Category Archives: Ripped from the Headlines

Branding Health Insurance Exchanges To Make The Sale


By Pauline Bartolone, Capital Public Radio

September 25, 2012

This story is part of a partnership that includes Capital Public RadioNPR and Kaiser Heath News.

As states work to comply with the federal health care law, many are designing their insurance exchanges, where people will be able to shop for coverage.

But just the word “exchange” sounds to many like off-putting government-speak, and some states are eager to come up with a more appealing name for these new marketplaces.

Peter Lee, who directs California’s Health Benefit Exchange, says it’s up for a new name, and he says they want it to sound fresh, dynamic and innovative.

“What we’re trying to figure out is what’s a name that’s going to stick, that’s going to grab hold, that all Californians are going to say ‘Boy, that’s where I go to find healthcare,’ ” Lee says.

The exchange will have a website where people can buy private health insurance, and many consumers will have government subsidies to help them purchase the insurance. Planners hope at least 3 million California customers will enroll for benefits starting in 2014. But that 3 million is a diverse bunch — so organizers want a name that will graball of them.

“Almost half of the people that are going to be eligible for subsidized coverage in the exchange are Spanish-speaking,” Lee says. “But that’s not the only market. We have about 600,000 people that speak Asian-Pacific Islander languages. Some of them speak Mandarin; some speak Hmong.”

Lee and his team solicited names in California and got hundreds of suggestions. Among them: Avocado, Ursa, Eureka — names or concepts uniquely Californian. They tested them with focus groups.

The name Avocado got laughs but is now out of the running. Other names were borrowed from Spanish, like Calvida and Beneficia. They considered Healthifornia and Wellquest.

Claudia Caplan, a marketing expert with the RP3 Agency in Maryland, has done everything from naming fast-food hamburgers to marketing for a freight rail carrier. She says a name for a new health marketplace should have humanity but shouldn’t be too cute.

“This is a whole new world for people in terms of how they’re going to access insurance, and it might be wise to give them a name that makes them feel metaphorically wrapped in some nice, warm arms that are going to take care of them,” Caplan says.

Still, a name isn’t as important as what you build around it, she notes. “It’s going to be such a turnoff if you give it this great, nurturing name and it just turns out to be the DMV all over again,” Caplan says.

California’s exchange staff is sharing notes with counterparts in other states. Maryland just came up with its name and logo.

Dr. Joshua Sharfstein, Maryland’s Secretary of Health and Mental Hygeine and chairman of that state’s exchange, says they tossed around action names. “We had some that had verbs in them like ‘Cover Me Now Maryland,’ ‘Cover Insure Maryland,’ ‘Get Health Care Maryland,’ those sorts of things,” Sharfstein says.

He says one person even suggested “” But the Maryland planners went with something safe and trustworthy: Maryland Health Connection.

“We thought it was simple,” says Sharfstein. “It illustrated the importance of connecting: connecting with insurance brokers, producers, connecting people to insurance products as well as connecting people to health care and health.”

California is expected to release its new name and logo in November. The frontrunners? Eureka, a reference to the gold rush (and the state’s motto), and Ursa, which is Latin for bear and a symbol on California’s state flag. Condor is off the table. While uniquely Californian, it is a vulture that almost went extinct.

This story is part of a partnership that includes Capital Public Radio, NPR and Kaiser Heath News.


Public Health In Pictures: Indonesian Tobacco Farmers Protest Against Regulations of Smoking

Public Health In Pictures: Indonesian Tobacco Farmers Protest Against Regulations of Smoking

Thousands of tobacco farmers surrounded the presidential palace in Jakarta today, protesting a new tobacco bill that they say will result in massive job losses.

The new law would ban cigarette advertising and sponsorship, prohibit smoking in public and add graphic images to packaging. Indonesia is the world’s third-largest tobacco consuming country. Around 30 percent of Indonesians above the age of 10 smoke an average of 12 cigarettes a day, according to a 2008 report.

