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(c) 2010-2026 Jon L Gelman, All Rights Reserved.

Saturday, December 14, 2013

New York Data Show Hospital Charges All Over The Map

Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org

New York State has pulled back the curtain on hospital charges with a new database showing what each hospital charges for 1,400 different procedures.

The differences can be dramatic: At Bellevue Hospital, the median charge for an uncomplicated birth  is $6,330, and at NYU Langone Medical Center next door, the median charge is $12,222.

Lutheran Medical Center in Sunset Park, Brooklyn, typically charges $5,686 and Maimonides Medical Center, a dozen miles away, $14,763.
Patterns can be difficult to discern, and can vary from procedure to procedure. Overall, academic medical centers are more costly because of the additional staff needed for medical training, the greater use of technology, and the severity and complexity of patients.

But those factors do not account for why at Westchester Medical Center, the median charge for a vaginal delivery is $22,143, and at New York Presbyterian Weill Cornell Medical Center, it is $11,900.

The Greater New Hospital Association said the information is “complex and can be confusing,” because “hospital charges do not reflect the far lower payments hospitals actually receive for the services they provide.” Medicare and Medicaid reimburse much less than what hospitals charge, and insurers and managed care companies also negotiate rates that have little to do with what hospitals ask to be paid.

People without insurance, however, are subject to these sticker prices. In practice, hospitals typically...
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AIA to Urge Renewal of TRIA to Workers Compensation

The American Insurance Association (AIA) will highlight the importance of renewing the Terrorism Risk Insurance Act (TRIA) at the National Association of Insurance Commissioners' (NAIC) 2013 Fall National Meeting, underscoring TRIA's role in the workers' compensation marketplace.   The NAIC meeting will take place December 14-18 in Washington, D.C.
"Workers' compensation insurers are particularly affected by a terrorist attack," said J. Stephen ("Stef") Zielezienski, AIA senior vice president and general counsel. "By definition, workers' compensation policies must cover all risks, including terrorism, because workers' compensation covers all injuries and deaths that are deemed under a state's law as work-related without distinguishing the source of the injury."  Coupled with the nature of a terrorist attack, this makes the risk difficult to manage without the partnership provided by TRIA."
Zielezienski will appear before the Workers' Compensation (C) Task Force on Tuesday, December 17.  In his presentation, Zielezienski will focus on the expected impact on employers, insurers and state regulators should TRIA sunset at the end of 2014.    
"Without TRIA, workers' compensation insurers would have to make difficult decisions on how to manage their aggregated exposure, particularly for geographically-concentrated risks like terrorism," said Zielezienski.  "If an insurance company elects to reduce their exposure by not offering as much capacity, then state residual markets and workers' compensation pools would have to absorb the risk.  Ultimately, workers' compensation insurers would be responsible for these losses because they reinsure these residual market risks, but the extreme losses from catastrophic terrorism could stress the private markets and create economic uncertainty."
Zielezienski will also focus on what responsibilities state governments might assume for workers' compensation should TRIA not be reauthorized.   Both AIA and the NAIC are advocating for the long-term reauthorization of TRIA.  The NAIC passed a resolution at its 2013 Summer National Meeting in Indianapolis urging Congress to reauthorize the successful program. 

When Life Goes On, and On ...

The debate over a longer lifespan confronts many issued including medical costs, insurance coverage and quality of life. Workers' Compensation programs pay for lifetime care also in most instances. Today's post is shared from the NYTimes.org  .
To the Editor:
Re “On Dying After Your Time,” by Daniel Callahan (Sunday Review, Dec. 1): Mainstream aging research neither promises radical immortality nor seeks to keep old people sick longer. Aging is a driving factor in the most prevalent and costly chronic diseases. Research indicates that interventions slowing aging delay the onset of these diseases. Therefore, they extend not only life span but also health span, the disease-free and functional period of life.
Fundamentally, the goals of aging research are not dissimilar from efforts to prevent or treat Alzheimer’s or other chronic diseases in that they both seek to improve quality of life in the elderly. The difference is that interventions in aging may prevent not just one but a range of debilitating diseases simultaneously.
The reality is that the world is rapidly getting older. With baby boomers leaving the work force, there won’t be enough workers to pay the ever-increasing Medicare costs of the retired. Extending health span will lower Medicare costs and allow aging people to stay engaged.
Interventions that slow human aging will provide a powerful modality of preventive medicine: improving quality of life by keeping people...
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EU high court rules same-sex couples entitled to same benefits as married couples



The extension of dependency benefits to same sex marriages won a boast from EU Court of Justice.  Today's post is shared from Jurist.org.


