COLUMBUS, Ohio--(BUSINESS WIRE)--

While facing the prospect of living more years in retirement, women nearing retirement underestimate how much they will need to pay for their future health care costs even more so than men nearing retirement, according to a Nationwide Financial survey released today.

According to the survey conducted by Harris Interactive of 1,250 Americans with at least $250,000 in household assets, women close to retirement estimate they will spend $4,624 each year on health care beyond what Medicare covers. Thats 21 percent less than the $5,882 men nearing retirement estimate they will spend each year on things like premiums, copayments and deductibles. However, both are way off. A 2012 study found a 65-year-old couple retiring today would need $240,000 to cover medical expenses during their retirement years and that doesnt include long-term care costs. 1

The fact is women live longer than men, which means they will spend more time in retirement and that places women at a greater risk of outliving their retirement assets, said John Carter, president of sales and distribution for Nationwide Financial. It also may increase their chances of incurring long-term care costs during their golden years. Thats why its especially important for women to plan for health care costs in retirement.

According to the survey, nearly half of both women and men say they are terrified of what health care costs may do to their retirement plans. Yet, women respondents nearing retirement are much more likely than men respondents to say they have not estimated:

On average, women estimate that Medicare will cover 65 percent of their annual health care costs. But, similar to men respondents, when asked how they came to this percentage, 85 percent either guessed or did not know. Only 2 percent said they were told this by a financial advisor.

Women are also slightly more likely than men to say they are somewhat unconfident to not at all confident in their plan to live comfortably in their retirement years (46 percent vs. 39 percent men).

Opportunity for advisors

While 65 percent of women have discussed their retirement with a financial advisor of those who have, only one in 10 talked about how much they should expect to pay in health care costs apart from Medicare (compared to one in four men).

Of those who have discussed retirement with a financial advisor, 77 percent of women say they were helpful to very helpful estimating health care costs in retirement (63 percent men) and a whopping 86 percent say they were helpful to very helpful discussing the role Medicare will play in their retirement (52 percent men).

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Women Nearing Retirement Underestimate Future Health Care Costs More Than Men

WASHINGTON--(BUSINESS WIRE)--

Forty-seven million women are getting greater control over their health care and access to eight new prevention-related health care services without paying more out of their own pocket beginning Aug. 1, 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.

Previously some insurance companies did not cover these preventive services for women at all under their health plans, while some women had to pay deductibles or copays for the care they needed to stay healthy. The new rules in the health care law requiring coverage of these services take effect at the next renewal date on or after Aug. 1, 2012for most health insurance plans. For the first time ever, women will have access to even more life-saving preventive care free of charge.

According to a new HHS report also released today, approximately 47 million women are in health plans that must cover these new preventive services at no charge. Women, not insurance companies, can now make health decisions that will keep them healthy, catch potentially serious conditions at an earlier state, and protect them and their families from crushing medical bills.

President Obama is moving our country forward by giving women control over their health care, Secretary Sebelius said. This law puts women and their doctors, not insurance companies or the government, in charge of health care decisions.

The eight new prevention-related services are:

The health care law has already helped women in private plans and Medicare for the first time gain access to potentially life-saving tests and services, such as mammograms, cholesterol screenings, and flu shots without coinsurance or deductibles. Todays announcement builds on these benefits, generally requiring insurance companies to offer, with no copay, additional vital screenings and tests to help keep women healthy throughout their lives.

These services are based on recommendations from the Institute of Medicine, which relied on independent physicians, nurses, scientists, and other experts as well as evidence-based research to develop its recommendations. These preventive services will be offered without cost sharing beginning today in all new health plans.

Group health plans and issuers that have maintained grandfathered status are not required to cover these services. In addition, certain nonprofit religious organizations, such as churches and schools, are not required to cover these services. The Obama administration will continue to work with all employers to give them the flexibility and resources they need to implement the health care law in a way that protects womens health while making common-sense accommodations for values like religious liberty.

