Original Story: freep.com
Waiting for a lung transplant is hard enough but waiting for one that fits could take even longer.
"Many of the patients on the waiting list have small lung sizes because of their disease," said Dr. Martin Strueber, a transplant specialist with Spectrum Health in Grand Rapids. "Especially, children have a hard time waiting for a suitable donor graft because of size issues. The organ donors have average lung sizes." A Grand Rapids health care lawyer is reviewing the details of this story.
The answer, Strueber has found, is a custom fitting of lungs to recipients.
"It's a the technique we learned from adult lung surgery," Strueber said. "It's a technique for reducing the size of patient lungs that have the disease of emphysema. We just modified this technique to use it to reduce oversized lungs for lung transplant patients."
The results have been shorter wait times for patients who risk death if they are delayed. This year, the Richard DeVos Heart and Lung Transplant Program at Spectrum, where Strueber works, performed 28 lung transplants and had just eight people on the waiting list. A Detroit health care attorney is following this story closely.
"We want our waiting list to be very short and we want our patients to be transplanted as fast as we can so that we have no mortality on the waiting list," Strueber said. "That's the goal."
The center logged a 93% survival rate for recipients one year after their transplants. One successful recipient was Sidney Whitaker, 66, of Hart. In April 2014, he was diagnosed with idiopathic pulmonary fibrosis, a condition where scar tissue forms in the lungs, causing them to thicken to the point that they can't move oxygen into the bloodstream properly.
"They didn't say it was it a death sentence," Whitaker said. "They weren't real sure initially what it was."
But after a lung biopsy, Whitaker learned how serious it was.
"You do nothing and you die or you get a transplant," Whitaker said.
On Dec. 31, 2014, he was officially listed on the transplant list and told to keep his phone charged to receive a call and to be ready to get to the hospital within three hours. On Jan. 31, he receive a new lung. But it didn't take. A Grand Rapids hospital lawyer has experience with hospital and health care related cases.
"The lung just wasn't working," said Dr. Reda Girgis, medical director for the lung transplant program at Spectrum. "That's why it was urgent to get that donor."
About a week later, Whitaker received a new, modified lung that took almost immediately.
"He got through it fairly well," Girgis said. "He's going to have his one-year anniversary in February. He's doing extremely well. He can do basically what he wants."
Whitaker's wife, Jill, was stunned by how quickly her husband responded.
"He was off oxygen in 24 hours," she said. Two months after his last surgery, he went home.
"I have zero restrictions," said Whitaker, who continues to pick garlic, corn, asparagus, and potatoes that he grows on his 10-acre farm and sells at his Many Blessings Market.
His wife, Jill, said she and her husband have become big advocates of the program.
"We got to celebrate our 45th wedding anniversary in July," Jill Whitaker said. "I wasn't sure we'd have that."
Strueber said the lungs can be modified in one of two ways to make them fit. One is known as a lobectomy, the removal of an entire lobe of a lung before transplanting. The other is what's known as lung shaving, surgically removing portions of a lobe.
"If the lung is really too big, it's usually a combination of a lobectomy and the lung shaving procedure," Strueber said. "You can take like 40% to 50% of it off. We have like donors being a huge male and then we transplant a small female, 100 pounds or less. It is all doable. It needs to be customized to the chest of the organ recipient."
In addition to being an expert in lung shaving, Strueber is a pioneer in what's known as minimally invasive lung transplants.
"The incisions are just in between the ribs," he said. "The chest bone stays intact."
Strueber was born and trained in Germany and was courted to Grand Rapids two years ago to be part of a growing transplant program in Grand Rapids.
"You have a community that needs the research. There is a lot of opportunity," he said. "I found that very interesting and challenging."
29 December 2015
20 November 2015
UNITEDHEALTH MAY DUMP OBAMACARE PLANS, PUTTING CALIFORNIA EXPANSION IN DOUBT
Original Story: latimes.com
Industry giant UnitedHealth has warned it may quit selling Obamacare coverage across the country, raising questions about an expansion in California.
The nation's largest health insurer cut its earnings forecast Thursday, citing slower growth on public exchanges under the Affordable Care Act and higher-than-expected claims for those individual policies. A San Diego health care lawyer have experience with multiple industry types and implications of detrimental health care practices or incidents.
The company said it was pulling back on its marketing of health-law coverage just a few weeks after open enrollment began Nov. 1. UnitedHealth said it will decide in the first half of next year “to what extent it can continue to serve the public exchange markets in 2017.”
UnitedHealth Chief Executive Stephen Hemsley told analysts and investors that “we cannot sustain these losses.... We can't really subsidize a marketplace that doesn't appear at the moment to be sustaining itself.”
The announcement comes as UnitedHealth is seeking a toehold in California’s Obamacare market — after snubbing the state two years ago. A Cleveland health care attorney is following this story closely.
Nationwide, UnitedHealth has more than 500,000 people enrolled on government exchanges out of about 10 million Americans who have signed up. Rivals Anthem and Aetna both have a bigger presence with a combined enrollment of about 1.6 million people.
Analysts said the exchanges can continue to function without UnitedHealth, but stagnant enrollment is a concern industrywide.
UnitedHealth’s exit “would be a blow to multiple exchange markets, but not a death knell,” said Bill Melville, a senior analyst for Decision Resources Group, a research firm in Burlington, Mass. “All insurers in the exchanges are facing similarly rough head winds.”
Enrollment growth has slowed as many of the uninsured balk at buying high-deductible health plans, even with federal subsidies available. It's crucial for insurers to sign up enough healthy people to help pay for sicker policyholders who eagerly seek out coverage.
Federal officials estimate that about 10.5 million uninsured Americans are eligible to sign up for coverage through the marketplaces but have not enrolled.
“The policies are still too expensive, and the deductibles and co-pays are too high for other than the poorest,” said Robert Laszewski, a healthcare consultant in Virginia who has closely tracked the overhaul.
He noted that much of the reduction in the ranks of the uninsured has come from expanding Medicaid, the government health program for the poor.
The Obama administration said the number of health plans offering exchange policies has increased since the 2014 launch, and it expects the individual market will stabilize as adjustments are made. A Houston health care lawyer is reviewing the details of this story.
“The health insurance marketplace is entering its third year and continues to grow, giving millions of Americans access to quality affordable insurance,” said Ben Wakana, a spokesman for the U.S. Department of Health and Human Services. “Today’s statement by one issuer is not indicative of the marketplace’s strength and viability.”
UnitedHealth just joined the Covered California exchange this month after sitting out the first two years. The company sought permission in January to sell statewide, but California officials limited the insurer to several smaller markets for 2016.
Those areas are predominantly rural counties in Northern California, but they also include Santa Barbara, Ventura and San Luis Obispo counties.
Covered California imposed that restriction because UnitedHealth left the state's individual market at the end of 2013 and spurned the launch of the exchange.
Peter Lee, executive director of Covered California, said he spoke with UnitedHealth officials Thursday and remains confident about the company’s continued expansion in the state.
"We have every indication they are all in for 2016 and 2017," Lee said in an interview. "The fact United did badly in other parts of the country, like many health plans did, is exactly why they want to be in California." A Coral Gables health care lawyer provides professional legal counsel and extensive experience in many aspects of health care law.
A spokesman for UnitedHealth said no decision has been made on its future participation in Covered California. “We will make an assessment of 2017 markets in the first quarter of 2016,” spokesman Tyler Mason said.
Many consumer groups welcomed UnitedHealth's arrival in Covered California in order to give people more choice and inject more competition into the market. The top four insurers in the exchange, led by Anthem and Blue Shield of California, control about 94% of Covered California enrollment.
The state has about 1.3 million people enrolled, and nearly 90% of them receive federal premium subsidies.
Covered California fell short of its enrollment goal during the second sign-up period, and it has acknowledged that reaching the remaining uninsured is difficult.
This week, the state said 34,000 new enrollees had picked out a health plan since Nov. 1. That's behind last year's pace but within state projections, officials said.
The announcement Thursday marked a sudden shift for UnitedHealth, which had sounded bullish about the health law in recent months. The company initially sold coverage on only four government-run exchanges before expanding to 23 this year. It will be selling in 34 states for 2016.
UnitedHealth said it cut its profit forecast to account for $425 million in losses it expects on individual policies this year and in 2016. The company expects 2015 earnings of about $6 a share, down from its previous estimate for $6.25 to $6.35 a share.
Shares of UnitedHealth slid $6.62, or 5.7%, to $110.63 in Thursday trading. Other health stocks took a beating after the company’s warning. Shares of Anthem, the nation’s second-largest health insurer, fell 7%, and hospital chain Tenet Healthcare dropped 8%.
After the news from UnitedHealth, HMO giant Kaiser Permanente reiterated its support for health-law exchanges.
“American healthcare is undergoing significant change and evolution, and the health exchanges are part of that disruption,” said Kaiser Permanente CEO Bernard Tyson. “While there have been challenges at times, we believe at the end of the day they are causing healthy disruption.”
Industry giant UnitedHealth has warned it may quit selling Obamacare coverage across the country, raising questions about an expansion in California.
