<![CDATA[NBC New York - Health News - [NY Feature Page] Health]]>Copyright 2017http://www.nbcnewyork.com/news/healthen-usSun, 28 May 2017 03:42:32 -0400Sun, 28 May 2017 03:42:32 -0400NBC Local Integrated Media<![CDATA[Doctors in Brazil Using Fish Skin to Help Burn Victims]]>Fri, 26 May 2017 16:17:01 -0400http://media.nbcnewyork.com/images/213*120/DIT_NAT_FISH_BANDAGES_052617_1-149582887236800001.jpg

Doctors in Brazil are using skin from farm-raised tilapia to heal burn victims. According to the doctors, the tilapia skin can cut down on the painful process of changing bandages and can actually help heal wounds faster than traditional bandages.]]>
<![CDATA[How the GOP Bill Could Affect 'Essential Health Benefits']]>Thu, 25 May 2017 12:42:06 -0400http://media.nbcnewyork.com/images/213*120/Congressional-Budget-Office-HR-1628.jpg

If the Republican health reform plan becomes law, states trying to save money on health insurance are likely to seek cuts on services like maternity care, mental health and dentist visits for kids, the Congressional Budget Office found Wednesday.

NBC News reports that health care advocates find the lack of an "essential health benefits" coverage requirement in the bill, passed by the House before the CBO score was released, will leave many patients without adequate coverage.

"Women and their families will pay higher costs and receive less coverage, especially for maternity care, under the American Health Care Act," said Stacey Stewart, president of the March of Dimes, which funds research to prevent birth defects.

Essential benefits requirements from "Obamacare" are very popular with American voters. The CBO predicted that some states will opt out of them, so they can seek lower premiums, leaving some people living there likely priced out of the market.



Photo Credit: CBO]]>
<![CDATA[Marijuana Extract Helps Some Kids With Epilepsy: Study]]>Wed, 24 May 2017 19:24:49 -0400http://media.nbcnewyork.com/images/213*120/marijuanageneric_1200x675.jpg

A medicine made from marijuana, without the stuff that gives a high, cut seizures in kids with a severe form of epilepsy in a study that strengthens the case for more research into pot's possible health benefits.

"This is the first solid, rigorously obtained scientific data" that a marijuana compound is safe and effective for this problem, said one study leader, Dr. Orrin Devinsky of NYU Langone Medical Center.

He said research into promising medical uses has been hampered by requiring scientists to get special licenses, plus legal constraints and false notions of how risky marijuana is.

"Opiates kill over 30,000 Americans a year, alcohol kills over 80,000 a year. And marijuana, as best we know, probably kills less than 50 people a year," Devinsky said.

The study was published Wednesday by the New England Journal of Medicine.

For years, desperate patients and parents have argued for more research and wider access to marijuana, with only anecdotal stories and small, flawed studies on their side. The new study is the first large, rigorous test — one group got the drug, another got a dummy version, and neither patients, parents nor doctors knew who took what until the study ended.

It tested a liquid form of cannabidiol, one of marijuana's more than 100 ingredients, called Epidiolex. It doesn't contain THC, the hallucinogenic ingredient, and is not sold anywhere yet, although its maker, GW Pharmaceuticals of London, is seeking U.S. Food and Drug Administration approval.

The company paid for, designed and helped run the study, and another doctor involved in the study has related patents.

Patients in the study have Dravet (drah-VAY) syndrome , a type of epilepsy usually caused by a faulty gene. It starts in infancy and causes frequent seizures, some so long-lasting they require emergency care and can be fatal. Kids develop poorly, and their mental impairment seems related to the frequency of seizures — from 4 to as many as 1,717 a month in this study.

Allison Hendershot's 12-year-old daughter Molly was four months old when she had her first. It lasted an hour and a half, and emergency room doctors medically induced a coma to stop it. Molly, who lives in Rochester, New York, has tried more than half a dozen medicines and a special diet, but her seizures continued.

"We literally could not count how many" before she started in the study, her mom said.

It included 120 children and teens, ages 2 to 18, in the U.S. and Europe. They took about a teaspoon of a sweet-smelling oil twice a day (drug or placebo) plus their usual anti-seizure medicines for 14 weeks. Their symptoms were compared to the previous four weeks.

Serious seizures with convulsions dropped from around 12 a month to about six for those on the drug and did not change in the others. Three patients on the drug became seizure-free during the study.

It's no panacea, though. Diarrhea, vomiting, fatigue, sleep problems and other issues were more frequent in the drug group. Twelve patients quit the study — nine on the drug and three in the placebo group.

Hendershot thinks her daughter got the dummy medicine because they saw no change in her seizures until the study ended and all participants were allowed to try the drug.

By the second day they saw a difference, and "she went seizure-free for two months. It was pretty remarkable," Hendershot said.

The fact the drug came from marijuana "did not matter to me at all," she said. "If it helps, we're happy. I think people hear 'cannabis' or that it comes from marijuana and immediately there's a stigma attached to it."

For those who swear marijuana helped them, "anecdote has been confirmed by data," Dr. Samuel Berkovic writes in a commentary in the medical journal. He is an epilepsy researcher at the University of Melbourne in Australia, where medical marijuana was legalized last year, and has worked with Devinsky in the past.

The drug is being tested in a second large study in kids with Dravet syndrome, and in studies of some other types of epilepsy.


Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[How to Identify Heat Stroke]]>Tue, 23 May 2017 17:26:07 -0400http://media.nbcnewyork.com/images/213*120/DIT_NAT_HEAT_STROKE_GUIDE_052417_1-149557390684400001.jpg

With summer here, it's important to know the dangers of high temperatures. Heat stroke can be dangerous. Here are some ways you can identify heat stroke and what you should do when you see some of its symptoms.]]>
<![CDATA[Researchers Discover 40 More Genes for Intelligence ]]>Mon, 22 May 2017 16:30:11 -0400http://media.nbcnewyork.com/images/213*120/brain_1200x675.jpg

Researchers found 40 new genes linked with intelligence Monday in study, but they say their finding doesn't show any clear genetic pattern for intelligence, NBC News reported. 

Instead, it shows that intelligence is possibly even more complex than anyone thought, and not easily explained. And it means specially designed smart babies are not in anyone's near future.

The study pointed to 52 genes that influence intelligence, some of them previously identified. Yet they account for less than 5 percent of the variation in human intelligence, the research team reports in the journal Nature Genetics.

Many of the genes have other known roles as well, although most are involved in brain development, the international team of researchers found.



Photo Credit: Getty Images]]>
<![CDATA[NBC 4 New York & NY Giants Health & Fitness Expo]]>Thu, 07 May 2015 18:17:38 -0400http://media.nbcnewyork.com/images/225*120/300x160_HFE.jpg]]><![CDATA[Kids Under 1 Shouldn't Drink Fruit Juice: Pediatrician Org.]]>Mon, 22 May 2017 18:20:50 -0400http://media.nbcnewyork.com/images/217*120/juicegeneric.jpg

Fruit juice, long recommended as a source of vitamin C for children, has no nutritional value for kids under 1 year old and isn't as good as fresh fruit for other kids, according to a leading pediatrician group.

The American Academy of Pediatricians recommends that babies not be fed any fruit juice in the first year of their lives, according to a policy statement released Monday. One-hundred percent fresh or reconstituted juice can be gradually introduced into toddlers' diets, but kids up to 18 should drink at most one cup of it per day.

Fruit juice is lacking in the protein and fiber that is found in fruits, according to the recommendations, being published in the June issue of Pediatrics. That can lead to too much or too little weight gain.

"Parents may perceive fruit juice as healthy, but it is not a good substitute for fresh fruit and just packs in more sugar and calories," said Melvin B. Heyman, co-author of the policy, in a statement. "Small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under 1."

It's the first change in the academy's recommendations for 16 years, according to the statement.

Fruit drinks do not have the same value as fruit juice, the pediatricians note, and doctors may prescribe fruit juice in some instances.

The Juice Products Association on Monday saying "U.S. juice manufacturers have long supported the nutrition guidelines of the American Academy of Pediatrics and we agree with the AAP’s recommendation that 100% fruit juice, in both fresh and reconstituted forms, 'can be a healthy part of the diet of children older than 1 year when consumed as part of a well-balanced diet.'

"Further, juice manufacturers are aligned with the AAP’s recommendations regarding fruit juice consumption by infants. These guidelines were first published in Pediatrics in July 2015," the statement said.  



Photo Credit: Getty Images, File]]>
<![CDATA[New Guidelines Issued on How Much Juice Is Too Much for Kids]]>Mon, 22 May 2017 17:24:59 -0400http://media.nbcnewyork.com/images/213*120/baby-generic-new.jpg

Children younger than the age of 1 should not have any fruit juice — apple, pear, grape or otherwise — in their diets, according to new guidelines from the American Academy of Pediatrics. 

The academy says that while some fortified fruit juices may provide vitamins, they lack the fiber and protein critical for growth and can lead to excessive weight gain and tooth decay. 

The policy statement released Monday and published in the June issue of the journal "Pediatrics," is the first change in recommendations on fruit juice since 2001. The 2001 policy, reaffirmed in 2006, recommended no fruit juice for kids younger than 6 months, 4 to 6 ounces daily for children between ages 1 and 6 and 8 to 12 ounces for kids 7 and older. 

"Since then, however, considerable concern has been expressed about increasing obesity rates and risks for dental caries," the statement says. 

The new policy advises parents give no juice at all to children before age 1 unless "there is a strong clinical basis for it in the management of constipation." The threshold has also increased: a maximum of 4 ounces daily for kids 1 to 3, 4 to 6 ounces for children ages 4 to 6 and 8 ounces for children 7 and older. Rather than juice, AAP says parents should give their children whole fruits and emphasize water and milk. 

"The policy clarifies that there is virtually no role for juice during the first year of life and that expensive juice products designed specifically for infants are not of value," the AAP statement said. "When juice is served to older toddlers, it is important that it not be sipped throughout the day or used to calm an upset child."



Photo Credit: Getty Images]]>
<![CDATA[Teen With Measles May Have Exposed Others in New Jersey]]>Sat, 20 May 2017 00:16:36 -0400http://media.nbcnewyork.com/images/214*120/Measles_Generic_722x406_19018080101.jpg

A teenager who visited the U.S. while infected with measles may have exposed others to the highly contagious disease during his or her stay at a hotel and a hospital in Bergen County, the New Jersey Dept. of Health said Friday.

The 16-year-old was vacationing in the U.S. between May 12 and May 15, officials said.

The teen stayed at the Ramada Rochelle Park on West Passaic Street from May 12 to May 13, and was hospitalized at The Valley Hospital in Ridgewood from May 13 to May 15.

The Valley Hospital is contacting people who may have been exposed to the disease, which is spread through the air, mucus and saliva.

People in contact with the teen could develop symptoms as late as June 5, officials said.

Symptoms of measles include rash, high fever, cough, runny nose and red, watery eyes.

The disease can cause serious complications such as pneumonia and swelling of the brain. Measles infection in a pregnant woman can lead to miscarriage, premature birth or a low-birth-weight baby.



Photo Credit: File photo]]>
<![CDATA[Diarrhea-Causing Parasite on Rise in US Swimming Pools: CDC]]>Fri, 19 May 2017 23:26:24 -0400http://media.nbcnewyork.com/images/180*120/GettyImages-452286155.jpg

Last year saw more than twice as many outbreaks of the parasitic infection known as "Crypto," which is linked to swimming pools and water parks, than were seen two years before that, according to the Centers for Disease Control.

There were at least 32 outbreaks caused by the Cryptosporidium parasite in 2016, up from 16 in 2014, according to preliminary data published in CDC's Morbidity and Mortality Weekly Report, released Thursday.

It can spread through the feces of another person who is infected, including through pool water that's been contaminated with diarrhea, according to the CDC. Chlorine can't easily kill the parasite, meaning it can last for up to 10 days in water that is otherwise properly treated.

One mouthful of contaminated water can leave a healthy person sick with diarrhea, cramps and vomiting for up to three weeks.

"To help protect your family and friends from Crypto and other diarrhea-causing germs, do not swim or let your kids swim if sick with diarrhea," said Michele Hlavsa, chief of CDC's Healthy Swimming program, in a statement. "Protect yourself from getting sick by not swallowing the water in which you swim."

In comparison, 20 Crypto outbreaks linked to swimming were reported in 2011, 16 in 2012, and 13 in 2013. It is not clear whether the number of outbreaks has increased or whether better surveillance and laboratory methods are leading to better outbreak detection.

Crypto is the most common cause of diarrhea, illness and outbreaks linked to swimming pools or water playgrounds because it is not easily killed by chlorine and can survive up to 10 days in properly treated water.

Swallowing just a mouthful of water contaminated with Crypto can make otherwise healthy people sick for up to three weeks with watery diarrhea, stomach cramps, nausea, or vomiting, and can lead to dehydration.

The CDC provides more information here

Copyright Associated Press / NBC New York



Photo Credit: Dean Mouhtaropoulos/Getty Images for Laureus]]>
<![CDATA[States Make Move in Fight Over Health Care Reform]]>Thu, 18 May 2017 19:32:40 -0400http://media.nbcnewyork.com/images/213*120/healthcareprotests_1200x675.jpg

Democratic attorneys general in more than a dozen states announced Thursday they would attempt to intervene in a federal lawsuit that threatens to undercut funding for the Affordable Care Act.

The legal move is intended to give the states a foothold in the case that could disrupt the lives of millions of Americans.

The lawsuit was filed by House Republicans against the Obama administration and challenged the constitutionality of aid payments estimated at $7 billion this year.

The insurance subsidies help cover medical expenses for lower-income Americans.

At issue is how the Trump administration will handle the lawsuit.

Speaking in Los Angeles, California Attorney General Xavier Becerra said there is no way to predict the direction of the Trump White House in the matter.

"That unpredictability by itself, that instability in the health care marketplace, is what raises costs," he said.

Since President Donald Trump took office in January, Democratic attorneys general have repeatedly contested his administration's proposals, including on softening environmental protections.

The California Medical Association said in a statement that the health care subsidies are "crucial to ensure that low-income families can afford the cost of coverage, doctors' visits and life-saving medical treatment."

The nonpartisan Congressional Budget Office recently concluded earlier this year that insurance markets would probably be stable in most areas under the Obama-era Affordable Care Act. But Trump has predicted it "soon will explode."

Parties in the case are expected to meet next week.

In an earlier ruling, a U.S. district judge in Washington found the law does not explicitly authorize those expenditures.

The case has been on hold by mutual agreement of the House and the Trump administration. Insurers, which are legally obligated to provide assistance to qualifying customers, continue to be reimbursed by the government.

Along with California, states involved in the legal action are New York, Connecticut, Delaware, Hawaii, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Minnesota, New Mexico, Pennsylvania, Vermont and Washington state.

Copyright Associated Press / NBC New York



Photo Credit: LightRocket via Getty Images]]>
<![CDATA[Consumer Reports Ranks Top Sunscreens of 2017]]>Fri, 19 May 2017 08:17:49 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-200535755-001.jpg

If you think all sunscreens are created equal, think again.

Consumer Reports has released its annual list of top sunscreens as well as a warning about the SPF number on some bottles: If you put too much faith in them, you could be putting your skin at risk.

SPF, which stands for sun protection factor, measures how well a sunscreen guards against ultraviolet B (UVB) rays, the chief cause of sunburn and a contributor to skin cancer.

For the fifth year in a row, Consumer Reports found some sunscreens during testing failed to provide the level of protection promised on the package. In fact, of the more than 60 products tested, 23 were found to have less than half of the labeled SPF number.

The Food and Drug Administration requires manufacturers to have their products tested to determine the SPF because sunscreens are classified as over-the-counter drugs. However, the agency doesn’t routinely test sunscreens itself and manufacturers don’t have to report their results to the FDA unless the agency requests them.

According to Consumer Reports, an FDA official at a public meeting in June 2016 said the agency only had the resources for 30 employees to cover more than 100,000 over-the-counter drugs, which limits what they can do to oversee sunscreens.

"Manufacturers test sunscreens for SPF before their products hit the market, but unless they are reformulated, that may be the only testing they do. That’s one reason CR tests sunscreens," Trisha Calvo, Consumer Reports Health Editor, said.

The agency found a number of sunscreens that provide solid protection against sunburn, skin cancer and wrinkles and are also a good value.

Below are 14 recommended sunscreens that received excellent overall ratings:


  • LA ROCHE-POSAY - Anthelios 60 Melt-In Sunscreen Milk, $36
  • EQUATE (Walmart)- Sport Lotion SPF 50, $5
  • PURE - Sun Defense Disney Frozen Lotion, SPF 50, $6
  • COPPERTONE - WaterBabies Lotion, SPF 50, $12
  • EQUATE (Walmart)- Ultra Protection Lotion, SPF 50, $8
  • OCEAN POTION - Protect and Nourish, SPF 30, $8
  • AVEENO - Protect and Hydrate lotion, SPF 30, $8
  • UP and UP (Target)- Sheer Dry-Touch Lotion, SPF 30, $5
  • COPPERTONE - Clearly Sheer Lotion, SPF 50, $7
  • NEUTROGENA - CoolDry Sport Lotion, SPF 30, $9.50
  • NEUTROGENA - Ultra Sheer Dry-Touch Lotion, SPF 45, $9.50
  • HAWAIIAN TROPIC - Sheer Touch Ultra Radiance Lotion, SPF 50, $10.50
  • WELL AT WALGREENS - Baby Lotion, SPF 50, $3
  • COPPERTONE - Sport High Performance Lotion, SPF 50, $12




Photo Credit: Getty Images
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<![CDATA[Vaccine May Cut HPV Infections, an Oral Cancer Risk, in Men]]>Wed, 17 May 2017 22:54:03 -0400http://media.nbcnewyork.com/images/213*120/hpvvaccinegeneric_1200x675.jpg

The HPV vaccine that helps prevent cervical cancer in women also might lower the risk in young men of oral infections that can cause mouth and throat cancers, a new study finds.

These cancers are rising fast, especially in men, and research suggests that HPV, the human papillomavirus, is spreading through oral sex. The actor Michael Douglas brought attention to this risk several years ago when he blamed his cancer on it.

This is the first study of whether the vaccine might prevent oral HPV infections in young men, and the results suggest it can. No men who had received at least one dose were later found to have infections of HPV strains linked to cancer, but more than 2 percent of unvaccinated men had them.

"There may be additional benefits to vaccinating your son or daughter" besides the problems the vaccine already is known to prevent, said Dr. Maura Gillison of the University of Texas MD Anderson Cancer Center.

Results were released Wednesday by the American Society of Clinical Oncology ahead of presentation at its annual meeting next month.

THE VIRUS

HPV is very common — most sexually active people have been exposed to it. Some types cause genital warts. Usually, the virus causes no symptoms and goes away, but some people develop long-lasting infections of strains that can cause cancer.

The vaccine was approved in 2006 to prevent cervical cancers in women, and later, for some others including anal cancer in men. But acceptance has been slow — only about half of those eligible are getting it now, according to the latest information.

Now, awareness is growing of HPV's other risks — oral infections are blamed for 70 percent of cancers in the mouth and back of the throat. About 11,600 of these occur each year in the U.S. and rates are rising 5 percent per year. They're four times more common in men than women.

There are now more mouth and throat cancers caused by HPV in the U.S. each year than there are cervical cancers.

Oral sex is the main risk factor for getting an HPV infection in the mouth or throat, Gillison said. While "oral sex does not give you cancer," the infection in rare cases can develop into cancer over many years, she explained.

THE STUDY

She led the study, funded by the National Cancer Institute , while previously at Ohio State University. Researchers interviewed 2,627 men and women ages 18 to 33 years in a national health study from 2011 to 2014 about whether they had been vaccinated, and tested oral rinse samples from them for HPV.

Infections with worrisome HPV strains were found in far fewer people who had received any shots — an 88 percent lower risk. The results in men were striking — no infections in the vaccinated group versus 2.13 percent of the others.

The study was observational, so it can't prove the vaccine was responsible. But it may no longer be ethical to do an experiment where one group gets no vaccine, because its benefits for preventing other cancers is known. It might be possible to do such a study in people over 26, the age limit now for HPV vaccination, Gillison said. If a benefit were shown, it might lead to expanding the group for whom the vaccine is recommended.

The bottom line is that the vaccine helps, and "so few people who should be getting it are," said Dr. Richard Schilsky, chief medical officer of the oncology society who had no role in the study.

WHAT PATIENTS SAY

Scott Courville wishes it existed when he was young. The 43-year-old construction inspector from St. Martinville, Louisiana, was treated last year for HPV-related tonsil cancer that spread to lymph nodes.

"I went through 33 rounds of radiation and six rounds of chemotherapy," lost 100 pounds, and now has damaged taste buds and sinuses, and constant ringing in his ears, he said.

His three teenaged sons and stepsons are getting the vaccine.

"There was no question at all" that they would, only how soon, he said.

Tom Jackson also had an HPV-related tonsil cancer, found in 2013, and works to fight stigma over an infection that is largely sexually spread.

As a school board trustee in Houston, "I believe strongly that all children should receive all vaccinations," Jackson said. "The horror of HPV cancer is tremendous," and not to be "whitewashed" by squeamishness or reluctance to discuss prevention, he said.

THE VACCINES

The vaccines are recommended mostly for young people, ideally before they're exposed to HPV.

Merck's Gardasil is approved in the U.S. for females 9 through 26 to prevent cervical, vulvar, vaginal and anal cancers and genital warts. For males ages 9 through 26, it's approved for preventing anal cancer and genital warts. A newer version of Gardasil that includes more HPV virus types is approved for males 9 through 15.

GlaxoSmithKline's Cervarix vaccine is approved for females 9 through 25 to prevent cervical cancer.

All require two or three shots, depending on age.

Other ways to help prevent oral HPV infections are limiting the number of sex partners and not smoking. Condoms or dental dams may help.

Signs and symptoms of mouth and throat cancers may include a long-lasting sore throat, earaches, hoarseness, enlarged lymph nodes and pain when swallowing.


Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Common Lead Test May Be Wrong, FDA and CDC Say]]>Wed, 17 May 2017 15:10:59 -0400http://media.nbcnewyork.com/images/206*120/AP_551526133025.jpg

As NBC News reports, many children and pregnant women may need to get new lead tests because one of the most common lab tests may have given falsely low readings, the Food and Drug Administration said Wednesday.

The blood tests were made by Magellan Diagnostics and it's the only FDA-approved test used in most doctor's offices, the FDA said.

Any adult or child who had blood drawn for a lead test since 2014 may have to be re-tested, the FDA said.

Studies have shown many U.S. public water supplies are contaminated by lead.

Lead kills developing brain cells and the consequences are permanent. That can include lower IQ scores, poor school performance, inattention, impulsive behavior, aggression and hyperactivity.



Photo Credit: AP Photo/Carlos Osorio]]>
<![CDATA[Teen's Shocking Death Prompts New Questions About Caffeine]]>Wed, 17 May 2017 07:50:11 -0400http://media.nbcnewyork.com/images/213*120/Avoiding_Death_by_Caffeine.jpg

After a teenager died from ingesting too much caffeine, reporter Roseanne Colletti examines how much is considered dangerous.]]>
<![CDATA[Bullying Persists in School, Reports of Sex Crime Up: Study]]>Tue, 16 May 2017 09:18:08 -0400http://media.nbcnewyork.com/images/213*120/AP_17136014479847-school-bullying.jpg

One in every 5 middle and high school students has complained of being bullied at school and the number of reports of sexual assault on college campuses has more than tripled over the past decade, according to a federal study released Tuesday.

"There are areas of concern in terms of bullying and rates of victimization being high," said Lauren Musu-Gillette, one of the authors of the report by the National Center for Education Statistics and the Justice Department. "We are seeing a long term decline, but we still want people to be paying attention to areas where rates are still high."

Even though the overall prevalence of bullying has been declining in American schools over the past decade, 21 percent of students aged 12-18 reported being bullied in 2015, the report found. That was slightly below the international average.

"Bullying is a public health issue because it really affects the mental wellness and health of students and as we know at the extreme end it can lead to everything from suicide to reactive violence," said David Osher, vice president at the American Institutes for Research. "Because it happens, it doesn't mean it has to happen."

The picture was bleaker for gay, lesbian and bisexual students. Thirty-four percent of students who identified as LGBT complained of bullying, compared to 19 percent who identified as heterosexual.

"It's a high number and a disproportionate number in comparison. We still have a lot of homophobic bias and it plays itself in schools," said Charol Shakeshaft, an education professor at Virginia Commonwealth University. "Those students are singled out and isolated and harassed."

Shakeshaft lamented the Trump's administration decision earlier this year to rescind Obama-era guidance on the use of bathrooms and other facilities for LGBT students, which she said helped them feel safer. When rescinding the guidance the Education and the Justice departments said such decisions should be left to the states.

Osher said campaigns to raise awareness can only help so much in helping to fight bullying. He called for programs that build empathy and self-awareness, identity and provide support for students who have mental health problems and foster a positive climate in schools.

"If you directly focus on bullying without addressing overall issues regarding school climate, social and emotional development of students, you are likely .... to hit a ceiling," Osher said.

The report also found a significant rise in reports of sexual assault on university campuses. Such instances jumped from 2,200 in 2001 to 6,700 in 2014. Musu-Gillette cautioned however, that it is not clear from the research whether the number of actual sex crimes has increased or whether victims now feel safer reporting them to authorities.

Sexual misconduct in schools was also a problem. During the 2013-14 school year, 65 percent of public schools recorded one or more violent incidents. Less than 2 percent of those crimes were sexual battery and 0.2 percent were rape or attempted rape.

A year-long AP investigation revealed that there were about 17,000 reports of sexual assaults in high schools, junior highs and even elementary schools over a four-year period, from fall 2011 to spring 2015.

Other statistics are more encouraging, according to the government report. The number of school deaths dropped from 53 in the 2013 school year to 48 in 2014. Non-fatal incidents of violence and theft at schools are also occurring less frequently. There were 841,000 such occurrences in 2014, compared to 850,100 the previous year.

The percentage of high school students who report having been in a physical fight anywhere has decreased from 42 in 1993 to 23 percent in 2015. The percentage of students in grades 9-12 who reported carrying a weapon anywhere during the past month at the time when data was collected, fell from 22 percent in 1993 to 16 percent in 2015.

Alcohol consumption has also gone down. In 1993, 48 percent of students reported recent alcohol use, compared to 33 percent in 2015.

Black students were being disciplined more frequently than other students across the board. In 2012, 15 percent of African-American students received out-of-school suspensions, compared to 6 percent of all students.

"There is much work left to be done," said Peggy Carr, acting commissioner of the NCES. "The data show that many students do not feel safe at school and are victimized physically, verbally and emotionally."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Carolyn Thompson, File]]>
<![CDATA[Efforts to Reduce US Uninsured Stalled in 2016: CDC]]>Tue, 16 May 2017 06:13:13 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-495314721.jpg

After five consecutive years of coverage gains, progress toward reducing the number of uninsured Americans stalled in 2016, according to a government report that underscores the stakes as Republicans try to roll back Barack Obama's law.

The Centers for Disease Control and Prevention estimated that 28.6 million people were uninsured last year, unchanged from 2015. The uninsured rate was 9 percent, an insignificant difference from 9.1 percent in 2015.

The numbers, released Tuesday, suggest that the two main components of the Affordable Care Act, or ACA, were reaching their limits in Obama's final year as president. Premiums for private insurance were about to jump, and 19 states continued to refuse the ACA's Medicaid expansion. The number of uninsured could start climbing again under some of the policies now being considered by President Donald Trump and congressional Republicans.

The politically unpopular GOP bill passed narrowly by the House would limit Medicaid financing and curtail subsidies for many consumers buying their own private policies. Republicans also would repeal the requirement that most Americans carry health insurance or risk fines. The legislation would lead to an estimated increase of 24 million uninsured people within 10 years, according to congressional analysts. Under "Obamacare," there are 20 million fewer uninsured since 2010.

"It's disappointing that it's stalled out," said health economist Gail Wilensky, a Republican. "The real question is, will we be able to keep the gains that we have made?" Critical of the ACA and co-author of an alternative plan by GOP policy experts, Wilensky nonetheless supports the goal of expanding coverage. She's concerned about the impact of the House bill on Medicaid, the federal-state program for low-income and disabled people.

The latest numbers come from CDC's National Health Interview Survey, which is considered an authoritative source, and publishes findings earlier than the Census Bureau. The survey's estimates for 2016 were based on data for nearly 97,500 people.

The report validates a trend other major surveys have noted. For example, the Gallup-Healthways Well-Being Index found that the uninsured rate for U.S. adults edged up slightly during the first three months of this year, a period for which there's yet no publicly available CDC data.

"It looks like we are kind of sticking a landing and holding on to the gains," said Katherine Hempstead, who directs research on health insurance at the nonpartisan Robert Wood Johnson Foundation. "To increase coverage, you would have to see more states take up the Medicaid expansion, and some reforms to increase take-up in the individual (private) market."

Could the number of uninsured start rising again? Absolutely, say both Wilensky and Hempstead.

"This release is really timely because it just helps everybody focus on what's at stake," said Hempstead.

The report found a significant increase in the percentage of people under age 65 covered last year through government-sponsored insurance markets like HealthCare.gov. About 11.6 million (4.3 percent) had marketplace insurance in the last three months of 2016, compared with 9.1 million (3.4 percent) in the same period the previous year.

States that expanded Medicaid were more effective at reducing the number of uninsured. Of the 16 states with adult uninsured rates significantly lower than the nation as a whole, 15 expanded Medicaid. In that group, only Wisconsin had not extended coverage for low-income people.

Conversely, of the nine states that had significantly higher uninsured rates, only New Mexico expanded Medicaid.

The CDC numbers do not reflect any changes directly attributable to Trump, who took office this year on Jan. 20.

During the campaign and since then, the president has made some expansive promises about health insurance, talking of coverage for everybody and much more affordable premiums and deductibles. But Trump has also embraced a GOP bill that would make more people uninsured, even if it fulfills his campaign promise to repeal "Obamacare." And he's threatened to stop paying subsidies that reduce out-of-pocket costs such as deductibles for people with modest incomes.

Hillary Clinton, whom Trump defeated, had promised to increase government assistance for private insurance costs, and also work to convince holdout states to expand their Medicaid programs.

"This is really pre-election activity" reflected in the CDC survey, said Wilensky. "It's news because people need to know we seem to have reached a plateau." Whether that will look the same a year from now is unclear, she added.

Copyright Associated Press / NBC New York



Photo Credit: Joe Raedle/Getty Images, File]]>
<![CDATA[Senate Moderates Hold Bipartisan Health Care Talks]]>Mon, 15 May 2017 21:23:50 -0400http://media.nbcnewyork.com/images/211*120/AP_17136032403447.jpg

Moderate senators from both parties met Monday to explore whether they can work on bipartisan legislation overhauling the nation's health care system.

The evening session came as Republican senators have begun closed-door meetings aimed at crafting a GOP bill scuttling much of President Barack Obama's health care law.

With the political stakes high over health care, there seems little chance that a band of moderates from both parties would produce a package that will become the Senate's chief bill, at least until Republicans have exhausted efforts to produce their own legislation.

But Monday's meeting underscored that Democratic and Republican centrists consider it important to show home-state voters that they are seeking middle ground and are not using the issue to score partisan points.

There are already divisions between conservatives and GOP moderates over what their party's bill should look like, with the two factions clashing over issues including Medicaid cuts. Republican leaders are hoping to produce a consensus GOP bill by this summer.

Sens. Susan Collins, R-Maine, and Bill Cassidy, R-La., were organizers of Monday's meeting. Attendees included several other Republicans plus three Democrats: Sens. Heidi Heitkamp of North Dakota, Joe Manchin of West Virginia and Indiana's Joe Donnelly.

Collins told reporters the meeting was aimed at trying to "get away from the partisanship that has made it very difficult to come up with solutions."

In January, Collins and Cassidy introduced legislation that would give states the option of retaining Obama's law. As an alternative, states could enroll people in low-cost, high-deductible plans or let them purchase more expensive policies.

Cassidy said the bill he sponsored with Collins would be "a good place to start," but said senators were open to other ideas.

An aide to one Democrat who attended the session said the lawmakers discussed health care ideas in "broad strokes."

Manchin, Donnelly and Heitkamp all face re-election next year in states that Donald Trump easily carried in last November's presidential voting.

Republicans have long pledged to repeal Obama's 2010 statute and replace it with GOP policy prescriptions. The legislation is one of President Donald Trump's top priorities, and the party has little interest in easily abandoning its effort to show voters they are addressing their promise.

For their part, Democrats have refused to engage in talks with Republicans unless the GOP drops its repeal mantra and agrees to work toward adjustments in Obama's statute. Democratic leaders are in no rush to help Republicans in their drive to dismantle Obama's overhaul, which has fared poorly in public opinion surveys.

With unanimous Democratic opposition expected, Republicans holding a 52-48 Senate majority would lose if just three GOP senators oppose their party's plans. If they secure 50 Republican votes, the bill would pass because Vice President Mike Pence would break the tie.

Collins and Cassidy said they expected the bipartisan lawmakers to meet again.

Associated Press reporter Erica Werner contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: J. Scott Applewhite/AP, File]]>
<![CDATA[Trump Details Anti-Abortion Ban Over US Global Health Aid]]>Mon, 15 May 2017 20:06:02 -0400http://media.nbcnewyork.com/images/213*120/trump64.jpg

President Donald Trump is moving forward with a plan to massively expand a ban on federal dollars going to international groups that perform abortions or provide abortion information.

Senior administration officials said Monday a plan to expand the so-called "Mexico City Policy" had gone into effect. The policy would apply broadly to organizations receiving U.S. global health assistance, compared with past versions of the ban which specifically targeted international family planning groups.

In all, about $8.8 billion in funding could be impacted, far more than the $600,000 covered under the previous version of the ban, which critics call the Global Gag Rule. The expanded policy is being dubbed "Protecting Life in Global Health Assistance." The officials, who requested anonymity and were not authorized to speak on the record, said the ban would apply to groups working on HIV/AIDS, malaria, maternal and child health, reproductive issues and global health.

Officials said the new policy would be applied immediately to new funding issued and then to existing arrangements as they are amended. To receive funding, health organizations must pledge not to provide abortions or abortion information or provide support to any groups that do. There is an exemption in cases of rape, incest or when the woman's life is at risk.

Aid to national and local governments will be exempted, as is humanitarian assistance, migration aid and disaster relief. The Secretary of State could also authorize exemptions on a case-by-case basis.

Officials said there will be a comprehensive review of the impact of the changes over the next six months.

Trump reinstated the policy — a political football instituted by Republican administrations and rescinded by Democratic ones since 1984 — days after he took office, promising to expand the scope. Obama had lifted the ban when he took office in 2009.

Just how many groups will be impacted in the short term was not clear. Administration officials declined to speculate on how many organizations would not meet the new criteria. Health experts noted that in many areas, groups partner with each other to provide more services, so those relationships could come under scrutiny.

Jen Kates, director of global health and HIV policy at the non-partisan Kaiser Family Foundation, said the policy was a significant expansion compared with past Republican administrations.

"Right now there's a lot of unknowns," she said. "This is a much bigger expansion. And the U.S. role in global health has increased over time. The U.S. footprint right now is quite big in global health."

Suzanne Ehlers, president of Washington-based Population Action International which lobbies in the U.S. and developing countries for women's reproductive health, said in a statement that the change would "cause unspeakable damage to integrated care efforts across all health sectors."

"Despite the Trump administration's ludicrous rebranding of the policy, the Global Gag Rule is unmistakably deadlier than ever," said Ehlers.

Anti-abortion leader Marjorie Dannenfelser, president of the Susan B. Anthony List, welcomed the news, saying in a statement that "with the implementation of Protecting Life in Global Health Assistance, we have officially ceased exporting abortion to foreign nations."

Some critics noted that the president on Sunday released a statement marking Women's Health Week. He said "we recognize the importance of providing women access to the best, evidence-based health information and care, and growing our medical knowledge through basic and applied research support."

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Boy, 16, Dies After Drinking Large Soda, Latte, Energy Drink]]>Mon, 15 May 2017 18:07:48 -0400http://media.nbcnewyork.com/images/214*120/GettyImages-571245571.jpg

A 16-year-old South Carolina boy who collapsed in a classroom had so much caffeine over a two-hour span that it killed him, a medical examiner said Monday. 

Davis Allen Cripe died April 26 at Palmetto Health Parkridge Hospital after collapsing at Spring Hill High School. He drank a large diet soda, a latte and an energy drink in the two hours before he fell ill, Richland County Coroner Gary Watts said in a press conference Monday. 

Watts officially ruled the cause of death as a caffeine-induced cardiac event. He said Cripe had no family history that would have compounded the effects of caffeine and said the boy was otherwise healthy when he died. 

"We lost Davis from a totally legal substance," Watts said. "It was so much caffeine at the time of his death that it caused his arrhythmia."

The coroner said caffeinated drinks can be "very dangerous."

"I'm telling my friends and family: Don't drink them," he said. 

Cripe's father, Sean Cripe, attended the press conference. He said he hoped his son's death would save other lives by exposing the potential dangers of excessive caffeine.



Photo Credit: Getty Images]]>
<![CDATA[Diesel Pollution Worse Than Tailpipe Tests Estimate: Study]]>Mon, 15 May 2017 13:29:20 -0400http://media.nbcnewyork.com/images/213*120/AP_17135537263646-El-Monte-California-Emissions-Test.jpg

Pollution from diesel trucks, buses and cars globally is more than 50 percent higher than levels shown in government lab tests, a new study says.

That extra pollution translated to another 38,000 deaths from soot and smog in 2015, the researchers estimated.

The work published Monday in the journal Nature was a follow-up to the testing that uncovered the Volkswagen diesel emissions cheating scandal. Researchers compared the amount of key pollutants coming out of diesel tailpipes on the road in 10 countries and the European Union to the results of government lab tests for nitrogen oxides.

