Story TimelineWalmart aims at Amazon with no cost NextDay deliveryWalmart Onn Android tablets try to beat Amazon at its own gameWalmart InHome Delivery will test your trust issues to the max READ: Target takes on Amazon with same-day delivery for online ordersGrocery deliveries are exactly what they sound like — a way for consumers to shop through a company’s mobile app, pay using the app, and then wait for someone to bring the groceries to their door. The service is vital for those who are unable to leave their homes and a massive convenience for everyone else, but there is a downside: the delivery fee.Depending on the company used, each food order may come with a flat shipping fee somewhere between $5 and $10; other services require customers to sign up for a plan and pay a flat monthly fee to get a certain number of deliveries every month. Walmart Grocery, the company’s online food shopping service, offers both a flat $9.95 fee for a single delivery and a $12.95/month rate for monthly subscriptions.AdChoices广告As first spied by TechCrunch, Walmart also added a $98 annual subscription to its grocery delivery service, enabling customers who regularly get grocery deliveries to save money over the course of a full year. The new plan is called Delivery Unlimited, and as its name suggests, subscribers can order whatever groceries they need and the packages will be delivered with no additional costs. The rate is one dollar less than Shipt’s annual $99 plan, which Target customers must get if they want otherwise free deliveries under the retailer’s new same-day delivery service. It’s unclear at this time how many regions are covered by Walmart’s new Delivery Unlimited service. The option to order and pay through the app, then pick up the order at a Walmart store remains free. The grocery delivery market is heating up and that’s good news for consumers. Days after Target launched same-day deliveries for online purchases in most of the United States, Walmart has expanded its own alternative to include a new $98 annual subscription for grocery deliveries. The annual subscription is a discount over the flat rate and monthly plan options Walmart already offered.
Viewpoints: Insuring Medical Treatments Are Well Researched; GOP Govs Reluctance On Exchanges May Backfire The New York Times: Testing What We Think We Know By 1990, many doctors were recommending hormone replacement therapy to healthy middle-aged women and P.S.A. screening for prostate cancer to older men. Both interventions had become standard medical practice. But in 2002, a randomized trial showed that preventive hormone replacement caused more problems (more heart disease and breast cancer) than it solved. … Then, in 2009, trials showed that P.S.A. screening led to many unnecessary surgeries and had a dubious effect on prostate cancer deaths (Dr. H. Gilbert Welch, 8/19). Bloomberg: Republican Governors Should Want Homemade ExchangesEven though the Health and Human Services Department staffers who are working on plans for the federally imposed exchanges are trying their best to get input from insurance officials in every state, they will be hard-pressed to design unique exchanges for each of the states that refuse to design their own. It’s more likely that the federally operated exchanges will have a one-size-fits-all quality. And this will make the states’ health-insurance systems more difficult and costly to administer (Elena Marks, 8/19). Politico: A Health Mandate Businesses Might Like The health reform law may have been upheld by the Supreme Court, but it won’t alter the alarming fact that employee health costs have exploded to become the third largest expense in business today, eroding the financial health of thousands of companies. That’s because the cause of this health cost crisis has nothing to do with the health law, but is instead due to the declining health of the American worker. A recent study found that an astonishing 86 percent of all full-time employees in the U.S. — that’s six of every seven workers — are now either overweight or have a chronic (but usually preventable) health condition that significantly raises their health costs (Darrell Moon, 8/20). Los Angeles Times: A Flawed Medi-Cal Fix The state Senate’s top Democrat, Darrell Steinberg, is making a last-minute push for a bill that would allow some injured people to seek recovery for medical bills that are larger than what their doctors and hospitals actually collected. The goal, Steinberg says, is to generate more money for Medi-Cal, the state’s