According to the senior author of the study, Adil H. Haider, M.D., M.P.H., an assistant professor of surgery at the Johns Hopkins University School of Medicine, “It’s a double whammy. Minorities are much more likely to get injured by this mechanism and much more likely to die by this mechanism.”

Haider, along with Rubie Sue Maybury, M.D., M.P.H., reviewed information on over 26,000 patients who were hit by motor vehicles between 2002 and 2006. The research, which was provided by the National Trauma Data Bank, showed that African-American patients had a 22% greater risk of death, and Hispanic patients had a 33% greater risk than white patients who were involved in similar accidents. In addition, those patients who are uninsured had a risk of death that was 77% greater than that of those with insurance, even if they received treatments in hospital emergency rooms, which have long been assumed to be the health care industry’s great equalizer.

Haider, who also holds the position of co-director of the Johns Hopkins Center for Surgical Trials and Outcomes Research, reiterated that the greater death risks for minorities and the uninsured are not accounted for by increased rates of injury. “Do we treat minorities and the uninsured differently? I don’t think so, but we’ve got to ask the question. We don’t actually know what is leading to these disparities.”

Other studies have shown that both ethnicity and insurance status may increase the risk of mortality because of differences in available services, or delay in treatment. As well, a greater prevalence of (or lack of treatment for) common comorbidities such as diabetes, hypertension, or obesity, may be factors that increase the risk of death among injured crash victims who are uninsured or belong to ethnic minorities.

Haider pointed out that since underlying causes for these risk disparities can’t be easily addressed, policymakers need to focus on accident prevention programs for pedestrians, especially in inner cities, where a significant number of these deadly crashes happen. He held up the great success with regard to the use of seat belts and safety seats for children as innovations that have saved lives, and said that pedestrian education could also help, though, he conceded, the problem of injury to pedestrians may be more complicated.

Other Johns Hopkins researchers who worked on this study are Cassandra Villegas; Elliott R. Haut, M.D.; Kent Stevens, M.D., M.P.H.; and David T. Efron, M.D.

In a ruling which was posted on the state Supreme Court’s website, it was said that the law, which set a 1 percent fee on claims paid by private health insurers and companies with self-insured health plans, was in violation of the state’s Constitution. The request to overturn the law came from State Insurance Commissioner Kim Holland.

Michael Ridgeway, an attorney for the Insurance Department, argued that the bill never received the necessary three-fourths vote when it passed the House and Senate votes.

Holland’s efforts were supported by the Independent Insurance Agents of Oklahoma, which commended the Supreme Court for its ruling, with the group’s president and CEO Dan Ramsey stating in a press release, “Commissioner Holland was correct in filing this lawsuit to protect Oklahoma policyholders from seeing health insurance premiums increase by an estimated $78 million annually as a result of this legislation and we appreciate her efforts to take this aggressive position.”

The California Senate passed two bills which provide the functions and mechanisms of the exchange. One, which is waiting for the governor’s approval, sets up an online exchange where consumers will be able to compare participating insurance plans. The exchange will be operated by a state-appointed five-member board.

The second bill, which has been sent back to the state Assembly for its approval, details the exchange’s role in health care insurance, and creates a California Health Trust Fund which would finance the exchange.

Unsurprisingly, both bills passed along party lines, with Democrats approving, and Republicans opposing the initiatives.

According to the Patient Protection and Affordable Care Act, state-based exchanges for both small businesses and individuals to purchase health care insurance must be up and running by January 1, 2014, though either non-profit groups or government agencies may administer them.

While Governor Arnold Schwarzenegger announced in April that we would support health care reform, stating he would “…work with the federal government to get this done…” he has not stated whether or not he would be signing either of these bills.

The sad truth, and the one HHS Secretary Kathleen Sibelius hit squarely on the head, is that premiums are set without much in the way of accountability or transparency. As a result, over the last decade rates have doubled, pricing many consumers out of even the most minimal coverage.

While 26 states and the District of Columbia already have the power to reject unfair premium increases, they don’t necessarily have the money to enforce those decisions. That’s where federal oversight and federal funds are sorely needed as the nation moves into the next phases of insurance and health care reform.

The monies, in this case, are part of $250 million included in the Affordable Care Act for grants to provide health insurance premium reviews over the next 5 years.

By 2014, the hope is that increased competition in the insurance marketplace coupled with lower overhead and the establishment of insurance-exchanges for high-risk customers will mitigate the need for what amounts to price gouging with coverage rates.

The states that receive the money can use it in multiple ways to improve the premium review process, but overall, it’s a positive step forward in protecting consumers from steep health care rates as the broader health care reform program is set in place.

The named companies, entities and individuals were ordered to cease and desist from all unauthorized insurance business, including delivering, issuing, mailing, offering, or soliciting any resident of Louisiana any kind of certificate, coverage, plan, policy, or “any other contract” which claims to provide insurance benefits or medical discounts for health benefits.

In addition to receiving C&D orders, the named people and companies were directed to provide a complete list of all Louisiana businesses or residents that had purchased any products from them, and report all premiums that were received in connection with those customers. In addition, they were required to notify any of the affected Louisiana consumers of the C&D order, and issue immediate refunds of any monies or premiums held in behalf of those consumers.

