www.DukeEmployees.com - Duke Energy Employee Advocate
Health - Page 3
"when the going gets ugly, the ugly get going"
Verify New Medical CoverageEmployee Advocate – www.DukeEmployees.com – January 17, 2005
Duke continues to keep employees off balance by constantly tinkering with healthcare benefits. In 1996, healthcare benefits were completely changed. You can forget learning how the new system operates, because it constantly changes.
This year’s changes were said to have saved money for Duke. No savings were passed on to employees; their rates just did not get jacked up more this year.
Did you get a gnawing feeling when you were informed that you would be getting cheaper coverage? Cheaper does not necessarily mean better. Cheaper means less cost for Duke. Less cost usually means less value received.
A reader warns employees to check the status of their physicians with the new insurance program. The link below is to his message:
Bush Sides with Corporations on AsbestosEmployee Advocate – www.DukeEmployees.com – January 13, 2005
Did anyone really have any doubt which side G. W. Bush would take on asbestos illness compensation: employees or corporations? Bush is all for protecting corporation and getting them off the hook cheaply. Below is a USAction press release:
“We urge Congress to remember the innocent victims,” says USAction President William McNary
January 11, 2005
(Washington, DC)— As the Senate begins hearings on asbestos today, USAction President William McNary urged Senators to remember the innocent workers and their families who are the real victims, rather than the corporate wrong-doers. McNary released the following statement:
“President Bush missed an opportunity last week to demonstrate his concern for innocent workers and their families who were knowingly exposed to asbestos. He never once talked about the real tragedy: the healthcare crisis facing the tens of thousands of American workers who, without being told, were exposed to this deadly substance.
“The President didn’t talk about the horrible diseases that come from exposure, or the fact that asbestos manufacturers, and their insurers, have known for over half a century that the substance was deadly, and knowingly exposed workers anyway. He also neglected to mention that the victims—honest workers coming home from work—unwittingly took the poison home with them on their work clothes, and tragically exposed their spouses and children.
“Instead, the President used his bully pulpit last week to repeatedly make clear that his number one priority is to protect asbestos manufacturers, the insurance industry, HMOs, the pharmaceutical companies and the nursing home industry from being held accountable for poisoning their workers; for injuries from medical errors, harmful drugs and other products.
“USAction believes that the first step Congress should take is to ban asbestos. The starting point for a federal trust fund must be the needs of current and future workers, their families and others exposed to this deadly product, not the needs of the very industries that knowingly poisoned them.”
“We urge the Senate to support Senator Murray’s proposed ban on asbestos and to develop a trust fund that truly is fair to innocent workers and their families.”
GAO Not Under Bush’s ThumbEmployee Advocate – www.DukeEmployees.com – October 11, 2004
As the top government official, G. W. Bush has been using the federal agencies against the very people that they are supposed to support. But one agency stands out for not kowtowing to G. W. Bush’s whims: the Government Accountability Office (GAO). This is the agency that sued VP Dick Cheney for keeping the details of the Energy Task Force meetings hidden from the public.
Of course the GAO has more authority than a mere agency. It is the bipartisan investigative arm of Congress.
The GAO is still on a roll, according to The New York Times. The GAO charged that the Bush administration has improperly allowed some private health plans to limit Medicare patients' choice of health care providers. The elderly have been subjected to increased out-of-pocket costs. No money has been saved for the government as was predicted by Medicare officials.
All the ways the Bush administration has hurt the American citizens will not be fully known for some time. The most amazing thing is that on election day some citizens will cast their vote for more of the same!
Deadly SootEmployee Advocate – www.DukeEmployees.com – July 1, 2004
Evidence that soot in the air can be deadly has been accumulating for many years. After all these years, the Environmental Protection Agency (EPA) is talking about taking action.
The EPA has labeled the air in 22 states as being unhealthy because of microscopic soot – tons of it. The cause: power plants, diesel-burning vehicles, and factories.
On Tuesday, the EPA said 243 counties are probably in violation of the federal air standard for soot. Most of the offending counties are in the eastern third of the U. S.
EPA Administrator Mike Leavitt said reducing microscopic soot is ``the single most important action we can take to make our air healthier.'' He said that airborne soot causes thousands of cases of respiratory or cardiovascular illnesses annually. It causes 95,000 cases of bronchitis each year. Soot also results in 15,000 Premature deaths annually.
