Sunday, May 16, 2010

Small business insurance and healthcare reform

Well, for better or worse, the healthcare bill has been signed into law. There is no immediate benefit in being angry. There are a number of legal actions started by various Attorneys General alleging that the reforms are unconstitutional. Even if some of these cases succeed on the issue of mandatory insurance for private individuals, this will not necessarily strike down the whole bill. The likelihood is we will be left with all the provisions dealing with small businesses. Keeping it real, we have to start planning for the future on the law as it is. The good news is that the main raft of provisions will not become active until 2014. This gives the lawmakers plenty of time to have second thoughts. Just as important, there are sets of regulations to be written clarifying the detail of how some of the new features are to work at state level. However, this is an outline of what we can expect.

The states are to establish SHOP exchanges where small businesses can group together and buy insurance. For these purposes, until 2016, a business is considered small when it has no more than 50 employees, with states having the option of increasing the limit to 100 employees. To calculate numbers, you pro-rate the full- and part-time employees. Independent analysts predict group premiums will drop no more than 4%, while the value of the cover will rise by up to 3%. To bridge until the exchanges are operating, a tax credit system will come into force. If your business has less than ten employees with an average annual pay of less than $25,000, the credit is 35% of the health plan cost. There are partial credits where the number of employees is less than 25 and their average annual pay is less than $50,000. When the exchanges start, the credit increases to 50% for the first two years.

With immediate effect, there are a ban on terms designed to cap the value of claims, and limits on the right of insurers to cancel policies except in cases where actual fraud can be proved. As from 2014, the insurers must accept all employees without regard to pre-existing conditions. Their calculation of premium rates can only be based on location, age and whether an individual smokes. As from 2014, small businesses with more than 50 employees will be required to provide a health plan or pay an annual penalty of $750 for every full-time employee denied cover. This can rise to $2,000 if coverage is still denied.

So, tomorrow, you will be going out into the same market as before the reform bill became law. Finding cost-effective small business insurance will continue to be a struggle. Indeed, many insurers may increase premiums now so that, when the SHOP exchanges do come into force, they have a margin to play with to deal with the competition. However, when you buy, check that the new terms on the total value claimable and restrictions on the right to cancel have been introduced. If you buy your small business insurance through an agent, ask direct questions. It saves time fighting over whether wording is unlawful later on.

Propecia keeps your hair thick and plentiful

When you are young, it's easy to walk around as if nothing can ever go wrong in your life. Although you had acne for a few months as a teen, you got through that. Now the rest of your life is going to be smooth sailing. So what if there are a few extra hairs in your comb or caught in the drain after you finish your shower. This is nothing to worry about. Except the sad reality is that anyone, no matter what their age or gender, can lose their hair. It can be heredity, caused by some underlying medical condition, a side effect of a drug you are taking. The list goes on. Unless you are taking preventative measures to reduce the risk of hair loss, you need guidance on when to seek a formal diagnosis. Too early and you wasted your money because your doctor could find nothing wrong. Too late and there's little chance of any treatment helping the hair to regrow. For the record, male pattern baldness can begin during your teens and this is permanent hair loss. Why permanent? Because the growth cycle shortens and every time you shed your hair, it grows back thinner and more likely to fall out. As this speeds up, your hair stops regrowing and there's no cure.

This is what to think about. At some point, you will notice more hair than usual is falling out. Make a note of the date. If possible, get someone in the family or a friend to take pictures of your head so you can monitor any changes to the shape of the hair. Then watch what happens. Is the loss only occasional or is it continuous? If you have good days and bad days, think about what you eat and what you did. Is there a cause and effect at work? In particular, look for anything that might make the loss worse. Now look around the family. If you are cut off from most of your relatives, ask if there is any history of hair loss on either side of the family.

This gives you enough information about the emerging physical pattern and the rate of loss to share with your doctor. There will be a physical examination of your scalp to judge the appearance of your hair, e.g. whether any hairs are broken off. There is usually a pull test to see how many come out, and skin samples taken to eliminate the possibility of an infection. There will also be a review of your medical history and general wellness to identify any underlying problems such as thyroid disease that may be causing the loss. If this is simple male pattern baldness, the standard treatment is generic propecia. This is taken once-daily and, over time, slows loss and encourages some regrowth. The benefits are lost and hair loss will resume if you stop taking generic propecia. Some commitment to continuing treatment is necessary. More generally, there are preventative measures in changing the way you handle your hair and modifying your diet. Your doctor or dermatologist will advise on how to minimize the effects of hair loss.

