New Orleans’ Best Bars

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By
Marty Padgett

You may have heard: New Orleans got trashed. Five years ago, Hurricane Katrina demolished wide swaths of the city. And still today, the perception of most of America is of a shattered demi-monde, with zombie locals wandering through debris-littered streets, wondering when the next storm is coming.

None of that is true anymore, if it ever was. Parts of the city stayed open through the storm—and if not, quickly came back to life. Of course, we’re talking about the bars. While most of the city ditched for the Interstates or rode the storm out in the Superdome, at least two establishments kept their doors open. Both were bars.

It’s like nowhere else on earth, when it comes to booze. The cocktail may have been invented here, and in New Orleans drinking isn’t just entertainment, it’s subtext. It’s a way of life. In the 85 blocks that make up the French Quarter, there are at least 100 places licensed to sell you alcohol, and maybe as many without a license. It’s so ingrained, the city’s annual Tales of the Cocktail event draws more than distillers showing their wares: it attracts droves of enthusiasts in what has been compared to a “Star Trek convention for drunks.”

With the cultural embargo lifted on the city—if the Southern Baptists’ women’s convention can come back, so can your annual meeting—you’ll need some back-pocket advice on the right places to drink, and what to imbibe. And since it’s still New Orleans, it’s still good to know the places within safe staggering distance back to your hotel.

The horrors of hurricanes, the frozen Pat O’Brien’s ones, are better left to underage lushes in the making. There are hundreds of places to indulge in the French Quarter alone—but a great handful not to miss. Take your clients to the first set, and once they’re put to bed, check out the second set on your own:

Arnaud’s French 75: A visit to New Orleans should include one of the old-line Creole dining rooms, and Arnaud’s is one of the most convenient and least dated of the group that includes Antoine’s, Galatoire’s and Commander’s Palace (a cab ride away in Uptown). The bar, French 75, wears its lush mahogany fittings as if they’d been there since the 1800s, when in fact it has been open only a year. Servers wear black jackets and crisp white shirts, and the air conditioning is set to subzero, a nice respite from the occasional hot and humid December day. Dimly lit in the evenings, it’s a cozy setting for small groups with some appreciation for old New Orleans.

When to go: Before dinner at Arnaud’s

What to drink: Something stiff to gird yourselves for tomorrow’s meeting—or the bar’s eponymous brandy-and-champagne cocktail

Find it: 813 Bienville St., just north of Bourbon

http://www.arnauds.com/bar.html

Boondock Saint: For the after-work hours, it doesn’t get more focused than the Saint. Come to drink and talk over the fierce “Irish Car Bombs” served up by Ukrainian barmaids who give expert instruction, in case you don’t know the means of consumption: drop the shot glass of whiskey into the pint of Guinness, and quaff it all at once. Repeat. Repeat until the British have left the area, or maybe just until they leave the bar in disgust. Friday afternoons, linger until the bar crawls begin—bartenders from other places wander through in pajamas on their own circuit, and usually have a few extra Jell-O shots to dole out if you’re good. Like any good Irish-flavored place, there’s cops involved: an NOPD officer’s a part-owner.

When to go: Friday evening as the pours get longer—or any midnight, really.

What to drink: An Irish Car Bomb, if you’re free of a politically correct mind

Find it: 731 Saint Peter St.

Carousel: Conveniently sited in the Hotel Monteleone, the Carousel is close enough but just far enough away from the Bourbon Street gutter. The name comes from the actual revolving carousel that functions as the bar. No ponies to ride, but you’ll make slow revolutions while the barkeep shakes sloe fizzes and the like. Remember, the sidecar is based on old cold remedies, so you can fake an oncoming sickness for cover. The hotel itself is a piece of local history and has a classic marble-trimmed lobby, though rooms will seem small.

When to go: Saturday midday, to escape the heat and after the hotel check-in rush has waned.

What to drink: A sugar-rimmed sidecar, served in a martini glass, always does well.

Find it: 214 Royal St., to the right of the hotel entry.

http://www.hotelmonteleone.com/

Flanagan’s: It’s almost a house rule: To work the bar at this darkened hangout, you need some ink, somewhere. The kitchen staff is exempt, but most are tatted up anyway. (The menu promises little, and delivers it. But grilled cheese?you’re covered.) Show up late in the afternoon, and the local color will entertain you with stories about train rides, the details of their storm plans for the season, and possibly, the particulars of hiking the Appalachian Trail solo. Around 7 p.m. the bar bulges with ghost-tour groups for 30 minutes while they wait for dark, then reverts to an under-30 crowd that doesn’t know a stranger. Despite the pool table and slot machines, it’s far from a dive: The big-screen TVs play the History Channel and old Cary Grant-Grace Kelly movies, and there’s wireless if you need to check in and cloak your location via Facebook.

