Tuesday, December 1, 2009

Looking For Waste in the Health Care System? Try Anywhere

Francine Hardaway - Serial entrepreneurship veteran
Posted: December 1, 2009 12:00 PM BIO Become a Fan Get Email Alerts Bloggers' Index
Looking For Waste in the Health Care System? Try Anywhere

Read More: Health Care, Maggie Mahar, Mammograms, Medicare Fraud Cost, Pharmaceutical Industry, Simivastin, Vitorian, Zetia, Living News

How much of our rising health care costs comes from fraud in the health care system by players who know how to game it for their own benefit? Enough to cloud the reform debate, that's for sure. And it can't be pinned on one player; it's up and down the value chain in medical care.

On the one hand, you have the recent 60-Minutes report on drug dealers in Miami who defraud Medicare by opening fake clinics and pharmacies. They get reimbursed for artificial limbs ordered for patients whose IDs they have bought on a black market for Medicare information.

Further up the line you have hospitals who bill Medicare for procedures that could be done in an outpatient setting where they would cost less, or for total care of a patient whose actual care is split between two hospitals, both of whom bill for the entire care. (Go look on the Center for Medicare and Medicaid Services web site for the Recovery Audit Contractor pilot program in which this was discovered.

And then there's the sweetheart deal the insurers got to participate in the Medicare Advantage program, which was started when CMS was afraid not enough providers would participate in Medicare. In Medicare Advantage, all the players get paid more than by regular Medicare for providing the same services. Medicare Advantage is targeted by the cost-cutting initiatives, but here's what the plans said: "many commenters contend that, if rates are reduced, MA organizations will have trouble maintaining their provider networks, because they will have to pay providers less, and will have to raise premiums, increase co-pays and deductibles, especially in rural areas, Puerto Rico, in the case of Special Needs Plans (SNPs), PACE plans, and plans that are in direct competition with cost plans."

Finally, we get to the pharmaceutical companies, where we learn that "by suppressing negative studies, relentlessly pursuing positive trial results, and paying academic researchers to promote their therapy, Merck Schering-Plough has managed to hold onto a $4.6 billion market for a drug that has never been proven to be better than cheaper generics in preventing heart attacks or death. "

That's a pretty shocking allegation from the HealthBeatBlog, where Maggie Mahar, maker of the film "Money-Driven Medicine," does her investigative work. It seems that Merck Schering-Plough holds the patents on Vitorin and Zetia, two widely advertised drugs that in studies have proven no more effective than the vitamin niacin and a generic statin, simivastin.

And this doesn't even begin to touch controversial issues like outcomes-based medicine, which might mean fewer mammograms, CT scans, and other procedures that irradiate us often unnecessarily as the doctor either tries to prevent malpractice allegations or perhaps even owns the imaging center.

Everywhere you look there is waste and downright fraud in the health care system, perpetrated by both payers and providers, public and private. I have no doubt that Obama is right that we could fund health care reform by cleaning up the waste, but the lobbyists for the staus quo don't want it cleaned up. They are profiting from waste and fraud, not from legitimate services, IMHO

Comment

cuppajoe
I would suggest that it is not all just out and out fraud. Here, in a community of about 80,000 where I currently reside, one can go to one hospital for a specific lab test, and Medicare is charged about $225.00; In a second hospital in the same basic community, the exact same test, bills Medicare approximately $80.00 for the same test.

And, to further look at this, there are an estimated 5,000 of these tests performed in this community each month; it is estimated that the more expensive hospital performs 75% of these tests. If my math is correct, 75% of 5000 is 3750. and the difference between $225. and $80 is $145.00 $145 x 3750 = $543,750 per month, or $6,525,000 per year, for one test, in one community. If these numbers apply, even remotely to the national picture, this one test, which is necessary, may well be costing Medicare more than a BILLION dollars more than it need cost.

