Reforming American Health Care
(The Economist, London, June 27, 2009)
"America’s health care is the costliest in the world, yet quality is patchy and millions are uninsured. Incentives for both patients and suppliers need urgent treatment...No one will be astonished to hear that health care costs more in Indiana than in India. However, a few might be surprised to learn that Americans spend more than twice as much per person on health care as Swedes do. And many may be shocked to be told that in Miami people pay twice as much as in Minnesota, even for far worse care. The American health-care system, which gobbles up about 16% of the country’s economic output, is by far the most expensive in the world…The Congressional Budget Office (CBO) estimates that on current trends spending on Medicare and Medicaid, the government schemes for the old and the poor, will rise from 4% of GDP in 2007 to 12% in 2050. The prospect of long-term fiscal disaster is the main reason why efforts to reform health care are gaining momentum in Washington, DC…Comparisons with other rich countries and within the United States show that America’s health-care system is not only growing at an unsustainable pace, but also provides questionable value for money and dubious medical care. Three troubling symptoms stand out: uneven quality of care, inadequate coverage and soaring costs."
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Health-Care Reform in America: This Is Going to Hurt
(The Economist, June, 27, 2009)
"Barack Obama was elected in part to fix America’s health-care system. Now is the time for him to keep his word."
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Related story:
How Much Would Health Care Overhaul Cost? Experts Aren’t Sure
David Lightman
(The Sacramento Bee, July 2, 2009)
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Insured, but Bankrupted by Health Crises
Reed Abelson
(The New York Times, June 30, 2009)
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'Frequent Fliers' Add Billions to Hospital Bills
Joanne Kenen
(The Washington Post, June 30, 2009)
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Wal-Mart Says It Backs a Mandate on Insurance
Sheryl Gay Stolberg
(The New York Times, June 30, 2009)
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Opinion round-up:
Getting a Second Opinion on Healthcare Reform: There Are Voices Besides the AMA
Opinion,
Rahul Rajkumar, physician at Brigham and Women's Hospital in Boston
and Harold Pollack, professor of social service administration at the University of Chicago
(Los Angeles Times, June 30, 2009)
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Time for Iron Man
Opinion, E.J. Dionne Jr.
(The Washington Post, June 29, 2009)
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Editorial
(The New York Times, June 28, 2009)
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The Forbidding Arithmetic of Healthcare Reform
Opinion, Joan Vennochi
(The Boston Globe, June 28, 2009)
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The Pitfalls of the Public Option
Opinion, N. Gregory Mankiw, professor of economics at Harvard
(The New York Times, June 27, 2009)
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Congress 'Discovers' an Old Idea
Opinion, Patrick McIlheran
(Milwaukee Journal Sentinel, June 27, 2009)
Patient-Centered Healthcare
Opinion,
Thomas M. Ryan, chairman, CEO, and president of CVS Caremark
(The Boston Globe, June 26, 2009)
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(Associated Press, July 1, 2009)
"The percentage of Americans with private health insurance has hit its lowest mark in 50 years, according to two new government reports. About 65 percent of non-elderly Americans had private insurance in 2008, down from 67 percent the year before, according to preliminary data released Wednesday by the U.S. Centers for Disease Control and Prevention. ‘It's bad news,’ said Kenneth Thorpe, a health policy researcher at Emory University. In the 1970s and early 1980s, nearly 80 percent of Americans had private coverage, according to CDC officials. Some experts blamed the faltering economy and corporate decisions to raise health insurance premiums -- or do away with employee coverage -- as the main drivers of the recent data."
Editorial
(The Boston Globe, July 1, 2009)
"As the Commonwealth of Massachusetts and its 6 million residents struggle to pay their medical bills, they have a new tool on their side, starting today. A law cracking down on the marketing that pharmaceutical firms do with doctors goes into effect…All the favors that drug companies do for doctors raise overall health costs in two ways. First, they are a substantial part of the $57.5 billion that the industry spends annually on marketing, a cost that gets added on to each prescription a patient buys. Second, the industry’s goal in influencing doctors is often to get them to prescribe a new, higher-priced medication…While Massachusetts, the sixth state to restrict drug-industry gifts to doctors, has the most comprehensive law, it is far from perfect."
