One of the many surprises with insurance companies
is that the public forgets that these companies are businesses.
They survive because they make a profit. They make their profit
by having more money coming into the business then going out. If
an insurance company has an excessive amount of claims then it must
raise the cost of coverage. Another factor with Insurance Companies,
the public has become very price sensitive...the public shops around
for the 'best' price not necessarily the best coverage.
Because of the competitive nature of shopping around, insurance
companies can offer coverage that costs less but only if it covers
less. Medicare and Medicaid (USA governmental programs for low income
groups and retired people) currently offer coverage; however in
many parts of the USA, these people, having governmental coverage,
are unable to find physicians who will accept them as patients because
of the low reimbursement rates that are offer by the government.
The disease management company is accepting financial responsibility
for providing the specified care to patients covered by the disease
management contract, and faces the risk that the cost of care will
exceed its revenue. Unfavorable variation from the expected levels
of utilization or cost of services can cause losses to the disease
management company. The management company should take steps to
reduce its financial risk, including:
|
Document Name & Link to Document
|
Description
|
File Size /Type
|
|
$2.8M Katrina verdict against
Allstate |
Allstate Insurance Co. must pay a Louisiana man who lost his
home to Hurricane Katrina more than $2.8 million in damages and
penalties, a federal jury decided Monday in a case that hinged
largely on whether it was wind or storm surge that wiped out his
house. |
|
|
14 Ways to
Guarantee That Your Long-Term Disability insurance Claim is
Denied and you Lose in Court |
Reason for
report-“I am sick and tired of seeing people lose their chance
at getting disability benefits because they didn’t know (and the
insurance company won’t tell them) the traps they can easily
fall into.” |
3,111 kb pdf |
|
2005 State
Medicaid Eligibility Cutbacks: Proposed & Recently-Enacted |
July 5, 2005
Report on the changes in the eligibility cutbacks that are
occurring within the US |
|
|
Adolescent
Confidentiality and privacy Under HIPAA |
Adolescents
are more likely than adults to have their state-protected right
to medical confidentiality violated by providers or insurers |
281 kb pdf |
|
Assess
the value of American investment
|
How does a venture capitalist decide where to
invest his money? He compares the potential for return against
the risk, and when the return appears to be significant and
the risk isn't too great, he invests. As our country makes
decisions about its future investment in medical research,
it might apply a similar standard.
|
|
|
BASILE PAPPAS and THEODORA PAPPAS, H/W, v.
PENNSYLVANIA HOSPITAL INSURANCE CO. (PHICO) and THE
COMMONWEALTH OF PENNSYLVANIA MEDICAL PROFESSIONAL LIABILITY
CATASTROPHE LOSS FUND (CAT FUND) |
Court
dismisses HMO's claim for protection from tort cases under
ERISA; technically a health insurance case but ramifications
for disability insurance. |
|
|
COBRA
Rules
|
COBRA is a federal law that requires employers
to allow employees and dependents losing health insurance to
stay on the employer’s plan.