They calculated that 5 million more tons was being spewed than the lab-based 9.4 million tons. Governments routinely test new vehicles to make sure they meet pollution limits.

Experts and the researchers don't accuse car and truck makers of cheating, but say testing is not simulating real-world conditions.

"The paper shows how much human failure costs," said Jens Borken-Kleefeld, a transportation scientist at the International Institute for Applied System Analysis in Austria who wasn't part of the study.

The researchers included a team from the International Council on Clean Transportation, a nonprofit research and advocacy group, that arranged the testing that first showed VW diesel cars were rigged to cheat on emissions tests. They used previously published tests of pollutants coming from thousands of vehicles, all models, to calculate the extra pollution in 2015. Worldwide, three-quarters of that extra pollution is from trucks and buses.

Other research connects soot and smog to heart and lung diseases, with pollution killing more than 4 million people every year around the world, said lead author Susan Anenberg, a researcher at Environmental Health Analytics and a former U.S. government scientist.

The researchers calculated that the extra nitrogen oxides were responsible for about 31,400 deaths in 2015 because of tiny soot particles in the air and 6,600 deaths from extra smog. The European Union, which has mostly diesel cars, had an extra 11,500 deaths; China, 10,600; India, 9,300; and the United States, 1,100.

In Europe, new truck regulations are working and much of the excess pollution is coming from cars, said study co-author Ray Minjares of the clean transportation group.

Study authors and outside experts said the solution to the problem is stronger enforcement, regulations and testing.

"I do not find these results surprising, but they are significant because the extent of the problem has been underappreciated, and it's one that too many policymakers prefer to sweep under the rug," University of Michigan Energy Institute's John DeCicco said in an email. "So most of what is going on is not cheating but rather inadequate testing and enforcement."

Allen Schaeffer, executive director of the U.S. industry group Diesel Technology Forum, said it's impossible to design a lab test that could cover all real-world driving possibilities but industry officials and regulators are working on it.

"It's important to understand that diesel has been a technology of continuous improvement, meaning that today's generation of new diesel technology is lower in emissions and more efficient than one built 10 or even five years ago," Schaeffer said in a statement.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Nick Ut, File]]>
<![CDATA[What Namastes in Vegas: Yoga Makes Inroads in Gambling Mecca]]>Mon, 15 May 2017 09:10:31 -0400http://media.nbcnewyork.com/images/213*120/AP_17135010863731-Yoga-Las-Vegas-Casinos.jpg

Surrounded by imposing Las Vegas hotel-casinos in the foreground and desert mountains in the background, the group breathed deeply and loudly as an instructor guided them through their poses: upward dog, downward dog, lord of the dance.

The participants, though, weren't the only ones shifting positions in this mirrorless space with Instagram-enviable views.

The three women and a man were inside a cabin of the world's tallest Ferris wheel, stretching and holding poses as the marquees of The Mirage, Linq, Harrah's and Caesars Palace appeared and faded from sight.

This gambling oasis isn't known for mind-steadying experiences. But as the city broadens the range of interests and wallets it appeals to, companies have carefully selected an array of unique, picture-perfect sites where visitors and locals can say "Namaste." Call it yoga a la Vegas, and picture dolphins, helicopters, red rocks and ritzy high-rises.

"High plank, low plank, up dog, down dog," Raffi Yozgadlian said as he guided the group at the High Roller observation wheel through a series of yogi calisthenics at about 550 feet above ground.

The instructions stopped three-quarters into the class, and out came the cellphones. It was time for a few photos of handstands and other poses with the Bellagio, Cosmopolitan and an Eiffel Tower replica in the background.

"I was like, whoa. You have the Strip and you can take that in, or you have the mountains and you can take that in," said Carly Benson, a Las Vegas resident whose tripod headstand photo is now on Instagram. "I was a little concerned about how my balance was going to be, and surprisingly, being able to zone in the landscape, I had better balance there than I sometimes do on the ground."

Visitors and locals in need of their downward dog also can take classes surrounded by an outdoor installation of neon signs in the summer; by request, poolside at the MGM Grand; or on the grassy fields of a recreation area just outside the city in the shade of Red Rock Canyon National Conservation Area.

For those who prefer the indoors, the studio with floor-to-ceiling glass windows on the eighth floor of the opulent Mandarin Oriental hotel offers views of the Las Vegas Strip.

The unorthodox settings fit with a nationwide trend of yoga instruction moving out of the studio and into parks, breweries, museums and other locations. Some classes incorporate goats and butterflies.

Caesars Entertainment, which owns the High Roller, thought the Ferris wheel would be a good place for a fitness class and decided yoga was the perfect fit. Each cabin fits up to 40 people standing and in benches.

"It's a one-hour class, so it's a fulfilling practice, and whether you are a yoga enthusiast or first-timer or someone who just wants to have that amazing Instagram yoga moment here in Vegas, it presents a unique experience," said Lindsay Sanna, Caesars' senior director of marketing. The class is $75 per person.

At the Mirage, yogis of all skill levels can sign up for an hourlong class in the underwater viewing area of the dolphin tanks at Siegfried and Roy's Secret Garden and Dolphin Habitat. On a recent Friday morning, a group began the experience by taking a few breaths while sitting on their mats facing bottlenose dolphins through glass windows.

"Of course, you can pop your eyes open if you want to see the dolphins," Janet Ziter told the class, which included devoted and beginner yoga practitioners. Dolphins swam next to three windows while soothing music played.

This class, too, incorporated a mini-photo shoot. And so a guest held the crow pose — hands planted on the floor, shins resting on the back of his upper arms and feet lifted up — for a few seconds until a dolphin swam behind him and a friend snapped a photo.

Instructors with the yoga-focused company Silent Savasana teach the classes at the High Roller and also lead what's perhaps Las Vegas' most luxurious of yoga experiences: a helicopter ride from the airport to a nearby state park and a class atop bright red Aztec sandstone outcrops.

The class in a remote area of the 63-square-mile (163-square-kilometer) Valley of Fire State Park allows participants to take in a breathtaking view of bright blue skies and sandstones while flowing from pose to pose.

The exact location of the 75-minute, six-person class depends on the day's wind conditions. The experience concludes with a flight over the Las Vegas Strip.

Some may be priced out of the $3,499 experience, which includes champagne. But Maverick Helicopters, which for years has offered trips to other destinations in the U.S. Southwest, says at least six groups have participated this year.

Shandelle Troy practices yoga regularly and recently celebrated her birthday by taking the class. Outfitted with typical black yoga pants and a teal tank top, she assumed a spot close to the helicopter and a few yards (meters) from the instructor.

"Yoga is so spiritual, so being out there in nature makes it so much better," the resident of Henderson, Nevada, said between sips of bubbly.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/John Locher]]>
<![CDATA[School Districts Brace for Changes in Medicaid Distributions]]>Mon, 15 May 2017 08:06:39 -0400http://media.nbcnewyork.com/images/213*120/AP_17133202434446-health-overhaul-medicaid-schools.jpg

For school districts still getting their financial footing after the Great Recession, the Medicaid changes being advanced as part of the health care overhaul are sounding familiar alarms.

Administrators say programming and services even beyond those that receive funding from the state-federal health care program could be at risk should Congress follow through with plans to change the way Medicaid is distributed. They say any reduction in the estimated $4 billion schools receive in annual Medicaid reimbursements would be hard to absorb after years of reduced state funding and a weakened tax base.

"If they have less Medicaid money, something's going to go away," said Randy Liepa, superintendent of the Wayne County Regional Education Service Agency, which works with 33 school districts in the Detroit area. The agency covers about 21,000 children with special needs who are on Medicaid and it helps districts recoup about $30 million annually in reimbursements.

Districts would have to look at non-mandated positions and programs if forced to bear more of the costs for services for poor and disabled students required by federal law, said Thomas Gentzel, executive director of the National School Boards Association.

The Senate is up next in efforts to do away with President Barack Obama's health law, and school leaders are watching to see whether the changes advanced by the House survive. The House bill would transform the open-ended federal entitlement, which reimburses schools a percentage of the cost of the eligible services they provide to poor and disabled students, to one where reimbursements will come in a fixed, per-person amount.

But, said Kriner Cash, superintendent of public schools in Buffalo, New York, "individual student care comes with highly variable costs, especially in the case of students with disabilities." In the school district, more than 80 percent of students are low income and 22 percent have disabilities. The district gets about $2.5 million annually from Medicaid.

In March, a Congressional Budget Office estimate for an earlier version of the House bill found that federal Medicaid subsidies to states would be $880 billion less over 10 years.

President Donald Trump's administration argues that states will get more freedom to experiment with the program and make sure that people who rely on Medicaid get the care and coverage they need.

Medicaid spending is "not getting out of control because of schools, because schools are getting less than 1 percent of the dollars," said Sasha Pudelski, assistant director of policy and advocacy at The School Superintendents Association. "It's not kids who are breaking the bank."

An association survey polling 1,000 school leaders reported that schools spent two-thirds of the money to support specialists, from school nurses and social workers to speech pathologists.

The association, as part of a coalition of more than 50 school and child health advocates, warned congressional leaders in a recent letter against shifting more costs to states and in turn, local communities. They said that would lead to cuts in services and benefits to children, especially in districts with high poverty rates.

"A lot of districts have never really covered from the Great Recession, they're still in it," Gentzel said, "and some states have not restored their funding. I think it's the context of all of this that's almost as important as the story about Medicaid."

Opponents of the changes say these are potential impacts:

SCHOOL NURSES

Students needing to check their temperature or searching for a tampon may not be able to walk down the hall to see a school nurse. Health professionals such as nurses, physical therapists, speech pathologists, social workers and psychologists may be forced to rove between schools, outsourced or have some of their duties taken on by administrative staff.

"There are health barriers to students getting their education," said Donna Mazyck, executive director of the National Association of School Nurses. Individualized Education Plans mandated under federal law may require nurses to give medication and tend to feeding tubes and tracheotomies. "That service won't be done if Medicaid isn't paying for it," she said.

MENTAL HEALTH
Behavioral issues in the classroom are often addressed with counseling through social workers and psychologists. Schenectady City School District in New York, where a majority of students live in poverty, has had a dramatic increase in the number of social workers at its schools dealing with mental health issues. "They're all front-line responders to kids in crisis," Superintendent Laurence Spring said. He said they counsel kids traumatized by domestic violence and street crimes and others who experience anxiety from not having enough food at home. The district files for about $2 million in annual Medicaid reimbursements.

HEALTH SCREENINGS
When schools host campus-wide preventative screenings, for everything from vision, hearing, asthma and mental health, some costs are recouped based on the number of Medicaid-eligible students who are treated. Advocates say that vulnerable children may not have access to such preventative services outside of school, but the screenings can catch health issues before they become more serious.

Liepa, from the Detroit-area agency, said children living in poverty regularly come to school facing significant impairments to their health and with little or no support at home to address them, which ultimately affects learning. "It's no different than if they're coming in hungry, which is supported by the federal lunch program."

COMMUNITY OUTREACH
School districts often direct and assist students' families with resources, such as helping them sign up for Medicaid or referring them to an eye doctor for glasses. Some hours spent on these administrative tasks are reimbursable by Medicaid.

Poquoson City Public Schools in Virginia spend some of their $35,000 in annual reimbursements for events targeting children who aren't even in school yet, in hopes of getting families resources as early as possible. "It's a jump start for kindergarten. If we can get some services, with disabilities, at an early age, they're likely far more successful in the years with us," Superintendent Jennifer Parish said.

EQUIPMENT AND SUPPLIES
A major hit on school budgets could mean less for new or replacement equipment and supplies. That could affect things such as outfitted buses, assistive devices and other items for children with special needs so they can be in school. This could trickle down to non-mandated items such as special science lab materials or theater club costumes for general education students.

Liepa said the Medicaid money has helped school districts afford programs and operational costs, from upgrading buses to buying new textbooks, while balancing their budgets. "It's been a life-saver for school districts. It's one less thing I have to worry about or think about reducing," he said.

SPORTS, CLUBS AND ACTIVITIES
Optional but highly popular programs for students and families, such as sports, clubs and after-school activities, could be slashed, as the offerings are generally the first to go in a budget crisis.

"Most districts have long picked the low-hanging fruit in their budgets," Gentzel said.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/John Locher]]>
<![CDATA[Brazil Declares End to Zika Emergency After Fall in Cases]]>Fri, 12 May 2017 07:33:12 -0400http://media.nbcnewyork.com/images/213*120/ZIKA_AP_815397555643.jpg

Brazil declared an end to its public health emergency over the Zika virus on Thursday, 18 months after a surge in cases drew headlines around the world.

The mosquito-borne virus wasn't considered a major health threat until the 2015 outbreak revealed that Zika can lead to severe birth defects. One of those defects, microcephaly, causes babies to be born with skulls much smaller than expected.

Photos of babies with the defect spread panic around the Western Hemisphere and around the globe, as the virus was reported in dozens of countries. Many would-be travelers canceled their trips to Zika-infected places. The Centers for Disease Control and Prevention and others recommended that women who were pregnant shouldn't travel to affected areas. The concern spread even more widely when health officials said it could also be transmitted through sexual contact with an infected person.

The health scare came just as Brazil, the epicenter of the outbreak, was preparing to host the 2016 Olympics, fueling concerns the Games could help spread the virus. One athlete, a Spanish wind surfer, said she got Zika while training in Brazil ahead of the Games.

In response to the outbreak, Brazil launched a mosquito-eradication campaign. The Health Ministry said those efforts have helped to dramatically reduce cases of Zika. From January through mid-April, the Health Ministry recorded 95 percent fewer cases than during the same period last year. The incidence of microcephaly has fallen as well.

The World Health Organization lifted its own international emergency in November, even while saying the virus remained a threat.

"The end of the emergency doesn't mean the end of surveillance or assistance" to affected families, said Adeilson Cavalcante, the secretary for health surveillance at Brazil's Health Ministry. "The Health Ministry and other organizations involved in this area will maintain a policy of fighting Zika, dengue and chikungunya."

All three diseases are carried by the Aedes aegypti mosquito.

But the WHO has warned that Zika is "here to stay," even when cases of it fall off, and that fighting the disease will be an ongoing battle.

Adriana Melo, the Brazilian doctor who raised alarm bells in the early days of the outbreak about a link between Zika and birth defects, said the lifting of the emergency was expected following the decline in cases.

"The important thing now is that we don't forget the victims," Melo said.

Copyright Associated Press / NBC New York



Photo Credit: AP, File]]>
<![CDATA[Patients Beg for Pricey Drugs on Facebook Black Market]]>Thu, 11 May 2017 16:28:31 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-141926979.jpg

Desperate patients are swapping pricey pharmaceutical drugs on Facebook, NBC News reported.

NBC News searched Facebook and found postings to trade insulins, EpiPens, asthma inhalers and other prescription medications.

"If it weren't for the online diabetes community I would be dead," said Amy Leyendecker, a 43-year-old medical transcription student from Kentucky living with Type-1 diabetes who requires daily doses of insulin to stay alive.

Doctors say patients like Leyendecker take a big gamble.

"Patients can put themselves in grave danger by using insulin 'traded' online," said Dr. Joshua Miller, medical director of diabetes care at Stony Brook Medicine, running the risk of infection, or fluctuating blood sugar levels if the insulin was expired or stored incorrectly.



Photo Credit: John Moore/Getty Images]]>
<![CDATA[Aetna Drops Last 2 State Markets Under Affordable Care Act]]>Thu, 11 May 2017 15:17:51 -0400http://media.nbcnewyork.com/images/213*120/AP_16229419820877.jpg

While Republicans rewrite the Affordable Care Act in Washington, the future of the current law has grown hazier with the nation's third-largest health insurer completely divorcing itself from state-based insurance markets.

Aetna said late Wednesday that it won't sell individual coverage next year in its two remaining states — Nebraska and Delaware — after projecting a $200 million loss this year. It had already dropped Iowa and Virginia for next year. The insurer once sold the coverage in 15 states, but slashed that to four after losing about $450 million in 2016.

The government-backed marketplaces are a pillar of the Obama-era federal law because they allow millions of people to buy health insurance with help from income-based tax credits. But insurers like Humana, and now Aetna, have been fleeing that market, and the remaining coverage options are growing thin. Other companies like the Blue Cross-Blue Shield insurer Anthem say they are wary of returning without a guarantee that the government will provide cost-sharing subsidies that reduce expenses like co-payments. Those are separate from the tax credits that help pay premiums.

The White House has assured lawmakers it will continue paying the subsidies, but it has offered no long-term guarantee.

About 12 million people bought coverage for this year on the exchanges, and every market had at least one insurer offering coverage. But a growing number were down to one.

Companies are in the middle of figuring out their prices and coverage plans for next year, and insurance experts expect some holes to develop in those marketplaces.

"All it takes is one insurance company to exit, and that can create panic for other insurers and they pull out too," said Cynthia Cox, a health insurance expert for the nonprofit Kaiser Family Foundation, which studies health care. "Insurers don't want to be the last one holding the bag."

The federal law prevents insurers from rejecting patients based on their health, so if competitors pull out, the last insurer may be left covering all the high-cost patients in that market.

Metropolitan or highly populated areas are still expected to draw several insurers. But rural areas may not be attractive to insurers looking to cut losses. They generally have a smaller, older population.

Ultimately, insurers with the most common brand in health insurance, Blue Cross-Blue Shield, will decide the fate of the marketplaces. Many of those plans specialize in individual insurance and have a long-standing presence in their markets. They also are the only remaining option on exchanges in nearly a third of the nation's more than 3,100 counties.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Jessica Hill, File]]>
<![CDATA[Buzz Kill: California Police Work to Detect Drugged Drivers]]>Thu, 11 May 2017 12:48:28 -0400http://media.nbcnewyork.com/images/213*120/AP_17130735362057.jpg

Police in three California counties are testing what amounts to a breathalyzer for drug users — a device that some authorities and lawmakers said Wednesday is desperately needed now that voters have legalized recreational marijuana in the state.

When legalization takes full effect next year, California will become the world's largest market for pot.

Yet California is among the states with legalized marijuana that are struggling to find a reliable test and gauge for marijuana impairment that can stand up in court and lead to convictions.

Law enforcement and academic experts say settling on such a test is complicated because drugs affect everyone differently and there is wide variation in the potency of pot and other drugs and the way they are consumed. As a result, there is no consensus on what level amounts to impairment.

The demonstration of the testing device Wednesday outside the California Capitol involved a Sacramento police officer using a cheek swab to collect saliva from another officer posing as a suspect.

The swab was then plugged into a walkie-talkie-sized device that shows within five minutes whether any of six drugs are present in saliva.

The equipment has been tested in Kern, Los Angeles and Sacramento counties under a law sponsored by Assemblyman Tom Lackey, a Palmdale Republican.

"We want this to become statewide," Lackey said.

California Highway Patrol Sgt. Glen Glaser, who coordinates the patrol's drug recognition expert program, said there are too many variables to rely on a saliva or breath test.

"The science is still developing," he said. "The mere presence of a drug should not make a person feel like they're subject to arrest if they're not impaired."

In addition, prosecutions are more difficult because there is no presumed level of drug intoxication in California, unlike the 0.08 percent blood alcohol level at which drivers are presumed drunk.

Michigan and Vermont recently authorized the tests that are also used in some other states and nations, according to Lackey's office.

Lackey, a former California Highway Patrol member, unsuccessfully carried a bill two years ago that would have allowed police to use such "oral fluid" devices to test for drugs in much the same way officers currently use breathalyzers to test drivers' blood-alcohol level.

Suspects are currently free to refuse to take the drug tests.

Police mainly rely on field sobriety tests if they suspect a driver is under the influence of alcohol or drugs. While drunken driving tests mainly test physical skills, drugged driving screening also looks for cognitive changes.

For instance, suspects are told to tip back their heads and estimate when 30 seconds have passed; some drugs make time seem to slow down while others produce the sensation that time has accelerated, Glaser said.

The state Assembly last month unanimously approved a bill requiring the CHP to create a task force to recommend best practices, policies and legislation involving tests for drugs. The bill now goes to the Senate.

Fred Delfino, product manager for Alere Toxicology, said the company's device demonstrated Wednesday has an accuracy rate of 95 percent, enough to identify which drivers should be required to provide blood samples to show the actual level of intoxication.

More California police departments are using the saliva tests after a Kern County judge last year accepted the results as admissible evidence in a drugged driving case, said Lauren Michaels, marijuana and drunken driving policy expert for the California Police Chiefs Association.

The CHP and other agencies are cooperating with the Center for Medicinal Cannabis Research at the University of California, San Diego, as part of a two-year, $1.8 million study.

The center is analyzing and trying to improve the tests used by human drug-recognition experts and the saliva testing.

Researchers also are trying to learn if there is a particular level of marijuana intoxication that impairs driving, said Thomas Marcotte, the study's chief investigator and co-director of the research center.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Rich Pedroncelli]]>
<![CDATA[Study Identifies Root Cause of Gray, Balding Hair]]>Thu, 11 May 2017 09:51:42 -0400http://media.nbcnewyork.com/images/213*120/gray+hair+study+ut+southwestern.jpg

Scientists in North Texas have identified the cells that cause hair to turn gray and to go bald – findings that could one day help identify possible treatments.

Researchers from the University of Texas Southewestern Medical Center accidentally stumbled upon the discovery while studying a rare genetic disease that causes tumors to grow on nerves. 

"When we saw the mice that we were expecting to form a tumor turned gray, we were really excited!" said Dr. Lu Le, an associate professor of dermatology at UT Southwestern.

The researchers found that a protein called KROX20, more commonly associated with nerve development, switches on in skin cells that become the hair shaft.

These hair cells then produce another protein called stem cell factor (SCF). In mice, these two proteins turned out to be important for baldness and graying.

When researchers deleted the SCF gene in mice, the animals' hair turned white; when they deleted the cells that produce KROX20, the mice stopped growing hair and eventually went bald, according to the study.

"We were really excited because as a dermatologist, I treat patients with hair disease, so when we found the root cause of why hair turns gray and hair loss, we just cannot let it go," Le said.

More research is needed to understand if the process works similarly in humans, and Le and his colleagues plan to start studying it in people.

Le hopes that, armed with this knowledge, scientists can develop a topical compound or transplant the necessary gene to hair follicles to correct these cosmetic problems.

Researchers say the findings could one day also provide answers about why humans age in general as hair graying and hair loss are among the first signs of aging.

At Hair Revival Studio in Dallas, clients say the possibility of a treatment for gray hair and baldness sounds remarkable.

"Everyone wants to have a good head of hair. There's a lot of confidence that comes with that," said Brandon Stewart.



Photo Credit: NBC 5 News]]>
<![CDATA[Study Warns of Noisy Knees]]>Wed, 10 May 2017 20:23:54 -0400http://media.nbcnewyork.com/images/213*120/Study_Warns_of_Noisy_Knees.jpg

A long term study has found that noisy knees could indicate that a joint disease is coming. Roseanne Colletti reports.]]>
<![CDATA[Descendants of Syphilis Study Subjects Emerging From Shadows]]>Wed, 10 May 2017 09:04:19 -0400http://media.nbcnewyork.com/images/213*120/tuskegee-syphilis-study.jpg

Decades later, it's still hard to grasp what the federal government did to hundreds of black men in rural Alabama — even if you're among their descendants, lighting candles in their memory.

For 40 years starting in 1932, medical workers in the segregated South withheld treatment for unsuspecting men infected with a sexually transmitted disease simply so doctors could track the ravages of the horrid illness and dissect their bodies afterward.

Finally exposed in 1972, the study ended and the men sued, resulting in a $9 million settlement. Twenty years ago this May, President Bill Clinton apologized for the U.S. government. It seemed to mark the end of this ugly episode, once and for all.

Except it didn't.

Relatives of the men still struggle with the stigma of being linked to the experiment, commonly known today as the "Tuskegee Syphilis Study." For years they have met privately to share their pain and honor the victims.

And, amazingly, that class-action lawsuit filed by the men in 1973 has outlived them all. The litigation continues to this day, with a federal court currently considering a request that will help determine the study's final legacy.

A key, unanswered question: What should be done with unclaimed settlement money that still sits in court-controlled accounts?

___

Lille Tyson Head wants you to know that her father, Freddie Lee Tyson, wasn't just a man infected with syphilis.

Once a sharecropper in the fields of rural eastern Alabama, Tyson became a carpenter early in his marriage to Johnnie Mae Neal Tyson. He helped build Moton Field, where the famed "Tuskegee Airmen" learned to fly during World War II, he later worked as a firefighter there, his daughter said. He also worked for the government after it established the Tuskegee National Forest in eastern Alabama. Around 1960, he moved the family out of the Jim Crow South to Connecticut, where he worked in a factory.

"He was a wise man, very gentle. He was a disciplined man. Active in the church, loved his family and his extended family," said Head, of Wirtz, Virginia, one of the Tysons' eight children. "He was a good man. He had a sense of humor, he was a good dancer."

Though he displayed no symptoms, Tyson also was born with congenital syphilis inherited from his mother, Head said. And that is how he became a participant in "The Tuskegee Study of Untreated Syphilis in the Negro Male."

Located about 40 miles east of the state capital of Montgomery, Macon County is one of the poorest places in a poor state. In the early 1900s, the majority black county was a hotbed for syphilis, which affected about 35 percent of its residents of reproductive age.

In 1929, government doctors working in conjunction with a philanthropic fund began treating syphilis patients in the county with bismuth and mercury. Few people were cured, according to a summary from the Centers for Disease Control and Prevention, and some died.

Three years later, the U.S. Public Health Service, working with state and local health agencies, began what was supposed to be a short-lived program in Tuskegee to record the progression of the illness, which begins with a small sore and can progress to open wounds, blindness, deafness, mental illness and death.

Workers initially recruited 600 black men into a health program with the promise of free medical checks, free food, free transportation and burial insurance in a county where many blacks had never even seen a doctor. The men were tested and sorted into groups — 399 with syphilis and another 201 who were not infected.

The disease-free men were used as a control group. Health workers told syphilitic fathers, grandfathers, sons, brothers and uncles only that they had "bad blood."

None of the men was asked to consent to take part in a medical study. They also weren't told that "bad blood" actually was a euphemism for syphilis. Instead, doctors purposely hid the study's purpose from the men, subjecting them during the study's early months to painful spinal taps and blood tests.

Medical workers periodically provided men with pills and tonic that made them believe they were being treated, but they weren't. And doctors never provided them with penicillin after it became the standard treatment for syphilis in the mid-1940s.

The government published occasional reports on the study, including findings which showed the men with syphilis were dying at a faster rate than the uninfected. But it's doubtful any of the men — or their wives, girlfriends or other sexual partners — had any idea what had happened until an Associated Press story was published nationwide on July 26, 1972.

The next morning, farmer and community leader Charlie Pollard walked into Fred Gray's law office in Tuskegee. Gray already was a civil rights legend by that point: His clients included Martin Luther King Jr. and Rosa Parks following her arrest in Montgomery in 1955 for refusing to give up her seat on a city bus to a white man.

Pollard "came into my office and asked me if I had been reading in the newspaper about the men who were involved in the syphilis tests for 'bad blood,'" Gray wrote in a memoir.

Pollard was among the men in the study, and his visit with Gray led to the lawsuit and the multimillion-dollar settlement reached with the government on Aug. 28, 1975. In all, Gray said in an interview, government documents showed 623 men were involved in the study.

Payments to men and their heirs differed based on whether men were infected or were in the control group, whether they were dead or alive. Living participants who had syphilis got $37,500; heirs of deceased members of the control group received $5,000. Women and children who were infected with syphilis got lifetime medical and health benefits, and a handful still survive, according to the Centers for Disease Control and Prevention.

For decades, the study has been widely blamed for distrust among U.S. blacks toward the medical community, particularly clinical trials and other tests. In medical and public health circles, it's known as the "Tuskegee effect.

___


Freddie Lee Tyson quit the study during the 1950s after hearing rumblings that "something was wrong," Lille Head said.

Unaffected by the disease despite years of being in the study's syphilitic group, Tyson learned the true nature of the program only when the rest of the country found out, his daughter said. His wife and children all tested negative for syphilis, but Tyson was traumatized and feared the disease would show up somewhere in his family.

"After he found out about it he had to live with it. That could bring a person down if he wasn't strong. He was angry and he was upset," she said.

The lawsuit settled years before, Tyson died in 1988 at age 82 after an automobile accident. Today, the 72-year-old Head chairs Voices of our Fathers Legacy Foundation, a nonprofit organization formed in 2014 by the men's relatives to tell the story of the victims of the Tuskegee study.

Through the decades, their loved ones have been portrayed both as unwitting victims of a horrid experiment and as ignorant hicks who brought trouble on themselves with promiscuous behavior. Many descendants are still steamed over a 1997 movie called "Miss Evers Boys," which they believe cast the men in a bad light. A big part of the foundation's purpose is rounding out the narrative of the men's lives by telling the story of people like Freddie Lee Tyson, Head said.

Descendants of the men began gathering a year or two after Clinton hosted five remaining test survivors in the White House. The meetings are held in conjunction with Tuskegee's National Center for Bioethics in Research and Health Care, established in 1999 to address ethical and human rights issues in science, particularly concerning minorities.

The last man involved in the syphilis study died in 2004 and this year, for the first time, relatives both allowed The Associated Press into their annual gathering and invited the public to a ceremony where they lit candles for the men.

This year's ceremony included about 110 descendants, friends, community members, a gospel choir from Tuskegee University and public officials. There were speeches by Head and attorney Gray and others. The "community day of healing" was a big step for the families, Head said.

"It was important that the people of Macon County knew what the descendants were doing, and it gave them a chance to come out and be a part not only of the healing but also remembering of the men," she said. In the future, she hopes, more descendants "will come out of the shadows and be a voice for their fathers and grandfathers."

Retired public health nurse Amy Pack both visited with men of the study through her job in Macon County and had relatives who were among the test subjects, including great-uncle Seth Barrow. She said the foundation is still trying to find additional descendants; there's a small chance that syphilis dating back to the years of the study could still be in the bloodlines of families who are unaware of their connection to the study, she said.

___

The legal fallout from the Tuskegee syphilis study lives on at the federal courthouse in Montgomery.

Settlement funds were used for decades to compensate study participants and more than 9,000 of their relatives. Court workers were unable to locate other descendants, and some never responded to letters from the clerk's office, which disbursed millions before the last payment was recorded in 2008.

Court officials won't say how much money is left, but documents indicate the balance is mostly interest earnings from money first paid by the government decades ago. Gray said he's heard it's less than $100,000.

Some family members say the money should be used for additional funding for medical screenings for the men's families, and others want a long-discussed memorial at the old hospital where the study was run at Tuskegee University.

U.S. District Judge Myron Thompson is currently considering a request Gray filed in August to use the remaining money to fund operation of the Tuskegee Human and Civil Rights Multicultural Center, a combination museum and town welcome center that includes a display about the syphilis study.

The center is located in an old bank building owned by the county, and it's operated by a nonprofit headed by Gray and his daughter; the organization had net assets of more than $850,000 in 2015, with money coming from grants and donations, tax records show. The names of the men who were involved in the program are etched in a circle on the floor as a memorial.

In his address to descendants during the community service, Gray made what amounted to a closing argument for using the money for the museum, which is open only during the summer because of funding shortages. Gray told descendants that the men of the study — the people he represented after that meeting with Charlie Pollard — wanted a lasting memorial to their legacy, and he has worked for 20 years to make it happen at the center.

A judge refused a similar request from Gray to provide the leftover money to the museum in 2004 after the government insisted it should get the money, records show.

But Pollard's 92-year-old daughter, Ralphine Pollard Harper, said she likes the idea. People need to know what happened, she said, even if her father didn't like discussing the study.

"He'd get mad about it," she recalled. "He said, 'They just took us up here and made guinea pigs of us.'"

Copyright Associated Press / NBC New York



Photo Credit: National Archives]]>
<![CDATA[Senate Group Draws Fire for Lack of Women Working on Health Care]]>Tue, 09 May 2017 15:36:24 -0400http://media.nbcnewyork.com/images/213*120/mcconnell-gop-senate.jpg

The core group of 13 Republican senators tasked with crafting health care legislation to repeal Obamacare is under fire for not including any women senators, NBC News reports.

Some Republican women, like Sen. Lisa Murkowski of Alaska, have expressed disappointment at being shut out of the working group, led by Senate majority leader Mitch McConnell. 

McConnell has denied there is a problem with the group’s makeup, saying that every Senate Republican will have their say.

Democrats have been quick to point out the lack of women in the group. "I would hope that Senator McConnell would be a little more sensitive to the fact he's picked a dozen men on his side, there are certainly some very competent women he could've chosen," Sen. Dick Durbin, D-Ill., told MSNBC Tuesday.



Photo Credit: Jacquelyn Martin/AP]]>
<![CDATA[Side Effects Emerge After Approval for Many US Drugs: Study ]]>Tue, 09 May 2017 15:49:50 -0400http://media.nbcnewyork.com/images/213*120/prescriptions_1200x675.jpg

Almost one-third of new drugs approved by U.S. regulators over a decade ended up years later with warnings about unexpected, sometimes life-threatening side effects or complications, a new analysis found.

The results covered all 222 prescription drugs approved by the U.S. Food and Drug Administration from 2001 through 2010. The researchers looked at potential problems that cropped up during routine monitoring that's done once a medicine is on the market. The 71 flagged drugs included top-sellers for treating depression, arthritis, infections and blood clots. Safety issues included risks for serious skin reactions, liver damage, cancer and even death.

"The large percentage of problems was a surprise," and they included side effects not seen during the review process, said Dr. Joseph Ross, the study's lead author and an associate professor of medicine and public health at Yale University.

While most safety concerns were not serious enough to prompt recalls, the findings raise questions about how thoroughly drugs are tested before approval, said drug safety expert Thomas Moore. But Ross said the results suggest that the FDA "is kind of doing a great job" at scrutinizing drugs after approval.

New drugs are generally tested first in hundreds or even thousands of people for safety and effectiveness.

"We know that safety concerns, new ones, are going to be identified once a drug is used in a wider population. That's just how it is," Ross said. "The fact that that's such a high number means the FDA is working hard to evaluate drugs and once concerns are identified, they're communicating them."

The researchers analyzed online FDA data on new drugs and the agency's later safety announcements. Problems surfaced on average about four years after approval. Results were published Tuesday in the Journal of the American Medical Association.

The FDA said in a statement that it performs post-market monitoring "to identify new safety information that may impact product labeling." The agency said it would review the study findings but declined to comment further.

The study counted black-box warnings for dozens of drugs; these involved serious problems including deaths or life-threatening conditions linked with the drugs. There were also dozens of alerts for less serious potential harms and three drug withdrawals because of the potential for death or other serious harm.

Among the drugs with added warnings: Humira, used for arthritis and some other illnesses; Abilify, used for depression and other mental illness; and Pradaxa, a blood thinner. The withdrawn drugs and the reason: Bextra, an anti-inflammatory medicine, heart problems; Raptiva, a psoriasis drug, rare nervous system illness; and Zelnorm, a bowel illness drug, heart problems.

Safety issues were most common for psychiatric drugs and biologic drugs — made from living cells rather than chemicals — than for older drug types. Drugs brought to market through "accelerated" approval were slightly more likely to have later safety issues than those approved through conventional channels, a link seen in some previous research.

In recent years, there has been increasing pressure on the FDA from consumers and others to speed up its regulatory review process to get new drugs to the market sooner, Ross said.

Moore, a senior scientist for drug safety and policy at the Institute for Safe Medication Practices, said the new results raise concerns about whether new drugs are being extensively tested before approval. He noted that since 2011, drugs have increasingly been approved based on studies in small numbers of patients amid public criticism questioning whether the FDA is keeping potential cures away from patients.

"The answer is, you can't know whether they're valuable and lifesaving treatments unless you test them" adequately, Moore said.

PhRMA, a drug industry trade group, is reviewing the study, said spokeswoman Holly Campbell. In a statement, she said the industry is committed to post-market surveillance of new medicines, but added, "Even with rigorous clinical studies and regulatory review it may be impossible to detect certain safety signals until several years after approval, once the medicine is in broader use."


Copyright Associated Press / NBC New York



Photo Credit: ASSOCIATED PRESS]]>
<![CDATA[Life Expectancy Varies by 20 Years Across US Counties]]>Tue, 09 May 2017 10:10:06 -0400http://media.nbcnewyork.com/images/213*120/america-life-expectancy-jama-study.jpg

Americans' life expectancy varies by nearly a generation across counties in the United States, according to a new study, from a high of 87 years in Colorado's ski country to a low of 66 years in southwest South Dakota, with other parts of the Dakotas, Appalachia and the Mississippi river basin close behind.

NBC News reported that obesity and diabetes could explain a big chunk of that 20-year difference, published in the Journal of the American Medical Association's JAMA Internal Medicine Monday.

Many studies have shown that where Americans live has a big effect on how long they live. But Dr. Christopher Murray's team at the University of Washington found that the disparity has increased by five years since 1980, when they looked at life expectancy and risk of death for each county across the U.S. from then until 2014.

"The magnitude of these disparities demands action, all the more urgently because inequalities will only increase further if recent trends are allowed to continue uncontested," the team wrote.



Photo Credit: American Medical Association]]>
<![CDATA[Bacteria Could be Behind Mysterious Outbreak in Liberia: CDC]]>Mon, 08 May 2017 18:21:04 -0400http://media.nbcnewyork.com/images/213*120/bacteriainLIberia_1200x675.jpg

A contagious bacterial infection appears to be the cause of at least some cases in a mysterious outbreak in Liberia, U.S. health officials said Monday.

The bacteria can cause meningitis, a dangerous brain infection, as well as blood infections. The country has reported 31 illnesses, including 13 deaths. The germ is spread through close contact with someone who's infected, so other people are being monitored, health officials said. Nearly all the victims had attended a funeral in southeastern Liberia in West Africa.

The U.S. Centers for Disease Control and Prevention tested samples from four of the deceased people and found the bacteria , called Neisseria meningitidis. The bacteria is to blame for a "meningitis belt" in sub-Saharan Africa that passes close to Liberia.

