At the same time we have numerous audience members who are quickly losing whatever bejeebies they might possess. If you are among the 470,000 Americans employed by the health insurance industry, for instance or among the tens of thousands of health insurance brokers in this country, you might feel like people are out to get you. Good catch because people are out to get you. Dont feel too bad, though, youre not alone. Theyre also out to get doctors, hospitals, pharmaceutical companies and a host of others.
Every health care reform idea on the table is scary to someone. Government-run plans, exchanges, mandates to sell coverage, mandates to buy coverage, taxes, cost containment. The list of proposals go on endlessly. Everybody with a stake in health care (which is everybody) has something to lose from some these reforms and someone is out there working hard to make sure these stakeholders lose it. In the health care reform everyone is an archer and everyone is a target.
So as someone with a stake in the system, but who has also spent more time than sane people should involved in politics and the legislative process, I would like to offer some simple advice to my fellow targets:
Dont Panic.
Dont get comfortable, but dont panic.
The good news is the health care reform most likely to emerge from Congress will be far more moderate than the proposals whipping around the Capital hallways today imply. This is theater and its politics. Everyone in Washington is busy staking out negotiating positions, trying to score points, and auditioning for an appearance on CNN, Fox or MSNBC. Which means what they say matters, but not as much as theyd like to think it does.
In negotiations you expect to compromise so you start off asking for more than you expect to get. Every eight year old discussing bed time knows this. So do politicians. What were seeing at this point is primarily Democrats and Republicans anchoring their positions. In Kabuki Theater, actors will strike stances that identify their role in the story. In Congressional theater, this role is played by lawmakers.
Which leads us to the effort of scoring points. Nothing revs up the base like lambasting opponents. The number of people who make a living by keeping a significant portion of the American population seething is significant and appalling. These people (and I use the term loosely) paint the world in terms of good and evil, black and white, us and them. Anyone who disagrees with is a traitor, a fool, a liar or all of the above. They care less about moving the country forward than in adding to their power or their bank account. (Have you ever noticed how often their diatribes are followed by an appeal for cash or an advertisement?) These blowhards replace bombast for thought. They have honed the cheap shot and the stiletto implication into art forms. Fortunately theres a cozy spot in Hell reserved for them where theyll have to listen to themselves blather for eternity. Until then, were the ones stuck in their noisy hurricanes of malicious hot air.
The subset of these sub-humans who hold public office will be especially prominent during this portion of the legislative process. Ignore them. Like the extreme positions taken by negotiators, the extreme rhetoric spouting from these Katrinas of politics are designed to rile you up, get your money and generate news clippings, not educate or move the debate forward.
The real action on health care reform is taking place in the nooks and crannies of Washington where moderates dwell. For example, keep your eye on the Senate Finance Committee. They seem to be trying to find solutions the nation can afford and that might actually work. Track the movements of moderates in the Senate, too. Senators Olympia Snow and Susan Collins are the two trendsetters on the amazing-shrinking-group of GOP moderates.
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The nation is grateful for a commitment that can never fully be repaid when an American citizen raises their right hand to take the formal oath to protect the U.S. Constitutionand by extension fiercely guard the daily freedom everyone of us enjoy.
This weekend reminds us all of the universal consensus that surrounds the commitment to protect our protectorsthe troops. For the past, present, and future of American liberty, and liberty around the world, is built upon the shoulders of their unwaivering dedication and willingness to sacrifice for our great nation.
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Visit IIHMR website www.iihmr.org for information about Academic courses and Training programmes offered by the instiute, Admission procedures, Placement records and latest News Events including admission results.
Institute of Health Management Research, IIHMR Jaipur - www.iihmr.
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But it's interesting to me that in what I read as Alexander's attempt to spread the blame around so that there's some taint on Democrats for the Republican torture program, he's jumping across an important line in the hopes of relieving his party of some of the burden. Alexander leaps seamlessly from proposing that the Department of Justice investigate itself and/or the executive branch to proposing that the executive branch begin investigating the legislative branch, and Members of Congress individually.