|
|
|
Confronting the New Health Care Crisis: |
Improving Health Care Quality and Lowering costs by Fixing our
Medical Liability System provided by US Department of
Health and Human Services
|
132 kb pdf |
|
Containing
costs while maintaining Quality
|
Articles on how insurance companies are trying
to reduce costs
|
|
|
|
|
Controversies:
Should all patients with Hepatitis C be Treated
|
Healthcare costs for Hepatitis C Virus include managing patients'
symptoms, managing other organ involvement, treating Hepatitis C Virus with
antiviral agents, and managing end-stage liver disease as
well as the cost of liver transplantation. Wong and coworkers
estimated that the annual US healthcare cost for Hepatitis C Virus will
exceed $1 billion by the year 2008
|
|
|
Cost
of Hepatitis C in relation to insurance costs
|
Report on the cost of Hepatitis C Virus
|
|
|
Cost of Illness Handbook
APPENDIX A: INFLATION AND
DISCOUNTING FACTORS
GLOSSARY AND ABBREVIATIONS
EXECUTIVE SUMMARY
INTRODUCTION TO THE COST OF
ILLNESS HANDBOOK
INTRODUCTION TO THE COSTS OF
CANCERS
COST OF STOMACH CANCER
COST OF KIDNEY CANCER
COST OF LUNG CANCER
COST OF COLORECTAL CANCER
COST OF BLADDER CANCER
INTRODUCTION TO THE COSTS OF
DEVELOPMENTAL ILLNESSES AND DISABILITIES
COST OF LOW BIRTH WEIGHT
COST OF CLEFT LIP AND PALATE
COST OF LIMB REDUCTIONS
COST OF CARDIAC ABNORMALITIES
COST OF SPINA BIFIDA
COST OF CEREBRAL PALSY
COST OF DOWN SYNDROME
COST OF REDUCING HIGH BLOOD LEAD
LEVELS
INTRODUCTION TO THE COST OF
RESPIRATORY
COST OF ASTHMA
COST OF ACUTE RESPIRATORY
DISEASES
REFERENCES
SYMPTOMS
SYMPTOM GROUPS
|
Reliance on cost of illness information is controversial for
many reasons. COI usually includes only direct medical
costs that substantially underestimate total costs
(discussed in Chapter 1 of the Handbook). COI estimates can
be extensively manipulated by economists to achieve desired
results (e.g., OMB now requires such heavy "discounting"
that some serious illnesses appear to have no costs). More
scrutiny and critique by health professionals is needed in
this area, given the role economic analyses play in federal
health protection policies.
This appendix provides information on the inflation of medical
services and computations that can be used to calculate the
present value of futurecosts. This information can be used
to modify the values presented in the various Handbook
chapters.
This glossary provides brief definitions of some technical terms
used in the handbook. Special effort was made to include
those that are used repeatedly or that may cause confusion
because they have a number of different meanings (e.g.,
colloquial versus technical).
The societal benefits of environmental regulations and programs
are typically manifested by the reduction in adverse health
effects. These reductions are associated with decreased
exposure to environmental agents. Ideally, valuation of
these human health benefits would include all costs to
society associated with the benefits, including medical
costs, work-related costs, educational costs, the cost of
support services required by medical conditions, and the
willingness of individuals to pay to avoid the health risks.
These factors can be referred to in aggregate as society’s
total willingness to pay to avoid an illness.
The cost of illness is an estimate of the incremental direct
medical costs associated with medical diagnosis, treatment,
and follow-up care. This includes various cost elements,
such as physician visits, hospitalization, and
pharmaceuticals. This Handbook does not estimate the costs
in lost time or wages that may be incurred by either a
patient or his or her unpaid caregiver. The costs also do
not include pain and suffering, which may be substantial.
This section of the handbook contains chapters that describe
costs of medical treatments for a variety of cancers that
have been associated with exposure to environmental agents.
Cancer is one of the three leading causes of death in the
United States and throughout the world (Williams and
Weisburger, 1993). It is a serious illness that has been
associated with environmental exposures in both human and
animal studies.
Stomach cancer, also called gastric cancer, refers in most cases
to adenocarcinoma, which comprises 90 to 95 percent of all
gastric malignancies.
Kidney cancer is a malignancy within the kidneys and may be
localized or have spread to multiple sites (Bennet and Plum
1996). It represents one to three percent of all adult
cancers in the United States (Javadpour 1984, Klein et al.,
1993). Kidney cancer occurs most frequently in individuals
in their fifties through seventies, with two to three times
as many males as females developing the disease
Lung cancer is a malignancy within the lungs and may be localized
or have spread to multiple sites (Bennet and Plum 1996). All
types of lung cancer likely originate from a common
pluripotent stem cell. There are four types of lung cancer:
squamous (epidermoid), adenocarcinoma, large cell, and small
cell (oat cell).
Colorectal cancers are malignancies of the colon or rectum. They
are most often adenocarcinomas that are thought to develop
through genetic alterations in the cells. Colorectal cancers
can be differentiated, based on the site of the tumor(s). As
noted above, however, they are considered as a single cancer
type for this cost analysis.
Bladder cancers are tumors that arise from the transitional cell
lining of the urinary tract. These are a part of a larger
group of tumors that are all related and are referred to as
urothelial cell cancers. Urothelial cell cancers may occur
in the kidneys, ureter, bladder, urethra, and the ducts of
the prostate.
