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Insurers exceed state rate caps for last-resort health coverage

admin — Wed, 28 Jan 2009 12:17:30 +0000

The coverage at issue was established in 1996 by the federal Health Insurance Portability and Accountability Act, or HIPAA. A key goal was ensuring that people who lost their jobs were able to remain insured. HIPAA works in tandem with COBRA, a federal law that extends job-based group insurance coverage, entirely at the individual’s expense, for up to three years after a person leaves or loses a job. (COBRA stands for Consolidated Omnibus Budget Reconciliation Act, the 1986 law that created the program.)
Under HIPAA, insurers must offer their most popular coverage options to people whose COBRA coverage has run out, regardless of pre-existing conditions.
The higher premiums charged by the California insurers, which vary by the policyholder’s age and region, add up. For example, Blue Shield’s monthly premium for a family of four in Los Angeles with a 40-year-old primary policyholder is $1,461. That’s $401 a month, or $4,812 a year, above the cap.
Anthem’s 2009 monthly premium for the same family was $1,356 — $296 a month, or $3,552 a year, above the cap.
In response to The Times’ findings, Anthem initiated a review and discovered errors in its rates, spokeswoman Peggy Hinz said.
So far, Anthem has determined that it has been overcharging enrollees ages 60 to 64 since 2006. Anthem said it appeared others had also been overcharged, and it was reviewing charges to all members since 2006. The company is sending letters to members who may have been overcharged and has promised reimbursement for overpayments, with interest. Anthem members with questions may call (800) 636-8991.
Blue Shield, on the other hand, stood by its rates and maintained that it had done nothing wrong.
“We think we are obeying the letter of the law, and there’s never been any indication that we aren’t,” spokesman Tom Epstein said.
Blue Shield, a nonprofit based in San Francisco, said that even with the higher rates it lost about $7 million on its HIPAA coverage last year and expects to lose up to $20 million on such policies this year.
“It’s been a pretty consistent money loser,” Epstein said.
For consumers, HIPAA coverage is expensive even under the state-issued rate structure. People without pre-existing conditions can obtain cheaper health insurance on the open market. Those who buy HIPAA coverage tend to have continuing medical conditions that most insurers would otherwise refuse to cover.
“These are people typically with pre-existing conditions — serious health conditions — who absolutely need health insurance and healthcare but are blocked from the marketplace,” said Rep. Jackie Speier (D-Hillsborough).
Even people with minor medical blemishes find themselves in need of HIPAA’s guaranteed coverage.
One 63-year-old woman in the Bay Area tried to buy insurance on the open market after her COBRA coverage ran out four years ago. But she was rejected for what she called “piddly reasons,” including maintenance chiropractic visits and the use of Fosamax, a widely prescribed drug that helps bones absorb calcium. She ended up with a HIPAA policy through Anthem.
Even with Anthem’s promised rate rollback, she will pay more than $700 a month for her HIPAA coverage — too much, she said, for a policy with a $1,500 deductible.

Soothing 'til the last minute: Pregnancy massage can reduce stress …

admin — Tue, 20 Jan 2009 11:51:23 +0000

The hour Molly Will spends getting a massage each month is just about the best 60 minutes of the expectant mother’s month.
“It’s nice to have (my husband) rub my back at the end of the day,” but getting a professional massage helps alleviate tension and aches, said Will, 29. Her first baby is due March 5.
Will is among other expectant mothers who are taking advantage of a relatively new service offered in north central Wisconsin.
Aspirus Women’s Health began offering pregnancy massages this winter. The Wellness Spa in Stevens Point has offered it during the last four years.
Among the myriad of benefits, massage can help reduce stress and anxiety, said Vicki Ellias, a certified massage therapist at Aspirus Women’s Health.
According to the American Pregnancy Association in Irving, Texas, massage during pregnancy also could help reduce stress hormones and swelling, lessen pain in the back and joints, ease headaches and improve sleep.
Given those benefits, adding massage for expectant mothers just made sense, said Sheri Holmes, who manages Aspirus Women’s Health.
As the pregnancy progresses, a mother’s center of balance shifts forward and she adjusts her posture accordingly, but the change can trigger muscle and joint discomfort.
Massage also could help prepare the body for labor.
“It can help you realize where you hold your tension, and you can practice letting it go,” Ellias said. “The more relaxed and in control you are, the better labor goes.”
Special precautions, such as having the expectant mother lie on her side to avoid straining the abdomen, are key during a massage, said Ellias, who went through special training for pregnancy massage. Massage might not be appropriate for women with high-risk pregnancies, so talking with a doctor is key.
Megan Kirk, a coordinator at Wellness Spa, said women should avoid hot stone massages and other heat treatments as a precaution.
Will, a pharmaceutical sales representative, said regular massages help her.
“It’s the only time you truly get comfortable,” she said.