The EU Court of Justice [official website] ruled [press release, PDF] Thursday that in countries in which same-sex couples cannot legally marry, same-sex couples in a legal union are entitled to the same legal benefits as married couples. The case stemmed from an employment benefits issue in France that was appealed to the court before the country legalized same-sex 
marriage [JURIST report] in May. The court ruled on the issue despite the country's legalization of same-sex marriage. It held that a union in which two partners commit to live together and provide for each other in a way that makes them legally bound to one another is analogous to a marriage agreement and, thus, makes the couple entitled to the same benefits as married couples when marriage is not an option to them. It also held that a collective bargaining agreement granting paid leave and a bonus to employees who marry was illegal because it discriminates against same-sex couples who cannot legally marry. The court also rejected all of the public interest reasons offered in support of the collective bargaining agreement, stating that none of them were sufficient to justify the discriminatory nature of the agreement.
Same-sex marriage has been a controversial issue internationally. Earlier this week, Australia's high court struck down legislation [JURIST report] that legalized same-sex marriage because it conflicted with a 1961 law and could not override the...
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Fee Schedules and Value

Medical costs are a major cost to the nation’s workers’ compensation system. Trying to cap them by schedules is a problem. What type of schedule becomes a political football, sometimes causing chaos. The free market certainly has it advantage though. Employee should as the right to choose their doctor and doctors should be flexible to charge the “going rate” for their communities. NJ operates without a fee schedule, but lacks the free selection component. Access and free choice will go along way to balancing out costs. Demand for participation will increase and employers and workers will both be winners. Today's post is shared from http://daviddepaolo.blogspot.com  .

And it isn’t surprising that the Workers’ Competition Research Institute reported Thursday that states without medical fee schedules in their workers’ compensation systems have seen the most rapid increases in prices for outpatient hospital and professional services, while states with fee schedules based on fixed amounts generally fared better.

"States without fee schedules saw faster price growth than states with fee schedules, and, for states with charge-based fee schedules, we saw prices for hospital outpatient services growing faster than states with fixed prices," said Rebecca Yang, the author of WCRI's 2nd Edition of its Outpatient Cost Index and the Fifth Edition of its Medical Price Index for Workers' Compensation, in a webinar yesterday.

...
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EPA plans to sharply reduce inspections

Reallocating resources for enforcement, the US EPA will be targeting large industry for polluters. On the other side of the coin, the employees and potentially exposed bystanders, in smaller industries will  potentially suffer occupational exposures. The balancing act could be eliminated by merely increasing funding to the EPA for its enforcement effort. Today's post is shared from the LATimes.org  .

WASHINGTON — The Environmental Protection Agency plans to substantially reduce inspections and civil enforcement cases against industry over the next five years, arguing that focusing on the biggest polluters would be the most effective way to clean up air and water.

refinery

In a draft strategic plan, the EPA proposes to cut federal inspections by one-third from the 20,000 inspections it conducted in the last fiscal year, ended Sept. 30.

Moreover, it plans to initiate about 2,320 civil enforcement cases a year, compared with the 3,000 cases initiated last fiscal year, a 23% reduction.

The EPA said the shift for fiscal years 2014 to 2018 is not a retreat from enforcement but a more effective allocation of resources.

Friday, December 13, 2013

Washington is reducing the deficit but abandoning the unemployed

When injured workers are hurt, employers have the tendency to replace the workers. After temporary disability benefits are exhausted then injured workers traditionally look toward State unemployment funds to survive. Congress is about to severely limit that safety net by drastically reducing unemployment benefits. Today's post was shared by Steven Greenhouse and comes from m.washingtonpost.com

There's one big thing left out of the Murray-Ryan budget deal: unemployment insurance.
On December 28, federal jobless benefits expire for 1.3 million workers. These aren't normal unemployment benefits. These are the extended, emergency benefits meant to help the long-term unemployed.
A little-known fact about the economy is that short-term unemployment -- the percentage of the labor force unemployed for five weeks or less -- is back down to where it was before the recession. It's long-term unemployment -- which lasts more than 27 weeks -- where the crisis lingers.
No one has a very good answer for these workers. They're often stuck in areas of the country where jobs are scarce. They face a vicious cycle of employment discrimination in which employers don't want to hire them because they've been unemployed for so long, which in turn extends their unemployment and makes it even harder for them to find a job. And now we're just cutting them loose.