For women who are pregnant or nursing, the new preventive services include gestational diabetes screening as well as breast-feeding support, counseling and supplies. Health services already provided under the health care law include folic acid supplements for women who may become pregnant, Hepatitis B screening for pregnant women, and anemia screening for pregnant women.

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Health care law gives women control over their care, offers free preventive services to 47 million women

What do health care, gun control, and cybersecurity have in common? Nothing. Unless you're the U.S. Senate.

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Senate Injects Health Care, Gun Control Into Cybersecurity Debate

PITTSBURGH--(BUSINESS WIRE)--

The Center for Connected Medicine, a global thought leader defining the transformation of health care, today welcomed Varian Medical Systems as its newest strategic partner. A leading manufacturer of medical devices and software for treating cancer and other medical conditions, Varian joins five founding and nine other strategic partners contributing to the Centers mission of developing a blueprint to overcome the fragmented state of health care today.

The health care industry is undergoing rapid change, and the connected medicine model is vital for creating a more sustainable system, says Chris Toth, vice president of Oncology Systems marketing at Varian Medical Systems. Our collaboration with the Center allows us to showcase how our medical technologies can be integrated into a seamless environment that puts patients at the center of care.

Varian officially joined the Center earlier this spring. We are impressed with Varians corporate vision and mission, notes Angela Pantelas, Executive Director at the Center for Connected Medicine. Cancer treatment demands that multiple providers, often located in multiple facilities, become involved in a patients care. Varian recognizes how vital it is for these clinicians to be connected, communicating and coordinating their approaches for the ultimate wellbeing of the patient. We are delighted to add Varians perspective to the Centers efforts.

Established in 2009, the Center for Connected Medicine services as the worlds first collaborative health care executive briefing center and has hosted nearly 11,000 visitors representing 57 countries. Those touring the Center engage in discussions about how best to overcome barriers in order to achieve a more cohesive approach to medicine, and experience ways technology developed by each of the Centers partners can be integrated to transform and enhance care delivery.

Varian is a world-wide leader in medical technology, says Andrew Watson, MD, MLitt, FACS, Medical Director at the Center for Connected Medicine. The companys breadth of offerings for treating patients is invaluable, and the companys holistic point of view will help us further define solutions for health care. We are looking forward to leveraging the contributions Varian will make to the Centers mission.

ABOUT THE CENTER FOR CONNECTED MEDICINE

The Center for Connected Medicine is defining the transformation of health care by serving as a global thought leader. As the worlds first collaborative health care executive briefing center, it is committed to developing the blueprint for innovative patient-centered and population health models using strategically integrated health information technology. Established in 2009 and located in Pittsburgh, the Center for Connected Medicine is comprised of five founding partners Alcatel Lucent, General Electric, IBM, UPMC and Verizonand nine strategic partners representing various facets of the health information community. By creating connections among those who deliver, receive and support health care, the Center promotes cultural change, coordinated care delivery and greater patient engagement. To learn more about connected medicine, as well as the Centers vision and initiatives, please visit http://www.connectedmed.com.

ABOUT VARIAN MEDICAL SYSTEMS

Varian Medical Systems, Inc., of Palo Alto, California, is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, and brachytherapy. The company supplies informatics software for managing comprehensive cancer clinics, radiotherapy centers and medical oncology practices. Varian is a premier supplier of tubes and digital detectors for X-ray imaging in medical, scientific, and industrial applications and also supplies high-energy X-ray devices for cargo screening and non-destructive testing applications. Varian Medical Systems employs approximately 5,900 people who are located at manufacturing sites in North America, Europe, and China and approximately 70 sales and support offices around the world. For more information, visit http://www.varian.com.

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The Center for Connected Medicine Welcomes Varian Medical Systems as Newest Strategic Partner

WASHINGTON, DC -

Beginning Wednesday, August 1st, millions of women will have access to eight new preventative health care services, with no out of pocket cost.

The "Preventative Women's Health Care Amendment" is a part of President Obama's Affordable Care Act. The eight services were based on recommendations from the institute of medicine.

Health and Human Services Secretary Kathleen Sebelius says the new services will improve health care for nearly 47 million women.

