Cost Can Limit Choice of Erectile Function Drug, from the June 2014 Harvard Men's Health Watch

June 10, 2014, 4:59 am

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For men with erectile problems, taking one of the four medications available can produce an erection 70% of the time.

Boston, MA (PRWEB) June 10, 2014

For the estimated half of men between the ages of 40 and 70 who have trouble getting or sustaining an erection, taking a medication can often remedy the problem. With four erectile dysfunction drugs on the market, men have options. But their choices are often limited by cost and health insurance rules, reports the June 2014 Harvard Men's Health Watch.

Four erectile dysfunction drugs are available in the United States: avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). They are meant to be taken a few hours before sexual activity. A low-dose version of tadalafil can be taken every day.

Does it make any difference which of the four erectile dysfunction drugs a man chooses? "Yes, there can be differences," says Dr. Louis Liou, chief of urology at Harvard-affiliated Cambridge Health Alliance in Boston. "For new patients, I have them try different ones to see what works best."

These drugs work for about 70% of men with erectile dysfunction. They generally kick in within 15 to 60 minutes (avanafil is the fastest). How long they last ranges from four hours to more than a day (tadalafil lasts longest). Side effects vary, but the most common ones are headache, flushing, upset stomach, nasal congestion, urinary tract infections, vision problems, diarrhea, dizziness, and rash. A man may experience side effects with one of these medications but not another.

The main obstacle to men using an erectile dysfunction drug is often its cost, says Dr. Liou. Some insurers limit men to as few as four pills a month. After using up his ration, a man's out-of-pocket cost for a single pill can be as high as $20.

It pays to shop around, because pharmacy prices vary. Various web-based tools can help men easily compare prices. Men may be able to save money by splitting higher-dose pills. And some manufacturer discount programs help men get a limited supply of medication not covered by insurance.

Read the full-length article: "Which drug for erectile dysfunction?"

Also in the June 2014 issue of the Harvard Men's Health Watch:·     Better health through coconut oil: myth or reality?
·     Six steps to a healthy heart
·     Shingles vaccination pros and cons
·     Drug-free ways to soothe a sore neck

The Harvard Men's Health Watch is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $20 per year. Subscribe at http://www.health.harvard.edu/mens or by calling 877-649-9457 (toll-free).

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Media: Contact Kristen Rapoza at hhpmedia(at)hms(dot)harvard(dot)edu for a complimentary copy of the newsletter, or to receive our press releases directly. Reported by PRWeb 20 hours ago.

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Chill out, North Carolina! State ranks among most stressed

June 10, 2014, 5:20 am

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North Carolina ranks No. 9 on a list of the most stressed-out states, according to a national survey by Movoto. Using data from the U.S. Census Bureau's American Community Survey and factors such as length of commute, unemployment, hours worked, population density, percentage of income spent on housing and percentage of population without health insurance, Movoto – a real estate brokerage firm that operates in 30 states – reports the top 10 most stressed-out of the lower 48 states are as follows: 1.… Reported by bizjournals 20 hours ago.

MNsure procedures will get federal audit

June 10, 2014, 5:50 am

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A watchdog unit of U.S. Department of Health and Human Services will review Minnesota's health exchange practices, which officials said are part of a Congressional inquiry. Minnesota Public Radio has a report on the review, which will focus on whether MNsure can properly screen eligibility for health-insurance enrollees. A MNsure spokesman said the audit was expected following a similar review of the federal health exchange. Reported by bizjournals 19 hours ago.

Survey Reveals Consumer-Focused Shopping and Enrollment Is the Most Important Capability for a Successful Health Exchange

June 10, 2014, 6:03 am

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Most insurers expected to offer private single-insurer exchanges by the end of 2016, according to an Array Health survey

Seattle (PRWEB) June 10, 2014

Array Health, a leading provider of private health insurance exchange technology, today released a report which reveals consumer-focused shopping and enrollment is the most valuable capability for a successful private exchange, according to opinions of healthcare industry professionals. The results, collected May 2014, indicate continued growth for the private exchange market, as more than 75 percent of respondents believe most insurers will offer proprietary exchanges by the end of 2016. Consumers are realizing the benefits of a whole new way to shop for health insurance – and insurers are expected to respond to this need.

Array Health’s report, “Health Check: A Survey on Private Health Insurance Exchanges,” includes survey results of more than 80 healthcare leaders across the industry. The survey gathered responses from attendees at the 2014 Blue National Summit in Orlando, Fla., and subscribers of Atlantic Information Services (AIS) health insurance publications.

The results, which are depicted in an infographic, indicate further expansion of products offered via private exchanges is expected. Eighty percent of health insurer respondents believe most private exchanges will include core medical, dental and vision as well as ancillary products by January 2015. Other key findings from the report include:·     Health insurers are opting for single-insurer exchanges over multi-insurer private exchanges. More than half of insurer respondents said they will use a private single-insurer exchange as a sales channel for their products by the end of 2014.
·     Employers are expected to move their sponsored health benefits onto private exchanges by 2016. Fifty-seven percent of all survey respondents think the majority of employers will offer their benefits through an exchange by the end of 2015. Health insurers were more optimistic with 63 percent predicting the majority of employers will move onto private exchanges by the end of 2015.
·     Respondents expect insurers will sell to all market segments via private single-insurer exchanges. Most interest focused on large groups, small groups and individuals.
·     Respondents are very positive about the adoption of single-insurer exchanges. Seventy-five percent of respondents predict the majority of health insurers will offer a private single-insurer exchange by the end of 2016 and 93 percent believe most health insurers will have their own single-insurer exchange by 2018.
·     There is greater optimism about employers’ near-term adoption of defined contribution strategies than there was one year ago. Compared to the 2013 survey results, respondents to the 2014 survey are more optimistic about the adoption of defined contribution within the next three years.

