Rss Feed
Tweeter button
Facebook button
Webonews button

Saharan dust creates health hazard, hurricane hindrance


  • The sun sets through Saharan dust in Houston on Sunday, July 1. For a few days the city was covered in the dust that had traveled across the Atlantic Ocean from Africa. A new dust storm created hazy skies again this week. (Elizabeth Conley/Houston Chronicle) Photo: Elizabeth Conley, Staff Photographer / Houston Chronicle / ©2018 Houston Chronicle

Caption

Close



This NASA graphic from June 28 shows dust from the Saharan Desert makes its way west from the country of Chad in central Africa.

This NASA graphic from June 28 shows dust from the Saharan Desert makes its way west from the country of Chad in central Africa.

Photo: NASA Earth Observatory


While you wait for the skies to clear of Saharan dust, have a laugh at these weather memes.

While you wait for the skies to clear of Saharan dust, have a laugh at these weather memes.

Photo: Tumblr



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

Photo: Twitter



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #Texas #Summer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #Texas #Summer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #Texas #Heat Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #Texas #Heat Twitter

Photo: Twitter




Repeated weather advisories regarding Saharan dust have been issued this month.

Satellite models from NASA’s Earth Observatory showed plumes of dust blowing across the Atlantic in late June—most of it originating from the Bodele Depression, a dried Saharan lake bed in northeastern region of the central African country of Chad. Easterly trade winds blow the dust westward across the Atlantic to the Amazon, the Caribbean, and states along the Gulf Coast, including Texas.

Lynnanne Nguyen reports.


Media: Fox4



After traveling across the ocean, the dust visibly manifests in Houston as hazy beige or gray skies during the day and bright orange or yellow skies at sunrise and sunset.

“It’s not so much out of the ordinary,” meteorologist Matt Lanza, managing editor of Space City Weather, told the Chronicle earlier this month when the first Saharan dust blanketed the city. “It only happens a couple times per summer.”


SCIENTIFIC REASONS: Houston’s beautiful orange pink sky at sunset, explained

Meteorologist Travis Herzog of KTRK-TV ABC13 says the dust clouds normally sweep through Houston in the summer months of May, June and July.

The dust brings with it a variety of implications for people and for the environment.

It is mainly a respiratory hazard, said Dr. David Engler, a Houston allergy and immunology specialist.

Engler said Tuesday that his practice has seen an increase in patients with respiratory trouble over the past three to four weeks. Young and elderly patients, as well as patients with chronic lung conditions such as emphysema or severe asthma are most vulnerable.

“Go outside, get in your car, leave the air conditioning on, recirculate (your air),” Engler said. He said he tells patients with respiratory risks to minimize their time outside.

For those who have no choice but to go outside, Engler recommends wearing N95 masks as a preventative measure. The masks, which filter out 95 percent of particulate matter, can be bought at local hardware and home improvement stores. Online the N95 masks are sold in boxes of 10, 20 and more with prices ranging from about $7 to $25 per box depending on the features and sellers.

Engler also suggests taking an extra shower after coming back indoors.

MILKY SKY: Saharan dust making for dingy Houston skies

“Take the clothes you’ve been wearing—either put them right in the washing machine or maybe put them in a covered hamper,” he said. “(The dust) really sticks in the hair, so make sure to not only shower but to shampoo also.”

From an environmental perspective, the Saharan dust and the winds that transport it act as a hurricane deterrent.

“We think a dust storm has three main components that can suppress a hurricane,” NOAA researcher Jason Dunion said in a NASA article.

“One, it’s got super-dry air. Hurricanes don’t like dry air in the middle parts of the atmosphere, and that’s exactly what the Saharan Air Layer has,” he said. “A Saharan dust storm also has a very strong surge of air embedded within it, called the mid-level easterly jet, that can rip a storm apart that’s trying to develop. We call that vertical wind shear. And then the third piece is all this dust.”

The dust particles are thought to suppress cloud formation, according to NASA, which prevents the intensification of ocean waves in tropical disturbances.

SILVER LINING: African dust is ‘kryptonite’ for Houston’s hurricanes

The dust is also linked to algal blooms, though this issue is less relevant to Houston. According to NASA, the dust clouds deposit iron in the coastal waters of West Florida. A plant-like bacteria, called Trichodesmium, uses that iron to convert nitrogen in the water into a form that is usable by other marine organisms. Higher levels of iron mean more usable nitrogen, which encourages blooms of toxic algae, known as a red tide. However, this phenomenon tends to affect the coast of Florida more than that of Texas.

Wednesday’s forecast for Houston calls for a partly cloudy day with a high of 97 degrees and a low of 79, according to the Weather Channel. The chance of rain is slim, at just 10 percent. ABC13 predicts a Wednesday high of 98, and a low of 78. The haze from Saharan dust will, however, remain.

“African dust is expected to linger with at least light amounts covering the entire state,” the Texas Commission of Environmental Quality said in its Wednesday forecast. “The heaviest dust is forecast to remain over the northern half of the state” and “parts of Houston are predicted to fall under the lower to middle end of the ‘moderate’ range.”

Article source: https://www.chron.com/news/houston-texas/houston/article/Saharan-dust-creates-health-hazard-hurricane-13083513.php

Destiny’s Child’s Michelle Williams ‘proudly’ seeking mental health help

Michelle WilliamsImage copyright
Getty Images

Destiny’s Child singer Michelle Williams says she has “sought help” for the good of her mental health.

The 37-year-old has previously spoken about being depressed and “suicidal”.

In an Instagram post, Michelle said that as a mental health awareness advocate, she “listened to the same advice” she’s given to others.

She’s had messages of support from artists including original Destiny’s Child member LaTavia Roberson and Missy Elliott.

Skip Instagram post by michellewilliams

A post shared by Michelle Williams (@michellewilliams) on Jul 17, 2018 at 12:01pm PDT

End of Instagram post by michellewilliams


Instagram post by michellewilliams: Image Copyright michellewilliams
michellewilliams

“For years, I’m in one of the top-selling female groups of all time suffering with depression, Michelle Williams said in an interview on US TV in October 2017.

“It got really, really bad, to the point of being suicidal.”

She added: “I was at that place where it got so dark and heavy because sometimes you feel like ‘I’m the provider, I take care of people, I’m not supposed to be feeling this way – what do I do?’

“I wanted out.”

Image copyright
Getty Images

Image caption

Michelle Williams (left) was reunited with her Destiny’s Child bandmates Beyonce and Kelly Rowland at the Coachella festival in April

Missy Elliott responded to the news on Twitter, saying: “I want to lift our sis up in prayer because there are so many people battling this and many trying to deal with it alone”.

She added: “Let’s keep the ones who are openly dealing with it uplifted and be encouraging to them”.

Skip Twitter post by @MissyElliott

End of Twitter post by @MissyElliott

Meanwhile, LaTavia Roberson, who was in Destiny’s Child before Michelle, said she is a “class act”.

She wrote: “Depression is real especially in our community.”

Skip Twitter post by @IamLaTavia

End of Twitter post by @IamLaTavia

US celebrity gossip website TMZ reported that Michelle Williams has checked into a mental health facility in California.

Newsbeat has contacted her manager for comment.

Follow Newsbeat on Instagram, Facebook and Twitter.

Listen to Newsbeat live at 12:45 and 17:45 every weekday on BBC Radio 1 and 1Xtra – if you miss us you can listen back here.

Article source: https://www.bbc.co.uk/news/newsbeat-44869567

Zika and health cuts blamed for rise in baby death rates in Brazil

The number of children dying in their first year of life has risen in Brazil for the first time since 1990.

