Author: Serkadis

“Despite spending more than twice as much as other developed countries, the United States still lags behind in terms of access and quality, an international survey said Wednesday,” Agence France-Presse reports. The Health Affairs study, which was based on survey responses from thousands of primary care physicians, also found that people in the United States were more likely to struggle to gain access to or pay for treatment than patients in 10 other countries evaluated because of insurance restrictions and high health care costs. “The United States is the only industrialized democracy that does not ensure that all of its citizens have health care coverage, with an estimated 36 million Americans uninsured,” the French news agency reports (11/5).

The Seattle Post Intelligencer‘s travel writer shares the views of some residents of other developed countries on their native health systems. A person from Sweden – one of the countries covered in the Health Affairs survey – says, “The health and medical services have an obligation to strengthen the situation of the patient, for example, by providing individually tailored information, freedom to choose between treatment options, and the right to a second opinion in cases of life-threatening or other particularly serious diseases or injuries. Having lived here all my life and raised my family here in Stockholm, I honestly do not see anything bad with our health care system” (Steves, 11/4).

One category of medical mysteries that stumps expert doctors and policymakers alike falls under the heading: What works? News reports on two new studies – and one that was never completed – offer insight into that issue.

It turns out that “one of the first things you do at a doctor’s visit” may not do much to improve your health, the Chicago Tribune reports. The value of collecting family medical histories turns out not to be supported by evidence, according to a review of 137 studies conducted during the past 14 years. The review was sponsored by the U.S. Agency for Healthcare Research and Quality and published in the Annals of Internal Medicine. “Overall, there was not even enough evidence to say how history collection affects patient outcomes. … [P]atients tend to report the absence of disease in relatives better than the presence of disease” (Roan, 11/4).

Separately, a recent innovation in bypass surgery turns out to be worse than the method it has begun to replace, The New York Times reports. Surgeons traditionally stopped patients’ hearts, letting machines called “pumps” do the work, while operating, but some worried the pump caused strokes, memory loss and personality changes. So-called off-pump surgery on still-beating hearts gained popularity during the past seven years, and now around 20 percent – more than 225,000 operations – are done off pump. But, a “rigorous” study of 2,203 patients finds that the off-pump procedures have poorer outcomes in terms of repeat surgeries, deaths, strokes and heart attacks. The study was sponsored by the Department of Veterans Affairs and appeared in the New England Journal of Medicine (Kolata, 11/4).

Meanwhile, a planned study to determine which patients actually need heart defibrillators could not be completed when the device industry ceased paying for the research, which it had funded as part of a deal with the Medicare program, The New York Times reports in a second story. In 2004, Medicare expanded eligibility for the devices to almost twice as many patients, on the condition that device makers pay for the study to create evidence that would justify – or refute – the policy change. “Five years later, Medicare underwrites more than half of the $4 billion the nation now spends annually on defibrillators, but the agency is no closer to knowing how many lives that big investment is saving. That is because the device companies did not finance the study beyond their initial $4 million commitment, and Medicare did not pick up the slack. As a result, researchers still cannot gather data that would identify the types of patients who would most benefit from a defibrillator.” That’s only one example of how consumers and doctors have “little if any comparative data when choosing a device” (Meier, 11/4).

Walmart.com said Thursday it will start offering its Top 10 pre-order DVD movie titles at just $10 each as well as "free home delivery" on its entire catalog of DVD and Blu-ray titles (excluding box sets).

The move comes as the retailer continues its aggressive efforts to win over more holiday bargain shoppers. Last week Walmart announced it would let customers pre-order 10 of the most popular upcoming books for as little as $10 each, sparking a price war with Amazon.com.

Customer will be able to pro-order popular titles online including "Harry Potter and the Half-Blood Prince," "Night at the Museum: Battle of the Smithsonian," "Star Trek," and "Angels and Demons."

"This will be a challenging holiday season for our customers, and we recognize that more of them are choosing Walmart.com every day as the website with the lowest prices," said Raul Vazquez, Walmart.com’s CEO.

"We’re excited to offer our Top 10 pre-order DVD movies titles for just $10 as well as free home delivery on our entire assortment of DVD and Blu-ray titles. This is yet another example of how we continue to help our customers save money online at Walmart.com during the holidays and beyond."

