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How Medicare Pales Against Health Care Abroad

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The American public really likes Medicare: in a Harvard School of Public Health survey, 72% had a favorable opinion of the federal health program for people 65+ and 54% in a Kaiser Family Foundation poll said Medicare is “working well for most seniors.” But a new, bubble-bursting 11-country survey finds that, in reality, Medicare pales against many other nations that also have universal health coverage for their older populations.

More precisely, according to the Commonwealth Fund’s 20thInternational Health Policy Survey, the health and well-being of many of those in Medicare is generally worse than for people over 65 in the 10 other countries (Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom). The headline for the survey, just published in Health Affairs: Adults 65 and older in the U.S. are sicker than those of a similar age in other countries with universal health coverage and are more likely to go without needed care because of costs.

Dissatisfaction Among High-Need People Around the World

Lest you think health care is stellar in the other nations surveyed, however, there’s this: across all 11, many “high-need” people 65+ (those with multiple chronic conditions and/or trouble with the basic activities of daily living) expressed dissatisfaction with the quality of health care they’d received.

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The U.S. has a significantly higher rate of high-need older adults (43%) than most of those other countries, however. And, the researchers said, high-need elderly are more likely to suffer economic hardship, experience depression and anxiety, live alone and feel socially isolated and be at greater risk for falls than those who aren’t high need. America also has the highest proportion of people 65+ with multiple chronic conditions.

More Financial Barriers for Older Americans

“U.S. seniors face more financial barriers to care than those in other countries and are, in effect, hit with a triple whammy — higher health care costs, higher out-of-pocket costs and because the U.S. doesn’t invest heavily in social services, they are more likely to struggle to have their basic needs met,” said Robin Osborn, lead author of the study and vice president and director of the International Program in Health Policy and Practice Innovations at The Commonwealth Fund, a private foundation studying America’s health care system.

Said Commonwealth Funds President Dr. David Blumenthal: “Clearly there are struggles everywhere, but here in the U.S., we are hearing loud and clear that many of our seniors, especially those who are sickest, need more support if they are going to get the health care they need and live healthy lives.” The United States, the researchers noted, has disproportionately low spending on social care services, compared to health services. While some countries spend $2 on social services for every dollar on health care, the U.S. spends less than 60 cents.

One caveat about the survey: older adults living in nursing homes and other facilities weren’t sampled.

The Survey’s Key Findings on Medicare vs. Other Countries

Now to some of the key findings in the survey, the Commonwealth Fund’s first one looking at the experiences of high-need older adults. “The real test of a health care system is how well it performs for patients with the greatest need,” said Osborn. And, she added, “our focus on the high-need elderly brought into sharp relief the extent to which they were exposed to financial barriers when it came to care.”

Here’s how America’s Medicare system performs against the other 10 nations:

41% of Americans 65+ said it was somewhat difficult to get after-hours care. While that was better than the 64% of Swedes who had this complaint, it was much worse than in the Netherlands and Norway, where under 30% had problems getting after-hours care.

31% of Americans age 65+ who are high-need skipped medical care because of their costs. That’s more than 15 times the rate in Sweden. Older Americans have comparatively high out-of-pocket expenses in Medicare, with co-payments, deductibles and premiums and bills for prescription drugs. Also, Medicare doesn’t cover certain expensive health costs such as hearing aids. In Canada, the Netherlands and the United Kingdom, there are no deductibles or cost sharing for primary care. France exempts people from cost sharing for primary care and prescription drugs if they have any of 32 chronic conditions.

25% of Americans 65+ said they were often worried about having enough money to buy nutritious meals and pay for housing, utilities or medical needs. In France, the Netherlands, New Zealand, Norway, Switzerland, Sweden and the U.K., only 10% or less had similar concerns.

24% of Americans 65+ who needed help with activities of daily living (like eating and dressing) said they didn’t get the help they needed because of costs. That was the highest of all countries surveyed. Just 6% or less in Sweden, France, the Netherlands and the U.K. said they didn’t get this kind of help due to costs.

Citing costs, in the past year, 23% of Americans 65+ either didn’t go to the doctor when they were sick, didn’t fill a prescription or skipped a dose or didn’t get a recommended test or medical treatment. America ranked worst on this measure. By contrast, no more than 5% of people 65+ in France, Norway, Sweden and the U.K. skipped needed care because of costs. (This statistic is shown in the graphic in the article, where figures are percentages.)

