Saturday, October 5, 2013

How Much Will Your Life Be Worth Under Obamacare?

Verne Strickland / Blogmaster / October 5, 2013

(Image credit: AFP/Getty Images via @daylife

How much will your life be worth to the federal government under ObamaCare? Less than you might think. We can make an educated guess by looking at which medical screening tests the government U.S. Preventive Services Task Force (USPSTF) considers worthwhile.
The USPSTF made headlines a few years ago when it recommended against annual screening mammograms for women age 40-49 (but rather starting at age 50). This was a departure from long-standing guidelines from the American Cancer Society and the American College of Radiology recommending mammography beginning at age 40.

Under ObamaCare, Medicare and private insurers will be required to cover preventive services with a USPSTF “A” or “B” rating, but not those with lower ratings. Hence, the USPSTF recommendations are not just academic — they will have real teeth.
With respect to breast cancer, the USPSTF argued that the risk of cancer for women age 40-49 was too small to justify routine screening, using “the number needed to screen to save one life” as a key metric.
As the American Cancer Society observed,

The USPSTF says that screening 1,339 women in their 50s to save one life makes screening worthwhile in that age group. Yet USPSTF also says screening 1,904 women ages 40 to 49 in order to save one life is not worthwhile… With its new recommendations, the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them.

Although the USPSTF does not directly consider the costs of screening tests when formulating its recommendations, those recommendations can also be analyzed in economic terms. The average cost of a mammogram is roughly $100. Hence, the federal government considers it appropriate to spend $134,000 on screening mammography to save a single woman — but not $190,000. So in a sense, this is a measure of the price the government is setting on her life. (Under pressure, Secretary of Health Sebelius later backpedalled from those guidelines, declaring them non-binding.)
What about men’s lives? The USPSTF has given a “D” rating (“not recommended”) for prostate cancer screening with the PSA blood test, arguing insufficient benefit. According to the Mayo Clinic, a major study showed that, “to save one life after eight years, nearly 1,400 men needed to be screened.” A PSA test costs roughly $60 – $80. Assuming a screening interval of 4 years, this means that the government recommends against spending $168,000 – $224,000 on PSA testing to save the life of one man.
More recently, the USPSTF approved low dose screening CT scans for detecting early lung cancer in smokers. This test will save one life for every 320 people screened. At a cost of roughly $250 – $400 per scan, this works out to $80,000 – $128,000 per life saved.
Hence, the USPSTF has approved screening tests worth roughly $100,000 per life saved, but not tests costing roughly $200,000.
Of course, the cost of the initial screening test is not the only relevant factor. With all such tests, patients and doctors must also weigh the risk of an undetected cancer vs. the risk of a false positive result (and associated risks of potentially unnecessary additional tests and treatments). Hence, the USPSTF estimates a much higher “$5,277,308 to prevent 1 prostate cancer death” with PSA screening, based on costs of treating patients who initially test positive but ultimately prove not to have a fatal cancer, rejecting that as “not high-value care.”
It is instructive to compare the $200,000 (or $5,300,000) figures with values that other branches of the federal government place on a human life. Regulatory agencies such as the EPA routinely utilize a figure called the “Value of a Statistical Life” (VSL) when conducting cost-benefit analyses of policies that affect public health. In 2011, the New York Times reported that the EPA set the VSL value at $9.1 million and the FDA at $7.9 million.
Those who favor more regulation prefer a higher VSL, because it allows them to impose more expensive mandates on businesses while still claiming that the benefits outweigh the costs. Conversely, when the Bush Administration in 2008 dropped the EPA VSL from $7.8 million to $6.9 million, many on the political left were outraged, viewing it a backdoor method to gut environmental regulations. Imagine the outcry if the Bush administration had attempted to set the VSL at a mere $5,300,000 (let alone $200,000).
My point is not that the federal government should set a higher dollar value on a patient’s life under ObamaCare. Rather, the government should not be setting any such value at all, whether it’s $200,000, $5 million, or $20 million.
Patients (in consultation with their doctors) should be free to decide for themselves whether a medical test or treatment is worth it to them, based on their specific personal and economic circumstances. Just as the government should not (and cannot) decide who you should marry, where you should live, or what job you should accept, it should not make such highly personal medical choices for you.
Rather than the USPSTF “one size fits all” approach, the American Urological Association properly recommends a more nuanced approach towards prostate cancer screening based on a patient’s family history, race/ethnicity, and individual tolerance for cancer risk. According to the AUA, men aged 55 to 69 “should talk to their doctors about the risks and benefits of PSA screening and make a decision based on their personal values and preferences.”