That's not by itself out of the question. The DOJ can and does investigate Members of Congress all the time, when corruption or like accusations are suspected. But how fascinating that Republicans, who have all along insisted that the torture scandal was merely a matter of "policy differences" should now propose an executive branch probe into the particulars of how that policy was debated in the legislative branch. Particularly that a Member of Congress should propose it. It seems to me that if you truly believe that torture was just a routine matter of policy, then an executive branch probe into the Congressional debate (such as it was) over the policy would be as bold a frontal assault on the speech and debate clause of the Constitution as might be imagined.
On the other hand, if you believe as I do that the program and how it was handled was likely criminal in nature, then by all means you should let your investigation go wherever the facts lead.
What interest could Senator Alexander have in seeing the deliberative process withing the legislative branch criminally probed by the executive, if he really believes the Republican line that torture was just a matter of "policy differences?"
If he really believes that, then his proposal for widening the investigation is a shocking surrender of Article I constitutional prerogatives.
And that's without mentioning that I think that there are pretty obvious differences between how to approach the investigating the roles of those who ordered, formulated and executed the policies and an investigation of those who were briefed in the abstract, told it was all on the up-and-up, and then forbidden from talking about it or inquiring further.
But now that I've mentioned that, it also strikes me as curious that Alexander seems to think there's some serious liability among Members of Congress because of their alleged "knowledge" of the program, even as he and his fellow Republicans fought tooth and nail for the past eight years for the proposition that "national security" issues like this torture program were the exclusive purview of the "unitary executive" and an inherent part of the President's "commander in chief powers."
If there was one thing the Bush/Cheney "administration" was crystal clear about, it was their assertion that these issues were their exclusive prerogative, and they would brook no intrusions into it. They would reject Congressional subpoenas and go so far as to order the US Attorneys not to prosecute their contempt, they would unilaterally nullify provisions of law adopted in Acts of Congress using signing statements, and would otherwise defy any attempt by Congress to impose its will on the conduct of the war and other "national security" fucntions.
For Lamar Alexander to have sat through that intentional diminution of Congressional powers, and indeed to have participated in it for eight years, and then suggest that any investigation into executive wrongdoing had to include a probe of Congressional complicity is patently absurd.
But not surprising.
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Id like to start out with a very general question: What exactly is the market failure that a public plan is needed to address, that can’t be addressed in a marketplace of private plans with suitable regulation, perhaps with guaranteed issue, community rating, etc., and with mechanisms like risk adjustment? Some might point to the Federal Employees Health Benefits program as a system where competing private plans have seemed to work fairly well.
Jacob, why dont we start with you?
JACOB HACKER: The central argument for having a public plan competing as a choice within a new national insurance exchange is that it provides a set of essential security guarantees. It ensures that Americans without insurance from their place of work can find a plan that offers quality affordable care through a broad choice of providers in all parts of the country. The central premise of having such a plan is that the private insurance market, even if regulated, is not going to have enough pressure on it to provide such affordable quality care without a public plan competing with it.
So I see the public plan as a benchmark for private plans, showing them how to provide good coverage at a reasonable cost with transparency and stability, and I also see it as an essential backstop thats there for those who are not well served by private insurance plans. My vision is of a system in which the public plan and private plans are competing on a level playing field to give consumers what they want and deliver value, so that both the public plan and the private plans are able to maximize their strengths and improve upon their weaknesses. I believe its a win-win bargain for that reason.
LEN NICHOLS: Whatever those of us who have always had good insurance, and advanced degrees, and good employers think, there are a lot of people who dont trust private insurance to follow the new rules that I think all of us would agree are going to be necessary to make insurance markets both efficient and fair. That lack of trust is a real phenomenon, and the public plan provides a kind of a safety valve, if you will, for people who are mistrustful of private insurance. As John Bertko and I said, in the long run if the rules are enforced appropriately as I expect them to be, the need for such a safety valve may diminish, but in the short run its real, and we have to take it very seriously.