In 1997, the EPA issued a ''fine particulates'' standard. It was challenged by industry, all the way to the Supreme Court. The EPA won, but the new standard has still not been implemented.
The Super PollutersEmployee Advocate – www.DukeEmployees.com – June 3, 2004
Wednesday, the Commission for Environmental Cooperation and Reuters reported the biggest air polluters in the United States and Canada. The super polluters are: Coal and oil-fired power plants. Of the 50 top polluters, coal and oil-fired power plants filled 46 slots!
Coal plants are responsible for 64 percent of all mercury air emissions!
But hasn’t the Bush administration loosened the mercury emission standards for power plants? Yes it has! Citizens may be sicker and die sooner, but corporations will be raking in more money. It is fitting that the very top polluter is in the state that gave us G. W. Bush – Texas.
The only justice is that as the citizens die off from air pollution, so will the politicians and CEO’s. They will have to breathe the same dirty air. And, as long-winded as some of them are, they will be sucking in a lot more polluted air that the average citizen.
Medicare Bill Rewards Insurers and AARPEmployee Advocate – www.DukeEmployees.com – January 15, 2004
Harvard Medical School and Public Citizen researched the new Medicare Drug Bill and found what many people had already suspected. Bureaucratic cost will increase; Insurers and AARP will reap rewards. The study will be published in Friday's International Journal of Health Services.
Health care bureaucracy was found to have cost the US $399.4 billion, last year.
Study author, Dr. David Himmelstein, said “The recent Medicare bill means a huge increase in administrative waste and a big payoff for the AARP. At present, Medicare's overhead is less than 4 percent. But all of the new Medicare money, $400 billion - will flow through private insurance plans whose overhead averages 12 percent. So insurance companies will gain $36 billion from this bill. And the AARP stands to make billions from the 4 percent cut it receives from the policies sold to its members.”
Dr. Steffie Woolhandler, a study author, said “Hundreds of billions are squandered each year on health care bureaucracy, more than enough to cover all of the uninsured, pay for full drug coverage for seniors and upgrade coverage for the tens of millions who are underinsured. U.S. consumers spend almost twice as much per capita on health care as Canadians who have universal coverage and live two years longer. The administrative savings of national health insurance make universal coverage affordable.”
The Price of Cheap Medical AdviceEmployee Advocate – DukeEmployees.com - December 31, 2003
Virginia Anderson wrote about the importance of treating sprained ankles for the Cox News Service. Ignoring an ankle sprain can lead to a lifetime of problems.
Lamar Fleming, professor of orthopedics at Emory University, said “If they are properly treated, they do quite well. The problem is that they are not.”
This article contradicts the “money saving” advice offered in a booklet displayed in a Duke Energy clinic. The advice was basically that your ankle is probably not fractured, so don’t worry about it; just put ice on it! The booklet gave a lot more “cheap” medical advice. Chest pains are probably just indigestion or a muscle strain; no problem!
The real message in this booklet was clear: “ We do not care if you live or die; just do not use any insurance benefits!”
Top Scientists on Mercury PollutionHubbard Brook Research Foundation – Press Release – December 16, 2003
(December 15, 2003) Today, the Bush Administration is expected to release its new regulations regarding mercury pollution from electric utilities. The details of this rule were leaked to the media revealing less stringent standards than expected, delayed implementation and potential mercury trading among power plants.
In response to this announcement, some of the Nation's top scientists have come together for the first time, to release new and existing research pointing out the connections between emissions of mercury and mercury in fish and other aquatic life.
"Taken together, this science presents compelling information on the nature, extent and severity of the ecological consequences of mercury pollution associated with air emissions," says Dr. Charles Driscoll, professor of Civil and Environmental Engineering at Syracuse University and board member of the Hubbard Brook Research Foundation. "With a hazardous pollutant, such as mercury, we hope that science will play a central role in informing public policy," he adds.
Dr. Driscoll and his colleagues are releasing new findings and calling attention to recent research from across the U.S. to shed light on the extent of the mercury problem and the extent to which air emissions are responsible for high mercury in lakes, fish and loons. Specifically:
As part of this overall effort to disseminate current research, Dr. Driscoll and the Hubbard Brook Research Foundation have requested a briefing with EPA Administrator Michael Leavitt to present the latest science of mercury pollution.