The nation's largest health insurer cut its earnings forecast Thursday, citing slower growth on public exchanges under the Affordable Care Act and higher-than-expected claims for those individual policies. A San Diego health care lawyer have experience with multiple industry types and implications of detrimental health care practices or incidents.
The company said it was pulling back on its marketing of health-law coverage just a few weeks after open enrollment began Nov. 1. UnitedHealth said it will decide in the first half of next year “to what extent it can continue to serve the public exchange markets in 2017.”
UnitedHealth Chief Executive Stephen Hemsley told analysts and investors that “we cannot sustain these losses.... We can't really subsidize a marketplace that doesn't appear at the moment to be sustaining itself.”
The announcement comes as UnitedHealth is seeking a toehold in California’s Obamacare market — after snubbing the state two years ago. A Cleveland health care attorney is following this story closely.
Nationwide, UnitedHealth has more than 500,000 people enrolled on government exchanges out of about 10 million Americans who have signed up. Rivals Anthem and Aetna both have a bigger presence with a combined enrollment of about 1.6 million people.
Analysts said the exchanges can continue to function without UnitedHealth, but stagnant enrollment is a concern industrywide.
UnitedHealth’s exit “would be a blow to multiple exchange markets, but not a death knell,” said Bill Melville, a senior analyst for Decision Resources Group, a research firm in Burlington, Mass. “All insurers in the exchanges are facing similarly rough head winds.”
Enrollment growth has slowed as many of the uninsured balk at buying high-deductible health plans, even with federal subsidies available. It's crucial for insurers to sign up enough healthy people to help pay for sicker policyholders who eagerly seek out coverage.
Federal officials estimate that about 10.5 million uninsured Americans are eligible to sign up for coverage through the marketplaces but have not enrolled.
“The policies are still too expensive, and the deductibles and co-pays are too high for other than the poorest,” said Robert Laszewski, a healthcare consultant in Virginia who has closely tracked the overhaul.
He noted that much of the reduction in the ranks of the uninsured has come from expanding Medicaid, the government health program for the poor.
The Obama administration said the number of health plans offering exchange policies has increased since the 2014 launch, and it expects the individual market will stabilize as adjustments are made. A Houston health care lawyer is reviewing the details of this story.
“The health insurance marketplace is entering its third year and continues to grow, giving millions of Americans access to quality affordable insurance,” said Ben Wakana, a spokesman for the U.S. Department of Health and Human Services. “Today’s statement by one issuer is not indicative of the marketplace’s strength and viability.”
UnitedHealth just joined the Covered California exchange this month after sitting out the first two years. The company sought permission in January to sell statewide, but California officials limited the insurer to several smaller markets for 2016.
Those areas are predominantly rural counties in Northern California, but they also include Santa Barbara, Ventura and San Luis Obispo counties.
Covered California imposed that restriction because UnitedHealth left the state's individual market at the end of 2013 and spurned the launch of the exchange.
Peter Lee, executive director of Covered California, said he spoke with UnitedHealth officials Thursday and remains confident about the company’s continued expansion in the state.
"We have every indication they are all in for 2016 and 2017," Lee said in an interview. "The fact United did badly in other parts of the country, like many health plans did, is exactly why they want to be in California." A Coral Gables health care lawyer provides professional legal counsel and extensive experience in many aspects of health care law.
A spokesman for UnitedHealth said no decision has been made on its future participation in Covered California. “We will make an assessment of 2017 markets in the first quarter of 2016,” spokesman Tyler Mason said.
Many consumer groups welcomed UnitedHealth's arrival in Covered California in order to give people more choice and inject more competition into the market. The top four insurers in the exchange, led by Anthem and Blue Shield of California, control about 94% of Covered California enrollment.
The state has about 1.3 million people enrolled, and nearly 90% of them receive federal premium subsidies.
Covered California fell short of its enrollment goal during the second sign-up period, and it has acknowledged that reaching the remaining uninsured is difficult.
This week, the state said 34,000 new enrollees had picked out a health plan since Nov. 1. That's behind last year's pace but within state projections, officials said.
The announcement Thursday marked a sudden shift for UnitedHealth, which had sounded bullish about the health law in recent months. The company initially sold coverage on only four government-run exchanges before expanding to 23 this year. It will be selling in 34 states for 2016.
UnitedHealth said it cut its profit forecast to account for $425 million in losses it expects on individual policies this year and in 2016. The company expects 2015 earnings of about $6 a share, down from its previous estimate for $6.25 to $6.35 a share.
Shares of UnitedHealth slid $6.62, or 5.7%, to $110.63 in Thursday trading. Other health stocks took a beating after the company’s warning. Shares of Anthem, the nation’s second-largest health insurer, fell 7%, and hospital chain Tenet Healthcare dropped 8%.
After the news from UnitedHealth, HMO giant Kaiser Permanente reiterated its support for health-law exchanges.
“American healthcare is undergoing significant change and evolution, and the health exchanges are part of that disruption,” said Kaiser Permanente CEO Bernard Tyson. “While there have been challenges at times, we believe at the end of the day they are causing healthy disruption.”
02 November 2015
THE NARRATIVE FRAYS FOR THERANOS AND ELIZABETH HOLMES
Original Story: nytimes.com
Few people, let alone those just 31 years old, have amassed the accolades and riches bestowed on Elizabeth Holmes, founder and chief executive of the blood-testing start-up Theranos.
This year President Obama named her a United States ambassador for global entrepreneurship. She gave the commencement address at Pepperdine University. She was the youngest person ever to be awarded the Horatio Alger Award in recognition of “remarkable achievements accomplished through honesty, hard work, self-reliance and perseverance over adversity.” She is on the Board of Fellows of Harvard Medical School. Macomb elder care provides family respite care and adult and senior assistance.
She has been showered with rapturous media attention. Time named her one of the 100 Most Influential People in the World this year. She was the subject of lengthy profiles in The New Yorker and Fortune. Over the last week, she appeared on the cover of T: The New York Times Style Magazine, and Glamour anointed her one of its eight Women of the Year. She has been on “Charlie Rose,” as well as on stage at the Clinton Global Initiative, the World Economic Forum at Davos and the Aspen Ideas Festival, among numerous other conferences.
Theranos, which she started after dropping out of Stanford at age 19, has raised more than $400 million in venture capital and has been valued at $9 billion, which makes Ms. Holmes’s 50 percent stake worth $4.5 billion. Forbes put her on the cover of its Forbes 400 issue, ranking her No. 121 on the list of wealthiest Americans. Senior care in Grosse Pointe offers the highest quality of in-home care.
Her wealth and fame rest almost entirely on a simple but nonetheless “revolutionary” and “disruptive” technology: Theranos’s ability to run a wide range of lab tests from a tiny sample of blood from a finger prick, in that way eliminating the need for intravenous blood draws. (Ms. Holmes has said that her inspiration was a personal aversion to needles.)
Thanks to an investigative article in The Wall Street Journal this month by John Carreyrou, one of the company’s central claims, and the one most exciting to many investors and doctors, is being called into question. Theranos has acknowledged it was only running a limited number of tests on a microsample of blood using its finger-prick technology. Since then, it said it had stopped using its proprietary methods on all but one relatively simple test for herpes.
Theranos has denied many elements of the Journal article on its website.
For most of its tests, Theranos said that it uses conventional equipment on samples drawn intravenously by needle, which makes its approach pretty much like that of its big competitors, Quest Diagnostics and Laboratory Corporation of America Holdings, whose stocks have gyrated on the start-up’s perceived threat. Elderly care in Madison Heights provides medical and non-medical support for catastrophic care patients.
This week the Food and Drug Administration released reports based on inspections of Theranos facilities this summer. It concluded that the company’s miniature blood containers — called “nanotainers” — were “unapproved” medical devices for tests beyond herpes.
“While we work with the F.D.A. on clearance of our nanotainer tubes,” said Tilden Katz, a Theranos spokesman, “we have chosen to conduct our tests through venous draws.” He added: “Our proprietary devices are making it possible to run finger-stick samples for tests that could never be run on finger-stick before.”
Amid the controversy, Walgreens said it would not open new Theranos blood testing centers while it sought answers about the company’s technology.
“This isn’t how you introduce technology that claims to be groundbreaking and revolutionary in the health care field,” said Michael Cherny, an analyst at the investment bank Evercore Partners who was an early and vocal skeptic about many of Theranos’s claims.
“Every other person goes through some level of peer review,” Mr. Cherny told me this week. Theranos “decided to shun that approach.”
“In my view,” he said, “that calls into question what’s under the hood of the platform.”
Others raised questions about Theranos and what now appear to have been some pretty bold claims, in some cases long before The Journal’s exposé. Kevin Loria, a reporter on the Business Insider science team, wrote several pointed articles and produced a number of prominent skeptics among clinical pathologists and the broader medical community. The New Yorker and Fortune articles also were skeptical about the lack of peer review for Theranos’s technology. And Eleftherios Diamandis, the head of clinical biochemistry at Mount Sinai Hospital in Toronto, raised numerous issues in a June medical journal article.
“The constant was that nobody had any idea how this works or even if it works,” Mr. Loria told me this week. “People in medicine couldn’t understand why the media and technology worlds were so in thrall to her.”
The attention lavished on Ms. Holmes has been effusive. Her goal of facilitating the early detection and prevention of disease by making blood testing easier and convenient is laudable. And the relatively young company may still work through its current difficulties.