The agency disclosed the results Monday, after sharing them with Liberian health officials.

The bacteria lives in the throat. It's spread through kissing, living with or having other close contact with an infected person. The CDC statement did not specify whether the Liberians had developed meningitis, which infects the brain and spinal cord, or a blood infection. Both can be fatal, and death can occur in only a few hours. The bacteria can cause the kind of mental confusion seen in patients in the Liberia outbreak.

Most of the cases were linked to an April 22 funeral in the coastal town of Greenville in Sinoe County.

Ebola was initially suspected but was ruled out.


Copyright Associated Press / NBC New York



Photo Credit: AP Photo]]>
<![CDATA[Health Care Fight Shifts to Senate, Where GOP Wants a Reboot]]>Tue, 09 May 2017 06:56:23 -0400http://media.nbcnewyork.com/images/213*120/AP_16347567513902-mitch.jpg

It took blood, sweat and tears for Republican leaders to finally push their health care bill through the House last week. Don't expect the process to be less arduous in the Senate, though more of the angst in that more decorous chamber will likely be behind closed doors.

No one expects a new bill to be written quickly, but Senate Majority Leader Mitch McConnell, R-Ky., has started a process for producing one. Republican senators have made clear their measure will differ markedly from the House legislation, which has drawn withering criticism from Democrats who see it as a pathway to winning a House majority in the 2018 elections.

"This process will not be quick or simple or easy, but it must be done," McConnell said Monday.

MCCONNELL'S WORKING GROUP
McConnell dislikes surprises and drama. Both characterized the House's chaotic four months of work on its bill, which saw revolts by conservatives and moderates derail initial versions and humiliate President Donald Trump and Speaker Paul Ryan, R-Wis.

McConnell has included himself in a group of 12 GOP senators essentially tasked with privately producing a bill that can pass the Senate. Republicans control the chamber 52-48.

Democrats are virtually certain to unanimously oppose the Republican effort to repeal much of President Barack Obama's health care overhaul. So Republicans are using a special process preventing a Democratic filibuster that would require 60 votes to end. McConnell will need 50 GOP votes to pass a bill, a tie Vice President Mike Pence could break.

That means McConnell can lose just two Republicans, so his group has a strategically shaped membership.

THE GROUP'S ROSTER
Sens. Lamar Alexander, R-Tenn., Mike Enzi, R-Idaho, and Orrin Hatch, R-Utah, chair pivotal committees. Sens. Rob Portman, R-Ohio, and Cory Gardner, R-Colo., are from states that used Obama's law to add hundreds of thousands of beneficiaries to Medicaid, an expansion they want to protect but the House bill would end. Gardner chairs the Senate GOP's campaign committee.

Sens. Ted Cruz, R-Texas, and Mike Lee, R-Utah, are conservative firebrands who represent states that didn't expand Medicaid but want additional funds for that program. Sens. John Cornyn, R-Texas, John Thune, R-S.D., and John Barrasso, R-Wyo., are in the Senate GOP leadership, and Tom Cotton, R-Ark., is an ambitious up-and-comer who frequently criticizes the House measure.

Democrats and liberal activists have lambasted McConnell for appointing a group with no female members.

POSSIBLE CHANGES
Portman is among Republicans whose states dislike the House's Medicaid cuts because they'd face a wave of constituents losing coverage under the health care program for the poor. The House would end the extra federal money states get for new beneficiaries under Obama's Medicaid expansion by 2020, and some GOP senators want a delay.

Much Medicaid money is used to combat the illegal use of addictive opioid drugs. That's another reason for GOP senators from hard-hit Midwestern and Northeastern states to oppose such cuts.

Obama's law helps millions buy private insurance with federal subsidies geared to income and policy premiums. The House instead links its aid to age, with older people getting larger tax credits. Thune and others want to shift the subsidies more generous to lower earners.

Cruz said House conservatives won "a positive improvement" with provisions letting states get federal waivers so insurers can charge some people with pre-existing conditions higher premiums, and letting states decide which medical services insurers must cover. He said "considerably more work" was needed to lower premiums.

In addition, the filibuster-free process Republicans are using requires that legislative provisions be related to raising or decreasing the federal deficit, and not primarily driven by policy changes. Conservative health care analyst James Capretta says the odds for survival "are low" for House language allowing state waivers for higher premiums on people with pre-existing conditions.

Also in jeopardy: a provision forbidding consumers to use federal subsidies to buy insurance covering abortion.

The Senate parliamentarian will decide whether provisions must be stricken from the bill. The Senate could override that with 60 votes.

POLITICAL ERUPTION
The pro-Democratic group Save Our Care is running ads in 24 districts whose GOP House members backed the bill asking, "How could you do this to us?" Obama urged lawmakers to use "courage" to protect health care for poorer Americans, a rare public comment on public policy since leaving office.

Underscoring political sensitivities, critics attacked Rep. Raul Labrador, R-Idaho, for saying at a town hall meeting that "nobody dies" from lack of health care. He later said that "wasn't very elegant."

Republicans are advertising too. The American Action Network, with links to House GOP leaders, is advertising nationally and in Ryan's district promoting the bill.

Sen. Bill Cassidy, R-La., was set to appear on ABC's "Jimmy Kimmel Live" after saying any GOP bill must pass "the Jimmy Kimmel test." The talk show host last week delivered a tearful monologue describing life-saving heart surgery his newborn son had received and saying lawmakers must help people afford health care.

LOOKING AHEAD
The nonpartisan Congressional Budget Office is expected to release its analysis of the House bill this month. It projected an earlier version would toss 24 million people off health coverage, a damaging blow that made it harder for House Republicans to pass their bill.

No one is certain when the Senate might approve its bill, though some following the process think that could come by July 4.

Copyright Associated Press / NBC New York



Photo Credit: Susan Walsh/AP, File]]>
<![CDATA[New Testing Method Revolutionizes Allergy Identification]]>Mon, 08 May 2017 13:28:38 -0400http://media.nbcnewyork.com/images/232*120/Screen+Shot+2017-05-08+at+1.22.10+PM.png

A new finger prick test can identify more than 100 allergens, revolutionizing the more laborious methods currently in use.

Dr. Janet Pate with Nurture Pediatrics in Bellaire, Texas says that until now the only proven allergy tests were to draw vials of blood or do a scratch test, which only test for 14 allergens and can be uncomfortable.

Pate said the new Allergypro test can confirm up to 120 allergens with just four drops of blood.]]>
<![CDATA[Measles Outbreak Caused by Vaccine Skeptics: Health Depts.]]>Mon, 08 May 2017 22:06:26 -0400http://media.nbcnewyork.com/images/177*120/measlesminnesota_1200x675.jpg

An outbreak of measles in Minnesota has led to 44 infected people, nearly all of them children, the Minnesota department of health says. Eleven kids are in the hospital and more cases of measles are expected, NBC News reported.

Doubts about vaccines helped fuel Minnesota's biggest outbreak of measles in decades and attracted determined vaccine skeptics eager to exploit fear, health officials say.

But the outbreak has not only caught people's attention; it has helped demonstrate that anti-vaccine activists are wrong, state and county health officials say.



Photo Credit: AP]]>
<![CDATA[Gray Death: The New Killer Drug in the War Against Opioids]]>Sat, 06 May 2017 07:15:04 -0400http://media.nbcnewyork.com/images/213*120/gray-death.jpg

Ominously named Gray Death, the killer drug cocktail is making headlines in the ongoing war against the national opioid crisis, NBC News reported.

What exactly is Gray Death? Start with heroin. Mix in the powerful painkiller fentanyl, which has 50 times more punch. Add a dash of carfentanil, which is an animal tranquilizer 100 times more powerful than fentanyl and made to be used on tigers and elephants.

While limited to the Gulf Coast and states like Georgia and Ohio, it is still on the federal Drug Enforcement Agency's radar. and "we are monitoring the potential spread of this deadly combination of drugs,"

"It's mad science and the guinea pigs are the American public," Russ Baer of the federal Drug Enforcement Agency told NBC News. "The ingredients come from abroad but this is made in America."



Photo Credit: AP]]>
<![CDATA[FDA Approves New Drug to Treat ALS]]>Fri, 05 May 2017 18:47:39 -0400http://media.nbcnewyork.com/images/213*120/AP_16349646792865.jpg

The U.S. Food and Drug Administration has approved a new drug Friday to treat patients suffering from amyotrophic latersclerosis (ALS) or commonly known as Lou Gehrig's disease.

The drug, Radicava, is the first new treatment approved specifically for ALS in 22 years.

"This is the first new treatment approved by the FDA for ALS in many years, and we are pleased that people with ALS will now have an additional option" said Eric Bastings, M.D., deputy director of the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research.

The drug is "an intravenous infusion given by a health care professional," with "an initial treatment cycle of daily dosing for 14 days, followed by a 14-day drug-free period," the FDA said in a news release.

ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Eventually, people with ALS lose the ability to initiate and control muscle movement, which often leads to total paralysis and death within two to five years of diagnosis. For unknown reasons, veterans are twice as likely to develop ALS as the general population.

The ALS Association, the only national nonprofit fighting ALS on every front, applauded FDA's fast decision in approving the drug.

The FDA approved Radicava less than a year after Mitsubishi Tanabe Pharma Corporation submitted a New Drug Application. The only other approved treatment specifically for ALS, riluzole, was approved in 1995.

"We thank the FDA and MT Pharma for working together to expedite the approval of the first new ALS-specific treatment in decades," said Barbara Newhouse, president and CEO of The ALS Association.

More information about Radicava, including Frequently Asked Questions, can be found at www.alsa.org/radicava.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Andrew Harnik, File]]>
<![CDATA[How to Protect Yourself From the 2017 Lyme Disease Surge]]>Fri, 05 May 2017 11:17:44 -0400http://media.nbcnewyork.com/images/213*120/Lyme-Disease-Tick.jpg

The Center for Disease Control has predicted a surge in the number of Lyme-carrying ticks in the Northeast and Midwest from April through the beginning of the summer.

While there is a higher risk of contracting Lyme disease this year compared to previous years, there are various precautions people can take to reduce their risk of getting the tick-borne illness after spending time outdoors. 

“When hiking, wear pants and socks, stay in the middle of paths as much as possible, avoiding tall grass and leaf piles where ticks tend to hide,” Dr. Patricia DeLaMora, a pediatric infectious disease physician at Weill Cornell Medicine and New York-Presbyterian, said in an email.

DeLaMora advises people to wear insect repellent with 20-30 percent DEET while outside. She also suggests treating “camping, shoes and gear” with Permethrin, an anti-parasite spray.

Ticks can also find themselves into your home via your household pet.

“Check your pets for ticks as well, as a tick can ‘catch a ride’ on a pet and then attach to a human,” DeLaMora said.

Lyme disease symptoms vary and can be similar to the flu. Symptoms include, fatigue, muscle and joint pain, headache and fever.Circular rashes are also a product of the disease.

Symptoms can appear in less than a week after a tick bite, according to experts.

A doctor should be contacted for medical advice and treatment immediately if someone believes they have been bitten by a tick.

]]>
<![CDATA[Johnson & Johnson Ordered to Pay $110M in Talc Powder Case]]>Fri, 05 May 2017 10:27:34 -0400http://media.nbcnewyork.com/images/213*120/Powder-GettyImages-119270124.jpg

A St. Louis jury has awarded a Virginia woman a record-setting $110.5 million in the latest lawsuit alleging that using Johnson & Johnson's baby powder caused cancer.

The jury ruling Thursday night for 62-year-old Lois Slemp, of Wise, Virginia, comes after three previous St. Louis juries awarded a total of $197 million to plaintiffs who made similar claims. Those cases, including the previous highest award of $72 million, are all under appeal.

Slemp, who was diagnosed with ovarian cancer in 2012, blames her illness on her use of the company's talcum-containing products for more than 40 years. Her cancer has spread to her liver, and she was too ill to attend the trial. About 2,000 state and federal lawsuits are in courts across the country over concerns about health problems caused by prolonged talcum powder use.

Johnson & Johnson, based in Brunswick, New Jersey, said in a statement that it would appeal and disputed the scientific evidence behind the plaintiffs' allegations. The company also noted that a St. Louis jury found in its favor in March and that two cases in New Jersey were thrown out by a judge who said there wasn't reliable evidence that talc leads to ovarian cancer.

"We are preparing for additional trials this year and we will continue to defend the safety of Johnson's Baby Powder," the statement said.

Talc is a mineral that is mined from deposits around the world, including the U.S. The softest of minerals, it's crushed into a white powder. It's been widely used in cosmetics and other personal care products to absorb moisture since at least 1894, when Johnson & Johnson's baby powder was launched. But it's mainly used in a variety of other products, including paint and plastics.

Much research has found no link or a weak one between ovarian cancer and using baby powder for feminine hygiene, and most major health groups have declared talc harmless. Still, the International Agency for Research on Cancer classifies genital use of talc as "possibly carcinogenic."

Attorneys with Onder, Shelton, O'Leary & Peterson, the firm that handled the St. Louis cases, cited other research that began connecting talcum powder to ovarian cancer in the 1970s. They cite case studies showing that women who regularly use talc on their genital area face up to a 40 percent higher risk of developing ovarian cancer.

Copyright Associated Press / NBC New York



Photo Credit: Bloomberg via Getty Images]]>
<![CDATA[This Is How Tri-State Reps Voted on the Health Care Bill]]>Thu, 04 May 2017 18:15:11 -0400http://media.nbcnewyork.com/images/213*120/AP_17124741528885.jpg

The Republican health care bill narrowly passed in the House Thursday, delivering a victory for President Donald Trump just six weeks after nearly leaving the measure for dead.


House approval sends the measure to an uncertain fate in the Senate, where some Republicans consider the bill too harsh. Polls have shown President Barack Obama's health care overhaul — which the GOP bill would largely repeal — has actually gained in popularity as the debate over a replacement health care program has accelerated.

The measure skirted through the House by a thin 217-213 vote, as all voting Democrats and 20 mostly moderate Republican holdouts voted no.


Here's how representatives from New York, New Jersey and Connecticut voted. All Democrats and some Republicans voted against the bill, and a little more than a half dozen Republicans voted for it. 

NY REPUBLICANS:

COLLINS: YES

DONOVAN: NO

FASO: YES

KATKO: NO

KING: YES

REED: YES

STEFANIK: YES

TENNEY: YES

ZELDIN: YES

NY DEMOCRATS:

CLARKE: NO

CROWLEY: NO

ENGEL: NO

ESPAILLAT: NO

HIGGINS: NO

JEFFRIES: NO

MALONEY: NO

MEEKS: NO

MENG: NO

NADLER: NO

RICE: NO

SERRANO: NO

SLAUGHTER: NO

SUOZZI: NO

TONKO: NO

VELAZQUEZ: NO

NJ REPUBLICANS:

Frelinghuysen: YES

Lance: NO

LoBiondo: NO

MacArthur: YES

Smith: NO

NJ DEMOCRATS:

Watson Coleman: NO

Gottheimer: NO

Norcross: NO

Pallone: NO

Pascrell: NO

Payne: NO

Sires: NO

CT REPUBLICANS:

NONE

CT DEMOCRATS

Courtney: NO

DeLauro: NO

Esty: NO

Himes: NO

Larson: NO

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Olympic Medalists Raise Awareness About Kids' Mental Health]]>Thu, 04 May 2017 22:05:48 -0400http://media.nbcnewyork.com/images/213*120/20170504+Phelps+and+Schmitt+2.jpg

Olympic gold medalists Michael Phelps and Allison Schmitt partnered with the Substance Abuse and Mental Health Services Administration Thursday to raise awareness about children’s mental health.

The two chaired a discussion Thursday night focused on the mental health care that kids need -- and how families can access mental health resources -- for National Children’s Mental Health Awareness Day 2017.

This year’s theme was “Partnering for Help and Hope.”

Both said that reaching out for help was key to their recovery. "Sometimes we need to see it's possible, that it can and does work, to see how we can accomplish it ourselves," Schmitt said.

“I'm so glad we both found the courage to ask for help," Phelps said.

He described the support that he received from his coach, Bob Bowman.

"He taught me so many things ... he was always pushing for me to go out and get help," Phelps said. "He was on board and he learned from the process as well ... it was something we both grew from. 

"I can never, ever thank him enough."

Schmitt said she struggled to share her story, but realized it could do some good. "When I chose to speak out on my own struggle, my only goal was to save one life," she said. "No person should have to endure these struggles alone."

Phelps, the most decorated Olympian in history, and Schmitt, an eight-time Olympic medalist, have been up-front about their own struggles with mental health and substance abuse. 

Phelps had been arrested for driving under the influence in 2004 and 2014; a photo of him using pot at a party in 2009 cost him sponsorships and led to a brief ban from swimming.

In an interview with NBC Sports’ host Bob Costas, Phelps said he thought about taking his own life.

"The struggles I have had weren’t easy, and they weren't fun. But they are a part of my journey," Phelps said Thursday. "I truly encourage everybody to ask for help or to reach out to somebody … and to be there in a time of need."

He checked himself into a rehab clinic in October 2014. Now, his Michael Phelps Foundation works to support active lifestyles for young people.

Schmitt made her first Olympic appearance at the 2008 Beijing games. but depression hit after the 2012 London Olympics, CNN reports. Schmitt said she considered driving her car off the road on the way to her sisters’ hockey game after two seasons that did not land her a spot on the USA swim team. 

It was Phelps who helped Schmitt get help, and she thanked him for that Thursday.

"Thank you for being that lending hand for hope and help," she said.

Phelps also encouraged others to reach out.

"This is something we all have the power to change, and we can make a difference," Phelps said.



Photo Credit: NBC Washington
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<![CDATA[GOP Health Care Bill Narrowly Passes House, Heads to Senate]]>Thu, 04 May 2017 17:56:33 -0400http://media.nbcnewyork.com/images/213*120/AP_17124702369357.jpg

The Republican health care bill narrowly passed in the House Thursday, delivering a victory for President Donald Trump just six weeks after nearly leaving the measure for dead.

House approval sends the measure to an uncertain fate in the Senate, where some Republicans consider the bill too harsh. Polls have shown President Barack Obama's health care overhaul — which the GOP bill would largely repeal — has actually gained in popularity as the debate over a replacement health care program has accelerated.

The measure skirted through the House by a thin 217-213 vote, as all voting Democrats and 20 mostly moderate Republican holdouts voted no.

Trump saluted the bill as "a great plan and I think it will get even better," saying more than once — "Make no mistake: this is a repeal and replace of Obamacare."

Beaten but unbowed, Democrats insisted Republicans will pay at election time for repealing major provisions of the law. They sang the pop song "Na Na Hey Hey Kiss Him Goodbye" to the GOP lawmakers as the end of the voting neared. The Republicans seemed unworried, many of them busing to the White House for a victory appearance with the president.

The vote on the American Health Care Act came after the House added several changes to insurance coverage requirements to the GOP's prized legislation. More than a dozen Republicans joined Democrats to allow the bill to pass by a wafer-thin margin.

Lawmakers heading to that celebrating were greeted with chants of "shame!" outside the Capitol.

Since it collapsed in March, the measure was revamped to attract most hard-line conservatives and some GOP centrists. In a final tweak, leaders added a modest pool of money to help people with pre-existing medical conditions afford coverage, a concern that caused a near-fatal rebellion among Republicans in recent days.

GOP candidates including Trump have made repealing Obama's statute an epitome of their campaign pledges since its enactment in 2010, claiming it's a failing system that's leaving people with rising health care costs and less access to care.

"It's time to live or die by this day," GOP leaders told the rank and file at an early morning, closed-door meeting to rally support, said Rep. Dennis Ross, R-Fla.

Democrats defended Obama's law, one of his crowning domestic achievements, for expanding coverage to 20 million Americans and forcing insurers to offer more generous benefits. They said the GOP measure would toss millions off coverage while delivering tax cuts to the wealthy.

"How can you do this to the American people, how can you do this to the people you represent?" asked Rep. Jim McGovern, D-Mass.

The bitter health care battle dominated the Capitol even as Congress prepared to give final approval to a bipartisan $1 trillion measure financing federal agencies through September.

The House passed that legislation Wednesday 309-118, and Senate passage seemed certain as early as Thursday. That would head off a weekend federal shutdown that both parties preferred to avoid —especially Republicans controlling the White House and Congress.

The health care vote was scheduled after the White House and congressional leaders barraged rank-and-file holdouts with pressure in recent days and claimed they had the votes to prevail.

Just Tuesday, The Associated Press had counted 21 Republicans saying they would oppose the bill — one short of the 22 defections that would kill it if all Democrats voted no. Many others were undecided.

"House Republicans are going to tattoo this moral monstrosity to their foreheads, and the American people will hold them accountable," House Minority Leader Nancy Pelosi, D-Calif., said Wednesday.

The bill would eliminate tax penalties Obama's law which has clamped down on people who don't buy coverage and it erases tax increases in the Affordable Care Act on higher-earning people and the health industry. It cuts the Medicaid program for low-income people and lets states impose work requirements on Medicaid recipients. It transforms Obama's subsidies for millions buying insurance — largely based on people's incomes and premium costs — into tax credits that rise with consumers' ages.

The measure would retain Obama's requirement that family policies cover grown children until age 26.

But states could get federal waivers freeing insurers from other Obama coverage requirements. With waivers, insurers could charge people with pre-existing illnesses far higher rates than healthy customers, boost prices for older consumers to whatever they wish and ignore the mandate that they cover specified services like pregnancy care.

The bill would block federal payments to Planned Parenthood for a year, considered a triumph by many anti-abortion Republicans.

The nonpartisan Congressional Budget Office estimated in March that the GOP bill would end coverage for 24 million people over a decade. That office also said the bill's subsidies would be less generous for many, especially lower-earning and older people not yet 65 and qualifying for Medicare.

A CBO estimate for the cost of latest version of their bill was not ready before the House conducted its vote.

Ryan pulled the plug on a March 24 vote as conservatives opposed the bill for not fully repealing Obama's law and GOP moderates considered its cuts too severe.

That was a jarring setback for Trump and Ryan. But leaders gradually rebuilt support, nailing down conservatives with provisions establishing the coverage waivers.

Earlier this week, moderates objected that constituents with pre-existing conditions could effectively be denied coverage by insurers charging them exorbitant premiums. At least a dozen of them said Wednesday they would oppose the legislation, including GOP Reps. Charlie Dent of Pennsylvania, a moderate leader, Leonard Lance of New Jersey and New York's Dan Donovan.

But GOP leaders seemed to win over a raft of wavering lawmakers after adding $8 billion over five years for state high-risk pools, aimed at helping seriously ill people pay expensive premiums. That was on top of $130 billion already in the bill for states to help customers, though critics said those amounts were insufficient.

To snuff out a glaring political liability, Republicans planned to approve a second bill. It would delete language in the health care measure entitling members of Congress and their staffs to Obama's coverage requirements, even if their home states annul them.

NBC editor Asher Klein and Associated Press writer Andrew Taylor contributed.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Evan Vucci]]>
<![CDATA[Dangerous Opioid Combo 'Gray Death' Is Latest Mixing Trend]]>Thu, 04 May 2017 14:04:06 -0400http://media.nbcnewyork.com/images/213*120/U-47700-DEA.jpg

It's being called "gray death" — a new and dangerous opioid combo that underscores the ever-changing nature of the U.S. addiction crisis.

Investigators who nicknamed the mixture have detected it or recorded overdoses blamed on it in Alabama, Georgia and Ohio. The drug looks like concrete mix and varies in consistency from a hard, chunky material to a fine powder.

The substance is a combination of several opioids blamed for thousands of fatal overdoses nationally, including heroin, fentanyl, carfentanil — sometimes used to tranquilize large animals like elephants — and a synthetic opioid called U-47700.

"Gray death is one of the scariest combinations that I have ever seen in nearly 20 years of forensic chemistry drug analysis," Deneen Kilcrease, manager of the chemistry section at the Georgia Bureau of Investigation, said.

Gray death ingredients and their concentrations are unknown to users, making it particularly lethal, Kilcrease said. In addition, because these strong drugs can be absorbed through the skin, simply touching the powder puts users at risk, she said.

Last year, the U.S. Drug Enforcement Administration listed U-47700 in the category of the most dangerous drugs it regulates, saying it was associated with dozens of fatalities, mostly in New York and North Carolina. Some of the pills taken from Prince's estate after the musician's overdose death last year contained U-47700.

Gray death has a much higher potency than heroin, according to a bulletin issued by the Gulf Coast High Intensity Drug Trafficking Area. Users inject, swallow, smoke or snort it.

Georgia's investigation bureau has received 50 overdose cases in the past three months involving gray death, most from the Atlanta area, said spokeswoman Nelly Miles.

In Ohio, the coroner's office serving the Cincinnati area says a similar compound has been coming in for months. The Ohio attorney general's office has analyzed eight samples matching the gray death mixture from around the state.

The combo is just the latest in the trend of heroin mixed with other opioids, such as fentanyl, that has been around for a few years.

Fentanyl-related deaths spiked so high in Ohio in 2015 that state health officials asked the federal Centers for Disease Control and Prevention to send scientists to help address the problem.

The mixing poses a deadly risk to users and also challenges investigators trying to figure out what they're dealing with this time around, said Ohio Attorney General Mike DeWine, a Republican.

"Normally, we would be able to walk by one of our scientists, and say 'What are you testing?' and they'll tell you heroin or 'We're testing fentanyl,'" DeWine said. "Now, sometimes they're looking at it, at least initially, and say, 'Well, we don't know.'"

Some communities also are seeing fentanyl mixed with non-opioids, such as cocaine. In Rhode Island, the state has recommended that individuals with a history of cocaine use receive supplies of the anti-overdose drug naloxone.

These deadly combinations are becoming a hallmark of the heroin and opioid epidemic, which the government says resulted in 33,000 fatal overdoses nationally in 2015. In Ohio, a record 3,050 people died of drug overdoses last year, most the result of opioid painkillers or their relative, heroin.

Most people with addictions buy heroin in the belief that's exactly what they're getting, overdose survivor Richie Webber said.

But that's often not the case, as he found out in 2014 when he overdosed on fentanyl-laced heroin. It took two doses of naloxone to revive him. He's now sober and runs a treatment organization, Fight for Recovery, in Clyde, about 45 miles (72 kilometers) southeast of Toledo.

A typical new combination he's seeing is heroin combined with 3-methylfentanyl, a more powerful version of fentanyl, said Webber, 25. It's one of the reasons he tells users never to take drugs alone.

"You don't know what you're getting with these things," Webber said. "Every time you shoot up you're literally playing Russian roulette with your life."

Associated Press researcher Rhonda Shafner in New York contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: DEA]]>
<![CDATA[Pre-Existing Conditions and the Health Plan: Who's Covered?]]>Thu, 04 May 2017 19:08:34 -0400http://media.nbcnewyork.com/images/213*120/678036940-Fred-Upton-Congress-Health-Bill.jpg

The Republican push to replace the Affordable Care Act was revived this week in Congress by a small change to their plan designed to combat concerns over coverage for those with pre-existing health problems.

The change helped get the bill through the House of Representatives in a tight vote Thursday, but experts say it may make little difference in the hunt for affordable coverage for these patients.

The bill proposes setting aside an additional $8 billion over five years to help states cover those who may be subject to higher insurance rates because they've had a lapse in coverage. That's on top of about $100 billion over a decade for states to help people afford coverage and stabilize insurance markets.

The problem, experts say, is that the money is unlikely to guarantee an affordable alternative for those who get coverage under a popular provision of the Affordable Care Act that prevents insurers from rejecting people or charging higher rates based on their health.

"Many people with pre-existing conditions will have a hard time maintaining coverage because it just won't be affordable," said Larry Levitt, a health insurance expert with the Kaiser Family Foundation, which studies health care issues.

The ultimate impact on those with pre-existing conditions remains unknown. The bill now heads for the Senate, where it is expected to change, and the plan leaves many important coverage decisions up to the states. Still, it is making some who are now covered by the Affordable Care Act nervous.

John S. Williams, an attorney in New Orleans whose multiple sclerosis medication costs $70,000 a year, buys insurance through the Affordable Care Act's marketplace. Without protections for pre-existing conditions he fears he would have to close his law practice and find a job with that offers a group insurance plan.

"We always hear about job growth and business creation — being able to have affordable health care drives that," Williams said. "I have tremendous satisfaction with owning a business, but I know that if I can't get coverage, I would be forced to get a different job. I can't not have coverage for my multiple sclerosis."

Here's how coverage may change for those with pre-existing conditions under the plan:

WHAT CHANGES?

States will be able to get federal waivers allowing insurers to charge higher premiums to people with pre-existing illnesses who have let their coverage lapse. States can then use federal money to fund government-operated insurance programs for expensive patients called "high-risk pools."

HOW DO THESE POOLS OPERATE?

Patients who couldn't get or afford insurance could apply for coverage through these high risk pools, which existed before the Affordable Care Act was passed. Even though they were charged far higher rates, up to double the amount paid by consumers with no serious ailments, care for these patients is so expensive that government money was needed to fund the programs.

DO THEY WORK?

In the more than 30 states that had high-risk pools, net losses piled up to more than $1.2 billion in 2011, the high point of the pools before the Affordable Care Act took full effect. Medical expenses outpaced premiums collected, and losses averaged $5,500 per person enrolled. States used fees and taxes to make up the difference, and states sometimes made it more difficult to some to qualify for care.

IS THE FEDERAL MONEY ENOUGH?

An analysis by the health care consulting firm Avalere found that the money would only be enough to fund high-risk pools in a few small states. High-risk pools could fill up fast with patients who have a lapse in coverage.

People with pre-existing conditions could lose their insurance if they can no longer work due to their health. The Republican health plan also is expected to raise premiums for older people, who are more likely to have a pre-existing condition.

"This gets complicated fast," Avalere President Dan Mendelson said.

About 2.2 million people in the individual insurance market have some sort of pre-existing chronic condition, according to Avalere.

WHAT MIGHT THIS MEAN FOR PATIENTS?

Because the bill is expected to change, and because it leaves big decisions up to the states, it's hard to say now what it would mean. Also, federal auditors have not had time to analyze the plan.

Proponents of the bill note that people in poor health would still be protected as long as they maintain coverage. If they don't, the higher premiums they are charged would revert back to standard rates after 12 months, assuming the customer could afford to keep paying.

In the past, risk pools have not guaranteed coverage. States have established waiting lists to get into their risk pools or restricted admission to the pools, since they ultimately have to balance their budget and they have no way to predict how high costs will climb.

"There is no guarantee in the law that people with pre-existing conditions would get access to affordable coverage," said Kaiser's Levitt.

Adrienne Standley, the operations director at a start-up apparel business in Philadelphia, is not waiting to find out. Her plan through the Affordable Care Act covers treatment for her asthma and attention deficit disorder, but she's afraid the Republican plan will mean she can no longer afford doctor's visits and medication.

"I'm looking at stockpiling, making sure I have an inhaler," she said. "I'm pretty scared to lose coverage."

Copyright Associated Press / NBC New York



Photo Credit: Zach Gibson/Getty Images]]>
<![CDATA[Measles Outbreak Sickens Dozens of Minnesota Somalis]]>Wed, 03 May 2017 19:12:17 -0400http://media.nbcnewyork.com/images/213*120/somalimeaslesoutbreakmichigan_1200x675.jpg

An outbreak of measles in Minnesota has sickened more than 30 children in recent weeks, primarily in the state's large Somali-American community, where many parents avoid the measles-mumps-rubella vaccine because of unfounded fears that it causes autism.

Somalis are just the latest example of a tight-knit community in which the highly contagious disease has gained a foothold in the U.S. in recent years.

Medical professionals and state health officials are working to contain the virus, but they expect more measles cases in coming weeks. A look at the situation:

MEASLES OUTBREAK

As of Wednesday, 34 measles cases were confirmed in Minnesota. It's the largest outbreak in the state since 1990, when 460 people contracted measles and three died.

Nearly everyone infected is unvaccinated, and all but a few are of Somali descent. So far, 11 children have been hospitalized.

The source of the outbreak is unknown, said Kris Ehresmann, infectious disease director with the state Department of Health. But since measles was declared eliminated in the United States in 2000, outbreaks in the U.S. are typically caused when international travelers are infected overseas and bring the virus home.

Nine other states have seen measles cases so far this year, but none has reported an outbreak of Minnesota's magnitude, according to the Centers for Disease Control.

WHY SOMALIS?

Somali children are getting sick because the community has a low rate of immunization for measles, mumps and rubella, Ehresmann said. Unvaccinated children from other communities are also at risk.

According to the Health Department, 42 percent of Minnesota-born Somali toddlers had received the MMR vaccine as of 2017 — but the community's immunization rate hasn't always been that low.

In 2004, 92 percent of Somali toddlers had the MMR vaccine. The community's immunization rate fell sharply to 70 percent in 2008 amid a perception that autism was becoming more common among Somali children.

A University of Minnesota study that examined 7- to 9-year-olds in Minneapolis in 2010 found no statistical difference between the rate of autism among Somali children and white children, Ehresmann said.

OPTING OUT

Minnesota law requires that a child be vaccinated before enrolling in child care, early education or school. But it also allows exemptions for medical reasons or "conscientiously held beliefs."

A 2014 study by the American Board of Family Medicine found 35 percent of Somali parents surveyed believed the measles vaccine causes autism, compared with 8 percent of non-Somalis.

Research that links the vaccine to autism has been widely discredited. But Anab Gulaid, a University of Minnesota researcher who worked on the autism study, said autism is often diagnosed in children around the same age as they receive their measles vaccine, so some fears persist.

"It's an emotional issue for people," she said.

Other communities with low vaccination rates have also been affected by measles in recent years. Nearly 20 people in the Orthodox Jewish community in Los Angeles were sickened by measles in December. Fifty-eight were sickened in 2013 when the measles swept through Orthodox Jewish communities in New York.

In Ohio, 360 people got the measles in 2014 after unvaccinated Amish travelers visited the Philippines and brought the disease home.

Minnesota health officials say they'd like to see at least 95 percent of the population immunized to protect everyone from measles, a highly contagious disease that can cause respiratory problems, brain swelling, or death.

COMMUNITY FEARS

Dozens of Somali parents attended a recent meeting organized by groups that believe there's a link between vaccines and autism. Some in attendance said they would rather face measles, or a child's death, than a lifetime of autism.

Patti Carroll, with the Vaccine Safety Council of Minnesota, said the goal was to empower parents.

"We did a presentation that helped the Somalis put the measles and the MMR vaccine into perspective," Carroll said. "It's their right to say no."

Sophia Mohamed, a New Brighton mother of two who believes her 16-year-old son got autism after receiving the MMR vaccine as a toddler, said officials need to listen to parents like her.

"We are not against the vaccine, but we want a safe vaccine," Mohamed said. "We have a choice ... I don't need any researcher to tell me. I know. I saw the results."

MEDICAL COMMUNITY ON ALERT

Evidence-based research has repeatedly shown no relationship between the MMR vaccine and autism, and there should be no hesitations about vaccines, said Patsy Stinchfield, senior director of infection control at Children's Minnesota hospital.

"In medical science, there is no debate about the safety of vaccines," she said.

Stinchfield worked at the hospital during the 1990 outbreak and recalls when an entire floor was turned into a measles ward. Two of the three deaths that year were children at the hospital.

The hospital has taken extra precautions.

On Tuesday, two workers sat at a desk outside the clinic's main lobby, assessing all patients who entered for risk of measles. A negative air filter hummed in the background, sucking away contaminated air, while all the clinic's tiniest patients and parents were told to wear masks.

Anyone with measles' symptoms is ushered in through a back door, away from other patients.

Amira Hassan, 4, came for a wellness check Tuesday and wore a mask in the waiting room. Her father, Mohamud Hassan, said she's been vaccinated, and he doesn't refuse a vaccine if a doctor says it's OK.

Hassan, who is Somali, said rumors about vaccines persist, but it's best to ask a doctor or someone who knows. He chose vaccination, saying: "If your child is going to school, you don't want other kids to be affected too."


Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[New Deals for Drugs: No Heart Attack or Your Money Back]]>Wed, 03 May 2017 13:56:44 -0400http://media.nbcnewyork.com/images/213*120/drugrebates_1200x675.jpg

Warranties and money-back guarantees, long used to entice buyers of products like hand tools and kitchen gadgets, are now being used to sell something more crucial: pricey new-generation drugs for diseases like rheumatoid arthritis and cancer.

Deals being negotiated between drugmakers and the insurers who buy medicines now sometimes include extra rebates — or even full refunds — if drugs don't help patients as expected.

It's part of an effort driven by insurers and government health programs to align the cost of care with the quality of care, and slow the relentless growth of prescription drug costs.

"We're spending less money on drugs that are less effective," said Dr. Michael Sherman, chief medical officer for the not-for-profit insurer Harvard Pilgrim, which has several of these deals and is negotiating more. Sherman says one-fourth of every dollar it spends on patient care goes to prescription drugs.

For the patient, it doesn't mean a check in the mail if cancer comes back after a round of treatment. But it does mean patients could get a drug that an insurer might otherwise be unwilling to pay for and that might help them. And insurers, who now can track how patients fare through electronic medical records, will be reducing wasteful spending and making at least a dent in overall health care costs.

"It's going to be part of the solution" to soaring drug prices, predicts Roger Longman, CEO of Real Endpoints, an analytics company that assesses the value of medicines for drugmakers, insurers and other clients.

Many new drugs now top $100,000 per year or course of treatment, even though their benefits are unclear or only marginally better than cheaper, older drugs. Buyers of those new drugs, usually insurance companies, are hesitant to pay without assurance the drugs will help patients. Not only is that bad for patients, it makes insurers spend even more on complications and hospital stays if the drugs don't work.

As a result, insurers often restrict access to expensive new drugs. Sometimes that's achieved by making patients pay more out of their own pockets, or making doctors wade through red tape to get authorization for a patient's medicine. Sometimes patients have to try cheaper drugs first, and only when they fail — and the patients' health has deteriorated — are they allowed to get the pricey new drug.

