Obamacare Exchanges in CA, WA, and OR Post Premiums Drastically Lower Than Many Projections

From Sarah Kliff in the Washington Post:

The Congressional Budget Office predicted back in November 2009 that a medium-cost plan on the health exchange – known as a “silver plan” – would have an annual premium of  $5,200. A separate report from actuarial firm Milliman projected that, in California, the average silver plan would have a $450 monthly premium.

Now we have California’s rates, and they appear to be significantly less expensive than what forecasters expected.

On average, the most affordable “silver plan” – which covers 70 percent of the average subscriber’s medical costs – comes with a $276 monthly premium. For the 2.6 million Californians who will receive federal subsidies, the price is a good deal less expensive, the amount noted in green below.

 

This is what is happening in the states whose governors and legislatures are not seeking to sabotage the implementation of the Affordable Care Act. California, Washington, and Oregon are showing similarly low rate offerings on the insurance exchanges, which at the beginning will apply mainly to individuals who were not previously insured.

In other words, the Affordable Care Act is providing affordable insurance to those previously unable to purchase it.

Antibiotic-Resistant Germs in Supermarket Meats

One more reason to just stop eating it. Also a clarion call to drastically overhaul the industrial model of animal agriculture that considers antibiotics a normal part of animal feed.

More than half of samples of ground turkey, pork chops and ground beef collected from supermarkets for testing by the federal government contained a bacteria resistant to antibiotics, according to a new report highlighting the findings.

The data, collected in 2011 by the National Antimicrobial Resistance Monitoring System — a joint program of the Food and Drug Administration, the Agriculture Department and the Centers for Disease Control and Prevention — show a sizable increase in the amount of meat contaminated with antibiotic-resistant forms of bacteria, known as superbugs, like salmonella, E. coli and campylobacter.

Many animals grown for meat are fed diets containing antibiotics to promote growth and reduce costs, as well as to prevent and control illness. Public health officials in the United States and in Europe, however, are warning that the consumption of meat containing antibiotics contributes to resistance in humans. A growing public awareness of the problem has led to increased sales of antibiotic-free meat.

The Agriculture Department has confirmed that almost 80 percent of all antibiotics sold in the United States are used in animal agriculture, and public health authorities around the world increasingly are warning that antibiotic resistance is reaching alarming levels.

40% Failure Rate on Hip Transplants: Executives Knew But Hid the Evidence

This level of corruption in the service of corporate profits is no surprise to anyone who follows developments in the drug and medical device industries. Still, if I step back a bit, it is nothing short of breathtaking.

THIS month, Johnson & Johnson is facing more than 10,000 lawsuits over an artificial hip that has been recalled because of a 40 percent failure rate within five years. Mistakes happen in medicine, but internal documents showed that executives had known of flaws with the device for some time, but had failed to make them public.

It would be nice to imagine that this kind of behavior is exceptional, but in reality, the entire evidence base for medicine has been undermined by a casual lack of transparency. Sometimes this is through a failure to report concerns raised by doctors and internal analyses, as was the case with Johnson & Johnson. More commonly, it involves the suppression of clinical trial results, especially when they show a drug is no good. These problems would be bad enough on their own, but they are compounded by a generation of “fake fixes” that have delivered false reassurance, and so prevent realistic public discussion.

The best evidence shows that half of all the clinical trials ever conducted and completed on the treatments in use today have never been published in academic journals. Trials with positive or flattering results, unsurprisingly, are about twice as likely to be published — and this is true for both academic research and industry studies.

Read the rest of the article. It actually gets worse.

 

 

U.S. Allows Chemicals in Food That Are Illegal Elsewhere

One more reason to read ingredient lists and not to trust the safety of listed items that aren’t actually recognizable foods.

Why the difference? The U.S. Food and Drug Administration would not provide a representative for an interview, but in past statements to the media and on its website the agency has presented a variety of reasons for allowing controversial chemicals in food, ranging from a lack of resources for research to assurances that the substances are safe in small doses.

In the case of BVO, the agency has allowed “interim” use of the ingredient since 1970, pending additional toxicological tests. Asked why it has not addressed the interim status in more than 40 years, the agency cited a need to “maximize its resources” and said addressing the issue is “not a priority for the agency at this time.”

“FDA’s mission is first and foremost to protect public health by ensuring that foods are safe and properly labeled,” the agency said in a statement, contending that science-based implementation of federal law has helped make the U.S. food supply “the safest in the world.”