It’s a worrying setback for a country once seen as a model of poverty reduction.

The infant mortality rate rose by nearly 5% between 2015 and 2016, an increase health officials and specialists have blamed on the outbreak of the Zika virus that year, as well as cuts to health services prompted by an economic crisis from which Brazil is struggling to recover.

Fatima Marinho, director of the non-communicable diseases department and information and analysis at the health ministry, said she expects the 2017 figures to exceed the 2015 levels.

“We are going backwards, not forwards,” Marinho said. “We cannot go on with the situation. Or we lose everything we have gained in 15 years.”

Denise Cesario, executive manager of the Abrinq Foundation, a non-profit group in São Paulo that focuses on children’s and teenagers’ rights, said: “The rate is very significant. It is very worrying if we consider that this economic crisis will still impact on social conditions for years to come.”

Infant mortality is regarded as one of the key measures of a country’s development. Brazil was praised for its success towards meeting the UN millennium development goal targets in a 2010 study published in the American Journal of Public Health, which said the country had made “rapid strides in improving maternal, newborn, and child health”.

But government figures for 2016 revealed by the Folha de S Paulo newspaper, and since published by the health ministry, showed that Brazil’s infant mortality rate rose from 13.3 deaths per 1,000 live births in 2015 to 14 deaths per 1,000 live births in 2016, a 4.8% increase and the first since the current system of tracking progress began in 1990.

Even relatively affluent states like São Paulo showed a 2.7% increase. Nationally, the death rate for children up to the age of five also rose nearly 4%.

Brazil had been lauded for combining economic growth with poverty reduction via landmark government programmes like the Bolsa Família – or family allowance – a cash-transfer scheme for families who made sure their children remained in school and were up to date with vaccinations.

In 2014, however, the country fell into recession. Faced with a deficit after winning re-election, President Dilma Rousseff began to cut spending and in 2016 the budget for Bolsa Família failed to match inflation.

Funding was slashed for the Rede Cegonha (the Stork Network), a government health programme for women that focused on birth, postnatal health and family planning, said Cesario.

Rousseff was suspended in May 2016 and impeached three months later. Her replacement, Michel Temer, introduced more drastic cuts and froze spending.

Government officials have been so alarmed by the increase in infant and child deaths that they called a special meeting of state health secretaries in June. Deaths from preventable diseases like diarrhoea and pneumonia also rose in 2016. Folha also reported a 12% increase in deaths from diarrhoea in under-fives, with 19% of those occurring in semi-arid regions that have been battling drought in recent years.

“How can children in Brazil in the 2000s die of diarrhoea? This number is shocking,” said Marinho, noting that the birth rate fell by around 5% percent in 2016 because women were avoiding having children during the Zika epidemic.

Jurandi Frutuoso, executive secretary of the national council of health secretaries and a former health secretary of north-eastern Ceará state, said less than half of Brazil’s health spending comes from government – the rest is from private health plans and people’s own pockets – and spending has failed to keep pace with the growing population, technological advances and medical inflation. At the same time, the proportion spent by federal government has fallen, leaving cash-strapped states and cities unable to pick up the slack.

“The system lives with very serious under-financing,” he said.

Cesario said the country’s next president must prioritise children. Temer is not standing in presidential elections in October.

“We need the next president to be committed to childhood, to understand the situation of the most vulnerable families, so we can prioritise children,” she said.

Article source: https://www.theguardian.com/global-development/2018/jul/17/zika-health-cuts-blamed-rise-baby-death-rates-brazil

Advisers applaud House bills to expand health savings accounts

Last week, the House Ways and Means Committee approved a roster of bills designed to increase HSA contribution limits and the number of people who qualify to use them.

“It’s exciting to see Congress recognize that we need to expand the use and availability of HSAs and to remove some of the limitations,” said Peter Stahl, president of consulting firm Bedrock Business Results.

One of the bills would increase the annual contribution limits — currently $3,400 for an individual and $6,900 for couples — by allowing contributions to the amount of the deductible and out-of-pocket limitations. HSAs are paired with high-deductible health plans.

Another bill would enhance the ability of spouses to contribute to HSAs, and another would allow seniors who are still working to continue to contribute to HSAs.

Investment advisers were happy to see the House action because HSAs — tax-advantaged savings and investment accounts for medical expenses that are expected to reach about $52 billion in assets next year — are becoming increasingly popular with their clients.

“We’re encouraging it, and for the most part our clients are taking advantage of HSAs,” said John Jespersen, lead financial adviser for Buttonwood Financial Group. “From a fiduciary perspective, it makes sense to empower individuals to take greater responsibility for their health care.”

Ned Hodder, owner of Hodder Investment Advisors, said he is noticing more interest in HSAs from young clients as well as 401(k)-plan clients, who are both looking for ways to increase tax-deferred savings.

Money in HSAs can be contributed and withdrawn tax-free for medical expenses. In retirement, money withdrawn for non-medical uses is subject to income tax.

“I’d like to see the amount you can contribute increase,” Mr. Hodder said.

Fidelity Investments also backs the HSA reform bills.

“Proposals that would increase contribution limits and allow for spousal catch-up would position HSAs as an even more valuable tool for health savers,” Meg Reilly, Fidelity vice president for policy communications, wrote in an email.

Adjusting those limits upward is likely to be a struggle this year. Most of the HSA bills approved last week drew significant Democratic opposition.

Rep. Richard Neal, D-Mass., ranking member of the House Ways and Means Committee, asserted at last Wednesday’s committee vote that the bills are designed to undermine the Affordable Care Act.

“The provisions we are considering today provide America’s wealthiest another option to stash tax-free money at a cost of $92 billion to tax payers,” Mr. Neal said. “Most of the legislation today does very little for the average American. Instead, we should be strengthening and protecting already existing health programs like the ACA, Medicare and Medicaid — not slashing them.”

The bills could be approved by the Republican-majority House but then stall in the Senate, where Democrats have enough members to filibuster.

“It’s difficult to get any legislation passed because it’s purely along partisan lines,” Mr. Stahl said.

Roy Ramthun, president and founder of HSA Consulting Services, sees a glimmer of hope.

“We’re mostly hearing [from Democrats] about Medicare for All, but I’m sure there is some support for HSAs at the center of the political spectrum,” Mr. Ramthun said. “Moderate Democrats don’t have a big objection to HSAs.”

The fact that HSA expansion ideas are getting committee votes now gives them momentum.

“It would not surprise me to see some of them make their way into legislation that becomes law,” said Jack Towarnicky, executive director of the Plan Sponsor Council of America. “If not this year, then in future years.”

Article source: http://www.investmentnews.com/article/20180716/FREE/180719942/advisers-applaud-house-bills-to-expand-health-savings-accounts

Health Insurers Are Vacuuming Up Details About You — And It Could Raise Your Rates

This story was co-published with NPR.

To an outsider, the fancy booths at last month’s health insurance industry gathering in San Diego aren’t very compelling. A handful of companies pitching “lifestyle” data and salespeople touting jargony phrases like “social determinants of health.”

But dig deeper and the implications of what they’re selling might give many patients pause: A future in which everything you do — the things you buy, the food you eat, the time you spend watching TV — may help determine how much you pay for health insurance.

With little public scrutiny, the health insurance industry has joined forces with data brokers to vacuum up personal details about hundreds of millions of Americans, including, odds are, many readers of this story. The companies are tracking your race, education level, TV habits, marital status, net worth. They’re collecting what you post on social media, whether you’re behind on your bills, what you order online. Then they feed this information into complicated computer algorithms that spit out predictions about how much your health care could cost them.