Drugs valued at €212m seized by Garda last year

admin — Wed, 17 Dec 2008 05:17:06 +0000

Monday, January 5, 2009
CONOR LALLY, Crime Correspondent
THE VALUE of illicit drugs seized by garda last year exceeded €200 million. The total value of main drug types seized last year was €212.3 million, compared with €167.5 million in 2007.
The seizures in both years are well ahead of trends in the previous five years, when drugs valued at between €80 million and just over €100 million were seized annually.
There were increases in value of almost all drug types seized in 2008, with heroin and cocaine showing strong gains.
The combined value of all cocaine seized by garda in 2008 was €131.7 million, by far the biggest of any drug type. This compares with €123.4 million for cocaine seizures in 2007.
The annual 2008 figure includes the haul of about 1.5 tonnes found on a boat off the Cork coast in November.
While the Cork seizure was by far the biggest of any drug type last year, a similar seizure was made in 2007, also in the waters off Cork.
It means the inclusion of the massive November haul, which was destined for Britain, does not skew the comparable annual drug seizure figures for the past two years.
Following cocaine, combined heroin seizures were worth more in value than any other drug type during last year, when €40.2 million worth of the drug was found by garda. This compares with €29.7 million in 2007.
It is believed last year was the first time heroin seizures passed the €40 million mark.
Cannabis in various forms – including plants, herb and resin – with a combined value of €38.4 million was seized during last year, up from €10.5 million in 2007.
Ecstasy seizures were down from €2.88 million in 2007 to €1.99 million last year. Demand for the drug is only a fraction of what it was in the early part of the decade.
The drug seizure figures for 2008 have been compiled by An Garda Sochna. They are provisional and may change.
Garda sources said while the record seizures reveal a continued strong demand for drugs in the Republic, the increases also suggest the force is enjoying more success than ever against drugs gangs.
The Garda figures do not include drug seizures made by Revenue’s Customs and Excise service, which reached about €30 million last year, mainly at airports and ports.
Some of Revenue’s seizures were made outside ports of entry after drugs were allowed to travel on to their delivery destinations while under surveillance by garda and Customs officials.
Excluding the 1.5 tonnes of cocaine found in Cork, most of the drugs seized by garda were found in a large number of search operations.
These typically resulted in quantities of drugs valued at between several hundred thousand euros and one or two million euros being found. However, in relation to the heroin trade, seizures tended to be fewer and larger.
This indicates that a small number of well-organised gangs are running the lucrative heroin trade, while the cocaine and cannabis trade is more fractured.
For example, five heroin seizures during the year account for just over half of all heroin seized in the State last year.
In January, garda found heroin valued at €7 million in Palmerstown, Dublin.
In June, some €4 million worth of the drug was found in Clondalkin, Dublin. In July, heroin valued at €4 million was found in a car near the M50.
In October, €2.4 million worth of the drug was found in Templeogue, Dublin.
Last month €6 million worth was found in two Dutch trucks in Dublin Port.
Most of the heroin seized here originates in Afghanistan. It is imported to Ireland via mainland Europe, mainly Spain and the Netherlands.
Most of the cocaine originates in Colombia and other Latin American countries. It usually enters the State via southern Spain, to where it is shipped often via west Africa. Cannabis is grown across the world with large-scale production in Morocco, Lebanon and Pakistan.