"Starting tomorrow, thanks to the new health care law, all insurance policies will be required to cover new vital care that women need to stay healthy. And they will have to cover the care without charging women anything out of pocket," Sebelius said.

It means that insurance companies that didn't cover the services at all will now have to provide them, and also, insurers that charged patients co-pays for those services will now have to provide them free of charge to the patient.

"It will also be illegal finally in America to charge women more than men just because they are women. In other words, being a woman will no longer be a preexisting condition in this country," said Sebelius.

The goal is to detect potentially serious conditions earlier, increasing the chances of survival and minimizing cost.

"One of the most important tools we women have is mammograms. But in the midst of the health care debate, they wanted to take our mammograms away from us. Well, hey, not while I'm here," said Sen. Sen. Barbara Mikulski (D-Maryland). "What we now will be able to do is that the top killers of women will no longer go undetected."

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No more co-pays for birth control, other preventative care

30-07-2012 16:40 Health care is changing in New Jersey with fallout from the reform bill and various hospital mergers and acquisitions. President and CEO of Hackensack University Health Network Robert Garrett told NJ Today Managing Editor Mike Schneider that he believes health care reform will make New Jersey healthier and that hospitals need to grow in order to provide a more efficient health care system. For more New Jersey news, visit NJ Today online at

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Hospital Exec. Says Health Care Reform Act is a Mixed Bag but Will Make NJ Healthier - Video

BOISE Weeks after the U.S. Supreme Court decided to uphold contested elements of the health care reform law, Idaho lawmakers are now facing the difficult task of how to move forward.

On Monday, a 14-member panel met in Boise to hear more about the questions Idaho must answer in the upcoming months. States have until Nov. 16 to submit their exchange plans.

The critical components of the Affordable Care Act require states to decide if they will expand Medicaids eligibility requirements and if they should implement some sort of insurance exchange.

For Idaho, these decisions force lawmakers to work with a law they have adamantly opposed ever since it passed in 2010. Highlights of Idahos rocky relationship with the law include Gov. C.L.Butch Otter suing the federal government for passing the law and legislatures refusing to accept the $20 million offered from the feds to help fund the exchange.

Were looking for ways to keep the federal government out of peoples decision when it comes to health care, said Sen. Dean Cameron, co-chair of the Senate-House health care task force, during a meeting Monday in Boise.

In just a few months, Idaho must submit a proposal on how it will go about setting up an exchange. The online marketplace would allow individuals to shop and compare health insurance coverage, an option currently unavailable for consumers.

States have three options when it comes to setting up an exchange. 1) Create and manage a state-run exchange; 2) Let the federal government develop and control the exchange; 3) Come up with some sort of partnership that splits the responsibilities of the exchange with the federal government.

States can also choose to partner with the U.S. Department of Health and Human Services until they come up with their own exchange, said Joy Wilson, health policy director for the National Conference of State Legislatures

There are pros and cons to that option, Wilson said. Kind of depends how comfortable you are having HHS having that big of a role in your insurance market.

However, if Idaho declines to set up its own exchange, the federal governments exchange may not be as ideal for the state, Wilson said.

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Panel Discusses Health Care Reform Impacts for Idaho

SACRAMENTO (KABC) -- It's not just state pensions putting a huge strain on the state's budget, it's retired state workers' health care benefits. In fact, according to a new report, in just 35 years those benefits will consume the entire state budget.

Public-employee retiree healthcare is yet another cost adding pressure to the state budget. A new report by California Common Sense estimates unfunded liabilities outside pensions, known as Other Post-Employment Benefits (OPEBs), to total than $62 billion.

"One of the things that may have caught many analysts and the state off guard was the rising costs of health care," said Autumn Carter, executive director, California Common Sense.

The report found:

- Costs have doubled every five years since 1999.

- If nothing is done, OPEBs will consume the entire state budget within 35 years.

- And pre-funding health care benefits annually, instead of pay-as-you-go, would save the state $21 billion in the long run.

The state would love to put away money every year for retiree health care costs, just like it does for pensions, but it's unrealistic given California's budget crisis.

