South Carolina — one of the leaders in the effort to create the Interstate Insurance Product Regulation Compact — has withdrawn from the compact because of a conflict over long-term care insurance rate increase application reviews.
Members of the Interstate Insurance Product Regulation Commission, the body that oversees the compact, voted in December 2021 to keep a rule that lets the compact review and approve requests for LTCI rate increases under 15%.
The rule conflicts with a new South Carolina law that requires the director of the South Carolina Department of Insurance or a director designee to review and rule on all LTCI rate filings.
A new report commissioned by the Canadian Medical Association (CMA) looks at the broader health impacts of COVID-19 in Canada. The November report, called A Struggling System, explores a range of growing problems, from mental health issues to substance abuse and deteriorating social determinants of health. Sadly, the report also confirms a fact that many have suspected since the beginning: that delays in care have led to thousands of preventable deaths.
“Although it is not surprising that more Canadians died in 2020 than in a typical year,” the authors write, “the number of excess deaths was greater than can be explained by COVID-19 alone. While there may be several drivers of these excess deaths, delayed or missed care due to shutdowns of services and lack of sufficient capacity in overburdened health systems may be a contributing factor.”
After analyzing the data, the authors estimated that delayed and missed health care contributed to more than 4,000 excess deaths not related to COVID-19 between August and December 2020. Needless to say, the total number of preventable deaths over the pandemic to date is likely much higher.
In the 1960s, the federal government—in its infinite wisdom—thought that cars were too unsafe for the general public. In response, it passed automobile safety legislation, requiring that seat belts, padded dashboards, and other safety measures be put in every automobile.
Although well-intended, auto accidents actually increased after the legislation was passed and enforced. Why? As Lansburg explains, “the threat of being killed in an accident is a powerful incentive to drive carefully.”
In other words, the high price (certain death from an accident) of an activity (reckless driving) reduced the likelihood of that activity. The safety features reduced the price of reckless driving by making cars safer. For example, seatbelts reduced the likelihood of a driver being hurt if he drove recklessly and got into an accident. Because of this, drivers were more likely to drive recklessly.
His work has led to a theory called “The Peltzman Effect,” also known as risk compensation. Risk compensation says that safety requirements incentivize people to increase risky behavior in response to the lower price of that behavior.
This study tested the hypothesis that seat belt usage is related to driver risk taking in car-following behavior. Individual vehicles on a Detroit area freeway were monitored to identify seat belt users and nonusers. Headways between successive vehicles in the traffic stream were also measured to provide a behavioral indicator of driver risk taking. Results showed that nonusers of seat belts tended to follow other vehicles closer than did users. Users were also less likely than nonusers to follow other vehicles at very short headways (one second or less). The implications of these findings for occupant safety in rear end collisions are discussed.
Author(s): Buseck, Calvin R. von, Leonard Evans, Donald E. Schmidt, and Paul Wasielewski
Publication Date: 1980
Publication Site: jstor, originally published in SAE Transactions, vol 89
Cite:
von Buseck, Calvin R., et al. “Seat Belt Usage and Risk Taking in Driving Behavior.” SAE Transactions, vol. 89, 1980, pp. 1529–33. JSTOR, http://www.jstor.org/stable/44633774. Accessed 21 May 2022.
Second, one of the key drivers of these stable and low benefit ratios has been steady-to-declining rates of claims incidence. In a recent paper published by the SOA and co‑authored by Gen Re’s Jay Barriss, Individual Disability incidence rates were shown to have steadily improved over the 2005 to 2015 period, relative to the latest Individual Disability Valuation Table (IDIVT) incidence rate expectations.10 The favorable incidence rate trends have likely continued into at least into 2020 as Gen Re analysis on our reinsured blocks of disability business show continuing-to-stable incidence trends since 2015.
