Thursday, September 22, 2016

Anthem, Cigna Have Accused Each Other of Merger Breach - WSJ

The ink has barely made it to the paper, and Anthem and Cigna have gotten cold feet regarding their proposed merger.

The blowback from the public and the DOJ, FTC are working, even without a formal filing or restraining order. In order to save face....blame each other. It's a no lose situation for counsel for either company.  What the heck, those guys are on multi-mllion dollar retainers either way...A nice cash flow for the junior non  partner attorneys for the big law firms in the health and insurance niche.  They most likely reasoned it would cost more money to litigate than to simply carry on as they are now. (that is how obscene the amount of money is at stake and how much money these companies have under their mattresses. How long is the American public going to put up with these rules that bankers and insurance companies write for themselves ? Are we a ship of fools ? Yes

Sometimes it makes me wish I had gone to law HMOs no ObamaCare, no EMRs Meaningful use, MACRA, MIPS, Accountable Care Organization, getting paid for volume, not outcomes....etc. Now that I am retired (I am young only 73 and my life expectancy is still pretty good according to the latest stats. I could retrain here at my local Western law school and make some really big bucks !

Doctors don't seem to have time anymore for Wednesday (or is it Thursday) afternoon golf..but since I am retired I do. Even though I don't play golf I am willing to give up my afternoon nap time to study for my new profession.

Anthem, Cigna Have Accused Each Other of Merger Breach - WSJ

The Top Gun of Health Train Express Blogs for 2016 (so far)

Our readership fluctuates quite a bit, averaging a paltry 200-300 users/day. Most of the readership is from the U.S. and the U.K.

This year we had several posts that went well above 1000 readers/day.  Like most internet publications readership depends heavily upon Google searchs.  Readership continues for days, weeks months and even years.  We network our contributions on facebook, twitter Newsana, Digg, Redditr and a list of email subscribers. We have an RSS  feed as well.

Top Gun Posts:

Mark Zuckerberg, Priscilla Chan unveil $3 billion effort to cure disease

Mark Zuckerberg and spouse have joined the list of other philanthropists such as William and Melinda Gates,  Paul Allen, Sean Parker, Mayor Michael Bloomberg, and the Koch brothers are donating billions of dollars to many scientific and health related research efforts.

Sean Parker, the cofounder of Napster, has committed $250 million to develop new cancer treatments. Former New York City Mayor Michael Bloomberg is leading a coalition of philanthropists putting up $100 million for a separate cancer initiative. And philanthropist and entrepreneur Paul Allen committed $100 million in March to an initiative that backs risky, cutting-edge science that more conventional funders might avoid.

Paul Allen created the Paul G. Allen Family Foundation  launched in 2010, funds scientists who take “out-of-the-box approaches at the very edges of knowledge,” as Allen put it. The program’s 2015 awards for Alzheimer’s research, for instance, largely passed over scientists who focus on the leading (and, so far, leading-to-nothing-useful-to-patients) hypothesis that the disease can be treated by eliminating amyloid plaques.
Billionaire businessmen Charles and David Koch have also given tens of millions to cancer research.
And Bill Gates funds public health projects around the world, including malaria and polio prevention efforts, through his charitable foundation.

Mark Zuckerberg, Priscilla Chan unveil $3 billion effort to cure disease

Wednesday, September 21, 2016

UnitedHealth survey: More shop around for healthcare, but insurance literacy falls short

While more American consumers are taking advantage of tech tools to comparison shop for healthcare, they still lack basic knowledge about health insurance and dread selecting a health benefits plan.

This one of the major failures of the American Health System.  Interestingly it is also a major failure in the American Tax System.  Two items so important to every citizen cause great angst and frustration for all.

A new survey from UnitedHealth details those and other findings, offering both positive signs for consumer engagement and areas that suggest health insurers have more work to do as they look to improve their members' experience.
Indeed, “this survey underscores why UnitedHealthcare is working to simplify the healthcare experience for people and help them take full advantage of their healthcare benefits,” Rebecca Madsen, UnitedHealthcare chief consumer officer, said in an announcement.
Here’s a look at some of the survey’s key findings:

  • Nearly a third of respondents have used the internet or mobile apps during the last year to compare the cost of medical services, which is more than double the rate in 2012. The uptick was most significant among young people.
  • Among all comparison shoppers, 81 percent described the process of using online or mobile resources as “very” or “somewhat” helpful.
  • Fifty-six percent of survey respondents who are employed full time said they would be interested in using a wearable fitness tracker as part of a workplace wellness program.
  • Thirty-seven percent of respondents said they were “very" or “somewhat" likely to use telemedicine to access healthcare services.