It will be interesting to see if Amazon.com and other retailers follow Walmart’s lead.

 

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Federal Drug Administration Commissioner Margaret A. Hamburg announced a new “Safe Use” program for drugs on Wednesday.

The program sets out “to reduce the misuse of medications, saying that at least 50,000 hospitalizations a year could be prevented if physicians, pharmacists, patients and parents used greater care in dispensing and taking drugs,” The Washington Post reports. “The Institute of Medicine estimates that at least 1.5 million preventable injuries and deaths result each year from overdosing, mix-ups and unintended exposure to prescription drugs. Children are often the victims — one study found that, between 2003 and 2006, more than 9,000 children were accidentally exposed to prescription drugs such as codeine and morphine. The cost of these preventable injuries is estimated at about $4 billion annually by the Institute of Medicine” (Layton, 11/4).

Los Angeles Times: “The FDA called on doctors, other healthcare professionals and consumers to help identify drugs and circumstances that may be particular problems. The agency will hold public hearings to gather information, said Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research.” The FDA has identified several specific issues, including “the overuse of acetaminophen, a pain reliever that can cause liver damage when taken to excess. The drug is the primary ingredient in Tylenol and is included in several other over-the-counter medications, so it can be difficult for consumers to judge how much they’ve consumed. The FDA also will scrutinize the information provided to patients, such as package inserts, labels and instructions that pharmacists give when dispensing prescriptions” (Zajac, 11/5).

CNN: “In an effort to ensure safer use, the agency also released new guidelines for companies that make or distribute over-the-counter medications that come with dose delivery devices such as droppers, spoons or cups” (Young, 11/4).

Americans are increasingly scrutinizing their drug choices to find ones that work but don’t break the bank. The Associated Press reports: “Last year pharmaceutical companies spent more than $4 billion urging patients like you to ‘ask your doctor’ about their drugs. But if you want a prescription that won’t empty your wallet, while still keeping you well, you might start asking your doctor about drugs you don’t see on TV. As unemployment continues to rise, experts estimate that 50 million Americans are without health care coverage, forcing many to bear the full cost of their prescriptions. Compounding the problem are steadily rising drug costs. The senior advocacy group AARP reports that prices for the most popular drugs rose 8.7 percent on average last year, more than twice the rate of inflation. Fortunately there are cheaper alternatives to many of these pills.” The AP also includes several important points to consider when choosing drugs (Perrone, 11/4).

As House Democrats move towards a weekend vote, they must resolve a series of outstanding issues, The Hill reports. Blue Dog Democrats, a fiscally conservative voting bloc, said up to 30 of their members “are considering voting against the bill because of concerns that it will increase healthcare costs in its second 10 years.”  Rep. Luis Gutierrez, D-Ill., and other members of the Congressional Hispanic Caucus could vote against the bill if it blocks undocumented immigrants from buying insurance on proposed exchanges. Abortion, the most divisive of the issues, has split enough Democrats from the party to block legislation, one anti-abortion Democrat, Rep. Bart Stupak, D-Mich., said (Soraghan and Hooper, 11/4).

One  issue comes down to the fine print beneath a plan to move people with pre-existing health problems into high-risk insurance pools when private companies turn them down, the Associated Press reports. The proposal is meant to immediately help people in that difficult situation, but in the Senate Finance Committee bill, it would require patients to be uninsured for six months before they become eligible. That’s enough time for the very sick, such as cancer patients, to “go from bad to death,” one cancer policy expert said. The House bill “doesn’t include a waiting period” (Alonso-Zaldivar, 11/5).

Some moderates remain concerned about the House bill’s biggest revenue-raising provision: “a 5.4 percent surtax on adjusted gross income above $500,000 for individuals and $1 million for couples filing jointly. That raises $460.5 billion,” CongressDaily reports. Some House moderates convinced their leadership to raise those limits from the much lower thresholds that were initially proposed. But, other remain concerned. One lawmaker is worried that the thresholds are not indexed for inflation and would begin affecting more people over time (Cohn, 11/5).