Wednesday, May 12, 2010

Finding cheap health insurance is now easier

Well, after all the excitement and the best efforts of the GOP to say "No" loud and long enough to make a difference, the President signed the healthcare reform into law. The partisans are now into the equally exciting game of trying to decide whether this is the greatest victory since Abraham Lincoln, with a little help from General Ulysses S. Grant, won the Civil War or the greatest disaster since Hurricane Katrina reminded us Nature can be devastating. Allowing for the fact this is a complicated piece of legislation, this is a little difficult to predict because so much of it is not designed to take effect for years. Calling for immediate repeal does not seem helpful when no one can say how the future will turn out. As time passes and we dig ourselves out of the recession, it is entirely possible this may turn out to have been a good "thing" on balance. If "things" do not look quite as good, a little tinkering may set matters to right. History has a way of judging "things" rather differently than we expect. This leaves us with the next twelve months during which there are elections and an opportunity for voters to have their say. What is due to happen and will this make the reform look good enough to keep?

1. There will be a payment of $250 to people in Medicare. This is designed to close the Part D donut hole. In 2011, there will be a 50% discount on the branded drugs in the hole with the hole closing by 2020.
2. Starting on January 1, 2011 there will be no co-payments for preventative medical care. This care will also be exempted when calculating the deductible.

3. Starting in three months, there will be a temporary re-insurance program for employers to cover retirees in the age range 55 to 64.

4. Starting in six months, insurers shall not cancel a policy if a claim is made nor discriminate against children with a pre-existing condition. There are also to be new controls to prevent insurers from imposing caps on coverage.5. Before the reform, the majority of people were insured by their employers. Starting immediately, small businesses can claim, tax credits of 35% of premiums if they decide to buy a health plan. This rises to 50% in 2014. Up to now, small businesses have always claimed they were the victims of discrimination, priced out of the market by the insurance industry. With a government subsidy, this argument looks less real.

Whether this will be enough to sway public opinion is anyone's guess. Health insurance has provoked some seriously extreme reactions and it will take time for people to take a more calm view of what the reforms offer. The reaction of the insurance companies is also difficult to predict. Some may react to the new controls by increasing their premiums. Insurers are, after all, for-profit organizations and they have never shown themselves slow in coming forward with premium hikes. This makes it even more important to get the maximum possible number of health insurance quotes before deciding on which policy or plan to buy. When midterm elections come in November 2012, 36 seats in the Senate and all the seats in the House are up for grabs. Experts predict the Democrats will lose seats. But, with President Obama in the White House, no repeal will be signed into law.

Ambien should be replaced by talk therapy

Looking around the journals published so far in 2010, it's clear the research community is finally beginning to challenge the assumption that America should be medicated. If you listen to the pharmaceutical industry and the doctors who are paid to stand up and promote drugs as the best treatment for any disorder, you will hear a consistent pattern of propaganda. All our products have the FDA seal of approval. The clinical trials show our products are safe and effective. The health insurance industry pays most of the price for our products. Take our pills and get better. Indeed, when it comes to the top-selling sleeping pills, there are record numbers of prescriptions being written by doctors. The reason? Well, its not hard to suspect stress levels are increasing thanks to the recession. Unemployment is high. Credit levels have been reduced, There are foreclosures in every neighborhood. That's bound to make sleep more difficult. What's curious about the new records being set in the number of prescriptions is the additional financial burden this places on families when they can least afford it, and the implied assumption that sleeping pills can cure the underlying social and economic problems causing the stress.

