Ovarian Cancer Screenings Are Not Effective, Panel Says
By DENISE GRADY
Tests commonly recommended to screen healthy women for ovarian cancer do more harm than good and should not be performed, a panel of medical experts said on Monday.
The screenings — blood tests for a substance linked to cancer and ultrasound scans to examine the ovaries — do not lower the death rate from the disease, and they yield many false-positive results that lead to unnecessary operations with high complication rates, the panel said.
“There is no existing method of screening for ovarian cancer that is effective in reducing deaths,” said Dr. Virginia A. Moyer, the chairwoman of the expert panel, the United States Preventive Services Task Force. “In fact, a high percentage of women who undergo screening experience false-positive test results and consequently may be subjected to unnecessary harms, such as major surgery.”
The advice against testing applies only to healthy women with an average risk of ovarian cancer, not to those with suspicious symptoms or those at high risk because they carry certain genetic mutations or have a family history of the disease.
The recommendations are just the latest in a series of challenges to cancer screenings issued by the panel, which has also rejected P.S.A. screening for prostate cancer in men and routine mammograms in women under 50. The task force is a group of 16 experts, appointed by the government but independent, that makes recommendations about screening tests and other efforts to prevent disease. Its advice is based on medical evidence, not cost.
Wendell Potter [1]
OPINION: Maine's health care fantasy
Wendell Potter [1]
OPINION: Maine's health care fantasy [2]
What happened in Maine is a sobering reality check on the oft-repeated myth that getting rid of ObamaCare and other consumer protections is the answer to our health care problems. If the government will just get out of the way, the myth-makers would have us believe, the free market will magically transform our dysfunctional health care systems into one of the world’s very best.
The voters in Maine fell for magical thinking in 2010 when they turned over control of the legislature and governor’s office to candidates who promised to block ObamaCare and implement what they called “common sense” free-market solutions. Once they did, they assured voters, insurance premiums would fall and more people would have access to affordable care.
Sure enough, soon after being sworn in, lawmakers passed legislation that in many ways took Maine in the opposite direction of where President Obama wanted to go. When newly elected Republican Governor Paul LePage signed the bill into law —a bill enthusiastically endorsed by insurance companies — many consumer protections enacted over two decades disappeared. Especially hard hit: people living in rural areas and folks over 40.
Among other things, the new law abolished protections for rural families that had required insurers to have at least one doctor in their provider networks within 30 miles of where those families lived and at least one hospital within 60 miles. The law also allows insurance companies to effectively double rates for older residents. That provision is affecting not only individuals and families, but also small businesses that employ older workers. Within months of the bill’s passage, insurers began jacking up the rates they charged businesses with older workers by 90 percent or more.
Even so, backers of the new law continued to insist that after it had been in effect for awhile, the measure would help a majority of Mainers.
But those promises have turned out to be empty, as Consumers for Affordable Health Care, a statewide advocacy group, found following a review of company reports filed with the Maine Bureau of Insurance since the law was enacted. What they found should dash the hopes of even the most ardent free-market supporters.
The group found that more than half of individual policyholders saw their rates go up, not down. It was even worse for small businesses: 90 percent of them got rate increases instead of decreases. And, as consumer advocates had feared, hardest hit were indeed older workers and people living in rural areas, most of whom saw good coverage options previously available to them disappear.
In response to the group’s report, backers of the law said they still expect rates will eventually go down for many people as more young folks start buying policies. Their optimism is based on the theory that as insurers charge older people more, they can charge younger people less. If the theory holds, previously uninsured young people will begin signing up for coverage in droves. Once that happens, the pool of insured residents will increase and insurers, being good corporate citizens, will then lower premiums for everybody else.
http://www.publicintegrity.org/print/10829
The voters in Maine fell for magical thinking in 2010 when they turned over control of the legislature and governor’s office to candidates who promised to block ObamaCare and implement what they called “common sense” free-market solutions. Once they did, they assured voters, insurance premiums would fall and more people would have access to affordable care.
Sure enough, soon after being sworn in, lawmakers passed legislation that in many ways took Maine in the opposite direction of where President Obama wanted to go. When newly elected Republican Governor Paul LePage signed the bill into law —a bill enthusiastically endorsed by insurance companies — many consumer protections enacted over two decades disappeared. Especially hard hit: people living in rural areas and folks over 40.
Among other things, the new law abolished protections for rural families that had required insurers to have at least one doctor in their provider networks within 30 miles of where those families lived and at least one hospital within 60 miles. The law also allows insurance companies to effectively double rates for older residents. That provision is affecting not only individuals and families, but also small businesses that employ older workers. Within months of the bill’s passage, insurers began jacking up the rates they charged businesses with older workers by 90 percent or more.
Even so, backers of the new law continued to insist that after it had been in effect for awhile, the measure would help a majority of Mainers.
But those promises have turned out to be empty, as Consumers for Affordable Health Care, a statewide advocacy group, found following a review of company reports filed with the Maine Bureau of Insurance since the law was enacted. What they found should dash the hopes of even the most ardent free-market supporters.