"We're cutting K-12 education. We're cutting higher education. We're cutting every program for the poor, every program for children and health care," said Service Employees International Union (SEIU) spokesperson Terry Brennand. "It makes very little sense to take $3 billion more out of the budget, pre-fund this and cut $3 billion deeper."

So the state can only continue to pay for retiree health care using pay-as-you-go, which Common Sense warns could have unpopular consequences.

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Public employee retiree health care strains California budget

The majority of Iowa's top-ranking state government employees enrolled in a new health care plan and will pay 20 percent of their premiums - a plan advocated earlier this month by Gov. Terry Branstad.

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Majority of top state employees enroll in health plan

BOSTON Massachusetts House and Senate negotiators have filed the final version of a bill they say will save up to $200 billion in health care costs over the next 15 years and help guarantee the sustainability of the states landmark 2006 health care law.

The bill rejects a proposed luxury tax for hospitals that charge more than 20 percent above the state median price for a service, but includes $135 million in grants to help community hospitals make the transition to new electronic medical records systems.

Another goal of the bill is to allow residents better access to their own medical records and cut down on unnecessary and expensive repeat medical testing.

Sen. Richard Moore, an Uxbridge Democrat and one of those working on the final bill, said another top aim of the bill is to set a cost growth goal close to the states rate of inflation, far less than current year-to-year increases in insurance and medical costs.

I think its a very good bill, Moore said.

The bill would also encourage the creation of so-called accountable care organizations health care networks that take a more coordinated approach to medicine. There are already five accountable care organizations in Massachusetts.

Such organizations are considered key to the transition away from more piecemeal medical care that rewards doctors for each test or procedure to care that looks at the entire patient and the best way to maintain overall health.

Rep. Steven Walsh, D-Lynn, also worked on the final version of the sweeping bill and said hes confident it will benefit patients, health care providers and business which could see a reduction on the cost of health premiums.

He said the bill should also win the approval of Gov. Deval Patrick, who has also made health care cost control a top priority.

Im very confident that the governor will sign this, Walsh said, noting that every member of the conference committee working on the compromise legislation both Democratic and Republican members signed off on the final bill.

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Compromise health care bill released

30-07-2012 11:27 Delta Health Care:Government flags off campaign for cancer awareness

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Delta Health Care:Government flags off campaign for cancer awareness - Video

Pelee Island has found a permanent solution to its health care dilemma.

The Windsor-Essex chapter of the Victorian Order of Nurses has been chosen as the permanent health care provider to staff the Pelee Island nursing station and its 24/7 on-call nursing service.

The Erie St. Clair Local Health Integration Network made the announcement on Friday on the island. The nursing station will be open on weekdays from 8.30 a.m. to 4.30 p.m. (with a slightly different schedule possible on Wednesdays), 365 days a year. When the clinic is closed, nurses will be on-call, working in conjunction with paramedics.

Pelee Island found itself in a health care conundrum last summer when its full-time nurse, Marlene Pierce, retired. The LHIN established a task force to determine how to best serve the island. While it has a small population, questions remained about whether a nursing station was an adequate service for the island.

In the interim, the island had a hodgepodge of health care providers. The first was a combination of Leamington District Memorial Hospital staff who operated the clinic during the day while Pierce was lured out of retirement for a few months to provide after-hours care. After that, the Harrow Family Health Team stepped in to provide staff for the nursing station during daytime hours. The VON was brought on in January this year for a test-phase in which nurses worked on rotation to provide 24/7 care.

After an application process, the VON was selected to keep running the nursing station.

Andrew Ward, executive director for the Erie St. Clair VON, said that along with a team of three nurses working on rotation, two Windsor-based physicians, Dr. Albert Ng and Dr. Wayne Chan, will consult with the nurses by phone. As well, the nursing station is connected to the Ontario telemedicine network.

"It really widens the access to the residents of Pelee Island," Ward said.

He said in the evenings when the clinic is closed, residents who require care should call 911 and paramedics will determine whether to call in the nurse or take the patient to hospital on the mainland.