But that so many eminent authorities — from Henry Kissinger, who had served on the company’s board; to prominent investors like the Oracle founder Larry Ellison; to the Cleveland Clinic — appear to have embraced Theranos with minimal scrutiny is a testament to the ageless power of a great story.
“It all fit together perfectly: the college dropout, the fear of needles, the humanitarian mission,” Mr. Cherny said. “She checked all the boxes.” Warren elder care provides high tech nursing services, including assistance with medical equipment.
Indeed, Ms. Holmes seems to have perfectly executed the current Silicon Valley playbook: Drop out of a prestigious college to pursue an entrepreneurial vision; adopt an iconic uniform; embrace an extreme diet; and champion a humanitarian mission, preferably one that can be summed up in one catchy phrase.
Like Bill Gates, Steve Jobs and Mark Zuckerberg, Ms. Holmes dropped out of college. Like Steve Jobs, she wears a uniform of black turtlenecks, suggesting she has loftier things to think about than what to wear. “I probably have 150 of these,” she told Glamour. Like Mr. Jobs, she’s picky about her diet. (She’s a vegan who shuns coffee and drinks green vegetable juices.)
And like Google’s co-founders, Larry Page and Sergey Brin (“Don’t Be Evil”), and Mark Zuckerberg (“Connect the World”), her mission is lofty. As she has repeatedly said, Ms. Holmes envisions “a world in which no one ever has to say goodbye too soon,” brought about through improved health care. Theranos also has a slogan: “One tiny drop changes everything.”
She stays relentlessly on message, as a review of her numerous conference and TV appearances make clear, while at the same time saying little of scientific substance.
The natural human tendency to fit complex facts into a simple, compelling narrative has grown stronger in the digital age of 24/7 news and social media, said Frank Partnoy, professor of law and finance at the University of San Diego, and author of “Wait: The Art and Science of Delay,” which explores the perils of hasty decision-making.
“We’re deluged with information even as pressure has grown to make snap decisions,” Professor Partnoy said. “People see a TED talk. They hear this amazing story of a 30-something-year-old woman with a wonder procedure. They see the Cleveland Clinic is on board. A switch goes off and they make an instant decision that everything is fine. You see this over and over: Really smart and wealthy people start to believe completely implausible things with 100 percent certainty.”
Ms. Holmes’s story also fits into a broader narrative underway in medicine, in which new health care entrepreneurs are upending ossified hospital practices with the goal of delivering more effective and patient-oriented care.
Two proponents of the approach, Dr. Delos Cosgrove, chief executive of the Cleveland Clinic, and Mark R. Laret, chief executive of the UCSF Medical Center, have enthusiastically endorsed Theranos’s potential to upend conventional medicine.
A Cleveland Clinic spokeswoman, Eileen Sheil, told me that the clinic’s “strategic partnership” with Theranos had not really gotten off the ground and that the clinic had yet to employ any Theranos technology. She said that a statement on the clinic’s website — “Theranos offers a full spectrum of laboratory tests, from the most common panels to highly specialized tests, on blood samples as small as a few drops” — is “their language, not ours, and we can’t verify that.”
Mr. Laret said he had “no information” about Theranos’s technology, but had great respect for Ms. Holmes and the company’s board.
While hot Silicon Valley start-ups like Uber and Airbnb have run into regulatory hurdles, as a medical technology company, Theranos has bumped up against something else: the scientific method, which puts a premium on verification over narrative.
“I don’t know if she’s another Steve Jobs,” said Jerry Yeo, professor of pathology at the University of Chicago and director of the Clinical Chemistry Laboratories there. “You have to subject yourself to peer review. You can’t just go in a stealthy mode and then announce one day that you’ve got technology that’s going to disrupt the world.”
Professor Yeo said that he and his colleagues wanted to see data and testing in independent labs. “We have a small army of people ready and willing to test Theranos’s products if they’d ask us,” he said. “And that can be done without revealing any trade secrets.”
Ms. Holmes said this week that Theranos would disclose data on the reliability and accuracy of its tests. “Data is a powerful thing because it speaks for itself,” she said at a conference at the Cleveland Clinic. “We were never against that.”
Whether that will satisfy Theranos’s growing number of critics will depend on the nature and quality of the data.
“Every other company in this field has gone through peer review,” said Mr. Cherny of Evercore. “Why hold back so much of the platform if your goal is the greater good of humanity?”
Few people, let alone those just 31 years old, have amassed the accolades and riches bestowed on Elizabeth Holmes, founder and chief executive of the blood-testing start-up Theranos.
This year President Obama named her a United States ambassador for global entrepreneurship. She gave the commencement address at Pepperdine University. She was the youngest person ever to be awarded the Horatio Alger Award in recognition of “remarkable achievements accomplished through honesty, hard work, self-reliance and perseverance over adversity.” She is on the Board of Fellows of Harvard Medical School. Macomb elder care provides family respite care and adult and senior assistance.
She has been showered with rapturous media attention. Time named her one of the 100 Most Influential People in the World this year. She was the subject of lengthy profiles in The New Yorker and Fortune. Over the last week, she appeared on the cover of T: The New York Times Style Magazine, and Glamour anointed her one of its eight Women of the Year. She has been on “Charlie Rose,” as well as on stage at the Clinton Global Initiative, the World Economic Forum at Davos and the Aspen Ideas Festival, among numerous other conferences.
Theranos, which she started after dropping out of Stanford at age 19, has raised more than $400 million in venture capital and has been valued at $9 billion, which makes Ms. Holmes’s 50 percent stake worth $4.5 billion. Forbes put her on the cover of its Forbes 400 issue, ranking her No. 121 on the list of wealthiest Americans. Senior care in Grosse Pointe offers the highest quality of in-home care.
Her wealth and fame rest almost entirely on a simple but nonetheless “revolutionary” and “disruptive” technology: Theranos’s ability to run a wide range of lab tests from a tiny sample of blood from a finger prick, in that way eliminating the need for intravenous blood draws. (Ms. Holmes has said that her inspiration was a personal aversion to needles.)
Thanks to an investigative article in The Wall Street Journal this month by John Carreyrou, one of the company’s central claims, and the one most exciting to many investors and doctors, is being called into question. Theranos has acknowledged it was only running a limited number of tests on a microsample of blood using its finger-prick technology. Since then, it said it had stopped using its proprietary methods on all but one relatively simple test for herpes.
Theranos has denied many elements of the Journal article on its website.
For most of its tests, Theranos said that it uses conventional equipment on samples drawn intravenously by needle, which makes its approach pretty much like that of its big competitors, Quest Diagnostics and Laboratory Corporation of America Holdings, whose stocks have gyrated on the start-up’s perceived threat. Elderly care in Madison Heights provides medical and non-medical support for catastrophic care patients.
This week the Food and Drug Administration released reports based on inspections of Theranos facilities this summer. It concluded that the company’s miniature blood containers — called “nanotainers” — were “unapproved” medical devices for tests beyond herpes.
“While we work with the F.D.A. on clearance of our nanotainer tubes,” said Tilden Katz, a Theranos spokesman, “we have chosen to conduct our tests through venous draws.” He added: “Our proprietary devices are making it possible to run finger-stick samples for tests that could never be run on finger-stick before.”
Amid the controversy, Walgreens said it would not open new Theranos blood testing centers while it sought answers about the company’s technology.
“This isn’t how you introduce technology that claims to be groundbreaking and revolutionary in the health care field,” said Michael Cherny, an analyst at the investment bank Evercore Partners who was an early and vocal skeptic about many of Theranos’s claims.
“Every other person goes through some level of peer review,” Mr. Cherny told me this week. Theranos “decided to shun that approach.”
“In my view,” he said, “that calls into question what’s under the hood of the platform.”
Others raised questions about Theranos and what now appear to have been some pretty bold claims, in some cases long before The Journal’s exposé. Kevin Loria, a reporter on the Business Insider science team, wrote several pointed articles and produced a number of prominent skeptics among clinical pathologists and the broader medical community. The New Yorker and Fortune articles also were skeptical about the lack of peer review for Theranos’s technology. And Eleftherios Diamandis, the head of clinical biochemistry at Mount Sinai Hospital in Toronto, raised numerous issues in a June medical journal article.
“The constant was that nobody had any idea how this works or even if it works,” Mr. Loria told me this week. “People in medicine couldn’t understand why the media and technology worlds were so in thrall to her.”
The attention lavished on Ms. Holmes has been effusive. Her goal of facilitating the early detection and prevention of disease by making blood testing easier and convenient is laudable. And the relatively young company may still work through its current difficulties.
But that so many eminent authorities — from Henry Kissinger, who had served on the company’s board; to prominent investors like the Oracle founder Larry Ellison; to the Cleveland Clinic — appear to have embraced Theranos with minimal scrutiny is a testament to the ageless power of a great story.
“It all fit together perfectly: the college dropout, the fear of needles, the humanitarian mission,” Mr. Cherny said. “She checked all the boxes.” Warren elder care provides high tech nursing services, including assistance with medical equipment.