This section of the handbook focuses on developmental illnesses
and disabilities that may be associated with exposure to
environmental agents. Its chapters (III.2 through III.9)
provide data on the direct medical costs of individual
effects or groups of similar types of developmental effects.
As in previous chapters, information is not included on all
elements of willingness to pay (WTP) to avoid the illness.
Low birth weight is a serious medical condition that occurs in
approximately seven percent of all infants born in the
United States (Oski, 1993). It is associated with multiple
adverse effects in numerous organ systems and carries a much
higher risk of death than normal birth weight. Consequently,
considerable medical resources are devoted to the treatment
of LBW infants and the medical expenditures on these infants
is estimated to be $5 billion per year
Cleft lip and palate occur when structures in the nose and mouth
fail to close during embryonic development. These birth
defects appear as openings or incomplete structures in the
centerline of the face and mouth. They often occur
concurrently (approximately 50 percent of the time), due to
the mechanism of damage that leads to these defects
Children with limb reductions frequently have other birth
defects. In 30 to 53 percent of affected children, other
malformations are present, including anomalies of the heart,
kidney, anus, abdominal walls, esophagus, vertebrae, and
palate. Webbing between digits and spina bifida are also
associated with this defect
A number of cardiac anomalies occur at birth or in early infancy,
and are quite varied. These are structural defects in the
development of the heart, arteries, and associated tissues.
They arise when the function, movement and relationships
among cardiac cells fail to progress normally. Five defects,
all conotruncal heart anomalies, are discussed in this
chapter. The specific anomalies include: truncus arteriosus,
transposition of the great arteries, double-outlet right
ventricle (DORV), single ventricle, and tetralogy of Fallot.
Spina bifida occurs when the neural tube, from which the brain
and spinal cord develop (central nervous system), fails to
close properly. Depending on where closure fails to occur,
portions of the brain, spinal cord, and nerves connected to
them will not function properly. If failure to close occurs
on the lower portion of the spinal cord, then the bowel,
bladder or sexual organs will be affected. Failure at
mid-level may cause paralysis or malfunction of the arms and
legs. Anomalies at higher levels may affect the brain. In
most spina bifida cases, the normal flow of cerebrospinal
fluid is also blocked (Arnold-Chiari malformation), which
would result in hydrocephalus unless treated
Cerebral palsy is a motor disorder appearing in early childhood
that is caused by brain damage (Waitzman et al., 1996).2 It
is the most common movement disorder of childhood and
affects approximately one to six children per 1,000 births.
The estimate varies considerably because mild cases may not
be determined in early childhood, and all cases may be
obscured by other developmental disabilities, such as
seizures and mental retardation. The most severe cases may
result in rapid death and not be detected. When estimates of
the incidence of cerebral palsy are based on evaluations in
the neonatal period, the occurrence will be underestimated.
Down syndrome occurs as a result of having three, rather than
two, copies of chromosome 21 (hence the name “trisomy 21”).
Mental retardation and a group of physical characteristics
are commonly associated with Down syndrome. In addition, a
number of serious defects in critical organs (e.g., heart,
digestive system) are also commonly found in people with
Down syndrome. The syndrome involves clusters of external
physical anomalies, learning disabilities, and organ system
anomalies.
Elevated PbB levels in young children occur when children are
exposed to lead via any media (i.e., air, water, food,
soil). Elevated PbB in children is a considerable public
health concern, due to the potential adverse effects of lead
on multiple organ systems and the particular susceptibility
of young children to many of these effects, including
neurological damage. Lead is toxic to the kidneys and is
associated with low birth weight, male sterility, cancer,
and a wide array of neurological disorders.
Respiratory illnesses involve the upper or lower respiratory
system, which usually includes the nose, tonsils, throat,
mouth, trachea (wind pipe), and all the structures of the
lungs (bronchi, alveoli, etc.). Respiratory illnesses also
are usually defined to include ear infections, sinusitis,
and related illnesses (Oski et al., 1994). Often the
illnesses involve multiple parts of the respiratory system.