It makes no sense to me. The test does not require the intervention of, nor the direct supervision of a physician, uses an inexpensive test strip, and one nurse can comfortably accomplish, with no rush, about 4 or 5 tests per hour. Without any degradation of nurses, is it really necessary to bill medicare approximately $1000 per hour for a nurse's time?

Loneliness can be contagious, new study finds

Feelings of isolation can spread through groups of friends as easily as a cold
Loneliness can not only make you feel more socially isolated, it can make you more anxious, more shy and cause you to believe you have poor social skills.

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By Diane Mapes
msnbc.com contributor
updated 8:40 a.m. ET, Tues., Dec . 1, 2009

We’re used to hearing about people spreading colds and flu. But according to a new study in the Journal of Personality and Social Psychology, there’s another human condition that’s equally contagious: loneliness.

“Loneliness spreads across time,” says John Cacioppo, a neuroscientist and psychologist at the University of Chicago and one of the authors of the study. “It travels through people. Instead of a germ, it’s transmitted through our behaviors.”

The longitudinal study, conducted by the University of Chicago, the University of California-San Diego and Harvard, interviewed more than 5,000 people over the course of 10 years, tracking their friendship histories and their reports of loneliness. Participants were part of the Framingham Heart Study, which has studied cardiovascular risks in people in Framingham, Mass., since 1948 and has since been expanded to include other research topics such as loneliness and depression.

In the study, researchers found that lonely individuals tend to move to the fringes of social networks (and, no, we’re not talking about Facebook or Twitter here), where they have fewer and fewer friends.

But before they move to the periphery, they “infect” or “transmit” their feelings of loneliness to their remaining friends. With fewer close relationship, these friends then become lonely and eventually move to the fringes of the social network, again passing their loneliness on to others. Thus, the cycle continues.

“When people get lonely, they’re more likely to interact negatively with others they encounter,” says Cacioppo. “If you have two neighbors and they’re friends and one becomes lonely, they’ll start to treat the other less friendly. Ultimately, they’re less likely to be friends.”

Ironically, loneliness can not only make you feel more socially isolated, it can make you more anxious, more shy and cause you to believe you have poor social skills. Cacioppo says previous research also shows that loneliness can make people less trustful of others and can make the brain more “defensive.”

“Your brain tells you people are rejecting you,” he says. “Loneliness may warp the message that you’re hearing.”

A biological signal
While loneliness can be “contagious,” Cacioppo says it’s important to note it’s not a disease, nor is it a personal weakness. It’s actually a biological reaction, much like hunger or thirst or pain.

“Society tends to think of it as an individual characteristic — there are just loners,” he says. “But that’s the wrong conception of what loneliness is. It’s a biological signal motivating us to correct something that we need for genetic survival. We need quality relationships. We don’t survive well on our own.”

Studies, in fact, show loneliness can actually be harmful to both mental and physical health, leading to depression, high blood pressure, increases in the stress hormone cortisol, and compromised immunity.

Unfortunately, quality friendships can sometimes be difficult to find or maintain in our busy, BlackBerried society.

“I get lonely sometimes but I tend not to seek people out to do things because they’re all married or committed or need to find a babysitter and then it just turns into a circus,” says Tina Kurfurst, a 46-year-old database coordinator from Seattle. “I went out to dinner with some people from work the other night and one of the women kept saying, ‘Wow, you’re funny, why don’t we hang out more often?’ And I just thought, ‘Well, because you have a husband and a 12-year-old and a 17-year-old and it just doesn’t happen. You don’t have time for me.”

Stephanie Smith, a clinical psychologist with a private practice in Erie, Co., says she tries to encourage her lonely patients — which can range from college students to stay-at-home moms to high-powered CEOs — to find at least one friend in their same situation.

“If you have kids, know at least one other person who has kids,” she says. “Or if you don’t, find someone who doesn’t. It’s important to have people in your life who share your interests and your stage of life.”

But you don’t have to have a slew of BFFs.