Insurer of last resort gains numbers in downturn

admin — Mon, 24 Nov 2008 13:11:59 +0000

WASHINGTON (AP) — That day in July was one that Tammy Morse won’t soon forget.
Five months earlier, her husband lost his job as a recruiter for the financial services industry. Now it was the summer and the family savings were gone. She saw no way to get health insurance coverage for her family other than to apply for Medicaid.
And that was why she made the drive from her Stratford, Conn., home to the nearest office of the state’s Department of Social Services.
“It was humbling,” said the mother of two. “It’s funny how your attitude changes, because honestly, I was probably a little judgmental previously. … For lack of a better way to put it, that was for other people. It wasn’t for me.”
Around the country, similar stories are playing out for thousands of families.
Since the recession began a year ago, many states have seen increases in the Medicaid rolls just as tax revenues are falling below projections. Governors have lobbied President-elect Barack Obama and Congress to help them weather the downturn by increasing the federal government’s share of Medicaid spending for at least two years.
The governors said the extra $40 billion would ease the service cuts or tax increases that legislatures need to balance state budgets.
The unemployment rate has jumped from about 4.7 percent last December, when the recession began, to 6.7 percent today. Economists estimated in a Kaiser Family Foundation report that each 1 percent gain in the unemployment rate adds 1 million people to the Medicaid and State Children’s Health Insurance Program.
In Connecticut, a state faring better than many, enrollment in the Medicaid program, called HUSKY (Healthcare for Uninsured Kids and Youth), has climbed from about 312,000 last December to about 329,500 in November — a 6 percent increase. Many who lost their jobs were eligible to continue group health insurance. But that is not an option in most cases because they no longer have an employer picking up a large share of their premiums.
Cassandra Edmonds, a single parent who joined HUSKY in October, is a newcomer to the program like Morse. Her job as a parent-activities coordinator with the Bridgeport school district was eliminated to save money. She has found a job selling life insurance, but her earnings are low enough that she is eligible for HUSKY coverage.
The insurance is particularly important for her 4-year-old son, who has glaucoma and tubes in his ears to prevent repeated infections. He has to check in with a specialist about every three months for each condition. Edmonds said she never imagined she would be relying on government safety nets to make that happen.
“I never really thought I would be without a job,” Edmonds said. “I have an MBA. I’m not trying to sound cocky or anything.”
Donny Djurkovic doesn’t have a master’s in business administration, but he did have decades of work experience when he lost his job with a small food company. Djurkovic, like Morse and Edmonds, is from the Bridgeport area.
He said he was able to continue health insurance for himself, but insuring his son would have increased his premium to more than $1,200 a month. So his son, 6, went without insurance for a few months, leading to much worry.
“I put his bicycle in the shed. I didn’t want anything to happen, to be honest with you,” Djurkovic said.
He learned about HUSKY from a pharmacy clerk and took her advice to apply. Despite the relief, he admits to some feelings of guilt about accepting the government’s assistance.
“In all these years, I never had put my hand out and I was so proud of myself and everything. But there is unfortunately times when you do need it,” he said. “And I still feel bad. Would you believe this? When I see my unemployment insurance, I say this is not me. I’m not used to it.”
Medicaid insures nearly one in six low-income people in the U.S. The program typically covers the very poor and about half of enrollees are children. Spending came to $333 billion in the budget year ending Sept. 30, 2007. Washington picks up about 57 percent of that; the states cover the remainder.
Michael Cannon, director of health policy studies at the Cato Institute, a liberterian think tank, sympathizes with new families now relying on Medicaid. Still, he disagrees that the federal government should reward states that did not plan adequately for the bad times. Better planning would mean setting aside more money for rainy day funds and not expanding the scope of Medicaid during the good economic times, he said.
“The states make these promises they know they can’t keep and then they run to Congress to bail them out,” Cannon said. “And Congress typically ends up bailing them out.”
Cannon said the net result is the government gradually is becoming more responsible for paying for health insurance coverage.
The bill will fall to future generations. “And who better to push those costs onto than to people who can’t even vote yet?” Cannon said.
Advocacy groups report that 43 states face budget shortfalls this year or next. The Center on Budget and Policy Priorities estimates states face a $79 billion gap they must bridge this year.
Nineteen states have enacted or proposed cuts in their Medicaid or State Children’s Health Insurance Program budgets for the current budget year or for 2010, according to Familes USA, which conducted a state-by-state survey:
_Arizona now requires adults to reapply for Medicaid every six months rather than annually, which is expected to reduce the rolls by 4,500.
_California does the same for children, and Republican Gov. Arnold Schwarzenegger proposed reduce eligibility limits for parents from 100 percent of the poverty level to 72 percent. That would drop it from $17,600 to $12,600 for a family of three. The state also is considering putting new applicants for children’s insurance on a waiting list.
_Nevada eliminated vision care for adults and limited coverage for personal care services that reimburse providers for helping people meet basic needs such as feeding and bathing.
_South Carolina enacted a limit on prescriptions and refills to a maximum 31-day supply.
_Rhode Island limited coverage for prescription drugs to generics.
The most common Medicaid cut that states made was to lower payments to doctors and other providers; some 14 states have done so this year. Medicaid patients already often have trouble finding a doctor who will take them, so the payment cuts could make that problem worse.
Diane Rowland, executive vice president at the Kaiser Family Foundation, said that boosting the Medicaid matching rate will prevent higher rates of uninsured and maintain patient access to hospitals, nursing homes and home health care.
“In the absence of this kind of stimulus, you might see more layoffs in the health care sector,” she said. “These dollars can start to flow to states the day after Congress enacts it because it’s just changing the formula for how Medicaid bills are shared.”
Rowland said some states did expand during the good times, causing a portion of the budget crunch they now face, but for the most part, the problem is the economy.
“It’s not so much an issue of expansion. It’s an issue of how we deal with a downturn in the economy,” she said. “On the income side, we have unemployment insurance. On the health care side, all we have is Medicaid and the State Children’s Health Insurance Program.”

