CareSource has named another new executive to oversee its Ohio operations. The downtown Dayton-based company, which works in health insurance and Medicaid managed care plans, has named Dan Hounchell as the new vice president of operations for the Ohio market. Hounchell will be responsible for executing the company's strategy for Ohio, where the great majority of the 1.5 million people it serves are located. He will report to Steve Ringel, who is the market president for Ohio. “Dan’s industry… Reported by bizjournals 1 day ago.

An informal survey conducted by The AIS Report on Blue Cross and Blue Shield Plans finds that almost half of the individual health insurance market will not get a federal subsidy for coverage.

Washington, DC (PRWEB) September 09, 2016

About 40% of the individual insurance market doesn’t receive federal premium subsidies and will need to absorb the full cost of the substantial rate hikes that are expected for the 2017 plan year, according to an exclusive survey of Blue Cross Blue Shield plans, conducted by The AIS Report on Blue Cross and Blue Shield Plans, the results of which appear in the September 2016 issue. Published independently by AIS, The AIS Report is not affiliated with or sponsored, endorsed or approved by the Blue Cross Blue Shield Association or any of the independent Blue Cross and Blue Shield companies.

The Obama administration recently played down expected double-digit rate increases by explaining that most people who buy coverage through an insurance exchange will be insulated from soaring premium costs. But Blues plans say a substantial part of their non-group business buys coverage outside of the exchanges. Moreover, about 15% of people who buy coverage through an exchange don’t qualify for a subsidy.

“Every time I hear the administration or Obamacare supporters say 83% or 85% of those purchasing on the exchange are getting a subsidy, it is just terribly disingenuous,” industry consultant Robert Laszewski tells The AIS Report. “The middle class is getting killed by these already high premiums and deductibles...and they will take the full hit from these new increases.”

Visit http://aishealth.com/archive/nblu0916-02 to read the article in its entirety, which also includes details on the exchange and non-exchange enrollment in the non-group market among several Blues plans across the United States.

About The AIS Report on Blue Cross and Blue Shield Plans
The AIS Report on Blue Cross and Blue Shield Plans delivers timely news and insightful analysis of new products, market share, strategies, conversions, financing, profitability and strategic alliances of Blue Cross and Blue Shield plans, which are major players in every U.S. health insurance market. The monthly newsletter is designed for plan managers and others who consider BCBS plans to be partners or competitors. Visit http://aishealth.com/marketplace/ais-report-blue-cross-and-blue-shield-plans for more information. A thoroughly objective publication, The AIS Report is published independently by AIS and is not affiliated with or sponsored, endorsed or approved by the Blue Cross and Blue Shield Association or any of the independent Blue Cross and Blue Shield companies.

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for nearly 30 years. It develops highly targeted news, data and strategic information for managers in hospitals and health systems, health insurance companies, medical group practices, purchasers of health insurance, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, databases, websites, looseleafs, strategic reports, directories, webinars, virtual conferences and training programs. Learn more at http://AISHealth.com. Reported by PRWeb 1 day ago.

While Obamacare’s grander claims about lowering health-care costs and rationalizing our crazy health-care system have mostly failed to come to pass, the one thing supporters have been able to point to is the falling number of uninsured people. Reported by Newsmax 22 hours ago.

The Internet of Things (IoT) Revolution is picking up speed and it will change how we live, work, and entertain ourselves in a million ways big and small.

From agriculture to defense, retail to healthcare, everything is going to be impacted by the growing ability of businesses, governments, and consumers to connect to and control their environments:

· “Smart mirrors” will allow consumers to try on clothes digitally, enhancing their shopping experience and reducing returns for the retailer
· Assembly line sensors will detect tiny drops in efficiency that indicate critical equipment is wearing out and schedule down-time maintenance in response
· Agricultural equipment guided by GPS and IoT technology will soon plant, fertilize and harvest vast croplands like a giant Roomba while the “driver” reads a magazine
· Active people will share lifestyle data from their fitness trackers in order to help their doctor make better health care decisions (and capture discounts on health insurance premiums)

No wonder the Internet of Things has been called “the next Industrial Revolution.” It’s so big that it could mean new revenue streams for your company and new opportunities for you. The only question is: Are you fully up to speed on the IoT?

Research analysts John Greenough and Jonathan Camhi of BI Intelligence, Business Insider's premium research service, spent months of researching and reporting this exploding trend and have put together a report on the Internet of Things that explains its exciting present and the fascinating future.

It covers how IoT is being implemented today, where the new sources of opportunity will be tomorrow and how 17 separate sectors of the economy will be transformed over the next 20 years, including:

· Agriculture
· Connected Home
· Defense
· Financial services
· Food services
· Healthcare
· Hospitality
· Infrastructure
· Insurance

· Logistics
· Manufacturing
· Oil, gas, and mining
· Retail
· Smart buildings
· Transportation
· Connected Car
· Utilities

 

If you work in any of these sectors, it's important for you to understand how the IoT will change your business and possibly even your career. And if you’re employed in any of the industries that will build out the IoT infrastructure—networking, semiconductors, telecommunications, data storage, cybersecurity—this report is a must-have.

Among the big picture insights you’ll get from *The Internet of Things: Examining How the IoT Will Affect The World*:

· IoT devices connected to the Internet will more than triple by 2020, from 10 billion to 34 billion. IoT devices will account for 24 billion, while traditional computing devices (e.g. smartphones, tablets, smartwatches, etc.) will comprise 10 billion.
· Nearly $6 trillion will be spent on IoT solutions over the next five years.
· Businesses will be the top adopter of IoT solutions because they will use IoT to 1) lower operating costs; 2) increase productivity; and 3) expand to new markets or develop new product offerings.
· Governments will be the second-largest adopters, while consumers will be the group least transformed by the IoT.

And when you dig deep into the report, you’ll get the whole story in a clear, no-nonsense presentation:

· The complex infrastructure of the Internet of Things distilled into a single ecosystem
· The most comprehensive breakdown of the benefits and drawbacks of mesh (e.g. ZigBee, Z- Wave, etc.), cellular (e.g. 3G/4G, Sigfox, etc.), and internet (e.g. Wi-Fi, Ethernet, etc.) networks
· The important role analytics systems, including edge analytics, cloud analytics, will play in making the most of IoT investments
· The sizable security challenges presented by the IoT and how they can be overcome
· The four powerful forces driving IoT innovation, plus the four difficult market barriers to IoT adoption
· Complete analysis of the likely future investment in the critical IoT infrastructure: connectivity, security, data storage, system integration, device hardware, and application development
· In-depth analysis of how the IoT ecosystem will change and disrupt 17 different industries

*The Internet of Things: Examining How the IoT Will Affect The World* is how you get the full story on the Internet of Things.

To get your copy of this invaluable guide to the IoT universe, choose one of these options:

1. Subscribe to an ALL-ACCESS Membership with BI Intelligence and gain immediate access to this report AND over 100 other expertly researched deep-dive reports, subscriptions to all of our daily newsletters, and much more. >> *START A MEMBERSHIP*
2. Purchase the report and download it immediately from our research store. >> *BUY THE REPORT*

The choice is yours. But however you decide to acquire this report, you’ve given yourself a powerful advantage in your understanding of the fast-moving world of the IoT.

Join the conversation about this story » Reported by Business Insider 23 hours ago.

Fuels Growth for Leading Predictive Analytics Technology for Insurance & Healthcare Industries

Princeton, NJ (PRWEB) September 09, 2016

Edison Partners is pleased to announce leading a $4.5M Series A round of financing in Atlanta-based Big Cloud Analytics Inc. (BCA), a leader in predictive analytics solutions for insurance and healthcare industries. Funds will be used to expand sales and marketing efforts, as well as product development.

BCA is making healthcare simple and easy to understand by using IoT data from smart watches, wearables and other connected devices in 29 countries to inform decision-making. The company is growing 250% year over year with the help of partners like CDW and Merck, and has been recognized by CIO Review as one of the Top 100 most promising companies in Big Data globally.

“We are impressed with BCA’s leadership team and the momentum they have created in bringing predictive analytics based on wearable device data to healthcare and insurance customers,” said Joe Allegra, Edison General Partner, who led the investment and has joined the board of directors. “The company has attracted marquee customers and channel partners, validating its potential to lead the market in the US, Europe and Australia.”

