Sunday, June 30, 2013

As Doctors Leave Syria, Public Health Crisis Looms

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Refugees fill cans with water inside a camp in Baalbek, Lebanon, for Syrians who have fled the fighting in their country.

Spencer Platt/Getty Images

Refugees fill cans with water inside a camp in Baalbek, Lebanon, for Syrians who have fled the fighting in their country.

Spencer Platt/Getty Images

The death toll in Syria's ongoing civil war may now be as high as 100,000. As the violence mounts, another emergency is looming: a public health crisis across the region.

That's the conclusion of a new study published by the British medical journal The Lancet. Syria's health care system is near collapse. Outbreaks of disease are on the rise in the country, and refugees sheltered beyond the border are also at great risk.

One medical clinic in a poor neighborhood in Beirut is always busy. The two-story building is up a narrow street of cinder-block homes. Syrian refugees have moved in, adding to the crowding and the caseload, Dr. Abdul Kader Abbas says. He says he's treated 758 Syrian families here � many already sick when they arrived in this densely packed neighborhood.

"With the additional numbers," Abbas says, "we are afraid that any disease could spread easily in such circumstances." That's the same warning spelled out in the latest Lancet report.

Seventy percent of Syria's medical professionals have fled the country. Public health researchers Dr. Adam Coutts and Dr. Fouad Fouad say there has been a dramatic rise in communicable disease.

For example, Coutts says, there were 7,000 cases of measles in northern Syria in the past few months after a vaccination program was disrupted by war, and the list is growing to include TB, leishmaniasis, typhoid and cholera, which will come up during the summer months.

Leishmaniasis is spreading so fast among the displaced people inside of Syria that it is now called the "Aleppo boil" � for the running skin sores transmitted by sand fleas. Fouad says with the collapse of Syria's health care system, many Syrians have not had any medical care or medicine for more than two years.

When you consider chronic diseases like diabetes, Type 1 and 2, and cancer, Fouad says, you start to see that more people are dying of disease rather than war.

Disease moves easily across boundaries along with the refugees. Coutts and Fouad warn this could lead to a public health crisis for the entire region. By the end of this year, the Syrian refugee population is expected to reach more than 3 million.

In Jordan, the patient load in hospitals has jumped 250 percent in the past five months. Lebanon's health system is under strain with more registered refugees than any of its neighbors.

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"With this huge influx of refugees now in Lebanon," Fouad says, "the number will come to change the whole system."

One expected change is in the school system. U.N. officials estimate that when school starts in the fall, Syrians will outnumber Lebanese kids in the country's public schools. That worries Hayda Mohammed Al Jeeshi, the nurse at the health care center.

She says many Syrian kids missed childhood vaccinations before they fled to Lebanon and that puts Lebanese children at much greater risk. The measles outbreak that started in northern Syria is now showing up among the refugee community in Lebanon.

Scrambling to care for one of the world's largest refugee populations is another burden of the Syrian war. The U.S. government has upped its contribution to host countries to more than $800 million, with an additional $300 million pledged this month for food, shelter and health care.

"Diseases don't care whether you're for Assad, or against Assad, or uninterested in politics," says Anne Richard, the U.S. assistant secretary of state for refugees, who was in Lebanon this week. "It strikes everyone, as an equal opportunity."

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Wednesday, June 26, 2013

How The End Of DOMA Will Affect Obamacare, Federal Employees

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Sunday, June 23, 2013

Ohio Family-Planning Services At Mercy Of Budget Bill

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Family-planning clinics would be pushed down the list of health services receiving funding from the state if a budget bill moving through the Ohio Legislature is signed into law.

iStockphoto.com

Family-planning clinics would be pushed down the list of health services receiving funding from the state if a budget bill moving through the Ohio Legislature is signed into law.

iStockphoto.com

Working its way through the Ohio Legislature is a state budget bill that has major implications for the way family-planning services are provided. The Ohio budget contains language that puts family-planning clinics at the bottom of the list to receive funding.

Family Planning Association of Northeast Ohio operates several independent family-planning clinics. They do not provide abortions and have no affiliation with Planned Parenthood, but the clinics are still at the end of the line under a new tiered system because they give referrals.

Ahead of the facilities are local health departments, places like emergency rooms and free clinics. Family Planning's executive director, Mary Wynne-Peaspanen, says if there's any money left over � which she says is not likely � "then they could consider applications from independent, specialty clinics like my organization and like Planned Parenthood."

The budget bill from the Republican-controlled Legislature could well put the nonprofit out of business. Since 1970, it has served primarily low-income women, but it's facing an anticipated 40 percent hit to its funding.

"They've been very clear about the fact � at the General Assembly � that their target is Planned Parenthood. But that doesn't change the fact that there are other organizations that will be impacted by this funding," Wynne-Peaspanen tells Jacki Lyden, host of weekends on All Things Considered.