Even President Obama’s own doctor adopted this more nuanced approach. When President Obama turned 50, he made an “informed patient request” for a PSA test and received it, even though this violated the guidelines set by his own federal task force. If it’s wrong for patients to undergo routine PSA testing, then that meant the President’s doctor was acting irresponsibly. Conversely, if it was right for the President (in consultation with this doctor) to override USPSTF guidelines and tailor his medical care to his individual preferences, then you too should enjoy that same freedom.
Most proposed systems of free-market health reform enable patients to decide how best to spend their own medical dollars through mechanisms such as Health Savings Accounts. In contrast, ObamaCare imposes numerous restrictions on what health insurance individuals must purchase, what services insurers must include, how doctors and hospitals can be paid, and how physicians should practice.
When the government controls how medical dollars may be spent, it in effect sets the price of a human life. The USPSTF guidelines have given us a hint of what that price will be. Under ObamaCare, you’d better hope that this price at least keeps up with inflation.

Friday, October 4, 2013

Bachmann: Congress should do whatever it takes to stop Affordable Care Act -- "Obamacare"

Verne Strickland / Blogmaster / September, 2013

Michele Bachmann is urging Congress to do whatever it takes to stop Patient Protection Act Affordable Care Act aka Obamacare.

She makes the following observations about it:

Almost every one of President Barack Hussein Obama’s promises about Obamacare has turned out to be false. President Barack Hussein Obama has lied about abortion not being funded under Obamacare. No one should hand over any private information to the health-care exchanges and the federal data hub. The HHS admits there is no way to prevent Obamacare fraud. People are not trusting the government after the NSA lies and abuse of private information.

People don't believe the government Obamacare files can be hacked but they are easily accessible even by amateur computer users. The government isn't even trying to use high level cyber security to protect Americans’ private healthcare information contained in the Obamacare system servers. You can't trust the people running the heath-care exchanges because they have neither been vetted for security clearance nor necessary healthcare experience, licenses, and certifications.

The people running the health-care exchanges obviously are neither properly trained pertaining to healthcare information protocols nor trained in data security measures. The people running Obamacare are completely unprepared to go forward because they are shovel ready, rank amateurs, and off the street temporary employees. They're making the decision to move forward based upon politics not healthcare credentials. President Barack Hussein Obama arrogantly gives speeches where he clearly says he is more concerned with saving face than keeping our health-care data secure.

10 minutes ago

I believe Obama is a blatant self admitted fraud. But it has nothing to do with Obama's birth. Obama’s critics have it all backwards. They are looking in the wrong place. Obama isn't a foreigner portraying himself as an American. Obama’s an American who fraudulently portrayed himself as a foreigner to receive special status afforded to foreigners to the USA.

By Obama's own admission he was a poor student who smoked pot, rarely attended class, and got mediocre grades, from Occidental (a good but not great college). Obama's only chance of transferring into Columbia was a made-up story of being an exotic foreigner. It’s pretty clear how Obama got into Columbia, and I believe it was by lying.

Obama was a smart kid, even then gave “great interviews,” and talked (lied) his way into Columbia University as an Indonesian student, using his Jakarta grade school transcripts (and perhaps Passport/citizenship papers) as fake representation of papers of proof. Columbia University probably asked very few questions.

Columbia University admissions officers were thrilled to have an Indonesian student to brag about. Columbia University got what they wanted – “diversity.”

Tuesday, October 1, 2013

Global study: World not ready for aging population, says U.N. (whatever that is.)

