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State Workers’ Compensation Insurance Covers Weight Loss Surgery : Court Ruled SAIF Corp To Pay For Worker’s Gastric Bypass Surgery

According to a court in Oregon, the state workers’ compensation insurance can also cover weight loss surgery, but it should be required for treating an injury related to the job of the workers.

The Supreme Court of Oregon has recently ruled that the chartered agency of the state, SAIF Corp, which is responsible for handling compensation insurance, has to pay for the gastric-bypass surgery that is required before performing a knee replacement on an injured worker.

Edward G. Sprague used to work as a mechanic and got a knee injury in the year 1976. He made a claim with SAIF through which he was compensated and was allowed to go through the surgical procedure. At that time, his weight was 225 pounds. Since then, he gained weight to 320 pounds and also developed arthritis in his knee.

In the year 1999, he injured the same knee again while carrying out his work in a bakery. The physician of Sprague suggested that he should go for a knee replacement but before that, he has to go through a weight loss surgery so that best results can be achieved. When Sprague’s claim was rejected by the bakery’s workers’ compensation plan, saying that the arthritis is the result of the previous injury, he decided to go after SAIF.

Initially, SAIF said that the weight problem of Sprague is pre-existing, for which, it is not liable. But a court of appeals, and now Supreme Court, has said that SAIF has to pay because the arthritis of Sprague was because of the initial injury and his weight loss surgery was directly essential for treatment of his arthritis.

Christopher Moore of Eugene, the lawyer of Sprague, told to a newspaper of Oregon that he was not expecting this ruling to result in such a tide of workers’ compensation claims for weight loss surgery. He said that obesity like that of Sprague is quite rare and requirement of weight loss surgery for treatment of an injury is even rarer.

Health Insurance Reform Myths

Changes have become an essential thing to be done in our health care system. Can you imagine the premiums of health insurance doubling over the next decade, Medicare trust funds going bankrupt and number of the uninsured continue to increase? These are the circumstances we will have to face if a meaningful reform in the health insurance sector is not made soon.

Special interests in protection of the status quo have employed half truths, deception and cunning tactics to make us believe that the system is still not in a critical condition. In reality, the costs of health care are consuming 16% of the GDP (Gross Domestic Product) and the increasing costs of health care are creating a problem for millions of people who are already struggling because of the present day economic downturn. As a result of this, we are not able to fix our economy unless the realm of health care is fixed.

AARP is a dynamic organization of 40 million members, one of the aims is to protect and strengthen the Medicare. With a long history of fighting for quality health care, it has become a target of those who intend to put a stop to any steps taken to reform the health care system. For a long period of time, the country has been undergoing a system which is too expensive, in which a lot of resources are wasted and yet, a large number of people are left without health care. So far, no bills passing through the Congress have yet been approved but the organization is dedicated to make reforms in the health care system.

Unfortunately, the myths are very popular among the masses today and instead of solving the issues with a positive comment, many of them are working hard on misleading the Americans. Let us take some of their distortions straight out.

No matter what happens, the AARP will never support the proposal which aims at jeopardizing Medicare. Rather, it is fighting for reforms which preserve access to the doctors and gives assurance that they will be fairly paid by the Medicare while making a reduction in fraud and waste. The association is working with the members of both the parties to close Part D coverage gap or the ‘doughnut hole’ for the prescription drugs. Reforming the health care system will help in controlling their ever-increasing prices throughout the system, including the Medicare.

There are no provisions which allow the Medicare to ask you to sign a paper, asking you to determine how you want to end your life. Asking you to do this is cruel and unforgivable. Rather, provisions will allow the physicians to get money for the time they spend on your counseling and for answering the questions of the clients about things like advance directives, durable attorney powers, hospice care and living wills. The patient has the sole right to avail this service.

Let us make things clear. May be some people are trying to scare off the senior citizens, but nothing is there in any proposal which will lead to the rationing of the care for elder Americans or any other age group. In any case, even if such a statement comes up, AARP will take the first step to ward it off.

Some of the fringe groups are making statements that the reform of the health insurance system is a back door attempt to create socialized medicine. But this is not true as it is the government which directly employs doctors and owns hospitals. Instead of this, the aim of the reform is implementing a system that will be much like one members of the Congress present today.

There is a range of affordable and good quality private health plans that the people may choose from. Some of them are offered by the employers, some by state and some by insurance exchange supervised by the federal government. The plans will not be allowed to not accept anyone based on the age or health of the individuals and will have strict cost sharing limits, making the coverage affordable for all.

Text messaging On Mobile Phones Affecting Quality Of Sleep

A recent study revealed that text messages on mobile phones are making an impact on the quality of sleep for almost 50% of the 16 year old people. According to a report, the sleep of 25% of 13 year old youngsters can also be affected.

The Leuven study on media and adolescent health was conducted in Flanders in which about 2500 children studying in 1st and 4th year - aged 13 and 16 years were asked how many times they wake in the night because of incoming SMS messages in their mobile phones. In the 13 year old children, 13.4% reported that they wake up 1-3 times in a month, 5.8% wake up one in a week, 5.3% wake up many times in a week and 2.2% wake up every night. In the group of 16 year old children, 20.8% wake up 1-3 times in a month, 10.8% wake up at least one time in a week, 8.9% wake up many times in a week and 2.9% wake up every night.