Are you a woman who recently changed your name? You could be newly married and have a pricey pregnancy pending. Or maybe you’re stressed and anxious from a recent divorce. That, too, the computer models predict, may run up your medical bills.

Are you a woman who’s purchased plus-size clothing? You’re considered at risk of depression. Mental health care can be expensive.

Low-income and a minority? That means, the data brokers say, you are more likely to live in a dilapidated and dangerous neighborhood, increasing your health risks.  

“We sit on oceans of data,” said Eric McCulley, director of strategic solutions for LexisNexis Risk Solutions, during a conversation at the data firm’s booth. And he isn’t apologetic about using it. “The fact is, our data is in the public domain,” he said. “We didn’t put it out there.”

Insurers contend they use the information to spot health issues in their clients — and flag them so they get services they need. And companies like LexisNexis say the data shouldn’t be used to set prices. But as a research scientist from one company told me: “I can’t say it hasn’t happened.”

At a time when every week brings a new privacy scandal and worries abound about the misuse of personal information, patient advocates and privacy scholars say the insurance industry’s data gathering runs counter to its touted, and federally required, allegiance to patients’ medical privacy. The Health Insurance Portability and Accountability Act, or HIPAA, only protects medical information.

“We have a health privacy machine that’s in crisis,” said Frank Pasquale, a professor at the University of Maryland Carey School of Law who specializes in issues related to machine learning and algorithms. “We have a law that only covers one source of health information. They are rapidly developing another source.”

Patient advocates warn that using unverified, error-prone “lifestyle” data to make medical assumptions could lead insurers to improperly price plans — for instance raising rates based on false information — or discriminate against anyone tagged as high cost. And, they say, the use of the data raises thorny questions that should be debated publicly, such as: Should a person’s rates be raised because algorithms say they are more likely to run up medical bills? Such questions would be moot in Europe, where a strict law took effect in May that bans trading in personal data.

This year, ProPublica and NPR are investigating the various tactics the health insurance industry uses to maximize its profits. Understanding these strategies is important because patients — through taxes, cash payments and insurance premiums — are the ones funding the entire health care system. Yet the industry’s bewildering web of strategies and inside deals often have little to do with patients’ needs. As the series’ first story showed, contrary to popular belief, lower bills aren’t health insurers’ top priority. 

Inside the San Diego Convention Center last month, there were few qualms about the way insurance companies were mining Americans’ lives for information — or what they planned to do with the data.


The sprawling convention center was a balmy draw for one of America’s Health Insurance Plans’ marquee gatherings. Insurance executives and managers wandered through the exhibit hall, sampling chocolate-covered strawberries, champagne and other delectables designed to encourage deal-making.

Up front, the prime real estate belonged to the big guns in health data: The booths of Optum, IBM Watson Health and LexisNexis stretched toward the ceiling, with flat screen monitors and some comfy seating. (NPR collaborates with IBM Watson Health on national polls about consumer health topics.)

To understand the scope of what they were offering, consider Optum. The company, owned by the massive UnitedHealth Group, has collected the medical diagnoses, tests, prescriptions, costs and socioeconomic data of 150 million Americans going back to 1993, according to its marketing materials. (UnitedHealth Group provides financial support to NPR.) The company says it uses the information to link patients’ medical outcomes and costs to details like their level of education, net worth, family structure and race. An Optum spokesman said the socioeconomic data is de-identified and is not used for pricing health plans.

Optum’s marketing materials also boast that it now has access to even more. In 2016, the company filed a patent application to gather what people share on platforms like Facebook and Twitter, and link this material to the person’s clinical and payment information. A company spokesman said in an email that the patent application never went anywhere. But the company’s current marketing materials say it combines claims and clinical information with social media interactions.

I had a lot of questions about this and first reached out to Optum in May, but the company didn’t connect me with any of its experts as promised. At the conference, Optum salespeople said they weren’t allowed to talk to me about how the company uses this information.

It isn’t hard to understand the appeal of all this data to insurers. Merging information from data brokers with people’s clinical and payment records is a no-brainer if you overlook potential patient concerns. Electronic medical records now make it easy for insurers to analyze massive amounts of information and combine it with the personal details scooped up by data brokers.


Justin Volz, special to ProPublica

It also makes sense given the shifts in how providers are getting paid. Doctors and hospitals have typically been paid based on the quantity of care they provide. But the industry is moving toward paying them in lump sums for caring for a patient, or for an event, like a knee surgery. In those cases, the medical providers can profit more when patients stay healthy. More money at stake means more interest in the social factors that might affect a patient’s health.

Some insurance companies are already using socioeconomic data to help patients get appropriate care, such as programs to help patients with chronic diseases stay healthy. Studies show social and economic aspects of people’s lives play an important role in their health. Knowing these personal details can help them identify those who may need help paying for medication or help getting to the doctor.

But patient advocates are skeptical health insurers have altruistic designs on people’s personal information.

The industry has a history of boosting profits by signing up healthy people and finding ways to avoid sick people — called “cherry-picking” and “lemon-dropping,” experts say. Among the classic examples: A company was accused of putting its enrollment office on the third floor of a building without an elevator, so only healthy patients could make the trek to sign up. Another tried to appeal to spry seniors by holding square dances. 

The Affordable Care Act prohibits insurers from denying people coverage based on pre-existing health conditions or charging sick people more for individual or small group plans. But experts said patients’ personal information could still be used for marketing, and to assess risks and determine the prices of certain plans. And the Trump administration is promoting short-term health plans, which do allow insurers to deny coverage to sick patients.  

Robert Greenwald, faculty director of Harvard Law School’s Center for Health Law and Policy Innovation, said insurance companies still cherry-pick, but now they’re subtler. The center analyzes health insurance plans to see if they discriminate. He said insurers will do things like failing to include enough information about which drugs a plan covers — which pushes sick people who need specific medications elsewhere. Or they may change the things a plan covers, or how much a patient has to pay for a type of care, after a patient has enrolled. Or, Greenwald added, they might exclude or limit certain types of providers from their networks — like those who have skill caring for patients with HIV or hepatitis C.

If there were concerns that personal data might be used to cherry-pick or lemon-drop, they weren’t raised at the conference.

At the IBM Watson Health booth, Kevin Ruane, a senior consulting scientist, told me that the company surveys 80,000 Americans a year to assess lifestyle, attitudes and behaviors that could relate to health care. Participants are asked whether they trust their doctor, have financial problems, go online, or own a Fitbit and similar questions. The responses of hundreds of adjacent households are analyzed together to identify social and economic factors for an area.

Ruane said he has used IBM Watson Health’s socioeconomic analysis to help insurance companies assess a potential market. The ACA increased the value of such assessments, experts say, because companies often don’t know the medical history of people seeking coverage. A region with too many sick people, or with patients who don’t take care of themselves, might not be worth the risk.

Ruane acknowledged that the information his company gathers may not be accurate for every person. “We talk to our clients and tell them to be careful about this,” he said. “Use it as a data insight. But it’s not necessarily a fact.”

In a separate conversation, a salesman from a different company joked about the potential for error. “God forbid you live on the wrong street these days,” he said. “You’re going to get lumped in with a lot of bad things.”


Justin Volz, special to ProPublica

The LexisNexis booth was emblazoned with the slogan “Data. Insight. Action.” The company said it uses 442 non-medical personal attributes to predict a person’s medical costs. Its cache includes more than 78 billion records from more than 10,000 public and proprietary sources, including people’s cellphone numbers, criminal records, bankruptcies, property records, neighborhood safety and more. The information is used to predict patients’ health risks and costs in eight areas, including how often they are likely to visit emergency rooms, their total cost, their pharmacy costs, their motivation to stay healthy and their stress levels.

