain is essentially coasting. Since he has no battles he would seem to have the time, but he's not going out of his way to talk about it," Field said. Brody's retirement has not yet affected the forums, but Field expects it will at some point. A forum will soon be filmed with Senator Ted Kennedy in his U.S. Senate office. Former Speaker of the House Newt Gingrich has already taped a forum, and current Speaker Nancy Pelosi has agreed to film a counterpoint piece. In two weeks a forum will be taped with former congressman Billy Pauzin, president of pharmaceutical manufacturer PhRMA. Field also hoped to schedule a forum with George Halvorson, the head of Kaiser Permanente, who has agreed to participate in the series. Until then, health care issues will continue to fill the airwaves."You really can't pick up the paper or turn on the television without hearing about cost and coverage," Brody said. But it was three other "C's" - consistency, complexity and chronic illness - that he said are being neglected by politicians and the national media. According to Brody, the "dirty secret" of American health care is that accurate and complete care is given only 55 percent of the time, according to studies. "We're not talking about the kind of weird disease you have to come to Hopkins for," he said. Brody cited a study by the RAND Corporation, which found that doctors prescribe aspirin, beta-blockers or cholesterol-lowering medication for only half of heart attack outpatients. But other initiatives, such as teaching interns how to properly insert blood lines, have helped. Hopkins reduced the number of blood line infections from two times above the national average to eight months without a single infection in some ICUs. "That saves us between 11,000 and 22,000 dollars, as well as morbidity and mortality for the patient," Brody said. The United States is the leader in health care costs, and, according to Brody, the American medical system leads the world in another area: complexity. "If you ever tried to look at your hospital bill, you need to hire an accountant," Brody said. Throughout the years, Hopkins Hospital has seen the number of insurance plans rise to 770, each with their own rules and regulations. Dealing with the complex billing and collections system takes its toll - the Hospital spends 20 percent of costs on administration. While Brody saw a simple solution to this issue through the adoption of billing standards, such a proposal would take a political force that does not yet exist."Nobody is driven to enforce this because of the fear that it would be socialized medicine. Everybody's well-intentioned but it just gets worst and worse," he said. But with the government the major payer in health care, "whether you believe in socialized medicine or you hate it, it's here," Brody said. The final "C" in Brody's analysis of the health care system was chronic illness. "If you want to deal with health care costs you have to deal with the chronic patients because that's where the money is," Brody said. While in 2005 almost half of all Americans lived with a chronic illness, these diseases account for more than 75 percent of all medical care costs, according to the Centers for Disease Control. Brody cited a study by the National Institutes of Health, which found that older generic drugs were just as effective as the more expensive patented drugs. "If Medicare would implement the simple policy of generic substitution except when there are clinical disparities, we would have conservatively saved 5 billion dollars a year," he said. What seemed like a simple solution was complicated by politics. Pharmaceutical companies have restricted Medicare from negotiating medicine prices. Brody acknowledged two high-profile medical professionals in the audience: Nobel Laureate Peter Agre and Board of Trustees Vice Chair Mark Rubenstein. "I probably have to rewrite my speech because they'll be fact-checking it," he quipped.