KRISTEN GELINEAU September 30, 2013 11:07 PM

The world is aging so fast that most countries are not prepared to support their swelling numbers of elderly people, according to a global study being issued Tuesday by the United Nations and an elder rights group.
The report ranks the social and economic well-being of elders in 91 countries, with Sweden coming out on top and Afghanistan at the bottom. It reflects what advocates for the old have been warning, with increasing urgency, for years: Nations are simply not working quickly enough to cope with a population graying faster than ever before. By the year 2050, for the first time in history, seniors older than 60 will outnumber children younger than 15.
Truong Tien Thao, who runs a small tea shop on the sidewalk near his home in Hanoi, Vietnam, is 65 and acutely aware that he, like millions of others, is plunging into old age without a safety net. He wishes he could retire, but he and his 61-year-old wife depend on the $50 a month they earn from the shop. And so every day, Thao rises early to open the stall at 6 a.m. and works until 2 p.m., when his wife takes over until closing.
"People at my age should have a rest, but I still have to work to make our ends meet," he says, while waiting for customers at the shop, which sells green tea, cigarettes and chewing gum. "My wife and I have no pension, no health insurance. I'm scared of thinking of being sick — I don't know how I can pay for the medical care."
Thao's story reflects a key point in the report, which was released early to The Associated Press: Aging is an issue across the world. Perhaps surprisingly, the report shows that the fastest aging countries are developing ones, such as Jordan, Laos, Mongolia, Nicaragua and Vietnam, where the number of older people will more than triple by 2050. All ranked in the bottom half of the index.
The Global AgeWatch Index (www.globalagewatch.org) was created by elder advocacy group HelpAge International and the U.N. Population Fund in part to address a lack of international data on the extent and impact of global aging. The index, released on the U.N.'s International Day of Older Persons, compiles data from the U.N., World Health Organization, World Bank and other global agencies, and analyzes income, health, education, employment and age-friendly environment in each country.
The index was welcomed by elder rights advocates, who have long complained that a lack of data has thwarted their attempts to raise the issue on government agendas.
"Unless you measure something, it doesn't really exist in the minds of decision-makers," said John Beard, Director of Ageing and Life Course for the World Health Organization. "One of the challenges for population aging is that we don't even collect the data, let alone start to analyze it. ... For example, we've been talking about how people are living longer, but I can't tell you people are living longer and sicker, or longer in good health."
The report fits into an increasingly complex picture of aging and what it means to the world. On the one hand, the fact that people are living longer is a testament to advances in health care and nutrition, and advocates emphasize that the elderly should be seen not as a burden but as a resource. On the other, many countries still lack a basic social protection floor that provides income, health care and housing for their senior citizens.
Afghanistan, for example, offers no pension to those not in the government. Life expectancy is 59 years for men and 61 for women, compared to a global average of 68 for men and 72 for women, according to U.N. data.
That leaves Abdul Wasay struggling to survive. At 75, the former cook and blacksmith spends most of his day trying to sell toothbrushes and toothpaste on a busy street corner in Kabul's main market. The job nets him just $6 a day — barely enough to support his wife. He can only afford to buy meat twice a month; the family relies mainly on potatoes and curried vegetables.
"It's difficult because my knees are weak and I can't really stand for a long time," he says. "But what can I do? It's even harder in winter, but I can't afford treatment."
Although government hospitals are free, Wasay complains that they provide little treatment and hardly any medicine. He wants to stop working in three years, but is not sure his children can support him. He says many older people cannot find work because they are not strong enough to do day labor, and some resort to begging.
"You have to keep working no matter how old you are — no one is rich enough to stop," he says. "Life is very difficult."
Many governments have resisted tackling the issue partly because it is viewed as hugely complicated, negative and costly — which is not necessarily true, says Silvia Stefanoni, chief executive of HelpAge International. Japan and Germany, she says, have among the highest proportions of elders in the world, but also boast steady economies.
"There's no evidence that an aging population is a population that is economically damaged," she says.
Prosperity in itself does not guarantee protection for the old. The world's rising economic powers — the so-called BRICS nations of Brazil, Russia, India, China and South Africa — rank lower in the index than some poorer countries such as Uruguay and Panama.
However, the report found, wealthy nations are in general better prepared for aging than poorer ones. Sweden, where the pension system is now 100 years old, makes the top of the list because of its social support, education and health coverage, followed by Norway, Germany, the Netherlands and Canada. The United States comes in eighth.
Sweden's health system earns praise from Marianne Blomberg, an 80-year-old Stockholm resident.
"The health care system, for me, has worked extraordinarily well," she says. "I suffer from atrial fibrillation and from the minute I call emergency until I am discharged, it is absolutely amazing. I can't complain about anything — even the food is good."
Still, even in an elder-friendly country like Sweden, aging is not without its challenges. The Swedish government has suggested people continue working beyond 65, a prospect Blomberg cautiously welcomes but warns should not be a requirement. Blomberg also criticized the nation's finance minister, Anders Borg, for cutting taxes sharply for working Swedes but only marginally for retirees.
"I go to lectures and museums and the theater and those kinds of things, but I probably have to stop that soon because it gets terribly expensive," she says. "If you want to be active like me, it is hard. But to sit home and stare at the walls doesn't cost anything."
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Associated Press writers Malin Rising in Stockholm, Tran Van Minh in Hanoi, Vietnam, and Amir Shah in Kabul contributed to this report.

Sunday, September 29, 2013

Verne Strickland Blogmaster / September 29, 2013

Netanyahu: Don't Be Fooled By Iran's 'Smiley Campaign'

