Health Insurance Blog

‘Our child are the most precious gift we have. Whenever they are in pain we suffer their pain and if you suspect that your child might have strep throat or an ear infection, you need to take care of them immediately but to get an appointment with pediatrician is not so easy, or to wait in the doctor’s office as well.

Every parent has faced this dilemma. But now there are new options coming up,courtesy of the competitive market. Retail Health Clinics are opening in big stores and local pharmacies around the country where you will be seen by a nurse practitioner within 15 minutes most likely getting a prescription that you can fill right there, Generally cost of the visit varies from $40 to $60.

Prices vary for different services like flu shots($15-$30) to care for allergies poison ivy and pink eye($50-$60) and tests for chloresterol, diabetes and pregnancy( less than $ 50).

No appointment is necessary, open day time, evenings and weekends.These clinics are creating new model with more limited services at lower prices and almost always staffed by nurses.There are about 325 of these retail clinics operating nationwide today. Seventy six of them are in Wal-Marts in 12 states and it will expand to 400 clinics by the end of the decade and 2000 in five to seven years.

The nurses staffing the clinics are under physician supervision and follow strict protocols, if problems are more serious . And the clinics create computerized patient records accessible through out the chain, can also be emailed and send fax to a hospital or doctors if needed.

These clinics are attractive to the 4.5 million people who have health insurance with higher deductible and want an affordable option for some of their regular care. These will be run by outside firms including for-profit ventures like Redclinic as well as local and regional health plans and hospitals.

And competition also worked to force prescription drug prices down: When Wal-Mart announced last year that it was dropping the price of several hundred generic medicines to $4 for a month’’s supply, other pharmacies, from Target to corner drug stores, followed suit.

Wal-Mart now says that a third of all prescriptions filled at its pharmacies are for the $4 generics, and 30% of them are filled by people without insurance. Because health care is largely regulated and licensed at the state level, some states are more friendly than others at having non-physicians deliver care.

Government can get in the way, of course, with protectionist policies that throw up more regulatory barriers to entry. With many congressional leaders hostile to free-market solutions, these policy changes are unlikely in the next two years. But as consumers get a taste of what consumer-friendly health care is like, they may well demand that the top-down, centralized health-care delivery of the 20th century give way to a system more in tune with the demands of 21st-century consumers seeking greater value and efficiency.

Critics of engaging private competition in the health sector will argue that the vast majority of health-care dollars are spent on a relatively small percentage of patients with serious illness, especially those with multiple chronic conditions. This industry is on its infancy and gradually increase day by day. Retail clinics could be just the beginning of consumer friendly innovation. And it is helping everyday, people who haven’t got insurance and also people who are in immediate need.

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SENSE IN SAFEGUARDING EVENTIf anyone knows the value of a good insurance policy, it’s Romeo Lavarias. As the director of emergency management operations for Miramar, Fla., Lavarias has seen his share of disasters. So it was a no-brainer when his fiancee, Stephanie Goldstein, suggested buying insurance for their wedding, set for July during the upcoming hurricane season.

“My job is to prepare our city in the event of a disaster, so naturally, this is right up my alley,” said Lavarias, whose city was hit by Hurricane Wilma in 2005. Heading into a prime weddings month in June, and with weddings becoming ever more elaborate and expensive, more couples are opting to buy wedding coverage.

Natural disasters aside, many reception facilities now require liability coverage for outof-control celebrations. Wedding planners often require insurance, too, in case of cancellations. Increasingly, policies cover all sorts of contingencies. Lost the bridal dress? No problem. Guests stranded by a hurricane or a Denver snowstorm? Covered. Photographer ruins pictures? Piece of cake to re-stage. There is even a policy that offers reimbursement in case of cold feet.

Fewer than 1 percent of the betrothed purchase policies in the United States, said Kyle Brown, executive director of the Bridal Association of America in Bakersfield, Calif. But given that the average cost for a wedding is $27,000, according to insurance industry estimates, Brown thinks it’s a good buy. “For 1 percent or 2 percent of the cost of your entire wedding, you can insure it,” Brown said. Since Hurricane Katrina, New Orleans wedding planner Jennie Keller requires every couple to buy insurance.

She once required it just for couples marrying during hurricane season, which runs from June through November. “I know that you can’t play around with Mother Nature,” she said. “Wedding insurance will cover it all even if you cancel your wedding.”

