The number of people without health insurance would rise by 22 million in a decade if a revised Senate Republican bill replaced large parts of the Affordable Care Act, according to a report from the Congressional Budget Office.
Reported by Wall Street Journal 5 hours ago.
CBO Says Revised Senate Plan Would Increase Uninsured by 22 Million
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Health insurer plans Alabama expansion, will partner with Brookwood
A new player is planning to enter the Birmingham health insurance market, and it has already established a partnership with a major local health provider. Bright Health has filed with the federal government to offer Medicare Advantage plans in Jefferson and Shelby counties for fall 2017 enrollment for the 2018 plan year. The Minnesota-based company is collaborating with Brookwood Baptist Health and its physician alliance to create a partnership in the Birmingham market. The partnership will give…
Reported by bizjournals 3 hours ago.
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Math is not the friend of the Republican Party
Math is not the friend of the Republican Party.
As the GOP leadership fights to find the votes from Trumpcare, the bill that just won’t die, the Congressional Budget Office issued two new scores for how Republican proposals would affect the health insurance system.
First, the government office ... Reported by L.A. Times 3 hours ago.
As the GOP leadership fights to find the votes from Trumpcare, the bill that just won’t die, the Congressional Budget Office issued two new scores for how Republican proposals would affect the health insurance system.
First, the government office ... Reported by L.A. Times 3 hours ago.
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Insurance hikes in store for most as Oregon approves rates
Final health insurance rates for 2018 in Oregon are out, and they’re basically unchanged from regulators’ preliminary decision last month. For the seven companies in the individual market, the rate changes range from a 1.6 percent decrease for BridgeSpan Health Co. to a 14.8 percent increase for Kaiser Foundation Health Plan of the Northwest, according to the Department of Consumer & Business Services. The one change from the preliminary decisions was Providence Health Plans’ individual rate,…
Reported by bizjournals 2 hours ago.
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Who are Oregon's health care visionaries?
The Portland Business Journal's Health Care of the Future event has morphed over the past two years into one of the region's premiere health care gatherings. It has featured nationally renowned speakers — Eric Dishman, head of precision medicine at the National Institute's of Health, and Marilyn Tavenner, former administrator for the Centers for Medicare & Medicaid Services and current CEO of America's Health Insurance Plans, to name two. The event has drawn more than 700 participants to the Hilton…
Reported by bizjournals 1 hour ago.
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Fact Check: Trump Made Several Misleading Claims in Times Interview
President Trump distorted health insurance, the F.B.I.’s relationship to the president, the biography of his deputy attorney general and French history.
Reported by NYTimes.com 3 days ago.
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Meet our Best Places to Work finalists: This medical marijuana company grows its team through health insurance
We're introducing our 34 Best Places to Work finalists daily leading up to our awards event Aug. 17 at Main Event Entertainment, where our Best Places rankings will be revealed. Our survey partner, Quantum Workplace, administered anonymous workplace satisfaction surveys of employees at companies that were nominated by the public. The companies that received the highest scores are our Best Places finalists. Meet the Verdes Foundation, a medical cannabis company and a finalist in the medium company…
Reported by bizjournals 2 days ago.
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Every former CBO director just called out the 'recent attacks on the integrity and professionalism of the agency'
Every single former director of the Congressional Budget Office signed onto a letter to Congress that called out some of the "recent attacks on the integrity and professionalism of the agency and on the agency’s role in the legislative process."The CBO was created in 1974 as a way to provide Congress with nonpartisan analysis of proposed legislation.
In the past few weeks, the Trump administration has taken to attacking the CBO after the analysis office reported that the healthcare bill proposed by Republicans in the Senate would leave 22 million more Americans without insurance in 2026, compared to current law.
The former directors defended the office. "CBO's approach produces consistent comparisons of competing legislative proposals and unbiased projections of the impact of policy changes. Unfortunately, even nonpartisan and high-quality analysis cannot always generate accurate estimates," the eight former directors wrote in the letter.
The letter also comes just two days after the Department of Health and Human Services released a report on the Consumer Freedom Amendment proposed by Senator Ted Cruz that would allow insurance plans that don't comply with two regulations set up under the Affordable Care Act, the law better known as Obamacare: community rating and essential health benefits.
The HHS report took a look at what the amendment would do in the context of the ACA — not the BCRA bill. Consulting group McKinsey was contracted to produce the analysis, Politico reported.
The report came to the conclusion that Cruz's amendment would lower premiums in both the traditional ACA plans and the less regulated ones. That goes against what experts have said about the amendment in the context of the BCRA. Many say that it is likely premiums for both types of plans would likely rise if the amendment was put in place. The insurance industry's lobbying group said the amendment would lead to "widespread adverse selection and unstable health insurance markets."
On Thursday, the CBO scored an updated version of the bill, but that version didn't include the CFA, meaning the effects of that amendment have not been analyzed by the agency.
The former directors urged Congress to keep considering CBO analysis as part of crafting new legislation. "In sum, relying on CBO’s estimates in the legislative process has served the Congress — and the American people — very well during the past four decades," the directors wrote. "As the House and Senate consider potential policy changes this year and in the years ahead, we urge you to maintain and respect the Congress’s decades-long reliance on CBO’s estimates in developing and scoring bills."
*SEE ALSO: There's a 'looming healthcare crisis for the millennial generation' — and it's just getting started*
*DON'T MISS: Americans are facing rising out-of-pocket healthcare costs — here's why*
Join the conversation about this story »
NOW WATCH: 'You're inflaming everybody!': Watch reporters clash with Sanders over press coverage Reported by Business Insider 2 days ago.
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Doctors' group tells Senate to fix, not repeal 'Obamacare'
CHICAGO (AP) — The nation's largest doctors' group urged senators on Friday to stop trying to repeal or replace Barack Obama's Affordable Care Act and instead begin a bipartisan effort to stabilize the insurance marketplace. "Each bill results in millions more Americans without health insurance coverage, weakened markets, less access to affordable coverage and care, and the undermining of funding for state Medicaid programs," wrote Dr. James L. Madara, the group's CEO, in a letter to Majority Leader Mitch McConnell, R-Ky., and Minority Leader Chuck Schumer, D-N.Y.
Reported by SeattlePI.com 2 days ago.
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Reassured For Life, an Alberta Life Insurance Brokerage, is Now Open
A new insurance brokerage opens to service Alberta’s families and small businesses.