“Sometimes people get overwhelmed and think ‘I need to have 15 best friends,’” she says. “But it doesn’t need to be that big. One friend, one relationship, can be very powerful.”

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Facebook and Twitter are no substitute for the real thing, though.

“If you’re isolated due to a disability or a spouse with Alzheimer’s, then Facebook can be a real boon,” says Cacioppo. “But if you’re spending your time on Facebook rather than face-to-face with friends, it increases your loneliness. It’s about quality. Lonely people use social networks as a substitute; non-lonely people use them to synergize the relationships they already have. The person with 4,000 friends on Facebook may well be a very lonely person.”

The secret, says Cacioppo, is realizing loneliness is nothing more than your body sending you a signal.

“All normal humans feel lonely at some point in time, just like they feel hunger and thirst and pain,” he says. “But while we have cupboards filled with food, taps for water and medications for pain, we don’t have anything comparable for loneliness. I’m not saying you need a cupboard full of friends, but if you feel lonely, pay attention and take the time to repair it.”

Comment

I cant remember who said it but somebody said they judge ones mental health by the quality and quantity of their friendships.

Monday, November 23, 2009

Advice From Grandma

Op-Ed Columnist
Advice From Grandma

By THOMAS L. FRIEDMAN
Published: November 21, 2009

President Obama’s visit to China this week inevitably invites comparisons between the world’s two leading powers. You know what they say: Britain owned the 19th century, America owned the 20th century, and, it’s all but certain that China will own the 21st century. Maybe, but I’m not ready to cede the 21st century to China just yet.

Times Topics: China -Why not? It has to do with the fact that we are moving into a hyperintegrated world in which all aspects of production — raw materials, design, manufacturing, distribution, fulfillment, financing and branding — have become commodities that can be accessed from anywhere by anyone. But there are still two really important things that can’t be commoditized. Fortunately, America still has one of them: imagination.

What your citizens imagine now matters more than ever because they can act on their own imaginations farther, faster, deeper and cheaper than ever before — as individuals. In such a world, societies that can nurture people with the ability to imagine and spin off new ideas will thrive. The Apple iPod may be made in China, but it was dreamed up in America, and that’s where most of the profits go. America — with its open, free, no-limits, immigrant-friendly society — is still the world’s greatest dream machine.

Who would cede a century in which imagination will have such a high value to an authoritarian society that controls its Internet and jails political prisoners? Remember what Grandma used to say: Never cede a century to a country that censors Google.

But while our culture of imagination is still vibrant, the other critical factor that still differentiates countries today — and is not a commodity — is good governance, which can harness creativity. And that we may be losing. I am talking about the ability of a society’s leaders to think long term, address their problems with the optimal legislation and attract capable people into government. What I increasingly fear today is that America is only able to produce “suboptimal” responses to its biggest problems — education, debt, financial regulation, health care, energy and environment.

Why? Because at least six things have come together to fracture our public space and paralyze our ability to forge optimal solutions: 1) Money in politics has become so pervasive that lawmakers have to spend most of their time raising it, selling their souls to those who have it or defending themselves from the smallest interest groups with deep pockets that can trump the national interest.

2) The gerrymandering of political districts means politicians of each party can now choose their own voters and never have to appeal to the center.

3) The cable TV culture encourages shouting and segregating people into their own political echo chambers.

4) A permanent presidential campaign leaves little time for governing.

5) The Internet, which, at its best, provides a check on elites and establishments and opens the way for new voices and, which, at its worst provides a home for every extreme view and spawns digital lynch mobs from across the political spectrum that attack anyone who departs from their specific orthodoxy.

6) A U.S. business community that has become so globalized that it only comes to Washington to lobby for its own narrow interests; it rarely speaks out anymore in defense of national issues like health care, education and open markets.

These six factors are pushing our system, which was designed to have divided powers and to force compromises, into the realm of paralysis. To get anything big done now, we have to generate so many compromises — couched in 1,000-plus-page bills — with so many different interest groups that the solutions are totally suboptimal. We just get the sum of all interest groups.