When to go: Anytime, really—but avoid the tour-group hour if you want a seat in front of the taps.

What to drink: It’s a beer bar and a beer crowd. Louisiana’s favorite is Abita, in Purple Haze or Amber garb.

Find it: 625 Saint Philip St.

http://flanagans-pub.com/

One-Eyed Jacks: An old theater space that still specializes in the theater of the living, Jacks has Candace, the best bartender to escape Detroit and land in the Quarter. Find the schedule and plan ahead for the events, which include “The Bingo! Show,” which is like bingo, if Baz Luhrmann were in charge, and “Fleur du Tease,” a burlesque for those who still appreciate the art of carefully placed clothing. Bonus: It’s close enough to Bourbon Street to break from the pack and let others know you’ll be “right down there.”

When to go: Make it late, but check out the Web site for shows, which can pack the front room.

What to drink: Definitely a beer place, but the wall of half-empty whiskey bottles suggests a world of options.

Find it: 615 Toulouse St.

http://www.oneeyedjacks.net/

Ritz-Carlton Library: New Orleans likes its swank, even if it was born somewhere else. The Ritz-Carlton chain is Canadian, you know. It’s one of a type of bars you’ve toured in other cities, but is distinguished here as a private smoking club where your cigar still has protected rights. It’s at the Canal Street edge of the Quarter, and for souses with spouses, it’s paired smartly with a world-class spa. Martinis are a little showy here, though the cognac concierge on duty won’t sneer if you order one instead of the dozens of spirits available. It is private, but day passes are available.

When to go: Fridays at 5 p.m., while waiting for dinner reservations nearby.

What to drink: anything older than 25 years will let you fit in. You’re here to gawk quietly, or in more polite terms, to “network.”

Find it: 921 Canal St., at Canal and Bourbon (opposite side of the street, Bourbon becomes Carondelet Street.)

http://www.ritzcarlton.com/en/Properties/NewOrleans/Dining/TheLibraryLounge/Default.htm

Marty Padgett is a U.S.-based motoring journalist, and the executive editor of The Car Connection.



BusinessWeek: LifeStyle

Will Holiday Shoppers Be Merry or Miserly?

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By
Ben Steverman

For retailers and consumer-focused businesses, it’s now time for what Mattel (MAT) Chief Executive and Chairman Robert Eckert calls “the early fall jitters.”

The 2009 holiday season is approaching quickly, and with nearly 1 in 10 Americans officially out of work there are plenty of reasons to be worried. As merchandise is being shipped to them, stores have no guarantee that shoppers will show up to buy. Fears are heightened by memories of last year’s disastrous fourth quarter.

“We’re coming off probably the worst holiday season in memory,” says Doug Hart, a partner in the retail practice at BDO Seidman, an accounting and financial services firm.

Holiday retail sales dropped 3.8% last November and December, reflecting consumer panic as the U.S. navigated through an unprecedented financial crisis.

Although many economists believe that the U.S. economy ended its recession during the summer, few expect consumer spending to bounce back. The National Retail Federation predicts holiday sales to fall a further 1% this year. After almost two years of recession, Americans have less money to spend. For retail analysts such as Wayne Hood at BMO Capital Markets, “Real income growth is the most important driver.”

Consumers still cutting back?

Retailers know this and are being cautious. “Retailers continue to be reluctant to make inventory bets and it will undoubtedly be a difficult holiday for parents whose job status and financial well-being are uncertain,” said Mattel’s Eckert, speaking to analysts after the toy giant announced quarterly results on Oct. 16.

Various surveys back up the contention that consumers remain gloomy. In a survey released by the National Retail Federation on Oct. 20, consumers said they plan to spend an average of 2.74 on holiday-related shopping this year, a 3.2% drop from last year. Mattel’s rival Hasbro (HAS), told analysts on Oct. 19 that its surveys showed most consumers planning to spend at last year’s levels—with a quarter intending to spend less and only about 10% contemplating an increase.

Notwithstanding the pessimism hanging over the holidays, many experts and investors sound increasingly optimistic.

“We see consumers ready to come back out again,” says Mike Unger, managing director at Karabus Management, a subsidiary of PricewaterhouseCoopers that specializes in advising retailers. Tired of the recession, shoppers want to go back to stores and hunt for bargains, Unger believes.

Recent data have given small reasons to be optimistic. In September, U.S. retail sales excluding autos ticked up 0.5%, following a 1% rise in August.

But predicting the mood of the American consumer is more art than science.