The Journal of the American Medical Association reports talk therapy is more effective than sleeping pills. The research team gave the participants sleeping pills alongside therapy sessions and measured which had the better outcome. Because the talk asked why people were finding it difficult to sleep and discussed ways of resolving problems, people with the therapy sessions had better sleep than those on pills. This follows on research testing the effectiveness of cognitive behavioral therapy which teaches people how to change their habit patterns to restore sleep. Therapists encourage people to avoid naps during the day, adopt a set routine for going to bed, and physically change the bedroom to minimize light and noise that might disturb sleep. When combined with techniques to address the cause of stress and relax, CBT has consistently been found to outperform sleeping pills.When you look at the statistics, there can be little doubt we use too many sleeping pills. Add in the increasing use of online pharmacies which supply drugs without the need for a prescription, and the scale of reliance on sleeping pills is almost certainly worse than we imagine. Why should we care? Because all the sleeping pills on the market can cause dependence. As people continue to take them, tolerance builds and the pills actually become less effective. Increasing the dose confirms the dependence and can lead to unwanted side effects. Yes, ambien is one of the better pills and there are fewer problems with its use, but if your insomnia has been disrupting your life for six months or more, you should consider undergoing therapy first. CBT is clearly the best. To help you focus during this learning period, your doctor may offer the use of a sleeping pill. If you decide to accept, ambien is the best but you should only take it for a few weeks at low dose. The long-term restoration of sleep is going to come from the therapy. Although this is a short-term cost to meet, your life will improve with natural sleep and your finances will be better of without having to buy sleeping pills for the rest of your life.

Tuesday, May 11, 2010

All doctors know when to prescribe Xanax in case of anxiety disorders

Well, it's that time of the decade again and the American Psychiatric Association (APA) is going through it ritual of revising the Diagnostic and Statistical Manual (DSM). Let's be clear why this is important. For better of worse, the DSM is like a bible, containing words of wisdom on which clusters of symptoms represent which disorders. The idea is to do away with the zip code lottery of diagnosis. In one US state you might be diagnosed as a bit eccentric. With the same behavior in a different state, you might be considered a danger to the community and committed to care. With the DSM as a guide, you hope to get the same diagnosis no matter who the patient is, where he or she may be found and who the doctor is. Unfortunately, the APA is caught in a terrible conflict of interest. The majority of its members regularly receive gifts and incentives from the drug manufacturers. This benevolence is designed to encourage the use of the relevant drugs. When these same doctors sit down to discuss diagnoses and which drugs to recommend, they cannot forget all the past generosity. It inevitably influences their decisions. More importantly, if particular drugs receive approval in the DSM, this represents several billion dollars in revenue. The manufacturers therefore spend heavily in trying to ensure their drugs continue to be linked to the relevant disorders. The result is the DSM is full of disorders that are only poorly defined and linked to drugs often little more effective than placebos.

If we go back sixty years, psychiatry in the US was still running in parallel with the European tradition of scientific method. This produced carefully defined diagnoses for general conditions, leaving practitioners with some flexibility to take a common sense view of the individual patient. Hence, the technical term might be a "nervous breakdown" which is a catch-all definition for anyone who has a few problems. But as the pharmaceutical industry used its economic power, these broad definitions were increasingly broken down into separate classes of disorder. As each new batch of disorders was defined, the manufacturers produced drugs specifically targeting each new disorder. In reality, people are still having nervous breakdowns and, truth be told, all the major drugs are interchangeable because the separate disorders are really only one or two basic types.

What prompted this redefinition of terms? Firstly, the introduction of the benzodiazepines. The manufacturers wanted a distinction between anxiety disorders and depression for marketing purposes. Once the APA gave in, it was the slippery slope to the present confused mess. As everyone knows, all depression has elements of anxiety and panic, just as anxiety and panic are indistinguishable from elements in depression. Recent surveys have found doctors routinely prescribing benzodiazepines such as xanax regardless of the diagnosis as anxiety or depression, and finding the same excellent results. Secondly, the APA wanted to move away from Freudian analysis and to ground diagnosis in observable symptoms. This led to the introduction of "major depression" and "bipolar disorder" which lump different sets of symptoms together in either a stable or unstable form. As the SSRIs came in as treatments for major depression, the pressure to keep inventing new disorders grew. Now all the anxiety and panic disorders are multiplying. Needless to say, xanax remains the most effective treatment no matter what labels are attached to the symptoms. If you are anxious, xanax is the answer. Sadly, the APA will not sympathize with such a simple view of the world.

Monday, May 10, 2010

Life insurance types – term policies

The selection of insurance products and offers you can choose from on the market is overwhelming. And choosing a policy to insure your life with can be tricky, requiring you to both evaluate your insurance needs and spend some time on comparing the offers you get from different providers. It's not just a possibility you can think of while buying insurance, it's a firm requirement that the product you want to buy meets your exact personal needs and can be adjusted to your budget, not the other way.