Despite campaign claims that the middle class would face no tax hikes under President Obama’s administration, “as Congress inches closer to forging a massive package of health-care reforms, it’s increasingly clear how difficult it will be to keep that pledge,” BusinessWeek reports. For instance, one critic “argues that Congress has purposely loaded onto the corporate sector the increased taxes needed to pay for the reforms to avoid politically unpopular individual tax hikes. But the added costs will eventually be shifted to customers” (Sasseen, 11/4).

TPG Capital and the Canada Pension Plan have agreed to buy IMS Health (NYSE: RX), a provider of data on prescription drug sales, for $22 per share (50% premium to last Friday’s closing price). The total deal would be valued at around $5.2 billion, including the assumption of debt. Goldman Sachs is providing the leveraged finance. 

PRESS RELEASE

IMS Health (NYSE: RX), the world’s leading provider of market intelligence to the pharmaceutical and healthcare industries, today announced that it has entered into a definitive agreement to be acquired by investment funds managed by TPG Capital (“TPG”) and the CPP Investment Board (“CPPIB”) in a transaction with a total value of $5.2 billion, including the assumption of debt.

The agreement was unanimously approved by the IMS Board of Directors based upon the recommendation of the Transaction Committee that was established to undertake a review of IMS’s strategic alternatives. Under the agreement, IMS shareholders will receive $22.00 cash for each share of IMS common stock they own, representing a premium of approximately 50 percent over the closing share price on Friday, October 16, 2009, the last trading day prior to public speculation that IMS was considering its strategic alternatives.

The transaction has fully committed financing, consisting of a combination of equity to be invested by TPG and CPPIB and debt financing to be provided by certain affiliates of Goldman, Sachs & Co., including its principal loan and mezzanine funds.

“This transaction enables our shareholders to realize substantial value from their investment in IMS with an immediate cash premium, while at the same time strengthening our position to capture long-term growth opportunities,” said IMS Chairman and CEO David R. Carlucci. “With the backing of world-class private equity partners, we will continue our focus on expanding into new markets, further improving the quality and depth of offerings we deliver to our clients, and playing a bigger role in the healthcare market.”

“IMS Health has consistently demonstrated it is the definitive source of critical data and services to the evolving healthcare industry,” said Jonathan Coslet, Senior Partner, TPG. “We are pleased to join with our long-time partner, CPP Investment Board, and a talented management team to continue the growth of this outstanding franchise.”

“We are pleased to make a significant investment in IMS Health which is the market leader in its industry with a strong customer base,” said Mark Wiseman, Senior Vice President, Private Investments, for CPP Investment Board. “CPPIB and TPG are like-minded, long-term investors and we look forward to working together and in partnership with management to help grow the business.”

Completion of the transaction is subject to approval of IMS shareholders, regulatory approvals and customary closing conditions and is expected to occur by the end of the first quarter of 2010.

Foros Securities LLC acted as financial advisor to the Transaction Committee of the Board. Lazard rendered a fairness opinion to the Transaction Committee. Morris, Nichols, Arsht & Tunnell LLP acted as legal advisor to the Transaction Committee.

Deutsche Bank Securities Inc. acted as financial advisor to the Company, and Sullivan & Cromwell LLP acted as legal advisor to the Company.

Goldman, Sachs & Co., BofA Merrill Lynch, Barclays Capital, Evercore Partners, and J.P. Morgan acted as financial advisors to TPG and CPPIB. Ropes & Gray LLP acted as legal advisor to TPG and CPPIB. CPPIB was also separately advised by Torys LLP.

About IMS

Operating in more than 100 countries, IMS Health is the world’s leading provider of market intelligence to the pharmaceutical and healthcare industries. With $2.3 billion in 2008 revenue and more than 50 years of industry experience, IMS offers leading-edge market intelligence products and services that are integral to clients’ day-to-day operations, including product and portfolio management capabilities; commercial effectiveness innovations; managed care and consumer health offerings; and consulting and services solutions that improve productivity and the delivery of quality healthcare worldwide. Additional information is available at http://www.imshealth.com.