The Company’s proprietary COVALENCE analytics platform gathers data from a wide array of activity trackers and uses proprietary algorithms to compute advanced population health analytics, manage population wellness and achieve improved claims outcomes. BCA is able to analyze data in real time for millions of users per customer, and display data in easy to understand dashboards at both the broad and individual level.

“We are excited to have a financial and operating partner like Edison to help us accelerate our growth,” said J Patrick Bewley, Big Cloud Analytics CEO. “We are already benefiting from the firm’s value-add -- from their CEO leadership development event at West Point in June to ongoing sales and marketing guidance.”

Edison has invested in and guided more than 20 Healthcare IT businesses and is actively investing out of its latest fund, Edison VIII. Current Healthcare IT portfolio companies include ClearPoint Learning, Lincor Solutions, Trialscope and, recent addition, Virtual Health. Noteworthy exits include CambridgeSoft, Dendrite, DiagnosisOne, InnaPhase, Octagon, POMs, Portico, Premier Health Exchange (PHX) and Taratec.

About Big Cloud Analytics
Big Cloud Analytics leads the market in real-time predictive analytics technology for the Internet of Things (IoT). Recognized in 2015 by Intel as a Health Innovation Award Finalist and by CIO Review as one of the Top 100 most promising companies in Big Data globally, the Company provides disruptive end-to-end solutions comprising both software and hardware through its proprietary COVALENCETM Analytics Platform. Big Cloud serves life and health insurance and other healthcare organizations, such as hospitals, pharma, senior living facilities, etc. as well as employers for population health management. For more information, visit http://www.bigcloudanalytics.com.

About Edison Partners
For 30 years, Edison Partners has been helping CEOs and their executive teams navigate the entrepreneurial journey and build successful companies. Through the unique combination of expansion capital and the Edison Edge platform, consisting of strategic advisory, the Edison Director Network, and executive education, Edison employs a holistic approach to nurturing invention and creating value for growth stage businesses ($5 to $20 million in revenue) in financial technology, healthcare IT, enterprise IT, and marketing technology industries. Edison investment objectives also include: buyouts, recapitalizations, spinouts and secondary stock purchases.

Edison’s active portfolio has created aggregate market value exceeding $5 billion. Its long-tenured team based in Princeton, NJ manages more than $1 billion in assets throughout the eastern United States. Reported by PRWeb 21 hours ago.

CMS has proposed its annual Notice of Benefit and Payment Parameters, which would apply to participation in Affordable Care Act (ACA) Health Insurance Marketplaces for 2018. Reported by Mondaq 19 hours ago.

ATLANTIC CITY, N.J. (AP) — Billionaire Carl Icahn's management team is asking state gambling regulators for permission to shut down the Trump Taj Mahal casino next month. [...] because he announced on Aug. 4 his plan to close the casino and went nearly a month without formally asking regulators for permission to do it, some strikers began questioning whether Icahn truly planned to close it or whether the shutdown threat was a bluff to get the striking union to accept the casino's final offer. The main issue in the strike is a demand by Local 54 of the Unite-HERE union to restore health insurance and pension benefits that a bankruptcy judge terminated in 2014 before Icahn officially owned the Taj Mahal. Reported by SeattlePI.com 19 hours ago.

WASHINGTON (Reuters) - The chairman of the U.S. Senate Judiciary Committee probing Mylan NV's EpiPen price hike on Friday said its response to his query was "incomplete," and called on the drugmaker to give more details over how much government health insurance programs pay for the allergy treatment. Reported by Reuters 16 hours ago.

Authored by 'Ola Nordmann',

*Despite Norwegian mainstream media and political establishment support for Hillary Clinton* (They also supported Mark Rubio and Bernie Sanders when they were running), I would like to apologize for our politicians and voice my support for Trump.* I believe that Americans need to think about what is at stake from lifelong socialists’ perspective.  *Despite what people read about Norway being the best place to live, *it comes with a price*. Everyone needs to mostly agree, not raising concern, even when feeling wronged. Going outside the line leads to ostracization. (It’s like being Amish in some ways.)

*We are not that creative.* We would like to think so, but compared to Minnesota, our American cousin (similar population, culture, and climate), we are far behind – left in the dust. Minnesota has many diverse and world class companies like 3M (Minnesota Mining and Manufacturing), Polaris (snowmobiles and motorcycles), and Medtronic (Innovative medical equipment).  Our largest companies are mostly resource related: Statoil (state oil company), Telenor (our innovative phone company) and Yara (fertilizer). The government substantially owns many of them, not making them real companies that compete for their daily existence, like their Minnesota counterparts.

*If you ever come to Norway, you will find around half the TV shows are American! *We have Dr. Phil, NCIS, Cake Boss, Fast and Loud and so on.  Our version of Cops and Storage Wars will put you to sleep. Recently, a major Norwegian media outlet launched a reality show, called Oslo S, about our central train station. The theme is bouncers and bums exchanging pleasantries – Yawn. Other shows come from Australia, Sweden and the UK. I wish we could be more American, in this regard, making our own entertainment to cover all the time slots, instead of importing it.

*Our education system teaches conformity and compliance.* It does not teach critical reasoning, questioning the system or exploring the media’s agenda.  When you graduate, you will be unable to take charge and make a decision. (Good decisions always disappoint someone. Otherwise, the choice would not need arbitration in the first place) Instead, you will learn that everyone must be included, finding a compromise. This indoctrination process often leaves your team uncompetitive or product useless, falling short of market demands. It’s more important that everyone is happy than to remain profitable, which ensures long-term enterprise survival.  The lack of confidence taught in our education system is crippling.  This insecurity makes us somewhat socially retarded with foreigners. When we go abroad, we travel in groups, sticking to ourselves, not interacting with the locals. It may explain our unfriendly ranking.   

*Many well to do Norwegians acknowledge the systems shortcomings, opting for private education*. Some even send their kids boarding schools in England and Ivy League universities in America. We have a hard time getting those kids to return home, leading us forward. Instead, they add to America’s vastness and achievements. Recently, private schools in Norway started to pick up.   

Our Economy is equally as boring. After oil (65%), we sell fish and aluminum*. Our Central Bank did such a wonderful job devaluing the currency, allowing the Chinese to buy our expensive water company. Many more of our unique companies are now vulnerable to foreign takeover.*

*Our technology sector will not save the economy after oil’s demise (at least not now). * Although there are some interesting firms, doing cool stuff, they are no comparison to those in California, Boston or New York. We get good people, but America gets the best of the best, driven by a deeply human desire to succeed. 

If we were truly innovative: we would have lured Elon Musk to Norway to make Tesla’s here (we are on a per-capita basis one of the world’s largest consumers of electric cars).  It would have complimented our emission-free hydroelectric industry, which generates 99% of Norway’s power. We should have invested our oil fund money into becoming leaders in 3D metal and alloy printing. This technology would be an ideal complement to our small but highly skilled workforce, losing jobs in the oil industry.  We could have been exporting commercial aircraft and car parts, made to order and on demand, diversifying the economy.  Nevertheless, our leaders in the Central Bank and Politics learned to play it safe, avoiding risk and confrontation, all their life. They never learned that not taking risk is also a risk. We are experiencing that right now – the repercussions of doing nothing.

Our cultural basis comes from the Janteloven. Essentially if we see our neighbor with a new Cadillac, *we get jealous, hastily concluding that he stole it instead of sacrificing to earn it. We will never openly express our distaste. We just hold it in and do something passive aggressive like reporting him to the tax office*. When the American neighbor sees the luxury car, he gets motivated and works extra hard.  Afterward, he buys a Bentley, one-upping the neighbor. Economies and innovation benefit from competition, not envy and passive-aggressive behavior mixed with feelings of inadequacy.  

*If you want to live in Norway, you have to be comfortable with complacency.*  Things are “great” because they don’t change, making life predictable. Norway is for those needing direction, protection, and an identity. It is for those who want to take it easy, seeking a steady routine, usually after they made it. For the outliers, ambitious and the hungry– those few who make the greatest contributions for posterity –America is your place.

In the American workplace, in general, respect is earned based on actions and not given. In Norway, we tell such anxious people to relax and not worry so much, subtly suppressing them.  Americans, even if they don’t like you, will at least respect you if you’re productive.