By JOSEF FEDERMAN 09/29/13 04:34 PM ET EDT

JERUSALEM — Mortified that the world may be warming up to Iran, Israeli Prime Minister Benjamin Netanyahu is taking an unpopular message to the White House and the United Nations this week: Don't be fooled by Tehran's new leadership.
Netanyahu contends Iran is using conciliatory gestures as a smoke screen to conceal an unabated march toward a nuclear bomb.
He will deliver those strong words of caution – and fresh intelligence – in an attempt to persuade the U.S. to maintain tough economic sanctions and not allow the Islamic republic to develop a bomb or even move closer to becoming a nuclear threshold state.
With the White House cautiously optimistic about its dialogue with Iran, Monday's meeting between Netanyahu and President Barack Obama could be tense.
"I will tell the truth in the face of the sweet talk and the onslaught of smiles," Netanyahu said before boarding his flight to the U.S. on Sunday. "Telling the truth today is vital for the security and peace of the world and, of course, it is vital for the security of the state of Israel."
Israeli leaders watched with great dismay what they derisively call the "smiley campaign" by Iran's new president, Hassan Rouhani, last week. Rouhani delivered a conciliatory speech at the United Nations in which he repeated Iran's official position that it has no intention of building a nuclear weapon and declared his readiness for new negotiations with the West.
Capping off the visit, Rouhani and Obama held a 15-minute phone call as the Iranian leader was traveling to the airport. By the end of the call, the first conversation between the nation's leaders in 34 years, Obama was suggesting that a breakthrough on the nuclear issue could portend even deeper ties between the U.S. and Iran. U.S. and European diplomats hailed a "very significant shift" in Iran's attitude and tone.
For Netanyahu, such sentiments are nothing short of a nightmare.
For years, he has warned that Iran is steadily marching toward development of nuclear weapons, an assessment that is widely shared by the West because of Iran's continued enrichment of uranium and its run-ins with international nuclear inspectors.
The Israeli prime minister contends Rouhani's outreach is a ploy to ease international sanctions and buy time. Iran says its nuclear program is for peaceful purposes only.
Israel considers a nuclear-armed Iran an unacceptable threat, given repeated Iranian assertions that the Jewish state should not exist. Israel has a long list of other grievances against Iran, citing its support for hostile Arab militant groups, its development of long-range missiles and alleged Iranian involvement in attacks on Israeli targets in Europe and Asia.
On Sunday, Israel announced the arrest of a Belgian-Iranian businessman on espionage charges.
Netanyahu says the new Iranian leader must be judged on his actions, not his words. In the meantime, he says sanctions and other international pressure, including the threat of military action, must be increased. He has likened Iran to North Korea, which used the guise of international negotiations to secretly develop a nuclear weapon.
Netanyahu appears to enjoy widespread domestic support for his tough approach. Israel's Channel 10 TV released the results of a poll Sunday night showing that 78 percent of respondents don't believe Iran wants to resolve the nuclear problem. Fifty-nine percent said they do not think the U.S. will reach an agreement with Iran, while just 29 percent said they expect a resolution. The station did not say how many people were questioned or provide a margin of error.
Zalman Shoval, a former Israeli ambassador to the U.S. who now serves as an adviser to Netanyahu, said the prime minister would present Obama with "some very hard facts" based on intelligence showing that Iranian behavior has not changed.
Similarly, in his speech at the U.N., "he will make it very clear that Israel and the world at large should continue to be on guard," he said.
Over the years, Israel has issued shifting assessments of how close Iran is to producing a weapon. Last year, Netanyahu presented a cartoon diagram to the U.N. showing that Iran would enter the final phase of weapons production by mid-2013. Israel has since backed off that assessment.
Netanyahu's intelligence minister, Yuval Steinitz, said international pressure forced Iran to slow production.
While American officials are well aware of Israel's concerns, they say there are no plans to reverse the latest diplomatic push.
Two senior Obama administration officials said that the U.S. expects Israel to be skeptical about Iran's overture, and that the U.S. is similarly skeptical.
Obama will try to convince Netanyahu that the U.S. won't consider lifting sanctions until Iran takes concrete actions to show it is serious about a verifiable, transparent agreement, said the officials, who spoke on condition of anonymity because they were not authorized to discuss the matter with the media.
Obama will also seek to assure his Israeli counterpart that if the U.S. reaches a deal with Iran, it will ultimately advance Israel's security interests by resolving the nuclear issue without the need for military intervention.
Obama's bottom line remains that Iran can't be allowed to develop a nuclear weapon, the officials said.
Israel, though, wants the U.S. to establish clear "red lines" to prevent Iran from pressing forward with its nuclear program and moving toward threshold status – having the capability to build a nuclear weapon without actually possessing one. That scenario is unacceptable to Israel.
Netanyahu has laid out four demands: that Iran stop enriching uranium; that its stockpiles of enriched uranium be removed from the country; that a fortified underground enrichment facility be closed; and that Iran not make plutonium, another possible path toward nuclear weapons.
Eytan Gilboa, an expert on U.S.-Israel relations at Israel's Bar-Ilan University, predicted a "very difficult conversation" on Monday.
The Americans "like Rouhani. They think he represents a new policy, a new approach and therefore should be given at least a chance. Netanyahu's strategy is to say that this whole thing is a big hoax," Gilboa said. "There are no buyers for his message."
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Associated Press writer Josh Lederman in Washington contributed to this report.