Global health news – October 7

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Making hard decisions: WSU President Elson Floyd on splitting up with UW – Puget Sound Business Journal

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elson-floyd-wsu-president*304xx2996-4494-299-0Q: What brought about the decision to split up?

A: It was the view of the UW that in order to continue our participation in the WWAMI program we had to be “100 percent in,” and that was the term that was used by UW. And by that they meant we could not continue in the WWAMI program while pursuing aspirations to have a second medical school in the state.

via Making hard decisions: WSU President Elson Floyd on splitting up with UW – Puget Sound Business Journal.

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Mercer Island boil-water advisory remains in effect

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Mon Oct 6, Noon – For the fourth day in a row, the City of Mercer Island announces that the latest water-sample test results are clear: all 18 of the samples revealed no presence of E. Coli or Total Coliform.

This includes seven samples collected with permission from residential properties. A map of the locations is available at: www.mercergov.org/files/Boil-Water_Public_Map_SampleSites_IGS.pdf

As elevated chlorination spreads ever further through the water mains, and ongoing investigative work continues to rule out many possible sources of water contamination, the multi-agency task force is now discussing the threshold needed to return to normal operations.

We need to finish the super-chlorinating process and implement our Response Plan to the point where we have either found the source or ruled out enough possibilities to feel sufficiently confident that if E. coli once existed in our system, it is now gone due to the various measures we have at this time however, the boil-water advisory is still in place.

Yesterday, Public Health – Seattle & King County reported a potential case of E. Coli infection in an Island resident; the patient has not been hospitalized.  Lab tests are still pending, and it is not possible to say whether there is any link to Mercer Island water at this point.

To report illness to Public Health, residents should call 206-296-4774.

Mercer Island School District plans to continue a regular school schedule using “heat and eat” food and special water procedures, approved by Public Health – Seattle & King County. Unless otherwise notified, parents should visit the school’s website (www.mercerislandschools.org) for the latest information. Continue reading

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Harborview volunteers to care for Ebola patients should need arise

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HarborviewFrom Washington State Department of Health

Harborview Medical Center has volunteered to become one of the hospitals willing to consider receiving U.S. patients evacuated from Western Africa for treatment of Ebola.

The decision follows the Centers for Disease Control and Prevention’s request last week to find hospitals around the country that could treat citizens who have been on the frontlines of the international crisis.

“Consistent with Harborview Medical Center’s mission and role of serving the public in Seattle, King County and our region, we’re willing to consider accepting U.S. residents who may be infected with Ebola,” said Dr. Timothy Dellit, associate medical director of the Seattle hospital. “It will depend on the hospital’s current capacity and our ability to maintain our critical functions.”

There are no patients with Ebola in Washington, and there are no plans to evacuate patients to the region in the near future.

There are no patients with Ebola in Washington, and there are no plans to evacuate patients to the region in the near future. However, the hospital and state and local health officials are ready. Continue reading

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States negotiate for better drug prices

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Because of skyrocketing prescription drug prices, some state Medicaid programs and prison systems are limiting certain drugs to only the sickest patients. Some states are negotiating better pricing.

By Michael Ollove
Stateline

Twenty-dollar bill in medicine bottleThe new hepatitis C drug Sovaldi promises a cure rate of well over 90 percent, compared to 45 percent (at best) for older drugs. But when Sovaldi went on the market earlier this year for as much as $84,000 for a single course of treatment, critics blasted the cost as “exorbitant” and “gouging.”

It is estimated that between 3.2 million and 5.2 million Americans have hepatitis C, an infectious illness that can eventually compromise the liver.

The disease falls disproportionately on the poor and the incarcerated, which makes it a particular challenge for Medicaid, the federal-state health plan for the poor, and for state prison systems.

One study by Express Scripts, a drug benefits management company, estimated it would cost states $55 billion to provide Sovaldi to all prisoners and Medicaid beneficiaries with hepatitis C.

Because of its high cost, some state Medicaid programs and prison systems are refusing to provide Sovaldi to any but the sickest patients. Most recently, Oregon last month threatened to limit access to the drug unless it can get Sovaldi at a deeply discounted price.

“Sovaldi is a seminal event,” said Matt Salo, executive director of the National Association of Medicaid Directors. “It’s clear that states are not equipped to handle this. They simply do not have the tools to maintain control.”

But Sovaldi is only the beginning. Expensive new treatments for certain cancers, rheumatoid arthritis and other conditions also have rattled Medicaid officials, patients and health care providers.

What can states do to hold down drug costs? Drug pricing is a complicated and opaque process. Here are some of the basics.

Question: Is each state Medicaid program on its own when it comes to drug pricing?

