Tobacco Firms’ Tactics Limit Poorer Nations’ Smoking Laws
By SABRINA TAVERNISE
Tobacco companies are pushing back against a worldwide rise in antismoking laws, using a little-noticed legal strategy to delay or block regulation. The industry is warning countries that their tobacco laws violate an expanding web of trade and investment treaties, raising the prospect of costly, prolonged legal battles, health advocates and officials said.
The strategy has gained momentum in recent years as smoking rates in rich countries have fallen and tobacco companies have sought to maintain access to fast-growing markets in developing countries. Industry officials say that there are only a few cases of active litigation, and that giving a legal opinion to governments is routine for major players whose interests will be affected.
But tobacco opponents say the strategy is intimidating low- and middle-income countries from tackling one of the gravest health threats facing them: smoking. They also say the legal tactics are undermining the world’s largest global public health treaty, the W.H.O. Framework Convention on Tobacco Control, which aims to reduce smoking by encouraging limits on advertising, packaging and sale of tobacco products. More than 170 countries have signed it since it took effect in 2005.
More than five million people die annually of smoking-related causes, more than from AIDS, malaria and tuberculosis combined, according to the World Health Organization.
Alarmed about rising smoking rates among young women, Namibia, in southern Africa, passed a tobacco control law in 2010 but quickly found itself bombarded with stern warnings from the tobacco industry that the new statute violated the country’s obligations under trade treaties.
“We have bundles and bundles of letters from them,” said Namibia’s health minister, Dr. Richard Kamwi.
Three years later, the government, fearful of a punishingly expensive legal battle, has yet to carry out a single major provision of the law, like limiting advertising or placing large health warnings on cigarette packaging.
In Food Cravings, Sugar Trumps Fat
By ANAHAD O'CONNOR
What makes a milkshake so irresistible?
Is it the sweet flavor that our taste buds are after? Or the smooth and creamy texture? Or perhaps it is the copious blend of fat and sugar?
An intriguing new study suggests that what really draws people to such treats, and prompts them to eat much more than perhaps they know they should, is not the fat that they contain, but primarily the sugar.
The new research tracked brain activity in more than 100 high school students as they drank chocolate-flavored milkshakes that were identical in calories but either high in sugar and low in fat, or vice versa. While both kinds of shakes lit up pleasure centers in the brain, those that were high in sugar did so far more effectively, firing up a food-reward network that plays a role in compulsive eating.
To their surprise, the researchers found that sugar was so powerful a stimulus that it overshadowed fat, even when the two were combined in large amounts. High sugar shakes that were low in fat ramped up the reward circuitry just as strongly as the more decadent shakes that paired sugar and fat in large quantities, suggesting that fat was a runner-up to sugar, said Eric Stice, the lead author of the study, which was funded by the National Institutes of Health and published in The American Journal of Clinical Nutrition.
“We do a lot of work on the prevention of obesity, and what is really clear not only from this study but from the broader literature over all is that the more sugar you eat, the more you want to consume it,” said Dr. Stice, a senior research scientist at the Oregon Research Institute. “As far as the ability to engage brain reward regions and drive compulsive intake, sugar seems to be doing a much better job than fat.”
The new findings add to a growing number of brain studies that are providing a more complex understanding of what drives people to overeat in the first place.
Heavily processed foods loaded with fat and sugar activate and potentially alter the same reward regions in the brain that are hijacked by alcohol and drugs of abuse. Though the extent to which these foods can provoke addictive behavior remains controversial, the results may help explain why millions of people who diet and struggle to lose weight ultimately fail.
“The obesity epidemic and the problems with overeating don’t have too much to do with people overeating fruits and healthy foods. They have a lot to do with people overeating excess sugars and fats,” said Nicole Avena, a faculty member at the New York Obesity Research Center at Columbia University, who was not involved in the new study.
Is Obamacare out of the woods? We’ll have to wait a little longer to know
Posted Dec. 12, 2013, at 1:18 p.m.
Has Obamacare turned a corner and recovered from its bungled start? Or should Americans expect more problems to pile on as the Affordable Care Act gets off the ground?
A reasonable conclusion might fall somewhere in the middle. The latest insurance enrollment numbers released by the federal government show the law’s online exchanges are lagging in signing up lower-income people for coverage. And we still don’t know if healthcare.gov is working as well on the back end as it now is on the front end.
Still, while enrollment for October and November fell short of Obama administration goals, the fact that many more are now applying for coverage and going through the steps to purchase it is a promising sign the Obama administration has made significant improvements to the infamous healthcare.gov website.