The Hubbard Brook Research Foundation (HBRF) is a non-profit organization dedicated to improving the understanding and stewardship of terrestrial and associated aquatic ecosystems through scientific research, long-term monitoring, and public education. HBRF is affiliated with the Hubbard Brook Ecosystem Study which was founded in 1963 and is known world-wide for the discovery of acid rain in North America.
N.C. Worst in Air PollutionNC Public Interest Research Group – Press Release – December 6, 2003
North Carolina Worst In The Nation For Toxic Air Pollution: Pending EPA Decision May Let Largest Toxic Mercury Polluters Off The Hook
RALEIGH—Today, the NC Public Interest Research Group (NCPIRG), the Clean Air Task Force, and National Environmental Trust released a new report, "Toxic Neighbors." The study shows that power plants in North Carolina emitted more than 78 million pounds of toxic chemicals—including 2,956 pounds of toxic mercury—into the air in 2001, more than electric utilities in any other state. The EPA will decide how and whether to regulate toxic mercury pollution by December 15.
"Toxic pollution from power plants is dangerous, widespread, and largely preventable," said Elizabeth Ouzts, director of NCPIRG. "The EPA should require power plants to install the best available pollution controls, which would reduce the hazardous pollution documented in this report by 90 percent."
Mercury pollution is one of the most poisonous forms of air pollution. First emitted into the air, mercury settles in the beds of rivers, lakes, and streams. Fish such as king mackerel, bowfin, and largemouth bass accumulate mercury in their muscle tissue. Pregnant women place their fetuses at risk for brain damage and developmental delays when they consume mercury-contaminated fish. Women of child-bearing age, subsistence fishers, and recreational anglers are also at risk. Eight rivers, lakes and streams in North Carolina are under advisory due to mercury contamination.
According to Toxic Neighbors, the biggest emitters of toxic mercury in North Carolina were the Roxboro-Semora Plant in Person County, which released 680 pounds of mercury in 2001, and the Belews Creek plant in Stokes County, which emitted 480 pounds. These two plants also led the state in overall toxic chemical releases.
"Recent data collected by the Centers for Disease Control and Prevention revealed that one in 12 women of childbearing age in the U.S.—nearly 5 million women—have levels of mercury in their blood higher than EPA's safe threshold," said Martha Keating of the Clean Air Task Force, a co-author of the report. "This has enormous public health implications for our future generations."
The study is being released as the Bush administration is poised to propose standards for mercury emissions from power plants that fall far short of the requirements of the Clean Air Act and represent a significant weakening of the law. The Clean Air Act states that the EPA must require that utilities install the best performing pollution controls. The study documents that some existing controls on power plants can reduce mercury pollution by 90 percent.
However, an EPA proposal leaked Tuesday indicates that the Bush administration first plans to revoke the treatment of mercury as a hazardous air pollutant. This change means that power plants will no longer be required to install the maximum pollution controls at each and every plant and instead allows some plants to avoid making reductions by buying emissions credits from less-polluting facilities. Second, the Agency subverts its previous determination that under the Clean Air Act mercury could and should be reduced to the maximum extent possible, as much as 90 percent, by 2007, and instead allows five to six more times the mercury to be emitted for at least a decade longer.
"Pregnant mothers and our children are our most vulnerable citizens, and they face the greatest risks from even very small amounts of mercury exposures," said Richard Weisler, a Raleigh physician. "It would be a catastrophic mistake if we fail to require our power companies to use readily available air-cleaning methods to protect our children before they are harmed by mercury exposures."
In North Carolina, the recently-enacted "Clean Smokestacks" legislation requires reductions in soot and smog-forming pollution from North Carolina's power plants beginning in 2007, and is predicted to reduce mercury emissions by as much as 60 percent. However, the law does not require specific reductions in mercury or other toxic chemical releases.
"It's high time for the dirtiest power plants to reduce the threats that toxic pollutants pose to public health and the environment," said Ouzts. "The technology is here. We call on the Bush administration to drop their proposal to weaken current law and issue a rule that will protect public health by reducing power plant mercury emissions by 90 percent."
Toxic Neighbors evaluated the 2001 Toxics Release Inventory (TRI) data, the nation's database of toxic air, water and land pollution released each year. The data is the most recent TRI data available. The report shows that in addition to leading the nation in overall toxic chemical releases, North Carolina ranked 4th nationwide for emissions of dioxin and dioxin-like compounds.