version of Medicaid. Indeed, state and federal laws have made it difficult for Medi-Cal to recover much of what it spends on medical care even when the victims win judgments against the people who injured them. But Steinberg wants to solve that problem the wrong way (8/17). The Dallas Morning News: Parkland Requires A Turnaround Mind-Set If there was any doubt that tough and decisive hands-on leadership is needed at Parkland Memorial Hospital, recent headlines drive home the point: first, federal monitors’ most recent harsh critique of Parkland’s reform efforts, then the hospital’s stunning announcement last week that it is severely understaffed and in “crisis mode” (8/19).Health Policy Solutions: Peaceful Death At Risk When Emotion Overwhelms Good MedicineDoctors often try to dissuade patients and their families from seeking treatments they believe to be futile, and as a result, many choose instead to focus on care that enriches their quality of life. But there are some who challenge this practice, saying that doctors who discourage further treatment and allow patients to die comfortably and in peace are killing them. The critics suggest that doctors who recommend against further treatment show a lack of respect for the elderly, the disabled and the very sick. They say (maybe even believe) that doctors and hospitals have financial incentives for not treating them. They fail to accept that the reality is exactly the opposite (Dr. Aroop Mangalik, 8/19). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
State Roundup: Federal Judge Says Milwaukee Can Raise Retiree Contribution A selection of health policy stories from California, Texas, Michigan, Minnesota, Wisconsin, Kansas and Oregon.The Dallas Morning News: Commissioners Approve Health Care Stipend For Gay, Unmarried EmployeesDallas County will give a stipend to unmarried and gay employees who provide health care benefits to their partners. County commissioners approved the new program in a narrow 3-2 vote, which was split along party lines. Democratic commissioners hailed the move as a way to attract and retain talent, embrace the county’s diversity and compete against private companies who already provide domestic partner benefits. Republican commissioners said the move, which is estimated to cost taxpayers $100,000 a year, made bad economic sense and was an end-run around state and federal laws barring gay marriage (Formby, 10/30).Milwaukee Journal Sentinel: Federal Judge Rules Milwaukee County Could Shift Some Health Costs To RetireesMilwaukee County’s move to charge its retirees for some health care costs – a change made in 2012 that shifted millions of dollars in costs from taxpayers to retirees as well as active employees – was upheld in federal court Tuesday. U.S. District Judge William E. Callahan Jr. ruled against Esther Hussey, who retired from the county in 1991 after 35 years and said she was promised free health insurance. She worked primarily in the register of deeds office. Callahan sounded sympathetic to Hussey, 85, comparing her case to another in which Pabst Brewing retirees felt “an element of betrayal” over losing health benefits (Schultze, 10/30).HealthyCal: Permanent Housing Offers Stability For Those With Mental IllnessThe Mental Health Services Act approved by voters as Proposition 63 in 2004 provides more funding to county-based mental health programs. The funding from a 1 percent tax on personal income in excess of $1 million was expected to fund the implementation of treatment, prevention and early intervention programs for those with serious mental illness. Still, the cost of not serving the needs remains high. An experiment in Los Angeles, started in 2008, concluded that giving homeless residents permanent housing with no strings attached provides a savings to taxpayer (Flores, 10/31). The Texas Tribune: Senate Panel Takes Aim At Prescription Drug AbuseSpeaking Tuesday at a Senate panel hearing on prescription drug abuse, doctors and law enforcement officials touted the importance of agencies sharing information to more effectively look for pharmacies and doctors involved in the usage of prescription drugs outside of medically sanctioned purposes (Chammah, 10/30).The Dallas Morning News: Officials Unveil Plan To Eliminate Childhood Obesity In Dallas By 2020Community leaders met Tuesday to unveil a plan to eliminate childhood obesity in Dallas by 2020. The plan, named Charting the Course for a Healthy Future, was introduced at Texas Scottish Rite Hospital for Children after nearly two years of planning by a coalition of more than 60 organizations and community leaders. “Reducing childhood obesity will have a profound impact on the health and quality of life for all North Texans,” said Susan Hoff, chief strategy officer of United Way of Metropolitan Dallas (Fancher, 10/30).