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Some dementia can be treated, but my mother waited 10 years for a diagnosis

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Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

By Roni Caryn Rabin
KHN

When my mother, Pauline, was 70, she lost her sense of balance. She started walking with an odd shuffling gait, taking short steps and barely lifting her feet off the ground. She often took my hand, holding it and squeezing my fingers.

Her decline was precipitous. She fell repeatedly. She stopped driving and she could no longer ride her bike in a straight line along the C& O Canal. The woman who taught me the sidestroke couldn’t even stand in the shallow end of the pool. “I feel like I’m drowning,” she’d say.

A retired psychiatrist, my mother had numerous advantages — education, resources and insurance — but still, getting the right diagnosis took nearly 10 years. Each expert saw the problem through the narrow prism of their own specialty. Surgeons recommended surgery. Neurologists screened for common incurable conditions.

The answer was under their noses, in my mother’s hunches and her family history. But it took a long time before someone connected the dots. My mother was using a walker by the time she was told she had a rare condition that causes gait problems and cognitive loss, and is one of the few treatable forms of dementia.

“This should be one of the first things physicians look for in an older person,” my mother said recently. “You can actually do something about it.” Continue reading

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Fines remain rare even as health data breaches multiply

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Medical records jumbled on shelves

By Charles Ornstein ProPublica

This story was co-published with NPR’s Shots blog.

In a string of meetings and press releases, the federal government’s health watchdogs have delivered a stern message: They are cracking down on insurers, hospitals and doctors offices that don’t adequately protect the security and privacy of medical records.

“We’ve now moved into an area of more assertive enforcement,” Leon Rodriguez, then-director of the U.S. Department of Health and Human Services’ Office for Civil Rights, warned at a privacy and security forum in December 2012.

But as breaches of patient records proliferate 2013 just this month, insurer Anthem revealed a hack that exposed information for nearly 80 million people 2013 federal overseers have seldom penalized the health care organizations responsible for safeguarding this data, a ProPublica review shows.

Since October 2009, health care providers and organizations (including third parties that do business with them) have reported more than 1,140 large breaches to the Office for Civil Rights, affecting upward of 41 million people. They’ve also reported more than 120,000 smaller lapses, each affecting fewer than 500 people.

In some cases, records were on laptops stolen from homes or cars. In others, records were targeted by hackers. Sometimes, paper records were forgotten on trains or otherwise left unattended.

Yet, over that time span, the Office for Civil Rights has fined health care organizations just 22 times.

By comparison, the California Department of Public Health, which also levies fines against hospitals for breaches of patient privacy, imposed 22 penalties last year alone 2014 and another eight in the first two months of this year. Continue reading

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Behind Supreme Court’s Obamacare case, a secretive society’s hidden hand

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by Nina Martin ProPublica

The Supreme Court has no shortage of potentially precedent-shattering cases on its docket this term. But the one the justices are hearing tomorrow, King v. Burwell, could be the most consequential.

King focuses on the issue of whether low-income people who get insurance under the Affordable Care Act’s federal exchanges are entitled to tax subsidies. Much has been said (and written) about what could happen if the justices rule “no”: Millions of people in as many as 37 states could lose their health coverage. The political earthquake could be cataclysmic.

Yet, few reports have highlighted the role of the Federalist Society, the conservative law group whose ideas are at the intellectual heart of the King v. Burwell challenge. That’s not surprising, given that the group’s members have played a mostly behind-the-scenes part in King 2014 and in many of the most significant conservative legal victories of the last 30 years.

In a new book, “Ideas with Consequences: The Federalist Society and the Conservative Counterrevolution,” Pomona College political scientist Amanda Hollis-Brusky channels her inner investigative journalist to trace the group’s influence on the courts, and especially, the Supreme Court. Continue reading

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Both High and Low Intensity Exercise Benefit Weight, Waist –Doctors Lounge

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Running shoes full shotFor people who are obese and sedentary, any exercise can help trim abdominal fat, but it may take a bit more effort to get other health benefits, a new study suggests. The findings were published in the March 3 issue of the Annals of Internal Medicine.

via Both High and Low Intensity Exercise Benefit Weight, Waist –Doctors Lounge.

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Insurers’ Biggest Fear: A Health-Law Death Spiral – WSJ

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License: <a href="https://creativecommons.org/licenses/by-sa/2.0/">(license)</a>Without the tax credits, insurance-industry officials say, the individual insurance markets in those states are likely to start collapsing, as many people drop coverage they can no longer afford, leaving only those less-healthy consumers who value insurance because they’re likely to need care. That would drive up premiums, because insurers would raise rates to cover the costs of this smaller, sicker pool. Then even more people would likely refuse the ever-more-expensive coverage.

via Insurers’ Biggest Fear: A Health-Law Death Spiral – WSJ.
photo credit: Singularly in May via photopin (license)

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Coffee may not be bad for you but jury’s still out about whether it’s good for you – The Washington Post

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Photo by Jean Scheijen

The reality is that there’s a growing body of research that supports the idea that coffee, in reasonable amounts, may not be as bad for you as people once thought. Brewed coffee, for instance, has been found to contain a tremendous amount of good-for-you antioxidants. In fact, the nation’s top nutrition panel earlier this year weighed in on coffee for the first time in its history, saying that “strong evidence” shows it is “not associated with increased long-term health risks among healthy individuals.”