Retailers are on their toes this year

“You never want to underestimate the consumer,” says Kelli Hill, a portfolio manager and analyst at Ashfield Capital Partners. Americans like to spend money, she notes, and they’ve stopped doing so for the past year. “There’s just a lot of pent-up demand,” she says. Americans might not be able or willing to run up their credit cards, but they’re starting to realize the recession is over. So they will think: “‘Let’s enjoy the holiday.’”

There’s even evidence that retailers might enjoy the holiday. Consumer-focused firms were stunned by last year’s sudden crisis, and then profits plunged. This year they are better prepared for surprises.

Retailers have done an excellent job cutting costs, experts say. Caught with too much inventory last year, they are stocking lighter quantities this holiday season. With less merchandise on the shelves, they should need to offer fewer discounts to unload it. In addition, chains have slashed expansion plans and closed unprofitable stores, Hart says, and have even demanded rent reductions from landlords.

Analysts believe all this cost-cutting will boost profits even as sales remain flat. According to analyst estimates tracked by Thomson Reuters (TRI), consumer discretionary earnings are expected to double in the fourth quarter of 2009 from the previous year.

“The cost-cutting has been aggressive,” Unger says. Retailers have “put themselves in a position where they can survive a holiday downturn if there is one.”

Survival isn’t an abstract question for consumer firms in this economy. Last year’s grueling Christmas season drove several high-profile retailers into bankruptcy, including Circuit City.

Expect discounts, meager inventories

If consumer spending does recover unexpectedly, stores could run out of product faster. “If you walk into any kind of store today and you see something you like, buy it,” Hill says. “Because it’s probably the only one they have.”

Retailers may be cautious, but that doesn’t mean they won’t offer discounts this holiday season. Another lesson learned over the past year, Hood says, is that consumers want good deals. “The consumer is making sure that they provide value,” Hood says.

Wal-Mart (WMT) benefited from its reputation as a discounter last year, but now many other retailers are trying to get in on the act, including Macy’s (M). Last year “retailers that discounted gained market share,” Hart says. Store shelves should feature more gifts and products designed to sell in the to range, he says.

There are still few signs that U.S. consumers are planning to open their wallets wide this holiday season. Given the jobs outlook and a shortage of consumer credit, we’re unlikely to see a return to the spending levels of 2007 and earlier.

But with the stock market up and the recession assumed to be over, many are betting that retailers can avoid last year’s ruined holiday. Even if sales remain flat, retailers and other consumer-focused firms are at least better prepared.

Steverman is a reporter for BusinessWeek’s Investing channel.



BusinessWeek: LifeStyle

Country Clubs: Stuck in the Rough

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By
Dean Foust

From the day it opened its gates in 1998, Superstition Mountain Golf and Country Club was one of the “it” clubs in the Phoenix area. Boasting a Spanish Colonial clubhouse and a pair of Jack Nicklaus-designed courses with majestic mountain views, the club exuded an air of wealth and success. And because Superstition Mountain was the host course for a popular Ladies Professional Golf Assn. tournament, its members got to hobnob with such stars as Annika Sorenstam—a perk that made writing a 0,000-plus initiation check a little easier.

But as the economic downturn suddenly made a club membership seem more extravagance than necessity, Superstition’s luck took a turn for the worse. With membership slipping and the developer behind the club and the adjoining residential development suffering his own financial problems, Superstition’s lenders foreclosed and now plan to sell the property at auction this December. What happens then is anyone’s guess, given that Superstition Mountain has only about half the 780 members originally envisioned. “It’s just not feasible that the members take it over at this point,” says Keith Bierman, the court-appointed receiver for the club.

For generations of golfing executives, joining a private club not only provided a venue to entertain clients but also served as a validation of their success. Now the economic downturn has created an existential crisis for many of the nation’s 4,400 country clubs. To be sure, elite clubs such as Augusta National, Shinnecock Hills Golf Club outside New York City, and Riviera Country Club in Los Angeles remain impervious to the current downdraft, as do many of the most established, old-money clubs across the country. Hammered hardest are the thousands of middle- and lower-tier courses, as well as many, like Superstition, that sprouted throughout the Sun Belt during the past decade. Already, dozens are in foreclosure. And according to the National Golf Foundation (NGF), as many as 15% of the rest say they’re suffering serious financial problems. Among the troubled are such venerable clubs as the Country Club of Lansing, Mich., and the former IBM Heritage Country Club outside Binghamton, N.Y., both of which are in foreclosure.

