Many Parents With Insurance Policy Have Uninsured Kids
Many kids are uninsured, but sometimes the parents have a policy. Parents typically get insurance through work that covers them but cannot afford the extra thousands of dollars that may be needed for a plan that also covers their children, the researchers found in the Journal of the American Medical Association.
“I think there’s been a myth that all uninsured children have uninsured parents, and so if we cover the parents we can cover the kids,” Dr. Jennifer DeVoe of Oregon Health & Science University, who led the study, said in an interview.
“In most cases the parents have insurance through work at reduced rate or no cost, but adding their family is unaffordable,” DeVoe added.
The Census Bureau said in August 8.1 million, or 11 percent, of children under 18 had no health insurance in 2007.
The researchers calculated that about 28 percent of these uninsured children — or about 2.3 million — had at least one parent with health insurance. Most are from low- or middle-income families, DeVoe said.
The high cost of health care and medical insurance and the large numbers of Americans who remain uninsured have been key issues in the U.S. presidential campaign this year.
The study found that children of single parents and children in Hispanic families were more likely than others to lack health insurance even if a parent is covered. It was also more likely in the South and West.
Source: Reuters
Testing Prototype Myeloma Medication
For some people the prospect of a prototype medication can be hopeful, and testing can be done with the consent of the patient and corporations involved.
Baron has described Tysabri as a “last chance effort for life” in his 61-year-old fathers battle with late-stage multiple myeloma. Doctors last week gave Fred Baron only days to live, his son said. Tysabri is approved for people with multiple sclerosis or Crohns disease, but is only in the early clinical trial stage for multiple myeloma.
Patients can seek to use drugs outside the authorized use under what the Food and Drug Administration calls single-patient investigations. But permission must ultimately come from the drug manufacturer, said Judy Leon, an FDA spokeswoman. Biogen Idec Inc., which manufactures Tysabri, didnt grant permission to treat Fred Baron with the drug, company spokeswoman Naomi Aoki said late Thursday.
Biogen has maintained the regulatory risks of giving him special access to Tysabri are too great. The company stood by its decision despite appeals from such prominent figures as former President Bill Clinton and cyclist Lance Armstrong. Andrew Baron said the Mayo Clinic, working with the FDA, found a legal basis for using Tysabri on his father. Mayo Clinic spokesman John Murphy said he had no information about the case. Leon said the FDA could not comment on individual cases, but said no preferential treatment had been given to Baron.
The FDA approved about 250 single-patient investigations in 2007, Leon said. Fred Baron has bankrolled millions for Democrats in Texas. He made headlines this summer when he acknowledged sending money to Edwards former mistress. Baron has said Edwards had no involvement with the payments, which were used to resettle Rielle Hunter, Edwards former mistress, in California. Aoki has said there is no data showing Tysabri would work in Fred Barons case.
He was turned down for the companys clinical trial, but Aoki said she could not say why. Aoki said Tysabri was first approved for multiple sclerosis in 2004, then pulled from the market after three people taking the drug suffered a rare brain infection. Two died, she said.
Source: mibax
New Generation Biological Drugs Saftey Testing
New generation biological drugs have at times experienced safety concerns, a few companies have even issued warnings a short time after the product entered the market. More thorough testing before approval by government agencies would prevent that scenario from happening.
That might surprise some doctors who may have thought that these new treatments might be safer than traditional chemical-based medicines.
Researchers found that most of the warnings came within five years after these biologicals won government approval in the United States and Europe between 1995 and 2007.
Many traditional medicines wind up with safety warnings too after they go on the market. But experts said there were no similar studies of older medicines that made it possible to compare safety issues between the two groups of drugs.
The new study, by Dutch researchers, is the first comprehensive examination of these newer medicines, a driving part of the biotech revolution.
The drugs are known as biologicals because theyre made from living material and they typically affect the bodys disease-fighting immune system. Many relieve severe symptoms by suppressing that system.
Its that same mechanism that can result in side effects often not seen with traditional chemical-based medicines, said Dr. Charles Bennett, a Northwestern University drug safety expert. These can include brain and fungal infections and cancer.
Many are genetically engineered and Bennett said that because they typically resemble naturally occurring proteins, many doctors have assumed they were safer than traditional chemical-based medicines. But he said the study shows thats not necessarily true.
“They have an important role,” Bennett said. “Theyre really the next generation of pharmaceuticals.”
He said the results simply show that doctors and patients should be aware that the drugs have many potential side effects that may not be listed on the label.
Among the drugs under examination are Genentech Inc.s psoriasis drug Raptiva, which just last week the Food and Drug Administration warned may contribute to a life-threatening brain illness and infections; and Exubera, an inhaled insulin product, linked with lung cancer risks. Exubera was approved by the FDA in 2006 but Pfizer Inc. stopped selling it last year.
