Costs to Consumers

Forwarded from Stephen Patrick 

Health Care Marketplace | Average 2008 Employee Out-of-Pocket Costs for Family Health Care To Increase 10.5%, According to Milliman Index

[May 15, 2008]

      The cost of health care for the average U.S. family with employer-sponsored health coverage will increase 7.6% this year, due in part to rising prescription drug prices, according to a Milliman study released on Wednesday, Dow Jones reports. The fifth annual Milliman Medical Index analyzed historical claims data and trends in provider contracting and examined the drivers and components of medical spending. According to the study, the cost of medical services, including premiums, will increase by $1,109, from $14,500 in 2007 to $15,609 in 2008 for an average family of four enrolled in an employer-sponsored PPO. 

The study also found that the cost of pharmacy services is expected to increase by 10.6% to $2,302, compared with single-digit increases for physician services, inpatient and outpatient care (Knight, Dow Jones, 5/14). Drug spending has slowed the past two years, according to the study. However, this year’s increase is a trend that Milliman believes will continue, the Wall Street Journal reports (Fuhrmans, “Health Blog,” Wall Street Journal, 5/14).

According to the study, employers are expected to pass on more of the cost to their employees. Employers will shift around 10.5% more of the cost to workers through higher premiums and out-of-pocket costs, such as deductibles, copayments and coinsurance, the study found. Of the total $15,609 cost, employers will pay $9,442, while employees will spend $3,492 on premiums and $2,675 in out-of-pocket costs (Dow Jones, 5/14). In 2008, employers will pay roughly 60% of medical costs, while employees will pay 40% (Johnson, CQ HealthBeat, 5/14).

Comments 

According to study co-author Lorraine Mayne, a Milliman principal and consulting actuary, this is the second consecutive year employees’ share of spending will increase by double digits (Dow Jones, 5/14). She added that the report is “likely to increase pressure on the next presidential administration to address health care costs” (Fuhrmans, “Health Blog,” Wall Street Journal, 5/14). 

Gary Brace, Milliman principal and study co-author, said, “This is a trend we expect will continue for several years, as fewer high-volume drug patents expire,” adding, “For many Americans, this rate of increase is exceeded only by fuel and certain food costs” (Dow Jones, 5/14). According to CQ HealthBeat, “The study adds to the existing gloom and doom related to medical costs as projections by federal analysts show that health spending in the United States will double by 2017″ (CQ HealthBeat, 5/14).

Keep Your Online Persona Clean

Something to keep in mind…

 The following was obtained from StudentDoctor.net. 

Author: Brittney Warrick

The online world has evolved substantially over the past decade. Today it is commonplace for students to have a presence on social sites such as Facebook, Xanga, LiveJournal, or MySpace. But what most students do not appreciate is the fact that potential employers and schools may use these sites to evaluate their applicants.  They use them to weed out candidates for their positions and to decide if a potential employee is the type of person that would make a good “fit”.  Thus, our pages on Facebook and MySpace have become additions to our resumes and personal statements. One survey conducted by ExecuNet in 2007 found that 83% of recruiters use the Internet to evaluate their candidates and 43% of those have turned down a candidate based on what they saw online. The burning question is: how can students protect their personas on the Internet? 

The first step is to lock down your sites so that you can control who gains access. This will protect the information that you post online. However, it is important to remember that many institutions may hire students or have sites themselves and they could request access to your site.

The next step is to stop and ask yourself, “Would I put this information in my resume or personal statement?” A picture of you drunk at a party is clearly not a good way to promote yourself. Also, if you choose to blog about your stance on controversial topics or rant just to blow off steam, do not use your full name. It is also important to make sure that your friends do not post inappropriate pictures or information about you on their sites.

The last thing is to use your online presence to advertise your good qualities. You can post information about your leadership, maturity, growth and potential. According to the 2007 ExecuNet survey, some 70% of recruiters have said that finding positive information about a candidate would increase the applicant’s chance of getting a position.

As a safeguard, it is always a good idea to periodically run a Google search on your name and determine what information is out there. If there is negative information then try to counteract it by increasing the positive information. You can do this by starting a blog about your professional and personal growth or writing articles for a Web site.

The main thing is to keep a clear head when posting information about yourself on the Internet. It would be a shame to lose out on an opportunity because of something posted on a MySpace page. Keep it clean and professional and sites may be able to work for you.