The pain isn’t over, either. The number of golfers belonging to clubs now is down to 2.1 million—900,000 below the peak in the early 1990s. Experts such as consultant Jim Koppenhaver, whose Buffalo Grove (Ill.) firm, Pellucid, monitors the industry, believes at least 400—and worst case, 1,000—private clubs will have to close, convert to public play, or be absorbed into healthier clubs before the carnage is over. “The whole country club model is at risk,” says Koppenhaver. But “for a lot of golfers, the value proposition of belonging to a club is hard to pencil out.”

While it would be easy to ascribe the clubs’ woes to the economic crisis, experts say the seeds were planted in the early 1990s, when Congress enacted tax reforms that eliminated or reduced the ability of club members—and, more practically, their corporate employers—to deduct club dues as a business expense. That raised the effective cost of joining clubs and gave rise to a new breed of upscale public courses some executives view as suitable, and cheaper, places to entertain clients. Societal changes had an effect as well. While earlier generations of men viewed their clubs as weekend sanctuaries from work, if not from the wife and kids, many executives in their 40s and 50s are opting to spend their weekends not on the course but on sports fields coaching their kids’ teams.

SUDDEN SHORTFALLS

The clubs themselves share the blame for their plight. Some took on huge loans to fund extensive renovations to courses and clubhouses, racking up debts they are currently struggling to repay. And while 500 of the clubs surveyed by the NGF say they’ve been running at a deficit, experts believe 2010 could claim even more victims. Most clubs give members a certain window each fall to suspend or shift to a cheaper plan in the coming year, and experts say many are doing just that. “There are clubs that are finding out right now that they’re not going to make it next year,” says David Shaw, a Greenvale (N.Y.) consultant to clubs.

To plug these shortfalls, troubled clubs are resorting to a variety of measures. At the roughly 500 clubs that told the National Golf Foundation they were suffering serious financial problems, heavy membership losses were a key culprit. As a result, 90% reported they had tried recruiting new members with discounted initiation fees—and some, such as Inwood Country Club, a 108-year-old establishment on Long Island, N.Y., have waived their initiation charges for golf members. Others are merging with neighboring clubs to cut labor costs, which account for about half the expenses at an average club. That allows the clubs to share the cost of a bookkeeper, food-service director, and other staff. In Cleveland, two clubs facing declining memberships—Sand Ridge and Mayfield—merged three years ago, a move that enabled them to slash overhead enough to keep both courses. But with their combined membership down from more than 700 to 550 in the years since, the renamed Mayfield Sand Ridge Club is entertaining approaches from other clubs looking to merge their way in, too. “We’re doing fine, but we’re still looking for anything that would help our club,” says Jon Outcalt, Mayfield’s president.

TEED OFF

Despite their best intentions, some of the clubs’ efforts to stay afloat have current members grumbling. The offenses include opening the banquet rooms to outsiders and renting the courses for corporate outings and charity events. Not surprisingly, a number of the disputes involve money—and lawyers. At some clubs, members have sued when the clubs dragged their feet on refunding their initiation fees until replacement members are found, a process that can take years at struggling clubs. In Lexington, Ky., seven members of the University Club of Kentucky filed suit in 2003 after club officials slashed the initiation fee from ,500 to as little as ,000. That, said members, violated the club’s vows that the value of their memberships wouldn’t decline. While the club and litigants reached a private settlement, Randolph Addison, a Dallas attorney who specializes in private-club matters, says the courts usually uphold the right of private clubs to alter their fees.

In the end, some industry insiders believe the long-term solution is to reinvent the country club, moving beyond golf to a broader array of services that meet the changing needs of younger members. In San Clemente, Calif., the once-bankrupt Bella Collina Towne & Golf Club has sold 120 new memberships in the past six months by adding pilates, karate lessons, and even a vegetable garden (for the restaurant) that members’ kids help plant.

On the golf course, Bella Collina now offers a free junior golf program and permits members to take lessons from the club’s instructors at no charge. That last move created turnover among the teaching pros, who viewed the cash from paid lessons as a perk of the job. But club officials say the gesture has helped get more mothers and children out on the course with their fathers. “The country club has to evolve and become like piazzas in Italy, the town square where families—and not just the men who are golfing—meet on weekends,” says John G. Fornaro, one of the investors who bought Bella Collina last year. That’s good advice, but it may be coming late to clubs where the wolf is already at the door.

Foust is chief of BusinessWeek‘s Atlanta bureau.



BusinessWeek: LifeStyle

Many Americans Still Leery of Swine Flu Vaccine

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By Amanda Gardner
HealthDay Reporter

TUESDAY, Oct. 13 (HealthDay News) — Even as the H1N1 swine flu vaccine is distributed coast to coast, many people say they have safety concerns that may stop them from getting vaccinated.