(St. Paul) Pioneer Press: Watchdog: U Students Say New Health Insurance Process Causing HeadachesSome students at the University of Minnesota say they are being charged for the university health care plan, even though they have private insurance and notified the U of their coverage when they registered for class last spring. The problem appears to be related to a change in the university’s health insurance verification process. The new system uses electronic verification when students register for classes to confirm that students are covered by a private insurance provider. The glitch is that the system recognizes only five major providers: Blue Cross and Blue Shield, HealthPartners, Medica, MinnesotaCare, and Preferred One (Tritschler, 10/30). Kansas Health Institute News: Advocates Of Mid-Level Dental Care Prepare For Legislature Hays dentist Melinda Miner is one of a handful in her profession who publicly support licensing a new type of mid-level dental provider as a way to increase Kansans’ access to oral health care. She’s also among the relative few who will see Medicaid patients. “Only 25 percent of us see the problems,” Miner said. “Most dentists live in a different world. Their patients pay cash and can afford the expensive treatments. They don’t see the dental decay and the problems in people who can’t pay.” Miner was among about 25 people who met today in Topeka as part of the Kansas Dental Project, a coalition of advocacy groups seeking to improve dental care for children, the elderly and the medically underserved (Cauthon, 10/30).California Healthline: Payments Delayed To CBAS CentersCalifornia centers that offer adult day services are having trouble getting reimbursed for services provided to Medi-Cal beneficiaries under the state’s new Community Based Adult Day Services program launched on Oct. 1. “We are not getting paid. And I don’t know when we will get paid. I’m not expecting anything at this point,” said Manooch Pouransari, who runs the Grace Adult Day Health Care center in Santa Clara. “My experience is similar to many other centers,” he said. “We haven’t been told who to bill, where to bill, how to bill. And we found the same thing on their side, the MCOs (managed care organizations), they don’t know any of that, either” (Gorn, 10/31).The Lund Report: Member Insists OEBB Overpays For Prescription DrugsTamara Weaver questions why the Oregon Educators Benefit Board (OEBB) is paying more for prescription drugs through its mail order company than at Costco, her local retail pharmacy. OEBB is responsible for selecting the health plans for the majority of Oregon’s public school teachers, community colleges and state universities (Scharer, 10/30). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
UnitedHealthcare is dropping 10 to 15 percent of its doctors from Medicare Advantage plans around the nation, a move that will force some seniors to find new doctors or change plans.The Columbus Dispatch: Medicare Insurer UnitedHealthcare Cuts Doctor Network UnitedHealthcare is dropping an undisclosed number of doctors from its Medicare Advantage provider network in Ohio, which will force some senior citizens to find new physicians or change plans, according to a physician-advocacy group. “This is one of the most significant (provider) network narrowings we’ve ever seen in the Medicare Advantage world,” said Todd Baker, director of professional relations with the Ohio State Medical Association. He said physicians have been receiving termination letters from UnitedHealthcare for about six weeks (Sutherly, 10/26). The Newark Star-Ledger: UnitedHealthcare Drops 10-15 Percent Of Its Doctors In Medicare Advantage Plans UnitedHealthcare this month began terminating contracts with physicians across the nation who participate in the Medicare Advantage plans, alarming doctors who say the move will disrupt their relationships with patients and make care harder to find. A UnitedHealthcare spokeswoman said the company is dropping 10 to 15 percent of its physicians nationwide, although she declined to say how many are affected in New Jersey. Doing so will save money and improve care, spokeswoman Mary McElrath-Jones (Livio, 10/26). UnitedHealthcare Cuts Doctors From Medicare Advantage Plans This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