About TPG Capital

TPG Capital is the global buyout group of TPG, a leading private investment firm founded in 1992 with approximately $45 billion of assets under management and offices in San Francisco, London, Hong Kong, New York, Fort Worth, Washington, D.C., Melbourne, Moscow, Mumbai, Paris, Luxembourg, Beijing, Shanghai, Singapore and Tokyo. TPG Capital has extensive experience with global public and private investments executed through leveraged buyouts, recapitalizations, spinouts, joint ventures and restructurings. TPG Capital’s healthcare investments have included Axcan Pharma, Biomet, Fenwal, IASIS Healthcare, Quintiles Transnational, and Surgical Care Affiliates, among others. TPG’s technology investments have included SunGard, Fidelity National Information Services, Sabre Holdings, Aptina, Avaya, and Intergraph, among others. Please visit www.tpg.com.

CPP Investment Board

The CPP Investment Board is a professional investment management organization that invests the funds not needed by the Canada Pension Plan to pay current benefits on behalf of 17 million Canadian contributors and beneficiaries. In order to build a diversified portfolio of CPP assets, the CPP Investment Board invests in public equities, private equities, real estate, inflation-linked bonds, infrastructure and fixed income instruments. Headquartered in Toronto, with offices in London and Hong Kong, the CPP Investment Board is governed and managed independently of the Canada Pension Plan and at arm’s length from governments. At June 30, 2009, the CPP Fund totaled $116.6 billion of which $18.4 billion represents private investments. For more information about the CPP Investment Board, please visit www.cppib.ca.

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Doctors and lawyers are disputing the true costs of defensive medicine, while surgeons oppose provisions being considered by the Senate for health reform.

The Seattle Times reports that “defensive medicine” is under scrutiny as part of the congressional consideration of health care reform. “Doctors say the hidden costs of the tests along with malpractice insurance and lawsuit awards are major drivers behind the soaring cost of care. Trial attorneys say bad medicine, not lawsuits, is to blame.” Democrats generally have taken the lawyers’ side while Republicans have pushed for malpractice reform. 

The feud “has made it tough to put an accurate price tag on the cost of the issues. … Doctors say the price of defensive medicine and malpractice insurance accounts for up to 10 percent of health care spending. Lawyers say malpractice settlement costs amount to less than 0.5 percent of the $2.5 trillion spent each year on health care. The cost of annual malpractice premiums can vary wildly depending on specialty, geographic location and insurance carrier” (LeBlanc, 11/4).

The Hill reports that groups representing surgeons delivered a letter to Senate Majority Leader Harry Reid, D-Nev., laying out their opposition to Senate proposals for health care reform. “The critical dispatch from American College of Surgeons contrasts sharply with its July endorsement of the House’s original healthcare reform bill. The surgeons, like the American Medical Association (AMA) and other physician groups, backed the House measure in large part because it included a permanent reform the Medicare’s broken payment system for doctors, which must be adjusted by Congress each year to prevent steep cuts.”

“The surgeons object to funds for surgeons being redirected to primary care physicians; a proposal to create an independent commission on Medicare payment policy that would not require congressional action to take effect; requirements that doctors participate in a quality measurement program; and other components of the [Senate] Finance Committee bill … [including] the Senate’s decisions to not enact a permanent reform to the Medicare payment system and to not enact limits on lawsuits for medical malpractice” (Young, 11/4).

Congress Daily reports: “Surgeons are becoming more and more vocal as they break from the physician pack in their protest of Democratic healthcare proposals, sending Senate leaders a warning letter Wednesday and aiming to stir the pot at this weekend’s American Medical Association meeting in Houston. … Six surgical groups, including the American Association of Neurological Surgeons, the American Society of General Surgeons and the American Academy of Facial Plastic and Reconstructive Surgery, plan during AMA’s conference to force a debate on AMA’s original support for the House bill” (Edney, 11/5).

Microsoft’s CEO isn’t getting ahead of himself; for the time being, Steve Ballmer’s taking a "first things first" approach.  However, he indicated today that if the proposed U.S.-only Microsoft-Yahoo search partnership goes through, an international agreement may follow.

According to Mayumi Negishi, Ballmer said at a news conference in Tokyo, "It’s possible that we will extend that partnership (with Yahoo) outside the U.S.  We will have to wait and see if we can get approval and consummate that partnership inside the U.S. first."

