Healthcare costs – Medic Buzz Wed, 05 Jan 2022 07:02:15 +0000 en-US hourly 1 Healthcare costs – Medic Buzz 32 32 Indiana legislative leaders aim for ‘out of control’ healthcare prices Wed, 05 Jan 2022 04:58:33 +0000

Todd huston

Key Indiana lawmakers are stepping up pressure on hospitals and health insurers to cut “runaway costs” of health care, saying prices in Indiana are well above the national average and must come down.

Speaker of the House of Representatives Todd Huston and Speaker of the Senate Rodric Bray on Tuesday sent a joint letter to 20 hospital and insurance managers, telling them to submit a plan by April 1 that would reduce the prices of hospitals in Indiana at or below the national average by 2025.

“In the absence of a viable plan, we will have no choice but to pursue legislation aimed at legally reducing prices,” the letter said.

The letter did not say what type of legislation could be drafted to deal with the cost of health care in Indiana. But it signaled that the Indiana General Assembly would not hesitate to venture into one of the most complex and regulated industries in the country, unless the players take sufficient action to bring prices down.

Rodric Bray

The letter pointed out that Indiana’s hospital costs – or the expenses that hospitals charge to cover their overheads and keep the doors open – are the fifth highest in the country, according to a 2020 RAND Corp study. .

The study also found that Indiana ranks sixth nationally for hospital price disparities – ahead of New York City, California, Massachusetts and other larger states with higher cost of living – in how much private insureds pay for care versus what Medicare would pay for care. have paid for the same service.

“The ability of Hoosiers to pay hospital prices that are often 50% or more above the national average is untenable and unfair,” said the letter from Bray and Huston. “To ensure the economic viability of Hoosiers healthcare payers, we need your help in solving this problem.

Several Indianapolis-based hospital systems, including the Indiana University Health and Community Health Network, referred questions Tuesday to the Indiana Hospital Association, a professional group that lobbies on behalf of its members.

Brian Tabor, the association’s president, called Bray and Huston’s letter “disappointing.” He said the RAND study confused health care unit costs with Indiana’s relative health care costs, which he said were in line with neighboring states.

“I think it kind of perpetuates this notion that Indiana is an outlier in health care costs,” Tabor said. “And I don’t think that’s helpful in trying to create a collaborative environment to address affordability.”

He added that several hospital systems have recently taken steps to freeze or lower prices.

Indiana University Health, which charges the highest hospital fees in the Indianapolis area, last month said it was freezing prices until 2025 to help align with national average prices.

Also last month, Parkview Health System in Fort Wayne said it had struck a deal with insurer Anthem Blue Cross and Blue Shield of Indiana to provide more affordable services. According to the RAND study, Parkview was Indiana’s most expensive hospital system.

Details of this deal were not made public. Anthem did not immediately respond to IBJ for comment on the Parkview deal or the letter from Bray and Huston.

But some groups have said hospitals in Indiana are charging excessively high prices, citing numerous studies, including the RAND study. One group, Hoosiers For Affordable Healthcare, says a large chunk of the cost of hospital care is borne by Indiana employees and their workers, holding back the state and hurting the Hoosiers portfolio.

“Please join Hoosiers for Affordable Healthcare in thanking President Huston and President of the Senate Pro Tempore Bray for their leadership in reducing the cost of hospital care for Hoosiers!” The group tweeted on Tuesday.

Huston and Bray’s letter was careful to thank doctors and hospitals in Indiana for their work during the pandemic. But in a press release, Huston, R-Fishers, said he heard from many Hoosiers and employers who are “rightly frustrated and overwhelmed” with the prices of healthcare.

“Now is the time to bring the stakeholders together and craft a plan that would see payers realizing tangible savings,” Huston said in written remarks. “Our goal is to maintain a high quality of care while reducing costs. “

Bray, R-Martinsville, said in a press release that he understands healthcare pricing structures are complicated.

“But that’s no excuse to ignore the problem and let prices rise – at a rate well above inflation – to the detriment of hard-working Hoosiers and business owners.”

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Restore Hyper Wellness secures $ 140 million investment Mon, 03 Jan 2022 05:30:23 +0000

Restore Hyper Wellness, a leading provider of proactive wellness solutions, has landed a $ 140 million investment led by General Atlantic.

WHO: Launched in Austin, Texas, in 2015, Restore Hyper Wellness is an innovative new category of care: Hyper Wellness. Restore provides expert advice and a wide range of cutting-edge wellness modalities integrated under one roof. These modalities include biomarker assessments, intravenous infusion, intramuscular (IM) injections, mild hyperbaric oxygen therapy, whole body and localized cryotherapy, infrared sauna, red light therapy, compression, assisted stretching, HydraFacial and Cryoskin. Restore’s mission is to make Hyper Wellness accessible and affordable so people can do more of what they love to do.