Among the companies that offer it are Fireman’s Fund, WedSafe Wedding Insurance Program offered through Affinity Insurance Services Inc. and Traveler’s Insurance, which added the coverage in February.

Depending on the company and the type of coverage, a policy can cost anywhere from a couple hundred dollars to more than $1,000. Typical coverage can include reimbursement of nonrefundable deposits for misfortune such as a death in the family or a military deployment.

Some policies cover repairs for a damaged dress or replacement of lost wedding attire; theft of gifts; and the cost of gathering wedding party members to retake photographs and videotape. Policies also can pay for some counseling if canceled or postponed nuptials cause emotional stress, according to the Insurance Information Institute in New York.

Even a “change of heart” can be insured in a special option Fireman’s Fund Insurance Co. began offering this month that costs about $25 on top of the policy. It’s for those who pay for a wedding only to have the groom or bride back out, said insurance broker Rob Nuccio of RV Nuccio and Associates, who wrote the option.“Oftentimes, there is an innocent person involved in that.

There is the poor father who lays out 50 grand and he’s just left dumbfounded,” Nuccio said. Not everyone is won over by the policies, however. Independent insurance agent Michelle Mestnik of Colorado Springs and fiance Nathan Green opted for a $350 liability policy for their July 7 wedding, which is expected to cost about $10,000. Mestnik doesn’t think she needs specific wedding insurance. “I have looked into it. It does not sound like that great a deal,” she said. WAYS TO PROTECT YOUR INVESTMENT Here are some ways to protect marrying couples and their guests: Insurance: A number of companies offer specific insurance for weddings, covering such items as lost or damaged dresses; cancellation or postponement due to weather, military deployment or death in the family. There also is an option from Fireman’s Fund that covers “change of heart” or cold feet. Insurance is just one protective step that engaged couples should consider, said Michael McCann, a former United Nations security chief.

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A widely used diabetes pill raises the risk of heart attacks and possibly death, according to a scientific analysis that reveals what some experts are calling another Vioxx-like example of the government failing to protect the public from an unsafe drug.

More than 6 million people worldwide have taken the drug, sold as Avandia and Avandamet, since it came on the market eight years ago to help control blood sugar in people with the most common form of diabetes. About 1 million Americans use it now.Pooled results of dozens of studies on nearly 28,000 people revealed a 43 percent higher risk of heart attack for those taking Avandia compared to people taking other diabetes drugs or no diabetes medication, according to the analysis published online Monday.

The study, published by the New England Journal of Medicine, also found a trend toward more heart-related deaths.The findings are frightening because two-thirds of diabetics die of heart problems, so a drug that boosts this possibility is especially hazardous for them.

Still, the actual risks to any single patient appear small. Diabetics should talk to their doctors before stopping any medication, said a statement issued by the American Diabetes Association and two groups of heart doctors.Avandia’’s maker, British-based GlaxoSmithKline PLC, disputed the results of the analysis but acknowledged that its own similar review found a 30 percent increased risk — information it gave last August and possibly even earlier to the U.S. Food and Drug Administration.

But the company said that more rigorous studies did not confirm excess risk.FDA officials issued a safety alert Monday and said they likely would convene an advisory panel, but planned no immediate changes to the current side effect warnings on the drug’’s packaging.Several members of Congress expressed alarm.

A hearing is due on 6th June.Avandia is used to treat Type 2 diabetes, the most common form of the disease, which is linked to obesity and afflicts 18 million Americans and 200 million people worldwide.

This form of diabetes occurs when the body does not make enough insulin or cannot effectively use what it manages to produce.Avandia, or rosiglitazone, helps sensitize the body to insulin and was considered a breakthrough medication for blood-sugar control. It also is combined with metformin and sold as Avandamet.

Only one other drug like it — pioglitazone, sold as Actos and Actoplus Met by Takeda Pharmaceuticals — is sold in the United States.Avandia had total U.S. sales of $2.2 billion in 2006, slightly trailing $2.6 million for Actos, according to IMS Health, a healthcare information company.

About 13 million Avandia prescriptions were filled in the U.S. last year. A one-month supply of Avandia sells for between $90 and $170.GlaxoSmithKline also has been testing Avandia to try to prevent diabetes in those at high risk of it, and, in separate studies, to prevent Alzheimer’’s disease.

