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Thousands of Pennsylvania women could lose some health coverage

HARRISBURG — Some 90,000 Pennsylvania women are at risk of losing access to the free family planning and women’s health-care coverage they now receive through a special Medicaid program.

But they may be able to gain the coverage right back by applying for broader private coverage through the state’s revamped Medicaid program, or through the federal government’s health insurance marketplace.

SelectPlan for Women — essentially a limited-benefit category of Medicaid — offers services such as birth control, breast exams, Pap smears (a screening test for cervical cancer) and other women’s health-related services at no cost, according to its website. Women age 18-44 with income below 214 percent of the federal poverty guidelines who have no private insurance, and no Medicaid insurance, are eligible.

Those who have limited health plans that do not include family planning benefits also may be eligible.

The website gives no indication the program will be ending at year’s end, but women’s advocates say they have been told to prepare for the program’s termination. On Thursday, the Corbett administration said “no final decisions have been made.”

“The Corbett administration will not let any of these women in Pennsylvania go without access to health-care coverage — we will ensure that,” said Kait Gillis, a spokeswoman for the state Department of Welfare, in an email. “We are still in conversations working through some of the issues [and] we are coordinating with the federal government on any outstanding health-care waivers, including SelectPlan.”

SelectPlan is not a full health insurance plan with a comprehensive range of benefits; some of those losing coverage will be eligible to reapply for new, full health-care plans under Gov. Tom Corbett’s “Healthy PA” Medicaid overhaul. Others, who make more than 138 percent of the federal poverty level, will be able to apply for full benefits plans through the Affordable Care Act’s online health insurance exchanges.

In both cases, women will be able to receive tax subsidies toward their monthly premiums, and for women making less than the federal poverty limit, they won’t have to pay any monthly premiums to gain Healthy PA Medicaid-style coverage.

But they might have to pay copays, and will have limits on their visits and usage. With the SelectPlan, there are no visit limits, no premiums and no co-pays, making it a valuable safety net for women.

“SelectPlan has been very important for low-income women who can’t get family planning care any other way,” said Sue Frietsche, senior staff attorney at the Women’s Law Project in Pittsburgh.

The federal Medicaid waiver for the plan will expire Dec. 31.

Several advocacy groups have said the state’s Department of Public Welfare should continue to offer SelectPlan to women who are not eligible for coverage under the new Healthy PA, and should additionally automatically transition eligible women into Healthy PA, to ensure continued access to care.

“Why let people’s benefits expire?” Ms. Frietsche said.

Making women reapply for new coverage means additional administrative costs for the state, and a likely loss of coverage for patients in the meantime, according to a briefing prepared by the left-leaning Pennsylvania Budget and Policy Center, Community Legal Services of Philadelphia, and the Pennsylvania Health Access Network. The groups also worry that the women will be lost in the shuffle in a time of bureaucratic chaos, as the state is also going to be trying to enroll hundreds of thousands of newly insured people into the Healthy PA program, which takes effect Jan. 1.

The state is automatically moving other groups of people from other categories of Medicaid coverage to the new coverage but is not doing the same for SelectPlan women, the groups say.

Furthermore, since many of the women in SelectPlan initially applied for full Medicaid, or may have children in Medicaid or another assistance program, the state probably has the information it needs to transition them.

“DPW has a lot of information from these women,” such as their income and household size, said Laval Miller-Wilson, executive director of the Pennsylvania Health Law Project.

Healthy PA is the governor’s alternative to a straight-up expansion of the Medicaid program; federal regulators have approved portions of the plan that would allow several hundred thousand uninsured Pennsylvanians to purchase private insurance with a federal subsidy.

It remains to be seen if it will ever become reality, however. The governor’s opponent in the Nov. 4 election, Democrat Tom Wolf, who is leading in the polls, has made it clear he favors a traditional Medicaid expansion, as permitted under the federal Affordable Care Act. But if he were to win, by the time he takes office hundreds of thousands of Pennsylvanians may have already applied for private coverage through the Healthy PA program, making it hard to immediately undo.

Article source: http://www.post-gazette.com/news/state/2014/10/24/90-000-in-Pa-may-lose-women-s-health-coverage/stories/201410240037

NY, NJ Govs Issue Mandatory Quarantine for Travelers Who Treated Ebola …

5:50 p.m. ET: What will you do for 21 days, alone? New York and New Jersey governors announced Friday afternoon that all travelers entering the United States at JFK and Newark Liberty International Airports who have had direct contact with patients afflicted with Ebola in Sierra Leone, Liberia and Guinea will be quarantined for 21 days.

“Since taking office, I have erred on the side of caution when it comes to the safety and protection of New Yorkers, and the current situation regarding Ebola will be no different,” said NY Governor Andrew Cuomo in a statement. “The steps New York and New Jersey are taking today will strengthen our safeguards to protect our residents against this disease and help ensure those that may be infected by Ebola are treated with the highest precautions.”

“I have been clear that we will take whatever steps are necessary to protect the public health of the people of New Jersey which is exactly what these joint efforts with Governor Cuomo will do with additional screening and heightened standards for quarantine,” said New Jersey Governor Chris Christie. “By demanding these enhance measures, we are ensuring that any suspected cases are identified quickly and effectively, and that proper safeguards are executed.”

The New York Times reported that White House officials are concerned that this announcement, which was not done in consultation with public health officials, will deter the effort to send more people to help with the outbreak in West Africa.

“These kind of policy decisions are going to be driven by science, and by the best advice of our medical experts, and by our scientists that have four decades of experience in dealing with Ebola outbreaks in West Africa,” said Josh Earnest, the White House press secretary, to reporters on Friday.

