Category: Morbidity

ChatGPT: A conversation about underwriting and life insurance

Mary Pat Campbell

Link: https://www.dig-in.com/opinion/chatgpt-a-conversation-about-underwriting-life-insurance

Excerpt:

RGA decided to put ChatGPT to the test by posing three questions related to underwriting and the future of life insurance. The answers from ChatGPT that follow are entirely AI-generated. Following those responses is a brief FAQ that further explores this emerging topic.

How will COVID-19 affect U.S. long-term mortality?

It is difficult to predict the long-term effects of COVID-19 on mortality in the United States. The pandemic has already had a significant impact on mortality, with over 1.1 million COVID-attributed deaths reported in the country. However, it is possible that the mortality rate from COVID-19 could decline over time as more people become immune to the virus and as effective vaccines are developed and distributed.

There are also other factors that could affect the long-term mortality rate from COVID-19. For example, the effectiveness of public health measures, such as mask-wearing and social distancing, in controlling the spread of the virus could have a significant impact on the number of deaths. In addition, the availability of effective treatments for COVID-19 could also play a role in reducing the mortality rate from the virus.

It is important to continue monitoring the situation and taking steps to control the spread of the virus to minimize the impact on mortality.

Author(s): ChatGPT, Jeff Heaton, Dave Rengachary

Publication Date: 14 Feb 2023

Publication Site: Digital Insurance

Association of Cardiovascular Health With Life Expectancy Free of Cardiovascular Disease, Diabetes, Cancer, and Dementia in UK Adults

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2801750?guestAccessKey=9c49772f-a1bb-4a29-9a46-445f585b3781&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=olf&utm_term=022723

Cite: JAMA Intern Med. Published online February 27, 2023. doi:10.1001/jamainternmed.2023.0015

Graphic:

Excerpt:

Question  What is the association of cardiovascular health (CVH) levels, estimated by the American Heart Association’s Life’s Essential 8 score, with life expectancy free of major chronic diseases?

Findings  In this cohort study of 135 199 adults from the UK Biobank study, high CVH level was associated with substantially longer life expectancy free of 4 major chronic diseases (cardiovascular disease, diabetes, cancer, and dementia) in both men and women. Furthermore, the disease-free life expectancy was similar between low and other socioeconomic groups among participants with high CVH.

Meaning  These findings support improvement in population health by promoting a high CVH level, which may also narrow health disparities associated with socioeconomic status.

Author(s): Xuan Wang, MD, PhD1; Hao Ma, MD, PhD1; Xiang Li, MD, PhD1; et al

Publication Date: 27 Feb 2023

Publication Site: JAMA Internal Medicine

One-Year Adverse Outcomes Among US Adults With Post–COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2802095

JAMA Health Forum. 2023;4(3):e230010. doi:10.1001/jamahealthforum.2023.0010

Graphic:

Excerpt:

Key Points

Question  Do postacute sequelae of SARS-CoV-2 increase risks of 1-year adverse outcomes?

Findings  In this case-control study of 13 435 US adults with post–COVID-19 condition (PCC) and 26 870 matched adults without COVID-19, the adults with PCC experienced increased risks for a number of cardiovascular outcomes, such as ischemic stroke. During the 12-month follow-up period, 2.8% of the individuals with PCC vs 1.2% of the individuals without COVID-19 died, implying an excess death rate of 16.4 per 1000 individuals.

Meaning  Individuals with PCC may be at increased risk for adverse outcomes in the year following initial infection.

Author(s): Andrea DeVries, PhD1; Sonali Shambhu, BDS, MPH1; Sue Sloop, PhD1; et al

Publication Date:

Publication Site: JAMA Health Forum

Long COVID Correlates With High Mortality: Health Insurer

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2023/03/03/long-covid-correlates-with-high-mortality-health-insurer/

Excerpt:

A giant health insurer says health plan enrollees who suffered from long COVID-19 symptoms were more than twice as likely as other enrollees to die during a 12-month follow-up period.

Andrea DeVries, a researcher at Elevance Health, and three colleagues found that, during the year studied, 2.8% of the 13,435 enrollees classified as having “post-COVID-19 condition” died, according to a study published in the JAMA Health Forum, which is affiliated with the Journal of the American Medical Association.

That compares with a death rate of just 1.2% for similar enrollees without COVID-19 during the same period.

….

Elevance Health is the company formerly known as Anthem. The company provides or administers major medical coverage for about 48 million people.

