Current Events in December 2016

There's a lot of talk about the high cost of health care, but do you know which conditions contribute most to health care spending?

If you said diabetes, you're right -- a new study finds diabetes costs $101 billion annually in diagnosis and treatment and is growing 36 times faster than the cost of heart disease, the leading cause of death and the second most-expensive condition. 

"While it is well known that the US spends more than any other nation on health care, very little is known about what diseases drive that spending." said Dr. Joseph Dieleman, lead author of a paper published in JAMA and Assistant Professor at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. "IHME is trying to fill the information gap so that decision-makers in the public and private sectors can understand the spending landscape, and plan and allocate health resources more effectively."

In fact, the study found that just 20 conditions make up more than half of all spending on health care in the United States.

While diabetes and heart disease primarily affected consumers 65 and over, lower back and neck pain, the third-most-expensive condition, primarily strikes adults of working age.

These three top spending categories, along with hypertension and injuries from falls, comprise 18% of all personal health spending and totaled $437 billion in 2013.

This study distinguishes between spending on public health programs from personal health spending, including both individual out-of-pocket costs and spending by private and government insurance programs. It covers 155 conditions.

$2.4 trillion

In addition to the $2.1 trillion spent on the 155 conditions examined in the study, Dr. Dieleman estimates that approximately $300 billion in costs, such as those of over-the-counter medications and privately funded home health care, remain unaccounted for, indicating total personal health care costs in the US reached $2.4 trillion in 2013.

Other expensive conditions among the top 20 include musculoskeletal disorders, such as tendinitis, carpal tunnel syndrome, and rheumatoid arthritis; well-care associated with dental visits; and pregnancy and postpartum care.

Other key findings include:

• Women ages 85 and older spent the most per person in 2013, at more than $31,000 per person. More than half of this spending (58%) occurred in nursing facilities, while 40% was expended on cardiovascular diseases, Alzheimer's disease, and falls.
• Men ages 85 and older spent $24,000 per person in 2013, with only 37% on nursing facilities, largely because women live longer and men more often have a spouse at home to provide care.
• Less than 10% of personal health care spending is on nursing care facilities, and less than 5% of spending is on emergency department care. The conditions leading to the most spending in nursing care facilities are Alzheimer's and stroke, while the condition leading to the most spending in emergency departments is falls.
• Public health education and advocacy initiatives, such as anti-tobacco and cancer awareness campaigns, totaled an estimated $77.9 billion in 2013, less than 3% of total health spending.

Top 10 diseases

The top 10 most costly health expenses in 2013 were:

1. Diabetes - $101.4 billion

2. Ischemic heart disease - $88.1 billion

3. Low back and neck pain - $87.6 billion

4. Hypertension - $83.9 billion

5. Injuries from falls - $76.3 billion

6. Depressive disorders - $71.1 billion

7. Oral-related problems - $66.4 billion

8. Vision and hearing problems - $59 billion

9. Skin-related problems, such as cellulitis and acne - $55.7 billion

10. Pregnancy and postpartum care - $55.6 billion

Toyota Motor Engineering & Manufacturing is recalling 12 model year 2016 Avalon, and 2017 Camry vehicles manufactured August 3, 2016, to September 12, 2016.

The front passenger knee air bag module may have been attached to the lower instrument panel with incorrect fasteners.

If the air bag was installed with incorrect fasteners, the fasteners may become loose over time, affecting the air bag deployment and increasing the risk of injury.

What to do

Toyota will notify owners, and dealers will inspect the fasteners, and if necessary, replace the instrument panel brace and body bracket and reattach the air bag assembly, free of charge. The recall is expected to begin in December 2016.

Owners may contact Toyota customer service at 1-800-331-4331. Toyota's number for this recall is G05.

H-E-B, in cooperation with Dawn Food Products, is recalling certain bakery products that may be contaminated with Salmonella.

There have been no reports of illness to date in connection with these items.