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(Associated Press, June 30, 2009)
"The government is about to spend millions to try to uncover the best treatments for scores of ailments -- and how to handle these four biggies leads a list of top 100 questions that doctors need answered. One of medicine's secrets: Doctors often have to guess at which treatment or test is best for a certain patient. There's very little good scientific evidence comparing them. As part of the economic stimulus package, Congress set aside a down payment of $1.1 billion to start figuring that out, so patients don't waste time and money on poor choices. But where to start? Tuesday, the prestigious Institute of Medicine delivered a blueprint -- the top 100 priorities to study first. 'This program is a program about improving decisions for patients,' said Dr. Harold Sox of the American College of Physicians, who co-chaired the IOM report. Some of the questions may surprise patients and families."
See also:
Finding What Works in Health Care
Opinion, William C. Weldon, chairman and chief executive officer of Johnson & Johnson
(The Washington Post, July 2, 2009)
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Bruce Japsen
(Chicago Tribune, June 29, 2009)
"Despite repeated calls by President Obama and members of Congress for people to have a medical home -- a primary-care physician -- those doctors usually receive low pay for what they do. Such doctors include family physicians, pediatricians and internists who are generally paid less than specialists but are key to keeping patients well and out of the more expensive hospital care setting…Medicare-driven compensation also rewards doctors who do procedures over those who diagnose illness and dispense prescriptions…Primary-care physicians say it's more than just paying doctors a fee when they come to the office -- they need incentives to cover their costs of coordinating follow-up care, including return visits to make sure a diabetic patient is taking medications or adhering to a wellness program. Payments, these doctors say, should be performance-based so doctors are rewarded when they successfully manage their patients' care."
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(Associated Press, June 29, 2009)
"From the Colorado homeless shelter to rural Pennsylvania clinics that can accept new patients, health centers that serve the poor are among the first places the federal stimulus package is being spent. The stimulus law sets aside $2.5 billion for free and low-cost health clinics, and a big chunk of it -- about $500 million -- is already being spent. The White House has promised another burst of money this summer…Health clinic executives say the money will allow them to keep their doors open as the rolls of uninsured patients grow. An estimated 64 million people use rural health clinics, a number that is expected to rise as people lose their jobs and health insurance...The health clinic grants are one-time boosts, not long term health care fixes. The stimulus won't make up for a lack of doctors in poor and rural areas, a shortage the Association of American Medical Colleges says is growing and could reach 159,000 doctors by 2025."
Christina Pazzanese
(The Boston Globe, June 29, 2009)
"Massachusetts is recognized as a pioneer in public health…But now the state’s network of community health departments is stretched so thin that some are unable to provide important services, public health officials said…The question, officials said, is whether the cuts already seen in a handful of communities are a bellwether of what is to come across the state...'I think this summer we’ll see more significant cuts,' as communities come to grips with the reality of shrinking state aid, Valerie Bassett, executive director of the Massachusetts Public Health Association, said in an interview last month…Massachusetts is one of only a few states nationwide that do not provide direct public health funding beyond grants to municipalities, officials said. Unlike most parts of the country, where public health is overseen and funded at the county level, cities and towns here generally work on their own, said Bassett."
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Editorial
(Los Angeles Times, June 29, 2009)
"The cost problem has multiple causes, but a primary one is the overuse of medical services and technology. Today's health insurance system gives physicians and hospitals little incentive to practice medicine cost-effectively. And as long as they can pass their costs on to consumers in the form of ever-rising premiums, insurance companies don't need to be disciplined spenders either. To create the right incentives, insurers should move away from paying for each treatment or service performed for a patient -- an approach that rewards volume, not effectiveness -- and instead base reimbursements on the treatment plans that produce the best results."
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Benny Evangelista
(San Francisco Chronicle, June 28, 2009)
"Sean Chai tapped the screen of the tabletop home medical monitor, which began to talk…After uploading data from the blood pressure cuff, the monitor asked if the visitor had taken his daily medication and 'do you find yourself in a depressed mood most days?' In the future, the answers could trigger scheduling software for a doctor's appointment or initiate a direct video call to the physician. Or it might display video of admonishments from the patient's children. Chai is the senior information technology manager for Kaiser Permanente's Sidney R. Garfield Health Care Innovation Center. His job is to imagine the future of medical technology and test gadgets such as the home monitor to see if they are practical."