However, the new analysis casts a pall on its prospects for prevention as well as treatment, many specialists said. The study was led by Dr. Steven Nissen and statistician Kathy Wolski at the Cleveland Clinic. Nissen accepts no personal fees for consulting for any drug makers.While the analysis doesn”t spell out the actual the rate of heart attacks among Avandia users, the 43 percent excess risk is in line with what a similar analysis found for lower doses of Vioxx use, Nissen said.

Another context for that number: Heart attack risks are lowered about 25 percent by cholesterol-reducing statin drugs — ample reason to prescribe them.The Avandia studies Nissen analyzed were not designed to look for heart risks and many of them were so short — some only 24 weeks — that risks may only appear over long term.Avandia’’s label already warns about possible heart failure and other heart problems when taken with insulin.

The drug also raises LDL or bad cholesterol, and can cause fluid retention and weight gain. Glaxo also has reported some patients suffered more bone fractures, swelling of the legs and feet, and rare reports of swelling in the eye that can cause vision problems.Glaxo’’s shares trading in the United States closed down $4.53, or 7.9 percent, at $53.18.Nissen used publicly available information from an earlier $2.5 million Glaxo settlement with the state of New York to do his study.

He also led earlier research that derailed a similar diabetes drug, Pargluva, that seemed headed for FDA approval until safety issues emerged. A fourth drug in the same class, Rezulin, was withdrawn in 2000 after it was linked to liver problems ‘Diabetes drug may raise risk of heart attack ‘, 0, ”, ‘publish’, ‘open’, ‘closed’, ”,

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‘The inability to perform the material and substantial duties of your regular occupation, the insurance company will consider your occupation to be the occupation you are engaged in at the time you become disabled, they will pay the claim even if you are working in some other capacity.

This has become the most common definition of total disability in the industry today. Most insurance carriers that have stopped offering own-occupation disability insurance have moved to an income replacement definition. You will find the first part of the definition is very similiar to an own-occupation definition, but it is with the second part that the major change occurs.

A typical income replacement definition will look something like this: Because of sickness or injury you are unable to perform the material and substantial duties of your occupation, and are not engaged in any other occupation.

As there is a major difference between an income replacement and an own-occupation definition of total disability. The income replacement definition will penalize you during a claim if you make the decision to go back to work, or earn another source of earned income while on a claim. if somebody wants to go back to work in some capacity, the insurance company may offset your monthly benefit check.

There is a common misconception that own-occupation disability insurance costs a lot more than an income replacement policy. While I am certain that in some scenarios this is true, as a blanket statement it is false. There are many professional occupations where an own-occ contract is actually less expensive than an income replacement policy. Many companies, as an example, do not like writing individual disability insurance on physicians.

It is very likely that an own-occupation disability insurance policy may be less expensive from a company that still enjoys writing disability insurance for doctors.Families dangerously underestimate their vulnerability… and they dangerously overestimate their coverage,” said Karen Ignagni, president of AHIP, Washington.

About 58% of Americans believe that they have disability coverage, even though only 35% actually do, Ignagni said. AHIP has set up a Web site to educate consumers about the risks they face at http://www.yourincomeatrisk.org AHIP also is trying to contribute to the general body of knowledge about disability and disability insurance, by releasing a policy brief and a survey report addressing disability issues.

In 2005, private disability insurers spent an average of $3,200 on each disabled employee receiving rehabilitation and return-to-work services, Beal writes. There are three basic types of renewability on the market today. Non-Cancellable and Guaranteed Renewable Guaranteed Renewable Conditionally Renewable elimination period is a fairly easy choice to make.

The elimination period is the period of time between the onset of a disability, and the time you are eligible for benefits. It is best thought of as a deductible period for your policy. For an individual disability insurance policy the industry has made the most attractive offer a 90 day elimination period. They will charge you with an extremely high rate if you choose to go with a shorter elimination period of 30, or 60 days. They will give you a price break if you can go longer than 90 days.

While the cost of having a shorter elimination period is much higher, you will find that going with a longer elimination period does not save you much money at all for the risk you take on. It is my opinion that insurance carriers set it up so that the logical choice is a 90 day elimination. Most options past 90 days are 180, 365, and 720 day elimination periods. It is important that you understand once the elimination period has been satisfied, you receive actual benefit checks at the end of the month. In reality, a 90 day elimination period means you are four months away from getting any claims dollars on a disability insurance claim.

