Jonathan Kantrowitz

Lack of health insurance might have led or contributed to nearly 17,000 deaths among hospitalized children in the United States in the span of less than two decades, according to research led by the Johns Hopkins Children’s Center.

According to the Hopkins researchers, the study, to be published Oct. 30 in the Journal of Public Health, is one of the largest ever to look at the impact of insurance on the number of preventable deaths and the potential for saved lives among sick children in the United States.

Using more than 23 million hospital records from 37 states between 1988 and 2005, the Hopkins investigators compared the risk of death in children with insurance and in those without. Other factors being equal, researchers found that uninsured children in the study were 60 percent more likely to die in the hospital than those with insurance. When comparing death rates by underlying disease, the uninsured appeared to have increased risk of dying independent regardless of their medical condition, the study found. The findings only capture deaths during hospitalization and do not reflect deaths after discharge from the hospital, nor do they count children who died without ever being hospitalized, the researchers say, which means the real death toll of non-insurance could be even higher.

“If you are a child without insurance, if you’re seriously ill and end up in the hospital, you are 60 percent more likely to die than the sick child in the next room who has insurance,” says lead investigator Fizan Abdullah, M.D., Ph.D., pediatric surgeon at Hopkins Children’s.

The researchers caution that the study looked at hospital records after the fact of death so they cannot directly establish cause and effect between health insurance and risk of dying. However because of the volume of records analyzed and because of the researchers’ ability to identify and eliminate most factors that typically cloud such research, the analysis shows a powerful link between health insurance and risk of dying, they say.

“Can we say with absolute certainty that 17,000 children would have been saved if they had health insurance? Of course not,” says co-investigator David Chang, Ph.D. M.P.H. M.B.A. “The point here is that a substantial number of children may be saved by health coverage.”

“From a scientific perspective, we are confident in our finding that thousands of children likely did die because they lacked insurance or because of factors directly related to lack of insurance,” he adds.

Given that more than 7 million American children in the United States remain uninsured amidst this nation’s struggle with health-care reform, researchers say policymakers and, indeed, society as a whole should pay heed to their findings.

“Thousands of children die needlessly each year because we lack a health system that provides them health insurance. This should not be,” says co-investigator Peter Pronovost, M.D., Ph.D., director of Critical Care Medicine at Johns Hopkins and medical director of the Center for Innovations in Quality Patient Care. “In a country as wealthy as ours, the need to provide health insurance to the millions of children who lack it is a moral, not an economic issue,” he adds.

In the study, 104,520 patients died (0.47 percent) out of 22.2 million insured hospitalized children, compared to 9, 468 (0.75 percent) who died among the 1.2 million uninsured ones. To find out what portion of these deaths would have been prevented by health insurance, researchers performed a statistical simulation by projecting the expected number of deaths for insured patients based on the severity of their medical conditions among other factors, and then applied this expected number of deaths to the uninsured group. In the uninsured group, there were 3,535 more deaths than expected, not explained by disease severity or other factors. Going a step further and applying the excess number of deaths to the total number of pediatric hospitalizations in the United States (117 million) for the study period, the researchers found an excess of 16,787 deaths among the nearly six million uninsured children who ended up in the hospital during that time.

Other findings from the study: . More uninsured children were seen in hospitals in the Northeast and Midwest than in the South and West. However, hospitals from the Northeast had lower mortality rates than hospitals from the South, Midwest and West.

. Insured children on average incurred higher hospital charges than uninsured children, most likely explained by the fact that uninsured children tend to present to the hospital at more advanced stages of their disease, which in turn gives doctors less chance for intervention and treatment, especially in terminal cases, investigators say.

. Uninsured patients were more likely to seek treatment though the Emergency Room, rather than through a referral by a doctor, likely markers of more advanced disease stage and/or delays in seeking medical attention.

. Insurance status did not affect how long a child spent overall in the hospital.

Representatives will propose legislation to ensure Mayors don’t reward themselves with perks, such as special pension deals

Calling New Britain Mayor Timothy Stewart’s special hazardous duty pension arrangement completely wrong and disingenuous, State Representative Chris Caruso of Bridgeport, State Representative David McCluskey of West Hartford and State Representative Jamie Spallone of Essex called for new legislation to prevent Mayors who are on leave from city employment from giving themselves special perks, such as the time Stewart received toward a hazardous duty firefighter pension for years he did not work as a firefighter.