People who downsize their homes tend to have higher health care costs, the company says. As do those whose parents didn’t finish high school. Patients who own more valuable homes are less likely to land back in the hospital within 30 days of their discharge. The company says it has validated its scores against insurance claims and clinical data. But it won’t share its methods and hasn’t published the work in peer-reviewed journals. 

McCulley, LexisNexis’ director of strategic solutions, said predictions made by the algorithms about patients are based on the combination of the personal attributes. He gave a hypothetical example: A high school dropout who had a recent income loss and doesn’t have a relative nearby might have higher than expected health costs. 

But couldn’t that same type of person be healthy? I asked.

“Sure,” McCulley said, with no apparent dismay at the possibility that the predictions could be wrong.

McCulley and others at LexisNexis insist the scores are only used to help patients get the care they need and not to determine how much someone would pay for their health insurance. The company cited three different federal laws that restricted them and their clients from using the scores in that way. But privacy experts said none of the laws cited by the company bar the practice. The company backed off the assertions when I pointed that the laws did not seem to apply.

LexisNexis officials also said the company’s contracts expressly prohibit using the analysis to help price insurance plans. They would not provide a contract. But I knew that in at least one instance a company was already testing whether the scores could be used as a pricing tool.

Before the conference, I’d seen a press release announcing that the largest health actuarial firm in the world, Milliman, was now using the LexisNexis scores. I tracked down Marcos Dachary, who works in business development for Milliman. Actuaries calculate health care risks and help set the price of premiums for insurers. I asked Dachary if Milliman was using the LexisNexis scores to price health plans and he said: “There could be an opportunity.”

The scores could allow an insurance company to assess the risks posed by individual patients and make adjustments to protect themselves from losses, he said. For example, he said, the company could raise premiums, or revise contracts with providers. 

It’s too early to tell whether the LexisNexis scores will actually be useful for pricing, he said. But he was excited about the possibilities. “One thing about social determinants data — it piques your mind,” he said. 

Dachary acknowledged the scores could also be used to discriminate. Others, he said, have raised that concern. As much as there could be positive potential, he said, “there could also be negative potential.” 


It’s that negative potential that still bothers data analyst Erin Kaufman, who left the health insurance industry in January. The 35-year-old from Atlanta had earned her doctorate in public health because she wanted to help people, but one day at Aetna, her boss told her to work with a new data set.

To her surprise, the company had obtained personal information from a data broker on millions of Americans. The data contained each person’s habits and hobbies, like whether they owned a gun, and if so, what type, she said. It included whether they had magazine subscriptions, liked to ride bikes or run marathons. It had hundreds of personal details about each person. 

The Aetna data team merged the data with the information it had on patients it insured. The goal was to see how people’s personal interests and hobbies might relate to their health care costs. But Kaufman said it felt wrong: The information about the people who knitted or crocheted made her think of her grandmother. And the details about individuals who liked camping made her think of herself. What business did the insurance company have looking at this information? “It was a dataset that really dug into our clients’ lives,” she said. “No one gave anyone permission to do this.”

In a statement, Aetna said it uses consumer marketing information to supplement its claims and clinical information. The combined data helps predict the risk of repeat emergency room visits or hospital admissions. The information is used to reach out to members and help them and plays no role in pricing plans or underwriting, the statement said.


Justin Volz, special to ProPublica

Kaufman said she had concerns about the accuracy of drawing inferences about an individual’s health from an analysis of a group of people with similar traits. Health scores generated from arrest records, home ownership and similar material may be wrong, she said.

Pam Dixon, executive director of the World Privacy Forum, a nonprofit that advocates for privacy in the digital age, shares Kaufman’s concerns. She points to a study by the analytics company SAS, which worked in 2012 with an unnamed major health insurance company to predict a person’s health care costs using 1,500 data elements, including the investments and types of cars people owned. 

The SAS study said higher health care costs could be predicted by looking at things like ethnicity, watching TV and mail order purchases.  

“I find that enormously offensive as a list,” Dixon said. “This is not health data. This is inferred data.” 

Data scientist Cathy O’Neil said drawing conclusions about health risks on such data could lead to a bias against some poor people. It would be easy to infer they are prone to costly illnesses based on their backgrounds and living conditions, said O’Neil, author of the book “Weapons of Math Destruction,” which looked at how algorithms can increase inequality. That could lead to poor people being charged more, making it harder for them to get the care they need, she said. Employers, she said, could even decide not to hire people with data points that could indicate high medical costs in the future.

O’Neil said the companies should also measure how the scores might discriminate against the poor, sick or minorities.

American policymakers could do more to protect people’s information, experts said. In the United States, companies can harvest personal data unless a specific law bans it, although California just passed legislation that could create restrictions, said William McGeveran, a professor at the University of Minnesota Law School. Europe, in contrast, passed a strict law called the General Data Protection Regulation, which went into effect in May.

“In Europe, data protection is a constitutional right,” McGeveran said. 

Pasquale, the University of Maryland law professor, said health scores should be treated like credit scores. Federal law gives people the right to know their credit scores and how they’re calculated. If people are going to be rated by whether they listen to sad songs on Spotify or look up information about AIDS online, they should know, Pasquale said. “The risk of improper use is extremely high. And data scores are not properly vetted and validated and available for scrutiny.”


As I reported this story I wondered how the data vendors might be using my personal information to score my potential health costs. So, I filled out a request on the LexisNexis website for the company to send me some of the personal information it has on me. A week later a somewhat creepy, 182-page walk down memory lane arrived in the mail. Federal law only requires the company to provide a subset of the information it collected about me. So that’s all I got.

LexisNexis had captured details about my life going back 25 years, many that I’d forgotten. It had my phone numbers going back decades and my home addresses going back to my childhood in Golden, Colorado. Each location had a field to show whether the address was “high risk.” Mine were all blank. The company also collects records of any liens and criminal activity, which, thankfully, I didn’t have.

My report was boring, which isn’t a surprise. I’ve lived a middle-class life and grown up in good neighborhoods. But it made me wonder: What if I had lived in “high risk” neighborhoods? Could that ever be used by insurers to jack up my rates — or to avoid me altogether?

I wanted to see more. If LexisNexis had health risk scores on me, I wanted to see how they were calculated and, more importantly, whether they were accurate. But the company told me that if it had calculated my scores it would have done so on behalf of their client, my insurance company. So, I couldn’t have them.

Senior research fellow Claire Perlman contributed to this story.

Have you worked in health insurance? ProPublica and NPR are investigating the industry and want to hear from you. Please complete our brief questionnaire.

Article source: https://www.propublica.org/article/health-insurers-are-vacuuming-up-details-about-you-and-it-could-raise-your-rates

We won’t know more about marijuana’s health benefits until feds stop labeling it a Schedule I drug

First, because marijuana remains a federal Schedule I drug, research is severely restricted. However, there has been extensive research done in Europe and Israel. This research has shown multiple health benefits for those who take cannabidiol, or CBD, and a combination of CBD and THC, the main psychoactive ingredient of marijuana.

Article source: http://www.latimes.com/opinion/readersreact/la-ol-le-marijuana-research-20180717-story.html

My Health Record systems collapse under more opt-outs than expected

Australians attempting to opt out of the government’s new centralised health records system online have been met with an unreliable website. Those phoning in have faced horrendous wait times, sometimes more than two hours, often to find that call centre systems were down as well, and staff unable to help.

The Australian Digital Health Agency (ADHA), which runs the My Health Record system, is reportedly telling callers that they weren’t expecting the volume of opt-outs.