An international arrangement would make a great deal of sense for Microsoft and Yahoo.  After all, Google’s extremely popular in many places around the world, so any measures the two companies take to fight it in America would be appropriate elsewhere.

Also, even if Microsoft and Yahoo can’t make any inroads on Google’s market share, being more efficient in lots of countries is better than being more efficient in one if they can save money by working together.

So we’ll see what happens in early 2010, assuming Microsoft and Yahoo are able to implement their U.S. deal as planned at that point.  And we’ll try to keep an eye on what the two companies have to say to international regulators in the meantime.

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Government Executive.com: “Sixteen Republican representatives wrote to Oversight and Government Reform Committee Chairman Edolphus Towns, D-N.Y., to demand that he schedule hearings on reform proposals’ potential impact on the Federal Employees Health Benefits Program.” The letter asks for clarification on if FEHBP would meet requirements for a “qualified health benefits plan” and would be a qualifying plan under health care reform. Towns said plans have five years to become compliant with minimum standards for coverage and that FEHBP changes, if any, would be minor and easy to accomplish (Rosenberg, 11/4).

UPI reports that some House Republicans are pushing an amendment to the House health care reform bill that would require lawmakers to enroll in a government-run public option. It would bar lawmakers from participating in FEHBP (11/4).

The Hill: “Instead, members would have to rely on the Health Insurance Exchange and the public option plan House Democrats are proposing in their latest healthcare reform effort” (Romm, 11/4).

Google has launched what it calls the Google Dashboard, which is a central place Google users can go to find their data for different Google products they use when signed into a Google account. It also provides direct links to control your personal settings.

"Over the past 11 years, Google has focused on building innovative products for our users," the company says. "Today, with hundreds of millions of people using those products around the world, we are very aware of the trust that you have placed in us, and our responsibility to protect your privacy and data. In the past, we’ve taken numerous steps in this area, investing in educating our users with our Privacy Center, making it easier to move data in and out of Google with our Data Liberation Front, and allowing you to control the ads you see with interest-based advertising."

The dashboard covers Google products like Gmail, Calendar, Docs, Web History, Orkut, YouTube, Picasa, Talk, Reader, Alerts, Latitude, Friend Connect, Health, Profile, Contacts, Tasks, and Web History.

Google Analytics, Checkout, App Engine, Bookmarks, Base, Groups, Sites, Knol, Local Business Center, Maps, Merchant Center, News, Notebook, Webmaster Tools, Subscribed Links, and Toolbar sync are not yet available on the dashboard. Since Google uses the term "yet," I assume that they will be included in the future.

"The scale and level of detail of the Dashboard is unprecedented, and we’re delighted to be the first Internet company to offer this — and we hope it will become the standard," Google says.

The dashboard is available at google.com/dashboard. It is also available in the settings for your Google account.

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The HTC-built DROID ERIS will go on sale tomorrow at Verizon stores for $99 after a $100 mail-in rebate and two-year contract agreement. Equipped with HTC’s “Sense” user interface, the ERIS “offers customers the opportunity to customize a seven-panel wide home screen with a wide variety of widgets designed to bring the most important information to the surface.” On sale tomorrow at Verizon’s retail stores and website.

Michael Scott points us to yet another (yes, another) case of copyfraud, where someone sends a DMCA takedown notice to stop criticism, rather than actual infringement. In this case, the party accused of misusing the DMCA in this manner (which is illegal) is whoever is behind the website PerfectPitch.com, who offers a fee-based training program that is supposed to help people learn to have (surprise, surprise) perfect pitch. Mac Donn had put up a blog post on TheSession.org, asking about the general concept of having perfect pitch (not the course specifically) leading to a relatively tame discussion in the comments. However, one comment sorta kinda maybe referred negatively (barely) to the website PerfectPitch.com, suggesting that that there are plenty of free resources to help train your ears. In response, it certainly appears that the owner of PerfectPitch.com, Gary Boucherle, sent a DMCA takedown request to Google, who removed all links for that supposedly-offending page from its search index.

But, of course, that makes no sense. Nothing on the page violates the copyright of Boucherle at all. There isn’t any content from his website. There is just a reference to it (and it’s basically an aside, rather than a direct discussion). From what’s presented, it’s difficult to see how this isn’t a violation of the DMCA with Boucherle claiming copyright on content that he has no rights (at all) over, in attempt to remove from Google’s index a webpage that suggests that there are free alternatives that are better than paying for expensive courses.