“We are very encouraged by this year’s survey results, which indicate continued momentum toward the broad-scale adoption of private exchanges,” said Jonathan Rickert, CEO of Array Health. “While the survey is only a snap shot, the responses are in line with analysts’ predictions and support projections that explosive growth in private exchanges will likely occur in the next two to three years. We are fortunate to experience firsthand the wave of innovation taking place in this new market.”

Download the survey report.

Download the survey infographic.

About the Report: “Health Check: A Survey on Private Health Insurance Exchanges”
Survey respondents included representatives from health insurers, software or services companies, brokers, producers, state and federal government agencies and third party administrators among others. The survey was distributed to attendees at the 2014 Blue National Summit in Orlando, Fla., and to AIS subscribers. The survey ran for one week in May 2014. The results of this report are compiled from 88 anonymous respondents. All percentage calculations were rounded up to the nearest whole number.

Follow Array Health on Twitter @ArrayHealth.

About Array Health
Array Health is a leading provider of private insurance exchange technology. Its cloud-based software platform enables health plans of any size to deliver their own branded online exchange—a strategic channel that helps them compete and thrive. It also provides employers a new way to control costs and gives members a better way to buy benefits. Array Health is a privately held company based in Seattle. To learn more, visit arrayhealth.com. Reported by PRWeb 19 hours ago.

TENS Machine Manufacturing in the US Industry Market Research Report Now Available from IBISWorld

June 10, 2014, 7:14 am

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Operators in the TENS Machine Manufacturing industry were dealt a significant blow after the 2012 Medicare decision to eliminate coverage of industry devices; consequently, industry growth has slowed and is expected to remain subdued over the next five years. For these reasons, industry research firm IBISWorld has added a report on the TENS Machine Manufacturing industry to its growing industry report collection.

New York, NY (PRWEB) June 10, 2014

Manufacturers of transcutaneous electrical nerve stimulation (TENS) devices, which provide electric currents to the nerves to stimulate them for therapeutic purposes, have experienced a significant threat to revenue growth during the past five years. Prior to 2012, industry firms enjoyed robust growth, as the expanding elderly population (who use TENS machines for chronic pain management) provided a growing market for industry devices. However, according to IBISWorld Industry Analyst Jocelyn Phillips, “a 2012 Medicare decision to eliminate coverage of industry devices prescribed for chronic lower back pain dealt a severe blow to the industry, which relies on Medicare for a significant portion of its funding.”

As a result of this change, industry growth slowed considerably and is expected to remain subdued during the next five years. Revenue for TENS machine manufacturers is expected to increase just 1.0% in 2014, to $502.2 million. Robust pre-2012 revenue growth, coupled with the growing elderly population, higher disposable incomes and increased access to private health insurance will likely keep annualized industry revenue growth afloat at 2.9% during the five years to 2014. However, even that modest growth is expected to slow during the five years to 2019.

Average industry profit margins managed to inch up during the five years to 2014, as small, low-profit companies exited the industry, leaving behind firms with higher margins. However, profit margins will likely decrease during the five years to 2019 due to both the continued imposition of a 2.3% medical device excise tax and the industry's increased spending on wages, as companies scramble to create cutting-edge devices to compete with low-cost imports. Nonetheless, there may still be hope for the TENS Machine Manufacturing industry. “The portion of the population aged over 65 is expected to increase from 2014 to 2019, potentially expanding the market for industry devices,” says Phillips. Disposable income is also expected to increase, allowing even those patients left unassisted by Medicare to consider buying industry devices out of pocket. Moreover, Medicare is continuing to approve TENS device payments for clinical trials designed to assess the therapy's effectiveness, and any potential successful outcome of these trials may pave the way for expanded Medicare coverage of industry products.

For more information, visit IBISWorld’s TENS Machine Manufacturing in the US industry report page.

Follow IBISWorld on Twitter: https://twitter.com/#!/IBISWorld.
Friend IBISWorld on Facebook: http://www.facebook.com/pages/IBISWorld/121347533189.

IBISWorld industry Report Key Topics

The TENS Machine Manufacturing in the US industry manufactures transcutaneous electrical nerve stimulation (TENS) devices. These machines provide electric currents to the nerves to stimulate them for therapeutic purposes, mainly for pain relief.

Industry Performance
Executive Summary
Key External Drivers
Current Performance
Industry Outlook
Industry Life Cycle
Products & Markets
Supply Chain
Products & Services
Major Markets
Globalization & Trade
Business Locations
Competitive Landscape
Market Share Concentration
Key Success Factors
Cost Structure Benchmarks
Barriers to Entry
Major Companies
Operating Conditions
Capital Intensity
Key Statistics
Industry Data
Annual Change
Key Ratios

About IBISWorld Inc.
Recognized as the nation’s most trusted independent source of industry and market research, IBISWorld offers a comprehensive database of unique information and analysis on every US industry. With an extensive online portfolio, valued for its depth and scope, the company equips clients with the insight necessary to make better business decisions. Headquartered in Los Angeles, IBISWorld serves a range of business, professional service and government organizations through more than 10 locations worldwide. For more information, visit http://www.ibisworld.com or call 1-800-330-3772. Reported by PRWeb 18 hours ago.