The key words here are “healthy individuals.” Due to its high caffeine content, brewed coffee may always be a source of insomnia, irritability, acid reflux and other negative side effects for others, especially those with underlying conditions, such as anxiety disorder or heart disease. More importantly, there’s still a lot of work that needs to be done to make the leap between coffee not being bad for you and coffee being the cause of better health. [Photo by Jean Scheijen]

via Coffee may not be bad for you but jury’s still out about whether it’s good for you – The Washington Post.

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Drugs Using Testosterone Will Label Heart Risks – NYTimes.com

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Male Symbol by Rei-artur/Creative Commons LicenseThe Food and Drug Administration said Tuesday that manufacturers of testosterone drugs used by millions of Americans will be required to change labels for the drugs to warn that they could increase the risk of heart attacks and strokes and should not be prescribed to treat symptoms in men brought on by age, such as declining sexual drive.

via Drugs Using Testosterone Will Label Heart Risks – NYTimes.com.

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Drugs: Heroin Overdose Deaths in U.S. Have Tripled Since 2010 – Bloomberg Business

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320px-HeroinMore than 8,200 Americans—an average of 23 people each day—died of heroin overdoses in 2013. That’s according to a new report from the Centers for Disease Control (CDC), and it’s the latest evidence that the nation’s heroin problem is becoming more severe. The rate of overdose deaths in 2013, the CDC report states, is almost triple what it was in 2010.

via Drugs: Heroin Overdose Deaths in U.S. Have Tripled Since 2010 – Bloomberg Business.

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Racial and ethnic disparities persist in teen pregnancy rates

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African-American and Latina girls are more than twice as likely as white girls to become pregnant before they leave adolescence, which continues to confound states.

SLN_Feb03_teenpregnancy

By Teresa Wiltz
Stateline

LaNita Harris of the Oklahoma City County Health Department explains two of the posters the department uses in its Teen Pregnancy Prevention program. Although teen pregnancy and birth rates have dropped the past two decades, states still face the reality that black and Latina teens are more than twice as likely as white teens to become pregnant. (AP)

It’s a problem once thought to be intractable, and yet pregnancy and birth rates for black and Latina teens have dropped precipitously in the past two decades—at a much faster clip than that of white teens.

Despite this, black and Latina girls are more than twice as likely as white girls to become pregnant before they leave adolescence.

This glass half-full, half-empty scenario is a dilemma that continues to confound states. The racial and ethnic disparities surrounding teen pregnancy are stubborn, often a cause and consequence of poverty and a complex array of societal factors.

Teen pregnancies are usually unplanned and come with a steep price tag, costing U.S. taxpayers up to $28 billion a year, according to the Office of Adolescent Health, which is part of the U.S. Department of Health and Human Services.

Some states like Mississippi have found innovative ways to tackle the problem by targeting specific populations, while others like Kansas are serving up bills that make it more difficult for teens to access sex education, which is a critical component of preventing pregnancy in adolescence, according to advocates such as the National Campaign to Prevent Teen and Unplanned Pregnancy. Continue reading

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What’s at stake as health law lands at Supreme Court again

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By Sarah Varney
KHN

BURNSVILLE, N. C.— It’s been a bitterly cold winter in the Blue Ridge Mountains for Julia Raye and her 13-year-old son, Charles. But despite the punishing weather, 2015 has been looking good: Raye is finally able to afford insulin and the other medications she needs to keep her diabetes under control.

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Julia Raye of Burnsville, N.C. is paying $30 a month for insurance under Obamacare. (Photo credit: PBS Newshour)

She’s a self-employed auditor who relies on a $400 per month government subsidy to afford the private health plan she bought on healthcare.gov, the online federal marketplace for health insurance.

Before the Affordable Care Act made tax credits available to low- and moderate-income workers, Raye was uninsured. Back then, just one of her diabetes medications cost her $320.

“During that time, I had no insurance, and I really wasn’t taking my medicine. There were times when my sugars and things would get up to 600,” Raye said. “I remember getting to a point where the ambulance had to go take me in because I was pretty much in a diabetic shock.”

On Wednesday, the U.S. Supreme Court will hear oral arguments in a case that could cripple the Affordable Care Act and imperil financial assistance to 8.2 million health insurance shoppers like Raye in the states that rely on the federal health insurance exchange.

Since January 2014, Raye has had steady insurance, paying just $30 a month, while her son was covered by Medicaid, the public insurance program for low-income people. Treating her diabetes has improved her vision and the numbness in her feet, and, at age 48, she has gotten a long overdue mammogram.

Raye says she is watching the latest legal challenge to the Affordable Care Act with growing anxiety. If the court wipes out her subsidy, Raye says she wouldn’t be able to pay for treatment. Her diabetes would again worsen, she would be unable to work and she and her son would face financial ruin, she says.

Continue reading

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No, Drinking Coffee Won’t Save Your Life Or Prevent Heart Attacks

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Photo by Jean Scheijen

Once again the media has swallowed the bait hook, line, and sinker. Following the publication of a new study in the journal Heart last night, hundreds of news reports have now appeared extolling the miraculous benefits of coffee.

Here’s just one typical headline from the Los Angeles Times: “Another reason to drink coffee: It’s good for your heart, study says.”

But a careful look at the study and previous research on coffee makes clear that this type of reporting is completely unwarranted. [Photo by Jean Scheijen

via No, Drinking Coffee Won’t Save Your Life Or Prevent Heart Attacks.

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