22% of Americans 65+ spent $2000 or more out-of-pocket for health care in the past year. In every other country surveyed other than Switzerland (31%), fewer than 10% of residents 65+ spent $2,000 or more.

15% of Americans 65+ reported going to the emergency room for a condition that could have been treated by a regular doctor or place of care had one been available — the highest of all nations in the survey. Rates of avoidable ER visits were 8% or below in all the other countries surveyed except Canada (11%). “Going to the emergency room, particularly for the elderly, will increase the fragmentation of care,” said Osborn. “These patients probably won’t have their health records, so they’ll be repeating tests. And they may not remember what happened in the ER when they do go to their doctor.”

Older adults in the U.S. — as well as in Canada and the U.K. — were the most likely to say they didn’t always or often hear from their regular doctor on the same day when they contacted the physician with a medical concern. But truly long waiting times to see a doctor when sick were most prevalent in Germany, Canada, Sweden and Norway; there, 26 to 34% said they had to wait six or more days for an appointment in the past year (18% of Americans said this).

All told, Blumenthal said, as a nation, “we are a little complacent about the value and benefits of Medicare.”

The Silver Lining for Medicare Beneficiaries

Where America’s health system for its older Americans shined in the survey, however, was on prevention and staying healthy.

More than half (53%) of Americans 65+ with a regular doctor or place of care said their physician talked to them about exercise and healthy eating —  the highest of all nations. Similarly, 63% of Americans 65+ who felt they are at risk for falls said their doctor discussed falls with them, a higher rate than all the other countries except France (65%) and Australia (tied with the U.S. at 63%).

But “across all countries, most survey respondents said their physicians were not engaged with them in conversations about mental health,” said Osborn. “That’s a missed opportunity. Depression when coupled with other chronic conditions can increase costs 50% or more.”

When asked about pending legislation that could help Medicare beneficiaries in a significant way, Blumenthal pointed to the bipartisan-sponsored CHRONIC Act (Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care). “It would support chronic care to a greater extent than current Medicare,” he noted. For example, the bill would extend the federal Independence at Home program for the chronically ill who are homebound and offer more flexibility for nontraditional, nonmedical services for Medicare Advantage plans.

A final thought: No one country performed the best on all measures in the Commonwealth Fund survey. “So every country can learn from the others,” said Osborn.

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This Health Supplement Company Made Millions By Making Up Fake News And Fake Celeb Quotes, FTC Says

One online ad claimed that Jennifer Aniston owed her youthful skin to a wrinkle-smoothing cream. On the website Every Day With Dr. Oz, the celebrity doctor and talk show host Mehmet Oz seemingly talked up a weight-loss pill. And a Men’s Health article reported that a supplement was making actor Jason Statham “jacked.”

But according to the Federal Trade Commission, this reporting and marketing was all untrue. The agency alleges it was part of a vast online network of fake news sites, fake customer testimonials, and fake celebrity endorsements that existed to promote unsubstantiated health claims about more than 40 weight-loss, muscle-building, and wrinkle-reduction products. It apparently worked: People nationwide spent $179 million on these products over a five-year period, the FTC alleges.

What’s more, the agency says, customers who thought they were signing up for “free” and “risk-free” trials were in fact automatically charged recurring monthly fees without their consent.

Three people who ran the promotional network through Tarr Inc., a Del Mar, Calif., company, have agreed to settle the charges, the FTC announced Wednesday. Under a court order, Tarr Inc. must pay the agency more than $6 million, and it is prohibited from using the marketing and sales tactics it had allegedly used. The company did not admit guilt.

Leonard Gordon, an attorney for Tarr Inc., told BuzzFeed News by email, “We’re pleased that the matter has been resolved.”

The FTC’s investigation sheds light on how it says this company appears to have spread unsubstantiated health claims like “LOOK 10 YEARS YOUNGER IN LESS THAN 4 WEEKS” and “30% MORE MUSCLE MASS IN 30 DAYS OR LESS!” across the internet. This breed of advertising has become ubiquitous online in part because it successfully mimics authentic news stories and bypasses traditional banner ads.

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Express Scripts signs a deal with start-up Propeller Health as it ups investment in digital health

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Tim Wentworth, CEO of Express Scripts.

Express Scripts, the largest pharmacy benefits manager in the U.S., has struck a deal with a Bay Area start-up to better treat patients with chronic respiratory problems.