Indeed, Ms. Holmes seems to have perfectly executed the current Silicon Valley playbook: Drop out of a prestigious college to pursue an entrepreneurial vision; adopt an iconic uniform; embrace an extreme diet; and champion a humanitarian mission, preferably one that can be summed up in one catchy phrase.
Like Bill Gates, Steve Jobs and Mark Zuckerberg, Ms. Holmes dropped out of college. Like Steve Jobs, she wears a uniform of black turtlenecks, suggesting she has loftier things to think about than what to wear. “I probably have 150 of these,” she told Glamour. Like Mr. Jobs, she’s picky about her diet. (She’s a vegan who shuns coffee and drinks green vegetable juices.)
And like Google’s co-founders, Larry Page and Sergey Brin (“Don’t Be Evil”), and Mark Zuckerberg (“Connect the World”), her mission is lofty. As she has repeatedly said, Ms. Holmes envisions “a world in which no one ever has to say goodbye too soon,” brought about through improved health care. Theranos also has a slogan: “One tiny drop changes everything.”
She stays relentlessly on message, as a review of her numerous conference and TV appearances make clear, while at the same time saying little of scientific substance.
The natural human tendency to fit complex facts into a simple, compelling narrative has grown stronger in the digital age of 24/7 news and social media, said Frank Partnoy, professor of law and finance at the University of San Diego, and author of “Wait: The Art and Science of Delay,” which explores the perils of hasty decision-making.
“We’re deluged with information even as pressure has grown to make snap decisions,” Professor Partnoy said. “People see a TED talk. They hear this amazing story of a 30-something-year-old woman with a wonder procedure. They see the Cleveland Clinic is on board. A switch goes off and they make an instant decision that everything is fine. You see this over and over: Really smart and wealthy people start to believe completely implausible things with 100 percent certainty.”
Ms. Holmes’s story also fits into a broader narrative underway in medicine, in which new health care entrepreneurs are upending ossified hospital practices with the goal of delivering more effective and patient-oriented care.
Two proponents of the approach, Dr. Delos Cosgrove, chief executive of the Cleveland Clinic, and Mark R. Laret, chief executive of the UCSF Medical Center, have enthusiastically endorsed Theranos’s potential to upend conventional medicine.
A Cleveland Clinic spokeswoman, Eileen Sheil, told me that the clinic’s “strategic partnership” with Theranos had not really gotten off the ground and that the clinic had yet to employ any Theranos technology. She said that a statement on the clinic’s website — “Theranos offers a full spectrum of laboratory tests, from the most common panels to highly specialized tests, on blood samples as small as a few drops” — is “their language, not ours, and we can’t verify that.”
Mr. Laret said he had “no information” about Theranos’s technology, but had great respect for Ms. Holmes and the company’s board.
While hot Silicon Valley start-ups like Uber and Airbnb have run into regulatory hurdles, as a medical technology company, Theranos has bumped up against something else: the scientific method, which puts a premium on verification over narrative.
“I don’t know if she’s another Steve Jobs,” said Jerry Yeo, professor of pathology at the University of Chicago and director of the Clinical Chemistry Laboratories there. “You have to subject yourself to peer review. You can’t just go in a stealthy mode and then announce one day that you’ve got technology that’s going to disrupt the world.”
Professor Yeo said that he and his colleagues wanted to see data and testing in independent labs. “We have a small army of people ready and willing to test Theranos’s products if they’d ask us,” he said. “And that can be done without revealing any trade secrets.”
Ms. Holmes said this week that Theranos would disclose data on the reliability and accuracy of its tests. “Data is a powerful thing because it speaks for itself,” she said at a conference at the Cleveland Clinic. “We were never against that.”
Whether that will satisfy Theranos’s growing number of critics will depend on the nature and quality of the data.
“Every other company in this field has gone through peer review,” said Mr. Cherny of Evercore. “Why hold back so much of the platform if your goal is the greater good of humanity?”
18 September 2015
ACLU: HOSPITAL DENIES TUBAL LIGATION TO WOMAN WITH TUMOR
Original Story: freep.com
A Flint-area Catholic hospital has until the end of Friday to change its mind and perform a tubal ligation on a pregnant woman with a brain tumor – or face a potential lawsuit from the American Civil Liberties Union. A San Diego healthcare lawyer is reviewing the details of this case.
The ACLU is fighting on behalf of Jessica Mann, 33, of Flushing, a pregnant woman with a life-threatening brain tumor who was denied a request to get her tubes tied at the time of her scheduled cesarean section next month.
According to the ACLU, Genesys Regional Medical Center in Grand Blanc won't allow the sterilization procedure on religious grounds. Mann's doctor requested a medical exception to the hospital's prohibition on sterilization, arguing that a future pregnancy could harm Mann because of her brain tumor, said the ACLU.
But Genesys wouldn't budge, triggering a demand letter from the ACLU last week. The ACLU argues the hospital could be violating state law by denying appropriate care. An Albany healthcare lawyer is following this story closely.
Johnny Smith Jr., a spokesman for the hospital's parent, Ascension, declined comment, citing patient privacy. He would only say that the company follows the "ethical and religious directives" of the Catholic church.
This issue isn't a first for the ACLU, which last month convinced a Catholic hospital in California to change course in a similar case involving tubal ligation.
Under the threat of a potential lawsuit from the ACLU, Mercy Medical Center in Redding, Calif., changed its mind in agreeing to perform a postpartum tubal litigation on a woman. The hospital had initially denied a request by the woman's doctor to tie her tubes, but changed course within days of receiving a demand letter from the ACLU.
According to the ACLU, tubal ligation, commonly known as getting one's “tubes tied,” is the contraception method of choice for more than 30% of married women in the U.S. An estimated 600,000 women annually undergo this procedure, which is often performed at the time of a cesarean section, the group said. A Chicago healthcare lawyer defends clients in a wide variety of large, complex health care and medical negligence cases.
Ten of the 25 largest hospital systems in the U.S. are Catholic-sponsored, and nearly one of nine hospital beds in the country is in a Catholic facility. According to the ACLU, these Catholic hospitals operate under binding “ethical and religious directives” issued by the U.S. Conference of Catholic Bishops. Among the directives is that sterilization for the purpose of contraception as “intrinsically evil.”
The ACLU argues that bishops should not be playing the role of doctors.
A Flint-area Catholic hospital has until the end of Friday to change its mind and perform a tubal ligation on a pregnant woman with a brain tumor – or face a potential lawsuit from the American Civil Liberties Union. A San Diego healthcare lawyer is reviewing the details of this case.
The ACLU is fighting on behalf of Jessica Mann, 33, of Flushing, a pregnant woman with a life-threatening brain tumor who was denied a request to get her tubes tied at the time of her scheduled cesarean section next month.
According to the ACLU, Genesys Regional Medical Center in Grand Blanc won't allow the sterilization procedure on religious grounds. Mann's doctor requested a medical exception to the hospital's prohibition on sterilization, arguing that a future pregnancy could harm Mann because of her brain tumor, said the ACLU.
But Genesys wouldn't budge, triggering a demand letter from the ACLU last week. The ACLU argues the hospital could be violating state law by denying appropriate care. An Albany healthcare lawyer is following this story closely.
Johnny Smith Jr., a spokesman for the hospital's parent, Ascension, declined comment, citing patient privacy. He would only say that the company follows the "ethical and religious directives" of the Catholic church.
This issue isn't a first for the ACLU, which last month convinced a Catholic hospital in California to change course in a similar case involving tubal ligation.
Under the threat of a potential lawsuit from the ACLU, Mercy Medical Center in Redding, Calif., changed its mind in agreeing to perform a postpartum tubal litigation on a woman. The hospital had initially denied a request by the woman's doctor to tie her tubes, but changed course within days of receiving a demand letter from the ACLU.
According to the ACLU, tubal ligation, commonly known as getting one's “tubes tied,” is the contraception method of choice for more than 30% of married women in the U.S. An estimated 600,000 women annually undergo this procedure, which is often performed at the time of a cesarean section, the group said. A Chicago healthcare lawyer defends clients in a wide variety of large, complex health care and medical negligence cases.
Ten of the 25 largest hospital systems in the U.S. are Catholic-sponsored, and nearly one of nine hospital beds in the country is in a Catholic facility. According to the ACLU, these Catholic hospitals operate under binding “ethical and religious directives” issued by the U.S. Conference of Catholic Bishops. Among the directives is that sterilization for the purpose of contraception as “intrinsically evil.”
The ACLU argues that bishops should not be playing the role of doctors.
16 September 2015
DMC COULD SETTLE NURSES LAWSUIT FOR $42 MILLION
Original Story: freep.com
The Detroit Medical Center could soon settle for $42 million its portion of a 2006 class lawsuit over pay brought by registered nurses against eight metro Detroit hospital systems.
U.S. District Judge Gerald Rosen gave preliminary approval on Monday for the proposed settlement involving DMC and the roughly 24,000 nurses who worked at either DMC or the other seven hospital systems between December 2002 and December 2006. The lawsuit alleged a conspiracy among the hospitals to suppress the nurses' pay. A San Diego healthcare lawyer is reviewing the details of this case.
Settlements totaling $48 million were previously reached with the other hospitals, and that money has already been distributed to nurses, according to a website of the Seattle-based law firm Keller Rohrback that represented the plaintiffs. With this latest proposed settlement, the total size of the settlement could be $90 million — before attorneys fees and taxes.