I wonder how much tobacco are in those cigarettes? …cough

more info:

Pills Can Prevent HIV Infection


According to the New York Times, two new studies released on Wednesday add to the growing body of evidence that taking a daily pill containing one or two AIDS drugs can keep an uninfected person from catching the fatal human immunodeficiency virus. As it becomes ever clearer that modern antiretroviral drugs can not only treat the disease but prevent it, pressure is likely to increase on donors to find more money to supply them in places like Africa and on pharmaceutical manufacturers to either sell them cheaply or release their patents to companies that can.

Until a few years ago, condoms and abstinence were alone in that tool kit. Recent studies have added circumcision, vaginal microbicides, a daily pill for the uninfected (known as pre-exposure prophylaxis, or PrEP) and early treatment for the infected (known as “treatment as prevention”).

One study released Wednesday, known as Partners PrEP and conducted in Kenya and Uganda by researchers from the University of Washington, showed that participants who took a daily Truvada pill — a mix of tenofovir and emtricitabine — had a 73 percent lower chance of getting infected. The study was done in 4,758 “discordant couples,” those in which one partner was infected and the other was not. Partners who took a Viread pill — which contains only tenofovir — had a 62 percent lower chance.

The second study, called TDF2 and done in Botswana by the C.D.C., found that those taking Truvada had a 63 percent lower chance of infection. The subjects were 1,200 sexually active young adults.

The studies were due to be released at an AIDS conference in Rome next week. But the University of Washington study was stopped early because it was so clear that the pills were working that it would be unethical to continue distributing placebos. The C.D.C. decided to release its results simultaneously.

Information taken directly from published July 13, 2011. Written by Donald G. McNeil Jr.

Uninsured Have Limited Options Until 2014



Let’s talk about this some more with NPR health policy correspondent Julie Rovner, who’s in our studios.

Julie, good morning.

JULIE ROVNER: Good morning.

INSKEEP: Just to clarify what’s happening here, isn’t the health care law that Congress passed last year supposed to cover or at least give people an opportunity – everybody an opportunity to get covered in a situation like this?

ROVNER: Well, yes. And assuming it doesn’t get repealed or ruled unconstitutional, it will. And it will help couples like these. But, as Jenny pointed out in her story, that won’t happen until the year 2014. And between now and then there’s a lot of frustration and consternation on the part of patients and, I might add, states.

INSKEEP: What are the options for people in a situation like the Boyles, because there must be many?

ROVNER: Well, yes. There is a new program that’s already in effect called a high-risk pool that was established into law and it’s supposed to give the uninsured a way to get insurance between now and then, sort of a bridge to coverage, if you will.

INSKEEP: High-risk pool, that just means you’re at high-risk for disease. Insurers are not really very interested in giving you anything very affordable and so you’re thrown into this pool people where you’re supposed to be able to get insurance.

ROVNER: Exactly. Now technically, this couple could get into one of these pools, which are available in every state. But there are some big catches that have kept a lot of people from signing up.

INSKEEP: Catches?

ROVNER: Catches. Yes. One big one is that in order to get into those pools you have to have been uninsured for at least six months. That means in cases like the Boyles, where they’re losing insurance at the end of the month, they’d have to wait until September before they could sign up for the program.


ROVNER: Another big obstacle in the high-risk pools is price. I did a little research. In Pennsylvania, it would cost each of the Boyles $283.20 a month or $600 for the two of them. That’s a lot less than the high-risk pools that a lot of states run on their own. But it’s still a whole lot more than the $36 a month that they’ve been paying under the plan that’s ending.

INSKEEP: Oh, okay. So the question is if you got the $600 a month or almost $600, you can benefit but if not, you’re out of luck? So how many people are signing up for the new high-risk pools under the new health care law, the National Health Care Law?

ROVNER: Well, a whole lot fewer than have been expected. Nationally, as of February 10th, there were just over 10,000 people enrolled in the plans. Now that’s a 50 percent more than there were back in November. But it’s way below the estimates that were between 200,000 and 375,000 people that were expected to enroll in the first year.