Edmonton, AB (PRWEB) July 21, 2017
Reassured For Life (http://www.reassured.ca), is now open.
“Reassured For Life is a life insurance brokerage firm servicing Albertans,” says owner and licensed broker Nerissa McNaughton. “I launched this firm because I know talking about life, accident, sickness, business and health insurance can be difficult, but it is a very necessary conversation. I make it easy. As a broker I have access to all the life insurance products in Canada, and my approach is to provide you with information so you are empowered to make your own decisions about the coverage you need. There are no pushy sales tactics and no requests for referral names and numbers.”
McNaughton also described her flexible work approach of extended office hours, and the ability to work via phone, text and email. “In most cases, the majority – if not all – of the assessments and applications can be done remotely. This frees applicants from having to come into an office during their busy work day. I also communicate in the ways that make my clients the most comfortable, be it on the phone, through texting, Facebook messenger, in person over coffee, etc.”
“My goal,” McNaughton concludes, “is to give Albertans the insurance they need, and in the most comfortable and convenient way possible. My focus is not on making a sale, but on helping each family and business owner make the best possible, and most informed choice for their needs and financial situations. Following the close of the application, I stay in touch and remain available for policy updates, changes, questions and to help with claims. That’s where the ‘reassured for life’ part comes in. My clients get the long-term peace of mind they deserve.”
To learn more about Reassured For Life and to get your no-obligation assessment and quote, email nerissa(at)reassured(dot)ca. Keep up with the latest life insurance news by visiting the Reassured For Life blog at http://www.reassured.ca/blog, and see how much you can save on life insurance with the instant term quote tool at reassured.ca/get-a-free-term-life-insurance-quote.
About Reassured For Life
Not knowing where the money is going to come from for you and your family if you become disabled, develop a critical illness, have an accident while travelling, or if you pass away is a nagging stress in the back of your mind that you just don’t need. Having a small business that is vulnerable to the loss of a key person is stressful. Not having an affordable health benefit plan for the employees of your small business creates unnecessary turnover. All of these problems – and more – are easily solved with the reassurance of life, health, accident, sickness and small business insurance. Contact me today for free advice and a consultation. We’ll chat, and you’ll get honest, practical advice and no-obligation quotes.
Contact Details:
Nerissa McNaughton
Edmonton, AB
Phone: 780-918-0848
Source: Reassured For Life
### Reported by PRWeb 2 days ago.
Edmonton, AB (PRWEB) July 21, 2017
Reassured For Life (http://www.reassured.ca), is now open.
“Reassured For Life is a life insurance brokerage firm servicing Albertans,” says owner and licensed broker Nerissa McNaughton. “I launched this firm because I know talking about life, accident, sickness, business and health insurance can be difficult, but it is a very necessary conversation. I make it easy. As a broker I have access to all the life insurance products in Canada, and my approach is to provide you with information so you are empowered to make your own decisions about the coverage you need. There are no pushy sales tactics and no requests for referral names and numbers.”
McNaughton also described her flexible work approach of extended office hours, and the ability to work via phone, text and email. “In most cases, the majority – if not all – of the assessments and applications can be done remotely. This frees applicants from having to come into an office during their busy work day. I also communicate in the ways that make my clients the most comfortable, be it on the phone, through texting, Facebook messenger, in person over coffee, etc.”
“My goal,” McNaughton concludes, “is to give Albertans the insurance they need, and in the most comfortable and convenient way possible. My focus is not on making a sale, but on helping each family and business owner make the best possible, and most informed choice for their needs and financial situations. Following the close of the application, I stay in touch and remain available for policy updates, changes, questions and to help with claims. That’s where the ‘reassured for life’ part comes in. My clients get the long-term peace of mind they deserve.”
To learn more about Reassured For Life and to get your no-obligation assessment and quote, email nerissa(at)reassured(dot)ca. Keep up with the latest life insurance news by visiting the Reassured For Life blog at http://www.reassured.ca/blog, and see how much you can save on life insurance with the instant term quote tool at reassured.ca/get-a-free-term-life-insurance-quote.
About Reassured For Life
Not knowing where the money is going to come from for you and your family if you become disabled, develop a critical illness, have an accident while travelling, or if you pass away is a nagging stress in the back of your mind that you just don’t need. Having a small business that is vulnerable to the loss of a key person is stressful. Not having an affordable health benefit plan for the employees of your small business creates unnecessary turnover. All of these problems – and more – are easily solved with the reassurance of life, health, accident, sickness and small business insurance. Contact me today for free advice and a consultation. We’ll chat, and you’ll get honest, practical advice and no-obligation quotes.
Contact Details:
Nerissa McNaughton
Edmonton, AB
Phone: 780-918-0848
Source: Reassured For Life
### Reported by PRWeb 2 days ago.
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Jimmy Kimmel Offers Update on Infant Son's Health
Billy was born with a congenital heart condition that required surgery to fix, and it was a trying time for the family. [...] he praised the Affordable Care Act and urged Republican lawmakers not to repeal it, since prior to its passage, babies born with congenital heart issues like his son's could be turned down for health insurance because they were deemed as having a pre-existing condition. On Friday, Kimmel took to Twitter to share an adorable photo of Billy at three months old and offer a reminder that the fight for healthcare continues and that every child deserves the treatment his son received.
Reported by SeattlePI.com 2 days ago.
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Health Insurance CEO On Expanding Coverage
NPR's Scott Simon talks with Michael Neidorff, CEO of the health insurance company Centene Corporation, which has expanded coverage on the insurance marketplace even as other insurers have withdrawn.
Reported by NPR 2 days ago.
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Did Trump’s bizarre idea that health insurance costs $12 a year come from this Fox News commercial?
President Donald Trump baffled many reporters this week when he told the New York Times that it was possible to buy health insurance for only $12 a year. “You are basically saying from the moment the insurance, you’re 21 years old, you start working and you’re paying $12 a year for insurance, ...
Reported by Raw Story 1 day ago.