References

Cooper, Lauren. Protecting your online reputation. Young Money. Available at http://education.incharge.org/careers/advice/79
Accepted to College.com. http://acceptedtocollege.com/planning/online-presence/

MORE COOL LINKS

For information about the AMA-MSS Annual Assembly in Chicago on June 12 – 14, please visit: http://www.ama-assn.org/ama/pub/category/9534.html

You can find information regarding the Steven Thompson Loan Forgiveness Program here: http://www.oshpd.ca.gov/HPEF/Text_pdf_files/ST_app.pdf

Thank you,

Adam Dorsey

Outreach and Programs Officer

California Medical Association

1201 J Street, Ste. 200

Sacramento, CA 95814

office (916) 551-2056

mobile (916) 502-3344

fax (916) 551-2027

adorsey@cmanet.org

UPDATE ON LOAN DEFERMENT AND THE 20/220 PATHWAY

Also, here is more information on the 20/220 pathway. Feel free to share this with your colleagues:

Help CMA and AMA reinstate the 20/220 pathway for economic hardship deferment. Recently, students and residents asked their Congressional members to reinstate the 20/220 pathway at AMA’s 2008 Lobby Day.  Many members pointed out how confusing this issue is. 

Here is an update:

• Background review: In 2007, Congress eliminated the 20/220 pathway for economic hardship deferment - the way up to 2/3 of residents avoided making student loan payments during three years of training.  Your AMA has been highly engaged in DC on working to get 20/220 reinstated.
• What’s happened recently: The AMA has been working to have 20/220 reinstated under the Department of Educations’ regulatory authority, but this seems unlikely to be successful.  Thus, our advocacy staff is continuing aggressive efforts to obtain a legislative reinstatement of 20/220.
• How you can help: Please, call your Congressman/woman and your Senators.  Tell them your story - how much debt you have, and how programs like 20/220 help you during your residency.  Ask them to support S. 2303 and H.R. 4344 - House and Senate bills that would reinstate 20/220 (both are currently in committee).  Also, they can give us back 20/220 through the addition of language reinstating the pathway in the Higher Education Act Reauthorization bills, S. 1642 and H.R. 4137.  Further - please tell other residents and students about this - we need as many calls and emails to Congress as possible.
• What happens if we don’t get 20/220 reinstated:  This program is slated to end 7/1/2009.  If it ends as scheduled - if we don’t achieve a legislative victory - if you can’t make payments on your student loans, you will have to enter forbearance - and interest will accrue on your already large debt burden.  There is a new Income Based Repayment program (IBR) which will begin on 7/1/2009, which will help keep your payments low - but we project that residents will still struggle to make these payments, particularly those of you in high cost of living areas or with families.

For more information, visit www.ama-assn.org/go/loandeferment

CMA FOUNDATION CHARITY BASKETBALL TOURNAMENT FOR STUDENT-RUN FREE CLINICS

 We are excited to announce a new California medical school charity event, benefiting CMA Charitable Foundation in establishing student-run free clinics.  From preliminary discussions with Joe Dunn (CEO of the CMA) and with many of you, we have decided to host the First Annual California Medical Student Basketball Tournament.  The tournament will be held in Los Angeles in conjunction with the CMA student leadership conference, September 21-22.  More details to follow.

Ideally, we hope to have representation from each medical school campus.   We are looking for participation from students to alumni physicians.   Just getting students from all our schools together for a couple days would be a great fringe benefit. We are seeking representatives from each school to be regional coordinators, working with us and the team at CMA to assist in coordination and organizing teams.

Should you be interested in assisting us with this event, in any capacity, please email csarkiss@ucla.edu.  We look forward to hearing back from you and look forward to creating a memorable and worthwhile event.

Keep an eye out for more information to come.

Best,

Chris Sarkiss and Aaron Alexander-Bloch, MSI’s

David Geffen School of Medicine at UCLA

Chair and Vice Chair of the UCLA Chapter of AMA

LLU SWEPT CMA LEADERSHIP ELECTIONS

Congratulations!!!!!!!!!