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Looking at the expenditures on Medicare plans, many measures are being implemented to control the expense on medicare and improve the overall health standards, like health promotion programs for older people.

Health promotion programs for older people can improve health, prevent disability, delay mortality, improve the overall quality of life — and save Medicare money by reducing the need for medical services, according to a new study. The study, sponsored by the Centers for Medicare and Medicare Services (CMS), is published in the journal Clinical Interventions in Aging (Dove Medical Press).Researchers from Thomson Healthcare and Cornell University led the research project, which examined the relevant scientific literature and concluded that well-designed health promotion initiatives can deliver a positive return-on-investment to the Medicare program.

“Medicare is confronting rising healthcare costs, an aging population, and the high prevalence of chronic disease among the elderly. It needs innovative approaches to manage an urgent situation,” said lead author Ron Z. Goetzel, Ph.D., a vice president at Thomson Healthcare and director of the Institute for Health Productivity Studies at Cornell University. “This study suggests that well-designed health promotion programs can improve seniors’ quality of life and save money.”

According to the new research, health promotion and disease prevention programs are most likely to be successful if they can achieve lasting changes in health-related behaviors. Effective programs also are tailored to individual needs, sufficiently intensive, and complemented by social supports.CMS sponsored this study as it prepares to launch a three-and-a-half year research project, called Senior Risk Reduction Demonstration (SRRD), that will evaluate the health and economic impact of providing health promotion services to Medicare beneficiaries. “This project is an important step in changing the Medicare program’s focus from disease treatment to disease prevention,” Goetzel said.

The SSRD will make health promotion services available to non-institutionalized Medicare beneficiaries through private sector vendors. Enrollment in the program will be voluntary. The demonstration will emphasize self-care — reducing risk behaviors such as smoking, inactivity, and poor eating habits, and promoting healthy behaviors such as exercise and a balanced diet. “Research has found that 5 percent of Medicare beneficiaries — presumably many with chronic diseases — account for nearly half of Medicare spending,” Goetzel said. “And 40 percent of beneficiaries account for only 1 percent total spending.

Clearly, preventing or postponing the onset of chronic disease can save money while improving lives.”About Thomson HealthcareThomson Healthcare is the leading provider of decision support solutions that help organizations across the healthcare industry improve clinical and business performance.

Thomson Healthcare products and services help clinicians, hospitals, employers, health plans, government agencies, and pharmaceutical companies manage the cost and improve the quality of healthcare.Thomson Healthcare is a part of The Thomson Corporation, a provider of value-added information, software tools and applications to professionals in the fields of healthcare, law, tax, accounting, scientific research, and financial services.

The Corporation’’s common shares are listed on the New York and Toronto stock exchanges.

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‘Barack Obama projected on cutting down of government subsidies by $150 billion under medicare. He alleged that the money could be used to fortify the Medicare program largely, together with a cutback in the prices being paid by the seniors for the prescriptions. According to his crusade there are atleast 53,000 lowans in private plans under medicare advantage program.

If the government cuts its payments to the insurance companies there are possibilities that they will face a decline in coverage or a raise in pocket costs. According to the supporters of these programs they provide extra benefits than the government. But the critics argue that the government’’s service is much better and generous and should be reduced.

The Medicare Payment Advisory Commission estimates the payments of the government to cover Medicare. Obama with his appearance and a written statement said that they should do everything they can for stopping the insurance industry from misleading the seniors.According to MedPAC the overpayments are bringing up the Medicare costs.

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Doctors Reaping Millions for Use of Anemia Drugs- New York Times May 09, 2007Two of the world’’s largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses.

The payments are legal, but very few people outside of the doctors who receive them are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe the medicines at levels that might increase patients” risks of heart attacks or strokes.

Industry analysts estimate that such payments — to cancer doctors and the other big users of the drugs, kidney dialysis centers — total hundreds of millions of dollars a year and are an important source of profit for doctors and the centers. The payments have risen over the last several years, as the makers of the drugs, Amgen and Johnson & Johnson, compete for market share and try to expand the overall business.