Copyright (c) The Windsor Star

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Health care on Pelee Island to be provided by VON

BREWER, Maine Penobscot Community Health Care is the latest Maine health organization to join a national effort that rewards doctors for keeping their patients healthy and happy.

PCHC announced Monday that it will join Eastern Maine Healthcare Systems accountable care organization, a group of providers tasked with better coordinating treatment for seniors covered by Medicare and saving taxpayer money.

Under the model, formalized under the federal health reform law, doctors and hospitals that show they have improved Medicare patients health and satisfaction get a cut of any savings in the form of bonus payments. Providers that dont make the grade either forgo the extra money or pay a penalty.

You dont get any financial gain in an ACO unless the most important thing happens, which is you have to demonstrate that your patients are getting healthier and that theres a very high level of satisfaction by your patients, said Kenneth Schmidt, president and CEO of PCHC.

The new approach is designed to upend the existing system that pays health care providers based on the number of patients they see and the amount of services and procedures they order. The hope is that doctors, nurses and other providers will work together to keep better tabs on patients health.

PCHC is the only organization to join EMHS accountable care organization since the system, parent to Eastern Maine Medical Center in Bangor, announced late last year that it was among the nations first to adopt the new model. PCHC, a network of community health centers in Greater Bangor, is also the first of its kind in Maine to embrace the approach, according to EMHS.

A portion of PCHCs roughly 8,000 patients on Medicare, the federal health insurance program for senior citizens, will be enrolled in the accountable care organization, Schmidt said. PCHC serves close to 60,000 patients altogether, most of whom are seniors and lower income.

While the community health center joined the accountable care organization in June, Medicare patients wont officially take part until Jan. 1, 2013, he said. Patients can continue to see providers outside of the accountable care organization and can also opt out of sharing their personal information with the program.

While PCHC has already shifted toward less expensive and more effective preventive care, the new partnership with EMHS will improve care for chronically ill patients, such as by further reducing avoidable emergency room visits, said Dr. Robert Allen, PCHCs executive medical director. A patient with uncontrolled diabetes, for example, can check in with a nurse every day by phone or email to make sure blood levels stay in check, he said.

Three other Maine health groups announced a similar effort to improve care and cut costs for Medicare patients earlier in July.

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Penobscot Community Health Care joins effort to improve health of Medicare patients

WASHINGTON--(BUSINESS WIRE)--

Today the National Committee for Quality Assurance (NCQA) released its new Case Management (CM) Accreditation program for organizations managing care for patients with complex health care and social needs. Already, three organizations will be the first to seek NCQA accreditation: Alere (www.alere.com), Monroe Plan for Medical Care (www.monroeplan.com) and OptumHealth Care Solutions (www.optumhealth.com).

Designed for case management programs in provider, payer or community-based organizations, NCQAs CM Accreditation ensures that patients with complex conditions receive effective, coordinated patient-centered services that lead to good outcomes. In becoming an NCQA-Accredited Case Management program, organizations make a clear statement that they are dedicated to providing personalized effective care- not just checking a box for another distinction.

NCQAs Case Management Accreditation:

Additionally, it is the only program that assesses quality during a patients transition between care settings. As patients health needs often fall through the cracks when they move from one setting to the next, effective case management can ensure continuity of critical services as patients travel through the system.

Case Management Accreditation moves us closer to measuring quality across population health management initiatives, said Margaret E. OKane, President, NCQA. Not only does it add value to existing quality improvement efforts; it also demonstrates an organizations commitment to the highest degree of improving the quality of their patients care.

Alere is delighted for the opportunity to become one of the first-adopters of NCQAs Case Management Accreditation, said Scott Schell, Executive Vice President and Chief Clinical Officer, Alere. Holistic case management solutions represent the ideal platform for optimally managing increasing complexities in patient care, multiple co-morbidities, complicating social and financial challenges, and multiple sites and providers of care delivery. Together these changes underscore the need for systematic evaluation of program effectiveness and expanded accreditation standards.