In fact, more than a few governors declined to set up their own high-risk pool programs and they let the federal government step in and do it. They were afraid that the program would be overrun with people and become too expensive.

INSKEEP: All right. Well, why has it been a flop instead?

ROVNER: Well, if you ask federal officials, of course, they say it is not a flop. They point out it’s still very new, that programs like the Children’s Health Insurance Program, which now covers more than nine million low and moderate income children, also got off to a relatively slow start. But there’s other reasons that this particular program hasn’t been all that popular. A couple we’ve already mentioned, the six-month waiting period and that it’s expensive, but there’s also the problem that a lot of people who could be enrolling in this plan just don’t know that it’s out there.

We keep talking so much about how this new coverage isn’t going to start until 2014, people have no idea that some of its already begun.

INSKEEP: Okay, so let’s get back to the Boyles, this couple that we’ve profiled. They’ve got a problem, they’ve got a problem now. What options do they have?

ROVNER: Well, for actual health insurance between now and 2014, there are not that many options unless, obviously, one of them finds a job that offers employee health insurance. In the meantime, they can probably get primary care from a community health center. There’s more than 1,200 health centers that serve more than 20 million people every year, most of them low income or uninsured.

INSKEEP: Just to be clear, there’s a lot of states where there are cutbacks in health coverage that people have today or have had up until today. You say there are some other options? But aren’t there efforts in Congress to cut back on the options?

ROVNER: Yes, there are. The budget bill that’s moving through Congress right now would cut funding by more than a billion dollars and it might make that kind of service a lot harder to come by.

INSKEEP: How are the problems in various states going to affect the national debate then, over health care?

ROVNER: Well, nearly every state is struggling with budget shortfalls. Health costs are a huge part of every state’s health problem. The nation’s governors are coming to Washington later this month and they are going to be talking about what they want to do about the Medicaid program, a huge, huge budget issue, and what they’re going to do about health costs. It’s a really big issue. So there’s a lot more to come on this subject.

INSKEEP: Julie, it’s always a pleasure to talk with you.

ROVNER: Thank you, Steve.

INSKEEP: That’s NPR health policy correspondent Julie Rovner.

Fatty foods may cause cocaine-like addiction –


Scientists have finally confirmed what the rest of us have suspected for years: Bacon, cheesecake, and other delicious yet fattening foods may be addictive.

A new study in rats suggests that high-fat, high-calorie foods affect the brain in much the same way as cocaine and heroin. When rats consume these foods in great enough quantities, it leads to compulsive eating habits that resemble drug addiction, the study found.

Doing drugs such as cocaine and eating too much junk food both gradually overload the so-called pleasure centers in the brain, according to Paul J. Kenny, Ph.D., an associate professor of molecular therapeutics at the Scripps Research Institute, in Jupiter, Florida. Eventually the pleasure centers “crash,” and achieving the same pleasure–or even just feeling normal–requires increasing amounts of the drug or food, says Kenny, the lead author of the study.

“People know intuitively that there’s more to [overeating] than just willpower,” he says. “There’s a system in the brain that’s been turned on or over-activated, and that’s driving [overeating] at some subconscious level.”

In the study, published in the journal Nature Neuroscience, Kenny and his co-author studied three groups of lab rats for 40 days. One of the groups was fed regular rat food. A second was fed bacon, sausage, cheesecake, frosting, and other fattening, high-calorie foods–but only for one hour each day. The third group was allowed to pig out on the unhealthy foods for up to 23 hours a day.

Not surprisingly, the rats that gorged themselves on the human food quickly became obese. But their brains also changed. By monitoring implanted brain electrodes, the researchers found that the rats in the third group gradually developed a tolerance to the pleasure the food gave them and had to eat more to experience a high.

They began to eat compulsively, to the point where they continued to do so in the face of pain. When the researchers applied an electric shock to the rats’ feet in the presence of the food, the rats in the first two groups were frightened away from eating. But the obese rats were not. “Their attention was solely focused on consuming food,” says Kenny.