An analysis of the state marketplace by First Data released Thursday found serious problems with management and communications.The Oregonian: Kitzhaber Cleans House, Announces Reforms In Wake Of Cover Oregon Health Insurance Exchange ReportGov. John Kitzhaber announced a major managerial house-cleaning Thursday in response to the state’s ongoing health insurance exchange fiasco. Among those departing is perhaps Kitzhaber’s closest and most important health care reform ally, Bruce Goldberg, the Oregon Health Authority director who’s led Cover Oregon since January. Kitzhaber said he also asked the Cover Oregon board to remove Triz DelaRosa, chief operating officer for Cover Oregon, and Aaron Karjala, Cover Oregon’s chief information officer. “We have made mistakes and we will learn from it,” Kitzhaber said, following the release of an independent report highly critical of the state’s work on the project (Budnick, 3/20).The Oregonian: Republicans Pounce On Cover Oregon Problems, Point Fingers At Gov. John KitzhaberOpponents of Gov. John Kitzhaber were quick to paint the Democratic incumbent as out of touch and incompetent Thursday following the release of an investigation into the mishandled Cover Oregon project. The Republican Governors Association blasted out an email tying Kitzhaber to President Barack Obama’s healthcare plan, calling it “Oregon’s nightmare.” And the Republican frontrunner in the gubernatorial primary, state Rep. Dennis Richardson, piled on (Esteve, 3/20).The New York Times: Health Care Exchange In Oregon Not Meeting High Hopes As the federal health care overhaul was rolled out over the last few years, Oregon was invariably the eager overachiever in the first row, waving a hand to volunteer. The governor, John Kitzhaber, a doctor who left the emergency room for politics, made health care his main issue. … Yet for all that, by some measures Oregon has among the most dysfunctional online insurance exchanges in the nation. … On Thursday, a grim-faced Mr. Kitzhaber released a new report, commissioned by the state with a private company, that underscored how systemic Oregon’s failure has been (Johnson, 3/20).The Washington Post: After Disastrous Rollout, Oregon Considers Health Exchange Options Oregon Gov. John Kitzhaber (D) has fired the head of the state’s online health-care exchange — the second to leave the organization in three months — after chronic technical issues that left uninsured residents unable to purchase insurance mandated by the Affordable Care Act. Plagued by technical issues, breakdowns in supervisory management and shoddy work by an outside vendor that received tens of millions of dollars in state funding, Cover Oregon, the state’s online health insurance exchange has been one of the worst in the country (Wilson, 3/20). Gov. Kitzhaber Sweeps Out Cover Oregon Leadership, Promises Reforms This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
Mr. G was a patient well known to our multidisciplinary team at a safety-net hospital in Chicago. At this point, he had been readmitted to our hospital seven times in the previous six weeks, sometimes so short of breath that he couldn’t walk more than five steps before having to sit down. (Carolyn Dickens, Denise Weitzel and Stephen Brown, 3/7) Christine Grounds and Jonathan Mir shared their experience raising a son with microcephaly in a STAT video posted last week. Their candor — including an acknowledgement that she would have terminated the pregnancy had she known about Nicholas’s birth defect — has drawn strong reaction from viewers. (Emily Hager, 3/7) In a series of stories all this week, Trend CT uses data to better understand the state’s intractable drug-overdose problem. (Andrew Ba Tran, 3/7) In addition to using the inhaler my medical doctor gave me, there are a thousand things I am supposed to do to try and manage my asthma. Get allergy tests. Buy fancy vacuums and dust-mite covers for every fabric surface in my home. Give up my shelves of old books and vinyl records. Performing these acts of self-care is exhausting, expensive, and often difficult to measure in terms of results. The day of that acupuncture appointment, I was delivered a relatively easy diagnosis, a narrative that I could seize on to explain my ongoing illness to myself: I got sick because he died and I never recovered. (Manjula Martin, 3/3) Wired: Medicare Scammers Steal $60 Billion A Year. This Man Is Hunting Them U.S. News And World Report: Microcephaly: After Diagnosis, A Life