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A Doctor’s Vision of the Future of Medicine
Opinion,
Leroy Hood, a pioneer of systems biology and medicine and founder of the Institute for System Biology
(Newsweek, June 27, 2009)
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Jay Weaver
(The Miami Herald, June 27, 2009)
"A new sense of urgency is shaping the U.S. government's fight against Medicare fraud as the Obama administration strives to sell the public on expanding healthcare to cover uninsured Americans…Experts estimate the huge entitlement program loses at least $60 billion to fraud every year, with Miami-Dade County at the center of the national crisis. 'The Obama administration is committed to turning up the heat on Medicare fraud'…HHS Secretary Kathleen Sebelius said during a news conference at the Justice Department with Attorney General Eric Holder…'Every dollar we can save by stopping fraud can be used to strengthen the long-term fiscal health of Medicare, bring down costs and deliver better service to Medicare beneficiaries.' The government's job will be anything but easy. During the past five years, thousands of Medicare fraud offenders have shown that they can outsmart the vulnerable healthcare system for the elderly and disabled…Consider the series of eye-opening criminal cases this week."
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Steve Connor
(The Independent, London, July 2, 2009)
"Scientists have discovered a remarkable similarity between the genetic faults behind both schizophrenia and manic depression in a breakthrough that is expected to open the way to new treatments for two of the most common mental illnesses, affecting millions of people. Previously doctors had assumed that the two conditions were quite separate. But new research shows for the first time that both have a common genetic basis that leads people to develop one or other of the two illnesses. Three different international studies investigated the genetic basis of schizophrenia by pooling their analysis of about 15,000 patients and nearly 50,000 healthy subjects to find that thousands of tiny genetic mutations -- known as single nucleotide polymorphisms (SNPs) -- are operating in raising the risk of developing the illness…However, one of the most surprising findings to emerge from the three studies was that the same array of genetic variations in SNPs was also linked with bipolar disorder, a discovery that is at odds with the orthodoxy in psychiatry stating that the two conditions are clinically distinct, the scientists said."
(Associated Press, June 29, 2009)
"A surprising number of teenagers -- nearly 15 percent -- think they're going to die young, leading many to drug use, suicide attempts and other unsafe behavior, new research suggests. The study, based on a survey of more than 20,000 kids, challenges conventional wisdom that says teens engage in risky behavior because they think they're invulnerable to harm. Instead, a sizable number of teens may take chances ‘because they feel hopeless and figure that not much is at stake,’ said study author Dr. Iris Borowsky, a researcher at the University of Minnesota. That behavior threatens to turn their fatalism into a self-fulfilling prophecy…The study suggests a new way doctors could detect kids likely to engage in unsafe behavior and potentially help prevent it, said Dr. Jonathan Klein, a University of Rochester adolescent health expert who was not involved in the research."
Cynthia Hubert
(The Sacramento Bee, June 28, 2009)
"[F]or reasons that are unclear, diagnoses [of Autism] have skyrocketed and the condition is surfacing in an estimated 1 in 150 children. As a tidal wave of these youngsters moves toward adulthood with complex behavioral and medical problems, society is largely unprepared. 'We don't have the programs. We don't have the research,' said Dr. Robert Hendren, director of the UC Davis M.I.N.D. Institute. 'We have this very large adult population of autistics coming along, and we don't know how to deal with them. We just haven't come to terms with it.' But the futures of hundreds of thousands of autistic people in America cannot be ignored for long, said Hendren and others…Nationally, the number of autistic children expected to need extensive adult services by 2023 is about 380,000 people, and the bill for caring for them will be in the billions of dollars. Care providers are just beginning to grapple with how to deal with the surge, even as governments slash social services to cope with budget deficits."
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Clyde Haberman
(The New York Times, June 29, 2009)
"Before too long, you may be forced to stare at a photo of blackened lungs, oozing decay, every time you go to the bodega for a quart of milk…The photo is the latest idea from the city’s Department of Health and Mental Hygiene, part of its nonstop campaign to acquaint the citizenry with the wickedness of smoking. Show smokers right there at the checkout counter how much gunk coats their lungs and maybe they will reconsider plunking down that Hamilton for a pack of cigarettes. That’s the theory."