WHY: Roll back plans to leverage the investment to help accelerate its rapid growth. The company, which operates through a franchise model, has 115 locations in 34 states and plans to add more than 100 more in 46 states by the end of next year.

IN THEIR OWN WORDS: “We believe everyone should have access to proactive health modalities that help them feel better, so they can do more of what they love,” said Jim Donnelly, co-founder and CEO of Restore. “We define a new healthcare experience that we describe as efficient, social and transparent. Our prevention-oriented model (compared to the traditional health care model) is still new to many consumers and communities. For this reason, it was important to find an investment partner who has experience in creating new categories. We are excited to partner with General Atlantic because of their solid track record of investing in category-building brands. “

“Jim and Steve are visionary founders who created a comprehensive new model that seamlessly integrates proactive wellness and preventative medicine,” said Shaw Joseph, CEO of General Atlantic. “We look forward to leveraging our experience supporting innovative, high growth companies as we partner with the Restore team to tailor their services to populations of all kinds, from people with chronic pain to athletes. elite.

“The average American life expectancy is 79 years, while the average American life expectancy – the years we live in good health and without disease in general – is only 63 years,” said Steve Welch. , co-founder of Restore. “It means that the last 16 years of the average American’s life is increasingly weakened, unable to do the things they love. Thanks to Restore’s Hyper Wellness model, customers can feel better with every visit. In the long run, we hope to prove that we can help extend the lifespan of our customers, allowing them to continue to live fully while simultaneously reducing system health costs.

“We believe Restore is uniquely positioned to capture a significant share of the high-growth, fragmented and underserved wellness market,” said Lexie Bartlett, director of the Consumer team at General Atlantic. “As consumers take a more proactive approach to managing their health and wellness, the Restore team has developed an integrated multimodal offering to deliver new treatment solutions that can meet their diverse needs.

Jim Donnelly continued, “The democratization of wellness is long overdue. Better outcomes and options shouldn’t be just for the rich. We are very proud to make Restore accessible to all walks of life. In return, our passionate customers have become great brand ambassadors and offer the gift of better well-being when they bring their friends and family to Restore. “


  • General Atlantic has invested $ 140 million in Restore Hyper Wellness, which marks the company’s first foray into the wellness industry.
  • Bloomberg reported that Restore is valued at over $ 500 million.
  • According to Crunchbase, Restore has raised a total of $ 153 million to date.
  • In 2021, the company’s system-wide sales grew 158% and provided over 1.5 million services, following similar year-over-year growth from 2020. By 2022, Restore aims to open a new store every four days, on average.
  • In 2020, Restore sold 241 new franchise locations (289% year-over-year growth). The restoration finished 2020 with 74 locations and will approach 150 open locations by the end of 2021.
  • Piper Sandler & Co. has been the exclusive advisor to Restore.
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Stimulus Control Live Fourth Update: $ 8,000, Child Tax Credit, Medicare, COLA Benefits 2022 … Sat, 01 Jan 2022 13:47:32 +0000

Manchin’s stance sees Goldman Sachs lowering US economic growth forecast

Joe Manchin’s position on the “Build Back Better” bill prompted the investment bank Goldman Sachs lowers forecast for US economic growth. Manchin’s rejection of the bill threatened to scuttle hundreds of billions of dollars in funding for climate change measures and to meet the Biden administration’s climate goals.

Manchin has expressed concern over a number of proposals in Biden’s domestic policy bill, including several climate proposals and the extension of monthly child tax credit payments.

Biden told reporters after Manchin’s rejection that he and the senator were “Will do something” on the legislation.

Manchin’s support is crucial in the Senate chamber where Democrats have the least amount of control and Republicans are united in their opposition to the bill. Senate Majority Leader Chuck Schumer has said the chamber will vote on a package in early 2022.

United States Representative Pramila Jayapal, one of the top Liberal Democrats in the House, asked Biden to continue focusing on social spending legislation and urged him to resort to executive action despite Manchin’s public rejection of the plan.

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Babson graduate Pooja Ika launches eternalHealth, Massachusetts’ first new Medicare Advantage health plan since 2013 Thu, 30 Dec 2021 21:07:00 +0000

BOSTON–(COMMERCIAL THREAD) – eternalHealth, the first new health plan to be approved in Massachusetts since 2013, officially announced the launch of the company, offering high quality and affordable Medicare Advantage plans.

Based in Back Bay in Boston, the company was founded by Babson College graduate Pooja Ika in 2019, who is the CEO. Since then, EternalHealth already has a team of 20 people and has raised $ 10 million from successful entrepreneurs in health and tech. It also caught the eye of Red Sox legend David Ortiz, known as Big Papi. Ortiz has decided to partner with the organization as a Brand Ambassador, stating that he truly believes in the mission of eternalHealth.