The group found that more than half of individual policyholders saw their rates go up, not down. It was even worse for small businesses: 90 percent of them got rate increases instead of decreases. And, as consumer advocates had feared, hardest hit were indeed older workers and people living in rural areas, most of whom saw good coverage options previously available to them disappear.
In response to the group’s report, backers of the law said they still expect rates will eventually go down for many people as more young folks start buying policies. Their optimism is based on the theory that as insurers charge older people more, they can charge younger people less. If the theory holds, previously uninsured young people will begin signing up for coverage in droves. Once that happens, the pool of insured residents will increase and insurers, being good corporate citizens, will then lower premiums for everybody else.
http://www.publicintegrity.org/print/10829
OPINION: The illusory promise of free-market health care miracles
Republican rhetoric aside, the answers lie elsewhere
OPINION: The illusory promise of free-market health care miracles [2]
While listening to the promises to repeal ObamaCare during the Republican National Convention, I was reminded of what those of us in the health insurance industry said when our friends in Congress were able to block passage of President Clinton’s health care reform legislation 18 years ago.
Like the politicians in Tampa, we insisted then that a big government program not only wasn’t needed, but would be harmful — that what the government really needed to do was get out of the way and let the free market work.
Insurance company spokesmen like me assured the public that our then-novel managed care plans, coupled with the invisible hand of the market, would do the trick. Leave it to us, we said, and we’ll get medical costs under control and enroll every American in a good HMO.
The proponents of a pure free-market health care system hope that Americans have amnesia and can be persuaded to blame President Obama for the problems that grew almost immeasurably worse between the demise of the Clinton plan and the passage of the Affordable Care Act. They want us to believe, despite overwhelming evidence to the contrary, that health insurers and the largely unfettered, loosely regulated marketplace can somehow turn things around. And that we should reward insurers for their failure by turning the Medicare program over to them.
In many respects, the free market approach to health care has indeed been just what the doctor ordered, although not for patients. We spend twice as much on health care per person as western European countries do on average. Yet, according to the Commonwealth Fund, 81 million Americans are now either uninsured or underinsured — far more than during the Clinton administration. And with just a few exceptions, we rank well below almost every other developed country in measures of health outcomes, such as longevity and infant mortality.
There is fresh evidence almost every week that our uniquely American free market health care system continues to fail us.
Last week, in a piece about hospitals buying physician practices, The Wall Street Journal reported that patients are getting bills for doctor visits that are much higher than they were before their doctor’s medical group became part of a hospital system. Hospitals are charging more for physician services they now own just because, well, they can, thanks to the free market.
The story quoted insurance executives saying that one of the reasons insurers are raising premiums is because they’re having to pay more for physician and outpatient services as a result of this trend. And because insurers have moved millions of us into high-deductible plans, we’re having to pay more out of our own pockets, too. So we’re getting hit where it really hurts — our pocketbooks — twice.
Another reason for skyrocketing premiums: Hospitals are also merging with each other to have more clout at the negotiating table with insurers. According to the health care consulting firm Irving Levin Associations, there were 86 hospital mergers or acquisitions last year. That’s compared to 75 in 2010 and 51 in 2009.
Those mergers and acquisitions not only have been enabled by our free market approach to health care, they’ve been necessitated by it. The consolidation among hospitals is accelerating because of the even more rapid consolidation in the insurance industry. The two biggest health insurers, UnitedHealthcare and WellPoint, are giants because of their numerous acquisitions over the past several years. As a result of this consolidation, almost every metropolitan area in the country is now dominated by just one or two big insurers.
Our View: Maine health law better for insurers than patients
Other states have taken a more constructive approach to lowering costs through wellness.
Faced with already high health care costs and steep inflation in health care premiums, Maine Republicans have used their legislative majorities and control of the Blaine House to change course.
Their policy has relied on dropping coverage for people on MaineCare, fighting national health care reform in the State House and in court, and changing regulations that reduce risk for insurance companies and shift it on to consumers.
We have opposed all of those strategies, and while the MaineCare cuts and court battles have not yet been resolved, we are starting to see the results of the insurance reform that was passed on a partisan vote in 2011.
According to a study by Consumers for Affordable Health Care, the insurance reforms called Public Law 90 have not stopped overall increases in the insurance premiums, but it has redistributed them.
The new rates are hardest on older rate payers and those who live in rural areas. This will benefit young people in southern Maine and will reduce risk for insurance companies but will not do much to promote the health and economic well-being of the state as a whole.
For a sign of a path that could have been taken instead, Mainers can look to Arkansas, another small state with a large poor population and Medicaid shortfalls, where lawmakers have embraced reform as a way to lower costs.
In Arkansas, state officials are working with federal counterparts, private insurance companies, hospitals and doctors to move the state off fee-for-service compensation to a primary care system designed to improve outcomes
LePage wants low-cost Canadian drug program back, but it’s no simple matter
Posted Sept. 11, 2012, at 7:43 p.m.
AUGUSTA, Maine — At least two state senators and Gov. Paul LePage are interested in a legislative fix that would allow 1,200 Maine households to continue purchasing lower-cost prescription drugs through a Canadian firm that distributes medications by mail.