Asthma is a leading cause of morbidity among children and is the
most commonly cited reason for school absenteeism,
accounting for one-third of all school days lost. It is the
most common cause for hospitalization of children. The
median age of onset of asthma is four years; however, more
than 20 percent of children who are diagnosed with asthma
develop symptoms during the first year of life
Indoor air contamination in non-industrial buildings has received
increased attention in recent years due to improved
understanding of the potential impact of indoor air quality
on the health of residents and workers. Air pollutants that
are known to cause irritation, allergic responses, and
infection are numerous, and vary widely in their potency and
in the responses they elicit. Groups of illnesses that
result from exposure to contaminants in indoor air have been
categorized as “sick or tight building syndrome,” or with
other designations that encompass a variety of diseases and
symptoms. Some groups of illnesses have highly specific
target organs.
Symptoms are of interest because in some cases they are the only
information sources available that describe the adverse
response effect to pollutant exposure. This situation is
commonly encountered in the study of indoor air pollutants,
which may elicit a number of symptoms in the absence of a
definitive disease diagnosis.
Many environmental irritants and allergens, whether chemical
or biological, can cause systemic toxicity and irritation of
mucous membranes, leading to pain and related symptoms. The
Indoor Environments Division has been evaluating impacts of
various indoor air pollutants. This analysis examines the
direct medical costs of addressing symptom groups, such as
eye irritation, throat irritation and pain, coughing,
headaches, and other nonlife-threatening medical conditions,
to address the division’s specific requirements |
All files are pdf and in some cases-increase down-load time
should be expected |
|
DECISION AND COST-EFFECTIVENESS ANALYSIS |
Decision-Tree methodology: Discounting is the method to adjust
future health outcomes and costs to their value in the
present. Value in the present is called “net present value”,
or NPV. This technique has long been used to represent time
preference for costs. Recently a consensus has been reached to
discount health outcomes. Not doing so leads to some logical
conundrums in CEAs. On average people exhibit time
preferences for health outcomes similar to those for costs. |
|
|
Delays, Denials & Deceptions-The truth about LTD insurance
|
Claimants
who succeed in the battle for benefits tend to be savvy,
articulate and persistent individuals with the resources to
obtain sophisticated medical evidence and aggressive
attorneys. Poorer, older, less-educated and extremely ill
claimants seldom fare as well. The sickest and least
privileged among us may be easily brought down by insurance
company employees who find them fair game for harassment,
deception and intimidation. |
|
|
Disease
management
|
Insurance report on Successful Disease Management
Programs
|
PDF 211KB
|
|
Disease Management: Findings from Leading State Programs |
Disease management programs are designed to contain costs
by improving health among the chronically ill. More than 20
states are now engaged in developing and implementing
Medicaid disease management programs for their primary
care case management and fee-for-service populations
|
378 kb pdf |
|
Disparities in State Health Coverage: A Matter of Policy or
Fortune? (Large Report-Increase
Download Time) |
This paper explores the reasons why states differ in their
Medicaid coverage of the at-risk population, focusing in particular
on the large disparities in Medicaid spending associated
with these differences.
|
3374 k pdf |
|
EMTALA:
A general guide for the physician assistant |
Advocacy groups for patients' rights are becoming more
prominent and vocal in the United States. Some consumer groups
have begun to publish information on the Internet about the EMTALA
compliance of physicians and hospitals. One Web site, for example,
lists 527 confirmed EMTALA violations at hospitals between 1997
and 2001 and notes that one in five US hospitals has been cited for
EMTALA violations since 1988. Some hospitals are now beginning
to distribute patient rights brochures, which detail what each patient
should expect when visiting the hospital. The distribution of these
brochures appears to be a response to growing emphasis on patient
rights and the dissemination of EMTALA information and increased
EMTALA violation assessments.
|
|
|
EMTALA: The Basic Requirements, Recent Court Interpretations,
and More HCFA Regulations to Come |
In 1994 the Health Care Financing Administration (HCFA) issued
interim final regulations to implement EMTALA (42 CFR 489). Yet, due
to federal Paperwork Reduction Act "technicalities," the regulations
were not enforced until September 1995. Over the succeeding years,
the regulations have been amended to add additional requirements for
hospitals and physicians. Also, included in this report are several
court cases and their resolutions
|
|
|
EMTALA-complete regulations from the Department of Health and
Human Services |
Medicare Program—Clarifying policies related to the responsibilities of
Medicare-participating hospitals in treating individuals with Emergency
Medical Conditions
|
|
|
EMTALA-Implementations
and Enforcement Issues—a GAO report |
EMTALA requires hospitals that participate in Medicare to provide a
medical screening examination to any person who comes to the
emergency department, regardless of the individual’s ability to pay.