Is Travel Insurance Necessary? -- Savings Experiment

June 10, 2014, 7:16 am

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Filed under: Travel, Savings Experiment

View Poll

Every time you book a flight, hotel or rental car, the same question always pops up: Should you get travel insurance? Here are a few things to consider before you spend the extra cash.

First and foremost, watch out for duplicate coverage. Always check with your health insurer, as well as your homeowners, life and auto policies to see if you already have coverage for some of the travel risks you face.

For example, if you're a member of AAA, you actually have benefits that are quite similar to some of the travel policies out there. These are the kinds of things you should look into.

The next step is to assess your trip. What are the risks? Say you're going out of the country for an extended period. Emergency medical coverage can be really valuable if your regular health insurance doesn't already cover you while abroad.

While premiums can vary based on age and trip length, a typical plan will cost between $50 to $100 for a short international trip. This relatively small investment can save you from potentially catastrophic bills in case anything goes wrong.

So, is travel insurance necessary? Usually not, but be sure to assess your risks. Check existing coverage before you buy and don't pay for plans that cover small, manageable losses. Safe travels.
 

Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 18 hours ago.

House of Cards-Style Corruption in Virginia

June 10, 2014, 8:16 am

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In the Netflix show "House of Cards," Kevin Spacey plays Frank Underwood -- a shrewd and cunning politician who methodically manipulates his way into higher levels of power like a chess game, often through blackmail, bribery, and other forms of skullduggery. Phil Puckett, a Virginia state senator, is truly embodying the worst of Frank Underwood, throwing his constituents under the bus to secure benefits for himself and his family.

State Senator Phil Puckett, a Democrat, announced his resignation today after 16 years in the senate. Puckett is from Southwest Virginia, which is largely poor and rural. His resignation will trigger a special election which Republicans are likely to win, giving the GOP a majority in the Senate. If a Republican replaces Puckett, his daughter gets a judgeship and he gets a position as Deputy Director of the state tobacco commission.

Should the Republicans win the Senate, they're likely to take Medicaid expansion out of the state budget, making access to health care impossible for 400,000 Virginians -- particularly poor and rural Virginians in Russell County, where Puckett used to serve. Unless McAuliffe is willing to veto the Republican budget and trigger a state government shutdown on July 1, nearly half a million Virginians won't get access to the health care they need.

Puckett's daughter, Martha P. Ketron, has had her judicial appointment up in the air since the start of this year's legislative session. Last year's elections, in which former DNC chair Terry McAuliffe won the governor's race, also saw the 40-seat State Senate switch hands from GOP control to Democratic control. State Senator Ralph Northam won the Lieutenant Governor's race and a Democrat narrowly won his old Senate seat in a special election this January. Republicans have been blocking Ketron's confirmation for a judgeship in Juvenile and Domestic Relations District Court, on the grounds of an informal policy that doesn't allow for relatives of legislators to serve as judges. Ketron was named as an interim judge in July of 2013 and requires confirmation from the legislature to serve a 6-year term. Puckett's resignation from the senate means the anti-nepotism policy will no longer apply.

The sweetheart deal for Puckett and his family will likely come at a lethal cost to Virginians who depend on Medicaid expansion. A Harvard study recently found that as many as 17,000 Americans may die due to lack of Medicaid expansion in states where Republican governors have opted out of expanding the program under Obamacare.

Out of the 8 million Americans who lost the ability to get health insurance under expanded Medicaid programs, 432,000 diabetics won't be able to have access to medication, 659,000 women won't have access to mammograms, and 3.1 million women in need of regular pap smears won't have health insurance to make those exams and treatments available. Former Florida governor Charlie Crist claims 6 Floridians die each day due to current governor Rick Scott's decision to not expand Medicaid, which Politifact rated "half-true," only on the grounds that the number is actually closer to 3 a day.

Blocking Medicaid expansion isn't only a loss for people who need Medicaid -- it's also political suicide. According to Public Policy Polling results collected this past April, five Republican governors who chose not to expand Medicaid are trailing in their bids for re-election. Maine governor Paul LePage and Pennsylvania governor Tom Corbett are both losing popularity among their blue-state constituents. Red state constituents are losing confidence for Kansas governor Sam Brownback and Georgia governor Nathan Deal. And in Florida, Rick Scott's opposition to Medicaid expansion is widely opposed by a 58 to 33 margin.

At the federal level, Mitch McConnell may lose his re-election bid in Kentucky, as his constituents are supportive of Kynect -- Governor Steve Beshear's expansion of health insurance for Kentuckians. McConnell has been put in such a precarious position over Obamacare's popularity among Kentuckians that he's taken the position of wanting to repeal Obamacare but keep Kynect, which a Washington Post fact-checker called "not credible." 413,000 Kentuckians have signed up for Kynect, the state-based exchange funded by Obamacare, and most qualified for the federal subsidy that lowers premium costs.

The fact that Senator Puckett is letting the GOP buy him out with a cushy job and a prestigious position for his daughter so they can successfully block Medicaid expansion isn't just nakedly corrupt, it's also lethal. Puckett deserves to be investigated and the Democratic leadership needs to hold fast to either having a budget that expands access to healthcare, or having no budget at all.