Nationwide, through the end of November, healthcare.gov and the 17 state-operated online insurance marketplaces had received applications for insurance to cover nearly 3.7 million people; that’s up from 1.5 million people at the end of October. Some 2.3 million people found out they were eligible to enroll in a marketplace plan (up from 1.1 million a month earlier), and about 365,000 had followed through and chosen a health plan.
The Congressional Budget Office has projected 7 million people will enroll in an exchange-offered plan in 2014.
One indicator that shows the progress healthcare.gov has made since October is the fact that successful enrollments through the federal website are gaining ground on enrollment figures in states operating their own enrollment websites.
At the end of October, the federal website was responsible for just a quarter of health coverage signups. By the end of November, the number of healthcare.gov signsup had increased more than fivefold. State-run marketplaces experienced less than a threefold increase. Still, states operating exchanges on their own are so far responsible for more signups — 227,000 — than the federal website — 137,000.
In Maine, the federal government has received insurance applications for 16,325 people (by comparison, about 130,000 people in Maine lack health insurance). Some 12,667 Maine people had found out they’re eligible for marketplace coverage, and 1,747 people had selected a plan by the end of November, up from 271 a month earlier.
So, is Obamacare is on track to accomplish some of its chief objectives?
U.S Chamber official visits Maine to describe latest efforts to lessen Obamacare’s effect on businesses
Posted Dec. 12, 2013, at 1:52 p.m.
AUGUSTA, Maine — Though most people by this point accept that the Affordable Care Act is here to stay, efforts continue to tweak the historic health insurance reform law and lessen its effect on businesses, according to a representative of the U.S. Chamber of Commerce, who was in Maine on Thursday morning to discuss the subject.
Jennifer Pierotti, the U.S. Chamber’s manager of health care policy, spoke about changes to the Affordable Care Act, also known as Obamacare, the chamber will be lobbying for in the coming year at a forum on health care policy held by the Maine State Chamber of Commerce in Augusta.
The federal government has continued its implementation of the ACA, also known as Obamacare, despite the various delays and glitches its rollout has confronted. Those delays, according to Peter Gore, vice president of government relations at the Maine chamber, “have resulted in a unique opportunity for businesses to step back and seek answers and solutions to the questions they have.”
Pierotti said some individuals and businesses are facing sticker shock as they see what changes the health insurance law are causing.
“My dad even called me up the other day. He said ‘Jennifer, did you know that my retiree health plan covers up to $100,000 of gender reassignment surgery, but it will not cover my hearing aid?’” she said. “So, needless to say, there will be a lot of yelling at Christmas this year.”
Pierotti offered an update on the “infamous” website glitches that have plagued the rollout of the federal exchange marketplace at healthcare.gov. Since the beginning of October, 364,000 people have signed up for health insurance, including 137,000 through the federally facilitated exchange and 227,000 through 14 state-run exchanges.
“So, if 3 million people sign up in December the administration will hit its year-end goal,” she said, though noting that doesn’t include people who go through direct enrollment.
Full repeal of the Affordable Care Act is not a viable option, Pierotti admitted, though some diehards continue pushing for that outcome. Instead, the U.S. Chamber is lobbying for a number of changes to the law that the business advocacy group claims would improve availability of health insurance and lessen the effect on employers.
“There’s been a growing sentiment this year that there’s a huge space for people offering realistic approaches to what needs to be changed in the health care law,” she said, noting that it’s a bipartisan sentiment driven by growing concern among constituents. “These are issues affecting business in real time and there are changes that need to be made that we can do through the legislative process.”
Obamacare set up to benefit insurers
By Jonathan Walker, M.D.
The Journal Gazette (Fort Wayne, Ind.), Dec. 8, 2013
The rollout of the Affordable Care Act, aka Obamacare, has been anything but auspicious. And, depending on one’s politics, reactions have ranged from despair to vindictive glee. But if you are stuck on the superficial level – watching the president backpedal while wondering about the problems with the online exchanges – you are being misdirected from the real drama.
It all started about 10 years ago. The big for-profit insurance companies – WellPoint, Cigna, United and the others – realized they were heading for trouble. Their business model is simple; they have to put profits over patients in order to survive. But people were starting to get frustrated with how those companies behaved.
There were movies, articles and books calling out the way those companies were denying coverage, throwing people off plans, and hiding behind walls of impenetrable bureaucracy. There were lawsuits accusing them of large-scale fraud, and high-profile news stories implicating them in poor medical outcomes.