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Opinion
Patrick Fleenor, chief economist at the Tax Foundation
(Los Angeles Times, June 29, 2009)
"Nicholas Goldberg's 'How and why taxes go up, in smoke' (June 14) reads more like press release from the anti-smoking lobby than an objective question-and-answer backgrounder: Smoking is bad and the state needs more money, therefore hiking the cigarette tax is good. If smokers quit, so much the better. It's a win-win! Oh, if life were only so simple. There are no easy answers to California's budget woes. These problems have been building for decades. Perhaps it's time for citizens to fundamentally reappraise exactly what they want the state government to do and devise a fair and efficient tax system for collecting revenue. Hiking what is already one of the most unfair and disruptive taxes on the books will only increase the harm to smokers and nonsmokers alike."
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Denis Campbell
(The Observer, London, June 28, 2009)
"A growing global trade in black market cigarettes is killing tens of thousands of people a year, causing massive health problems and costing governments billions of pounds, a hard-hitting report warns today. A staggering 657 billion cigarettes a year are sold illicitly by organised crime gangs, half of all tobacco sold in some countries is contraband, and £24.6bn in taxes are never paid, it says. The report makes plain that, contrary to the tobacco industry's claims, cigarette smuggling is much more common and damaging in poorer countries. Inefficient law enforcement, lax border controls and corruption among police and government officials mean smugglers find it easier to move large consignments of stolen or counterfeit cigarettes into countries in the developing world. More than five million people a year die worldwide from tobacco use, and about 80% of all smokers live in developing countries. The World Health Organisation classifies tobacco as the leading cause of preventable death."
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Sarah Arnquist
(The New York Times, June 29, 2009)
"The United States has a single poison control hot line -- 800-222-1222 -- available all day, every day for questions about potential poisonings. About two million people call the hot line annually. Half the calls concern children 5 and younger. Calls to the poison hot line, like those to 911, are redirected to local call centers financed with local money. One state’s poison calls could be answered by experts elsewhere, Ms. Giffin said, but the state would have to pay for that service. 'If one state can no longer sustain the cost of a poison center, no other state is going to be able to provide that service,' she said. The federal government provides less than 20 percent of poison center financing, and the rest comes primarily from the states. Given the budget constraints most states face, poison control experts worry that California could set an ominous precedent by eliminating the nation’s largest program. Michigan has reduced its financing and will downsize in July to one poison center, from two."
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Editorial
(Houston Chronicle, June 29, 2009)
"There is nothing sadder than the death of a child -- except perhaps the accidental death of a child -- one that could have easily been prevented…Most of the deaths have occurred outside, in pools, bayous, ponds and streams, but children are at risk inside too -- from bathtubs, sinks, toilets, buckets, even aquariums. It takes about two minutes for a child to lose consciousness, and four to six minutes to suffer irreversible brain damage. The other deadly summertime hazard, especially for young children, is being left alone in a car…Since a child’s heat-regulating system is not as efficient as an adult’s, the body temperature rises three to five times faster…The bottom line is eternal vigilance. Never leave a child alone, even for a few seconds."
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Opinion
Wendy Parmet, a professor of law at Northeastern University School of Law, and author
(The Boston Globe, June 30, 2009)
"Over the last five years, the catchphrase for US pandemic policy was 'preparedness.' At its core, preparedness emphasized the need to keep watch and be ready for a public health catastrophe, such as a highly lethal pandemic. As a result, policies based on preparedness emphasized not only the need to enhance surveillance, to detect the onset of a new outbreak, but also emergency measures, including coercive emergency laws, that were designed to keep out or contain a dangerous new pathogen. States were urged to revise their public health laws, to grant health officials clearer authority to impose quarantines and other highly coercive measures. Laws were also passed immunizing drug companies and healthcare workers for medical responses to an epidemic. All these laws, preparedness advocates argued, would facilitate a robust response in the event of a public health emergency. The H1N1 pandemic reveals the fallacy of relying on public health emergency laws to contain an epidemic."
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(Associated Press, June 29, 2009)
"In a startling measure of just how widely a new disease can spread, researchers accurately plotted swine flu's course around the world by tracking air travel from Mexico. The research was based on an analysis of flight data from March and April last year, which showed more than 2 million people flew from Mexico to more than 1,000 cities worldwide. Researchers said patterns of departures from Mexico in those months varies little from year to year; swine flu began its spread in March and April this year. Passengers traveled to 164 countries, but four out of five of those went to the United States. That fits with the path of the epidemic a year later. The findings were reported Monday in the New England Journal of Medicine. The research shows promise in forecasting how a new contagion might unfold, indicated one government health official who praised the work."