  • Only 7 percent of respondents could successfully define all four basic health insurance concepts: plan premium, deductible, co-insurance and out-of-pocket maximum. Consumers had the most trouble defining co-insurance and out-of-pocket maximum.
  • Many survey respondents underestimated the actual cost of specific healthcare services. For a knee replacement procedure, for example, 63 percent estimated the cost to be lower than the national average of $35,000, and only 11 percent answered correctly.
  • The task of selecting a health plan is not one that consumers relish, as 25 percent would rather file their annual income taxes. And 28 percent said having to review their health benefits during open enrollment would be worse than the hassle of losing their mobile phone.

In addition, despite the increased uptake of tech tools by consumers, 78 percent of respondents preferred speaking with a customer service representative to resolve an issue or ask a question--the clear winner over email, online chat or mobile app. When customers do speak to a representative, 30 percent ranked the person’s knowledge as the most important factor of the experience.

The system must be deconstructed to one in which the number of choices is much less, more intuitive and less subject to making critical errors in selecting coverage.

Fierce HealthCare

Monday, September 19, 2016

Help Preserve Our Privacy-Data Selling for Profit Epidemic |

It is your data, but are you sharing the profit ?

Each time I check my mail or bank statement I do not see any deposits coming from my health insurance company or hospital for the moneys they earned from selling my data, anonymized or not. This information is becoming more commonly known.

The larger question is it  still your data if your identifying information has been removed? Apparently so,  as this challenge has been rebuffed by powerful corporate interests. Profiteering from a sick or well person's data is now acceptable business practice.

This story is curated from an article by Barbara Duck in You Caring

The Story

I am an active consumer advocate and write about our data being sold frequently and we don't know to who, what kind of data they sell, and how it will impact us. We need a law to require all who sells data in the US to buy a license and disclose what they sell and to whom. Here's the reason why...(Think Anthem Breach)

This call was different as the caller proceeded to tell me that their records indicate that I am one who takes blood thinners.  They also had my name and address information which they disclosed at the beginning of the call.  So what's the problem here?

I don't take blood thinners, never been prescribed any and have not taken any in my life!  

Where did this information come from?  It was derived by the data sellers on the internet piecing together information they mine and some algorithm determined with making this match that "I take blood thinners"!  This is enough to make anyone mad as hell!  It made me mad as I used to be a data base person that did this kind of work too.  I have a pretty good idea on the data mechanics here.  

Now we hear that the hackers of Anthem came from China, do you want your records sold all over China and the US?  That's why they hacked to get data to sell, period.  Hackers can repackage our data, hide the original formats and bingo they have a money maker.  When this happens and being there's no licensing attached to identify origins, well companies will end up buying stolen data at some point, why we need licensing!!  Here's the rest of what happened to me..

Long and short of this, my data has been sold and I have been repackaged and who knows how many other places have this "flawed data" about me on file?  I'm not one who has ever taken blood thinners and I have no way to fix this.

I have no way to find who did this to get it corrected and remember this is all on my own dime and time too!  The data sellers don't care as flawed data gets the same price as good data, so I'm screwed and can't remove this and I don't know where and when it will appear again and I'm mad.  My hands are completely tied and I can't fix this.  This is why we need an index for this.

I have no way to find who did this to get it corrected and remember this is all on my own dime and time too!  The data sellers don't care as flawed data gets the same price as good data, so I'm screwed and can't remove this and I don't know where and when it will appear again and I'm mad.  My hands are completely tied and I can't fix this.  This is why we need an index for this.

Who in the hell are all these data sellers?  

Now when people do research about me to find what's on the web, I have no clue when this will pop up again and it will at some point, depends how many bought this information about me.  So I go apply for a loan as an example and guess what "I'm a person that takes blood thinners" shows up.  

With all the extensive data searching we do today, this person who could be the one approving the loan will see this!  What could be their next move?  Easy, look and purchase more data about me, like get an actuary report from another data seller that shows the risk of how long they think I will live!!  This happens folks and this an example with me here but it happens.  

So depending on what comes back if my risk of not living long enough has impact, well guess what, I get no loan.

More about other matters:

Here's some additional reference and information with more details about how this works against us with privacy and no transparency....