Maryland ranks last in disaster preparedness

admin — Sun, 21 Sep 2008 05:09:44 +0000

BC-MD–Disaster Preparedness,0122
Eds: APNewsNow.
BALTIMORE (AP) — A new study finds Maryland tied for last among states nationwide in readiness for a health emergency.
Maryland scored a five out of 10 possible points on indicators for health emergency preparedness capabilities according to the study released Tuesday by the Trust for America’s Health and the Robert Wood Johnson Foundation.
Tied with Maryland were Arizona, Connecticut, Florida, Montana, and Nebraska. More than half of states and the District of Columbia scored a seven or less. Louisiana, New Hampshire, North Carolina, Virginia, and Wisconsin scored the highest with 10 out of 10.
The study’s authors say their report has found steady progress over the past six years, but federal and state cuts are putting that progress at risk.

Warped facts in last presidential debate

admin — Thu, 21 Aug 2008 01:27:51 +0000

WASHINGTON (AP) — The final presidential debate was a last hurrah, of sorts, for tall tales told before a large national audience by Republican John McCain and Democrat Barack Obama.
The two took familiar liberties with facts in a matchup that also gave viewers a brand-new head-scratching exchange over a man McCain called “my old buddy, Joe, Joe the plumber.”
Each candidate again twisted his rival’s health care plan. McCain told a golden oldie about the U.S. buying oil from hostile countries. Obama gave a squishy answer about abortion. And they criticized each other’s advertising in ways that lacked precision about what’s really going on.
But it was Joe the plumber who threatened to steal the show as McCain — who doesn’t know the guy — used him as an example of how average Americans could be taxed to the max by the Democrat. He was referring to Joe Wurzelbacher, a Toledo, Ohio, plumber who wants to buy his own plumbing company and complained to Obama on Sunday that he’d pay more taxes under his plan.
McCain made plumber Joe sound perhaps too much like an average Joe: “What you want to do to Joe the plumber and millions more like him,” he told Obama, “is have their taxes increased and not be able to realize the American dream of owning their own business.”
The company Wurzelbacher wants to buy earns more than $250,000 a year, which would make him decidedly above average in income. But McCain was right that Wurzelbacher’s tax load would probably increase, because Obama proposes to raise taxes on income over that amount.
OBAMA: Said that if families get a $5,000 tax credit for buying health insurance and the insurance then costs $12,000, that’s a loss for them.
THE FACTS: The tax credit offered by McCain is more generous for the vast majority of people than the current tax break, which they would lose, according to the Tax Policy Center. Now, people don’t pay taxes on the health benefits they get from work. Obama’s statement gives the impression that $5,000 is all that workers will be getting to help them pay for a health plan, but that’s just what the federal government will provide. Economists say most employers would still contribute to their workers’ health insurance. The Lewin Group, a health care consulting firm, found that by taxing health benefits but providing a tax credit, the average family would come out $1,411 ahead.
McCAIN: “We have to stop sending $700 billion a year to countries that don’t like us very much.”
THE FACTS: This is a reference to U.S. spending on oil imports. McCain has repeatedly made this claim. But the figure is highly inflated and misleading. According to government agencies that track energy imports, the United States spent $246 billion in 2007 for all imported crude oil, a majority of it coming from friendly nations including neighboring Canada and Mexico. An additional $82 billion was spent on imported refined petroleum products such as gasoline, diesel and fuel oil. A majority of the refined products come from refineries in such friendly countries as the Netherlands, Canada, the United Kingdom, Trinidad-Tobago and the Virgin Islands.
OBAMA: “One hundred percent, John, of your ads — 100 percent of them — have been negative.”
THE FACTS: The statement is mostly true when it comes to McCain’s current commercial spots. But by saying McCain’s ads “have been” 100 percent negative, Obama ventures into misleading territory. A recent study by the Wisconsin Advertising Project at the University of Wisconsin-Madison found that in the first week of October “nearly 100 percent” of McCain’s ads were negative. The study also reported, however, that to date 73 percent of McCain’s ads have been negative and that 61 percent of Obama’s ads have been negative.
McCAIN: “Sen. Obama is spending unprecedented amounts of money in negative attack ads on me.”