Neither DMC nor the other hospital systems have admitted to any wrongdoing or to underpaying nurses. All eight hospital systems contended they acted independently in setting their nurses' pay and benefits and didn't collude to keep wages low. A Grand Rapids healthcare lawyer is knowledgeable in all areas of general health care.
The other hospitals and health systems were Henry Ford Health System, Mt. Clemens General Hospital (now McLaren Macomb), what is now St. John Providence, Oakwood Healthcare, the former Bon Secours Cottage Health Services, Beaumont Hospital and Trinity Health.
The DMC on Tuesday referred all comment to its attorney in the case, Veronica Lewis of Dallas-based Gibson, Dunn & Crutcher, who said in a statement that "The settlement is not an admission of liability but rather a business decision to bring the matter to a resolution. We remain committed to our nurses and value the hard work and dedication of all our hospital staff." A Charleston healthcare lawyer is following this story closely.
An attorney representing the nurses, Mark Griffin of Keller Rohrback, declined comment.
More information regarding the settlement is available at detroitnursewages.com. The size of each individual check would be determined by the number of hours a nurse worked and his or her pay rate.
The Detroit Medical Center could soon settle for $42 million its portion of a 2006 class lawsuit over pay brought by registered nurses against eight metro Detroit hospital systems.
U.S. District Judge Gerald Rosen gave preliminary approval on Monday for the proposed settlement involving DMC and the roughly 24,000 nurses who worked at either DMC or the other seven hospital systems between December 2002 and December 2006. The lawsuit alleged a conspiracy among the hospitals to suppress the nurses' pay. A San Diego healthcare lawyer is reviewing the details of this case.
Settlements totaling $48 million were previously reached with the other hospitals, and that money has already been distributed to nurses, according to a website of the Seattle-based law firm Keller Rohrback that represented the plaintiffs. With this latest proposed settlement, the total size of the settlement could be $90 million — before attorneys fees and taxes.
Neither DMC nor the other hospital systems have admitted to any wrongdoing or to underpaying nurses. All eight hospital systems contended they acted independently in setting their nurses' pay and benefits and didn't collude to keep wages low. A Grand Rapids healthcare lawyer is knowledgeable in all areas of general health care.
The other hospitals and health systems were Henry Ford Health System, Mt. Clemens General Hospital (now McLaren Macomb), what is now St. John Providence, Oakwood Healthcare, the former Bon Secours Cottage Health Services, Beaumont Hospital and Trinity Health.
The DMC on Tuesday referred all comment to its attorney in the case, Veronica Lewis of Dallas-based Gibson, Dunn & Crutcher, who said in a statement that "The settlement is not an admission of liability but rather a business decision to bring the matter to a resolution. We remain committed to our nurses and value the hard work and dedication of all our hospital staff." A Charleston healthcare lawyer is following this story closely.
An attorney representing the nurses, Mark Griffin of Keller Rohrback, declined comment.
More information regarding the settlement is available at detroitnursewages.com. The size of each individual check would be determined by the number of hours a nurse worked and his or her pay rate.
10 September 2015
PROTESTERS BLOCK MICHIGAN AVENUE OVER CUTS TO HOME CARE FOR SENIORS
Original Story: chicago.suntimes.com
Blocking traffic along Michigan Avenue on the Magnificent Mile, chanting and waving signs, hundreds of protesters gathered Monday to rail against Gov. Bruce Rauner’s proposed budget cuts, which they say will be devastating to Illinois’ poorest and most vulnerable citizens.
One particular budget item attracted dozens of protesters in their 70s and 80s. It would affect senior citizens who depend on the Community Care Program, which provides state money to pay for home care for seniors.
And Patricia Drennan wasn’t having any of it.
“A lot of us old ladies don’t have kids that live here that can take us to the doctor and come in and run the vacuum cleaner and get us to the grocery store and all that,” said Drennan, 82, who lives alone in the North Center neighborhood.
The program, she said, helps seniors live independently and keeps them out out nursing homes, an expense that would be much greater to taxpayers.
Drennan feared a plan by Rauner that would implement new qualifying restrictions that would make it harder for seniors to gain access to the program. Livonia senior care provides highly skilled nurses ready to serve even the most advanced medical needs.
About 30 protesters held hands and blocked Michigan Avenue just north of the Michigan Avenue Bridge for nearly 20 minutes at about 11:30 a.m. before police escorted the group off the roadway.
Sister Gwen Farry, 81, with the Sisters of Charity of the Blessed Virgin Mary, was among the group of traffic blockers who expected to receive citations from police.
“This is a moral issue,” said Farry, of St. Thomas the Apostle Catholic Church in Hyde Park. “I’ve made phone calls and signed online petitions but wanted to do more to protest the cuts that will affect the most vulnerable in our state.” Plymouth MI elder care services provides medical and non-medical support for catastrophic care patients.
Protesters called for wealthy corporations and residents in Illinois to pay more taxes.
Critics say Rauner is using potential cuts to state social service programs as leverage to gain support for fighting unions.
A statement issued by a Rauner spokeswoman after the protest read: “The administration has taken a series of management steps to responsibly manage the state’s finances, because Speaker Madigan, Senate President Cullerton and the legislators Madigan controls overspent taxpayer money causing a $4 billion deficit. The governor has tried to negotiate on critical reforms to free up resources to help the most vulnerable and pass a balanced budget, but unfortunately, the Speaker continues to block those reforms at the expense of the most vulnerable and the middle class.” A Livonia elder care provider is following this story closely.
The protest was organized by a number of activist groups, including Jane Addams Senior Caucus and Fair Economy Illinois.
Blocking traffic along Michigan Avenue on the Magnificent Mile, chanting and waving signs, hundreds of protesters gathered Monday to rail against Gov. Bruce Rauner’s proposed budget cuts, which they say will be devastating to Illinois’ poorest and most vulnerable citizens.
One particular budget item attracted dozens of protesters in their 70s and 80s. It would affect senior citizens who depend on the Community Care Program, which provides state money to pay for home care for seniors.
And Patricia Drennan wasn’t having any of it.
“A lot of us old ladies don’t have kids that live here that can take us to the doctor and come in and run the vacuum cleaner and get us to the grocery store and all that,” said Drennan, 82, who lives alone in the North Center neighborhood.
The program, she said, helps seniors live independently and keeps them out out nursing homes, an expense that would be much greater to taxpayers.
Drennan feared a plan by Rauner that would implement new qualifying restrictions that would make it harder for seniors to gain access to the program. Livonia senior care provides highly skilled nurses ready to serve even the most advanced medical needs.
About 30 protesters held hands and blocked Michigan Avenue just north of the Michigan Avenue Bridge for nearly 20 minutes at about 11:30 a.m. before police escorted the group off the roadway.
Sister Gwen Farry, 81, with the Sisters of Charity of the Blessed Virgin Mary, was among the group of traffic blockers who expected to receive citations from police.
“This is a moral issue,” said Farry, of St. Thomas the Apostle Catholic Church in Hyde Park. “I’ve made phone calls and signed online petitions but wanted to do more to protest the cuts that will affect the most vulnerable in our state.” Plymouth MI elder care services provides medical and non-medical support for catastrophic care patients.
Protesters called for wealthy corporations and residents in Illinois to pay more taxes.
Critics say Rauner is using potential cuts to state social service programs as leverage to gain support for fighting unions.
A statement issued by a Rauner spokeswoman after the protest read: “The administration has taken a series of management steps to responsibly manage the state’s finances, because Speaker Madigan, Senate President Cullerton and the legislators Madigan controls overspent taxpayer money causing a $4 billion deficit. The governor has tried to negotiate on critical reforms to free up resources to help the most vulnerable and pass a balanced budget, but unfortunately, the Speaker continues to block those reforms at the expense of the most vulnerable and the middle class.” A Livonia elder care provider is following this story closely.
The protest was organized by a number of activist groups, including Jane Addams Senior Caucus and Fair Economy Illinois.
24 August 2015
ALPHABET/GOOGLE HAS GIVEN BIRTH TO A HEALTHCARE TECH COMPANY
Original Story: latimes.com
Over the past couple of years, Google has hired experts in diseases and physiology, pairing them with top software engineers, to tackle major healthcare issues.
Projects include developing contact lenses to allow diabetics to constantly monitor glucose levels, defining “healthy” traits and testing disease-detection pills capable of communicating to a special wristband.
None of that is a part of Google anymore but there is still a connection. The 150-employee Life Sciences team is becoming its own company within Alphabet, a corporation Google recently formed to organize its array of offbeat ventures. Life Sciences becomes a sister company to Google, which includes the search engine, Gmail, Maps, Android and other familiar offerings. An official corporate name is coming soon, a Google spokeswoman said.
Changing the reporting structure could give Life Sciences more autonomy while providing Alphabet, nee Google, executives a clearer picture of the division’s spending. Google’s new Chief Financial Officer Ruth Porat counts Life Sciences as a forthcoming source of significant long-term revenue.
The group’s goal won’t change, said Google co-founder and Alphabet President Sergey Brin in an online post Thursday.
