Poor Children Show a Decline in Obesity Rate
By SABRINA TAVERNISE
After years of growing concern about obesity among children, federal researchers have found the clearest evidence yet that the epidemic may be turning a corner in young children from low-income families.
The obesity rate among preschool-age children from poor families fell in 19 states and United States territories between 2008 and 2011, federal health officials said Tuesday — the first time a major government report has shown a consistent pattern of decline for low-income children after decades of rising rates.
Children from poor families have had some of the nation’s highest rates of obesity. One in eight preschoolers in the United States is obese. Among low-income children, it is one in seven. The rate is much higher for blacks (one in five) and for Hispanics (one in six).
Several cities have reported modest drops among school-age children, offering hints of a change in course. But gains were concentrated among whites and children from middle- and upper-income families, and were not consistent across the country.
“We’ve seen isolated reports in the past that have had encouraging trends, but this is the first report to show declining rates of obesity in our youngest children,” said Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, which prepared the report. “We are going in the right direction for the first time in a generation.”
The cause of the decline remains a mystery, but researchers offered theories, like an increase in breast-feeding, a drop in calories from sugary drinks, and changes in the food offered in federal nutrition programs for women and children. In interviews, parents suggested that they have become more educated in recent years, and so are more aware of their families’ eating habits and of the health problems that can come with being overweight.
Health officials noted a small decline in the national rate for low-income children for the first time in December, but they did not regard it as important because they lacked a geographic breakdown to show whether the pattern had taken hold in many states.
Obamacare months behind in testing data security
Posted Aug. 07, 2013, at 9:42 a.m.
NEW YORK — The federal government is months behind in testing data security for the main pillar of Obamacare: allowing Americans to buy health insurance on state exchanges due to open by Oct. 1.
The missed deadlines have pushed the government’s decision on whether information technology security is up to snuff to exactly one day before that crucial date, the Department of Health and Human Services’ inspector general said in a report.
As a result, experts say, the exchanges might open with security flaws or, possibly but less likely, be delayed.
“They’ve removed their margin for error,” said Deven McGraw, director of the health privacy project at the non-profit Center for Democracy & Technology. “There is huge pressure to get (the exchanges) up and running on time, but if there is a security incident they are done. It would be a complete disaster from a PR viewpoint.”
The most likely serious security breach would be identity theft, in which a hacker steals the Social Security numbers and other information people provide when signing up for insurance.
The inspector general’s report, released without fanfare last Friday, found that the Centers for Medicare & Medicaid Services or CMS — the agency within HHS that is running Obamacare — had set a May 13 deadline for its contractor to deliver a plan to test the security of the crucial information technology component.
A test was to have been performed between June 3 and 7. But the delivery deadline slipped and the test — assessing firewalls and other security elements — is now set for this week and next.
“CMS,” concludes the inspector general’s report, “is working with very tight deadlines.”
The delays mean that the ruling by CMS’s chief information officer certifying the Obamacare IT system as secure will be pushed back from Sept. 4 to Sept. 30, a day before enrollment under the Patient Protection and Affordable Care Act, the law that established Obamacare, is supposed to start.
“Several critical tasks remain to be completed in a short period of time,” the report concluded.
Any additional delays could mean CMS would not have the information it needs to authorize use of the system by Oct. 1, the inspector general found.
CMS spokesman Brian Cook said the agency is confident the Obamacare exchanges will open on time. “We are on schedule and will be ready for the marketplaces to open on Oct. 1,” he said.
IDENTITY THEFT?
When people try to enroll in health insurance starting on Oct. 1 for insurance plans taking effect in 2014, their identity, income and other information they furnish with their application will be funneled through a federal “data hub.”
http://bangordailynews.com/2013/08/07/health/obamacare-months-behind-in-testing-data-security/print/
How Obamacare can help workers, keep business competitive
Posted Aug. 06, 2013, at 12:10 p.m.