© Copyright 2008 News-Letter
By: Marie Cushing
Posted: 4/10/08When it comes to fixing the American health care system, politicians are failing. That was the message University President William Brody delivered during a lecture Monday on the major issues facing the health care system in America. The soon-to-retire president says the major problems with the health care system are not being discussed - and that college students will be the ones to suffer. "This is your future we're describing. I turn 65 next year. I'll go on Medicare, and you'll have to pay for it. And guess what? I can spend as much as I want and you will foot the bill," he said. With the cost of the health care system near two trillion dollars, polls show that health care is among the leading domestic issues for Americans today. But for Brody, politicians have not been taking a strong stand on the issues. He cited the lack of involvement by high-profile presidential candidates in the Hopkins-sponsored series of health care forums as an example. "Other than Mitt Romney, we struck out. They didn't want to talk about the issue ... people running for office are scared to have to commit themselves to a policy," Brody said. Assistant to the President Michael Field, who has helped organize the forums and helped Brody draft his remarks, said coordinators have not given up on attracting the top candidates. "We have been trying and we're continuing to try. It has something to do with this being such a topsy-turvy campaign cycle. Nothing went according to people's plans. And I think it has something to do with the fact that some politicians prefer not to talk," Field said. Although New York Senator and Democratic presidential hopeful Hillary Clinton agreed to film a forum earlier in the year, a date has not been set. Field attributed the delay to the hectic campaign schedule. "Sens. Obama and Clinton, who do want to talk, are so frenetically tied up that it's difficult to get on their schedules. We'll see if this changes after the party conventions," he said. No agreement has been made with Arizona Sen. John McCain, the likely Republican presidential nominee. "John McCain is essentially coasting. Since he has no battles he would seem to have the time, but he's not going out of his way to talk about it," Field said. Brody's retirement has not yet affected the forums, but Field expects it will at some point. A forum will soon be filmed with Senator Ted Kennedy in his U.S. Senate office. Former Speaker of the House Newt Gingrich has already taped a forum, and current Speaker Nancy Pelosi has agreed to film a counterpoint piece. In two weeks a forum will be taped with former congressman Billy Pauzin, president of pharmaceutical manufacturer PhRMA. Field also hoped to schedule a forum with George Halvorson, the head of Kaiser Permanente, who has agreed to participate in the series. Until then, health care issues will continue to fill the airwaves."You really can't pick up the paper or turn on the television without hearing about cost and coverage," Brody said. But it was three other "C's" - consistency, complexity and chronic illness - that he said are being neglected by politicians and the national media. According to Brody, the "dirty secret" of American health care is that accurate and complete care is given only 55 percent of the time, according to studies. "We're not talking about the kind of weird disease you have to come to Hopkins for," he said. Brody cited a study by the RAND Corporation, which found that doctors prescribe aspirin, beta-blockers or cholesterol-lowering medication for only half of heart attack outpatients. But other initiatives, such as teaching interns how to properly insert blood lines, have helped. Hopkins reduced the number of blood line infections from two times above the national average to eight months without a single infection in some ICUs. "That saves us between 11,000 and 22,000 dollars, as well as morbidity and mortality for the patient," Brody said. The United States is the leader in health care costs, and, according to Brody, the American medical system leads the world in another area: complexity. "If you ever tried to look at your hospital bill, you need to hire an accountant," Brody said. Throughout the years, Hopkins Hospital has seen the number of insurance plans rise to 770, each with their own rules and regulations. Dealing with the complex billing and collections system takes its toll - the Hospital spends 20 percent of costs on administration. While Brody saw a simple solution to this issue through the adoption of billing standards, such a proposal would take a political force that does not yet exist."Nobody is driven to enforce this because of the fear that it would be socialized medicine. Everybody's well-intentioned but it just gets worst and worse," he said. But with the government the major payer in health care, "whether you believe in socialized medicine or you hate it, it's here," Brody said. The final "C" in Brody's analysis of the health care system was chronic illness. "If you want to deal with health care costs you have to deal with the chronic patients because that's where the money is," Brody said. While in 2005 almost half of all Americans lived with a chronic illness, these diseases account for more than 75 percent of all medical care costs, according to the Centers for Disease Control. Brody cited a study by the National Institutes of Health, which found that older generic drugs were just as effective as the more expensive patented drugs. "If Medicare would implement the simple policy of generic substitution except when there are clinical disparities, we would have conservatively saved 5 billion dollars a year," he said. What seemed like a simple solution was complicated by politics. Pharmaceutical companies have restricted Medicare from negotiating medicine prices. Brody acknowledged two high-profile medical professionals in the audience: Nobel Laureate Peter Agre and Board of Trustees Vice Chair Mark Rubenstein. "I probably have to rewrite my speech because they'll be fact-checking it," he quipped.
© Copyright 2008 News-Letter
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