Despite the dramatic decline in infant and maternal mortality during the 20th century, challenges remain. Perhaps the greatest is the persistent difference in maternal and infant health among various racial/ethnic groups, particularly between black and white women and infants. Although overall rates have plummeted, black infants are more than twice as likely to die as white infants; this ratio has increased in recent decades. The higher risk for infant mortality among blacks compared with whites is attributed to higher LBW incidence and preterm births and to a higher risk for death among normal birthweight infants (greater than or equal to 5 lbs, 8 oz [greater than or equal to 2500 g]) (18). American Indian/ Alaska Native infants have higher death rates than white infants because of higher SIDS rates. Hispanics of Puerto Rican origin have higher death rates than white infants because of higher LBW rates (19). The gap in maternal mortality between black and white women has increased since the early 1900s. During the first decades of the 20th century, black women were twice as likely to die of pregnancy-related complications as white women. Today, black women are more than three times as likely to die as white women.
During the last few decades, the key reason for the decline in neonatal mortality has been the improved rates of survival among LBW babies, not the reduction in the incidence of LBW. The long-term effects of LBW include neurologic disorders, learning disabilities, and delayed development (20). During the 1990s, the increased use of assisted reproductive technology has led to an increase in multiple gestations and a concomitant increase in the preterm delivery and LBW rates (21). Therefore, in the coming decades, public health programs will need to address the two leading causes of infant mortality: deaths related to LBW and preterm births and congenital anomalies. Additional substantial decline in neonatal mortality will require effective strategies to reduce LBW and preterm births. This will be especially important in reducing racial/ethnic disparities in the health of infants.
Approximately half of all pregnancies in the United States are unintended, including approximately three quarters among women aged less than 20 years. Unintended pregnancy is associated with increased morbidity and mortality for the mother and infant. Lifestyle factors (e.g., smoking, drinking alcohol, unsafe sex practices, and poor nutrition) and inadequate intake of foods containing folic acid pose serious health hazards to the mother and fetus and are more common among women with unintended pregnancies. In addition, one fifth of all pregnant women and approximately half of women with unintended pregnancies do not start prenatal care during the first trimester. Effective strategies to reduce unintended pregnancy, to eliminate exposure to unhealthy lifestyle factors, and to ensure that all women begin prenatal care early are important challenges for the next century.
Author(s): Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.
With nonbinary genders recognized on legal documents, customers are beginning to ask for forms and applications to include nonbinary options as well—so they’re not forced into a false selection. Even so, a person still could make an inaccurate selection. A customer falsely selecting a nonbinary gender is slightly less risky for the insurance company than selecting a false binary gender, as nonbinary rates are likely to fall somewhere between male and female to ensure they’re not discriminatory.
In the end, providing false information on an insurance application is fraudulent activity regardless of the question. Many of the states that include nonbinary gender markers on birth certificates and/or driver’s licenses already require the individual to sign an affidavit stating that they are not changing their gender marker for a fraudulent purpose. The benefits of including options for nonbinary customers and the potential for more accurate risk evaluations hopefully will outweigh a possible increase in fraudulent activity.
The pandemic is not done. The number of new infections — surely an undercount due to unreported home tests — again tops 75,000 per day. The number of hospitalizations has climbed 20 percent over the past two weeks. The Biden administration has warned there could be 100 million more Americans infected by early next year. Yet Congress seems unwilling to provide more money for basic responses such as tests and vaccines, even as it becomes increasingly clear that even mild cases can lead to dangerous long-term damage.
Yet there are positive developments to consider as well. Vaccinations and certainly boosters are not where they should be, but three out of four Americans have received at least a single dose and two-thirds are fully vaccinated. The Commonwealth Fund has estimated that, absent vaccines, an additional 2.3 million Americans would have died, and 17 million more would have been hospitalized. Public health measures such as masking have largely fallen out of favor, but they helped prevent a death toll that could have been even more terrible.
“A million is way too many people, but as a result of the work that has been done, through public health and vaccination, it’s a number that’s a lot lower than it might have been,” says David Fleming, a distinguished visiting fellow at the Trust for America’s Health. “If we did not do those things, we would not be looking at the 1 million death threshold, we’d be looking at the 3 million death threshold.”
Public health officials say they’re investigating cases of severe liver disease “of unknown origin” among children in Canada as global scientists race to understand a mysterious hepatitis outbreak that has affected nearly 200 youths around the world.
