Posts Tagged ‘Healthcare’
Why, yes – I have a master’s degree in education
The fastest-growing jobs in the United States through 2017 are expected to be those requiring an advanced education, a study released Thursday found.
The report compiled by CareerBuilder and Economic Modeling Specialists International, says job creation will accelerate from 2013 to 2017 compared with 2009 to 2013, gaining 4.4 percent compared with 3.5 percent.
Jobs requiring an associate degree or a master’s degree are expected to grow 8 percent, the report says, while jobs requiring a bachelor’s degree — which generally takes four years and falls between associates and master’s degrees — are expected to grow 6 percent.
Jobs that require “short-term, on-the-job training trail at 4 percent,” the study projects.
In a list of jobs expected to grow 8 percent or more through 2017, personal care and home health aides top the list with growth expected at 21 percent.
Jobs for market research analyst and marketing specialists are expected to grow 14 percent, as are jobs for medical secretaries.
Jobs for emergency medical technicians and paramedics are projected to grow 13 percent, while jobs for software developers are projected to rise 11 percent.
The final job with double-digit growth expected is medical assistants, with growth of 10 percent predicted, CareerBuilder said…
The top 18 include, in descending order, registered nurses, network and computer systems administrators, pharmacy technicians, landscapers, and social and human services assistants, all expected to grow 9 percent, and computer systems analysts, management analysts, cooks, insurance agents, nursing assistants, licensed practical and licensed vocational nurses and food preparation workers and servers, including fast-food, the report said.
Middle-aged? Stick to figuring out ways to survive. Sooner or later the cost of living will begin to accelerate to match the increases of those with growing income. If you want longer-term worries consider your kids and grandkids. The quality of K-12 education ain’t especially getting better inside the United States. Compared to other literate nations and competing with them for jobs, we’re in a deeper hole that’s on the way to becoming downright subterranean.
While there’s no shortage of pundits who finished their college years before malaise and a matching decline set in – they continue to praise the value of our advanced education. That will continue to sort out with underfunded public schools getting more and more of the student base and giving back less in return. Or so it seems.
Seven months pregnant, at a time when most expectant couples are stockpiling diapers and choosing car seats, Renée Martin was struggling with bigger purchases.
At a prenatal class in March, she was told about epidural anesthesia and was given the option of using a birthing tub during labor. To each offer, she had one gnawing question: “How much is that going to cost?”
Though Ms. Martin, 31, and her husband, Mark Willett, are both professionals with health insurance, her current policy does not cover maternity care. So the couple had to approach the nine months that led to the birth of their daughter in May like an extended shopping trip though the American health care bazaar, sorting through an array of maternity services that most often have no clear price and — with no insurer to haggle on their behalf — trying to negotiate discounts from hospitals and doctors…
When she became pregnant, Ms. Martin called her local hospital inquiring about the price of maternity care; the finance office at first said it did not know, and then gave her a range of $4,000 to $45,000. “It was unreal,” Ms. Martin said. “I was like, How could you not know this? You’re a hospital.”
Midway through her pregnancy, she fought for a deep discount on a $935 bill for an ultrasound, arguing that she had already paid a radiologist $256 to read the scan, which took only 20 minutes of a technician’s time using a machine that had been bought years ago. She ended up paying $655. “I feel like I’m in a used-car lot,” said Ms. Martin, a former art gallery manager who is starting graduate school in the fall.
Like Ms. Martin, plenty of other pregnant women are getting sticker shock in the United States, where charges for delivery have about tripled since 1996, according to an analysis done for The New York Times by Truven Health Analytics. Childbirth in the United States is uniquely expensive, and maternity and newborn care constitute the single biggest category of hospital payouts for most commercial insurers and state Medicaid programs. The cumulative costs of approximately four million annual births is well over $50 billion.
And though maternity care costs far less in other developed countries than it does in the United States, studies show that their citizens do not have less access to care or to high-tech care during pregnancy than Americans.
RTFA. It’s long, detailed, and scary.
When Dwight Eisenhower left office as president he warned of the political power of the military-industrial complex. Well, they ended up owning enough of Congress that they suck down the lion’s share of our non-insurance federal budget. That leaves what is now being called the medical-industrial complex. And between insurance companies, pharmaceutical manufacturers, healthcare providers and hospitals they seem bound and determined to take the rrest of that budget – and our life savings.
A group of 18 doctors, researchers and public health experts have jointly urged the Food and Drug Administration…to take action on energy drinks to protect adolescents and children from the possible risks of consuming high amounts of caffeine.