Senator Puckett's office did not return calls for interview requests.

(This article originally appeared on Reader Supported News.) Reported by Huffington Post 17 hours ago.

Ohio and Virginia Chambers of Commerce Launch Private Health Insurance and Benefits Exchange through CieloStar

June 10, 2014, 8:09 am

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MINNEAPOLIS, June 10, 2014 /PRNewswire/ -- CieloStar, a leading nationwide healthcare benefit distribution and payment technology company, announced today that it has partnered with the Ohio Chamber of Commerce and the Virginia Chamber to open private health insurance and benefits... Reported by PR Newswire 17 hours ago.

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Cancer Care in the US: The Achilles Heel of a Profit-Driven System

June 10, 2014, 8:50 am

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Care of cancer in this country is outpacing other health care problems and is already pricing itself beyond the reach of many Americans unfortunate enough to contract the disease. In my 2009 book, The Cancer Generation: Baby Boomers Facing a Perfect Storm, this storm warning was included:

• Cancer soon to be nation's No. 1 cause of death

• Costs soaring out of control

• Decreasing access, increasing disparities

• Widening gaps in quality of care

• Insurance costs more and covers less

• Profit-driven market-based system is unaccountable and unsustainable

• Reform is blocked by powerful market stakeholders

• Seventy-nine million Baby Boomers face increased risk of cancer as they age, and will confront this challenge with dwindling resources. (1)

Now, five years later, let's see where we are with this gathering storm.

Here are markers that show that the situation worsens every year as costs and prices continue to escalate, access and affordability decline, and gaps in quality of care further widen:

• In Massachusetts, out-of-pocket (OOP) costs for breast cancer treatment are as high as $55,250 for women with high-deductible health insurance. (2)

• Typical yearly OOP expenses of 20 to 30 percent for cancer treatment often amount to one-half of the average annual household income. (3)

• Many insured cancer patients are forced to reduce the frequency of their prescribed medications or cut their spending on food and clothing in order to make ends meet. (4)

• Over the 10-year period from 2004 through 2014, the Consumer Price Index (CPI) has increased by about 2.3 percent a year while the Milliman Medical Index, which measures the actual cost of health care, has increased by an average annual rate of 7.6 percent. (5)

• With some newer cancer drugs costing as much as $100,000 per round of treatment, there are still perverse financial incentives for many oncologiststo prescribe more expensive drugs. (6)

• Insurers' narrowed networks often exclude major cancer centers, often interrupting continuity of care by treating oncologists and burdening patients with much higher OOP costs. (7,8)

• In other attempts to rein in their (not the patient's!) costs, insurers are starting to adopt "reference pricing," by which they just pay a portion of cancer drugs' costs, leaving the rest to the patient.

• Chemotherapy continues to be overused in terminally ill cancer patients,with little hope of extending life or adding to quality of life.

• A recent report from the International Federation of Health Plans (IFHP) found that prices for medical procedures, tests, scans and treatments in the U.S. still have the highest prices among ten countries, are not related to patient outcomes, and "in some cases reflect a damaging degree of market failure." (9)

All this represents an ominous trend, standing out more starkly all the time compared to other advanced countries around the world, where comprehensive cancer care is available to everyone, typically with little or no cost-sharing and often with better outcomes. The Affordable Care Act (ACA) has not contained costs and prices, but instead has allowed insurers and the drug industry to continue to profiteer at patients' expense. Future developments in cancer care will certainly add to the cost and price problem, such as gene-based designer cancer drugs. (10)

Markets will never fix this kind of problem. Nor will most parts of the medical industrial complex, driven as they are to profits before service. As other countries have found many years ago, the government must become more involved in pricing and financing of health care services, together with a more rigorous process of assessing services based on scientific evidence, efficacy and cost-effectiveness.

Fortunately, we are now seeing a major backlash from many oncologists, the cancer doctors who provide most of our cancer care. The American Society of Clinical Oncology (ASCO) has identified this top priority for its members:

For patients with advanced solid-tumor cancers who are unlikely to benefit, do not provide unnecessary anticancer therapy, such as chemotherapy, but instead focus on symptom relief and palliative care. (11)

More recently, leading oncologists have called on their colleagues, working with ASCO, to champion single-payer national health insurance as the only way to bring necessary cancer care to all Americans.

With ACA now the law of the land, and its retention of the private insurance industry at the center of the health system, the trend toward high-deductible health plans, underinsurance, and cost shifting to patients will almost certainly worsen. 59 years of private-sector solutions have failed. There needs to be a major paradigm shift in our approach to funding health care in the United States. . . . Because ACA will fail to remedy the problems of the uninsured, the underinsured, rising costs, and growing corporate control over caregiving, we cannot in good conscience stand by and remain silent. ... Life is short, especially for some patients with cancer; they need help now ... All our patients deserve dignity. It is our moral and ethical obligation as physicians to advocate for universal access to health care. (12)

These words are right on target, and need to be heeded if we are ever going to redress increasing inequities and disparities in cancer care, and start to catch up with the rest of the world.

This post was originally featured here.*Suggested Reading: *
1. Geyman, JP. The Cancer Generation: Baby Boomers Facing a Perfect Storm. Monroe, ME. Common Courage Press, 2009.

2. National Center for Health Statistics. Financial burden of medical care: early release of estimates from the National Health Interview Survey, January-June 2011. 2012.

