A study published in the Pediatrics journal today seeks to examine the connection between teenagers who send and receive sexually explicit messages on their cell phones — “sexting” — and teenagers who engage in sexually risky behavior, such as not using condoms. The study concludes that sexting is correlated with sexually risky behavior, and encourages parents and health officials to talk to teens to discourage the behavior:

Sexting, rather than functioning as an alternative to “real world” sexual risk behavior, appears to be part of a cluster of risky sexual behaviors among adolescents. We recommend that clinicians discuss sexting as an adolescent-friendly way of engaging patients in conversations about sexual activity, prevention of sexually transmitted infections, and unwanted pregnancy. We further recommend that discussion about sexting and its associated risk behavior be included in school-based sexual health curricula.

Providing teenagers with accurate information about preventing pregnancy and STIs is certainly an important component of comprehensive sexual education, but concerns about the dangers of sexting are misplaced. Sexting itself is no more inherently dangerous for teens than any other type of sexual expression. Teens who report engaging in sexting are simply more likely to be sexually active than teens who have never sent or received an explicit message — an earlier study on the same subject found that about 86 percent of the teen respondents who sexted reported that they were sexually active, a full 30 percentage points higher than the rate of sexual activity among the non-sexters — and those increased rates of sexual activity lead to an increased potential for unsafe sexual behavior.

Lumping sexting in with actually risky physical behaviors — such as being uninformed about where to find and how to use a range of effective birth control methods — does a disservice to teenagers’ sexuality. While teenagers absolutely need to hear accurate information about practicing safe sex from parents, health officials, and educators, the failures of abstinence education programs demonstrate that stigmatizing sexual expression is not an effective way to ensure healthy behaviors in young adults. Teenagers’ use of technology isn’t directly encouraging them to make risky sexual decisions. Neglecting to adequately address sexual health in the classroom is.

The Center for Public Integrity (CPI) has released a study on doctors’ increasing use of more complex, and consequently more expensive, medical billing codes for their Medicare patients — a practice that CPI estimates has cost the seniors on Medicare an extra $11 billion dollars.

Medicare billing codes were established in order to provide doctors with a simple method of indicating how much time and effort their Medicare patients were costing them. Using billing codes, doctors can charge Medicare for their services based on the complexity of each patient’s medical problems and the amount of time spent with each Medicare patient. Accordingly, doctors who take on patients with more difficult, time-consuming medical issues can be appropriately compensated by using a higher billing code number. Of course, this means that seniors who are deemed to have more complex problems or take up more time during a doctor’s visit are billed at considerably higher rates than those with more common ailments.

Doctors with Medicare patients have almost full discretion over which codes to use for their patients, so the billing and coding system works more-or-less on an honor code. However, the Center’s examination of a decade’s worth of Medicare claims and government audits shows that, while doctors have invoked higher-level codes, there does not appear to be a corresponding increase in the nature or complexity of services rendered:

Medical groups argue that the fee hikes are justified because treating seniors has grown more complex and time-consuming, both due to new technology and declining health status. [...] But the Center’s analysis of Medicare claims from 2001 through 2010 shows that over time, thousands of providers turned to more expensive Medicare billing codes, while spurning use of cheaper ones. They did so despite little evidence that Medicare patients as a whole are older or sicker than in past years, or that the amount of time doctors spent treating them on average was rising.

While it’s impossible to know precisely why doctors and hospitals moved to better-paying codes in recent years, it’s likely that the trend in part reflects “upcoding” — the practice of charging for more extensive and costly services than delivered, according to Medicare experts, analysis of the data and a review of government audits.

Although the report explores difficulties experienced by doctors who serve Medicare patients, including the inability of repayment rates to stay on par with medical office inflation, the sharp increases in high-fee code use are striking. According to CPI’s research, the percentage of the three least complex and expensive patient-visit billing codes (Codes 99211-99213) have been trending steadily downward for the last decade, especially the last three years. By contrast, use of the second-most expensive billing code (Code 99214) has sharply risen each year since 2001, ballooning to 36% of all Medicare patient visits in 2010, nearly double its rate in 2001.

To get an idea of what this means for Medicare beneficiaries’ expenses, CPI explains that Code 99211 — which indicates a simple medical problem and short office visit — charges approximately $20 from Medicare, whereas a more complex medical visit under Code 99215 charges about seven times that amount at $140. And if billing fraud and coding errors in Medicare are left unchecked, those numbers will only go up even further, increasing the cost of care for America’s seniors.

Republican lawmakers are continuing to delay setting up the state-run health insurance exchanges required under Obamacare as an act of resistance against President Obama’s health reform law. Even though the federal government will be forced to step in to implement exchanges for the states that don’t turn in their exchange plans for approval by November, some Republican governors are refusing to work on exchanges until after the election in case Mitt Romney wins and repeals Obamacare. However, despite the political battle over health care reform, not all Republican officials are convinced that refusing to set up health exchanges is the best course of action.

Reuters points out that some GOP officials like Mike Chaney, Mississippi’s insurance commissioner, have quietly worked against their party to take steps toward creating state-level insurance exchanges. Although his state’s lawmakers are deeply opposed to Obamacare — Mississippi was one of the 26 states that sued the administration over the health reform law — Chaney explained that resisting Obamacare’s health care exchange will force state officials to scramble after the November election:

Insurance officials like Chaney, however, want a better contingency plan in case the Republicans lose, as the 10-day window between the election and the exchange deadline will not give them enough time to prepare an exchange.

“They can’t just leave this to the will of the wind,” Chaney said in an interview.

“This isn’t about politics. It’s about following the law,” he added. “And I think I’m better equipped to operate an exchange in my state than the federal government.”

Chaney is not the only Republican to take this stance. Reuters interviewed half a dozen other Republican state health officials who agreed they would prefer to plan for state-run exchanges now rather than accept a federally-run exchange when the clock runs out, and some are working to do so. However, the contentious political climates in their states don’t always make this possible. Although Chaney said he worked “under the radar” to prepare for an exchange in Mississippi, mounting pressure from conservatives in the state curbed his work in mid-July, and he has since released a statement promising to hold off on any further work toward establishing an exchange until after the election.

Former Senate Majority Leader Bill Frist (R-TN) has already urged Republican governors to embrace health care reform and take the necessary steps to set up exchanges in their states. As Frist and Chaney both point out, state-run exchanges are actually consistent with conservative federalist ideals. If Republican legislators continue to block them, they could help prove Chaney’s assertion that “this isn’t about politics” very wrong.