Washington, D.C., United States (AHN) – The number of Americans heading abroad for medical care rose sharply last year amid high health care costs and a poor economy in the United States, according to medical tourism industry figures.

Some of their preferred locations for life-saving surgeries and other procedures are India and Mexico, the health information company Health Digital Systems reported.

Surgeries like hip replacements, dental implants and heart bypasses can cost half as much in Southeast Asia and Latin America compared with the United States.

Among the six million Americans who traveled abroad for medical care last year, 45 percent traveled to Asia, 26 percent to Latin America and 2 percent to the Middle East, according to industry statistics.

Health care officials in the countries treating foreigners are upbeat about their patients. Medical tourism, primarily from the United States and Europe, represents a nearly $100 billion a year industry.

Mexico’s Health Ministry recently produced a report saying “the globalization of health services can offer excellent medical care at lower costs than developed countries.”

The health ministry has developed a strategic plan to encourage medical tourism by continuing “the effort to improve the perception of public safety and promote [Mexico's] image as a global capital of culture and entertainment.”

Any success by Mexico’s health providers in reaching American patients is most obvious in border cities like Monterrey, Tijuana and Chihuahua, according to the Health Digital Systems. Pharmacies, hospitals and medical specialty practices have sprung up to take care of them.

However, patients also assume risks by trusting their health care to foreign medical standards.

Only 2 percent of Mexico’s hospitals have earned “Joint International Commission” certification.

The certification means a hospital and its staff have met international standards that would allow them to be reimbursed by foreign medical insurance companies.

India’s medical tourism industry is losing patients to competing hospitals in Singapore, Thailand and Malaysia amid concerns about poor sanitation.

Indian hospitals have been struggling with a “superbug” that is resistant to disinfectant.

As a result, some patients are reporting they become sick when they enter Indian hospitals for other treatments.

Nevertheless, the discount price of foreign medical treatment is creating a backlog of patients for hospitals with good reputations.

Mediescape, an Indian medical tourism company, reports that India’s hospitals offering medical services to patients from the United States and Europe say their booked up to December.

Between 15 percent and 20 percent of India’s hospital income now comes from medical tourism, according to industry data.

There were 800,000 foreign patients in India last year. They are expected to generate a $3 billion a year industry for India by 2015, up by more than a third from 2010.

Behind the figures on rising medical tourism is the desperation of patients who cannot afford health care in the United States, where about 40 percent of the population lacks adequate medical insurance, according to U.S. government statistics.

Some Americans are even treating themselves for serious ailments, not always with successful outcomes, according to a recent survey by TMD Limited, a medical tourism company.

“Today we are seeing many breast cancer patients that self-treated for years,” said Antonio Jimenez, a doctor raised in New Jersey who now runs the Hope4Cancer Institute in Mexico’s Baja California. “Unfortunately, cancer treatment is not a do-it-yourself project.”

Many of the women search for treatments on the Internet.

“We see more and more women who have spent thousands of dollars on supplements and wonder cures they used at home,” Jimenez said. “When those treatments fail, they look for a clinic that can help.”

The American Cancer Society reports that 230,480 American women will be diagnosed with breast cancer this year. Of those, 39,520 will die.

View full post on All Stories

Washington, DC, United States (KaiserHealth) – The end of federal stimulus spending is going to mean nothing but pain for state Medicaid programs in fiscal 2012.

State Medicaid spending is projected to grow by an average of 29 percent in the budget year that began July 1, the biggest increase in the history of the federal-state health insurance program for the poor and disabled, according to a report released Thursday.

The recession drove up Medicaid enrollment sharply, but the federal government stepped in with extra funds beyond its usual share to help states cover the costs. Now, states are scrambling to make up for the end of billions of dollars in federal stimulus funding that helped sustain the program from March 2009 through June 2011. The huge jump in their Medicaid costs should prove temporary, assuming that the economy continues to improve. Typically, state Medicaid spending rises 5 percent to 10 percent annually.