The study appears in Wednesdays Journal of the American Medical Association.
The results are a concern, and they underscore the need for closer scrutiny of drugs after their approval, said lead author Thijs Giezen of the University of Utrecht.
But he said the study also is reassuring because most problems showed up relatively soon after the drugs became available, which minimized the potential for widespread harm.
“If most issues are discovered within the first few years, then the system is working,” Giezen said.
Bennett says its unreasonable to think that the studied drugs safety issues should have been discovered before they were marketed. Thats because drug approval is based on relatively small studies with patients who generally are healthier than those in the general population. It often takes real-world experience for side effects to appear, he said.
Many biological drugs have advantages over conventional medicine, but the study shows their risks need to also be considered, said Thomas Moore of the Institute for Safe Medication Practices.
Source: mibax
Hand, Foot and Mouth Virus Targets Mainly Children, Several Ill in China
A virus in China is making several people ill. Hand, foot and mouth is easily contracted by children, about 100 have become ill from the virus so far.
Citing a provincial health official, Xinhua said the children who died from the infectious disease were under a year old and came from different towns. Twenty-two of the infected children were still hospitalized for treatment, the report said.
The provincial government has sent eight epidemic prevention experts to the city to help local medical staff conduct citywide checks on children, Xinhua said.
Hand, foot and mouth disease is common in young children and is characterized by fever, mouth sores and a rash with blisters. It is spread by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. It is not related to foot and mouth disease, which infects cattle, sheep and swine.
In spring, the spread of the virus sickened more than 24,000 people and killed dozens across China before authorities reported a slowdown in infections in May in Anhui, the province where the outbreak was first reported.
Anhui was the worst-hit province with 26 deaths, and the outbreak was first reported there in March.
Source: mibax
Canandian Ban on BPA For Food and Infant Items
The controversial chemical added to plastics is facing a ban in Canada. Infant and food items with BPA are expected to see a reduction or complete phase out.
“Many Canadians…have expressed their concern to me about the risks of bisphenol A in baby bottles,” Environment Minister John Baird said in a statement. “Todays confirmation of our ban on BPA in baby bottles proves that our government did the right thing in taking action to protect the health and environment for all Canadians.”
Canadas announcement came six months after its health ministry labeled BPA as dangerous. Health Minister Tony Clement said a report on bisphenol A has found the chemical endangers people, particularly newborns and infants, and the environment, citing concerns that the chemical in polycarbonate products and epoxy linings can migrate into food and beverages.
Baby bottles frequently contain BPA, used to harden plastic and make it shatterproof.
Several U.S. states are considering restricting BPA use, some manufacturers have begun promoting BPA-free baby bottles, and some stores are phasing out baby products containing the chemical. Wal-Mart Canada and other major retailers in Canada in recent months have begun removing BPA-based food-related products such as baby bottles and sipping cups from store shelves.
The scientific debate over BPA could drag on for years. The European Union and the U.S. Food and Drug Administration say the chemical is safe. However, the FDA is awaiting word from a scientific panel expected to deliver an independent risk assessment later this month.
The chemicals industry maintains that polycarbonate bottles contain little BPA and leach traces considered too low to harm humans.
Robert Brackett, chief science officer for the Grocery Manufacturers Association, said Friday that Canadas precautionary action regarding the use of BPA is disproportional to the risk determined by public health agencies.
The biggest concern with this widely used chemical, traces of which can be found in more than 90 percent of Americans, has been over BPAs possible effects on reproductive development and hormone-related problems.
Source: mibax
Medicaid Spending Increase on Cost of Coverage
The amount of spending on Medicare is rising, the costs to maintain the organization is seeing an increase. Actuaries said the cost surges they expect in the coming decade are not unique to Medicaid. Costs for every form of health coverage have increased rapidly and reflect new, better and more complex services as well as wage inflation in the medical sector. While Medicaid will grow at a 7.9 percent rate, the overall economy over the next 10 years is projected to grow at a rate of 4.8 percent.
Health and Human Services Secretary Mike Leavitt said the analysis was a reminder that Medicaid spending is on an unsustainable path.
“If nothing is done to rein in these costs, access to health care for the nations most vulnerable citizens could be threatened,” Leavitt said.
Medicaid is a federal-state partnership. The program cost $333.2 billion in the fiscal year ending Sept. 30, 2007, with the federal government paying about 57 percent of that tab and states the remainder.
Actuaries said the growth rate for the coming decade does not reflect the current economic woes the country is facing. Medicaid rolls tend to increase when the economy struggles. About half of enrollees are children, who got an estimated $2,435 worth of benefits, while adults obtained $3,586 in benefits. Expenses are substantially greater for the disabled and elderly - more than $14,000 per person.