*I do not want to see America become Norway. *First, it’s impossible. Our history and evolutionary paths are different. Second, the human species, as a whole, would cease to advance.  We will never get the next iPhone, Tesla or action movie.

*Below are my observations about Trump and why Americans, and the world for that matter, should consider him.*

-*Trump is more Interesting than the Kardashians*-

The obnoxious family is popular here, polluting our airwaves daily.  Trump is the first Presidential Candidate (based on observation) to get more press than them. People are talking about Trump, America and what’s wrong. Moreover, they are talking about “why.”  Everyday people, who normally watch sports and reality shows, are having vigorous debates about real topics that affect their lives.

Trump made politics interesting to the entertainment drugged masses! His presidency would mean more democracy, not less. More people will start to pay attention to the government than Kim Kardashian’s backside.  Everything usual will get disrupted.  A new culture of calling things as you see it will rise (or return, depending on how long you have been around.

The media and public will scrutinize Trump’s every move. It will be interesting to know what he is up to. Everyone will be watching his speeches and commenting the day after. It will be far from routine. Democracy needs public participation. Good or bad: as the antics ensue, more outsiders will get energized and inspired, bringing new faces to politics. 

-*Loathed by Billionaires, Goldman Sachs and Mainstream Media*-

I find it interesting that the very wealthy are suddenly vocal, vigorously opposing Donald J Trump’s presidency. Mark Cuban, Warren Buffet, Bill Gates and George Soros have all made statements against “The Donald.” Buffet, Gates, and Soros are avid supporters of Hillary Clinton. Goldman Sachs top management are not allowed to donate to Trump’s campaign.

*As an average seventy-something Norwegian farmer, looking at American from the outside, I find the vigorous billionaire opposition “interesting.”  Moreover, this is amplified by CNN (which we get here in Norway as part of our standard cable package).  CNN used to be fact based news only. Now they morphed into the Clinton News Network, attempting to shape public opinion, garnering support for globalism.  *

Perhaps the billionaire’s enterprises benefit from bloated government spending (this is speculation and worthy of investigation)?  These Billionaires are so rich that the interest earned on their idle cash and investments amounts to tens of thousands of dollars per day. What do they have to lose either way? Why is this so important to them? Maybe it’s to their advantage that the ladder (better known as the American Dream), where people can ascend through the rungs, achieving different levels of success through hard work, is broken?

Don’t Americans find it strange, despite technological advancements and increased productivity, that medical care, education, and housing costs are rising. I thought technology was supposed to make things cheaper, easier and more abundant. Remember when people went from horse and buggy to the Ford Model T – what happened? (A middle mobile middle class was born). Based on what I read about American life, it seems like now, when there is a new technology or innovation to make life easier, things get worse. Jobs become less stable than decades earlier.  People are working longer hours for less.  The housing standard is now a cramped condo instead of a house with a yard. It appears a  lot of people are on edge. 

*American’s need to ask themselves, reflecting back one generation (20 years), how billionaires have made their lives better? Billionaires have substantially increased their wealth in the past 20 years, have you? *

*American’s have a history of being rebellious, unpredictable, self-reliant and wild, rooting for the underdog. In this case, the underdog is Trump. The world needs this from you: not to become “European,” stuck in discussion while opportunity passes. *

-*Government & Opportunity *-

Unlike Libertarians, I do believe the government has a role in the private sector, ensuring competition exists and industries, serving national interests, are secured. (It would be crazy if the American army bought guns and tanks made in China to save money.) It is important that America secures its’ ability to produce heavy machinery, rockets, automobiles, high-tech, food, and medicine. However, this doesn’t mean the government support monopolies.

*In the past, the American government would break up monopolies to ensure competition which also pushed innovation.* In the past, they broke up the railroad, oil, and telephone monopolies, leading to innovation in energy, transportation, and communications. Since the failed attempt to break up Microsoft, the US and many world governments seemed to have looked the other way while corporate conglomerates keep on growing. The unchecked growth leads to corruption and stagnation. These mega companies can exert influence over local, state and even national governments who inadvertently put all their eggs in one basket. Even worse, when the mega corporation gets in trouble, they extort governments to bail them out, at taxpayer expense, otherwise threatening a crisis or mass layoffs. 

Hence, governments must act like icebreaker boats, breaking down the massive ice flows so all can pass through the channel, not only the big boats. *This observation was especially true with the bank bailouts.* When they got in trouble, the big bank CEO’s claimed the fallout would be on the order of a natural disaster. Although Americans have a history of resiliency, bouncing back stronger from disasters, the US Government bailed the failed banks out while the people, owning homes and banking products, lost out. (Many Norwegian towns lost a lot, believing in US Mortgage securities during the 2008 crisis).  The government, supposedly elected by the people, should have let the banks fail and help the victims of the systematic and institutionalized fraud, keeping them in their homes.

The Glass–Steagall Act was enacted in 1933 after the 1929 stock market crash to separate investment and commercial banks. Hence, the act limited the size of the banks and therefore limited the risks to the market. In 1998, Bill Clinton stated that this act was no longer relevant, and Congress repealed it in 1999. Many argue that Glass-Steagall would have averted the 2008 financial crisis.  When Trump proposed to reinstate the act, Wall Street jumped on him. 

*American’s should think long and hard about whose side Wall Street is on. *

-*Right vs. Correct *-

*The big problem in the World today is the lack of honesty: objective and fact based.* Without proper facts, it’s difficult to make good decisions.  Europe, Norway included, has embarked down the Political Correctness (PC) path. So much so that people waste a lot of time deciding how to say something in a polite and “correct” way, often sacrificing the truth. This behavior leads to bad decisions or none at all.*  Instead of listening to the raw content, meant to help reach a good decision, PC people focus on the tone and word choice, missing the main point altogether.*

*Often the liberals will call you a sexist, racist or narcissist, responding to a direct and logical challenge that questions a popular assumption or long held belief. * In Norway, we mandate that corporate boards have a set percentage of women. In technical companies, it is difficult to find qualified women, so ones from outside the profession are assigned. Sacrificing needed knowledge and experience for “correctness,” often leads to sub-optimal performance. If there is a woman on the board of an innovative American company, it’s because she is qualified and not to fill a quota. She worked hard, putting in the hours, getting her to the top. (I recently saw a post where someone posted a list of company ranking them from highest to lowest regarding women on the board. When I asked them to post the margins compared to their global competitors, Someone rebuffed me as a sexist.)

Instead of doing quotas, the government should focus on recruiting more women into the profession and ensure all the barriers are removed. Anyone, regardless of gender or background, should be able to excel in the given profession based on merit. No one should be blocked because of race. In essence. all obstacles should be cleared from the roads so that everyone can get on the highway, reaching their full potential. The focus should be on getting access to those who don’t have it in the beginning and not forcing quotas at the end.

Recently, we had a situation in Norway where a Norwegian Bank employed the services of an Indian IT provider, bringing people onshore to build a payment app. During the development process, the Indians worked outside the regulations, putting in a lot of extra time under duress. The Norwegian managers apparently did not have knowledge that their Indian management counterparts were breaking the law. In my opinion, I believe that the Norwegian managers may have been too afraid to ask difficult questions to the Indians, fearing a PC backlash and being branded a racist.

*PC can snuff out the truth, blocking people from doing the right thing. Being correct over being right can suppress expression and push negative sentiment underground. *People cannot express legitimate concerns because they are more afraid to offend someone, even if they need it. In a sense, this is discrimination. Is it only white males that get to hear the honest and raw truth while everyone else gets the sugar coated and often distorted version of it? Perhaps this explains the rise of nationalist parties.

Some nationalist parties are extreme and irrational (Golden Dawn in Greece) and others address legitimate concerns (UKIP).  The mainstream media does not differentiate.  Being in a democracy requires a lot of work, on the individuals part, collecting and analyzing the facts for yourself.  Remember that ad revenue powers mass media. Perhaps people should think twice before thinking mainstream media outlets are benevolent.

Focus on success has been America’s edge: greed and the desire to make money trumps personal feelings, race, and gender. American’s simply want the best people on their team, seeing only green. In this sense, greed is fair and democratic, rewarding merit while blind to other factors.  Last time I was in America, I noticed that people go pretty far when they are good at something they enjoy.