3. Kantarjian, H, Steensma, D, Sanjuan, JR et al. High cancer drug prices in the United States: reasons and proposed solutions. Journal of Oncology Practice, May 6, 2014.

4. Zafarm, SY, Peppercorn, JM, Schrag, D et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience. Oncologist 18: 381-390, 2013.

5. Girod, C, Mayne, LW, Weltz, SA et al. 2014 Milliman Medical Index, Milliman, May 20, 2014.

6. Mathews, AW, Insurers push to rein in spending on cancer care. Wall Street Journal, May 28, 2014: A1.

7. Tozzi, J. Obamacare limits choices under some plans. Bloomberg Businessweek. March 20, 2014.

8. Andrews, M. Warning: opting out of your insurance plan's provider network is risky. Kaiser Health News, March 18, 2014.

9. IFHP publishes 2013 price report. International Federation of Health Plans, 2014.

10. Wheelwritht, V. Adventures in personal genomics. The Futurist, May-June 2014, 43-45.

11. American Society of Clinical Oncology. Oncology "Top Five" list identifies opportunities to improve quality and value in cancer care. April 3, 2012.

12. Drasga, RE, Einhorn, LH. Why oncologists should support single-payer national health insurance. Journal of Oncology Practice, January 2014. Reported by Huffington Post 16 hours ago.

Zane Benefits Releases New Information on Employer Health Care Arrangements

June 10, 2014, 10:22 am

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An employer health care arrangement is an agreement by the employer to contribute to employees' health care costs.

Park City, UT (PRWEB) June 10, 2014

Today, Zane Benefits, the #1 Online Health Benefits Solution, published an introduction to employer health care arrangements.

According to Zane Benefits’ blog post, Employers use employer health care arrangements either as a stand-alone health benefit or as a supplemental health benefit, integrated with a group health insurance plan.

For example, with a stand-alone arrangement, the employer might reimburse for individual health insurance premiums as an alternative to a group health insurance plan. Whereas with a supplemental arrangement, the employer might reimburse employees for health care expenses not covered by the insurance plan -- such as dental, vision, or deductible expenses.

Click here to read the full article.

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About Zane Benefits
Zane Benefits, the #1 Online Health Benefits Solution, was founded in 2006 to revolutionize the way employers provide employee health benefits in America. We empower employees to take control over their own healthcare, while helping employers recruit and retain the best talent. Our online solutions allow small and medium-sized businesses to successfully transition to a health benefits program that creates happier employees, reduces costs and frees up more time to serve their customers. For more information about ZaneHealth, visit http://www.zanebenefits.com. Reported by PRWeb 15 hours ago.

State terminates licenses of 15 Florida health care firms (database)

June 10, 2014, 12:00 pm

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The Florida Agency for Health Care Administration pulled the licenses of 15 health care companies in Florida in May, including two in Central Florida. The two local companies were: Injury Care Inc. in Orange County. The state denied the renewal of the health care clinic. A Caring Connextion Inc., a home and community-based services company in Orange County. The state terminated A Caring Connextion from being reimbursed by Medicaid, the state and federal joint health insurance program for low-income… Reported by bizjournals 13 hours ago.

New Website "YourHealthInsuranceCompanySucksWhen.org" Channels Consumer Horror Stories Conversation

June 10, 2014, 11:54 am

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SANTA MONICA, Calif., June 10, 2014 /PRNewswire-USNewswire/ -- A new website launched this week by Consumer Watchdog, www.YourHealthInsuranceCompanySucksWhen.org, has unleashed an intense conversation by consumers nationwide about their health insurance horror stories. The site invites... Reported by PR Newswire 13 hours ago.

Massachusetts Inches Toward Health Insurance For All

June 10, 2014, 12:17 pm

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The state is close to having most of its eligible residents covered. But a failed website has delayed the processing of applications, and some of those waiting may yet decide not to buy health plans. Reported by NPR 13 hours ago.

Pullling a Puckett: A Brief History of Selling Out

June 10, 2014, 2:22 pm

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Pity poor Phillip Puckett.

There he was, an Virginia state senator no one had ever heard of, figuring no one would notice when he traded his constituents' well-being for a new job and a judgeship for his daughter. But no! Now the Internet is abuzz with the news and Puckett has more or less been accused of accepting a bribe. And he's been called all sorts of nasty names too: corrupt, traitorous, venal, and worse. Sheesh, the life of an obscure state legislator ain't what it used to be.

But no one seems to recognize that by bailing out when the going got tough, Senator Puckett is simply doing what many others before him have done, and often with good results. "Pulling a Puckett" has a rich history that deserves our respect, and Puckett now joins a distinguished list of those who have not been daunted by the adage "quitters never win."

Earlier this year Ukrainian president Viktor Yanukovych fled to a neizvestnoe mestonakhozhdenie (an "undisclosed location") in Russia after he waffled, bungled and then try to squash the unrest in his country. Of course, Yanukovyich was a bit smarter than Puckett when he flew the coop because he had lined his pockets before he slipped out of town. Which is a good lesson to remember: If you are going to betray the people who voted for you, make sure you've already cashed the checks.

Last year Pope Benedict pulled a Puckett when he became the first pontiff since 1294 not to die in power. It was real testament to the men who elected Benedict that they managed to find an actual member of the Hitler Youth to call "His Holiness," but in truth Benedict was not the people's choice. Now comes news from The Vatican that their banking operations seem to have been run by distant relatives of Tony Soprano. Smart move Pope Puckett: Get out before the financial cazzata over which you preside hits the fan.