Both the 2009 economic stimulus law, which provided an additional $87 billion in federal funding for Medicaid, and the 2010 federal health overhaul prohibited states from tightening eligibility requirements. So states have had to look elsewhere for cuts to make up for the loss of the extra federal funds.

“On a bad day a Medicaid director can feel like a Sherpa climbing Mount Everest,” said Valerie Harr, New Jersey’s Medicaid director.

To counter the cost surge in Medicaid, which covers 60 million people and typically accounts for a quarter of state budgets, nearly every state is either reducing benefits, cutting fees to doctors and hospitals, or both, according to the report by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured. (KHN is an editorially independent program of the foundation).

“This is a huge challenge for states, particularly with the demands on their already limited administrative resources,” said Robin Rudowitz, associate director of Kaiser’s commission.

Diane Rowland, executive vice president of the foundation and the commission’s executive director, said the combination of two recessions since 2001 “and a decade of constrained spending has left no cushion, and many of the latest cuts will hit at the core of the Medicaid program.”

Although states are bearing a bigger share of the Medicaid burden this year than they have in the recent past, overall Medicaid spending (state and federal dollars) is projected to grow by only 2.2 percent, the lowest amount since 2006, the Kaiser report said. That is because the stimulus funding ended, and program costs are stabilizing as the national economy shows tentative signs of recovery and enrollment growth slows.

To get through the current budgetary crunch, here’s some of what states are doing to control costs, according to the 11th consecutive Kaiser survey of state Medicaid directors:

Eighteen states in both fiscal 2011 and 2012 reported eliminating, reducing or restricting benefits. The most common were cuts to dental, therapies, medical supplies and durable medical equipment, and personal care services.

Five states in fiscal 2011 and- states in fiscal 2012 increased co-payments or imposed new ones on recipients. In contrast, only one state did so in 2010. Most copayment changes were for pharmacy and emergency room visits.

Thirty-nine states lowered provider payment rates in fiscal 2011, and 46 states plans to do so this year.

Seventeen states in fiscal 2011 and 24 states in fiscal 2012 added to the number of Medicaid recipients who are covered by private managed care companies.

Although Medicaid enrollment growth has slowed this year, an estimated 16 million more people will be covered under the program starting in 2014 as a result of the 2010 Affordable Care Act. A new study by Harvard School of Public Health researchers published in the journal Health Affairs suggests that figure could actually range from a low of 8.5 million to a high of 22.4 million.

The federal government will pick up 100 percent of costs for these newly eligible recipients initially, decreasing to 90 percent in 2020.

The 26 states challenging the constitutionality of the federal health law in Florida v. HHS have argued that the Medicaid expansion places an unfair burden on them.

Today, the federal government pays on average 56 percent of Medicaid costs, though its share is higher in the poorest states.

Enrollment in Medicaid has grown rapidly since 2006 as the economy unraveled and millions of people lost their jobs and their health benefits. But the pace slowed in fiscal 2011, when enrollment rose 5.5 percent; states project a 4.1 percent enrollment increase in 2012, the report said.

Darin Gordon, Tennessee’s Medicaid director and vice president of the National Association of Medicaid Directors, said tax revenues are up in his state but not enough to keep up with rising Medicaid costs. “Things are not in an ideal state, as the state is still trying to climb out of a hole, but we are seeing some modest revenue growth,” he said.

He said when federal stimulus money went away, the state took money it had diverted to other state programs the past two years and allotted it to Medicaid.

While the financial picture is brightening, Gordon worries the congressional super committee will suggest major cuts in Medicaid. “Medicaid is very much on the table,” he said.

Jordan Rau contributed to this article.

– Provided by Kaiser Health News.

View full post on All Stories

Harare, Zimbabwe (IRIN) – Zimbabwe’s small-scale farmers are favoring tobacco over maize because they are paid immediately on delivery, while the Grain Marketing Board (GMB), the state-run cereal distribution monopoly, often takes months to pay for the staple, say some small-scale farmers.