“On hold with @MyHealthRec for over 1.5 HOURS to opt out without providing my drivers license/passport number. Turns out their entire backed system has crashed and they are telling support staff to just punch peoples details into the website. Confidence inspiring!” tweeted one caller.

“The person i’m speaking to is stressed as f***. Its their first day. I feel bad for her but she also has no idea what’s going on and puts me on hold every time I ask something that’s not on the script.”

The problems started early on Monday, the first day of the three-month opt-out period before digital health records are created automatically.

“Call operator Laura answers. Pleasantly politely tells me she can help. Uses my Medicare number to locate my record. But can’t change alter my record as system down. She apologizes, guesses this is why I’m having trouble online and suggests I try again later,” tweeted Dr Leslie Cannold at 7.29am.

Cannold, a research ethicist and health regulator, said she’d like to see government prove the value of My Health Record, as well as their capacity to keep it secure, before she opts in to have one. The system should also be designed to allow users to withdraw their record at any time. Currently, opting out merely marks your data as “unavailable”, while actually keeping it on the system until 30 years after your death.

Must read: The Australian government and the loose definition of IT projects ‘working well’

Those opting out have cited a wide range of privacy and security concerns — something this writer thinks is completely understandable. The ADHA’s Dr Steve Hambleton has downplayed the risks.

“I can absolutely categorically state that none of the apps and none of the use of the My Health Record data will be able to be sold to third parties — that’s absolutely prohibited,” he said.

And yet earlier this month, the My Health Record partner app HealthEngine was caught doing exactly that.

We know full well that prohibiting something doesn’t mean it won’t happen.

Some of those opting out were concerned that the ADHA website used Google’s reCAPTCHA, which works by sending data offshore for analysis, potentially including personal data.

“The Privacy Policy linked from the opt-out page says ‘We will not disclose or store overseas any personal information you give us, but that’s not how reCAPTCHA works,” wrote consultant Justin Warren.

“reCAPTCHA watches what you do on the page via injected JavaScript controlled by Google, which sends info to ‘an Advanced Risk Analysis backend for reCAPTCHA that actively considers a user’s entire engagement with the CAPTCHA — before, during, and after’ …

“Personally I think the devs just wanted to use modern web tools to prevent bots from spamming the page, and it didn’t occur to them to think about the privacy concerns because they never do on other, less sensitive, websites. Which is just the kind of careful handling of sensitive data you want from a centralised national database of the entire population’s health information.”

Others were concerned that their health records could be disclosed in court under section 69 of the My Health Records Act 2012, or to law enforcement agencies without a warrant under section 70.

Law enforcement access can be provided if the ADHA “reasonably believes that the use or disclosure is reasonably necessary” for “the prevention, detection, investigation, prosecution, or punishment of criminal offences” or “the protection of the public revenue”, among other reasons. The “enforcement bodies” with access are defined in the Privacy Act 1988, and are much broader than those authorised under the telecommunications data retention legislation.

“[The Australian public service] needs to understand that statutory interpretations aren’t just for days in court, proper governance of your interpretation means stating it openly and legitimating it,” tweeted Darren O’Donovan, senior lecturer in administrative law at La Trobe University.

“The objective criteria are key because ‘reasonable belief’ of ‘reasonable necessity’ is [a] pretty forgiving standard.”

So far, the government has spent more than AU$4 billion on the digital health records system, which started life as the “personally controlled e-health records” (PCEHR) project in the 2010-2011 federal Budget.

Only 1.9 percent opted out of the initial trial involving 1 million people. The ADHA therefore projected that around 500,000 Australians would opt out during the three-month window.

The system was originally planned to be opt-in, but poor adoption rates led to the government flipping it to an opt-out system. Victoria’s then privacy commissioner David Watts called that a fundamental breach of trust.

“I actually designed the regulatory system for e-health in Australia, and I swore black and blue … that we would never be an opt-out system, and always be an opt-in. And of course it’s now an opt-out system in order to drive take-up of e-health, because AU$4 billion had been spent on it and very few people had registered,” Watts told a privacy conference in 2016.

One might think that after a series of Australian government IT disasters, they’d have planned more carefully for an unexpected overload and have a strategy in place for crisis communications.

But as of 16:00 AEST on Monday, the ADHA’s social media accounts were showing nothing but a generic promo, and even that wasn’t posted until lunchtime.

The Australian government still seems to have a real problem with computers. Those opting out of My Health Record would seem wise to be doing so.

Previous Coverage

Cancelled My Health Record data to be kept in limbo

Those choosing to opt-out of the My Health Record service will still have their data visible if they reactivate their account.

Less than 2 percent of My Health Record trial users opted out

Perhaps more worryingly, the use of privacy controls is sitting under the 0.1 percent mark.

My Health Record stands up cybersecurity centre to monitor access

Those who choose to keep their My Health Record will also have a real-time log of who has accessed their information.

My Health Record opt-out period from July 16 to October 15, 2018

The window for Australians to opt out of an electronic health record has been announced by the government.

My Health Record secondary data must stay in Australia and not be used for ‘solely commercial’ reasons

The Australian government’s My Health Record data use guidelines require the data governance board to make case-by-case decisions on how the data can be used.

Article source: https://www.zdnet.com/article/my-health-record-systems-collapse-under-more-opt-outs-than-expected/

Gubernatorial candidates criticize health board’s medical marijuana rules

Gubernatorial candidates from the Democratic, Republican and Libertarian parties say the Oklahoma Board of Health thwarted the will of voters last week by approving rules for medical marijuana that bar smoking pot and require pharmacists to staff dispensaries.

Drew Edmondson, the Democratic nominee for governor, said the rules represent “yet another failure of government” and blamed Gov. Mary Fallin for the chaos surrounding the rules.

He said, “State Question 788 passed by an overwhelming majority of Oklahoma voters, who recognize the benefits medical marijuana could provide for veterans, cancer patients and others suffering from a host of treatable ailments … Our best hope is that the tide in Oklahoma turns in November, and that when it does, the people’s voice will finally be heard and respected.”

Edmondson, who served as Oklahoma attorney general for 16 years, said a ban on smokable marijuana has been ruled unconstitutional in one state.

Article source: https://newsok.com/article/5601453/gubernatorial-candidates-criticize-health-boards-medical-marijuana-rules

The Health 202: Trump White House finds new reason to target Medicaid

THE PROGNOSIS

The Trump administration is trying out a new argument to defend its support of work requirements for social safety net programs like Medicaid: The Johnson-era “War on Poverty” was victorious and now most Americans don’t need the aid. 

The White House, in a lengthy report released at the end of last week, focuses on Medicaid, food stamps and housing assistance data to make its case for why non-disabled, working-age, low-income Americans should meet some employment eligibility thresholds to qualify for the government assistance. 

As our colleagues Jeff Stein and Tracy Jan wrote over the weekend, it’s the same old Republican position with a new twist. Whereas for years the GOP’s reason for overhauling the safety net programs was because they didn’t work to bring people out of poverty, the Trump White House is now essentially saying the decades-old efforts were a success, so are no longer needed. 

The White House Council of Economic Advisers argues that “a dramatic reduction in material poverty” has “coincided with a substantial reduction in self-sufficiency of the non-disabled working-age population.” 

“Non-disabled working-age adults have become increasingly reliant on welfare and experienced stalled employment growth, in part because of the disincentives welfare programs impose on increasing one’s own income,” they write. ”Program work requirements, which require recipients to work or engage in work-related activities in order to maintain benefits, can help overcome this problem.”