The miniversion of this is California, which, as others have noted, is becoming America’s biggest “failed state.” Californians had hoped they could overcome their dysfunctional system by electing an outsider, a former movie star, Arnold Schwarzenegger. He would slay the system, like the Terminator. But he couldn’t.

Mr. Obama was elected for similar reasons. People had hoped that his unique story, personality and speaking skills could bring the country together, overcome paralysis and deliver nation-building at home. A lot of the disappointment settling in among Obama voters today is prompted by their dawning realization that maybe, like Arnold, he can’t.

China’s leaders, using authoritarian means, still can. They don’t have to always settle for suboptimal. So what do we do?

The standard answer is that we need better leaders. The real answer is that we need better citizens. We need citizens who will convey to their leaders that they are ready to sacrifice, even pay, yes, higher taxes, and will not punish politicians who ask them to do the hard things. Otherwise, folks, we’re in trouble. A great power that can only produce suboptimal responses to its biggest challenges will, in time, fade from being a great power — no matter how much imagination it generates.

Grandma said that, too.

Supercomputing for the Masses

Supercomputing for the Masses

By ASHLEE VANCE
Published: November 22, 2009

PORTLAND, Ore. — For decades, the world’s supercomputers have been the tightly guarded property of universities and governments. But what would happen if regular folks could get their hands on one?

Oak Ridge National Laboratory
The Jaguar supercomputer at the Oak Ridge National Laboratory, the world's fastest, links thousands of mainstream chips.

The price of supercomputers is dropping quickly, in part because they are often built with the same off-the-shelf parts found in PCs, as a supercomputing conference here last week made clear. Just about any organization with a few million dollars can now buy or assemble a top-flight machine.

Meanwhile, research groups and companies like I.B.M., Hewlett-Packard, Microsoft and Intel are finding ways to make vast stores of information available online through so-called cloud computing.

These advances are pulling down the high walls around computing-intensive research. A result could be a democratization that gives ordinary people with a novel idea a chance to explore their curiosity with heavy computing firepower — and maybe find something unexpected.

The trend has spurred some of the world’s top computing experts and scientists to work toward freeing valuable stores of information. The goal is to fill big computers with scientific data and then let anyone in the world with a PC, including amateur scientists, tap into these systems.

“It’s a good call to arms,” said Mark Barrenechea, the chief executive of Silicon Graphics, which sells computing systems to labs and businesses. “The technology is there. The need is there. This could exponentially increase the amount of science done across the globe.”

The notion of top research centers sharing information is hardly new. Some of the earliest incarnations of what we now know as the World Wide Web came to life so that physicists and other scientists could tap into large data stores from afar.

In addition, universities and government labs were early advocates of what became popularized as grid computing, where shared networks were created to shuttle data about.

The current thinking, however, is that the labs can accomplish far more than was previously practical by piggybacking on some of the trends sweeping the technology industry. And, this time around, research bodies big and small, along with brainy individuals, can participate in the sharing agenda.

For inspiration, scientists are looking at cloud computing services like Google’s online office software, photo-sharing sites and Amazon.com’s data center rental program. They are trying to bring that type of Web-based technology into their labs and make it handle enormous volumes of data.

“You’ve seen these desktop applications move into the cloud,” said Pete Beckman, the director of the Argonne Leadership Computing Facility in Illinois. “Now science is on that same track. This helps democratize science and good ideas.”

With $32 million from the Energy Department, Argonne has set to work on Magellan, a project to explore the creation of a cloud-computing infrastructure that scientists around the globe can use. Mr. Beckman argued that such a system would reduce the need for smaller universities and labs to spend money on their own computing infrastructure.

Another benefit is that researchers would not need to spend days downloading huge data sets so that they could perform analysis on their own computers. Instead, they could send requests to Magellan and just receive the answers.