Although experts say those fears are unwarranted, a recent Associated Press-GfK poll found only about half of Americans said they are planning to get the vaccine. Most of those are older people — so far among the least vulnerable to the virus.

Almost three-quarters of respondents said they were concerned about the vaccine’s safety (although many of these said they still were going to get the shot).

A University of Michigan poll found that only 40 percent of parents wanted to get their children inoculated.

And a survey released Tuesday — commissioned by the American Society of Health-System Pharmacists that polled pharmacy directors at 341 hospitals across the country — found that many hospital employees are asking if the H1N1 vaccine is safe.

In response, experts and officials continue to stress that not only is the vaccine safe, it’s the surest way to protect yourself from the H1N1 swine flu virus.

“The H1N1 vaccine is made in exactly the same way, using the same material, the same companies, the same process as the seasonal flu vaccine we make every single year and give to tens and tens of millions of people,” said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases.

Fauci explained that even the seasonal flu vaccine is changed slightly each year, with slightly different strains.

Had the H1N1 virus emerged just a little bit earlier, it would have been included in this year’s regular flu shot, he stated.

“We wouldn’t be talking about safety now if [the H1N1 vaccine] were given within the context of the seasonal flu,” Fauci continued.

Nor has the vaccine been made too quickly, as some have worried. In fact, “it hasn’t been faster at all,” said Dr. Robert Frenck, a professor of pediatrics at Cincinnati Children’s Hospital and a member of the American Academy of Pediatrics’ committee on infectious diseases.

The seasonal flu vaccine goes into production around March and is available around August. The H1N1 virus was isolated in May and became available this month.

Side effects from the H1N1 vaccine have been mild, including tenderness and swelling at the injection site and a mild fever. In China, four of 39,000 people vaccinated reported muscle cramps and headaches.

“We’ve had experience with this particular variety of killed vaccine for 20 years, and the risks are primarily swollen arm and low-grade fever,” said Dr. Nathan Litman, director of pediatrics at the Children’s Hospital at Montefiore Medical Center in New York City. “There are some very, very rare other events, but some of them happen naturally even in those who don’t have the vaccine. The risk of disease and complications of disease is far greater than the vaccine.”

Some concerns were precipitated by an earlier experience with swine flu vaccine. In 1976, the U.S. government vaccinated 43 million people against swine flu following an outbreak at Fort Dix in New Jersey. Some 500 of those vaccinated developed a rare neurodegenerative condition called Guillain-Barre syndrome, which many experts believe was linked to the shot. Twenty-five of those 500 died.

But the equation for this year’s swine flu pandemic is already vastly different. The 1976 virus never spread beyond 240 soldiers stationed at the base, while the current outbreak has already sickened more than 340,000 people worldwide, killing 4,100 or more, according to the World Health Organization.

More information

Visit the U.S. Department of Health and Human Services for more on the H1N1 swine flu.

SOURCES: Anthony Fauci, M.D., director, U.S. National Institute of Allergy and Infectious Diseases; Robert Frenck, M.D., professor, pediatrics, Cincinnati Children’s Hospital, and member, American Academy of Pediatrics’ committee on infectious diseases; Nathan Litman, M.D., director, pediatrics, and chief, pediatric infectious diseases, the Children’s Hospital at Montefiore Medical Center, New York City;
Sept. 24, 2009, University of Michigan poll; Associated Press; Oct. 13, 2009, news release, American Society of Health-System Pharmacists, Bethesda, Md.

Copyright © 2009 ScoutNews, LLC. All rights reserved.



BusinessWeek: LifeStyle

More Americans than not want health law repeal: poll

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WASHINGTON |
Wed Nov 16, 2011 9:29am EST


WASHINGTON (Reuters) – As the U.S. Supreme Court prepares to review President Barack Obama’s healthcare reforms, more Americans want to it repealed than want to keep it, a poll released on Wednesday shows.

WASHINGTON (Reuters) – As the U.S. Supreme Court prepares to review President Barack Obama’s healthcare reforms, more Americans want to it repealed than want to keep it, a poll released on Wednesday shows.

A Gallup survey of more than 1,000 U.S. adults found that 47 percent favor the repeal of healthcare reform, versus 42 percent who want the law kept in place. Eleven percent had no opinion.

But the survey also showed that 50 percent of Americans believe the federal government has a responsibility to make sure everyone has health coverage, compared with 46 percent who do not.

The results, which have a 4 percentage point margin of error, suggest a sharply divided U.S. public as the Supreme Court prepares to begin hearing legal arguments next March from 26 states and an independent business group that want the law struck down as unconstitutional.

The Patient Protection and Affordable Care Act would extend health coverage to more than 30 million uninsured Americans by expanding Medicaid and establishing special state-run insurance markets called exchanges.