*The world is counting on the American ideal that “right is might, saying it like it is.” Being right over correct gives us the data in the purest form, free of distraction, allowing for the best possible decision.*

-*Globalism vs. Nationalism*-

Being proud of your country and voting for politicians who put national interests ahead of global ones is not racist like liberal mainstream media would like you to believe. Racism is when you institute policies to block certain people from opportunity or services, based solely on their genetics, personal beliefs, ethnic background or religion. Sexism is when you do this based on gender.

*It is not racism to be opposed to helping those outside your borders when so many inside, who paid into the system, need help *(education, medical care, access to basic services, etc.).  BREXIT highlights this prioritization very clearly. Countries can grow, add diversity and obtain skills with a proper immigration and integration policy.

The American’s have done so much to help the world, twice saving Europe from self-destruction. Instead of rebuilding themselves in full force, the rebuilt the conflict perpetrators. 

The American system, based on the premise of strong individuals (families) and weak government, yield self-determination and personal responsibility. Based on my reading of the American system and Constitution, states should take more responsibility for themselves, minimizing the role of the Federal government.  This way the people have more say about the spending of their tax contributions. The further away the money goes (to DC vs. the state capital), the less the taxpayer sees regarding benefits.  It appears that a lot of money “gets stuck” in Washington DC. Many in the EU feel that a lot of money gets stuck in Brussels (Although Norway is not a member of the EU, we still pay the membership fee and follow the rules. We agreed to this to save our fishing and oil industry). 

It’s easier to help others and save the world when your situation is stable. Moreover, stability and prosperity lead to more openness and acceptance of outsiders.

*Trump is right to put Americans first, especially if they are paying taxes to the American government.*

-*Failures vs. Success *-

*Everyone is criticizing Trump about past failures.* These are probably the same people that say failure is part of success, which is true. Here is an example of someone who failed a lot and then succeeded as president. He was also considered a bit wacky back in the day:

-*Russian Reality *-

*I am far from being a Russia fan. I am just stating the facts, hoping the Americans can see this issue from another angle. *

Although Norway’s experience with Russia during WWII was positive, helping us drive out the Germans and then leaving afterward, many do not have a positive view of them because of the media. They did not occupy us, and we later became trade partners, mainly exchanging fish for metal.

*However, Trump is right to reach out to Vladimir Putin. *We have a terrorist problem in the Middle East caused by faulty American and Western European policy.  The USA, UK, and Russia were allies in WWII, defeating the Nazi’s. The Russians lost the most people in the conflict, created by Europe. Are they really so bad?

*The US and Europe created the current situation in Ukraine, making empty promises to the opposition, hanging them out to dry when Russia responded via proxy. *Putin hacked NATO by supporting rebels not wearing national uniforms, taking advantage of the EU’s bureaucracy. They are still debating: invasion or insurgency? Europe remains naïve to many things. All the while Ukrainian corruption rages on no matter who is in power. In fact, they cannot get their top leaders to comply with reporting, which is a pre-requisite to a visa-free regime.  

Soviet Soldiers are buried in Norway – Memorialized for their sacrifice.

*I am upset that our government blindly follows Obama, regarding this issue. *Russia is our neighbor, and we have a long-standing relationship. Ironically the trade sanctions we imposed, on America’s behalf, hurt us more than them. Our exports to Russia fell while theirs to us rose markedly in 2015. Now is bad timing, considering that the American frackers are destroying our offshore oil industry, albeit fair and square by “building a better mousetrap.” 

*Norway has to stop being pathetic, acting like an American lap dog.* We need to be more “American” in the sense that we make our own decisions and determine our destiny. Norwegians know all about America, but most Americans don’t know we exist. Therefore we must take care of ourselves, not depending so heavily on others for our protection. If the Finns managed to hold back Russia in 1939-1940, we should be able to do the same if an unlikely event were to happen. 

The greater issue is that Europe (EU) needs to grow up.  How does a country (Russia) of 143 million with a GDP of $1.2 trillion nominal (smaller than California) stare down a federation with over 500 million people and a $19 trillion economy?  WTF right? We have not taken responsibility for our own lives, crutching on America.

*Trump is right. NATO is outdated and requires re-evaluation. *America, being the World’s babysitter, has done so at the cost of their own people and prosperity. By breaking up NATO, perhaps we can organize with Sweden, Finland and Denmark a robust defense alliance. But then for what? Russia has never intended any harm to us.  (The antics with airplanes flying close to the border don’t count. Everyone does that on both sides.) 

-*The Border Wall *-

*Trump is right. A nation is defined by borders and rules. *There are people in the country who pay taxes and follow a law, expecting security in return.* In light of the recent migrant crisis, we also built a wall.*

The wall with Mexico is more of a metaphor for an advanced border control system than an actual concrete structure.  The actual wall could be built with drones, robotic and sensor technologies offered by FLIR Systems in America and Kongsberg Gruppen in Norway.  Our defense company is an expert in sensor technologies and remote weapon systems. Our leaders should be getting in good with Trump to line up some business. Participation in the border wall project would stimulate innovation in Norway, which we dearly need.

*I personally feel that when the EU parliament and Angela Merkel, unilaterally decided to let in massive amounts of refugees, they inadvertently endorsed dictatorships and terror groups.* They allowed ISIS and other dictators to seize abandoned properties, assets, and agricultural lands, strengthening their hold. Maybe like Castro in the Mariel boatlift in 1980, the regimes sending us refugees emptied out their prisons on Europe.  We will never know until it’s too late, manifested as horrific crimes and gang activity.

*I want to make it clear that there is nothing wrong with bringing in refugees and immigrants. It just has to be done in a proper and controlled manner, not to overwhelm the system or society*. Otherwise, legal immigrants get short changed. The legal immigrants often wait in cues, sometimes for years, having earned outstanding credentials, only to start over when they arrive in a western country.

*Western countries have to acknowledge and deal with the ideological conflicts, assimilating the people to western standards. *Otherwise, you get Sharia courts and back alley law, enforced by intimidation and risk of family ostracization. If the West really wants to fix the problems, the feminists should fight for the rights of Muslim women in their home countries, many of which are western allies.

*The American way, teaching people to fish, is better than the European way, giving the fish outright, on refugee integration. *Work defines your character, and it is what defines an American regardless of background, belief or gender.

*Don’t try to be like us, blindly helping people and giving them a lot of “free stuff.”  *Prolonged destitution leads to self-loathing, mutating into resentment against the host. Mixed with idle time and the fact misery loves company, results in the current European situation. Listen to Ronald Reagan instead. 

-*Trump Care vs. Obama Care*-

*America’s biggest problem is obesity*. It’s destroying America from the inside out, more so than any terrorist organization or other external threats. *When people don’t feel good physically, they lose it mentally and spiritually.*  America’s greatest power, more than flags, history, land, guns, and innovation is its’ spirit. The American soul, defiant, driven, determined, brave and wild is unique. It’s what makes American unmeasurable and surprising.

*Fat acceptance is about as sensible as condoning drunk driving. *It tells those in question that it’s ok to give up on themselves, endangering their own health. This view may not be “correct” but it’s factually right, regarding public health.

Healthcare is something we get right in Norway. So here is some advice.Public health starts with the lifestyle and eating habits. *If Trump wants to solve the American health care crisis, he needs to take on the food industry the same way he took on John McCain and the Republican party, laying them to waste. If government must provide free medical care, then it must, through policy, steer people towards healthy eating and fitness.* Recently, retired US military leaders stated that the obesity epidemic poses a risk to national security, making it difficult to recruit qualified people.

*Perhaps, Trump Care should invest part of the defense budget into a network of sports facilities, making all the Olympic sports accessible to everyone.* Inner city kids could take up rowing or learn cross country skiing. Rural Americans can get more access to swimming pools and Soccer. Not only will America rack up more medals but the Army would have a greater pool which to draw. This initiative would be a far better investment than supporting other nation’s defense programs. I am confident Trump Care could bring the cost of medications for the public through bulk buying like the Canadians do.  The savings from preventative medicine (proper eating and exercise) along with reduced obesity rates would lead to substantially lower private health insurance costs, making emergency room visits possible for everyone without experiencing bankruptcy afterward. 

