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Daily Archives: July 11, 2016

Obama Renews Call For A Public Option In Health Law

President Barack Obama Monday called on Congress to revisit the controversial idea of providing a government-run insurance plan as part of the offerings under the Affordable Care Act.

The so-called “public option” was jettisoned from the health law by a handful of conservative Democrats in the Senate in 2009. Every Democrat’s vote was needed to pass the bill in the face of unanimous Republican opposition.

But in a “special communication” article published on the website of the Journal of the American Medical Association, the president said a lack of insurance plan competition in some areas may warrant a new look.

“Now, based on experience with the ACA, I think Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited,” Obama wrote.

ACA1The president also called on Congress to take more steps to rein in the cost of prescription drugs and make government assistance more generous for those who still cannot afford health coverage, while urging the 19 states that have not yet expanded the Medicaid program under the health law to do it.

The public option has been a point of controversy from the start. It was included in the version of the health law passed by the House, and had support from most Democrats in the Senate, before it was dropped. Many liberals hoped — and conservatives feared — that having the government provide insurance alongside private companies would be a step toward a full government-run system.

Presumptive Democratic presidential nominee Hillary Clinton — under pressure from Sen. Bernie Sanders’ call for a single-payer government system — in February endorsed the idea of including a public option to allow people ageಷ and older to purchase Medicare coverage. On Saturday, as part of a deal with Sanders, Clinton announced she will also “pursue efforts to give Americans in every state in the country the choice of a public-option insurance plan,” which is broader than what Obama is endorsing.

But even if Clinton wins and the Democrats take back control of Congress in November, a true public option remains a political longshot.

The article, titled “United States Health Care Reform: Progress to Date and Next Steps,” is apparently the first by a sitting president published by the prestigious medical journal.

It includes a justification for the health law, statistics on how its implementation has improved both insurance coverage and health care quality, as well as recommendations for further action.

Kristie Canegallo, the White House deputy chief of staff for implementation, told a group of health reporters that the article grew out of a comprehensive review of the law ordered by the president late last year.

The review was to look at “what’s working, what’s not, and what we should do about it,” she said. Upon receiving the review, she added, Obama “thought it was important to share some of this publicly.”

Among those parts of the law the administration says are working are the coverage provisions. “The number of uninsured individuals in the United States has declined from 49 million in 2010 to 29 million in 2015,” the president wrote.

The article also claims that the health law has played a substantial role in slowing the rate of health spending.

“While the Great Recession and other factors played a role in recent trends, the [president’s] Council of Economic Advisers has found evidence that the reforms introduced by the ACA helped both slow health care costs growth and drive improvements in the quality of care,” says the article.

Jason Furman, chairman of the council, told reporters at the briefing that the continuing slow growth in health spending so many years out from the recession makes the argument that the economy is mostly responsible for the slowdown “absurd at this point.”

While most of the piece is a chart-driven, footnoted recitation of the impact of the health law, Obama did use his perch to suggest the current state of politics in Washington threatens progress going forward.

“Any change is difficult, but it is especially difficult in the face of hyperpartisanship,” he wrote. “Republicans reversed course and rejected their own ideas once they appeared in the text of a bill that I supported.”

Republicans, however, are continuing their assault on the health law. Just last week, two House Committees released a joint investigative report and held two hearings asserting that the administration is illegally providing funds to help lower-income individuals pay for their health coverage.

The claim is also the subject of a lawsuit currently in federal court.

The White House, however, remains unimpressed with by the claim.

“The Department of Justice … has made clear we have a permanent appropriation for this,” said Canegallo.

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Patients Sometimes Take Antibiotics Without Consulting A Doctor, Study Finds

Suffering from a sore throat or runny nose? For some people, that many mean opting to use antibiotics without seeing a doctor, a practice that health experts say may not help cure the disease and could help aggravate the problem of antibiotic-resistant germs.

A study published Monday in the journal Antimicrobial Agents and Chemotherapy concluded that many people are tempted use antibiotics without a doctor’s prescription. They rely on drugs purchased from ethnic grocery or drug stories or the leftovers in their medicine cabinets, potentially contributing to the spread of antibiotic-resistant bacteria and causing damaging side effects.