Even curious individuals on the fringe of academia may have a chance to delve into things like climate change and protein analysis.

“Some mathematician in Russia can say, ‘I have an idea,” Mr. Beckman said. “The barrier to entry is so low for him to try out that idea. So, this really broadens the number of discoverers and, hopefully, discoveries.”

The computing industry has made such a discussion possible. Historically, the world’s top supercomputers relied on expensive, proprietary components. Government laboratories paid vast sums of money to use these systems for classified projects.

But, over the last 10 years, the vital innards of supercomputers have become more mainstream, and a wide variety of organizations have bought them.

At the conference, undergraduate students competed in a contest to build affordable mini-supercomputers on the fly. And a supercomputer called Jaguar at the Oak Ridge National Laboratory in Tennessee officially became the world’s fastest machine. It links thousands of mainstream chips from Advanced Micro Devices.

Seven of the world’s top 10 supercomputers use standard chips from A.M.D. and Intel, as do about 90 percent of the 500 fastest machines. “I think this says that supercomputing technology is affordable,” said Margaret Lewis, an A.M.D. director. “We are kind of getting away from this ivory tower.”

While Magellan and similar projects are encouraging signs, researchers have warned that much work lies ahead to free what they consider valuable information for broader analysis.

At the Georgia Institute of Technology, for example, researchers have developed software that can evaluate scans of the brain and heart, and identify anomalies that might indicate problems. To advance such techniques, the researchers need to train their software by testing it on thousands of body scans.

But it is hard to find a repository of such scans that a hospital or a government organization like the National Institutes of Health is willing to share, even if personal information can be stripped away, said George Biros, a professor at the Georgia Institute of Technology. “Medical schools don’t make this information available,” he said.

Bill Howe, a senior scientist at the eScience Institute at the University of Washington, has urged research organizations to reveal their information. “All the data that we collect in science should be accessible, and that’s just not the way it works today,” he said.

Mr. Howe said high school students and so-called citizen scientists could make new discoveries if given the chance.

“Let’s see what happens when classrooms of students explore this information,” he said.

Comment

While I agree with the basic philosophy, there will always be those that will take that information and use it in destructive ways. Some method of checks must be in place to insure that destructive consequences dont happen. Perhaps levels of security could be put into place, or something along that line of thought. The VA has done thousands of body scans over the past 15 years or so, and they have been digitalized so they could be quickly accessed and utilized. All that would remain would be copying them without the identifying information. Medical research data like that might be a good place to start. I belong to a grid computing system that researches genomic links for the cure of cancer (Rosetta@home). I leave my computer on all day while I am at work so that that data can be analyzed.

On Single-Sex Buses, Relief From Unwanted Contact

Mexico City Journal
On Single-Sex Buses, Relief From Unwanted Contact
Jennifer Szymaszek for The New York Times
Women, who complain of harassment on Mexico City’s crowded transportation system, have found a haven in restricted buses.

By MARC LACEY
Published: February 11, 2008

MEXICO CITY — Body-to-body contact is inescapable on Mexico City’s crowded public transportation system. Get on a train or a bus during rush hour and a man in a business suit may have his arm resting against your shoulder, a woman toting a bulky shopping bag may have her back pressed against your flank, and a teenager listening to an iPod may tap his sneaker all over your newly shined left shoe.

VideoMore Video » But many women complain that not all the contact is incidental. Among the 22 million passengers who use the bus and subway system daily, women say, are lecherous men taking advantage of the cheek-to-jowl conditions to leer and grope and then quietly disappear.

“There are good men in Mexico, but they’re not the ones on public transport,” said Mariana Vasquez, 30, who waited to board a bus recently on her way to a job interview at a law firm. “They try to touch you. They don’t give you a seat. Where are the gentlemen?”

One place they are not is on new women-only buses that Mexico City began running in January to reduce the harassment. With pink placards and insistent drivers who growl at any man who tries to step aboard, the buses are quickly becoming a hit among women.