THE FACTS: Obama is spending unprecedented amounts of money on ads, period — negative or otherwise. Obama is outspending McCain and the Republican Party by more than 2-to-1 in presidential ads. At one point in August, 90 percent of the ads Obama was airing were against McCain. The study by the Wisconsin Advertising Project found that about 34 percent of Obama’s ads are now negative.
McCAIN: Said of Obama’s running mate Sen. Joe Biden: “He had this cockamamie idea of dividing Iraq into three countries.”
THE FACTS: Biden actually proposed dividing Iraq into three semiautonomous regions, not separate countries. He was a prime sponsor of a nonbinding Senate resolution that called for Iraq to have federal regions under the control of Kurds, Shiites and Sunnis in a power-sharing agreement similar to the one that ended the 1990s war in Bosnia.
OBAMA: Said he would be “completely supportive” of late-term abortion restrictions “as long as there’s an exception for the mother’s health and life.”
THE FACTS: Obama leaves himself a lot of latitude in this answer. A woman’s “health” has been so broadly interpreted that it can include conditions, including psychological conditions, that are difficult to diagnose or prove. Anti-abortion advocates say that makes the ban meaningless, because it leaves too much subjective judgment in the equation.
MCCAIN: “Sen. Obama, as a member of the Illinois state Senate, voted in the Judiciary Committee against a law that would provide immediate medical attention to a child born in a failed abortion. He voted against that.”
OBAMA: “If it sounds incredible that I would vote to withhold lifesaving treatment from an infant, that’s because it’s not true.”
THE FACTS: As a state senator, Obama opposed three legislative efforts, in 2001, 2002 and 2003, to give legal protections to any aborted fetus that showed signs of life. The 2003 measure was virtually identical to a bill President Bush signed into law in 2002 — a bill that passed before Obama was in the U.S. Senate, but one that Obama said he would have supported. The state of Illinois already had a law to protect aborted fetuses born alive and considered able to survive. Among those opposed to the state effort was the Illinois State Medical Society, which argued that the bill would interfere with the doctor-patient relationship and expand civil liability for doctors. Critics said the proposed legislation would have undermined the landmark Supreme Court case on abortion, Roe v. Wade, in ways the federal law would not.
McCAIN: “Senator Obama talks about voting for budgets. He voted twice for a budget resolution that increases the taxes on individuals making $42,000 a year.”
THE FACTS: The vote was on a nonbinding resolution and did not increase taxes. The resolution assumed that President Bush’s tax cuts would expire, as scheduled, in 2011. If that actually happened, it could mean higher taxes for people making as little as about $42,000.
OBAMA: “We can cut the average family’s premium by $2,500 a year.”
THE FACTS: If that sounds like a straight-ahead promise to lower health insurance premiums, it isn’t. Obama hopes that by spending $50 billion over five years on electronic medical records and by improving access to proven disease management programs, among other steps, consumers will end up saving money. He uses an optimistic analysis to suggest cost reductions in national health care spending could amount to the equivalent of $2,500 for a family of four. Many economists are skeptical those savings can be achieved, but even if they are, it’s not a certainty that every dollar would be passed on to consumers in the form of lower premiums.
McCAIN: “Vouchers, where they are requested and where they are agreed to, are a good and workable system, and it’s been proven.”
THE FACTS: McCain’s education plan proposes more private-school vouchers for only one jurisdiction: Washington, D.C. It’s unclear whether the four-year-old Washington program is actually working. So far, the Education Department has found little if any difference in the test scores of kids who got vouchers to attend private school.
McCAIN: “We can eliminate our dependence on foreign oil by building 45 nuclear power plants right away.”
THE FACTS: For nuclear power to lower oil dependency would require a massive shift to electric or hybrid-electric cars, with nuclear power providing the electricity. No new U.S. nuclear reactor has been built since the 1970s. Although 15 utilities have filed applications to build 24 new reactors, none is expected to be built before 2015 at the earliest. Turmoil in the credit markets could force cancellation of some of the projects now planned, much less spur construction of 45 new reactors, as reactor costs have soared to about $9 billion apiece.
AP writers Tom Raum, Libby Quaid, Lolita C. Baldor, Kevin Freking and H. Josef Hebert contributed to this report.