Helen Branswell
(The Globe and Mail, Toronto, June 27, 2009)
"If you went by statements from the pharmaceutical industry, you might be tempted to think it was nearly time to roll up your sleeve for a swine-flu shot. In the race to produce a pandemic vaccine, several companies have declared themselves front-runners, suggesting that their products are on the verge of being ready. But are they on the verge of being ready for use? Maybe not just yet…Making vaccine and convincing regulatory agencies that the substance is safe to inject into humans are separate matters. That is always the case, but it's especially true when the vaccine in question is to protect against swine flu. The last time mass vaccination against a swine-flu virus was undertaken, a spike in cases of Guillain Barré syndrome among those vaccinated led U.S. authorities to abandon the program."
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Ari B. Bloomekatz
(Los Angeles Times, June 29, 2009)
"Inmates call Ron Osorio 'West Hollywood' because the words are printed on the cream-colored cloth bag he carries inside Men's Central Jail each Friday. The bag is filled with 300 Lifestyle condoms. Osorio, who works for the nonprofit Center for Health Justice, has been visiting the jail almost weekly since 2001, when Los Angeles County Sheriff Lee Baca approved a small but groundbreaking program that allowed the health group to pass out prophylactics to inmates in a segregated unit for gay men…According to a United Nations report published last year on HIV and AIDS in places of detention, about 1.9% of prisoners in the United States are known to be HIV-positive. The report also says the issue is international and calls for more education, efforts to reduce the supply of drugs in institutions, and condom distribution as a way to combat the diseases."
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Editorial, Dante Ramos
(The Boston Globe, June 29, 2009)
"This isn’t an easy place for public-health programs to reach, but nearly 15 percent of people in the surrounding Nyanza Province [Kenya] are thought to be HIV-positive. In no small way, the effort to contain AIDS in the world depends on what happens in settings like these. The US Centers for Disease Control and Prevention understands this. In conjunction with the Kenya Medical Research Institute, the CDC has hired counselors to visit homes in a designated survey area and test those over age 15 and children whose mothers are HIV-positive or deceased…Our visit revealed how much HIV testing efforts need to adapt -- and have adapted -- to landscapes and family structures far removed from those in urban and suburban America."
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Gardiner Harris
(The New York Times, June 30, 2009)
"A federal advisory panel voted narrowly on Tuesday to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver. The two drugs combine a narcotic with acetaminophen, the ingredient found in popular over-the-counter products like Tylenol and Excedrin. High doses of acetaminophen are a leading cause of liver damage, and the panel noted that patients who take Percocet and Vicodin for long periods often need higher and higher doses to achieve the same effect. Acetaminophen is combined with different narcotics in at least seven other prescription drugs, and all of these combination pills will be banned if the Food and Drug Administration heeds the advice of its experts. Vicodin and its generic equivalents alone are prescribed more than 100 million times a year in the United States."
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Katie Balestra
(The Washington Post, June 30, 2009)
"Benzodiazepines, often prescribed to manage anxiety, panic and sleep disorders, include Xanax, Ativan, Valium and Klonopin. Originally pushed as an alternative to barbiturates, their use has grown rapidly in the past 30 years. But critics say their long-term effects have gone largely unaddressed. Health professionals and consumers are increasingly recognizing that taking the drugs for more than a few weeks can lead to physical dependence, often ending with a grueling withdrawal…John Steinberg, a physician and former medical director of the chemical dependency program at the Greater Baltimore Medical Center, estimates that 10 to 20 percent of those taking the drugs for extended periods will have problems with dose escalation and physical dependence. 'For a serious side effect, that's a fairly large, significant number,' he said. 'It is, after all, a devastating and debilitating adverse effect for those who experience it.'"
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Stephen Smith
(The Boston Globe, June 29, 2009)
"Americans spend billions of dollars annually on pills, herbs, and other medical products known variously as alternative, complementary, natural, and homeopathic. And the users -- including some traditionally trained physicians -- swear by them, even if federal drug regulators don’t. Manufacturers argue that many of the products -- especially herbs -- have survived the crucible of time, used through the ages without complaint. Consumer advocates counter that longevity is no substitute for gold-standard scientific evidence…Never has it been more important for patients and doctors alike to understand the potential promise and peril carried in the amber bottles of hope stocked on bulging shelves."
