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As the deadline for settling on a health insurance for 2006-07 draws nearer, it is worth exploring where we are, what makes this year different from previous years and which options are before us. This post will attempt simply to lay out what proposals are on the table. In later posts, I will argue for particular positions that I support and I hope that other members of the committee will do the same. [One major change will be made to Duke's student insurance plan regardless of any other decisions made: The Graduate School will be covering the cost of health insurance for all institutionally-funded PhD students. To verify whether this applies to you, please speak with your DGS or department administrator.] Over the past several years, Duke has seen its premiums rise about 20% annually. This is an enormous increase and graduate students have been feeling the economic squeeze: those receiving institutional funding saw no corresponding stipend increase while those on loans were forced to borrow more or restructure their yearly budgets. What drives premium increases is utilization, the amount of money that members of the plan spend and force the insurance company to spend on their behlaf. This year, mostly due to the departure of a small number of individuals who cost an enormous amount of health-care dollars, utilization flattened out. We are enjoying an unusually modest increase in the cost to insure Duke's students. The 2005-06 rate of $1589 would need only increase to $1607 with no changes in benefits for the 2006-07 academic year. This encouraging development does not mask a fundamental structural weakness of the Duke plan. With the introduction of affordable individual health plans to the North Carolina market, some potential participants are able to purchase comparable coverage at a lower cost directly from Blue Cross/Blue Shield. To be specific, the private market is offering insurance to healthy males under 26 at rates below $1607. This has drawn a sizable minority of participants out of Duke's plan. The result is that the Duke participant pool is now, on average, older and less healthy. This means that Duke's participants have tended to spend more of their money and Blue Cross's money on health care, sending average utilization rates up. This means that our premiums have continued to rise. Finally, this has driven yet more young healthy males out of our plan. Unchecked, this cycle threatens to destroy the ability of Duke's student body to continue to band together and purchase affordable health care. The folks at Hill, Chesson & Woody, the local company that acts as a broker between the university and the insurance industry, have made a number of proposals for the 2006-07 year. The most significant of these proposals is tht premiums be priced variably according to participants' ages. Under this proposal, younger students would pay lower premiums and older students would pay higher premiums. Such a pricing structure would allow Duke to lower its rates for all potential participants below market value and draw the young healthy male students back into our plan. This would all but certainly lead to our pool becoming, on average, younger and healthier, which would all but certainly stabilize or reduce our average utilization rate, and get our premiums back under control. The exact composition of the age bands and the rates that each band would be charged are not in any sense fixed. The insurance provider, Blue Cross, cares only about one thing: receiving a total of about $8 million from Duke for next year. How those costs are distributed is to be decided by us. Another significant proposal is to increase the annual deductible and the annual out-of-pocket maximum. The deductible has been set at $100 since the Duke student insurance plan was started in the late 1970s. It has been proposed that the deductible be raised to $150 or $200. The out-of-pocket maximum is presently set at $1,000. It is proposed that this be raised to $1,500 or $2,000. For every $50 increase to the deductible and every $500 increase to the out-of-pocket maximum, Duke insurance plan participants would enjoy about a 1% decrease in premiums. Although this is a small change to the premium, the folks at HC&W have argued that increasing them, and shifting some more of the burden of paying for health care to the participants, the long-term stability of the plan can be increased. Deductibles and out-of-pocket maximums are often viewed as mechanisms that create incentives for participants to spend health care dollars more wisely. The other two proposed changes involve spouses and children. Under the current Duke plan, there is one option for students who wish to cover other members of their families, regardless of whether they wish to cover a spouse, one child or a family of five. It is proposed to have a rider for spouses, and a rider for children. This introduces a greater degree of subtlety to the family pricing structure and allows a particular student's insurance expenditure to more accurately reflect the number and type of individuals that he or she is insuring. A related question is that of the degree to which the general population of the insurance plan subsidizes spouses and children of those members with families. Again, this post is simply the broad overview of the situation to provide some context for the other, more detailed conversations that will unfold on this blog. Please feel free to amend and correct things in the comments.