5:30 p.m. ET: Get your flu shot and stop freaking out, NYC. City officials said that all officials followed the exact protocols in handling Dr. Craig Spencer as soon as he was considered to be at risk for Ebola on Thursday. His fiance is being quarantined, and the medical detectives are determining all possible contacts that may need to be in quarantine. New York City’s mayor emphasized that casual contact cannot lead to this disease.

“There is no cause for everyday New Yorkers to be alarmed,” said Mayor Bill de Blasio in a press conference Friday afternoon. “Only through direct and intimate contact can that disease be transmitted. New Yorkers who have not been exposed to an infected person’s bodily fluids are not at risk, and there’s no reason for New Yorkers to change their routine in any way.”

The mayor also said it will help address this public health situation if every New Yorker gets his or her flu shot.

Dr. Mary Travis Bassett, commissioner of the New York City Department of Health, said that health officials visited and cleared the Brooklyn bowling alley where Dr. Spencer visited the night before he began to develop symptoms.

Health officials emphasized that Thursday morning was the first time Dr. Spencer had any noticeable temperature change at 100.3. Dr. Bassett said she had reviewed the patient’s self-monitoring temperature log and there was no increase in temperature until Thursday morning. Spencer took his temperature on Wednesday night.

5:11 p.m. ET:
Sad news in Mali. A toddler infected with Ebola died while being treated at a hospital in Kayes, Mali on Friday, according to the Associated Press.

This is the first Ebola case in Mali, but the region is preparing for many more. The toddler was bleeding from her nose while traveling on a bus from Guinea, where there is a larger outbreak. The 2-year-old came in to close contact with 43 people who are currently being monitored and held in isolation. The child was diagnosed with Ebola on Thursday.

3:00 p.m. ET: Where he went, what he did, where he ate.

The New York City Department of Health released the timeline of Dr. Craig Spencer’s past 10 days in the United States.

The New York City Department of Health released the timeline of Dr. Craig Spencer’s past 10 days in the United States.

1:29 p.m. ET: Is a cure on the way?

The World Health Organization announced on Friday that by 2015 two different experimental Ebola vaccines could be ready for distribution to up to 1 million people. And by March, five more vaccines will undergo testing. There is no guarantee that these experimental drugs will work. But if early tests prove to be safe and successful, the WHO hopes that it will create an immune response to Ebola.

“As we accelerate in a matter of weeks a process that typically takes years, we are ensuring that safety remains the top priority, with production speed and capacity a close second,“ said Marie-Paule Kieny, WHO Assistant Director-General of Health Systems and Innovation, in a prepared statement.

The two trial vaccines were developed by GlaxoSmithKline in the US with the National Institute of Health, and by the Canadian Public Health Agency licensed to US Company New Link Genetics. These vaccines are currently undergoing trials in the United States, United Kingdom, and Mali.

12:42 p.m. ET: President Obama meets with Ebola-free nurse Nina Pham.

WASHINGTON, DC – OCTOBER 24: U.S. President Barack Obama gives a hug to Dallas nurse Nina Pham in the Oval Office of the White House October 24, 2014 in Washington, DC. Pham, a nurse who was infected with Ebola from treating patient Thomas Eric Duncan at Texas Health Presbyterian Hospital in Dallas and was first diagnosed on October 12, was declared free of the virus on Friday. (Photo by Olivier Douliery-Pool/Getty Images)

President Obama meets with Nina Pham, the Texas Health Dallas nurse who recovered from Ebola, this afternoon.

12:12 p.m. ET: Second nurse with Ebola free of virus. Amber Vinson, one of two nurses who contracted Ebola, is free of the virus, Emory University announced Friday. Unlike Texas Health nurse Nina Pham, Vinson will remain hospitalized for “continued supportive care,” the hospital said in a public statement.

10:55 a.m. ET: Dallas nurse declared Ebola-free. Nina Pham, the Texas Health Dallas nurse who contracted Ebola after caring for the first US patient with the disease, has been successfully treated, according to the National Institutes of Health. Pham was sent to the NIH’s Special Clinical Studies Unit in Maryland for treatment. She will be discharged from the center today and head back to Dallas.

Nurses in the emergency department at Texas Health Presbyterian Hospital Dallas watch Nina Pham being released from the hospital.

“Her colleagues and friends eagerly look forward to welcoming her back,” Texas Health Resources CEO Barclay Berdan said in a public statement. “Her courage and spirit, first in treating a critically ill Ebola patient and then in winning her own battle against the disease, has truly inspired all of us.”

Unlike the other US patients who tested positive for Ebola, Pham did not receive experimental medication, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease said in a media briefing Friday.

9:30 a.m. ET: House holds hearing. The House Oversight and Government Reform committee held a hearing on the federal government’s response to the Ebola crisis.

5:17 a.m. ET: Surface wipes that fight Ebola? Researchers at U.S. Army Natick Soldier Research, Development and Engineering Center are testing a disinfectant that can kill the Ebola virus on surfaces. The produce is already used in West Africa and in some hospitals in the US, included the Nebraska Medical Center, where Worcester doctor and Ebola survivor Rick Sacra was treated.

Last night: 10:00 p.m. ET:
New York City says it’s prepared.

In a press conference Thursday night, New York state and city officials outlined plans to calm fears after physician Dr. Craig Spencer tested positive for the Ebola virus. He had returned to the United States from treating Ebola patients in Guinea 10 days ago.

“We are prepared to quarantine contacts as necessary. Medical detectives are at work putting together pieces of the timeline,” New York City’s Mayor Bill de Blasio said in a press conference Thursday evening.

“Let’s be clear. Ebola is very hard to contract being on a subway car or being near someone who has the disease,” Blasio said.

“We are as ready as one could be for this circumstance,” New York Governor Andrew Cuomo said in a press conference. “What happened in Dallas was actually the exact opposite….We had the advantage of learning from the Dallas experience.”