Pharmaceutical companies have an incentive here, too: These deals may help them sell more of the new drug they've spent hundreds of millions of dollars or more developing.

For example, a new generation of injected cholesterol drugs does an impressive job of reducing so-called bad cholesterol. But the drugs, Amgen's Repatha and Sanofi's Praluent, cost $14,000 a year, while cheap generic pills do a good job of lowering cholesterol for most people for $300 a year or less.

Predictably, insurers often reject prescriptions for these drugs.

So Amgen, trying to boost disappointing sales for a drug expected to be a huge seller, is offering full refunds to insurers if patients have a heart attack or stroke while taking its drug. On Tuesday, Amgen announced its first deal to do so, with Harvard Pilgrim. Sanofi has a contract with insurer Cigna to pay extra rebates if patient cholesterol doesn't fall as much as expected.

"It demonstrates the fact that we are standing behind the value the product has, and we're willing to put some money behind it," said James Borneman, Sanofi's head of strategic pricing.

Some insurers are now demanding these deals, which are expected to become standard for some drugs: super-expensive medicines for cancer and rare diseases, and others that are used widely enough to cost insurers millions. In addition, the drugs must have a benefit that's easy to measure, such as keeping kids with asthma out of the emergency room or preventing growth of cancerous tumors for a certain period.

Cigna has been pursuing more of these types of deals after finding that some of its earlier efforts "met or exceeded expectations in terms of benefit to our customers, patients," said Chris Bradberry, who heads Cigna's prescription benefit program.

One of its early deals, with drugmaker Merck for its diabetes pills Januvia and Janumet, dates to 2009, with rebates pegged to how much patients lower blood sugar.

"We keep re-signing that agreement, so I think they're pretty satisfied," said Bob McMahon, head of U.S. marketing at Merck, which also has such contracts with insurers and hospital systems covering medicines for infections and high cholesterol.

Other companies with such deals for one or more medicines include drugmakers Eli Lilly, Johnson & Johnson, Novartis, Novo Nordisk and Roche's Genentech unit; insurers Aetna and Priority Health, and prescription benefit manager Express Scripts.

On their own, these deals are unlikely to reverse the persistent rise in medical spending, experts say. But they improve the chance that the money will at least go to treatments that work best — by making sure insurers and drug companies have something at stake along with the patient.

"There's a risk on both sides with these contracts," said Dr. Mark Fendrick, director of the University of Michigan's Center for Value-Based Insurance Design. "Both want to make sure they'll get the outcome they want."



Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Overcoming Opioids: When Pills Are a Hospital's Last Resort]]>Tue, 02 May 2017 08:50:38 -0400http://media.nbcnewyork.com/images/213*120/AP_17047735665417-Alternatives-to-Opioids-Hospitals.jpg

A car crash shattered Stuart Anders' thigh, leaving pieces of bone sticking through his skin. Yet Anders begged emergency room doctors not to give him powerful opioid painkillers — he'd been addicted once before and panicked at the thought of relapsing.

"I can't lose what I worked for," he said.

The nation's opioid crisis is forcing hospitals to begin rolling out non-addictive alternatives to treatments that have long been the mainstay for the severe pain of trauma and surgery, so they don't save patients' lives or limbs only to have them fall under the grip of addiction.

Anders, 53, from Essex, Maryland, was lucky to land in a Baltimore emergency room offering an option that dramatically cut his need for opioids: An ultrasound-guided nerve block bathed a key nerve in local anesthetic, keeping his upper leg numb for several days.

"It has really changed the dynamics of how we care for these patients," said trauma anesthesiologist Dr. Ron Samet, who treated Anders.

An estimated 2 million people in the U.S. are addicted to prescription opioids, and an average of 91 Americans die every day from an overdose of those painkillers or their illicit cousin, heroin.

This grim spiral often starts in the hospital. A Harvard study published in the New England Journal of Medicine in February raised the troubling prospect that for every 48 patients newly prescribed an opioid in the emergency room, one will use the pills for at least six months over the next year. And the longer they're used, the higher the risk for becoming dependent.

Doctors and hospitals around the country are searching for ways to relieve extreme pain while at the same time sharply limiting what was long considered their most effective tool. It's a critical part of the effort to overcome the worst addiction crisis in U.S. history but, as Anders' experience shows, their options are neither simple nor perfect.

Anders' excruciating injury eventually did require a low opioid dose when the nerve block wore off but, Samet said, far less than normal.

"Provide them with good pain relief initially, for the first 24 to 48 hours after surgery, the pain that comes back after that isn't necessarily as hard and as strong," said Samet, an assistant anesthesiology professor at the University of Maryland School of Medicine.

And some doctors are discovering an added benefit of cutting back or even eliminating opioids. At the University of Pittsburgh Medical Center, a program called "enhanced recovery after surgery" is getting some patients home two to four days faster following major abdominal operations, using non-opioid painkillers that are gentler on the digestive tract.

"Our patients are very afraid of pain, especially the patients with a history of opioid addiction," said Dr. Jennifer Holder-Murray, a UPMC colorectal surgeon who helped start the program. "When they come back to me and tell me they didn't even fill their opioid prescription, that's a remarkable experience."

In trauma centers and surgery suites, there are no one-size-fits-all replacements for prescription opioids — narcotic painkillers that range from intravenous morphine and Dilaudid to pills including Percocet, Vicodin and OxyContin. They so rapidly dull severe pain that they've become a default in hospital care, to the point where it's not uncommon for patients to have an opioid dripping through an IV before they wake from surgery, whether they'll really need it or not.

Now, amid surging deaths from drug overdoses, some hospitals and emergency rooms are rethinking their own dependence on the painkillers, taking steps to make them a last resort rather than a starting reflex.

The new approach: Mixing a variety of different medications, along with techniques like nerve blocks, spinal anesthesia and numbing lidocaine, to attack pain from multiple directions, rather than depending solely on opioids to dampen brain signals that scream "ouch." It's known by the wonky name "multimodal analgesia."

Consider colorectal surgery, so painful that standard practice is to administer IV opioids in the operating room and switch to a patient-activated morphine pump right afterward. The University of Pittsburgh program ended that opioid-first mentality. Instead, doctors choose from a wide mix of options including IV acetaminophen and prescription-strength anti-inflammatory painkillers known as NSAIDs, anti-seizure medications such as gabapentin that calm nerve pain, muscle-relaxing drugs, and others.

Without the opioid side effects of nausea, vomiting and constipation, patients may find it easier to start eating solid food and walking around hours after surgery. Some do still need a low opioid dose, Holder-Murray cautioned, but few require a morphine pump. And for those who go home earlier, the approach can save hundreds, even thousands, of dollars.

"It's not just changing a medication or two. It's a whole culture change," she said.

At MedStar Georgetown University Hospital, anesthesiologist Dr. Joseph Myers is adding to his non-opioid cocktail a long-acting version of the numbing agent bupivacaine that's squirted into wounds before they're stitched closed. Called Exparel, it's controversial because it costs more than standard painkillers. But Myers said it lasts so many hours longer that he recently used it for a cancer patient who had both breasts removed, without resorting to opioids.

Hours after surgery, she was "eating crackers and drinking ginger ale and she says she's fine," he recalled.

At Stanford University, pain psychologist Beth Darnall says it's not just about using different medications. Patients who are overly anxious about surgical pain wind up feeling worse, so doctors also need to address psychological factors if they're to succeed in cutting the opioids.

In Baltimore, Anders remembers waking up in the University of Maryland's Shock Trauma Center and telling doctors and nurses, "I am a recovering addict." Years earlier, another car crash had led him to a pain clinic that prescribed Percocet "just like candy," Anders said.

Before getting addiction treatment, he said, "I came close to losing my job, losing my wife."

Samet, the anesthesiologist, estimates that Anders' nerve block cut by tenfold the amount of opioids he'd otherwise have received for his latest injury. Samet wheeled over a portable ultrasound machine, placed a probe over Anders' pelvis and searched the black-and-white screen for the dots that mark key nerves. He threaded a tiny tube directly to Anders' femoral nerve, allowing for repeated infusions of a non-addictive numbing medication for three days.

"It's like a Godsend. If you can have something like this, why would you want to take anything else?," Anders said a day after surgeons implanted a rod in his femur to fix the break. "I can wiggle my toes, I can move my foot, there's feeling right above the ankle," but in that damaged thigh, "I can't feel anything."

Patients need to ask about these kinds of alternatives, Samet said, but they're not available at all hospitals. Nerve blocks are becoming more common for elective bone surgery than in fast-paced trauma care, for example.

What Samet calls a lingering weak link: Even if patients go home with only a small supply of an opioid for lingering post-surgical pain, too often they get a refill from another doctor who assumes that prescription must be OK if a hospital chose it.

Not Anders. Sent home with some low-dose oxycodone, he discarded the last 20 pills.

"I didn't want them," he said, "and I didn't want nobody else getting their hands on them."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Patrick Semansky]]>
<![CDATA[Nevada Coalition Seeks Unprecedented Insulin Refund Law]]>Mon, 01 May 2017 17:33:07 -0400http://media.nbcnewyork.com/images/213*120/insulinnevadarefundlaw_1200x675.jpg

Aiming to rein in soaring prescription drug prices, an unlikely Nevada coalition is trying to force pharmaceutical companies to disclose how they set insulin prices — and issue refunds to diabetics or their insurance companies if annual price hikes surpass inflation.

Las Vegas casino owners have banded together with their employees' unions of cooks, servers and other resort workers to support the unprecedented legislation in their effort to control their own medical insurance costs.

The bill expected to face its first vote in early May would attempt to cap how much employers, insurers and corporate middle men pay for insulin, which is injected to manage blood sugar levels. Lawmakers also hope the bill would cap what diabetics pay out of their own pockets near their current cost levels — typically between $50 and $600 per month, depending on diabetics' insurance coverage.

It remains far from clear that the bill, if passed, would survive legal challenges or have the intended effect. But it would make Nevada the first U.S. state to force detailed release of drugmakers' proprietary information and effectively establish a price control on prescription drugs via the refund plan.

The bill is expected to pass in both houses of Nevada's Democratic-controlled Legislature. Republican Gov. Brian Sandoval, in an interview with The Associated Press, did not rule out signing it.

The move in Nevada illustrates public ire reaching critical mass over price hikes on insulin, epinephrine, antibiotics and other common prescription medicines, said Steve Brozak, president of the New Jersey-based WBB Securities investment banking firm, which focuses on health care.

Brozak and other industry experts warned against assuming government intervention would result in lower pharmacy bills, and said drugmakers would likely sue to block the law. They said price constraints could have unintended consequences.

"I don't think this will work in the way people think it will, but this could be the shot across the bow," Brozak said.

The bill would trigger reimbursements to insurers and others who pay for diabetes-related drugs when price increases outpace the national Consumer Price Index Medical Care Component, which rose between 2 percent and 5 percent each of the last 10 years.

"There is no question that lives are at stake and that, every day that people have to make the choice between their medicine and putting food on the table, we go further down the road to reaching a true public health crisis," said bill sponsor Sen. Yvanna Cancela, former political director with the Culinary Union 226 lobbying for the bill's passage.

The pharmaceutical industry argues that basing refunds on sticker prices would be ineffective because those rates constantly fluctuate and the market is much more complex than bill supporters say. Drugmakers also say prices reflect research costs and point a finger at insurance companies that have drastically increased co-pays and deductibles.

Nevada's casino owners and unions representing casino workers have long opposed each other in wage proposals but formed their rare lobbying partnership after reviewing costs in their negotiated health care plans.

Insulin and other diabetes medications represent 21 percent of prescription costs for the casino unions' 57,000 Nevada members, and increased 21 percent from 2015 to 2016, said Bobbette Bond, health policy director at Unite Here Health, which oversees Culinary Union 226 health plans.

About one in every 11 Nevada residents had diabetes in 2014, similar to the national average that year, according to the Centers for Disease Control and Prevention.

Jacobo Perez-Jimenez, a Las Vegas cook who has diabetes, said a monthly bottle of insulin cost him $7 in 2011. Now he pays $75.

Perez-Jimenez, whose health insurance covers part of his medical costs, said insulin makers are "killing people with those prices."

The Nevada effort comes less than a year after the pharmaceutical industry won a major victory against prescription drug price controls in California. Ohio voters will consider the same proposal in November.

Lawmakers in about half of U.S. states have made some attempt to curb prescription drug prices.

Vermont last year adopted a law asking drugmakers to justify certain price increases of 15 percent or more, and California legislators are now seeking notification of price hikes above 10 percent.

The Nevada bill would mark the first time drugmakers would be required to publicly detail business data about specific drugs including research costs and discounts they give insurers, pharmacy benefit managers and wholesalers.

Supporters claim disclosure will prompt manufacturers to lower prices, but market experts said there's no guarantee the idea would work and the notion disappoints some consumers who want immediate action.

"Even if they cough up that information, what would it benefit me?" said Soila Solano, a diabetic resident of Las Vegas. "How would I know if they're really, you know, giving you the right information?"


Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[5 Myths About Quitting Sugar, Debunked]]>Mon, 01 May 2017 12:56:22 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-519743196-sugar.jpg

A lot of people vow to quit sugar as the weather warms up, but as NBC News' Better team discovered, it's easier said than done to make it 10 days without the sweet stuff.

People hold some several misconceptions about sugar, from denying they have a problem to knowing where sugar lurks.

For example, most Americans consume nearly twice the amount of recommended sugar — 50 grams, or 12 teaspoons — every day, Dish on Fish blogger Rima Kleiner said.

If you're embarking on your own no-sugar challenge this spring, NBC News gathered five myths about quitting sugar to school yourself.



Photo Credit: Luis Ascui/Getty Images, File]]>
<![CDATA[FDA Approves 1st Targeted Drug for Certain Leukemia Patients]]>Fri, 28 Apr 2017 16:36:06 -0400http://media.nbcnewyork.com/images/213*120/leukemiadrug_1200x675.jpg

U.S. regulators have approved the first targeted drug for certain patients with an aggressive form of leukemia.

The Food and Drug Administration on Friday approved the drug for adults with acute myeloid leukemia who have a genetic mutation called FLT3. Also OK'd was a test to identify those patients. The drug, Rydapt, known chemically as midostaurin, is used along with chemotherapy.

The drug's maker, Novartis Pharmaceuticals Corp., said it is the first new medicine for the blood cancer in 25 years. It was also approved for three very rare blood disorders.

In patient testing, Rydapt with chemotherapy extended the time before the leukemia worsened or the patient died, compared to chemotherapy alone.

Novartis said the list price will be $14,990 for four weeks of treatment.


Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Trump Names Anti-Abortion Leader to High Post at HHS]]>Fri, 28 Apr 2017 13:39:06 -0400http://media.nbcnewyork.com/images/213*120/yoestantiabortion_1200x675.jpg

The White House says President Donald Trump is appointing the former president of a leading anti-abortion organization to a senior position at the Department of Health and Human Services.

Charmaine Yoest, who actively supported Trump in his campaign, will serve as assistant secretary of public affairs at HHS. From 2008 until February 2016, she was president of Americans United for Life, which campaigned at the federal and state level for tough restrictions on abortion.

Among the many state bills backed by the group under Yoest's leadership were measures that would ban most abortions after 20 weeks of pregnancy, require women seeking abortions to undergo a sonogram and impose tough regulations on abortion clinics that could lead to their closure.

The appointment was assailed by abortion-rights groups.

"Charmaine Yoest has spent her whole professional life opposing access to birth control and a woman's right to a safe, legal abortion," said Dawn Laguens, executive vice president of Planned Parenthood. "While President Trump claims to empower women, he is appointing government officials who believe just the opposite."

Anti-abortion leader Marjorie Dannenfelser, president of the Susan B. Anthony List, praised Yoest as "one of the pro-life movement's most articulate and powerful communicators."

Dannenfelser also noted that Yoest — in a sign of the ideological shift taking place in Washington — will be replacing Kevin Griffis, who joined Planned Parenthood earlier this month as vice president of communications.

Many anti-abortion leaders, including Yoest, were initially cautious about Trump's bid for the presidency, but became staunch supporters after he pledged to support several of their key goals. These included a federal 20-week abortion ban, a halt to federal funding for Planned Parenthood, and appointment of Supreme Court justices who would be open to overturning Roe v. Wade, the 1973 decision that established a constitutional right to abortion.

Yoest began her career serving under Ronald Reagan in the Office of Presidential Personnel and was an adviser to former Arkansas Gov. Mike Huckabee's 2008 presidential campaign. Most recently she has served as a senior fellow at American Values, a conservative group in Washington.


Copyright Associated Press / NBC New York



Photo Credit: AP Photo]]>
<![CDATA[DEA Offering Disposal of Unused, Unwanted Prescription Pills]]>Fri, 28 Apr 2017 07:36:42 -0400http://media.nbcnewyork.com/images/213*120/National-Rx-Drug-Take-Back-Day.jpg

The Drug Enforcement Administration will provide the opportunity for the safe disposal of expired, unused or unwanted prescriptions pills or patches on Saturday.

Scores of locations across the country are participating in the DEA's National Prescription Drug Take Back Day. Each site will be open from 10 a.m. to 2 p.m. The services are free and no questions will be asked. Liquids or needles will not be accepted.

The program seeks to prevent prescription-pill abuse and theft and keep dangerous medications out of community water supplies.

The DEA says in a news release that more than 3,500 tons of pills have been turned in for proper disposal across 12 previous events.

Information on collection sites can be found at dea.gov or by calling 1-800-882-9539.

Copyright Associated Press / NBC New York



Photo Credit: Department of Justice]]>
<![CDATA[Wait for Calorie Count on Burgers, Pizza May Get Longer]]>Fri, 28 Apr 2017 07:28:44 -0400http://media.nbcnewyork.com/images/213*120/AP080718051784calories7915.jpg

Consumers hoping to consistently find out how many calories are in that burger and fries may have to wait — again.

New government rules to help people find out how many calories are in their restaurant meals are set to go into effect next week after years of delays. But they could be pushed back again if grocery stores, convenience stores and pizza delivery chains get their way.

Originally passed as part of the health care overhaul in 2010, the law requires restaurants and other establishments that sell prepared foods and have 20 or more locations to post the calorie content of food "clearly and conspicuously" on their menus, menu boards and displays. The delays have come as those businesses that never wanted to be part of the law say it is burdensome and have fiercely lobbied against it.

Facing a May 5 compliance deadline set by the Food and Drug Administration last year, those groups are eyeing a massive spending bill that Congress will have to pass in the next week to keep the government open. They're hoping to either delay the menu labeling rules again or include legislation in the larger bill that would revise the law and make it easier for some businesses to comply.

At the same time, the FDA is signaling it may act on the issue even sooner. In a typical first step before a rule or decision is announced, the agency has sent language to the White House for review that would delay the compliance date.

A delay would be the latest of many. The FDA took more than four years to write the rules, and establishments originally had until the end of 2015 to comply. That was pushed to 2016 and then to May 2017.

The idea behind the menu labeling law is that people may pass on that bacon double cheeseburger at a chain restaurant, hot dog at a gas station or large popcorn at the movie theater if they know that it has hundreds of calories. But grocery stores and convenience stores have said the rules would be more burdensome for them than they would be for restaurants, which typically have more limited offerings and a central ordering point. The majority of prepared foods in grocery stores will have to be labeled — from the salad bar to the hot food bar to cookies in the bakery.

The industry groups are backing legislation by Rep. Cathy McMorris Rodgers, R-Wash., that would narrow labeling requirements for supermarkets by allowing stores to use a menu or menu board in a prepared foods area instead of putting labels on individual items. It would also allow restaurants like pizza chains that receive most of their orders remotely to post calories online instead of at the retail location, as the rules now require.

McMorris Rodgers, a member of House leadership, has been pushing for her legislation to be included in the spending bill. But if it's not included, a delay by the FDA could give Congress the needed time to pass it.

With the nutrition-minded Obama administration out of office and President Donald Trump promising to repeal burdensome regulations, the groups think they may finally have a chance to win some concessions on the law. Jon Taets of the National Association of Convenience Stores says his group is doing "a full court press" to get some changes.

The American Pizza Community, an advocacy group for pizza companies, is also pushing for a revision. They say the FDA rules, which require menu boards in the restaurants, don't make any sense because most of their customers don't come into the store.

The law "works for fast food and sit-down restaurants, but it does not work for pizza companies," says Tim McIntyre, an executive at delivery giant Domino's and head of the pizza group.

Nutrition advocates who worked closely with the Obama administration say the rules should go forward. Margo Wootan, a lobbyist at the Center for Science and the Public Interest who helped negotiate the original legislation with the restaurant industry, says the rules are important because people get a third of their calories from eating out and restaurant portions tend to be larger.

"Congress and the Trump administration should listen to the millions of Americans who want to make informed choices when eating out rather than the whining of a few special interests," she says.

The National Restaurant Association also came out against a delay Thursday, saying a patchwork of state laws would be "even more burdensome." Many restaurants have already posted the calorie labels, but they aren't required to until next week.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Ed Ou, File]]>
<![CDATA[AI Predicts Heart Attacks Better Than Doctors: Study]]>Thu, 27 Apr 2017 18:35:24 -0400http://media.nbcnewyork.com/images/213*120/AP_206901288533.jpg

New research suggests that artificial intelligence may be better at determining which patients are at high risk for a heart attack than their doctor, NBC News reported.

AI computer programs developed at the University of Nottingham in England were significantly more accurate at predicting which patients were at high risk.

The program's algorithm analyzes more types of patient data over a longer time period. It also takes into account the interactions of certain medications that are now known to be associated with a heightened risk for heart disease.

"You'll always need doctors and nurses. An AI algorithm won't be able to tell you that the patient was nervous because they had a big job interview in the afternoon...and thus their blood pressure was high on the day. What AI does allow is for doctors to become more efficient at their job," Dr. Stephen Weng, a research fellow at the University of Nottingham, told NBC News.



Photo Credit: AP Photo/Toby Talbot, File]]>
<![CDATA[Utah Rep. Chaffetz Gives Transparent Reason for Leave]]>Thu, 27 Apr 2017 13:33:29 -0400http://media.nbcnewyork.com/images/213*120/GOPRepJasonChaffetz_1200x675.jpg

Republican lawmaker Utah Rep. Jason Chaffetz revealed medical fixtures that had been holding his foot together for the last 12 years on his Instagram account.

Recently Chaffetz announced he would be taking a leave of absence and may not run for reelection in 2018. According to his Instagram post which reveals an x-ray of his foot, he said he would have the medical screws and plates removed from his foot after doctors advised him that the hardware could lead to a serious infection.

In the post, Chaffetz wrote, "Yes, I wish I could say I was cliff diving in Mexico but the truth is I fell off a ladder while repairing something in my garage." 

Chaffetz is chairman of the House Oversight Reform Committee and best known for his investigations of Hillary Clinton and alleged missteps by the Obama administration over the 2012 Benghazi attacks.



Photo Credit: Getty Images]]>
<![CDATA[California Weighs Huge Health Care Remake: Dumping Insurers]]>Wed, 26 Apr 2017 14:17:48 -0400http://media.nbcnewyork.com/images/213*120/AP_17116136988387-Ricardo-Lara-Single-Payer-Health.jpg

A proposal considered by California lawmakers would substantially remake the health care system of the nation's most populous state by eliminating insurance companies and guaranteeing coverage for everyone.

The idea known as single-payer health care has long been popular on the left and is getting a new look in California as President Donald Trump struggles to repeal and replace former President Barack Obama's health care law.

The proposal, promoted by the state's powerful nursing union and two Democratic senators, is a longshot. But supporters hope the time is right to persuade lawmakers in California, where Democrats like to push the boundaries of liberal public policy and are eager to stand up to the Republican president.

Hundreds of nurses are planning to rally Wednesday in Sacramento before a hearing in the Senate Health Committee.

"We have the chance to make universal health care a reality now," Democratic state Sen. Ricardo Lara of the Los Angeles-area city of Bell Gardens said last month. "It's time to talk about how we get to health care for all that covers more and costs less."

The measure would guarantee health coverage with no out-of-pocket costs for all California residents, including people living in the country illegally.

Private insurers would be barred from covering the same services, essentially eliminating them from the marketplace. Instead, a new state agency would contract with health care providers such as doctors and hospitals and pay the bills for everyone.

However, an essential question is still unanswered: Where will the money come from? California health care expenditures last year totaled more than $367 billion, according to the Center for Health Policy Research at University of California, Los Angeles.

The measure envisions using all public money now spent on health care — from Medicare, Medicaid, federal public health funds and "Obamacare" subsidies. But it would also require tax increases on businesses, individuals or both.

Lara, who wrote the legislation with Democratic Sen. Toni Atkins of San Diego, says they are working on the details.

Employers, business groups and health plans have mobilized in opposition, warning that the measure would require massive tax increases and force patients into lengthy waits to see a doctor.

They say the state should stay focused on implementing Obama's health care law, which is credited with significantly reducing the ranks of the uninsured in California.

"California can't afford a single-payer health care system," said Charles Bacchi, president and CEO of the California Association of Health Plans. "It's going to reduce the quality of care. We think it will restrict access to care, and it will be incredibly disruptive to all the Californians who currently get health care coverage through their employer."

The idea faces significant hurdles.

The legislation, SB562, would affect everyone — not just the roughly 8 percent of Californians without insurance — including people on Medicare and private, employer-sponsored insurance, plans that are generally well-liked.

Replacing billions of dollars in health care spending by employers and individuals would require significant tax increases, which must have support from two-thirds of the Assembly and Senate.

Even if it were to clear the Legislature and be signed by Democratic Gov. Jerry Brown, it would require cooperation from Trump's administration to waive rules about federal Medicare and Medicaid dollars.

The idea to substantially increase the government's role in health care comes as Trump and Republicans in Congress look to reduce it. The conservative House Freedom Caucus on Wednesday announced its support for a newly revised GOP health care bill, a month after the group's opposition forced Republican leaders to pull the legislation.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Rich Pedroncelli, File]]>
<![CDATA[Blood Tests Track Lung Cancer Gene Changes, Aiding Treatment]]>Wed, 26 Apr 2017 13:42:08 -0400http://media.nbcnewyork.com/images/213*120/lungcancertreatment_1200x675.jpg

Researchers have taken an important step toward better lung cancer treatment by using blood tests to track genetic changes in tumors as they progress from their very earliest stages.

With experimental tests that detect bits of DNA that tumors shed into the blood, they were able to detect some recurrences of cancer up to a year before imaging scans could, giving a chance to try new therapy sooner.

It's the latest development for tests called liquid biopsies, which analyze cancer using blood rather than tissue samples. Some doctors use these tests now to guide care for patients with advanced cancers, mostly in research settings. The new work is the first time tests like this have been used to monitor the evolution of lung tumors at an early stage, when there's a much better chance of cure.

Only about one third of lung cancer cases in the United States are found at an early stage, and even fewer in other parts of the world. But more may be in the future as a result of screening of longtime smokers at high risk of the disease that started a few years ago in the U.S.

Early-stage cases are usually treated with surgery. Many patients get chemotherapy after that, but it helps relatively few of them.

"We have to treat 20 patients to cure one. That's a lot of side effects to cure one patient," said Dr. Charles Swanton of the Francis Crick Institute in London.

The new studies he led suggest that liquid biopsies might help show who would or would not benefit from chemotherapy, and give an early warning if it's not working so something else can be tried.

Cancer Research UK, a charity based in England, paid for the work, and results were published online Wednesday by Nature and the New England Journal of Medicine .

To be clear: This kind of care is not available yet — the tests used in these studies are experimental and were customized in a lab to analyze the genes in each patient's cancer. But the technology is advancing rapidly, and many companies are working on tests that can do this.

"This is coming, and it's coming fast," said Dr. David Gandara, a lung specialist at the University of California, Davis, who had no role in the studies but consults for two companies developing liquid biopsies. A test that could spare many people unnecessary treatment "would be huge," he said.

In the studies, researchers analyzed tumors from about 100 people with non-small cell lung cancer, the most common form of the disease. Even in these early-stage cases, they found big variations in the number of gene flaws, and were able to trace how the tumors' genes changed over time.

People with many gene or chromosome problems were four to five times more likely to have their cancer return, or to die from their disease within roughly two years.

They also looked at 14 patients whose cancers recurred after surgery, and compared them to 10 others whose did not. Blood tests after surgery accurately identified more than 90 percent of them that were destined to relapse, up to a year before imaging tests showed that had occurred.

The results suggest that using liquid biopsy tests to help select and adjust treatments is "now feasible," at least from a scientific standpoint, the authors write.

A big issue is cost, though. Liquid biopsies sold now in the U.S., which don't do all the things the ones in this study did, cost nearly $6,000 in the United States. They may save money in the long run, by preventing futile treatment, but this has yet to be shown.

Copyright Associated Press / NBC New York



Photo Credit: ASSOCIATED PRESS]]>
<![CDATA[FDA Warns of 14 'Fraudulent' Cancer Cure Companies]]>Tue, 25 Apr 2017 20:53:28 -0400http://media.nbcnewyork.com/images/213*120/FDAfakecurecancerdrugs_1200x675.jpg

The Food and Drug Administration posted warning letters sent to 14 manufacturers, telling them to remove their fraudulent cancer curing products on the internet, NBC News reported. 

The FDA said most of the products are sold websites and social media sites can be harmful and waste money. 

The products that are not tested nor approved by the FDA come in all shapes and sizes, from creams to teas. Some contain ingredients that can be risky or interact dangerously with prescription drugs.



Photo Credit: FDA Photo]]>
<![CDATA[Hardball Health Care Option May Cost Taxpayers, and Trump]]>Tue, 25 Apr 2017 13:39:15 -0400http://media.nbcnewyork.com/images/213*120/Trump-Price-AHCA.jpg

Counting down to a budget deadline, the White House has toyed with a hardball health care tactic to force Democrats to yield on President Donald Trump's priorities.

The administration just might eliminate billions of dollars in disputed "Obamacare" subsidies.

But a study out Tuesday from a nonpartisan group suggests that could backfire. Stopping the Affordable Care Act payments at issue may actually wind up costing the federal government billions more than it would save.

The Kaiser Family Foundation found that taxpayers would end up paying 23 percent more than the potential savings from eliminating the health law's "cost-sharing" subsidies, which help low-income people with insurance deductibles and copayments.

It works out to an estimated $2.3 billion more in 2018, or an additional $31 billion over 10 years.

How's that possible? The short answer is that insurers would still be free to raise premiums, driving federal spending even higher because premiums are also subsidized under a different provision of the program. "You end up with a counter-intuitive result," said Larry Levitt, one of the study's authors.

Former Congressional Budget Office director Douglas Holtz-Eakin, a Republican economist, reviewed the Kaiser study for The Associated Press and concurred. "I think this may even be a conservative estimate," he said. "It says what's at stake: double-digit premium increases and more money out of the Treasury, not less."

An earlier study from Covered California, the health insurance marketplace in the nation's most populous state, reached similar conclusions.

The cost-sharing subsidies amount to about $7 billion this year. Provided to low-income customers who buy a silver-level plan, the assistance can reduce deductibles of several thousand dollars to just a couple of hundred. About 3 in 5 consumers on HealthCare.gov and state marketplaces qualify. The cost-sharing help is provided directly by insurers, who are reimbursed by the government.

The money is under a legal cloud because of a federal judge's ruling in a lawsuit by House Republicans against the Obama administration.

The judge agreed with GOP lawmakers that the health law lacked a specific congressional appropriation for the subsidies, meaning that spending the money would violate the Constitution. All parties have agreed to put the ruling on hold and the disputed payments continue.

Congress could clear up the issue by appropriating the money in the pending budget bill to keep the government running and avoid a partial shutdown by this weekend. That bill is looming as a test of whether Washington can carry out basic government functions in the contentious Trump era.

Or the new administration could appeal the district judge's ruling, as the Obama administration had planned.

With no resolution, the situation has compounded uncertainty over the ultimate fate of "Obamacare."

Trump has suggested the cost-sharing subsidies could be a bargaining chip to bring congressional Democrats to the table on health care, after an unpopular GOP alternative bogged down.

And White House budget director Mick Mulvaney has suggested the health care payments could be tied to Democratic support for financing the president's wall on the Mexican border.

Trump and GOP lawmakers still say they want to repeal Obama's health law, which provides coverage for some 20 million people through subsidized private coverage and expanded Medicaid.

Insurers, doctors, hospitals, consumer groups and the U.S. Chamber of Commerce have urged lawmakers to preserve the cost-sharing subsidies, warning that insurance markets could unravel without the money, jeopardizing coverage for millions.

By law, insurers are obligated to provide the assistance even if government repayment isn't guaranteed. Without the money, insurers might just bail out of the program altogether. But the Kaiser study modeled what might happen if companies stayed in the market even without government reimbursement for their cost-sharing expenses.

To compensate, those insurers would have to jack up premiums to cover what they'd spend on helping consumers with deductibles and copayments. Premiums are subsidized separately, and there is no legal dispute about those payments. Part of the reason overall government spending would increase is that many more people get subsidized premiums than receive cost-sharing assistance.

The premium increases would be higher in states that have not expanded Medicaid under the Obama health law, the Kaiser study also found. Those states tend to be Republican-led and supportive of Trump in last year's election.

"Either this ends up costing the federal government more money, or there's chaos that leads to people losing their health insurance," said the Kaiser Foundation's Levitt. "This would hardly be an orderly transition to a new system."

The White House says no final decisions have been made.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/J. Scott Applewhite, File]]>
<![CDATA[Simulating Mom's Womb in Research to Help Earliest Preemies]]>Wed, 26 Apr 2017 06:30:32 -0400http://media.nbcnewyork.com/images/213*120/simulatedwomb_1200x675.jpg

Researchers are creating an artificial womb to improve care for extremely premature babies — and remarkable animal testing suggests the first-of-its-kind watery incubation so closely mimics mom that it just might work.

Today, premature infants weighing as little as a pound are hooked to ventilators and other machines inside incubators. Children's Hospital of Philadelphia is aiming for a gentler solution, to give the tiniest preemies a few more weeks cocooned in a womb-like environment — treating them more like fetuses than newborns in hopes of giving them a better chance of healthy survival.

The researchers created a fluid-filled transparent container to simulate how fetuses float in amniotic fluid inside mom's uterus, and attached it to a mechanical placenta that keeps blood oxygenated.

In early-stage animal testing, extremely premature lambs appeared to grown normally inside the system for three to four weeks, the team reported Tuesday.

"We start with a tiny fetus that is pretty inert and spends most of its time sleeping. Over four weeks we see that fetus open its eyes, grow wool, breathe, swim," said Dr. Emily Partridge, a CHOP research fellow and first author of the study published in Nature Communications.

"It's hard to describe actually how uniquely awe-inspiring it is to see," she added in an interview.

Human testing still is three to five years away, although the team already is in discussions with the Food and Drug Administration.

"We're trying to extend normal gestation," said Dr. Alan Flake, a fetal surgeon at CHOP who is leading the project and considers it a temporary bridge between the mother's womb and the outside world.

Increasingly hospitals attempt to save the most critically premature infants, those born before 26 weeks gestation and even those right at the limits of viability — 22 to 23 weeks. Extreme prematurity is a leading cause of infant mortality, and those who do survive frequently have serious disabilities such as cerebral palsy.

The idea of treating preemies in fluid-filled incubators may sound strange, but physiologically it makes sense, said Dr. Catherine Spong, a fetal medicine specialist at the National Institutes of Health.

"This is really an innovative, promising first step," said Spong, who wasn't involved with the research.

One of the biggest risks for very young preemies is that their lungs aren't ready to breathe air, she explained. Before birth, amniotic fluid flows into their lungs, bringing growth factors crucial for proper lung development. When they're born too soon, doctors hook preemies to ventilators to keep them alive but risking lifelong lung damage.

Flake's goal is for the womb-like system to support the very youngest preemies just for a few weeks, until their organs are mature enough to better handle regular hospital care like older preemies who have less risk of death or disability.

The device is simpler than previous attempts at creating an artificial womb, which haven't yet panned out.

How the "Biobag" system works:

  • The premature lambs were delivered by C-section and immediately placed into a temperature-controlled bag filled with a substitute for amniotic fluid that they swallow and take into their lungs.
    "We make gallons of this stuff a day," said fetal physiologist Marcus Davey. It's currently an electrolyte solution; he's working to add other factors to make it more like real amniotic fluid.
  • Then the researchers attached the umbilical cord to a machine that exchanges carbon dioxide in blood with oxygen, like a placenta normally does.
  • The lamb's heart circulates the blood, without the need for any other pump.

The researchers tested five lambs whose biological age was equivalent to 23-week human preemies, and three more a bit older. All appeared to grow normally, with blood pressure and other key health measures stable and few complications during the weeks they were inside the womb-like device.

The study didn't address long-term development. Most of the lambs were euthanized for further study that found normal organ development for their gestational age. One was bottle-weaned and is now more than a year old, apparently healthy and living on a farm in Pennsylvania.

Flake stressed that the womb-like system isn't intended to support preemies any younger than today's limits of viability — not what he calls the more "sensationalistic" idea of artificially growing embryos.

He acknowledged that parents might question the approach, but notes that the preemies always could be whisked into standard care if they fared poorly in the new system. And while he said further adaptation of the device is needed before it can begin human testing, he envisioned parents being able to see the baby and even piping in the sound of mom's heartbeat.

Copyright Associated Press / NBC New York



Photo Credit: Children’s Hospital of Philadelphia via AP]]>
<![CDATA[Colorado Abortion Law, 1st in US, Marks 50th Anniversary]]>Tue, 25 Apr 2017 08:57:04 -0400http://media.nbcnewyork.com/images/213*120/AP_17115062691464-Planned-Parenthood-Rocky-Mountains-Denver.jpg

Tuesday marks 50 years since a groundbreaking Colorado law significantly loosened tight restrictions on legal abortions.

Before the law, Colorado — like many states — allowed abortions only if a woman's life was at stake.

In 1967, a Democratic freshman state lawmaker introduced a bill that allowed abortions if the woman's physical or mental health was threatened, if the unborn child might have birth defects or in cases of rape or incest.