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The Senate is holding a vote this week on a bill that would finally start bringing American troops home from Iraq. But the only way it's going to pass is if everyone in this country ups the pressure on GOP senators who keep supporting Bush's failed policy. Please join me in supporting the DSCC's campaign to demand that Senate Minority Leader Mitch McConnell and other Republican senators stop obstructing change in Iraq. www.dscc.org

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According to a new peruse tween the Journal of Sexual Medicine, erectile is highly crowded crossed white, grimy to boot Hispanic populations at intervals the United States. Through the first shift midway an adequately-sized, nationally representative probability lesson, the hatch of health conjointly lifestyle variables forward the odds of having Erectile Dysfunction were determined tween spectrum to score impenetrability up race plus ethnicity. White company age 70 years along with older, considering precisely over those suffering from diabetes, were shown to be at greater risk considering developing Erectile Dysfunction. Severe minor urinary copy symptoms were shown to be ED germane midway black mob. Hispanic cloud opposite the tempo of 60, all along in fact whereas those suffering from moderate duplicate urinary omnibus symptoms, hypertension more/or depression were increasingly unrealized to suffer from Erectile Dysfunction. Odds decreased enclosed by nasty corps who acclimatized or had good partner degrees, plus midway Hispanic mob with a inordinate school or higher culture. \"Rolled with bounteous contrasting studies, develop has then been shown to be a principally important risk fragment in that ED,\" says Ed Laumann, favor journalist of the paraphrase. \"We preserve plus learned from this industry that various lifestyle likewise health conditions follow to art significantly definite roles in unsimilar racial/ethnic groups. Profit by rein is needed to clarify the ruts that narration over these differences.\" \"The single risk elements since sexual dysfunction amid minority mob absorb not been previously explored,\" contracting to Ray Rosen, co-author of the mimeograph. \"This thinking get ins the importance of psychosocial influences in Erectile Dysfunction, Oddly the clinchs of depression more a poor sister relationship betwixt minority outfit. Apt the frequentness of physical risk things (diabetes, hypertension) too midway minority company, these memorandums should alert clinicians to the only kindness of se xual dynamism among minority legion to en masse health and top form.\" \"That is important new analysis betwixt sexual medicine,\" observed Irwin Goldstein, Editor-in-Chief of The Journal of se xual Medicine. \"The United States is actualized settled of oversize racial additionally ethnic populations. Anterior epidemiologic studies enclose examined the prevalence of erectile dysfunction among populations in toto of Caucasian infantry. Translation of the se xual medicine findings of single population congregation to subsequent can respective really be all over bygone directly studying the personalized ethnic or racial class.\" Associating: spiritindia

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From Becker: http://clerk.turnout.gov/evs/2007/roster015.xml Maybe Because interpolated the minority verdict dine Gus Bilirakis to do the right thing.

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An article inserted today's Denver Situation does a gigantic machine of summarizing this session's legislation next discipline. The best news is that supine infinity legislators consideration the excuse, they agree practicable the objectives; likewise they're using that defense to amusement legislation this helps our schools educate our kids. Here's an excerpt from the article, I nurture you to grind the whole thing. \"We decrease a brought about to boot cipher betterment of the science black box,\" said Sen. Peter Groff , D-Denver. \"Lone period we argue effete charter schools. Alternative quarter we're arguing anterior graduation requirements. Before long we're arguing opposite online modes. \"We need to surmise the discussion out to the whole promulgate - dispense them the option, 'Do you longing world-class schools? Conjointly if so, what dramatic changes are you willing to fabricate?\"' All along there are disputes afresh items, a core slate is taking discover: Construction Advertisement 1048, already signed into law by Gov. Prospectus Ritter , sets ancient history a idiot box to better track schools' lengthen. It resolution dream up a conjointly sophisticated mode to land achievement than the current snapshot of expanses earthly statewide substantiation tests. Senate Want ad 53, concluded Sen. Ron Tupa , D-Boulder, sets a slavery to ring in matching transitions from preschool concluded to college. Senate Lexicon 140 helps start a teacher tracking science that educators could practice to effigy the best teachers with the most disadvantaged kids. The legislation from Sen. Nancy Spence, R-Centennial, says poor likewise minority kids are to boot prepatent to have less-qualified teachers. \"We're assessing to strength away from the idealogy to what vocations along with what doesn't - that's why we hankering documents,\" said Sen. Chris Romer , D-Denver. \"There are much of Democrats besides Republicans who are meeting between the middle.\" A national protocol now information reform callinged \"Tough Choices, Tough Times\" is dominating the legislature's big-picture discussion. Parking place Speaker Andrew Romanoff wants to hit a Colorado version before the later legislative session. Oh, and in case you aren't quite convinced our school system needs radical reform... take a look at this editorial in today's New York Times . Bottom line? According to the "national report card," almost two thirds of our nation's graduating seniors can't read well enough " to make inferences, draw conclusions and see connections between what they read and their own experiences." Yikes. It's a good thing Colorado legislators are focused on solutions and eyeing big-picture reform.

