Patt Morrison for June 8, 2011

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We may be poised to see some changes in how we pay our bills. The ubiquitous plastic cards that can solve your every payment problem are currently being faced with two recent propositions. One, Anthem Blue Cross may be implementing a 15 dollar convenience charge to clients who elect to pay with debit or credit cards. In the absence of any real explanation, critics are seeing this as an obvious money grab. Meanwhile and conversely, the Senate voted today 54-45 in favor of reducing debit card swipe fees. Some politicians have voiced concern that small banks would have to hike prices in other areas, like checking fees, to break even. Others can muster little pity for America’s financial institutions, the majority of which will be hurt little by the proposed cuts. Tune in and find out about the changes being made to what’s in your wallet!
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There’s a practice that’s becoming more common among drug companies and its beginning to alarm consumer advocate groups and politicians alike. Consumers may not realize that the makers of popular pharmaceuticals strike deals with the manufacturers of generic drugs in order to keep lower cost versions of a particular drug off the pharmacy shelves. The Federal Trade Commission is wading into the battle, urging an appeals court to outlaw certain deals that are struck to delay the introduced of cheaper generic drugs. At the heart of this arrangement is a bargain that is struck to keep a generic product off the market for a year. This allows a drug manufacturer to retain its monopoly and enables the company to continue to charge the highest market value without fear of competition. The pharmaceutical companies argue that the arrangement saves billions of dollars by avoiding the frequent litigations that occur as patent-disputes arise. Is the cost to the consumer worth the pain-killer for big pharma?
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The DSM—or Diagnostic and Statistical Manual of Mental Disorders—is known as the “bible” of psychology and psychiatry because it contains the criteria needed for diagnosis of each mental disorder. It has not been revised in almost twenty years, and the new version, the DSM-5, set to come out in May 2013, is likely to create entirely new disorders such as hyperactive sexual disorder, gambling behavioral addition, hoarding disorder (which public health officials are happy about because of the public risk—animal hoarding, fire trap, oh my!), ADHD in older teens and adults (previously considered a problem of children), anxious depression, and binge eating disorder (previously just in the appendix). Some claim that these new disorders are unnecessary and will result in over diagnosing and excessive prevalence rates. The DSM task force claims that additions are necessary because, for example with anxious depression, more than 50% of people with depression also have anxiety and that mixed group has shown the poorest response to medication. Similarly, the DSM says that merging Asperger’s Syndrome into the Autism Spectrum disorders will grant more access to services. Others, however, such as the proud support group “Asbies,” want to protect Asperger’s as its own disorder. The new DSM is also expected to reduce personality disorders from 10 to 6—eliminating dependent personality disorder, paranoid personality disorder, histrionic personality disorder (acting very emotional and dramatic to get attention), and schizoid personality disorder (lifelong pattern of indifference to others and social isolation). Will disorder additions and eliminations mean more services for some and less for others? Do new disorders exist and ones we previously thought existed not actually exist? Are some of these new disorders medicalizing human behavior?
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Blue Shield lowering premiums

Blue Shield of California has announced that it will reduce, your read that right, reduce premiums by 2.5% for many of its policyholders. The health insurance giant has been under the watchful eye of regulators and Congress for enacting a series of steep rate increases. The adjustment should be reflected in subscribers’ October bill and will amount to about $167 million in savings for its 2 million customers. And as if that wasn’t enough, the company says that it will cap its earnings to no more than 2 percent of annual revenue. Anything Blue Shield makes above and beyond the cap will be refunded to policy holders. The company plans to return $180 million for 2010. Why did Blue Shield decide to lower its premiums and give back money to its subscribers and how much?
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Controversy is raging in Sacramento over AB 52, a new bill that would give state officials the right of prior-approval over premium hikes for health insurance. The bill’s regulatory proposal is not new—prior approval of heath rates is law in 34 states as well as Washington, D.C.—and the process has been used in auto and homeowner policies since 1988. Steep rate increases, and the mistakes revealed in companies’ calculation of them, aren’t novel either. But health insurance companies and the California Association of Health Plans are vigorously opposing the measure, questioning AB 52’s power to address the health care cost increases that underlie premium hikes. They also say that the measure’s requirements would cost tax payers $30 million a year, though the bill’s fees to insurers ought to cover the cost of prior-approval. Proponents argue that such regulation would encourage fairer, more accurate rate increases, and point out that health insurance regulators can only use persuasion and public announcements—not actual rejection—to get companies to decrease their rates under existing California law. Should premium hikes be regulated? If not, how will increased costs affect low-income patients and those who need medical care the most?
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