The Health Shopper

Los Angeles Times consumer affairs reporter David Lazarus has written an informative primer on some of the key differences between drugs and dietary supplements such as vitamins. The key difference: Unlike pharmaceutical drugs, which must go through rigorous testing to prove their safety and effectiveness, supplements don't undergo any scrutiny unless complaints about their safety start to pile up. 

And pile up they have, at least in a couple cases. In the past month, the CEO of Enzyte-which offered "natural enhancement for men"-was sentenced to 25 years in prison "for bilking customers out of $100 million." The manufacturer of Airborne-a common herbal supplement that individuals take to ward off colds-has paid $30 million in fines for making unsubstantiated claims.  And a recent study in the Journal of the American Medical Association found that supplements with the chemical Ayurvedic can lead to dangerously high levels of metals in the bloodstream.

A new clinical trial has found that Vytorin, a cholesterol drug with $5 billion in annual revenue taken by 3 million Americans, doesn't lower heart disease risk but may increase cancer risk. The limited good news from the trial is that, according to Business Week, is that the increase in cancer risk has not been proven conclusively, and since there is no clear cause for an increase in cancer risk and other trials have not shown similar results, it is possible that the results were ultimately a fluke.

Still, not good news.  A few months ago, the leading professional group for cardiologists recommended against prescribing Vytorin, though some patients are still on the drug.  Definitive proof about the drug's effectiveness is expected in 2012.

The Environmental Working Group has released a study finding that only a small percentage of commonly used sunscreens adequately protect consumers from sun exposure and potential skin cancers.  According to the study, just 15 percent of available sunscreens meet the group's standards for adequate protection against UVA and UVB rays.  As the San Francisco Chronicle notes, sunscreens that offer inadequate protection can give people a false sense of security against skin cancer-including serious skin cancers such as melanoma-and provoke them to spend more time exposed to sun than they otherwise should.

For the organization's list of the most protective sunscreens, see here.

Over at Freakonomics, health writer Julie Salamon tells the story of a college student who, in response to a high fever, went to an emergency room, was given some Tylenol and charged $1,089.50. Naturally, Salamon points out that $1,000 for a Tylenol seems a bit excessive. In defense of the hospital, prominent doctor and medical blogger Kevin, M.D. argues that the patient wasn't just paying for the Tylenol, but for the doctor's opinion and space in the hospital itself, and that the charge for the space and labor was fair.

Regardless of one's feelings on the matter, it's important to remember that hospitals-particularly emergency room visits-are expensive. As Consumer Reports points out in a new article on managing hospital visits: Save the ER for emergencies. For minor aches and illnesses, it's a better idea to look for an urgent care facility or call the family doctor first.

On the other hand, in a true emergency-such as sudden, severe chest pain, shortness of breath dizzying headaches, major blood loss-get to the hospital as soon as possible.  And don't drive yourself.

Check out the rest of Consumer Reports' advice here.

Business Week has a long feature that suggests that many colleges and universities offer inadequate coverage to their students. Many insurance plans have low caps on insurance reimbursements-for example, Connecticut College enrolls its students in an Aetna sponsored plan that caps its reimbursements at $10,000, while other colleges, such as Ross University, have plans with daily reimbursement limits that don't cover hospital expenses. According to a recent report by the General Accounting Office, more than 50 percent of college students have health plans with benefit limits of $30,000 or less.

Business Week also notes that in many instances, college students and their families are spending nearly as much on these inadequate plans as they would spend buying coverage in the individual market.   

A new study from the Kaiser Family Foundation and the Urban Institute suggests that for every percentage point increase in unemployment, 1.1 million more Americans will lose health coverage. An additional 600,000 children and 400,000 adults, according to the study, will move onto public insurance programs such as Medicaid and S-CHIP, which would cost a total of $3.4 billion in state and federal revenues. The New York Times notes increasing health costs coupled with concerns about the economy is also impacting individuals with health coverage. In a recent poll cited by the Times, 42 percent of adults said that someone in their family had foregone medical treatment due to cost.

The New York Times has an interesting article on some of the challenges that early retirees face in finding health insurance. The article notes that for most people-especially those with no existing medical concerns-"the best, least-expensive option is to buy an individual policy" rather than opt into COBRA coverage through an employer. The story focuses on a couple in their early 60s who decided to leave their jobs before they were eligible for Medicare who were able to find an individual insurance policy for about $400 a month, which was about half the cost of paying for COBRA coverage. The couple did, however, have to spend some time shopping around due to some minor pre-existing medical conditions.

The article also offers another key point for early retirees: When leaving a job, individuals have 60 days to start COBRA coverage-that is, opt to pay to remain on an employer's plan-or else lose the option. As the Times notes, many early retirees may want to opt into COBRA initially until they have found coverage elsewhere.

Consumers paid less for drug co-pays in 2007 than they did in 2006, according to a new study from Express Scripts. Although the decrease in the average co-pay was small, it stemmed from smart consumer behavior. Since 2002, consumers have switched over to generic medications in large numbers, as generic drugs now account for 64 percent of prescriptions, up from 42 percent in 2002. According to Express Scripts, consumers save an average of $15 per prescription when buying generic.  

A couple months ago, we noted that Fair Issac has partnered with Tenet Hospitals and other partners to develop a medical credit score. Today's Wall Street Journal examines the trend of hospitals examining patient finances after billing, which has drawn complaints from consumer rights groups who worry that hospitals will use credit ratings to determine whether or not to provide elective and other non-emergency care. Consumer groups also worry that hospitals could force individuals to tap into credit lines or other assets in order to cover the costs of bills.

Hospital officials, on the other hand, say that they are not using financial information to deny care but to direct charity care to the neediest patients. For example, one woman qualified for charity care knee surgery after providing a detailed financial history to demonstrate that she couldn't afford to pay the bills on her own. At the non-profit hospital Orlando Regional Healthcare, billing staff are classifying patients by likelihood of paying and focusing on getting "moderate risk" patients to pay their bills before they become delinquent.

According to a new study in Health Affairs, national spending on health care will double by 2017 to $4.3 trillion, assuming health spending continues to increase annually by 6.7 percent. As a result, estimates place per capita health spending in 2017 at $13,101, up from $7,026 in 2006. Because the study's authors project increases in health spending to outpace national economic growth, they suggest that by 2017, health costs will total 19.5 percent of the GDP.

Although the study's authors estimate increases in all areas of health spending, they project that the largest growth will occur in Medicare and other federal programs as baby boomers get older and move from private insurance to Medicare. Medicare alone, with a projected price tag of $844 billion, will account for one fifth of health spending by 2017, while the government's total share of health spending will increase to $2 trillion. Prescription costs are also expected to rise quickly from $761 per person in 2007 to $1,537 per person in 2017. The study's authors see out-of-pocket spending increasing to $464.3 billion in 2017, up from $269.3 billion in 2007.