Joseph A. Stankaitis, Chief Medical Officer, Monroe Plan for Medical Care and NCQA Review Oversight Committee member noted, With the Affordable Care Act driving monumental changes in the healthcare delivery arena, Monroe Plan believes that achieving NCQA accreditation for case management would provide a greater degree of assurance for its regulators, partners, practices and communities by demonstrating that Monroe Plan has what it takes to provide optimal person-centered care.

OptumHealth Care Solutions Inc. is excited to be an early adopter of the Case Management Accreditation program. It is an opportunity to continue to showcase our commitment to the highest in quality standards, explained Margaux Frazee, Director of Enterprise Audit and Accreditation for OptumHealth Care Solutions, Inc.

Current NCQA-Accredited health plans or accountable care organizations and NCQA-Recognized patient-centered medical homes are eligible for automatic credit when they work with an NCQA-Accredited CM organization. Organizations can apply for accreditation and receive a three-year or two-year accreditation status based on performance against the standards.

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New Case Management Accreditation Raises the Bar in Care Coordination Evaluation

As the U.S. maternal mortality rate continues to increase, the new health care law could offer improvements in preventative care for women. Yet, definitive answers to why more American mothers are dying remain scarce

Credit: Celine Vignal on Flickr, under Creative Commons 2.0 (CC BY-NC-SA 2.0)

(WOMENSENEWS)--The future of pregnant women in the United States will significantly change Aug. 1.

That is when the new health care law, the Affordable Care Act, will require insurance providers and Medicaid to cover clinical preventative services for women, including pre-natal care, all without charging a co-pay, co-insurance or a deductible.

Under the new guidelines, millions of women will gain access to health care services for free, including well-woman preventative care visits and screenings for gestational diabetes and sexually transmitted infections. These guidelines do not include maternity care or simply any service the doctor orders. However, starting in 2014, all maternity care will be covered by all new individual, small business and government exchange plans.

"This will provide an extraordinary opportunity to improve women's health not only during pregnancy but before, between and beyond pregnancy, and across the life course," said Dr. Michael C. Lu, the associate administrator of the Maternal and Child Health Bureau of the Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services.

Not only will preventative care be provided next year without cost to women, under the new health care law, $125 million will go this year to the Maternal, Infant and Early Childhood Home Visiting Program to expand maternal and newborn support for mothers at home.

The changes are being introduced amid a wealth of data indicating that the number of mothers dying in America during or shortly after pregnancy is consistently growing. The rate of maternal mortality in the United States has more than doubled, rising from 6.6 deaths per 100,000 live births in 1987 to 16. 1 per 100,000 live births in 2009 the highest among developed nations, Lu's agency reports.

Various studies have attributed higher risk of maternal death to race, income, region, C-section rates, obesity-related problems and chronic disease. States where poverty exceeded 18 percent, the immigrant population exceeded 15 percent and the C-section rate exceeded 33 percent had 77 percent, 33 percent and 21 percent higher risks of maternal mortality, respectively, a 2007 report by Gopal K. Singh of the Health Resources and Services Administration indicated.

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U.S. Health Law May Curb Rising Maternal Deaths

WASHINGTON - After years of shipping data-processing, accounting and other back-office work abroad, some health care companies are starting to shift clinical services and decision-making on medical care overseas, primarily to India and the Philippines.

Some of the jobs being sent abroad include so-called pre-service nursing, where nurses at insurance companies, for example, help assess patient needs and determine treatment methods.

Outsourcing such tasks goes beyond earlier steps by health care companies to farm out reading of X-rays and other diagnostic tests to health professionals overseas. Those previous efforts were often done out of necessity, to meet overnight demands, for instance.

But the latest outsourcing, which has contributed to the loss of hundreds of domestic health jobs, is done for financial reasons. And the outsourcing of nursing functions, in particular, may be the most novel - and possibly the most risky - of the jobs being shifted.

At the forefront of the trend is WellPoint Inc., one of the nation's largest health insurers and owner of Anthem Blue Cross, California's biggest for-profit medical insurer.