The DeVries looked at claim records for 249,013 Elevance plan enrollees ages and older who were diagnosed with COVID-19 from April 1, 2020, through July 31, 2020 — before regulators had adopted a long COVID diagnosis code.

The team began by identifying enrollees with COVID-19 who had been enrolled in an Elevance plan for at least five months before being diagnosed with COVID-19 and who had survived for at least two months after the diagnosis date.

Because of the lack of a long COVID-19 diagnosis code, the team used claims for other conditions, such as loss of the sense of smell, brain fog, anxiety and heart rate problems, to come up with a list of enrollees with long COVID.

Author(s): Allison Bell

Publication Date: 3 March 2023

Publication Site: Think Advisor

CalPERS’ Refusal to Put Clearly Insolvent Long-Term Care Insurance Plan in Bankruptcy Increases Harm to Policyholders and Makes Board and Responsible Executives Liable

Mary Pat Campbell

Link: https://www.nakedcapitalism.com/2023/02/calpers-refusal-to-put-clearly-insolvent-long-term-care-insurance-plan-in-bankruptcy-increases-harm-to-policyholders-and-makes-board-and-responsible-executives-liable.html

Graphic:

Excerpt:

The CalPERS long-term care fiasco continues, with the board and staff taking a course of action that increases harm to policyholders by continuing to bleed them rather than put the program in bankruptcy.

For those new to this train wreck, the public comment at the February 14 CalPERS board meeting by policy-holder and certified financial planner Lawrence Grossman provides an introduction. A key bit of background is that state legislation allowed CalPERS to jump on the long-term care insurance bandwagon in the 1990s. Most of these insurance plans have gotten into a world of hurt by underestimating the degree to which proper elder care would extend lifepsans of policy-holders and overestimating the lapse rate (lapsed policies mean the premiums paid by dropouts benefit the remaining policyholders). But CalPERS’ recklessness and incompetence were in a league of its own.

CalPERS not only considerably underpriced its policies compared to commercial competitors, but it made matters worse via giving CalPERS policyholders the options of lifetime benefits (as opposed to fixed dollar benefits) and inflation protection. Inflation protection would seem like an incredible promise for any long-term insurance scheme. Yet the policies were advertised as CalPERS policies, not those of a free-standing “CalPERS Long-Term Care Fund,” as in not backed by CalPERS or the state of California.

….

Four years later and things are going according to CalPERS’ abusive plan. Even though Judge Highberger clearly rejected CalPERS’ position that it can violate policy terms and raise premiums, CalPERS has continued to increase premiums because the court so far has issued only preliminary decisions. Note these increases are vastly in excess of those implemented by commercial carriers.

Author(s): Yves Smith

Publication Date: 15 Feb 2023

Publication Site: naked capitalism

Masks Make ‘Little or No Difference’ on COVID-19, Flu Rates: New Study

Mary Pat Campbell

Link: https://reason.com/2023/02/07/masks-covid-dont-work-cochrane-library-review-mandate/

Excerpt:

The wearing of masks to prevent the spread of COVID-19 and other respiratory illnesses had almost no effect at the societal level, according to a rigorous new review of the available research.

“Interestingly, 12 trials in the review, ten in the community and two among healthcare workers, found that wearing masks in the community probably makes little or no difference to influenza-like or COVID-19-like illness transmission,” writes Tom Jefferson, a British epidemiologist and co-author of the Cochrane Library’s new report on masking trials. “Equally, the review found that masks had no effect on laboratory-confirmed influenza or SARS-CoV-2 outcomes. Five other trials showed no difference between one type of mask over another.”

That finding is significant, given how comprehensive Cochrane’s review was. The randomized control trials had hundreds of thousands of participants, and made useful comparisons: people who received masks—and, according to self-reporting, actually wore them—versus people who did not. Other studies that have tried to uncover the efficacy of mask requirements have tended to compare one municipality with another, without taking into account relevant differences between the groups. This was true of an infamous study of masking in Arizona schools conducted at the county level; the findings were cited by the Centers for Disease Control and Prevention (CDC) as reason to keep mask mandates in place.

Author(s): Robby Soave

Publication Date: 7 Feb 2023

Publication Site: Reason

Long COVID Is Keeping Significant Numbers of People Out of Work, Study Finds

Mary Pat Campbell

Link: https://www.yahoo.com/news/long-covid-keeping-significant-numbers-125618654.html

Source of study: https://ww3.nysif.com/

Link to study (will download): https://ww3.nysif.com/~/media/Files/NYSIF_Publications/PDF/NYSIFLongCOVIDStudy2023.ashx

Graphic:

Excerpt:

Long COVID is having a significant effect on America’s workforce, preventing substantial numbers of people from going back to work while others continue needing medical care long after returning to their jobs, according to a new analysis of workers’ compensation claims in New York state.