Of Uncertainty If Willie Sutton had to choose a criminal career today, he’d be ripping off Medicare too. As the bank robber supposedly said: That’s where the money is. The program spends more than $600 billion a year on health care for 54 million people, most of them seniors. It is a massive pool of underguarded funds ripe for skimming. (J.C. Herz, 3/7) Microcephaly has been in the headlines in recent months as global health officials have turned their attention to the threat of Zika, a mosquito-borne virus believed to be linked to a surge of microcephaly cases in Brazil. The virus can be sexually transmitted, and the U.S. is bracing for the possibility that Zika may appear here as the weather gets warmer. Amid the hysteria over Zika, however, the families of the 25,000 children already diagnosed with microcephaly in the U.S. every year have been overlooked. According to the Foundation for Children with Microcephaly, the condition affects 2.5 percent of births each year. (Kimberly Leonard, 3/4) Pacific Standard: Are My Emotions Making Me Sick? Longer Looks: The Readmission Cycle; Opioids in Connecticut; Medicare Scammers Each week, KHN’s Shefali Luthra finds interesting reads from around the Web. STAT: Raising A Child With Microcephaly: Outsiders ‘Cannot Know Our Experience’ This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Health Affairs: Mr. G And The Revolving Door: Breaking The Readmission Cycle At A Safety-Net Hospital Trend CT: Why Connecticut’s Drug Overdose Crisis Isn’t Slowing Down
We have already seen several pieces of evidence that Tesla’s massive Powerpack battery project in Australia is quite financially successful, but now we get all the numbers as Neoen, Tesla’s partner in the project, files for IPO.The giant battery cost ~$66 million and it reportedly already made up to $17 million during the first ~6 months of operation. more… Source: Charge Forward
Lincoln Aviator At 2018 New York Auto Show – Live Photos & Videos Lincoln Aviator Plug-In Hybrid SUV Spied Author Liberty Access TechnologiesPosted on January 27, 2019Categories Electric Vehicle News 2020 Lincoln Aviator Lands In LA With Potent Plug-In Power There’s plenty of elegance inside, too, and now we know exactly how much all that grandeur will cost. You can step into a Standard trim Aviator for $52,195, but going all-out for a fully loaded Black Label Grand Touring hybrid tips the scale at $91,145. Both prices include delivery and other assorted fees.Plug-In Hybrid Gets ExpensiveHow far does your hard-earned money go in the Aviator world? We’ll start with a close look at the Black Label Grand Touring, which checks nearly all the option boxes right off the bat. The model starts at $88,895 and comes fully equipped with the luxury and dynamic handling packages, the latter of which includes adaptive suspension and air-ride components. Adaptive steering is in there, not to mention all-wheel drive with the high-end 21-inch wheels. It’s also fitted with Lincoln’s hybrid powertrain – a 3.0-liter twin-turbo V6 connected to a ten-speed automatic. Details on that system are still being sussed out, but Lincoln says it should produce a projected 450 horsepower (336 kilowatts) and a whopping 600 pound-feet (813 Newton-meters) of torque. Source: Electric Vehicle News Base models are still well-equipped and start at $52,195.We’ve been rather impressed with the new Lincoln Aviator since the prototype first broke cover last year at the New York Auto Show. The production model arrived just a couple months ago for the LA Auto Show, looking quite similar to its concept-cousin. That’s a good thing, because the swooping lines and acres of tinted rear greenhouse combine to create a refreshingly elegant SUV.More Aviator Inside, the Black Label Grand Touring comes standard with the upgraded Revel 28-speaker sound system, navigation, 30-way heated/massaging seats, a panoramic roof, and lots of leather as well. Only two options are available – the class IV trailer tow package for $500 and a special coat of Chroma Caviar Dark Gray paint, costing $1,750. All total that brings us to $91,145.On the flip side, the Standard model isn’t exactly a barebones grocery getter. It powers the rear wheels with a 400-hp (298-kW) twin-turbo V6, treats front-seat passengers to 10-way heated seats, and the cool glass cockpit with SYNC 3 and Lincoln’s Co-Pilot360 driver assist suite is also included – as it is on all Aviator models.Order banks for the new Aviator will open next month, with production models arriving at dealerships in the spring.