Neither Amgen nor Johnson & Johnson has disclosed the total amount of the payments. But documents given to The New York Times show that at just one practice in the Pacific Northwest, a group of six cancer doctors received $2.7 million from Amgen for prescribing $9 million worth of its drugs last year.

Yesterday, the Food and Drug Administration added to concerns about the drugs, releasing a report that suggested that their use might need to be curtailed in cancer patients. The report, prepared by F.D.A. staff scientists, said no evidence indicated that the medicines either improved quality of life in patients or extended their survival, while several studies suggested that the drugs can shorten patients” lives when used at high doses.

Yesterday’’s report followed the F.D.A.’’s decision in March to strengthen warnings on the drugs” labels.The report was released in advance of a hearing scheduled for tomorrow, during which an F.D.A. advisory panel will consider whether the drugs are overused.

The medicines — Aranesp and Epogen, from Amgen; and Procrit, from Johnson & Johnson — are among the world’’s top-selling drugs, with combined sales of $10 billion last year. In this country, they represent the single biggest drug expense for Medicare and are given to about a million patients each year to treat anemia caused by kidney disease or cancer chemotherapy.Dr. Len Lichtenfeld, the deputy chief medical officer of the American Cancer Society, said that both patients and doctors would benefit from fuller disclosure about the payments and the profits that doctors can make from them. “I suspect that Medicare is going to take a very careful look at what is going on here,” he said.

Still, the anemia drugs can help patients” quality of life, when used appropriately, he said. “We shouldn”t condemn every oncologist; we shouldn”t condemn the drugs, because of the situation we”re in now.”Federal laws bar drug companies from paying doctors to prescribe medicines that are given in pill form and purchased by patients from pharmacies.

But companies can rebate part of the price that doctors pay for drugs, like the anemia medicines, which they dispense in their offices as part of treatment. The anemia drugs are injected or given intravenously in physicians” offices or dialysis centers. Doctors receive the rebates after they buy the drugs from the companies.

But they also receive reimbursement from Medicare or private insurers for the drugs, often at a markup over the doctors” purchase price.Medicare has changed its payment structure since 2003 to reduce the markup, but private insurers still often pay more.

Combined with those insurance reimbursements, the rebates enable many doctors to profit substantially on the medicines they buy and then give to patients.The rebates are related to the amount of drugs that doctors buy, and physicians that agree to use one company’’s drugs exclusively typically receive higher rebates.Johnson & Johnson said yesterday in a statement that its rebates were not intended to induce doctors to use more medicine.

Instead, the rebates “reflect intense competition” in the market for the drugs, the company said.Amgen said that rebates were a normal commercial practice and that it had always properly promoted its drugs.”Amgen is dedicated to patient safety,” said David Polk, a spokesman. “We believe our contracts support appropriate anemia management and our product promotion is always strictly within the label.”Both companies” stocks fell yesterday after release of the F.D.A. report.

Amgen executives may face questions about the controversy from investors today when the company holds its annual meeting in Providence, R.I.Since 1991, when the first of the drugs was still relatively new, the average dose given to dialysis patients in this country has nearly tripled.

About 50 percent of dialysis patients now receive enough of the drugs to raise their red blood cell counts above the level considered risky by the F.D.A.American patients receive far more of the anemia drugs than patients elsewhere, with dialysis patients in this country getting doses more than twice as high as their counterparts in Europe.

Cancer care shows a similar pattern. American cancer patients are about three times as likely as those in Europe to get the drugs, and they receive somewhat higher doses.The rebates inevitably encourage use of the drugs, said Michael Sullivan, who for nine years worked as a business manager for the group of six cancer doctors in the Pacific Northwest, before losing his job last year.

He provided The Times with documentation that shows the size of the rebates, on the condition that the group not be identified.”Personally, I think rebates should go away,” said Mr. Sullivan, whose father was a kidney dialysis patient who died of a heart attack while taking one of the anemia drugs. “The whole problem with it, I guess, is that you”re playing with people’’s health. It’’s not the same as buying widgets.”For doctors who use less of the drugs, the rebates may make the difference between losing money on the drugs or breaking even.