“Eighty percent of health care decisions are made by women for their families. However, women remain under-represented in the health sector, ”said Ms. Ika, passionate about health care since her childhood. “Having women at the forefront of our business increases engagement, improves results, and allows us to make more comprehensive decisions about health care for the whole family. ”

Ms. Ika said eternalHealth is committed to being a new kind of plan focused on building lasting relationships with its members.

“At the base, we believe in trust, transparency and integrity with all our partners. This includes our members, health systems, physicians and all other health care delivery partners, ”added Ms. Ika. “We have gone through a legitimate and rigorous verification process by state officials and now we are delighted to say that we are the first new health plan launched in Massachusetts since 2013.”

With its innovative technology-driven platform, eternalHealth dramatically reduces administrative and operating costs across its business. The cost savings allow more money to be spent on actual medical care, while passing the savings on to members with robust yet affordable products. As EternalHealth acquires around 10,000 members, it aims to keep its selling and administrative costs at 8%, which has been a challenge for many Medicare Advantage health plans starting up across the country.

eternalHealth understands the importance of having a member-centric platform. Along with the friendly and helpful customer service reps, members also have access to an easy-to-use portal and app that makes them feel empowered to take charge of their own care. Illustrated by their mission, “Your Forever Partner in Healthcare,” EternalHealth builds unique relationships with all of its members. The company’s commitment and investment in preventive and chronic care management delineates their proactive and non-reactive approach to healthcare. This is supported by members who wish to use consumer-centric tools to better manage their care and well-being.

About eternalHealth

Boston-based eternalHealth provides high-quality care to Massachusetts residents at low cost, while emphasizing preventative care and transparency. Founded, owned and built by women, EternalHealth is a Medicare Advantage health plan that offers HMO and PPO products. For more information on our plans and services, please visit our website at

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]]> Advances in wearable medical devices, now and in the future Wed, 29 Dec 2021 06:04:52 +0000

The size of the global wearable medical device market is expected to grow at a compound annual growth rate of 19.5%, from $ 17.4 billion in 2020 to $ 56.6 billion by 2030, according to a report by Market Watch. The evolution of home care and remote patient monitoring devices, along with the emphasis on wearable devices for fitness and healthy lifestyle purposes, are expected to influence this growth at an increasing rate.

Why wearables, why now?
In an article called Wearable Health Devices – Vital Signs Monitoring, Systems and Technologies, Duarte Dias and João Paulo Silva Cunha, note that “wearable health devices are increasingly helping people to better monitor their health both at the level of activity / fitness for the tracking of health. ‘self-health and medical level providing more data to clinicians with potential for earlier diagnosis and direction of treatment. The technological revolution in the miniaturization of electronic devices enables the design of more reliable and adaptable wearable devices, contributing to a global change in the approach to health surveillance. “

A beneficial function of wearables, as well as implantable devicesis that it is possible to design them as smart devices to deliver digital health data and facilitate telemedicine.

The technological features of wearable devices make it easier for patients and physicians to monitor vital signs, physiological and biochemical parameters, such as glucose levels and physical activities. Additionally, portable drug delivery devices provide a reliable means of drug therapy without requiring administration by trained personnel. These capabilities improve the efficiency of patient diagnostics and therapy, not only providing a better patient experience, but also helping to lower healthcare costs.

The reliance on the data provided by these devices will make it imperative to have a reliable means of collecting data, which in turn drives the demand for biocompatible and implantable material solutions with features such as conductivity, tracing, adhesion and lubricity.

Challenges associated with wearables
Human factors, such as patient comfort, ease of mobility in everyday life, heavy-duty use, and error-free operation to ensure patient safety, are the most significant challenges for portable devices.

From a device designer and manufacturer perspective, these issues translate into new challenges, such as incorporating much smaller devices and more functionality into less space. Risk mitigation takes on new dimensions as there may be no more trained personnel, such as a doctor or nurse, involved in the application of a device. In addition, when designing a portable device, engineers should consider not only the design for functionality and human factors, but also Design for Manufacture (DfM.)

Selection of suitable materials is essential in reducing the risk of tissue irritation, inflammation, infection, and in the worst case scenario, rejection. Silicone is the preferred elastomeric choice thanks to decades of proven results and consistent advancements in antimicrobial and anti-inflammatory solutions in response to demand for wearable devices.

The industry is also making great strides in tackling the trend of reusable rather than single-use devices and components. Reusable garments require materials that prevent bacterial growth and may be able to withstand multiple sterilization routines. Synthetic materials play a major role in medical devices due to their continuous development and innovation to meet increasingly stringent requirements.

At the onset of the COVID-19 pandemic, emergency use authorization accelerated actions in the health and medical industry in the United States. Other countries have taken similar steps to ensure more capacity for products and devices such as masks, gowns, gloves and test kits.

