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Trump campaign says he has ‘taken the issue back’ on health care: report | TheHill

A top campaign aide to President TrumpDonald John TrumpNASA exec leading moon mission quits weeks after appointment The Hill’s Morning Report — After contentious week, Trump heads for Japan Frustration boils over with Senate’s ‘legislative graveyard’ MORE said the White House has taken back the issue of health care from Democrats amid calls on the left for the party to embrace “Medicare for All” ahead of the 2020 election.

Tim Murtaugh, the president’s 2020 campaign communications director, told Reuters that Trump “has taken the issue back” from Democrats following the GOP’s failure to repeal the Affordable Care Act in 2017, according to an article published on Friday.

“[Democrats are] taking the Blue Cross [insurance] card out of your wallet and making it worthless,” he said.

Murtaugh added in the interview that Democrats have squandered their victories in the 2018 midterm elections by focusing on impeachment instead of hammering the Trump administration over how to fix the Affordable Care Act.

“The big conversation was about healthcare, and what are they talking about? Impeachment,” Murtaugh told Reuters, adding: “They won the election, but they haven’t done a damn thing with it.”

His remarks come despite recent polling that found that more than half of Republicans would support the implementation of a Medicare for All health care system.

Republicans including Trump himself have ripped the idea, championed in the 2016 election by Sen. Bernie SandersBernie Sanders2020 Democrats join striking McDonald’s workers Billionaire’s M gift to Morehouse grads points way to student debt solution Poll: Nearly half of Clinton’s former supporters back Biden MORE (I-Vt.), predicting that such a plan would not work if it was to be implemented.

“In practice, the Democratic Party’s so-called Medicare for All would really be Medicare for None,” Trump wrote last year in a USA Today op-ed. “Under the Democrats’ plan, today’s Medicare would be forced to die.”

Article source: https://thehill.com/homenews/campaign/445390-trump-campaign-says-he-has-taken-the-issue-back-on-health-care-report

Sen. Alexander Releases Bipartisan Plan To Lower Health Costs, End Surprise Bills

In a year already marked by a wide variety of congressional health care legislation, Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), the chair and ranking Democrat of the Health, Education, Labor and Pensions Committee, on Thursday released the details of a plan they hope can help bring down health costs and eliminate surprise medical bills for patients.

“These are common sense steps we can take, and every single one of them has the objective of reducing the health care costs that you pay for out of your own pocket,” Alexander said in a statement. “We hope to move it through the health committee in June, put it on the Senate floor in July and make it law.”

It would be a mammoth piece of legislation, targeting nearly every area of the health care industry for reform, including surprise medical bills, prescription drugs, transparency, public health and health information. Alexander said at a White House event earlier this month that he hopes to get the package to the Senate floor by the end of July.

“When you have a chairman and a ranking member that have worked together on a bipartisan package in the committee of jurisdiction, it always gives more weight to the product,” said Dean Rosen a former Republican senior health adviser and a partner at Mehlman Castagnetti Rosen Thomas.

“Folks should take this package seriously,” he added.

The draft bill released by the senators offers three options to curb surprise bills, those unexpected and often pricey bills patients face when they get care from a doctor or hospital that isn’t in their insurance network. It would use an independent arbitrator to settle disputes between insurance plans and providers and set a standard benchmark for physician pay, ideas that have popped up in other draft legislation circulating in the House and Senate.

The novel part from Alexander and Murray is the idea of an “in-network guarantee.” It requires that any hospital considered “in-network” for a health plan must promise that everyone working there is also in-network.

This would avoid situations in which patients choose a hospital because they know their insurance company will cover the bill, only to find out that one of the doctors they saw was out-of-network, leaving the patient with a hefty bill.

It also requires that labs and diagnostic tests be in-network, cutting off another avenue of surprise bills.

“From a policy perspective, there’s a rationale that this is the ideal approach,” said Loren Adler, the associate director of USC-Brookings Schaeffer Initiative for Health Policy.

Often called “network matching,” it’s an approach championed by the health insurance industry. James Gelfand, senior vice president for health policy for the ERISA Industry Committee, named it specifically as a solution during testimony at a surprise bill hearing in the House Ways and Means Committee on Tuesday. Rep. Lloyd Doggett (D-Texas) has suggested something similar in bills introduced in this session and two past congresses.

It’s possible that this option will upset provider groups, who risk receiving lower payments and having less leverage with insurance companies. Adler said these fears are mostly unfounded because hospitals have a vested interest in being fully staffed; they’ll step in if insurance companies try to lowball doctors.