Rep. Richard Lamm said he feared he might be committing political suicide by introducing the bill to the overwhelmingly male, Republican-dominated Legislature.

But within weeks, Republican Gov. John Love signed the bill into law, making Colorado the first state to loosen restrictions on abortion — six years before the U.S. Supreme Court would legalize it nationally.

"I was pushing on a half-open door. It gave way so much more easily than I ever dreamed it would," recalled Lamm, now 81, in an interview with The Associated Press.

But all abortions still had to be approved by three-doctor panels at participating hospitals and were only permitted during the first 16 weeks of pregnancy.

Instead of ending his newfound political career, Lamm went on to serve three terms as the state's governor. He is currently the co-director of the University of Denver's Institute of Public Policy Studies.

Lamm said recently that when he introduced the legislation, the women's movement was just starting to take off and the concept that citizens should have more personal freedom was becoming more important in society.

At the time, abortion was not one of the Colorado Republican Party's most pressing issues and there was no organized opposition in the state to abortion rights because the idea was so new, Lamm said.

Key to Lamm's effort was ally Ruth Steel, an activist who had lobbied lawmakers in 1965 to allow public health officials to discuss and to provide birth control with residents. She worked closely with John Bermingham, a Republican state senator who is now 93 and retired, to shepherd the contraception bill though the Legislature.

While on lobbying trips to the Capitol, Steel dressed formally, wearing a hat and gloves, but had no qualms talking to lawmakers frankly about issues related to sex, Lamm said.

A woman in charge of proofreading bills in the basement of the Capitol was essential to advancing the bill through the Legislature, Bermingham said in an interview.

Bermingham learned that she supported the bill, and he asked her to wait until a Senate leader who opposed it would be away so the bill could be introduced without being assigned to a committee seen as sure to kill it.

While the bill was under debate, a woman denied an abortion at Denver's public hospital shot herself in the abdomen and survived. The fetus did not survive. The doctor who treated the woman testified on the bill, Bermingham said.

After the Legislature approved the measure, opponents picketed outside the governor's mansion.

Love, a Republican who died in 2002, said at the time that he struggled with what to do with the bill. He said he was conflicted over whether abortion would be used as an alternative to birth control.

In the era of divisive and turbulent social and political change, he said his mail was about evenly divided between supporters and opponents.

Love ultimately decided to sign the bill to keep government out of what he viewed as a personal decision, said his son, Dan Love. The elder Love was re-elected in 1970.

Eleven other states followed suit. And four more lifted all abortion restrictions — New York, Washington, Hawaii and Alaska — before 1970. The 1973 Supreme Court's Roe v. Wade decision legalized abortion nationwide.

In Colorado, opponents had feared the state would become "an abortion mecca" for women seeking to end their pregnancies. That did not happen, partly because women who wanted abortions had to appear before a hospital panel and could not simply show up and get them.

There were only 10 abortions reported to the state health department in 1966. Between the law's signing in April and the end of 1967, 120 abortions were reported. The patients ranged from a 12-year-old girl who had been raped to a 48-year-old woman. About a quarter were from outside Colorado.

Most were performed based on psychiatric grounds or therapeutic reasons with no additional specifics provided.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Brennan Linsley, File]]>
<![CDATA[Overcoming Opioids: Special Schools Help Teens Stay Clean]]>Tue, 25 Apr 2017 10:12:43 -0400http://media.nbcnewyork.com/images/213*120/AP_17094517868224-Hope-Academy-Teen-Addiction-Treatment.jpg

When Logan Snyder got hooked on pills after a prescription to treat pain from a kidney stone, she joined the millions already swept up in the nation's grim wave of addiction to opioid painkillers.

She was just 14.

Youth is a drawback when it comes to kicking drugs. Only half of U.S. treatment centers accept teenagers and even fewer offer teen-focused groups or programs. After treatment, adolescents find little structured support. They're outnumbered by adults at self-help meetings. Sober youth drop-in centers are rare. Returning to school means resisting offers to get high with old friends.

But Snyder is lucky: Her slide ended when her father got her into a residential drug treatment program. Now 17 and clean, she credits her continued success to Hope Academy in Indianapolis, a tuition-free recovery school where she's enrolled as a junior.

"I am with people all day who are similar to me," she says. "We're here to hold each other accountable."

The opioid epidemic, which researchers say is the worst addiction crisis in U.S. history, has mostly ensnared adults, especially those in their 20s, 30s and 40s. But teens have not been spared: Each day, 1,100 start misusing pain pills. Opioids killed 521 teens in 2015, federal data show.

Not enough is known about opioids and teen brains. But getting hooked early is trouble — the vast majority of adults in treatment report they started using as teenagers.

Researchers say young recovering addicts do better at places like Hope, special schools that use peer communities to support sobriety. There are only about three dozen such schools in the U.S., but interest is growing among educators and health officials because of the opioid epidemic.

"I get a phone call every day from somebody who wants to start a recovery high school," says Rachelle Gardner, an addiction counselor who helped found Hope in 2006 as a charter school through the mayor's office. "It's horrible to watch young people die. And who wants that to be our legacy?"

Hope's 41 teenagers have abused marijuana, alcohol, painkillers and heroin. Most, like Snyder, have been through residential treatment, some more than once. Others, like 17-year-old Aiden Thompson, arrive with no treatment after a crisis.

"I was really pissed off because I didn't want to be here," says Thompson, who came to Hope last year after his mom discovered his vodka and pill stash. "Everything they said, I was like: 'That can't be true. No. No way.'"

A week later, though, he found himself talking in group meetings. Now, he said, "I don't even want to think about where I would be" without the school.

Teens like Snyder and Thompson can change in these settings, even after years of drug abuse, in part because social acceptance is a fundamental need for people their age. The sway of positive peer pressure — what students at Hope call "the community" — is quiet, almost intangible. It's as simple as two teens passing in the hall: "You all right?" says one boy. The other nods, "Yeah, I'm all right."

A student council plans events like coffee-and-music mornings. To join the council, a student must have 30 days of sobriety.

Random drug tests keep it real. Failing a urine test prompts a meeting with recovery coach Brad Trolson, who employs a technique called motivational interviewing, using open-ended questions and reflective listening to encourage students to think for themselves.

"They're not used to anyone saying, 'What do you think you should do next?'" Trolson says.

It's a daily fight, he says. Many have addicted parents or histories of abuse or neglect, key risk factors for addiction.

"Their wounds will start to heal and they'll come open again," he says. "You end up addressing those wounds over and over again."

Thompson, who relapsed over winter break, says he's learning to focus on one day of recovery at a time. "I'm clean for today and that's all that matters," he says. "I don't want to put all this weight on my shoulders to feel like I have to stay clean forever. I can just take it a day at a time and not be freaked out by it."

"Just for today" and other Alcoholics Anonymous slogans are the common language at Hope.

The school also embraces treatment with medication and doesn't see it as a crutch, as some AA adherents do. Two students get monthly shots of Vivitrol to block opioid cravings and one takes Suboxone, another anti-craving drug.

"Whatever mechanism our students need in order to maintain a life of sobriety we will support," Gardner says.

Nationally, teen drug use is in long-term decline, according to an annual federal youth assessment of risky behaviors. But about 5 percent of high school seniors say they've abused prescription narcotics such as oxycodone. Other federal data show about 1.3 million adolescents, ages 12 to 17, need treatment for alcoholism or drug addiction.

As part of research funded by the National Institute on Drug Abuse, Andy Finch of Vanderbilt University is studying whether kids who've been treated for addiction do better in recovery schools. Early evidence shows recovery-school students are less likely to relapse than students who attend traditional schools after treatment.

"There's a place in every community for a school like this," says Finch, who expects to publish his findings later this year.

On a recent morning at Hope, students and teachers gather for an all-school meeting called "circle." A golden retriever named Banks pads about, then sits beside 18-year-old Ian Lewis, who hugs him with a tattooed arm.

"Animals give unconditional love and sometimes that's hard for other people to give to each other," Lewis says. He wants to be a vet someday. His owl-and-skull tattoo reminds him to be wiser than two user friends who overdosed and a third who died driving drunk.

Today's circle is led by Snyder, who still has "a lot of hard days" and fears ending up like her user friends who died. She, too, has her eyes on graduation and college.

"We don't get perfect," she reads aloud, "but we do get better."

Snyder's hardest days are when she wakes up and skips her inner pep talk. Also hard are days when family problems close in, and days when she sees others escaping through drugs and wants to join them. Days when she can't imagine how she's going to solve her problems. Days when she feels alone.

Her new friends pull her back from the edge. They remind her that she doesn't want others to feel around her the way she feels around an addicted family member in her life.

"That helps me to want to get better," she says.

There are no magic words, Snyder says, for those desperate to rescue a young addict.

"Presence helps me rather than words," she says. "If I don't want you to talk, then don't talk. Listen to me."

Above all, she wants to hear she's not alone "because I often feel like that."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Michael Conroy]]>
<![CDATA[3 African Countries Chosen to Test 1st Malaria Vaccine]]>Mon, 24 Apr 2017 10:51:53 -0400http://media.nbcnewyork.com/images/213*120/malariaafrica_1200x675.jpg

Three African countries have been chosen to test the world's first malaria vaccine, the World Health Organization announced Monday. Ghana, Kenya and Malawi will begin piloting the injectable vaccine next year with hundreds of thousands of young children, who have been at highest risk of death.

The vaccine, which has partial effectiveness, has the potential to save tens of thousands of lives if used with existing measures, the WHO regional director for Africa, Dr. Matshidiso Moeti, said in a statement. The challenge is whether impoverished countries can deliver the required four doses of the vaccine for each child.

Malaria remains one of the world's most stubborn health challenges, infecting more than 200 million people every year and killing about half a million, most of them children in Africa. Bed netting and insecticides are the chief protection.

Sub-Saharan Africa is hardest hit by the disease, with about 90 percent of the world's cases in 2015. Malaria spreads when a mosquito bites someone already infected, sucks up blood and parasites, and then bites another person.

A global effort to counter malaria has led to a 62 percent cut in deaths between 2000 and 2015, WHO said. But the U.N. agency has said in the past that such estimates are based mostly on modeling and that data is so bad for 31 countries in Africa — including those believed to have the worst outbreaks — that it couldn't tell if cases have been rising or falling in the last 15 years.

The vaccine will be tested on children five to 17 months old to see whether its protective effects shown so far in clinical trials can hold up under real-life conditions. At least 120,000 children in each of the three countries will receive the vaccine, which has taken decades of work and hundreds of millions of dollars to develop.

Kenya, Ghana and Malawi were chosen for the vaccine pilot because all have strong prevention and vaccination programs but continue to have high numbers of malaria cases, WHO said. The countries will deliver the vaccine through their existing vaccination programs.

WHO is hoping to wipe out malaria by 2040 despite increasing resistance problems to both drugs and insecticides used to kill mosquitoes.

"The slow progress in this field is astonishing, given that malaria has been around for millennia and has been a major force for human evolutionary selection, shaping the genetic profiles of African populations," Kathryn Maitland, professor of tropical pediatric infectious diseases at Imperial College London, wrote in The New England Journal of Medicine in December. "Contrast this pace of change with our progress in the treatment of HIV, a disease a little more than three decades old."

The malaria vaccine has been developed by pharmaceutical company GlaxoSmithKline, and the $49 million for the first phase of the pilot is being funded by the global vaccine alliance GAVI, UNITAID and Global Fund to Fight AIDS, Tuberculosis and Malaria.

Southeast Asia, Latin America and the Middle East also have malaria cases.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Future of Revamped Health Care Bill Remains Dubious in House]]>Fri, 21 Apr 2017 21:39:32 -0400http://media.nbcnewyork.com/images/213*120/AP_17111707588504.jpg

President Donald Trump on Friday downplayed the significance of pushing Republican health care legislation through the House next week, a retreat from more bullish White House pronouncements a day earlier, which had gotten a skeptical reception at the Capitol.

In brief comments to reporters Friday, Trump said the attempt to rekindle the GOP drive to repeal President Barack Obama's health care law is "coming along well." But he said there was "no particular rush" to do it next week, when Congress returns from its spring recess.

"It doesn't matter if it's next week. Next week doesn't matter," Trump said at the White House.

Those comments represent a ratcheting back from Thursday, when Trump said at a news conference that there was "a good chance" of passing health legislation soon, adding, "I'd like to say next week."

Amplifying those comments, a senior White House official was also expressing confidence Thursday that a breakthrough on the mired Republican health care bill could emerge in the House next week. That official was not authorized to discuss the internal process publicly and insisted on anonymity.

The White House is eager to pass the health bill quickly, partly because Trump will likely hit his 100th day in office — April 29 — without having signed a major piece of legislation.

But that goal is running straight into the time-consuming, push-and-pull reality of Congress, not to mention enduring divisions between the conservative and moderate wings of Trump's party.

Many GOP lawmakers and aides have expressed doubt that the House would vote next week on health legislation, just a month after an earlier version died for lack of support within the party. They cited the higher priority of passing a spending bill to avert a government shutdown. Also, there's uncertainty over a developing deal to revive the Republican health bill. In any case, it would take time to sell such an agreement to lawmakers.

Republicans are also expressing doubts that a health care compromise that's been discussed between party conservatives and moderates would win enough support to put the bill over the top. The party has long promised to repeal Obama's 2010 health care law, and the House bill would replace it with less generous subsidies and eased insurance requirements.

An outline of a deal has been crafted by Rep. Mark Meadows, R-N.C., who heads the hard line House Freedom Caucus, and Rep. Tom MacArthur, R-N.J., a leader of the centrist Tuesday Group. Vice President Mike Pence also played a role in shaping that plan, Republicans say.

The plan would deliver a win to moderates by amending the GOP health care bill to restore Obama's requirement that insurers cover specified services like maternity care. But in a bid for conservative support, states would be allowed to obtain federal waivers to abandon that obligation.

In addition, states could obtain waivers to an Obama prohibition against insurers charging sick customers higher premiums — a change critics argue would make insurance unaffordable for many. To get those waivers, states would need to have high-risk pools — government-backed insurance for the most seriously ill people, a mechanism that has often failed for lack of sufficient financing.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Susan Walsh]]>
<![CDATA[CVS, Starbucks and the Love-Hate Relationship With Sugar ]]>Fri, 21 Apr 2017 10:46:39 -0400http://media.nbcnewyork.com/images/213*120/CVS-Starbcucks.jpg

Healthy foods are taking real estate from candy at some CVS stores, the store chain announced Thursday, a response to changing customer preferences and shopping habits, NBC News reported.

In CVS Pharmacy's new store prototype there's less space for sugary snacks, particularly at the front of the store, where healthier food, vitamins, supplements and cosmetics with more natural ingredients will be displayed.

"It seems pretty clear that CVS has a fairly serious approach to trying to create a healthier environment in its stores," said Marion Nestle, a professor of nutrition at New York University, pointing to its 2014 decision to stop selling tobacco products.

But she and other food branding experts note that health food labeling can mislead or misdirect consumers, too. The fancifully colored "Unicorn" Frappuccino from Starbucks could have as much as 76 grams of sugar, because Starbucks is known more for coffee than milkshakes.



Photo Credit: CVS Handout, AP]]>
<![CDATA[Germ in Raw Milk, Poultry Now Tops Food Poisoning List]]>Thu, 20 Apr 2017 20:52:28 -0400http://media.nbcnewyork.com/images/213*120/Detectan-brote-de-gripe-aviar-en-granja-de-proveedor-de-Tyson-Foods.jpg

The U.S. government's latest report card on food poisoning suggests that a germ commonly linked to raw milk and poultry is surpassing salmonella at the top of the culprit list.

The report counts cases in only 10 states for nine of the most common causes of foodborne illness, but is believed to be a good indicator of national food poisoning trends.

Highlights from Thursday's report from the Centers for Disease Control and Prevention:

WHAT'S MAKING US SICK?
The most common bug last year was campylobacter. It's mostly a problem in unpasteurized dairy products, but also is seen in contaminated chicken, water, and produce. Salmonella was No. 1 for the last 20 years but last year moved down to No. 2. Other causes like listeria, shigella and E. coli trail behind.

IS FOOD POISONING GETTING WORSE?
Actually, no. Last year, there were no significant changes in new case rates for most kinds of food poisoning, compared to the previous three years. The new report tallied about 24,000 illnesses and 98 deaths in the 10 states. The CDC estimates that 1 in 6 Americans get sick from contaminated food each year, though most cases are not reported.

ANY OTHER GOOD NEWS?
Yes. There's been a continued decline in illnesses from what used to be the most common strain of salmonella — called Salmonella Typhimurium. That's possibly because of vaccinations of chicken flocks and tighter regulations.

WHAT CHANGED IN THE REPORT?
Before this report, the CDC only counted results from traditional lab tests, which can take a couple of days. But the agency is now including results from new rapid tests, which check for 20 or more bugs and give results in an hour. Those tests are picking up more campylobacter but with the caveat that those might be dead germs that didn't cause any illness. While quicker, the new technology doesn't offer as many specifics and is making it more difficult to understand food poisoning trends.

CAN I PREVENT FOOD POISONING?
Yes. Carefully wash and clean food, and cook meat, poultry and eggs thoroughly. Avoid raw milk and unpasteurized juices. Promptly refrigerate leftovers. According to a U.S. government report, leafy greens like lettuce and spinach are the biggest source of food poisoning, and produce, in general, accounted for nearly half of all illnesses.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Sweet Drinks Linked to Dementia: Study]]>Thu, 20 Apr 2017 18:26:51 -0400http://media.nbcnewyork.com/images/213*120/NC_drinksdementia0420_1500x845.jpg

Don't be so fast to finish that soda. The latest report from the Framingham Heart Study found that people who frequently drink sodas and fruit juices are more likely to have a poorer memory and less brain volume. Additionally, people who drink artificial sweeteners were three times as likely to develop both strokes and dementia. ]]>
<![CDATA[White House Pushes Uncertain Bid to Revive Health Care Bill]]>Thu, 20 Apr 2017 20:21:41 -0400http://media.nbcnewyork.com/images/213*120/656969512-Donald-Trump-Medicaid.jpg

Eager for a victory, the White House expressed confidence Thursday that a breakthrough on the mired Republican health care bill could emerge in the House next week. The chamber's GOP leaders, burned by a March debacle on the measure, were dubious and signs were scant that an emerging plan was gaining enough votes to succeed.

During a White House news conference, Trump said progress was being made on a "great plan" for overhauling the nation's health care system, though he provided no details.

"We have a good chance of getting it soon," Trump said. "I'd like to say next week."

The White House optimism is driven largely by a deal brokered by leaders of the conservative Freedom Caucus and the moderate Tuesday Group aimed at giving states more flexibility to pull out of "Obamacare" provisions. A senior White House official acknowledged that it was unclear exactly how many votes Republicans had, but said House Speaker Paul Ryan, R-Wis., has told the White House that a vote could come together quickly.

Yet GOP lawmakers and aides to party leaders, conservatives and moderates alike were skeptical that the House would vote next week on the health legislation. They cited the higher priority of passing a spending bill within days to avert a government shutdown, uncertainty over details of the developing agreement and a need to sell the idea to lawmakers.

Trump said he planned to get "both" a health care deal and a spending bill.

Many Republicans also expressed doubts that the health care compromise would win over enough lawmakers to put the bill over the top, especially moderates. The bill would repeal President Barack Obama's health care law and replace it with less generous subsidies and eased insurance requirements.

"Every time they move the scrimmage line, you risk losing other people who were 'yes' but this changes them to a 'no,'" Rep. Dan Donovan, R-N.Y., said Thursday of attempts to win over one end of the GOP spectrum without losing votes from the other side. The Staten Island centrist said he remained a no vote, partly because the legislation would increase Medicaid costs for New York City's five boroughs.

The White House official and most lawmakers and GOP congressional aides who spoke were not authorized to discuss the internal process publicly and insisted on anonymity.

An outline of a deal has been crafted by Rep. Mark Meadows of North Carolina, who heads the hard-line Freedom Caucus, and New Jersey Rep. Tom MacArthur, a Tuesday Group leader. Vice President Mike Pence also played a role in shaping that plan, Republicans say.

The plan would deliver a win to moderates by amending the GOP bill to restore Obama's requirement that insurers cover specified services like maternity care. But in a bid for conservative support, states would be allowed to obtain federal waivers to abandon that obligation.

In addition, states could obtain waivers to an Obama prohibition against insurers charging sick people higher premiums than customers who are healthy. To get those waivers, states would need to have high-risk pools — government-backed insurance for the most seriously ill people, a mechanism that critics say has often failed for lack of sufficient financing.

"It looks to me like we're headed in the right direction," Rep. Dave Brat, R-Va., a Freedom Caucus member, said Thursday. He said that assuming the outline is translated into legislative text he backs and is added to the health care bill, he would now support the legislation and believes most of Freedom Caucus' three dozen members would also back it.

The Tuesday Group has roughly 50 members. But they don't necessarily vote as a bloc, and it is unclear how many colleagues MacArthur would bring with him to such an agreement.

The White House is anxious to pass legislation quickly, partly because Trump will likely hit his 100th day in office without a having signed a major piece of legislation. The White House is eager to cap the stretch with a significant achievement that could give the president a burst of momentum.

But House GOP leaders face the same problem that's plagued them for seven years of trying to concoct a plan for repealing Obama's 2010 law: The party's conservatives and moderates are at odds over how to do it. With Democrats solidly opposed, Republicans can lose no more than 21 House votes to prevail, and Ryan short-circuited a planned vote last month because more than that would have defected.

That was a major embarrassment to Ryan and Trump, and House leaders are loath to bring a revised health care bill to the House floor unless they are convinced it would pass.

Ryan sent a mixed message about the bill's prospects in remarks Wednesday to reporters in London.

"It's difficult to do. We're very close," he said, adding, "It's just going to take us a little time."

Copyright Associated Press / NBC New York



Photo Credit: Alex Wong/Getty Images, File]]>
<![CDATA[CDC to Launch Awareness Campaign Warning of Opioid Dangers]]>Wed, 19 Apr 2017 16:21:08 -0400http://media.nbcnewyork.com/images/213*120/cms770.jpg

The Centers for Disease Control and Prevention plans to launch a new ad campaign to raise awareness about the dangers of opioid addiction.

CDC acting director Anne Schuchat discussed the problem at the National Rx Drug Abuse & Heroin Summit on Wednesday in Atlanta.

Schuchat said the rising rate of deaths and addiction due to opioids is a crisis for the nation.

She said the aim of the new campaign is to get doctors and patients thinking about the problem and know the risks involved with opioids before there's a tragedy.

Schuchat said the hope is that patients will become aware of these risks early on, so they can discuss the issue when they talk with their doctor instead of facing problems later.

Copyright Associated Press / NBC New York



Photo Credit: John Moore/Getty Images, File ]]>
<![CDATA[Overcoming Opioids: The Quest for Less Addictive Drugs]]>Mon, 17 Apr 2017 06:59:25 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-517239628-opioid-pills.jpg

Tummy tucks really hurt. Doctors carve from hip to hip, slicing off skin, tightening muscles, tugging at innards. Patients often need strong painkillers for days or even weeks, but Mary Hernandez went home on just over-the-counter ibuprofen.

The reason may be the yellowish goo smeared on her 18-inch wound as she lay on the operating table. The Houston woman was helping test a novel medicine aimed at avoiding opioids, potent pain relievers fueling an epidemic of overuse and addiction.

Vicodin, OxyContin and similar drugs are widely used for bad backs, severe arthritis, damaged nerves and other woes. They work powerfully in brain areas that control pleasure and pain, but the body adapts to them quickly, so people need higher and higher doses to get relief.

This growing dependence on opioids has mushroomed into a national health crisis, ripping apart communities and straining police and health departments. Every day, an overdose of prescription opioids or heroin kills 91 people, and legions more are brought back from the brink of death. With some 2 million Americans hooked on these pills, evidence is growing that they're not as good a choice for treating chronic pain as once thought.

Drug companies are working on alternatives, but have had little success.

Twenty or so years ago, they invested heavily and "failed miserably," said Dr. Nora Volkow, director of the National Institute on Drug Abuse.

Pain is a pain to research. Some people bear more than others, and success can't be measured as objectively as it can be with medicines that shrink a tumor or clear an infection. Some new pain drugs that worked well were doomed by side effects — Vioxx, for instance, helped arthritis but hurt hearts.

Some fresh approaches are giving hope:

  • "Bespoke" drugs, as Volkow calls them. These target specific pathways and types of pain rather than acting broadly in the brain. One is Enbrel, which treats a key feature of rheumatoid arthritis and, in the process, eases pain.
  • Drugs to prevent the need for opioids. One that Hernandez was helping test numbs a wound for a few days and curbs inflammation. If people don't have big pain after surgery, their nerves don't go on high alert and there's less chance of developing chronic pain that might require opioids.
  • Funky new sources for medicines. In testing: Drugs from silk, hot chili peppers and the venom of snakes, snails and other critters.
  • Novel uses for existing drugs. Some seizure and depression medicines, for example, can help some types of pain.

The biggest need, however, is for completely new medicines that can be used by lots of people for lots of problems. These also pose the most risk — for companies and patients alike.

ONE DRUG'S BUMPY ROAD
In the early 2000s, a small biotech company had a big idea: blocking nerve growth factor, a protein made in response to pain. The company's drug, now called tanezumab (tah-NAZE-uh-mab), works on outlying nerves, helping to keep pain signals from muscles, skin and organs from reaching the spinal cord and brain — good for treating arthritis and bad backs.

Pfizer Inc. bought the firm in 2006 and expanded testing. But in 2010, some people on tanezumab and similar drugs being tested by rivals needed joint replacements. Besides dulling pain, nerve growth factor may affect joint repair and regeneration, so a possible safety issue needed full investigation in a medicine that would be the first of its type ever sold, said one independent expert, Dr. Jianguo Cheng, a Cleveland Clinic pain specialist and science chief for the American Academy of Pain Medicine.

Regulators put some of the studies on hold. Suddenly, some people who had been doing well on tanezumab lost access to it. Phyllis Leis in Waterfall, a small town in south-central Pennsylvania, was one.

"I was so angry," she said. "That was like a miracle drug. It really was. Unless you have arthritis in your knees and have trouble walking, you'll never understand how much relief and what a godsend it was."

Her doctor, Alan Kivitz of Altoona Center for Clinical Research, has helped run hundreds of pain studies and consults for Pfizer and many other companies. "You rarely get people to feel that good" as many of them did on the nerve growth factor drugs, he said.

A drug with that much early promise is unusual, said Ken Verburg, who has led Pfizer's pain research for several decades.

"When you do see one, you fight hard to try to bring one to the market," he said.

An independent review ultimately tied just a few serious joint problems to tanezumab and the suspension on testing was lifted in August 2012. But a new issue — nervous system effects in some animal studies — prompted a second hold later that year, and that wasn't lifted until 2015.

Now Eli Lilly & Co. has joined Pfizer in testing tanezumab in late-stage studies with 7,000 patients. Results are expected late next year — about 17 years after the drug's conception.

AVOIDING PAIN TO AVOID DRUGS
What if a drug could keep people from needing long-term pain relief in the first place? Heron Therapeutics Inc. is testing a novel, long-acting version of two drugs — the anesthetic bupivacaine and the anti-inflammatory meloxicam — for notoriously painful operations like tummy tucks, bunion removal and hernia repair.

Company studies suggest it can numb wounds for about three days and cut patients' need for opioids by 30 to 50 percent.

There's a good chance of preventing brain responses that lead to chronic pain if patients can get through that "initially very rough period," said Dr. Harold Minkowitz, a Houston anesthesiologist who consults for Heron and treated Hernandez in the tummy tuck study.

Hernandez was part of an experiment testing the drug versus a placebo and doesn't know whether she got the drug or a dummy medicine. But she hurt less than she expected to and never filled a prescription for pain pills.

"The goal would be to have half or more of patients not requiring an opiate after they go home," said Heron's chief executive, Barry Quart. "You have far fewer opiates going out into society, far fewer opiates sitting in medicine cabinets that make their way to a high school."

Studies so far are mid-stage — too small to prove safety and effectiveness — but Heron plans more aimed at winning approval.

ON THE HORIZON
Many companies have their eyes on sodium channel blockers, which affect how nerves talk to each other and thus might help various types of pain. Others are testing cell therapies for nerve pain. Stem cells can modulate immune responses and inflammation, and may "overcome a raft of problems," said Cheng of the pain medicine academy.

Some companies, including Samumed, Centrexion Therapeutics and Flexion Therapeutics, are testing long-acting medicines to inject in knees to relieve arthritis pain. Samumed's aims to regenerate cartilage.

And then there's marijuana. A cannabis extract is sold as a mouth spray in Britain for nerve pain and other problems from multiple sclerosis. But cannabinoid research in the U.S. has been hampered by marijuana's legal status. A special license is needed and most researchers don't even try to obtain one, said Susan Ingram, a neurosurgery scientist at Oregon Health & Science University.

She is studying cannabinoid receptors in the brain, looking at how pain affects one type but not another. Such work might someday lead to drugs that relieve pain but don't produce a high or addiction.

Selective activity has precedent: The drug buprenorphine partially binds to opioid receptors in the brain and has become "an extraordinarily successful medication" for treating addiction, said Volkow, of the national drug institute.

"It has shown pharmaceutical companies that if you come up with a good intervention, there is an opportunity to recover their costs," she said.

Copyright Associated Press / NBC New York



Photo Credit: John Moore/Getty Images, File]]>
<![CDATA[How Trump Insurance Changes Could Affect Coverage Next Year]]>Fri, 14 Apr 2017 17:15:09 -0400http://media.nbcnewyork.com/images/213*120/paulryanhealth_1200x675.jpg

A much tighter sign-up deadline and coverage delays will be waiting for some health insurance customers now that President Donald Trump's administration has finished a plan designed to stabilize shaky insurance markets.

Shoppers will have a shorter time period to choose a 2018 plan and a harder time enrolling outside that window if they lose a job or have some other special circumstance that affects their coverage. Insurers also will have more flexibility to design lower-cost coverage under a set of changes announced Thursday for the Affordable Care Act's insurance exchanges.

The exchanges, accessed by customers through the federal HealthCare.gov or state-run sites, were established as a way for people to compare and shop for insurance coverage. But insurers have raised prices sharply or abandoned markets in many regions, leaving some customers with little choice.

Companies are considering leaving more markets for next year because they say they are losing money. The administration as responded with a series of changes aimed at reducing the number of insurance company defections while it pursues a broader remake of the federal law.

These changes may help convince insurers to return to the market for next year, but they also could make shopping tougher for consumers in a few ways.

Customers will have 45 days to shop for 2018 coverage, starting Nov. 1 and ending Dec. 15. In previous years, they had twice that much time, and could still buy coverage until Jan. 31. The tighter time frame aims to prevent people from gaming the system by waiting until they become sick before signing up for coverage.

The smaller enrollment window could be tough on some shoppers because they often have to search for an insurance plan that includes their doctor to avoid big medical bills. That's no quick task when a patient has several doctors, insurers are leaving exchanges, and those that remain have narrow doctor networks. Then shoppers have to figure out whether they can afford the coverage and if any tax credits are available to help.

"It's a very delicate subject when you're dealing with someone's health and if the plan doesn't work, you're stuck with it for the next year," said Dallas-based broker Tanya Boyd. "It's not a five-minute conversation."

The administration also placed curbs on "special enrollment periods" that allow consumers to sign up or change coverage outside the normal enrollment period if they have a big change in their life like a move, divorce or the birth of a child. Insurers say loose enforcement of these periods has been an expensive problem because it also allows people to game the system.

Customers will now have to verify first that they qualify for a special-enrollment period before they can enroll. That could create coverage delays.

"For some people, the hassle or difficulty in pulling together verification could discourage them from signing up altogether," said Larry Levitt, a health insurance expert with the Kaiser Family Foundation, which studies health care issues.

The administration also gave insurers more flexibility to design lower-cost coverage that may attract younger and healthier customers, which would help insurers offset the higher cost of insuring older, less healthy people. That lower-cost coverage could come with a higher deductible, though, which means those customers will need to pay more out of their own pockets for most care before the insurer starts paying.

Whether these changes help convince insurers to stick around for 2018 remains to be seen. They are weighing their options and may soon announce whether they plan to offer coverage for next year. But customers won't know for sure for months, because insurers can still back out up to a few weeks before the start of the open enrollment period.

Insurers have called the changes — most of which they had requested — a step in the right direction. But a key concern has yet to be addressed.

Insurers, doctors, hospitals and the business community have asked the Trump administration to preserve "cost-sharing" subsidies that help reduce the impact of high deductibles and copayments for consumers with modest incomes. These are separate from the better-known so-called premium subsidies that most customers receive.

The cost-sharing subsidies, estimated at $7 billion year, have been challenged in a court case that's now on hold. Without the payments, experts say, the government marketplaces that provide private insurance for about 12 million people will be overwhelmed by premium increases and insurer departures.

The Trump administration has indicated that the payments will continue as long as the case is being litigated, but insurers want more of an assurance that these subsidies will be available next year.

In a Wall Street Journal interview this week, Trump raised the possibility of shutting off the money if Democrats won't bargain on health care. But the president also said he hasn't made up his mind, and that he doesn't want people to get hurt.

Most communities will have competing insurers on their public marketplaces next year, but a growing number will be down to one, and some areas may face having none.

Premium increases averaged 25 percent this year for standard plans in states served by HealthCare.gov.

Prices could climb another 10 percent or more next year due to higher medical expenses that affect coverage sold both on and off the public exchanges, according to Dave Dillion of the Society of Actuaries.

 

AP writer Ricardo Alonso-Zaldivar contributed to this report from Washington, D.C.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Hyland's Teething Tablets Recalled Over Levels of Toxic Herb]]>Fri, 14 Apr 2017 17:06:27 -0400http://media.nbcnewyork.com/images/213*120/Hyland-Teething-Tablet-Recall.jpg

The maker of Hyland's teething tablets has issued a recall for any remaining packages at the urging of U.S. regulators, who say the medicine has inconsistent levels of a herb that can be poisonous.

Standard Homeopathic Co. of Los Angeles, stopped making and shipping the tablets last October. It said it's notifying distributors and stores to return any leftover products, while consumers should throw them out.

The recall announced late Thursday covers Hyland's Baby Teething Tablets and Hyland's Baby Nighttime Teething Tablets, meant to relieve gum discomfort from emerging teeth.

The Food and Drug Administration, which has been investigating the safety of such products for some time, had issued a warning in September that homeopathic teething tablets containing the herb, belladonna, shouldn't be used. Belladonna, also called nightshade, is a poisonous herb that nonetheless has been used at low dosages as a homeopathic medicine for centuries.

"FDA believes that belladonna represents a serious health hazard to children and that the effects of belladonna are unpredictable," the company said in its recall notice.

According to the FDA, some homeopathic teething products are made with very small amount of belladonna, but at levels so low they should not be detectible even with FDA's sophisticated testing. However, the agency found varying levels of belladonna when it tested Hyland's teething tablets, including some that far exceeded what was listed on the labels.

The company stopped making the tablets, but the FDA had been urging the company to issue a recall for months.

The FDA noted at the time that such tablets were sold online and in stores by Hyland's, pharmacy chain CVS and other companies. CVS promptly pulled from store shelves and stopped online sales of all belladonna-containing teething products, including its store brand and Hyland's.

FDA urged consumers to contact a doctor if young children who have used the teething tablets have symptoms including seizures, difficulty breathing, lethargy, skin flushing and agitation.

Copyright Associated Press / NBC New York



Photo Credit: Hyland's Homeopathic via FDA]]>
<![CDATA[Trump Allows States to Block Some Abortion Provider Funding]]>Fri, 14 Apr 2017 07:02:12 -0400http://media.nbcnewyork.com/images/180*120/criticos-veto-1.jpg

Further chipping away at his predecessor's legacy, President Donald Trump signed legislation Thursday that lets states deny federal family planning money to Planned Parenthood and other abortion providers.

Trump's action erases a rule, finalized shortly before President Barack Obama left office in January, that said states could not block the money. It's the latest Obama regulation that Trump has overturned.

Undoing the prohibition also gives Republicans and anti-abortion groups a victory after House Republicans failed to agree last month on a bill they had sought for years to overhaul the health care system. The failed House bill, which Trump supported, would have blocked federal money for Planned Parenthood for a year, in addition to repealing portions of Obama's 2010 health law.

Federal law already prohibits government money for abortion, except in cases of rape or incest, or to save a woman's life.

The rule tossed out by Trump required state and local governments to distribute federal dollars for family planning services, including contraception, sexually transmitted diseases, fertility, pregnancy care, and breast and cervical cancer screening, to qualified health providers, irrespective of whether the providers also performed abortions.

Republicans and abortion opponents said the new law will let states divert money now going to groups that perform abortions to organizations that do not.

Democrats and abortion rights advocates said it represented an attack on women.

Seema Verma, who oversees Medicare and Medicaid, said after Trump signed the bill in the Oval Office that the administration wants states to decide what's best for them and the people they serve.

Marjorie Dannenfelser, president of the anti-abortion group Susan B. Anthony List, said the change will lead to better care for women and girls. She said the law "simply ensures that states are not forced to fund an abortion business with taxpayer dollars." She said states will now have the option to spend federal family planning funds on comprehensive health care clinics.

Stephanie Schriock, president of Emily's List, which supports Democratic female candidate for public office who support abortion, said the bill is another example of politicians chipping away at women's rights and making it harder for the less fortunate to get health care.

"We won't stand for it," Schriock said.

Dawn Laguens, executive vice president of the Planned Parenthood Federation of America, said the administration should build on the progress that's been made "instead of enacting policies that take us backward."

The measure narrowly cleared the Senate in late March after Sen. Johnny Isakson, R-Ga., who had been absent while recovering from spinal surgery, returned to Washington to vote, bringing the tally to 50-50 in the 100-member chamber.