Secondly, to back up what Jacob just said about the benchmark: The benchmark function is very important in general, but its particularly important in year one, when we would have a lot of changes and a lot of new stuff. People who worry about the lack of transparency historically in private insurance would be reassured by a bid from an entity that was designed to break even, to not earn a profit. One would expect that premium bid to be actuarially fair if — and again, I think we all three would agree — the playing field among these plans is as level as possible. Bertko and I tried to lay out the conditions under which that playing field could indeed be made level.
STUART BUTLER: I view the emergence of the public-plan idea as a nuclear minefield on the road to getting agreement on universal coverage. I think theres been a lot of progress already made in ways of assuring people there will be available plans. They’re looking at risk-adjustment mechanisms, they’re looking at an insurance exchange with certain rules, and so on. I think progress has been made with insurance companies towards guaranteed issue, and so on. These are all steps going in the right direction.
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Connie Culp, a 46-year-old Ohio woman, lost a large part of her face in 2004 when her husband shot her in the face, then turned the gun on himself. He went to prison for seven years. According to the Associated Press, the gunshot destroyed Culps nose, cheeks, the roof of her mouth and one eye and left hundreds of bone fragments and shotgun pellets lodged in her face. Only her upper eyelids, forehead, lower lip and chin remained. Culp could not breathe without the aid of a tube inserted into her windpipe.
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The problems we have with our health care system (high cost, and gatekeepers that deny treatment, restrict choice, and discourage proper care) cannot be corrected with our current health insurance apparatus.
Just as private mercenary corporations have no incentive to prevent or end war, and private prison/security corporations have no incentive to reduce crime and recidivism outside their walls, so private health insurance corporations have no incentive to approve needed health care. The primary competitive incentive of the health insurance industry is to cut costs and increase profits by restricting and denying health care to those that will or do need it.
We can no longer afford, private health insurance corporations controlling health care and deciding who can and cannot get what treatment, when, and from which doctors. Keeping the insurance apparatus we have results in the U.S. having by far, the highest per capita cost of health care, and the worst health care outcomes in the industrialized world. Its incredible, but true, that we all pay more than universal comprehensive health care would cost, in order to let the insurance and managed care corporations just say no to needed health care. Letting those profiteering gatekeepers say to health care for some doesnt save us money. It costs us money - and it harms our health.
Its about values -
marketplace values and the value of certain investments, versus human values, family values and the value of life and health. Which side are YOU on.
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VA Watchdog dot Org will follow VA news and let you know about policy, regulation and benefit changes at the Department of Veterans' Affairs. And, what you won't find here is as important as what you will find. You won't find rumors, rants or conspiracy theories here... there are no Black Helicopters on this site.
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Republicans led by Senators Sam Brownback of Kansas delayed a final vote on the nomination of Mr. Hill, a career diplomat with bipartisan support, after the Senate easily cleared an initial procedural hurdle on a 73 to 17 vote. Sixty votes were needed.
Mr. Brownback accused Mr. Hill of lying to him about earlier negotiations with North Korean over its nuclear program and of failing to move aggressively against North Korea on the question of human rights violations.
“This is a person that we now want to promote to the biggest diplomatic post we have in the world,” Mr. Brownback said.
But other Republicans urged the Senate to move forward with Mr. Hill, saying his presence in Iraq was crucial.
“It is important to get our next ambassador in place as quickly as possible,’’ said Senator Richard Lugar of Indiana, senior Republican on the Foreign Relations Committee, who praised Mr. Hill for agreeing to accept such a difficult assignment.
‘We need an ambassador in Iraq,” said Senator Saxby Chambliss, a conservative Georgia Republican who just returned from a trip to Iraq and Afghanistan. “We need it desperately.”
Senator John Kerry, Democrat of Massachusetts and chairman of the Foreign Relations Committee, said Mr. Hill, who has been an envoy in multiple hot spots, was following the instructions of the Bush administration when dealing with Korea.
“This should not be a controversial nomination,” Mr. Kerry said. “There are very few American diplomats with more experience than Chris Hill where it matters most.”
Senate officials said they expected Mr. Hill to be confirmed Tuesday.