Aurora, the self-driving startup that already has relationships with a number of automakers, has just announced its newest collaboration, working with Fiat Chrysler Automobiles (FCA) on self-driving commercial vehicle platforms. more…Subscribe to Electrek on YouTube for exclusive videos and subscribe to the podcast.https://www.youtube.com/watch?v=V1zk7Eb8r-s&list=PL_Qf0A10763mA7Byw9ncZqxjke6Gjz0MtThe post Aurora and Fiat Chrysler launch self-driving commercial vehicle partnership appeared first on Electrek. Source: Charge Forward
Lost your password? Remember me Username Password John Leininger joins Bieging Shapiro & Barber from Bryan Cave . . .You must be a subscriber to The Texas Lawbook to access this content. Not a subscriber? Sign up for The Texas Lawbook.
Remember me Username Lost your password? Password The value of M&A transactions in the energy sector plummeted 65 percent during in the first half of 2016. Overall corporate deals worth $500 million or more were down by 13 percent. Billion-dollar plus transactions were down 19 percent. Private deals are up. Deals involving bankruptcy assets are up. The Texas Lawbook’s exclusive Corporate Deal Tracker has all the M&A data from H1 2016 and predictions for the rest of the year . . .You must be a subscriber to The Texas Lawbook to access this content. Not a subscriber? Sign up for The Texas Lawbook.
Lost your password? Username Kimberly Houston’s fascination with the law may have begun with “Matlock,” but it’s grown into an expertise on such weighty subjects as employment misclassification and regulatory compliance. As Corporate Counsel for Liberty Mutual, the insurance giant, Houston has wrestled with large-scale undertakings, from a class action defense to the development of the company’s new corporate campus in North Texas. And now she’s a finalist in the Outstanding Corporate Counsel Awards. Read about her in The Texas Lawbook.You must be a subscriber to The Texas Lawbook to access this content. Password Remember me Not a subscriber? Sign up for The Texas Lawbook.
Source:https://www.utah.edu/ Jul 27 2018New research published by University of Utah S.J. Quinney College of Law Professor Jorge Contreras in Science this week explores the current state of sharing resources in the biomedical research field and whether the fragmentation of property ownership can stifle research progress, instead of advancing it.Contreras’ essay “The anticommons at 20: concerns for research continue”examines complicated questions about intellectual property rights and the creation of new products to improve human health in connection with the 20thanniversary of prominent research that explored the same issues two decades ago.In 1998, researchers Michael A. Heller and Rebecca S. Eisenberg published “Can Patents Deter Innovation? The Anticommons in Biomedical Research” in Science. In their research, the duo used the “tragedy of the commons” metaphor introduced by Garrett Hardin in 1968 and applied it to the biomedical research field. While Hardin’s “tragedy of the commons” suggests that people overuse shared resources because they don’t have an incentive to conserve, Heller and Eisenberg suggested that biomedical researchers could suffer from a different affliction — an “anticommons” — because people underuse resources that are owned by many in small portions because of ensuing battles over intellectual property rights. Such behavior can result in development of fewer products -;a trend that potentially can stall important breakthroughs for bettering health. Heller and Eisenberg suggested that the “anticommons” in biomedical research is one reason the privatization of biomedical research needed to be considered carefully.Related StoriesScientists develop universal FACS-based approach to heterogenous cell sorting, propelling organoid researchComplement system shown to remove dead cells in retinitis pigmentosa, contradicting previous researchOlympus Europe and Cytosurge join hands to accelerate drug development, single cell researchTwenty years later, concerns for research advancement on this front continue, Contreras writes in the newly published Sciencefindings. His new essay examines whether predictions by Heller and Eisenberg made 20 years ago came true and what these outcomes can teach society today.”Even though most would agree that the patent-fueled anticommons that Heller and Eisenberg predicted for biomedical research did not come to pass, their fundamental insight about the dangers of over-propertization and fragmentation of ownership are still important today,” said Contreras.”For example, instead of patents, many companies are now using trade secrets to cordon off large areas of research. And there are proposals being made to give individuals ownership of data about themselves, data that used to be beyond the reach of property laws. Anticommons could arise in these areas, even without patents.”Contreras noted that public policy discussions around how to address these issues continue. He has provided suggestions to ease the blocking of ideas that too-restrictive property regimes can create.”I’ve recommended, for example, that data ownership not be parceled out to every living individual, because doing that would make biomedical research much harder to conduct, which could deprive us of discoveries that could otherwise have life-saving impact. This is the message that Heller and Eisenberg had twenty years ago: be careful about assigning property interests too widely, because the result could be gridlock,” said Contreras.