Polio’s Last Stand

admin — Sat, 16 Aug 2008 13:49:05 +0000

In the universe of global diseases, polio would seem to be a minor problem. Fewer than 2,000 people in the world were stricken last year. AIDS and malaria, by contrast, killed more than three million people. In a list of the world’s most threatening infectious diseases, polio would rank pretty far down—past measles, meningitis, influenza and drug-resistant tuberculosis, to name a few. Which raises the question: why did
release $255 million of his foundation’s money on Wednesday to fight polio?
The answer many health officials give is that polio is on the brink of being eliminated once and for all. A campaign of mass inoculations around the world, led by the World Health Organization, has reduced cases by 99 percent, cornering the disease in a few pockets of resistance. What’s needed, health officials argue, is an infusion of funds to get them over the hump.
Trouble is, it’s not clear that more money is going to do the trick. It’s not easy to wipe a disease off the face of the planet—especially one like polio, which spreads easily and quickly through contact and occasionally through contaminated food and water. Only one in 200 children who contract the virus shows symptoms (usually paralysis), which makes the other 199 silent carriers. Indeed, more than two decades of fighting the disease around the globe has taught health workers that it is far more stubborn than originally thought. The failure to deliver the knockout blow has cast doubt on whether eradication is a viable strategy in the war on polio—even with a donor as bold and wealthy as Gates.
The polio eradication campaign began in earnest in 1988. It came on the heels of the smallpox campaign, which became the first (and only) disease ever to be eradicated; the WHO had declared it dead eight years before. Even though polio cases numbered 350,000 that year, it was by no means the most urgent threat, but health officials decided that a campaign to deliver the vaccine would serve also to improve access to
for measles and other diseases. That turned out to be true for the most of the world. Polio dropped to a little more than 1,600 cases last year, but it hasn’t disappeared. It stubbornly persists in several poor, densely populated areas—for reasons that money may not fix.
, where the culprit is poor governance. Despite the cooperation of the health ministry in Abuja, polio vaccines aren’t being delivered reliably to children in
, a northern state where 20 to 30 percent of children remain unvaccinated. One problem is that the oral vaccine, which is cheaper than the injectable one, requires refrigeration, which is hard to come by in Africa. Also in Nigeria’s north, illiteracy and a lack of trust in the government, which is notorious for corruption, may be the bigger problem. In 2003, inoculations in Kano came to a halt when rumors spread among tribespeople that the vaccine caused sterility. By the time health officials were able to convince local leaders that the rumors were unfounded, the virus had “exploded” out of Nigeria, says
, a senior advisor at the Centers for Disease Control in Atlanta. It quickly spread to 20 or so neighboring sub-African countries where it had previously been eliminated as well as to Yemen and distant Indonesia. Putting out that fire set the eradication effort back several years and added nearly $1 billion to its cost. More resources would help health workers respond to such a setback in the future, but getting more children to take the vaccines is going to take some doing.
are completely different, but no less intractable. Although local government in Uttar Pradesh and Bihar have been efficient and cooperative in carrying out inoculation, the vaccines themselves are not wholly effective. Scientists don’t understand exactly why, but they suspect that the typical child harbors so many intestinal bugs that the immune system is overwhelmed and fails to pick up on the vaccine. In relatively sanitary Europe or the United States, a child typically requires three doses of an oral vaccine to gain immunity; kids in northern India need as many as 12 doses. Getting this
to children and keeping track of who’s gotten what is a staggering logistical challenge.
New funding would help, of course. All told, contributions from Gates, the Rotary Foundation and the German and British governments amount to an infusion of $630 million toward the effort. That could help bring injectable vaccines, which are more effective and expensive than the oral versions, to India. It could also help increase the support for inoculations in Nigeria, reaching more children, and increasing the presence of health workers to advocate for the program. On the other hand, it won’t guarantee that health workers will reach every last child. Nor will it do much to help efforts in war-torn areas of Pakistan and Afghanistan, where the disease also persists. “New funding is necessary but not sufficient,” says Cochi. “The job will be won or lost based on what happens in the countries and at local levels.”
Smallpox took about a decade to wipe out. The polio effort, now 21, is burning through more than $600 million a year, with no end in sight. D.A. Henderson, the former WHO official who headed up the smallpox program in the 1970s, believes that control, rather than eradication, might be the best option for polio—dialing back inoculations, and concentrating on responding quickly to outbreaks. Cochi agrees that the current program is unsustainable but fears that a cutback in inoculations would lead to an unacceptable rise in new cases. Eradication is an all-or-nothing gamble: the disease is wiped out, or it comes back. Gates and the other donors are upping the ante.