Stakeholders such as industry trade groups, lobbyists and consultants will get a chance to air those concerns at a closed briefing on the draft on Capitol Hill Thursday.

The Alexander-Murray proposal joins an array of efforts on surprise billing. The White House held an event featuring patients, several House committees have held hearings, and bipartisan groups in the House and Senate have proposed legislation, including a bill from Sens. Bill Cassidy (R-La.) and Maggie Hassan (D-N.H.). In addition to Alexander and Murray’s proposal, the details of another bipartisan bill were released Thursday from Rep. Raul Ruiz (D-Calif.) and Rep. Phil Roe (R-Tenn.), both also physicians.

But Alexander and Murray’s proposal also covers a wide array of issues, and it’s not clear how that will play in Congress just a few months from the start of a presidential election season.

“The steps we are taking on important issues like surprise medical billing, drug prices, maternal mortality, and vaccine hesitancy show we can make progress when both sides are at the table ready to put patients and families first,” said Murray.

“I think it is an ambitious package,” Rosen said. “I think it’s probably going to be a challenge to get all of this done.”

The Alexander-Murray proposal also tackles prescription drug pricing reform, another issue that has raised bipartisan concerns and spurred hearings across the Capitol this spring.

Instead of regulating drug prices, the package would address patent protections, making it easier for generics to get to market and harder for brand-name drugs to maintain exclusive patents for lengthy periods.

It also addresses pharmacy benefit managers, which have lately come under scrutiny in the drug pricing debate. PBMs act as middlemen between drugmakers and insurance plans to negotiate prices and have been blamed by some in the pharmaceutical industry for keeping medication costs high.

The proposal suggests requiring PBMs to give quarterly reports on costs, fees and information about rebates — which are the discounts drugmakers offer to PBMs in exchange for making sure their medication is covered under a health plan. The bill also requires that 100% of these discounts be passed on to consumers.

Other provisions include requiring health plans and providers to give patients estimates of out-of-pocket-costs for a service within 48 hours of a request and mandating that medical bills be sent within 30 days of a procedure.

The bill addresses a host of other health-related issues, including some making headlines recently:

  • Money for programs to educate people about vaccines and programs to reduce vaccine-preventable diseases.
  • Grants to study and improve maternal mortality and improve pregnancy and postpartum care.
  • Money for better training for health care professionals to prevent discrimination and bias.
  • Measures to improve privacy and cybersecurity for health information and electronic medical records.

Related Topics

Cost and Quality Health Care Costs Health Industry


Article source: https://khn.org/news/sen-alexander-releases-bipartisan-plan-to-lower-health-costs-end-surprise-bills/

Trump admin aims to roll back transgender health protection

WASHINGTON (AP) — The Trump administration proposed Friday to roll back Obama-era discrimination protections for transgender people in health care, a move LGBT groups warn will unleash a wave of discrimination.

The Health and Human Services Department released a proposed regulation that in effect says “gender identity” is not protected under federal laws that prohibit discrimination in health care.

It is part of a backdrop of administration actions to limit or move back some of the new recognition for LGBT people, in areas ranging from military service to housing.

RELATED: Protests against President Trump’s proposed transgender military ban

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The proposed rule from HHS reverses the Obama administration, which found that the Affordable Care Act’s anti-discrimination section does indeed protect transgender people seeking health care services.

Friday’s action had been long-expected by activists on both sides of the nation’s social issues divide. Trump’s religious conservative base has argued that the Obama administration stretched the meaning of “sex discrimination” when it included gender identity as a protected class. Civil rights and LGBT groups say that view is logically and legally flawed.

The rule is unlikely to have immediate consequences beyond the realm of political debate. It faces a 60-comment period and another layer of review before it can be finalized. Court challenges are expected.

“Despite the goals of this White House…courts have been clear for decades that prohibitions on sex discrimination encompass discrimination against transgender individuals,” said Louise Melling, deputy legal director with the American Civil Liberties Union. Her organization, she added, will see the administration in court.

Melling said the impact of the proposed rule goes beyond transgender people and could also subject women to discrimination for seeking an abortion. The proposal would remove “termination of pregnancy” as grounds for making a legal claim of discrimination.

HHS official Roger Severino told reporters that the administration is going back to the literal text of the ACA’s anti-discrimination law to correct what it sees as an overly broad interpretation. Severino heads the HHS Office for Civil Rights, which is charged with enforcing anti-discrimination protections.