Gov. Cuomo also said this instance “is lucky” because the Ebola patient, Craig Spencer, was a doctor with experience treating people with Ebola and understands how the disease works. Cuomo also said that there are four suspected people who had contact with Dr. Spencer and may be at risk for the disease. The health officials have been in touch with each of these individuals.

The governor emphasized that the city has been preparing for weeks and “the proof is in the pudding.”

Dr. Spencer completed work in Guinea on Oct. 12 and arrived in the United States on Oct. 17, said Dr. Mary Travis Bassett, commissioner of the New York City Department of Health. Spencer was well throughout his journey and arrived in the United States with no symptoms. Bassett said Spencer took his own temperature twice a day.

On Oct. 21, Dr. Spencer “began to feel somewhat tired” but Bassett emphasized that the first actual symptoms began Thursday between 10 and 11 a.m. this morning with a fever and some other symptoms. He was brought to Bellevue Hospital as a person considered at high risk for Ebola.

The day before his symptoms began, Spencer went on a three-mile jog and took the New York Subway A train, No. 1 train, and L train. Spencer also went bowling in Williamsburg and was feeling well at that time except for his feeling of fatigue, according to Dr. Bassett. The bowling alley is closed waiting for inspection by public health officials. Spencer had close contact with his fiance and three friends who are all healthy and being quarantined. One of the contacts is in the hospital. Bassett said Spencer also took an Uber car home, but he had no physical contact with the driver and the driver isn’t considered to be at risk.

8:30 p.m. ET: Confirmed case in NYC. New York public health officials confirmed Thursday evening that the physician, Craig Spencer, who was admitted to Bellevue Hospital in New York City for Ebola-like symptoms Thursday afternoon, has tested positive for the virus. Spencer returned to New York City 10 days ago from working with Doctors Without Borders treating patients in Guinea. City officials spent the afternoon contact tracing, a process of tracking back every person Spencer may have exposed to the virus.

The New York Times reported that Dr. Spencer traveled from Manhattan to Brooklyn on the subway Wednesday evening to visit a bowling alley and took a taxi home. He was self-monitoring according to Doctors Without Borders, and reported a temperature of 103 degrees Thursday morning. Health officials are urging that Ebola is not contagious unless the person is displaying symptoms such as a fever, headache, or abdominal pain.

“As a further precaution, beginning today, the Health Department’s team of disease detectives immediately began to actively trace all of the patient’s contacts to identify anyone who may be at potential risk,” New York Health Commissioner Mary T. Bassett said in a statement about the suspected Ebola case Thursday afternoon. “The Health Department staff has established protocols to identify, notify, and, if necessary, quarantine any contacts of Ebola cases.”

Ashoka Mukpo, the Rhode Island cameraman who returned home this week after recovering from the virus, tweeted the following in light of the news about Dr. Spencer:

The latest numbers:

Number of cases worldwide in the current outbreak: 9,936 (Climbed 720 in five days)

Number of deaths: 4,877 (Climbed 322 in five days)

Countries currently affected by Ebola: Mali, Guinea, Liberia, Sierra Leone, Spain, and the United States of America.

Countries where the outbreak has ended: Nigeria (Oct. 19), Senegal (Oct. 17)

And here’s your daily reminder not to panic:

The likelihood of contracting Ebola in Massachusetts remains very low, according to the state’s public health officials. You have to be in direct contact with an infected person’s bodily fluids while they are contagious (displaying symptoms of Ebola). Even if someone has been exposed, symptoms may appear in as little as two days, and in as many as 21 days, after exposure. The CDC says the average is 8 to 10 days.

Ebola symptoms:

- Fever (greater than 38.6°C or 101.5°F)

- Severe headache

- Muscle pain

- Weakness

- Diarrhea

- Vomiting

- Abdominal (stomach) pain

- Unexplained hemorrhage (bleeding or bruising)

Need more details? Here’s an MGH physician dropping some knowledge for you.

Article source: http://www.boston.com/health/2014/10/24/ebola-today-nyc-doctor-tests-positive-for-ebola/JRBXLBuNuJG2vaknVOjNVL/story.html

Health Officials Expect to Start Vaccine Trials in West Africa as Early as …

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Article source: http://www.nytimes.com/2014/10/25/business/ebola-vaccine-trials-planned-for-december.html

More health insurance changes on the way

Employers are increasingly pushing enrollment in high-deductible, low-premium health insurance plans, according to benefits experts, which means it might be time to break out the calculator and reconsider current policies.

Employees in Chicago and across the country are getting their first looks at what they will be paying for health insurance in 2015 with the start of open enrollment, the annual window in which workers can make changes to their elected benefits, including health insurance. Open enrollment is typically held in October and November each year.

“Don’t assume that nothing’s changing even if your current option is still available,” said Craig Rosenberg, practice leader of health and welfare benefits at consulting firm Aon Hewitt. “There are probably some new choices that are available for you.”

Three-fourths of employers aim to offer high-deductible plans coupled with a health savings account in the next three years, and 20 percent will only offer those type of plans, according to data from Mercer, a financial services company with a health and benefits arm. To qualify for a health savings account, a plan has to have a minimum deductible of $1,250 for employee-only coverage and $2,500 for family coverage. Others are offering private health exchanges, which give employees several options for coverage.

Overall costs likely will rise again in 2015, by about 4 percent, according to Mercer, modest compared with previous years. But some employees are seeing much sharper increases, making high-deductible plans more attractive. Consumers who opt not to obtain coverage, either through their employer or through the federal Affordable Care Act, will also pay more. Those individuals will pay a greater penalty for not securing coverage, increasing to $325, or 2 percent of household income, whichever fee is greater, from $95 this year, or 1 percent of yearly household income.

High-deductible, low-premium plans are often called consumer-directed health plans and paired with a health savings account that allows workers to pay for eligible expenses with tax-free dollars, experts said.