As the industry changed direction, the main challenge with portable drug delivery devices was to ensure that production remained stable, so that people with chronic conditions could continue with their normal treatments at home. Manufacturers of wearable devices have also had to maintain production while part of their workforce was quarantined or their factories temporarily closed.

By mobile smart devices, the need for data protection and patient privacy has added a whole new level of complexity. Device manufacturers struggle to keep up with regulatory requirements and the constant stream of changes, such as by the FDA or through the New Medical Device Regulation (MDR) 2017/745, ISO 13485, in terms of mitigating risk in supply chain, or ISO 10993, in terms of biohazardous devices, or chemical control standards and other regulations. Regulatory oversight is increasing at all levels of manufacturing and across the supply chain for these devices.

Innovations and solutions
Innovations and solutions for wearable devices occur at the technological level of devices, their materials and manufacture. When it comes to device technology, innovations are occurring in telemedicine and patient-centered therapies that collect information to perform data-driven actions for the patient. For example, by relying on sensors, devices collect information and present it to patients, doctors and caregivers so that proactive decisions can be made based on real-time data. In addition, portable devices are moving from purely mechanical to small computers that treat patients wherever they are. In manufacturing, device makers strive to make devices smaller and more complex so that they can solve new challenges. For example, a wide variety of drugs (in powder and liquid form) are incorporated into small, silicone-based delivery devices, which can release the drug directly to the required site with fewer side effects. In addition, companies are looking to make implantable devices more bioabsorbable.

In terms of materials for wearable devices, older technology is used due to the highly regulated nature of the market, the high cost of change, and the adversity of change. This, in turn, creates a need for customization of materials, chemicals and additives to accommodate increasingly specialized applications and increased regulatory compliance. Additionally, we can expect volatile organic matter (VOC) content and lower bioabsorbable materials to make further inroads in wearable and implantable devices.

At the manufacturing level, innovation revolves around the need for customized and robust solutions in individual applications and devices.

Wearable manufacturing is moving in two main directions. The first is to combine several materials and / or components into one. In a portable drug pump, for example, multiple functions and requirements must be integrated into a small space and must meet tolerance constraints. To accomplish this, device designers work with specialty manufacturers to incorporate multi-component Liquid Silicone Rubber (LSR) parts with silicone materials tailored to specific application needs and process requirements.

The second innovation in wearable manufacturing is the micro-sizing of devices. Manufacturers are challenged to come up with new technologies, systems, tools and manufacturing equipment to produce devices and components that can fit in a 5mm³ space, weigh less than 0.02g, or have lower specifications at 0.5 mm.

Set up for success
Many challenges in wearable device development can be overcome by partnering with an experienced medical and healthcare component manufacturer who has expertise in all aspects of engineering from initial concept development to full production. high volume series including prototyping, product and process development, materials selection, processing, tool making, quality, validation planning, scaling and automation.

A manufacturing partner in the medical and healthcare industry must have a robust quality system with clean room facilities and demonstrate good manufacturing practices for the application at hand. Expertise in medical device regulations, such as the US FDA or the European MDR, is fundamental to supporting the device validation process.

With the rise of telemedicine and patient-centered healthcare, the demand for wearable medical devices and their components will continue to increase. Patients and healthcare providers expect wearable devices to be low-restrictive, comfortable, and error-free. Therefore, manufacturers need to focus on making these devices smaller, more efficient, and more rugged. Many challenges associated with manufacturing portable medical devices can be overcome by selecting a partner who understands all aspects of process and materials engineering and has the resources and quality systems to respond to changing market conditions.

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Covid News: White House promises more Covid treatments Sat, 25 Dec 2021 15:19:31 +0000
Credit…Stefani Reynolds for The New York Times

WASHINGTON – The Supreme Court said Wednesday evening it would hold a special hearing next month to assess the legality of two initiatives at the heart of the Biden administration’s efforts to tackle the coronavirus in the workplace.

The court said it would act with exceptional speed on the two measures, a vaccine or testing mandate for large employers and a vaccination requirement for some healthcare workers, setting the stage for arguing on Friday, January 7. The judges were not due to return to the bench until the following Monday.

Both sets of cases were part of what critics call the shadow court case, in which the court rules on emergency requests, sometimes on matters of great importance, without full briefing or argumentation. The court’s decision to hear arguments on the claims may have been a response to growing criticism of the practice.

The more drastic of the two measures, targeting companies with 100 or more employees, would affect more than 84 million workers and is at the heart of the administration’s efforts to fight the pandemic. The administration estimated that the measure would vaccinate 22 million people and avoid 250,000 hospitalizations.

The second measure requires health care workers in hospitals that receive federal money to be vaccinated against the virus. It will “save hundreds if not thousands of lives every month,” the administration wrote in an emergency request.