Closer to home, aspiring TV star and former Alaska governor Sarah Palin did a Puckett in 2009. She made the difficult decision to abandon her elective office when she realized she was living in the smallest, least dense media market in the country, and that her daughter would never be part of the cast of Big Brother living in Alaska. Now Sarah Palin is on TV all the time! The lesson here is that there is no shame in pursuing your career dreams, even if you have to be elected to office first. Perhaps it was always Senator Puckett's dream to be a deputy commissioner of a tobacco somethingorother. New promise to voters: I'll pledge to serve you until something better comes along!

This summer, of course, we will mark the 40th anniversary of the biggest Puckett event in American history. In August 1974 Richard Nixon, smiling his jowly smile and waving his "V for victory" wave abandoned the presidency for the sunnier climes of southern California. Sure Nixon left town two steps ahead of an impeachment, but he spent the next 20 years reinventing himself as an "elder statesman," confidante of presidents and diplomats. Nixon showed us that while sins might not be forgiven, crimes could be pardoned, especially if you hand-pick your successor. Puckett take-away here? F. Scott Fitzgerald was dead wrong: Nixon proved that there are nothing but second acts, at least in American political lives.

Even the famously stoical, stiff-upper-lipped British have not been strangers to Pucketting. In 1936 King Edward VIII abdicated the throne to be with the woman he loved. A truly romantic story, and his abandonment of his post permitted him and his wife to take their anti-Semitism and their admiration of Nazi Germany to France, where they lived happily ever after during the war. With their departure, England was spared the embarrassment of having those two around while the nation fought off the Nazis, and Colin Firth and Helena Bonham Carter were able to move into Buckingham Palace. Or was that only in the movie The King's Speech? I can't remember.

So there is often an upside to pulling a Puckett, and I'm sure there will be one in Virginia. In exchange for selling out tens of thousands of Virginians who won't now get health insurance have every confidence that his daughter will be the BEST juvenile court judge ever. And people in Puckett's district will have the chance to elect a new senator who isn't so obviously for sale.

Steven Conn teaches history at Ohio State University. His new book, Americans Against the City, is due out this summer with Oxford University Press. Reported by Huffington Post 11 hours ago.

Mass. Inches Toward Health Insurance For All

June 10, 2014, 1:34 pm

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Mass. Inches Toward Health Insurance For All Reported by ajc.com 11 hours ago.

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More Mental Hospitals, HIPAA Reform Needed

June 10, 2014, 1:36 pm

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While we know a lot about Elliot Rodger, the young man who murdered six, injured 13 others and then killed himself on a rampage in Isla Vista, California, on May 23, we still do not know as much as we should to derive all the painful lessons; there are ambiguities galore. But his case has rightly energized the debate about gun laws and the fragmented American mental health "system."

I'd guess that the Second Amendment was far more about state militias than individual possession. Otherwise, why did the founders write in the amendment of the need for a "well-regulated militia" as its justification? (Especially note the phrase "well-regulated.") Still, the amendment is badly written, and it's impossible to know for sure what the founders wanted. Meanwhile, the firearms makers and gun-rights absolutists hold sway in Congress, whatever the public-opinion polls, and presumably will continue to do so for the indefinite future. (The one argument that gun-rights absolutists have that I think has a smidgen of sense is that our heavily armed population might make it more difficult for a dictatorship in Washington or outside invader to impose its will. Still, could they defeat military forces?)

Anyway, since the late 60s and early 70s, with the new drugs marketed as panaceas for severe mental illness, and the deinstitutionalization movement, which closed many mental hospitals, it's been increasingly tough to commit people to institutions against their will.

Things got worse with the Health Insurance Portability and Affordability Act (HIPAA) of 1996, a part of which makes it agonizingly arduous for relatives to obtain essential psychiatric and other medical information about adult mentally ill people. We need to make it easier for families to obtain such information and then be able to act on it by obtaining a court order to involuntarily hold people who have shown themselves as potentially dangerous.

Legislation in Congress filed by Rep. Timothy Murphy (R-Penn.), Congress's only clinical psychologist (Congress needs many more of them!), would help. It would encourage states to commit severely mentally ill people to mental hospitals or mandatory outpatient treatment by, among other things, loosening the privacy rules to give families more actionable clinical facts about troubled relatives.

But unfortunately it fails to speak to the need to build more mental hospitals, both private and state-run. Far too many of the mentally ill will not cooperate in outpatient therapy, be it sessions with therapists and/or taking medication. The fact is that some people need to be committed for long periods, and some for the rest of their lives. And that's what happens anyway. We use our prisons for this function; at least half of America's huge jail population is mentally ill in varying degrees, with many out-and-out insane.

At the same time, laws should be changed to more clearly limit the ability of people declared by a judge to be mentally ill to buy guns. Further, there should be more legal mechanisms to let police obtain warrants to take firearms away from people deemed dangerous. (And, yes, I know that Elliot Rodger stabbed to death three of his victims. But it's far easier and faster to kill people with guns than with any other weapon, except of course with what a competent bomb maker could make.) Look at the mass murders of recent years. As it is, the police have remarkably little legal power to stop crazy people from perpetrating violent crimes.