Mr. Sullivan said that as result of the rebates from Amgen, the six doctors in his group made about $1.8 million in net profit on the drugs they prescribed.Unlike most drugs, the anemia medicines do not come in fixed doses. Therefore, doctors have great flexibility to increase dosing — and profits. Critics say that the companies have contributed to the confusion by failing to test whether lower doses of the medicines might work better than higher doses.”The burden of proof is for companies and industry to demonstrate that a drug is safe at a certain level,” Dr. Ajay Singh, an associate professor at Harvard Medical School. Dr. Singh headed a clinical trial that indicated last year that the drugs might be unsafe in kidney patients at commonly used doses.Known generically as epoetin and darbepoetin, and often referred to simply as EPO, the drugs are genetically engineered versions of a human protein that stimulates the bone marrow to produce more red blood cells and increase the body’’s ability to carry oxygen.Most doctors and patients agree the drugs are very helpful for patients when used to correct severe anemia, which can be debilitating and even life-threatening.

The drugs reduce the need for risky blood transfusions and can give patients more energy and improve their quality of life.”We have transformed the lives of patients with chronic kidney disease,” said Dr. Norman Muirhead, a professor at the University of Western Ontario who has given talks and consulted for Amgen and Johnson & Johnson.

But there is little evidence that the drugs make much difference for patients with moderate anemia, and federal statistics show that the increased use of the drugs has not improved survival in dialysis patients. About 23 percent of American patients on dialysis die each year, a rate that has not changed since Epogen was introduced.Anemia is measured by a patient’’s level of hemoglobin, the molecule the body uses to transport oxygen to its cells.

Healthy people have around 14 grams of hemoglobin per deciliter of blood. Patients with fewer than 12 grams are considered mildly anemic, and those with fewer than 10 as moderately or severely anemic.The labels on the drugs, as currently approved by the F.D.A., encourage doctors to aim for a hemoglobin level of 10 to 12. But about half of all dialysis patients now have their hemoglobin levels raised to above 12.Critics of the drugs say their increased use has been driven by profit.

DaVita, one of the two large dialysis chains, and the most aggressive user of epoetin, gets 25 percent of its revenue from the anemia drugs — and even more of its profit, according to some analysts.Dr. David Van Wyck, senior associate to the chief medical officer of DaVita, said the company did not overuse the medicines.Doctors determine how much to use, Dr. Van Wyck said. “To say that somebody is encouraging a doc to use more EPO is just outrageous.”Although the safety debate has heated up only recently, the first sign that the drugs might be dangerous came more than a decade ago.

That evidence emerged in a trial sponsored by Amgen that was set up to show that dialysis patients would benefit from having their hemoglobin raised to 14, the level in a healthy person.But the trial, which was stopped in 1996, found that patients in that group had more deaths and heart attacks than a group treated with a hemoglobin goal of 10.

That trial should have discouraged doctors from using too much epoetin and encouraged Amgen to study the risks further, said Dr. Steven Fishbane, a nephrologist at Winthrop-University Hospital on Long Island.Instead, use of epoetin continued to soar. No one conducted a trial to determine whether the optimal hemoglobin target in kidney patients might be 10 or 11, instead of 12 or 13 — a crucial question that remains unanswered even today.

Dr. Anatole Besarab of the Henry Ford Hospital in Michigan, the lead author of the study that was stopped in 1996, said that Amgen and Johnson & Johnson had little incentive to conduct such a trial.Dr. Robert M. Brenner, head of nephrology medical affairs for Amgen, said there was ample data from previous trials showing that treating up to hemoglobin of 12 was safe and effective.Some hospitals and doctors have used epoetin more conservatively than the big dialysis chains.Dr. Ronald A. Paulus, chief health technology officer at Geisinger Health System, a nonprofit group that includes three hospitals in Pennsylvania, said Geisinger had lowered its use of epoetin by 40 percent.

Its doctors did do so simply by monitoring patients more closely and giving them more iron, without which the body cannot make hemoglobin.Dr. N. D. Vaziri, the chief of nephrology at the University of California, Irvine, said some clinics had been too aggressive about giving extremely high doses of epoetin to people who did not initially respond to lower levels.

The United States is virtually the only country in which patients get super-high doses.”You create a toxicity situation,” said Dr. Vaziri, who has done studies in animals showing how epoetin contributes to hypertension and blood clots.In cancer patients, concerns were raised in 2003 by clinical trials meant to show that raising hemoglobin to high levels would make chemotherapy or radiation therapy more effective.