“Woo-hoo!” bellowed Catalina Garduño the other day as man after man was turned away from the bus she was riding. Her outbursts animated the other women on board, who joined in the celebration. As they rolled along Paseo de la Reforma on their way home from work, the atmosphere resembled a ladies’ night on wheels.

Their relief reached beyond their escape from being accosted physically.

“We don’t get paid as much as they, yet we work just as hard,” said Ms. Garduño, a saleswoman. “We are tired of their machismo. We don’t feel sorry for them at all.”

A few rows back, Abigail Llanes, 21, expressed a similar sentiment.

“We get to sit now,” she said, beaming. “It’s great.”

As complaints of harassment have grown, Mexico has experimented over the years with various remedies. Some subway cars have been reserved for women. Some buses allow women, disabled people and those with children to use designated entrances at the front. But the new buses may be the boldest approach so far.

Men’s reactions run the gamut. Some declare the program discriminatory. Some curse at the bus drivers who leave them standing at the curb.

Plenty of men, though, say they endorse the idea.

“We have no respect,” Adolfo Flores, 30, a law student, said of the unseemly way many men treat women.

Mr. Flores was getting his shoes shined as buses passed by behind him. The shoeshine man, Esteban Hernández, 57, piped in with his own theory about the groping.

“We have the animal instinct,” he said, smiling. Touching a woman, he said, “is a way of showing masculinity — it’s very bad.”

Just how bad the abuse problem — which is raised by women in cities the world over — has become in Mexico is difficult to say. Last year, just seven women lodged official complaints of harassment on Mexico City’s buses. There are more reports of sexual incidents on the subways, with roughly one a day filed with the authorities. But Mexican officials believe those figures do not reflect the full extent of the problem.

“Most women don’t report what happens to them,” said Ariadna Montiel, who directs the public bus system, noting that as a young architecture student years ago she traveled by public transportation and experienced the harassment firsthand. “I know it’s a serious problem.”

Ms. Montiel said she had no intention of neglecting men. “We have to guarantee that all users are taken care of,” she said, adding that coed buses roll along in close proximity to the women’s buses to ensure that nobody is waiting too long.

Passengers say the atmosphere aboard women’s buses is entirely different. As the buses become more popular, and crowded, some women politely offer their seats to others. And, they say, the lechers are gone.

Still, the experiment cannot solve the underlying problem of how the sexes interact in the metropolis. Only four of the city’s bus routes have women-only buses. That number will rise to 15 in the months ahead, but coed buses will remain the rule in most areas.

To complement the single-sex buses, the Institute of Women in Mexico City, a government body that promotes opportunities for women, is pushing a public education campaign to make clear to men that inappropriate touching is illegal. In March, a new ordinance will make it easier to prosecute those found harassing women in public places.

“This is not against men,” insisted Martha Lucia Micher Camarena, the institute’s director general. “This is positive discrimination that responds to the demands of women. And it’s also for men because it protects their daughters, sisters and mothers.”

Comment

There was another article about groping on the New York subways. The obvious answer is to put some undercover cops, males and females, on these subways and buses and catch these jerks. Prosecute a dozen or so and the word will get out.

4 signs you're in retirement denial

Portfolio and home values have tanked, but you won't see that reflected in most people's retirement plans. Here's how to tell if you need a reality check.

[Related content: retirement, retire well, financial planning, debt, home prices]
By U.S. News & World Report
Optimism is good; denial isn't. When it comes to retirement plans, the evidence is overwhelming: The recession will delay retirements for millions and reduce the standard of living of many people who are, or thought they were, near retirement.

A recent Pew Research Center survey, for example, says most middle-aged Americans are thinking about altering their retirement plans. Yet despite the short-term adjustments that consumers are making -- looking for bargains, saving more -- many continue to hold expectations about retirement that experts say are simply no longer realistic.

Here are four signs that you may be in denial about how the Wall Street and housing meltdowns have changed your retirement prospects.

