Saturday, September 22, 2018

Hilary Hahn - Prokofiev - Violin Concerto No 1 in D major, Op 19

20th Century Classical Music: Prokofiev: Dance of The Knights

Hospitals’ Secret Contracts With Insurers Are Keeping Health Care Expensive: Report

Evie Fordham Sept 22/2018

Hospital systems are making secret contracts with insurers that are keeping health care costs high, a Wall Street Journal report revealed, prompting alternative health care advocates to point out the flawed nature of the U.S. health care system.

“Health care is the only industry I can think of where technology is used as an excuse for price to go up and productivity to go down because of these perverse incentives,” The Health Rosetta founder Dave Chase told The Daily Caller News Foundation. “The perverse incentives at a high level are generally, either directly or indirectly, the worse job [the hospitals] do, the more they get paid.”

TheWSJ’s Tuesday report detailed “dozens of contracts with terms that limit how insurers design plans” so they cannot exclude powerful hospital systems, which when included in health plans can drive up costs for employers and employees.

These secret contracts often include clauses that mandate insurers steer consumers away from less costly health care providers or give hospitals the ability to “mask” their prices, according to TheWSJ. If plans did not include these more costly health care systems, they could be up to 10 percent cheaper, the report stated.

Some major health care systems with insurer contract clauses that could be driving up health plan costs reportedly include:
  • Johns Hopkins Medicine in Maryland
  • Northwell Health in New York
  • OhioHealth in Ohio
  • Aurora Health Care in Wisconsin
  • Atrium Health in North Carolina
  • Sutter Health in California
Atrium Health is facing a civil antitrust lawsuit from the Department of Justice, and Sutter Health is facing an anticompetitive practices lawsuit from the California attorney general. Both Atrium Health and Sutter Health say the lawsuits have no basis, TheWSJ reported.

Hospital systems have increased their leverage with insurers through mergers and takeovers, often becoming the only providers in certain areas. There was “the highest number recorded in recent history” in 2017 with 115 of these types of deals, a 13-percent increase from 2016, according to a report by health care forecasting firm Kaufman Hall.

“It’s the insurers that retain the greatest leverage,” Melinda Hatton of the American Hospital Association told TheWSJ.

Many in the hospital industry maintain that insurers have controlled the game for a long time, and these secret contracts are just a way to gain a little bit of control back. But hospitals are already “the largest single component of health-care spending in the U.S.” at over $1 trillion each year, TheWSJ reported.

Because of this dichotomy, some predict major changes in how consumers pay for health care coming down the pike. CNBC columnist Jake Novak predicted a rise in hospital systems offering their own insurance plans in a 2017 article. (RELATED: Big Pharma Making Big Money With Illegal Kickbacks? Drug Companies Face More Scrutiny After News Of Humira Lawsuit)

“The insurance industry gets its justification to exist by selling the idea that only it can help make those mysterious health care costs affordable,” Novak wrote. “If the bean counters figure out a way that hospitals can do better without the private insurers around, it’s hard to see why they wouldn’t simply sweep them away faster than Amazon put an end to your local book store.”
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Thank You Ms Fordham and the DC.

Thursday, September 20, 2018

Groucho Marx, The Laws of My Administration

Hat Tip to American Greatness

Great column on the Democrat Punch and Judy fits of hysteria trying to Bork the confirmation of Trump's 2nd Supreme Court nominee: Brett Kavanaugh. 

The Playbook, the Press, the Plan, and the Patsies

Tuesday, September 18, 2018

Are Drug Side Effects Driving Depression Rates?

By Peter Simons September 18, 2018

According to new research, between 2013 and 2014, 38.4% of adults took a medication that lists depression as a potential side effect, and 9.5% received three or more such medications. About 23.5% took a drug that listed increased suicidality as a side effect. The researchers found that the use of these drugs was associated with people developing depression and suicidality.

“Use of prescription medications that have depression as a potential adverse effect was common and associated with greater likelihood of concurrent depression,” the researchers write.

The research, published in the Journal of the American Medical Association (JAMA), was led by Dima M. Qato, PharmD, MPH, PhD, at the Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, and also included Katherine Ozenberger, from that same institution, as well as Mark Olfson, a psychiatrist and public health specialist from Columbia University, New York.

Numerous medications include depression and suicidality as a potential side effect, including hormonal contraceptives, beta-blockers, proton pump inhibitors, anti-anxiety medications, and, paradoxically, “antidepressants” themselves.

The researchers found that rates of depression were higher in those taking medications that listed depression as a side effect. They controlled for numerous other factors, including gender, race, age, education level, socioeconomic status, marital status, employment, and multiple medical conditions (e.g., hypertension, cancer, diabetes, and many others).

The authors also controlled for potential confounds and reverse causality by using a statistical method called sensitivity analyses. For instance, the researchers conducted additional analyses to test if removing those who used psychotropic medications would alter the outcome, or if removing those who had hypertension (which is also associated with depression) would alter the outcome. In all of these cases, the association between medication use and depression continued to be statistically significant.

These results indicate that even when removing potential confounding cases (such as other psychotropic drugs, or people with illnesses linked to depression), there was still a link between medication use and the development of depression.

The connection between these drugs and depression were even more powerful for people who took three or more medications that had depression as a side effect. In fact, according to the researchers, about three times as many people who took three or more of these drugs developed depression when compared to those who were not on such medications:

“The estimated prevalence of depression was 15% for those reporting use of 3 or more medications with depression as an adverse effect vs 4.7% for those not using such medications.”