"Power plants have released these harmful pollutants day in and day out for years," said Keating. "Electric utilities are the most widespread, long-lived industrial generators of toxic releases, not just in North Carolina, but across the entire United States."
NCPIRG is a statewide public interest advocacy organization.
The Clean Air Task Force is a non profit organization dedicated to restoring clean air and healthy environments through scientific research, public education and legal advocacy.
Employee Benefits Go SouthEmployee Advocate – DukeEmployees.com - September 21, 2003
Bloomberg.com posted Mr. Graef Crystal’s article about CEO pay going North at Duke Energy. The Boston Globe published Kimberly Blanton’s article about employee benefits going South. The interesting thing is that the two trends are happening simultaneously!
As CEO pay doubles, triples, quadruples, and quintuples, employees continue to lose more and more benefits. Many CEO’s already make hundreds of times more than their employees. But that is not enough. Millions of dollars per year in compensation is not enough. Employee benefits must be squeezed to provide more money for the CEO feeding trough.
A decade ago, two-thirds of Americans had employer paid health insurance. Two-thirds is not good enough, but it was a lot better than the numbers now. Less than one-half of employees currently have employer paid health insurance, according to the latest US Bureau of Labor Statistics. The majority of US workers have no paid health insurance, and usually receive less in total compensation. So, that leaves them with less money with which to buy private insurance. Many are deprived of paid health insurance and are also deprived of enough money to buy their own insurance.
The insurance that employees have left becomes less valuable each year. Some, such as Duke Energy employees, will have their insurance cut off at age 65. These employees will only have meager Medicare coverage. Corporations are also working to force those already retired into solely depending on Medicare.
John Edwards Wants Health StudyEmployee Advocate – DukeEmployees.com - August 26, 2003
Senator John Edwards wants the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) to review the Bush plan for lifting pollution controls.
The senator said “The least you can do is have somebody, the NIH or CDC, look at what effect it's going to have on public health. I think they refused to do it because they know what the answer would be.”
The Medicare Band-Aid ®Employee Advocate – DukeEmployees.com - August 22, 2003
The New York Times reported that the federal Medicare program may soon decide if an expensive lung operation would be covered. The treatment could be the last ray of hope for thousands of elderly patients. The problem is that Medicare benefits are shrinking to pay for tax cuts.
Many new medical treatments may not be available to those on Medicare. The way it usually works is that the doctors know what Medicare will not pay for and these treatments are not offered as an option for those unfortunate patients.
Patients have had to sue Medicare to get needed treatment. This is the system that most Duke Energy employees will be tossed into when they reach 65. The promised lifetime medical coverage has turned into a Band-Aid.®
Even the employees that have already retired and have company paid health coverage are at risk. The Equal Employment Opportunity Commission has proposed changing the rules so that these retirees can be forced into Medicare.
You may have to sue to get medical treatment and it looks like the only chance of receiving the pension that you were promised is to sue for it.
That’s the new trend. After working your whole life for certain benefits, you have to sue to stand a chance of receiving them!
Vapor BenefitsEmployee Advocate – DukeEmployees.com - August 12, 2003
Cash Balance Plans are not the only way employees are coming up short, according to The Wall Street Journal. You may find that your disability-income insurance is worthless, just when you need it.
Donya Anderson had $7.36 per month deducted from her paycheck for disability-income insurance, sold by UnumProvident. But when she needed the insurance, it was not there. Her claim was denied.
She made the reasonable decision to sue UnumProvident. She ran into one of the endless little hidden loopholes that the average employee could not possibly know about. The Employee Retirement Income Security Act (ERISA) exempts employer-sponsored pension plans from state law.
And, you thought ERISA was your friend! Not only that, but the Supreme Court has ruled that punitive damages can not be awarded in ERISA cases! The ERISA law and the Supreme Court teamed up to do Ms. Anderson in. They will be glad to do the same for you.
You could pay premiums on employer-sponsored health-care coverage for twenty years. When you have a claim, the insurance company could simply deny it and that’s the end of it!
ERISA laws were intended to protect pensions. But, now the law has migrated into other areas. And, not to the benefit of the employee. The law is protecting an entity that needs no protection – the insurance company.
Joseph Belth, professor emeritus for insurance at Indiana University in Bloomington, said “They've turned ERISA on its head. It was supposed to protect employees, and it's being used to protect insurers.”
A smoking gun was uncovered in 1995. A Provident Corp. memorandum written by a Provident assistant vice president stated: “…there are some gray areas, and ERISA applicability may influence our course of action… The advantages of ERISA coverage in litigious situations are enormous.”