Aug 20 2018Chagas disease, caused by infection with a parasite called Trypanosoma cruzi (T cruzi), causes chronic heart disease in about one third of those infected. Over the past 40 years, Chagas disease has spread to areas where it had not traditionally been seen, including the United States, according to a new American Heart Association scientific statement published in the American Heart Association journal Circulation.The statement. summarizes the most up-to-date information on diagnosis, screening and treatment of T cruzi infection. Infection occurs when feces from the infected blood sucking insect triatomine enters the skin through the bite site or in the eye. Triatomine insects are found in Central and South America, where they infest adobe houses and in the Southern United States. The disease can also be passed through contaminated food or drink, from pregnant mothers to their babies, and through blood transfusions and organ transplants.The health risks of Chagas disease are well-known in Latin America where most cases are found in countries that include Brazil, Argentina, Bolivia, Paraguay, Mexico and El Salvador. However, doctors outside of Latin America are largely unaware of the infection and its connection to heart disease. Countries where infected individuals have been diagnosed include the United States with an estimated 300,000 cases, Spain with at least 42,000 cases, Italy, France, Switzerland, the United Kingdom, Australia and Japan.”This statement aims to increase global awareness among physicians who manage patients with Chagas disease outside of traditionally endemic environments,” said Maria Carmo Pereira Nunes, M.D., Ph.D, co-chair of the committee that produced the statement. “This document will help healthcare providers and health systems outside of Latin America recognize, diagnose and treat Chagas disease and prevent further disease transmission,” said Pereira Nunes, who is a cardiologist at the Federal University of Minas Gerais in Belo Horizonte, Brazil.Related StoriesImplanted device uses microcurrent to exercise heart muscle in cardiomyopathy patientsNew method improves detection of atrial fibrillation in stroke survivorsMathematical model helps quantify metastatic cell behaviorAlthough 60-70 percent of people infected with T cruzi never develop any symptoms, those that do can develop heart disease, including heart failure, stroke, life threatening ventricular arrhythmias (heart rhythm abnormalities) and cardiac arrest. In the Americas, Chagas disease is responsible for more than seven times as many disability-adjusted life-years lost as malaria. However, if caught early, an infection can be cured with medications that have a 60 to 90 percent success rate, depending on when in the course of infection the patient is treated.”Early detection of Chagas disease is critical, allowing prompt initiation of therapy when the evidence for cure is strong,” said statement co-author Caryn Bern, M.D., M.P.H., professor of epidemiology and biostatistics at the University of California in San Francisco.The risk of infection is extremely low for most travelers and residents of endemic countries. To minimize risk, people should avoid sleeping in houses with un-plastered adobe walls and/or thatch roofs, and avoid unpasteurized sugar cane juice, açai fruit juice and other juices when visiting affected countries. Source:https://newsroom.heart.org/news/chagas-disease-caused-by-a-parasite-has-spread-outside-of-latin-america-and-carries-a-high-risk-of-heart-disease?preview=23a47636aa174da9a0961e83215ae416
Source:https://www.jhsph.edu/news/news-releases/2018/aca-health-insurance-ads-targeted-younger-healthier-consumers.html Reviewed by James Ives, M.Psych. (Editor)Sep 21 2018The themes in television advertisements for health insurance plans have shifted over time, possibly reflecting the shrinking pool of health plans offered through the Affordable Care Act (ACA) as well as rising plan premiums, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.In the study, published online in the Journal of Health Politics, Policy and Law, the researchers analyzed the volume and content of media messages included in insurance advertisements that were aired over a million times in the U.S. from late 2013 through spring 2016. One key finding: explicit mentions of Obamacare or ACA declined sharply.”These marketplace health plans that became available following the passage of the health care law under President Obama were heavily government-subsidized and contributed to substantial declines in