Vice President Mike Pence, in his constitutional role as president of the Senate, cast the tie-breaking vote.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File]]>
<![CDATA[Marathons May Delay Medical Care for Non-Runners]]>Thu, 13 Apr 2017 09:06:10 -0400http://media.nbcnewyork.com/images/213*120/20151006+Marine+Corps+Marathon1.jpgMarathons can be risky for hearts, but not necessarily those of the runners. It takes longer for nearby residents to get to a hospital for emergency heart care on the day of a race and they're less likely to survive, a U.S. study finds.

Photo Credit: Getty Images]]>
<![CDATA[Apple Working on the Holy Grail for Treating Diabetes]]>Wed, 12 Apr 2017 19:30:41 -0400http://media.nbcnewyork.com/images/213*120/Tim-Cook-GettyImages-476377538.jpg

Apple has hired a small team of biomedical engineers to work at a nondescript office in Palo Alto, miles from corporate headquarters, CNBC reported Wednesday.

They are part of a super secret initiative, initially envisioned by the late Apple co-founder Steve Jobs, to develop sensors that can non-invasively and continuously monitor blood sugar levels to better treat diabetes, according to three people familiar with the matter.

Such a breakthrough would be a "holy grail" for life sciences. Many life sciences companies have tried and failed, as it's highly challenging to track glucose levels accurately without piercing the skin.

The initiative is far enough along that Apple has been conducting feasibility trials at clinical sites across the Bay Area and has hired consultants to help it figure out the regulatory pathways, the people said.

Copyright Associated Press / NBC New York



Photo Credit: Bloomberg via Getty Images, File]]>
<![CDATA[The Most Popular Easter Candies Ranked by Nutrition]]>Thu, 13 Apr 2017 09:21:44 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-57339112.jpg

'Tis the season for dyeing Easter eggs — and snacking on chocolate ones. Worried you'll wreck your healthy eating streak come Easter Sunday on April 16?

NBC News sized up the nutrition labels of some of the most popular Easter candies, with a strong focus on calories, fat and sugar content per serving — as well as the serving size.

Reese’s Peanut Butter Eggs top the list at only 90 calories and 8 grams of sugar per serving. Health-conscious snackers can also choose Tootsie Easter Egg Shaped Pops, which rank at No. 2.

Brach’s Tiny Jelly Bird Eggs round out NBC’s list at No. 9, with 250 calories and a whopping 53 grams of sugar per serving.



Photo Credit: Joe Raedle/Getty Images]]>
<![CDATA[Trans Fat Ban Linked With Fewer NY Heart Attacks & Strokes]]>Wed, 12 Apr 2017 14:23:47 -0400http://media.nbcnewyork.com/images/213*120/transfatfoodGETTY.jpg

Local bans on artery-clogging trans fats in restaurant foods led to fewer heart attacks and strokes in several New York counties, a new study suggests.

The study hints at the potential for widespread health benefits from an upcoming nationwide ban, the authors and other experts say. The U.S. Food and Drug Administration in 2015 gave the food industry until next year to eliminate artificial trans fats from American products.

New York City enacted a restaurant ban on the fats in 2007 and several counties in the state did the same. Hospital admissions for heart attacks and strokes in those areas declined 6 percent starting three years after the bans, compared with counties without bans. The results translate to 43 fewer heart attacks and strokes per 100,000 people, said lead author Dr. Eric Brandt, a Yale University cardiology fellow.

His study was published Wednesday in JAMA Cardiology.

Trans fats, also called partially hydrogenated oils, enhance food texture and structure. They were once commonly used to make restaurant fried chicken, French fries, doughnuts and other foods and found in grocery items including cookies, crackers and margarine.

These fats can boost blood levels of unhealthy cholesterol, increasing risks for heart problems. The FDA in 2006 required them to be listed on food labels and the food industry has been switching to healthier oils.

The researchers examined hospital admissions data from 2002 to 2013 in 11 New York counties that adopted bans and in 25 counties that did not. Admissions for heart attacks and strokes declined in all counties, going from more than 800 to less than 700 per 100,000 people, but the drop was steeper in counties that enacted bans.

Alice Lichtenstein, a heart and nutrition specialist at Tufts University's Boston campus, said the results are encouraging but that other changes could have contributed, such as smoking bans and mandatory calories on menus.

Dr. Mark Creager, former American Heart Association president, said the results echo previous studies "and are consistent with the thinking of most scientists" on potential benefits of these bans.

"Policies such as these when adapted on a nationwide level will be good for our entire population," said Creager, director of Dartmouth-Hitchcock Medical Center's heart center in Lebanon, New Hampshire.

Copyright Associated Press / NBC New York



Photo Credit: Scott Olson/Getty Images]]>
<![CDATA[New Robot Helps People With Paralysis Walk]]>Wed, 12 Apr 2017 09:56:00 -0400http://media.nbcnewyork.com/images/214*120/Screen+Shot+2017-04-12+at+9.55.07+AM.png

A wearable robotic leg brace that can help partially paralyzed people walk was unveiled in Tokyo on April 12.

The Welwalk WW-1000 system is made up of a motorised mechanical frame that fits on a person's leg from the knee down. Patients wearing the robotic device can then practice walking on a special treadmill that can support their weight. It was designed by Toyota Motor Corp. along with specialists from Fujita Health University.

One hundred such systems will be rented to medical facilities in Japan later this year, Toyota said.

Copyright Associated Press / NBC New York

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<![CDATA[After Flint Water Crisis, Group Files Suit for AG Emails]]>Tue, 11 Apr 2017 16:29:37 -0400http://media.nbcnewyork.com/images/213*120/michiganAGSchuette_1200x675.jpg

Michigan Attorney General Bill Schuette was sued Tuesday after his office rejected a public-records request for his and 20 staffers' private emails that a liberal advocacy group said were used to conduct government business over a six-year period.

Progress Michigan filed its lawsuit in the Court of Claims, nearly six months after the department largely denied the request by saying it did not possess the records. State employees who use personal email accounts to perform official functions are clearly creating public records subject to Michigan's Freedom of Information Act, according to the suit.

When Republican Gov. Rick Snyder, whose office is exempt from Michigan's open-records law, voluntarily released thousands of pages of emails related to the Flint water crisis last year, some emails showed Snyder and his staff using their personal accounts.

Progress Michigan said it learned through previous FOIA requests that the Republican attorney general and at least 12 other current or former employees had used their personal email accounts for official work. The suit cites a series of emails between May 2014 and May 2015 in which senior staff meetings, news conferences and media interviews were scheduled.

"For the attorney general to come back and say they don't exist and we don't possess them is simply not true," said Mark Brewer, the group's attorney. "We attached examples to the complaint of the fact that they do exist. So the question before the court is, 'Is the attorney general lying about whether they exist or not or were they improperly destroyed or what happened to these emails?'"

Schuette spokeswoman Andrea Bitely said the suit was being reviewed. She declined to comment further on pending litigation.

The use of private email for government business has become more prominent nationally. Republicans frequently criticized Democratic presidential nominee Hillary Clinton's use of a private email server as secretary of state. Vice President Mike Pence more recently has come under scrutiny for using an AOL account to conduct state business when he was Indiana's governor.

Brewer said he was unaware of any Michigan court ruling specifically on the issue of government officials' having to disclose private emails that discuss official business.

"What's critical under the Freedom of Information Act is, 'Have you created a public record?'" he said. "The medium in which it's created is irrelevant." 

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Prostate Cancer Tests Get Gov. Panel's OK, With Caveats]]>Tue, 11 Apr 2017 09:12:09 -0400http://media.nbcnewyork.com/images/213*120/AP_17098053067250-Prostate-Cancer-Screening.jpg

An influential U.S. government health panel is dropping its opposition to routine prostate cancer screening in favor of letting men decide for themselves after talking with their doctor.

The new draft guidelines echo those of several leading medical groups, but they don't make the decision any easier for men: With their doctor's help, they have to decide whether to take an imperfect PSA test that has a small chance of detecting a deadly cancer and a larger chance of triggering unneeded worry and treatment with serious side effects.

"This isn't a one-size-fits-all" recommendation, said the panel's chair Dr. Kirsten Bibbins-Domingo, a San Francisco internist who already follows the advice and discusses the potential pros and cons with her patients.

Men whose greatest concern is reducing their chances of dying from cancer are sometimes willing to face the consequences and choose testing. "Other men will realize the likely benefit is small and aren't willing to risk the harms," she said.

PSA screening to detect the most common male cancer is among the most heated topics in men's health. It involves a simple blood test for elevated levels of a protein that may signal cancer but also can be caused by less serious prostate problems. It can find cancer that frequently doesn't need treatment because it's too small and slow growing to become deadly. Doctors say there's no good way to tell which early cancers might become lethal. The next step is often radiation or surgery to remove the prostate, which may result in impotence and incontinence.

The U.S. Preventive Services Task Force says its latest recommendation is based on new evidence indicating that routine PSA blood tests can slightly reduce some men's chances of dying from prostate cancer and that drastic treatment can be avoided with close monitoring when cancer is detected.

The shift shelves the panel's 2012 guidance, which prompted criticism from some urologists — specialists who treat the disease — and angered some prostate cancer patients certain that PSA screening had saved their lives.

The new advice published Tuesday closely aligns the panel with medical groups that also support shared-decision-making. The biggest remaining difference is timing. The task force draft says screening conversations should begin at age 55. Other groups say start earlier, depending on family history of prostate cancer and other factors. It recommends against testing men aged 70 and older.

The panel leaves open how often men should be screened. It does not recommend earlier testing for blacks and those with a family history but says they should know their risks are higher.

Dr. Meir Stampfer, a Harvard University cancer expert, called the new advice "a more reasoned approach." He said PSA tests make sense if they do not lead to overly aggressive treatment. His research suggests that more than 1 in 5 men worldwide have undetected prostate cancer, including more than 40 million Americans, but that most will die of other causes.

The task force's 2012 advice against screening said there was little evidence that PSA screening was reducing deaths. Since then, PSA screening rates have declined by as much as 10 percent, and now fewer than one-third of U.S. men get the tests. Fewer men are being diagnosed with early-stage disease, when it is more treatable, while more are being diagnosed with more aggressive harder-to-treat cancer.

The panel says its new advice stems from long-term research indicating that for every 1,000 men offered PSA screening, one to two will avoid death from prostate cancer and three will avoid prostate cancer spreading to other organs.

Newer research also has shown benefits from "active surveillance" of men whose initial PSA tests and biopsies indicate slow-growing cancer that hasn't spread, the panel said. This approach includes repeated PSA tests and close monitoring, which can delay or even avoid the need for treatment.

The task force's recommendations influence U.S. government policy and are widely followed by primary care physicians. Medicare and many private insurers have continued to pay for the screening. The government-appointed volunteer panel reviews evidence and issues advice for a variety of screenings and treatments.

"It sounds like cooler heads have prevailed," said Dr. Jim Hu, a urologist and prostate cancer specialist at New York-Presbyterian/Weill Cornell Medical Center who called the old advice "draconian."

The prostate cancer recommendations, announced online in the Journal of the American Medical Association, are open for public comment on the task force website until May 8. Final guidance will come months later but the panel's guidelines typically echo its draft advice.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Eric Risberg]]>
<![CDATA[Fresh Express Recalls Packaged Salad After Bat Found: CDC]]>Mon, 10 Apr 2017 08:24:22 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-71902781.jpg

Fresh Express recalled some of its prepackaged salad mix after a dead bat was found inside a container sold in a Florida Wal-mart, according to the Centers for Disease Control and Prevention.

Two people said they found a dead bat in their purchased package, and that they had eaten some of the salad before discovering the animal, according to a CDC statement

The center added that the bat was sent to its lab to be tested for rabies, but the animal's deteriorated condition did not allow for a conclusive test.

Wal-Mart removed the product from its store shelves.

The company on Saturday announced a recall of a limited quantity of its 5-ounce Organic Marketside Spring Mix packages. The salads were sold in a clear container with production code G089B19 and best-if-used-by date of April 14, 2017. The announcement said the recalled packages were only distributed to Wal-mart stores located in the Southeastern region of the United States.

As a precaution, the pair who ate the salad were recommended to undergo rabies treatment. However, the CDC said transmission of the disease by eating a rabid animal is "extremely uncommon."

"Both people report being in good health and neither has any signs of rabies," the CDC said in the statement.

Consumers who ate salad from recalled packages without animal matter are not at risk, the CDC added.

Still, Fresh Express advised anyone who has purchased the recalled product to throw it out and not eat it. Those who have questions or wish to receive a full refund for their purchase can call the Fresh Express Consumer Response Center 1-800-242-5472 from 8 a.m. to 7 p.m. Eastern Time.

The CDC said it is working with the Florida Department of Health and the U.S. Food and Drug Administration to support an investigation of the incident.



Photo Credit: Getty Images, File]]>
<![CDATA[Woman's Blood Leads to Potential Treatment for Ebola Cousin]]>Sat, 08 Apr 2017 17:39:49 -0400http://media.nbcnewyork.com/images/213*120/AP_383650526882.jpg

A woman came back from a trip to the Uganda jungle with Marburg virus, a cousin of Ebola that's even deadlier, NBC News reported.

Now, Michelle Barnes' blood has a provided a potential cure for the infection.

Researchers at Vanderbilt University and Mapp Biopharmaceutical Inc. isolated an especially potent immune system protein called a monoclonal antibody from Barnes and have used it to cure monkeys infected not only with Marburg virus, but with a related virus called Ravn.

They are working to find ways to mass-produce the antibody and test it in people.

The hope is to have supplies ready in case of outbreaks of viruses like Marburg and Ebola, which killed more than 11,000 people and sickened 28,000 in a 2014-2016 epidemic in West Africa.

"If somebody needed to get Marburg virus so you could donate your cells for research, I am glad it was me," Barnes said. "I happen to have really good immunity."



Photo Credit: AP Photo/Ben Curtis]]>
<![CDATA[Cancer-Causing HPV Virus Affects 1 in 4 US Men: Study]]>Thu, 06 Apr 2017 13:57:32 -0400http://media.nbcnewyork.com/images/213*120/vaccine-AP_701393247962.jpg

New government statistics show that 25 percent of men have the strain of HPV (human papillomavirus or human wart virus) that causes cancer, NBC News reported.

Twenty percent of women have the same strain as well, and 45 percent of men have some kind of genital HPV, according to new data from the National Center for Health Statistics. People under 25 are able to receive a vaccine that can protect them from cancer-causing HPV strains, but for the rest of the population, the virus is still an issue.

Neck and head cancer are some of the implications of HPV, and some experts say that 70 percent of all head and neck cancers are caused by HPV, most likely spread through oral sex.

"Human papillomavirus is the most common sexually transmitted infection in the United States," wrote the team at the NCHS, part of the Centers for Disease Control and Prevention.



Photo Credit: John Amis/AP, File ]]>
<![CDATA[People With Chronic Pain Scared by Ohio's New Opioid Rules]]>Thu, 06 Apr 2017 06:38:37 -0400http://media.nbcnewyork.com/images/213*120/AP_16273781823723oxy.jpg

People dealing with chronic pain say recent moves by Ohio's governor to fight the plague of opioid overdoses could leave them suffering, NBC News reported.

Gov. John Kasich restricted how many painkillers may be prescribed to patients, but people who rely on the drugs say the rules could force them to go underground to find relief from their anguish.

"We are being punished for being in pain," said Amy Monahan-Curtis, 44, who has been living in agony since 1993 due to a condition called cervical dystonia, which causes her neck muscles to contract involuntarily.

She doesn't believe assurances from officials that the rules only apply to acute pain, not chronic pain.



Photo Credit: Toby Talbot/AP]]>
<![CDATA[FDA Approves More Drugs, and Faster, Than Europe: Study ]]>Wed, 05 Apr 2017 19:24:16 -0400http://media.nbcnewyork.com/images/213*120/genericpharmacy_1200x675.jpg

Contrary to some political claims, the U.S. Food and Drug Administration approved more drugs, and two to three months faster on average, than European regulators did in recent years, new research shows.

"It's an urban myth" that the FDA is slower than other countries to clear promising treatments for patients, said the agency's longtime cancer drugs chief, Dr. Richard Pazdur.

He had no role in the approval rate research, which was published Wednesday in the New England Journal of Medicine.

The new research compared how new drugs fared before the FDA and the European Medicines Agency between 2011 and 2015. The FDA approved more drugs than the Europeans — 170 versus 144 — with a median review time of 306 days versus 383 days in Europe.

Reviews were speedier at the FDA for drugs for cancer and blood diseases, but not other maladies, compared to the Europeans. The FDA also moved quicker on so-called orphan drugs, for relatively rare conditions.

The results are similar to a previous analysis that some of the same researchers did for therapies approved between 2001 and 2010. The latest study was done by Dr. Nicholas Downing at Boston's Brigham and Women's Hospital, Audrey Zhang at New York University and Dr. Joseph Ross at the Yale School of Medicine.

President Donald Trump has called the FDA's drug approval process "slow and burdensome," and his nominee to head the agency, Dr. Scott Gottlieb, has criticized what he calls unnecessary regulations. Gottlieb's confirmation hearings began on Wednesday.

Some other doctors defended the FDA's track record.

"We're the best in the world. Our FDA is great," said Dr. George Demetri of the Dana-Farber Cancer Institute. He is a board member of the American Association for Cancer Research, and spoke from the group's annual meeting in Washington, attended by some 20,000 cancer scientists from around the world. 

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Trump's FDA Pick Says Tackling Opioid Crisis a Top Priority]]>Wed, 05 Apr 2017 16:48:59 -0400http://media.nbcnewyork.com/images/213*120/Scott_Gottlieb_AEI.jpg

The doctor nominated to head the powerful Food and Drug Administration told senators Wednesday that his first priority would be tackling the opioid crisis, and he pledged that science will prevail at the agency despite his extensive financial ties to medical companies it regulates.

Dr. Scott Gottlieb is a physician-turned-health consultant who has criticized many FDA regulations as unnecessary and has what opponents call unprecedented financial entanglements.

But Gottlieb told a Senate health committee that as a cancer survivor, he knows firsthand the importance of "what the FDA does for every one of us" and promised to "lead the FDA as an impartial and passionate advocate for public health."

He stressed the balance between speeding new products to market and making sure that good science continues to guide the FDA's decisions.

"We should reject a false dichotomy that it all boils down to a choice between speed and safety," Gottlieb said. At the same time, "we need to make sure we're getting the most bang for our regulatory buck," he added.

Gottlieb said opioid addiction is "the biggest crisis facing the agency" and as serious a public health challenge — for the entire government, not just FDA — as infectious diseases like Ebola or Zika. He said tackling the crisis would be his first priority and will "require dramatic action," including finding ways to spur development of non-addictive alternative painkillers as well as addiction treatments.

Gottlieb, 44, is no stranger to the FDA, which regulates products that affect about a quarter of all consumer spending — everything from new drugs and medical devices to food safety, nutrition labeling, tobacco and e-cigarettes, animal drugs and cosmetics. He was a deputy commissioner under President George W. Bush.

"My hope is that you will help move the agency forward so that America's patients benefit from the remarkable discoveries our nation's researchers are working on," said Sen. Lamar Alexander, R-Tenn., who chairs the Senate Health, Education, Labor and Pensions Committee.

But critics have focused on Gottlieb's finances, citing government data showing he received hundreds of thousands of dollars in consulting or other fees from several FDA-regulated companies in recent years, on top of income from positions in a venture capital firm and investment bank that also fund health companies.

In ethics documents filed last week, Gottlieb said that if confirmed as FDA's commissioner he would recuse himself for a year from decisions involving about 20 companies, including drug giant GlaxoSmithKline, and would resign positions including as a board member or consultant with nine other health-related companies. Gottlieb also is a resident fellow at the conservative American Enterprise Institute, from which he said he also would resign.

But Sen. Patty Murray of Washington, the committee's senior Democrat, questioned whether recusals are enough to erase the bias of being a pharmaceutical industry insider when dozens of drugs being developed by those companies could come before the FDA.

"What I'm concerned about is how your involvement with so many companies shapes your priorities," she said.

Gottlieb responded, "I get it. I understand how important the impartiality of this agency is so people continue to have trust in the decisions FDA makes."

"I want to earn and keep the public's trust," he said.

Other issues raised Wednesday:

—Gottlieb made clear that he disagreed with President Donald Trump's contention that vaccines may be linked to autism. Gottlieb said that has been "one of the most exhaustively studied questions in scientific history" and it was time to accept the conclusions of those studies that "there is no causal link."

—Gottlieb said he was committed to tobacco control, saying, "I am not going to countenance a rise in adolescent smoking rates in this country under my watch." Pressed on e-cigarettes that increasingly come with kid-friendly flavors like gummy bears, Gottlieb said vaping has a role in helping established smokers quit but that with the flavorings, "I recognize there is a line here somewhere and I don't know where that line gets drawn."

—On drug pricing, Gottlieb said it was time to adjust FDA policies that make it difficult to quickly approve lower-cost generic versions of certain treatments, particularly drug-and-device combinations.

—As for FDA's food side, Gottlieb deferred questions about advice on seafood consumption during pregnancy, genetically engineered salmon and new nutrition labels set for next year, saying he needed to hear from FDA's scientists and staff.

Copyright Associated Press / NBC New York



Photo Credit: AEI]]>
<![CDATA[1 in 10 US Pregnant Women With Zika Have Babies With Defects]]>Tue, 04 Apr 2017 19:59:22 -0400http://media.nbcnewyork.com/images/213*120/zikamosquito_1200x675.jpg

About 1 out of 10 women in the United States who tested positive for the Zika infection had a fetus or baby with Zika-related birth defects, according to a new report from the Centers for Disease Control and Prevention. 

The CDC's Vital Signs report is the first to provide an analysis of a subgroup of 250 pregnant women in the U.S. with confirmed test results of Zika virus infection. Zika testing remains complex because there is a narrow timeframe for obtaining a positive laboratory result, and many infected people do not show symptoms, the CDC said. 

The lack of motivation for testing led the CDC to monitor all pregnant women with any evidence of recent Zika infection. In 2016, nearly 1,000 pregnant women from the 44 states who completed their pregnancies had some evidence of a recent Zika infection and were at risk of having a fetus or baby with Zika-related birth defects.

Most of the women acquired Zika during travel to an area where the virus was known to be present.

“Zika virus can be scary and potentially devastating to families. Zika continues to be a threat to pregnant women across the U.S.,” CDC acting director Anne Schuchat said in a statement. “With warm weather and a new mosquito season approaching, prevention is crucial to protect the health of mothers and babies. Healthcare providers can play a key role in prevention efforts.”

Zika infection during pregnancy can cause serious damage to the brain and microcephaly in developing fetuses. It also can lead to congenital Zika syndrome in babies, a pattern of birth defects that includes brain abnormalities, vision problems, hearing loss, and problems moving limbs. Babies may also appear healthy at birth but have underlying brain defects or other Zika-related health problems, the CDC said.

The report found Zika still poses a serious risk during pregnancy and it's important for pregnant women to continue taking steps to prevent exposure to the virus through mosquito bites and sexual transmission.

Nearly 1,300 pregnant women with evidence of possible Zika infection were reported to the U.S. Zika Pregnancy Registry from Jan. 15 to Dec. 27, 2016. Of the 1,000 pregancies completed by the end of the year, more than 50 had Zika-related birth defects. 

Confirmed infections in the first trimester posed the higest risk with 15 percent of those fetuses or babies having Zika-related birth defects, the report found. 

The CDC's registry data included all 50 states, Washington, D.C. and territories except Puerto Rico. The Zika Active Pregnancy Surveillance System is a separate system to monitor pregnancies in Puerto Rico.

In Puerto Rico, over 39,000 cases were confirmed last year and over 3,000 women confirmed with Zika infection were pregnant. Almost 400 pregnant women were hospitalized and the Zika infection led to 5 recorded deaths, according to the Puerto Rico’s health department.

Last week, the Puerto Rico Department of Health, who has worked with the CDC to combat Zika infections in Puerto Rico, showed in recent results a dramatic, continuing decline of the Zika virus. Currently, there are no pregnant women who are infected with the Zika virus and the number of infected women and men, combined is under 3000. 

Peggy Honein with the CDC's Zika Response team said that many babies born to mothers with possible Zika infection "are not receiving brain imaging after birth to help diagnose serious brain defects.” She called for healthcare providers to ask about possible Zika exposure when caring for pregnant women and their babies. 

The CDC recommended healthcare providers also educate families on Zika prevention, provide all needed tests and follow-up care and support babies and families.



Photo Credit: Getty Images]]>
<![CDATA[WH Healthcare Revival Effort Gets Mixed Reaction]]>Tue, 04 Apr 2017 22:51:25 -0400http://media.nbcnewyork.com/images/213*120/speaker-paul-ryan-healthcare.jpg

A White House offensive to resurrect the moribund House Republican health care bill got an uneven reception Tuesday from GOP moderates and conservatives, leaving prospects shaky for the party to salvage one of its leading priorities.

Vice President Mike Pence and other top administration officials were offering to let states request federal exemptions from insurance coverage requirements imposed by President Barack Obama's health care overhaul. Top House conservatives and moderates met with Pence into the evening Tuesday in hopes of finding common ground, but the odds for success seemed long.

At the White House, Pence said he and President Donald Trump "remain confident that working with the Congress we will repeal and replace Obamacare," while White House spokesman Sean Spicer said Trump wanted an agreement, if possible.

"I'm not going to raise expectations, but I think that there are more and more people coming to the table with more and more ideas about how to grow that vote," Spicer said.

But there was no evidence that the proposal won over any GOP opponents who'd forced Trump and party leaders to beat an unceremonious retreat on their bill on March 24, when they canceled a House vote that was doomed to failure.

"We want to make sure that when we go, we have the votes to pass this bill," House Speaker Paul Ryan, R-Wis., told reporters. He said talks were in "the conceptual stage" and declined to predict a vote before Congress leaves town shortly for a two-week recess — when lawmakers could face antagonistic grilling from voters at town hall meetings.

Later in the day, Rep. Steve Scalise, R-La., his party's chief vote counter, said talks were not at "a place where there is consensus" on health care and indicated a vote this week was unlikely.

Under the White House proposal, states could apply for a federal waiver from a provision in Obama's statute obliging insurers to cover "essential health benefits," including mental health, maternity and substance abuse services. The current version of the GOP legislation would erase that coverage requirement but let states reimpose it themselves, language that is opposed by many moderates.

In addition, the White House would let states seek an exemption to the law's provision banning insurers from charging higher premiums for seriously ill people. Conservatives have argued that such restrictions inflate consumers' costs.

Reaction from rank-and-file GOP lawmakers was mixed. Moderate Rep. Frank LoBiondo, R-N.J., and conservative Rep. Mo Brooks, R-Ala., each said they remained "no" votes, with Brooks saying states should be allowed to opt out of Obama's insurance requirements without seeking federal permission.

"It is wrong to require the states to come to Washington, D.C., on bended knee," Brooks said.

Rep. Jim Renacci, R-Ohio, was among several moderates warning that a quick vote would be counter-productive.

"If leadership hasn't learned the lessons of the failures of two weeks ago, then they'll bring something forward where nobody knows about it and try and get it passed," Renacci said.

Even so, some members of the House Freedom Caucus, the hard-right group whose opposition helped sink the Republican bill last month, were showing signs of accepting less than many originally wanted. The group's leader, Rep. Mark Meadows, R-N.C., said talks were boiling down to curbing several of Obama's coverage requirements — a far cry from the full repeal of the statute that many initially preferred.

"It perhaps is as much of a repeal as we can get done," Meadows told reporters. He added, "That's the calculation we have to make."

Similarly, some moderates whose opposition was also instrumental in the legislation's failure expressed cautious optimism that the White House offer would produce results.

"We have to do things that will win people from both sides of the spectrum. Of course it's hard," said Rep. Tom MacArthur, R-N.J., a leader of the Tuesday Group of House GOP moderates.

A poll by the nonpartisan Kaiser Family Foundation flashed a warning for the White House, showing that 3 in 4 Americans want the Trump administration to make Obama's law work.

About 2 in 3 were glad the House GOP bill didn't pass last month. But people split evenly between wanting to keep or repeal Obama's statute.

The underlying House Republican bill would repeal much of Obama's 2010 law. It would erase its tax fines for consumers who don't buy policies, federal aid to help many afford coverage and Medicaid expansion for additional poor people.

Instead, substitute GOP tax subsidies would be less generous than Obama's for many lower earners and people in their 50s and 60s, the overall Medicaid program would be cut, tax boosts on higher earners would be ended and consumers who let coverage lapse would face 30 percent premium hikes.

AP reporters Erica Werner, Richard Lardner, Kevin Freking, Ken Thomas and Ricardo Alonso-Zaldivar contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: J. Scott Applewhite, AP]]>
<![CDATA[Mylan Hit With Racketeering Suit Over Price Hikes of EpiPen]]>Mon, 03 Apr 2017 15:25:02 -0400http://media.nbcnewyork.com/images/213*120/epipen1.jpg

Mylan was slapped Monday with a class-action racketeering lawsuit that claims the company overcharged patients as part of an illegal scheme to secure sales, CNBC reported.

The suit, filed in U.S. District Court in Seattle, alleges the "skyrocketing" list price of EpiPen was the result of the drugmaker's payments of rebates to pharmacy benefit managers — including CVS Caremark, Express Scripts and Optum Rx — which handle prescription drug benefit programs for insurance plans.

The suit noted when EpiPen prices were increasing most dramatically, other companies tried to introduce competing devices. But those companies never succeeded in displacing Epipen's market dominance because Mylan paid pharmacy benefit managers higher rebates, the suit said.

The suit claims violations of consumer protection laws of all U.S. states, as well as a violation of the Racketeer Influenced and Corrupt Organization Act.

A spokeswoman for Mylan had no immediate comment on the lawsuit.



Photo Credit: AP]]>
<![CDATA[A 'Sci-Fi' Cancer Therapy Fights Brain Tumors, Study Finds]]>Mon, 03 Apr 2017 12:05:50 -0400http://media.nbcnewyork.com/images/213*120/optunetherapy_brain_cancer_1200x675.jpg

It sounds like science fiction, but a cap-like device that makes electric fields to fight cancer improved survival for the first time in more than a decade for people with deadly brain tumors, final results of a large study suggest.

Many doctors are skeptical of the therapy, called tumor treating fields, and it's not a cure. It's also ultra-expensive — $21,000 a month.

But in the study, more than twice as many patients were alive five years after getting it, plus the usual chemotherapy, than those given just the chemo — 13 percent versus 5 percent.

"It's out of the box" in terms of how cancer is usually treated, and many doctors don't understand it or think it can help, said Dr. Roger Stupp, a brain tumor expert at Northwestern University in Chicago.

He led the company-sponsored study while previously at University Hospital Zurich in Switzerland, and gave results Sunday at an American Association for Cancer Research meeting in Washington.

"You cannot argue with them — they're great results," and unlikely to be due to a placebo effect, said one independent expert, Dr. Antonio Chiocca, neurosurgery chief at Brigham and Women's Hospital in Boston.

Dr. George Demetri of the Dana-Farber Cancer Institute in Boston and a board member of the association hosting the conference, agreed but called the benefit modest, because most patients still die within five years. "It is such a horrible disease" that any progress is important, he added.

ABOUT THE TREATMENT

The device, called Optune, is made by Novocure, based in Jersey, an island near England. It's sold in the U.S., Germany, Switzerland and Japan for adults with an aggressive cancer called glioblastoma multiforme, and is used with chemo after surgery and radiation to try to keep these tumors from recurring, as most do.

Patients cover their shaved scalp with strips of electrodes connected by wires to a small generator kept in a bag. They can wear a hat, go about their usual lives, and are supposed to use the device at least 18 hours a day. It's not an electric current or radiation, and they feel only mild heat.

It supposedly works by creating low intensity, alternating electric fields that disrupt cell division — confusing the way chromosomes line up — which makes the cells die. Because cancer cells divide often, and normal cells in the adult brain do not, this in theory mostly harms the disease and not the patient.

WHAT STUDIES SHOW

In a 2011 study, the device didn't improve survival but caused fewer symptoms than chemo did for people whose tumors had worsened or recurred after standard treatments. The U.S. Food and Drug Administration approved it for that situation.

A second study, in newly diagnosed patients, was stopped in 2014 after about half of the 695 participants had been tracked for at least 18 months, because those using the device were living several months longer on average than the rest.

The FDA expanded approval but some doctors were leery because the device wasn't compared with a sham treatment — everyone knew who was getting what. Study leaders say a sham was impractical, because patients feel heat when they get the real thing, and many would refuse to shave their heads every few days and use an inconvenient device for years if the treatment might be fake.

Some doctors said they would withhold judgment until there were long-term results on the whole group.

THE NEW RESULTS

Now they're in: Median survival was 21 months for those given Optune plus chemo versus 16 months for those on chemo alone. Survival rates were 43 percent versus 31 percent at two years; 26 percent versus 16 percent at three years, and 13 percent versus 5 percent at five years.

Side effects were minimal but included blood-count problems, weakness, fatigue and skin irritation from the electrodes.

"The device is now impossible to ignore ... it absolutely is an advance," said Dr. Andrew Lassman, brain tumor chief at the Columbia University Medical Center/New York-Presbyterian Hospital. He consults for Novocure, as do some doctors running the study.

The latest National Comprehensive Cancer Center guidelines include Optune as an appropriate treatment for brain tumors. It's also is being tested for pancreatic, ovarian and lung cancers; electrodes are worn on the belly or chest for those.

THE PRICE

A big issue is cost — roughly $700 a day. Most U.S. insurers cover it but Medicare does not and "we are paying," said Novocure's chief executive, Bill Doyle. "We've never refused a patient regardless of insurance status."

The price reflects "an extremely sophisticated medical device, made in very low quantities," with disposable parts changed several times a week and a support person for each patient, he said. Plus 17 years of lab, animal and human testing.

That cost? "The round number is half a billion dollars," Doyle said.

ONE PATIENT'S EXPERIENCE

Joyce Endresen's insurance covers all but about $1,000 a year for her device. "It's a great plan, and that's why I still work," said Endresen, 52, employed by a direct mail company in suburban Chicago.

She has scans every two months to check for cancer and "they've all been good," she said. "We celebrated two years of no tumor in December and went to South Africa."

Doctors say many patients won't try the device because of the trouble involved or because they don't want a visible reminder of their cancer. Not Endresen.

"I wear it and wear it proudly," she said. "It's an incredible machine and I'm fine not having hair."

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Mylan Says EpiPen Manufacturing Partner to Expand Device Recall]]>Fri, 31 Mar 2017 20:10:53 -0400http://media.nbcnewyork.com/images/213*120/epipen1.jpg

A recall of the emergency anti-allergy medicine EpiPen is expanding to the U.S. and other markets in North America, Europe, Asia and South America because the allergy shots may not work.

The notice issued Friday by Mylan N.V. expands upon warnings made earlier this month after two reports of the device failing.

Mylan didn't immediately respond to a question about how many devices are affected by the recall. The U.S. Food and Drug Administration says the recall covers 13 lots distributed from December 2015 through July 2016.

The problems could be potentially life-threatening, although Mylan described the incidence of the defects as "extremely rare."

The EpiPen is used to treat allergic reactions to certain food and bug bites

The products can be replaced at no charge by calling 877-650-3494 or emailing customer.service@mylan.com.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Mark Zaleski, File]]>
<![CDATA[US Enrolls Volunteers in Large Test of Possible Zika Vaccine]]>Fri, 31 Mar 2017 15:06:28 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-543392276-Mosquito.jpg

U.S. health officials have begun enrolling volunteers for critical next-stage testing of an experimental vaccine to protect against Zika, the mosquito-borne virus that can cause devastating birth defects in pregnant women.

The first volunteer was vaccinated Wednesday at Baylor College of Medicine in Houston, as the National Institutes of Health gears up for a two-part study that aims to enroll at least 2,400 people in Texas, Florida, Puerto Rico and five at-risk countries: Brazil, Mexico, Panama, Costa Rica and Peru.

Zika has caused an epidemic of birth defects — including babies with abnormally small heads and brains — in parts of Latin America and the Caribbean, and continues to spread to a creeping list of other countries. For the U.S. the risk has largely been to travelers, although mosquitoes spread the virus in parts of southern Florida and Texas last year, where health officials remain on guard.

But while Zika largely disappeared from the headlines over the winter, mosquito season is fast approaching — and the risk persists internationally.

"It is imperative that public health research continue to work to contain the spread of the virus," Dr. Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, said Friday in announcing the $100 million study.

First-stage safety testing of a so-called DNA vaccine against Zika signaled no side effect concerns, Fauci said — allowing the NIH-created shots to progress to the next stage of testing that will help tell if they really work.

It's a two-part study. First, researchers will evaluate 90 healthy adults given different doses to determine the best one. Those volunteers will be tested at Baylor, the University of Miami and University of Puerto Rico.

Once the correct dose is picked, the larger part of the study could begin as early as June at those sites and additional ones in the at-risk countries — giving 2,400 volunteers either the experimental vaccine or dummy shots. Pregnant women can't receive the experimental shots but women of child-bearing age can enroll. All the volunteers will be tracked for nearly two years to see if the vaccine really protects against Zika infection.

This is a totally new kind of vaccine. Traditionally, vaccines are made using a dead or weakened virus to train the body's immune system to recognize and fight that infection.

In contrast, the DNA vaccine works through trickery: It's made with a circular piece of DNA carrying genes from the Zika virus that, once in the body, make particles that resemble Zika enough to alert the immune system but cannot cause infection.

The NIH also is testing the safety of some more traditional Zika vaccine candidates, but the easier-to-make DNA vaccine was the first ready to advance to this second stage of human testing.

Don't expect a vaccine to be widely available any time soon. If Zika causes lots of illness this year, Fauci said researchers may have clues by early 2018 about how well the shots work — but if natural infections slow, they'll need many more volunteers to get an answer.

For most people, Zika causes no symptoms or only mild ones such as fever, aches, an itchy rash or red eyes. But aside from the pregnancy risk, Zika sometimes causes a temporary paralyzing condition called Guillain-Barre syndrome, and there's some evidence that it also may trigger heart problems in adults who previously were healthy.