He pushed back on the charge that the rule would open the door to widespread discrimination, for example, when a transgender person seeks emergency room care after an auto accident. He said other laws protect individuals in such situations, adding that the administration is committed to making sure health care services are provided fairly to all.

Severino also said that the proposed rule does not come with a new definition of sex discrimination. Earlier, a leaked internal document suggested the administration was debating whether to issue an immutable definition of sex, as based on a person’s genital organs at birth.

The Obama-era rule dates to a time when LGBT people gained political and social recognition. But a federal judge in Texas said the rule went too far by concluding that discrimination on the basis of gender identity is a form of sex discrimination, which is forbidden by civil rights laws.

Under the original rule, a hospital could be required to perform gender-transition procedures such as hysterectomies if the facility provided that kind of treatment for other medical conditions. The rule was meant to carry out the anti-discrimination section of the Affordable Care Act, which bars sex discrimination in health care but does not use the term “gender identity.”

In the Texas case, a Catholic hospital system, several states and a Christian medical association argued that the rule went beyond the law as written and would coerce providers to act against their medical judgment and religious beliefs.

Article source: https://www.aol.com/article/news/2019/05/24/trump-admin-aims-to-roll-back-transgender-health-protection/23734507/

Why You Should File A Health Care Proxy Form ASAP

It’s actually fairly easy to secure a proxy. Each state has its own form that can be downloaded from the state website — like New York’s form or California’s — or you can get one from your health care provider. If you live in Pennsylvania, Delaware or New Jersey, you can use a quick service called Five Wishes, according to Linden. Download the form, fill it out, go over your wishes with your proxy, and then, depending on your state’s policies, go get it notarized or bring in two witnesses.

Article source: https://www.huffpost.com/entry/health-care-proxy-form_l_5ce56d45e4b0547bd130b99d

Thousands of cancer diagnoses tied to a poor diet, study finds

(CNN)Your diet may have more impact on your cancer risk than you might think, a new study has found.

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Article source: https://www.cnn.com/2019/05/22/health/diet-cancer-risk-study/index.html

How the malaria vaccine could change world health

“In each house were three or four patients who complained of chilling, severe headaches, sweating, pain in back and extremities. After four or five relapses, the headaches and pain became unbearable for many patients who then exhibited a muddling delirium with coma, ending in death. Most were between the ages of five and 20 years. Since they are far away from even the simplest clinic, which means no possibility of saving their lives, they are dying like bees in a smoked hive.” This is an extract from a field report of the 1958 malaria epidemic in Ethiopia that killed about 150,000 people in a single season, but it could have been from the last days of the Roman Empire, whose fall has been attributed to the disease, or Ancient Egypt, or India in the 19th Century, or indeed most of the inhabited world during most of history.

Malaria is humanity’s curse. It is among the oldest of human diseases, infecting our earliest ancestors, influencing our recent evolution, and causing an estimated half of all deaths since the Stone Age. Today, nearly half of the world’s population is at risk from malaria – it kills more than 400,000 people a year, most of them in Africa, where a child dies every two minutes from the disease. But now hopes have been raised of an end to the scourge: the first malaria vaccine is being rolled out in immunisation programmes in Malawi, Ghana and Kenya.

The new vaccine has been developed by GlaxoSmithKline with the support of the Bill Melinda Gates Foundation, and others including the World Health Organization (WHO) and Gavi, the global vaccine alliance. It took 32 years of research, and cost more than $700m (£552m).

Trials show it to be just 40% effective at preventing the disease over four years. That’s about as effective as influenza vaccine, but considerably less than the 97% effective diphtheria vaccine. And yet, it may well be the most significant win in our war with malaria for several decades, preventing many thousands of deaths and reducing the great social and economic burden that comes with experiencing or caring for someone with chronic sickness. Public health officials in Africa are allowing themselves to become excited about the barely imagined prospect of eradicating the disease.

I never thought there would be a vaccine in my lifetime, but now we have a chance – Anthony Nsiah-Asare, director general of Ghana Health Service

“I never thought there would be a vaccine in my lifetime, but now we have a chance,” says Anthony Nsiah-Asare, director general of Ghana Health Service, who is coordinating the vaccine’s implementation. “We’ve seen how it has been eradicated in some continents, so it should be possible in Africa, and now we have real hope that it could be.”

Even if it is possible, we can be sure that such a foe will not be defeated easily – after all, it has spent thousands of years adapting to comfortable reliance on its human hosts.

