Saturday, June 30, 2012
This is a thorough discussion of how to insure Pre-existing conditions
Here is a must-read sample:
'Moreover, in 1996, Congress provided an important protection to workers by making it unlawful for employer-sponsored plans to impose exclusions on pre-existing conditions for workers in continuous group insurance coverage. This means that if a person stays covered by job-based plans long enough (usually six months), he can move from one job to another without fear of losing insurance protection, or of having to wait longer than other new hires before gaining coverage for ailments he may have developed. If a new hire maintained insurance in his old job, his new employer's plan must cover him — even if the worker has developed an expensive medical condition.
In theory, this law — called the Health Insurance Portability and Accountability Act (or HIPAA) — also provided "portability" rights to people moving from job-based plans to individually owned coverage. The law gave state governments a few options for meeting this mandate: They could establish high-risk pools (which, as discussed below, is the approach most states have followed); they could require that all individual-market health insurers within their states offer insurance to all eligible individuals, without any limits on coverage of pre-existing medical conditions; or they could use their regulatory powers to create a mix of rules that would have similar results. But unfortunately, none of these approaches has worked well enough, and today many people still end up falling through the cracks.
The problem starts with HIPAA's requirement that a worker first exhaust his right to temporary continuous coverage under his former employer's plan (through a federal program called COBRA, which lets workers keep buying into their employers' insurance plans, generally for up to 18 months after leaving their jobs) before he can enter the individual insurance market without a pre-existing condition exclusion. Many workers are not aware of this requirement (though employers must advise them of it in a written notice); even if they are, the premiums required to stay in an employer's plan through COBRA are often too high for them to pay. This is because COBRA premiums must cover both the employer and employee share of costs, and generally provide more expensive comprehensive benefits than individual-market alternatives. And unlike premiums paid in employer-based plans, these COBRA premiums do not receive any tax advantage — making them more expensive still. As a result, many workers facing this fully loaded "sticker shock" price choose not to pay the premiums, simply hoping for the best until they can find new jobs (and new coverage). In so doing, they inadvertently waive their HIPAA rights — leaving themselves vulnerable to exclusions and high costs for pre-existing conditions when they try to buy insurance on their own.
But even if a sick person abides by HIPAA's requirements and remains continuously insured — thereby protecting himself from pre-existing condition exclusions in the individual market — nothing in current federal law prevents insurers from charging him more than they charge healthy people. Insurers are prohibited only from denying coverage for a pre-existing condition altogether; it is quite permissible, however, for insurance providers to charge unaffordable premiums (unless an individual state's laws happen to prevent or restrict the practice), thus achieving essentially the same outcome.
Likewise, current law and regulations provide no premium protections for persons moving between individual insurance policies. A healthy worker who leaves an employer plan for the individual market might find an affordable plan at first — but if he ever wanted to switch insurers (or was forced to by, say, moving to a new state), he would fac e the risk of having his premium recalculated based on a new assessment of his health.
Of course, the fact that the problem of pre-existing condition coverage is limited almost entirely to the individual market does not mean that it pervades that market. In 2008, at the request of the U.S. Department of Health and Human Services, health economists Mark Pauly and Bradley Herring examined how people with chronic health conditions, and thus high anticipated health-care expenses, actually fared when seeking insurance in the individual market. Pauly and Herring found little, if any, evidence that enrollees in poor health generally paid higher premiums for individual insurance. Nor did they find that the onset of chronic conditions is necessarily associated with increased premiums in subsequent years. Existing "guaranteed renewability" requirements in federal and state law already prevent insurers from continuously reclassifying people (and the premiums they pay) based on health risks. And most private insurers already provided such protection as standard business practice before they were legally required to do so.
But even if the exclusions and prohibitive premiums caused by pre-existing conditions are not a universal problem in the individual insurance market, they clearly affect many Americans. Estimates range from 2 to 4 million, out of a total population of about 260 million people under the age of 65. More important than the sheer number, however, is the fact that many Americans know someone who has faced this situation directly, and fear that they could find themselves in the same boat — which explains the strong public support for changing the way insurance companies treat pre-existing conditions.'
Monday, June 18, 2012
'In a significant step forward for the development of a potential new cancer treatment, scientists have found how a common cold virus can kill tumors and trigger an immune response, like a vaccine, when injected into the blood stream.
Researchers from Britain's Leeds University and the Institute of Cancer Research (ICR) said by hitching a ride on blood cells, the virus was protected from antibodies in the blood stream that might otherwise neutralize its cancer-fighting abilities.
The findings suggest viral therapies like this, called reovirus, could be injected into the blood stream at routine outpatient appointments - like standard chemotherapy - making them potentially suitable for treating a range of cancers.
The study, part-funded by the charity Cancer Research UK and conducted on 10 patients with advanced bowel cancer, confirmed that reovirus attacks on two fronts - killing cancer cells directly and triggering an immune response that helps eliminate leftover cancer cells.'
Sunday, June 10, 2012
Monday, June 4, 2012
'THE first time I questioned the conventional wisdom on the nature of a healthy diet, I was in my salad days, almost 40 years ago, and the subject was salt. Researchers were claiming that salt supplementation was unnecessary after strenuous exercise, and this advice was being passed on by health reporters. All I knew was that I had played high school football in suburban Maryland, sweating profusely through double sessions in the swamplike 90-degree days of August. Without salt pills, I couldn't make it through a two-hour practice; I couldn't walk across the parking lot afterward without cramping.
While sports nutritionists have since come around to recommend that we should indeed replenish salt when we sweat it out in physical activity, the message that we should avoid salt at all other times remains strong. Salt consumption is said to raise blood pressure, cause hypertension and increase the risk of premature death. This is why the Department of Agriculture's dietary guidelines still consider salt Public Enemy No. 1, coming before fats, sugars and alcohol. It's why the director of the Centers for Disease Control and Prevention has suggested that reducing salt consumption is as critical to long-term health as quitting cigarettes.
And yet, this eat-less-salt argument has been surprisingly controversial — and difficult to defend. Not because the food industry opposes it, but because the actual evidence to support it has always been so weak.
When I spent the better part of a year researching the state of the salt science back in 1998 — already a quarter century into the eat-less-salt recommendations — journal editors and public health administrators were still remarkably candid in their assessment of how flimsy the evidence was implicating salt as the cause of hypertension.
"You can say without any shadow of a doubt," as I was told then by Drummond Rennie, an editor for The Journal of the American Medical Association, that the authorities pushing the eat-less-salt message had "made a commitment to salt education that goes way beyond the scientific facts."
While, back then, the evidence merely failed to demonstrate that salt was harmful, the evidence from studies published over the past two years actually suggests that restricting how much salt we eat can increase our likelihood of dying prematurely. Put simply, the possibility has been raised that if we were to eat as little salt as the U.S.D.A. and the C.D.C. recommend, we'd be harming rather than helping ourselves.
WHY have we been told that salt is so deadly? Well, the advice has always sounded reasonable. It has what nutritionists like to call "biological plausibility." Eat more salt and your body retains water to maintain a stable concentration of sodium in your blood. This is why eating salty food tends to make us thirsty: we drink more; we retain water. The result can be a temporary increase in blood pressure, which will persist until our kidneys eliminate both salt and water.'