“It is wrong for elected officials to use their powers of office to put taxpayers’ money in their own pockets through a special deal no one else could get,” said Caruso, the former chairman of the General Administration and Elections Committee, who was instrumental in passing the pension revocation bill aimed at corrupt public officials.

At issue is the fact that New Britain’s Civil Service Director, who answers directly to Stewart, granted Stewart – at his own request — six years of time toward his firefighter pension. The Civil Service Director counted the years Stewart has been Mayor as if they were years he was still working as a city firefighter, including two years toward his hazardous duty pension. Stewart is on leave from his job as a New Britain firefighter.

State law allows municipal employees who are elected to full-time elected office up to four years of unpaid leave to serve in office. After the first four years, the law guarantees nothing to the municipal employees, but does allow a municipality to extend the leave under the terms it decides. The City of New Britain, while Stewart served as Mayor, decided to use that discretionary power to allow Stewart to count the six years he’s served as Mayor toward his pension, including two years he needed for a hazardous duty pension. The city firefighters’ union has challenged this decision before the state labor board but, in a split decision, the labor board decided that the city has the power to provide this special benefit to Stewart. The union is presently appealing that decision to the Superior Court.

“Mayor Stewart ‘asked’ a subordinate to give him a special deal on his pension,” said Caruso “Not surprisingly, the city’s Civil Service Director, who reports directly to the mayor, did what her superior asked of her. Anyone can see that this stinks. It is stunning that an elected official would have the gall to do this. That is why I am calling for state legislation to ensure that this can never happen again.”

“As someone who worked for the State Police Union for 7 years, I obviously have a great deal of respect for fire and policemen, and the safety and service they provide to us all,” said McCluskey. “But it is wrong for any Mayor, whether they are a Democrat or a Republican, to add to their hazardous duty pension when they in fact were not working in potentially life-threatening situations. Being the Mayor of a city or town certainly does not rise to the level of our policemen responding to a crime, or a fireman running into a burning building to save a family.”

“This situation certainly raises an issue for the legislature to take up in the next session,” said Spallone, co-chair of the Government Administration and Elections Committee. “Firefighters, police officers and probation officers are at risk every day, and hazardous duty pay recognizes that sacrifice. To preserve the integrity of hazardous duty pay and benefits, this loophole should be closed.”

The special deal Stewart worked out puts him over the 20 work years he needs to get a full pension. But it goes further, allowing Stewart to continue to increase his pension amount for each year he is Mayor, as if he were actually still working as a firefighter. State law does already does not allow state employees to add to their hazardous duty pension if they are not performing a hazardous duty job.

While she’s trumpeted her time as the Chief Executive Officer of World Wrestling Entertainment (WWE) as evidence that she knows how to run a business and create jobs, the WWE, under Linda McMahon’s leadership, accepted a $3 million state taxpayer bailout just weeks before she announced her run for the U.S. Senate in Connecticut. In addition to the $3 million in state taxpayer-funded credits it collected earlier this year, WWE has also accepted at least $12.3 million in credits in 2007, and had applied for as much as $5 million more.

“Connecticut voters may find it interesting that Linda McMahon – in the midst of a state budget crisis, when core government services are being slashed and taxes are being raised – took a $3 million taxpayer-funded bailout just weeks before pledging to spend $30 million to run for U.S. Senate in Connecticut,” said Connecticut Democratic Party Communications Director Colleen Flanagan.

McMahon in her first televised political commercial trumpeted her “hard work and perseverance,” saying, “It wasn’t always easy, but we grew it into a publicly traded company that’s creating jobs here in Connecticut today.”

“According to Linda McMahon, big government is bad, so long as it’s not helping her and her family rake in billions,” said Flanagan. “But clearly it’s a different story if it helps the McMahons and WWE. In that case, Linda McMahon is more than happy to accept taxpayer-funded bailouts, while crying foul against programs like these all the way to the bank.”

After it became clear that Governor Rell had been less than forthcoming regarding the controversy involving herself, Chief of Staff Lisa Moody and UConn Professor Kenneth Dautrich, Connecticut Democratic Party Chairwoman Nancy DiNardo submitted a FOI request to both Governor Rell and the Office of Policy and Management, (OPM) requesting, among other things, material related to the infamous focus groups, including transcripts, audio or video that may exist. Those requests were hand-delivered to Governor Rell’s office, as well as to OPM, on Tuesday, October 13.

By Connecticut Freedom of Information Act (FOIA) regulations, entities which receive an FOI request have four business days in which to reply, acknowledging receipt of the request.