Malaria is a disease caused by a protozoan called a plasmodium – essentially, a single-celled parasitic animal that moves around eating human tissue. Of the five different types of malaria that infect humans, Plasmodium falciparum is the most deadly. The plasmodium is spread in the bites of Anopheles mosquitoes, which transfer infected blood between people. Consequently, the disease thrives in environments where the mosquitoes thrive: warm conditions with pooled water (mosquito larvae live in water and cannot survive to adulthood without it), and plenty of human blood for the adult insects to feast on. The poorly maintained drainage in the crowded swamps around Rome were ideal, and deadly malarial epidemics caused miscarriages and killed children and adults alike, which, some historians believe, eventually brought the Empire to its knees.

Even cooler places, such as Britain, have not always been spared. Malaria, known as marsh fever, was common in the south of the country for centuries, killing thousands, and was attributed to bad air – or “mal aria” in Latin – from the marshes. The last indigenous cases were two Londoners, who contracted the disease in Stockwell as recently as 1953.

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It was only in the 1890s that an army doctor living in India dissected a mosquito and managed to prove that malaria was caused by a parasite spread by the insects. European countries and others that have eliminated malaria have most often done so with environmental change – such as draining swamps, clearing slums and other mosquito breeding sites, and using insecticides and oiling standing water. Richer countries have been able to eradicate the disease through these methods, even in tropical latitudes where the mosquitoes are most efficient, such as Singapore.

However, it is in sub-Saharan Africa, where it first evolved, that the disease has proved most entrenched, historically killing half of children before the age of five. It is thought that malaria first reached epidemic proportions there with the advent of agriculture (and so, land-clearance) on the continent, around 4,000 to 5,000 years ago – there are references to malaria in Sumerian and Egyptian texts dating from 4,000 years ago. Since then, humans and protozoa have maintained an intimate relationship.  

Our human bodies haven’t taken this assault unyieldingly. Over generations, affected populations have evolved various strategies to outwit the plasmodium, including by changing the shape of the blood’s oxygen-carrying haemoglobin, often at considerable cost. Sickle-cell anaemia and thalassemia, for instance, both cause weakness and reduce life-expectancy, but they also protect against potentially fatal infections of malaria, and so are far more common in exposed populations.

Multigenerational genetic strategies aside, the plasmodium has proved a tough adversary for our immune system. That’s because it is a much more complex organism than the bacteria and viruses our bodies usually fight. It is highly adaptable, so as soon as our immune system starts recognising and attacking its molecular coating (antigens), the parasite produces a different configuration to outfox us.

The plasmodium’s most effective defence is its complicated lifecycle, during which the organism morphs into completely different forms while inside our body, each presenting different antigens to our befuddled immune system.

A bite from an infected mosquito introduces around 100 sporozoites into the victim’s blood, which circulate only for up to 30 minutes before migrating to the liver, where they hide in its cells. Here, they multiply over the next 7-10 days, morphing into merozoites, which burst out of the liver cells in protective sacs, evading the immune system. Once in the bloodstream, the sacs disintegrate and the merozoites invade the red blood cells, rapidly and exponentially multiplying and destroying the blood cells.

This destructive “blood phase” causes the periodic fevers associated with malaria. Some of the merozoites then morph into sexual forms of the parasite, male and female gametes. These will then be ingested by a biting mosquito and, within the insect’s abdomen, morph into ookinetes, which burrow into the gut wall and form oocysts. Inside the oocyst, new sporozoites form, ready to be spread by the mosquito to a new victim.

The sporozoites are only in the blood briefly and there are too few of them for the immune system to reliably recognise and mount an attack, and by the time the merozoites are circulating, the parasite is so damaging and so fast-changing that the immune system again struggles to gain control. As soon as our bodies manage a response against one type of antigen on the merozoites, the exponential explosion of new forms outdoes this effort.

So to combat each new infection, a human host must mount a new and “strain”-specific immune response to each antigenically distinct parasite in that mosquito bite, as well as the new antigens that arise during the course of the infection. Because of this, a single malarial infection can be prolonged over many months to years. Only when a sufficiently wide spectrum of parasite strains has been experienced is any immunity achieved.

Every individual exposed to endemic malaria faces a long and dangerous battle to achieve even partial immunity to malaria, and the most vulnerable are the youngest. Very young children appear to have a poor capacity to acquire effective anti-malarial immunity of any sort, but anyone who hasn’t previously experienced the endemic strain of infection also faces great threat.