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Nicaraguan Health Care: A Post-Revolutionary Failure – Analysis
By Paxton Duff*
**The FSLN: Hope**
In 1979, the Frente Sandinista de Liberación Nacional (FSLN) overthrew dictator Anastasio Somoza in Nicaragua, replacing the regime with the left-wing revolutionary party, commonly known as the Sandinistas. This event cast Nicaragua into rarified air: due in part to pressure from the United States, alternatives to democratic systems in twentieth-century Latin America were normally right-leaning (i.e. fascist) authoritarian regimes. Nicaragua, as a socialist regime, was “one of the very few exceptions” to the dominance of the political Right.^1 This revolution spawned hope for the implementation of a progressive social agenda, including universal health care. Mired in a decade of civil war against the Contras, the FSLN domestic agenda gradually declined until the party was unseated in 1990; however, one of its leaders, Daniel Ortega, returned as president in 2006. To this day, the Nicaraguan health care system, a beacon of hope for the future of Nicaragua in 1979, has never achieved the expected level of success, especially in light of the socialist healthcare success of Latin America’s revolutionary predecessor, Cuba. Nicaragua’s healthcare system has struggled immensely due to internal dissension, misaligned government incentives, and a failure to emulate the pattern of success demonstrated by other socialist countries, such as Cuba.
**Internal Dissension**
Contributing to Nicaragua’s unstable political climate for almost forty years, the United States immensely impeded the country’s development — and opportunity for healthcare success — through its Cold War actions. The United States’ fear of a socialist domino effect led to a preference for right-wing authoritarian dictators — hence its thinly-veiled funding and support for the Contras in the Nicaraguan Civil War of the 1980s. While the socialist regime of Cuba successfully prevented U.S.-led military opposition, the FSLN could not stop the United States’ large financial support of the Contra movement; in 1986 alone, the U.S. provided the Contras with $100 million in aid.^2 The FSLN’s inability to thwart U.S. intervention debilitated the regime’s ability to focus on internal improvement during the decisive nascent years following the Revolution. The possibility of universal healthcare, a system ideally emulating the state-led model in Cuba, largely dissipated in 1990; the economy, in shambles, contributed to the shift toward the center and away from the FSLN— a party that has been irrevocably divided since 1994. The modern-day version of the FSLN returned to power under President Ortega, who was democratically elected in 2006. Ortega promised to implement a progressive social-development model (poder ciudadano) that was the antithesis of the neoliberal globalization model that the country followed for sixteen years.^4
The extreme political and economic volatility during and after the Nicaraguan Civil War prevented the implementation of necessary infrastructure and proper resource allocation.^5 This instability plunged Nicaraguan citizens into poverty that has been largely inescapable to this day. Following the FSLN’s loss of power in 1990, an economic and humanitarian crisis befell Nicaragua. An estimated 29 percent of the population was undernourished for the remainder of the decade; from 2000–2002, Nicaragua had a poverty rate of 69 percent, 23 percent above the Latin-American average.^6 This widespread poverty and malnourishment arose due to the failure of multiple Nicaraguan regimes to install basic measures to protect the citizens most in need. Even today, about 30% of health facilities nationwide do not have access to electricity, and 45% lack necessary water access — equally disturbing are the more than 60% of facilities that have no sterilization systems.^7 The alternating socialist and neoliberal regimes also caused Nicaraguan leadership to waver between public and privately funded healthcare pathways. Presently, only 54% of Nicaragua’s healthcare is publicly funded, compared to an average public funding of over 90% in countries that have implemented socialist systems.^8 Since the 1979 revolution, Nicaraguan social spending has been inefficient and poorly targeted; on the rare occasions that the health industry is prioritized, capital has been allocated to expensive, curative medicine that, according to scholar Jennifer Pribble, does “less for poverty levels than investment in basic education and primary health care.”^9 Simply put, the Nicaraguan health care system failed to evolve after the 1979 revolution due to the government’s failure to address the root of most medical issues, such as the establishment of a diverse, decentralized system.
**Modern Health Failures**
The Nicaraguan Constitution spells out the desired state-led healthcare system: “Every Nicaraguan has an equal right to health. The State shall establish the basic conditions for its promotion, protection, recuperation and rehabilitation” (sec. 3 art. 59).^10 With Ortega’s return to the presidency in 2007 and his socialist agenda, Nicaragua finally had the chance to enact these Constitutionally promised health policies. Despite this opportunity, the system remains rampant with glaring structural failures. Data highlighting inequality in health care accessibility are quite stunning. At the time of Ortega’s return, Nicaragua had 32 hospitals, yet only three existed in the country’s rural Caribbean region, which covers 55 percent of the national territory.^11 In 2015, 30 percent of Nicaraguans lived below the poverty line — a figure that is especially dangerous for rural residents of the east coast.^12 In this impoverished climate, twenty percent of Nicaraguan children suffer from chronic malnutrition, a condition that has lasting developmental effects.^13 Eighty percent of the economically-active population, comprising nearly two million people in 2006, have no health insurance at all.^14 In a country where the government leads half of all healthcare and only 10% of the GDP is allocated to address the growing health concerns, universal healthcare is far from a reality.^15
Maternal and infant mortality is a pressing issue that continues to this day, a situation that is worsened by confounding legal decisions. The administration decided, in 2006, to outlaw abortion without exception, including cases where the fetus poses a danger to the mother — or even in situations involving rape.^16 This ban on abortion, according to Human Rights Watch, led to the death of at least 80 mothers during childbirth within the first year of the law’s implementation.^17 Additionally, the numerous childbirths that occur without the observation of medical professionals in Nicaragua not only contribute to the struggles of maternal and infant health, but run counter to the eradication of unsupervised births that is a staple of successful healthcare systems. In a country where maternal health issues account for four times more hospital admissions (29%) than the second leading cause (pneumonia), the enacted policies continue to foster perverse results.^18 Abortion restrictions and inequality of medical access exemplify the larger failure to implement preventative and educative solutions into the Nicaraguan system.
The prevalence of HIV in Nicaragua and the ensuing cultural response epitomize Nicaragua’s unsuccessful, inverted approach to major healthcare issues. In the 1990s, the rate of HIV skyrocketed, and the epidemic never ceased; from 2009 to 2010, an 11 percent increase in HIV diagnoses highlighted the failure to address a disease of grave national concern.^19 In a 2011 study by Henry Espinoza et al., women of reproductive age in Nicaragua reported a condom usage rate between 4–12%.^20 The study cites “gender norms tolerating male sexual irresponsibility,” an inhibition “of women from actively speaking to their male partners about safe sex,” “discrimination against homosexuals and people living with HIV,” and widespread ignorance about condom use as challenges to controlling the disease.^21 Nicaragua’s Ministry of Health (MINSA) handles the epidemic with highly centralized treatment, almost entirely in Managua. Addressing the root causes of HIV — investing in basic, decentralized health facilities and focusing on preventative education instead of costly treatments — is the only clear path forward, yet it is a path that has been frustratingly ignored by both MINSA and the government as a whole.