But critics have long countered that “work requirements impose additional barriers to receiving health care and food for those who need such assistance,” our colleagues write. “And [critics] accuse the administration of underestimating the difficulty of climbing out of poverty, even in a robust economy.”

Let’s focus here on what this debate means for Medicaid. 

Earlier this year, President Trump signed an executive order giving states more autonomy over their Medicaid programs by allowing them to request waivers from the federal government to add parameters like work requirements. So far, four states’ applications have been approved by the Centers of Medicare and Medicaid Services: Arkansas, Indiana, Kentucky and New Hampshire, while seven other states have applications pending: Arizona, Kansas, Maine, Mississippi, Utah, Ohio and Wisconsin. 

Kentucky was primed to be the first to implement the requirements before a federal judge ruled just a few weeks ago that the government hadn’t fully considered the implications and sent the plan back for further consideration. CMS Administrator Seema Verma, in a meeting with reporters last week, said she couldn’t talk about the specific case, but that the administration was committed to lifting people on Medicaid out of poverty. 

“This administration is committed to giving states flexibility . . . states are trying to do inventive things and we’re trying to be supportive of that,” she said. “[Medicaid] has evolved and changed. It was intended to be for a very vulnerable population and with the ACA it’s serving able-bodied individuals. We should give them a pathway out of poverty.”

Groups that advocate for the poor that brought the suit against Kentucky contend, among other reasons, that such substantial changes to Medicaid should go through Congress. 

If it were up to the House GOP, that wouldn’t be a problem. Adding work requirements to safety-net programs has been a long-time goal. In fact, the majority party recently released a proposal it says will balance the budget in nine years with large cuts to entitlement programs, including a work requirement for Medicaid. 

This new report from the White House doubles down on that effort by trying to paint a rosier picture of poverty in America. It points out that Medicaid, which costs $566 billion to cover 71 million people, grew from 6 percent in 1969 to 22 percent in 2017, but that poverty had fallen 90 percent since the program began. 

Suzanne Mettler, a political scientist at Cornell University, told our colleagues that the Trump officials’ take on the government’s anti-poverty efforts is “an opportunistic frame to try to advance the same end.”

“It is ironic,” she added. ”For ages [Republicans have] been saying it’s a failure, and suddenly they are trying to declare victory and call it all off.”

To underscore it’s position that Medicaid disincentivizes healthy, low-income Americans from working, the administration says that 61 percent of recipients on Medicaid are non-disabled, working-age adults, yet 60 percent of that group work less than 20 hours per week. 

But the Kaiser Family Foundation has a completely different set of statistics for the Medicaid population that shows 43 percent of recipients work full-time and 19 percent work part-time. And in the states that did expand Medicaid under the Affordable Care Act, low-wage, part-time work would not be sufficient to even afford ACA marketplace health coverage, Kaiser researchers write.

In an article titled, “Implications of Medicaid Work Requirements, they wrap up what’s at stake this way:

These data points show that even among those working full-time, work can be fragile, unpredictable, and may not help people rise out of poverty. Even a temporary illness or emergency situation for those working in hourly jobs could result in failure to meet new hourly work requirements. The subsequent loss of health coverage could exacerbate financial insecurity. Finally, workers will need to verify work status regularly, and many Medicaid adults may face barriers in complying with reporting requirements due to limited experience with or access to computers. Three in ten Medicaid adults say they never use a computer, but Arkansas is requiring use of on-line accounts to verify work status, and other states may rely on online reporting.

And Eliot Fishman, senior director of Health Policy at FamiliesUSA and former head of the government’s work with states on Medicaid waivers at CMS, tweeted last night a thread about the White House’s new report, writing there’s no evidence from job numbers that Medicaid, or the expansion of it, led to less people entering the workforce. In fact, he counters, “you could make the case that extending health coverage to low income people helped them to re-enter the workforce, for example by accessing mental illness or substance use treatment.”

So, where does this all leave Medicaid? For now, exactly as its long been: A partisan football to be lobbed back and forth when politically expedient.

But President Trump’s Supreme Court nomination gives conservatives an advantage in its quest to make Medicaid access contingent on factors like employment. If a case questioning states’ right to make changes to its Medicaid program comes before the highest court, a rightward turn of the bench could result in a fragmented program wherein eligibility limits are based on where a person lives. 

This 1975 microscope image made available by the Centers for Disease Control and Prevention shows a cluster of smallpox viruses. (Fred Murphy/CDC via AP)

AHH: The Food and Drug Administration late last week approved the first drug to treat smallpox, an anti-viral pill that could potentially stop the spread of a deadly pandemic, the New York Times’s Donald G. McNeil Jr. reports.

Most people under the age of 40 have not been vaccinated for smallpox because routine administration of the vaccine stopped after it was eradicated in 1980. The approved pill, known as Tpoxx, has not yet been tested on humans with the eradicated disease. “But it was very effective at protecting animals deliberately infected with monkeypox and rabbitpox, two related diseases that can be lethal,” Donald writes. “It also caused no severe side effects when safety-tested in 359 healthy human volunteers, the F.D.A. said.”

FDA commissioner Scott Gottlieb said the advancement “affords us an additional option should smallpox ever be used as a bioweapon.” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases told the TImes the FDA’s approval  of the drug is “definitely a good thing.”

“Research on tecovirimat — originally designated ST-246 — began at the institute after the 9/11 terrorist attack on the World Trade Center,” Donald reports. “The research accompanied efforts to stretch the national stockpile of smallpox vaccine by safely diluting it.”

Former Health and Human Services Secretary Tom Price. (Michael Reynolds/EPA-EFE/Shutterstock)

OOF: The Department of Health and Human Services’s internal iatchdog concluded in a 58-page report that former secretary Tom Price wasted at least $341,000 in government funds over the course of his tenure amid a failure to follow federal travel requirements, our Post colleagues Mark Berman and Amy Goldstein report.

Price resigned in September following criticism over his extensive use of charter flights.

“Our rigorous review of [Price]‘s use of chartered, military, and commercial aircraft found that 20 out of 21 trips did not comply with applicable federal regulations and HHS policies and procedures, resulting in waste of at least $341,000 in federal funds,” a spokesman from the inspector general’s office said in a statement. “We recommend the Office of the Secretary review the lack of compliance with federal requirements and determine appropriate actions to recoup the travel costs.”

The report found Price’s office did not compare charter flight costs with commercial travel costs, or for certain chartered flights, did not choose cheaper alternatives.

In a statement, a spokesman for Price criticized media coverage of the report, stating it “inaccurately states the report takes issue with Dr. Price’s actions… In fact, the report addresses overall functions of Department staff charged with administering travel.”

A McDonald’s in Brandon, Miss. (Rogelio V. Solis/Associated Press)

OUCH: McDonald’s has stopped selling salads at 3,000 of its restaurants nationwide over a parasite outbreak that sickened dozens of customers in multiple states, mainly in the Midwest, according to The Post’s Lindsey BeverThe salads were removed from the restaurants until McDonald’s can get a new supplier, the chain said in a statement.

“The announcement comes after public health authorities in Illinois and Iowa warned that a number of recent cyclospora infections in those states appear to be linked to the salads,” Lindsey writes. She wrote the cyclospora cayetanensis parasite can contaminate food and water and can lead to a non-life-threatening intestinal illness called cyclosporiasis, per the CDC.

“McDonald’s is committed to the highest standards of food safety and quality control,” the company said in a statement, adding it was cooperating with the outbreak investigation.

Detainees are seen inside a facility where tent shelters are being used to house separated family members at the Port of Entry in Fabens, Tex., on June 21. (Matt York/AP)

— The federal judge involved in the ongoing reunification of migrant families called out the Trump administration late last week for suggesting that expediting the process would be risky for children.