We see this kind of abuse of the DMCA all too frequently, as various parties use it as a sledgehammer to censor content they dislike, rather than for anything having to do with copyright infringement. It’s a massive problem with the DMCA’s notice and takedown process, which puts tremendous pressure on services like Google to simply remove the content first, before there’s any actual evidence of infringement.

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All day today we will be live streaming the White House Tribal Nations Conference at the Department of the Interior, including opening and closing remarks from the President and discussions ranging from jobs to energy to housing to health care.  As part of President Obama’s sustained outreach to the American people, this conference will provide leaders from the 564 federally recognized tribes the opportunity to interact directly with the President and representatives from the highest levels of his Administration.  Each federally recognized tribe has been invited to send one representative to the conference.

Watch all day at WhiteHouse.gov/live.

UPDATE: During the President’s opening remarks, he discussed the Memorandum he was about to sign:

And that’s why representatives of multiple agencies are here today — because if we’re going to address the needs of Native Americans in a comprehensive way, then we’ve got to mount a comprehensive response.

A major step toward living up to that responsibility is the presidential memorandum that I’ll be signing at this desk in just a few moments.  In the final years of his administration, President Clinton issued an executive order establishing regular and meaningful consultation and collaboration between your nations and the federal government.  But over the past nine years, only a few agencies have made an effort to implement that executive order — and it’s time for that to change.  (Applause.) 

The memorandum I’ll sign directs every Cabinet agency to give me a detailed plan within 90 days of how — the full implementation of that executive order and how we’re going to improve tribal consultation.  (Applause.)  After all, there are challenges we can only solve by working together, and we face a serious set of issues right now. 

He also discussed how tribes face the same kinds of challenges all of America faces, and how he plans to address those challenges.  In closing, he made clear that he is an ally:

So there’s a lot of work to be done today.  But before we get at it, I want to close with this.  I know you’ve heard this song from Washington before.  I know you’ve often heard grand promises that sound good but rarely materialize.  And each time, you’re told this time will be different.  But over the last few years, I’ve had a chance to speak with Native American leaders across the country about the challenges you face, and those conversations have been deeply important to me.

I get it.  I’m on your side.  I understand what it means to be an outsider.  I was born to a teenage mother.  My father left when I was two years old, leaving her — my mother and my grandparents to raise me.  We didn’t have much.  We moved around a lot.  So even though our experiences are different, I understand what it means to be on the outside looking in.  I know what it means to feel ignored and forgotten, and what it means to struggle.  So you will not be forgotten as long as I’m in this White House.  (Applause.)  All right.  Thank you.  Thank you.  Thank you.

Together, working together, we’re going to make sure that the First Americans, along with all Americans, get the opportunities they deserve.  So with that, if I’m not mistaken, I am in a position now to start signing this memorandum, and then we’re going to do a little Q&A.  So get everything set up — how many pens do you want me to use?  Eight pens.  (Laughter.)  I don’t know who’s getting the pens, but —

(The memorandum is signed.)

 

You already know we smashed this one, but in case you don’t…  Release date? Check. Spy shots? Yes please. Unboxing? Sure. Press release? Well, we figure we would let Verizon handle that one. Today, HTC and Verizon officially announced the November 6th launch of the DROID Eris on the “there’s a map for that” network. This handset has all the goodies: Wi-Fi, GPS, a 5 megapixel camera, 3.2″ touch screen display, and HTC’s Sense UI. The price tag is set at $99 on contract after a $100 mail-in rebate. We’ve given this puppy enough attention, but you can hit the press release for all the minutia.Read

“The Congressional Budget Office said Wednesday that the alternative health care bill proposed by House Republicans would have little impact in extending health benefits to the roughly 30 million uninsured Americans, but would reduce average insurance premium costs for people who have coverage,” The New York Times reports. “The Republican bill, which has no chance of passage, would extend insurance coverage to about 3 million people by 2019, and would leave about 52 million people uninsured, the budget office said, meaning the proportion of non-elderly Americans with coverage would remain about the same as now, at roughly 83 percent.” A CBO analysis of the Democratic version found that 96 percent of legal residents would be covered. “House Republicans, including their leader, Representative John A. Boehner of Ohio, have said that they did not intend for their legislation to expand insurance coverage, because they viewed that goal as unaffordable. Instead, they said the bill was tailored narrowly to reduce costs” (Herszenhorn, 11/4).

