When Identity Theft Gets Personal

A new article in Network World talks about the transition of data theft from attacks on banks and retailers to attaches on individuals.

In the past, someone would hijack a credit card number and make some purchases using th28h0ogrvthat number.  You would have to replace your card, but once you notify the card company, your financial liability is limited to $50.

With debit cards, the liability is larger, and the time it takes to resolve the incident is longer.

Identity theft started with stealing more information than just a card number and opening accounts at retailers in your name.  If the thief selects merchants with special promotions (e.g., n payments for 90 days), they could do a lot of damage before anyone would notice anything amiss.  You would be liable for the bill or have to prove to a judge that you didn’t open the account.  Proving that you didn’t do something is tricky.  thpvgyxwu3

The next generation in identity theft is filing fake tax returns in your name to get a refund from the Federal government sent to an account that isn’t yours.  Think about it:

  1. When you go to file, if you are already getting a refund, its been sent to someone else.  You have to prove you didn’t get it.
  2. Is the thief’s refund larger than what you were supposed to get?  The IRS is going to ask you for repayment of the money you didn’t get.
  3. The information in the return submitted by the thief is probably wrong.  Are you on the hook for filing a false return?  That’s a crime?
  4. Will the false tax return affect your eligibility for subsidy for healthcare under the Affordable Care Act?
  5. Will the false tax return affect your calculated benefit under Social Security?
  6. How many years of your life are you going to have to spend fixing this mess?

What you need to do

  • If you  have a refund due, file early.  Get there before the crooks do.
  • Retain a legitimate service for helping fix (not just monitor) identity theft issues.
    • Example:  Aflac partners with EZ-Shield at a cost to subscribers of less than $5.00 per year.  It’s a very good deal.
  • Monitor your credit reports.  There are three major services and you can pull a free report from each of them each year.  If you pull one in April, one in August and one in September, that will give you year-round visibility to your reports for no cost.
  • Consider contacting the credit agencies and putting a fraud alert on your account.  That means any merchant asked to open an account in your name will have to call you to verify the request.

Whatever you do, take this seriously.  Identity theft is highly stressful and time consuming, and if you have to retain a lawyer on your own, expensive.  You don’t need it.

Also remember that the targets of theft usually aren’t the rich.  Thieves most often target the young and middle income, you usually are more careless and have fewer protections in place.


Sources:

Hart, Jason, “Data breaches: This time it’s more personal,” Network World, Sep 20, 2016 11:09 AM PT.  http://www.networkworld.com/article/3121992/security/data-breaches-this-time-its-more-personal.html?token=%23tk.NWWNLE_nlt_networkworld_daily_news_alert_2016-09-20&idg_eid=62d72ddabd31ab552b8906988a473783&utm_source=Sailthru&utm_medium=email&utm_campaign=Network%20World%20PM%20News%20Alert%20for%20Tue%20Sept.%2020&utm_term=networkworld_daily_news_alert#tk.NWW_nlt_networkworld_daily_news_alert_2016-09-20

Picture credits:  Pittsfield Police

Drug Price Reform — When, Not If

Brand name drugs are expensive.  They’re more expensive in the US than elsewhere, but they’re still expensive, regardless.

Prices are based on a number of factors, including what manufacturers think they can get insurance companies and governments to accept.  List prices are paid by consumers without health insurance.  Insurers and government programs pay negotiated rates often substantially below list.

Prices are supported by patent and exclusivity laws that protect original manufacturers.(2)  The US is the leader in this, to the point that drug companies will discard work on promising medicines if they believe they cannot obtain patents for them.(1)  For US consumers, it means they pay higher prices than people in other countries for the same drugs from the same manufacturers.  Congress has also made it illegal for US consumers to buy drugs elsewhere and bring them into the US.

“The current model for cancer drug pricing is not sustainable and harms patients and families as well as our health care system.” (5)

“Americans with cancer pay 50 percent to 100 percent more for the same patented drug than patients in other countries. As oncologists we have a moral obligation to advocate for affordable cancer drugs for our patients.”(6)

Take GSK’s Advair inhaler as an example.  The cash price of the 500/50 version of the inhaler for a consumer without insurance in the US is between $560 and $600 for a one-month supply.(3)  The price for the same product in Canada is $84.00.(4)  Some US consumers with insurance will pay a higher copay than the cash price in Canada.  With Horizon Omnia, I was quoted a price of over $300 for this drug by the pharmacy department at Wegman’s.