In previous studies, rats have exhibited similar brain changes when given unlimited access to cocaine or heroin. And rats have similarly ignored punishment to continue consuming cocaine, the researchers note.

The fact that junk food could provoke this response isn’t entirely surprising, says Dr.Gene-Jack Wang, M.D., the chair of the medical department at the U.S. Department of Energy’s Brookhaven National Laboratory, in Upton, New York.

“We make our food very similar to cocaine now,” he says.

Coca leaves have been used since ancient times, he points out, but people learned to purify or alter cocaine to deliver it more efficiently to their brains (by injecting or smoking it, for instance). This made the drug more addictive.

According to Wang, food has evolved in a similar way. “We purify our food,” he says. “Our ancestors ate whole grains, but we’re eating white bread. American Indians ate corn; we eat corn syrup.”

The ingredients in purified modern food cause people to “eat unconsciously and unnecessarily,” and will also prompt an animal to “eat like a drug abuser [uses drugs],” says Wang.

The neurotransmitter dopamine appears to be responsible for the behavior of the overeating rats, according to the study. Dopamine is involved in the brain’s pleasure (or reward) centers, and it also plays a role in reinforcing behavior. “It tells the brain something has happened and you should learn from what just happened,” says Kenny.

Overeating caused the levels of a certain dopamine receptor in the brains of the obese rats to drop, the study found. In humans, low levels of the same receptors have been associated with drug addiction and obesity, and may be genetic, Kenny says.

However, that doesn’t mean that everyone born with lower dopamine receptor levels is destined to become an addict or to overeat. As Wang points out, environmental factors, and not just genes, are involved in both behaviors.

Wang also cautions that applying the results of animal studies to humans can be tricky. For instance, he says, in studies of weight-loss drugs, rats have lost as much as 30 percent of their weight, but humans on the same drug have lost less than 5 percent of their weight. “You can’t mimic completely human behavior, but [animal studies] can give you a clue about what can happen in humans,” Wang says.

Although he acknowledges that his research may not directly translate to humans, Kenny says the findings shed light on the brain mechanisms that drive overeating and could even lead to new treatments for obesity.

“If we could develop therapeutics for drug addiction, those same drugs may be good for obesity as well,” he says.

via Fatty foods may cause cocaine-like addiction –

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Your Health Bill Questions Answered : NPR


Audio available on link below

Now that the big health bill is law, people have more questions than ever. How will it affect their families and their health care? NPR’s health policy correspondent, Julie Rovner, explains some of the key provisions in the new law.

My son is going to turn 23 in June. Under the new health bill, he can stay on our plan until he’s 26, but I’ve heard this doesn’t go into effect for six months. Do we have to enroll him in alternative insurance in those intervening months, or will he be allowed to stay on that plan continuously? — Patricia Fontana of Berkley, Calif.

This is a provision that doesn’t take effect for six months, and actually, most people won’t have a chance to enroll their children in their plans until their next open season. For some people, it won’t be until next January.

So, yes, you’re going to have to find other insurance. For those with employer-provided insurance, under COBRA they can pay to add their young adult children to their plan, but this can be very expensive. For healthy young people, you can probably find some cheaper insurance for them in the intervening months, and that’s what most people are going to have to do.

This year, adults who are uninsured because of pre-existing conditions will have access to affordable insurance though a temporary subsidized high-risk pool. Can you explain the high-risk pool? If I am eligible, will my husband and daughter be covered, too? — Sarah Tamor of Santa Monica, Calif.

A national high-risk pool is supposed to start in 90 days to cover those who have been uninsured for six months and have pre-existing conditions. There’s $5 billion to help subsidize it, but the premiums could still be pretty high, as they are in most of the state high-risk pools that exist. And the premiums can vary by age — older people can be charged four times as much as younger people.

You have to have been uninsured for six months in order to be eligible. I don’t think your husband and daughter will be allowed to join unless they are also high-risk, and they probably wouldn’t want to because premiums will be high.

Insurance companies won’t have to insure those with pre-existing conditions until 2014, so a national high-risk pool will be there in the interim.