The Washington Post: “Republicans said their plan was not intended to rapidly expand coverage, but to take a step-by-step approach that begins with lower insurance costs. Rep. Dave Camp (Mich.), the senior Republican on the House Ways and Means Committee, hailed the CBO’s assessment as confirmation that the GOP plan would bring insurance premiums down by as much as 10 percent in the small group market, a significant improvement over the Democratic bill” (Montgomery, 11/4).

Roll Call: “In 2016, the CBO estimates that small group insurance premiums would drop 7 percent to 10 percent compared with current law. Individual insurance prices would drop 5 percent to 8 percent, and in the large group market, the plan would cut prices from zero to 3 percent. However, the CBO said some people could see higher premiums, including, potentially, older and sicker people” (Kucinich and Dennis, 11/4).

Los Angeles Times: “The GOP bill is an amalgam of market-oriented measures that would limit medical malpractice lawsuits, expand the use of tax-sheltered medical savings accounts, let people shop for insurance outside of their own states, and make it easier for small businesses and hard-to-insure people to get coverage. The ideas reflect conservatives’ suspicion of sweeping new programs, federal spending and additional regulation. Unlike the Democratic plan, it does not include subsidies or other provisions that would make coverage more affordable to people of modest means.” The proposals in the bill have long been on the Republican “wish list, yet they were not enacted even when the party controlled Congress and the White House. And they are being resurrected at a time when some Republicans warn that the party is in danger of being seen as guardians of an unpopular status quo in healthcare” (Hook, 11/5).

Think of the Myka ION as a nettop built for your HDTV. The little media streamer utilizes an 1.6 GHz Intel Atom 330 CPU and an NVIDIA ION GPU to provide your TV with quality high-definition content. Actually, the Myka ION is more computer than dedicated media playback device, which is good thing. Well, a Linux-powered computer with Boxee and XBMC installed, that is.

The company claims that the Myka ION has enough juice to power Boxee, Hulu, and other Internet sites as well as playback HD content encoded at a high bit rate. After peeking the specs, which includes 2GB of DDR2 memory and the aforementioned hardware, I don’t see why it couldn’t. Video can be outputted to a display via VGA, DVI, or HDMI and the audio can ride on either optical or dig-COAX digital channels or over analog outputs. There is even a wireless network option, along with a Blu-ray drive and various hard drive size options.

But it’s the software that makes a streamer successful and this guy is stacked. It has everything: Boxee, XBMC, Hulu Desktop and it’s own GUI powered by a full version of Ubuntu 9.10. Needless to say that the Myka ION can probably play back any video file you throw at it.

All this nerdy goodness doesn’t come cheap. The base model Myka Ion without wireless or a Blu-ray drive and only a 160 GB hard drive, costs $379 and will take 4 – 6 weeks to ship. Once you add all the options, the price climbs to a $769, which is on par with media centers from Dell and HP. But Dell and HP don’t ship with what looks like to be a killer software suite.

More college students are finding health care on campus. The Wall Street Journal reports: “As more parents lose their jobs—and their insurance—in the recession, more college students are having to scramble for health care. College officials say visits to campus health clinics are up sharply as students increasingly rely on these services, generally paid for by tuition or entrance fees, to cover basic health needs like checkups and lab tests. More students also are buying college-sponsored insurance plans to cover more extensive medical needs, like prescription drugs and visits to specialists. Some, though, are taking their chances, going with inadequate coverage or none at all, the officials say.”

“Health clinics and insurance plans vary widely from college to college. Some campuses offer only basic primary care, while others have a broad array of specialists on staff, from gynecologists to orthopedists. Insurance plans at some colleges cover claims of as much as $1 million a year, while others have limits of just $50,000 or less. For most people, health-coverage details won’t play a significant role in where students decide to attend school. But as campus visits heat up in coming months ahead of application deadlines for the next academic year, it’s worth paying attention to how a school’s health center works and what its insurance plan covers. Such factors could play a big role in students’ well-being and expenses during their college years” (Chaker, 11/5).