The start-up, called Propeller Health, has an FDA-approved set of apps and tools for people with asthma and chronic obstructive pulmonary disease, or COPD, such as a connected inhalers that are synced up to a user’s smartphone.

The idea behind the program is to help patients avoid over-using their so-called “rescue inhalers,” which could worsen symptoms over time, and to make sure they don’t neglect their controller medications that can be taken at anytime to prevent flare-ups. Essentially, it’s about saving money by helping patients prevent bad and expensive outcomes, like trips to the emergency room.

Propeller also provides insight into other factors that might make symptoms worse for people with these conditions, like weather changes. And as part of the deal, Express Scripts has said it will provide dedicated pharmacists to support patients by reviewing the data and providing real-time feedback.

The companies plan to launch the service to patients enrolled in Express Scripts’ Pulmonary Care Value Program in early 2018.

The goal is to make a dent in the estimated $1.3 billion annual cost of treating asthma and COPD, said Express Scripts’ chief innovation officer Glen Stettin.

It’s unclear how many patients will sign up to the program, he said, but about 5 million are eligible — and about 12 to 15 percent of those are likely afflicted with one of these conditions. So it could be as many as 750,000 people.

This partnershipcomes at a time when many suspect that Amazon will someday compete with Express Scripts and other pharmacy benefits managers, as it moves into the multibillion dollar pharmacy market. Express Scripts sits between payers, like employers, and the rest of the health system, and will negotiate prices with drug manufactures.

Some believe that Amazon can undercut this set of companies, automate processes and ultimately bring down drug prices.

But Express Scripts, which currently counts Amazon as a customer, said the timing is purely coincidental. “Considering that we’ve been working on this for the past three years, I wouldn’t say it’s related to any recent news events,” said Stettin.

Express Scripts CEO Tim Wentworth has also stressed that becoming a pharmacy benefits manager is “a lot more than dispensing drugs,” and therefore, it has a strong position in the market.

Both companies declined to share the financial terms of the deal. But they did say that Express Scripts will pay Propeller as patients start to use its offering, rather than the insurers themselves.

The partnership is part of a broader trend of insurance companies, employers and pharmacy benefits managers looking for ways to reduce health costs by leveraging digital tools from Silicon Valley companies, like apps and sensors. Propeller is one of a small group of start-ups that refer to themselves as “digital therapeutics,” meaning they use technology to augment or replace traditional medicines.

“Through this partnership we’re getting to a size and scale we haven’t before,” said Propeller Health CEO David Van Sickle.

The first ‘digital pill’ has just been approved — here’s how it could revolutionize health care

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Pill split

The era of the digital pill is upon us.

Regulators at the U.S. Food and Drug Administration just greenlighted a tiny, swallowable sensor called Abilify MyCite that tracks when the patient takes their meds. The tablet is specifically targeted to people with mental health conditions like schizophrenia and bipolar disorder and is the first of its kind to get approved.

Digital pills, which typically include a sensor about the size of a grain of sand, can travel safely through the body and communicate with some kind of external device, like an app or a wearable patch.

They aim to solve a big and expensive problem: Patients not taking their meds on time, or at all. That costs taxpayers somewhere in the realm of $100 billion to $289 billion a year in the U.S. alone.

When patients don’t get their scripts filled or finish a dose, their symptoms get worse and they often end up in the hospital. The hope for this new category of tech is to provide health providers with a GPS tracking system of sorts for the human body. By tracking a patient’s compliance with their regimen, rather than relying on what they self-report, they can nudge them if needed.

Another big-picture goal for digital pills is to better tailor or personalize medications for patients.

Clinical trials aren’t known for their diversity, which has resulted in medications being prescribed in a one-size-fits-all manner. One outcome is that women will often end up taking larger doses than required, as a medication has been tested out on a larger male.

A third hope is that a digital pill, when analyzed alongside other vital signs, can provide some insight into how a patient is responding to their meds in real time and allow physicians to adjust their dose as needed.

Could tech replace pills?

Digital pills are designed to augment traditional therapies. But some in the medical community believe that tech can someday replace pills altogether — a category sometimes referred to as “digital therapeutics.”

Digital therapeutics goes beyond sensor-laden pills to include other digital elements, like coaching via a mobile app to help a patient achieve a better health outcome.

As an example, one company in the space, Propeller Health, has a program for people with chronic respiratory disease that includes a mobile app and a rescue inhaler packed with sensors. The idea is that Propeller can track which patients aren’t taking their controller meds frequently enough, and alert them to that fact. The company also looks at external triggers, such as weather events and air quality.