These days I’ve become aware of people discussing the need for healing and resiliency to an extent I just don’t remember from the past. This Saturday I came across an OpEd in The New York Times discussing the ubiquity of trauma and the importance of being able to face it so you can heal from the experience.
“Death,” Dr. Mark Epstein claimed, “(and its cousins: old age, illness, accidents, separation and loss) hangs over all of us.” True, “trauma is an ineradicable aspect of life,” but our experiences of crises — how likely, what kinds and how quickly we’re able to recover from them — are shaped by the world we live in.
As Americans, we’re culturally primed to think about what we or our family should do or what we could have done differently, but this way of thinking obscures 40 years of societal changes that dramatically changed the risks we face and the resources we have available to weather them.
During the 1960s, many workers could expect to retire from the same company where they first started. While working, they could take paid vacations, paid sick days and get access to free, or almost free, medical care. Their access to health insurance was secured by their employer but subsidized by the federal government through tax abatements.
Many fathers, although not all, could afford to support a stay-at-home wife or a wife who organized part-time work hours so she could still attend to the needs of her children, husband and older relatives for care. These arrangements represented a post-World War II societal consensus about the proper responsibilities of the government, employers and individuals for providing the support working families need.
During the late 1970s this ostensible agreement started breaking down as employers sought to cut production costs by paying fewer taxes and by reducing their obligations to employees. These latter changes included cutting benefits and replacing permanent workers through outsourcing and hiring temporary workers who weren’t eligible for benefits.
Production workers without college degrees were the first to have to find new ways to support their families under these arrangements. Low-skilled mothers started working more hours to support their families, but the new service work available to them was often part-time or temporary and didn’t include benefits, including paid sick leave.
Over the last 10 years, these contingent employment practices have spread to other areas. It’s not uncommon, for instance, to find medical or legal professionals hired on short-term contracts through specialized temporary agencies.
If these new contract arrangements are necessary for companies to remain competitive in today’s economy, Americans need to develop new public programs to support workers and their families as they weather the new risks produced by these changes. The nation and its employers still need healthy, productive workers.
If companies are going to continue to offload the costs for health care and paid leave, we need new public programs, like the Affordable Care Act, which will help citizens to retain their access to health care for themselves and their families, as they move from job to job.
Get bosses out of insurance business
By Dr. Judith Dasovich
Springfield (MO) News-Leader, Aug. 3, 2013
Employee-sponsored health insurance, or ESI, should be replaced with an affordable, efficient financing system.
During World War II, wage controls forced employers to compete for labor through benefits. Today, it is a burden on business and workers.
ESI puts American companies at a disadvantage. They have expenses that foreign competitors do not. Negotiations surrounding it sour relations between management and labor. Hiring is constrained by the cost of ESI. Entrepreneurship is stifled.
Starting a small business often means buying health insurance through the individual market. This is more expensive and may not be available due to pre-existing conditions. The Affordable Care Act is supposed to outlaw denial of coverage, but it doesn’t outlaw price gouging.
ESI is expensive and inefficient. Overhead averages 14 percent compared to less than 3 percent for traditional Medicare because of complexity, marketing costs and administrative pay.
One of Springfield’s largest employers uses Coventry insurance. Coventry’s CEO makes $13 million a year, or $49,765 a day. Doctors, hospitals and businesses are all forced to incur higher overhead because of ESI’s business model.
ESI restricts freedom. Patients cannot choose their doctors or hospitals. They have to switch providers if the plan changes. This is dangerous and expensive. Workers pay for insurance while they are healthy. When they get sick, they lose their jobs and insurance. COBRA is time limited and too expensive for most people without incomes. This is an inhumane situation for the worker, but a sweet deal for the insurance companies.
It is a myth that higher out-of-pocket expenses control medical costs. Americans pay more than anyone in the industrialized world, but medical spending is much higher.
We have higher infant, maternal and overall mortality. People do not choose ovarian cancer or rheumatoid arthritis, like they choose a used Honda over a new BMW. They cannot “shop around.”