If a hospital determines that the person has an emergency medical
condition, it must provide treatment to stabilize the condition or provide
for an appropriate transfer to another facility.
|
|
|
EMTALA-State
Operations Manual |
Interpretive guidelines, responsibilities of Medicare participating
hospitals in emergency cases
|
|
|
ERISA Disability Litigation How To Sue Your LTD Insurance
Carrier In United States Federal Court Without an Attorney |
This
report is oriented to those persons who are disabled by
Chronic Fatigue and Immune Dysfunction Syndrome (a.k.a. CFIDS,
CFS, M.E.) and other so called "self-reported conditions" such
as Fibromyalgia Syndrome (FMS) and Multiple Chemical
Sensitivity (MCS) who must sue to recover long term disability
benefits from employee benefit plan providers (insurance
companies). |
|
|
|
|
Estimated future of Hepatitis C morbidity, mortality, and
costs in the US
|
This study estimated future morbidity, mortality,
and costs resulting from hepatitis C virus (Hepatitis C Virus).
|
PDF 133 KB
|
|
FTC Antitrust Actions in Health care Services and Products |
In the
mid-1970’s, the FTC formed a division within the Bureau of
Competition to investigate potential antitrust violations
involving health care. The Health Care Services and Products
Division consists of approximately thirty-five lawyers and
investigators who work exclusively on health care antitrust
matters. |
293 kb pdf |
|
Health and Disability insurance and Social Security Disability |
Patients
with chronic illnesses unfortunately must advocate for
themselves, whether it be with a doctor or an insurance company.
Knowing your rights will help. If you have internet access, you
have access to the best research tool in the world. |
487 kb pdf |
|
Health
care exposure
|
Report on exposure to toxin and infectious diseases
in the work area
|
PDF 471 KB
|
|
Health
care fraud
|
Insurance magazine (mid-way thru paper) reports
on Healthcare fraud
|
PDF 346 KB
|
|
Health
care workers with AIDS
|
Report from CDC on the numbers and types of
positions within healthcare who have become infected with
AIDS
|
PDF 42 KB
|
|
Health
Insurer Benefits
|
OXFORD HEALTH PLANS reported improved first-quarter
earnings yesterday and raised its profits forecast for the
year, becoming the latest health insurer to benefit from a
nationwide trend of moderating hospital and drug costs
|
|
|
Health
Spending Growing Faster than US Economy
|
For the first time in almost a decade, federal
health economists reported January 8, health expenditures
outpaced the growth of the economy.
|
|
|
High
Income Americans opt out of Health Insurance
|
Of the 41 million Americans currently uninsured,
the largest portion is made up of the working poor, but those
with high-incomes are quickly joining in, as growth in uninsured
wealthy and poor rose almost equally last year.
|
|
|
HIPPA-portability
|
Report from insurance industry on HIPPA requirements
|
PDF 50 KB
|
|
HIV
Exposure Report Form
|
Exposure form for Law Enforcement-Calif.
|
PDF 80 KB
|
|
Insurance
|
Report from insurance industry on capitation
(limits of cost) concerning healthcare coverage
|
PDF 462 KB
|
|
Insurance
privacy issues
|
Magazine article from insurance industry (mid-way
thru) Article on Privacy Issues for Health Plans and HIPPA
regulations
|
PDF 336 KB
|
|
Insurance-Actuarial
aspects of Dread Disease
|
Actuarial aspects of Dread Disease Products
and the methods in marketing with pricing formulas for determining
costs
|
PDF 526 KB
|
|
Insurance-Hepatitis
C-health,
law protection
|
Hepatitis C Virus threatens silently-that has the potentially
could lay your operation low—risk management of
|
PDF 417 KB
|
|
Madison
Ave. Has Growing Role in Drug Research
|
Article on how Madison Avenue, whose television
ads have helped turn some prescription drugs into billion-dollar
products, is expanding role in drug development
|
|
|
Measuring Capacity
Building |
Capacity building has
become central to USAID health sector assistance strategies.