Employers have a financial incentive to offer such plans. Under the Affordable Care Act, employers in 2018 that offer plans that cost more than $10,200 for an individual or $27,500 for a family will be charged a 40 percent tax on the amount exceeding the threshold. By raising deductibles and lowering premiums, companies will lower their chance of triggering the tax.

Beth Umland, director of research for health and benefits for Mercer, said more than one-third of companies would hit that excise tax threshold if they made no changes to their plan offerings.

Premiums in consumer directed plans typically cost about 20 percent less than a traditional PPO or HMO plan, she said.

“If you’ve been scared off of consumer directed plans, this might be the year to man-up and take a look,” Umland said. “Employers want to get people into those plans for a variety of reasons. That’s the plan where they see long-term cost control, so to get folks to join it, it’s bargain basement premium contributions.”

Nancy Coletto, a Chicago-based partner in Mercer’s health and benefits practice, said employer health insurance plans are more likely to add an additional fee for dependents (spouses and adult children) who have access to health insurance at another workplace this year.

“Health care reform puts more responsibility on employers to cover more of their employees,” Coletto said. “Employers who are now covering more employees may make it more expensive to cover a dependent. Make sure you fully understand what costs are changing. That decision may be different than what it was before.”

Private exchanges — run by companies like Aon Hewitt, Mercer, Buck Consultants and Towers Watson — are predicted to grow in popularity in coming years, with 33 percent of more than 1,200 companies surveyed by Aon Hewitt saying they would prefer to offer a private health exchange in the next three to five years. Just 5 percent will use a private health exchange in 2015.

Aon Hewitt started its private exchange program for active employees three years ago with three companies. In 2015, Aon Hewitt anticipates about 30 companies will enroll its exchange, covering 850,000 employees and dependents. Mercer has signed up 170 companies in its private exchange for 2015, covering 975,000 active employees and dependents. The private health exchanges offer a variety of plans, from PPOs, more expensive month to month, to low-premium consumer directed plans.

“Don’t just buy on price alone,” Rosenberg said, “and instead look at the whole situation. … Look at how much you’ll spend out of pocket when you use the plan throughout the year. … You might find that the lowest-cost plan that you could buy might not end up being the lowest-cost plan with how you would use it.”

ehirst@tribune.com

Twitter @ellenjeanhirst

Tips for health insurance enrollment

Assess your needs

How much did you spend on health care out of pocket last year? Ask your health plan provider for your past medical and dental claims to calculate last year’s costs.

Account for any big changes

Are you planning to have a baby? Did someone in your family develop a new medical condition?

Evaluate the network

Mergers among doctors groups as well as hospital systems are reshaping the provider community, which could affect your choices.

Decide whether a consumer driven health plan is right for you

These lower how much money is taken out of each paycheck but leave you with a large deductible if anything happens. Couple this with a health savings account to help pay for out-of-pocket costs.

Determine whether to put a dependent on the same plan

If your spouse or adult child has access to health care through another provider, it may be more cost-effective to have him or her enroll with his or her employer plan, depending on fees.

Take advantage of health and wellness programs

Some companies offer financial incentives for completing certain questionnaires or various health-related activities.

Know how your coverage relates to public Affordable Care Act exchanges

If you’re eligible for health care through your employer, you won’t get federal tax credits to buy insurance through the public exchanges.

SOURCES: Adapted from materials and interviews with experts from Aon Hewitt, Mercer and the Employee Benefits Research Institute

Copyright © 2014, Chicago Tribune

Article source: http://www.chicagotribune.com/business/ct-open-enrollment-trends-1024-biz-20141023-story.html

Health Spas Aimed at Teaching Stressed Executives to Unwind

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Article source: http://www.nytimes.com/2014/10/23/your-money/health-spas-aimed-at-teaching-stressed-executives-to-unwind.html

Ebola Today: NYC Doctor Tests Positive for Ebola

10:00 p.m. ET:
New York City says they’re prepared.

New York state and New York City officials, in a press conference Thursday night, outlined the preparations of the city and the timeline of Dr. Craig Spencer, the physician who tested positive for the Ebola virus on Thursday. He had returned to the United States from treating Ebola patients in Guinea 10 days ago.

“We are prepared to quarantine contacts as necessary. Medical detectives are at work putting together pieces of the timeline,” New York City’s Mayor Bill de Blasio said in a press conference Thursday evening. “Let’s be clear. Ebola is very hard to contract being on a subway car or being near someone who has the disease.”

“We are as ready as one could be for this circumstance,” New York Governor Andrew Cuomo said in a press conference. “What happened in Dallas was actually the exact opposite….We had the advantage of learning from the Dallas experience.”

Gov. Cuomo also said this instance “is lucky” because the the Ebola patient, Craig Spencer, was a doctor with experience treating people with Ebola and understands how the disease works. Cuomo also said that there are four suspected people who had contact with Dr. Spencer and may be at risk for the disease. The health officials have been in touch with each of these individuals.

The governor emphasized that the city has been preparing for weeks and “the proof is in the pudding.”

Dr. Spencer completed work in Guinea on Oct. 12 and arrived in the United States on Oct. 17, said Dr. Mary Travis Bassett, commissioner of the New York City Department of Health. Spencer was well throughout his journey and arrived in the United States with no symptoms. Bassett said Spencer took his own temperature twice a day.

On Oct. 21, Dr. Spencer “began to feel somewhat tired” but Bassett emphasized that the first actual symptoms began Thursday between 10 and 11 a.m. this morning with a fever and some other symptoms. He was brought to Bellevue Hospital as a person considered at high risk for Ebola.

The day before his symptoms began, Spencer went on a three-mile jog and took the New York Subway A train, No. 1 train, and L train. Spencer also went to a bowling alley in Williamsburg and was feeling well at that time except for his feeling of fatigue, according to Dr. Bassett. The bowling alley is closed waiting for inspection by public health officials. Spencer had close contact with his fiance and three friends who are all healthy and being quarantined. One of the contacts is in the hospital. Bassett said Spencer also took an Uber car home, but he had no physical contact with the driver and the driver isn’t considered to be at risk.