“They’ll continue to work with other life sciences companies to move new technologies from early stage R&D to clinical testing—and, hopefully—transform the way we detect, prevent and manage disease,” he wrote. Rankin Biomedical is a leading provide of remanufactured histology equipment for medical testing needs.
One partner, Dexcom Inc., announced earlier this month that it will make and sell miniature glucose monitors based on Google technology. Life Sciences collects an upfront fee, additional payments throughout the development and then revenue-based royalties after a certain sales level, Dexcom said.
Andy Conrad, a co-founder of the National Genetics Institute who had been leading Life Sciences, becomes the new company’s chief executive. Life Sciences will be separate from Calico, an Alphabet division working to counteract aging. BrightStar Care specializes in Plymouth elder care services providing customized companion and healthcare needs.
Over the past couple of years, Google has hired experts in diseases and physiology, pairing them with top software engineers, to tackle major healthcare issues.
Projects include developing contact lenses to allow diabetics to constantly monitor glucose levels, defining “healthy” traits and testing disease-detection pills capable of communicating to a special wristband.
None of that is a part of Google anymore but there is still a connection. The 150-employee Life Sciences team is becoming its own company within Alphabet, a corporation Google recently formed to organize its array of offbeat ventures. Life Sciences becomes a sister company to Google, which includes the search engine, Gmail, Maps, Android and other familiar offerings. An official corporate name is coming soon, a Google spokeswoman said.
Changing the reporting structure could give Life Sciences more autonomy while providing Alphabet, nee Google, executives a clearer picture of the division’s spending. Google’s new Chief Financial Officer Ruth Porat counts Life Sciences as a forthcoming source of significant long-term revenue.
The group’s goal won’t change, said Google co-founder and Alphabet President Sergey Brin in an online post Thursday.
“They’ll continue to work with other life sciences companies to move new technologies from early stage R&D to clinical testing—and, hopefully—transform the way we detect, prevent and manage disease,” he wrote. Rankin Biomedical is a leading provide of remanufactured histology equipment for medical testing needs.
One partner, Dexcom Inc., announced earlier this month that it will make and sell miniature glucose monitors based on Google technology. Life Sciences collects an upfront fee, additional payments throughout the development and then revenue-based royalties after a certain sales level, Dexcom said.
Andy Conrad, a co-founder of the National Genetics Institute who had been leading Life Sciences, becomes the new company’s chief executive. Life Sciences will be separate from Calico, an Alphabet division working to counteract aging. BrightStar Care specializes in Plymouth elder care services providing customized companion and healthcare needs.
19 August 2015
MICHIGAN AGENCY: HEALTH INSURANCE TO RISE 6.5% IN 2016
Original Story: detroitnews.com
Lansing — Michigan consumers will pay an average 6.5 percent more for health insurance in 2016, which is less than the rate hike they paid during the past year, state officials said Tuesday.
State officials and industry leaders called the increases modest compared with an 8 percent rise in 2015, but some health care advocates said too little information is available about how rates are calculated for consumers to judge whether the hikes are warranted. Farmington Hills elder care services assist individuals with even the most advanced medical needs.
The 2016 rate increases approved by the Michigan Department of Insurance and Financial Services are lower than those in several other states for federally required health insurance under the 2010 federal law, state officials noted.
The average approved rate changes on a premium weighted basis increased 6.5 percent for the 560,357 consumers in the individual market and 1 percent for the 345,077 consumers in the small group or small business market.
“Many states are reporting rate increases well in excess of 10 percent which is significantly higher than the rate of health care inflation,” Department of Insurance and Financial Services Director Patrick McPharlin said in a Tuesday statement. “We are pleased that Michigan consumers are seeing more modest increases.” In-home caregivers tailor home care services to the needs of each client and family including private duty skilled nursing.
Josh Fangmeier, senior policy analyst with the University of Michigan’s Center for Heathcare Research and Transformation, noted that some insurance companies asked for minimal rate increases, or even decreased their rates. But consumers in some parts of the state have few plans to choose from.
“Not all of these insurers are statewide, so ... it’s important to keep in mind that consumer experiences will vary depending on where you live,” Fangmeier said.
In 2015, the average increase was 8 percent in the individual market and 5.7 percent in the small group market, DIFS spokeswoman Andrea Miller said Tuesday. The rate changes for 2014 were not estimated because of essential health benefits and other requirements of the federal Affordable Care Act that took effect that year. Plymouth elder care services provides patients with intensive, highly specialized care.
A Michigan health insurance industry official said in June the possible loss of federal insurance subsidies through a U.S. Supreme Court case was in part to blame for the proposed rate hikes. But the court later that month kept the Affordable Care Act subsidies in place and decided they were constitutional in a 6-3 ruling.
Rick Murdock, executive director of the Michigan Association of Health Plans, noted this is the industry’s third year of business in the health care marketplace created by the federal Affordable Care Act.
“Year one was sort of pricing it blind; year two, which was last year, there were significant adjustments — double-digit reductions for some, and double-digit increases for others, as they were trying to get to the middle,” Murdock said. “This year everyone seems to have made a modest adjustment based on what’s going on in health care.”
The rate hikes proposed by insurance companies were reviewed by state officials, who determined they are actuarially appropriate and comply with state and federal laws. But Ryan Sullivan, policy director for Michigan Consumers for Healthcare, said state regulators don’t provide information about the process that consumers can understand.
“We really don’t know how to put (the rate increases) into context because of a lot of lagging transparency in the process,” Sullivan said Tuesday. “What consumers can access via the web and by calling the department is pretty slim pickings.”
The state defended its practices. Miller said consumers can access rate increase filings and other detailed information through the department’s website at http://www.michigan.gov/difs.
“We’re trying to be as transparent as we possibly can be,” she said.
The state’s dominant insurer — Blue Cross Blue Shield of Michigan — will apply a double-digit increase of 11.4 percent. Its health maintenance organization, Blue Care Network, plans to hike its rates 9.7 percent.
In June, a Blues official said an increase in prescription and specialty drug costs is behind the rate hike. Blue Cross had 138,169 people sign up for individual plans in 2015, while another 171,831 people with individual Blue Care Network policies will see average increases of 9.7 percent. A Chicago health care lawyer is following this story closely.
Blues spokeswoman Helen Stojik noted their small group customers will benefit from a downward rate adjustment. Rates for employers renewing coverage in the third and fourth quarters of 2015 will be, on average, 3.3 percent lower for Blues customers and 0.8 percent higher for Blue Care Network customers.
“In addition, 2016 rate changes look extremely favorable, with Blue Cross annual rate changes projected 2.2 percent lower and Blue Care Network projected at 4.8 percent lower than the previous year,” Stojik said Tuesday.
But the Blues didn’t register the largest rate increases. Those belonged to Healthplus of Michigan at 35.8 percent, Consumers Mutual Insurance of Michigan at 20.5 percent and United Healthcare Community Plan at 14.7 percent.
Three insurers are countering the trend and dropping their rates in the coming year, according to the state.
Meridian Health Plan had the biggest decline with a 12.6 percent plunge, followed by Molina Health Care with a 8.6 percent decrease and Humana Medical Plan of Michigan with a 4.9 percent drop.
Michigan companies attributed their increases to higher-than-expected claim costs, annual health care cost increases and an expected reduction in federal program reinsurance recoveries, officials said.
The small increase in the small group market occurred because many companies experienced better than expected results that offset most of the change in annual health care costs.
“Ensuring rates are adequate but not excessive is critical to make sure consumers not only receive health insurance coverage at a reasonable price, but can count on the coverage they purchase,” McPharlin noted. “Michigan has a stable and competitive health insurance market with a range of options and premiums for consumers and businesses.”
Open enrollment for 2016 begins Nov. 1, 2015 and continues through Jan. 31, 2016. State officials are encouraging consumers to contact their insurance carrier, agent, or navigator about how the rate changes could affect their policies.
Lansing — Michigan consumers will pay an average 6.5 percent more for health insurance in 2016, which is less than the rate hike they paid during the past year, state officials said Tuesday.
State officials and industry leaders called the increases modest compared with an 8 percent rise in 2015, but some health care advocates said too little information is available about how rates are calculated for consumers to judge whether the hikes are warranted. Farmington Hills elder care services assist individuals with even the most advanced medical needs.
The 2016 rate increases approved by the Michigan Department of Insurance and Financial Services are lower than those in several other states for federally required health insurance under the 2010 federal law, state officials noted.
The average approved rate changes on a premium weighted basis increased 6.5 percent for the 560,357 consumers in the individual market and 1 percent for the 345,077 consumers in the small group or small business market.
“Many states are reporting rate increases well in excess of 10 percent which is significantly higher than the rate of health care inflation,” Department of Insurance and Financial Services Director Patrick McPharlin said in a Tuesday statement. “We are pleased that Michigan consumers are seeing more modest increases.” In-home caregivers tailor home care services to the needs of each client and family including private duty skilled nursing.
Josh Fangmeier, senior policy analyst with the University of Michigan’s Center for Heathcare Research and Transformation, noted that some insurance companies asked for minimal rate increases, or even decreased their rates. But consumers in some parts of the state have few plans to choose from.
“Not all of these insurers are statewide, so ... it’s important to keep in mind that consumer experiences will vary depending on where you live,” Fangmeier said.