Laura Faye Gephart - Student Board of Trustee for the CMA

Chris Ellstrom - CMA-MSS Chair and California Chair for the AMA-MSS

Daniel Torres - CMA Delegation to the AMA, Alternate Delegate

PBS Programming on Health Care Systems

Sick Around the World – Beginning April 15th
 
“Four in five Americans say the U.S. health care system needs “fundamental” change. Can the U.S. learn anything from the rest of the world about how to run a health care system, or are these nations so culturally different from us that their solutions would simply not be acceptable to Americans? FRONTLINE correspondent T.R. Reid examines first-hand the health care systems of other advanced capitalist democracies–UK, Germany, Switzerland, Japan and Taiwan–to see what tried and tested ideas might help us reform our broken health care system.”
 
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

Credit Turmoil Raises Student-Loan Worries

Credit Turmoil Raises Student-Loan WorriesBy ROBERT TOMSHO March 28, 2008Concern is growing that the U.S. Department of Education has yet to detail its plans for making emergency federal loans if students can’t borrow through normal channels for the coming school year. Typically, around this time of year, many students receiving admissions letters are referred by their colleges to one of 2,000 banks and other lenders that make loans through the federal government’s guaranteed-loan program, which supplies billions of dollars to pay for college and is by far the largest source of financial aid. But this year, investors who normally buy the loans in bundled lots have balked amid broader turmoil in the credit market. More than two dozen lenders representing about 10% of the loan volume have said they would be dropping out of the program. The Education Department andothers have said they expect that plenty of credit will still be available for college. But the signs of distress have prompted calls from Congress and elsewhere for the department to make plans to start an emergency lending channel, called the “lender of last resort” program, should it be needed. Under federal law, the Education Department can advance U.S. Treasury funds to the 35 student-loan guaranty agencies around the country if so many private lenders abandon the federal loan market that students are unable to obtain funds. But the last-ditch channel has never been triggered or tested. And the agencies say they still don’t know how they would request the funds if they need them, how much they could get, and how long it would take to receive them. In a letter to guaranty agencies on Wednesday, the department said it is still reviewing how and when such advances could be made. “Should the need arise, additional information and guidance will be issued,” wrote Lawrence Warder, the department’s acting chief operating officer for federal student aid. ”I think they are movingtoo slowly,” said Rep. George Miller (D., Calif.), chairman of the House Committee on Education and Labor, who has prodded the education department to make sure the lender of last resort program is ready and functional if needed. “If it takes this long to get the program into shape, what happensif, in fact, they are going to need it?” The government has estimated that 7.6 million students and parents would borrow $95.3 billion from private lenders during the 2008-2009 academic year in the Federal Family Education Loan, or FFEL, program. Department officials say they are concerned aboutthe uncertainty in the student loan market and have met with Treasury Department officials about funding issues. But they maintain their monitoring has yet to find instances of eligible students being unable to get a federal loan. They say their first priority is to make sure the guaranty agencies have their own contingency plans updated and in order. This week’s letter gives them 30 days to do so. It also orders them to find private lenders willing to serve as lenders of last resort and commit tospecific time periods and loan volumes. If a lending emergency develops, ”we are ready now and we would be ready in the future,” said Hanna Skandera, deputy chief of staff for Education Secretary Margaret Spellings. Philip Day, president and chief executive officer of the National Association of Student Financial Aid Administrators, said the federal officials should already be hammering out details of the funding advance system with guarantors. He noted that late spring is when students typically begin borrowing for the next academic year. The guaranty agencies have also been pressing the department to begin discussing the procedures for emergency federal advances now. One reason is that, amid the credit crunch, some have been having a tough time getting private lenders to commit to last-resort lending even though such loans are 100% guaranteed by the federal government. Sue McMillin, president and chief executive officer of the Texas Guaranteed Student Loan Corp., in Round Rock, Texas, said her agency has been turned down outright by some lenders and is still canvassing others. “Depending on how it plays out, we could have some limitations” on lending, she said. Guarantors say they also fear having to adapt to an untried federal-advance system after troubles have already begun. “It’s just prudent to have a process in place rather than having to scramble if we are having a problem,” said Terry L. Muilenburg, a senior vice president of Indianapolis-based United Student Aid Funds Inc., the nation’s largest guarantor of student loans.