How Clinical Guidelines Can Fail Both Doctors and Patients

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com



Any confusion over the recent news of cholesterol guidelines in the U.S. is perfectly understandable. On the one hand, the guidelines suggest that nearly half the population should use statins to stave off heart attacks and strokes. On the other, use of the drugs is not with potential side effects and, to many, will offer no substantive benefits. The controversy highlights a problem mired in an outdated way of thinking about health care and the doctor-patient relationship.
Guidelines came about after generations of physicians wanted to bring something more than “opinion and experience” to the patient’s bedside. In the late 1960s legislation for the U.S. Food and Drug Administration was amended to call for a demonstration of efficacy and an assessment of benefits and risk as prerequisite to the licensing of any pharmaceutical. Modern clinical science resulted, first slowly and now with an avalanche of clinical trials, each pouring forth outcome data galore.
The Burden of Clinical Data
Clinicians are expected to stay current with this wealth of information. The modern medical curriculum instructs all budding physicians on how to evaluate the quality and the clinical relevance of all such contributions to the body of clinical science. Because some (or perhaps many) find this exercise overwhelming, there are organizations—many academic and some without any discernible relationships with purveyors that could pose...
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It’s Doctors versus Hospitals Over Meaningful Use

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com



The Massachusetts Medical Society may be the first to notice that Meaningful Use EHR mandates favor large providers and technology vendors. Control over the Nationwide Health Information Network sets the stage for how physicians refer, receive decision support, report quality, and interact with patients. State health information exchanges and policy makers are caught in the cross-fire over health records interoperability. Are the federal regulations over Stage 2 being manipulated to put physicians and the public at a disadvantage?
On Dec. 7, the Massachusetts Medical Society took what might be the first formal action in the nation. A resolution stating:
“That the Massachusetts Medical Society advocate for a more open, affordable process to meet technology mandates imposed by regulations and mandates; e.g., that all Direct secure email systems, mandated by Meaningful Use stage 2, including health information exchanges and electronic health record systems, allow a licensed physician to designate any specified Direct recipient or sender without interference from any institution, electronic health record vendor, or intermediary transport agent.”
Scott Mace’s column Direct Protocol May Favor Large Providers and Vendors is the first to report on this unusual move by a professional society. Full disclosure: I’m a member of the MMS and the initiator of what became this resolution.
Meaningful Use is intended to support health reform by...
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Trek Recalls Madone Bicycles Due to Crash Hazard; Front Brake Can Fail

Today's post was shared by U.S. CPSC and comes from www.cpsc.gov

Trek Madone 5.2
Trek Madone 5.2
Units
6,800
Description
This recall involves model year 2013 Trek Madone bicycles with model numbers 5.2, 5.9, 6.2, 6.5, 7.7 or 7.9, and serial numbers starting with WTU and ending with G or H. A list of all serial numbers included in the recall is at www.trekbikes.com. Some of the recalled models are custom-ordered Project One Madones. The model number is printed on the bicycle frame. The serial number is printed on a sticker underneath the frame of the bicycle. The bicycles were sold in a variety of colors.
Incidents/Injuries
Trek has received five reports of loose front brake attachment bolts. No injuries have been reported.
Remedy
Consumers should immediately stop using the recalled bicycles and take the bicycles to a Trek dealer for a free replacement front brake system. 
Sold at
Bicycle stores nationwide from July 2012 through December 2013 for between $3,400 and $6,300, and for custom models between $4,000 and $15,000. 
Importer
Trek Bicycles Corp., of Waterloo, Wis.
Distributor
Trek Bicycles Corp., of Waterloo, Wis.
Manufactured in
Taiwan, United States and Germany