Will any major reforms involving the interface of guns and the mentally ill actually be implemented? Yes, though it may take a few more massacres. Meanwhile, who will lead to the way to build more mental hospitals to hold and treat people for whom outpatient treatment may be insufficient? Liberals and some libertarians will complain about the threat to civil liberties, conservatives about the cost. But what about the right of citizens not to be imperiled by dangerous people walking around, and what about the huge financial cost of law enforcement and incarceration for so many of these people?Robert Whitcomb (rwhitcomb51@gmail.com) oversees newenglanddiary.com. He is a former Providence Journal editorial-page editor, former finance editor of the International Herald Tribune and former managing editor of several newsletters on mental and behavioral health. He is currently a senior adviser at Cambridge Management Group, which provides consulting services to physicians and hospitals, and a Fellow at the Pell Center for International Relations and Public Policy. Reported by Huffington Post 11 hours ago.

Movoto ranks New Jersey as third most stressed state in the country

June 10, 2014, 4:51 pm

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[caption id="attachment_425172" align="alignnone" width="614"]
Movoto, a real estate blog, illustrated the most stressed-out states. Credit: Movoto[/caption] New Jerseyans are always filled with pride, even when they are stressed out to the max. Now, the property taxes and crowded population have paid off as real estate blog Movoto listed New Jersey as number three in a list of the 10 most stressed out states in America. You can just hear the Jersey pride coming from the shore towns. [related tag = "New-Jersey" limit=5] "New Jersey is known for two things around the country: Having the most people per square mile and having stupid-expensive property tax," blogger Chris Kolmar says. "And in true New Jersey style, these two things are points of pride." Movoto compiled information  from the 2008-2012 U.S. Census’ American Community Survey and based the criteria on unemployment rates, hours worked, population density and other stresses including: the percentage of population with a commute of over 20 minutes, housing income and those without health insurance. Movoto then scored the rankings of each state with a scale of 1 to 48 (with one being the most stressed out of the 48 lower states) and then averaged the score to compile the list. The garden state scored first in population density and housing income, third in long commute, 16th in unemployment rates, 20th in average hours worked and 29th in lack of insurance. New Jersey comes just behind Florida and Georgia as number one and number two, respectively.

The post Movoto ranks New Jersey as third most stressed state in the country appeared first on Metro.us. Reported by metronews 8 hours ago.

Comprehensive HIPAA Security Audits and Assessments for Atlanta, Georgia Covered Entities and Business Associates Now Available from the Healthcare Experts at NDB

June 10, 2014, 3:04 pm

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NDB now offers industry leading HIPAA security audits and assessment services for Covered Entities (CE) and Business Associates (BA) located in Atlanta, Georgia. With the passing of the Final Omnibus Ruling in January, 2013, the Health Insurance Portability and Accountability Act now has serious regulatory compliance teeth, those that come with large penalties and costly fines.

Atlanta, GA (PRWEB) June 10, 2014

NDB now offers industry leading HIPAA security audits and assessment services for Covered Entities (CE) and Business Associates (BA) located in Atlanta, Georgia. With the passing of the Final Omnibus Ruling in January, 2013, the Health Insurance Portability and Accountability Act now has serious regulatory compliance teeth, those that come with large penalties and costly fines. It means that now’s the time for Atlanta, Georgia businesses to get serious about ensuring the safety and security of Protected Health Information (PHI), and the proven and trusted HIPAA security specialists at NDB are ready and willing to help.

NDB, with years of regulatory compliance and HIPAA specific expertise, can help put in place all necessary information security and operational specific policies, procedures and processes as mandated by the Health Insurance Portability and Accountability Act. More specifically, NDB can assist in implementing necessary controls and drafting all mandated policy documents for the HIPAA Security Rule and Privacy Rule provisions.

The HPAA security audits and assessment services for Atlanta, Georgia businesses offered exclusively by NDB include an in-depth HIPAA Policy Packet, along with essential security awareness training documentation, forms, checklists, and more. Trust the experts at NDB for Atlanta, Georgia HIPAA compliance by calling NDB’s healthcare and cyber security expert Charles Denyer today at 1-800-277-5415, ext. 705, or via email at cdenyer(at)ndbcpa(dot)com. Reported by PRWeb 10 hours ago.