Protection from invaders

Historically, this protected Africans from colonial expansion. Europeans arriving on the continent died in such great numbers that the coast of Sierra Leone was known as the White Man’s Grave. Malarial mortality rates exceeding 50% per year of contact were the norm on the West African coasts. And, despite the great cost of achieving immunity, it is readily lost – several months without reinfection are enough to leave an individual vulnerable to the full impact of malaria.

As a result, places that experience less frequent epidemics of the disease among the indigenous population can record higher death rates than those where it is endemic. Everyone I speak to in Ghana is aware of the protective benefits that come with the regular infections that they all experience. They are made more bearable through drug treatments.

The first effective treatment came from Peru. Malaria was introduced to the Americas probably in the transport of West African slaves, and indigenous people were observed treating the fevers with the bark of the Cinchona tree. In the mid-19th Century, quinine, the active antimalarial component in the bark, entered widespread use among Europeans in West Africa, rapidly reducing mortality rates by more than 75%.

In the 20th Century, a new drug chloroquine proved effective at treating and also preventing malaria, and this, in addition to the use of insecticides, such as DDT, was revolutionary. The insides and outsides of human spaces were sprayed, and malaria deaths plummeted. As prosperity increased in Europe and North America, fewer people were exposed to infection, and entire countries were declared free of the disease. In the 1950s, the dream of global eradication of malaria seemed just a decade or two away.

The goal of eradication was quietly eclipsed by the aim of disease management, with an assumption that malaria will remain with us forever

It was never realised. Over the decades, the malarial parasites developed resistance to chloroquine, DDT and other drugs. Society turned against insecticides because of their environmental and health impacts, banning DDT, and large human populations in the tropics have remained mired in impoverished mosquito-infested conditions. What was achieved, however, was an unprecedented reduction in the morbidity and mortality due to malaria across vast regions of the tropical and subtropical world. New drugs, such as artemisinin, which was discovered in 1972 and is used in combination with other anti-malarials to reduce parasite resistance, have made malaria a chronic rather than deadly disease for many of those with access to them.

The goal of eradication was quietly eclipsed by the aim of disease management, with an assumption that malaria will remain with us forever. 

However, even when malaria doesn’t kill, repeated infections cause anaemia, weakness, body aches, dysfunction and disease of vital organs, enlargement of the spleen, infertility, miscarriage, cognitive impairment, delirium and susceptibility to other diseases. Malaria reduces length and quality of life, and in addition, it extracts a huge social and economic toll.

Caring for sick relatives and being unable to work because of fevers traps households in poverty – economists calculate that 1% negative growth each year in Africa over the last half a century can be attributed entirely to malaria. Malaria is a disease of poverty but also a disease that impoverishes.

Controlling for factors such as tropical location, colonial history, and geographical isolation, countries with intensive malaria had income levels in 1995 of only 33% that of countries without malaria, whether or not the countries were in Africa.

The burning injustice of continents of people held down by this ancient pestilence kept alive the hope for solutions. Governments and philanthropists have poured billions into the effort – last year, Bill Gates, who has made the battle against malaria a personal crusade, announced a further nearly $4bn (£3.16bn) in funding from his foundation and other donors. Much of this has gone towards highly effective mosquito-bite prevention strategies, including providing insecticide-treated bednets and eliminating breeding sites by removing or oiling standing water. But the hope of a vaccine has rumbled away in the background.

There have been many attempts at making one – all of them failing at some stage of clinical trials, falling for the same hurdles as our immune system: the tricky, shapeshifting plasmodium.

The licencing of the first proven malaria vaccine, called RTS-S, adds to our defensive arsenal and marks a significant step in the battle against the disease, enabling hopes of eradication to be raised again. The vaccine exposes the body to one of the most widely used antigens on the sporozoites, which are only in the blood briefly before secreting themselves in the liver.

Nevertheless, the hope is that by getting the immune system to attack this stage, the deadly febrile merozoites stage will be avoided in the blood. During its long development, a vaccine against hepatitis B was created, which produces a highly effective immune response, so the malarial researchers decided to add this to the sporozoite antigen in order to prime the immune system. It worked – early trials found it was 87% effective at eliminating the sporazoites.

The problem is if just one sporozoite escapes the liver and enters the blood phase as a merozoite, it has the capacity to reproduce exponentially and produce malaria. For this reason, clinical trials found that the vaccine is only 50% effective at preventing malaria for a year after inoculation, and this falls to 40% after four years.