Experience suggest that achieving better health
outcomes requires both an injection of resources and adequate
local capacity to use those resources effectively.
|
Pdf 135 kb
|
|
Medical records mashup would span a
lifetime |
Five major companies have joined forces and invested in what
appears to be the ultimate personal medical-records
database. Applied Materials, BP America, Intel, Pitney Bowes
and Wal-Mart Stores have sunk an undisclosed amount of money
into the Omnimedix Institute, a nonprofit organization that
developed and will manage the database, called "Dossia." |
|
|
Medicare Program; Clarifying
Policies |
This
final rule clarifies policies relating to the
responsibilities of Medicare-participating hospitals in
treating individuals with emergency medical conditions who
present to a hospital under the provisions of the Emergency
Medical Treatment and Labor Act (EMTALA). |
|
|
Medicare Modernization Act (MMA) and Dual Eligibles-A
Transition in Crisis |
MMA eliminates
Medicaid drug coverage for 6.4 million dual eligibles (those
enrolled in both Medicare and Medicaid) and moves them into
Medicare drug coverage on Jan. 1, 2006. Because Medicaid
coverage ends on the first day that Medicare coverage is
effective, the transition leaves literally no margin for
computer error, system failures, postal delays, or inevitable
disruptions and confusion involved in moving millions of the
frailest older and disabled adults out of one program and into
a very different one. |
140 kb pdf |
|
New Medicare Drug Benefit |
Table/chart of
how much will consumers pay over time |
240 kb pdf |
|
Outcomes
and Costs of Care in Hepatitis C
|
Based on the current evidence of the cost-effectiveness
and improved response rate of the combination regimen, it
seems very likely that combination therapy, with duration
therapy determined by genotyping alone and without pretreatment
liver biopsy or Hepatitis C Virus RNA quantitation, is also likely to be
a cost-effective approach.
|
|
|
Patients
paying Larger Percentage of Medical Costs
|
Faced with "rapidly rising" prescription drug
spending, which is climbing at about 15% per year, employers
and insurers have increasingly shifted the costs to patients,
who "may soon pay even more,"
|
|
|
Prescription For Danger |
"The insurance companies are
pushing all of us around, they're pushing the patient, the
consumer, they're pushing the physician and they're pushing
the pharmacist." The drugs and dosages an insurance company
prefers are called its 'formulary.' We discovered your
insurance formulary often depends on secret deals your health
plan makes with drug manufacturers. Depending on which drug is
not selling well, manufacturers give incentives -- what some
call kickbacks. |
|
|
Preventive Services: Helping Employers Expand Coverage |
By
purchasing health insurance for their employees, employers
influence access to health care for more than 168 million
insured Americans…Two out of every three Americans were
covered by private health insurance sponsored by employers in
2001 |
348 kb pdf |
|
Preventive Services: Helping States Improve Mandates
(Large file-please allow extra time for download) |
Mandating
coverage of a range of recommended preventive services can
improve health, prevent disease and disability, and
potentially lower some health costs |
1487 kb pdf |
|
Pulling away the safety nets |
The Safety
Net She Believed In Was Pulled Away When She Fell Debra Potter
made a good living selling disability coverage. But like many
working Americans, she learned the hard way that federal law now
favors insurers. |
|
|
Quality of Care-followed by publicly provided care |
Power Point
presentation |
807 kb pdf |
|
Re
unaffordable meds
|
People without insurance typically pay the world’s
highest prices for prescription drugs. That is because the
average American prices are the highest in the world and uninsured
Americans pay prices above the average
|
PDF 27 KB
|
|
Risk
& Management for Healthcare workers-bloodborne
|
Exposure to blood-borne pathogens poses a serious
risk to health care workers. Transmission of at least 20 different
pathogens by needle stick and sharps injuries has been reported.