The lack of preventative approaches in Nicaragua is exacerbated by blatant, misaligned government incentives that block potential progress. Although the Nicaraguan government has attempted to implement a state-centric and vertically-integrated system, issues abound throughout MINSA, the chief health provider and regulatory body of Nicaragua.^22 While MINSA has established a vertically-integrated system with three levels — a central system, a local comprehensive healthcare system (SILIAS), and a municipal system— the lack of adequate financing has weakened an already-underserved population; this dearth of finance has also worsened both cyclical poverty and the failures of preventative medication and community-health education.^23 In addition to a scarcity of hospitals (one per 213,000 people) and doctors (4.5 per 10,000 people), MINSA propagates the distributional issues that affect rural areas by “not providing financial incentives for staff to work in remote and difficult-to-access areas, such as the Caribbean Region.”^24 Adding insult to injury, Nicaraguan health workers are the lowest paid of any Central American country.^25 Thus, MINSA provides little incentive to become a doctor, and even less incentive to help the areas most in need, a pattern that will impede progress until fundamental changes are made.
**Conclusion**
For Nicaraguans seeking a better healthcare future, signs of hope exist. Although it was never able to stabilize and implement a successful state-led health care system due to its internal dissension and intervention from the U.S. against the FSLN, Nicaragua’s comparatively stable (to previous decades) and autonomous political situation provide the opportunity to overcome the repeated mistakes and ill-advised policies of the past. In addition to improving infrastructure, preventative care, and the education of both youth and adults in topics such as sexual health, the government is already taking concrete, cost-reducing steps. A system known as community-case management (CCM), implemented after Ortega’s return, provides access to curative services to poor children with pneumonia, diarrhea, or dysentery by “five to six-fold” over facility-based services.^26 The CCM model also addresses issues such as caregiver knowledge, community mobilization, and social relations that strengthen the health system and improve pediatric care.^27 Through community-based programs like CCM, MINSA is implementing creative solutions to patch up the longstanding structural and financial systemic flaws. Although a laborious and costly redressing of the Nicaraguan health system is necessary, hope of a better future persists.
**Paxton Duff*, Extramural Contributor at the Council on Hemispheric Affairs
Additional editorial support provided by Francisco J. Ugás Tapia, Senior Research Fellow, Haley Wiebel, Extramural Contributor, and Blake Burdge and Alex Rawley, Research Associates at the Council on Hemispheric Affairs
*Notes:*
1. Pribble, Jennifer, Evelyne Huber, and John D. Stephens. “Politics, Policies, and Poverty in Latin America.” Comparative Politics 41, no. 4 (2009): 388. Accessed May 29, 2017. http://www.jstor.org/stable/40599215.
2. “The Iran Contra Affairs: The Counterrevolutionaries (The Contras)” Brown University. Accessed May 29, 2017.
http://www.brown.edu/Research/Understanding_the_Iran_Contra_Affair/n-contrasus.php.
1. Ibid., p. 84.
2. Sequeira, Magda, Henry Espinoza, JJ Amador, et. al. “The Nicaraguan Health System.” Path. Seattle: 2011. P. 32. Accessed May 30, 2017.
3. Pribble et. al. “Politics, Policies and Poverty.” p. 387-88.
4. Sequeira, et. al. “The Nicaraguan Health System.” p. 17.
5. Willis, Katie, and Sorayya Khan. “Health Reform in Latin America and Africa: Decentralisation, Participation and Inequalities.” Third World Quarterly 30, no. 5 (2009): 995. Accessed May 29, 2017. http://www.jstor.org/stable/40388163.
6. Pribble et. al. “Politics, Policies and Poverty.” p. 392.
7. “Nicaragua’s Constitution of 1987 with Amendments through 2005.” Oxford University Press. Translated by Max Planck Institute. 6 June 2017. Accessed July 5, 2017. https://www.constituteproject.org/constitution/Nicaragua_2005.pdf.
8. Sequeira, et. al. “The Nicaraguan Health System.” p. 16.
9. “Nicaragua Overview.” The World Bank. 10 April 2017. Accessed May 30, 2017. http://www.worldbank.org/en/country/nicaragua/overview#1.
10. “Health Situation Analysis.” Organización Panamericana de la Salud. Managua, Nicaragua (2006). Accessed May 30, 2017.
11. Sequeira, et. al. “The Nicaraguan Health System.” p. 7.
12. “Nicaragua.” World Health Observatory. 2017. Accessed May 31, 2017. http://www.who.int/countries/nic/en/.
13. Boseley, Sarah. “Nicaragua refuses to lift abortion ban.” The Guardian. June 11, 2010. Accessed May 29, 2017.
14. Khaleeli, Homa. “Killer Law.” The Guardian. 8 October 2007. Accessed May 31, 2017.
15. Sequeira, et. al. “The Nicaraguan Health System.” p. 16.
16. Espinoza, Henry, Magda Sequeira, Gonzalo Domingo, Juan José Amador, Margarita Quintanilla, and Tala de los Santos. “Management of the HIV epidemic in Nicaragua: the need to improve information systems and access to affordable diagnostics.” Bulletin of the World Health Organization 89, no. 8 (2011): 619. Accessed May 30, 2017. http://web.b.ebscohost.com/ehost/detail/.
17. Ibidem.
18. Ibidem.
19. Sequeira, et. al. “The Nicaraguan Health System.” p. 11.
20. Ibidem.
21. Ibid., p. 12, 16.
22. Ibid.
23. George, Asha, Elaine P. Menotti, Dixmer Rivera, Irma Montes, Carmen María Reyes, and David R. Marsh. “Community Case Management of Childhood Illness in Nicaragua: Transforming Health Systems in Underserved Rural Areas.” Journal of Health Care for the Poor and Underserved 20, no. 4 (2009): 99-115. Accessed May 29, 2017. https://muse.jhu.edu/article/364527/summary.