Republicans Call Obamacare Subsidies A Risk To Taxpayers

June 10, 2014, 5:18 pm

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By David Morgan
WASHINGTON, June 10 (Reuters) - Congressional Republicans sought to portray Obamacare subsidies for low-income families as a financial risk for taxpayers on Tuesday, a claim that could become a new avenue for campaign attacks on Democratic candidates this fall.
At a hearing in the Republican-controlled U.S. House, witnesses from conservative groups said overpayments of federal subsidies to people newly enrolled in Obamacare health plans could reach hundreds of billions of dollars while jeopardizing the health coverage and federal tax refunds of subsidy recipients found to owe money.
Republicans are seeking to suspend the subsidies, which form the basis for the Obamacare health insurance marketplaces, until there is a system in place to better verify applicant information. About 85 percent of the 8 million people who have enrolled in private coverage under Obamacare sought subsidies, according to the administration.
The testimony came a week after the administration reported inconsistent data in the Obamacare health insurance applications of 2.2 million Americans, including 1.2 million with questionable income data. Officials say most inconsistencies are not errors but innocuous discrepancies that can be cleared up without a problem. But critics see a potential for major issues.
"The system (is) essentially unworkable," said Douglas Holtz-Eakin, a former director of the nonpartisan Congressional Budget Office who now heads the American Action Forum, a conservative policy institute.
Ryan Ellis, tax policy director at Americans for Tax Reform, a group led by anti-tax activist Grover Norquist, said subsidy overpayments could wreak havoc during next year's 2014 tax filing season as preparers and taxpayers come to terms with the effects of miscalculated insurance subsidies.
"Americans don't understand what this is going to do to them," Ellis said.
Republican lawmakers, who are using Obamacare as a major line of attack for November's midterm elections, took those claims as fresh evidence that Obama's Affordable Care Act (ACA) will harm American families and bloat federal deficits.
Democrats accused Republicans of using "fake outrage" to push their goal of repealing Obamacare.
"It sounds to me as though the testimony of some of the ... witnesses is fear-mongering to make people afraid," said Representative James McDermott, a Washington state Democrat.
Ron Pollack, executive director of Families USA and an advocate of the healthcare law, said the discrepancies were worth examining, but described the concerns as "much ado about very little."
Charges that ACA subsidies will hurt taxpayers and policyholders have not become fodder for the election campaign so far. But that could change in coming months.
"Obamacare has been a failure from start to finish and this is just the latest example. Highlighting Democrats support for Obamacare will be a key part of our efforts this fall," said Andrea Bozek, spokeswoman for the National Republican Campaign Committee. (Editing by Caren Bohan and Gunna Dickson) Reported by Huffington Post 8 hours ago.

So Who's The Guy Who Just Beat Eric Cantor? Meet Dave Brat

June 10, 2014, 10:25 pm

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David Brat, a tea party activist and professor, scored one of the biggest upsets in political history Tuesday when he defeated House Majority Leader Eric Cantor in the Republican primary to represent Virginia's 7th District.

Brat's campaign website crashed in the immediate aftermath of the news. Below, more about his background.

*His students seem to like him. *
Brat is an economics and ethics professor at Randolph-Macon College. He has an average rating of 3.4 from RateMyProfessor.com, though one anonymous student said: "For his papers, no one ever understood what he wanted for us to do. He was almost never there when we needed help." He got a bachelor’s degree in business from Hope College, a Masters in Divinity from Princeton and a Ph.D. in Economics from American University.

On a related note, Brat's campaign manager graduated from Haverford College in 2013.

*He's a real stickler for attendance.*
According to the course outline for a class he taught in 2004, he required his students to submit "typed notes summarizing the day’s reading to enter class," while "Four misses in this class results in automatic dismissal from the class."

*He's an Ayn Rand proselytizer.*
Brat has taught classes for a program sponsored by BB&T bank that aims to spread Ayn Rand's principles to college students. Brat got a $500,000 grant from the bank to bring the program to Randolph-Macon College and co-authored a paper titled “An Analysis of the Moral Foundations in Ayn Rand.”

Cantor's campaign labeled Brat as a "liberal economics professor," however.

*He doesn't think much of Cantor's conservative credentials.*
Brat said Cantor "doesn't understand what free markets are" in an interview Tuesday and calls himself a "free market guy." On his website, he claimed Cantor has been "a consistent supporter of big government."

As for himself, Brat said he will never increase taxes and vowed to repeal the Affordable Care Act. "We need to also scrap employer-based health insurance, and give those incentives to individuals to carry their own portable health insurance," he said of health care, adding that "If we did that, the issue of pre-existing conditions largely goes away."

Brat also pledged not to vote on a debt ceiling increase as part of a five-year promise.

*He had the backing of much of the anti-establishment establishment.*
Laura Ingraham, Mark Levin, Ann Coulter and Glenn Beck all came out in support of him leading up to the primary.

*He claims he won't be in office for too long.*
One of his main promises before the primary was to "fight for term limits - including for myself."

*His campaign was incredibly financially efficient.*
Brat won the primary even though Cantor radically outspent him, by more than 6 to 1. He spent about $120,000 to Cantor's more than $5.4 million.

*He appears to have successfully tarred Cantor as a "pro-amnesty" candidate.*
"A vote for Eric Cantor is a vote for open borders," Brat said at a campaign event with conservative radio host Laura Ingraham, according to Breitbart News. "A vote for Eric Cantor is a vote for amnesty. If your neighbor votes for Eric Cantor, they're voting for amnesty, and they know it," Brat added.

Brat told Breitbart News "One you announced that kids are welcome, they're going to head in," and has called Cantor "the No. 1 cheerleader in Congress for amnesty."

*He thinks religion has been short-shrifted.*
Brat wrote in a 2000 paper that "Religion has for too long been placed on the backburner of history when it may be one of the driving forces in history."

*He supports getting rid of the federal role in farm regulation.*
Brat has said that the federal government's role in farm regulation should be eliminated, and that the matter should be left up to the states.

*He will be running against one of his colleagues in November.*
Brat will face Jack Trammell, also a professor at Randolph-Macon, on November 4.

*He ran a campaign against Washington.*
"I am running to fix the economy, restore the constitutional system of checks and balances and to end this game of crony capitalism by the ruling class in Washington," Brat said when he announced his candidacy. On Tuesday, reacting to his defeat, Brat said he had nothing personal against Cantor but was frustrated with the GOP establishment. "I always said I’m not running against Eric Cantor as a person," he said on Fox News' "Hannity.""I ran against him on the principles espoused on my website." Reported by Huffington Post 2 hours ago.