With A New VA Scandal, We Need a Military Health Task Force

There’s a new Veterans’ Administration scandal brewing. A McClatchy investigation suggests that senior VA officials falsified report data and issued misleading public statements about the VA’s performance on everything from appointment scheduling to medical outcomes. We need to be sure we’re getting accurate information about the VA’s performance. But more importantly, the healthcare we provide to our soldiers and veterans should be the best in the world. That’s a way to honor them for their service, bolster our national security, and help build a better health system for all of us.

We need a high-level and nonpartisan Task Force to lead a major initiative that will redesign the entire military health system for the 21st Century. This Task Force can address the scandals and doubts of the past. More importantly, it can design the military health system of the future.

Presenting the “Cavalcade of Risk”

The Cavalcade of Risk is a “blog carnival,” or anthology of posts on a common topic or theme. It’s our turn to act as host. We have a rich bouquet of posts this month, so let’s get right to it:

Eric Turkewitz points us to a news story about risky recommendations from New Rochelle’s educators, as well as to a risk averse insurance company (is there any other kind?), in Hey, She’s Only 5 Years Old!!!. He also presents Conseco Insurance Scandal Follows Movie Plot, pointing out the similarities between the plot of a Francis Ford Coppola movie and the real-life allegations of bad faith against an insurer. (Guess whose behavior mimics that of the movie villain …) You’ll find them in New York Personal Injury Law Blog.

Rita Schwab has an observation to fuel the paranoia (or is that keen perception?) of those who feel … watched. She writes this in Copier Surveillance: “Yet one more bit of electronic surveillance to worry about in our high-tech society - photocopiers!” Apparently somebody can see those embarrassing “copies” of your anatomy you made after work. And you thought nobody was looking … Or course, Rita has a more serious point to make. It’s at MSSPNexus Blog.

Bob Sargent presents Title Insurance & Sleeping Roads posted at Insurance Agents E&O - Flood Exposure, saying, “Municipalities’ efforts in Vermont to reclaim ’sleeping roads’ have impacted landowner values and resulted in title insurance claims. While critics claim that title insurance is overpriced and even unnecessary, much of the cost goes to the prevention of claims, and claims do occur.”

We have a lot of health-related submissions this month. egon looks at health reform from the provider side and comes out strongly for single payer coverage in National Health Insurance In America - Part 1 and Part 2, posted at InsuranceHelpHub.com.

Henry Stern, LUTCF argues against mandatory HPV vaccination for young women in BS Update, posted at InsureBlog. He cites researchers who suggest that it could actually increase the risk of cancer.

Jason Shafrin finds a surprising angle on the Federal children’s health program for the uninsured. He writes, “Should the popular State Children’s Health Insurance Program (SCHIP) be renewed? Not according to the House Black Caucus.” It’s in Reauthorizing SCHIP, posted at Healthcare Economist.

David Williams presents Upgrade or downgrade? posted at Health Business Blog, saying, “In their zeal to protect consumers, regulators are forcing people to overinsure.” He cites the Massachusetts experience to do so - but then, regular readers of The Sentinel Effect will know that I consider the Massachusetts reform effort fundamentally flawed.

Guardian rates three popular web-distributed auto policies in Reviewing Popular On-Line Auto Insurance Quote Services » Insuranceonyourterms.com at insuranceonyourterms.com, asking: “Which one fared best?”

At Cato@Liberty, Michael F. Cannon celebrates the fact that there are Fewer Uninsured! than originally estimated. There are only 44.8 million, according to new figures, and they’re mostly healthy. So “don’t worry, be happy,” suggests Mr. Cannon … (granted, I’m paraphrasing a bit. I recommend that you read it yourself.)

Also from Cato@Liberty, Sigrid Fry-Revere presents Mandatory HPV Vaccines: Who Benefits? She writes that “the lure of government mandates has turned Merck, if it wasn’t already, into an unethical company.”

Michael F. Cannon looks at the affordability of health coverage in Cato-at-liberty » Health Insurance Do-Nots, also at Cato@Liberty.

And some really smart (and not bad-looking) guy at The Sentinel Effect takes a look at the possibility of a coming health privacy meltdown in Privacy, Crime, and Disaster: The Achilles Heel of Health Reform? He cites the story of two officials who have resigned in protest over the government’s failure to adequately address privacy concerns, and offers suggestions for both would-be reformers and career criminals …

We had a number of submissions in the area of private investment, too:

John presents Hedge fund investing guide 101 posted at OhCash.com, observing that “hedge funds have become a new craze among the investors who are looking for higher net returns and to diversify their investment portfolio.”

Silicon Valley Blogger overcomes his aversion to irritating stock picker Jim Cramer - which makes him a better man than I - in order to summarize Cramer’s latest book. You’ll find it in Mad Money Mayhem For Stock Pickers at The Digerati Life.

Matthew Paulson posts cautionary words about aggressive credit card company solicitation of students, leading to the possibility of excessive debt. The post is Students Borrowing Money Through Credit Cards at Higher Rates, at Getting To Graduation.