“U.S. District Judge Dana M. Sabraw in San Diego called an unscheduled, after-hours hearing via conference call Friday after a key federal official filed a sworn statement with the court saying that Sabraw’s deadlines for reuniting children were forcing the government to shorten the vetting process,” The Post’s Maria Sacchetti reports. “The statement implied that the deadlines could result in the government placing as many as 175 children with people who were not their biological parent, among other risks.”

During the call, Sabraw chided the administration for the “parade of horribles” it listed to portray the order as potentially hazardous. “That is on the government,” Sabraw said, per Sacchetti. “And that’s a failure of the process and it is inconsistent with the court’s order.”

Sabraw had also on Friday praised the administration for its “substantial” effort to reunite by last week’s deadline more than half of the 103 children in U.S. custody that had been separated.

Now, the government faces a July 26 deadline to reunify children between the ages of 5 and 17. HHS said it has identified 2,551 migrant children in that age group who are “potentially” eligible to be reunified with their parents, but officials will now have to determine whether the parents are able and fit to take the children.

Officials said they are set to return up to 200 kids a day to their parents, per our colleague. “Officials also signaled late Friday that not every family will be reunited; the same occurred with the smaller group of some 100 children age 5 or younger,” she added.

In a Friday night court filing, the Trump administration said it plans to expedite the reunification process for those 2,551 children, specifically noting it would adjust some of the methods used when reunifying children under age 5, including no longer using fingerprint and DNA testing to confirm parent identities, Politico’s Dan Diamond reports.

According to Politico’s Ian Kullgren, Sabraw also called for a 9:30 am status hearing today with attorneys for the federal government and the ACLU.

— Families who fled to the United States seeking asylum and were separated by U.S. officials may face another difficult choice once they are reunited. After migrant children are returned to their parents, parents will have to decide whether to work toward staying in the country legally, navigating a complex immigration system, or turn the children over to U.S. authorities so the kids will be allowed to stay even if parents are deported, Bloomberg’s ­­Kartikay Mehrotra explains.

“On Friday, the American Civil Liberties Union and U.S. government attorneys disclosed an agreement that leaves it up to immigrant parents to decide whether their children will stay with them in detention or be placed with social service workers,” Kartikay reports. “For the government, the agreement ensures its authority to detain adults in federal custody remains intact while families are reunified. The ACLU, meanwhile, got an assurance that if families consent to being held in custody, they aren’t waiving other legal rights going forward.”

Our Post colleague Michael Miller spoke with some of the migrant kids who have been kept in shelters after they were separated from their families.

“Experts warn that many of these children may be deeply traumatized by their experiences,” Michael writes. “Their voices have seldom been heard during the frenzied debate over family separation.”

“They always kept the boys and the girls separate,” said an 8-year-old girl from Guatemala. “And they punished us if we went near each other.”

One 11-year-old boy from Guatemala said he had to ask permission to hug his sister.

A 9-year-old boy from Brazil said: “I felt like a prisoner … I felt like a dog.”

President Trump speaks as Judge Brett Kavanaugh his Supreme Court nominee, listens in the East Room of the White House in Washington. (AP Photo/Evan Vucci)

 — In an interview with the Daily Mail’s Piers Morgan, Trump said he understood the concern that abortion-rights supporters have with his Supreme Court nominee. But he suggested it would be a “long time” before the Supreme Court may hear a case that could lead to a reversal of Roe v. Wade.

“I do understand, but I also understand that you know, that’s a 50/50 question in this country,” Trump said about the debate over Roe.

“I think he is going to be confirmed and someday in the distant future there could be a vote,” Trump added, referring to nominee Brett M. Kavanaugh. “There’s also a very good chance there won’t be a vote. We’ll have to see what happens. A case has to get up there. It could be a long time before a case ever gets up there.”

Meanwhile, our Post colleagues Robert Barnes and Ann E. Marimow detail Kavanaugh’s “first judicial hero” — the late Chief Justice William H. Rehnquist, who had a conservative record on issues including abortion.

Last year, Kavanaugh told the American Enterprise Institute in a Constitution Day speech that Rehnquist was his hero for his rejection of a “wall of separation between church and state” in his Roe v. Wade dissent. “Liberal groups, abortion rights activists and antiabortion organizations all have seized on the speech, as well as Kavanaugh’s rulings involving a undocumented teenage immigrant seeking an abortion while in federal custody,” our colleagues write.

Health and Human Services Secretary Alex Azar speaks during a Senate Finance Committee hearing. (AP Photo/Jacquelyn Martin)

— HHS is set to delete two decades of medical resources currently maintained by its Agency for Healthcare Research and Quality, also known as the National Guideline Clearinghouse.

It’s a key collection of medical guidelines and evidence-based research used by doctors and researchers, according to the Daily Beast‘s Jon Campbell, and the “guideline.gov” site is set to go offline after today. 

“Guideline.gov was our go-to source, and there is nothing else like it in the world,” Oregon Health Science University professor Valerie King told Jon. “It is a singular resource.”

“When doctors want to know when they should start insulin treatments, or how best to manage an HIV patient in unstable housing — even something as mundane as when to start an older patient on a vitamin D supplement — they look for the relevant guidelines,” Jon writes. “The documents are published by a myriad of professional and other organizations, and NGC has long been considered among the most comprehensive and reliable repositories in the world.”

“AHRQ agrees that guidelines play an important role in clinical decision making, but hard decisions had to be made about how to use the resources at our disposal,” AHRQ spokesperson Alison Hunt told Jon in an email. “The operating budget for the NGC last year was $1.2 million, Hunt said, and reductions in funding forced the agency’s hand.”

Senate Minority Leader Chuck Schumer (D-NY) speaks about healthcare during a news conference. (Mark Wilson/Getty Images)

— The Obamacare tables have turned for Democrats who are centering their campaigns around defending the same health-care law once used to target and defeat them, our Post colleague Sean Sullivan reports.

Now, Democratic candidates are pointing their fingers at Republicans’ failure to rescind the health-care law last year, and looking to rally voters around the ACA and convince them supporting Trump’s Supreme Court nominee would increase the likelihood that the high court would dismantle Obamacare.

“The strategy marks a dramatic turnabout from the previous two midterms when many Democrats avoided defending Obamacare, and illustrates the extent to which the law has taken root as millions of Americans have come to depend on it,” Sean writes “Republicans, who relentlessly attacked Democrats for supporting the ACA in 2010 and 2014, are now largely steering their campaigns toward different topics.”

“We’ve learned a lesson,” Sen. Richard J. Durbin (D-Ill.), the second-ranking Democratic senator said. “The American people are tuned in to the failure of the Republicans to come up with an alternative to Obamacare.”

Chris Wilson, a Republican pollster, told Sean Obamacare was “something to fire up our base. Now ‘protect Obamacare’ is a rallying cry for Democratic enthusiasm.”

Alexandria Ocasio-Cortez takes a moment between interviews in New York. (AP Photo/Seth Wenig)

—Alexandria Ocasio-Cortez and Sen. Bernie Sanders (I-Vt.) are heading to Kansas on July 20 to rally for Democratic congressional candidates running in red states.

“I’ve believed for years that the Democratic Party has committed political malpractice by writing off half the states in this country,” Sanders told our Post colleague Dave Weigel. “They’ve got to fight for every state in this country.”

Sanders and New York City congressional nominee Ocasio-Cortez will rally for James Thompson in the state’s 4th Congressional District and for Brent Welder in the state’s 3rd Congressional District.