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On the left side of the screen, if youve been to our site before, youll see familiar links to information about the California Public Health Association-North, including Membership, Sections, Donations, Album, and Resources.
On the right side youll see various ways to access postings on our site, by Category, by Most Recent, by Month, by Text Search, or by Tag. We hope to expand this section into a series of topic-based forums on public health.
Across the top are shortcuts to the most used parts of the site.
JOIN THE DIALOGUE.
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VA Watchdog dot Org will follow VA news and let you know about policy, regulation and benefit changes at the Department of Veterans' Affairs. And, what you won't find here is as important as what you will find. You won't find rumors, rants or conspiracy theories here... there are no Black Helicopters on this site.
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What does Mr. Williams have to say? Health insurers figured out years ago that their business is no longer about just collecting premiums and paying doctors and hospitals. Their customers are demanding additional value, such as covering medical innovations and technologies, having inclusive provider networks, promoting transparency and offering chronic disease care, wellness and prevention programs. Examples include Aetnas $1.8 billion investments in Active Health management and their Care Engine. And while the uninsured are a pressing problem, remember employers are successfully supporting health insurance for a whopping 177 million Americans, many of whom appear to be quite happy with the arrangement. The rising cost of their insurance is less a function of companies like Aetna and more a function of the underlying cost of health care. Employers and insurers have been working together on this for years and have had some notable successes in improving healthcare quality, dampening cost trends, increasing consumer choice, promoting transparency and covering wellness and prevention.
And heres a telling quote.
An enforceable individual coverage requirement, combined with subsidies and other changes to make coverage affordable, is the best way to ensure that all Americans have continuous access to insurance coverage and high-quality health care. Since 2005, we at Aetna have been speaking out in support of an individual coverage requirement, as we believe it is the critical step for achieving universal coverage. (year bolded by the DMCB)
So what is the link to the public plan? If there is guaranteed issue and an individual mandate, Mr. Williams suggests a public plan option would be unnecessary. He may or may not have a point about that, but he then raises a critically important issue that has conveniently gone unmentioned by the anti-insurer cognoscenti.
A public plan would probably set provider payment rates akin to those used in Medicare and Medicaid. Thats because the government has the leverage to squeeze low pricing from providers.
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Alaskans benefit from export activity. Given what is happening in economies around the world, its clear that Alaskas economy remains strong and our resources are still highly valued, said Governor Palin.
The governor noted Alaskas international activity also includes more than just export of natural resources. International interest in Alaska creates jobs across the state. In addition to traditional export of goods and services, there are Alaskans working in the visitor industry, at the states international ports and airports, and in education and language programs.
The $3.6 billion in Alaska exports represents an 11 percent decline from the previous year. World commodity prices and demand are beyond any states control. The decrease in the value of the Alaskas 2008 exports comes as prices for key resources fluctuated worldwide.
The value of Alaskas gold exports rose on smaller export volume, to $143 million. Zinc prices, which have driven the value of Alaskas total exports to the highest levels ever in the past two years, declined during 2008. The total value of zinc, lead and copper ore exports was $691 million.
Japan remains Alaskas top export market at $1.1 billion, followed by China at $733 million, Canada at $370 million, Korea at $366 million, Germany at $208 million, and Switzerland at $148 million.
In 2008, the value of Alaskas annual seafood exports was $1.8 billion, the fourth-highest year ever and a 9.1 percent decrease from the previous year. Alaska exported $553 million to Japan, the states largest seafood export market, $404 million to China, $226 million to Korea, $168 million to Germany, and $449 million to other markets around the world.
Wild Alaskan seafood is the cleanest, healthiest, tastiest protein on earth, and more people are discovering it everyday. Were fortunate to have the Alaska Seafood Marketing Institute pushing hard for our wonderful seafood in key international markets, said Governor Palin. We want to increase the value of our states sustainable fisheries in every way possible.