In contrast with continuous policies term insurance policies are designed to provide coverage only for a certain period of time, specified in the policy. A term policy will provide the benefits specified in it only if the insured person dies within the specified period. Besides, term policies do not have cash value accumulation potentials. So in case you are alive and well and your policy term expires, you won't receive any money. Another important aspect of term policies is that the premiums can't be fixed and it is likely that they will increase with the time passing. In order to make sure your rates are constant, choose a guaranteed level premium term policy that guarantees a fixed premium over the entire duration of the policy.

Advantages of term policies

Term policies are known to have the highest value for money you pay and the lowest price among other types of life insurance. That is why they are most beneficial for those families that have limited budget they have to fall into. These are some advantages you get with term policies:


Term policies have the lowest premiums for the largest death benefits obtainable.


Term policies are the least complex insurance product for insuring your life on the market.


Due to the simplicity of this product, there is a fierce competition between numerous providers offer term policies, which in turn allows effective comparison shopping when looking for a policy.


Term policies have the possibilities of "renewal" and "conversion". Renewal means that when the policy term expires you can prolong its duration, without buying a new policy. Conversion means that when the term of the policy expires you can convert your term policy into a permanent one, without buying a separate policy.

Waiver of premium

With term policies you also get an additional feature referred to as "waiver of premium". It allows you to halt premium payments for a stipulated period of time in case you are unable due to circumstances listed in the policy. Still, it is an optional feature that has its price.

Different time options

Term policies being a cheap life insurance options provide coverage for a period of time you feel appropriate. You can insure your life for a term of anything between one to thirty years, gaining death benefits if something happens to you during this term. It's a good way to plan your finances well ahead, making sure that such crucial things as mortgage or business loan will be paid out no matter what.

Different rates

There are many companies out there on the market that offer term insurance policies. Get life insurance quotes from them and you will probably get very attractive rates by shopping around.

When getting quotes for health insurance, check for gender discrimination

The lawmakers in Colorado are debating a change in the law to correct the gender discrimination currently requiring women to pay more than men to insure their health. The facts are uncompromising. In some 90% of all private health plans, women have premium rates 60% higher than men. This is so even though the statistics show women enjoy better health than men and make fewer claims. This is so even though the men used for comparative purposes are significantly older. And, if you feel you need any more confirmation of the basic unfairness, even men who smoke pay less than female non-smokers. As one of the women promoting the bill commented: insurers often refuse coverage because the applicant has a pre-existing condition. The way the premiums are loaded, it seems being a woman is a pre-existing condition.

The people who are paid to speak on behalf of the insurance industry usually fall back on the tried and trusted defense that women have medical needs specific to their gender. The most often quoted example is maternity and prenatal care. Ignoring the fact that men also have problems specific to their gender, such as erectile dysfunction, women are still quoted premiums 60% higher on policies excluding reproductive health needs. In other words, the discrimination persists even though the scope of the medical coverage is identical. So what's going on? The answer, in this instance, is slightly complicated. If we start with auto insurance, it's common knowledge that young men are statistically more likely than any other group of drivers to crash into another vehicle or some stationary object. Thus, where the policy discriminates between different groups of drivers, young men pay significantly more than women who tend to drive more safely. Not all auto policies do discriminate. By spreading the risk among a big group of drivers, the good subsidize the bad. But, most auto insurers do set different premium rates for different groups of drivers distinguished by gender and age. In medicine, it's a fact that men fall ill and die, whereas women tend to recover from illnesses. This is one of the reasons why women have a longer life expectancy than men. But it also explains why women cost more. They survive for longer with chronic problems requiring continuing treatment. Thus, if the premium is a reflection of the likely costs of treatment over a person's lifetime, it may appear slightly more reasonable to charge women higher premiums. Except this ignores the general rule that private health insurance stops at 65 as Medicare kicks in. The major long-term costs tend to occur after 65.

Colorado looks as though it may join the one or two other states with equality provisions. There's no evidence from these other states that men now have to pay significantly more. For now, insurers simply make less profit. As a woman, it's particularly important to research exactly what the different companies offer. Because of this, searching for cheap health insurance is a greater challenge. Always refer to the websites of the companies making the best quotes to see if there are additional discounts available or special policies for women. If there seems to be no cheap health insurance available, talk directly with the insurers to see whether the difference between the male and female premium rates can be reduced. Not everyone is lucky enough to live in a state committed to equality. It is for you to protect yourself as best as possible.