Trek Madone 5.9
Trek Madone 6.2

Trek Madone 6.2
Trek Madone 6.5
Trek Madone 6.5
Trek Madone 7.7
Trek Madone 7.7
Trek Madone 7.9
Trek Madone 7.9
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No Legislation is Stiring: Jobless Fear Looming Cutoff of Benefits

The US House of representative has passed a budget excluding the extension of unemployment benefits. Today's post was shared by The New York Times and comes from www.nytimes.com


Mary Helen Gillespie of Londonderry, N.H., is about to lose her last government lifeline. Since being laid off from a large banking firm in April, Ms. Gillespie, 57, has been living on little more than her unemployment insurance payments of $384 a week. She has burned through her savings and moved back in with her parents.
“There are times where I’ll go two, three, four days where I only have five dollars in my wallet and no money in my checking account,” said Ms. Gillespie, who worked as a corporate compliance officer at her previous employer,choking up as she described the difficulty of finding a job, any job, after her second extended period of joblessness since 2007. “I’ve been making decisions such as: Do I buy groceries or do I buy prescriptions?”
Ms. Gillespie’s 26 weeks of state benefits ran out this month, but she remained eligible for the emergency federal unemployment-insurance program, which has provided as many as 73 additional weeks of checks in states with high jobless rates.
Until now. Unless Congress acts — suddenly and unexpectedly — that recession-era initiative will expire at the end of the month. About 1.3 million current beneficiaries will lose aid. Also affected are an estimated 1.9 million more who would have been eligible for the program in the first half of 2014 after their state benefits ran out.
Democrats in Congress are pushing for an extension, which would cost the...
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Immigration Advocates Undeterred as House Departs Without Action

Today's post was shared by The New York Times and comes from www.nytimes.com

WASHINGTON — As the Republican-controlled House of Representatives wrapped up its work for the year on Thursday with no progress on immigration, leaders from both parties said they would return to the issue early in the new year.

Representative Robert W. Goodlatte, Republican of Virginia and chairman of the Judiciary Committee, said at a hearing that immigration would be a “top priority” in 2014. He said the House would advance a series of bills to strengthen enforcement, improve the legal immigration process and find “the appropriate legal status for those who are not here lawfully today.”

Despite the biting chill, the House minority leader, Nancy Pelosi of California, surrounded herself on the steps of the Capitol with dozens of Democratic lawmakers and with advocates who had been fasting in a tent on the National Mall to push the House to vote on an immigration bill.

“For us, it is inevitable that we will pass comprehensive immigration reform,” Ms. Pelosi said. “For some, it is inconceivable, and they will stand in the way. But we know it will happen, and we just have to shorten the time.”

Ms. Pelosi’s political theater was intended to identify Democrats with the fasters, whose protest had little effect on House Republican leaders but gained a wide following among Latino, immigrant and religious groups across the country.

An immigration overhaul has seemed close to death in the House more than once in recent...

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Head injuries in one football season cause measurable brain damage

Brain injuries Dartmouth-Princeton

Today's post was shared by FairWarning and comes from www.latimes.com

For college athletes who get through their sport's season concussion-free, new research suggests it may be too early to breathe a sigh of relief.

Following a season of grueling practices and hard-fought games, football and ice hockey players who had no outward sign of head trauma showed worrisome changes in brain structure and cognitive performance that weren’t shared by athletes who competed in varsity sports such as track, crew and cross-country skiing, according to a report published Wednesday in the journal Neurology.

The findings add to a growing body of evidence suggesting that a season-long succession of small hits — none hard enough to cause evident disorientation or draw medical attention — may prompt changes in the brain that cause problems with memory, mood or mental performance years down the road.

Or, they may heal during the off-season. Scientists are still trying to figure out how readily the brain recovers from injury, or whether there are thresholds beyond which damage can be cumulative or irreversible.

The new results don’t resolve the matter, but they do suggest that repetitive blows to the head are not without consequence, even when an athlete is able to get up and keep playing, said study leader Thomas McAllister, a psychiatrist at Indiana University.

“The management and detection of concussion is obviously important,” McAllister said. “But may not be sufficient.”

The study centered on 159 students at Dartmouth College in Hanover, N.H. — where...