In 1999, Alaska seafood exports to Europe accounted for less than 5 percent of the total seafood exports. In 2008, European markets continued their upward trend in importance to the Alaska seafood industry and accounted for 24.7 percent of the value of Alaskas seafood exports. The states 2008 energy exports of $501 million included $322 million of Liquefied Natural Gas to Japan. The export of LNG to Japan has occurred on a regular basis since 1969. In 2008, the operators of the LNG plant on the Kenai Peninsula received a two-year extension of the federal export license through 2011. Refined petroleum product exports from Alaska in 2008 totaled $156 million to China, Canada, and Japan. The value of the states coal exports grew in 2008 to $23 million of sales to Pacific Rim countries.
The rising price of gold brought the value of Alaskas 2008 export of gold to $143 million from $131 million in 2007. Switzerland is the major market for Alaskas gold exports.
High world-market prices increased the value of Alaskas zinc and lead ore exports in 2006 and 2007, more than tripling the value of those exports in less than three years. The 2008 drop in zinc prices has resulted in mineral exports valued at $691 million compared to $1.3 billion in 2007 on slightly smaller volume. Red Dog Mine, in northwest Alaska, is the worlds largest zinc mine. Canada was Alaskas largest ore market in 2008 followed by Japan, China, Korea, Germany, Belgium, Finland, Spain, and Mexico.
The value of Alaskas 2008 export of forest products was $83 million, down 3.23 percent, primarily to Japan, Korea and China. The source of the Alaska export numbers is the U.S. Census Bureau. The numbers do not reflect Alaska resources first transported to and warehoused in other U.S. states before export. For more information, contact trade specialist Patricia Eckert at (907) 269-7450.
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For your privacy and protection, when applying to a job online. Never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction.
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president should address. This was well before the election.
Here is what I said:
I would advise the next president to move quickly to formulate a plan
to cover all Americans with health insurance. It needs to be a
bipartisan consensus plan because nothing else has a chance of passing
Congress. Lots of good ideas have been proposed and debated for many
years; put them together and move on with the heavy lifting of
negotiating with Congress.
Increase the budgets for the federal health agencies in particular
the Food and Drug Administration, the Centers for Disease Control and
Prevention, and the National Institutes of Health. A huge increase in
their budgets would be a rounding error for the rest of the budget, and
it would make a big impact on the publics health. Avoid playing
politics with the Medicare and Medicaid programs. These gigantic
programs need a respite from tinkering, and the staffs running the
programs need to be rebuilt and strengthened.
Finally, ignore anyone who says that the U.S. Department of Health and
Human Services should be reorganized. Recent reorganizations have
caused more harm than good. Instead, pick people to run the department
and its agencies who are skilled in leading large government units; it
is not like a private business or a university.
Now at the beginning of 2009, Id add that the plan for health reform
should include a strong emphasis on quality. An investment in
measurement and improvement of health care quality and patient safety is
clearly an essential element of overall reform. This should include
funding for expanding the work of the Agency for Healthcare Research and
Quality, and for other key activities.
It is an exciting time for our nation. The incoming Obama
Administration is bring us all a sense of hope and opportunity.
I am more hopeful than I have been in many, many years that we might be
on the verge of making a dramatic improvement in health care and in the
health of the American people.
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GUJIAO, China - Rescuers wearing headlamps and oxygen backpacks carried dozens of miners to safety yesterday after a gas explosion at a coal mine in northern China killed at least 74. The blast at the mine, which had for years boasted an exemplary safety record, highlighted the perilous conditions that make China's mining industry the deadliest in the world.