Those companies knew they had to improve their reputation before popular opinion came down on them. Their biggest fear was that people might start looking at Medicare – the real public option – as a solution.
As a result, they agreed in principle to ignore pre-existing conditions. But they knew that would cost them a lot of money, so they advocated for what became the basic structure of Obamacare: a mandate to gather in healthy customers, the subsidies to help those customers buy their products, and the exchanges to funnel paying customers to their door.
They were so successful in their attempts to co-opt reform that in 2009, Business Week famously announced that they had “won” – that whatever shape reform would take, those companies had been able to get what they wanted from the bargaining table.
Think about that in the context of what you are learning from the news. The new law guaranteed that taxpayers would help those companies by administering the mandate that forces people to buy their product. We also pay for the subsidies that allow people to be able to afford what they are selling. We then have to pay to set up the exchanges so people can easily transfer that money to those companies.
There is even a part of the law that few people are aware of: if those companies have to pay for too many sick people, they can apply to the government to be reimbursed for their losses! One begins to wonder exactly whom the ACA was designed to help.
Given all this, the furor over the exchanges becomes especially grating. Taxpayers are being asked to pay for a shopping site – like Kayak.com, but far more complex. The site is supposed to work with each company’s myriad plans, and it is supposed to make sure those companies get the maximum amount of taxpayer dollars through the subsidies. Yet there is no sign that any of those companies are doing anything to actually help pay for or manage the site – we are stuck with it.
It is mind-boggling that Obamacare has been portrayed as a government takeover; it actually represents a corporate takeover of a good-faith attempt to improve access to health care. There are some really great parts to the ACA, but the fundamental structure perpetuates companies that, by their very nature, have to avoid paying for us when we are sick.
http://www.pnhp.org/print/news/2013/december/obamacare-set-up-to-benefit-insurers
The Journal Gazette (Fort Wayne, Ind.), Dec. 8, 2013
The rollout of the Affordable Care Act, aka Obamacare, has been anything but auspicious. And, depending on one’s politics, reactions have ranged from despair to vindictive glee. But if you are stuck on the superficial level – watching the president backpedal while wondering about the problems with the online exchanges – you are being misdirected from the real drama.
It all started about 10 years ago. The big for-profit insurance companies – WellPoint, Cigna, United and the others – realized they were heading for trouble. Their business model is simple; they have to put profits over patients in order to survive. But people were starting to get frustrated with how those companies behaved.
There were movies, articles and books calling out the way those companies were denying coverage, throwing people off plans, and hiding behind walls of impenetrable bureaucracy. There were lawsuits accusing them of large-scale fraud, and high-profile news stories implicating them in poor medical outcomes.
Those companies knew they had to improve their reputation before popular opinion came down on them. Their biggest fear was that people might start looking at Medicare – the real public option – as a solution.
As a result, they agreed in principle to ignore pre-existing conditions. But they knew that would cost them a lot of money, so they advocated for what became the basic structure of Obamacare: a mandate to gather in healthy customers, the subsidies to help those customers buy their products, and the exchanges to funnel paying customers to their door.
They were so successful in their attempts to co-opt reform that in 2009, Business Week famously announced that they had “won” – that whatever shape reform would take, those companies had been able to get what they wanted from the bargaining table.
Think about that in the context of what you are learning from the news. The new law guaranteed that taxpayers would help those companies by administering the mandate that forces people to buy their product. We also pay for the subsidies that allow people to be able to afford what they are selling. We then have to pay to set up the exchanges so people can easily transfer that money to those companies.
There is even a part of the law that few people are aware of: if those companies have to pay for too many sick people, they can apply to the government to be reimbursed for their losses! One begins to wonder exactly whom the ACA was designed to help.
Given all this, the furor over the exchanges becomes especially grating. Taxpayers are being asked to pay for a shopping site – like Kayak.com, but far more complex. The site is supposed to work with each company’s myriad plans, and it is supposed to make sure those companies get the maximum amount of taxpayer dollars through the subsidies. Yet there is no sign that any of those companies are doing anything to actually help pay for or manage the site – we are stuck with it.
It is mind-boggling that Obamacare has been portrayed as a government takeover; it actually represents a corporate takeover of a good-faith attempt to improve access to health care. There are some really great parts to the ACA, but the fundamental structure perpetuates companies that, by their very nature, have to avoid paying for us when we are sick.
http://www.pnhp.org/print/news/2013/december/obamacare-set-up-to-benefit-insurers
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