The Supreme Court has repeatedly upheld state vaccine mandates in various contexts against constitutional challenges. But the new cases are different, because they primarily pose the question of whether Congress authorized the executive branch to institute the requirements.

The answer will depend mainly on the language of the relevant laws, but there is reason to believe that the conservative majority of six judges on the court will be skeptical of the executive branch’s general claims.

The last time the Supreme Court reviewed a Biden administration program to fight the pandemic – a moratorium on evictions – judges shut it down.

“Our system does not allow agencies to act illegally even in the pursuit of desirable ends,” the court said in an unsigned notice in August about the dissent of the three liberal judges.

In a statement released Wednesday evening, the Biden administration pledged to vigorously defend the initiatives.

“Especially since the United States is faced with the highly transmissible variant of Omicron, it is essential to protect workers with vaccination requirements and testing protocols that are urgently needed,” said Jen Psaki. , the White House press secretary, adding: “We have confidence in the legal authority. for both policies.

The vaccination or testing requirement for large employers was issued in November by the Department of Labor’s Occupational Safety and Health Administration, or OSHA.

Employers are allowed to give their workers the option of getting tested every week instead of getting vaccinated, although they are not required to pay for the test. The rule makes an exception for employees who do not come into close contact with other people at their work, such as those who work from home or exclusively outside.

Under a 1970 statute, OSHA has the power to make emergency rules for workplace safety, provided it can demonstrate that workers are exposed to serious danger and that the rule is necessary.

States, businesses and religious groups have challenged the measure in courts of appeals across the country, and a unanimous panel of three judges from the United States Court of Appeals for the Fifth Circuit, in New Orleans, had ruled in favor of some of the challengers, blocking the measure.

Last week, after the challenges were consolidated in the U.S. Sixth Circuit Court of Appeals in Cincinnati, a divided three-judge panel restored the measure.

“The record establishes that Covid-19 continued to spread, mutate, kill and block the safe return of American workers to their jobs,” Majority Judge Jane B. Stranch wrote. “To protect workers, OSHA can and should be able to respond to hazards as they evolve. “

Dissenting, Justice Joan L. Larsen wrote that the administration “likely lacks the authority of Congress” to impose the vaccine or test requirement.

“The mandate is directly aimed at protecting the unvaccinated from their own choices,” she wrote. “Vaccines are available free of charge and unvaccinated people can choose to protect themselves at any time. “

Almost immediately, more than a dozen challengers asked the Supreme Court to block the measure.

The second set of cases the court has agreed to hear relate to the requirement that healthcare workers in hospitals receiving federal money be vaccinated against the coronavirus.

Federal judges in Missouri and Louisiana blocked the requirement, which provides exemptions for people with medical or religious objections, in rulings that apply in about half of the states.

In the 10-state Missouri case, Judge Matthew T. Schelp ruled that the administration exceeded its statutory authority in issuing the requirement and did not follow the proper procedures to do so. A three-judge split panel of the U.S. Court of Appeals for the Eighth Circuit in St. Louis refused to stay the decision while an appeal progressed.

In the Louisiana case, brought by 14 states, Judge Terry A. Doughty blocked the requirement for similar reasons. Calling it a “close appeal,” a panel of three judges from the Fifth Circuit declined to issue a suspension while the administration appealed.

The requirement, Solicitor General Elizabeth B. Prelogar told the court, was underpinned by “both science and common sense.”

“Require healthcare workers at facilities participating in Medicare and Medicaid to be vaccinated,” she wrote, “protects the health and safety of patients in these facilities by reducing their risk of contracting the virus that causes Covid- 19. “

The Supreme Court had previously requested responses to emergency requests in both sets of cases by December 30, suggesting it would issue orders soon after without hearing arguments. His decision to do so followed a roughly similar pattern in challenges to an abortion law in Texas. Here too, the judges scheduled the pleadings according to an exceptionally accelerated schedule.


An earlier version of this article was flawed when the Supreme Court asked for answers to emergency requests in two sets of cases concerning vaccination warrants. The court asked for the answers by December 30, not January 30.

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The cost of being overweight in New Zealand Thu, 23 Dec 2021 16:01:25 +0000

Health Sciences

Being overweight contributes to health problems that cost the country at least $ 2 billion a year – or 8% of our total health care budget – and billions more in economic impacts, but the problem is being carefully ignored by politicians. governments, writes Professor Boyd Swinburn

The latest results from the New Zealand health survey show a substantial increase in the prevalence of obesity among children and adults after plateauing for a decade.

This is very concerning and it makes a new report from the Sapere research group on the economic impact of being overweight in Aotearoa all the more important. The report was commissioned by Hapai Te Hauora and it is a welcome update on the two previous studies I participated in using data from 1991 and 2006.