National Trend

In Ohio and elsewhere, family-planning clinics typically provide a range of women's health services, like cancer screenings, blood pressure tests and contraceptive services.

Judy Waxman, vice president for health and reproductive rights at the National Women's Law Center, says the vast majority of women who are sexually active have used contraception at some point in their lives.

"So on one level, we as a nation have recognized that contraceptives are not only what everybody uses, but they also are very important for women's health," she says. "There is, however, a minority of politicians who try to use any issue related to 'sex' to make some kind of political hay out of it."

Waxman says a handful of states are looking at centers that receive Medicaid or state funding for family-planning services � and some are cutting the budgets. Those states include Indiana, Arizona, Wisconsin and now Ohio.

The Anti-Abortion Lobby

Michael Gonidakis is the president of Ohio Right to Life, one of the groups that lobbied hard for the current legislative approach. He admits the ultimate objective is a straightforward one.

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"Our goal is to find a way to end abortion. Not make it illegal, but to end it," he says. "We're big proponents of adoption reform, foster care reform, and we want to find ways to continue to help women who find themselves in unintended pregnancy, to realize that they can have their baby, that there's support services there for them to keep their child."

He doesn't expect that women will have less access to family planning, not even those who are low-income.

"There's nowhere � and I repeat, nowhere � in the state of Ohio where there won't be other options in a very close walking proximity to ... a clinic that may go out of business," he says. "We're doing some good things here in Ohio, and there's access to these types of services and care for low-income women across the state."

But it still worries Jess Locher, a 28-year-old uninsured cosmetologist in Chardon. She went to the local branch of the Family Planning Association as a teenager. Ten years later, the mother of two still goes to the same clinic because she can't afford anything else.

"If they took family planning away, I wouldn't be getting the female care that I need because my job doesn't offer me insurance, so I couldn't afford to go to a gynecologist," Locher says.

Take Texas, For Example

Ohio is on the verge of making decisions that would alter the way family planning is funded. Texas started down this road two years ago.

"When the Tea Party wave came through Texas in 2010, there was a big movement to oust Planned Parenthood from all of the state health programs," says journalist Becca Aaronson.

Aaronson, who covers health care for the Texas Tribune, says state lawmakers took a three-pronged approach to cutting family-planning funds. They cut family-planning funding, then set up a tiered financing system prioritizing comprehensive health clinics. Third, they prohibited any group affiliated with a provider that performed abortions from participating in the Medicaid women's health program.

More than 50 clinics throughout Texas closed their doors. As the dust settled, the consequences of this policy started to become apparent, Aaronson says.

"The state estimates that roughly 24,000 babies are going to be born as a result of these changes, and that's because women don't have as much access to birth control," she says.

The spike caused enough of a stir in Texas for state legislators to restore some of the funding to family planning.

"They decided to put an extra $100 million toward primary care for women's health, so that many uninsured women of all ages could get cancer screenings, diabetes treatment and family-planning access," Aaronson says.

Waxman of the National Women's Law Center considers the Texas legislation "a failure for women in the state."

"It's possible in some circumstances that women could go somewhere else, but many other health centers don't provide family-planning services because they know Planned Parenthood is available to do that," she says.

Stay Tuned

Waxman says the issue is an ideological one. "I can only hope that those people that are really outliers on this issue not continue to erode and really hurt the women in their states," she says.

Who's hurt and who's helped by laws on access to family-planning services is in part, of course, a matter of deeply held opinion and even religious faith.

In Ohio, Wynne-Peaspanen at the Family Planning Association is bracing herself.

"I've been with the agency for 27 years. And funding cuts happen and, you know, funding increases happen. But this is ... the most serious," she says.

Gonidakis from Ohio Right to Life says he's confident things will be just fine.

"I do not foresee any situation whatsoever where a woman's going to be denied services because of the availability of so many other clinics in the state of Ohio," he says.

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Friday, June 21, 2013

Universal Healthcare and Economic Freedom Go Hand-in-Hand

One of the most pernicious myths of the past half century is that guaranteeing healthcare for all Americans would strike a mortal blow against this country’s system of free enterprise.

That claim has been made endlessly in the context of the Affordable Care Act, and Obamacare critics are now ramping up their predictions of doom as implementation of the law grows near.

But as Robert Frank explained this weekend in the New York Times, the lived experience of other countries like Sweden with national healthcare systems doesn’t bear out the fears.

In fact, you don’t need to take the word of a progressive economist like Frank on this point. The Heritage Foundation’s research indicates the same thing.

Consider Heritage’s “Index of Economic Freedom,” which measures how friendly countries are to business, investors, and property rights.