Choice of providers is restricted. It is almost impossible to know the cost before obtaining a medical service. Medical emergencies do not allow patients time to shop. Having “skin in the game” does not control costs. If it did, we would have the cheapest health care in the world.
http://www.pnhp.org/print/news/2013/august/get-bosses-out-of-insurance-business
Salon, August 5, 2013
Until recently, the high-deductible health insurance plan – pay less up front, and more when you get sick – was something of a novelty product, marketed to the young and healthy. Now, however, high-deductibles are rapidly going mainstream – whether for young or old, professionals or poor alike.
Let’s say that you are in the market for a health insurance plan for your family. Perusing the choices on United Health’s website, you play it safe, avoid the plan labeled “high-deductible,” and settle on the company’s “comprehensive plan,” so-called “Copay Select.”
You expect a hefty annual premium, but are surprised to learn that after the premium is paid, you will still have a sizable deductible – money to be paid out-of-pocket for services ranging from lab tests to surgery – starting at $1,000 and ranging up to $12,500 per year. You may then be susceptible to “co-insurance” – additional out-of-pocket expenses of up to 30% of your medical bills –with maximums reaching as high as $10,000 per year. Then there are copays for visits to the doctor, as well as four “tiers” of cost sharing for prescription drugs.
Realizing that such expenses might turn a medical illness into a financial catastrophe, you consider waiting to 2014, when you can buy health insurance through the new exchanges created under the Affordable Care Act (ACA). You would, however, be disappointed to learn that the mid-level “silver” plans offered on the exchange are only required to cover 70% of your annual health care expenses. Out-of-pocket “cost-sharing” – in the form of copays, deductibles, or co-insurance – could go as high as $12,700 a year for your family, depending on your income.
Now those fortunate enough to have insurance through their employer might hope to be free from this phenomenon. The protection, however, is only partial, as plans in the employer market have been trending in a similar direction for years. Between 2006 and 2012, for instance, the percentage of covered workers with a deductible of $1,000 or more tripled, as did those with a deductible of more than $2,000.
Even those sufficiently impoverished to be eligible for public assistance are not immune: in January, the administration moved to allow states to charge Medicaid patients higher copayments for drugs, emergency room use and doctor’s visits.
Welcome to Copay Country.
To understand the origins of this new era of “cost-sharing,” we have to look back to the 1970s, when the rising costs of American health care became for the first time the predominant concern of policymakers.
http://www.pnhp.org/print/news/2013/august/your-doctor-copays-are-too-high
Springfield (MO) News-Leader, Aug. 3, 2013
Employee-sponsored health insurance, or ESI, should be replaced with an affordable, efficient financing system.
During World War II, wage controls forced employers to compete for labor through benefits. Today, it is a burden on business and workers.
ESI puts American companies at a disadvantage. They have expenses that foreign competitors do not. Negotiations surrounding it sour relations between management and labor. Hiring is constrained by the cost of ESI. Entrepreneurship is stifled.
Starting a small business often means buying health insurance through the individual market. This is more expensive and may not be available due to pre-existing conditions. The Affordable Care Act is supposed to outlaw denial of coverage, but it doesn’t outlaw price gouging.
ESI is expensive and inefficient. Overhead averages 14 percent compared to less than 3 percent for traditional Medicare because of complexity, marketing costs and administrative pay.
One of Springfield’s largest employers uses Coventry insurance. Coventry’s CEO makes $13 million a year, or $49,765 a day. Doctors, hospitals and businesses are all forced to incur higher overhead because of ESI’s business model.
ESI restricts freedom. Patients cannot choose their doctors or hospitals. They have to switch providers if the plan changes. This is dangerous and expensive. Workers pay for insurance while they are healthy. When they get sick, they lose their jobs and insurance. COBRA is time limited and too expensive for most people without incomes. This is an inhumane situation for the worker, but a sweet deal for the insurance companies.
It is a myth that higher out-of-pocket expenses control medical costs. Americans pay more than anyone in the industrialized world, but medical spending is much higher.