8:30 p.m. ET: Confirmed case in NYC. New York public health officials confirmed Thursday evening that the physician, Craig Spencer, who was admitted to Bellevue Hospital in New York City for Ebola-like symptoms Thursday afternoon, has tested positive for the virus. Spencer returned to New York City 10 days ago from working with Doctors Without Borders treating patients in Guinea. City officials spent the afternoon contact tracing, a process of tracking back every person Spencer may have exposed to the virus.

The New York Times reported that Dr. Spencer traveled from Manhattan to Brooklyn on the subway Wednesday evening to visit a bowling alley and took a taxi home. He was self-monitoring according to Doctors Without Borders, and reported a temperature of 103 degrees Thursday morning. Health officials are urging that Ebola is not contagious unless the person is displaying symptoms such as a fever, headache, or abdominal pain.

“As a further precaution, beginning today, the Health Department’s team of disease detectives immediately began to actively trace all of the patient’s contacts to identify anyone who may be at potential risk,” New York Health Commissioner Mary T. Bassett said in a statement about the suspected Ebola case Thursday afternoon. “The Health Department staff has established protocols to identify, notify, and, if necessary, quarantine any contacts of Ebola cases.”

Ashoka Mukpo, the Rhode Island cameraman who returned home this week after recovering from the virus, tweeted the following in light of the news about Dr. Spencer:

3:30 p.m. ET: Uh oh. A physician is currently being treated at Bellevue Hospital in New York City for Ebola-like symptoms after returning from a recent trip treating patients in the outbreak in West Africa. Doctors Without Borders confirmed with Boston.com that the patient is a physician who returned from working with Ebola patients in West Africa 10 days ago. CNN is reporting that the patient is a 33-year-old Columbia Presbyterian Hospital employee.

“The patient was transported by a specially trained HAZ TAC unit wearing Personal Protective Equipment (PPE),” New York Health Commissioner Mary T. Bassett said in a statement about the suspected Ebola case Thursday afternoon. “After consulting with the hospital and the CDC, DOHMH has decided to conduct a test for the Ebola virus because of this patient’s recent travel history, pattern of symptoms, and past work.”

The health care worker has a fever and gastrointestinal problems. City health officials expect the results of a preliminary test in the next 12 hours. After returning from West Africa, the physician regularly monitored his or her health status and notified Doctors Without Borders immediately when Ebola-like symptoms began.

1:30 p.m. ET: Because we CARE. If you’re traveling to the United States from West African countries afflicted with Ebola, the Centers for Disease Control and Prevention has prepared a special welcome package for you. Yesterday, the CDC announced that beginning Monday, all travelers from Liberia, Sierra Leone, and Guinea will be put under 21-day monitoring by health officials.

The Check and Report Ebola (CARE) Kit travelers will receive contains a digital thermometer, an Ebola virus symptom card, and a yellow wallet card that instructs travelers about who to contact if they begin to develop worrisome symptoms. The card will also let practitioners know that they are treating someone who has recently traveled from an Ebola-afflicted country.

CARE Kit from the CDC for all travelers from West African countries afflicted by the Ebola outbreak.

11:30 a.m. ET: What a sad homecoming. Teresa Romero, the nursing assistant who beat Ebola earlier this week in Spain, was just told by her husband that health officials euthanized her dog Excalibur out of a possible risk that he might spread or contract the virus from his owner. Her husband Javier Limon made a heartbreaking video plea from his isolation before the dog was put down:

Romero is demanding answers of Spanish authorities. Her husband told El Pais that ‘‘she is asking herself why they killed the dog, who wasn’t to blame for anything.’’

10:30 a.m. ET: North Korea behaves just as expected. After North Korea spent the past week enhancing inspections and quarantine measures at ports of entry, the country’s state media announced Thursday that all foreign tourists are banned from entering the country starting Friday. The news reached the rest of the world largely through the few tourist companies that coordinate travel to the country.

“Three days ago, they said that anybody who’s been to West Africa would have to provide a doctor’s certificate stating that they don’t have Ebola,” Gareth Johnson of Young Pioneer Tours, a travel operator based in China, told The New York Times. “And then today, they just said no foreign tourists at all.”

This isn’t the first time North Korea told the world to get lost. In 2003, the country shut its borders for three months due to the SARS outbreak. It won’t change much for Americans though. The United States State Department has frequently discouraged travel to North Korea, with the latest update in May 2014 warning that American citizens have frequently been detained and arrested there.

The latest numbers:

Number of cases worldwide in the current outbreak: 9,936 (Climbed 720 in five days)

Number of deaths: 4,877 (Climbed 322 in five days)

Countries currently affected by Ebola: Guinea, Liberia, Sierra Leone, Spain, and the United States of America.

Countries where the outbreak has ended: Nigeria (Oct. 19), Senegal (Oct. 17)

And here’s your daily reminder not to panic:

The likelihood of contracting Ebola in Massachusetts remains very low, according to the state’s public health officials. You have to be in direct contact with an infected person’s bodily fluids while they are contagious (displaying symptoms of Ebola). Even if someone has been exposed, symptoms may appear in as little as two days, and in as many as 21 days, after exposure. The CDC says the average is 8 to 10 days.

Ebola symptoms:

- Fever (greater than 38.6°C or 101.5°F)

- Severe headache

- Muscle pain

- Weakness

- Diarrhea

- Vomiting

- Abdominal (stomach) pain

- Unexplained hemorrhage (bleeding or bruising)

Need more details? Here’s an MGH physician dropping some knowledge for you.