Over the past three decades, the prevalence of obesity has increased dramatically, as have health care costs and population size, so it is useful to have up-to-date data on the costs of being overweight and overweight. ‘obesity. The main figure, before going into details, is that the direct health costs attributable to overweight and obesity amount to about $ 2 billion per year, which is about eight percent of the total budget of health. successive governments to be carefully ignored.

Cost of illness studies, like this one, have important uses and limitations. They essentially try to monetize the burden of a condition by estimating the health costs that can be attributed to the condition (direct costs), the associated loss of productivity (indirect costs) and the price society would put in the event of death. premature birth, disability or loss of quality of life attributed to the disease (intangible costs). However, these are only estimates and they can have very wide ranges, especially for intangible costs, depending on the methodology used and the assumptions made.

Before turning to each of these types of costs in turn, it is important to note two things. First of all, this report did not build costs from scratch, which the studies on data from 1991 and 2006 did (this is a long and laborious task). Instead, Sapere used a number of different and shorter methods to triangulate a range of plausible estimates for each of the cost types. I think this is perfectly adequate for the purposes of this type of study which essentially attempts to measure the burden of overweight and obesity on society.

The second very important point is that obesity is an unresolved societal problem driven by societal determinants (especially business) that all of society pays for – taxpayers, businesses and especially people living with obesity. The costs identified in this report should be interpreted as costs to the company of a societal problem. Children and adults living with obesity should not be blamed for any economic impact.

Direct costs are the most closely measured types of costs, and the analyzes use population-attributable fractions that estimate the extent to which major obesity-related diseases (in this report, type 2 diabetes, cardiovascular disease, breast and colorectal cancers and osteoarthritis) can be attributed to the excess weight of the population. Diabetes is the most difficult of the consequences of obesity to assess because it leads to many complications (it affects almost every organ in the body) and mechanisms of increased costs (for example, average longer hospital stays for all). admissions) which are not necessarily taken into account in the health data. like hospital discharges. Fortunately, PWC’s recent Type 2 Diabetes Costing Report had already done the heavy lifting to make these estimates.

A recently published 8-country study on the costs of overweight and obesity included Australia and a simple trans-Tasman per capita calculation yielded a very similar result to the $ 2 billion in direct costs per year or 8% of health spending. An OECD report on the cost of overweight and obesity for 52 countries also helped triangulate the estimate of eight percent of the health cost figure for New Zealand. I think we can have good faith in the direct costs of being overweight and note that this level of burden on taxpayers for a preventable condition really warrants more policy action than the current government is giving it.

The best estimates of indirect costs are between $ 7 billion and $ 9 billion per year. The lower estimate comes from the same OECD report and about half of this loss in productivity is due to presenteeism, with a quarter each attributed to absenteeism and lower employment levels. Economic commentators routinely lament New Zealand’s low productivity levels, but we rarely hear about how a healthier workforce can increase productivity.

Intangible costs are the most difficult and controversial costs to estimate because it is about monetizing the value of health and life. The two most common methods involve willingness to pay (estimating how much people would be willing to pay for years of life or for more quality of life or less disability) and break-even points (for example, Pharmac approves of drugs that cost between $ 4,200 and $ 32,300 per grade). adjusted life year gained). Using a variety of these methods, Sapere came up with a range of $ 2 billion to $ 26 billion. This is a wide range, as one would expect, and I would expect it to be closer to the upper figure to be consistent with other intangible cost estimates for studies of the cost of disease. However, although these numbers are the least robust of the cost estimates, they remind us that there is a price to be paid, in terms of shortened life and lower quality of life, by people living with obesity.

Since the arrival of Covid-19, all of this has been onerous for the government, the public, the media, and the health care system, leaving little bandwidth to deal with other pressing, but chronic, issues. Hopefully this new report, along with the latest one on the increasing prevalence of obesity, will serve as a reminder that there is still critical work to be done to convert all of the WHO recommendations on preventing obesity. obesity in children and adults in action.

This article was originally published on the Sciblogs site.

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Covid-19 vaccines save billions of dollars in the U.S. healthcare system Tue, 21 Dec 2021 19:50:08 +0000

Senator Bernie Sanders, in another rant against the biopharmaceutical industry, criticized the makers of Covid-19 vaccines for the “obscene” profits generated by these drugs. Indeed, Pfizer has estimated that its global sales of its Comirnaty vaccine will be $ 36 billion and that of Moderna’s vaccine, Spikevax, should be between $ 15 billion and $ 17 billion. These are extraordinary numbers for these companies. But are they justified?