The countries that rank the highest on the list are: Hong Kong, Singapore, Australia, New Zealand, Switzerland, Canada, Chile, Mauritius, Denmark, and the United States.

Of those ten countries, nearly every one has a universal healthcare system or mandates that individuals pay into medical savings accounts. Australia and Canada both have single-payer systems. Denmark’s system is pretty much government controlled. Switzerland’s system is similar in many ways to Obamacare. Among the top twenty nations on the list are Ireland, the U.K., Germany, Sweden, and Finland — other countries that also have universal healthcare systems.

There are some good reasons why such systems might go hand-in-hand with economic freedom. For one thing, as Robert Frank noted, these systems help keep down healthcare costs:

The United States spends more than $8,000 a person per year on health care, well more than twice what Sweden spends. Yet health outcomes are far better in Sweden along virtually every dimension.

Lower healthcare costs mean that business and individuals can channel more money into productive uses that foster a vibrant and globally competitive market economy.

Universal healthcare systems also make it easier for people to be entrepreneurs or self-employed. While we think of the United States as a place where people are uniquely likely to strike out on their own, this is largely a myth. The U.S. actually has a much lower self-employment rate than most developed countries. Australians, Brits, Germans, Swedes, and so on all are more likely to work for themselves than Americans.

It’s hard to say how much universal healthcare insurance determines self-employment rates, but common sense suggests you’re more likely to go out on your own if you’re not worried about losing your health insurance.

Now, does all this mean that Obamacare will produce more economic freedom in America? Not necessarily. Ironically, government run healthcare system are better for free enterprise than those — like the ACA — which impose mandates on employers.

I say ironically because, of course, such a truly “socialized” system was off the table during the healthcare debate thanks opposition by supposed defenders of economic freedom.

Monday, June 17, 2013

After Long Search, Komen Foundation Replaces Brinker As CEO

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Saturday, June 15, 2013

Commentary: On Being Young and Wanting Health Insurance

Ed. note: This blog was first published on BET. You can see the original post here.

I'm a 24-year-old server and bartender in Philadelphia, an uncle, and a father figure to my sister's three children. And I'm one of the millions of young Americans who can't afford health insurance.

Until recently, that never struck me as a big deal. �When you're young and healthy, you don't really think about health insurance-or at least you don't think about it until something goes wrong and you need it.

Not too long ago, I hurt my foot pretty badly, and thought that I may have fractured a bone.� It was the sort of injury that if I had insurance I would've gotten checked out, but since I wasn't covered and couldn't afford to go see a doctor, I ended up just working through the pain.

That experience made me think about the consequences that a really serious accident could have on the rest of my life.� Without insurance, one injury could just turn my future upside down.

That's why I'm looking forward to the new Health Insurance Marketplaces being created thanks to the health care law.� This October, I'll be one of the people checking out affordable health plans on HealthCare.gov.� I'll figure out which plan is the best fit for me and for my wallet, and I'll find out if I can get additional help covering costs from the new tax credits the law is making available.

Having health insurance is all about peace of mind-it means somebody's got your back in case anything happens to you.� And having that worry off my shoulders is going to make things so much easier for me as I work toward my goals, whether that ends up meaning going back to school or maybe looking for a better job.

Just because I'm young and healthy now doesn't mean I shouldn't be looking out for my future.� That's why I'll be visiting the Marketplace on October 1 to choose a health insurance plan.

You can learn more about the Marketplace and what you need to do to prepare for October.

Commentary: On Being Young and Wanting Health Insurance

Ed. note: This blog was first published on BET. You can see the original post here.

I'm a 24-year-old server and bartender in Philadelphia, an uncle, and a father figure to my sister's three children. And I'm one of the millions of young Americans who can't afford health insurance.

Until recently, that never struck me as a big deal. �When you're young and healthy, you don't really think about health insurance-or at least you don't think about it until something goes wrong and you need it.

Not too long ago, I hurt my foot pretty badly, and thought that I may have fractured a bone.� It was the sort of injury that if I had insurance I would've gotten checked out, but since I wasn't covered and couldn't afford to go see a doctor, I ended up just working through the pain.

That experience made me think about the consequences that a really serious accident could have on the rest of my life.� Without insurance, one injury could just turn my future upside down.

That's why I'm looking forward to the new Health Insurance Marketplaces being created thanks to the health care law.� This October, I'll be one of the people checking out affordable health plans on HealthCare.gov.� I'll figure out which plan is the best fit for me and for my wallet, and I'll find out if I can get additional help covering costs from the new tax credits the law is making available.

Having health insurance is all about peace of mind-it means somebody's got your back in case anything happens to you.� And having that worry off my shoulders is going to make things so much easier for me as I work toward my goals, whether that ends up meaning going back to school or maybe looking for a better job.

Just because I'm young and healthy now doesn't mean I shouldn't be looking out for my future.� That's why I'll be visiting the Marketplace on October 1 to choose a health insurance plan.