Article source: http://www.boston.com/health/2014/10/23/ebola-today-north-korea-bans-foreign-tourists-out-ebola-fear/559NpdQlaDFqUPyoJBmP1N/story.html

NHS needs extra cash and overhaul, say health bosses



GP writes prescription

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The plan wants more done to reduce obesity, smoking and drinking rates

Drastic changes to services and extra money is needed if the NHS in England is not to suffer, health bosses say.

A five-year plan for the NHS – unveiled by six national bodies – once again highlighted that an annual £30bn shortfall would open up by 2020.

It said changes, such as GP practices offering hospital services, would help to plug a large chunk of the gap.

But health chiefs said the NHS would still need above inflation rises of 1.5% over the coming years.

That works out at an extra £8bn a year above inflation by 2020. The current budget stands at £100bn a year, but all the political parties have already said this will be increased if they win power next year.

The plan – called the NHS Forward View – said the future of the health service depended on it becoming more efficient.

To achieve this, the plan called for a rethink about the way services were delivered.

Continue reading the main story

£100bn

NHS England budget for 2014-15

£30bn

Shortfall predicted by 2020

  • That could fund 100 hospitals

  • New ways of working could save £22bn

  • But NHS still needs an extra £8bn

It put forward a range of models – although stressed it was up to each local area to decide which ones to adopt.

These include:

  • Large GP practices to employ hospital doctors to provide extra services, including diagnostics, chemotherapy and hospital outpatient appointments
  • In areas where GP services are under strain, hospitals could be encouraged to open their own surgeries
  • Smaller hospitals to work as part of larger chain, sharing back-office and management services
  • Larger hospitals to open franchises at smaller sites, as Moorfields Eye Hospital has done in London
  • Hospitals to provide care direct to care homes to prevent emergency admissions
  • Volunteers could be encouraged to get more involved, by offering council-tax discounts

Many of these measures are designed to curb the rise in hospital admissions and impact of the ageing population – the source of most pressure in the health service.

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Case study: Working with care homes

Nurses and doctors from Airedale Hospital in West Yorkshire have set up video link-ups with local care homes.

It allows consultations to take place with residents on everything from cuts and bumps to diabetes management.

Emergency admissions from these homes have reduced by 35% and AE attendances by 53%.

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But the report – produced by NHS England, Public Health England, the regulator Monitor, the NHS Trust Development Authority, Care Quality Commission and Health Education England – also said more needed to be done to reduce obesity, smoking and drinking rates.

It suggested employers should be encouraged to incentivise their staff to become healthier by taking steps such as offering them shopping vouchers for healthy behaviour.

Meanwhile, councils could play their part by using their powers in areas such as planning and licensing to limit the opening of junk food outlets and the sale of cheap high-strength alcohol.

Graphs

Simon Stevens, chief executive of NHS England, the lead body for Forward View, said the NHS was at a “crossroads”.



Simon Stevens, NHS England chief executive

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NHS England chief executive Simon Stevens: NHS “must fundamentally change”

“It is perfectly possible to improve and sustain the NHS over the next five years in a way that the public and patients want. But the NHS needs to change substantially.”

He said if the health service did not improve, the “consequences for patients will be severe” in terms of what could be done to ensure patients received the best care in areas such as cancer and heart disease.

But he added there was no reason why a tax-funded NHS would not continue if the plans outlined were followed.

Health Secretary Jeremy Hunt said difficult decisions needed to be taken, but added the Conservatives were committed to “protecting and increasing” funding in real terms.



Jeremy Hunt

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Health Secretary Jeremy Hunt welcomes the report as “positive” but recognises there are “big, big challenges”

“A strong NHS needs a strong economy, then it is possible to increase spending this report calls for.

“We will need to find greater efficiencies savings, it will be tough to do so and don’t under estimate challenge.”

‘Close the gap’

Health minister Norman Lamb welcomed the report, saying it was “really imaginative thinking”.

“I think this combined case of more investment but also change… is absolutely the right message.”

The Liberal Democrat minister said his party wanted to “reopen” spending plans for 2015/16, saying “the NHS needs more money next year”. He said it would be “our top priority” for the Autumn Statement.

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Case study: The GP super-practice

Whitstable Medical Practice, in Kent, is one of the new super-practices that are being developed. It offers the traditional GP services alongside a host of services more associated with hospitals.

It operates out of three sites and employs nearly 150 staff, providing care for 34,000 people.

It runs maternity services, a minor injury unit with X-ray facilities and dedicated diabetes, heart disease and asthma clinics as well as diagnostics and minor surgery.

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Labour’s shadow health secretary Andy Burnham said some of the proposals were ideas Labour had already suggested.

“We’ve have found an extra £2.5bn for the NHS, we’ve said that the NHS will be our priority in the next Parliament, and alongside that, we’re saying that the time has come to bring social care into the NHS.”

Nigel Edwards, the chief executive of the Nuffield Trust think tank, said: “This report makes crystal clear that the NHS cannot continue with ‘business as usual’ if it is to meet the needs of a diverse and ageing population.”

Royal College of Nursing general secretary Peter Carter called the report “rigorous and realistic”.

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Do you work for the NHS? Or are you a patient? Will giving the NHS extra money help improve services? Share your experience by emailing haveyoursay@bbc.co.uk.

Article source: http://www.bbc.com/news/health-29726934

Precision Health: Policy Needs To Catch Up To Science

Guest post written by
Bob Kocher and David Beier

Mr. Kocher was a former special assistant to Pres. Obama for health care and economic policy. Mr. Beier was a former chief domestic policy advisor for VP Gore.

Technology is turning the 21st century into the century of personalization. Whereas a department store once showcased its wares in its windows hoping to entice the masses, stores of all sizes now send specific ads based on your preferences directly to your smart phone. Start-ups have made it possible to order eyeglasses made to fit from the comfort of your home or clothes tailored to your specifications.