And Zika is likely to become endemic in parts of the Americas, Fauci said. "I'm totally intent on getting this vaccine to the point it can be a usable vaccine."

Copyright Associated Press / NBC New York



Photo Credit: Kevin Frayer/Getty Images]]>
<![CDATA[Study Finds Link Between Slow Breathing, Brain Cells]]>Fri, 31 Mar 2017 14:10:57 -0400http://media.nbcnewyork.com/images/213*120/95570861.jpg

One common way to calm down is to breathe slower, and brain researchers say they've figured out how that works, "Today" reported.

A Stanford-led study of mice found that cells in the brain stem linked to mood and activity are triggered when the animal breathes slowly.

"There are many distinct types of breaths: regular, excited, sighing, yawning, gasping, sleeping, laughing, sobbing," said Mark Krasnow, a Howard Hughes Medical Institute biochemistry professor at Stanford University who oversaw the study. "We wondered if different subtypes of neurons within the respiratory control center might be in charge of generating these different types of breath."

The researchers are hopeful their findings, reported in the journal Science, can lead to therapies for stress, depression and more, even a better way to prevent sudden infant death syndrome.



Photo Credit: Dan Kitwood/Getty Images, FIle]]>
<![CDATA[The GOP 'Obamacare' Repeal Might Be Dead or Alive: Analysis]]>Fri, 31 Mar 2017 12:40:38 -0400http://media.nbcnewyork.com/images/213*120/AP_17068637615881-paul-ryan-american-health-care-act.jpg

President Donald Trump's plan to kill the Affordable Care Act, or "Obamacare," died last week. Or maybe it didn't.

The repeal effort seems to have assumed zombie status — somewhere between dead and alive.

This is never-say-die Washington, where big legislative proposals that are in the casket one day can show signs of a pulse and start climbing out the next.

It's a fairly common condition in the capital, where politicians who invest enormous political capital in a proposal are loath to let go.

"One of the keys to understanding Washington is to think a little bit like a coroner," says consultant Ari Fleischer, former press secretary to President George W. Bush. "You have to know when something's dead and when something's still kicking, and sometimes it's hard to tell the difference."

To say that Trump and Republican congressional leaders are sending mixed signals about the viability of the repeal effort is an understatement.

Last week, when it became clear that House Republicans didn't have enough votes to pass the health-care repeal bill, the White House said Trump had given it his all, left everything on the field, and was ready to move on.

Next up: taxes, the president said, without blinking.

His son Eric channeled Kenny Rogers' "The Gambler" in praising his father for knowing when to walk away.

"Guess what? We're moving on," the president's son told Fox News on Tuesday. "The best business people know ... when to hold their cards, know when to fold the cards."

That same night, though, the president told a bipartisan gathering of senators, "We're all going to make a deal on health care. That's such an easy one. So I have no doubt that that's going to happen very quickly."

Trump spokesman Sean Spicer said Wednesday the president had just been engaging in light-hearted banter.

But it was no laughing matter to plenty of Republicans on Capitol Hill, where conservatives elected on a promise to scrap the law continue to insist that reports of the repeal effort's death are premature.

"We don't quit," said freshman Rep. Brian Mast, a Florida Republican who lost both legs after being wounded in Afghanistan. "That's how we do things on the battlefield; that's how things should be done here."

On Thursday, House Speaker Paul Ryan added to the cacophony of conflicting statements when he told CBS that it's time for Plan B, where "we keep talking to each other and figure out how we get to 'yes.'"

For all of that, there is little evidence that leaders are working on a concrete plan to revive the repeal effort.

Why not admit that?

It could be the emotional attachment to a long-held goal. Or a matter of self-interest.

"These are creatures that need public recognition and public validation," says Stephen Wayne, a Georgetown University professor of government. "When they get behind something and it doesn't go anywhere, or they're embarrassed by it, it's a political failure. It's an ego failure."

Framing the situation more charitably, Fleischer offers this: "People in both parties generally have a lot of heartfelt investments in the policies they're pursuing. Particularly for core promises, the formality of declaring it dead is gut-wrenching, so you cling to hope and you don't declare it dead 'til you have no choice."

There are historical examples that demonstrate both the wisdom and folly of refusing to admit defeat.

President Ronald Reagan's push for a sweeping tax overhaul package was pronounced dead on Capitol Hill more than once before a bipartisan package won approval in 1986.

President Bill Clinton's push to revamp welfare was declared a failure repeatedly before it came together. His years-long effort to remake the health care system was declared a goner more than once — and really did die.

President Barack Obama's attempts to enact gun control measures after the 2012 shooting of schoolchildren in Newtown, Connecticut, ended with the president acknowledging in 2014 that until there was a fundamental shift in public opinion, "it will not change."

Between the clear victories and defeats lies a netherworld of legislative limbo.

Obama's push for big immigration changes stalled after the Senate in 2013 passed a bill with dim prospects of clearing the House, but the idea lived on in people's hopes and dreams. All the discussion of whether immigration reform was dead or alive was a pretty good indication that it was the former.

Obama never explicitly acknowledged the political reality that the Trans-Pacific Partnership trade deal was dead after Trump was elected. The White House just stopped actively lobbying Congress to pass it.

Obama's day-one vow to close the U.S. detention center at Guantanamo Bay in Cuba became increasingly less likely to succeed over his eight years in office. But he never admitted it was a promise unfulfilled until his last full day in office.

Robin Wagner-Pacifici, a sociology professor at the New School for Social Research, said there may be parallels to military surrenders, which fell into disuse in the latter part of the 20th century to be replaced by "conflict resolution or dispute resolution or accords of various kinds that had a much more fuzzy quality to them."

She said it may also be partly a matter of Trump's fragmented and sometimes contradictory ways of communication, in which "nothing is ever completely resolved or ended."

AP writer Erica Werner contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Congress Lets States Block Some Planned Parenthood Funding]]>Thu, 30 Mar 2017 18:18:01 -0400http://media.nbcnewyork.com/images/213*120/AP_17088710284006.jpg

Republican legislation letting states deny federal family planning money to Planned Parenthood and other abortion providers squeezed narrowly through the Senate Thursday, rescued by an ailing GOP senator who returned to the Capitol after back surgery and a tie-breaking vote by Vice President Mike Pence.

In Congress' latest clash mixing the politics of abortion, women's health and states' rights, Pence cast the decisive vote in a 51-50 roll call. The tally had been tied after two GOP senators, Alaska's Lisa Murkowski and Maine's Susan Collins, joined Democrats opposing the measure.

Senate approval sent the legislation to President Donald Trump, who was expected to sign it. The House voted its consent last month.

The bill erases a regulation imposed by former President Barack Obama shortly before he left office that lets states deny family planning funds to organizations only if they are incapable of providing those services. Some states have passed laws in recent years denying the money to groups that provide abortions.

Passage gives Republicans and anti-abortion groups a needed victory just six days after the party's highly touted health care overhaul disintegrated in the House due to GOP divisions. Besides erasing much of Obama's 2010 health care law, the failed House bill would have blocked federal funds for Planned Parenthood for a year.

There is already a ban on using federal funds for abortion except for rare instances.

Democrats assailed the legislation as an attack on women, two months after Trump's inauguration prompted a women's march on Washington that mushroomed into anti-Trump demonstrations around the nation.

"While Trumpcare was dealt a significant blow last week, it is clear that the terrible ideas that underpin it live on with Republicans in Congress," said Sen. Patty Murray, D-Wash., using a nickname for the failed House health care bill. Murray, among a stream of Democratic women senators who spoke, called the Senate measure "shameful" and "dangerous."

Republicans said the measure would let states divert money now going to groups that provide abortion to organizations that don't, like community health centers.

"It substituted Washington's judgment for the needs of real people," Senate Majority Leader Mitch McConnell, R-Ky., said of Obama's rule.

With Republicans controlling the Senate 52-48, the Collins and Murkowski defections could have derailed the bill because Sen. Johnny Isakson, R-Ga., has been absent since he had spinal surgery Feb. 20.

He had a second operation March 15 and has been recuperating in Georgia under doctor's orders. But he got permission to return to Washington for one day, his office said, and he did so using a walker.

"We didn't know at the time what it would be but it turned out to be the vice president's tie-breaker," Isakson told reporters after an earlier procedural vote.

The federal family planning program was created 1970, and in 2015 served 4 million clients at nearly 4,000 clinics. Most of the money is for providing services like contraceptives, family planning counseling, breast and cervical cancer screening and sexually transmitted disease prevention. It has a $286 million federal budget this year.

Most recipients are women, and two-thirds have incomes at or below the federal poverty level, around $12,000 for an individual. Six in 10 say the program's services are their only or most frequent source of health care.

Dawn Laguens, executive vice president of the Planned Parenthood Federation of America, mocked Pence.

"Mike Pence went from yesterday's forum on empowering women to today leading a group of male politicians in a vote to take away access to birth control and cancer screenings," she said.

Timothy Head, executive director of the conservative Faith & Freedom Coalition, hailed lawmakers for taking "the first step to stopping taxpayer subsidizing of the largest abortion provider" in the country.

The Congressional Review Act has lets lawmakers undo regulations enacted in the last months of the Obama administration with a majority vote. Congress has already used the law to eliminate Obama regulations dealing with pollution from coal mining operations and prevented some people with mental disorders from gun purchases.

Under the Constitution, the vice president casts tie breaking votes. Pence broke his first tie on the nomination of Education Secretary Betsy DeVos.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Pablo Martinez Monsivais]]>
<![CDATA[Pedestrian Deaths Spiked in 2016, Distraction Cited]]>Thu, 30 Mar 2017 15:04:56 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-55921972.jpg

Pedestrian deaths are climbing faster than motorist fatalities, reaching nearly 6,000 deaths last year — the highest total in more than two decades, according to an analysis of preliminary state data released Thursday.

Increased driving due to an improved economy, lower gas prices and more walking for exercise and environmental factors are some of the likely reasons behind the estimated 11 percent spike in pedestrian fatalities in 2016. The figures were prepared for the Governors Highway Safety Association, which represents state highway safety offices.

But researchers say they think the biggest factor may be more drivers and walkers distracted by cellphones and other electronic devices, although that's hard to confirm.

Walking and miles driven are up only a few percentage points, and are unlikely to account for most of the surge in pedestrian deaths, said Richard Retting, safety director for Sam Schwartz Transportation Consultants and the author of the report. Meanwhile, texting and use of wireless devices have exploded, he said.

"It's the only factor that that seems to indicate a dramatic change in how people behave," Retting said.

The report is based on data from all states and the District of Columbia for the first six months of 2016 and extrapolated for the rest of the year. It shows the largest annual increase in both the number and percentage of pedestrian fatalities in the more than 40 years those national records on such deaths have been kept, with the second largest increase occurring in 2015. Pedestrian deaths as a share of total motor vehicle crash deaths increased from 11 percent in 2006 to 15 percent in 2015.

"This latest data shows that the U.S. isn't meeting the mark on keeping pedestrians safe on our roadways," said Jonathan Adkins, the safety association's executive director. "Every one of these lives represents a loved one not coming home tonight, which is absolutely unacceptable."

Traffic fatalities overall jumped 6 percent last year, pushing deaths on U.S. roads to their highest level in nearly a decade and erasing improvements made during the Great Recession and economic recovery, according to data released last month by the National Safety Council, a leading safety organization. The council estimates there were more than 40,200 traffic deaths in 2016. The last time there were more than 40,000 fatalities in a single year was in 2007, just before the economy tanked. There were 41,000 deaths that year.

But pedestrian deaths are sharply outpacing fatalities overall, climbing 25 percent from 2010 to 2015, according to Retting's research. Total traffic deaths increased about 6 percent over the same period.

"We cannot look at distracted driving solely as an in-vehicle issue," said Kelly Nantel, a spokeswoman for the safety council. "That discounts the impact distraction could have on pedestrians."

On the other hand, "walking is working," she said. "Just as we need drivers to be alert, pedestrians have to be, too."

Another factor in pedestrian deaths is alcohol. Thirty-four percent of pedestrians and 15 percent of drivers involved in fatal crashes were intoxicated at the time, Retting said. But there is no indication that there has been a change in drinking habits that would account for the spike in deaths, he said.

More than twice as many states reported an uptick in pedestrian fatalities than had decreasing numbers.

The problem is greatest in large population states that have urban areas where people do a lot of walking. Delaware, Florida and Arizona had the highest rates of pedestrian deaths relative to their populations, while North Dakota, South Dakota and Wyoming had the lowest.

The striking increase in pedestrian deaths has grabbed the attention of the National Transportation Safety Board, the government panel that investigates accidents and makes safety recommendations. The board held a forum on pedestrian safety last year, and currently has an investigation underway to broadly examine the causes and potential solutions to the problem.

Pedestrians "are our most vulnerable road users," said NTSB member Bella Dinh-Zarr.

People are "more easily distracted than when we didn't have so many easily accessible, essentially, computers in our palms," she said. "We look at that as an increasing risk for pedestrians."

Copyright Associated Press / NBC New York



Photo Credit: Mario Tama/Getty Images]]>
<![CDATA[How to Take a Shower, According to Dermatologists]]>Fri, 31 Mar 2017 07:22:47 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-71429160.jpg

Too much hot water can actually be bad for our bodies, experts in hair and skin care told NBC News. Several dermatologists were asked to weigh in on the definitive way to take a shower.

1. Don't Shower Too Often

How often you should shower depends on your activity level — our experts say there's no hard-and-fast rule. But if you're not active, you can cut back to a few times a week.

2. Keep It Short

Water exposure can lead to dry skin and hair. A longer shower also "gives the water a chance to allow any cleansers to be more damaging," says Dr. Jessica Krant, a board-certified dermatologist.

3. Stay Cool

Hot water strips away natural oils and damages the skin faster, so stick to a lukewarm — or cooler — shower.

4. Don't Wash Your Hair Too Much

Hair is made of dead skin cells — it just doesn't need as much washing as the rest of our skin.

5. But Don't Wash Too Little, Either

Washing hair less often has become such a trend that dermatologists say some people are overdoing it, causing a scalp buildup of dandruff.

6. Focus on the Dirtiest Areas

Your arms and legs don't always need soap. For a quick shower, focus on your underarms, groin and feet.



Photo Credit: China Photos/Getty Images
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<![CDATA[McDonald's to Use Fresh Beef in Quarter Pounders Next Year]]>Thu, 30 Mar 2017 14:09:00 -0400http://media.nbcnewyork.com/images/213*120/McDonalds-AP_630251506987.jpg

Coming soon to McDonald's: Fresh beef.

The fast food giant said Thursday that it will swap frozen beef patties for fresh ones in its Quarter Pounder burgers by sometime next year at most of its U.S. locations. It's a major change for McDonald's, which has relied on frozen beef for more than 40 years. Employees will cook up the never-frozen beef on a grill when burgers are ordered.

"It's a really hot, juicy burger," said McDonald's USA President Chris Kempczinski.

Fresh beef has been the biggest selling point at rival Wendy's. Yet there are larger forces at work that have prompted other menu changes at McDonald's, known for decades more for the billions of people that it has served, rather than its culinary choices. The world's largest hamburger chain for some time has been attempting to improve its image as more people shun processed foods. It has tinkered with its recipes, removing artificial preservatives from chicken McNuggets and eliminating high-fructose corn syrup from its buns.

McDonald's is trying to stem a streak of adverse trends that led to an executive shake-up two years ago. The company brought in Steve Easterbrook as CEO to steer the company in a more promising direction. It's an ongoing endeavor. Earlier this month, McDonald's Corp. acknowledged that it lost 500 million customer transactions in the U.S. since 2012, mainly to other fast food rivals.

Big Macs and hamburgers will still be made with frozen beef. Kempczinski said the company is open to making changes to its other menu items.

It tested the fresh beef Quarter Pounders for about a year, eventually bringing it to more than 400 restaurants in the Dallas area and Tulsa, Oklahoma. Customers ordered more Quarter Pounders and visited the restaurants more often, said Kempczinski. Franchisees were happy, too, asking to keep the fresh beef even if the company decided not to roll it out nationally.

It's still too early to know if franchisees will raise their prices on Quarter Pounders, Kempczinski said. Employees will need to be trained to handle fresh beef safely and to cook the patties only when ordered. Frozen beef Quarter Pounder patties are typically cooked four or more at a time, and the burgers are left in a holding area until a customer orders it, Kempczinski said.

The Oak Brook, Illinois-based company said fresh beef Quarter Pounders will be available by the middle of 2018 at most of its 14,000 U.S. locations. Restaurants in Alaska, Hawaii and some airports won't be getting the fresh beef, the company said.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[EPA Denies Petition to Ban Pesticide Used on Crops]]>Wed, 29 Mar 2017 22:08:25 -0400http://media.nbcnewyork.com/images/213*120/AP_583145055114.jpg

The Environmental Protection Agency on Wednesday denied a petition by environmental groups that sought to ban a common pesticide used on citrus fruits, apples, cherries and other crops, reversing a proposal by the Obama administration to revoke all uses of the pesticide on food.

EPA Administrator Scott Pruitt said that by not banning chlorpyrifos the agency is providing "regulatory certainty" to thousands of American farms that rely on the pesticide.

"By reversing the previous Administration's steps to ban one of the most widely used pesticides in the world, we are returning to using sound science in decision-making - rather than predetermined results," Pruitt said.

The pesticide, in use since 1965, has sickened dozens of farmworkers in recent years. Traces have been found in waterways, threatening fish, and experts say overuse could make targeted insects immune to the pesticide.

U.S. farms use more than 6 million pounds of the chemical each year — about 25 percent of it in California.

The EPA banned home use of chlorpyrifos in 2000 and placed "no-spray" buffer zones around sensitive sites, such as schools, in 2012.

But environmental and public health groups said those proposals don't go far enough and filed a federal lawsuit seeking a national ban on the pesticide.

Environmental groups said Pruitt's decision ignores overwhelming evidence that shows even small amounts of chlorpyrifos can interfere with brain development of fetuses, infants and children.

"EPA's refusal to ban this dangerous pesticide is unconscionable," said Patti Goldman, the Earthjustice managing attorney handling the case. "EPA is defying its legal obligation to protect children from unsafe pesticides. We will be going back and asking the court to order EPA to take action now, rather than in 5 more years."

In October 2015, the Obama administration proposed revoking the pesticide's use in response to a petition from the Natural Resources Defense Council and Pesticide Action Network North America.

The EPA said then that its analysis didn't suggest risks from exposure to chlorpyrifos in food. But when those exposures are combined with estimated exposure from drinking water in certain watersheds, "EPA cannot conclude that the risk from aggregate exposure meets the Federal Food, Drug and Cosmetic Act safety standard," it said.

The EPA said Wednesday that the previous administration's proposal relied on a study "whose application is novel and uncertain, to reach its conclusions."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/J. Scott Applewhite]]>
<![CDATA[Dirty Air From Global Trade Kills at Home and Abroad]]>Wed, 29 Mar 2017 17:35:18 -0400http://media.nbcnewyork.com/images/213*120/china_factory_production_1200x675.jpg

A study that measures the human toll of air pollution from global manufacturing and trade shows how buying goods made far away can lead to premature deaths both there and close to home.

More than 750,000 people die prematurely from dirty air every year that is generated by making goods in one location that will be sold elsewhere, about one-fifth of the 3.45 million premature deaths from air pollution. The study says 12 percent of those deaths, about 411,000 people, are a result of air pollution that has blown across national borders.

"It's not a local issue anymore," said study co-author Dabo Guan, an economist at the University of East Anglia in England. "It requires global cooperation."

It has long been known that that the environmental burden of manufacturing often falls heaviest on countries where companies set up shop to take advantage of low labor costs and relatively loose environmental regulations. But this is the first study to bring together economic, manufacturing, trade, atmospheric and health data to calculate the number and location of premature deaths from air pollution.

It found that people in Western Europe buying goods made elsewhere were linked to 173,000 overseas air pollution deaths a year, while United States consumption was linked to just over 100,000 deaths, according to the study published in Wednesday's journal Nature.

What that looks like in China: 238,000 deaths a year associated with production of goods that are bought or consumed elsewhere. That number is 106,000 deaths in India and 129,000 deaths in the rest of Asia.

"We have a role in the quality of the air in those areas," study co-author Steven Davis, an atmospheric scientist at the University of California, Irvine, said in an interview. "We're taking advantage of our positon as consumers, distant consumers."

Still, the study says three-quarters of the 1 million air pollution deaths in China — and the nearly half a million deaths in India — are from production of goods that are consumed locally.

China and India also have pollution that travels elsewhere and kills between 65,000 and 75,000 people in other countries, the study said. India's migrating pollution kills more because China's pollution, which hits Japan and South Korea, often heads over the Pacific Ocean where its effects dissipate over the miles, Davis said. India's pollution heads directly to more populous neighboring countries.

The study starts by looking at the 3.45 million deaths a year that this and other studies say are triggered by tiny airborne particles often called soot or smog. About 2.5 million of those deaths are associated with making and consuming of goods, including the energy needed to produce and ship them. The rest are due to natural factors like dust and fires and other causes that can't be tracked, said study lead author Qiang Zhang, an atmospheric chemist at Tsinghua University in Beijing.

Like smoking, air pollution increases the risk of getting diseases like heart disease and stroke, said study co-author Michael Brauer, a public health professor at the University of British Columbia. Using well-established methods, researchers calculate death estimates using health statistics, pollution levels, and other factors.

Dr. Howard Frumkin, a former director of the National Center for Environmental Health at the U.S. Centers for Disease Control and Prevention now at the University of Washington, was not part of the study, but praised it. He said the calculations done by the study are crucial for understanding the larger problem.

"This is a moral question as much as a scientific one," Frumkin wrote in an email. "But the scientific approach here — linking data on manufacturing and associated pollution emissions, import and export flows, pollutant movement across national boundaries, and the health impact of pollution exposure — is exactly what's needed."

Producing more goods locally would change where deaths occur and potentially reduce overall deaths — if local emissions rules are tighter. Bringing back manufacturing to the United States, as President Donald J. Trump and politicians from both parties want, would bring more air pollution deaths to the U.S., but reduce deaths worldwide because pollution laws are stricter, Davis and others said.

Production is likely to remain concentrated in Asia, however, and it will have to be up to those countries to better regulate their own industrial emissions, said Peter Adams, an engineering professor and air pollution expert at Carnegie Mellon University in Pittsburgh, who wasn't part of the study. "Relying on consumer altruism," he said, won't be enough.

___

Follow Seth Borenstein at http://twitter.com/borenbears and his work can be found at http://bigstory.ap.org/content/seth-borenstein .

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[FDA Approves 1st Drug for Aggressive Multiple Sclerosis]]>Wed, 29 Mar 2017 13:29:48 -0400http://media.nbcnewyork.com/images/213*120/medications_generic_1200x675.jpg

U.S. regulators have approved the first drug for an aggressive kind of multiple sclerosis that steadily reduces coordination and the ability to walk.

The Food and Drug Administration approved Ocrevus late Tuesday after a large study found it slowed progression of the neurological disease and reduced symptoms.

While there are more than a dozen treatments for the most common form of MS, there's been nothing specifically for people with the type called primary progressive MS. That type of MS is relatively rare, affecting about 50,000 Americans.

The drug was also approved for relapsing forms of MS, which progress more slowly.

It's given intravenously every six months. The drug was developed by Genentech, part of Swiss drugmaker the Roche Group. Genentech, based in South San Francisco, California, said the initial list price without insurance will be $65,000 a year.

In primary progressive MS, the disease's course varies among patients, but symptoms gradually worsen from the start and there usually are no periods when symptoms subside. Most of the estimated 400,000 Americans with MS have the relapsing-remitting type, in which symptoms can wane for months, even years, between flare-ups.

Symptoms are caused by the immune system attacking the fatty coverings on nerves in the brain and spinal cord that protect them, much like insulation on electrical wiring. As the coverings deteriorate, nerve "messages" aren't properly transmitted, disrupting movement and muscle control.

For patients with primary progressive MS, life span on average is shortened by six years, said Dr. Fred Lublin, director of the MS center at Mount Sinai Health System in New York City.

Since 1993, 14 drugs have been approved to slow the most common form of MS, but everything tested against primary progressive MS failed until now, said Lublin, a consultant to Genentech who was on the committee overseeing the study.

"This therapy not only provides another treatment option for those with relapsing MS, but for the first time provides an approved therapy for those with primary progressive MS," Dr. Billy Dunn, director of the FDA's Division of Neurology Products, said in a statement.

In the study testing Ocrevus for primary progressive MS, which involved 732 patients, Ocrevus had a "modest but definite slowing effect on the rate at which people develop disabilities," said Lublin.

Compared to study participants getting dummy infusions, patients given Ocrevus infusions had slower declines in walking ability and slower disability progression over nearly 2 ½ years. The Ocrevus group also had fewer new brain-damaging lesions develop but slightly higher rates of certain side effects, including upper respiratory tract infections and tumors developing in various parts of the body.

The drug was also tested in two large studies involving 1,656 patients as a treatment for relapsing forms of MS. In those 96-week studies, patients given Ocrevus had lower relapse rates and reduced worsening of disability compared to participants given Rebif, a standard drug for relapsing MS, according to the FDA.

Ocrevus will be available in the U.S. within two weeks, Genentech said, noting the average price of MS medicines has quadrupled over the past 12 years. As a "first step" in reversing that trend, the company said, it priced Ocrevus 25 percent below Rebif's list price.

The price shouldn't limit access, analyst Jeffrey Holford at Jefferies LLC wrote to investors on Wednesday. He forecasts peak sales of $5 billion a year.

___

Follow Linda A. Johnson at https://twitter.com/LindaJ_onPharma

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Mom Tells Son's Story in Fight for NIH Funding]]>Tue, 28 Mar 2017 23:43:50 -0400http://media.nbcnewyork.com/images/220*120/2017-03-28_2340.png

Pediatric cancer research is one of the least funded and proposed budget cuts to NIH will deplete it even more. A family whose child died from pediatric cancer is testifying on Capitol Hill Wednesday, March 29, to save the funding. Tammi and Jason Carr in Michigan founded the ChadTough Foundation to honor their son Chad, who died at age 5 after battling a brain tumor. News4’s Shomari Stone reports.

Photo Credit: Tammy Carr]]>
<![CDATA[States Push to Protect Birth Control Despite Failed GOP Bill]]>Tue, 28 Mar 2017 19:02:39 -0400http://media.nbcnewyork.com/images/213*120/plannedparenthoodprotest_1200x675.jpg

Even with the Republican failure to repeal Barack Obama's health care law, Democratic lawmakers in some states are pressing ahead with efforts to protect birth control access, Planned Parenthood funding and abortion coverage in case they are jeopardized in the future.

Republicans in the U.S. House of Representatives withdrew a bill last week that would have repealed Obama's Affordable Care Act. It would have halted federal funding for Planned Parenthood and curtailed the ability of many low-income women to obtain affordable birth control.

Despite that setback for the GOP, several Republicans said Congress might revisit health care in the future, and anti-abortion leaders have stressed they will not abandon their campaign to defund Planned Parenthood. The group is the No. 1 abortion provider in the U.S. but also offers extensive birth control and health-screening services.

In Nevada, state lawmakers and health advocates say they will continue to promote bills that would allow women to access 12-month supplies of birth control and require all health insurers to cover contraceptives at no extra charge, regardless of religious objections.

Another Nevada proposal seeks to provide alternative funding to help organizations such as Planned Parenthood. Some government-run clinics that rely on federal grants and are on the brink of closure also would benefit.

"Nevadans need these protections regardless of what's happening in Congress," said Elisa Cafferata, president of Nevada Advocates for Planned Parenthood Affiliates. "Family planning and preventative health care are still very much threatened."

Democratic state Sen. Julia Ratti said it was important to establish protections in state law "so that, regardless of what future federal provisions come through, we know we're doing the right thing in Nevada."

It's unclear whether Gov. Brian Sandoval, a Republican, will sign or veto the bills if they reach his desk.

Majority Democrats in the Maryland Legislature, with backing from some Republicans, passed a bill that would maintain family planning services provided by Planned Parenthood if the group ever lost federal funding.

The state Senate approved the bill Tuesday on a 32-15 vote, after it previously cleared the House of Delegates. It now goes to Republican Gov. Larry Hogan.

Asked whether the governor would sign or veto the bill, Hogan spokeswoman Amelia Chasse wrote in an email that the bill would be reviewed.

"The governor has consistently funded health care organizations in each of the administration's three budgets," Chasse wrote. "This legislation will be part of the governor's bill review process that includes hundreds of bills."

It would direct $2 million from Maryland's Medicaid budget and $700,000 from the state's general fund to family planning services. The bill's chief sponsor, state Delegate Shane Pendergrass, said Maryland would be unwise to assume that congressional Republicans were finished with efforts to repeal the Affordable Care Act.

"Could this come back in six months? Maybe," she said. "Do we want to make sure we're prepared if something happens? You bet we do."

In Oregon, Democratic state Rep. Jeff Barker said deliberations would continue on a bill he is sponsoring that would require health insurers to cover a full range of services, drugs and products related to reproductive health, including contraceptives, with no co-pay or deductible.

It also would prohibit any government interference in a woman's choice to have an abortion.

"It will be contentious, but I believe it will pass," Barker said. "We want to be sure that women have all their reproductive health needs taken care of."

The bill, which is awaiting referral to a House committee, could be up for a floor vote sometime next month.

"Our plan is to still move it forward," said House Speaker Tina Kotek, a Democrat. "It's really important to a lot of people on this particular area of health care."

Kotek also expressed no interest in tweaking the bill's language to the liking of Providence Health Plans, a Catholic-sponsored organization covering 260,000 Oregon residents. Last week, Providence threatened to pull out of the Oregon insurance market if the abortion proposal passes.

At the national level, Planned Parenthood celebrated the collapse of the GOP health care overhaul effort yet acknowledged that it will remain a target of the anti-abortion movement and its allies.

"We know this is the beginning, not the end," said Planned Parenthood's president, Cecile Richards.

U.S. law already prohibits federal money from being used to pay for most abortions, but the GOP health overhaul would have cut off more than $400 million in Medicaid reimbursements and other federal funding to Planned Parenthood for non-abortion services. That includes birth control provided to about 2 million women annually.

Kristi Hamrick of Americans United for Life, in an email, said the push to defund Planned Parenthood would continue.

"Too early to say how this might play out," she wrote.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[José Olé Taquitos Recalled for Possible Rubber, Plastic]]>Tue, 28 Mar 2017 08:54:45 -0400http://media.nbcnewyork.com/images/213*120/jose-ole-taquitos.jpg

Ajinomoto Windsor, Inc. is recalling more than 35,000 pounds of frozen "José Olé" taquito products that may be contaminated with rubber and plastic, according to the United States Department of Agriculture. 

The Lampasas-based company recalled 60-ounce packages of the frozen beef taquitos produced on Dec. 30, 2016. The recalled items include the case codes 3366365A, 3366365B, 3366365C and 3366365D and a "best by" date of Dec. 30, 2017.

The company initiated the recall after receiving two complaints of foreign material in its ready-to-eat beef products earlier this month. The foreign materials were pieces of rubber with white plastic that originated from the establishments processing equipment.

According to the USDA, there have been no confirmed reports of adverse reactions due to consumption of these products.

The items were shipped to retail locations in California, Florida, Illinois, Missouri, New York, Ohio, Pennsylvania, Wyoming and Texas.

Consumers who have purchased this product are urged to throw it away or return it to the place of purchase.



Photo Credit: U.S. Department of Agriculture]]>
<![CDATA[Rat-Borne Disease Kills Dogs in New Jersey]]>Mon, 27 Mar 2017 23:01:26 -0400http://media.nbcnewyork.com/images/213*120/dog+disease.jpg

The same rat-borne disease that killed a man in the Bronx is killing dogs in New Jersey, and veterinarians are warning pet owners to be on alert.

Leptospirosis is a bacterial infection dogs can catch from wildlife like squirrels and rats. The disease passes through urine, which pets may lick up when drinking from puddles or other standing water.

River Edge resident Shawn Kucharski often takes his dog Hershey for a morning walk. He said he was taken aback by the number of dogs who have contracted the disease in recent months.

“It is concerning because they go around and sniff everything and touch everything,” Kucharski said.

Veterinarians at Blue Pearl in Paramus say they’ve seen a clear upsurge in cases.

"We’ve probably had five or six cases of leptospirosis over the course of the winter," Dr. Tara Fetzer of Blue Pearl said. "A much higher number than we normally see."

Veterinarians believe the rise in cases is likely due to a warm winter — people have taken their dogs outside more often than they normally would during the cold months.

Still, two dogs have died, and humans can get leptospirosis too. A man in the Bronx recently died after contracting the disease from a rat.

The New Jersey Dept. of Health doesn't track cases of leptospirosis in dogs, but it says there haven't been any human cases in the state in the last five years.

Pet owners should look for signs and symptoms of the disease in their dogs, such as fever lethargy, loss of appetite, increased urination and inability to urinate. It’s also a good idea to be careful at dog parks, where dogs congregate and can pass along illnesses.

To avoid getting leptospirosis, people should practice good hand hygiene and avoid contact with pet urine.

]]>
<![CDATA[Now What? Options for Consumers as Health Law Drama Fades]]>Sun, 26 Mar 2017 03:43:21 -0400http://media.nbcnewyork.com/images/213*120/Speaker-Ryan-health-test.jpg

As the political drama over health care legislation in Washington fades, the rest of the country faces a more immediate concern: Getting insurance for next year.

The Republican health plan designed to replace the Obama-era health law known as the Affordable Care Act would not have taken full effect for a few years anyway — and now it's dead.

"We're going to be living with Obamacare for the foreseeable future," House Speaker Paul Ryan said Friday.

That means millions of Americans will have to navigate a current federal health care system that, while not "imploding" as President Donald J. Trump has said, is at least in flux.

Mary Vavrik, a 57-year-old freelance deposition court reporter from Anchorage, Alaska said she was relieved that the current health law will remain because she's happy with the coverage she gets through her exchange — even as she acknowledged that reforms are needed.

"It's not a perfect plan but I'm really grateful to have what I do have," she said.

Prices for insurance plans offered on the public insurance exchanges set up by the health care law have soared in many markets, and choices for customers have dwindled. That's because insurers have faced sizable financial losses on the exchanges in recent years, and have responded by either hiking prices or pulling out of certain markets altogether.

Now, attention will turn to administrative changes underway in Washington designed to stabilize the exchanges by preventing more insurer defections.

The open enrollment period to sign up for insurance for 2018 is slated to start this fall, but insurers are making decisions now about whether to participate. What kinds of plans will be available and how much they will cost will depend on a few key decisions by insurers and regulators in the coming weeks.

Will I have plans to choose from?
It depends on where you live. Choices are dwindling, but chances are at least one insurer will sell in your market. That company may offer several plans.

Generally, big cities will have more choices than rural areas where there may not be enough customers to attract insurers.

As of now, there are 16 counties in a region of Tennessee around Knoxville that have no insurers committed to sell coverage on the exchange next year. About a third of the nation's 3,100 counties are down to just one insurer.

Insurers have been pulling back, and more are expected to leave, but health care researchers are not predicting mass defections.

"For most consumers, (2018) will look a lot like '17," said Dan Mendelson, president of the consulting firm Avalere.

Customers can try to find coverage outside their exchange, but then they won't be able to use tax credits to help pay the bills, which may be particularly painful since many markets have seen prices soar.

Are there fixes in store?
Last month, the Health and Human Services Department, which runs exchanges in many states, proposed some adjustments to try to stabilize these marketplaces.

For example, insurers want greater scrutiny of people who sign up for coverage outside of the open enrollment period. Customers are supposed to be allowed to do so only if they have a life-changing event like the birth of a child, a marriage, or the loss of a job that provided coverage, but insurers have found that people are just waiting to sign up when they need care.

Another proposed adjustment would let insurers design cheaper plans tailored to younger people who may not need lots of health care but want to be protected in the event of a big injury or sickness. That could be very helpful, because insurers say they have struggled to attract younger and healthier customers to the marketplaces to balance out the claims they pay from those who use their coverage.

Those changes are expected to be finalized in the next month or so.

When will insurers make their decisions on 2018?
Some have said they want to see the final version of the proposed federal adjustments before deciding where and what kinds of coverage they will offer.

But insurers generally have to decide by this spring whether they will participate in order to leave enough time for regulatory approvals and marketing before enrollment starts next fall.

Aetna, the nation's third largest insurer, has set an April 1 deadline for deciding on 2018. The company has already pared its marketplace participation down to 4 states this year from 15 because of heavy financial losses.

Customers won't know for certain who is selling on their exchanges until early next fall. While insurers have to apply to sell coverage on their exchanges generally by late spring or early summer, they can drop out later.

Is the Affordable Care Act "imploding," as President Trump has said on Twitter?
No. The marketplaces are not expected to dissolve next year, even though choices have dwindled.

While there's debate over the law's tax burdens and its impact on government budgets, the federal plan has covered more than 20 million people.

About 11 million are covered through an expansion of Medicaid, the health program designed to help poor Americans. Another 12 million buy private insurance through the law's marketplaces, most with help from subsidies based on income. 

Associated Press reporter Mark Thiessen contributed from Anchorage.

Copyright Associated Press / NBC New York



Photo Credit: J. Scott Applewhite, AP]]>
<![CDATA[Robot Helps Boy Go to School]]>Sat, 25 Mar 2017 03:10:33 -0400http://media.nbcnewyork.com/images/213*120/Max+Robot.jpg

Despite a degenerative disease that makes going to school a life-threatening situation, a three-year-old Maryland boy attends classes every day thanks to technology allowing him to connect with his classmates, make friends and even join them for lunch.

Max Lasko and his mother operate a Beam telepresence robot from home, several miles from school.

“When Max first started, every time Max would beam in on the robot, they would be really excited and yell, ‘It's the robot! It's the robot!’” teacher Allyson Levine said. “But after about a week or two, it became, ‘Max is here.’”