It has been a costly, drawn out process, not without its critics, who believe the money could have been better spent on improved access to drug treatment and bednets. Malaria exerts such a terrible burden that even with this relatively low efficacy, however, that the vaccine has the potential to prevent many thousands of deaths.

The WHO has been optimistic about the project, with Matshidiso Moeti, WHO Regional Director for Africa, stating: “Innovation will enable us to outsmart the malaria parasite.” Even so, its actions are cautious, and rather than a continent-wide rollout, the project will take effect in stages, starting with pilot districts in Ghana, Malawi and Kenya this spring. The four doses needed for immunity are being added to the routine vaccination programme schedule for infants across these nations, all of which have relatively well-functioning public healthcare systems. And an accompanying education initiative urges the public to continue using their other prevention strategies, giving the programme the best chance. If it is effective, the vaccine will go global in two years’ time.

“It is a very special moment for us to see the vaccination programme begin. It’s been very emotional to see our work come to life,” says Lode Schuerman, director of global medical affairs at GSK, who has spent the past decade developing the vaccine. “It should be feasible to eliminate malaria.”

The danger, he warns, is in selecting interventions that reduce the disease incidence in some areas, but allow it to come back with deadly power against those with no immunity. “Knowing the parasite, I would use everything we have to once and for all address this burden,” he says.

This is just the start of what may be a new era of wins in the fight against malaria. Several other vaccines are also in the pipeline, including one that uses the whole sporozoites (irradiated for safety) and must be injected into a vein, but is 100% effective in laboratory trials – it will enter clinical trials next year on the island of Bioko of Equatorial Guinea.

Other researchers are targeting the mosquitoes that play such a vital role in spreading the plasmodium, looking at ways to genetically modify the insects so that they become sterile or unable to carry the parasite. Last year saw the first release of GM mosquitoes on the continent, with the introduction of 10,000 insects in Burkino Faso that carry a mutation to render the females sterile.

In Ghana, the vaccination clinics are gearing up to begin routine immunisation of malaria alongside those of other diseases, long since disappeared, such as polio and diphtheria. The warm air is thick with humidity and humming with mosquitoes. Anthony Nsiah-Asare slaps one away, and laughs when I ask if he’s ever had malaria. “No one who has been here more than a month has not been infected,” he says. “But now we will have vaccination. Now we will see the end of malaria.”

Gaia Vince is a writer and broadcaster specialising in science, the environment and social issues. Her first book, Adventures in the Anthropocene: A Journey to the Heart of the Planet We Made, won the 2015 Royal Society Winton Prize for Science Books. Her next book, Transcendence will be published in autumn 2019. Gaia blogs at WanderingGaia.com and tweets at @WanderingGaia.

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Article source: http://www.bbc.com/future/story/20190522-how-the-malaria-vaccine-could-change-world-health

Lemon vs. lime: Differences in nutrition, benefits, and uses

Lemons and limes are types of citrus fruit with very similar nutritional profiles and health benefits. However, there are also some differences between them.

Lemons come from a small evergreen tree native to South Asia.

Several types of citrus tree can produce limes, such as the key lime tree, which is native to Southeast Asia.

This article will discuss the similarities and differences between these fruits, including their health benefits, nutritional contents, and uses.

Health benefits

Lemons and limes contain lots of vitamin C, flavonoids, and antioxidants.

Both lemons and limes have a long history of use in traditional medicine. They each contain antioxidants, vitamins, and minerals and provide a range of health benefits.

People also make claims about the health benefits of lemon water and the potential benefits of drinking lime juice.

Lemons and limes have several shared health benefits because they share the following properties:

They contain lots of vitamin C

Both lemons and limes are high in vitamin C, an important antioxidant that helps protect cells from damage.

Vitamin C also helps the body absorb iron from foods and supports the immune system.

The body also uses vitamin C in the production of collagen, an important substance for healing wounds.


They contain flavonoids

Lemons and limes both contain flavonoids. Flavonoids are phytochemicals that may have several health benefits, such as for heart disease and metabolic disorders.

Animal and cell studies have suggested that flavonoids have anti-inflammatory, antidiabetic, cancer-fighting, and neuroprotective properties. However, more research is needed to fully understand their effects in humans.

Research into flavonoids is still in its early stages, but the initial findings are promising.

They contain antioxidants

Along with vitamin C, lemons and limes also contain other antioxidants.

Antioxidants help protect the body from cell damage, which appears to play a role in a range of chronic health conditions, such as diabetes, cancer, and dementia.

It is possible that antioxidants also help prevent these conditions from developing. However, again, research into this area is ongoing.