While adding to convenience, the power of this rapid personalization is that it is poised to transform health care as well. Imagine a world where treatments are based on your exact genetic make-up or that of the cancer or bacteria afflicted you—or picture a time in which your entire health history helps to craft clinical outcome goals. This is not science fiction. This is the promise of “precision health” in which we are able to use huge new sets of data and computing power to help patients and their clinicians’ figure which diseases and symptoms matter, reduce side effects, increase the likelihood that treatments will work, and eliminate wasteful spending along the way. Unfortunately, policy is not keeping pace with science. The rate at which we are converting our investments in research into useful medical treatments is stifled by a mix of misaligned incentives, underinvestment in the last mile of translational research, and outdated approaches to reimbursement and regulation.

Shifting Resources

We draw these conclusions after being in roles in which we helped to craft health policy; thus, we have a keen appreciation of how hard it can be to move the regulatory state and the legislative process in order keep pace with innovation. Yet, there is more that can be done now—by government, academia and the private sector—to make precision health a reality, improve health outcomes, reduce unnecessary health care costs, and cement U.S. global leadership in this new field. First, while we recognize that the National Institutes of Health (NIH), the world’s leader in biomedical research is underfunded, it should not shortchange precision health. It is a travesty that the current NIH budget has about 25 percent less purchasing power than its budget of 10 years ago. As a result, the NIH has diverted resources from translational precision health research at a point in time when early stage life sciences venture capital life science funding is also decreasing. This means promising projects are dying on the vine. Instead of cutting investment, the NIH should shift more resources to precision health. Moreover, to increase the odds of ongoing private sector investment in this field, the NIH also should co-invest in projects that are viewed by both the public and private sector as encouraging.

Early Market Access

Second, the FDA has to open the doors to early market access to promising treatments. Specifically, the FDA should offer “conditional approval,” based on smaller pivotal trials, for precision health diagnostics and therapeutics that in preliminary Phase 2 trials appear to have substantial cost savings (greater than 10 percent reductions in total cost of care) and large quality improvements. Early market access reduces cost to bring these products to market and will stimulate RD for innovations with these characteristics. We understand the risks in this approach, and that’s why early market access must be limited to precision health uses, and all patients must be registered so that outcomes and costs can be independently assessed. Products that do not deliver cost and quality benefits should either be removed from the market if unsafe and the remaining period of market exclusivity should be adjusted.

Clarity Over Cost-Coverage

Third, the Centers for Medicare and Medicaid Services (CMS) has sent unclear signals to the market concerning development, coverage and payment for precision health. The goal for CMS should be clarity that it will cover precision health products that lower costs and improve outcomes. CMS could advance the adoption of precision health tools by offering either reimbursement carrots or sticks for providers. For example, CMS could encourage the use of precision health tools by building it into quality measure reporting for Accountable Care Organizations. A concerted effort to liberate privacy-protected patient data on precision health cost and outcomes from Medicare, Federal Employees, Military Health and Veteran Administration would massively help the private sector adopt precision health approaches that work. Finally, the federal government is a enormous purchaser of health care for federal workers, and could drive market adoption by requiring its health plans to cover precision health approaches that are approved by the FDA and covered by Medicare at low cost to patients.

Implementation and Adoption

Lastly, to complete the last mile of implementation of precision health we will need doctors, hospitals and other providers to learn to use these tools and treatment in their practices. Since the adoption of evidence-based approaches can be notoriously slow, one catalytic step would be a program modeled on the Department of Education’s “Race to the Top” that offers financial rewards to successful early adopters of precision health programs that reduce costs and improve outcomes.

These policy changes are as simple as the field of precision health is complex. But this is the role government can, and should, play: investing in promising technologies, removing unnecessary barriers to growth, and doing what it can to stimulate a new market. If America does that, then our country can lead the world in precision health, creating jobs and saving lives for decades to come.

Article source: http://www.forbes.com/sites/realspin/2014/10/22/precision-health-policy-needs-to-catch-up-to-science/

Introducing Health Goth, a New Lifestyle Trend

Photo: healthgoth.com

Somewhere in between normcore, cyberpunk, goth, and sportswear chic exists the possibly real trend known as “Health Goth.” It’s been kicking around since spring, actually, but it seems to have entered the mainstream this week, much to the chagrin of OG Health Goths the world over. But what is “Health Goth,” asks everyone else? Here’s a quick FAQ so you, too, may commune in the graveyard (gym) with ease:

Health Goth FAQ:

What does this term mean?
It’s exactly what it sounds like. Or, for a more intellectual approach, here’s some fancy rhetoric from AM Discs’ explainer: “Health Goth relies on an anti-nostalgic dystopian present, refracting the Other by means of an exaggerated profile and tribal-aesthetics … Health Goth creates a proto-narrative of returning to paradise lost by embracing mortality as a One-World consciousness and devotion as means to deliver us from late Capitalism … Health Goth speaks to an intrinsic psychic connection with the elements, be they fire, water or fauna and the ability to incorporate ambient nature into the corporeal realm.” Sounds neat!

What in the —
I know, child. I know. At its essence: wearing black but also working out and eating right. It’s having an appreciation for both Hot Topic and Equinox. Death is great, but your body is not decaying yet, you know, so treat it right. But no need to go to Lululemon or anything.

Where did the trend originate?
According to Complex, Health Goth was borne of the dark recesses on a Facebook page started by cool Portland musicians Mike Grabarek and Jeremy Scott. They told the magazine that they were “attributing a name to describe a feeling that already existed.” That feeling of sadness, but also sportiness.

How can I recognize a Health Goth?
Well, they are probably waiting in line for the Alexander Wang x HM collab right now. Go, quick! Observe. Or else it’s the guy on the treadmill swathed in many layers of Rick Owens. Easier shorthand: Imagine Rick Owens. But really just imagine Fairuza Balk’s character from The Craft going to gym class. What would she wear? That’s Health Goth.