2nd Annual Medical Student Benefit Dinner

The Loma Linda University AMA Student Chapter would like to invite you to attend our 2nd annual fundraiser. On Sunday evening, April 13, we will be holding a silent auction, dinner, and concert at the Redlands Country Club. The concert will feature violinist Jason Uyeyama with piano accompaniment. Please come in your finest black tie attire, and enjoy bidding on your favorite items!Tickets are on sale now:  $35 for residents and students, and $65 for non-students

• Reserve a Ticket(s)
• Donate an item to the silent auction: Donation Letter & Donation Fax

We thank you in advance for your support!LLU AMA Student Chapter

NEW “Physicians for Healthy Communities” Mini-Grant Program

The Obesity Prevention Project is pleased to announce the launch of our new “Physicians for Healthy Communities” Mini-Grant Program. 
 
The Obesity Prevention Project is offering small grants to medical student organizations, physicians and component medical societies throughout the state of California. Grants will range from $250 to $1000 and will support obesity prevention related advocacy and community outreach projects that enhance the well-being of California’s communities.
 
For questions regarding the mini-grant program, please contact:

Laura Faye Gephart

lgephart@llu.edu

707-327-6511

Big Pharma Faces Grim Prognosis

Industry Fails to Find
New Drugs to Replace
Wonders Like Lipitor

By BARBARA MARTINEZ and JACOB GOLDSTEIN
December 6, 2007; Page A1

Over the next few years, the pharmaceutical business will hit a wall.

Some of the top-selling drugs in industry history will become history as patent protections expire, allowing generics to rush in at much-lower prices. Generic competition is expected to wipe $67 billion from top companies’ annual U.S. sales between 2007 and 2012 as more than three dozen drugs lose patent protection. That is roughly half of the companies’ combined 2007 U.S. sales.

Read More

AMA Supports Legislation to Restore Medical Student Loan Deferment

Nov. 28, 2007

CHICAGO – The American Medical Association (AMA) voiced its strong support for new legislation introduced by Senator Richard Burr (R-NC) and Senator Johnny Isakson (R-GA) to permanently reinstate medical student loan deferment eligibility during residency. The government’s Council on Graduate Medical Education now predicts a shortage of 85,000 physicians by the year 2020, as the U.S. population ages. Making it harder for students to defer medical student loans during a portion of their residency years could further deter the best and brightest from pursuing a career in medicine.

In a recent letter to the senators, the AMA thanked them for their leadership on this important issue and pledged its support to help advance the legislation. Helping medical students, residents and young physicians better finance their education and manage their high debt burden is a top legislative priority for the AMA.

“The average medical student today graduates with $139,000 in debt,” said AMA Board Member Chris DeRienzo, fourth-year medical student at Duke University School of Medicine. “Making it harder for residents to pay back this high debt can deter young physicians from going into primary care medicine or practicing in underserved areas where patients desperately need them.”

The new legislation, S. 2303, would permanently restore the medical student loan deferment program, known as the “20/220 pathway,” which allows medical residents to defer payment on their loans for up to three years during their residency training based on economic hardship. This bill also expands the current economic hardship qualifications, which may allow more medical residents to benefit from this program.

“We applaud Senator Burr and Senator Isakson for recognizing the critical importance of the medical student loan deferment program that so many of our nation’s hardworking medical residents rely upon during their training,” said Mr. DeRienzo. “We are committed to working with Congress and the Department of Education on a long term solution for continued loan deferment eligibility for medical residents.”

At the urging of the AMA, the Department of Education temporarily postponed elimination of the medical student loan deferment eligibility on November 1. The elimination was part of the recently-enacted H.R. 2669, the College Cost Reduction and Access Act. Congressional action is needed to permanently restore this loan deferment eligibility for medical residents.

For more information, please contact:

Melissa Smith
AMA Media Relations
(312) 464-4443
melissa.smith@ama-assn.org

Please Join Our AMA Listservs

1. AMA-MSS Region 1 Listserv
To subscribe, go to http://www.ama-assn.org/ama/pub/category/7275.html

2. AMA-MSS International Health Policy and NewsThe MSS.international.health.policy@enews.ama-assn.org listserv provides information about current international health topics and serves as a resource for students looking for opportunities to study abroad.
To subscribe, go to http://www.ama-assn.org/ama/pub/category/7275.html

In addition, we have several other listservs and electronic communications that you can sign up for, which are listed below.