Prices are becoming detached from research costs.  The price for insulin for the treatment of diabetes has tripled in the last decade, despite the fact that the product has been largely unchanged for decades.(7)  (Synthetic insulin was introduced in the US in 1982, following development in India.)

More increases apparently are pending.(9)

Some people are angry about pricing, and one country is finally taking action.  Colombia has ordered Novartis to lower the price of its leukemia drug, Gleevec.  If the company does not comply, Colombia has threatened to break the patent and issue licenses for production of a generic version of the product.  According to Fox News, members of the US Congress are involved in lobbying the Colombian government to protect the drug company.  US Senator Orin Hatch of Utah is one of the people named in the news report as having close ties to the pharmaceutical industry.(8)

Whether Colombia breaks the current pricing model, or it happens elsewhere, it’s just a question of time.  Current prices are artificial and based on government intervention in the markets, and not on free market economics.

However, that’s the paradox that some conservative politicians like to ignore:  one is against government controls unless the controls lead to higher profits for your friends.

 

 


Sources:

(1) Frakt, Austin. “How Patent Law Can Block Even Lifesaving Drugs,” The New York Times.  28 Sept. 2015.  http://www.nytimes.com/2015/09/29/upshot/how-patent-law-can-block-even-lifesaving-drugs.html?_r=0

(2)  “Frequently Asked Questions on Patents and Exclusivity.”  US Health and Human Services, Food and Drug Administration.  http://www.fda.gov/Drugs/DevelopmentApprovalProcess/ucm079031.htm#How%20many%20years%20is%20a%20patent%20granted%20for?

(3) GoodRX.com.  http://www.goodrx.com/advair-diskus?form=inhaler&dosage=500mcg-50mcg&quantity=1&days_supply=&label_override=Advair%20Diskus

(4) Canada Pharmacy Online.  http://www.canadapharmacyonline.com/DrugInfo.aspx?name=Advair+0042

(5) Fred Hutchinson Cancer Research Center. “Expert opinion on how to address the skyrocketing prices of cancer drugs,” Science Daily.  12 February 2016.

(6) Mayo Clinic.  “Oncologists reveal reasons for high cost of cancer drugs in U.S.”  Science Daily.  16 March 2015.

(7) University of Michigan Health System,  “Sugar shock: Insulin costs tripled in 10 years, study finds,”  Science Daily.  5 April 2016.  https://www.sciencedaily.com/releases/2016/04/160405122030.htm

(8) “Colombia battles world’s biggest drugmaker over cancer drug,” Fox News Health.  18 May 2016.  http://www.foxnews.com/health/2016/05/18/colombia-battles-worlds-biggest-drugmaker-over-cancer-drug.html

(9) Frellick, Marcia.  “17 Essential Drugs at Risk for Price Boost, Analysts Say,” Medscape. 19 May 2016.  http://www.medscape.com/viewarticle/863544?src=wnl_mdplsnews_160520_mscpedit_wir&uac=153634BV&impID=1103558&faf=1

C-Section Cons and Pros

TheVCphoto2 C-Section rate is an important criteria in selecting an obstetrician.  Neither the decision to do the procedure nor the choice of doctor are trivial, but they are related.

The C-Section is the most common surgery performed in the US.  The primary factor determining whether this procedure is performed is the doctor and hospital the woman chooses, and not medical need.(7)  The rate of Cesarean births was 4.5% when first measured in 1965; it was over 32% in 2014.  As of 2014, Louisiana and New Jersey led the US in the highest rate of C-Sections — over 38%.(7)

The increase in C-Sections hasn’t made childbirth safer for either pregnant women or the newborn.  The rate of maternal death in childbirth has doubled since 1985, from 7.4 to 17.8 per 100,000 births.(9)  However, there is a question about how much of this increase is real or do to changes in government reporting.(6)

The rate of newborn mortality in the US is slightly worse than the rate in Bosnia.  According to the CIA World Factbook, the US rate is 5.87 per 1,000 births (2015 estimate).  There are more than 50 countries with lower rates of newborn mortality, including Canada, all European countries, all Commonwealth countries, Singapore, Taiwan and South Korea.