Bryan C. Fleming also examines the danger of interest, this time when online institutions promise that you’ll be the one earning it. Too good to be true? Check out 6 Percent Online Savings Accounts, posted at Bryan C. Fleming.

Larry Russell argues against “active” investment strategies in Passive index investment strategies are superior, because they narrow the range of outcomes and lower your risk. it’s posted at THE SKILLED INVESTOR Blog. He argues that “passive, index-oriented investment strategies tend to be superior, because they narrow the range of outcomes, and thus, they reduce the total investment risk associated with your portfolio. Active investment strategies increase your risk, while lowering your expected net return.”

Ranjan addresses investment strategies with apparent reluctance inHow to Add Value To Your Money, posted at Musings on Money.

Lastly, Jon Coppelman makes some observations about the risk of multitasking in The Delusions of Multitasking. It’s in Workers’ Comp Insider. John suggests that all using all our new high-tech capacity to do a hundred things at once is actually dangerous.

Nonsense. Why, I’m composing this on my wireless-enabled laptop as I drive to the airport and I’m … hey! look out! aargh!

< …. >

Our Online Seminar On Auditing Managed Care

Here’s one from the Dept. of Shameless Self-Promotion. We’ll be giving an online seminar this Thursday for medical management, claims, and insurance professionals. Here’s the info:

MedMetrics Offers Free Audio Conference On Evaluating the Effectiveness of Your Managed Care Programs - How to Conduct an Electronic Audit

Published 02-13-2007

Presented by Richard Eskow
Sponsored By WorkersCompensation.com

Bend, OR (WCNPC) - The effectiveness of Workers Compensation managed care programs is increasingly being questioned. Do managed care programs actually result in better outcomes? Do they save money? Provider networks, case management, utilization review, and other medical management techniques have been implemented throughout the industry in a broad-brush, �one size fits all� fashion.

How can payers know its managed care vendors � or internal departments � are working effectively and getting positive results? How can the effectiveness of a medical management vendor or department be measured? What is its impact on claims? How can payers use that data to report back to clients (internal or external), and to improve their effectiveness?

In this seminar, Mr. Eskow will review techniques for conducting an electronic audit of medical management programs. Mr. Eskow also address practical issues of gaining access to vendor data, common mistakes in data interpretation, and how to convert data into useful information that can be converted to a medical/claims business strategy.

This complementary audio conference will be held February 22, 2007 at 10 am Pacific, 11 am Mountain, 12 noon Central and 1 pm Eastern times. Please respond to this e-mail to register. Include your name, title, name of your company and telephone number. Two days before the seminar you will receive course materials and conference access information by e-mail.

Richard Eskow, a seasoned senior-level workers compensation medical management consultant, is a MedMetrics Data Action Team Associate. Other MedMetrics D.A.T.A. consultants are Kimberly Wiswell, Lynne Poppe, and Janet Jamieson, PhD.

Health Knowledge Systems and Eskow & Associates are affiliated with MedMetrics, the sponsoring organization.  For further information or to enroll, email Karen Wolfe at karenwolfe@medmetrics.org.

Now Open For Comments

The “Comments” function is now working. I look forward to hearing from you.

Eli Lilly Settles Zyprexa Claims, But Still Has Problems

Eli lilly made a move to settle 18,ooo claims that it failed to adequately warn users that Zyprexa can cause diabetes.  It still faces 1,200 personal injury claims and some threatened lawsuits from state attorneys general.

On the plus side for Lilly, for the most part they’ve been able to avoid banner headlines over this suit.  The press hasn’t been as interested in this case as might have been expected with a big number like 18,000.

Kaiser Breaks With Industry to Advocate Restrictions On Unfair Cancellations

Kaiser has announced it is “working with state regulators to develop standards to protect its members from unfair cancellations of health insurance, a move that the state’s largest HMO hopes could lead to industrywide reforms.”

This may be in response to a member’s lawsuit. As the Times reports, this is a break with other major state insurers:

Other health plans, including Blue Cross of California and its rival Blue Shield, are fighting regulators and former policyholders for the right to rescind coverage when medical information relevant to the policy-granting decision is left out of an application — even if the omission is an honest mistake or the result of a foggy memory or poorly worded question.

This controversy involved individual health coverage, rather than group (employer) plans. It has led to a rash of lawsuits and horror stories about people who answered the insurer’s pre-enrollment questions in good faith and paid their premiums on time, only to be denied treatment when its urgently needed. Not only is it a potentially a bad-faith issue, but it may violate California law. (Kaiser is based in California.)

Unfair cancellations are a major impetus for widespread health reform, including universal coverage. So are the obstacles people face when trying to get new coverage while suffering from ongoing health conditions, however minor. (The wonk term for this issue, in case you haven’t heard, is portability.) The Times addressed that issue in a separate piece.

In the current political climate, health insurers continue these practices at their own peril. Even from a purely pragmatic point of view, Kaiser’s on the right track.