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From 2000-2007, Ron Rozensky served as Chair of the Department in which I work (Clinical and Health Psychology at the University of Florida). In the role, and since then as a colleague, he has been personally supportive of me. Although my positive views of him are not "independent and objective", I nonethless believe that he would serve APA and Division 20 well if elected as APA President. As I wrote last year, I do believe, within APA, that Ron really is the right candidate. The historical tensions with APA, between "science and practice" have not (to my knowledge) abated. In recent years, "science" has effectively banded together to promote excellent prestige candidates (e.g., Sternberg, Halpern, Seligman)...but in so doing some in the "practice" constituency have felt disenfranchised. In addition, for Division 20, science-practice is not a dichotomy but a partnership, as we work with Section II/Division 12 to further geropsychology. I believe that Ron has embraced the science-practice synthesis, and he may be invaluable in bridging constituencies in APA. Honestly, I'm not sure we have had too many "bridge building" candidates. Ron is NOT a scientist (in the sense that he has not had a funded or prolific program of research). But he has overseen (for seven years) an academic department with substantial NIH funding (which grew above the rate of the NIH budget doubling, and continues to grow) and productivity, and one which was rated in the top-20 of programs in its' class (i.e., Clinical) in US News and World Report. He also oversaw the clinical psychology service for University of Florida. What this means is that he has a keen understanding of both academic psychology and institutional practice. Ron has spent relatively less time (but some, not recently) in private practice, but I think he has some connection to that. He has also been active in APA's educational affairs, and has thereby shown a strong willingness to work for APA's educational mission. Ron's personal statement in response to Division 20 questions elucidates the ways in which--programmatically and personally--he has been supportive of aging research and scholarship. His own avocation is as "Health Psychologist". As our partnership with the Health Psychology division evinces, the focus on psychological antecedents, consequences, and interventions in chronic disease can be a key area of overlap with aging-focused scientists. Ron has consulted for some time with a private foundation interested in incontinence work. While Chair at UF, Ron personally oversaw the hiring of several faculty with aging interests, he supported our participation in "aging organizational" activities, and he provided the departmental infrastructure for our NIA-funded T32 grant in aging. In this year's crop of candidates, I also believe most Division 20 faculty will find that he really is the only one with research-relevant credentials (having overseen a Research I academic department for many years), and his focus is the most closely aligned with aging. I think he would be a good President for Division 20. Michael -- Michael Marsiske, Ph.D., Associate Professor Department of Clinical and Health Psychology University of Florida PO Box 100165 101 S. Newell Dr.
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Fewer than 50 million people searched online for any health information in 2002; that reached 150 million in 2008.
MR's database is very rich and large, enabling the firm to examine subgroups of people searching conditions from "A to V:" from acid reflux to Viagra.
Who is the average ePharma Consumer? He/she is married with median income of $55,400, and is 41 years old (the mean age). She is equally probable of being a He.
What's striking about this year's ePharma Consumer poll is the proliferation of sites that citizens are using to access prescription drug information. General health portals such as WebMD, EverydayHealth, Yahoo!, Mayo Clinic, Drugs.com, and Drugstore.com are core health consumer destinations. But increasingly, ePharma Consumers are looking to blogs, government sites (esp. CDC, FDA, and NIH), wikis, and drug ratings sites.
A growing destination for ePharma Consumers is online video. Including but not limited to YouTube, citizens are visiting WebMD and AOL to view videos not just for pure information, but to learn "how to's" such as tips for self-injecting meds where the image-in-action adds value to the online experience.
The number of health insurance company sites is also a fast-growing category, even for ePharma visitors.
And then there's Google: still the granddaddy of health search, and for ePharma searchers, too. New this year is MR's ability to help clients do search analytics on Google, targeting organic search, paid search (in the main results or on the "right-side" of the page), etc. One intriguing finding Bard mentioned was that older ePharma consumers are more likely to click on paid-search results.
40% of ePharma Consumers visited pharmaceutical corporate websites in 2008. Johnson Johnson's site appeared to be the most highly rated, albeit not the most-visited; more visited sites included Pfizer, Merck and GSK.
Manhattan Research polled 6,566 U.S. adults 18 and over online in the fourth quarter of 2008.
Health Populi's Hot Points: ePharma Consumers, and I would posit health citizens overall, use different websites at different times on the health care continuum. Consider the newly-diagnosed individual with a new prescription versus someone who has been managing diabetes for a decade and is looking for some disruptive innovation in personal chronic care.
One key finding stands out for me in this version of the ePharma Consumer data: that is, consumers' high value on the pharma company's quality of online service. This extends to user-friendliness, accessible information, clear explanations, transparency, and coupons as money-saving tools.
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They were, and long had been, the Libby Terriers borrowing for their school mascot that feisty breed whose bark, arguably, is bigger than its bite.
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