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Editorial
(The Globe and Mail, Toronto, June 27, 2009)
"Canadians are a salty people. They are dying for their salt. One in every eight heart attacks and strokes is caused by salt. Isn't that stupid, to die for salt? Others were just as salty, but they did something about it. Japan decided in the 1950s that it had a problem with salt intake. Finland made the same decision in the 1970s, and the United Kingdom got serious early in this decade. All have managed to reduce the consumption of salt. But Canada -- though it has a two-year-old Sodium Working Group, chaired by Health Canada -- has yet to truly tackle the problem. The working group needs to get to work. It may be that Canadians' patience for another public-health campaign is limited. There have been smoking, trans-fat, exercise and obesity campaigns, among others. Public-health fatigue may be setting in. But there's a strong argument for paying attention to salt."
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Karen McVeigh
(The Guardian, London, July 1, 2009)
"Scientists said that while links between stomach cancer and eating meat had already been reported, they had uncovered a 'striking difference' in the risk of blood cancers including leukaemia, multiple myeloma and non-Hodgkin lymphoma between the groups…The study also reported that the total cancer incidence was significantly lower among both the fish eaters and the vegetarians compared with meat eaters. The study, published in the British Journal of Cancer, is part of a long-term international study, the European prospective investigation into cancer and nutrition (Epic). Today's findings were based on a study of 61,000 people who scientists followed over 12 years. During this time, 3,350 participants were diagnosed with cancer. Of those, 68% (2,204) were meat eaters, 24% (800) were vegetarians and 9.5% (300) ate fish but no meat."
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Robin McKie
(The Observer, London, June 28, 2009)
"Diets rich in fat from red meat and dairy products can increase a person's risk of contracting cancer of the pancreas, researchers are warning. Scientists at the National Cancer Institute in the United States asked more than half a million people to provide precise details of their diet over six years. The team found that those who consumed most animal fat had a higher risk of developing the cancer…For most, the prognosis is poor: only 2% to 3% survive for five years or more…The researchers collected data on 308,736 men and 216,737 women. Each completed a 124-item food questionnaire in 1995 and 1996. During an average of six years of follow-up, 1,337 people were diagnosed with pancreatic cancer. Men who consumed the most fat from animal sources had a 53% increased risk of developing pancreatic cancer and women had a 23% increased risk, compared with men and women who ate the least fat, the study found. In addition, it was discovered that people who ate high amounts of saturated fats had 36% higher rates of pancreatic cancer than did those who ate low amounts."
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Jennifer Yang
(The Globe and Mail, Toronto, June 27, 2009)
"Childhood physical abuse may be linked to the development of cancer later in life, a new University of Toronto study has found. The study discovered that people who've been physically abused as children were 49 per cent more likely to develop cancer as adults…While substantial research already links childhood abuse with mental-health problems and illnesses such as irritable bowel syndrome, there is little scholarship on the connections between childhood physical abuse and cancer, says the study's lead author…One possible explanation is the theory that abused children are more prone to abnormal levels of cortisol, a fight-or-flight hormone that helps people deal with stressful situations. Chronic stress has been linked with other maladies such as heart disease and arthritis so perhaps cortisol levels also affect cancer rates, Dr. Fuller-Thomson suggests."
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Gina Kolata
(The New York Times, June 27, 2009)
"Among the recent research grants awarded by the National Cancer Institute is one for a study asking whether people who are especially responsive to good-tasting food have the most difficulty staying on a diet. Another study will assess a Web-based program that encourages families to choose more healthful foods. Many other grants involve biological research unlikely to break new ground…Yet the fight against cancer is going slower than most had hoped, with only small changes in the death rate in the almost 40 years since it began. One major impediment, scientists agree, is the grant system itself."
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Bonnie Rochman
(TIME, July 6, 2009)
"New research shows that within a few short years of getting hitched, married individuals are twice as likely to become obese as are people who are merely dating. The study, published in the July issue of Obesity, set out to determine how romantic relationships affect the tell-no-lies number on the scale. Researchers tracked changes over a handful of years in the weight and relationship status of 6,949 individuals, and their findings don't bode well for commitment…the study notes that unmarried women who have been living with their sweeties for five years or less run a 63% increased risk of obesity. What about unmarried men? On average, they have no increased risk during cohabitation."