Why does every good thing for employees always get perverted? One reason: employees do not pay enough attention to the sleaze bags that manage to get into Congress. If enough employees were to wake up to what is happening, the corporate toadies in Congress could be rendered ineffective in one election cycle. For good measure, the rest of them could be eliminated in the next election cycle.
It’s not that difficult. Just look at the candidates voting records. Those who give the store to the corporations should be showed the door. Until this happens, employees will continue to come up short on every turn.
U.S. Joining Suit Against MedcoWashington Post – by Charles Duhigg - June 25, 2003
Tuesday, June 24, 2003; Page E01
The U.S. attorney in Philadelphia announced yesterday that he is joining a complaint against Medco Health Solutions Inc. that alleges the nation's second-largest pharmacy-benefit manager improperly canceled prescriptions, switched medications without physician approval and sent patients partially filled orders.
The U.S. attorney's office has been investigating whistle-blower allegations against the company since 1999 and intends to file its own complaint in September, said Associate U.S. Attorney James G. Sheehan.
The government has decided to intervene in two lawsuits brought by three whistle-blowers. Those suits allege that Medco changed prescriptions without a physician's approval to favor more expensive drugs produced by Merck & Co. and induced physicians with false information to switch to higher cost Merck drugs. Medco also destroyed mail order prescriptions without filling them and in other cases mailed patients less than the number of pills ordered but charged for the full amount, the lawsuits allege.
Medco is a subsidiary of Merck.
"We know from industry studies that almost half of mail order participants will run out of medicine within two days if they fail to receive their new prescriptions," said Patrick L. Meehan, the U.S. attorney for the eastern district of Pennsylvania.
Medco officials contend that the allegations are untrue or "reflect years-old isolated issues that were identified and corrected," said Ann Smith, director of public affairs at Medco. At no time was the quality of patient care compromised, Smith said.
Most Americans know pharmacy benefit managers, or PBMs, from the plastic cards they hand over at local pharmacies when filling a prescription. Major employers and health plans hire these companies to negotiate with drug companies to control drug costs for plan enrollees, and to oversee the complex paperwork associated with filling prescriptions.
The Senate is considering plans to provide prescription drug coverage to the elderly that may enhance the clout of pharmacy-benefit managers, industry analysts say. The companies are expected to administer government drug spending under some plans, according to congressional testimony offered by the National Association of Chain Drug Stores, and to receive a larger share of government reimbursements for prescription drugs.
More than 62 million Americans get prescriptions processed through Medco, according to the company. Medco handles pharmacy benefits totaling nearly $30 billion per year, including $1.2 billion from Blue Cross Blue Shield as part of the Federal Employees Health Benefits Program.
George Bradford Hunt and Walter W. Gauger, who both worked as pharmacists in Medco's Las Vegas processing facility, and Joseph Piacentile, a physician, allege in their complaints that on busy days Medco would cancel or destroy prescriptions to avoid penalties for delays in filling orders. Customers would be told that the prescriptions had never been received, Sheehan said.
The company is also accused of fabricating records and, when the handwriting on prescriptions was unclear or difficult to read, simply guessing at what they said, according to Sheehan. The government's suit against Medco could ask for damages in the millions of dollars and new oversight systems.
Merck acquired Medco in 1993 at a time when other drugmakers were purchasing pharmacy-benefit managers. By the end of the 1990s, all pharmaceutical manufacturers but Merck had sold their units amid concerns that the drug companies would use the benefit managers to push their own drugs, rather than doing what was best for clients.
In 1998 Merck signed a settlement agreement with the Federal Trade Commission stating that "Medco has given favorable treatment to Merck drugs." Last December, Medco agreed to pay $42.5 million to settle a class-action lawsuit alleging that the company improperly promoted higher priced Merck drugs rather than seeking the best price from alternative pharmaceutical companies. Merck announced it intended to spin off Medco last year, but delayed the initial public offering of shares because of the depressed stock market.
Yesterday's announcement marks the first significant legal action by a federal agency against a pharmacy-benefit manager. Previously, attorneys general of at least 25 states have opened inquiries into Medco to determine whether it has violated state laws, and New York State Attorney General Eliot L. Spitzer said last Friday that his office was investigating another company, Express Scripts Inc., for allegedly overbilling state health plans…