The law is Obama’s signature domestic policy achievement, and a high court decision to overturn the reforms could deal a severe blow to his re-election prospects in the middle of the 2012 presidential campaign. A ruling to retain it could help his campaign.

The Supreme Court would be expected to rule by July.

Obama, a Democrat, is opposed by a field of Republican candidates who want the healthcare reform law repealed as a symbol of an intrusive government seeking to raise taxes and burden businesses with new regulation.

Public opposition to the law, particularly among the elderly, helped Republicans wrest control of the House of Representatives from Democrats in the 2010 midterm elections.

But advocates of the reforms say the law will reduce the soaring growth of healthcare costs over time and provide medical care to millions of families who currently have no protection.

The November 3-6 Gallup poll also showed a small reduction in public support for private insurance as the basis for gaining medical services in the .6 trillion U.S. healthcare system.

The findings said 56 percent of adults continue to prefer private insurance versus 39 percent who would favor a government-run system. That compares with a 61 percent to 34 percent margin a year ago.

(Reporting by David Morgan; editing by Philip Barbara)


Reuters: Health News

Health-Care Reform: The Mandate Debate

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By
Catherine Arnst

How much is health insurance worth to you? That’s the key question lots of experts in Washington are trying to answer as Congress attempts to hammer out a health-care reform bill. Economists say the only way to cover most, if not all, of the nation’s 47 million uninsured is by instituting an “individual mandate” that would require everyone either to purchase insurance or pay a fine. The great unknown, however, is how high the penalty should be to motivate the desired response.

In the bill approved by the Senate Finance Committee on Oct. 13, there are no fines at all the first year it goes into effect, in 2013. In 2014 individuals would have to shell out 0 in annual penalties if they choose to forgo insurance, and by 2017, the number jumps to 0. That’s starting to sound like a meaningful sum. But consider that the average yearly insurance premium for an individual policy is around ,000. For just a few hundred dollars during the first years the law is in place, a healthy person might decide to forgo the costly security of insurance.

That’s what insurers fear, at any rate. The 1,500 members of America’s Health Insurance Plans (AHIP), a powerful industry lobbying group, struck a deal with President Barack Obama earlier this year to end the practice of charging more for preexisting conditions in return for an individual mandate. Insurers figured they could afford to charge everyone the same amount as long as they had access to some 30 million new customers, many of them healthy. That would allow them to spread the risk over a much larger pool.

Lower Fines, Higher Premiums?

AHIP President Karen Ignagni blasted the Finance bill for taking the teeth out of the individual mandate, saying the low penalties will create “a powerful incentive for people to wait until they are too sick to purchase coverage.” A PricewaterhouseCoopers report commissioned by AHIP calculated that, if the fines remain as described in the bill, health-insurance premiums will end up higher than if no reform bill is passed, because insurers will have to raise rates to pay for all the new, sicker enrollees.

Economists agree that the penalties are too low to prompt all the uninsured to sign up but disagree with the AHIP assumption that no one will change their behavior once an individual mandate goes into effect, even if it makes economic sense. “We don’t know what the magic number needs to be for the penalty to be effective,” says Jonathan Gruber, professor of economics at the Massachusetts Institute of Technology. “But the fact is, most of us are law-abiding. No one riots over buying car insurance, it’s just a fact of life. This could turn out to be the same.”

The only real-world experiment in the U.S. seems to bear Gruber out. Massachusetts has been requiring all residents to buy insurance since 2007, the only state with a mandate. In the first year the fine was 9, rising this year to ,020—half the cost of the cheapest individual insurance premium. The percentage of uninsured residents has dropped from 5.7% in 2006 to 2.6% now, with an additional 428,000 residents covered; about half signed up the first year despite the low penalty for failing to do so. In 2008, 86,000 residents paid the fine rather than take insurance, while another 71,000 were exempt because they did not meet minimum income levels.

Still, some Bay Staters are gaming the system. Dr. Marylou Buyse, president of the Massachusetts Association of Health Plans, says most of the state’s insurers have had cases where people sign up for insurance for a few months, have lots of medical procedures, and then drop coverage. “Their health-care claims tend to be two to three times higher than the average,” says Buyse. “That’s a good argument for having a fairly tough mandate.” The association is now studying ways to close off this loophole.

Instilling an Insurance Culture

Despite the overall success of the Massachusetts mandate, economists warn against assuming the rest of the nation will follow suit. The measure had extremely high popular support in the state and passed the legislature with only two votes against. Elsewhere—particularly in the South and Southwest, where uninsurance rates and distrust of the government are both high—people may not be so eager to sign up.