The country has suffered consistent bouts of food insecurity since 2000 after President Robert Mugabe’s ZANU-PF implemented its fast track land reform which saw thousands of white farmers displaced, often violently, to make way for landless black Zimbabweans.

Tobacco production – a major foreign currency earner – plummeted from 237 million kg in 2000 to 49 million kilograms in 2008. Production has since recovered and the Zimbabwe Tobacco Association (ZTA) said 132 million kg was auctioned in 2011.

The profile of tobacco farmers has changed in the last decade. Prior to 2000, 1,500 of the then about 4,500 commercial farmers produced 97 percent of the tobacco delivered to sales floors, while other commercial farmers generally shunned maize production because of price controls – which remain – and opted for cash crops such as paprika, cut flowers and cotton, while growing yellow maize for stock feed.

Cereal production for food security before 2000 was largely the domain of small farmers who benefited from the sophisticated agricultural input system which supported commercial farmers and were able to easily source cheap fertilizer and seeds. The disruption of commercial farming activities also saw the collapse of Zimbabwe’s agricultural input industries.

ZTA’s chief executive officer, Rodney Ambrose, told IRIN 67,000 tobacco growers – resettled on former white farmland – registered in 2011, of which only about 17,000 were considered large growers, including 300 white farmers still active in the sector, and that by and large the quality of tobacco delivered to the auction floors was “very good”.

Samuel Chizemo, a new tobacco farmer in Karoi about 150 kilometers north of Harare, told IRIN more farmers were opting to grow tobacco in place of maize, because of GMB delays in payment, although some was grown for personal consumption.

“Tobacco is a cash crop and unlike other crops which are delivered to the GMB we get paid cash on delivery,” he said and estimated he earned about US$8,000 from his tobacco crop this year and was paid promptly.

Some farmers, he said, were forced to sell the maize to third parties at a lower price than the controlled price of US$285 a ton, so it was the middlemen that profited from the grain, who could afford to wait for payment from the marketing board.

The USAID-funded Famine Early Warning Systems Network (FEWS NET) said in its September 2011 fact sheet that about 1.68 million people would require emergency food assistance during the lean season, from January to April 2012. This was a 12 percent decline from the previous year for the same period.

Chizemo is one of 36 small-scale farmers working six hectare divisions of formerly white-owned farmland which was redistributed in 2001. They are all cultivating tobacco as contract farmers.

This year the average price of tobacco per kg was $2.73, slightly lower than the previous year of US$2.89.

Hard beginnings

Initially, Zimbabwe’s hyperinflationary environment – which was effectively ended through the scrapping of the local currency and its replacement in 2009 with the US dollar, Botswana pula and South African rand – financial difficulties, and the farmers’ inexperience of growing and curing tobacco hamstrung their first attempts in 2003.

“Besides us not having the know-how, it is a very expensive crop to grow,” Chizemo said.

Irrigation systems were also removed by the evicted farmer, which limited the area under cultivation, as the new farmers had to carry drums of water from a nearby river to ensure the crops did not wither in the early stages.

The refusal of banks to grant loans to the new farmers because of concerns over the security of land ownership saw the Tobacco Industry and Marketing Board (TIMB) petition President Robert Mugabe’s ZANU-PF government in 2004 to permit tobacco companies to offer farmers contracts whereby the necessary inputs, such as fertilizer and chemicals, were provided ahead of the planting season.

Under the contract agreement the farmers must sell to an agreed auctioneer until they have paid the loan for the inputs and are then free to sell the surplus to whoever they choose.

New farmers were also offered advice, assisted in the paying of wage bills and in some cases supplied with food.

However, it was the scrapping of the local currency, which saw tobacco’s renaissance.