The study, published Tuesday by New York’s largest workers’ compensation insurer, found that during the first two years of the pandemic, about 71% of people the fund classified as experiencing long COVID either required continuing medical treatment or were unable to work for six months or more. More than a year after contracting the coronavirus, 18% of long COVID patients had still not returned to work, more than three-fourths of them younger than 60, the analysis found.

“Long Covid has harmed the work force,” said the report, by the New York State Insurance Fund, a state agency financed by employer-paid premiums. The findings, it added, “highlight long Covid as an underappreciated yet important reason for the many unfilled jobs and declining labor participation rate in the economy, and they presage a possible reduction in productivity as employers feel the strains of an increasingly sick work force.”

Author(s): Pam Belluck

Publication Date: 24 Jan 2023

Publication Site: Yahoo (originally published at NYT)

Incidence of COVID-19 Among Persons Experiencing Homelessness in the US From January 2020 to November 2021

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2795298

Graphic:

JAMA Netw Open. 2022;5(8):e2227248. doi:10.1001/jamanetworkopen.2022.27248

Excerpt:

Question  How many cases of COVID-19 in the US have occurred among people experiencing homelessness?

Findings  In this cross-sectional study of 64 US jurisdictional health departments, 26 349 cases of COVID-19 among people experiencing homelessness were reported at the state level and 20 487 at the local level. The annual incidence rate of COVID-19 was lower among people experiencing homelessness than in the general population at state and local levels.

Meaning  The findings suggest that incorporating housing and homelessness status in infectious disease surveillance may improve understanding of the burden of infectious diseases among disproportionately affected groups and aid public health decision-making.

Author(s): Ashley A. Meehan, MPH1; Isabel Thomas, MPH1,2; Libby Horter, MPH1,3; et al

Publication Date: August 18, 2022

Publication Site: JAMA Open Network

Public Health Agencies Try to Restore Trust as They Fight Misinformation

Mary Pat Campbell

Link: https://khn.org/news/article/public-health-agencies-try-to-restore-trust-as-they-fight-misinformation/

Excerpt:

Across the country, health officials have been trying to combat misinformation and restore trust within their communities these past few years, a period when many people haven’t put full faith in their state and local health departments. Agencies are using Twitter, for example, to appeal to niche audiences, such as NFL fans in Kansas City and Star Wars enthusiasts in Alabama. They’re collaborating with influencers and celebrities such as Stephen Colbert and Akbar Gbajabiamila to extend their reach.

Some of these efforts have paid off. By now, more than 80% of U.S. residents have received at least one shot of a covid vaccine.

But data suggests that the skepticism and misinformation surrounding covid vaccines now threatens other public health priorities. Flu vaccine coverage among children in mid-December was about the same as December 2021, but it was 3.7 percentage points lower compared with late 2020, according to the Centers for Disease Control and Prevention. The decrease in flu vaccination coverage among pregnant women was even more dramatic over the last two years: 18 percentage points lower.

Other common childhood vaccination rates are down, too, compared with pre-pandemic levels. Nationally, 35% of all American parents oppose requiring children to be vaccinated for measles, mumps, and rubella before entering school, up from 23% in 2019, according to a KFF survey released Dec. 16. Suspicion swirling around once-trusted vaccines, as well as fatigue from so many shots, is likely to blame.

Author(s): Laurie Sausser

Publication Date: 3 Jan 2023

Publication Site: Kaiser Health News

Under Government Pressure, Twitter Suppressed Truthful Speech About COVID-19

Mary Pat Campbell

Link: https://reason.com/2023/01/02/under-government-pressure-twitter-suppressed-truthful-speech-about-covid-19/?utm_medium=email

Excerpt:

Twitter’s ban on “COVID-19 misinformation,” which Elon Musk rescinded after taking over the platform in late October, mirrored the Biden administration’s broad definition of that category in two important respects: It disfavored perspectives that dissented from official advice, and it encompassed not just demonstrably false statements but also speech that was deemed “misleading” even when it was arguably or verifiably true. In a recent Free Press article, science writer David Zweig shows what that meant in practice, citing several striking examples of government-encouraged speech suppression gleaned from the internal communications that Musk has been disclosing to handpicked journalists.