These technologies tend to have a clear business model, if they can prove that they work. Propeller’s solution is compelling for pharmacy benefits managers, insurers and pharmaceutical companies, which are all looking for ways to make medications more effective and prevent costly health outcomes like a trip to the emergency room.

But a more ambitious set of start-ups sees a future where a digital regimen could replace a pill entirely.

The idea is that a virtual coach, in combination with other services, could help a patient change their behavior to become more healthy or less anxious. And in these cases, they wouldn’t require a pill at all. One example of that is Big Health, which has an app that is designed to treat insomnia by training users to change their habits around bedtime. Or Virta Health, which helps people with type 2 diabetes get off their meds through a combination of exercise and nutrition.

As venture capitalist Vijay Pande recently put it, in the future “it’s going to seem backward and even barbaric that our solution to everything was just giving out pills.”


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AMA opposes any weakening or pullback of Obamacare’s minimum health benefits

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Ulysses Hernandez (L), an insurance agent from Sunshine Life and Health Advisors, speaks with Yuricel Duran as she shops for insurance under the Affordable Care Act at a store setup in the Mall of Americas on November 1, 2017 in Miami, Florida.

The nation’s largest physicians’ group voted Tuesday to oppose any watering down or elimination of Obamacare’s required minimum health coverage benefits.

The American Medical Association’s move came after months of unsuccessful efforts by Republican congressional leaders to repeal and replace major parts of Obamacare.

A number of those bills would have weakened or gutted Obamacare’s so-called essential health benefits.

Those EHBs cover 10 categories that health insurance plans must cover, and include emergency services, hospitalization, pregnancy and newborn care, prescription drugs, lab service and preventative care.

Republicans had considered loosening the rules around EHB coverage because doing so would have allowed insurers to charge lower premiums to customers. The EHB mandate has been blamed for driving up premium prices in the individual insurance market higher than they had been before passage of the Affordable Care Act.

The AMA said Tuesday that its opposition to any weakening of the EHB mandate was based on a report by the group’s Council of Medical Service that raised concerns about the effects of such a move.

That report noted “if insurers are allowed to offer plans with skimpier coverage, plan designs could potentially discriminate against people with pre-existing conditions.”

“In addition,” the report said, “individuals who use services and benefits no longer included in the EHBs could face substantial increases in out-of-pocket costs.”

AMA CEO urges Senate not to repeal Obamacare


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US tax bill should include repeal of health insurance mandate: Senate Republican leader

WASHINGTON (Reuters) – Senate Republican leader Mitch McConnell on Tuesday threw his support behind including a repeal of the Obamacare mandate for individual health insurance in the Senate’s tax reform bill.

“We’re optimistic that inserting the individual mandate repeal would be helpful and that’s obviously the view of the Senate Finance Committee Republicans as well,” McConnell told reporters.

Reporting by Susan Cornwell and Richard Cowan; Writing by Makini Brice; Editing by David Alexander

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Coffee drastically lowers your risk of heart failure and stroke: Every extra cup boosts your longevity by 8%, study …

  • Adding an extra cup a day can decrease the risk of stroke by eight percent and heart failure by seven percent, a new study shows
  • The research found that the more you consume, the lower the risk of developing those conditions become
  • Machine-led analysis was done by the University of Colorado and compared to two previous studies
  • ‘The association between drinking coffee and a decreased risk of heart failure and stroke was consistently noted in all three studies,’ a researcher said

Kayla Brantley For



Everyone can decrease their risk of stroke and heart failure just by drinking an extra cup of coffee a day, according to new research.

A study found that with every cup, the addictive beverage lowers the risk of stroke by eight percent and heart failure by seven percent.

Adding just one extra cup of coffee a day may be enough to reduce the risk, and the research published by the American Heart Association found no limit to how much you can consume.

This study adds to the growing body of evidence that the drink has valuable health benefits, as previous research has found it to fight certain cancers, relieve headaches, help lose weight and make you live longer. 

Adding an extra cup a day can decrease the risk of stroke by eight percent and heart failure by seven percent, new research from the University of Colorado shows

Adding an extra cup a day can decrease the risk of stroke by eight percent and heart failure by seven percent, new research from the University of Colorado shows

Researchers used a machine to analyze data from the long-running Framlingham Heart study, which has investigated heart disease for more than 60 years.