Unsatisfied with these kinds of answers, activists and public health watchdogs have urged the FDA and food makers to halt the use of various chemicals until safety can be fully determined. Food companies, they note, have reformulated their products for other countries — including members of the European Union, China, Australia, Japan and India — but seem reluctant to change their products in the U.S. until they must.”

Flaxseed Helpful for Hypertension

From a report delivered at this week’s American Heart Association conference:

LOS ANGELES — Adding flaxseed to the diets of patients with peripheral arterial disease (PAD) resulted in large drops in blood pressure (BP) of around 10 mm Hg systolic and 7 mm Hg diastolic after six months, according to the results of a double-blind, placebo-controlled study.

“This reduction of SBP and DBP after administration of dietary flaxseed is the largest decrease in BP ever shown by any dietary intervention,” said Dr Delfin Rodriguez (University Hospital Holguin, Cuba) speaking here today at the American Heart Association 2012 Scientific Sessions. Such reductions would be expected to result in around a 50% fall in the incidence of stroke and a 30% reduction in MI, he added.

Rodriguez explained that the trial, FLAX-PAD, was conducted in PAD patients because they happened to have a clinic for the disease in their center and, as around 75% of PAD patients have concomitant hypertension, “it was an easy population to study.”

Subgroup analyses of only the PAD patients with hypertension showed a greater reduction in SBP, of about 15 mm Hg, in these patients than in the study population as a whole and a similar reduction in DBP, he noted.

“Flaxseed represents a particularly attractive strategy for controlling hypertension in economically disadvantaged communities and countries, and its BP-lowering effects compare favorably with those of antihypertensive drugs and lifestyle modifications, such as a low-salt diet and weight loss,” he noted.

Rodriguez said that he and his colleagues chose to study flaxseed because animal studies have shown it has antiatherogenic, anti-inflammatory, and antiarrhythmic effects and may reduce circulating cholesterol and trans-fatty acid levels.

Oregon’s Major Medicaid Experiment

As the reporters in this Washington Post article explain, the effort to get more effective health care while controlling costs is the goal of many of the health reform efforts now underway. This Oregon project may be the most of all. If it works, it can create a model for others to emulate.

So Kitzhaber did something that many before him have done in desperate times. The governor who favors cowboy boots over dress shoes made a bet that Oregon could not afford to lose.

The deal Kitzhaber struck was this: The Obama administration would give the state $1.9 billion over five years, enough to patch the budget hole. The catch: To secure that, Oregon’s Medicaid program must grow at a rate that is 2 percent slower than the rest of the country, ultimately generating $11 billion savings over the next decade. If it fails, those federal dollars disappear.

Oregon is pursuing the Holy Grail in health-care policy: slower cost growth. If it succeeds, it could set a course for the rest of the country at a pivotal moment for the Affordable Care Act. Under the law, many states will expand Medicaid programs to cover everyone below 133 percent of the federal poverty line, adding 7 million Americans to the program in 2014 and leaving states looking for the most cost-effective way to cover that influx of patients.

In Oregon alone, Medicaid is expected to enroll 400,000 new patients by 2022, nearly doubling its current numbers, according to an Urban Institute analysis.

As Oregon’s population grows, the state has come to realize that Medicaid is not a bottomless bucket of money. The state’s budget cannot sustain that. Instead, it strives to deliver what health policy experts call “the triple aim”: higher-quality care that leads to better outcomes, all delivered at a lower cost.

 

Worldwide, Obesity Now a Greater Problem Than Hunger

The only exception is sub-Saharan Africa. A world in which people have struggled for milliennia against having too little has now become one in which most now face a different problem — having too much, or at least too much of the wrong things.

From a CNN report on a new study published in The Lancet:

The report revealed that every country, with the exception of those in sub-Saharan Africa, faces alarming obesity rates — an increase of 82% globally in the past two decades. Middle Eastern countries are more obese than ever, seeing a 100% increase since 1990.

“The so-called ‘Western lifestyle’ is being adapted all around the world, and the impacts are all the same,” Mokdad said.

The health burden from high body mass indexes now exceeds that due to hunger, according to the report.

And for the first time, noncommunicable diseases like diabetes, stroke and heart disease top the list of leading causes of years spent sick or injured.

“All these problems are tied to obesity,” Mokdad said. “We’re even seeing a large percentage of people suffering back pain now. If we could lower the obesity rates, we’d see the numbers of noncommunicable diseases and pain decrease as well.”

