The Center for Public Integrity

UDDANAM, India — A tangle of green blankets the land amid thick tropical heat. Shady groves of cashew trees strew the ground with juicy, perfume-scented fruits. Men can be seen climbing coconut palms to tap into the trunks for wine. The region’s name, Uddanam, comes from a word in Sanskrit that means “Beautiful Garden” or “Paradise.”

Uddanam’s rich terrain seems an unlikely place for the mysterious strain of illness tormenting the area. For more than a decade, a rash of chronic kidney disease has been striking down the villagers of this remote agricultural belt in the state of Andhra Pradesh, India. In some villages, the disease has impacted from 24 to 37 percent of the population, two to three times higher than elsewhere in the district, according to unpublished results from a study by Harvard Medical School.

As the death toll mounts, the seemingly idyllic region has become stigmatized. In contrast to Nicaragua’s “Island of the Widows,” which is named for the alarming rate of chronic kidney deaths among the community’s husbands, residents of Uddanam say they now have trouble getting married at all.

“Other people, they don’t want to come for marriage,” said Dr. Priya Prathibha, the state medical officer in the hard-hit village of Varaka. “They are not giving any bride or bridegroom to this area, this Uddanam area.”

KEBITHIGOLLEWA, Sri Lanka — For two decades, chronic kidney disease has been a mystery and death sentence in Sri Lanka, striking 15 percent of the residents of its north central region.

This summer, after years of secretive official research, a glimmer of scientific hope emerged. The government and World Health Organization announced in June that they identified a key cause of the disease in Sri Lanka: chronic exposure to arsenic and cadmium, likely consumed in food.

Yet in a disease that has confounded experts across continents, even potential breakthroughs come with asterisks. The new report left huge questions unanswered — including where in the country the toxins were found, how they entered the food and what foods were contaminated. The key unsolved question: the extent fertilizers and pesticides contributed to the outbreak.

In Sri Lanka’s lush northern farmlands, the mystery and the death sentences continue. Lacking firm answers from the scientific community, some victims’ best hope for survival comes through the spiritual community — and offers of kidney transplants from Buddhist monks and those they inspire to make extraordinary sacrifices for strangers.

At 21, Sampath Kumarasinghe is among the victims awaiting that miracle.

The soft-spoken farmer was diagnosed last September with kidney damage so severe it had reached its terminal phase: end stage renal disease. Healthy his entire life, he suddenly became feverish and too sick to work in the rice paddies. His mother mortgaged their land to pay for his medical care, and they began the search for a kidney donor. One day, like a vision, a man appeared in his hospital offering to donate his kidney.

“I am only thinking of ways to save my son’s life,” said Sampath’s mother, Punchirilalage Dingiri Manike. “That is what I think of day and night.”

Politicians who are promising to repeal ObamaCare won’t find any evidence in the Kaiser Family Foundation’s analysis of health insurance costs that the law has caused premiums to skyrocket, as many of those politicians have contended.

On the contrary, premiums have increased on average only 4 percent over the past year, the lowest rate of increase in years, according to Kaiser’s 2012 Employer Health Benefits Survey, which was released last week. Double-digit premium increases were once the norm, especially during the George W. Bush administration. Premiums increased 10 percent in 2004 and 13 percent in 2003.

So the good news is that premiums increased only 4 percent. The not so good news is that, because of all those past double-digit increases, the average premium for employer-sponsored health coverage has reached a record high of $15,745. And because employers have been shifting more and more of the cost of coverage to workers, employees are now paying, on average, nearly 30 percent of that total, much more than they used to. The hike in worker contributions has far outstripped the overall rise in premiums.    

A study published last year in Health Affairs found that the gains in wages U.S. workers made over the past decade were more than wiped out by increases in the cost of health care and health insurance. Kaiser’s annual surveys document that: since 2002, premiums have increased 97 percent, which is three times as fast as wages (33 percent) and inflation (28 percent).

That’s not all the bad news, unfortunately. More Americans are now enrolled in high deductible plans, because that’s frequently all their employers are offering. Kaiser found that the percentage of workers enrolled in plans with an annual deductible of $1,000 or more has increased from 10 percent in 2006 to 34 percent in 2012. The growth has been even greater for employees of small firms.