Twitter’s moderation of pandemic-related content was intertwined with government policy from the beginning. Even before Joe Biden was elected president and his administration began publicly and privately demanding that social media companies suppress speech it viewed as a threat to public health, the company’s guidelines deferred to the positions taken by government agencies such as the Centers for Disease Control and Prevention (CDC). And those rules explicitly covered “misleading information” as well as “demonstrably false” statements.

….

That July, Twitter sought to clarify “our rules against potentially misleading information about COVID-19″ (emphasis added). “For a Tweet to qualify as a misleading claim,” the company said, “it must be an assertion of fact (not an opinion), expressed definitively, and intended to influence others’ behavior.” Possible topics included “the origin, nature, and characteristics of the virus”; “preventative measures, treatments/cures, and other precautions”; “the prevalence of viral spread, or the current state of the crisis”; and “official health advisories, restrictions, regulations, and public-service announcements.”

That was a very wide net, potentially encompassing anyone who questioned the CDC’s ever-shifting guidance or criticized government policies, such as lockdowns and mask mandates, aimed at reducing virus transmission. While the intent requirement ostensibly allowed dissent as long as it was not aimed at influencing behavior, that limitation did not mean much in practice, since moderators were apt to infer the requisite intent when they encountered tweets that implicitly or explicitly deviated from the recommendations of “public health authorities and governments.”

….

Another example that Zweig cites: Last August, @KelleyKga, a self-described “public health fact checker,” responded to another Twitter user’s claim that “COVID has been the leading cause of death from disease in children” since December 2021. “What an excellent example of cherry picking!” @KelleyKga wrote. “If you narrow it down to only the specific months you specify, which include the largest Covid wave (seen across the world), AND you ignore all non-disease deaths, AND you ignore cancer, heart disease, SIDS, then COVID is ‘leading.'”

Author(s): Jacob Sullum

Publication Date: 2 Jan 2023

Publication Site: Reason

23 Tidbits About the Human Operating System

Mary Pat Campbell

Link: https://www.linkedin.com/pulse/23-tidbits-human-operating-system-nate-worrell/

Graphic:

Excerpt:

1- We Aren’t Totally Human – Almost half of the cells in our body don’t come from us. We have a universe of microorganisms, each of which brings their own DNA into the mix. From a BBC report:

“The human genome – the full set of genetic instructions for a human being – is made up of 20,000 instructions called genes.

But add all the genes in our microbiome together and the figure comes out between two and 20 million microbial genes.

Prof Sarkis Mazmanian, a microbiologist from Caltech, argues: “We don’t have just one genome, the genes of our microbiome present essentially a second genome which augment the activity of our own.

“What makes us human is, in my opinion, the combination of our own DNA, plus the DNA of our gut microbes.”

2- We share DNA with Bananas and Copied Viral DNA: Our closest genetic relative is the chimp, but we are connected to dogs and cats and even fruit flies and yes, bananas.

Author(s): Nate Worrell

Publication Date: 1 Jan 2023

Publication Site: Longevity Assistant at LinkedIn

Social Security denies disability benefits based on list with jobs from 1977

Mary Pat Campbell

Link: https://www.washingtonpost.com/politics/2022/12/27/social-security-job-titles-disabled-applicants-obsolete/

Graphic:

Excerpt:

Every year, thousands of claimants like Heard find themselves blocked at this crucial last step in the arduous process of applying for disability benefits, thanks to labor market data that was last updated 45 years ago.

The jobs are spelled out in an exhaustive publication known as the Dictionary of Occupational Titles. The vast majority of the 12,700 entries were last updated in 1977. The Department of Labor, which originally compiled the index, abandoned it 31 years ago in a sign of the economy’s shift from blue-collar manufacturing to information and services.

Social Security, though, still relies on it at the final stage when a claim is reviewed. The government, using strict vocational rules, assesses someone’s capacity to work and if jobs exist “in significant numbers” that they could still do. The dictionary remains the backbone of a $200 billion disability system that provides benefits to 15 million people.

It lists 137 unskilled, sedentary jobs — jobs that most closely match the skills and limitations of those who apply for disability benefits. But in reality, most of these occupations were offshored, outsourced, and shifted to skilled work decades ago. Many have disappeared altogether.

Author(s): Lisa Rein

Publication Date: 27 Dec 2022

Publication Site: Washington Post