They may aid weight loss over time

Some sources claim that consuming lemon, or lemon-based products, can help with weight loss. For example, lemon water is a mixture of fresh lemon juice and water and is a part of some weight loss diets.

However, there is currently no scientific evidence to prove that lemon, or any lemon-based product, can result in weight loss above what adequate hydration promotes. Learn more about the lemon detox diet here.

Lemons can form part of a healthful diet that eventually leads to weight loss, but this is likely to be as a result of a reduced calorie intake, regular exercise, and other more substantial lifestyle improvements.



Nutrition

Lemons and limes share a similar nutritional profile, as we detail in the table below. These nutrients reflect what is present in a whole lemon or lime, not in the juice.

The nutritional benefits of lemons and limes are the same. Although lemons have slightly more of some vitamins and minerals, the difference is too small to have any effect.

Acidity

Both lemons and limes are high in citric acid. This means that they are acidic compared with many other foods.

Lemons and limes have very similar citric acid content, though lemons may have slightly more on average:

  • Lemon juice contains around 48 grams of citric acid per liter (g/L).
  • Lime juice contains around 45.8 g/L.



Uses

Lemon and lime rinds are popular in cooking.

Many foods and drinks contain lemons or limes due to their strong, sour flavours. This might be in the form of premade or freshly squeezed juice, or as chunks or slices of the fruit.

The fruits’ rinds have unique bitter flavors that make them popular in cooking. For example, people can use the juice or peel from both fruits for flavoring sauces, marinades, and salad dressings.

Also, lemon and thyme is a good combination for marinating chicken and fish. Lime works well with garlic, as well as with chilli powder for marinating meats.

Lemons and limes are good additions to many hot or cold drinks. For example, a person can add chunks of lemon or lime to water to make citrus water, or they can use lemon or lime to flavor teas.

Due to their high acidity, these citrus fruits are also effective at killing bacteria. Because of this, a range of citrus-based cleaning products are available, from bleaches to surface cleaners.

Also, some studies have shown that the essential oil of lemon and other citrus fruits can enhance mental state through inhalation and aromatherapy, exert antimicrobial properties, and reduce skin inflammation through the topical application of the peel.



Risks

Consuming lemons or limes in moderate amounts is generally safe. However, the fruits can cause a stinging pain when in contact with open wounds, such as a cut lip or a mouth ulcer.

Their high acidity also means that they may worsen heartburn or digestive issues in people with gastroesophageal reflux disease (GERD).

In large amounts, citric fruits can erode tooth enamel and cause cavities over time.

When using cleaning products that contain citrus or other irritating chemicals, use gloves and avoid contact with the skin.



Summary

Lemons and limes are citric fruits with very similar nutritional profiles. They are rich in vitamin C and contain other antioxidants and flavonoids that are beneficial to health.

Both fruits are common ingredients in a variety of foods and drinks. Their acidity also makes them good for use in cleaning products.

Both fruits are safe to consume in moderate amounts, but they can cause minor issues in some people, such as worsening the symptoms of GERD due to their acidity.

Article source: https://www.medicalnewstoday.com/articles/325228.php

Is Our Health Care Spending Worth It?

“One big question in figuring out where to direct dollars to improve lives is how effectively we can get people to change behavior,” said Anupam Jena, a physician and an economist who does research at the Harvard Medical School. “It may be true that diet and exercise affect health a great deal, but getting people to make lifestyle changes is sometimes vastly more difficult than getting them to take a pill or undergo a procedure.”

Another limitation of studies like this is that they rely, in part, on assumptions and estimates. But careful work can help us gain confidence that they’re not driving the results. For example, according to research by the Harvard economist David Cutler and colleagues, reduced smoking rates and other changes known to have big effects on mortality — like fewer deaths from auto accidents — can explain only 21 percent of the nearly eight-year increase in longevity between 1960 and 2000. So it’s not implausible that the health system could explain a fairly large share of the rest of that gain.

Mr. Cutler’s work also compared the life-lengthening benefits of the health system with what it costs. In total, each additional year of life gained between 1960 and 2000 attributed to the health system cost nearly $20,000. When focused just on the same gain for 65-year-olds, the average cost was about $85,000.

Both figures are below the typical amounts that society is willing to spend to gain a year of life. There’s no ironclad way to pin down the willingness to pay for a year of life in good health, of course — and it’s quite a controversial subject, as you might imagine — but estimates extend to at least $150,000.