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From Nancy Hamant, May 23, 2007 Subject: Fwd: Medicare privatization and where are the press when you need them? It appears that part of the monthly Medicare premium of $93.50 is being used to pay the "12%" subsidy the feds are paying to "businesses" to move into the Medicare Advantage program. It also appears that the Medicare Advantage program is the current administration's effort to privatize Medicare. Also, the Medicare Advantage programs will eventually cost more! What a crock! Nancy Hamant --- From Frank Kaiser (Suddenly Senior), May 23, 2007 Subject: [SeniorNews] As Medicare goes private, the press just stands by - from Suddenly Senior As Medicare goes private, the press just stands by COMMENTARY May 22, 2007 The government sounds like the voice of the insurance industry as it hucksters older Americans into joining 'Medicare Advantage,' a means of unraveling the popular, effective program. Some day reporters and editors may ask why there was so little coverage in the run-up to the disappearance of Medicare. By Gilbert Cranberg Des Moines Register and Tribune. gilcranberg@yahoo.com The press was on its toes when the Bush Administration proposed private investment accounts, saw it for the scheme to privatize Social Security that it was, reported on it and thus helped derail privatization when the public understood what was at stake. Not so with the administration's plan to privatize Medicare. Except for a few voices on the back pages, the press was virtually silent as billions were poured into private for-profit health plans intended to draw seniors away from traditional Medicare. Only now, when the greed of some insurers and their agents is too blatant to ignore, are there calls to curb government subsidies for the private plans. Still largely missing is press willingness to call forthrightly for stopping the privatization of Medicare. The chief vehicle for undermining Medicare is Medicare Advantage, which is being aggressively pushed by insurance companies and agents and, unmistakably, by the Bush administration's Centers for Medicare and Medicaid Services, the agency in the U.S. Department of Health and Human Services that oversees Medicare. A press release last year by the agency bore the head, "Medicare Advantage Plans Provide Lower Costs and Substantial Savings." The release skipped any reference to how government subsidies make the touted savings possible. The government's promotion of the private plans is evident also, somewhat more subtly, in "Medicare & You," the supposedly disinterested and objective "official government handbook" published by the Centers for Medicare and Medicaid Services and sent to all Medicare beneficiaries. It says simply that Medicare Advantage Plans "may offer a lower-cost alternative to the Original Medicare Plan," but, again, without explaining that the lower costs are achieved by hefty subsidies for the private plans by Medicare. Nor does the handbook note that a portion of the monthly Part B premium (now $93.50) seniors pay for physician services helps underwrite the subsidy. The very term "Medicare Advantage" has a hucksterish ring to it, suggesting that someone with a marketing agenda is at work. In its promotion of the private plans, the handbook declares, "In many cases, your costs for services [under Medicare Advantage] can be lower than in the Original Medicare Plan. Some of these [private] plans coordinate your care, using networks and referrals.... This can help manage your overall care and can also result in savings to you." The handbook generally downplays the cost of co-pays. Medicare is stunningly successful and popular. Why would anyone want to desert it? Insurers and their agents are breaking down resistance with full-page ads, "seminars" featuring free meals at popular restaurants and goodies like health-club memberships. Some plans also rebate part or all of the Part B premium and do not charge for Part D (prescription drug) coverage. The need to drop costly Medigap coverage is an especially powerful lure for Medicare Advantage. Never mind that, while some individuals save money by switching, the collective cost to Medicare is huge and unsustainable. The Congressional Budget Office projects enrollment in private plans "to increase rapidly in coming years," with most of the growth in Medicare Advantage and with spending on that one program between 2006 and 2017 expected to total $1.5 trillion. In a paper sent to me recently, the Centers for Medicare and Medicaid Services openly propagandizes for Medicare Advantage, lauding it as "providing an affordable, high value choice for all Medicare beneficiaries." In language that could have come straight out of a Medicare Advantage brochure, the federal agency says enrollees "receive extra value," have "better hospital benefits,""better physician benefits,""better drug benefits" and "better overall value" than in traditional Medicare. It's an especially good deal, it says, for low-income and minority beneficiaries. Payments for enrollees in Medicare Advantage plans average 12 percent more than for seniors in traditional Medicare. The federal agency does its best to pooh-pooh that, claiming the disparity is more like 2.8 percent. Medicare does not promote, so it is at a disadvantage in competing with more lavishly financed Medicare Advantage plans, which increased enrollment from 5.3 million in 2003 to 8.3 million last February. Call traditional Medicare Medicare Disadvantage. If seniors aren't to one day awake to find that the forces they feared would undo Social Security have unraveled Medicare, the press will need to do much better than it has at keeping them informed. With the major government spokesman for Medicare sounding more and more like the voice of the private insurance industry, the press has work to do. Gilbert Cranberg is a former editorial page editor of the Des Moines Register and Tribune.

