Global health news – February 23, 2015

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Globe floating in air

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UCLA outbreak highlights challenges of curbing infections

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carbapenem-resistan, Enterobacteriaceae - CDC

Carbapenem-resistan Enterobacteriaceae – CDC

By Jordan Rau
KHN

The bacterial outbreak at a Los Angeles hospital highlights shortcomings in the federal government’s efforts to avert the most lethal hospital infections, which are becoming increasingly impervious to treatment.

Government efforts are hobbled, infection control experts say, by gaps in monitoring the prevalence of these germs both within hospitals and beyond. The continued overuse of antibiotics — due to over-prescription by doctors, patients’ insistence and the widespread use in animals and crops — has helped these bacteria evolve into more dangerous forms and flourish.

In the outbreak at UCLA’s Ronald Reagan Medical Center, two patients have died and more than 100 may have been exposed to CRE, an antibiotic-resistant bacteria commonly found in the digestive tract. When this germ reaches the bloodstream, fatality rates are 40 percent. The government estimates about 9,000 infections, leading to 600 deaths, are caused each year by CRE, which stands for carbapenem-resistant Enterobacteriaceae.

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Close up of ERCP endoscope tip

UCLA Health says the infections probably were passed around by inadequately sterilized scopes used to peer inside a body.

Previous CRE outbreaks have occurred elsewhere in the country, including hospitals in Illinois and Seattle.

The immediate public health response has focused on the safety of the scopes and tracking down people who may have been exposed.

The U.S. Food and Drug Administration Thursday issued a warning about the devices. But the California outbreak comes amid the government’s broader struggle to spot and battle the swelling ranks of bacteria that are resistant to most, if not all, antibiotics. Continue reading

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Top five stories of the week

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Credit: Dan Shirly

Credit: Dan Shirly

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Fourth case of measles in Clallam County

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A fourth case of measles was identified in Clallam County. The fourth case is a 14-year old male who is a sibling of the second case. The 14-year old male was quarantined during his infectious period so he had no public contact.

640px-Map_of_Washington_highlighting_Clallam_County.svg

Dr. Jeanette Stehr-Green, Clallam County Health Officer, again under scored the importance of adherence to quarantine among exposed persons, daily reports to Public Health nurses regarding symptoms, and no contacts with unvaccinated individuals as critical to stopping the spread of measles.

A person with measles is contagious from approximately four days before the onset of rash to four days after the rash appears and should not be in contact with any susceptible persons during this time.

Clallam County Health and Human Service, Public Health Section will continue with no cost clinics on February 23, 24, 26, and 27.

Clinics will be held at 111 3rd St, Port Angeles.

Feb. 23 Feb. 24 Feb. 26 Feb. 27

8:30 a.m. – 4:00 p.m. 8:30 a.m. – 12:00 noon 8:30 a.m. – 4:00 p.m. 8:30 a.m. – 4:00 p.m.

People are encouraged to call 360-417-2274 to make appointments. Walk-ins will be served but there may be a wait.

HHS continues to evaluate when and where to have clinics outside of the Port Angeles area. All parents are encouraged to check the vaccination status of children. Two vaccinations for children are needed for protection.

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Health news headlines – February 21, 2015

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Egg cracked

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Tax time reprieve for Obamacare procrastinators

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clockBy Phil Galewitz
KHN

The Obama administration said Friday it will allow a special health law enrollment period from March 15 to April 30 for consumers who realize while filling out their taxes that they owe a fee for not signing up for coverage last year.

The special enrollment period applies to people in the 37 states covered by the federal marketplace, though some state-run exchanges are also expected to follow suit.

People will have to attest that they first became aware of the tax penalty for lack of coverage when they filled out their taxes. They will still have to pay the fine, which for last year was $95 or 1 percent of their income, whichever was greater.

Some people may not realize they face a penalty for not having coverage until they file their tax returns.

This year, the penalty for not having insurance coverage is $325 per person or 2 percent of household income, whichever is greater. By signing up during the special enrollment period for 2015 they can avoid paying most of the tax penalty for this year.

The Affordable Care Act requires most Americans to have health insurance or pay a financial penalty.

But some people may not realize they face a penalty for not having coverage until they file their tax returns ahead of the April 15 tax deadline. Continue reading

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Many uninsured don’t realize they may face a tax penalty

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Alert IconBy Michelle Andrews
KHN

A “teachable moment” is one way to describe the  consternation that many uninsured people may feel when they file their taxes this spring and realize they could owe a penalty for not having health insurance.

According to a new survey, the number of people who may need to be schooled is substantial: Forty-four percent of uninsured people who may be subject to the penalty say they know nothing or only a little about the penalty they may face.

Forty-four percent of uninsured people who may be subject to the penalty say they know nothing or only a little about the penalty.

The Urban Institute analysis was based on its December 2014 Health Reform Monitoring Survey of uninsured adults with incomes above the poverty level, a group that might be expected to owe a penalty for not having coverage.

For 2014, the penalty is the greater of $95 or 1 percent of annual income. In 2015, the penalty increases to 2 percent or $325, whichever is greater.

