Researchers Call into Question Marijuana's Ability to Treat Alzheimers

Past studies have indicated that low levels of marijuana's “active ingredient,” THC, could help prevent the accumulation of Amyloid plaques in the brain, and even stimulate brain cell growth.

A new study by Canadian researchers comes to a different conclusion. Using mice that carry a human genetic mutation that causes Alzheimer's disease, researchers studied the effects of HU210, a synthetic version of marijuana-derived compounds.

Mice treated with HU210 did not perform better than untreated mice on memory tests, according to the report. Furthermore, mice given higher doses of the synthetic compound had fewer brain cells than other mouse cohorts. The synthetic compound doesn't appear to have any beneficial effects on mice with Alzheimer's, according to the researchers.

The study appears in the current issue of the journal Current Alzheimer Research.

Now that is a buzz kill.

Anthem Responds to Sebelius on Rates

Here is the response that Anthem sent to me in reaction to HHS secretary's Sebelius's letter.

Anthem Blue Cross Regarding Letter from Secretary of Health and Human Services

February 8, 2010

Anthem Blue Cross in California has received the letter from Secretary Sebelius. We will reply to her promptly. It is important to note that individual medical insurance premiums do not reflect an individual member's personal claims experience. Therefore, as medical costs increase across our member population, premium increases to the entire membership pool result. Unfortunately, in the weak economy many people who do not have health conditions are foregoing buying insurance. This leaves fewer people, often with significantly greater medical needs, in the insured pool. We regret the impact this has on our members. It highlights, why we need sustainable health care reform to manage the steadily rising costs of hospitals, drugs and doctors . As such, it is important to go back to the beginning and get health care reform done right. At the same time, we are engaging with a broad range of key stakeholders across California to discuss the state's individual insurance market and share ideas on how we can collectively partner on meaningful change.

Anthem Blue Cross

Rate Adjustments

We understand and strongly share our members’ concerns over the rising cost of health care services and the corresponding adverse impact on insurance premiums. Unfortunately, the individual market premiums are merely the symptoms of a larger underlying problem in California’s individual market - rising health care costs. The increasing demand for medical services, the use of new prescription drugs, and demand for advanced technologies are driving up the cost of health care at an unprecedented rate. Anthem is investing in many initiatives to reduce the cost of care, promoting wellness and preventive care for our members and communities, as well as, working with providers to encourage high-quality, evidence-based care, which costs less over time. In addition, our health plans offer members significant discounts through access to a large network of health care providers across the country. These efforts, however, cannot completely offset all the increases linked to the cost of care. The pricing structure of our individual products is a reflection of the medical risks and costs associated with this market. As the cost of care increases, premiums rise accordingly.

Anthem regularly evaluates its rate structure to make sure that the cost of claims incurred is offset by the premiums collected, and that we anticipate the cost of future, expected claims. At times, based on the cost of covering benefits, rates may be either raised or lowered. To assist members who are looking to explore alternative plan options, Anthem offers a team of licensed Health Plan Advisors. These advisors are dedicated to assisting members in finding solutions to meet the balance between their coverage needs and their budget, especially in these challenging economic times.

Regarding how often an adjustment is made to a member’s rates:

Anthem complies with all state regulations regarding rate increases and depending on the plan, we are required to provide members with a 30 day notice of any rate adjustment.

It is important to note that premiums are expensive because the underlying health care costs are expensive. Anthem offers a variety of health benefit plans, and we are dedicated to working with our members to find health coverage plans that are the most appropriate, and affordable for their needs. We are more than happy to take a look at a member’s health benefit plan and review possible options to more closely meet the member’s current needs. This may include moving to a lower priced plan.

We are determined to support quality care for our members, we share their concerns about the upward rise in premiums and must adjust our rates as needed to cover the costs and risks associated with providing quality health care for all of our individual members.

I believe that the truth is in the middle somewhere. But Anthem makes some good points and points that I have written about in the past.

First, the insured patient also is paying for the uninsured patient. Hospitals rely on higher payments from traditional insurers to offset what they say are inadequate payments from Medicaid and less than satisfactory payments from Medicare. They count on higher payments from insurers like Anthem to help offset lower payments and to pay for the increasing amount of uninsured patients walking through their emergency departments where they must treat them. People are delaying care because they have no insurance and are therefore sicker when they need it. That drives up costs. Then you add to the fact what Anthem states - that the healthcare experience (that is a term HR professionals use) for the insured population becomes the basis for premiums. With the healthy opting out of insurance and the sicker staying in, the claims experience (read healthcare costs) will be higher and that is spread among everyone. So I may be in great shape and take care of myself but my obese colleague who smokes and is on my health plan as well uses more resources that I pay for in the end.

