Under his proposal, McCain would replace a tax break for employees who receive health insurance from employers with a refundable tax credit for families to purchase private coverage. According to the Morning News, the proposal seeks to “give those without company-provided health insurance the same tax advantages as those with coverage through work” and “encourage individuals to shop for less expensive insurance” to reduce costs.

By contrast, the plan proposed by presumptive Democratic presidential nominee Sen. Barack Obama (Ill.) would require most employers to offer health insurance to employees or pay into a federal fund to provide coverage. Obama’s plan would also have private health plans and a new public plan compete in the health insurance market, with subsidies for lower-income residents.
Concerns About McCain Proposal
Critics of the McCain proposal have raised concerns that the “amount of the tax credit will not be enough to purchase comprehensive coverage,” the Morning News reports. John Goodman, president of the National Center for Policy Analysis and a health care policy adviser to McCain, said that the campaign sought to make the amount of the tax credits less than the amount currently spent on employer-sponsored health insurance to encourage individuals and companies to purchase less expensive coverage. In an e-mail, Goodman wrote that the tax credits “would not subsidize bells and whistles (marriage counseling, acupuncture, etc.) as the current system does.”

In addition, critics “question whether individuals — especially those with chronic or pre-existing medical conditions — would be able to find health plans they could afford.” McCain has said that the proposal includes working with states to create a federally supported plan to help individuals who cannot obtain private coverage because of pre-existing medical conditions or no previous group coverage.

Meanwhile, some employers have raised concerns that the proposal would “encourage young and healthy workers to forgo company coverage, purchasing insurance on their own rather than paying income taxes on the benefit,” a trend that “would leave employers with only the costly sick workers to insure” and “could eventually lead to the death of company-provided health plans,” according to the Morning News. Andrew Webber, president and CEO of the National Business Coalition on Health, said, “If health benefits became taxable income, yes, I do think that more people would opt out” (Roberson, Dallas Morning News, 8/16).

Nelson Promotes Obama Health Care Proposal
Sen. Ben Nelson (D-Neb.) on Thursday at a fair in Iowa promoted the health care plan proposed by Obama, the Des Moines Register reports. According to Nelson, the proposal would have private health plans and a new public plan compete in the health insurance market and implement measures to reduce health care costs.

The North Balwyn Family Medical Centre, which treats up to 400 patients a week, has been closed by Sydney-based Primary Health Care.

The closure follows Primary Health Care’s acquisition and recent closures of former Symbion Health clinics in Box Hill South, Blackburn and Ferntree Gully.

Seven doctors, a nurse and paramedical staff were given redundancies “effective immediately” or told they would have to relocate last week.

Medical co-ordinator Richard Hince said staff were devastated.

“We had no warning,” Dr Hince said.

“It’s a total lack of concern for patient welfare.”

Patient Lynne Jordan, who has taken her family to the centre for 13 years, was appalled.

“Does the corporate Primary Health even care?” Ms Jordan asked.

The Balwyn North resident was told to take her family to the Primary Health Care “supercentre” in Ringwood, almost 20km away, or Mont Albert. “What’s going to happen to all the elderly patients who can’t travel?” Ms Jordan asked.

Melbourne East General Practice Network deputy chairman Chris Pearce said surrounding doctors would not be able to cope with the influx of patients.

“This is what happens when you treat general practice as a commodity,” Dr Pearce said.

He said the concept that the practices were not financially viable was “nonsense”. Australian Medical Association Victoria president Doug Travis said the days of solo GPs and small clinics were over.

Farmer’s markets have existed for years in the Anchorage and Fairbanks areas, and they are now beginning to spring up in Southeast Alaska as well. Since 2006, Haines and Gustavus have had regular Saturday farmer’s markets. This August Sitka and Juneau are joining the trend and hosting their first community-wide farmer’s markets.

Organizers see a number of reasons why farmer’s markets are important. Doug Osborne, health educator at the Southeast Alaska Regional Health Consortium (SEARHC) in Sitka, named three main ones: health, sustainability and community.

Healthy foods, healthy communities

During the Sitka Health Summit held this spring, the idea of a farmer’s market came up in a brainstorming session. A vibrant farmer’s market featuring fresh fish and local produce ended up being the most popular idea brought up in the summit, which aimed to create a healthy community and improve the quality of life for Sitkans.

“The quality of produce is just so much better if you can grow it locally,” said Linda Wilson, co-coordinator of the Sitka market. “The nutritional quality is higher and (local produce) will stay fresh longer.”

Wilson hopes the farmer’s markets will encourage everyone, especially young people, to develop healthier diets.

Much of the food found at farmer’s markets is organically grown, but even if it’s not, Alaskans-grown produce is less likely to be sprayed with pesticides, said Alison Arians with the South Anchorage farmer’s market

Consumer-driven health plans typically have lower premiums but higher deductibles and out-of-pocket costs for some medical procedures than other insurance plans. They typically include a health reimbursement account or health savings account that employers contribute to.