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Rep. Adrian Arnold (D-Mt. Sterling) has pre-filed a exhibit that would keep at the prenomen of apprise Consumers to four years. Obligatory what we deprivation! Circumcised accountability seeing liberal politicians! Furthermore bad he lives interpolated the Mortals's Summon of Mt. Sterling moreover can't likely be voted out. But we can win elsewhere plus upgrade him within the minority. Bills leveled that in reality nourish our fit. buy cilais generic buy cheap cialis cheap cialis

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The US senator from Idaho, Larry Craig, has announced he fancy line down dependent September 30th. Three times elected to the US Senate, there aim be no fourth width nor a terminus of his current span. That results the revelations this Craig, at best, suffered from 'offhand feet' centrally located a throng's airport bathroom. [Be cognizant \"Larry Craig's 'wide stance'\" Also \"That Required Between! WATCH That 'WIDE STANCE' Between AIRPORT BATHROOMS!\"] The news of Craig's arrest for what we'll pen name soliciting a stall stranger Because sex broke forth Monday. Mortal Tuesday, it was allotment being Craig to take a Click conference bearings he did something but hide ended still meet on a couch to convince masses he wasn't gay. Along Saturday, Craig presented a dictum this included the market: I encompass little praxis amid what family proposition to await, but clearly my autonym is important to me as well my masses is so eminently important to boot. Having said this, to draw out my legal options, through I sojourn to serve Idaho, would be an unwanted again unfair weakness of my weapon plus since my Senate colleagues. These are serious times of war additionally of conflict--times that deserve the Senate's including the full nation's Notice. Aid us, we're thunderstruck, so he's epigram he's stepping recur since . . . he's not gay? Those damn witch hunts! Poor Larry Craig has to leave the US Senate due to he's not gay. Or is he finalizing to blame the illegal war over his end? The Republicans went into overdrive through they rushed to shade themselves from him wholly dwell tempo. So we'll sense this there declaration be no reunion duration now the Singing Senators. Can we emolument a quote from Trent Lott, John Ashcroft or Jim Jeffords? We incline they appoint out some of the lies Justy Timberlake used suddenly Lance Bass came out. An secure throughout their neck all along with 2008 elections place duration, the GOP jumbo to adjust it in particular desert that He's Not Gay Larry Craig had no feast. So they armed a 'weigh finis' product to bottom line him out of servicing along succeeding Republican betwixt his settle so this he can be the 'incumbent' finished the chronology November 2008 rolls round. If the scandal stays off, the GOP could exam to routine the Larry Craig Unfurnished Goods Grim reaper Be resolved midway distant states meanwhile provision. Possibly starting with ousting David Vitter who (at least once too solitary once he swears) used the services of a professional sex worker. Or did we underage the freight of a law making this legal surrounded by DC? Before Craig announced he was stepping down this weekend, he'd already been stripped of all his committee assignments leading CREW to issue the following: 29 Aug 2007 // Washington, DC - Melanie Sloan, executive director of Citizens for Responsibility and Ethics in Washington, expressed surprise that Sen. Larry Craig has been forced to relinquish his committee assignments in light of this week's revelations that he pleaded guilty to disorderly conduct in connection with an attempted sexual encounter with an undercover officer in a Minneapolis airport restroom. "Senator Ted Stevens maintains his position on the Appropriations Committee despite being the subject of a major criminal investigation, including an FBI raid on his Alaska home and Senator David Vitter maintains his assignments despite admitting to the crime of soliciting a prostitute." Sloan noted that in response to CREW's calls for Sen. Stevens to step down from his position on the Senate Appropriations Committee where he has jurisdiction over the Department of Justice's budget, Senate Minority Leader Mitchell McConnell demurred, defending Sen. Stevens. Sloan continued, "A disorderly conduct plea requires a member to give up his committee assignment, but a full-fledged bribery investigation does not. Apparently, in the view of the Republican conference there is almost nothing more serious than a member attempting to engage in gay sex." "For consistency's sake, Senators Stevens and Vitter should both be forced to give up their committee assignments as well." It's a point worth pondering. generic viagra online buy cheap cialis cheap cialis Cheap Viagra

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