Consequently, Gruber agrees that the penalties in the Senate Finance bill aren’t strong enough to prompt a majority of the uninsured to sign up. He recommends a fine of ,250, the estimated average yearly cost an uninsured person now imposes on society from unpaid medical bills.

Experts say it is also important to educate the population, particularly healthy twentysomethings, that—much like buying car insurance—purchasing a policy is simply the right thing to do. As Richard Curtis, president of the nonprofit think tank Institute for Health Policy Solutions, says, “We need to instill a culture of insurance, a culture of mutual responsibility.”

Arnst is a senior writer for BusinessWeek based in New York.



BusinessWeek: LifeStyle

Behavioral therapy for obesity may help family too

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By Amy Norton


NEW YORK |
Wed Nov 9, 2011 5:30pm EST


NEW YORK (Reuters Health) – When obese people lose weight with behavioral therapy, their family members may get a bit trimmer as well, a new study suggests.

NEW YORK (Reuters Health) – When obese people lose weight with behavioral therapy, their family members may get a bit trimmer as well, a new study suggests.

Cognitive-behavioral therapy (CBT) is one option for managing obesity, though it’s not widely available. It focuses on changing people’s thoughts and attitudes on eating and other lifestyle habits, and giving them practical ways to make improvements — like tracking their daily calories and keeping an “eating diary.”

In the new study, Italian researchers wanted to know whether the things obese patients learn in CBT might have a “ripple effect” in their families.

They surveyed family members of 149 obese patients going through the CBT program at the University of Bologna — which consisted of 12 to 15 weekly group meetings.

Six months after their relatives started the program, the study found, family members — mainly spouses and adult children — showed some changes for the better as well.

On average, they’d cut more than 200 calories from their daily intake at the study’s start. They were also eating a bit less fat and refined carbohydrates, and a bit more fruit.

It all translated into a weight loss of just over two pounds, on average. But the effects were bigger for the 35 relatives who were actually obese themselves.

They lost an average of six pounds, and seven of them lost enough to become officially “overweight” instead of obese.

“CBT in a family member might have a ripple effect (for) other family members,” senior researcher Dr. Giulio Marchesini told Reuters Health in an email.

One reason could be that family members decided to make positive changes to help the person who was in CBT — like ridding the kitchen of sugary, fatty temptations.

Even more likely, Marchesini said, is that the person in behavioral therapy instituted some healthy changes at home. A majority of the CBT patients — 101 of the 149 — were women, and were likely “in charge” of meal planning, Marchesini pointed out.

“I do not know how much this possibility might translate into different cultures,” he noted, “but this is definitely the case among Italian families.”

The study, published in the Journal of the American Dietetic Association, had its limitations. One was that the researchers tried to survey almost 500 family members of their patients, but got responses from fewer than half — 230.

So the responses might have come from the most motivated patients and supportive families, and might not reflect the reality for everyone who tries CBT for weight loss, according to Marchesini’s team.

In general, cognitive-behavioral therapy requires motivation, since it’s time-consuming and people have to commit to changing their outlook and behavior. And it’s not universally available, Marchesini noted. That’s true in the U.S., as well as Italy.

He argued that the potential effects on an obese patients’ family should be taken into consideration when thinking about the cost-effectiveness of CBT.

In the U.S., the cost of CBT varies depending on the specific program, but a typical figure would be between 0 and 0 per hour. Insurance may or may not cover it.

There’s some evidence that other weight-loss treatments can end up having effects on family members as well. In a small study out last month, surgeons at Stanford University found that obese relatives of patients who underwent obesity surgery lost weight in the year following the procedure.

The benefits were small. On average, obese family members (limited to those living with the patient) lost eight pounds.

The study included only 35 patients and 50 family members, and it doesn’t prove that weight-loss surgery for one person will benefit the whole family. But the researchers said it makes sense that it might, since obesity is a “family disease.”

Even when people have surgery to treat severe obesity, they have to commit to lifelong lifestyle changes afterward.

SOURCE: bit.ly/uIwIuY Journal of the American Dietetic Association, November 2011.


Reuters: Health News

Judge blocks rules on graphic cigarette labels

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WASHINGTON |
Mon Nov 7, 2011 11:24am EST


WASHINGTON (Reuters) – A U.S. judge sided with tobacco companies on Monday, granting a temporary injunction blocking rules requiring new warning labels that use graphic images like a man exhaling cigarette smoke through a hole in his throat.

WASHINGTON (Reuters) – A U.S. judge sided with tobacco companies on Monday, granting a temporary injunction blocking rules requiring new warning labels that use graphic images like a man exhaling cigarette smoke through a hole in his throat.