“There is evidence in the published scientific literature that the caffeine levels in energy drinks pose serious potential health risks,” the doctors and researchers wrote.In their letter to Dr. Margaret A. Hamburg, the F.D.A. commissioner, the group argued that energy drink makers had failed to meet the regulatory burden placed on them to show that the ingredients used in their beverages were safe, specifically where children, adolescents and young adults are concerned. As a result, the group urged the F.D.A. to restrict caffeine content in the products and to require manufacturers to include caffeine content on product labels…
Less is known about the safe level of caffeine for a young teenager, experts say, apart from the fact that it is considered to be lower than for an adult. In their letter Tuesday to Dr. Hamburg, the group of researchers and scientists also pointed out that makers of energy drinks aggressively marketed their products to young teenagers and urged them to consume the drinks quickly. Including mixing them with booze!
In recent years, the number of reported emergency-room visits in which an energy drink was cited as the primary cause of a health problem, or a contributing factor, has grown sharply. In 2011, there were 20,783 such visits, compared with 10,068 in 2007. Problems typically linked to excessive caffeine consumption can include anxiety, headaches, irregular heartbeats and heart attacks.
Probably overdue. At least until and unless reasonable research indicates otherwise. Think we can count on the FDA to encourage that?
A common phrase in the current debate over the so-called fiscal cliff is “Medicare needs to be restructured.” The term serves as code for policies unlikely to be appealing to voters, a term that can mean everything and, thus, nothing.
The question is what problem restructuring is to solve in traditional Medicare, which remains one of the most popular health insurance programs in this country. People who use this vague term should always be challenged to explain exactly why and how Medicare should be changed.
Critics of traditional Medicare – even those who should know better – often accuse it of being “fee for service.” It is a strange accusation. After all, fee-for-service remains the dominant method of paying the providers of health care under private insurance, including Medicare Advantage, the option of private coverage open to all Medicare beneficiaries.
Describing Medicare as fee-for-service insurance is about as thoughtful as describing a horse as “an animal that has four legs,” a characteristic shared by many other animals. The practice is particularly odd, given that traditional Medicare as early as the 1970s was the first program to develop so-called “bundled payments” for hospital inpatient care – the diagnostically related groupings, known as D.R.G. – in place of fee-for-service payment of hospitals, an innovation that has since been copied around the globe.
A more descriptive term for traditional Medicare would be “free choice of providers” or “unmanaged care” insurance. These features, of course, would hardly be viewed as shortcomings among people covered by traditional Medicare or their families. Neither term would be a good marketing tool among voters for proposals to abandon traditional Medicare…
A case can be made, on theoretical and sometimes empirical grounds, that properly managed or coordinated care can on average yield superior medical treatments, at lower cost, than completely unmanaged care under classical indemnity insurance.
The problem has been and continues to be that this is not the folklore among patients or doctors. The latter, as noted, generally believe they can manage their patients’ care properly without outside interference into their clinical decisions. Among patients and doctors, the term managed care is still not quite respectable.
This can explain why critics of traditional Medicare delicately but nonsensically prefer to decry it as being fee for service rather than as free-choice-of-providers insurance or unmanaged-care insurance.
I hadn’t seen Uwe Reinhardt on television in a spell when he popped up on Tom Keene’s SURVEILLANCE yesterday morning on Bloomberg TV. I had forgotten his dry wit and political economist’s accurate simplicity of definitions. The folks I can understand the easiest also often make the most sense.
This blog post is one the earliest of his current series on Medicare.
Meanwhile, click the link and RTFA. Education, it’s wonderful.
Three years ago, at the height of the debate over health care reform, there was an uproar over a voluntary provision that encouraged doctors to discuss with Medicare patients the kinds of treatments they would want as they neared the end of life. That thoughtful provision was left out of the final bill after right-wing commentators and Republican politicians denounced it falsely as a step toward euthanasia and “death panels.”
Fortunately, advance planning for end-of-life decisions has been going on for years and is continuing to spread despite the demagogy on the issue in 2009. There is good evidence that, done properly, it can greatly increase the likelihood that patients will get the care they really want. And, as a secondary benefit, their choices may help reduce the cost of health care as well.
Many people sign living wills that specify the care they want as death nears and powers of attorney that authorize relatives or trusted surrogates to make decisions if they become incapacitated. Those standard devices have been greatly improved in recent years by adding medical orders signed by a doctor — known as Physician Orders for Life Sustaining Treatment, or POLST — to ensure that a patient’s wishes are followed, and not misplaced or too vague for family members to be sure what a comatose patient would want…
With these physician orders, the doctor, or in some states a nurse practitioner or physician assistant, leads conversations with patients, family members and surrogates to determine whether a patient with advanced illness wants aggressive life-sustaining treatment, a limited intervention or simply palliative or hospice care.