People are living longer than projected in 1990 — on average, 10.7 more years for men, and 12.6 more years for women. But for many of them, the quality of life during those years is not good. On average, people are plagued by illness or pain during the last 14 years of life, according to the study.

Researchers credit advances in medical technology for longer lives.

“We’ve figured out how to keep the person who suffered a stroke alive, but then they’re living disabled for years afterward. That’s not the quality of life that person expected, ” Mokdad said.

In Western countries, deaths from heart disease are down 70%. However, the number of people diagnosed with heart disease is increasing at alarming rates.

Noncommunicable diseases are a global challenge of “epidemic proportions,” according to Dr. Margaret Chan, director-general of the World Health Organization.

In a speech to the U.N. General Assembly last year, she said NCDs are a “slow-motion disaster” that eventually could break the bank.

States Spend Less Than 2% of Tobacco Settlement Money on Anti-Smoking Campaigns

This qualifies for placement in the Public Health Hall of Infamy.

The report blasted states for failing to reverse the budget cuts to tobacco prevention programs that occurred after that time, calling them even more problematic in light of recent surveys that show smoking declines in the U.S. have slowed.

Across the country, 19% of adults and 18% of high school students still smoke, those surveys show.

The $460 million being spent this year amounts to just 12.4% of the $3.7 billion that the CDC recommends on tobacco prevention spending for all states combined.

It would take less than 15% of total state tobacco revenues to fund programs at CDC-recommended levels, according to the report.

Only two states – Alaska and North Dakota – will fund tobacco prevention programs at CDC-recommended levels, while only three – Delaware, Wyoming, and Hawaii – will spend at half the recommended level, the report said.

Four states — New Hampshire, New Jersey, North Carolina, and Ohio — have allotted no state funds for tobacco prevention programs next year.

NY Times Article: Flu Shot Benefits Substantially Overrated

I have never found the hype behind flu shots convincing. Here’s new evidence supporting that skepticism.

It’s flu-shot season, and public health officials are urging everyone over 6 months of age to get one. Many businesses provide on-site flu shots, and some hospitals have told staff members that they have to wear masks if they do not get the vaccine. By 2020, United States health leaders want 80 percent of the population to get yearly shots.

For vaccine manufacturers, it’s a bonanza: Influenza shots — given every year, unlike many other vaccines — are a multibillion-dollar global business.

But how good are they?

Last month,, in a step tantamount to heresy in the public health world, scientists at the Center for Infectious Disease Research and Policy at the University of Minnesota released a report saying that influenza vaccinations provide only modest protection for healthy young and middle-age adults, and little if any protection for those 65 and older, who are most likely to succumb to the illness or its complications. Moreover, the report’s authors concluded, federal vaccination recommendations, which have expanded in recent years, are based on inadequate evidence and poorly executed studies.

“We have overpromoted and overhyped this vaccine,” said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy, as well as its Center of Excellence for Influenza Research and Surveillance. “It does not protect as promoted. It’s all a sales job: it’s all public relations.”

It’s my impression that it’s people over 65 to whom these vaccines have been most strongly promoted. And those are the folks who derive “little if any protection.”

 

 

Preventing Unintended Pregnancies and Abortions Through No Cost Contraception

Research evidence confirms beneficial effects of Obamacare’s contraception mandate.

Here’s the abstract of the article from Obstetrics and Gynecology, along with news and commentary from Think Progress Health:

A new study focusing on low-income women in St. Louis, MO concludes that expanding access to free contraception — just as the health care reform law does through its provision to provide birth control without a co-pay — leads to significantly lower rates of unintended teen pregnancy and abortion. Researchers found that when women weren’t prohibited by cost, they chose more effective, long-lasting forms of birth controland experienced much fewer unintended pregnancies as a result.

Researchers from the Washington University School of Medicine in St. Louis worked in partnership with the local Planned Parenthood affiliate to track over 9,200 low-income women in the St. Louis area, some of whom lacked insurance coverage, during a four-year Contraceptive CHOICE study. The CHOICE project simulated Obamacare’s birth control provision by allowing teens and women to select from the full range of FDA-approved contraceptive options and receive their preferred method at no cost. They found that birth rates among the teens who received free birth control in the CHOICE project were less than a fifth of the national teen birth rate — just 6.3 births per 1,000 teens, compared to 34.3 per 1,000 teens nationwide in 2010 — and abortion rates were less than half of both the regional and national rates.