Did you know you are "secretly" scored? What is a score? Well think back to school if you will and remember how you were graded, and this is happening all the time today, but it's not a test you are taking to get scored, companies and buying and selling your data and you don't even know it. Worse yet, when there are errors, guess what, the score is wrong, but you have no way to even know you have a flawed score out there that people are using to make some kind of decision. 

Did you know that when you call most insurance call centers they are "scoring" your voice?When you hear "this call may be recorded..." what's really occurring is that millions of computer algorithms are listening to you and determining what your current state of mind is. You can read more here about how that occurs and the software used. 

Do you know that health insurers are buying your Visa and Master Card records? They sure are and those too are analyzed and used along with other data they may have on file about you. This is becoming more common practice all the time. They could be doing that, but they have a lot more than just clothes purchases and could be looking at anything including your grocery bill, and so on.  

Do you want your health insurer to know everything you buy and scrutinize it? You can read more here about how that works. 

There really are few ways to track your information once it  goes into a  server either cloud based or in your office. The cost of insuring your privacy is considerable and is another addition to health care costs.

The over-riding weakness of the system is that all of the data resides in one place (or more) It is not compartmentalized and a simple breach can result in massive data exposure.

Help Preserve Our Privacy-Data Selling for Profit Epidemic | Other - YouCaring

Saturday, September 17, 2016

This Homemade Mosquito Spray will Protect you from the Zika Virus —

Home made Mosquito Repellant

The Zika virus spreads via vector transmission. Individuals infected with Zika do not display signs and symptoms of infection. In some cases, the following signs and symptoms are reported:
  • general feeling of discomfort
  • rash and muscle pain
  • mild fever
  • red eyes
The incubation period, that which is the time from exposure to the manifestation of symptoms, is still unknown, but is likely to be a few days to a week.
The most adverse effect of the Zika virus is microcephaly, a condition characterized by fatal congenital condition that is common among infants. This happens when a pregnant woman is exposed to the Zika virus. There have been new cases of the virus from UK to Brazil, exposing many newborns to congenital anomalies.
Based on research conducted so far, the virus does not spread from person to person like, a cold, but through vector transmission- a mosquito biting an infected person and then on to another individual who then contracts the virus.
To date, there is no known vaccine to prevent or medication to treat the Zika virus infection. One effective measure of avoiding infection is by avoiding mosquito bites altogether in places where cases of Zika virus have been reported.

Homemade Essential Oil Mosquito Spray Repellent
Instead of applying harsh mosquito spray ion the skin, use a homemade essential oil spray to avoid mosquito bites altogether. Here are the ingredients to make an all-natural essential oil repellent:
What you need:
2 tsp lemongrass essential oil
2 tsp eucalyptus essential oil
2 tsp citronella essential oil
13 ounces witch hazel
How to make:
  1. Combine the ingredients and shake well.
  2. Pour the essential oil mixture into spray bottles
  3. This essential oil preparation can last for a month or two. Make sure to store the mixture in glass spray bottles.

This Homemade Mosquito Spray will Protect your from the Zika Virus 

Friday, September 16, 2016

Agate Resources insiders made $34 million on sale of company that used public funds to provide health care to low-income Oregonians | Local | Eugene, Oregon

Is this a legal transaction ?

Is this an ethical transaction?

A small group of insiders in a private Eugene company that managed medical services for low-income Lane County residents made about $34 million when the company sold last year to a large out-of-state buyer, documents obtained by The Register-­Guard show.
For-profit Agate Resources owned and ran Trillium Community Health Plan, which oversees the Oregon Health Plan in Lane County, using federal and state government money to provide health care for about 94,000 low-income residents in Lane County and 2,000 in Douglas County.
The sale has been controversial because of concern that Agate held onto government Medicaid money to make itself attractive to a buyer, instead of spending more aggressively to provide doctors and medical services for Oregon Health Plan patients.
Early last year, 13,000 Lane County OHP patients did not have a primary care doctor. The problem wasn’t fully resolved until a year later.
Centene reported in its latest annual report that it bought Agate in September for $109 million. Agate shareholders divvied up that cash, according to the sale plan documents obtained by The Register-Guard.
Eleven Agate executives and directors became millionaires over night, the documents show. They include Chief Executive Officer Terry Coplin, who received the biggest single sale payout, of about $5.7 million, and Chief Financial Officer David Cole, who received about $4.2 million, the sale documents show.

Agate Resources insiders made $34 million on sale of company that used public funds to provide health care to low-income Oregonians | Local | Eugene, Oregon