A survey of new mothers in 2011-12 found several reasons for the increased use of C-Sections, including

  • Physician or hospital unwillingness to inform the patient about options
  • Hospital and doctor efficiency
  • Limited awareness of surgical risk
  • Blind faith in medical professionals
  • Doctors’ unwillingness to attend births in the middle of the night (4).

However, unnecessary C-Sections are expensive for insurers, resulting is a push not to do them.

In one case part of which I witnessed, a physician decided to delay a C-Section in the hope of a vaginal birth on a woman with a previous history of miscarriage.  That decision was catastrophic.  The placenta tore, the fetus died and the mother almost bled out.

Ultimately, the decision to do a C-Section should be based on medical prudence, and not on insurance, the doctor’s quality of life or hospital income.

What does birth cost?

Cost estimates vary wildly, depending on whether they focus on out-of-pocket expenses for the new parents or the total charge including what insurance pays, as well as by state.  (2)

How much the new parents pay depends on the kind of health insurance they have as well as any supplemental insurance.

What you can do?

If you are a loved one are involved in selecting an obstetrician, you need to quiz the doctor on how he/she makes decisions about doing these procedures.  If the doctor shows a clear preference for surgery in most cases, or expresses concern about insurance and costs, you need to find a different doctor.  The guiding consideration needs to be the woman’s medical condition and history, period.

Any “automatic” decision is probably wrong.  Even a carefully considered decision could be wrong.  There’s nothing trivial about these choices.

____

Sources:

(1) Almendrala, Anna.  “U.S. C-Section Rate Is Double What WHO Recommends,” Huffpost Parents.  http://www.huffingtonpost.com/2015/04/14/c-section-rate-recommendation_n_7058954.html

(2)”Average Charges for Giving Birth: State Charts.”  Transforming Maternity Care.  http://transform.childbirthconnection.org/resources/datacenter/chargeschart/statecharges/

(3)  CDC. “Births — Method of Delivery.”  http://www.cdc.gov/nchs/fastats/delivery.htm

(4) ChildbirthConnection.org.  “Cesarean Section.”  http://www.childbirthconnection.org/article.asp?ck=10456

(5) Haelle, Tara. “Your Biggest C-Section Risk May Be Your Hospital,” Consumer Reports. 13 April 2016.  http://www.consumerreports.org/doctors-hospitals/your-biggest-c-section-risk-may-be-your-hospital/

(6) Maron, Dina.  “Has Maternal Mortality Really Doubled in the U.S.?”  Scientific American.  8 June 2015.  http://www.scientificamerican.com/article/has-maternal-mortality-really-doubled-in-the-u-s/

(7) “10 states with the highest C-section rates,”  Fox News.  9 July 2014.  http://www.foxnews.com/health/2014/07/09/10-states-with-highest-c-section-rates.html

(8) Rappleye, Emily.  “The most common surgery in the world is often unnecessary — and this physician is out to fix it,” Becker’s Hospital Review.  16 May, 2016.  http://www.beckershospitalreview.com/hospital-management-administration/the-most-common-surgery-in-the-world-is-often-unnecessary-and-this-physician-is-out-to-fix-it.html

(9) Wallace, Kelly. “Why is the maternal mortality rate going up in the United States?” CNN.  11 Dec. 2015.  http://www.cnn.com/2015/12/01/health/maternal-mortality-rate-u-s-increasing-why/

 

 

 

 

Microcephaly and Politicians

Zika has hit the US.  According to the CDC, there are now 279 pregnant women on US soil with Zika (3).  That number is likely to skyrocket this summer.  Mosquitoes will bite infected women and spread the disease to others.  Others will visit infected areas, especially with the Brazilzika2.png Olympics this summer, and return with the disease.  Sexual activity may spread the disease.