Find the best places to retire

1. Your retirement plans haven't changed. This is the big one, and most people are kidding themselves if this is their view. McKinsey & Co. has developed what it calls a retirement readiness index (.pdf file). It measures changes in the values of retirement assets -- Social Security, pensions and financial holdings -- to determine the financial preparedness of households for retirement.

An index value of 100 means a household can maintain its current standard of living in retirement. A reading below 80, McKinsey says, "calls for large reductions in spending on basic needs, such as housing, food, and health care." The current index reading for a typical household is 63.

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2. Your retirement age hasn't changed. Hello! McKinsey says its polling finds that only about 25% of consumers are thinking about postponing retirement. If you're in the other 75%, stop and think about what would happen to your standard of living in retirement. You don't need a retirement readiness index.

First, add up Social Security and any pensions. Next, total up any retirement accounts and other financial assets and assume conservatively that 4% of that amount is available to you each year for spending needs. How does the total compare with what you're spending now?

Some financial planners say you can live for less in retirement, but health-care expenses likely will be steeper, and if you want to travel and enjoy leisure-time activities, your spending could rise, not fall.

Retirement out of reach for many

3. Your home is still your castle. Housing values fell sharply in most markets, and many experts say it easily could take a decade for them to return to the inflation-adjusted values of 2007. Yet McKinsey found that the percentage of consumers expecting to finance their retirements by tapping the equity in their homes actually has risen.

If you retire before your mortgage does

Take a serious look at the likely equity you'll have in your home when you reach your planned retirement age. Dean Baker, co-director of the Center for Economic and Policy Research, says those trillions in lost housing values will be a drag on the economy and retirements for years.

"I remain a pessimist on the prospect for a recovery anytime soon," he says.

Your retirement could last decades. Here are tips for living well for as long as you need.

4. You expect to be debt-free in retirement. While consumers generally have held steady on debt levels in the past year, debt among baby boomers actually has been rising, according to a survey from Securian Financial.

More than 60% of nonretirees polled said they expect to have no debt other than a mortgage when they retire, and only about 20% expected to have some debt. But more than half the retirees in the survey said they carried debts, excluding mortgages, into retirement.

Likewise, less than a quarter of nonretirees believe they will still owe money on a mortgage when they retire, but twice as many people who already have retired said they were still making mortgage payments when they stopped working.

8 ways to botch your retirement

This article was reported by Philip Moeller for U.S. News & World Report.

Comment

After five years of retirement I have gone back to work part-time. The value of my house has dropped 150k and my rentals, 200k. Of course that was only paper money but it still hurts. I can easily see myself working at least part-time for the next five years or so. Its not all bad as I am in a field where there are jobs available, in pretty good health, and at the top of my game professionally, after 28 years on the job!

Seven reasons to expect a slow-growth U.S. economy ahead

Seven reasons to expect a slow-growth U.S. economy ahead
Joseph Lazzaro
Nov 22nd 2009 at 3:00PMText SizeAAAFiled under: Economy

Is the U.S. headed for a "new normal" -- a slow-growth economy that lasts perhaps for as long as a decade? The evidence supporting the new-normal argument, predicting a future in which the U.S. GDP grows at no more than 2.0% to 2.5% per year, is compelling. That low growth rate would constrain corporate revenue, earnings growth and stock prices, among other consequences.

The U.S. has already registered below-trend GDP growth at this recovery's start -- just 3.5% in the third quarter, versus the more than 6% GDP growth typically registered in an expansion's initial stage. Here's why the slow-growth conditions might continue:

Housing sector doldrums: The massive overbuilding and the subsequent bust mean it will take at least another year to work off excess inventories in single-family homes, condos, co-ops, etc. Further, slumping prices will cause some families who would typically trade-up to stay put -- eliminating additional sector activity. As a result, housing won't be as strong a growth engine as it has been during previous expansions.