In 2015, the average increase was 8 percent in the individual market and 5.7 percent in the small group market, DIFS spokeswoman Andrea Miller said Tuesday. The rate changes for 2014 were not estimated because of essential health benefits and other requirements of the federal Affordable Care Act that took effect that year. Plymouth elder care services provides patients with intensive, highly specialized care.
A Michigan health insurance industry official said in June the possible loss of federal insurance subsidies through a U.S. Supreme Court case was in part to blame for the proposed rate hikes. But the court later that month kept the Affordable Care Act subsidies in place and decided they were constitutional in a 6-3 ruling.
Rick Murdock, executive director of the Michigan Association of Health Plans, noted this is the industry’s third year of business in the health care marketplace created by the federal Affordable Care Act.
“Year one was sort of pricing it blind; year two, which was last year, there were significant adjustments — double-digit reductions for some, and double-digit increases for others, as they were trying to get to the middle,” Murdock said. “This year everyone seems to have made a modest adjustment based on what’s going on in health care.”
The rate hikes proposed by insurance companies were reviewed by state officials, who determined they are actuarially appropriate and comply with state and federal laws. But Ryan Sullivan, policy director for Michigan Consumers for Healthcare, said state regulators don’t provide information about the process that consumers can understand.
“We really don’t know how to put (the rate increases) into context because of a lot of lagging transparency in the process,” Sullivan said Tuesday. “What consumers can access via the web and by calling the department is pretty slim pickings.”
The state defended its practices. Miller said consumers can access rate increase filings and other detailed information through the department’s website at http://www.michigan.gov/difs.
“We’re trying to be as transparent as we possibly can be,” she said.
The state’s dominant insurer — Blue Cross Blue Shield of Michigan — will apply a double-digit increase of 11.4 percent. Its health maintenance organization, Blue Care Network, plans to hike its rates 9.7 percent.
In June, a Blues official said an increase in prescription and specialty drug costs is behind the rate hike. Blue Cross had 138,169 people sign up for individual plans in 2015, while another 171,831 people with individual Blue Care Network policies will see average increases of 9.7 percent. A Chicago health care lawyer is following this story closely.
Blues spokeswoman Helen Stojik noted their small group customers will benefit from a downward rate adjustment. Rates for employers renewing coverage in the third and fourth quarters of 2015 will be, on average, 3.3 percent lower for Blues customers and 0.8 percent higher for Blue Care Network customers.
“In addition, 2016 rate changes look extremely favorable, with Blue Cross annual rate changes projected 2.2 percent lower and Blue Care Network projected at 4.8 percent lower than the previous year,” Stojik said Tuesday.
But the Blues didn’t register the largest rate increases. Those belonged to Healthplus of Michigan at 35.8 percent, Consumers Mutual Insurance of Michigan at 20.5 percent and United Healthcare Community Plan at 14.7 percent.
Three insurers are countering the trend and dropping their rates in the coming year, according to the state.
Meridian Health Plan had the biggest decline with a 12.6 percent plunge, followed by Molina Health Care with a 8.6 percent decrease and Humana Medical Plan of Michigan with a 4.9 percent drop.
Michigan companies attributed their increases to higher-than-expected claim costs, annual health care cost increases and an expected reduction in federal program reinsurance recoveries, officials said.
The small increase in the small group market occurred because many companies experienced better than expected results that offset most of the change in annual health care costs.
“Ensuring rates are adequate but not excessive is critical to make sure consumers not only receive health insurance coverage at a reasonable price, but can count on the coverage they purchase,” McPharlin noted. “Michigan has a stable and competitive health insurance market with a range of options and premiums for consumers and businesses.”
Open enrollment for 2016 begins Nov. 1, 2015 and continues through Jan. 31, 2016. State officials are encouraging consumers to contact their insurance carrier, agent, or navigator about how the rate changes could affect their policies.
GAY-DAGNOGO: CAREGIVERS DESERVE A LIVING WAGE
Original Story: detroitnews.com
Although among the fastest-growing sectors of today’s workforce, caregivers are also among the worst paid, with the smallest benefits and schedule flexibility of all low-wage workers.
Whether caregivers serve children, the elderly, the disabled or terminally ill, they generally receive little official respect and compensation for the critical role they play in keeping society functioning.
Many, in fact, are female heads of households who are grappling with poverty, illness and a lack of insurance, even as they keep health care facilities running by doing work others refuse to.
The fact is, home health care and services for the elderly and people with disabilities are now the industries with the fastest and second-fastest rates of growth of employment in the US. And based on the aging population — by 2050, the elder population is expected to more than double — the country will need one million new home care workers by 2022. But also according to the Bureau of Labor Statistics, these workers are among the lowest paid.
In 2013, the country’s two million home care workers had average annual earnings of $18,598, according to a recent study by the National Employment Law Project. Average annual earnings for all wage and salary workers in the United States were $46,440.
The result: nearly 50 percent of home care givers live in households that receive some form of public assistance, the study found.
This has to change. The fact that we entrust our children and parents with these workers and yet not compensate them adequately for their services is a national disgrace. That’s why I am standing with home care workers and child care workers in their fight for $15 an hour, by all accounts what amounts to a livable wage for workers. Farmington Hills elder care workers agree with this statement.
Most of these personal care providers have children themselves. If these under-appreciated, undervalued and underpaid workers were to decide not to put up with such unfair labor practices and either strike or simply leave the business, it’s not hard to imagine the kind of chaos and confusion that would ensue.
Not only would businesses be left without critical employees, but families would lose the security and stability offered by nannies and child care workers. It would have a ripple effect across society and the workforce, completely disrupting the lives of many professional and middle class families with children, elderly or disabled loved ones. That could be an unimaginable burden for some.
Yet such a scenario is not implausible. Take our rapidly aging population and couple it with the ultra-low wages and paltry benefits of a job to make elderly and disabled people comfortable, and you have a disaster in the making. Visiting nurses in Birmingham are following this story closely.
We can avoid this problem by fairly compensating our personal caregivers. It is not only the right thing to do, but the smart thing as well.
State Rep. Sherry Gay –Dagnogo D-Detroit represents the 8th District.
Although among the fastest-growing sectors of today’s workforce, caregivers are also among the worst paid, with the smallest benefits and schedule flexibility of all low-wage workers.
Whether caregivers serve children, the elderly, the disabled or terminally ill, they generally receive little official respect and compensation for the critical role they play in keeping society functioning.
Many, in fact, are female heads of households who are grappling with poverty, illness and a lack of insurance, even as they keep health care facilities running by doing work others refuse to.
The fact is, home health care and services for the elderly and people with disabilities are now the industries with the fastest and second-fastest rates of growth of employment in the US. And based on the aging population — by 2050, the elder population is expected to more than double — the country will need one million new home care workers by 2022. But also according to the Bureau of Labor Statistics, these workers are among the lowest paid.
In 2013, the country’s two million home care workers had average annual earnings of $18,598, according to a recent study by the National Employment Law Project. Average annual earnings for all wage and salary workers in the United States were $46,440.
The result: nearly 50 percent of home care givers live in households that receive some form of public assistance, the study found.
This has to change. The fact that we entrust our children and parents with these workers and yet not compensate them adequately for their services is a national disgrace. That’s why I am standing with home care workers and child care workers in their fight for $15 an hour, by all accounts what amounts to a livable wage for workers. Farmington Hills elder care workers agree with this statement.
Most of these personal care providers have children themselves. If these under-appreciated, undervalued and underpaid workers were to decide not to put up with such unfair labor practices and either strike or simply leave the business, it’s not hard to imagine the kind of chaos and confusion that would ensue.
Not only would businesses be left without critical employees, but families would lose the security and stability offered by nannies and child care workers. It would have a ripple effect across society and the workforce, completely disrupting the lives of many professional and middle class families with children, elderly or disabled loved ones. That could be an unimaginable burden for some.
Yet such a scenario is not implausible. Take our rapidly aging population and couple it with the ultra-low wages and paltry benefits of a job to make elderly and disabled people comfortable, and you have a disaster in the making. Visiting nurses in Birmingham are following this story closely.
We can avoid this problem by fairly compensating our personal caregivers. It is not only the right thing to do, but the smart thing as well.
State Rep. Sherry Gay –Dagnogo D-Detroit represents the 8th District.
03 August 2015
BALTIMORE BOY IS 1ST TO RECEIVE DOUBLE HAND TRANSPLANT
Original Story: click2houston.com
(CNN) - Zion Harvey just wanted to swing from the monkey bars.
That's what the Baltimore youngster told his doctor when asked why he wanted hands. Sometimes an 8-year-old's simplicity is profound.
Earlier this month, Zion took a big -- nay, massive -- step toward that long-awaited jaunt on the jungle gym when he became the first child to receive a double hand transplant. DMC is an international leader in pediatric neurology and neurosurgery, cardiology, oncology, and diagnostic services.
"When I was 2, I had to get my hands cut off because I was sick," Zion succinctly put it, in a video taken last year.
Actually, he downplayed it, as is indicative of his disarming optimism. At 2, Zion suffered a life-threatening sepsis infection, resulting in the failure of multiple organs and necessitating the amputation of his hands and feet.