“The Public Health Agency of Canada is aware of reports of severe acute hepatitis of unknown origin in young children in Canada,” the department said in a statement on Tuesday, in response to questions from CBC News.
“These are being investigated further to determine if they are related to cases in the United Kingdom and the United States. As the investigation evolves, we will keep the public updated accordingly.”
The latest available data from the World Health Organization (WHO) shows at least 169 cases of acute hepatitis of unknown origin have been reported in close to a dozen countries, with the bulk of the reports — 114 — from the U.K.
At least 169 cases of acute hepatitis in children aged one month to 16 years old have been identified in an outbreak that now involves 11 countries, the World Health Organization (WHO) said on Saturday.
Among the cases of acute hepatitis, at least one child has died and 17 children have required liver transplants, the WHO said in a news release.
“It is not yet clear if there has been an increase in hepatitis cases, or an increase in awareness of hepatitis cases that occur at the expected rate but go undetected,” the WHO said in a statement. “While adenovirus is a possible hypothesis, investigations are ongoing for the causative agent.”
This conversation about protecting hospitals, back in the era when New Yorkers were still being encouraged to go to restaurants, well before the coasts’ contagion began closing in on the Midwest in earnest, helped define what became, by some measures, one of the most effective and balanced Covid responses in the United States. Ricketts is a mandate-shunning Republican who runs a heavily Republican and rural state with a middling vaccination rate — factors that have been linked to worse pandemic health outcomes in other states. He never ordered a statewide shutdown when 43 other governors, Democrats and Republicans, did so; he has stood against, or even supported lawsuits over, local mask requirements; he has told state agencies not to comply with federal vaccine mandates and gotten scolded by the U.S. secretary of defense for objecting to such requirements for the National Guard. And yet by the fall of last year, when POLITICO crunched the data of state pandemic responses on a combination of health, economic, social and educational factors, one state came out with the best average: Nebraska.
The state had the best economic performance of any in the pandemic up to that point, and its students, according to available data, appear to have suffered little to no learning loss. Whereas many states saw a trade-off between health and wealth in the pandemic — often corresponding to more-restrictive Democratic leadership and less-restrictive Republican leadership, respectively — Nebraska also scored above the national average for health outcomes POLITICO evaluated last year (20th of 50 states). Nebraska was the first state to accumulate a 120-day stockpile of PPE in the nationwide scramble for supplies; was a national leader in opening schools; and was among the quickest getting federal aid to small businesses. As of now, its cumulative pandemic death toll per capita is near the lowest of all 50 states, according to the Kaiser Family Foundation. This, however, is grading on a hideous curve in a country that hasn’t managed the pandemic well in general: More than 4,000 Nebraskans have lost their lives to Covid. Lawler of the University of Nebraska Medical Center, who helped design the state’s early Covid response but has since grown critical of Nebraska’s approach, notes that South Korea has 14 times lower per capita Covid mortality than Nebraska. “Nobody,” he told me via text, “should be patting themselves on the back for doing 14 [times] worse.”
ProPublica’s analysis of five years of modeled EPA data identified more than 1,000 toxic hot spots across the country and found that an estimated 250,000 people living in them may be exposed to levels of excess cancer risk that the EPA deems unacceptable.
The agency has long collected the information on which our analysis is based. Thousands of facilities nationwide that are considered large sources of toxic air pollution submit a report to the government each year on their chemical emissions.
But the agency has never released this data in a way that allows the public to understand the risks of breathing the air where they live. Using the reports submitted between 2014 and 2018, we calculated the estimated excess cancer risk from industrial sources across the entire country and mapped it all.
The EPA’s threshold for an acceptable level of cancer risk is 1 in 10,000, meaning that of 10,000 people living in an area, there would likely be one additional case of cancer over a lifetime of exposure. But the agency has also said that ideally, Americans’ added level of cancer risk from air pollution should be far lower, 1 in a million. Our map highlights areas where the additional cancer risk is greater than 1 in 100,000 — 10 times lower than the EPA’s threshold, but still high enough to be of concern, experts say.
Author(s): Al Shaw and Lylla Younes, Additional reporting by Ava Kofman
Publication Date: last updated 15 Mar 2022, accessed 16 Mar 2022