Bloomberg estimates that as of December 21, 2021, 495 million doses have been administered in the United States out of a total of 8.79 billion doses administered worldwide. In the United States, the Pfizer vaccine is priced at $ 19.50 / dose or $ 39 for the standard two-dose regimen. Moderna’s vaccine costs $ 30 for its two-dose regimen and J&J, which only requires one dose, costs $ 10 / dose. Bloomberg does not provide a breakdown of the percentage of each vaccine that makes up the 495 million doses administered to date in the United States. most of the vaccinations to date. So, using the figure of $ 19.50, the United States will have spent – at most – $ 9.6 billion on Covid-19 vaccines.

What was the benefit of such an expense? The Commonwealth Fund, a private U.S. foundation dedicated to promoting a high-quality health care system, estimated that between December 12, 2020 and November 30, 2021, a total of 1,087,191 deaths were prevented with vaccinations. against Covid-19. Using the estimate, albeit high, of US $ 9.6 billion for Covid-19 vaccine purchases, the United States spent $ 8,880 for every life saved. The health care system regularly spends much more than that to save a life. The cost of a liver transplant exceeds $ 300,000. A basic hip replacement costs $ 40,000. Life-saving gene therapies can cost $ 2.1 million. Certainly, avoiding a death from Covid-19 is worth $ 8,880.

Even more striking figures come from savings in hospital costs. The Commonwealth Fund also estimated that, thanks to Covid-19 vaccines, 10,319,961 hospitalizations were prevented. American News and World Report reported that the average financial cost of hospitalization for a Medicare-insured Covid-19 patient is $ 21,752 / patient. This is the price of a 9 day stay. If the patient is severely infected and requires a ventilator resulting in a longer hospital stay of approximately 17 days, the cost to Medicare is $ 49,441. Even though the lower figure of $ 21,752 is used for argumentation purposes, the Covid-19 vaccines saved the health care system $ 224.5 billion. For example, the US $ 9.6 billion investment in vaccines has saved more than a million lives and nearly a quarter of a TRILLION in hospital costs. Of course, that doesn’t include the huge benefits that vaccinations have brought to the United States in other ways in terms of getting kids back to school, reopening businesses, etc.

Considering these important benefits of Covid-19 vaccines, it is difficult to view revenue from sales of these life-saving products as obscene. But, I guess Senator Sanders, unfortunately, will not agree.

COLUMN OF JOEL MEKLER: Need long-term care? Don’t Expect Medicare to Cover | Lifestyles Mon, 20 Dec 2021 07:00:00 +0000

Don’t fall for one of the biggest myths of all time: that Medicare covers long term care. If you thought Medicare would pay for long term care, like living in a retirement home, you are not alone. Medicare does not and has never covered long term care.

Consider these statistics.

Someone who is 65 today is almost 70 percent likely to need some type of long-term care and support service in their remaining years.

20% of those who reach the age of 65 will need care for more than five years.

About 35% of people who reach the age of 65 are expected to enter a retirement home at least once in their lifetime.

Over 56% of middle-income baby boomers believe Medicare will pay for their long-term care.

Almost 80 percent have no money set aside specifically for their long-term care needs.

According to a 2020 Genworth Cost of Care Survey, the national median annual cost of an assisted living facility is approximately $ 51,000; a whopping $ 105,000 for a private room in a nursing home; and approximately $ 55,000 for home help services.

Long-term care, often referred to as on-call care, is a range of services and supports to meet personal or health needs over an extended period of time. Typically, this is non-medical care provided by unauthorized caregivers.

As it is, Medicare will only cover long-term care if a beneficiary requires qualified services or rehabilitative care under Part A. This includes

Acute hospital care

Qualified nursing care

Palliative care benefits

These benefits are designed to help beneficiaries who are recovering from illness or injury. In order to meet eligibility for long-term care coverage through Medicare, a beneficiary must be hospitalized in an approved hospital for at least three days. From there, they must be admitted to a Medicare-certified nursing facility within 30 days of the hospital patient’s visit. Under the original health insurance, long-term care benefits are capped at 100 days. Once this amount is exceeded, the recipient is responsible for 100 percent of the costs.

In addition, the beneficiary must have a need for physical or occupational therapy as well as a medical condition that requires qualified nursing services. However, it is important to note that coverage is limited and only available for the short term.

As they age, most people prefer to live at home. But if you stay home and need home care for an extended period or permanently, Medicare only pays for it temporarily. For example, Medicare Parts A and B cover part-time or intermittent nursing care (skilled nursing care needed less than seven days a week or less than eight hours a day) for only 21 days.

Medicare does not pay for 24-hour home care, meals delivered to your home, household services such as groceries, cleaning and laundry (when these are the only services needed), or help personal care such as bathing dressing or using the bathroom.


Medicare Advantage plans offer the same coverage as Original Medicare, so they also cover qualified services or rehabilitative care for up to 100 days. However, recent policy changes now allow all Medicare Advantage plans to cover additional health care benefits for “daily maintenance.” These benefits can include assisted living activities, transportation to medical appointments, post-hospital meals, adult day care, home security modifications, to name a few. only a few.