The analysis by the University of Colorado was then compared with two other traditional studies to get the overall trend. Those studies were the Cardiovascular Heart Study and the Atherosclerosis Risk in Communities Study.

Laura Stevens, first author of the study, said: ‘The association between drinking coffee and a decreased risk of heart failure and stroke was consistently noted in all three studies.’

She added: ‘The work showed that each additional cup per day had an associated decrease of each outcome.’

Though the high caffeine content has stirred health concerns around coffee, the overwhelming amount of antioxidants in the drink has been linked to a number of health benefits including protecting against cancers.

The disease-fighting antioxidant levels may be essential in reducing the risk for stroke and heart failure, though more research must be done.

Machine learning works by finding associations within data, ‘much in the same way that online shopping sites predict products you may like based on your shopping history, and is one type of big data analysis,’ Stevens said. 

While many risk factors for heart failure and stroke are well known, the researchers believe there are still unidentified risk factors.

The researchers suggest that machine learning could help identify additional risk factors to improve existing risk assessments that are not 100 percent accurate.

The machine result also pointed to red meat reducing the risk of heart failure and stroke, but due to differing definitions of red meat, they couldn’t draw the same conclusion as coffee across all three studies.

A press release stressed that this type of study demonstrates an observed association, but does not prove cause and effect.

But researchers are still behind this learning technology.

Senior author Professor David Kao said: ‘Machine learning may be a useful addition to the way we look at data and help us find new ways to lower the risk of heart failure and strokes.’

The research was presented at the American Heart Association’s Scientific Sessions 2017, in California. 

Up to 400milligrams of caffeine a day or four cups of coffee is the suggested amount for adults. 

While pregnant women are suggested to have only 200milligrams of caffeine or two cups of coffee. The same advice goes for women who are breastfeeding as caffeine can be transferred to baby via breast milk.   

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Trump names former drug exec as new health secretary

  • FILE - In this June 8, 2006 file photo, then Deputy Health and Human Services Secretary Alex Azar meets reporters at the HHS Department in Washington.  Azar was a top HHS official during the George W. Bush administration. Photo: EVAN VUCCI, AP / AP2006



WASHINGTON (AP) — Turning to an industry he’s rebuked, President Donald Trump on Monday picked a former top pharmaceutical and government executive to be his health secretary.

If confirmed, Alex Azar would oversee a $1 trillion department responsible for major health insurance programs, including “Obamacare,” as well as medical research, food and drug safety, and public health.

The nomination of Azar is unusual because Health and Human Services secretaries have come from the ranks of elected officials such as governors, leaders in academia and medicine, or top executive branch managers — not industries regulated by the department.

“He will be a star for better healthcare and lower drug prices!” Trump tweeted in a morning announcement. Trump has a track record of making industry-friendly nominations, such as former ExxonMobil CEO Rex Tillerson as secretary of state and wealthy investor Wilbur Ross as secretary of commerce.

But Trump also has been a scathing critic of the drug companies, both as a candidate and as president.

Azar, 50, a lawyer by training, has spent most of the last 10 years with pharmaceutical giant Eli Lilly, rising to president of its key U.S. affiliate before leaving in January to start his own consulting firm. He’s also seen as an expert on government health care regulation.

As secretary, Azar would be returning to HHS after serving in senior posts in the George W. Bush administration. He would have to scrupulously avoid conflicts with Lilly’s far-reaching interests, from drug approval to Medicare reimbursement. The drugmaker has drawn criticism from patient advocacy groups for price increases to one of its biggest products: insulin, used to treat high blood sugar for nearly 100 years.

Azar’s earlier HHS nominations in the Bush era sailed through the Senate. This time, he’ll face Democrats wary of the administration’s unyielding quest to repeal the Affordable Care Act.

Top Democrats in Congress were skeptical, but also said they hoped Azar would bring a shift from an ideological hard line on “Obamacare.”

“It’s time to turn over a new leaf at HHS,” said Sen. Chuck Schumer of New York, the Democratic leader.

Sen. Patty Murray, D-Wash., flagged a potential conflict of interest, questioning how Azar “can fairly execute any significant effort to lower drug prices for patients.” Murray is the senior Democrat on the Health, Education, Labor and Pensions Committee.

But committee chairman Sen. Lamar Alexander, R-Tenn., cast Azar as a problem solver, saying “he has the qualifications and experience to get results.”

Insurers and for-profit hospitals also reacted positively, while the Public Citizen advocacy group likened Azar’s nomination to a “coup d’etat” by drug companies.

