Celerix Blog - Health Blogging Site

With unemployment rising, Dow Jones Newswires columnist Victoria Knight provides some strategies this week for keeping health insurance if you find yourself out of work.

Your spouse’s employer. Suppose you and your spouse both have full-time jobs. You’re both covered through your employer, so your spouse waives the coverage offered through work. Then you lose your job, and the insurance that came with it.

Turns out, you may not have to wait until next year to get coverage through your spouse’s employer. Your “special enrollment” rights under the law may allow you to enroll immediately. Don’t dawdle, though: Your rights expire 30 days after you lose coverage.

COBRA. This is the classic option for staying covered when you get laid off. For 18 months, you can keep the insurance you had through your work — but you have to pay the whole premium, including the part formerly subsidized by your company.

But COBRA doesn’t have to be an all-or-nothing proposition. For example, you can elect to pay for COBRA for yourself, but purchase a separate policy on the individual market for your children, which may prove to be cheaper than keeping them on your old policy.

Private and public options. If you’re relatively healthy, you may be able to find coverage on the private insurance market for less than you’ll pay through COBRA. Don’t be shy about considering high-deductible plans, which come with a lower premium than traditional coverage. Sure, a $10,000 deductible may sound like a lot. But a high deductible plan could save you from bankruptcy if you get seriously ill and wind up in the hospital.

Even if you’re not poor, your children may qualify for coverage through the state. Knight cites Wisconsin as an example, where all children without health insurance can enroll in a state program. Families over a certain income level pay premiums and, for certain services, co-pays.

The Health Blog’s never-ending tour of state health-reform efforts now pulls into New Jersey, where a bill passed this week requiring all children to have health insurance. As part of the deal, the state will expand subsidies to help poor parents insure their kids. The state’s governor is expected to sign it into law, the Philly Inquirer reports.

Insurance mandates are a much-debated issue in the national conversation about how to reduce the number of uninsured. Massachusetts has gone whole hog with a broad mandate that is getting more people to sign up for coverage. But state subsidies created along with the mandate are proving more expensive than expected.

Requiring kids to have insurance is a sort of Mandate Lite. The notion that all kids should have insurance is less politically contentious. And kids tend to be healthy, which makes them cheaper to insure — a fact not lost on legislatures that are finding themselves strapped for cash these days.

Even so, finding the money to fund the New Jersey plan may prove tough, the Associated Press reported yesterday. The state has budgeted $8 million to start funding the program in September, but it’s unclear whether that will be enough.

Expect to hear more on Mandate Lite this summer and fall. Barack Obama favors health-insurance mandates for all children; John McCain doesn’t.

More evidence that Wall Street will try to profit from anything: Credit Suisse is out today with a report it calls “Obesity and Investment Implications.”

“People across the globe are becoming very heavy very fast and, in response, corporate awareness of obesity-related markets is increasingly pronounced,” the report says.

Along with the drug companies and medical-device makers we’re used to paying attention to, the report looks at food companies, apparel makers and health-club companies that could benefit from increased efforts to slow the growth of our collective waistline.

“The larger a problem gets, the more attention and resources it gets,” Credit Suisse analyst Catherine Arnold, one of the coordinators of the project, told the Health Blog. “It does grow the size of the market for companies that are trying to reverse the problem.”

The authors sift through all this to deliver the “Healthier Living 15″ — an index of stocks the analysts think have “the greatest exposure to either healthier living products (i.e. athletic apparel and equipment) or ‘obesity fighting’ drugs and medical products.” The investment bank expects the companies in the basket to “experience outsized revenue and earnings growth over the next 5 years compared to their peers.”

Here are the companies on the list:

Health Care: Allergan sells a “Lap-Band” used in an increasingly popular type of obesity surgery. Novo Nordisk is big in the diabetes market, and Merck sells drugs for diabetes and high cholesterol. CVS may benefit by selling vitamins and prescription weight-loss drugs. Healthways contracts with employers and government entities to manage preventive care, among other things.

Food: General Mills should benefit from a move to “healthier, more convenient foods.” Kellogg and Danone also make the list, as does grocery chain Safeway, which is rolling out “lifestyle” stores. If you want a wild card, go for Kuala Lumpur Kepong, a Malaysian palm-oil company that may see an uptick in business as food makers look for alternatives to trans fats.

One in five people put off a trip to the doctor or went without health care last year, often because of money.

That figure, out today from the nonprofit Center for Studying Health System Change, is a big jump from the one-in-seven figure the group found in a 2003 survey.