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Stomach-churning CDC report on restaurant food safety

Today's post was shared by FairWarning and comes from www.sfgate.com

Improper handling of chicken is the deadliest among four major causes of food-borne illness. Photo: Penni Gladstone, SFC
Improper handling of chicken is the deadliest among four major causes of food-borne illness. Photo: Penni Gladstone, SFC

If you feel a little queasy after last night's dinner out, you're probably not alone.

About 48 million people a year in the United States come down with food-borne illnesses, and more than half of those illnesses can be traced to food from restaurants, delis, banquet halls and schools, according to a new report by the Centers for Disease Control and Prevention.

CDC experts observed kitchen practices and interviewed managers and workers at several hundred restaurants across nine states, including California. They zeroed in on four major causes of food-borne illness: storage and preparation of ground beef, chicken and leafy greens and the hygiene practices of food workers.

Many of their findings were alarming. Many restaurants did not enforce hand-washing policies for kitchen workers or designate certain cutting boards for raw poultry, they reported. More than half didn't regularly cook with meat thermometers. And a surprising number of workers admitted to coming to work ill, often because they didn't want to risk losing their jobs or leave the restaurant short staffed.

Restaurants fared better with leafy greens. Ninety-three percent kept purchasing records so they could trace where their greens came from in case of an illness-related recall, and 65 percent reported rejecting shipments if greens looked decomposed. However, a majority of greens delivered to...

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Cancer deaths rise to 8.2 million, breast cancer sharply up

A boy who is a cancer patient rests inside the children's ward at the Cancer Centre Welfare Home and Research Institute in Kolkata March 16, 2012. REUTERS/Rupak De Chowdhuri

LONDON (Reuters) - The global death toll from cancer rose to 8.2 million in 2012 with sharp rises in breast cancer as the disease tightened its grip in developing nations struggling to treat an illness driven by Western lifestyles.

Cancer deaths were up 8 percent from 7.6 million in a previous survey in 2008 and breast cancer killed 522,000 women last year, up 14 percent in the same period, according to the World Health Organisation's International Agency for Research on Cancer (IARC).

"Breast cancer is also a leading cause of cancer death in the less developed countries of the world," said David Forman, head of IARC's Section of Cancer Information, the group that compiles the global cancer data.

He said this was "partly because a shift in lifestyles is causing an increase in incidence, and partly because clinical advances to combat the disease are not reaching women living in these regions."

An estimated 14.1 million people developed cancer in 2012, up from 12.7 million in 2008. And 1.7 million women were newly diagnosed with breast cancer last year, up by more than 20 percent from 2008.

IARC's report, called GLOBOCAN 2012, gives the most up-to-date estimates for 28 different types of cancer in 184 countries and offers an overview of the global cancer burden.

It found that the most commonly diagnosed cancers worldwide in men and women combined were lung, breast and colorectal cancers. The most common causes of cancer death were lung, liver and stomach...

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Carbon Monoxide Safety Facts and Tips – How to prevent poisoning from a gas with no odor

Today's post was shared by US Dept. of Labor and comes from www.nsc.org

     NSC HOME > News & Resources > Resources > Carbon Monoxide   
 
Carbon Monoxide
Carbon Monoxide Safety Facts and Tips 
Carbon monoxide (CO) is an odorless, colorless gas that interferes with the delivery of oxygen in the blood to the rest of the body. It is produced by the incomplete combustion of fuels.
What Are the Major Sources of CO?
Carbon monoxide is produced as a result of incomplete burning of carbon-containing fuels including coal, wood, charcoal, natural gas, and fuel oil. It can be emitted by combustion sources such as unvented kerosene and gas space heaters, furnaces, woodstoves, gas stoves, fireplaces and water heaters, automobile exhaust from attached garages, and tobacco smoke. Problems can arise as a result of improper installation, maintenance, or inadequate ventilation.
What Are the Health Effects?
Carbon monoxide interferes with the distribution of oxygen in the blood to the rest of the body. Depending on the amount inhaled, this gas can impede coordination, worsen cardiovascular conditions, and produce fatigue, headache, weakness, confusion, disorientation, nausea, and dizziness. Very high levels can cause death.
The symptoms are sometimes confused with the flu or food poisoning. Fetuses, infants, elderly, and people with heart and respiratory illnesses are particularly at high risk for the adverse health effects of carbon monoxide.
An average of 166 people die each year as a...

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