Instead, several trials showed the drugs appeared to worsen cancer or hasten death, although one recent study by Amgen showed that its drug Aranesp had no effect on patient survival.The conflicting studies are among the issues the F.D.A. advisory committee is expected to discuss tomorrow.

Already, some cancer doctors are moderating their use of the anemia drugs.Dr. Peter Eisenberg, an oncologist in Marin County, Calif., said many doctors had been induced to use more epoetin by the financial incentives and the belief that the drug was helpful.”The deal was so good,” he said. “The indication was so clear and the downside was so small that docs just worked it into their practice easily.”Now it’’s much scarier than that,” he said. “We could really be doing.’

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When it comes to Medicare plans, one size does not fit all. It is a complicated business with enough rules and options to make your head spin. ”Medicare Advantage plans are like a double-edged sword” said Doug Barnette of Texarkana, who has sold insurance here for 30 years or so. ”Choice is good, but it is confusing to have so many choices. Barnette says people should not put all insurance salesmen in the same category.

Most agents they know wouldnt violate Medicares rule about selling policies door to door. ”In a perfect world, all the agents would do it right but they do not” Barnette said. Barnette, along with his son, Jay Barnette, have been selling Medicare Advantage since it was introduced in 2006. Like any licensed agent, they must undergo training to understand the product they are selling.

The material is complicated, they say. ”Not everyone in those classes passes” Jay Barnette said, and you must pass to be certified. And if the plans are complicated to the experts, think what it is like for the elderly trying to digest the information. Local agent Michelle Douglas says the benefit of a senior electing to have a local agent is peace of mind knowing they have someone close to discuss their coverage. ”We are local and we care.

We have a storefront where people can come and ask questions” Douglas said. ”If they dont go through someone local, they are setting themselves up for a problem. Douglas says she has seen Medicare plans benefit people who now have a more streamlined method of care rather than seeing too many doctors at once. ”Seniors dont like change” she said. ”But if they can get Medicare with added benefits they didnt have before, this is a benefit for them. Douglas says the result (of having Medicare) ”is having something offered that is a better choice for someone who might not have had a choice at all.

Douglas, says there are people who cannot qualify for traditional insurance but who do qualify for a Medicare plan. Having end stage renal disease is the only reason someone would not qualify for a Medicare program. All other health problems are accepted by plans, she said.

A partner company of QuickHealthInsurance.com, says the goal of the company is to provide services that meet and exceed expectations of beneficiaries in the community. ”There are certain services that are above and beyond what we are required to do. One example of how we do this is our continuity of care program where we pay for our members doctor for 90 days even if the doctor where they are receiving treatment is out of network”. ”We do that in order to establish a relationship with a person and the provider.

Medicare plans also have checks and balances in place to make sure beneficiaries needs are being met. ”Some of the people are not being informed they are going to have to change doctors (if they elect a Medicare plan)” Sunny said. ”Im not talking about a specific insurance agent.

It is just like, take a doctor. Some fully inform you of something and another might not. … Some of these agents want to make money so bad they are not going to say something. Obviously they are making money for it, its a job. But there are people who really care about the people they are selling it to and for those guys, I dont have a problem with that. If they are fully informed and the patient chooses (Medicare plans), then more power to them.

Sunny said his first and foremost concern is always the patient, and he has seen some cases when managed care programs that work similar to Medicare plans have let people down. ”It is called managed care for a reason, and they manage care for a reason” Sunny said. ”When you start telling doctors what they are going to do rather than the doctor telling you what to do, you have a problem. ”In a way that is what excites me about this market” he said. ”It is a matter of educating everyone, from beneficiaries, and the state and the brokers and the providers. This is a product that has a lot of information all together, and there are a lot of different products out there.

We are more than willing to do what we need to do. There is no doubt there have been some problems related to how some agents have sold the plans, and no lack of confusion in general. For example, Arkansas Insurance Commissioner Julie Benafield Bowman has fielded many calls from this corner of the state. She advises consumers to take time in choosing any insurance plan. ”Walk away from a hard sell” she said. ”Always get contact information from anyone selling insurance of any kind.

These plans and how they are sold are regulated. Agents working with Medicare cannot charge enrollment fees, cannot come to a persons home uninvited, cannot phone a person if a person is on the Do Not Call Registry and cannot send a person unwanted e-mails, among other things. If a consumer has a problem with the plan or how it was sold, the consumer should complain to the company in writing.