So it’s just a way of dressing?
It’s a lifestyle. Like Goop, but for the tortured and misunderstood person who straddles the worlds of the macabre and ’90s Adidas.

What constitutes a suitable Health Goth workout? 
If it makes your lats really pop in that leather harness, it works. For example: “xick pumps,” dead lifts (naturally), kettlebells — basically anything but SoulCycle.

What songs can I listen to while I jog, morosely, on the treadmill?
Death Metal. But Complex also recommends some gloomy rap by artists like Spooky Black or Yung Lean. (Emphasis on the lean, guys. Get that body-fat percentage down.)

But wait a second, will my patron saint Emily Dickinson approve of this embrace of athleticism?
One of the tenets laid out in the “Health Goth Bible” decrees, “Work out till you’re near death.” So, yes, yes she would.

All right, I’m sold! Is it still cool to hop on this bandwagon to the underworld?
Well, the Huffington Post and Marie Claire discovered Health Goth yesterday. According to some irate OG Health Goths, us mainstream narcs have already ruined it. Which probably means that — like joy, happiness, or your love of the Smiths when all the happy blonde girls started listening to them — this trend is dead.

Article source: http://nymag.com/thecut/2014/10/faq-do-you-know-what-health-goth-means.html

Health Care Costs Expected to Rise in 2015: Are You Ready?

While 2015 may seem like a long way off, decisions you make within the next few months could affect
how much you pay for health care in the coming year.

Health care
costs are expected to grow 6.8 percent overall next year, according to a report from
PricewaterhouseCooper’s Health Research Institute. While not all this growth
will be passed on to consumers, it’s likely you’ll see some increases,
particularly when it comes to your health insurance.

The report
points to economic improvements as part of the driving force behind the
increase, as people are now seeking medical care for things they put off when
times were tough. Investments in technology, specialty drugs and increased
physician employment are also spurring the growth.

For the
consumer, this increase in medical spending could mean paying more for
insurance, as employers look to cost trends like this to determine which health
plans to offer. Over the past several years, this has translated into a greater
number of employees being pushed into high-deductible plans, for which they
must pay more out of pocket before their coverage kicks in.

In fact, the
HRI report says enrollment in such plans has tripled since 2009, and among
employers that haven’t made the switch to such high-deductible plans, 44 percent say
they’re considering it.

Fortunately,
with open enrollment for employer-based health care plans and Obamacare plans
right around the corner, now is a great time to analyze your options and
prepare for the possible increases in cost.

Reviewing Your Health Insurance Plan

Open
enrollment is a period everyone should take advantage of, even if you’re content with your plan. You may find there’s a better or more affordable
option available that can fit your needs just as well.

Financial
advisor Brian Frederick of Stillwater Financial Partners in Scottsdale, Arizona,
recommends you try to assess how much health insurance you’ll need in the
coming year, considering any chronic conditions you may have or expected costs
and changes, like having a baby.

“If you don’t
see yourself going to a doctor for anything other than an annual checkup,
you’re going to need a different health plan than if you’re managing chronic conditions
or recovering from an accident or illness,” he says.

If your
employer switches to a high-deductible plan, for instance, you may not see much
of a change on your end if you’re relatively healthy and only go to the doctor
for preventive care, which is free
under the Affordable Care Act.

Depending how much your employer contributes to your insurance coverage, it may make
sense to look at other plans through the ACA marketplace. Frederick
says this is especially true if you need
coverage for a family.

“Look at how
heavily your employer subsidizes your care versus that of your dependents,” he
explains. “If they only subsidize the employee’s coverage, it might make sense
to have the dependents get their coverage on the open market.”

Other Opportunities to Save

Adjusting your
health insurance
coverage isn’t the only way to prepare for increased costs.

Consider
a Health Savings Account.
An HSA allows you to contribute pre-tax
dollars to an account used solely for health expenses. These expenses, like
your pre-deductible costs, copayments and medications, can easily add up, and
an HSA can help ensure you have the money available when you need it.

Shop
around.
Hospitals and clinics are providing a service, and just like
other service industries, there is competition. Consumers are becoming more aware
of their range of options and shopping accordingly. From the insurance
marketplace to greater price transparency in hospitals, it’s getting easier to
choose health care providers that balance quality and affordability. With a hospital comparison tool,
for instance, you can compare prices and quality ratings before scheduling a
procedure.

Save
on prescriptions.
While only 4 percent of Americans take specialty drugs – such as those used in the treatment of hepatitis C, multiple sclerosis and other
chronic and costly conditions – these drugs account for 25 percent of drug spending in
the U.S. But whether your medications are classified as specialty drugs or
not, monthly prescription costs have the potential to take a significant chunk
out of your personal health care budget. Save on prescriptions by opting for
generics when possible; comparing prices at local drug stores, wholesale clubs
and reputable online pharmacies; and talking with your doctor about low-cost
alternatives
.

Check
for coverage and billing errors.
A recent
study
from NerdWallet Health found Americans are frequently overcharged on
erroneous medical bills, with an estimated 4 in 5 of such bills containing
mistakes. Left unchecked, these errors contribute to the leading cause of
personal bankruptcy in America: medical debt. Always ask for an itemized
version of your medical bills, and review them with meticulous attention to
detail. Wrong dates of service, charges for procedures that were cancelled and
duplicate charges are all relatively common medical billing errors. If your
insurance company denies coverage, double-check their work. An error on their
part shouldn’t cost you.

Growth in the
health sector is a generally positive thing, marking a rebound after troubled
economic times. For most consumers, preparing for the potential increase
in costs can buffer the impact and ensure you enter 2015 equipped with proper
coverage
.

Article source: http://health.usnews.com/health-news/health-insurance/articles/2014/10/21/health-care-costs-expected-to-rise-in-2015-are-you-ready