Our colleague previously reported that Kansas’s 3rd district is the only one in the Great Plains that voted for Hillary Clinton in the 2016 presidential election. Welder has been endorsed by Sanders and Ocasio-Cortez and is running on a platform that includes a $15 minimum wage and a push for “Medicare for all,” Dave wrote.

“All over this country, you have people who understand that we need to [change] the minimum wage to a living wage; that health care is a right; that we need to rebuild our infrastructure,” Sanders said. “Those are popular issues in the Bronx. These are popular issues in Vermont. In Kansas, they’ve gone through the [former governor Sam] Brownback agenda, and they do not believe you should give tax breaks to the rich and cut Social Security.”

Michael Cohen, President Donald Trump’s personal attorney, walks along a sidewalk in New York. (AP Photo/Seth Wenig, File)

— A new report from Senate Democrats reveals the link between Swiss pharmaceutical giant Novartis and Trump’s personal lawyer Michael Cohen may have been broader than what the company disclosed in previous and perhaps misleading statements, Stat’s Ed Silverman and Ike Swetlitz report.

“Novartis explicitly sought to hire Cohen to gain access to ‘key policymakers’ and provided him with ideas for lowering drug costs, which later appeared in the Trump administration blueprint that was developed to address the issue,” they write. “With the findings, the report highlights a sensational series of events that have underscored concerns about the extent to which the pharmaceutical industry has attempted to influence the Trump administration. And the conclusions place Novartis in a very unflattering light, as the documents indicate the company saw the arrangement as a golden opportunity to buy access to the White House.”

Novartis said in a statement that it “disagree[s] with the report’s conclusion that we issued a misleading public statement regarding the extent of our engagement with Mr. Cohen,” according to Stat.

New York Governor Andrew Cuomo speaks during a news conference. (AP Photo/Seth Wenig)

— In a report requested by Gov. Andrew M. Cuomo, the New York State Department of Health recommended legalizing marijuana, noting that “the positive effects of a regulated marijuana market in NYS outweigh the potential negative impacts.”

Cuomo had asked for a report assessing the health, criminal justice, public safety, economic and educational impacts of a marijuana program by the state, our Post colleague Christopher Ingraham reports.

“It found that the legal regime of marijuana prohibition has ‘not curbed marijuana use and has, in fact, led to unintended consequences,’ like the disproportionate criminalization and incarceration of minorities,” Christopher writes. He adds such a program could be worth between $1.7 billion and $3.5 billion and bring in from $248 million to $677 million in tax revenue a year for New York. The report also acknowledges that pot is not as harmful as alcohol and tobacco and that legalization would lessen any limited harm.

“The report is notable for its full-throated adoption of arguments that have been put forth by legalization supporters for years,” Christopher writes.

— And here are a few more good reads from The Post and beyond: 

Coming Up

  • The House Veterans Affairs Subcommittee on Oversight and Investigations holds a joint hearing with the House Small Business Subcommittee on Investigations, Oversight and Regulations on “Achieving Government-wide Verification of Service Disabled Veteran Owned Small Businesses” on Tuesday.
  • The House Veterans Affairs Committee holds a hearing on “The VA Accountability and Whistleblower Protection Act: One Year Later” on Tuesday.  
  • The Senate Health, Education, Labor and Pensions Committee holds a hearing on health care costs on Tuesday.
  • The House Ways and Means Subcommittee on Oversight holds a hearing on combating Medicare fraud on Tuesday.
  • The House Ways and Means Subcomittee on Health holds a hearing on “Modernizing Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare Program” on Tuesday.
  • PhRMA holds an event on “The State of Care: Innovation Access” on Tuesday.
  • Politico holds its second Pro Summit on Tuesday.
  • The Senate Special Committee on Aging holds a hearing on “Supporting Economic Stability and Self-Sufficiency as Americans with Disabilities and their Families Age” on Wednesday.
  • Brookings Institution holds a event with FDA Commissioner Scott Gottlieb on Wednesday.
  • The FDA’s Blood Products Advisory Committee holds an open session on Wednesday.
  • The National Academies of Sciences, Engineering, and Medicine holds a workshop on the integration of health care and social services on Thursday.
  • The House Energy and Commerce Subcommittee on Health holds a hearing on “21st Century Cures Implementation: Examining Mental Health Initiatives” on Thursday.
  • The Alliance for Health Policy holds an event on “State Responses to the Evolving Individual Health Insurance Market” on Friday.

Protesters clash with officers outside an ICE facility in Portland: Trump blames Obama for Russia’s DNC hack

Article source: https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2018/07/16/the-health-202-trump-white-house-finds-new-reason-to-target-medicaid/5b4bbdc51b326b1e646953bf/

Private health insurance rankings to give consumers more information about coverage and benchmarks

Updated

July 15, 2018 14:18:11

Private health insurance premiums will be ranked in a bid to help consumers figure out exactly what they are paying for, from April next year.

The Federal Government has unveiled the new categories — gold, silver, bronze and basic — for the more than 70,000 private health insurance policies around the country, held by about 13 million Australians.

Should you have private health insurance?

Everything you need to know to understand Australia’s private health insurance system, personalised for you.

Federal Health Minister Greg Hunt argued the measure would give consumers more information about their coverage, and set benchmarks for the minimum services that would be offered under each policy regardless of insurer.

“What this means is we take the existing policies, no change in price, no change in coverage, but we make it simpler so everybody can see in one page exactly what is in place,” he said.

The changes to the system will result in more cancer treatments being covered by private health, particularly for women suffering breast and ovarian cancer.

“There’s been a disparity in the past between coverage of men and women for different types of cancers, so it’s another important day for cancer treatment for women,” Mr Hunt said.

‘Junk’ policies still a problem, argues Labor

Shadow Health Minister Catherine King welcomed the new categories, saying any measure to increase consumer knowledge was an improvement.

But Ms King argued the Government was not doing enough to get rid of low-cost policies that provided little coverage.

What it means for you

If you’re in your 20s and tossing up whether or not to buy private health insurance, take a look at what the proposed shake-up could do for you.

“What Labor has said is that we will remove the private health insurance rebate from those junk policies, in particular those ones that only offer private health insurance cover in public hospitals,” she said.

“We think that that is not warranted when you’ve got a number of consumers using that product, frankly, as an effort to minimise taxation as opposed to actually access private health insurance.

“What we’ve seen increasingly under this Government is more and more complexity in the sorts of products that are around, more exclusions, more excess payments, more gap payments in those products, and less value for money for consumers.”

The Coalition argues Labor’s approach to low-cost policies, which would be classified as “basic” under the new system, would do more harm than good.

“I know that the ALP wants to effectively knock out the basic categories, but that would lead to a 16 per cent price hike in private health insurance, which would drive hundreds of thousands, if not millions out of private health insurance,” Mr Hunt said.

Is health insurance worth it?

If you’re about to hit your 30s and you haven’t yet got private health insurance, the time to decide is now.

Private Healthcare Australia (PHA), which represents the major insurers, welcomed the new measures and said it would pass on information about the changes to customers early next year.

The organisation also defended cheaper policies.

“The basic and bronze tiers also provide affordable entry-level products for younger, healthier people who frequently go on to upgrade as they get older and their life circumstances change,” PHA chief executive Dr Rachel David said.

“The key issue with the lower cost tiers is effective communication to consumers about what is and isn’t covered so they know what they are buying.

“The new classification and information system addresses this.”

Topics:

health-insurance,

government-and-politics,

federal-government,

health,

australia

First posted

July 15, 2018 14:01:38


Contact Matthew Doran

Article source: http://www.abc.net.au/news/2018-07-15/private-health-insurance-categories-premiums-policies-coverage/9995988