Some plans offer a benefit, others may offer more in a calendar year, and the plan will likely require prior authorization and impose network restrictions. Medicare Advantage plans do not provide benefits for nursing home care or assisted living.

What are the chances that you or a loved one will need long term care services like these at some point in your life?

Rest house

Aid to life

Home care

Household services and chores

It turns out the odds are pretty good. Health care statistics predict that 7 in 10 people who turn 65 this year will need long-term care at some point in their lives. But these treatments can be very expensive. What options are available to help people with long term care costs?


Long-term care insurance will cover or reimburse all or part of the long-term care costs.

Many long term care insurance policies have limits on how long or how much they will pay. These policies can also become expensive over time. Insurance companies may take health concerns into account when determining eligibility for coverage.

The older the applicant, the more likely they will not be eligible. In 2019, almost a third of claimants aged 65 to 69 were denied coverage.

The type of coverage depends on the person’s health, financial situation, age at the time of application and other factors. If you want to consider purchasing a long term care insurance policy, you should consult a professional advisor who is familiar with these policies and the different options.


If long term care insurance is not a viable option for you because of its cost, consider your state’s Medicaid program.

As the primary payer in the United States for long-term and nursing home care, Medicaid is a joint program between the federal and state governments. Each state has its own registration process, qualification criteria and policies.

Generally, Medicaid is more of an option for people with low income and household assets. Having both Medicaid and Medicare should cover most of your long-term care expenses.

If your assets are too high, you will not be eligible for Medicaid. This means that you may have to exhaust your financial resources before you become eligible.


Consumers tend to worry about losing the money they spend on long-term care insurance if they don’t use it.

In recent years, insurance companies have taken steps to allay these concerns. These relatively new products combine life insurance and long-term care insurance. The idea is that the benefits of the policies will always be paid, in life insurance or in long term care. A policyholder can access some or all of the long-term care policy death benefit that meets business requirements. These combination products are still evolving.


Don’t rely on Original Medicare to pay for your long-term care costs.

Some Medicare Advantage plans may offer services and supports, but the benefits may be limited.

The sooner you start learning about long-term care, the different options, and what’s available in your community, the better.

Work with a trusted financial advisor to come up with a plan to cover the costs.

Be sure to carefully read the fine print of any long term care policy that you are considering.

(Joel Mekler is a Certified Senior Advisor. Email your Medicare questions to

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Looking for a new job? 5 benefits to watch out for Sat, 18 Dec 2021 12:00:27 +0000

Put them on your wishlist.

Nowadays, workers are quitting their jobs in droves and looking for better deals. If you’re not happy with your current job, you might be interested in getting a new one that pays better and comes with a schedule that works better for you.

But remember that your salary is only a part of your total compensation. It is also important to look for a job that offers a good package of benefits. In fact, the following benefits were high on the worker priority list in a recent MetLife study, and these are benefits you should be aiming for as well.

1. Health insurance

A good health insurance plan could make medical care easier to obtain and pay for. Some employers fully subsidize workers’ health insurance premiums, while others offer a partial subsidy.

You can also have different choices of packages to choose from. Pay attention to the insurance offered to you when looking for a new job and make sure you are eligible for it when you are hired.

2. A pension plan

It is common for workplaces to offer a 401 (k) plan for retirement savings purposes. If you find a new job that doesn’t offer one, you can still save for your retirement in an IRA. But companies that offer 401 (k) usually match worker contributions to some extent, which translates into free money for your retirement years.

3. Paid leave

Paid time off can be an important part of maintaining your mental and physical health. You might want to look for a company with a generous paid time off policy for things like sickness and maternity / paternity.

4. A health savings account

Some health insurance plans have a deductible high enough to make participants eligible for a Health Savings Account (HSA). An HSA allows you to save money for healthcare in a tax-efficient manner. HSA contributions are made with tax-free dollars. Put $ 1,000 in an HSA and the IRS will not tax $ 1,000 of your income.

HSA funds can also be invested so that they become a larger sum. And these funds never expire, so there is no pressure to use your money before the end of a given calendar year.

5. A flexible expense account

While not all health insurance plans are compatible with an HSA, Flexible Spending Accounts (FSA) are open to anyone with health expenses. Like an HSA, an FSA allows you to set aside pre-tax dollars for medical bills, but unlike an HSA, you must deplete your balance at the end of your plan year or risk losing it. Nonetheless, it is advantageous to use an FSA over a regular savings account for healthcare expenses because of the tax savings alone.

FSAs also include a component for the care of dependents. If you pay for child care, you can set aside pre-tax funds to cover your costs.

You can have a certain salary in mind when looking for a new job. But don’t forget to research the benefits that can save you money, help you achieve different goals, and generally improve your quality of life.

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