At age 4, after two years of dialysis, he received a kidney from his mother, Pattie Ray, and despite an early lifetime of hardship, Zion figured out not only how to get by, but how to do it with the widest of grins across his face.
Pre-surgery video shows Zion strumming a mandolin, playing foosball, scrolling through an iPad's offerings and playfully covering his younger sister's eyes with the stubs of his wrists.
He even put a positive spin on bullies.
"They don't mean to say mean things to me, but it just slips out," he said. "Somebody says something to me, and I just figure it slipped out and they didn't mean to say it. Everybody has their own way of thinking."
But don't take his heart-melting quips and smile for softness. Zion is tough as nails, maybe tougher.
"This is just another hurdle that he jumps. He jumps so many hurdles," Ray said before the surgery. "He's so amazing. This isn't the first amazing thing that he's done. He's been doing amazing things since he's been sick. I don't know many adults that can handle half of his life on a day-to-day basis." MetroHealth provides board-certified pediatricians, specialists, and nurse practitioners that offer skilled, experienced, and compassionate care for children.
'I will be proud'
Not even the prospect of a failed procedure daunted Zion. In the months before his operation -- Philadelphia's Shriners Hospital for Children and The Children's Hospital of Philadelphia evaluated him for 18 months before he was deemed a candidate for the surgery -- he was filmed bopping around on prosthetic legs without a hint of fear.
"When I get these hands, I will be proud of what hands I get," he said, falling into Ray's arms for a kiss.
"And if it gets messed up," he continued, his mother reassuring him that everything would be fine, "I don't care because I have my family."
Images from the 10-hour surgery looked more like a scrubs convention than an operating room. Among the 40 medical personnel that helped with the operation were a dozen surgeons, eight nurses and a team of at least three anesthesiologists.
"We know what we have to do today," Dr. L. Scott Levin told his troops before the operation began. "I know everybody assembled here has a commitment to this patient and making this a reality for this little boy. We can have complications. We can fail. We can have trouble. But we're not planning on it."
Puppy in his future?
The procedure is so complicated that the medical staff had to create tags with descriptions such as "ulnar artery" and attach them to the various vessels, bones, nerves and tendons that needed to be connected, said Levin, who is director of the hand transplantation program at The Children's Hospital of Philadelphia and who chairs the Department of Orthopaedic Surgery at Penn Medicine.
After many hours with Zion under the knife, Levin pointed to a sign of success: Zion's new hand was pink and when doctors pressed the palm, it turned white briefly and then pink again, indicating "capillary refill" or blood flow in the newly attached appendage.
When the surgery was complete, Levin delivered word to Zion's mother.
"We have some good news for you. Your little guy has two hands," he said.
Ray walked through Levin's handshake to embrace the surgeon.
In the days after his surgery, video shows Zion progressing out of a fog of sedation and learning to grip things with his new fingers. Again spinning his plight into a positive, he matter-of-factly tells his mother that he and sister Zoe want a puppy.
"Where's the puppy going to live?" Ray asks.
"My room! Where else?" the youngster replies.
Concerns remain
Zion's travails are not yet over. He will require a lifetime of immunosuppressant medication to avoid rejection of his new hands, which increases his chance of infection and cancer -- a fact Levin concedes raised concerns that were negated by Zion already taking anti-rejection drugs after his kidney transplant four years ago.
Zion also needs to stay at a rehabilitation unit for several more weeks, where he will undergo "rigorous hand therapy several times per day," before returning to his home in Baltimore, according to the hospital.
Not that Zion seemed terribly fazed.
"I just want to say this: Never give up on your dreams. It will come true," he told CNN affiliate KYW-TV.
Levin stressed that while Zion's bravery is to be applauded, the operation wouldn't have been possible without a grieving family, fresh off a crushing loss, putting its courage on display as well. It's remarkable, he said, that Gift of Life Donor Program, a regional organ procurement organization, found Zion a pair of hands mere months after he was placed on a waiting list in April.
"I think the difference is finding a family who has the courage to relinquish the arms of a child who just died and give hope and life and quality of life to a child who's still living," he told KYW.
As for what this trailblazing surgery might mean for other children hoping to have their hands restored, Levin said he hopes it's just the beginning.
"I hope he's the first of literally hundreds or thousands of patients that are going to be afforded this surgery," he said.
(CNN) - Zion Harvey just wanted to swing from the monkey bars.
That's what the Baltimore youngster told his doctor when asked why he wanted hands. Sometimes an 8-year-old's simplicity is profound.
Earlier this month, Zion took a big -- nay, massive -- step toward that long-awaited jaunt on the jungle gym when he became the first child to receive a double hand transplant. DMC is an international leader in pediatric neurology and neurosurgery, cardiology, oncology, and diagnostic services.
"When I was 2, I had to get my hands cut off because I was sick," Zion succinctly put it, in a video taken last year.
Actually, he downplayed it, as is indicative of his disarming optimism. At 2, Zion suffered a life-threatening sepsis infection, resulting in the failure of multiple organs and necessitating the amputation of his hands and feet.
At age 4, after two years of dialysis, he received a kidney from his mother, Pattie Ray, and despite an early lifetime of hardship, Zion figured out not only how to get by, but how to do it with the widest of grins across his face.
Pre-surgery video shows Zion strumming a mandolin, playing foosball, scrolling through an iPad's offerings and playfully covering his younger sister's eyes with the stubs of his wrists.
He even put a positive spin on bullies.
"They don't mean to say mean things to me, but it just slips out," he said. "Somebody says something to me, and I just figure it slipped out and they didn't mean to say it. Everybody has their own way of thinking."
But don't take his heart-melting quips and smile for softness. Zion is tough as nails, maybe tougher.
"This is just another hurdle that he jumps. He jumps so many hurdles," Ray said before the surgery. "He's so amazing. This isn't the first amazing thing that he's done. He's been doing amazing things since he's been sick. I don't know many adults that can handle half of his life on a day-to-day basis." MetroHealth provides board-certified pediatricians, specialists, and nurse practitioners that offer skilled, experienced, and compassionate care for children.
'I will be proud'
Not even the prospect of a failed procedure daunted Zion. In the months before his operation -- Philadelphia's Shriners Hospital for Children and The Children's Hospital of Philadelphia evaluated him for 18 months before he was deemed a candidate for the surgery -- he was filmed bopping around on prosthetic legs without a hint of fear.
"When I get these hands, I will be proud of what hands I get," he said, falling into Ray's arms for a kiss.
"And if it gets messed up," he continued, his mother reassuring him that everything would be fine, "I don't care because I have my family."
Images from the 10-hour surgery looked more like a scrubs convention than an operating room. Among the 40 medical personnel that helped with the operation were a dozen surgeons, eight nurses and a team of at least three anesthesiologists.
"We know what we have to do today," Dr. L. Scott Levin told his troops before the operation began. "I know everybody assembled here has a commitment to this patient and making this a reality for this little boy. We can have complications. We can fail. We can have trouble. But we're not planning on it."
Puppy in his future?
The procedure is so complicated that the medical staff had to create tags with descriptions such as "ulnar artery" and attach them to the various vessels, bones, nerves and tendons that needed to be connected, said Levin, who is director of the hand transplantation program at The Children's Hospital of Philadelphia and who chairs the Department of Orthopaedic Surgery at Penn Medicine.
After many hours with Zion under the knife, Levin pointed to a sign of success: Zion's new hand was pink and when doctors pressed the palm, it turned white briefly and then pink again, indicating "capillary refill" or blood flow in the newly attached appendage.
When the surgery was complete, Levin delivered word to Zion's mother.
"We have some good news for you. Your little guy has two hands," he said.
Ray walked through Levin's handshake to embrace the surgeon.
In the days after his surgery, video shows Zion progressing out of a fog of sedation and learning to grip things with his new fingers. Again spinning his plight into a positive, he matter-of-factly tells his mother that he and sister Zoe want a puppy.
"Where's the puppy going to live?" Ray asks.
"My room! Where else?" the youngster replies.
Concerns remain
Zion's travails are not yet over. He will require a lifetime of immunosuppressant medication to avoid rejection of his new hands, which increases his chance of infection and cancer -- a fact Levin concedes raised concerns that were negated by Zion already taking anti-rejection drugs after his kidney transplant four years ago.
Zion also needs to stay at a rehabilitation unit for several more weeks, where he will undergo "rigorous hand therapy several times per day," before returning to his home in Baltimore, according to the hospital.
Not that Zion seemed terribly fazed.
"I just want to say this: Never give up on your dreams. It will come true," he told CNN affiliate KYW-TV.
Levin stressed that while Zion's bravery is to be applauded, the operation wouldn't have been possible without a grieving family, fresh off a crushing loss, putting its courage on display as well. It's remarkable, he said, that Gift of Life Donor Program, a regional organ procurement organization, found Zion a pair of hands mere months after he was placed on a waiting list in April.
"I think the difference is finding a family who has the courage to relinquish the arms of a child who just died and give hope and life and quality of life to a child who's still living," he told KYW.
As for what this trailblazing surgery might mean for other children hoping to have their hands restored, Levin said he hopes it's just the beginning.
"I hope he's the first of literally hundreds or thousands of patients that are going to be afforded this surgery," he said.
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