*Norwegians want Americans to live long, healthy and happy lives so they can come and visit us, enjoying our natural wonders.*

-*Conclusion *-

*Trump could surprise everyone, becoming a great president. He is already turning the American political system upside down. Or, he could be a much-needed stick of dynamite applied to an unmovable obstacle – the political system. * (When explosives are used to remove obstacles, they are consumed in the process. After detonation, the obstacle is cleared and the explosive is gone.)

The worst case is that Trump will be a one term president. However,* he will destroy a lot of bad institutions in the process by shaming them on national TV, causing people to take action at the polls,* by protesting or through non-compliance – real democracy.  Imagine if Trump started calling out specific government officials, regarding project cost overruns and wasteful spending.

Perhaps Trump will Pardon Edward Snowden and offer Julian Assange free passage to California to spite his rivals? I would like to see them pardoned so they can come to Norway and accept long overdue Nobel Peace Prizes (when the committee comes to its’ senses).

*If Trump’s presidency is a catastrophic failure, the collateral damage would also take out the two party system in the process.* The US Election of 2020 may well consist of four to five political parties vying for power vs. two, giving Americans more choice.  There is really nothing to lose. This Trump statement applies to everyone not just black people.

*Many Europeans, Norwegians included, compare Trump to Hitler. This comparison is nonsense. *Trump grew up in a family and went to an Ivy League school, married and fathered five kids. Hitler was an utter failure at life, pushed up on a wave of fascism. Europe is the continent that produced 20^th-century dictators, not America.  It is Europeans who blindly follow like lemmings, not Americans. They are, in general, too unruly, varied and wild for a dictatorship to take hold.

Moreover, there are plenty of checks and balances, including his own family and the US Military. * The American military people I have met are very human and have a high standard when it comes to moral law.  They would never enforce Third Reich edicts.*

*Nevertheless, Trump could learn some diplomacy, perhaps from Nigel Farage (who sounds nice even when insulting people). *It will also be impossible to ban people based on religion. Religion is a personal declaration that can be changed. (I once met some Iranians who converted to Christianity, getting baptism papers, successfully obtaining refugee status in America).  Instead, the immigration process should be a uniform and rigorous process, consisting of background checks, psychological exams, and extensive interviews, verifying the applicant's legitimacy and intent. 

America needs to take care its’s own and the world needs to grow up, taking control of their own destiny. *Americans need to remember, they as individuals are very powerful, unique and yet compassionate people*.  They must not depend on large corporations and mass media but their instincts and values.  It will never be boring with Trump in the White House. Hence, why Kim Kardashian endorsed Hillary Clinton. Is it so bad that people will leave reality TV behind? Is it a bad thing that people find politics interesting, something that affects their life?  

*Please ask yourself: do you really want to be like us (socialist)? Then make your decision.  Good Luck in November.*

Yours Truly,

Ola Nordmann from Norway.

h/t AG Reported by Zero Hedge 9 hours ago.

Covered California, the marketplace for enrolling in California health insurance, closed the doors on open enrollment on January 31, 2016. HFG Coastal Insurance, a Paso Robles insurance company that specializes in assisting applicant enrollment in Covered CA, released a report discussing the record number of new enrollments and the options available to those who missed the deadline.

Paso Robles, CA (PRWEB) September 10, 2016

Covered California, the marketplace for enrolling in California health insurance, closed the doors on open enrollment on January 31, 2016. HFG Coastal Insurance, a Paso Robles insurance company that specializes in assisting applicant enrollment in Covered CA, recently released a report discussing the record number of new enrollments and the options available to those who missed the deadline.

HFG has been writing and servicing health insurance policies for over 20 years. When the Affordable care act was passed in 2010, HFG began to prepare for the inevitable changes in the health insurance market place and the introduction of Covered California so they could hit the ground running when the program was unveiled. All California residents may take advantage of this service to ensure they receive the right health coverage for the best price each year. The HFG Coastal Insurance Paso Robles office was open every Sunday in January to ensure all applicants received adequate coverage before the deadline.

By the end of the day on January 27, Covered CA had over 329,000 new enrollees. On January 29, just two days before enrollment closed, Covered CA announced that all applicants who started the enrollment process before January 31 would be allowed an extension, giving them until February 6 to complete their enrollment. The resulting influx of over 100,000 enrollees within the following 3 days pushed the number of new enrollees to an all-time high of more than 425,000 people. In conjunction with the approximately 1,149,000 renewals, the total number of individuals now insured through Covered CA is up to 1.6 million.

However, millions of California residents remain uninsured in a qualified health plan. For those individuals, there are still options. The most common way people enroll in Covered CA once the open enrollment deadline has passed is through a “qualifying event”.

Qualifying events may include:· Involuntary loss of other coverage
· Becoming a dependent
· Gaining a dependent (through childbirth, adoption, etc)
· Marriage or entered into domestic partnership
· Divorce
· Becoming a US citizen
· A permanent move to/within California
· An error in enrollment
· Employer-sponsored coverage reduces benefits or becomes unaffordable

Additionally, some residents are eligible to enroll in qualified health plans year-round, including Native Americans, and those who qualify for Medi-Cal and CHIP. Speaking with a HFG Coastal Insurance Paso Robles representative will help residents determine their best options for enrollment in 2016.

Many private insurance companies in California have opted to discontinue their involvement with the Covered California marketplace because of its increased complexity. HFG has recently assisted many clients who were referred from agencies that are not as experienced with the open enrollment. While health insurance is just one of HFG’s specialties, each agent employed with HFG has a particular insurance specialty, such as home, auto, life, or workers compensation. This diversity ensures that clients work with a specialist in every field of insurance they require.

HFG health insurance and employee benefits specialist Sarah Hinds states, “I don’t want my clients calling Covered CA or the insurance companies. Whatever the issue is, I can fix it much faster.” The process is simple and requires very little documentation when applicants meet with an HFG representative over the phone or in person at their office in Paso Robles.

Any individual who did not enroll or re-enroll in a qualified health insurance plan before the January 31st deadline will be subject to the penalty, which is $695 per adult and $347.50 for each child in a household up to $2085 per family or 2.5% of their income whichever amount is higher.

To avoid these fines and find out if you still qualify for 2016 enrollment, please call (805) 239-7443 or visit the HFG Coastal Insurance website at http://hfginsurance.net/ today.

HFG Coastal Insurance Services, Inc.
1818 Spring Street
Paso Robles, CA 93446
(805) 239-7443

Press release by Paso Robles online marketing service Access Publishing, 806 9th Street, #2D, Paso Robles, CA 93446 (805) 226-9890. Reported by PRWeb 4 hours ago.

As the world prepares to mark the fifteenth anniversary of the September 11 attacks, the UK Asbestos Training Association (UKATA) says the estimated 1,000 tons of asbestos rich dust released following the collapse of the World Trade Centre has the potential to claim more lives that the original 2,753 people murdered in 2001.

(PRWEB) September 11, 2016

As the world prepares to mark the fifteenth anniversary of the September 11 attacks, the UK Asbestos Training Association (UKATA) says the horrors of that day are not completely over. The estimated 1,000 tons of asbestos rich dust released following the collapse of the World Trade Centre has the potential to claim more lives that the original 2,753 people murdered on that shocking day in 2001.

As any public buildings built or refurbished before the year 2000 may contain asbestos, UKATA continues to back the Health and Safety Executive (HSE) in ensuring the duty to manage asbestos from regulation 4 of the Control of Asbestos Regulations 2012 are adhered to - ensuring no city in the UK ever confronts a 9/11 style dust cloud unprepared.

During construction of the World Trade Centre in 1966, asbestos was a widely used building material and while specialists were called in over subsequent years to help remove this asbestos, they could do nothing about the 400 tons of the material that formed part of the fabric of the building and was ultimately to fall as dust on thousands of New Yorkers in 2001.

“Donna Summer attributed the lung cancer that led to her death to this asbestos dust cloud and the death toll from this cloud could ultimately prove greater than from the initial attack,” said UKATA General Manager Craig Evans. “Estimates suggest 410,000 people could have been exposed when the towers collapsed and as asbestos diseases like mesothelioma take between 15 and 60 years to develop, the true cost in lives post 9/11 may not be fully appreciated for decades.”

A central caveat in health studies conducted post 9/11 is this latency period problem when it comes to cancers like mesothelioma, as decades can pass before a patient exhibits symptoms. This led to the inclusion of cancer in the 9/11 Health and Compensation Act (James Zadroga Act) in June 2012 - as experts estimate the cancers so far reported are most likely only the tip of the iceberg and Environmental Health Perspectives(among others) have published studies showing more conclusive evidence of a link between cancer and 9/11.