House Democratic leaders are preparing a rare Saturday night vote on sweeping health care reform.

The Washington Post reports: “Democratic whips worked their rank and file, while House leaders tried to secure a momentum-building endorsement from the AARP, the nation’s largest association of people over 50. President Obama, meanwhile, laid plans to visit Capitol Hill on Thursday or Friday to address House Democrats in a final push for his signature domestic initiative. … House Republicans are united in opposition to the majority’s health bill, so to pass the measure, Democrats will need at least 218 votes from their 258-member caucus.” During the amendment process, Republicans are expected to introduce their own bill, which is is unlikely to get much traction. “Further amendments are likely Friday, when the House Rules Committee will meet to determine the parameters of the floor debate” (Montgomery, 11/5).

The Associated Press: “Leaders stopped short Wednesday of declaring they had the 218 votes needed to pass the bill, and they were still negotiating language on abortion and immigration. But scheduling the vote meant those issues would have to be resolved and undecided lawmakers would have to declare themselves” (Werner and Alonso-Zaldivar, 11/5).

Meanwhile, The Hill reports that the GOP also is counting votes toward a tally of none. “Rep. Kevin McCarthy (Calif.), who serves as deputy GOP whip, told The Hill that the number of Republicans supporting the sweeping legislation will be ‘very, very close to zero’” (Hooper, 11/4).

CQ HealthBeat: “House Rules Committee Chairwoman Louise M. Slaughter said Wednesday that the rule for considering sweeping health care legislation will encompass anti-abortion language put forward by Rep. Brad Ellsworth, D-Ind.  The Ellsworth language would become part of the bill (HR 3962) if the House adopts the rule for floor consideration, Slaughter said. The proposal would explicitly prohibit federal funding for abortions and guarantee patients access to ‘pro life’ insurance plans that would not cover the procedure” (Epstein, 11/4).

Roll Call: Slaughter added “that final votes (on the entire bill) could begin around 6 p.m. but may not necessarily be finished by then. She also said there would be five hours of debate on the measure” (Dennis, 11/4).

The Wall Street Journal: “Democrats tacked new provisions onto the legislation late Tuesday. … One of the additions would raise $24 billion for the bill by eliminating a biofuels tax break for pulp and paper companies. Another would place tighter restrictions on insurance companies to prevent them from increasing consumers’ premiums without cause” (Adamy and Vaughan, 11/5).

Bloomberg: “The measure, which would require all Americans to get insurance, set up new online purchasing exchanges and provide subsidies to help people buy insurance, represents the biggest changes to U.S. health care since the 1965 creation of the Medicare system for the elderly” (Rowley, 11/5).

The Hill: “On Wednesday, lawmakers started clarifying their positions. Two committee chairmen — Armed Services Chairman Ike Skelton (D-Mo.) and Science and Technology Chairman Bart Gordon (D-Tenn.) — announced they will oppose the bill, and two freshmen who voted against the bill in committee switched to support it” (Soraghan and Hooper, 11/4). 

Politico: “…history also sits on the shoulders of Democrats these days, and having failed to act on health care in 1994 — and then having lost power — they feel an almost inexorable push to seize this moment before it slips away” (Rogers, 11/5).

The Hill reports in a separate story that the Saturday vote will present a defining moment for Blue Dog Democrats, the fiscally conservative moderates. “The number of Blue Dogs leaning toward or committed to ‘no’ votes could be in the 30s, according to members, although Blue Dog leaders stress that they’ve done no whip count. But perhaps just as many have strong preferences for the healthcare bill approved by the Senate Finance Committee” (Allen, 11/4).

Kaiser Health News reports on potential delays of a final bill: “If there isn’t a bill on Obama’s desk by Christmas, Obama supporters fear lawmakers could face a repeat of the brutal August town hall meetings where angry constituents railed against a government-run ‘public plan’ and other elements of proposed bills. And under that scenario, lawmakers could return to Washington in January considerably less enthusiastic about health care legislation” (Carey and Pianin, 11/5).