Answer: Not completely. The federal Omnibus Budget Reconciliation Act of 1990 mandates that drug makers give all Medicaid programs a 23 percent rebate off the Average Manufacturers Price (AMP) for all prescription drugs purchased, or the difference between the AMP and the best price given to a private payer. (Prisons aren’t covered by this discount provision and have to negotiate drug prices as any retailer does.)

In return for the rebates, Medicaid programs must carry all drugs approved by the U.S. Food and Drug Administration on their “formularies,” which is the list of the medications each health plan will pay for.  That guarantee means that the drug makers get access to substantial markets in all 50 states and the District of Columbia. Continue reading

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Wal-Mart adds in-store program to help customers compare insurance offerings – The Washington Post

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Walmart logoWal-Mart is teaming with DirectHealth.com, an online insurance comparison site and independent health insurance agency, to set up counters in its stores where consumers can talk to licensed agents about plan options.

via Wal-Mart adds in-store program to help customers compare insurance offerings – The Washington Post.

 

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Obamacare Enrollment: Second year a tougher challenge

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Miles Alva 176

This KHN story also ran in wapo

LOS ANGELES — As states gear up for round two of Obamacare enrollment next month, they have their sights set on people like Miles Alva.

Alva, 28, works part-time at a video store and is about to graduate from Cal State Northridge. Getting insured is about the last thing on his mind.

“It’s not a priority,” the television and cinema arts student said. “I am not interested in paying for health insurance right now.”

The second round of enrollment under the nation’s Affordable Care Act promises to be tougher than the first. Many of those eager to get covered already did, including those with health conditions that had prevented them from getting insurance in the past.

About 30 million to 40 million people remain uninsured in the United States.

About 30 million to 40 million people remain uninsured in the United States, according to various surveys.

“When you look at those who remain uninsured, they are in many ways harder to reach,” said Anne Filipic, president of Enroll America, a nonprofit group that signs up consumers for new health coverage. “This is really about doubling down and reaching those folks who didn’t get the message the first time.” Continue reading

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Health news headlines – October 6

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Global health news – October 6th

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Mercer Island boil-water advisory remains in place

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City Reveals Sunday Test Results and Next Actions
Boil-Water Advisory Still in Place

Drinking Water WarningSun Oct 5, 12:15 pm – The City of Mercer Island announces that the latest test results from water samples collected Saturday have been analyzed and are clear: all 18 of the samples revealed no presence of E. Coli or Total Coliform.

This includes seven samples collected with permission from residential properties.

Today’s test results mark the third day of samples free of contamination; at this time however, the boil-water advisory is still in place.

This morning, Public Health – Seattle & King County reported a potential case of E. Coli illness infection in an Island resident; the patient has not been hospitalized.

At this point, it is not possible to say whether there is any link to Mercer Island water; lab tests are pending. Contact Public Health for more information.

The City and WA State Department of Health continue to review implementation of the response plan and water quality test results in order to determine the earliest that the boil-water advisory can be lifted safely.

Mercer Island School District plans to continue a regular school schedule using “heat and eat” food and special water procedures, approved by Public Health – Seattle & King County. Unless otherwise notified, parents should visit the school’s website (www.mercerislandschools.org) for the latest information. Continue reading

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Possible case of E. coli in Mercer Island resident

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Not definitively linked to water or any specific source

Public Health – Seattle & King County has received a report of a Mercer Island child with presumptive E. coli O157 infection.  

Escherichia Coli_NIAID E Coli Bacteria

The result will be confirmed by the Washington State Public Health Laboratory next week.  At this point it is not possible to say whether there is any link between this case and the Mercer Island water system.

E. coli O157 infection is not uncommon in King County, averaging between 20-30 cases each year. The source of most of these E. coli cases is typically never identified.

“We don’t know whether the infection in this child was caused by the water on Mercer Island,” said Dr. Meagan Kay, Medical Epidemiologist for Public Health – Seattle & King County. “E.coli comes from a variety of sources including ground beef, unpasteurized milk and cheese, and produce. We may never be able to definitively link this case to a particular source.”

The child is not hospitalized.  It is not possible to definitively link this possible case of E. coli infection to water on Mercer Island because the child had multiple possible exposures, including water from the Mercer Island system and foods that can be contaminated with the bacteria. If additional cases due to the same exposure occur, the likelihood of identifying the source increases.

Public Health will continue to monitor for gastrointestinal illness in the community  and reminds health providers to promptly report cases or clusters of suspected E. coli infection as well as other notifiable enteric infections. Continue reading

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One proton center closes, but that doesn’t slow new construction

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proton therapy baltimore 300

In this May 2013 photo, construction continues at the Maryland Proton Treatment Center. (Photo by Jenny Gold/KHN).