Sen. Doug Thomas, R-Ripley, said Tuesday he has been working on legislation that would allow the Canadian firm, CanaRx, to continue supplying prescription medications to about 900 Maine state employees, 220 employees of the city of Portland and 83 employees of the Guilford-based company Hardwood Products Co.
Sen. Troy Jackson, D-Allagash, said he has submitted a legislative request, the first official step toward drafting legislation, in an effort to allow CanaRx to do business in Maine.
A spokeswoman for LePage said Tuesday the governor supports efforts to allow CanaRx to resume doing business in the state but that it’s too early to say whether LePage will propose his own legislation or sign onto another legislative effort.
The legislative proposals are a response to a recent determination by Attorney General William Schneider that CanaRx, as an international firm, cannot be licensed as a pharmacy in Maine.
The determination led CanaRx to shut down its MaineMeds program Aug. 15, a move that could endanger about $3 million in savings budgeted for the state employees’ health plan and create a $200,000 budget hole this year for the city of Portland.
Launched in 2003, CanaRX provides mail-order pharmacy services to public-sector health plans in Illinois, Vermont, Rhode Island and other states. It cuts costs by sending medications directly to prescription holders from pharmaceutical plants in Canada, the United Kingdom, New Zealand and Australia. Schneider, however, determined that the international delivery system makes it impossible for the Maine Board of Pharmacy to license CanaRx under Maine law.
“It’s a problem that we need to fix, and we will,” said Thomas.
Fat no longer: How Maine can reduce child obesity rates
Health factors are predictive of health status, such as rates of smoking, drinking and obesity among adults, air quality, the availability of clinical care, educational attainment and the percentage of children living in poverty. Health outcomes reflect the overall health of county residents, including deaths before age 75, self-reported poor mental and physical health among adults, and the percentage of babies born under a healthy weight.
Posted Sept. 11, 2012, at 3:18 p.m.
Maine should develop policies and programs that encourage children to eat healthy foods not just because it’s the humane thing to do but because of the long-term economic impacts. A healthier child is more likely to be a healthier, more productive adult.
It will require many different approaches to reduce the number of Maine children who are overweight or obese. Some methods include the following: ensuring that communities are walkable; supporting programs that educate pregnant women about a healthy diet; implementing fun school exercise programs that complement gym class, such as Move More Kids; and setting up more farmers markets to be able to accept food stamps.
Another effort also shows promise. Called FoodCorps, the national nonprofit service organization began in California on Earth Day in 2009, the day President Barack Obama signed the Edward M. Kennedy Serve America Act to expand AmeriCorps. It aims to improve students’ nutrition education, help schools grow vegetables able to be served in their cafeterias and connect students with local farms.
FoodCorps was rolled out in 10 states in August 2011. It was, to put it mildly, popular. More than 100 organizations in 38 states and the District of Columbia competed to have FoodCorps members come to their communities. Less than one-third of FoodCorps funding comes from the federal government; much of it comes from foundations.
Maine drew six FoodCorps members last school year who served 11,634 hours, conducted 1,530 activities with youth and engaged 168 volunteers. Hosted by the University of Maine Cooperative Extension, they helped build 12 new school gardens and 10 new community gardens, and revitalized 98 school and community gardens.
Premiums for family health plans hit $15,745
Posted Sept. 11, 2012, at 2:53 p.m.
WASHINGTON — It sounds like good news: Annual premiums for job-based family health plans went up only 4 percent this year.
But hang on to your wallets. Premiums averaged $15,745, with employees paying more than $4,300 of that, a glaring reminder that the nation’s problem of unaffordable medical care is anything but solved.
The annual employer survey released Tuesday by two major research groups also highlighted another disturbing trend: employees at companies with many low-wage workers pay more money for skimpier insurance than what their counterparts at upscale firms get.
Overall, “it’s historically a very moderate increase in premiums,” said Drew Altman, president of the Kaiser Family Foundation, which conducted the survey with the Health Research & Educational Trust.
He quickly added: “But even a moderate increase feels really big to workers when their wages are flat or falling.” The rise in premiums easily outpaced workers’ raises and inflation.
Following a 9-percent hike in premiums last year, the 2012 increase quickly became fodder for the political debate. Republicans said President Barack Obama’s promises to control health care costs ring hollow in light of the findings.
But the most significant cost-control measures in Obama’s law have yet to take effect, and the president’s big push to cover the uninsured doesn’t start until 2014. Those measures include a new tax on the most expensive insurance plans and a powerful board to keep Medicare spending manageable.
Trying to head off critics, the administration issued a report estimating that consumers have saved $2 billion as a result of the health care law. That’s due to a combination of insurance rebates for employers and individual policy holders, as well as closer state oversight of proposed rate increases, facilitated by Obama’s law.
Still, the Kaiser survey shows premiums for job-based family coverage rose by nearly $2,400 since 2009 when Obama took office, with a corresponding increase of nearly $800 for employee-only coverage.
“We aren’t happy to see any increase in health insurance premiums,” said Gary Cohen, head of the administration’s Center for Consumer Information and Insurance Oversight, adding that officials are “heartened” it was only a modest rise this year and look forward to slowing costs as more provisions of the health care law take effect.
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