U.S. District Judge Richard Leon granted a temporary injunction after determining that the tobacco companies would likely prevail in their lawsuit challenging the Food and Drug Administration’s requirement as unconstitutional because it compels speech in violation of the First Amendment.

(Reporting by Alina Selyukh and Jeremy Pelofsky in Washington, editing by Dave Zimmerman)


Reuters: Health News

Hangovers May Be Tougher for Migraine Sufferers

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MONDAY, Oct. 19 (HealthDay News) — As if migraine sufferers didn’t already have enough pain, new research has found that they may also be more prone to hangover headaches.

U.S. researchers studied the effects of alcohol on a group of rats that experience recurrent migraines as well as a group of control rats that don’t get the headaches. The study authors found that the rats with migraines experienced more pain four to six hours after ingesting alcohol than the control rats.

“Our results suggest that dehydration or impurities in alcohol are not responsible for hangover headache,” Michael Oshinsky, an assistant professor of neurology at Jefferson Medical College of Thomas Jefferson University, and a member of the Jefferson Headache Center team, said in a university news release.

“Since these rats were sufficiently hydrated and the alcohol they received contained no impurities, the alcohol itself or a metabolite must be causing the hangover-like headache. These data confirm the clinical observation that people with migraine are more susceptible to alcohol-induced headaches,” Oshinsky added.

The study was scheduled to be presented at the annual meeting of the Society for Neuroscience, held Oct. 17 to 21 in Chicago.

The researchers are now studying the mechanism for causing a headache, along with the metabolites of alcohol that trigger hangover headaches.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about migraine.

– Robert Preidt

SOURCE: Thomas Jefferson University, news release, Oct. 18, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.



BusinessWeek: LifeStyle

ADHD drugs do not increase heart problems in kids: study

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By Julie Steenhuysen


CHICAGO |
Tue Nov 1, 2011 10:01am EDT


CHICAGO (Reuters) – Stimulants used to treat attention deficit hyperactivity disorder do not increase the risk of heart attacks, strokes or sudden death, U.S. researchers said on Monday, in a finding that should reassure millions of parents whose children take the drugs.

CHICAGO (Reuters) – Stimulants used to treat attention deficit hyperactivity disorder do not increase the risk of heart attacks, strokes or sudden death, U.S. researchers said on Monday, in a finding that should reassure millions of parents whose children take the drugs.

Researchers studied the medical records of more than 1 million children and young adults aged 2 to 24 who were taking or had taken stimulants such as Ritalin or Adderall and found no sign of increased risk of heart problems.

“We don’t see any evidence of increased risk,” said Dr. William Cooper of Vanderbilt University, whose study was published in the New England Journal of Medicine.

The study in children is the first of three commissioned by the U.S. Food and Drug Administration to understand the potential heart risks of the drugs after U.S. and Canadian regulators received a number of reports in 2006 of heart attacks, strokes and sudden cardiac arrest in children taking the medications.

The reports prompted several FDA advisory committee hearings on heart problems, and Health Canada temporarily suspended marketing of ADHD drugs.

The concerns also prompted the American Heart Association to issue guidelines suggesting that children who were just starting to take the drugs should be tested for potential underlying heart problems.

“There was a lot of concern and confusion among families and providers about what the best approach would be to treating kids who had ADHD and who might benefit from these medicines,” Cooper said by phone.

COMMON CHILD DISORDER

ADHD is one of the most common child mental disorders, affecting around 3 to 5 percent of children globally.

Children with ADHD are excessively restless, impulsive and easily distracted, and often have trouble at home and in school. There is no cure, but the symptoms can be kept in check by a combination of behavioral therapy and medication.

In the United States, some 2.7 million people have prescriptions for ADHD drugs including Novartis’ Ritalin, known generically as methylphenidate, Johnson & Johnson’s Concerta, Shire’s Adderall and Vyvanse and Eli Lilly’s Strattera.

For the study, Cooper’s team used prescription data from four large, geographically and demographically diverse health plans on 1,200,438 children and youth, including both current and past users of the drugs. They checked health records for evidence of heart problems, including heart attacks, strokes and sudden cardiac deaths, in children who were currently taking the drugs or who had taken them.

The team found no increased risk of heart problems for either current or past users of the drugs. Yet because there were so few cases of serious heart problems — just 81 — the study may not have been large enough to detect it.

But even if there were a risk of heart problems, it is extremely slight, Cooper said.

FDA spokeswoman Sandy Walsh said in an e-mail the FDA continues to recommend that the drugs not be used in patients with serious heart problems.

The agency is expected to release fuller guidance later on Tuesday.

(Editing by Philip Barbara)


Reuters: Health News