Americans consistently rank the high cost of prescription drugs among their top health care priorities, ahead of divisive issues like repealing former President Barack Obama’s health care law.

Trump has been a sharp critic of the industry. “The drug companies, frankly, are getting away with murder,” he said at a Cabinet meeting this fall. Prices are “out of control.”

In the spring, a Trump tweet sent drug stocks tumbling after the president said he was working on a new system that would foster competition and lead to much lower prices. In meetings with industry executives, however, Trump has focused on speeding up drug approvals, a cost-reducing tactic they would back.

Professionally, Azar has another set of skills that may be valuable to the president. In his previous service at HHS, the Yale law graduate developed an insider’s familiarity with the complex world of federal health care regulation, serving first as the department’s chief lawyer and later as deputy secretary.

Frustrated by fruitless efforts to overturn the Obama-era health law in Congress, Trump might see the regulatory route as his best chance to make a mark on health care.

If confirmed, Azar would join the club of Trump administration officials from big business. Ross was chairman of a private equity firm he founded and later sold. Treasury Secretary Steven Mnuchin was a former Goldman Sachs executive and hedge fund manager. Tillerson was CEO of ExxonMobil.

Admirers say Azar’s drug industry experience should be considered an asset, not a liability.

“To the extent that the Trump administration has talked about lowering drug prices, here’s a guy who understands how it works,” said Tevi Troy, who served with Azar in the Bush administration and now leads the American Health Policy Institute, a think tank focused on employer health insurance.

“Would (Azar) have been better off if he had been meditating in an ashram after serving as deputy secretary?” asked Troy.

Trump’s pick to lead the Food and Drug Administration, Scott Gottlieb, also faced scrutiny for receiving consulting payments from drugmakers and medical device companies while in the private sector. Once in office, Gottlieb pushed efforts to lower drug prices by reworking FDA drug reviews to increase competition.

Azar would be Trump’s second HHS secretary, replacing former Georgia congressman Tom Price, ousted after his use of private charter planes for government travel displeased the president.


Associated Press health writers Matthew Perrone and Tom Murphy contributed to this report.

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Evan Rachel Wood Says Sexual Assault Allegations in the News Are Making Her PTSD Worse—and She’s Not Alone

Ever since sexual abuse allegations against Harvey Weinstein came out in early October, the news cycle has been full of stories about the past sexual misconduct of powerful men. While the #metoo movement has spurred survivors to open up about rape and harassment, the barrage of headlines has had an unintended effect: It’s become a strong trigger for some survivors of sexual assault and harassment.

RELATED: Lady Gaga Is Clearing Up a Common Myth About PTSD

Actress Evan Rachel Wood, who had previously disclosed her rape and sexual abuse, brought this to light in a recent tweet. “Has anyone elses [sic] PTSD been triggered thru [sic] the roof?” she asked her followers on Friday, November 10. ”I hate that these feelings of danger are coming back.”


Syria: UN health agency calls for immediate and unimpeded access to save lives in Ghouta

12 November 2017 – Amid worsening humanitarian, health and security situation in Syria’s besieged eastern Ghouta, the United Nations health agency has demanded that all parties to the conflict stop attacks on civilians, facilitate immediate medical evacuations, and allow safe passage of medical supplies.

“The situation is heartbreaking,” said Elizabeth Hoff, the head of the UN World Health Organization (WHO) operations in Syria, in a news release Sunday.

“We have now reached a critical point, where the lives of hundreds of people, including many children, are at stake. If they do not immediately get the medical care they urgently need, they will most likely die.”

Severe food and medical shortages are reported in eastern Ghouta, rural Damascus, where as many as 400,000 people remain besieged and cut-off from life-saving assistance. Among them, over 240 people require urgent advanced medical care, including 29 “priority” patients – mostly children – in critical condition who need immediate medical evacuation.

According to the UN agency, plans are in place for medical evacuations from Ghouta to hospitals and medical facilities in the capital, Damascus, and elsewhere. Medicines have also been prepared for immediate dispatch.

“At this stage, however, no formal approval for evacuations has been received from the responsible national authorities,” added WHO in the release.

In addition to the medical necessities in the region, malnutrition – especially among children – is reported to be rising, leaving them at a higher risk of life-threatening infectious diseases.

Safe drinking water is also reportedly hard to find and diseases like Brucellosis, Hepatitis A and tuberculosis have reappeared.

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