Their finding was not merely due to medication use in general—there was no difference in depression symptoms between those who took no medication and those who took even three medicines that did not have depression as a side effect. Thus, only drugs with depression listed as a side effect were associated with the development of depression.

According to the researchers, some of these medications are available over-the-counter (such as proton pump inhibitors and emergency contraceptives) in the US, and their packaging is often not thorough enough to describe the association of these drugs with depression and suicidality. Thus, consumers may not be aware that the medications they are taking could be responsible for their altered emotional state.

Additionally, the researchers note that calls for screening for depression have expanded considerably—yet screening instruments do not ask about potential medication side effects. Thus, screening for depression may result in someone receiving a diagnosis of depression (and potentially receiving antidepressants) when what is happening is that they are experiencing the side effect of another medication.


Qato, D. M., Ozenberger, K., Olfson, M. (2018). Prevalence of prescription medications with depression as a potential adverse effect among adults in the United States. JAMA, 319(22), 2289-2298. doi:10.1001/jama.2018.6741 (Link)

Thank you Mr Simons and MIA.

Monday, September 17, 2018

Global Climate Action Summit Attendees 'Choked' San Francisco Airport With Their Carbon-Spewing Private Jets

Emily Zanotti
September 17, 2018

A bevy of hotshot activists, celebrity environmentalists, and high-profile political leaders descended on San Francisco last week for the first annual Global Climate Action Summit. But, it seems, not all of them were committed enough to the cause of preventing global warming to use a carbon-friendly means of travel.

The San Francisco Chronicle reports that private jet traffic was up significantly at San Francisco's airports last week, largely because of environmentalist bigwigs jetting into town to meet about how to discuss curbing carbon emissions.

Airport officials claim traffic was up 30% on the private runways at San Francisco International Airport, and that corporate jets "filled the landing area's parking slots" and choked up air traffic.

The Chronicle wasn't specific about who was using the private jets to pop in for the Climate Change conference, but the now-annual event featured a number of environmental A-listers, from Al Gore, to Harrison Ford, to Alec Baldwin and Dave Matthews, all of whom can afford to and choose to fly by themselves rather than find a more eco-friendly way to attend an event dedicated to saving the planet.

Make no mistake: private jets are major carbon emitters. According to The Guardian — far from a "climate denial" publication — "an hour's flight on a private jet will emit more carbon dioxide than most Africans do in a whole year." Given how few passengers ride in a jet at one time, the carbon cost per passenger is extremely high, too. A passenger jet, fully loaded, puts "between 200-300kg of carbon dioxide put into the atmosphere per passenger per hour." A half full Lear Jet gives off "emissions per passenger-hour of 400-600kg of carbon dioxide."

If Al Gore flew in a half-full Lear Jet, he's responsible for the same amount of carbon dioxide as an average American family home creates in about two weeks.

There are "carbon offset" programs for people who like to "fly green," but they're more like buying environmental indulgences rather than really scrubbing out carbon emissions.

The attendees weren't any more carbon conscious on the ground. Once in San Francisco, the New York Times reports, few high-profile attendees took advantage of freely available carbon-neutral ground transportation. An expensive electric shuttle, provided to move attendees between event landmarks, was "nearly empty" all the time. 

Read More: Al Gore Climate Change Environmentalism Harrison Ford

Thank You Ms Zanotti and the Daily Wire.

Trump Gets Behind Senate Bill That Would End Gag Orders Against Pharmacists Sharing Money-Saving Info

Evie Fordham | Politics and Health Care Reporter
President Donald Trump got behind a bill ending pharmacist gag clauses the Senate is set to vote on Monday afternoon.

“Americans deserve to know the lowest drug price at their pharmacy, but ‘gag clauses’ prevent your pharmacist from telling you!” Trump tweeted Monday afternoon about the Patient Right to Know Drug Prices Act. “I support legislation that will remove gag clauses and urge the Senate to act.”
He accompanied the message with the hashtag “#AmericanPatientsFirst.”

Currently, insurers and pharmacy benefit managers use the gag clauses to “forbid pharmacists from proactively telling consumers if their prescription would cost less if they paid for it out-of-pocket rather than using their insurance plan,” according to a press release from Maine Republican Sen. Susan Collins, one of the bill’s authors.
The bill would lead to “a slight decrease in federal revenues,” according to the Congressional Budget Office, but that could be offset by another provision in the bill, reported Politico. Collins’s bill also targets “pay-for-delay,” a tactic where a brand drug company pays a generic manufacturer to withhold a product that would compete with the brand drug for market share. Closing this loophole could save consumers and taxpayers money, according to the Federal Trade Commission.

The bill’s other authors are Republicans Sens. John Barrasso of Wyoming and Bill Cassidy of Louisiana, as well as Democratic Sens. Claire McCaskill of Missouri and Debbie Stabenow of Michigan. (RELATED: StudySeniors Should Think Twice Before Reaching For The Aspirin Bottle)

The Senate has already approved a similar measure that applies to gag clauses as they apply to drugs needed by in Medicare Part D and Medicare Advantage participants, reported the Washington Examiner.

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Tags : donald trump medicare part d susan collins 

Thank You Ms Fordham and the DC.

Two Steps From Hell, Heart of Courage (Extended Version)