By 2014, there had been more than 2,500 reported cases of cancer among rescuers active during 9/11. The government health insurance scheme did not originally include cancers because they claimed that there was no link between the dust and the illnesses. However, the link has since been made and the victims are now able to claim compensation although it has already come too late for some.

Donna Summer is a high profile example of post 9/11 victims, but there are many others. Mr Leon Heyward’s development of lymphoma was ascribed to dust ingested post 9/11 and Jerry Borg’s death from pulmonary sarcoidosis was explained by 9/11 dust. It is highly unlikely they will be the last victims. As Craig explains, the issue has wider implications not just for buildings in the US, but the UK too.

“Asbestos is usually left in situ in a building unless it poses a credible threat,” added Craig. “However, post 9/11 we must take into account asbestos being released or disturbed unexpectedly. A terrorist attack is an extreme example when a gas explosion could deliver a similar result. The presence of asbestos in so many public buildings makes this no scare story but a very real concern. We must ensure people have training to recognise asbestos and that we have plans in place for buildings known to contain dangerous levels of asbestos were it ever to be released in dust form.

Estimates suggest 70% of buildings in the UK may contain asbestos, which means over 1.5 million buildings in the UK may still contain the substance nationwide. While UKATA acknowledges taking down every building containing asbestos is unrealistic, comprehensive training and a plan of what to do should the worst happen is essential to handle this killer substance safely.

“We can learn valuable lessons from 9/11 and the aftermath,” added Craig. “Fifteen years on, initial scepticism of a casual link between the dust and cancers caused by asbestos has been replaced by a growing acceptance of the truth. We owe all the victims and brave people who went out to save lives amid the dust and the rubble the compensation they deserve and indeed need to ensure should the worst ever happen again, we have the procedures in place to minimise the risks to public health asbestos poses.” Reported by PRWeb 12 hours ago.

Local head lice removal service offers prevention tips and products to raise awareness about the parasite and help families and schools avoid outbreaks this school year.

Miami, Florida (PRWEB) September 12, 2016

The CDC estimates that between 6 million and 10 million individuals are affected by head lice in the U.S. each year. As super lice have now been identified in 48 states, the need for public education is apparent. For this reason, the month of September has been designated National Head Lice Prevention Month, also known as Lice Awareness Month.

This year, in observance of the month, Miami-based head lice removal company, Lice Troopers, has put the focus on prevention--this includes public education on prevention methods and an offering of products that can aid in preventing epidemics of this common childhood parasite. While lice are not inherently dangerous and are not known to transmit pathogens, they're a nuisance to children, parents and teachers that do not go away on their own and must be treated.

“We pride ourselves on being a resource for everything associated with the head louse parasite. However we want to offer more than information and advice, we want to offer solutions as well,” says owner Arie Harel. The company is putting the focus on its all-natural lice prevention hair products like the Lice Repellent and on its unique Lice Free Membership, which allows members free screenings and treatments. Lice Troopers is also offering free lice screenings throughout the month of September at all of their locations.

September is the time to learn more about this parasite and how it can be safely and effectively prevented and, if necessary, treated. The National Pediculosis Association discourages the use of all chemical products and instead recommends a thorough combing with a comb designed specifically for the purpose. The manual removal process can be performed at home or by a reliable treatment service.

For more information, visit http://www.licetroopers.com, or call 800.403.5423.

Lice Troopers is the all-natural, guaranteed head lice removal service that manually treats and removes head lice safely and discreetly in child-friendly treatment centers, or other chosen location. Providing safe solutions for frantic families, the Lice Troopers team has successfully treated thousands of families with pediatrician-recommended services that may be reimbursed by many major health insurance carriers, flexible spending accounts and health savings accounts. Reported by PRWeb 5 hours ago.

Calling your health-insurance provider is right up on the Most Dreaded List with getting a colonoscopy. Reported by ajc.com 1 hour ago.

The Affordable Care Act (ACA) was enacted to ensure that most people would have access to affordable health care insurance and to decrease the high cost of health care in our country. I have previously written about the Independent Payment Advisory Board (IPAB) and the role they will play in decreasing costs, but it looks like Health Care Insurers are already acting to cut payments without even waiting for guidance from the IPAB.

Insurance companies are not in business to lose money. When they are paying out more for health care than they are bringing in in premiums and governmental subsidies, they will raise premiums, increase deductibles, ask for more subsidies, or pay less for the care rendered. As a surgeon, it is the decrease in my payment that is of most concern.

The "fee for service" model, recognized as a key driver for increasing health care costs, is being challenged. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) establishes new ways for paying physicians who are taking care of Medicare patients. Other third party payers will follow the MACRA model.

MACRA's value based programs have two different models. In the Merit Based Incentive Payments System, payment will be based on quality, resource use, clinical practice improvement and meaningful use of electronic health record technology. The terms are vague and have not yet been clearly defined but increased paperwork and data collection and analysis look to be labor intensive. Either the physicians will need to do this work themselves or hire people and train them to enter and analyze the data for them. If the different electronic health records do not communicate with each other, the data analysis will be difficult, if not impossible.

The second model will pay more for providers who participate in Alternative Payment Models such as Accountable Care Organizations (ACO), Patient Centered Medical Homes, and Bundle Payment Models. Details of payment with this model are still being worked out.

Under MACRA, physician's payments will increasingly rely on outcomes of their care. Value will need to be defined and measures of good care will need to be selected so that performance can be fairly judged. Measures, once selected, will be used to determine Medicare payments. Third party payers will likely follow the MACRA model. Historically, performance measures have not been shown to have much to do with quality so I am not optimistic that these proposed models will be workable.

In the near future, it will be pay for performance, MACRA, and, eventually, capitation with a global fee for each patient. The health care providers who survive will be the ones who provide the least costly care.

Highmark, a Blue Cross and Blue Shield provider that has programs in Pennsylvania, Delaware, and West Virginia has recently announced that they will be cutting payments to their participating physicians because of mounting losses from the plans they have provided through the ACA exchanges in those states. Highmark has found that they are paying out more in claims than they are collecting in premiums.

Highmark reports they lost $221 million in 2014 and claimed to lose another $500 million in 2015 because of the mismatch in claims and premiums. In the original ACA plan, recognizing that health insurers may be facing some significant losses until the system comes into balance, the ACA originally had federal subsidies which were meant to offset losses for the first three years of the Act. However, the Congress, which is now under republican control, has blocked the administrations access to these funds for the time being. As a result, companies like Highmark are only getting 13% of the subsidy money they were counting on.

Some of these losses will be handled by pay cuts to the physicians who are Highmark providers. Of course, Highmark could spread some of the losses to the participating hospitals but they have chosen not to do this. Apparently, cutting reimbursements to hospitals would require hospital specific negotiations whereas the doctor contracts are more flexible and "adjustments" are already built in to the present contract structure.

Highmark could have taken the losses and remained viable by dipping into their reserve funds and they have done this in the past, but they have now decided that subsidizing money-losing exchange plans is no longer a reasonable option.

Highmark is not the only insurer that is losing money under the ACA. The United Health Group has recently reported a $720 million loss for 2015. If they don't see a financial turnaround soon, it is predictable that they will pull out of the exchanges. Other insurers such as Aetna and Anthem are also losing money on the exchanges.

The insurers are facing increasing losses because the patients opting into insurance purchases are a riskier pool than the insurers had originally anticipated. Highmark has shown that the congestive heart failure rates for those among the ACA purchasers was 43% higher than for members of their regular commercial plans. Chemotherapy claims per ACA users has been found to be 49% higher than the regular commercial users. According to Robert Lowes writing in the March 3, 2016 edition of Medscape Medical News, these patients have high cost for care and the premiums paid by these patients (due to community ratings) do not cover the costs.

To remain in business, the insurers will need to increase their premiums and decrease their payments on claims. Decreased payments can be done by increasing deductibles on the plans as well as paying less for each claim made. It is hoped that more healthy people will opt into buying health insurance since the penalty (tax?) for not having health insurance is scheduled to rise. However, if the penalty is still significantly less than the premiums, it is unlikely that a rational healthy person will participate in the exchanges. This is even more likely due to "guaranteed issue" which allows a person to buy insurance at any time; this means he can wait until he is sick to buy the needed insurance.