“This kind of inappropriate use is very risky,” said Larissa Grigoryan, coauthor of the study and an instructor at the Baylor College of Medicine in Houston. “If you use antibiotics irresponsibly like this then resistance rates will increase.”

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This KHN story can be republished for free (details).

Between April and August last year, researchers surveyed 400 people in the waiting rooms of three primary care clinics around Houston, asking about their use of antibiotics in the past year. Two were public family medicine clinics serving diverse, mostly uninsured or underinsured patients. The third clinic served primarily managed care and privately insured patients. The survey participants were selected randomly to represent the racial and socioeconomic makeup of Harris County, one of the most populous counties in the state.

Researchers found that 5 percent of patients surveyed reported using antibiotics without prescriptions during the previous 12 months. However, 25 percent of the respondents said they were willing to use antibiotics if possible without contacting a medical professional. Fourteen percent stored antibiotics at home, most of which were left over from previous prescriptions. Those who stored antibiotics were 4.2 times more likely to indicate that they would use antibiotics without prescriptions.

The most common types included amoxicillin, azithromycin, ciprofloxacin and penicillin.

“The part that was most alarming is the percentage of people who say they would use antibiotics without contacting their doctors,” Grigoryan said.

Of the 5 percent who used non-prescription antibiotics, 40 percent of them purchased the drugs from pharmacies, even though such sales are illegal. Earlier studies have found that ethnic drug stores and groceries often sell antibiotics without prescriptions. Nearly a quarter of these people said they got the drugs from another country.

The patients also reported they got these medicines from relatives or friends.

Overuse and misuse of antibiotics is a concern because resistance to the drugs is a global threat, rendering procedures like routine surgeries vulnerable to fatal infections.

According to the Centers for Disease Control and Prevention, antibiotic resistance causes more than 23,000 deaths per year in the United States with more than 2 million Americans infected with antibiotic-resistant pathogens.

Antibiotic resistance occurs when bacteria adapt to the drugs, rendering the antibiotics useless against fighting infections. That sometimes happens when consumers misuse antibiotics, such as not taking a full course of the drug regimen prescribed by a physician.

The use of non-prescription antibiotics was more likely among those who use public clinics. Grigoryan speculates that those patients might do so to save money. “One of the reasons might be the copay … they still have to pay to see a doctor,” Grigoryan said, adding that another reason could involve getting to a medical appointment. “They don’t have adequate transportation.”

According to the study, most patients wanted the antibiotics to treat respiratory symptoms, such as a cough, sore throat or sinus infection. Previous research has shown that such symptoms, though the most common reason for antibiotic prescription among adults, are often viral rather than bacterial. Antibiotics are not effective for viral infections such as a cold. Still, physicians have been known to prescribe antibiotics unnecessarily when pressured by patients.

Researchers said a solution is to rein in illegal over-the-counter antibiotic sales in pharmacies or local stores. But Grigoryan said the main strategy should be education. The CDC and its European counterpart have launched campaigns to raise public awareness.

“We really need to educate the public it is risky to take antibiotics without contacting a doctor,” Grigoryan said. “You don’t need antibiotics for a minor illness.”

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Viewpoints: Zika And Planned Parenthood; The Public Option; Funding For Safety Net Hospitals

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State Highlights: Stakes Sky-High In Cincinnati’s Health Commissioner Battle; Hospital Closures Cripple Rural Tenn. Communities

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Texas Supreme Court Temporarily Blocks Deep Cuts To Disabled Children’s Therapy Program

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Study: For LGBT Women, Tailored Mindfulness Approach Key To Weight Loss Success

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Dallas Shooting: ‘It Was Like A War Zone,’ ER Doctors Recount

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Utah Reports First Zika-Related Death In Continental U.S.

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OxyContin-Maker Purdue Kept Quiet While An Los Angeles Drug Ring Thrived

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FDA Roundup: Weight-Loss Device Gets Mixed Doctor Reactions; E-Cigarette Rules Challenged In Court

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