You can learn more about the Marketplace and what you need to do to prepare for October.

Friday, June 14, 2013

Men: Don’t Wait for a Wakeup Call When it Comes to Your Health

As a group, we men are not known for doing a very good job of taking care of our own health.

National Men�s Health Week, from June 10 through Father�s Day on June 16, is a good time for us to start taking responsibility and doing what�s needed to stay healthy and active. That means eating right, taking the time to exercise, and�yes�talking to our doctors about what checkups we need.

Many health problems are preventable or more easily treated if we�re proactive about our health. The good news is the Affordable Care Act ensures that most health insurance plans cover recommended preventive services at no out-of-pocket cost.

Some of these services that are particularly important to men ages 40 to 64 include blood pressure and cholesterol checks, flu shots and tobacco cessation services.

Make sure your fathers, grandfathers, friends and uncles on Medicare know that they are eligible for these and other preventive services such as a yearly wellness visit, with no co-pays or deductibles.�

On October 1, 2013, there will be a new way for men to find affordable, quality health insurance through the Health Insurance Marketplace. You will be able to compare private insurance plans at the new Health Insurance Marketplace on HealthCare.gov and purchase the one that best suits your needs and wallet, for coverage starting January 1, 2014. You will also be able to use the same website to find out if you�re eligible for free or lower-cost coverage.

Beginning next year, you can�t be turned down or charged more because of a pre-existing condition, such as diabetes, asthma, high blood pressure, or because of the type of work you do.

Educate yourself and get information to share with all the men in your life -- your sons, brothers, fathers, uncles, cousins, partners, and friends -- by signing up now at HealthCare.gov.

During National Men�s Health Week, let�s man up and take control of our health�for the peace of mind and security that we and our families deserve.

There�s no better Father�s Day gift for the fathers and men � and women and children � who care for us.

Scientists Go Medieval To Solve Ancient Leprosy Puzzle

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Thursday, June 13, 2013

Judge Reluctantly Approves Government Plan For Morning-After Pill

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Friday, June 7, 2013

30 Million to Remain Uninsured Under Obamacare

Harvard and CUNY researchers say 4.9 million Texans and 3.7 million Californians will still be uninsured in 2016

A study released today on the Health Affairs blog finds that between 29.8 million and 31.0 million people will remain uninsured after the implementation of the Affordable Care Act in 2016 and breaks down those figures by state.

The research team from Harvard Medical School and the City University of New York School of Public Health projects that the demographic composition of today�s uninsured population will change little under Obamacare.

The share of the uninsured who are U.S. citizens will rise slightly from 80 percent to 81 percent. White persons (of all ethnicities) will continue to constitute 74 percent of all uninsured Americans. About 59 percent of the uninsured will have incomes between 100 percent and 399 percent of poverty, while 27 percent will have incomes below poverty.

The researchers also estimated uninsured figures for each state (see table below).

The study analyzed Census Bureau data on current patterns of uninsurance, and used a coverage prediction model based on the model used by the Congressional Budget Office.

The researchers projected two coverage scenarios for each state. One assumed that the state turns down a Medicaid expansion and the other assumed that the state implements Medicaid expansion despite the Supreme Court ruling that such expansion is optional. The national estimates use the Advisory Board Company�s latest summary of which states are likely to participate in the Medicaid expansion.

Study co-author Dr. Steffie Woolhandler, a professor at CUNY and visiting professor of medicine at Harvard, said: �Many people believe that Obamacare will cover everyone. But the reform is so deeply flawed that 30 million or more will still be uninsured after it�s fully implemented. Even if the Supreme Court hadn�t let states of the hook for Medicaid expansion, 26 million would have been uninsured. We need to replace Obamacare with a simple single-payer system that would cover everyone.�

Lead author Dr. Rachel Nardin, chief of neurology at Cambridge Health Alliance and assistant professor of neurology at Harvard, commented: �Even in Massachusetts, where a reform like Obamacare has been in place since 2006, too many patients still can�t get the care they need. Hundreds of thousands are still uninsured, and many more have such skimpy coverage that they face unaffordable co-payments.�

�The Uninsured After Implementation of the Affordable Care Act: A Demographic and Geographic Analysis,� Rachel Nardin, M.D., Leah Zallman, M.D., M.P.H., Danny McCormick, M.D., M.P.H., Steffie Woolhandler, M.D., M.P.H., David Himmelstein, M.D. Health Affairs blog, June 6, 2013.

Thursday, June 6, 2013

Court Says Some Morning-After Pills Must Be Available OTC Now

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NIH Chief Rejects Ethics Critique Of Preemie Study

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Saturday, June 1, 2013

Survivor Of Boston Marathon Bombings Has Long Road Ahead

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