The health care professional then signs a single-page medical order telling emergency medical personnel and other health care providers what to do if the patient is incapacitated. In most states, the patient or surrogate must also sign the medical order to indicate informed consent. The orders are conspicuously highlighted in a patient’s electronic medical record and follow patients from one setting to another — such as a hospital emergency room or nursing home — so that any health professional handling the case will know what interventions the patient might want…
No matter what the death-panel fearmongers say, end-of-life conversations and medical orders detailing what care to provide increase the confidence of patients that they will get the care they really want. In some cases, that could well mean the request to be spared costly tests, procedures and heroic measures that provide no real medical benefit.
RTFA for a broad understanding of your rights. It’s easy to drag your feet and put off a living will. The prospect ain’t exactly thrilling. But, do it – pay attention to the suggestions in this article and push your physician to cooperate if they must be pressed. Most are already ahead of you on this question.
Meanwhile – back in the US, back in the US, back in the US of A
France is set to reimburse 100 percent of the cost for all abortions, and provide free contraception to girls aged between 15 and 18 under a bill passed by France’s Lower House on Friday.
At present French women can only claim back between 70 and 80% for the operation, which can cost up to 450 euros.
The move to full reimbursement is designed to improve women’s access to abortions, and was included in the 2013 social security budget and a specific campaign promise of President Francois Hollande.
By allowing free contraception, France hopes to reduce the number of unwanted pregnancies and abortions.
Everywhere free contraception has been introduced, this is exactly what has happened. A bit of education helps, as well.
The much publicised move was welcomed by Martine Hatchuel, president of ANCIC, the French Association which counsels women on contraception and abortion. “It’s about time,” she said previously. “Minors should have access to contraception and it should be free and anonymous. But unfortunately just because a girl reaches 18 doesn’t mean she is out of the woods, and we would like to see this extended to women aged 25.”
Keep on rocking in the Free World. We’ll catch up to France on healthcare, some day.
Republican panel on birth control – no one who could possibly get pregnant!
A new study by researchers at Johns Hopkins University shows that fulfilling unmet contraception demand by women in developing countries could reduce global maternal mortality by nearly a third, a potentially great improvement for one of the world’s most vulnerable populations.
The study…comes ahead of a major family planning conference in London organized by the British government and the Bill and Melinda Gates Foundation that is an attempt to refocus attention on the issue…
The issue of family planning is fraught in the United States, where government assistance often gets caught up in political battles. Contraception has again become controversial this political season, though the United States remains a major donor…
This is only controversial in the minds of the mindless, backwards religious and rightwing nutballs — and cowards afeared of confronting them..
Maternal deaths have declined dramatically since 1990, down by a third, according to the World Health Organization…But about 16 percent of the world’s population lives in countries where fertility is still more than four children per woman, Mr. May said. The numbers of people are expected to more than triple in these places during this century, an issue that is urgent not only for their economies and environment, but also for the women themselves, who women’s rights advocates argue would benefit from more power to decide about bearing children…
Birth control reduces health risks, the researchers said, by delaying first pregnancies, which carry higher risks in very young women; cutting down on unsafe abortions, which account for 13 percent of all maternal deaths in developing countries; and controlling dangers associated with pregnancies that are too closely spaced.
Reactionaries hate and fear independent women, women who govern and guide their own lives – almost as much as they fear the liberty they prattle about in the dim halls of phony debate.
Politicians who chair hearings on why women should obey priests and pundits – without inviting a single female voice – are the signal example of what this discussion is about. Foolish men trying to hold onto a past when they believe silent and obedient citizens were the happiest in history.
Average life expectancy is one of two statistics commonly used to compare the health-care systems of different nations. (The other is infant mortality.)
One of the puzzles about the U.S. system is that we spend far and away the most money per capita for health care, but we rank 50th in average life expectancy — after Macau, Malta, and Turks and Caicos, among others.
We are all familiar with statistics about how much of health-care spending takes place in the last year of life, and with stories about old people who are tortured with costly treatments they don’t want and which prolong dying but don’t extend life in any meaningful sense.
Certainly, ailing old people should be allowed to die in peace, if that’s what they want, and not be subject to excruciatingly painful surgeries and drugs that will do nothing for them. These are more the fault of lawyers than doctors. In our experience, doctors can be all too cool and rational in their thinking about the end of life. It’s fear of lawsuits (or, in a few cases, trolling for customers) that prevents doctors from behaving rationally when prescribing treatment for the old and terminally ill…
So what do we do about old people who, on balance, would rather get even older — whatever that means in terms of “quality of life” — than give up? This is one of the indelicate, unmentionable questions in the health-care debate…
In short, all the Republican talk during the health-care- reform debate about “death panels” was melodramatic and unfair, but not ridiculous. One way or another, holding down health-care costs will require policies that deny treatment to people who want it. And want it because it will extend their lives.