|
PDF 354 KB
|
|
Risk of confidentiality breach can
make HIV patients shy from treatment |
"A breach of confidentiality carries the potential for a
greater consequence on the lives of these patients than it
may in many other diagnoses, and so confidentiality has a
deeper meaning for them," said Kathryn Whetten-Goldstein,
assistant professor in the Terry Sanford Institute of Public
Policy's Center for Health Policy, Law and Management and
primary investigator for the study, which was funded by the
Department of Health and Human Services. "A perceived risk
of a breach of confidentiality can prompt an HIV patient to
choose a clinic several hours away rather than one closer to
home, to withhold information from providers or even to
reject treatment altogether." |
|
|
Socio-Economic Aspects of Reproduction
|
The economic approach to analyse the health care services
system was used for many decades. Cost benefits (CB) studies
were developed to evaluate the economic gain related to the
expenditure for a specific treatment or health care method.
The great challenge of those studies are how to quantify, for
example, the life of a person, its health status or some
morbidity condition, in order to compare the cost of a
treatment to the benefit in terms of health, cure or death
avoidance. How much is the cost of a woman’s life?" |
|
|
The
Business of Medicine
|
AMA member is on a mission to educate other
physicians about the changing face of the business of medicine,
and its potential fallout on patients – particularly the elderly
|
|
|
The End of Health Care: Who Plays God in a System Bent on
Profit? |
"In the
spring of 1987, as a physician, I caused the death of a
man," testified Dr. Linda Peeno, to Congress. "Although this
was known to many people," she continued, "I have not been
taken before any court of law or called to account for this
in any professional or public forum. In fact, just the
opposite occurred: I was 'rewarded' for this. It bought me
an improved reputation in my job, and contributed to my
advancement afterwards. Not only did I demonstrate I could
indeed do what was expected of me, I exemplified the 'good'
company doctor: I saved a half million dollars."
"The decision about the California patient [in need of a
heart transplant] was made from the 23rd floor of a marble
building in Louisville, Kentucky," added Peeno, herself a
Louisville resident, a medical reviewer for Humana and
medical director at Blue Cross/Blue Shield Health Plans.
Peeno had no license to practice medicine in California, but
to her employer, this was irrelevant. "The patient was a
piece of computer paper, less than half full. The 'clinical
goal' was to figure out a way to avoid payment. The
'diagnosis' was to 'DENY.' Once I stamped 'DENY' across his
authorization form, his life's end was as certain as if I
had pulled the plug on a ventilator." |
|
|
The
Health Insurance Cost Spiral: How It Happened
|
Colorado must head-off another medical malpractice
crisis by re-affirming the limitations which allow injured
patients to be compensated but limit runaway verdicts.
|
|
|
The
high cost of Health goes Higher
|
Health Research and Educational Trust finds
that premiums for employer-sponsored health insurance, which
covers two of three Americans, increased an average of 11
percent in 2001, the largest increase since 1992. Overall
inflation during the same period was only 3.3 percent.
|
|
|
The Myth of Confidentiality
|
This standard has allowed patients to abandon their usual
hesitancy to confess their experiences, concerns, behaviors,
ailments, thoughts and fantasies to their health care
practitioner. Their confidence to make such confessions
comes from the covenant of trust to which we mental health
practitioners swear. The confidential relationship between
the therapist and patient has been considered part of the
core foundation for building what we refer to as the
"therapeutic alliance." Our covenant has been that we will
serve the good and do no harm to those persons who seek our
help and who trust us to provide it. |
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The
Other Drug War-Public citizen
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The lobbying side of the pharmaceutical companies
and how the pressure the government
|
318 KB PDF
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The Right to Equal Treatment: Student Toolkit to address
Racial and Ethnic Disparities in US Health Care |
The problem of racial and ethnic disparities in health is one
of the most serious human rights issues facing Americans
today. People in racial and ethnic minority groups in this
country tend to live shorter lives and suffer higher rates of
diseases than do whites. |
263 kb pdf |
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Tip
of iceberg
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Report by insurance industry on the risk of
exposure in the work area and what they should do about it
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445 KB PDF
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What
Happens When COBRA Ends
|
There are two federal laws that can be used
to continue health insurance once your COBRA Continuation
Coverage ends. Both provide access to health insurance without
having to prove that you are "insurable."
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