“Tobacco growing is making a big difference to our lives,” Thomas Gwata, 28, from the Nyazura area east of Harare, who started tobacco farming in 2006 on a formerly white-owned farm that was subdivided among 65 small farmers, who made thousands of dollars from this year’s crop.

The farmers also lack access to a curing facility.

“The farmer who took over the farm infrastructure does not allow us to use the [curing] barn as he says it’s on his land,” he told IRIN. “He is a cellphone farmer,” a term describing new farmers who received land, but are employed elsewhere and conduct their farming activities by calling their workers on cellphones.

Gwata and his fellow small-scale farmers built their own curing barn, but it was not as efficient as the barn constructed by the former white farmer.

Tree-felling

Without a coal supplier the tobacco farmers have resorted to tree-felling to get fuel for tobacco curing. “This is causing serious deforestation but we really do not have a choice,” he said.

“We have the land but we are not benefiting enough; agriculture is the driver of our economy so government should seriously look into putting money into the sector,” said Gwata. That may not happen any time soon though as the government remains cash-strapped.

TIMB chief executive officer Andrew Matibiri said the new farmers had also yet to come to grips with the tobacco industry systems, including notification of how much of the product they intended to grow.

“Some farmers are not aware of this and just bring their crop to the already overcrowded three auction floors in Harare which were designed for 4,000 growers,” he said.

However, Matibiri said the sector was being rejuvenated. “Besides earning the country much needed foreign currency, tobacco is now benefiting thousands of families rather than the small minority who grew it before.”

He forecast that tobacco production could grow to 350 million kg annually in three to four years – provided there was adequate financial support – thanks to demand from the European Union and China, which each purchase about 40 percent of the country’s tobacco crop.

im/go/cb

– Provided by Integrated Regional Information Networks.

View full post on All Stories

Dhaka, Bangladesh (AHN) – Bangladesh is keen to send thousands of workers to Libya who fled the beleaguered country in April.

Khandker Mosharraf Hossain, the government minister for expatriates’ welfare and overseas employment, on Sunday said officials plan to resend tens of thousands of construction workers and other employees back to Libya.

The Bangladesh embassy in the Libyan capital of Tripoli is negotiating with several Korean, Japanese and other private companies who had employed Bangladesh migrant workers but who were repatriated soon after the country plunged in civil war that ended last week with the death of dictator Muammar Gaddafi.

Diplomats in Tripoli said many international companies that shut down factories during the violence were also keen to reinstate Bangladeshi workers.

Despite its poor economy, Bangladesh had to bring home at least 36,000 migrant workers who had abandoned their jobs in Libya after the outbreak of civil unrest in North Africa.

International Organization for Migration (IOM) helped repatriate panic-stricken workers who poured into the neighboring countries of Tunisia and Egypt.

Hossain is confident that the country will be able to send tens of thousands of workers as there is need of a huge workforce to rebuild Libya.

Thousands of Bangladeshi doctors, nurses and engineers have opted to stay back at their work station in Libya. In fact they were asked not leave the workplace by employers, despite risk of their life during the eight months civil war.

View full post on All Stories

Washington, DC, United States (AHN) – The economy is weak in much of the nation, but it is still growing slightly and is not in recession, according to the Federal Reserve’s latest outlook released Wednesday.

According to the so-called Beige Book, although the country does have a robust economy, many districts still have growth in at least the “modest” or “slight” range.

The book is a summary of outlooks from the 12 district banks across the country published by the Federal Reserve eight times a year.

Fed officials say that overall economic activity in September continued to expand. Moreover, business spending increased a bit while consumer spending was up in most districts.

View full post on All Stories

New York City, NY, United States (AHN) – U.S. stocks sold-off on Wednesday dragged down by disappointing earnings from Apple and weak economic data that revealed the U.S. economy continues to grow at a weakened pace.

The Dow Jones Industrial Average closed down 72.43 to finish the day at 11, 504.62.