uninsurance rates in the U.S.,” says study lead author Colleen L. Barry, PhD, the Fred and Julie Soper Professor and Chair of the Department of Health Policy and Management at the Bloomberg School. “Yet, in the absence of an explicit mention of the law in ads, newly insured individuals may not have appreciated the connection between the law and the health benefits they were receiving.”The ACA, often called Obamacare, is a major health policy initiative enacted in 2010 that led to the introduction of new marketplace plans designed to make it easier for consumers to access health care through the individual and small group insurance market starting in 2014. Television ads for ACA plans, which are sponsored mostly by private insurers and through state and federal enrollment efforts, first began marketing to consumers in late fall 2013.For the study, through the Wesleyan Media Project at Wesleyan University, the researchers obtained a database of video files for all of the health insurance-related television ads that aired in U.S. media markets during the first three ACA open-enrollment periods in 2013-14, 2014-15 and 2015-16. The study authors took a random sample of the ads, ending up with 875 unique advertisements that represented 1,074,653 airings in all 50 states.The researchers viewed and coded each ad for characteristics including: the type of people featured in the ads, the activities they were engaged in, the references to ACA or Obamacare, and the messages about various benefits of the health plans available.One finding, not unexpected, was that overtime the ads increasingly included content aimed at selling policies to younger, healthier people, whose enrollment in large numbers is essential to the long-term plan solvency. Relatively few airings focused on elderly or disabled people, smokers or people receiving medical care in a hospital or clinic–the kinds of people who tend to generate more costly health insurance claims.Related StoriesDOJ lawyers try new tricks to undo Obamacare. Will it work?New federal health insurance rule could help millions of Americans save money on drugs and careFamily members’ drugs may be risk factor for overdose in individuals without prescriptions”What we saw over the three enrollment periods is that as costs became a greater concern for insurers, advertising increasingly targeted so-called ‘young invincibles’–younger and healthy individuals who may be tempted to forego insurance,” Barry says.The researchers also noted a shift, over the three open enrollment periods, toward messages emphasizing the availability of financial assistance with premiums, and away from messages emphasizing plan choice. The trend corresponded to sharp increases in average ACA plan premiums and reductions in plan choice as some major insurers pulled out of ACA marketplaces.Even more dramatic, Barry and her colleagues found, was the trend towards ads that did not mention ACA. “By the third enrollment period in 2016 only about 10 percent of the airings by non-government sponsors specifically referred to ACA or Obamacare,” Barry says. “So there was a real movement by those sponsors to avoid connecting their products with the law itself.”The researchers suggest that this trend may relate to a low level of public understanding of ACA, which advertisers may have increasingly recognized and accommodated–and which in turn may have worsened the public’s understanding.”Public opinion data have shown consistently that many Americans do not understand the key components of the law or believe they have benefited from it,” Barry says.The researchers worry that not making clear the connection between an individual’s health care and a major government program is problematic–not just for ACA but for government-sponsored programs generally. They cite the political scientist Suzanne Mettler, who has argued that public support for governmental programs will remain low, and indeed trust in government will remain low, insofar as citizens fail to see the benefits they receive from the government.”If we want the public to understand the value of major government initiatives like ACA, then it is important to highlight these connections between health care benefits and government initiatives more explicitly,” Barry says.”Assessing the Content of Television Health Insurance Advertising during Three Open Enrollment Periods of the ACA” was written by Colleen L. Barry, Sachini Bandara, Kimberly Arnold, Jessie Pintor, Laura Baum, Jeff Niederdeppe, Pinar Karaca-Mandic, Erika Franklin Fowler and Sarah Gollust.