People who don’t become aware of the penalty until they file their 2014 taxes in March or April could end up owing penalties for both years. The open enrollment period to sign up for 2015 health insurance was Feb. 15. – but now has been extended. (See story above.)

Under pressure from consumer advocates, the Obama administration on Friday said it will allow a special enrollment period from March 15 to April 30 for those who realize while filling out their taxes that they owe a fee for not signing up for coverage last year.

The special period applies to people in the 37 states covered by the federal marketplace, though some state-run exchanges are also expected to follow suit. Continue reading

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Why I love family-run restaurants: Insights from a food inspector

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cropped-eyob-in-idBy Eyob Mazengia, PhD, RS, Food Protection Program
Public Health – Seattle & King County

When I started as a food inspector, I was assigned to the International District. And I liked it. It was almost like walking into a new culture, a new era.

What fascinated me was that as a public health worker, I had permission to walk into people’s personal spaces. I liked the smells, the sounds of their languages, their wall hangings and the way things looked.

It was a privilege, really, to be allowed into their personal spaces. Going on food inspections in the I.D., it was like walking into 3-4 different countries every day, without traveling outside the neighborhood.

Over the years, I established good relationships with the restaurant establishments. They were no longer just restaurant operators—they were mothers, fathers, grown kids. They’re not just businesses—there’s a family behind every door, people who had often gone through difficult times to be here.

And as I got to know them, I could recognize the sacrifices they made to give their children better opportunities in the U.S., and what they left behind. Even those born and raised here, you could recognize the sacrifices they were making. Continue reading

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Figuring out if a doctor is in your plan is harder than you think

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Jigsaw puzzle with one piece to add

Photo: Willi Heidelbach

By Michelle Andrews
KHN

“Is this doctor in my insurance network?” is part of the litany of questions many people routinely ask when considering whether to see a particular doctor. Unfortunately, in some cases the answer may not be a simple yes or no.

That’s what Hannah Morgan learned when her husband needed surgery last fall to remove his appendix. When they met with the surgeon at the hospital emergency department near their Lexington, Ky., home, Morgan asked whether he was in the provider network for her husband’s individual policy, which he bought on the Kentucky health insurance exchange. The surgeon assured her that he was. When she got home, Morgan confirmed that he was in network using the online provider search tool for her husband’s plan.

But when she read the explanation of benefits form from the insurer, the surgeon’s services were billed at out-of-network rates, leaving the couple on the hook for $747. Continue reading

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Obamacare Is Barely Denting Corporate Profits – Bloomberg Business

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ACA health reform logoThe Patient Protection and Affordable Care Act — otherwise known as Obamacare — is putting such a small dent in the profits of U.S. companies that many refer to its impact as “not material” or “not significant,” according to a Bloomberg review of conference-call transcripts and interviews with major U.S. employers.

via Obamacare Is Barely Denting Corporate Profits – Bloomberg Business.

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Health news headlines – February 19, 2015

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Walking_Human_Walk

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Global health news – February 19, 2015

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Globe floating in air

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Pregnant and uninsured? Don’t count on Obamacare

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Blue Pregnant BellyBy Phil Galewitz
KHN

The Obama administration often touts the health benefits women have gained under the Affordable Care Act, including the option to sign up for coverage outside of open enrollment periods if they’re “having a baby.”

But advocates complain the special insurance enrollment period begins only after a birth. As a result, uninsured women who learn they are pregnant outside of the regular three-month open enrollment period, which this year ended Sunday, can get stuck paying thousands of dollars for prenatal care and a delivery — or worse, going without  care.

The special insurance enrollment period begins only after a birth.

The advocacy groups, including the March of Dimes, Planned Parenthood and Young Invincibles, are asking the administration to allow women to sign up whenever they become pregnant – a change opposed by the insurance industry. They say they’ve sought the change unsuccessfully for several years. Continue reading

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Even with insurance you can get hit with big medical bills

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Twenty-dollar bill in medicine bottleBy Julie Appleby
KHN

After Pam Durocher was diagnosed with breast cancer, she searched her insurer’s website for a participating surgeon to do the reconstructive surgery.

Having done her homework, she was stunned to get a $10,000 bill from the surgeon.

“I panicked when I got that bill,” said the 60-year-old retired civil servant who lives near Roseville, Calif.

Like Durocher, many consumers who take pains to research which doctors and hospitals participate in their plans can still end up with huge bills.

Sometimes, that’s because they got incorrect or incomplete information from their insurer or health-care provider.

“It’s not fair and probably not legal that consumers be left holding the bag when an out-of-network doctor treats them.”

Sometimes, it’s because a physician has multiple offices, and not all are in network, as in Durocher’s case.

Sometimes, it’s because a participating hospital relies on out-of-network doctors, including emergency room physicians, anesthesiologists and radiologists.

Consumer advocates say the sheer scope of such problems undermine promises made by proponents of the Affordable Care Act that the law would protect against medical bankruptcy.

“It’s not fair and probably not legal that consumers be left holding the bag when an out-of-network doctor treats them,” said Timothy Jost, a law professor at Washington and Lee University. Jost said it’s a different matter if a consumer knowingly chooses an out-of-network doctor.

Strategies to protect yourself from surprises. Continue reading

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