The following products, sold in H-E-B and Mi Tienda in-store bakeries in Texas and Mexico, are being recalled:

What to do

Customers who purchased the recalled products should return them to the store for a full refund.

Consumers with questions or concerns may contact H-E-B customer service at 1-855-432-4438, Monday through Friday from 8 a.m. to 8 p.m. (CST).

In 1997, ExxonMobil’s then-chairman Lee Raymond told the World Petroleum Congress that fossil fuels are not causing the earth’s temperature to rise. Fifteen years later, ExxonMobil’s CEO (and soon-to-be Secretary of State) Rex Tillerson began acknowledging that man-made climate change is real, but he argued that mankind still shouldn’t cut back on fossil fuels, describing global warming as a problem that can be solved with adaptation and engineering.

“You'd save millions upon millions of lives by making fossil fuels available to parts of the world that don't have it," he told the Council on Foreign Relations in 2012.

It’s assertions like those that have attracted scrutiny from state government officials who are currently investigating ExxonMobil over its decades-long public relations campaign casting doubt on global warming. Earlier this year, a group of Democratic state Attorneys General formed the group AGs United for Clean Power. Several have also launched civil investigations into ExxonMobil, demanding a long list of documents and records pertaining to public statements that company executives like Tillerson have made about climate change.

Exxon Sues AGs investigating it

ExxonMobil has responded by going on the offensive. Most recently, ExxonMobil filed a motion in court arguing that clean power-loving Attorney Generals are discriminating against the world’s largest publicly traded oil company. “ExxonMobil asserts a First Amendment interest to be free from viewpoint discrimination,” ExxonMobil and its team of attorneys wrote in December 19 court filings.

Who is behind the supposed discrimination? Massachusetts Attorney General Maura Healey and New York AG Eric Schneiderman. Both are evaluating whether ExxonMobil violated their states' consumer protection statutes. “Specifically, the investigation seeks information regarding whether Exxon may have misled consumers and/or investors with respect to the impact of fossil fuels on climate change, and climate change-driven risks to Exxon's business,” Healey’s office writes online.

ExxonMobil countered the civil investigations by filing a lawsuit earlier this year against Healey and Schneiderman, demanding its own stack of records and depositions from the AGs and the environmental groups that they have possibly allied with.

"Content-based discrimination"

In its December 19 filing, ExxonMobil argues that it should not have to turn over its communications or records, especially records relating to think tanks that have minimized the risks of global warming. “The CID [civil investigation demand] requests ExxonMobil’s documents and communications with 12 named organizations, all of which have been identified by advocacy organizations as, at times, opposing the views and policies favored by those advocacy organizations with respect to climate change science or policy,” the corporation writes in its December 19 motion.

“A state official’s targeting of speakers based on their views is improper content-based discrimination,” Exxon adds. The filing neglects to mention that ExxonMobil has a well-documented history of funneling millions of dollars into think tanks that subsequently cast doubt on global warming.

Exxon subpoenas green think tanks

As part of its lawsuit against the AGs, ExxonMobil has previously filed subpoenas demanding records from several environmental advocacy organizations, including the Union of Concerned Scientists and 350.org.

“They’ve hired a team of expensive lawyers to try and intimidate us into handing over all of our internal emails, documents, and communications,” 350.org Executive Director May Boeve wrote to website subscribers earlier this month, in a mass email asking for $15 donations. “Not long after we got the Exxon subpoena, we learned that the company's CEO Rex Tillerson was being considered for the position of Secretary of State. “

Attorneys for the Union of Concerned Scientists fired back to ExxonMobil’s subpoena in November with a letter pointing out that, according to the Union’s own research, “ExxonMobil and other companies had learned of the serious risk of climate change by 1988 at the latest...the fossil fuel companies then publicly denied or minimized the risks and secretly funded purportedly independent, contrarian climate research.”

"You need to contact our government and public affairs hotline," a person who answered the telephone at the office of ExxonMobil's in-house attorneys said when we called.

Exxon Recent Motion by Amy Cranks on Scribd