In 2010, WellPoint formed a separate business unit, Radiant Services, aimed at advancing outsourcing and other cost-saving strategies. WellPoint has eliminated hundreds of jobs in the U.S. over the last 18 months as it has moved jobs overseas, a company spokeswoman acknowledged.

The spokeswoman, Kristin Binns, said WellPoint's shifting of clinical jobs overseas was a small part of the outsourcing and being done through Radiant because it has the technical expertise and can ensure compliance with laws.

Nursing organizations, however, were cautious.

"It's obviously a very disturbing trend," said Chuck Idelson, a spokesman for the California Nurses Assn. "There are serious questions if you're talking about utilization reviews ... and making recommendations on procedures."

Nursing experts said there also may be licensing issues as states generally require certification for those practicing and dispensing health information.

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Worries grow as health care companies send jobs overseas

Health care and unemployment continue to top the list of issues Canadians deem worrisome but, according to a monthly poll, priorities vary widely when broken down by region.

Every month, the pollsters ask 1,000 people across the country via an online panel which three of the following topics do you find the most worrying about Canada? The options include health care, taxes, crime, poverty/inequality, immigration control, unemployment/jobs, corruption, education, environment and moral decline.

While most people, regardless of region, said health care and unemployment/jobs were their top concerns, further down the list, provincial differences become clear.

John Wright, senior vice-president of Ipsos Public Affairs, which has conducted the monthly survey in Canada since 1990, said this is a very diversified country . . . while there may be an underlying concern about the economy and health care which is constant the next number of issues are very regionalized and for very distinct reasons.

Wright said the issues can often be linked to current events in each province, demonstrating the effect news stories and government announcements have on public opinion.

In Eastern Canada, unemployment and poverty are top of mind, while the No. 1 concern for Quebecers is corruption. Further west, citizens in the Manitoba and Saskatchewan provinces cite crime as their greatest worry, above both unemployment and health care. Meanwhile, concern over inequality/poverty has risen consistently in the Prairies since January. In Alberta, health care dwarfs any other concern. Wright said thats fuelled largely by strains on the system brought by an increased population looking for jobs in the provinces booming oilsands. And, in British Columbia, much like Ontario, unemployment and health care top the list of concerns. However, while the environment is a growing concern in B.C., Ontarians have recently been more focused on crime.

The big three concerns in Ontario were unemployment/jobs (50 per cent), health care (45 per cent) and taxes (32 per cent). The environment was last in line of issues keeping Ontarians up at night, with just 12 per cent, beat only slightly by education, at 13 per cent.

In Quebec, corruption (47 per cent) trumped health care (46 per cent) and taxes (32 per cent) as the major concern for citizens.

Wright said the ongoing Charbonneau commission, which is looking into allegations of corruption involving construction firms, local and provincial governments, political parties and organized crime, has raised that issue from 25 per cent in December 2011 to top of mind today.

In Saskatchewan and Manitoba, crime (38 per cent) and unemployment/jobs (35 per cent) were top of mind. Health care and poverty/inequality were tied at 33 per cent. Crime, although on a decline from a recent high in September 2011, when 60 per cent of prairie dwellers cited it among their three top concerns, still beat out corruption (23 per cent) and the Environment and Education, which were tied on the bottom rung at 13 per cent.

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Health care, jobs top concerns for Canadians: poll

by Russ Wiles - Jul. 28, 2012 05:48 PM The Republic | azcentral.com

Now that the Supreme Court has upheld the Affordable Care Act, it's time to start picking through the details. Several key tax rules are scheduled to change in 2013, especially for higher-income individuals.

Republicans are still trying to overturn the law, and that could happen based on what transpires in the November election. But if nothing changes, here's what to expect in terms of the health-related tax impact, with focus on items that apply to individuals rather than businesses:

New Medicare tax. Higher payroll withholding is on the horizon with the introduction of a 0.9 percent tax starting in 2013. It will hit people with earned income exceeding $200,000 for singles and $250,000 for married couples filing jointly. That's in addition to the current Medicaid tax of 1.45 percent.

New investment-income tax. The legislation also imposes a 3.8 percent levy on interest, dividends, some rents and other unearned income for people above those $200,000/$250,000 income levels. This levy, also designed to support Medicare, starts in 2013.