Within four business days (Monday, October 19), OPM had complied and acknowledged receipt of the FOI request (and has since said that the documents are ready).

And from Governor Rell’s office? Nothing. Nada. Zilch. No acknowledgment of receipt, and certainly none of the materials requested have been released.

It’s now 11 business days later, a full 15 days total, and Governor Rell’s office, which has already shown its disdain for such requests, has continued to violate FOI regulations by refusing to acknowledge the receipt of DiNardo’s request.

“I am shocked, quite frankly, that the Governor’s office has now moved beyond being unhelpful, to straight up violating FOI regulations written into state law,” said DiNardo. “This is the same kind of how dare you question me indignant behavior that John Rowland mastered so well right before he went down.”

Here’s a report from Politico:

In hearings before the Senate Environment and Public Works committee Tuesday, several moderate Democrats expressed concerns that the EPA is jumping the gun in mandating new curbs on greenhouse gas emissions across a slew of industries.

“There is a great deal to be gained by certainty so people can make plans,” said Pennsylvania Democratic Sen. Arlen Specter. “If the EPA continues to have flexibility we don’t know where we are.”

The EPA proposed new regulations on greenhouse gas emissions from large industrial sources in a rule published by the Federal Registry late last week.

The so-called “tailoring” rule would force power plants, waste landfills, and other plants emitting over 25,000 tons of greenhouse gases a year to obtain permits demonstrating that they are using the best technology to minimize their emissions.

And from Max Baucus, who represents the great state of Montana (which would probably benefit from global warming):

Senator Max Baucus, the Montana Democrat who is the second-ranking member of the environment committee and chairman of the Finance Committee, warned his fellow Democrats that the Kerry-Boxer bill went too far and could end up delaying any action on global warming for months or years.

“The legislation before us today is about our economy,” Mr. Baucus told the committee. “Montana, with our resource-based agriculture and tourism economies, cannot afford the unmitigated impacts of climate change. But we also cannot afford the unmitigated effects of climate change legislation.”

He said the bill’s target of reducing greenhouse gas emissions by 20 percent below 2005 levels was too ambitious. He criticized the measure’s failure to limit the Environmental Protection Agency’s authority to impose additional regulations on carbon dioxide emissions beyond those in the bill.

Here’s what Barbara Boxer had to say about the bill:

EPA’s economic modeling found that the Kerry Boxer bill will carry only modest costs for America’s families – the overall impact being 22 to 30 cents a day.

Let’s talk about that.

What will America’s families get for 30 cents a day?

For 30 cents a day, we will put America in control of our own energy future and take a stand for home-grown American energy rather than foreign oil from countries who don’t like us.

For 30 cents a day, we will protect our children from dangerous pollution.

For 30 cents a day we will send a signal that sparks billions of dollars of private investment and job creation.

For 30 cents a day we will be the world’s leader in clean energy technology.

No climate bill has ever had this level of review and the Obama Administration stands behind this analysis. EPA spent five weeks analyzing the Waxman Markey bill and another two weeks analyzing our version.

Scientists in the Obama and Bush Administrations, and at the National Academy of Sciences and at the U.N. IPCC tell us that we have a narrow window of time in which to avert the ravages of global warming.

They tell us about frequent and intense storms, wildfires in the West, heat waves across the nation, increased droughts and flooding, threats to agriculture, global conflict, refugees and food shortages.

In 2005, Hurricane Katrina took an estimated 1,700 lives, displaced 1 million people, and cost well over $100 billion. Four years later, there is still suffering, and it will take billions more to protect the coast in that region.

Katrina provides a window into the kind of world we can expect if we fail to act.

S.1733 is our best insurance against a dangerous future. It is a responsible approach that sets attainable goals for gradual reductions in carbon emissions, and it protects consumers, businesses and workers as we move toward clean energy.

Global warming is a very real and immediate threat. Only significant and rapid actions can avert a disaster. The US needs to be a leader in this effort. It’s incredible that there isn’t one thinking Republican who can recognize the danger, and even more incredible that politicians who claim to be Demoocrats are fighting this crucial bill.

Matthew Hoh, a respected retired marine captain, resigned his post as a Foreign Service officer in Afghanistan last week, in protest over the war in Afghanistan.

Here’s what he said in he said in his resignation letter:

“I fail to see the value or the worth in continued US casualties or expenditures of resources in support of the Afghan government in what is, truly, a 35-year-old civil war.”