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On the Net:
Medicaid: http:http://www.cms.hhs.gov
Source: mibax
Child Universal Healthcare in Hawaii Lacks Funding
The universal healthcare program for children in Hawaii was successful in terms of people helped, but the sources of funding cannot support the need. Until the United States gets a comprehensive health plan for citizens, states will try to pick up the pieces.
“People who were already able to afford health care began to stop paying for it so they could get it for free,” said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. “I dont believe that was the intent of the program.”
State officials said Thursday they will stop giving health coverage to the 2,000 children enrolled by Nov. 1, but private partner Hawaii Medical Service Association will pay to extend their coverage through the end of the year without government support.
“Were very disappointed in the states decision, and it came as a complete surprise to us,” said Jennifer Diesman, a spokeswoman for HMSA, the states largest health care provider. “We believe the program is working, and given Hawaiis economic uncertainty, we dont think now is the time to cut all funding for this kind of program.”
Hawaii lawmakers approved the health plan in 2007 as a way to ensure every child can get basic medical help. The Keiki (child) Care program aimed to cover every child from birth to 18 years old who didnt already have health insurance - mostly immigrants and members of lower-income families.
It costs the state about $50,000 per month, or $25.50 per child - an amount that was more than matched by HMSA.
State health officials argued that most of the children enrolled in the universal child care program previously had private health insurance, indicating that it was helping those who didnt need it.
The Republican governor signed Keiki Care into law in 2007, but it and many other government services are facing cuts as the state deals with a projected $900 million general fund shortfall by 2011.
While its difficult to determine how many children lack health coverage in the islands, estimates range from 3,500 to 16,000 in a state of about 1.3 million people. All were eligible for the program.
“Children are a lot more vulnerable in terms of needing care,” said Democratic Sen. Suzanne Chun Oakland. “Its not very good to try to be a leader and then renege on that commitment.”
The universal health care system was free except for copays of $7 per office visit.
Families with children currently enrolled in the universal system are being encouraged to seek more comprehensive Medicaid coverage, which may be available to children in a family of four earning up to $73,000 annually.
“Most of them wont be eligible for Medicaid, and thats why they were enrolled in Keiki Care,” Diesman said. “Its the gap group that were trying to ensure has coverage.”
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On the Net:
Hawaii Medical Service Association: http://www.hmsa.com/
Source: mibax
Depression Treatment by Magnets, Patient Trials
The idea of illness treatment by magnets is not a new one. Depression is a condition that some people believe can be affected by EM fields, and a few patients are willing to try. The power of placebo is strong however, and strict scientific method is needed to prevent inaccurate studies.
“Were opening up a whole new area of medicine,” says Dr. Mark George of the Medical University of South Carolina in Charleston, who helped pioneer use of TMS in depression. “Theres a whole field now thats moving forward of noninvasive electrical stimulation of the brain.”
While theres a big need for innovative approaches - at least one in five depression patients is treatment-resistant - the question is just how much benefit TMS offers.
The FDA cleared the prescription-only NeuroStar based on data that found patients did modestly better when treated with TMS than when they unknowingly received a sham treatment that mimicked the magnet. It was a study fraught with statistical questions that concerned the agencys own scientific advisers.
For a more clear answer, the National Institutes of Health has an independent study under way now that tracks 260 patients and may have initial results as early as next year.
Quantifying the benefit is key, considering the price tag. TMS is expected to cost $6,000 to $10,000, depending on how many treatments a patient needs, says Dr. Philip Janicak of Rush University Medical Center in Chicago, who helped lead the NeuroStar study. Thats far more expensive than medication yet thousands of dollars cheaper than invasive depression devices.
Neuroscientists have been using TMS for years as a research tool in brain studies. Zap a powerful magnet over a certain spot on the head - where motion is controlled - and someones arm can suddenly, involuntarily, lash out. Beyond the “wow” factor, magnetized pulses were triggering brain activity.
The question was how to harness that activity in a way that might improve disease. TMS also is being studied in stroke rehabilitation and other brain disorders.
“Nobody thought this would work; it was a crazy idea. I had to do it at 6 in the morning before the real scientists came in,” South Carolinas George laughs as he recalls work he began in 1993.
But, “the brain is an electrical organ,” George adds, explaining the rationale. “Electricity is the currency of the brain. Its how the brain does what it does.”
For depression, psychiatrists aim the magnet at the left front of the head, the prefrontal cortex. Since everyones brain is different, they first zap the top of the head to find a patients motor-control region, and then carefully move 5 centimeters forward. Then, the NeuroStar beams about 3,000 pulses a minute during a 40-minute treatment, done about five times a week for up to six weeks.
The theory: Stimulating brain cells in the prefrontal cortex triggers a chain reaction that also stimulates deeper brain regions involved with mood.
The FDA cleared the device after focusing just on a subset of the patients initially enrolled - 164 who had failed one antidepressant during their current bout of depression, not those who were more severely treatment-resistant.