We have higher infant, maternal and overall mortality. People do not choose ovarian cancer or rheumatoid arthritis, like they choose a used Honda over a new BMW. They cannot “shop around.”
Choice of providers is restricted. It is almost impossible to know the cost before obtaining a medical service. Medical emergencies do not allow patients time to shop. Having “skin in the game” does not control costs. If it did, we would have the cheapest health care in the world.
http://www.pnhp.org/print/news/2013/august/get-bosses-out-of-insurance-business
Your doctor copays are too high!
We’ve chosen a cost-sharing system of high-deductible health care. Here’s why it’s grossly unfair to Americans
By Adam GaffneySalon, August 5, 2013
Until recently, the high-deductible health insurance plan – pay less up front, and more when you get sick – was something of a novelty product, marketed to the young and healthy. Now, however, high-deductibles are rapidly going mainstream – whether for young or old, professionals or poor alike.
Let’s say that you are in the market for a health insurance plan for your family. Perusing the choices on United Health’s website, you play it safe, avoid the plan labeled “high-deductible,” and settle on the company’s “comprehensive plan,” so-called “Copay Select.”
You expect a hefty annual premium, but are surprised to learn that after the premium is paid, you will still have a sizable deductible – money to be paid out-of-pocket for services ranging from lab tests to surgery – starting at $1,000 and ranging up to $12,500 per year. You may then be susceptible to “co-insurance” – additional out-of-pocket expenses of up to 30% of your medical bills –with maximums reaching as high as $10,000 per year. Then there are copays for visits to the doctor, as well as four “tiers” of cost sharing for prescription drugs.
Realizing that such expenses might turn a medical illness into a financial catastrophe, you consider waiting to 2014, when you can buy health insurance through the new exchanges created under the Affordable Care Act (ACA). You would, however, be disappointed to learn that the mid-level “silver” plans offered on the exchange are only required to cover 70% of your annual health care expenses. Out-of-pocket “cost-sharing” – in the form of copays, deductibles, or co-insurance – could go as high as $12,700 a year for your family, depending on your income.
Now those fortunate enough to have insurance through their employer might hope to be free from this phenomenon. The protection, however, is only partial, as plans in the employer market have been trending in a similar direction for years. Between 2006 and 2012, for instance, the percentage of covered workers with a deductible of $1,000 or more tripled, as did those with a deductible of more than $2,000.
Even those sufficiently impoverished to be eligible for public assistance are not immune: in January, the administration moved to allow states to charge Medicaid patients higher copayments for drugs, emergency room use and doctor’s visits.
Welcome to Copay Country.
To understand the origins of this new era of “cost-sharing,” we have to look back to the 1970s, when the rising costs of American health care became for the first time the predominant concern of policymakers.
http://www.pnhp.org/print/news/2013/august/your-doctor-copays-are-too-high
The Cost of a Smoker: $5,816
By SOPHIE EGAN
A smoker costs a private employer in the United States an extra $5,816 per year compared with a nonsmoker, according to an analysis of data collected from earlier studies on the costs of smoking.
Researchers at The Ohio State University estimated that the largest cost, at $3,077 annually, came from taking smoking breaks. Smokers took, on average, about five breaks a day, compared with the three breaks typically sanctioned for most workers.
The second largest cost, at $2,056, was related to excess health care expenses. Smokers typically have more health problems than nonsmokers, including heart and lung disease and various cancers.
The remaining costs came from increased absenteeism — the researchers found that smokers miss about two-and-a-half extra workdays each year — and lost productivity at work, perhaps because of nicotine’s withdrawal effects. The findings appeared online in June in the journal Tobacco Control.
“We certainly encourage businesses to provide smoking cessation programs. At least for large companies, it’s highly likely to save them money over time,” said Micah Berman, an assistant professor of public health and law at Ohio State and lead author of the analysis.
“We as a country, as communities, need to be making more efforts to address smoking systematically, not just through cessation but prevention,” he added.
No comments:
Post a Comment