Indianapolis-based UBA surveyed 18,019 health plans sponsored by 12,860 U.S. employers. The plans cover about 4.4 million people.

The survey showed that the total number of consumer-driven health plans has increased this year by 43 percent over 2007. They now account for nearly 13 percent of all plans offered by employers, UBA said in a news release.

Participation in the plans also increased over the past year. More than 11 percent of the insured in the survey were enrolled in consumer-driven health plans, up from 6 percent in 2007.

In 2008, employers have contributed an average of $1,209 to health reimbursement accounts for single employees and $2,274 to family plans, UBA said in the release. The average employer contribution to a health savings account was $642 for a single employee and $1,053 for a family plan.

To help keep costs down, many employers have implemented wellness programs, UBA said in the release. About 10 percent of employers surveyed currently offer a wellness program, compared with 7.4 percent in 2007. Many of those plans include health risk assessments, seminars, workshops or coaching for high-risk employees.

Preferred provider organizations (PPOs) represented 54 percent of all plans offered and 62.7 percent of employees were enrolled in them. Health maintenance organizations (HMOs) accounted for 21.3 percent of all plans offered, with 13.3 percent of all employees enrolled.

The average annual cost per employee for all plans was $7,327 for medical coverage only. Employees paid $3,210 of that cost, while employers paid $4,117. Average monthly premiums for all plans were $370 for single and $901 for family coverage.

Results from a 2007 survey, made public Tuesday, show that 16.7 percent of freshmen in Boulder Valley said they binge drink, up from 11.5 percent in 2005.

Boulder County health officials said they might start polling middle school students — along with high school students — for the bi-annual Youth Risk Behavior Survey.

“This really is showing that we need to be starting these prevention efforts even earlier,” said Heath Harmon, an epidemiologist for Boulder County Public Health.

Health officials have been working with Boulder Valley since 2001, and the St. Vrain Valley School District since 2003, to examine risky behaviors among adolescents in high school by administering a questionnaire.

The surveys cover topics such as alcohol use, drug abuse, sexual activity, body-image issues, depression and violence. Officials use the results to develop strategies to try to prevent, reduce or postpone dangerous behavior.

According to the newly released 2007 survey results, students are not just binge drinking at a younger age, but more Boulder Valley freshmen said they’ve smoked cigarettes, tried marijuana and had sex.

About 18 percent of Boulder Valley freshmen in 2007 reported having had sex. In 2005, the percentage was about 9.

“Whether we’re talking about sexual intercourse or substance use, one thing is clear,” Harmon said. “The earlier youths engage in the behavior, the better chance they have of experiencing long-term negative impacts in their lives.”

Looking across all grade levels, percentages decreased in some categories related to alcohol and drug use, and Harmon said that indicates parental influence and positive values can keep kids from testing dangerous waters.

The nation’s largest and most comprehensive benchmark survey of employer-sponsored plan design and plan costs, the 2008 UBA Health Plan Survey, found that Consumer Driven Health Plans, or CDHPs, increased by 43 percent from last year, and now comprise nearly 13 percent of all plans offered by employers. The percentage of employees enrolled in these plans nearly doubled, from six percent in 2007 to 11.2 percent this year.

While preferred provider organizations (PPOs) continue to dominate the market, representing 54 percent of plans offered by employers and nearly two-thirds (62.7%) of employees enrolled, health maintenance organization (HMO) participation continues to slip, and now represents just 21.3 percent of plans offered, with only 13.3 percent of employees enrolled.

“Certainly the continued growth of CDHPs is a key headline to come out of this year’s survey,” said Bill Stafford, UBA’s vice president of member services. “Fee For Service and Exclusive Provider Organizations now virtually disappeared from the market, and HMOs are losing ground as employers seek to help contain the rising cost of health care and insurance premiums.”

In fact, while average premiums increased by 7.4 percent for all plans (after any plan adjustments), first-year CDHP premiums decreased by 7.9 percent. This is perhaps not surprising given that CDHPs are designed to have lower premiums, but typically have higher deductibles and out-of-pocket costs for common procedures. Employers offset these higher out-of-pocket costs by offering employees a health reimbursement account (HRA) or a health savings account (HSA) and contributing funds. In 2008, the average employer contribution to an HRA was $1,209 for a single employee and $2,274 for a family; the average employer contribution to an HSA was $642 ($1,021 if employer contributions are eliminated) for a single and $1,053 for family coverage.

The survey by the Agency for Healthcare Research and Quality measured insurance premium costs for private employers and their employees.

Nationally, the average premium cost of a family insurance plan jumped from $4,954 to $11,381 a year, while the average cost of a single premium rose from $1,992 to $4,118.

Employers’ share rose from $3,679 to $8,491 a year for family coverage and from $1,650 to $3,330 a year for single coverage. Employees also saw their share rise significantly, from $1,275 to $2,890 a year for family coverage and from $342 to $788 a year for single coverage.

Arizona was not among the top 10 states in terms of the highest costs for private employer health insurance, but it did rank between 11th and 20th, according to the study. With the exception of the single employee contribution of $803, which was close to the national average, Arizona premiums and employee contributions are consistently above the national average.