It’s findings like these that have led some scholars to argue that health care is so valuable that we should be willing to spend even more on it.

Since 2000, we certainly have. In that year, to obtain an additional year of life from the health system for a 65-year-old cost nearly $160,000, more than double what it was in 1980, according to Mr. Cutler’s study.

“What we really want to know is, how much does an extra dollar spent on health care buy us today?” Dr. Jena said. “Just as you can overdo it with exercise — jogging six days a week isn’t going to give you appreciably more benefit from jogging five days a week — you can do so with health care.” Studies are mixed on this point: Some suggest that spending more provides substantial additional benefit; some suggest it doesn’t.

Article source: https://www.nytimes.com/2019/05/20/upshot/actual-worth-health-care-spending.html

For a Longer, Healthier Life, Share Your Data

Data-sharing agreements should be standardized so that doctors and hospitals don’t have to draft custom ones every time they want to share information.

Some effort has already been made to reform fines by taking into account the “culpability” of the organization — the extent to which a violation is caused by negligence. We should go further and calibrate fines according to the level of verifiable harm. Finally, fines should factor in the size of the institution. A million dollars may not mean much to the Mayo Clinic, but it could cripple a small hospital.

Lowering data-sharing barriers for these small hospitals is especially important if we want A.I. to be equally effective for all Americans. Models behave badly when they haven’t been trained on a representative data sample; facial recognition technology, for example, is far more effective on white men than on black women. If we draw our data exclusively from the large and wealthy health care systems, we risk reproducing that bias in medicine, further marginalizing the poorer and more rural communities that are often served by small hospitals.

Reforming HIPAA does not mean opening up all of our personal data to the highest bidder or for all uses. On the contrary. There are many areas today where the government and consumers should be demanding greater protections — particularly genetic testing, fitness trackers and smart watches, which are virtually unregulated.

But for us to reap the benefits of artificial intelligence, we need to make data sharing simpler. Unlike the far more substantial privacy sacrifices we’ve already made in so many other aspects of our lives, at least we’ll have something to show for our efforts — the potential for a longer, healthier life.

Luke Miner is a data scientist.

Follow @privacyproject on Twitter and The New York Times Opinion Section on Facebook and Instagram.

Article source: https://www.nytimes.com/2019/05/22/opinion/health-care-privacy-hipaa.html

Google sister-company Verily is teaming with big pharma on clinical trials

Verily sees clinical trials as a natural area of focus, since it already has a lot of experience with medical studies. And it’s a huge market opportunity, which is projected to be worth almost $69 billion by 2026, according to Grand View Research.

After it became an independent company within Alphabet in 2016, one of Verily’s first initiatives was the Baseline clinical study. That study kicked off in 2017, with a goal to enroll 10,000 participants from diverse backgrounds to figure out why people transition from being generally healthy to getting sick. Those patients were given a range of new technologies and tools, including DNA tests and activity-tracking wearables.

In recent months, Verily has moved beyond the Baseline study, which involved partnerships with Duke and Stanford Medicine, to start enrolling even larger numbers of people in its “registry.”

Verily’s Scarlet Shore, who runs Baseline, said the company uses Google ads to find patients based on health-related searches, and suggests that they join the project. It also has partnerships with health systems and patient associations, including Mayo Clinic and University of Pittsburgh, which will help spread the word among patients who are interested in participating in medical studies.

Anyone can enroll in the registry in about 15 minutes by answering some basic survey questions about their health. From there, they can access relevant clinical studies from Verily’s partners and undergo a consent process to sign up.

Shore said some patients might get paid, depending on the trial, but others are incentivized to sign up for altruistic reasons or to receive health information back from Baseline. Unlike most clinical trials, Baseline is hoping to share health data with the patient rather than keeping it under lock and key.

Health experts say that the clinical trials space is a big opportunity for Verily, if it keeps patient privacy safeguarded in the long term. What’s unique about Verily’s approach as a technology company is that it can incorporate data about patients’ real lives, and not just how they fare in the confines of a lab or hospital. That trend, in the pharmaceutical industry, is known as “real-world evidence.”

“The clinical trials marketplace and vendor space hasn’t been disrupted in quite some time, said Tom Cassels, chief strategy officer for a company called Leidos, which specializes in health technology. “So the opportunity to both improve the efficacy and speed of clinical trials is attractive, and it’s a huge market.”

Article source: https://www.cnbc.com/2019/05/20/alphabet-verily-doing-clinical-trials-with-novartis-sanofi-pfizer.html