Frugal consumers: Americans are in the midst of making up for a decade of unsustainable overconsumption -- spending fueled in many cases by debt -- by increasing their savings. Currently, Americans are saving at about a 3% annual rate, but it did approach 5% earlier in the year. Also, asset declines in stock portfolios and homes are further impressing upon Americans the need to save: People have realized that they can't count on their 401(k) or their home appreciation being quite as large bonanzas as they had hoped for. Because consumer spending accounts for roughly two-thirds of the U.S. economy, a sustained reduction in consumption will weigh on GDP growth.

Demographics: The U.S. population is aging, and its largest segment, the post-World War II baby boom generation, is starting to retire. That implies even less consumer spending, as adults typically decrease spending in their retirement years.

Export traffic jam: In general, U.S. multinational corporations are well-positioned for the next global economic expansion from the standpoints of product quality and distribution networks. The problem is, so are are many of their foreign-based competitors. Moreover, dozens of formidable emerging-market nations have export-dominant economies: They must export to grow. Hence, the current global expansion will probably feature a surplus of goods (at least initially) and intense competition. That's likely to keep U.S. export revenue below what it would be without those surplus goods, limiting the tailwind from exports to U.S. GDP.

U.S. budget deficit reduction: Spending for the bank bailout, related financial system measures and the fiscal stimulus package will have to repaid at some point. So will spending for the wars in Iraq and Afghanistan, which currently totals $934 billion, not counting interest. Health-care reform will limit entitlement spending growth in Medicare and Medicaid, but additional spending cuts and tax increases will be needed, and more resources will be removed from the private sector. Net result? Historically, tax increases have constrained U.S. GDP growth.

Workforce reduction: The current recession has resulted in the loss of more than 7.6 million jobs, and more than 15 million Americans are looking for work. Basically, current nonfarm payrolls are about at the level they were in early 2000. The nation needs to create 100,000 to 125,000 jobs each month just to keep the unemployment rate from rising. Further, even assuming a return to 200,000 to 225,000 monthly gains in jobs -- and that's a big assumption, given current demand conditions -- it would take the nation more than six years to replace all of the jobs lost so far during this recession. That suggests the U.S. will not nearly have the demand characteristics of previous expansions, with constrained household formation another damper on GDP growth.

Wage stagnation: The aforementioned slack in the labor force -- and the competition from lower-cost production centers abroad -- has led to another problematic trend: stagnant wages in many U.S. job segments. Simply, if this trend continues, it does not bode well for consumer spending.

Two Rays of Hope

PIMCO's Bill Gross, who heads the world's largest bond fund, has forecast a new era -- a period of "capitalism with limits" that will feature lower returns on equity, lower GDP growth and reduced job creation. He's not the only one forecasting a mild, U-shaped economic recovery.

Is there any chance that the U.S. can avoid this slow-growth future? What factors might counterbalance those mentioned above and enable the country to experience robust GDP growth again -- say, 6% in the expansion's initial stage, and above 3% thereafter? That's a good question. No economists have 6% initial expansion-stage forecasts out there now, but the key to achieving strong growth lies in the appearance of a domestic catalyst – a growth engine that really adds to job creation. Green technology holds promise, but it's not likely to create millions of new jobs, at least not initially.

However, two historical precedents -- macroeconomic "rays of light," if you will -- present counterarguments to the slow-growth forecast.

First, the U.S. economy has never fallen into a double-dip recession after an 18-month downturn.

Second, historically, once momentum has begun to increase in the U.S. economy, the economy has kept accelerating until the Fed "took the punch bowl away," i.e., until it increased short-term interest rates (and in the post-financial crisis era, that will include removing quantitative easing funds). This suggests that, as long as the Fed keeps interest rates low and quantitative easing in place, it will at least create conditions that are ripe for an increase in demand and commercial activity. Whether that increase in demand appears remains an open question.

Financial editor Joseph Lazzaro is writing a book on the U.S. presidency and the U.S. economy.