I also want to call your attention to this line from their statement: The increasing demand for medical services, the use of new prescription drugs, and demand for advanced technologies are driving up the cost of health care at an unprecedented rate.

I totally agree with this. We have become a society that demands the best. Worse we have become a society that says hey why take care of myself when their will be a drug, a device or a cure for what ails me. So we as individuals are responsible for this as well.

I applaud all the wellness efforts too but frankly there is only a fraction of people taking advantage of them.

That is why reform is not addressing some very systemic issues raised here before.

But I would also suspect that the amount cited by HHS may not be the amount that Anthem actually experiences from all of these converging forces. After all there is a strong profit story that HHS spells out and insurers are in business to make a profit.

This is so much more complicated than is being put forth in health care reform. My fear is that watered-down legislation that does not address systemic issues is going to be railroaded through in the end.

Sebelius Calls on Anthem Blue Cross to Justify 39% Premium Increase

I am not one to be a mouthpiece for the government but this caught my eye and seemed appropriate to pass on. I would be glad to blog about Anthem's response to this and do not profess that I have dug through the facts to know if HHS's figures are accurate though I would imagine they came from publicly available materials from Wellpoint.

Department of Health and Human Services Secretary Kathleen Sebelius today sent a letter to Anthem Blue Cross and called on the company to publicly justify its decision to raise premiums for its California customers. Here follows the letter:

February 8, 2010

Leslie Margolin
President, Anthem Blue Cross
Delivered Via Fax

Dear Ms. Margolin,

One of the biggest pressures facing families, businesses and governments at every level are skyrocketing health insurance costs. With so many families already affected by rising costs, I was very disturbed to learn through media accounts that Anthem Blue Cross plans to raise premiums for its California customers by as much as 39 percent. These extraordinary increases are up to 15 times faster than inflation and threaten to make health care unaffordable for hundreds of thousands of Californians, many of whom are already struggling to make ends meet in a difficult economy.

Your company's strong financial position makes these rate increases even more difficult to understand. As you know, your parent company, WellPoint Incorporated, has seen its profits soar, earning $2.7 billion in the last quarter of 2009 alone.

I believe Anthem Blue Cross has a responsibility to provide a detailed justification for these rate increases to the public. Additionally, you should make public information on the percent of your individual market premiums that is used for medical care versus the percent that is used for administrative costs. Policy holders in the individual market deserve to know if their premium increases would be invested in better medical care or insurance company overhead costs like salaries, profits, and advertising. I am aware that the State of California is investigating this matter, and urge Anthem Blue Cross to cooperate fully. In the meantime, I will be closely monitoring the situation.

At a time when health care costs are a critical threat to families as well as the nation's economy, I hope you appreciate the urgent nature of this request. I look forward to your prompt reply.
Sincerely,

Kathleen Sebelius

Secretary of Health and Human Services

Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

How to Deal with Health Care Ratings

Read our guest post in MDS Central.

Is Aging Healthy Out of Our Control?

Scientists have discovered genetic variations that could explain why some people seem to age faster than others perhaps suggesting that healthy aging may be somewhat out of our control. The researchers analyzed more than 500,000 genetic variations in search of those linked to aging. According to study co-leader Dr. Nilesh Samani, there are two forms of aging: chronological (based on how old something actually is in years, months, day) and biological (in which cells of some people are older or younger than their chronological age).

"There is accumulating evidence that the risk of age-associated diseases, including heart disease and some types of cancers, are more closely related to biological rather than chronological age," Samani said in a news release from the University of Leicester and King's College London.

Study co-leader Dr. Tim Spector said in the release that "what our study suggests is that some people are genetically programmed to age at a faster rate."

Due to their genes, he said, some people may age even faster when exposed to things "like smoking, obesity or lack of exercise, and end up several years biologically older or succumbing to more age-related diseases."

This is all fine and good if you actually know how your genes stack up and those genetic tests are not necessarily available or affordable. So err on the safe side. Take care of yourself so that your cells don't have a conniption!

Why Steve Jobs Should Run Healthcare!

New terms are being bantered about in healthcare. One is the accountable care organization. The idea is that a group of providers - primary care physicians, specialists, hospitals - would come together and be responsible for the cost and quality of care for a given population. In theory, and in talking with some hospital administrators, this organization could spread to include nursing and assisted living facilities, after all they are part of the continuum. So how do you make that happen with so many disparate parties, agendas and politics. Take a few lessons from Apple CEO Steve Jobs.

Let's Build Better Boards of Directors

Read our guest post in McKnight's Long Term Care News and Assisted Living.