Another strategy being used by the insurers is to deny payment for those drugs or procedures that do not meet the insurance company guidelines. This denial usually results in the health care provider appealing the decision which can be labor intensive and time consuming. Providers are justifiably aggravated as it seems like gatekeepers for the insurance companies are making clinical decisions on patients they have never seen. Also, guidelines have never been deemed to be the "standard of care" as each patient has their own unique characteristics which the provider needs to understand in order to make a reasonable medical judgment.

The "pay for performance model", MACRA, or even capitation will necessarily increase the time spent by the clinician in documenting care and coding properly. If they don't document and code properly, they will not be paid. The time spent with each patient must decrease. These administrative duties are not why we physicians went into medicine in the first place.

If the payments to physicians continue to decrease, there will come a time when overhead costs will exceed remuneration. Providers will either refuse to see patients with certain insurance or they will retire. Either of these two options can put the Affordable Care Act in jeopardy as providers are a critical resource in the health care model.

As to the future of medicine, I am not so optimistic. The goals used to be to improve and prolong life. But now the costs for medical care have become a factor in the equation. Ethicists are now debating the costs of care related to the perceived benefits. The "right to die", "duty to die", and "assisted suicide" are, again, in the press. I hope that we physicians can be strong enough and principled enough to continue to do what we believe is right for our patients and fight to keep others out of our business.

Can the government force the physicians to participate in the ACA? Can the government prevent the physicians from retiring? These questions will need to be litigated and will probably have to go to the Supreme Court for a definitive decision. This process will take time.

Darryl Weiman's website is www.medicalmalpracticeandthelaw.com

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 1 day ago.

By Nick Brown

SAN JUAN, Sept 12 (Reuters) - It began with what felt like a punch in the throat.

I assumed it was irritation from the cigar I’d smoked on my deck that afternoon in mid-June. But the sensation hung on. Within three days, I had a 102-degree Fahrenheit (38.9 degrees Celsius) fever, chills and bed-drenching night sweats.

For two weeks, symptoms came in waves. A skin rash. Joint pain. Then a dull throbbing behind my eyes. There was pain and redness too, in a certain exclusively male region, which ibuprofen didn’t relieve.

Then, I felt better. But a week later, the symptoms staged a comeback, with more eye pain and something new - small welts on my eyelids and temples. I had sporadic headaches, was so exhausted I slept 10 hours a night and even failed to wake up for a flight.

My mother was the first to suspect I was infected with the virus that arrived in Puerto Rico in December 2015, four months after I’d begun an assignment as Reuters’ San Juan bureau chief.

Initially, I laughed off her internet diagnosis as the overwrought worries of a long-distance mom. But I agreed to see my long-time physician during a visit home in late June.

After listening to my symptoms and learning I’d been working in San Juan, Dr. Kevin Wallace of Murray Hill Medical Group called the New York City Health Department and arranged to have my blood sent for screening. Eight days later, I got the news.

Mom was right. I had Zika.

 

EVOLVING KNOWLEDGE

Hundreds of thousands of people are estimated to have been infected with Zika in the Americas since the virus was detected in Brazil early last year. Most have no symptoms or experience only a mild illness.

But it can penetrate the womb in pregnant women, causing a rare but crippling birth defect known as microcephaly. In adults, it has been linked to Guillain-Barre syndrome, a temporary paralysis. And it can be passed on through sex, a unique characteristic among mosquito-borne viruses. There is no vaccine or treatment.

Last month, the U.S. government declared a public health emergency in Puerto Rico, the hardest hit among states and territories. More than 17,800 infections have been reported on the island, including more than 1,500 among pregnant women, and one case of microcephaly in an aborted fetus.

As a journalist and a patient, I’ve had access to some of the brightest minds studying Zika. But the virus has confounded experts at the highest levels and launched a global race to understand its risks.

Each month, new findings have led to changes in how the public is advised to stay safe. Compared to what we know about other diseases, such as flu and even Ebola, we are in new territory.

In my case, doctors were hard-pressed to explain why my symptoms returned about three weeks after the initial infection. Nor could they tell me how long I could be at risk for Guillain-Barre. Another mystery: were condoms enough to protect against sexual transmission?

In the weeks since I’ve recovered, that is proving to be one of the toughest questions to live with.

Both men and women can infect their sexual partners. In one case, scientists identified Zika virus in semen six months after the man’s symptoms appeared, though it’s not clear how long it can cause new infections.

Public health officials have warned couples not to conceive for at least six months after either a man or woman returns from a Zika outbreak area, even if they show no symptoms.

My wife and I, both in our early 30s, have had to consider how dangerous my bout with Zika could be to our plans to have children some day.

Our most intimate decisions now are affected by the uncertainty surrounding Zika: how long can I infect my partner? How likely is it that my baby would become sick if I do? Given how rapidly the expertise about Zika has evolved so far, how much faith should we put in the current thinking?

 

SHRUGGING IT OFF

When I took the one-year post in Puerto Rico, I figured my biggest health risk would be sunburn.

Even when Zika began circulating on the island, I didn’t worry. My wife Julie, a lawyer and publishing industry pro, had decided to stay at home in Brooklyn during my assignment, and we weren’t planning to have kids for at least a couple of years. So we gave Zika little more than a shoulder shrug.

I’m not sure when I was infected. I picked up more mosquito bites in San Juan than Twitter followers. I didn’t always use bug spray. I worked from home, an apartment in a colonial building without window screens, and kept the deck doors open to save money on air conditioning.

Locals are used to mosquito-borne illnesses, including dengue and chikungunya. Some, more concerned about pesticides than Zika, successfully fought aerial spraying with Naled. Many also are concerned about Zika’s threat to tourism, which could compound the island’s vast economic challenges.

One friend grew indignant when I mentioned writing this piece. “You’re a journalist,” she said. “You have a responsibility not to perpetuate hysteria.”

When I got sick, I didn’t consider going to a doctor in Puerto Rico. The economic crisis has made medical care unpredictable, and the waits are long. When I sought treatment for allergic reactions earlier in my stay, doctors refused my corporate health insurance and demanded cash.

Instead, I waited a few days to see Dr. Wallace during my visit to New York. I was his second potential Zika patient, though the first ultimately tested negative for the virus.

Eight days after my blood sample was submitted, a woman from the city health department called.

Have you heard from your doctor? she asked.

“No.”

“Oh?” she said. “You haven’t spoken to your doctor at all?”

I broke a long pause, saying, “Feel free to let the cat out of the bag.”

“Well,” she said, “you tested positive for Zika.”

The way it is supposed to work, the results are sent to the patient’s doctor in time to break the news before the city “interviewer” calls to address public health concerns. But Dr. Jay Varma, deputy commissioner of the New York City Health Department, acknowledged that doesn’t always happen.

 

MIXED REACTIONS

Some friends in Puerto Rico teased me when they learned I had Zika. Many of them had experienced chikungunya or dengue, and had stories about months of muscle pain or weeks in bed. Friends from the states, on the other hand, showed grave concern, offering thoughts, prayers and condolences. Some kept their distance for weeks. A few questioned whether it was safe for me to be around babies.

The evidence shows Zika clears the bloodstream quickly, and the virus doesn’t spread through casual interactions.

Julie and I weren’t quite sure how to react. We didn’t take it too seriously at first. I posted a glamour-shot selfie on Facebook with the caption: “This is the face of a man with Zika.”

As the weeks passed, it became clear that Julie and I were also a little rattled - and not fully on the same page. She canceled a planned long weekend visit to Puerto Rico. She wanted to minimize her exposure to Zika and arranged instead for us to meet in Florida.

This disappointed me. I had hoped to show her my new favorite places on the island. I clung stubbornly to the view that Zika fears were largely overblown. She reminded me that, given the unknowns about Zika’s impact on pregnancy, I was in no position to call the shots.

“Try to see it from a woman’s perspective,” she said.

We have heard a lot of different things about Zika, even from doctors, and she doesn’t totally trust the idea that the virus is manageable with the current medical advice.

What if Zika poses a threat for months or years after infection? If so, could that jeopardize our future plans to start a family? What if we got pregnant before we planned to?