24. Ibidem. Reported by Eurasia Review 18 hours ago.
**The FSLN: Hope**
In 1979, the Frente Sandinista de Liberación Nacional (FSLN) overthrew dictator Anastasio Somoza in Nicaragua, replacing the regime with the left-wing revolutionary party, commonly known as the Sandinistas. This event cast Nicaragua into rarified air: due in part to pressure from the United States, alternatives to democratic systems in twentieth-century Latin America were normally right-leaning (i.e. fascist) authoritarian regimes. Nicaragua, as a socialist regime, was “one of the very few exceptions” to the dominance of the political Right.^1 This revolution spawned hope for the implementation of a progressive social agenda, including universal health care. Mired in a decade of civil war against the Contras, the FSLN domestic agenda gradually declined until the party was unseated in 1990; however, one of its leaders, Daniel Ortega, returned as president in 2006. To this day, the Nicaraguan health care system, a beacon of hope for the future of Nicaragua in 1979, has never achieved the expected level of success, especially in light of the socialist healthcare success of Latin America’s revolutionary predecessor, Cuba. Nicaragua’s healthcare system has struggled immensely due to internal dissension, misaligned government incentives, and a failure to emulate the pattern of success demonstrated by other socialist countries, such as Cuba.
**Internal Dissension**
Contributing to Nicaragua’s unstable political climate for almost forty years, the United States immensely impeded the country’s development — and opportunity for healthcare success — through its Cold War actions. The United States’ fear of a socialist domino effect led to a preference for right-wing authoritarian dictators — hence its thinly-veiled funding and support for the Contras in the Nicaraguan Civil War of the 1980s. While the socialist regime of Cuba successfully prevented U.S.-led military opposition, the FSLN could not stop the United States’ large financial support of the Contra movement; in 1986 alone, the U.S. provided the Contras with $100 million in aid.^2 The FSLN’s inability to thwart U.S. intervention debilitated the regime’s ability to focus on internal improvement during the decisive nascent years following the Revolution. The possibility of universal healthcare, a system ideally emulating the state-led model in Cuba, largely dissipated in 1990; the economy, in shambles, contributed to the shift toward the center and away from the FSLN— a party that has been irrevocably divided since 1994. The modern-day version of the FSLN returned to power under President Ortega, who was democratically elected in 2006. Ortega promised to implement a progressive social-development model (poder ciudadano) that was the antithesis of the neoliberal globalization model that the country followed for sixteen years.^4
The extreme political and economic volatility during and after the Nicaraguan Civil War prevented the implementation of necessary infrastructure and proper resource allocation.^5 This instability plunged Nicaraguan citizens into poverty that has been largely inescapable to this day. Following the FSLN’s loss of power in 1990, an economic and humanitarian crisis befell Nicaragua. An estimated 29 percent of the population was undernourished for the remainder of the decade; from 2000–2002, Nicaragua had a poverty rate of 69 percent, 23 percent above the Latin-American average.^6 This widespread poverty and malnourishment arose due to the failure of multiple Nicaraguan regimes to install basic measures to protect the citizens most in need. Even today, about 30% of health facilities nationwide do not have access to electricity, and 45% lack necessary water access — equally disturbing are the more than 60% of facilities that have no sterilization systems.^7 The alternating socialist and neoliberal regimes also caused Nicaraguan leadership to waver between public and privately funded healthcare pathways. Presently, only 54% of Nicaragua’s healthcare is publicly funded, compared to an average public funding of over 90% in countries that have implemented socialist systems.^8 Since the 1979 revolution, Nicaraguan social spending has been inefficient and poorly targeted; on the rare occasions that the health industry is prioritized, capital has been allocated to expensive, curative medicine that, according to scholar Jennifer Pribble, does “less for poverty levels than investment in basic education and primary health care.”^9 Simply put, the Nicaraguan health care system failed to evolve after the 1979 revolution due to the government’s failure to address the root of most medical issues, such as the establishment of a diverse, decentralized system.
**Modern Health Failures**
The Nicaraguan Constitution spells out the desired state-led healthcare system: “Every Nicaraguan has an equal right to health. The State shall establish the basic conditions for its promotion, protection, recuperation and rehabilitation” (sec. 3 art. 59).^10 With Ortega’s return to the presidency in 2007 and his socialist agenda, Nicaragua finally had the chance to enact these Constitutionally promised health policies. Despite this opportunity, the system remains rampant with glaring structural failures. Data highlighting inequality in health care accessibility are quite stunning. At the time of Ortega’s return, Nicaragua had 32 hospitals, yet only three existed in the country’s rural Caribbean region, which covers 55 percent of the national territory.^11 In 2015, 30 percent of Nicaraguans lived below the poverty line — a figure that is especially dangerous for rural residents of the east coast.^12 In this impoverished climate, twenty percent of Nicaraguan children suffer from chronic malnutrition, a condition that has lasting developmental effects.^13 Eighty percent of the economically-active population, comprising nearly two million people in 2006, have no health insurance at all.^14 In a country where the government leads half of all healthcare and only 10% of the GDP is allocated to address the growing health concerns, universal healthcare is far from a reality.^15
Maternal and infant mortality is a pressing issue that continues to this day, a situation that is worsened by confounding legal decisions. The administration decided, in 2006, to outlaw abortion without exception, including cases where the fetus poses a danger to the mother — or even in situations involving rape.^16 This ban on abortion, according to Human Rights Watch, led to the death of at least 80 mothers during childbirth within the first year of the law’s implementation.^17 Additionally, the numerous childbirths that occur without the observation of medical professionals in Nicaragua not only contribute to the struggles of maternal and infant health, but run counter to the eradication of unsupervised births that is a staple of successful healthcare systems. In a country where maternal health issues account for four times more hospital admissions (29%) than the second leading cause (pneumonia), the enacted policies continue to foster perverse results.^18 Abortion restrictions and inequality of medical access exemplify the larger failure to implement preventative and educative solutions into the Nicaraguan system.