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(Reuters, July 1, 2009)
"Obesity rates continued to climb in the past year with 23 U.S. states reporting adults in their states are fatter now than they were a year ago, two advocacy groups said on Wednesday. Obesity rates did not decrease in a single state last year, and the groups warned that the U.S. obesity epidemic must be addressed as lawmakers reform the nation's health system. 'Our health care costs have grown along with our waistlines,' said Jeff Levi, executive director of Trust for America's health, which released the report along with the Robert Wood Johnson Foundation. He said the obesity epidemic is contributing to skyrocketing health costs, and said the problem has to be addressed at the highest levels of government. Being overweight or obese raises the risk of heart disease, diabetes, some cancers, arthritis and other conditions."
Related story:
State-by-state List of Obesity Rates, Rankings
(Associated Press, July 1, 2009)
(Associated Press, July 1, 2009)
"The odds of surviving cardiac arrest after getting CPR in a hospital are slim and have not improved in more than a decade, a big Medicare study concludes. Only about 18 percent of such patients live long enough to leave the hospital, researchers found. Blacks fared worse than whites -- a disparity only partly explained by more of them being treated in hospitals that did a poorer job of CPR. Results were published in Thursday's New England Journal of Medicine. Dr. Lance Becker, a University of Pennsylvania emergency medicine specialist and an American Heart Association spokesman, called the findings 'grim' and 'a wake-up call that we need to redouble our efforts' to find better ways to treat cardiac arrest…Researchers led by Dr. William Ehlenbach at the University of Washington in Seattle analyzed the care of 433,985 Medicare patients treated from 1992 through 2005 around the United States. Survival odds did not substantially change over time, they found. Blacks had survival rates about one-quarter lower than whites. Men, older patients, and people admitted from nursing homes also had lower survival rates after CPR."
Liz Kowalczyk
(The Boston Globe, July 1, 2009)
"Researchers, led by cardiologists at Massachusetts General Hospital, reported yesterday that testing patients for a protein associated with inflammation may help predict the risk of heart attacks and strokes in certain cases but that it is probably not useful as a widespread, routine screening tool. The Mass. General research does not directly contradict a landmark study from Brigham and Women’s Hospital last year -- which was highly supportive of testing for C-reactive protein -- but sounds a more cautious note on expanding its use. It is the latest study in one of cardiology’s hottest areas, which has pitted specialists in a decade-long back and forth over the value of screening patients with the test. A separate genetics study, reported in the same issue of The Journal of the American Medical Association, suggests that the protein itself is not the cause of heart disease but may merely be an indicator of its existence."
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Sarah Boseley
(The Guardian, London, June 29, 2009)
"Women who have a miscarriage are more likely to give birth prematurely in their next pregnancy, doctors have found…They found that women who experienced complications either early in their current pregnancy or who had had a miscarriage or other problem in a previous pregnancy were more at risk of going into labour prematurely or experiencing other difficulties in later weeks. Women who had experienced one or more miscarriages had nearly double the risk in their next pregnancy of giving birth prematurely. Those who had suffered three or more miscarriages were at even greater risk. Termination of a previous pregnancy, for any reason, also increased the risk of premature birth in a subsequent pregnancy. A whole range of problems in the first three months of a pregnancy were predictive of later complications
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Allen Reed
(Houston Chronicle, June 29, 2009)
"A recent decades-long study finds that binge drinking has decreased significantly or stayed stagnant across a variety of demographics except one: women. The study, conducted by the Washington University School of Medicine in St. Louis, examined nationwide data on more than 500,000 subjects gathered by the National Survey on Drug Use and Health between 1979 and 2006. According to the study, the most recent statistics showed that more than half of 21- to 23-year-old males reported that they binge drink, a level that has remained relatively unchanged since 1979. However, in 2006 almost 39 percent of women ages 21 to 23 reported that they binge drink. A percentage increase of 30 percent from 1979. Binge drinking, defined as consuming five or more drinks on a given occasion, declined for young men not in college and rose 20 percent among young women not in school."