TO: Cowboys need to revisit last season

admin — Sat, 26 Jul 2008 06:35:19 +0000

Terrell Owens hopes his coaches spent their bye week looking back at what made the Dallas Cowboys so successful lastseason.
In other words, how they got T.O. theball.
The outspoken wide receiver with the well-worn reputation for wanting to be involved simply hasn't been during the Cowboys' midseason swoon. He's been held to a pair of catches three times this season, doesn't have a 100-yard receiving game and has caught more than one touchdown pass justonce.
And only once has he been the Cowboys' leading receiver — when he caught five passes for a measly 33 yards in a 13-9 win over Tampa Bay, the team setting a dubious franchise record for fewest total yards in a victory in theprocess.
“We have to go back to the drawing table and look at the things that made us successful last year, moving me around a little bit, really just making an effort to get the ball in my hands on certain routes,” Owens said Tuesday, during a signing for his new book inManhattan.
A lot of the offensive woes have to do with the injury to quarterback Tony Romo, which certainly didn't help the Cowboys' downward spiral. A 4-1 start and aspirations of a first-round playoff bye have been replaced by a pedestrian 5-4 mark and the very real possibility of missing the postseasonaltogether.
“The reality is, you can have a lot of confidence but if you're going out there on the football field and not matching the play with the confidence, you're not doing so good,” Owens said. “I think that's very indicative of our record. You can't be good on paper, you have to do it on thefield.”
Romo hasn't played since he broke the pinkie finger on his throwing hand during a loss to Arizona on Oct. 12, but he practiced during the Cowboys' bye week and is expected to start Sunday night atWashington.
The Cowboys expect to have other important pieces back, too. Injured cornerback Terence Newman, left guard Kyle Kosier and running back Felix Jones all hope to play, and recently acquired wide receiver Roy Williams should be on thefield.
It's a critical game for Dallas, which finds itself looking up at the front-running New York Giants and second-place Washington in the brutal NFC East. The Cowboys are a game back of the Redskins and lost to them earlier thisyear.
It'd be an opportune time for Owens to have a breakout performance, especially if he's matched up against cornerback DeAngelo Hall. Remember, Owens was fined $35,000 by the league in December 2006 for spitting in Hall's face during a game against his former team, the Atlanta Falcons. The two reportedly settled their feud later with Deion Sanders serving as amediator.
“At the rate he's playing, I'm looking forward to a big day,” Owens said, smiling. “I'm no stranger to playing against him. I've had success against him just as much as everybody else has, so if he's out there, I'm looking forward to playinghim.”
Owens was in New York for a whirlwind publicity trip that included an appearance on the “Late Show” with David Letterman and a trip to the Sports Museum of America, where he donated a signed replica of his college jersey fromTennessee-Chattanooga.
Hundreds of fans also lined up outside the museum on a chilly, blustery morning to have Owens sign his book, “T.O.'s Finding Fitness.” The book includes several workout routines for different levels of fitness, diet suggestions and inspirationalstories.
“For the success I've had, it didn't come easy,” Owens said. “You got to be motivated, especially for the young kids who want to be the next Derek Jeter, the next LeBron James, the next Kobe Bryant. That's what these guys did to get to thislevel.”
The book also includes an explanation of his accidental overdose of pain medicine, how he's dealt with his own injuries and passages on overcomingadversity.
Adversity? Perhaps those are the sections his teammates ought toread.
“Everyone says we are out of the picture,” Owens said, shaking his head. “There's seven games left. We're not counting ourselves out by anymeans.”

Midwest dominant in medical device industry, but will it last?