Overall, 8% of people said in 2007 they had an unmet medical need in the prior 12 months, and another 12% said they delayed getting care. In 69% of cases, cost was part of the reason. The results were based on a telephone survey of about 18,000 people.

Many health wonks say that making people pay more medical costs up front will turn the public into savvier health-care consumers, improving the quality and efficiency of health care overall. Maybe so, but these findings are a reminder that people who are on the hook for more money may simply put off care, or skip it altogether.

Not surprisingly, the study found that the uninsured are especially likely to skip or delay care. On that note, this morning’s WSJ tells the story of Peter Koerner, a Pennsylvania store owner who didn’t have insurance when he accidentally sliced off half his thumb with a hydraulic wood splitter in late 2006.

Koerner was told he would have to be flown by helicopter to another hospital to have it reattached. He decided that was too expensive. “There’s no way I could be responsible for that kind of a price tag,” he told the WSJ.

Instead, Koerner said, “they basically cleaned up the wound a little bit, pulled some skin across the open wound and stitched it up.” The family has so far paid nearly $1,400 of about $5,100 in bills.

In 2004, Congress expanded a government bonus system to help stem the flow of skilled government workers heading for higher-paid jobs in the private sector. Now, at least one congressman is questioning the FDA’s use of the money.

Figures released yesterday show that last year, 28 top FDA officials together received more than $1 million in retention and merit cash bonuses, some for more than $50,000, the WSJ reports. Seventeen of the top paid officials made more than $200,000.

Overall, the FDA paid out some $35 million of incentive pay for fiscal-year 2007, up 29% from the year earlier.

In a statement, Rep. Bart Stupak (D., Mich.), a frequent FDA critic who heads a House panel reviewing FDA compensation, said, “It is outrageous that bonuses for top officials at FDA increased by nearly 30% over the past year despite the agency’s poor management.”

Last year, in a Washington Post letter to the editor, FDA commish Andrew von Eschenbach wrote:

“Responsible use of pay flexibilities helps the FDA find and keep expert, dedicated employees — and it has proven essential to our ability to fulfill our public health mission.”

Google, Microsoft and a bunch of other organizations said yesterday they have agreed to a set of privacy standards for online health records. You can read all about the framework here.

It’s pretty clear that there’s a lot of upside from having peoples’ health records online — less redundancy, fewer missing tests, no more faxing records from one doctor to another. But privacy is a big concern; a recent article in the NEJM pointed out that tech shops such as Google and Microsoft don’t have to abide by HIPAA, the federal law that covers patient privacy.

The new guidelines aim to give online records “at least the same level of protection already governing medical records on paper,” the AP reports.

The AARP, the American Academy of Family Physicians and Consumers Union also endorsed the framework yesterday, along with companies such as Aetna, Cisco and Intuit. A complete list of endorsements is here.

Time after time, Congress has jumped in at the last minute to block Medicare payment cuts to doctors. Will this be the time when time runs out?

A bill to block a 10.6% reduction in Medicare reimbursements stalled in the Senate yesterday. The cuts will take effect on July 1 — and a weeklong congressional recess starts tomorrow.

Republicans and Democrats seem to agree that the cuts are a bad thing. And a bill blocking them passed the House by an overwhelming 355-to-59 vote.

But Senate Republicans (and President Bush) don’t like the way the bill finds money for docs by cutting subsidies to Medicare Advantage, the privately administered Medicare plans. A procedural vote yesterday was 58-40 in favor of the legislation — but 60 votes were required for the bill to move ahead.

John McCain didn’t vote on the bill; Obama voted in favor. Here’s a list of how everyone voted. The WSJ notes that several of the nine Republicans who voted for the bill are facing tough re-election races.

The CEO of MedImmune, the biotech shop gobbled up last year by AstraZeneca, is quitting, the WSJ reports this afternoon.

David Mott (pictured) decided to leave because he thought it was “time for a change,” not because of any conflicts with AstraZeneca management, a company spokesman told the Journal.

Of course, the fact that Mott is apparently worth more than $100 million may also have had something to do with it.

Mott was the CEO of MedImmune who brokered the sale of his company to AstraZeneca for $15.6 billion, a premium of more than 20% on a stock price that had already run up on buyout talk.

This SEC filing from last June shows that, as part of the deal, he was paid more than $133 million when his stock options were canceled as part of the merger. That doesn’t include whatever shares he owned outright, nor whatever he saved up during the course of his career.

So why did he stick around for the past year? This SEC filing from last spring notes that he entered into a “retention terms sheet” to continue his employment for a year after the deal closed.