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Opinion
Eve Ensler, playwright and activist
(The Washington Post, June 30, 2009)
"Just over a year ago, in answering whether sexual violence in conflict was an issue that the U.N. Security Council should take on, then-Secretary of State Condoleezza Rice proclaimed, 'I am proud that, today, we respond to that lingering question with a resounding yes!'. With this statement, and with the cooperation of other power brokers at the table, the Security Council unanimously adopted Resolution 1820, which finally recognized sexual violence as a widely used strategy of warfare and cleared the path for the council to respond to it worldwide. U.N. Secretary General Ban Ki-moon is to report to the Security Council today on implementation of Resolution 1820. What will we learn? A year after adopting the resolution, Congo remains the worst place on the planet to be a woman."
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Opinion, Derrick Z. Jackson
(The Boston Globe, June 27, 2009)
"With malaria sapping so much life and potential, Uganda has been driven to spray the interior of homes with DDT. The insecticide, made infamous by Rachel Carson’s 'Silent Spring,' has long been banned in the United States for wildlife devastation…But malaria here in Uganda is so intense, top officials have answered local and international DDT critics by saying, as Vice President Gilbert Bukenya put it, 'You can start with my house. Those shouting against it are shouting ignorance. They are simply not informed'…the issue arouses great passion in sub-Saharan Africa, where access to the best drugs is woeful, and where simple home protections, such as window screens, are lacking. Uganda, a nation of 30 million people, had an estimated 10.6 million cases of malaria in 2006, according to the World Health Organization, with 70,000 to 110,000 deaths a year, according to government and university researchers. The disease seriously hampers economic development…The government this month announced a goal of having an insecticide-treated mosquito bed net in 85 percent of households and spraying the interior of all homes in the most hard-hit of districts. According to UNICEF, just 10 percent of 5-year-olds live in a house with an insecticide-treated net."
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Related story:
Uganda's Dilemma of Competing Goals
Opinion, Derrick Z. Jackson
(The Boston Globe, June 30, 2009)
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Edmund Sanders
(Los Angeles Times, June 27, 2009)
"Tragically, healthcare horror stories are common in Africa, where developing countries rarely have medical safety nets for the poor. But an increase in cases of cash-starved public hospitals and mortuaries detaining patients and even corpses over unpaid bills is spurring outrage in Kenya…'They know very well these people can never pay those bills,' said Njoroge Baiya, a Kenyan lawmaker who has raised the issue in parliament. 'A more humane policy should be developed.' Experts say government inaction makes the practice de facto public policy, even though its legality has been questioned. With such policies, it's little wonder that poor Kenyans who are seriously ill or dying often avoid hospitals, even though they might provide treatment or dispense painkillers and help control public contagion."
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Steve Connor
(The Independent, London, June 30, 2009)
"Older British women seeking fertility treatment are having to travel to Europe because they are finding it difficult to get IVF help at home, a study has found. Hundreds of women from the UK could be going to countries such as Spain, Slovenia and the Czech Republic where it is easier to gain access to IVF treatment, scientists discovered…'Access [to IVF] is a big reason for women in the UK. It's very difficult for us to get funding for patients over the age of 39. When they are 39 or 40 they're stuck. Britain is bad for access,' said Francoise Shenfield of University College London Hospital. The pilot survey's results, released yesterday by the European Society for Human Reproduction and Embryology in Amsterdam, were the first to quantify the scale of fertility tourism in Europe, Dr Shenfield said."
Andrew Grice
(The Independent, London, June 29, 2009)
"In an interview with The Independent yesterday, the Health Secretary Andy Burnham disclosed that the new 'entitlements' for patients would include a right to:
*An operation within 18 weeks of patients first seeing their GP
*A free health check-up for all at the age of 40
*Treatment from an NHS dentist
*Die at home if they suffer from a long-term medical condition
*See a cancer specialist within two weeks
*Be treated in accident & emergency departments within four hours."
(The Economist, London, June 27, 2009)
"As recently as 1968, well over a third of British adults had not a single natural tooth in their heads. So it is hardly surprising that, since its founding in 1948, the National Health Service has struggled to cope with the dental needs of the population…The legacy of bad teeth is still putting NHS budgets under strain. In recent years many dentists have turned to private practice as fees for doing NHS work have been squeezed…This week’s review recommends re-complicating rates a bit, and once again paying dentists partly according to the number of NHS patients on their books. It is quite a U-turn…As for advising on prevention, which is probably the most important part of modern dentistry, there is a problem. Britons who visit the dentist feel cheated if all they get is a quick peer and a reminder to floss. But that may change, and surprisingly quickly."
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