1. AMA-MSS eVoiceThe MSS e-Voice is a weekly e-newsletter providing information and news items specifically related to medical students, including meetings and events, community service projects, leadership applications and awards, information on the Medical Student Section, current events in the health care industry, and much more…information on the AMA is also included in this e-newsletter.
To subscribe, go to http://www.ama-assn.org/apps/listserv/x-check/join.cgi

2. AMA-MSS Health Policy and NewsThe MSS.Health.Policy.and.News@enews.ama-assn.org listserv is dedicated to the discussion of AMA and AMA-MSS policy and resolutions, as well as current national legislative issues. This listserv was set up as a forum for creative discussion on national policy, AMA policy, and AMA-MSS resolutions.
To subscribe, go to http://www.ama-assn.org/ama/pub/category/7275.html

3. AMA-MSS Community ServiceThe MSS.Community.Service@enews.ama-assn.org listserv provides information on the MSS National Service Project, community service projects being implemented at the chapter level, and news related to public health issues.
To subscribe, go to http://www.ama-assn.org/ama/pub/category/7275.html

4. AMA-MSS Recruiters ListservThe MSS-recruiters@egroups.com is a listserv dedicated to the dissemination of all announcements and recruitment tools for AMA-MSS recruitment drives for medical students and residents. Through the list, you will have access to sample letters, posters, brochures, PowerPoint presentations, and more.

Dr. Drug Rep

November 25, 2007

By DANIEL CARLAT

I. Faculty Development

On a blustery fall New England day in 2001, a friendly representative from Wyeth Pharmaceuticals came into my office in Newburyport, Mass., and made me an offer I found hard to refuse. He asked me if I’d like to give talks to other doctors about using Effexor XR for treating depression. He told me that I would go around to doctors’ offices during lunchtime and talk about some of the features of Effexor. It would be pretty easy. Wyeth would provide a set of slides and even pay for me to attend a speaker’s training session, and he quickly floated some numbers. I would be paid $500 for one-hour “Lunch and Learn” talks at local doctors’ offices, or $750 if I had to drive an hour. I would be flown to New York for a “faculty-development program,” where I would be pampered in a Midtown hotel for two nights and would be paid an additional “honorarium.”

I thought about his proposition. I had a busy private practice in psychiatry, specializing in psychopharmacology. I was quite familiar with Effexor, since I had read recent studies showing that it might be slightly more effective than S.S.R.I.’s, the most commonly prescribed antidepressants: the Prozacs, Paxils and Zolofts of the world. S.S.R.I. stands for selective serotonin reuptake inhibitor, referring to the fact that these drugs increase levels of the neurotransmitter serotonin, a chemical in the brain involved in regulating moods. Effexor, on the other hand, was being marketed as a dual reuptake inhibitor, meaning that it increases both serotonin and norepinephrine, another neurotransmitter. The theory promoted by Wyeth was that two neurotransmitters are better than one, and that Effexor was more powerful and effective than S.S.R.I.’s.

I had already prescribed Effexor to several patients, and it seemed to work as well as the S.S.R.I.’s. If I gave talks to primary-care doctors about Effexor, I reasoned, I would be doing nothing unethical. It was a perfectly effective treatment option, with some data to suggest advantages over its competitors. The Wyeth rep was simply suggesting that I discuss some of the data with other doctors. Sure, Wyeth would benefit, but so would other doctors, who would become more educated about a good medication.

A few weeks later, my wife and I walked through the luxurious lobby of the Millennium Hotel in Midtown Manhattan. At the reception desk, when I gave my name, the attendant keyed it into the computer and said, with a dazzling smile: “Hello, Dr. Carlat, I see that you are with the Wyeth conference. Here are your materials.” Read More

Hawaiian Happenings—what you missed at I-07

The Interim meeting held in Honolulu was not only fun, but it also yielded a variety of new policies that will define the AMA’s actions over the coming six months. Issues discussed included minority representation, prescription data mining, SCHIP funding, and the AMA’s action in response to the revocation of the 20/220 clause of the Higher Education Act. Check it out: 

Read the AMNews special section on the AMA Interim Meeting: http://www.ama-assn.org/amednews/2007/12/03/prhd1203.htm 

Your Next BIG Decision: Residency

Thanks to everyone who came out to our residency information session.  Below you can find the powerpoint file with information and links to various special groups.  Feel free to leave comments on the presentation.

POWERPOINT: Your next BIG decision