“The general cost of health care has risen at a faster rate,” said Jim Branscome, a statistician with the agency. “Employees are getting older, which also is a factor. There was a period of time about three or four years ago when it was going up 10 percent or more per year, and in the last couple of years, it seems to have moderated a bit.”

Overall, the rising cost of health insurance can be attributed to higher-quality health care, said Marjorie Baldwin, director of the School of Health Management and Policy in the W.P. Carey School of Business at Arizona State University.

“Overwhelmingly, economists believe that increasing costs of health care are related to improvements in technology,” she said. “We are able to treat diseases we could never treat before. We are able to keep alive people we could never keep alive before. But all of this costs money. So that is going to be a major contributor to the increasing health care costs.”

Employees are paying the higher costs because insurance is part of their compensation package, Baldwin said.

“It’s tied to employment, so people have the choice of plans that their employer picked and not the broad range of choices that they might have in the market,” she said. “Secondly, it’s regulated within states, and many times states will have a lot of regulations about what the minimal coverage is. So there may be people who would want to pay less for health insurance and only have catastrophic coverage … but that may not be allowed.”

There is broad agreement that we need affordable health care, but how to define and achieve affordability are less clear. Conservatives believe that affordability can be achieved with a flat tax credit given to individuals who purchase insurance on the private market. The most generous of such proposals would give a refundable credit of up to $2,500 for individuals and $5,000 for families. Conservatives claim that this would “level the playing field” and finally make health care affordable for all.

This concept, however, has several problems. The proposed tax credit is simply not enough money to make care affordable. The average family premium is $12,000, more than twice the amount covered by a tax credit. The credit appears even less adequate when the recipient lives in a high-cost market, with expensive basic necessities, health care, and insurance costs.

Low-income individuals and families would also suffer. They already allocate a much higher proportion of their income for health care costs. As such, a fixed tax credit, rather than one that rises as income falls, doesn’t level the playing field.

Finally, any consideration of affordability must include the cost of both premiums and out-of-pocket expenditures. The two aspects go hand in hand, since lower premiums often result in higher out-of-pocket costs.

Policymakers have already agreed that future health care reforms must make health care more affordable. The remaining challenge is to define a truly “level playing field” and make health care affordable for all Americans.

It seems the lunch hour has become one of the biggest casualties of the softening job market, with experts suggesting almost 70 per cent of workers eat at their desks on a daily basis.

Cramming everything into an eight-hour stretch seems to be the main problem for Aussie workers with employers piling up the workload in response to tightening budgets.

A US study found 55 per cent of employees cut back on their lunch time, and even used their lunch break for work-related activities.

Employers seem to have the attitude that more time spent working equates to more work produced, but this is not the case, ACTU President Sharan Burrow says.

“Lunch should not be skipped for both employee health and productivity,” she said.

Being the talk of the office seems to be one of the major reasons workers are handcuffing themselves to the furniture, with the fear of getting a bad name as a slacker being greater than the need to have a break.

“Workers are worried about what people will say if they take too long on their break,” dietician Tara Diversi says.

But Ms Diversi says spending even 20 minutes out of the office at lunch can lead to greater productivity.

“The biggest thing employers can do for productivity is encourage lunch. Workers tend to have a lot more energy if they take a break, meaning they’re more on the ball for the afternoon stretch,” she said.

Even if you don’t get out of the office the important thing is to switch off and remove the desk chains for a little while, said Ms Diversi.

“You will find you’re getting more work done than if you didn’t break at all,” she said.

Having a midday break not only benefits your work, but also leads to better overall health.

“Workers tend to go home feeling energised and are less likely to lounge around and snack if they’ve had a boost in the middle of the day,” said Ms Diversi.

You are legally entitled to a 30 minute lunch break. According to the Workplace Relations Act, bosses can’t ask employees to work for more than five hours continuously without an unpaid interval of at least 30 minutes.

This Act is across all industries, nationwide. However the question remains as to just how many workers get this type of break each day.

The ‘in the office’ lunch date can also mean we’re making the wrong choices when it comes to waistlines.

Desk-bound employees often get sucked in to eating more and eating more of the wrong thing. Raiding the office vending machine and taking short coffee breaks are band-aid solutions, Ms Diversi says.

“Employees need to make more proactive choices when it comes to lunch and taking breaks in the office,” she says.

According to the latest ABS obesity figures, 7.4 million Australians aged 18 years and over are either overweight or obese - and getting out of the office at lunch could just be the perfect opportunity for exercise.

Taking a walk for even 10 minutes or heading to the gym for 30 minutes during lunch are the top suggestions for fitting exercise in to your day.

“Anything is better than nothing at all,” said Ms Diversi.

How your bosses behave may be at the core of the problem, with lunch habits being modelled on those higher up the office food chain.

“Employers need to lead by example and get out of the office at lunch,” said Ms Diversi.

With senior management working through the day and not stepping out for lunch, workers feel they need to do the same, she said.