The prevalence of HIV in Nicaragua and the ensuing cultural response epitomize Nicaragua’s unsuccessful, inverted approach to major healthcare issues. In the 1990s, the rate of HIV skyrocketed, and the epidemic never ceased; from 2009 to 2010, an 11 percent increase in HIV diagnoses highlighted the failure to address a disease of grave national concern.^19 In a 2011 study by Henry Espinoza et al., women of reproductive age in Nicaragua reported a condom usage rate between 4–12%.^20 The study cites “gender norms tolerating male sexual irresponsibility,” an inhibition “of women from actively speaking to their male partners about safe sex,” “discrimination against homosexuals and people living with HIV,” and widespread ignorance about condom use as challenges to controlling the disease.^21 Nicaragua’s Ministry of Health (MINSA) handles the epidemic with highly centralized treatment, almost entirely in Managua. Addressing the root causes of HIV — investing in basic, decentralized health facilities and focusing on preventative education instead of costly treatments — is the only clear path forward, yet it is a path that has been frustratingly ignored by both MINSA and the government as a whole.
The lack of preventative approaches in Nicaragua is exacerbated by blatant, misaligned government incentives that block potential progress. Although the Nicaraguan government has attempted to implement a state-centric and vertically-integrated system, issues abound throughout MINSA, the chief health provider and regulatory body of Nicaragua.^22 While MINSA has established a vertically-integrated system with three levels — a central system, a local comprehensive healthcare system (SILIAS), and a municipal system— the lack of adequate financing has weakened an already-underserved population; this dearth of finance has also worsened both cyclical poverty and the failures of preventative medication and community-health education.^23 In addition to a scarcity of hospitals (one per 213,000 people) and doctors (4.5 per 10,000 people), MINSA propagates the distributional issues that affect rural areas by “not providing financial incentives for staff to work in remote and difficult-to-access areas, such as the Caribbean Region.”^24 Adding insult to injury, Nicaraguan health workers are the lowest paid of any Central American country.^25 Thus, MINSA provides little incentive to become a doctor, and even less incentive to help the areas most in need, a pattern that will impede progress until fundamental changes are made.
**Conclusion**
For Nicaraguans seeking a better healthcare future, signs of hope exist. Although it was never able to stabilize and implement a successful state-led health care system due to its internal dissension and intervention from the U.S. against the FSLN, Nicaragua’s comparatively stable (to previous decades) and autonomous political situation provide the opportunity to overcome the repeated mistakes and ill-advised policies of the past. In addition to improving infrastructure, preventative care, and the education of both youth and adults in topics such as sexual health, the government is already taking concrete, cost-reducing steps. A system known as community-case management (CCM), implemented after Ortega’s return, provides access to curative services to poor children with pneumonia, diarrhea, or dysentery by “five to six-fold” over facility-based services.^26 The CCM model also addresses issues such as caregiver knowledge, community mobilization, and social relations that strengthen the health system and improve pediatric care.^27 Through community-based programs like CCM, MINSA is implementing creative solutions to patch up the longstanding structural and financial systemic flaws. Although a laborious and costly redressing of the Nicaraguan health system is necessary, hope of a better future persists.
**Paxton Duff*, Extramural Contributor at the Council on Hemispheric Affairs
Additional editorial support provided by Francisco J. Ugás Tapia, Senior Research Fellow, Haley Wiebel, Extramural Contributor, and Blake Burdge and Alex Rawley, Research Associates at the Council on Hemispheric Affairs
*Notes:*
1. Pribble, Jennifer, Evelyne Huber, and John D. Stephens. “Politics, Policies, and Poverty in Latin America.” Comparative Politics 41, no. 4 (2009): 388. Accessed May 29, 2017. http://www.jstor.org/stable/40599215.
2. “The Iran Contra Affairs: The Counterrevolutionaries (The Contras)” Brown University. Accessed May 29, 2017.
http://www.brown.edu/Research/Understanding_the_Iran_Contra_Affair/n-contrasus.php.
1. Ibid., p. 84.
2. Sequeira, Magda, Henry Espinoza, JJ Amador, et. al. “The Nicaraguan Health System.” Path. Seattle: 2011. P. 32. Accessed May 30, 2017.
3. Pribble et. al. “Politics, Policies and Poverty.” p. 387-88.
4. Sequeira, et. al. “The Nicaraguan Health System.” p. 17.
5. Willis, Katie, and Sorayya Khan. “Health Reform in Latin America and Africa: Decentralisation, Participation and Inequalities.” Third World Quarterly 30, no. 5 (2009): 995. Accessed May 29, 2017. http://www.jstor.org/stable/40388163.
6. Pribble et. al. “Politics, Policies and Poverty.” p. 392.
7. “Nicaragua’s Constitution of 1987 with Amendments through 2005.” Oxford University Press. Translated by Max Planck Institute. 6 June 2017. Accessed July 5, 2017. https://www.constituteproject.org/constitution/Nicaragua_2005.pdf.
8. Sequeira, et. al. “The Nicaraguan Health System.” p. 16.
9. “Nicaragua Overview.” The World Bank. 10 April 2017. Accessed May 30, 2017. http://www.worldbank.org/en/country/nicaragua/overview#1.
10. “Health Situation Analysis.” Organización Panamericana de la Salud. Managua, Nicaragua (2006). Accessed May 30, 2017.
11. Sequeira, et. al. “The Nicaraguan Health System.” p. 7.
12. “Nicaragua.” World Health Observatory. 2017. Accessed May 31, 2017. http://www.who.int/countries/nic/en/.
13. Boseley, Sarah. “Nicaragua refuses to lift abortion ban.” The Guardian. June 11, 2010. Accessed May 29, 2017.
14. Khaleeli, Homa. “Killer Law.” The Guardian. 8 October 2007. Accessed May 31, 2017.
15. Sequeira, et. al. “The Nicaraguan Health System.” p. 16.
16. Espinoza, Henry, Magda Sequeira, Gonzalo Domingo, Juan José Amador, Margarita Quintanilla, and Tala de los Santos. “Management of the HIV epidemic in Nicaragua: the need to improve information systems and access to affordable diagnostics.” Bulletin of the World Health Organization 89, no. 8 (2011): 619. Accessed May 30, 2017. http://web.b.ebscohost.com/ehost/detail/.
17. Ibidem.
18. Ibidem.
19. Sequeira, et. al. “The Nicaraguan Health System.” p. 11.
20. Ibidem.
21. Ibid., p. 12, 16.
22. Ibid.
23. George, Asha, Elaine P. Menotti, Dixmer Rivera, Irma Montes, Carmen María Reyes, and David R. Marsh. “Community Case Management of Childhood Illness in Nicaragua: Transforming Health Systems in Underserved Rural Areas.” Journal of Health Care for the Poor and Underserved 20, no. 4 (2009): 99-115. Accessed May 29, 2017. https://muse.jhu.edu/article/364527/summary.