Along with the Louisiana Department of Insurance, the same scammers have had lawsuits and/or regulatory actions filed against them by the Federal Trade Commission and law enforcement agencies in 23 other states.

The FTC alone has filed three different lawsuits targeting fraudulent medical discount plans, and Attorneys General and Insurance Commissioners around the country have brought numerous actions to stop the scammers. Included among these lawsuits and actions are those addressing sham insurance, as well as illegal automated phone calls, fax blasting, and licensing violations.

According to the AMA, its report has data not available anywhere else, and includes information on how medical liability claims are impacted by age, gender, and type of practice for physicians.

According to the Insurance Journal highlights of the report include:

1. Nearly 61 percent of physicians age 55 and over have been sued.
2. There is wide variation in the impact of liability claims between specialties. The number of claims per 100 physicians was more than five times greater for general surgeons and obstetricians/gynecologists than it was for pediatricians and psychiatrists.
3. Before they reach the age of 40, more than 50 percent of obstetricians/gynecologists have already been sued.
4. Ninety percent of general surgeons age 55 and over have been sued.

The AMA’s immediate past-president J. James Rohack, M.D., talked about the report, saying, “Even though the vast majority of claims are dropped or decided in favor of physicians, the understandable fear of meritless lawsuits can influence what specialty of medicine physicians practice, where they practice and when they retire. This litigious climate hurts patients’ access to physician care at a time when the nation is working to reduce unnecessary health care costs.”

The AMA says that the number of medical liability claims is not an indication of the frequency of medical error, as the physician prevails 90 percent of the time in cases that go to trial, but even though 65% of claims are either dropped or dismissed they’re not without cost. The average defense of a medical liability claims ranges from $22,000 for the dropped or dismissed claims to more than $100,000 for those that go to trial, leading to increased costs for both physicians and patients.

Rohack said the findings “validate the need for national and state medical liability reform.”

Speaking to the press, California Insurance Commissioner Steve Poizner said, “We want as many people as possible scouring these rate filings to ensure they are mistake-free. The e-mail notification tool will expand access to these documents by informing the public of when there are new filings to peruse. This additional analysis, in conjunction with scrutiny by the Department of Insurance’s in house actuaries and independent actuaries retained by the Department, will help ensure that consumers are protected and insurers are spending 70 percent of premiums on medical benefits, as required by state law.”

Consumers who wish to participate in this program should visit http://www.insurance.ca.gov/email-updates/ and select which of the Department of Insurance’s updates they would like to receive.

Recently, Commissioner Poizner also that he wanted to create transparency by posting all health insurance rate filings for the individual market on the California Department of Insurance’s Web site. They can be found at http://www.insurance.ca.gov/0250-insurers/IndHlthRateFilings/, where interested readers are also able to post comments which will be read by CDI attorneys.

Additionally, Poizner announced that the rate filings of the four largest insurers in California’s individual health insurance will be subject to deeper scrutiny, by having them analyzed by an outside actuary. After today, the only large insurer that doesn’t have an active filing with the CDI is Health Net.

Health insurance rates in California do not require prior approval from the Department of Insurance the way homeowners and auto insurance rates do, but state law does require that seventy cents of every dollar collected in health insurance premiums must be spent on medical benefits. The actuarial review being instituted will allow verification that insurers are complying with this law.

-There’s already a shortage of front-line family physicians in some places and experts think that will get worse.

-People without insurance aren’t the ones filling up the nation’s emergency rooms. Far from it. The uninsured are no more likely to use ERs than people with private insurance, perhaps because they’re wary of huge bills.

-The biggest users of emergency rooms by far are Medicaid recipients. And the new health insurance law will increase their ranks by about 16 million. Medicaid is the state and federal program for low-income families and the disabled. And many family doctors limit the number of Medicaid patients they take because of low government reimbursements.

-ERs are already crowded and hospitals are just now finding solutions.

What do hospitals say about this likelihood? Well, Dr. Arthur L. Kellerman, a researcher with Rand Corp explains it thusly, “More people will have coverage and will be less afraid to go to the emergency department if they’re sick or hurt and have nowhere else to go…. We just don’t have other places in the system for these folks to go.”

What does this mean to you? If you are insured, start looking for a family practitioner, general practitioner or primary care physician now, before you actually NEED an appointment; most offices will squeeze in regular patients. Also, see if your insurance covers wellness care, which helps you use preventative measures to stay healthy, minimizing the likelihood of using an emergency room at all.

With a 31-2 vote, the Louisiana Senate passed the bill, which was sponsored by Representative Robert Johnson (D – Marksville). The bill would prohibit doctors and other health care providers and doctors from receiving coverage under state or private Medical Malpractice Acts when performing an abortion of an “uncomplicated viable pregnancy” that is not being performed in order to save the life of the mother.

Despite the concerns raised by some lawmakers over the denial of coverage for a legal medical procedure, the bill, House Bill 1453, is being sent to the governor’s desk for approval or veto. Representative Johnson admitted that he wasn’t aware of any other medical procedures that had no-coverage clauses.

No one spoke against the proposal on the Senate floor.