Meanwhile, the Oklahoma legislature creates a bill that removes any discretion in bringing infected babies to term.

Regardless of the intent in becoming pregnant, no one intends to bring a baby to term who will live for only 4-5 years and cost a fortune in terms of heartache and cash.  That’s not why someone becomes pregnant.

Women understand this.  The Zika outbreak is increasing demand for abortions in the countries that have been affected seriously thus far. (6)

However, because there is no lethal risk to the mother, under the Oklahoma law, a woman has no choice in bringing the baby to term.  The state will incur a mountain of costs in caring for these children, as most families cannot bear the load.

Even the Pope has expressed openness to the use of artificial contraception to deal with Zika.  (2)

Arguably, having a functioning brain should be a requirement for public office.

American writers have been quick to criticize Brazilian politicians for a slow response to the Zika outbreak.  However, as with the Michigan water crisis, this is evidence that American politicians can be just as oblivious.  The US Congress has been no better than Brazil’s in taking preventive action. (1)  The US is quite unprepared for the expected medical costs Zika will create. (5)

What actions can you take?

(a)  Adjust vacation plans.  The mosquito that carries Zika is prevalent in the US south, especially in the Gulf Coast region.

(b) Wear mosquito repellant.

(c)  If you or someone about which you care is pregnant, make sure they have access to good prenatal care and use it.  This is not a surprise you want.

(d) More controversially, lobby your local government for mosquito control measures.  That can affect other wildlife, but that may be a necessary sacrifice until this is past.  Hopefully, Zika won’t become a permanent part of our ecosystem.


Sources:

(1) Branswell, Helen.  “Congress is blocking key efforts to fight Zika, top health officials say,”  STAT News, 10 March 2016.  https://www.statnews.com/2016/03/10/zika-emergency-funding-anxiety/

(2) Burke, Dan and Cohen, Elizabeth. “Pope suggests contraceptives could be used to slow spread of Zika,” CNN.com, 16 February 2016.  http://www.cnn.com/2016/02/18/health/zika-pope-francis-contraceptives/index.html

(3) Cohen, Elizabeth.  “Number of pregnant women with Zika virus in U.S. triples, CDC says.”  CNN.  10:21 AM ET, Fri May 20, 2016.  http://www.cnn.com/2016/05/20/health/zika-cdc-numbers/index.html

(4)  “Oklahoma lawmakers OK bill criminalizing performing abortion.”  Associated Press. 19 May 2016.  http://www.msn.com/en-us/news/us/oklahoma-lawmakers-ok-bill-criminalizing-performing-abortion/ar-BBtfoqO?ocid=ansmsnnews11

(5) “Public Health Experts Warn U.S. Unprepared for Zika Outbreak,”  Insurance Journal, 13 April 2016.  http://www.insurancejournal.com/news/national/2016/04/13/404972.htm

(6) Simmons, Ann.  “Zika fears increase demand for abortions in countries where it’s illegal to have one,”  Los Angeles Times,  9 March 2016.

 

Bedbug Aesthetics

Why someone would do this research, I really can’t fathom.  Doesn’t matter what I think of course.  Someone paid for it, and someone did it.

It has been determined that bedbugs like the colors red and black, and dislike the colors green and yellow.  Really.

It seems counter-intuitive.  After all, green and yellow colors are far more likely to be found in nature than are red and black.  However, maybe being commonplace breeds contempt?

Anyway, the notion of red bedsheets collecting bedbugs is going to ruin a bunch of kinky fantasies.

[Source:  LiveScience.com, 4/27/2016]

Boomers: Living Longer but with Poorer Health

In the past, living longer was associated with having better health in one’s older years.  A new study by researchers at the University of Southern California indicates that this relationship is no longer true.

The study analyzed the increase in life expectancy among Americans between 1970 and 2010.  In turns out that most of the increase in life expectancy is in the time that an individual suffers from a major illness or disability.

That finding links the increase in life expectancy with a dramatic increase in healthcare costs.  However, there have been no changes in government funding of Medicare or Social Security Disability to match the change in need.

Source:  http://ajph.aphapublications.org/doi/10.2105/AJPH.2016.303120