24. Ibidem. Reported by Eurasia Review 18 hours ago.
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The Conversation: Ex-health insurance CEO: 5 common but faulty beliefs about paying for health care
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Man wielding a chainsaw goes on the rampage in Swiss town
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Independence Blue Cross and Jefferson Health commit to building a healthier Philadelphia and bringing care closer to home through innovation
Organizations sign new agreement focused on lowering cost of care and improving health of members, patients, and community-at-large through Independence Facilitated Health Networks model
PHILADELPHIA (PRWEB) July 24, 2017
Independence Blue Cross (Independence) and Jefferson Health, two organizations that already work hand-in-hand on an Innovation Collaboration program, have signed a five-year agreement that will marshal resources from both organizations to transform the access, quality, experience and cost of the care members and patients receive. The agreement also signifies Jefferson Health officially joining the Independence Facilitated Health Networks (FHN) model — a collaborative approach that is gaining regional and national traction for bringing health insurers and health systems together to improve the quality and lower the costs of care for members and patients. Jefferson Health has expanded in recent years to include Abington Health, Aria Health, and has signed a definitive agreement with Kennedy Health, creating a broad provider network blanketing the Greater Philadelphia area.
“We are proud to have a new, long-term agreement with Jefferson Health, an institution that shares our drive to transform health care in this region and across the country,” said Daniel J. Hilferty, president and CEO at Independence. “The agreement reflects a strong, innovative partnership and demonstrates the bold leadership that has made Jefferson a national leader in delivering improved patient care and health outcomes.”
The agreement and Jefferson Health’s participation in the Independence FHN model commits the organizations to work together to provide well-coordinated team-based care. The kind of care that will improve access for Independence members and Jefferson Health patients through innovative technology that monitors progress and allows patients to interact with a caring team of professionals regardless of whether the patient is at home, in the hospital or another setting such as JeffConnect® — the largest specialty telehealth initiative in the region. This approach is aimed at improving clinical outcomes, preventing the need for avoidable readmissions and reducing care costs.
The two organizations also have the opportunity to expand on the Innovation Collaboration they established together in June 2015, whose initiatives — like the Independence-Jefferson hack-a-thons — have already yielded implementable ideas using augmented intelligence, predictive data analytics, virtual reality, and drone technology. Each of these efforts has the same end goal of improving the health of members, patients, and the community-at-large.
“We have a unique opportunity in this new, expanded relationship with Independence to achieve our vision of reimagining health care, education and discovery to create value and improve lives. Jefferson is committed to bringing tomorrow’s health care to Philadelphia today and we have an innovative partner in Independence,” said Stephen K. Klasko, MD, MBA, president and CEO at Thomas Jefferson University and Jefferson Health. “We will leverage Jefferson Health’s unique strengths, such as our unique partnership with GE, our expanding telehealth program and our best-in-class physicians, nurses and employees to enhance patient and member access to better health care.”
Building on the Innovation Collaboration, the two organizations are now in talks to design initiatives for a healthier Philadelphia including:· Enhanced and more broadly implemented telehealth and virtual care services, bringing Jefferson care closer to home. This includes a number of initiatives like JeffConnect® virtual triage, which will guide patients to the best setting for unscheduled care, and virtual rounds that allow family members to communicate directly with the patient and providers in the hospital. Teams are also exploring a “hospital without beds” that allows doctors and health systems to care for patients remotely round-the-clock while also reducing the cost of care. These initiatives are supplemented with diagnostic services that connect patients with Jefferson Health doctors — anytime, anywhere — through their cell phone, tablet or computer with a webcam.
· An agreement to assess integrative medicine to help combat specific health issues. This will involve Independence working with Jefferson’s Marcus Institute of Integrative Health on issues like behavioral health and pain management to support and treat patients battling opioid addiction.
· Disease management programs to address common, costly, yet manageable health issues. This includes a digital diabetes management program with Jefferson Health and other health partners to create new, cost-effective ways of addressing the disease which can drastically affect health and quality of life.
· Comprehensive programs to address health disparities among cancer patients. Independence and Jefferson Health will explore leveraging the Sidney Kimmel Cancer Center's expertise to address cancer disparities in Philadelphia and beyond, through building on the Center's Men's Genetic Risk Clinic and using genetics to match the right patient to the right therapy for addition cancer diagnoses.
The agreement, effective September 1, 2017, will include the following facilities and physician practice groups recognized for excellence in patient care:
· Thomas Jefferson University Hospital (TJUH) and TJUH’s Methodist Hospital
· Abington Hospital and Abington – Lansdale Hospital
· Jefferson University Physicians
· Jefferson Urgent Care
· Jefferson University Radiology Associates
· Abington Health Physicians
· Aria Health
· Aria Health Physicians
About Independence Blue Cross
Independence Blue Cross is the leading health insurance organization in southeastern Pennsylvania. With our affiliates, we serve more than 8.5 million people in 25 states and the District of Columbia, including more than 2.5 million in the region. For almost 80 years, we have been enhancing the health and well-being of the people and communities we serve by delivering innovative and competitively priced health care products and services; pioneering new ways to reward doctors, hospitals, and other health care professionals for coordinated, quality care; and supporting programs and events that promote wellness. To learn more, visit http://www.ibx.com. Connect with us on Facebook at ibx.com/facebook and on Twitter at @ibx. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
About Jefferson
Jefferson, through its academic and clinical entities of Thomas Jefferson University and Jefferson Health, including Abington Health and Aria Health, is reimagining health care for the greater Philadelphia region and southern New Jersey. Jefferson has 23,000 people dedicated to providing the highest-quality, compassionate clinical care for patients, educating the health professionals of tomorrow, and discovering new treatments and therapies to define the future of care. With a university and hospital that date back to 1824, today Jefferson is comprised of six colleges, nine hospitals, 35 outpatient and urgent care locations, and a multitude of physician practices throughout the region, serving more than 100,000 inpatients, 373,000 emergency patients and 2.2 million outpatients annually.