"This 3.8 percent tax would be on top of any increase in the dividends/capital-gains/ordinary-income rates that (take effect) ... upon expiration of the Bush-era tax cuts at the end of 2012," according to tax-researcher CCH.

Top rates rising. That 3.8 percent Medicare addition plus scheduled regular-tax increases mean the top effective rate for high-income earners could go from the current 35 percent to 43.4 percent in 2013, said Jason Miller, manager of financial planning at Harris Private Bank in Scottsdale. The capital-gains rate could go from a top 15 percent this year to 23.8 percent next year.

Harvesting or prematurely locking in capital gains, normally an unwise strategy, could make sense, Miller added. So could accelerating income into 2012 rather than deferring it, if possible. In one strategy cited by Mark Luscombe, principal analyst at CCH in suburban Chicago, you might opt to convert a regular IRA into a Roth, paying the applicable taxes at this year's lower rates and thereby securing tax-free withdrawals in future years.

Incidentally, selling a home for a large capital gain after this year could be costly, since the gain could increase net investment income and boost adjusted gross income above the $200,000/$250,000 threshold amounts. However, most people won't face the tax on a home sale, as individuals still will be able to shelter up to $250,000 and couples $500,000 in gains on the sale of a primary residence, said Luscombe.

In other words, the new 3.8 percent tax applies to housing capital gains above the $250,000/$500,000 limits only if your income exceeds the thresholds.

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Health-care act to have tax impact

With the looming implementation of health care reform, many Napa County residents have begun to wonder how the new federal law will impact their lives and businesses.

The U.S. Supreme Court upheld the Obama administrations Patient Protection and Affordable Care Act, often referred to as Obamacare, in June on a 5-4 vote. The law will require almost every American to have health insurance by 2014 or pay a penalty.

While most Napa County residents agree that its good for everyone to have health coverage, many are divided on the law itself. Some say its too weak and they would prefer a single-payer health care system or Medicare for all. Others say the law goes too far and that the governments involvement in health care will do more harm than good.

Seven Napa County residents recently shared their opinions on health care reform and how they will be personally affected by the Affordable Care Act.

Ken Allen, 56

Napa resident and volunteer for the Napa Valley Museum

Ken Allen said health care is a human right and its an abomination that so many people are unable to afford care.

Allen has received health coverage through Kaiser Permanente for about 12 years.

He first became covered through his employer. After losing his job through company-wide layoffs, Allen continued with Kaiser through COBRA and Cal-COBRA, which extends an employers health insurance for 36 months after someone becomes unemployed. Once his Cal-COBRA coverage ran out, Allen said he chose to stick with Kaiser even though purchasing a policy as an individual more than doubled his monthly premium.

I think Kaiser is revolutionary in how they do things, Allen said, describing the health care provider as a one-stop shop.

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Making sense of health care reform

1:00 AM The approach wins praise and makes sense, but the U.S. health care system seems to work against it.

By LISA M. KRIEGER San Jose Mercury News

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Karen Gossage, a palliative care nurse, listens to the lungs of Marilyn Cronin, 58, of Soquel, Californa, who suffers from emphysema and liver failure, at her home this month.

Dai Sugano/San Jose Mercury News/MCT

WHAT IS PALLIATIVE CARE?

Palliative care -- from the Latin "palliare," which means "to cloak" -- grew out of the hospice movement of the 1970s.

It is care that helps patients with life-limiting illness in their final years. Its managers guide patients through difficult choices in planning for care and treatment and managing symptoms and spiritual, social and psychological issues.

Palliative care sharply contrasts in cost and patient experience with the prevalent end-of-life care in hospitals. Many studies confirm the high costs of physically and emotionally draining treatment for failing elderly people.

A study of the deaths of 5,158 elderly by UC San Francisco's Dr. Alexander Smith found that more than half had gone to the ER in the last month of their lives. Two-thirds went in their final six months. (Health Affairs, June 2012)

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Palliative care: A softer touch eases last years of life