The children were also asked to tell how tired they feel at different times. These findings suggest that the mobile phones are having a great effect on the quality of sleep of increasing number of adolescents. The threat of not having quality sleep is more important than the threat caused by entertainment media. The entertainment media influences a person’s time to go to bed while mobile phones actually lead to disturbed sleeping patterns.

Studies have been conducted to look into the effects of computers and televisions in the bedrooms on sleeping patterns of children, but little works are done on the effects of mobile phones, particularly when they are used for text messaging.

There are little but growing bodies of research that aim at looking into the effects of mass media on the sleeping patterns of youngsters. Nightmares and lack of sleep are always linked to viewing televisions.

Health Insurance Reform Increases Competition In Insurance Industry?

There has been a major argument between the congressional sponsors of the health insurance reform and President Barrack Obama that the health insurance exchange will lead to an increase in the competition. As per the exchange, the consumers will be allowed to make a choice between private health insurance plans with the premiums artificially increased by the government mandates and the government program that will artificially lower down the premiums.

Michael Cannon reported in ‘Fannie Med? Why a Public Option is Hazardous to your health’, on Aug. 6 Cato Institute paper that the new program by the government will literally expel a huge number of American from their present health insurance plans as a result of which, their relationship with their doctors will be threatened. The employers will choose to leave their current health plans for their employees and the private health plans will be closing down.

An analysis made by the Lewin Group estimates that if the Congress uses price controls of Medicare and if the programs become available to everyone, it will be able to attract 120 million Americans out of their private insurance plans. This number means more than 50% of the private insurance market. Mr. Cannon reports that a large number of those Americans will involuntarily leave their current insurance plans.

It is amazing that all the fearful people showing up for expressing their worries at the town hall meetings of this summer dismissed by the leaders of the Congress as hate mongers, racists and worse, has been saying.

Mr. Cannon advises that if the Congress aims at increasing the competition and making the health care more efficient, then there are other options available. Medicare should be converted into a program which gives vouchers to the seniors and frees them from purchasing any health care plan from the market.

Thousands of dollars will be made available to the workers which are currently controlled by their employers in the lieu of large health savings accounts. Likewise, the workers will be able to purchase any health care plan of their choice from the market.

Last but not the least; the Congress should increase the competition by asking the states not to deny entry of health plans and health care providers licensed from other states into the market. This means that the health insurance and clinician licenses will become portable across the state borders.

Such reformations will reduce the costs, increase the innovation and decrease the number of people without any insurance. All this will be done without additional spending by the government or higher taxes.

You must be wondering that if the things seem to be too good, then why they have still not reached the tables of Washington?

New Credit Card Rules – Beware Of Bank Fees Raise

New credit card protection rules from the federal government kicked in recently. But keeping in view the stricter rules, the banks are raising interest rates and fees, with a hope to offset the potential losses of revenues from these reform measures. Experts of personal finance, Bill Hardekopf analyzing the reform legislation commented that the three changes that came into effect are:

1. Credit card issuers are now required to send a notice to the credit card users before 45 days of increasing their rates, and not 15 any more. This will give a chance to the card holder to either pay off the credit card or to do his shopping.

Hardekopf says that the 30 extra days of receiving the notice is advantageous for the consumers. But because the consumers are now given more time before the increase in the rate, they get more time to do their shopping with lower interest rate or transfer their balance to another card. Yet, it has to be noted that the offers for balance transfers are not as liberal as they were in the past and most of the cards now charge 3% fees for a single balance transfer.

Increases in the rates are widespread in the current period, so the consumers need to pay due attention to their entire bill inserts, plain white envelopes in the mail and any email notifications. These are the ways how most of the credit card issuers notify their consumers about their increase in the rates.

Hardekopf also comments that it is surprising that the CARD act needs the bank to send an advance notice to the consumers about increase in the interest rate, but it does not ask the bank to send notice to the consumers if it closes their account or decreases the card’s credit limit.

2. Under the new rule of CARD act, the banks will need to mail the monthly statements to the consumers at least 21 days prior to the date when it is due to be paid. Earlier, this period was 14 days before due date.

Hardekopf says that these 7 extra days should not be considered as a time when you can wait and then pay the bill on the last date. The payments should be made regularly as per your schedule so that the issuers get the payment on time, well in advance of the 7 days provided to you. If this extra time is used for delaying the paying of the bill, the consumers may forget and may incur an expensive late fee.

3. Under this rule, the consumers are given the right to opt out the fee increases and rate hikes. Currently, some issuers are allowing their consumers to opt out, but the new CARD act makes this mandatory.

If a consumer opts out of the rate increase, he will no longer be able to do shopping with the card and he will need to pay off all the remaining balance under existing rates within a period of 5 years. If a consumer chooses to opt out, he will need to inform the issuer timely by sending an opt out letter to the bank rejecting the rate hikes. The mail should be sent registered receipt and the consumer should also keep the letter’s copy for his own record. Then, the balance will need to be paid at original rate. The account that has been closed will also be shown on the credit record of the consumer.