The Standard & Poor’s 500 Index fell 15.50 to close at 1,209.88. The tech heavy NASDAQ sunk 53.39, or 2.05 percent, to 2,604.04. Gold lost just over $2 an ounce and oil closed a hair lower at $86.09 a barrel.

Shares of Apple plunged 23.62, or more than 5 percent, closing at 398.62. The iPhone, iPod, and iPad maker failed to impressive analysts with its weaker than expected earnings. Shares continued to decline in after hours trading.

Trading was light on Wednesday as nervous, cautious and hesitant investors continue to sit on the sidelines as volatile markets and geo-political risks persist.

View full post on All Stories

New York, NY, United States (AHN) – U.S. stocks staged a late day rally Tuesday on hopes of a European rescue agreement.

The Dow Jones Industrial Average soared, closing up 180 points. The S&P 500 Index was better by 42 points and the NASDAQ rose more than 26 points.

Shares active in the session included investment banking behemoth Goldman Sachs. The firm reported its only second quarter loss ever since going public, but managed to finish the day up 5.35 points to close at $102. 25. Bank of America, which reported an impressive comeback from the same period a year earlier, jumped over 10 percent to finish at $6.64. Shares of tech giant IBM dropped more than 4 percent despite reporting a 7 percent increase in third quarter earnings. Dragging IBM lower were comments from the company stating that the stronger U.S. dollar has eaten away at its backlog and revenue.

Stocks opened lower Tuesday after the Producer Price Index pointed at inflationary pressures for the U.S. economy. But by mid-afternoon the bulls took over as speculation that an agreement would soon be reached over the mounting euro zone debt crisis.

Oil finished at $88.43 a barrel and gold shined brighter by $10 an ounce closing at $1663.30.

View full post on All Stories

Mooresville, NC, United States (AHN) – Looks like things are not improving at the home improvement retailer Lowe’s.

The Mooresville, NC-based company closed 10 underperforming stores Sunday. The retail giant said it plans to close another 10 stores in a month’s time in 15 states and eliminate 1.950 jobs. Before the closure, Lowe’s operated 1,750 stores nationwide.

The company said the move will allow it to focus on more profitable locations. Lowe’s also announced that it would cut the number of stores it opens annually in North American to between 10 and 15 starting in 2012 from the projected 30.

In August, Lowe’s warned that weather conditions and consumers worries about the ailing economy were hurting traffic and sales at its stores, and the company lowered its yearly forecast.

Shortly after 1 p.m. Monday, with the Dow down almost 200 points, shares of Lowe’s were up nearly 1 percent trading at $21.

View full post on All Stories

Harare, Zimbabwe (IRIN) – Stallholders at the Mupedzanhamo market on the outskirts of Zimbabwe’s capital, Harare, thought they were immune to the 2008 Indigenisation and Economic Empowerment Act, which requires large businesses such as banks and mining companies to relinquish at least 51 percent of their shares or interests to indigenous Zimbabweans.

They were wrong. Bustling Mupedzanhamo, where shoppers can buy anything from hairpins to refrigerators, has for many years provided traders with a small income and an escape from the country’s economic woes, but recently groups of youths have descended on the market, brandishing letters they claim authorize them to eject any trader that they believe is opposed to the black empowerment program.

Miriam Raradza, 38, a stallholder and widow living in the populous nearby suburb of Mbare, was forced out of the market last month after they accused her of belonging to the opposition Movement for Democratic Change (MDC) led by Morgan Tsvangirai, the prime minister in a coalition government formed in early 2009.

”They accused me and other stall owners of belonging to the MDC, which they said is opposed to indigenisation, and said we should stop doing business at Mupedzanhamo. Hundreds of people who are known MDC supporters have been booted out since the beginning of this year,” Raradza told IRIN.

She said members of the Chipanganos – a gang with a reputation for violence, based in Mbare and thought to have links with President Robert Mugabe’s ZANU-PF party – had hijacked the stalls and, in some cases, also the goods that their victims were selling, she said.