admin — Fri, 25 Jul 2008 17:40:04 +0000

Chicago, Ill.
– I’m just back from Zurich, Switzerland, where I had a chance to get some insights on the Swiss medical device industry. As I was asked to talk about the U.S. medical device industry and entry strategy into the U.S., a good look into the worldwide medical device industry helped me prep for the conference. It’s worth sharing with you.
The medical device industry is composed of a broad array of different types of products. These range from imaging, in vitro diagnostics, wound care products, infusion therapy, home health care, orthopedic devices (spinal and multiple joints), dental devices, surgical devices, and the fast-growing area of cardiovascular devices (including stents, cardiac arrhythmia management, and valves).
Like the drug industry, the growth of the cardiovascular device industry is fueled principally by the aging populations in the U.S., Europe, and Japan. All three regions have an accelerating segment of the population who are 65 years or older. They require significant amounts of healthcare, ranging around 12 percent of their total populations. This is expected to reach 25 percent or more within the next 10 or so years.
According to the July/Aug. 2008 edition of the medical device journal
, the medical device industry had sales of about $220 billion in 2007. While this is up 8 percent over 2006, it may well be underestimated and could be as high as $275 billion.
The U.S. share of this market is $75.6 billion, or 34 percent. This also may be underestimated and could be as high as $95 billion or 40 percent of the market. This market compares with the more than $600 billion market for drugs. Some of the major differences between the two markets are:
1. The medical device industry has few “blockbusters.” A blockbuster is defined as a product with $1 billion or more in annual sales. This, however, is changing with the advent of stents (and particularly the group of drug-eluding stents).
2. The longer development time, expense, and risk associated with drug approval.
3. The need for a separate reimbursement process in addition to the normal FDA approval process. Medical devices require identification of a CPT (current procedural terminology) code that guides hospitals, clinics, physicians, and insurance companies on a price for the service provided by the device.
4. Different branches of the U.S.
to approve drugs.
The differences between the two industries are rapidly diminishing as they are converging with new drug device combinations. Also, both industries have demonstrated substantial merger and acquisition activity to supplement product portfolio gaps and internal R&D issues.
Some of the major companies involved in the medical device industry are also very much involved in drugs. These companies include market leader
, and
. According to Medical Product Outsourcing, the leading medical device companies follow.
Interestingly enough, 16 of the top 20 companies are of U.S. origin (actually 17 if one includes Covidien). Ten of the top 20 companies have their headquarters in the Midwest, with another four companies with significant operations in the Midwest. However, medical device industry growth is measured by other parameters.
One of these measures is patent activity. In an analysis done by the
(a Chicago-based patent advisory firm), the U.S. remains the dominant player in medical device technology patents. There is also significant growth, though, in other countries in this area. Here are the leading geographic centers or clusters in the U.S. for these patents.
While the Minneapolis area is the leader in numbers of patent inventors, California is the leading state with 2,062 with the Midwest a very close second with 1,840. Another part of the Patent Board study focused on patent innovation quality and industry impact of patent assets (including current impact and science linkage).
The current impact score indicates the extent to which a company’s patents serve as a foundation for industry patents and technologies developed subsequently. According to this assessment, Boulder, Colo. replaced Minneapolis/St. Paul as the top-ranked area.
Columbus, Ohio also ranked high in this assessment. I believe this has to do with the presence of
in Columbus, which is a huge R&D engine for medical device technologies.
Though the U.S. is the clear leader in this field of medical device technology development, one important conclusion reached by the Patent Board in its assessment is that it’s beginning to lose ground to other countries. Having traveled to Israel, Japan, and Switzerland in 2008 and personally witnessed this phenomenon, I can attest to this conclusion. See you soon!

Shane Harwood given until last hour to prove fitness for Ford …

admin — Fri, 11 Jul 2008 14:06:58 +0000

Victoria fast bowler Shane Harwood will be given until the last hour to prove his fitness to play in the Ford Ranger Cup final against Queensland at the MCG on Sunday.
he sustained during the Sheffield Shield game against New South Wales and will be given as much time as possible, Bushrangers coach Greg Shipperd said.
“He’s the leading wicket-taker in the competition, he’s a vital member of our side, and so we will give him absolutely probably right up until the last hour before the game,” Shipperd said on Saturday.
“He looked pretty impressive, I must say, today in the nets. I think it just depends how he pulls up.
“He’s bowled two days in a row now and we’re looking forward to having him in the side.”
Shipperd said Queensland were in a similar situation with all-rounder Andrew Symonds,
.
“Two fine players and so you would (give them time) if you were in any team’s shoes,” he said.
“I think both teams have very capable reserves waiting and are ready to play.”
Victoria captain Cameron White, meanwhile, said that Harwood moved easily in the nets, but he had to pass a final test on Sunday.
“He had a light bowl today and probably the real test will be tomorrow when he goes flat out in the nets before the game, to give us a good indication,” White said.
White said the team would select from a group including fellow quick Darren Pattison, Jon Holland, John Hastings, Damien Wright and Clinton McKay if Harwood failed to prove his fitness.
Shipperd also said that Victoria would have extra motivation after losing the past two Ford Ranger Cup finals, and they had learned from their
.
“You can lose games of cricket,” he said.
“We’ve played some terrific cricket in all forms of the game all season and you’re likely to have a hiccup or two.
“I think what it will teach us is about the way they attack us, particularly with the ball.
“There’s a more experienced batting line-up in for this game and hopefully they’ve looked at the patterns that Queensland use to dismantle opposition batting sides.
“I think we’ll be better prepared this time around.”
White and David Hussey return from national duties to Victoria’s 13-man squad, but Dirk Nannes has been
.