Hoh says that the war is not truly a pan-Afghan insurgency, but rather a hundred different wars with variables unique to each valley.

And he calls Afghan President Hamid Karzai “a president whose confidants and chief advisers comprise drug lords and war crimes villains, who mock our own rule of law and counternarcotics efforts.”

He also said that the US presence merely provided “an occupation force against which the insurgency is justified.”

It is unlikely that one voice, even of a well-respected and battle toughened Marine will make much of a difference, but he certainly lends credence to Vice-President Joe Biden “counterterrorism” strategy that relies more on Predator drone strikes against Al Qaeda targets – a strategy that has shown some success in Pakistan’s tribal territories.

One hundred percent of credit cards offered online by the leading bank card issuers continue to include practices that will be outlawed once legislation passed in May takes effect next year, according to a new report by the Pew Health Group’s Safe Credit Cards Project. The report also found that advertised credit card interest rates rose an average of 20 percent in the first two quarters of 2009, even as banks’ cost of lending declined. With the Federal Reserve currently developing rules to ensure penalty charges are “reasonable and proportional” as required under the Credit CARD Act, the report also includes policy recommendations for regulators.

The new report, “Still Waiting: ‘Unfair or Deceptive’ Credit Card Practices Continue as Americans Wait for New Reforms to Take Effect,” examines all consumer credit cards offered online by the largest 12 bank issuers in America. These banks control more than 90 percent of outstanding credit card debt nationwide. The report also reviewed cards offered by the largest credit unions. The Pew Safe Credit Cards Project gathered data from July of this year on nearly 400 cards, building on its previous research from December 2008.

Key findings of the report show that:
– 99.7 percent of bank cards allowed issuers to increase interest rates on outstanding balances – a jump from 93 percent in December;
– 95 percent of bank cards permitted issuers to apply payments in a way the Federal Reserve found likely to cause substantial financial injury to consumers; and
– 90 percent of bank cards had penalty rate hikes with the vast majority imposed by “hair triggers” of one or two late payments in a year.

In July, median advertised annual percentage rates (APRs) for purchases on bank issued cards were between 12.24 and 17.99 percent, compared to a range of 9.99 to 15.99 percent in December 2008 (issuers advertise a range of rates depending on applicant credit profiles). Compared to December of last year, lowest advertised bank rates grew by more than 20 percent, while highest advertised rates grew by 13 percent. Pew’s previous report identified that issuers raised rates on nearly one-quarter of existing accounts, costing consumers a minimum of $10 billion in a one-year period between 2007 and 2008.

“Still Waiting” also provides the first comprehensive comparison of bank cards to those issued by credit unions, based on advertised terms and conditions. The analysis showed that credit unions offered much lower APRs, less punitive penalty rates and engaged in far fewer unfair or deceptive practices than their commercial peers.

To ensure that the Credit CARD Act is implemented to meet its goal of safeguarding the consumer, the report outlines policy recommendations for the Federal Reserve and other regulators to ensure that the new rules under development will:

– Regulate penalty interest rate increases in its rules governing “reasonable and proportional” penalty fees and charges in accordance with the law;
– Scrutinize partially variable rates, which can increase when the index rises but cannot drop below a minimum set by the issuer; and
– Eliminate credit card penalties that are not aligned with achieving the Act’s primary goals of protecting consumers against risky practices.

This is why Senate Banking Committee Chairman Chris Dodd (D-CT) has introduced a bill to immediately freeze credit card interest rates on existing balances.

In February the Quinnipiac Poll called Susan Bysiewicz an “early favorite in a Democratic primary with 44 percent, followed by Malloy with 12 percent and Amann with 4 percent.”

A poll the Susan Bysiewicz exploratory committee conducted earlier this month shows that not only is Jodi Rell vulnerable to a challenge, but that she is particularly vulnerable to a challenge from me.

In fact, in an initial head to head match-up, only 47% support Rell and 41% support Susan Bysiewicz.

Bysiewicz runs considerably stronger than Dan Malloy does against Rell, with Malloy at 31% to Rell’s 52%.

Meanwhile, in a poll of Bridgeport voters conducted for the blog Only In Bridgeport the following question was posed:
if the Democratic Primary for Governor were held today, would you support Secretary of the State Susan Bysiewicz or Stamford Mayor Dan Malloy?

The results:

Bysiewicz 31.44 percent, Malloy 14.56 percent