”I have been robbed of the only source of income that I had for about eight years. The money that I realized from the sale of used clothes was enough to send my three children to boarding school and buy all basic items,” Raradza said.

Stanley Ziwakaya, 42, a teacher from the low-income Harare suburb of Highfields, whose wife runs a small informal convenience store, or tuckshop, described the gangs preying on the traders as ”vultures feeding on the flesh of the poor who are at the edge of death”.

Empowerment brigades

”The militia in this area call themselves the Empowerment Brigade and are notorious for visiting vending sites, where they demand bribes from the poor vendors. They claim to be representing the youths who need economic empowerment,” Ziwakaya told IRIN.

A member of the ”brigade”, who identified himself only as Peter, defended their actions. ”Empowerment does not mean just taking over the mines, banks and big factories. We cannot do that because we don’t have the money, so we will start with the sell-outs who are opposed to indigenisation.”

The MDC opposed the indigenisation act, passed on the eve of the violent 2008 elections, when ZANU-PF lost its parliamentary majority for the for the first time since independence from Britain in 1980, and Mugabe lost the first round of the presidential elections to Tsvangirai, who subsequently withdrew from the second round in protest over the political violence.

After pressure from the Southern African Development Community, a regional body, and the international community, a unity government was set up in 2009.

Tsvangirai has called the indigenisation program a ZANU-PF political campaign strategy meant to win votes, and during a recent visit to the US described it as a ”warped indigenisation policy [that] has eroded investor confidence”.

According to John Robertson, a Harare-based economic consultant, ”This policy is the direct opposite of empowerment. The number of Zimbabweans who are poor, and those who will become poorer, will increase. The net effect is far much more poverty and far less self-sufficiency.”

He said ZANU-PF militias were using the flag of indigenisation to take over the businesses of “already struggling people, and what is worrying is that the police seem to be blessing their actions because they are not being arrested”.

More job losses

Robertson told IRIN it was likely that the indigenisation policy would force many foreign-owned companies to close down, leading to further job losses, while people struggling to find jobs would fail to do so because investors would keep away.

He compared the indigenisation policy to the fast-track land reform program launched in 2000, which led to the forced eviction of more than 4,000 white commercial farmers, often leaving the farm workers homeless and without a livelihood.

”The land reform program seriously injured the economy, thrived on clear violations of human and property rights and led to widespread misery. This is what will happen with the indigenisation program,” he said.

Welshman Ncube, president of the smaller MDC faction and minister of industry and commerce in the coalition government, said there were problems with the implementation of the empowerment program and also a lack of transparency.

”There would always be cases of greed, abuse and personal gain in the implementation of a program like the indigenisation drive, but what is important is that everything that is done by the government is made transparent to avoid the problems. That way, we can also be able to bring the culprits to book,” Ncube told IRIN.

There have been signs of economic recovery since the formation of the unity government in 2009, but economic activities are often subject to political decisions.

fm/go/he

– Provided by Integrated Regional Information Networks.

View full post on All Stories

Washington, DC, United States (AHN) – New jobless claims remained above the 400,000 mark for the week ending Oct. 8, according to the U.S. Department of Labor.

However, the 404,000 initial unemployment compensation claims filed for the week was slightly down, representing a drop of 1,000 claims from the previous week’s total of 405,000.

The less volatile 4-week moving average was 408,000, down by 7,000 from the previous week’s revised average of 415,000.

First-time jobless claims figures have remained stubbornly above the 400,000 mark since April, signaling that the nation’s jobs sector is not yet in a recovery, despite the fact that the recession officially ended in 2009 when a recovery began in the financial services sector of the economy.

Nevertheless, economists say that with the Main Street and jobs sectors of the economy not yet in recovery, some analysts recently began forecasting a double-dip recession.

The nation’s official unemployment rate remains at 9.1 percent.

View full post on All Stories