We’ve had to manage our different anxieties over the “what ifs” of Zika.

 

FOR SCIENCE

There’s plenty the experts are still figuring out, and that has been reflected in the shifting opinions about my case.

Ingrid Rabe, an epidemiologist with the U.S. Centers for Disease Control and Prevention, told meZika generally lasts a few days. While she couldn’t address my specific case, she speculated that a return of symptoms like mine could indicate the presence of a second virus.

A few weeks later, Dr. Varma told me it was possible, in severe cases, for symptoms to last longer or recur.

Of three acquaintances in Puerto Rico who developed Zika, all have complained, like me, of lingering health problems, in one case for longer than a month.

Two weeks into my infection, Dr. Wallace couldn’t tell me whether I remained at risk for Guillain-Barre. The city health interviewer, after consulting with doctors, told me the paralyzing condition would most likely have set in within days of Zika infection, so I was probably out of the woods.

Again, the information shifted over time. The CDC’s Rabe later told me it could take “a few weeks” for Guillain-Barre to appear. So far, I haven’t had any symptoms consistent with Guillain-Barre, and here’s hoping it stays that way.

Guidance on sex lacked precision as well. The city health interviewer recommended we “use condoms every time” for six months, reflecting CDC guidelines.

When I asked whether Zika can spread via saliva or oral sex, the city health interviewer didn’t answer directly. She said it can spread via “sexual activity,” and that saliva is “currently not being tested.” Rabe later told me “there’s been no evidence” that saliva can spread Zika.

The city health interviewer asked if I would join a CDC study gauging how long Zika can be spread through semen and urine. I’m one of 140 participants, though protocol calls for up to 250.

The study is a bit awkward. But, as a writer always looking for a good story, I could not pass it up.

Every two weeks, a study test kit arrives by FedEx in a box with dauntingly detailed instructions on how to produce and package my samples, then overnight them back to the center’s Colorado lab. I also answer a somewhat blush-inducing questionnaire about my recent sexual activity.

The CDC staffer assigned to my case sends cheery emails to let me know she has received my samples and sex report, an interaction that feels slightly too intimate. But I endure it in exchange for a $50 Visa gift card for each sample, and, more importantly, for the chance to learn and to contribute to science.

The downside: I don’t learn my results until the study ends in December.

 

(Reporting by Nick Brown; Editing by Michele Gershberg and Lisa Girion)

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 22 hours ago.

President Obama is enlisting the help of some health insurance companies to try to fix the Affordable Care Act, better known as Obamacare.

Obama dropped by a meeting between the Secretary of Health and Human Services Sylvia Burwell and 13 health insurance CEOs, including the CEOs of giants Humana and Cigna, to emphasize the need to work together on the ACA's public marketplaces.

Recently, a number of high-profile insurers have rolled back their offerings on the Obamacare exchanges. This has led to questions about the long-term sustainability of the ACA.

In addition to the meeting, Obama sent a letter to every health insurance CEO that is participating in the exchanges, asking for their help with improving the exchanges.

Obama acknowledged there have been struggles during the first few years of the exchanges.

"We know that this progress has not been without challenges," said the letter. "Most new enterprises have growing pains and opportunities for improvement. The marketplace, while strong, is no exception. Time and experience will help drive that improvement, as will constructive policy changes."

Obama said that Secretary Burwell and the HHS are working on making needed changes, as was his administration, but that the government needed their support to make it work.

"To that end, I want to enlist your help as we head into this fourth annual open enrollment period," said the letter from Obama. "We know that signing up more uninsured Americans for coverage generates benefits all around."

It continued by saying that the administration is attempting to address some challenges, including the fact that fewer than expected young people are signing up through Obamacare, making it costlier than projected for insurers. Here's Obama (emphasis added):

*And since the remaining uninsured are disproportionately younger and healthier, signing them up improves the risk pool and consequently the affordability of coverage for all enrollees*. Secretary Burwell has developed a data-driven plan to find and enroll those who still lack coverage, including by stepping up the outreach activities that worked best over the last 3 years; working with the Department of the Treasury to reach out to uninsured people who paid the individual responsibility fee for 2015; and increasing our focus on enrolling young adults. We are also hosting a Millennial Outreach and Engagement Summit at the White House on September 27focused exclusively on how to enroll more youth in the Marketplace during open enrollment.* We welcome efforts to increase your outreach during this open enrollment period."*

Obam concluded that the "work is not over" in implementing the ACA.

Of note, the CEOs of Aetna and UnitedHealthcare were not in attendance. Both companies are part of the "big five" nationwide insurers and have announced plans to roll back their Obamacare coverage substantially.

*SEE ALSO: The future of Obamacare*

Join the conversation about this story »

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Obama says in a letter to the nation's health insurers that most new enterprises have growing pains and opportunities for improvement, and the health insurance marketplace shaped by his health care law, "while strong, is no exception." Reported by SeattlePI.com 15 hours ago.

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Watch VideoTeenagers in low-income households are turning to illegal and, at times, dangerous means to help ensure they have enough to eat, according to a new study.

Washington, D.C.-based think tank the Urban Institute and nonprofit Feeding America held focus groups with 193 teens in 10 different communities who were considered "food insecure."

*SEE MORE: Arizona Is 50th State To Give Free Health Insurance To Low-Income Kids*

When money is tight for families, research has shown that the food budget is one of the first aspects of life at home to be affected. This leads to food insecurity, in which the family struggles to purchase enough affordable, nutritious food for everyone.

Researchers learned that many teens felt the need to go "outside of the legal economy" to make money to feed themselves and their families. 

Some shoplifted, while others intentionally failed out of school. And in 13 out of 20 focus groups, girls mentioned trading sex for money. 

One student told researchers, "It's really like selling yourself. You'll do whatever you need to do to get money or eat."

This can take the form of "transactional dating," meaning a teen "regularly sees and has sex with someone, often a significantly older man, in exchange for meals, material goods or cash," according to the report.  

The study notes that if the teens look for minimum wage jobs, they often struggle to compete with adults who have more flexible work schedules. And many don't benefit from government programs that help younger children. 

However, because they are of working age, many parents expect them to chip in more than their younger siblings.

The study went on to cite an expert who said there are 6.8 million children in the U.S. between the ages of 10 and 17 who "struggle to have enough to eat." Reported by Newsy 9 hours ago.

Attorney Scott McCullough, of McCullough & Leboff, P.A., elected to Board of Directors of the Lighthouse of Broward.

Davie, FL (PRWEB) September 12, 2016

Attorney Scott T. McCullough, co-founder of McCullough & Leboff, P.A., announced that he was recently elected to the Board of Directors of the Lighthouse of Broward, a preeminent resource for the visually impaired community. “As a member of the board, I hope to bring a very personal perspective to the management of all of the great work that the Lighthouse does and to provide even better services for the blind and visually impaired,” said McCullough, who has a son that has utilized the resources of the Lighthouse.

The mission of Lighthouse of Broward is to provide specialized rehabilitation and collaborative health care solutions that enhance the independence, productivity, and dignity of children and adults who are blind or visually impaired. All its services are tailored to individual needs by trained professionals working with the adult who has lost sight or the parent and visually impaired child to identify the exact skills that will lead to maximum independent functioning.

“I plan on increasing awareness of the Lighthouse and the services that it provides to the blind and visually impaired,” said McCullough. “I also aim to move the Lighthouse forward as a provider of services in the community so that it can be regarded as a beacon of services accepted by health insurance providers.”

About Scott McCullough, McCullough & Leboff, P.A.
Scott McCullough focuses on personal injury, wrongful death, and medical malpractice. The attorneys at McCullough & Leboff have more than 20 years of legal experience handling personal injury cases. They bring a different perspective to injury claims that comes from the vast knowledge gained by representing clients as plaintiffs and defendants in personal injury actions. The firm’s only focus at this time is to help those that have been injured or suffered loss due to injury or death. For more information, please call (954) 989-3435, or visit http://www.flafirm.com.

About the NALA™
The NALA offers small and medium-sized businesses effective ways to reach customers through new media. As a single-agency source, the NALA helps businesses flourish in their local community. The NALA’s mission is to promote a business’ relevant and newsworthy events and achievements, both online and through traditional media. For media inquiries, please call 805.650.6121, ext. 361. Reported by PRWeb 8 hours ago.