This KHN story also ran on NPR

Proton therapy has been touted as the next big thing in cancer care. The massive machines, housed in facilities the size of football fields, have been sprouting up across the country for a decade.

There are already 14 proton therapy centers in the U.S., and another dozen facilities are under construction even though each can cost $200 million to build.

But Indiana University shocked experts who watch the industry last month when it announced that it plans to close down its facility in Bloomington, as reported by Modern Healthcare.

“I never thought that in my lifetime I would see a proton center close,” says Amitabh Chandra, a professor at Harvard’s Kennedy School of Government who studies the cost of American medical care.

He’s surprised because until now, industry growth has been entirely in the other direction, even though there’s little evidence that proton therapy is better than standard radiation for all but a few very rare cancers.

“But we do know it is substantially more expensive and substantially more lucrative for physicians and providers to use this technology,” Chandra says.

In the Washington, D.C., area alone, three proton therapy centers are under construction — one at Johns Hopkins Medicine Sibley Memorial Hospital, another at MedStar Georgetown University Hospital, and a third, the Maryland Proton Treatment Center, is slated to open at the University of Maryland in Baltimore next year.

All three say they are continuing to build their centers, despite the news out of Bloomington. In email statements, two said that the larger population of the DC-Baltimore area can support a proton facility better than a small city like Bloomington. The third said it’s building a smaller, one room center that will be more cost effective.

Proton Therapy Baltimore 2 300

Dr. Minesh Mehta, medical director of the Maryland Proton Therapy Center stands with Dr. William F. Regine, radiation oncologist at the University of Maryland and James DeFilippi, vice president of project development at the construction site of the Maryland Proton Treatment Center in this May 2013 photo (Photo by Jenny Gold/KHN).

But in Indiana, a review committee determined that it just wasn’t worth spending the money that would be necessary to update their proton facility.

One reason for the closure is that insurers have been refusing to cover the treatment for common diseases such as prostate and breast cancer.

Cigna, for example, only covers proton therapy for a single rare eye cancer, says Dr. David Finley, the insurer’s national medical officer.

“When it’s used, however, for all other tumors, it’s not been shown to be any more effective than other forms of radiation therapy,” says Finley.

Proton beam therapy costs three to six times as much as standard radiation therapy for illnesses like prostate cancer, according to Finley. He adds that when insurers pay for expensive care that isn’t any better than the cheaper options, it can increase the cost of everyone’s health care.

“We said if two services offer the same result and one is much more expensive than the other one, we’re only going to pay for the one that is less expensive,” Finley says.

Other major insurers have also limited what they’ll cover with proton therapy, including Aetna and Blue Shield of California.

One health care payer that has not put any restrictions on proton therapy is Medicare. And Medicare pays much more for the treatment than it pays for standard radiation therapy.

“That’s the problem with Medicare payment policy,” says Harvard’s Chandra, “it not only covers treatments that are dubious treatments, it also covers dubious treatments extremely generously.”

But the doctors and researchers involved with building new proton beam facilities don’t think the treatment is dubious. They point to proton therapy’s potential to kill cancer without damaging surrounding tissue, and they say that it’s just a matter of time before clinical trials prove that proton therapy is worth the extra money.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

khn_logo_lightKaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

 

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Medicare fines hospitals with high readmission rates

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Medicare is fining a record number of hospitals – 2,610 – for having too many patients return within a month for additional treatments, federal records released Wednesday show.

Even though the nation’s readmission rate is dropping, Medicare’s average fines will be higher, with 39 hospitals receiving the largest penalty allowed, including the nation’s oldest hospital, Pennsylvania Hospital in Philadelphia.

The federal government’s penalties, which begin their third year this month, are intended to jolt hospitals to pay attention to what happens to their patients after they leave.

Last year, nearly 18 percent of Medicare patients who had been hospitalized were readmitted within a month.

Around the country, many hospitals are replacing perfunctory discharge plans—such as giving patients paper instructions—with more active efforts, such as ensuring that outside doctors monitor their recoveries and giving supplies of medication to patients who may not be able to afford them.

Others are still struggling to meet the new expectations. Before the program, some hospitals resisted such efforts because they weren’t paid for the services, and, in fact, benefited financially when a patient returned. Continue reading

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Is Texas Prepared for a Public Health Emergency? – Kaiser Health News

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200px-Flag-map_of_TexasState officials say Texas’ response teams are well-equipped to handle these cases and other potential public health crises. But the surge of recent threats here is raising questions from public health experts, who say they are worried about the state’s capacity to deal with more contagious diseases as they arise.

via Is Texas Prepared for a Public Health Emergency? – Kaiser Health News.

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Global health news – October 3rd

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Globe floating in air

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