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What do Albania, Sri Lanka and certain Mississippi counties have in common? Infant mortality rates that hover near 20 deaths per 1,000 live births. Such statistics, on the rise in several Southern states, reflect a complex weave of individual choices and public policy. Even so, no one should miss the loud alarm sounding in the reversal of years of steady progress against infant deaths.

Countering the trend ought to be a national priority. In 2005, the most recent data from state health officials, Virginia’’s infant mortality rate was 7.34 deaths per 1,000 live births. The increase over 2003 is infinitesimal – four one hundredths of a percentage point.

Still, that puts Virginia in the same league as Mississippi, Alabama, North Carolina, Tennessee, Louisiana and South Carolina, all of which saw infant mortality rates worsen in 2004, 2005 or both. It’’s particularly unsettling that one of the wealthier states in the nation ranks 35th on a key indicator of child and maternal health, and when Hampton Roads consistently trails the state average by a percentage point or two every year. On most measures of child well-being, the Old Dominion scores in the top third of the states. On infant mortality, it plummets. “When you contrast income and infant mortality, there’’s a significant discrepancy,” said Suzanne Clark Johnson, director of the child-advocacy group Voices for Virginia’’s Children.

Commendably, both her organization and the state health department are engaged in serious, long-term efforts to find solutions. Elsewhere across the South, experts point to a mounting obesity epidemic, state and federal cutbacks in Medicaid spending and a decline in easy availability of health-care services as potential contributors. Mississippi Gov.

Haley Barbour, for instance, came to office pledging to cut Medicaid spending, and has followed through on the promise. While experts debate ways to stem infant mortality, the Virginia experience with low-income public-health care suggests a couple of directions.

First, removing barriers helps. That became clear when former Gov. Mark Warner streamlined access to FAMIS, Virginia’’s version of the federal health initiative for low-income families. Requiring formal documentation or face-to-face interviews, steps that might seem reasonable to the middle class, can scuttle efforts to get health care to poor families.

Second, the sort of in-home, culturally sensitive care provided by programs such as Healthy Families and CHIP of Virginia (Children’’s Health Involving Parents) shows demonstrated success. Such highly personalized help may be more expensive at one level, but not in the long run if the reward is higher effectiveness. Commendably, the General Assembly hasn”t ignored Virginia’’s problem. In the past session, lawmakers expanded Medicaid eligibility, making more poor women eligible for pre natal care.

Producing more healthy infants can curtail costs for FAMIS or Medicaid down the road. Solving America’’s infant mortality problem may be akin to reducing traffic fatalities, Johnson suggested.

No one thing produced recent improvements. Stricter seat-belt laws, improved air bags, tougher speeding penalties and better engineered highways all helped. Multiple steps and unrelenting scrutiny may be the keys on infant mortality. Given the long-term ramifications, back-sliding is not an option.

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Wal-Mart stores President & CEO, Lee Scott, gave a speech at the World Health Care Congress in Washington, D.C.,about their intention to expand their business operations by entering into world of in-store health clinics with the help of local hospitals & other organisations. They are targeting around 400 health clinics, which may increase to 2000 over the next few years depending on the current market forces.

The American health care crisis has led Wal-Mart to find solutions supporting health care reforms. Scott further added that the clinics would be a great prospect for their business, but more notably it would provide customers with reasonable access to quality health care at local level.

His speech focused on the need for accomplishment of their goal that is betterment of health of the people of America. Government interventions in the health care sector is worsening & its time for some real & meaningful change which can be brought about by some private enterprises like Wal-Mart.

The $4 programme started by Wal-Mart has met with a spectacular response. Due to such low pricing of the prescription drugs by Wal-Mart, numerous other drug stores have dropped their prices heavily, which have led to saving of millions of dollars & has given the common people the facility to to afford better quality drugs.

Local hospitals & organisations that are independent of wal-mart will manage the health clinics & make customer satisfation their priority. Wal-Mart is also working with leaders in business, government & public policy on the “Better Health Care Together” coalition. Scott urges other companies & organisations to join the race that would ensure affordable & quality health care accessible to all Americans by 2012. As we say there is not a single person or group anywhere that cannot play a role towards betterment of masses.

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