This goes on already, all the time. Health insurance companies have been known to deny payment for treatments deemed unnecessary. Age limits for organ transplants are another example. All policies that involve denying care because of “quality of life” considerations are, in effect, “death panels.” But no society can afford to give every citizen every possible therapy…
How do you persuade fellow citizens to accept limits on their right to consume health-care resources? The trick, we think, is to ask them when they’re healthy, not when they’re sick. If you think a $200,000 operation is going to give you a few more years to live, it’s going to be hard to convince you that it’s not worth the cost. But before then, when your odds of needing that expensive operation are the same as everybody else’s, you might well choose a system that offers a higher life expectancy, even though it costs less. In fact, why wouldn’t you?
Bloomberg View articles don’t always try to answer the questions they ask. This is one that sort of suggests alternatives; but, the final resolution isn’t settled yet. We’re stuck with politicians, insurance companies, healthcare corporations and their own versions of “death panels” in charge of negotiating with us.
You already know who has the most power in that dialectic – and it ain’t us.
Flora Goldberg filed her tax return last year – but someone had beaten her to it
Besieged by identity theft, Florida now faces a fast-spreading form of fraud so simple and lucrative that some violent criminals have traded their guns for laptops. And the target is the United States Treasury.
With nothing more than ledgers of stolen identity information — Social Security numbers and their corresponding names and birth dates — criminals have electronically filed thousands of false tax returns with made-up incomes and withholding information and have received hundreds of millions of dollars in wrongful refunds, law enforcement officials say.
The criminals, some of them former drug dealers, outwit the Internal Revenue Service by filing a return before the legitimate taxpayer files. Then the criminals receive the refund, sometimes by check but more often though a convenient but hard-to-trace prepaid debit card.
The government-approved cards, intended to help people who have no bank accounts, are widely available in many places, including tax preparation companies. Some of them are mailed, and the swindlers often provide addresses for vacant houses, even buying mailboxes for them, and then collect the refunds there…
The fraud, which has spread around the country, is costing taxpayers hundreds of millions of dollars annually, federal and state officials say. The I.R.S. sometimes, in effect, pays two refunds instead of one: first to the criminal who gets a claim approved, and then a second to the legitimate taxpayer, who might have to wait as long as a year while the agency verifies the second claim…
Florida, with its large population of elderly residents and health care facilities, provides a wealth of opportunities for swindlers. South Florida, which had the highest rate of identity theft in the nation, and Tampa have been hit hardest…
“The I.R.S. is doing what they can to prevent this, but this is like a tsunami of fraud,” Mr. Ferrer said. “Everywhere I go, every dinner, every function I attend, someone will come up to me and tell me they are a victim — people in this office, police officers, firefighters…”
The agency, prodded by lawmakers and the public, is moving more aggressively to stop the avalanche. It has increased the number of investigators, put in place better technology that flags more returns, distributed personal identification numbers to victims for the next filing season and hired more workers to help taxpayers get their refunds. The agency, which had $300 million cut from its budget this year, has invested the same amount in combating the problem…
Fraudulent filers first used names and Social Security numbers of the deceased to file claims. The numbers become public by law and, until recently, were easily available on popular genealogy Web sites. Swindlers also used the Social Security numbers of prisoners.
When officials cracked down on those two avenues, the theft migrated to anywhere Social Security numbers are collected. Most vulnerable are records from health care facilities, assisted-living centers, schools, insurance companies, pension funds and large stores that issue credit cards. The police say employees steal the information and sell it, an increasingly common practice here.
Everyone is susceptible. Two dozen Tampa police officers, including one whose job it is to investigate identity-theft fraud, had their identities stolen and their tax refunds diverted this year.
There are many ways to fight this kind of crime. It ain’t going to be solved by people suddenly learning about identity theft and countering it online. Not while there isn’t any shortage of petty crooks hired to work in healthcare facilities and corporations – because they work for cheap. Cheap, that is, until the thefts start to roll through the ID’s they’ve stolen from the records they process.
A solid national ID system might work. Between Ron Paulistas and the earned distrust of government – don’t hold your breath waiting for that one. The IRS policy of issuing a special private ID is helpful up to a point. If everyone wants one – Congressional Republicans will be certain to put a stop to that “unneeded” expense. Just as they cut $300 million from this year’s budget because, after all, who wants the IRS to do a more efficient job?
I check on my ID a couple times a month. And the first couple of days the info for my income tax return is available – it gets filed. I just hope I can stay ahead of the crooks.