Whats a modest benefit? About 24 percent who got TMS scored significantly better on standard depression measures after six weeks, compared with 12 percent who got the sham, says Janicak. Thats about as well as patients respond to a single antidepressant, he says.
Some reported remarkable improvement.
“One day it was like a light switch went off,” says Steve Newman, 60, of Washington, D.C., who enrolled in the NeuroStar study at the University of Pennsylvania in 2005.
Newman had suffered repeated bouts of depression since he was a teenager, and drug after drug barely blunted it. He was considering shock therapy when he heard about TMS.
Source: mibax
Milk Recall Australia, Tainted Melamine Products Removed
The chemical melamine which fools milk checking tests by appearing to be a protein has tainted several products in Australia. The recall to get all melamine removed from grocery stores is currently underway. While it may make water look like milk, it contains no nutritional value.
A sample of the cakes was found to contain 4.4 parts per million of melamine, while the milk drink had 5.8 ppm, Food Standards spokeswoman Lydia Buchtmann said. The agency has set the safe limit at 2.5 ppm.
The other products previously recalled in Australia are Kirin Milk Tea, Lotte Koala Biscuits, Cadbury Eclairs and White Rabbit candies.
Milk powder contaminated with melamine has been blamed for the deaths of four infants and for sickening about 54,000 others in mainland China. Hong Kong has also found 10 children with kidney stones who had consumed Chinese-made milk products.
Melamine is used in the manufacturing of plastics, fertilizer, paint and adhesives. Health experts say ingesting a small amount poses no danger, but in larger doses, the chemical can cause kidney stones and lead to kidney failure.
Greed somewhere in the chain between where the milk was produced and the place of shipping caused this unfortunate scandal. The communist government is undergoing a crackdown on suspected people involved, but much is hidden from the public eye to prevent damage to the national image. This lack of transparency could lead to quality control issues in other exports.
Source: mibax
Laws Regarding Autism Insurance, State Lobbying
The issue of insurance policies covering autism is hotly contested, with agencies lobbying to keep it off the books. Parent groups are petitioning state governments to take action in form of initiative and referendum.
Two families. Two states. Big difference in out-of-pocket costs.
If autism advocates get their way, more states will follow Indianas lead by requiring health insurers to cover intensive and costly behavior therapy for autism.
In the past two years, six states - Texas, Pennsylvania, Arizona, Florida, South Carolina, Louisiana - passed laws requiring such coverage, costing in some cases up to $50,000 a year per child.
The powerful advocacy group Autism Speaks has endorsed bills in New Jersey, Virginia and Michigan and is targeting at least 10 more states in 2009, including New York, California and Ohio.
Other states, including Illinois, have similar bills in the works but arent working directly with Autism Speaks.
“This is the hottest trend in mandates weve seen in a long time,” said J.P. Wieske, a lobbyist for an insurance coalition that argues that these state requirements drive up insurance costs for everyone. “It is hard to fight them.”
For lawmakers, voting against these measures means voting against parents who are struggling to do the best for their children.
Parents tell moving stories about how behavior therapy works better than anything theyve tried. In two states, bills got nicknames like “Stevens Law” and “Ryans Law,” so voting against them was tough.
Arzu Forough of Kirkland, Wash., who is pushing a bill in her state, credits behavior therapy for teaching her son Shayan, at age 3, to make a sound to ask for a drink of water. Now 12, he is learning to converse about his favorite food and music, and to talk about his frustrations rather than throw tantrums.
Trained therapists, using principles of applied behavior analysis (ABA), created a system of rewards to teach Shayan these skills. As a preschooler, he got a piece of cheese when he said “bubba” for water. Now a therapist rewards him with tokens when he responds in conversation. He uses the tokens to “buy” privileges like going for a car ride.
Shayans improvements are a welcome relief to his mother, who once called for police help with her out-of-control son while she was driving.
The Foroughs have health insurance, but it doesnt cover Shayans therapy. Although they both work full time, they must live rent-free with her elderly mother to be able to afford his treatment.
Meanwhile, the Trivedi family of the Indianapolis suburb of Carmel, get 25 hours a week of behavior therapy for 11-year-old Ellie. They contribute co-pays and a deductible, totaling about $3,000. Insurance pays the rest, about $47,000 a year.
Michele Trivedi is an autism activist. She fought for years after a vaguely worded 2001 Indiana law required coverage but insurers still refused to pay for ABA. Finally in 2006, she helped convince the states insurance commissioner to issue a bulletin spelling out what was expected of insurers.
“Its no longer acceptable that blatant discrimination against people with autism occur,” Trivedi said.
Autism is a range of disorders that hinder the ability to communicate and interact. Most doctors believe there is no cure. An estimated 1 in 150 American children are diagnosed with it.
Source: mibax