### Reported by PRWeb 10 hours ago.
PHILADELPHIA (PRWEB) July 24, 2017
Independence Blue Cross (Independence) and Jefferson Health, two organizations that already work hand-in-hand on an Innovation Collaboration program, have signed a five-year agreement that will marshal resources from both organizations to transform the access, quality, experience and cost of the care members and patients receive. The agreement also signifies Jefferson Health officially joining the Independence Facilitated Health Networks (FHN) model — a collaborative approach that is gaining regional and national traction for bringing health insurers and health systems together to improve the quality and lower the costs of care for members and patients. Jefferson Health has expanded in recent years to include Abington Health, Aria Health, and has signed a definitive agreement with Kennedy Health, creating a broad provider network blanketing the Greater Philadelphia area.
“We are proud to have a new, long-term agreement with Jefferson Health, an institution that shares our drive to transform health care in this region and across the country,” said Daniel J. Hilferty, president and CEO at Independence. “The agreement reflects a strong, innovative partnership and demonstrates the bold leadership that has made Jefferson a national leader in delivering improved patient care and health outcomes.”
The agreement and Jefferson Health’s participation in the Independence FHN model commits the organizations to work together to provide well-coordinated team-based care. The kind of care that will improve access for Independence members and Jefferson Health patients through innovative technology that monitors progress and allows patients to interact with a caring team of professionals regardless of whether the patient is at home, in the hospital or another setting such as JeffConnect® — the largest specialty telehealth initiative in the region. This approach is aimed at improving clinical outcomes, preventing the need for avoidable readmissions and reducing care costs.
The two organizations also have the opportunity to expand on the Innovation Collaboration they established together in June 2015, whose initiatives — like the Independence-Jefferson hack-a-thons — have already yielded implementable ideas using augmented intelligence, predictive data analytics, virtual reality, and drone technology. Each of these efforts has the same end goal of improving the health of members, patients, and the community-at-large.
“We have a unique opportunity in this new, expanded relationship with Independence to achieve our vision of reimagining health care, education and discovery to create value and improve lives. Jefferson is committed to bringing tomorrow’s health care to Philadelphia today and we have an innovative partner in Independence,” said Stephen K. Klasko, MD, MBA, president and CEO at Thomas Jefferson University and Jefferson Health. “We will leverage Jefferson Health’s unique strengths, such as our unique partnership with GE, our expanding telehealth program and our best-in-class physicians, nurses and employees to enhance patient and member access to better health care.”
Building on the Innovation Collaboration, the two organizations are now in talks to design initiatives for a healthier Philadelphia including:· Enhanced and more broadly implemented telehealth and virtual care services, bringing Jefferson care closer to home. This includes a number of initiatives like JeffConnect® virtual triage, which will guide patients to the best setting for unscheduled care, and virtual rounds that allow family members to communicate directly with the patient and providers in the hospital. Teams are also exploring a “hospital without beds” that allows doctors and health systems to care for patients remotely round-the-clock while also reducing the cost of care. These initiatives are supplemented with diagnostic services that connect patients with Jefferson Health doctors — anytime, anywhere — through their cell phone, tablet or computer with a webcam.
· An agreement to assess integrative medicine to help combat specific health issues. This will involve Independence working with Jefferson’s Marcus Institute of Integrative Health on issues like behavioral health and pain management to support and treat patients battling opioid addiction.
· Disease management programs to address common, costly, yet manageable health issues. This includes a digital diabetes management program with Jefferson Health and other health partners to create new, cost-effective ways of addressing the disease which can drastically affect health and quality of life.
· Comprehensive programs to address health disparities among cancer patients. Independence and Jefferson Health will explore leveraging the Sidney Kimmel Cancer Center's expertise to address cancer disparities in Philadelphia and beyond, through building on the Center's Men's Genetic Risk Clinic and using genetics to match the right patient to the right therapy for addition cancer diagnoses.
The agreement, effective September 1, 2017, will include the following facilities and physician practice groups recognized for excellence in patient care:
· Thomas Jefferson University Hospital (TJUH) and TJUH’s Methodist Hospital
· Abington Hospital and Abington – Lansdale Hospital
· Jefferson University Physicians
· Jefferson Urgent Care
· Jefferson University Radiology Associates
· Abington Health Physicians
· Aria Health
· Aria Health Physicians
About Independence Blue Cross
Independence Blue Cross is the leading health insurance organization in southeastern Pennsylvania. With our affiliates, we serve more than 8.5 million people in 25 states and the District of Columbia, including more than 2.5 million in the region. For almost 80 years, we have been enhancing the health and well-being of the people and communities we serve by delivering innovative and competitively priced health care products and services; pioneering new ways to reward doctors, hospitals, and other health care professionals for coordinated, quality care; and supporting programs and events that promote wellness. To learn more, visit http://www.ibx.com. Connect with us on Facebook at ibx.com/facebook and on Twitter at @ibx. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
About Jefferson
Jefferson, through its academic and clinical entities of Thomas Jefferson University and Jefferson Health, including Abington Health and Aria Health, is reimagining health care for the greater Philadelphia region and southern New Jersey. Jefferson has 23,000 people dedicated to providing the highest-quality, compassionate clinical care for patients, educating the health professionals of tomorrow, and discovering new treatments and therapies to define the future of care. With a university and hospital that date back to 1824, today Jefferson is comprised of six colleges, nine hospitals, 35 outpatient and urgent care locations, and a multitude of physician practices throughout the region, serving more than 100,000 inpatients, 373,000 emergency patients and 2.2 million outpatients annually.
### Reported by PRWeb 10 hours ago.
↧
UC-Berkeley Health Plan Adds Laser Hair Removal to Transgender Coverage
The University of California in Berkeley is adding laser hair removal and fertility preservation to its available “transgenders health services” covered under the university’s student health insurance plan (SHIP).
-- Reported by CNSNews.com 8 hours ago.
-- Reported by CNSNews.com 8 hours ago.
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Swiss Police Search For Chainsaw Attacker Who 5 Injured in Schaffhausen
Police in Switzerland are still searching for a man that attacked five people in the Swiss town of Schaffhausen near the border with Germany with a chainsaw on Monday, according to BBC News. The culprit, Franz Wrousis, allegedly began his assault outside a health insurance office after 10:30 local time, with police warning that he is likely still armed with a chainsaw.Police consider the 51-year-old as "highly dangerous" and will likely react with aggression if forced into a corner so they're warning if anyone sees the man to call police immediately. More than 100 officers from Switzerland and Germany are involved in the search while central parts of the border town are closed off in the...
Reported by WorldNews 8 hours ago.
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