It looks like with the new law, we could find a policy in the risk pool right away if we were uninsured for six months, but if we have insurance — even if it is inadequate — we can’t change until 2014, when the [restrictions on] adult pre-existing conditions go away. Are these really our only options? — Audrey Hagan of Jackson, Wyo.

I’m afraid so. In this new interim risk pool that we were just talking about, you need to be uninsured for six months, and premiums are likely to be high. These are for people who have no other options. The idea is to give people something in the interim. But this couple has insurance, even though they write that it’s inadequate.

This high-risk pool is really for those who have nothing and want something to tide them over until 2014, when insurers can’t turn them away for pre-existing conditions.

I am a small-business owner, and every year my premium has gone up by at least 20 percent. Will the new health care law help keep the cost of health insurance down? — Katherine MacColl, Conway, Mass.

That is certainly the hope. It’s doubtful anyone really thinks this new law will bring premiums down. The idea is that it will stop premiums from going up as fast.

There is a large effort in this bill to protect small businesses. There is a tax break that goes into effect right away that will be from 35 percent of the premium up to 50 percent of the premium. There will be these new exchanges that will begin in 2014 that will hopefully help create competition that will help keep premiums lower, if not low. That will help small businesses, again.

There are a lot of things in this law that hopefully will create changes in the way health care is delivered and paid for that will help stem the growth of health care costs. But no one is suggesting this is the magic bullet.

How does the new law affect people who have insurance through the TriCare program? That’s the private insurance plan for Defense Department workers and military families.

It turns out that people with TriCare won’t be affected by the new law, and that’s both good and bad.

It’s good in that if you have TriCare, it means that you won’t have to go out and buy any other insurance. TriCare is sufficient to cover the individual mandate that you have insurance.

It’s bad if you have an adult child who’s 24 or 25 — you won’t be able to keep them on your TriCare, because TriCare only covers dependents up to age 23. A lot of people are upset by that, and there’s already been a bill introduced in the House that would allow people on TriCare to keep their dependents on TriCare until age 26.

I’m a medical student. I’ve heard from some doctors that reimbursements will decline. For those of us who have the choice of going into primary care or specializing, what will the economic incentives be? — Josh Roarke of Alexandria, Va.

In fact, there are incentives in this law to enlarge the pool of primary care doctors. One big one, which was added very late, is that they are going to increase payments for Medicaid primary care doctors to what Medicare pays. That will be a big increase.

There is increased loan forgiveness — up to $50,000 — for primary care doctors who join the National Health Service Corps. They go off and practice in underserved areas.

There’s going to be more primary care residency slots, and there will be other inducements for primary care doctors. As I mentioned earlier, there will be changes in the way doctors are paid and health care is organized, so those will be other kinds of longer term changes in the medical system that are supposed to encourage doctors to become primary care doctors. On the other hand, there’s not that much to be done about the fact that medical school is very expensive and that specialists will still be paid more than primary care doctors.

When will the “Cadillac” plan taxes come into play, and who will they affect? How do you know if you have a plan considered to be “Cadillac”? — Lisa Kantrowitz of Malvern, Pa.

The tax applies to very high-end plans, and it doesn’t take effect until the year 2018. Your plan has to be worth more than $10,200 for a single person and $27,500 for family coverage — that includes both what you and your employer pay if it’s employer provided insurance. Those plans can be worth more if you’re a retiree or in a high-risk profession, like a police officer or firefighter. Dental and vision coverage don’t count toward those totals.

How will the health care law be enforced? Who’s determining the rules and regulations, and who’ll be helping them with their specific cases?

The Department of Health and Human Services, with assistance from the Department of Labor, will be largely responsible for enforcement. But people are correct when they say that the Internal Revenue Service will play a role in this, because you will have to declare on your income taxes whether or not you have health insurance — that’s the individual mandate. If you don’t have insurance, that’s how you’ll pay the penalty that will be required — with your taxes.

via Your Health Bill Questions Answered : NPR.