Max was born with spinal muscular atrophy, which makes it difficult for him to move, breathe and eat. He can’t be in a classroom for fear of catching a cold or flu, which could be life-threatening for him.

“We felt that it was really important -- since Max's cognition is fully intact, his social intelligence is fully intact -- we wanted him to be able to interact with his peers but we wanted to do so safely,” said his mother, Kristen Lasko.

Max's mother is a teacher, and his father, Jonathan Lasko, is a computer scientist. They applied for and won a grant to cover the costs of the robot, and they asked the Bender Jewish Community Center in Rockville to accept Max into class.

“What our role is is just to be accepting of everyone,” said Ora Cohen Rosenfeld, head of the Bender JCC Early Childhood Center. “And I think this is teaching our children to see Max as a child just as they are with the same needs. He’s different and yet he's very much the same.”

Max is on a ventilator, and his mother puts "angel arms" on him so he can move his hands and participate in activities like coloring for a friend’s birthday picture book.

Max vocalizes but lacks strength for articulation. His mother understands everything he says.

Asked what he wants to be when he grows up, Max surprised his mother when he replied he wants to be a teacher like she is.

“A teacher?” his mother reacted. “You want to be a teacher? I didn’t know that. Wow.”

“I’m glad he has these teachers as role models,” Jonathan Lasko said. “He's looking ahead and imagining himself in the role of teacher, and just like any of us, he's not going to let his different abilities get in the way of doing what he is passionate about.”



Photo Credit: NBCWashington]]>
<![CDATA[Some Parts of 'Obamacare' Working Well, Problems With Others]]>Sat, 25 Mar 2017 05:09:28 -0400http://media.nbcnewyork.com/images/213*120/obamacare-que-pasara-thumbnail.jpg

Once again, "Obamacare" has survived a near-death experience. It won't be the end of the political debate, but House Speaker Paul Ryan acknowledges, "We're going to be living with 'Obamacare' for the foreseeable future."

Ryan pulled the "repeal and replace" bill drafted by House Republican leaders and blessed by President Donald Trump after it failed to muster enough support. It was the latest attempt to undo the Affordable Care Act, which already beat two Supreme Court challenges.

Trump blamed Democrats for the failure and repeated his dire predictions for the Obama-era law. "It's imploding, and soon will explode, and it's not going to be pretty," he said.

While some parts of the law have obvious problems, others are working well and have brought the country's rate of uninsured people to a record low.

The ACA has added coverage in two main ways: a Medicaid expansion to cover more low-income adults, and subsidized private health insurance through online markets such as HealthCare.gov. That's helped push the nation's uninsured rate below 9 percent.

But premiums and other costs are rising faster than expected, and insurers have pulled out of markets in many areas, reducing options for consumers.

A status check on the ACA's major elements, and the outlook for each:

___

MEDICAID

Status: Thirty-one states have expanded Medicaid. The federal-state health program for low-income people now covers about 1 in 5 people in the United States, from newborns to elderly nursing home residents. About half of the expansion states have Republican governors. Gov. John Kasich, R-Ohio, says it has allowed his state to offer "a stable source of care" for the working poor, the drug-addicted and the mentally ill. Although Medicaid is a notoriously stingy payer, hospitals have strongly supported the expansion as preferable to treating uninsured patients.

Outlook: The Medicaid expansion, which covers about 11 million people, remains in place. Other states may now want to take advantage of its generous federal payment rate for new enrollees. Rising costs are likely to be a problem both for states and the federal government.

Medicaid also will remain as an open-ended entitlement program, with the federal government matching a share of what each state spends on care for beneficiaries. The national average is about 60 percent.

Overhaul efforts will continue, but state governors will take the lead. Expect the federal Health and Human Services department under Secretary Tom Price to be receptive.

___

INDIVIDUAL HEALTH INSURANCE

Status: The health law was meant to expand and stabilize the market for individual health insurance, through which roughly 20 million people get coverage. It's been a roller-coaster ride instead. As sicker, costlier customers came into the market, premiums and deductibles shot up. Consumers eligible for the law's income-related subsidies were cushioned, but millions who still pay their own way are in shock. Former President Bill Clinton, in a candid moment, called it a "crazy system." Aetna CEO Mark Bertolini has pronounced the ACA's health insurance markets in a "death spiral."

Outlook: Unclear, with analysts offering different opinions. The "glass-half-full" view is that this year's premium increases will help stabilize the market, and 2018 probably won't bring another wild ride. The "glass-half-empty" view is that the markets continue to struggle to attract young, healthy customers, and that's going to keep pushing premiums higher, making coverage unattractive.

In the mix is a political wild card. The Trump administration will have to decide whether to continue paying billions in cost-sharing subsidies that help reduce deductibles for more than half of the consumers using markets like HealthCare.gov. The GOP House has challenged the subsidies in court. Insurers say the system would be unworkable without the money.

Finally, no one seems to have an answer for the problems of people who pay the full cost of their individually purchased health insurance policies. They get no help from the government to shield them from rising premiums. And they complain of fewer available low-premium options as a consequence of federal regulation.

Consumers using HealthCare.gov have also found they have fewer choices as some insurers exited the markets. About one-third of counties currently have just one marketplace insurer.

___

COVERAGE PENALTY

Status: As a way to get healthy people into the insurance pool, the ACA imposes tax penalties on uninsured people deemed able to afford coverage. Last year 6.5 million people paid penalties averaging $470, according to the IRS. An additional 12.7 million people claimed exemptions for financial hardship and other reasons. Some young adults in good health decide to pay the fine because they can't squeeze $100 a month for premiums out of their already tight budgets. Experts argue about whether the unpopular requirement has been particularly effective.

Outlook: The penalty remains the law of the land, but the Trump administration isn't likely to make enforcement a priority.

___

OLDER ADULTS

Status: Obama's law limited what insurers could charge their oldest, pre-Medicare customers to no more than three times what they charge young adults.

Outlook: That limitation remains in place for now. Congressional Republicans will keep looking for ways to loosen it, arguing that it would help lower premiums for young adults and help make insurance markets stronger. A budget bill could provide a vehicle for changes.

___

ESSENTIAL HEALTH BENEFITS

Status: The ACA requires insurers to cover "essential benefits," including outpatient care, emergency services, hospitalization, pregnancy, maternity and newborn care, mental health and substance abuse treatment, prescription drugs, rehabilitation, laboratory and diagnostic tests, preventive and wellness services, and pediatric care, including dental and vision services for kids.

The benefits are considered especially important for women, since birth control and other routine services are now covered as preventive care, at no charge.

Outlook: The ACA's benefits requirement remains in place. Republicans say it drives up costs, but convincing consumers of that will be difficult.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Compare the Withdrawn GOP Health Bill With Obama-Era Law]]>Fri, 24 Mar 2017 15:43:52 -0400http://media.nbcnewyork.com/images/213*120/650498064-Paul-Ryan-American-Health-Care-Act.jpg

The now-withdrawn House health care bill repeals major parts of former President Barack Obama's Affordable Care Act, or ACA, as Republicans push to scale back the federal government's role in health care.

The bill, short of votes, has been withdrawn Friday afterday.

Some elements of the Obama-era law are maintained in the pulled House GOP legislation. For example, parents can keep young adult children on their plans until age 26. And insurers can't turn away people with pre-existing medical problems. But Republicans hoped to scrap other requirements, including essential benefits such as maternity care coverage.

How the House bill, called the American Health Care Act, would have compared with the ACA:

COVERAGE

    ACA: About 11 million people are covered by expanded Medicaid in the 31 states that accepted it. Nationwide, an additional 12 million buy private health insurance through government-sponsored markets that offer subsidized premiums, catering to consumers who don't have job-based coverage. The uninsured rate is below 9 percent, a historic low. But people who make too much to get subsidies — those in the solid middle class and above — have seen steep premium increases and fewer options.
  • House GOP: The nonpartisan Congressional Budget Office estimates that the Republican bill will result in 24 million fewer people having health insurance by 2026, compared to the ACA.

OLDER ADULTS

  • ACA: Insurers can charge their oldest customers no more than 3 times what they charge young adults. That benefits older adults more prone to illness but has made coverage costly for young people, who maybe just need a prescription for allergy medicine. ACA tax credits to help pay premiums are keyed to income and the cost of insurance in local communities. Obama's law also offers cost-sharing subsidies that help low-to-moderate income people with out-of-pocket medical expenses, cutting deductibles from several thousand dollars to several hundred.
  • House GOP: Insurers can charge older customers 5 times what they charge young adults, more if a state allows it. Tax credits are keyed to age, with people over 60 but still too young for Medicare getting $4,000, double what someone under 30 would get. Still, groups like AARP say the combination of higher premiums and less aid for those with modest incomes translates to an "age tax" on older adults. They're concerned that age-based tax credits may be unsuitable for areas of the country with high medical costs. They're also worried about the repeal of cost-sharing subsidies in the GOP plan.

House Republicans acknowledge there's more work to be done to improve the math for older adults, and they have taken steps in their legislation to free up additional financing that the Senate can tap for that purpose. They've also created a big market stability fund for states, and they say money from the fund can be used to provide cost-sharing subsidies if states so choose.

MEDICAID

  • ACA: States that accept expanded Medicaid receive a generous federal match. The expansion covers people with incomes up to 138 percent of the federal poverty line, or about $16,640 for an individual. Most new beneficiaries are low-income adults with no children at home.

Medicaid is now the country's largest health insurance program, covering more than 70 million people. The federal-state program remains an open-ended entitlement, allowing states to draw down federal money for a portion of health costs incurred by low-income people.

  • House GOP: Ends the higher federal match for Medicaid expansion beneficiaries; Republicans say it makes no sense to provide more generous payments for able-bodied adults than for children or the disabled. States that already expanded Medicaid can continue to receive some enhanced federal payments, but only for "grandfathered" enrollees already covered.

Of much greater significance, the bill would overhaul the underlying framework of Medicaid, ending its open-ended federal financing. Each state would receive a limited, per-beneficiary amount based on enrollment and costs. Federal payments would be increased according to a measure of medical inflation, with higher increases for elderly, blind and disabled beneficiaries.

States would also be able to select a block grant to finance their Medicaid programs. And they could impose work requirements on able-bodied adults.

The budget office says the bill would reduce projected federal Medicaid spending by about $840 billion from 2017-2026, and roughly 14 million fewer people would be enrolled by 2026.

ESSENTIAL HEALTH BENEFITS

  • ACA: Requires insurers to cover "essential benefits," including outpatient care, emergency services, hospitalization, pregnancy, maternity and newborn care, mental health and substance abuse treatment, prescription drugs, rehabilitation, laboratory and diagnostic tests, preventive and wellness services, and pediatric care, including dental and vision services for kids. The benefits are considered especially important for women, since birth control and other routine services are now covered as preventive care, at no charge.
  • House GOP: Repeals essential benefits at the federal level, returning that responsibility to the states, where it previously resided. Republicans say they're not out to gut consumer protections, but that without federal requirements many consumers could find plans with lower premiums. For example, an older married couple might not be interested in a plan that provides maternity benefits. Doctors groups say consumers who buy limited insurance plans take a risk.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Trump Forces a Vote on Health Care Bill ]]>Fri, 24 Mar 2017 10:18:44 -0400http://media.nbcnewyork.com/images/213*120/HealthCareAM0324_MP4-149036463772500001.jpg

President Trump has issued an ultimatum to House Republicans on the health care bill designed to repeal and replace "Obamacare": vote today or no deal. If there's no deal, then Obamacare stands. In the option on the table, conservatives want to get rid of guaranteed coverage for maternity leave, mental health and emergencies. Some 32 Republicans were ready to vote no, enough to keep the bill from passing, but jockeying for support continued Friday ahead of the vote.]]>
<![CDATA[Critics Scoff at All-Male Photo of GOP Health Care Talks]]>Fri, 24 Mar 2017 09:26:35 -0400http://media.nbcnewyork.com/images/213*120/VP-Freedom-Caucus-Meeting-Men.jpg

A lack of women in a photo of negotiations over the Republicans' health care bill that was tweeted out by the vice president is drawing criticism from Democrats and other critics concerned over the bill's repercussions for women's health.

The photo shows Vice President Mike Pence at the center of a conference table during negotiations with the House Freedom Caucus. About two dozen men can be seen in the photo and not a single woman.

Washington U.S. Sen. Patty Murray drew attention to the absence of women in the room by retweeting the photo and sarcastically adding, "A rare look inside the GOP's women's health caucus."

A repeal of a maternity care requirement is among the concessions the Freedom Caucus is demanding in exchange for support of the bill.

There were more sources of outrage for supporters of government funding for women's health care on Thursday.

A Republican senator had to apologize for a comment about the possibility the bill would ease federal requirements on coverage of basic services like mammograms.

"I wouldn't want to lose my mammograms," said Sen. Pat Roberts of Kansas when asked about the bill's potential changes in an interview with a reporter for Talking Points Memo.

He later tweeted an apology: "I deeply regret my comments on a very important topic. Mammograms are essential to women's health & I never intended to indicate otherwise."

The comment had drawn flak on social media, as did another on women's health issues by White House press secretary Sean Spicer.

Asked about the issue, he said, "I think if you're an older man, you probably won't need maternity coverage."

There were 10.5 million children born in the U.S. with fathers between 40 and 44 years old between the years 2006 and 2010, according a National Health Statistics report.

President Donald Trump had his youngest child at the age of 59.

Copyright Associated Press / NBC New York



Photo Credit: @VP / Twitter]]>
<![CDATA[No Repeal for 'Obamacare' in Humiliating Defeat for Trump]]>Fri, 24 Mar 2017 23:20:00 -0400http://media.nbcnewyork.com/images/213*120/ryan-trump-healthcare.jpg

In a humiliating failure, President Donald Trump and GOP leaders pulled their bill to repeal "Obamacare" off the House floor Friday when it became clear it would fail badly — after seven years of nonstop railing against the law. Democrats said Americans can "breathe a sigh of relief." Trump said the current law was imploding "and soon will explode."

Thwarted by two factions of fellow Republicans, from the center and far right, House Speaker Paul Ryan said President Barack Obama's health care law, the GOP's No. 1 target in the new Trump administration, will remain in place "for the foreseeable future."

It was a stunning defeat for the new president after he had demanded House Republicans delay no longer and vote on the legislation Friday, pass or fail.

His gamble failed. Instead Trump, who campaigned as a master deal-maker and claimed that he alone could fix the nation's health care system, saw his ultimatum rejected by Republican lawmakers who made clear they answer to their own voters, not to the president.

He "never said repeal and replace it in 64 days," a dejected but still combative Trump said at the White House, though he repeatedly shouted during the presidential campaign that it was going down on Day One of his term.

The bill was withdrawn just minutes before the House vote was to occur, and lawmakers said there were no plans to revisit the issue. Republicans will try to move ahead on other agenda items, including overhauling the tax code, though the failure on the health bill can only make whatever comes next immeasurably harder.

Trump pinned the blame on Democrats.

"With no Democrat support we couldn't quite get there," he told reporters in the Oval Office. "We learned about loyalty, we learned a lot about the vote-getting process."

The Obama law was approved in 2010 with no Republican votes.

Despite reports of backbiting from administration officials toward Ryan, Trump said: "I like Speaker Ryan. ... I think Paul really worked hard."

For his part, Ryan told reporters: "We came really close today but we came up short. This is a disappointing day for us." He said the president has "really been fantastic."

But when asked how Republicans could face voters after their failure to make good on years of promises, Ryan quietly said: "It's a really good question. I wish I had a better answer for you."

Last fall, Republicans used the issue to gain and keep control of the White House, Senate and House. During the previous years, they had cast dozens of votes to repeal Obama's law in full or in part, but when they finally got the chance to pass a repeal version that actually had a chance to become law, they couldn't deliver.

Democrats could hardly contain their satisfaction.

"Today is a great day for our country, what happened on the floor is a victory for the American people," said House Minority Leader Nancy Pelosi, who as speaker herself helped Obama pass the Affordable Care Act in the first place. "Let's just for a moment breathe a sigh of relief for the American people."

The outcome leaves both Ryan and Trump weakened politically.

For the president, this piles a big early congressional defeat onto the continuing inquiries into his presidential campaign's Russia connections and his unfounded wiretapping allegations against Obama.

Ryan was not able to corral the House Freedom Caucus, the restive band of conservatives that ousted the previous speaker. Those Republicans wanted the bill to go much further, while some GOP moderates felt it went too far.

Instead of picking up support as Friday wore on, the bill went the other direction, with several key lawmakers coming out in opposition. Rep. Rodney Frelinghuysen of New Jersey, chairman of a major committee, Appropriations, said the bill would raise costs unacceptably on his constituents.

The defections raised the possibility that the bill would not only lose on the floor, but lose big.

The GOP bill would have eliminated the Obama statute's unpopular fines on people who do not obtain coverage and would also have removed the often-generous subsidies for those who purchase insurance.

Republican tax credits would have been based on age, not income like Obama's, and the tax boosts Obama imposed on higher-earning people and health care companies would have been repealed. The bill would have ended Obama's Medicaid expansion and trimmed future federal financing for the federal-state program, letting states impose work requirements on some of the 70 million beneficiaries.

The nonpartisan Congressional Budget Office said the Republican bill would have resulted in 24 million additional uninsured people in a decade and lead to higher out-of-pocket medical costs for many lower-income and people just shy of age 65 when they would become eligible for Medicare. The bill would have blocked federal payments for a year to Planned Parenthood.

Republicans had never built a constituency for the legislation, and in the end the nearly uniform opposition from hospitals, doctors, nurses, the AARP, consumer groups and others weighed heavily with many members. On the other side, conservative groups including the Koch outfit argued the legislation did not go far enough in uprooting Obamacare.

When Ryan made his announcement to lawmakers at a very brief meeting, he was greeted by a standing ovation in recognition of the support he still enjoys from many in Congress.

When the gathering broke up, Rep. Greg Walden of Oregon, chairman of the Energy and Commerce Committee that helped write the bill, told reporters: ""We gave it our best shot. That's it. It's done. D-O-N-E done. This bill is dead."

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Science Says: Who and What is to Blame for Cancer?]]>Thu, 23 Mar 2017 18:33:14 -0400http://media.nbcnewyork.com/images/213*120/cancercells_generic_1200x675.jpg

Cancer patients often wonder "why me?" Does their tumor run in the family? Did they try hard enough to avoid risks like smoking, too much sun or a bad diet?

Lifestyle and heredity get the most blame but new research suggests random chance plays a bigger role than people realize: Healthy cells naturally make mistakes when they multiply, unavoidable typos in DNA that can leave new cells carrying cancer-prone genetic mutations.

How big? About two-thirds of the mutations that occur in various forms of cancer are due to those random copying errors, researchers at Johns Hopkins University reported Thursday in the journal Science.

Whoa: That doesn't mean most cases of cancer are due solely to "bad luck." It takes multiple mutations to turn cells into tumors — and a lot of cancer is preventable, the Hopkins team stressed, if people take proven protective steps.

Thursday's report is an estimate, based on a math model, that is sure to be hotly debated by scientists who say those unavoidable mistakes of nature play a much smaller role.

But whatever the ultimate number, the research offers a peek at how cancer may begin.

And it should help with the "why me" question from people who have "done everything we know can be done to prevent cancer but they still get it," said Hopkins' Dr. Bert Vogelstein, a pioneer in cancer genetics who co-authored the study. "They need to understand that these cancers would have occurred no matter what they did."

GENE MUTATIONS CAUSE CANCER BUT WHAT CAUSES THE MUTATIONS?

You might inherit some mutations, like flaws in BRCA genes that are infamous for causing aggressive breast and ovarian cancers in certain families.

More commonly, damage is caused by what scientists call environmental factors — the assault on DNA from the world around us and how we live our lives. There's a long list of risks: Cigarette smoke, UV light from the sun, other forms of radiation, certain hormones or viruses, an unhealthy diet, obesity and lack of exercise.

Then there are those random copy errors in cells — what Vogelstein calls our baseline rate of genetic mutations that will occur no matter how healthy we live.

One way to think of it: If we all have some mutations lurking in our cells anyway, that's yet another reason to avoid known risks that could push us over the edge.

 

HOW CELLS MAKE TYPOS

New cells are formed when an existing cell divides and copies its DNA, one cell turning into two. Every time DNA is copied, about three random mutations occur, Vogelstein said.

We all harbor these kinds of mutations and most don't hurt us because they're in genes that have nothing to do with cancer or the body's defense mechanisms spot and fix the damage, said Dr. Otis Brawley of the American Cancer Society, who wasn't involved in the new research.

But sometimes the errors hit the wrong spot and damage genes that can spur cancerous growth or genes that help the cell spot and fix problems. Then the damaged cells can survive to copy themselves, allowing important mutations to gradually build up over time. That's one reason the risk of cancer increases with age.

 

THE STUDY FINDINGS

Thursday's study follows 2015 research by Vogelstein and statistician Cristian Tomasetti that introduced the idea that a lot of cancer may be due to "bad luck," because those random DNA copying mistakes are more common in some kinds of cancer than others. Cancer prevention advocates worried the idea might sway people to give up on healthier lifestyles.

This time around, the duo analyzed mutations involved in 32 types of cancer to estimate that 66 percent of the gene flaws are due to random copy errors. Environmental and lifestyle factors account for another 29 percent, while inherited genes made up just 5 percent of the mutations.

 

DIFFERENT ORGANS, DIFFERENT RISKS

The same person can harbor a mix of mutations sparked by random DNA mistakes, heredity or environmental factors. And which is the most common factor differs by cancer, the Hopkins team said.

For example, they estimate that random cell errors account for 77 percent of critical mutations in pancreatic cancer — while still finding some caused by lifestyle risks like smoking. And the random DNA mistakes caused nearly all the mutations leading to childhood cancers, which is not surprising because youngsters have had little time to be exposed to environmental risks.

In contrast, most lung cancer mutations were the result of lifestyle factors, mainly from smoking. And while lung tissue doesn't multiply frequently, the small number of mutations caused by chance DNA errors might explain rare cases of never-smokers who still get sick.

"This paper is a good paper," said the cancer society's Brawley. "It gives prevention its due respect."

 

OTHER SCIENTISTS SEE MORE TO THE STORY

Estimates from Britain suggest 42 percent of cancers are potentially preventable with a healthy lifestyle, and the Hopkins team says their mutation research backs that idea.

But Dr. Yusuf Hannun, Stony Brook University's cancer center director, contends that's just the number known to be preventable today — researchers may discover additional environmental risks we can guard against in the future.

He said the Hopkins paper exaggerates the effect of the unavoidable DNA mistakes. His own 2015 research concluded they account for 10 to 30 percent of cancer cases.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Death Rates Up For Middle Age Whites With Little Education]]>Thu, 23 Mar 2017 17:52:51 -0400http://media.nbcnewyork.com/images/213*120/employmenyt-application_1200x675.jpg

A sobering portrait of less-educated middle-age white Americans emerged Thursday with new research showing them dying disproportionately from what one expert calls "deaths of despair" — suicides, drug overdoses and alcohol-related diseases.

The new paper by two Princeton University economists, Anne Case and Angus Deaton, concludes that the trend is driven by the loss of steady middle-income jobs for those with a high school diploma or less.

The economists also argue that dwindling job opportunities have triggered broader problems for this group. They are more likely than their college-educated counterparts, for example, to be unemployed, unmarried or suffering from poor health.

"This is a story of the collapse of the white working class," Deaton said in an interview. "The labor market has very much turned against them."

Those dynamics helped fuel the rise of President Donald Trump, who won widespread support among whites with only a high school diploma. Yet Deaton said his policies are unlikely to reverse these trends, particularly the health care legislation now before the House that Trump is championing. That bill would lead to higher premiums for older Americans, the Congressional Budget Office has found.

"The policies that you see, seem almost perfectly designed to hurt the very people who voted for him," Deaton said.

Case and Deaton's paper, issued by the Brookings Institution, follows up on research they released in 2015 that first documented a sharp increase in mortality among middle-aged whites.

Since 1999, white men and women ages 45 through 54 have endured a sharp increase in "deaths of despair," Case and Deaton found in their earlier work. These include suicides, drug overdoses, and alcohol-related deaths such as liver failure.

In the paper released Thursday, Case and Deaton draw a clearer relationship between rising death rates and changes in the job market since the 1970s. They find that men without college degrees are less likely to receive rising incomes over time, a trend "consistent with men moving to lower and lower skilled jobs."

Other research has found that Americans with only high school diplomas are less likely to get married or purchase a home and more likely to get divorced if they do marry.

"It's not just their careers that have gone down the tubes, but their marriage prospects, their ability to raise children," said Deaton, who won the Nobel prize in economics in 2015 for his long-standing work on solutions to poverty. "That's the kind of thing that can lead people to despair."

The issues identified by Case and Deaton are likely contributing to a slight reversal in a decades-long trend of improving life-expectancy data. It's not entirely clear why these trends have affected whites much more than they have African-Americans or Hispanics, whose death rates are improving.

Case and Deaton note that many Hispanics are "markedly better off" than parents or grandparents who were born abroad, enabling a greater sense of optimism. African-Americans, they add, may have become more resilient to economic challenges given their long-standing disadvantages in the job market.

Other researchers have said that whites may have an easier time obtaining painkillers that are behind an epidemic of drug overdoses.

The data is clear, though: In 1999, the death rate for high school-educated whites ages 50 through 54 was 30 percent lower than the death rate for all African-Americans in that age group. By 2015, it was 30 percent higher.

The educational split is also growing. Even while the death rate for whites without a college degree is rising, the rate for whites who are college graduates is falling, Case and Deaton found.

The trends cut across diverse regions of the country, the researchers found. While the worst-hit spots include Appalachian states such as West Virginia and Kentucky, they also include such areas as Maine, Baltimore and eastern Washington state. The patterns are evident in rural sections and smaller cities as well as in some large metro areas, the research found.

Americans with less education are also faring much worse when compared with adults in other countries, Case and Deaton concluded. Death rates in Europe for people with limited education are falling — and in most countries, they're falling faster than death rates for those with more education.

For those reasons, Case and Deaton discount the notion that government disability benefit programs are responsible for some of these problems by enabling more Americans to stop working. Social welfare programs in Europe are typically more generous yet haven't caused a rise in death rates.

Given the long-running nature of these trends, many of which stem from the 1970s, reversing them could take years, Case and Deaton write. But there are immediate steps that could be taken, Deaton said in the interview. Routine prescriptions for opioids should be cut back.

And, "Europe has a much better safety net than we do, and they're not seeing the same sort of problems as we are," he said.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Bird Flu Outbreak Nation's Worst Since 2015: Expert]]>Wed, 22 Mar 2017 16:55:51 -0400http://media.nbcnewyork.com/images/213*120/EggPricesChickens-AP_16197600754915.jpg

A bird flu outbreak that has led officials to euthanize more than 200,000 animals in three Southern states already is the nation's worst since 2015 and new cases are still popping up, an expert said Wednesday.

Agriculture officials are trying to limit the damage, but it's unclear whether quarantines, transportation bans and mass killings will stop the spread, said Joseph Hess, a poultry science professor at Auburn University.

The disease was first confirmed in southern Tennessee earlier this month and has since been detected in northern Alabama and western Kentucky.

"We're at the point where it's a little here and a little there. It could fade away, but it could blow up into something bigger," said Hess, who also works with the Alabama Cooperative Extension System.

State officials say no infected birds have entered the nation's poultry supply, and the U.S. food chain isn't at risk.

The Kentucky Department of Agriculture said Tuesday that it was temporarily banning the transportation of poultry after a low-pathogenic form of the disease was found in a commercial flock of 22,000 hens in western Kentucky. The farm was placed under quarantine and the birds were killed.

The announcement came as the state of Alabama confirmed the presence of low-pathogenic bird flu in two flocks there, where more than 42,000 animals have been euthanized. High-pathogenic bird flu, a deadlier form of the illness, was previously detected in Tennessee, where 145,000 birds were put to death.

Hess said the illness is carried by waterfowl, which don't get ill but can pass along the disease to poultry.

The current outbreak has affected large commercial poultry houses, where at-risk birds often are put to death by the thousands with foam that smothers them, and smaller, backyard operations.

Earlier this month, the U.S. Department of Agriculture said a flock of 84,000 turkeys had been confirmed with a low-pathogenic bird flu virus in Wisconsin.

The viruses in the current outbreaks are different from the high-pathogenic virus that resulted in the loss of nearly 50 million birds in the Midwest chicken egg and turkey industry in 2015.

Copyright Associated Press / NBC New York



Photo Credit: File, AP/Charlie Neibergall]]>
<![CDATA[Seniors Worry About Loss of Meals Under Trump Budget Plan]]>Wed, 22 Mar 2017 19:27:02 -0400http://media.nbcnewyork.com/images/213*120/IMG_82502.jpg

Dale Lamphier, 97, never married and her closest living relatives―three nephews―live across the country. About two years ago, she moved to a senior housing complex in Westwood, New Jersey, a town she has lived in her whole life. She has been using the meal delivery service Meals on Wheels since her brother died about three years ago.

"Meals on Wheels is important because I can't do much shopping―very little," she said. "And I can't carry things. There are a lot of people here that can't."

There is a Trader Joe's about a block from her complex, which she walks to, but not often. She relies on her daily meal delivery.

North Jersey is just one of the thousands of Meals on Wheels branches that could see cuts to its funding under President Donald Trump's proposed budget plan. Jeanne Martin, the executive director of Meals on Wheels North Jersey, said her program reaches about 220 senior citizens across 30 towns in northern Bergen County. If Trump's budget plan passes, her branch will lose about $32,000―10 percent of her annual budget―and potentially more money from other Department of Health and Human Services grants.

As a whole, the national Meals on Wheels organization receives about 35 percent of its funding from the federal government. Trump is proposing to end the Community Development Block Grants, one of many federal grants that fund the program. Other cuts to Health and Human Services, the parent agency for Meals on Wheels, also could affect the program negatively, but the magnitude of those cuts is unknown. 

Martin has been the executive director of Meals on Wheels in North Jersey for 12 years. She said she has never seen a federal cut this large.

"I don't see any room for us in that budget," she said. "I haven't seen any positive things coming from [the Trump administration] in the social services or the senior service so far."

"It is going to impact our program," she said. "We're not going to be able to offer the subsidies to our clients that they really need."

Andre Sitbon, a Holocaust survivor in his early 90s, has been using Meals on Wheels for more than five years out of the Westwood seniors complex. Around three years ago Sitbon's wife died and he started having severe eye problems, which interfered with his love of cooking. He said the program "receives you with arms open," with extremely friendly staff and good food. On Monday he received meatloaf, mashed potatoes and mixed greens.

Another senior, a 65-year old mentally disabled man, had virtually nothing in his fridge except the two meals―one hot, one cold―that Martin delivered to him Monday morning. The only other parcels were an apple and a small carton of milk, which were given to him by Meals on Wheels the day before.

Martin estimated that about 30 percent of the seniors in her program are no longer visited by family and, like Lamphier, are isolated. Martin said the 550 local volunteer drivers who deliver the meals are often the ones who report health problems and find fallen or sick seniors. Meals on Wheels, she said, is "more than just a meal."

"We're helping people stay in their homes, which is where they want to stay," she said. "It's keeping people out of nursing homes. And they want to spend the rest of the time they have on this world in their homes and we're doing the best we can to give them that."

When Martin became director there were about 100 seniors in the program. The number has more than doubled during her tenure, though she thinks that there are hundreds more seniors who need assistance but are too isolated or too worried about appearing needy to receive help.

If Martin loses funding she would have to make changes to the program's model. The food is now prepared by four local nursing homes to meet federal guidelines. But if the program no longer receives federal funds, it would be free to receive donated meals from volunteers.

"It seems to me that all of the programs that support our most needy, vulnerable populations are the ones that are being jeopardized," said John Birkner Jr., the mayor of Westwood. He also said that recent comments made by Trump administration officials "trivialize" the importance of programs like Meals on Wheels.

Mick Mulvaney, Trump’s budget director, called Meals on Wheels a program that is "just not showing any results." 

"We can’t spend money on programs just because they sound good," he said at a news conference last Thursday. "Meals on Wheels sounds great. Again, that's a state decision to fund that particular portion, to take the federal money and give it to the states, and say look, we want to give you money for programs that don't work."

Martin called Mulvaney’s comments "insulting" and said he "couldn’t be more wrong."

Supporters have cited studies to back their case. A University of Illinois review in 2013 of home-delivery programs for seniors found that they "significantly improve" the nutritional quality of diets, as well as increased chances for socialization and an overall "higher quality of life."

Another study in 2015 by Brown University researchers found multiple benefits of Meals on Wheels for senior citizens, including reduced feelings of isolation and loneliness, an increased feeling of security and fewer falls and hospitalizations.

Martin said the cost of a year's worth of meals from her program was $1,500. She compared that to the cost of a one-day hospitalization. 

"So, if we're keeping someone well-nourished and doing a well-check on them, we're saving the government money by keeping them out of the hospital," Martin said. 

Meals on Wheels has about 5,000 local and state delivery programs that supply food to isolated, disabled or poor seniors. In 2016, they served about 2.4 million people, including more than 500,000 veterans.

National Meals on Wheels spokeswoman Jenny Bertolette confirmed to NBC that the program has seen a significant spike in donations since Mulvaney’s comments last Thursday. On a typical day, the nonprofit receives about $1,000 in individual online donations.

Three days after the preliminary budget was released, Meals on Wheels had received about $140,000 in donations. On Tuesday, the nonprofit told The Associated Press that it had received an additional $50,000 donation from NFL quarterback Colin Kaepernick. 

Bertolette said the organization was "thrilled about the public’s passionate support" but also said the additional donations could not replace what it gets from the federal government.

The portion of Meals on Wheels' budget that comes from the federal government is part of the Older Americans Act Nutrition Program, which falls under Health and Human Services. Trump is calling for an 18 percent cut to the department.

Each state uses Community Block Development Grants differently, so the amount that funds Meals on Wheels per branch varies widely. For example, one program in the suburbs of Detroit could lose 30 percent of its budget; on the other end, New York City's Meals on Wheels is funded through other grants, so it is not affected by the potential loss of Community Block Development Grants.

The program is also funded by private money.

"Cuts of any kind to these highly successful and leveraged programs would be a devastating blow to our ability to provide much-needed care for millions of vulnerable seniors in America," Ellie Hollander, president and CEO of Meals on Wheels America, said in a statement.

The cuts are no sure thing. Congress must pass the budget that Trump has outlined and there has already been support from both sides of the aisle for Meals on Wheels.

Sen. Cory Booker, D-N.J., tweeted that cuts to programs like Meals on Wheels "jeopardizes the health and safety of the poor."

Rep. Chris Collins, R-N.Y., told CNN he would "never vote to cut even one dollar" of Meals on Wheels.

Since Mulvaney's comments last week, Martin has gained three more volunteers and an additional donor. 

Even if the budget doesn't cut as much as the 10 percent that is currently threatened, to Martin "a cut is a cut." 



Photo Credit: Shannon Ho
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<![CDATA[High Court Bolsters Rights of Learning-Disabled Students]]>Wed, 22 Mar 2017 20:08:51 -0400http://media.nbcnewyork.com/images/213*120/AP_17081573502374.jpg

A unanimous Supreme Court on Wednesday bolstered the rights of millions of learning-disabled students in a ruling that requires public schools to offer special education programs that meet higher standards. The court struck down a lower standard endorsed by President Donald Trump's nominee to the high court.

Chief Justice John Roberts said that it is not enough for school districts to get by with minimal instruction for special needs children. The school programs must be designed to let students make progress in light of their disabilities.

The ruling quickly led to tough questions at the confirmation hearing of Supreme Court nominee Neil Gorsuch. Democratic Sen. Dick Durbin of Illinois said the high court had just tossed out a standard that Gorsuch himself had used in a similar case that lowered the bar for educational achievement.

In its ruling, the Supreme Court sided with parents of an autistic teen in Colorado who said their public school did not do enough to help their son make progress. They sought reimbursement for the cost of sending him to private school.

The case helps clarify the scope of the Individuals with Disabilities Education Act, a federal law that requires a "free and appropriate public education" for disabled students. Lower courts said even programs with minimal benefits can satisfy the law.

Roberts said the law requires an educational program "reasonably calculated to enable a child to make progress appropriate in light of the child's circumstances." He did not elaborate on what that progress should look like, saying it depends on the "unique circumstances" of each child. He added that there should also be deference to school officials.

"When all is said and done, a student offered an educational program providing merely more than de minimis progress from year to year can hardly be said to have been offered an education at all," Roberts said. "For children with disabilities, receiving instruction that aims so low would be tantamount to sitting idly awaiting the time when they were old enough to drop out."

At Gorsuch's hearing, Durbin said the nominee had gone beyond the standards of his own appeals court by adding the word "merely" in his 2008 opinion approving the "de minimis" — or minimum — standard for special needs education. Durbin suggested that Gorsuch had lowered the bar even more.

Gorsuch, handed a copy of the ruling during a break on the third day of his hearings, noted that his panel reached its decision unanimously based on a 10-year-old precedent.

Durbin also said Gorsuch had ruled against disabled students in eight out of 10 cases dealing with the IDEA.

"To suggest I have some animus against children, senator, would be a mistake," Gorsuch said.

Later, Sen. Amy Klobuchar, D-Minn., pressed Gorsuch again, saying he added the word "merely" to the standard "to make it even more narrow."

Gorsuch responded: "I disagree."

Disability advocacy groups argued that schools must offer more than the bare minimum of services to children with special needs.

The ruling does not go as far as the parents wanted. They had argued that educational programs for disabled students should meet goals "substantially equal" to those for children without disabilities. Roberts rejected that standard, saying it was "entirely unworkable."

The court's decision to require a more demanding test for progress has major implications for about 6.4 million disabled students who want to advance in school and rely on special programs to make that happen. School officials had cautioned that imposing higher standards could be too costly for some cash-strapped districts. They warned that it could also lead parents to make unrealistic demands.

The case involved a boy known only as Endrew F. who attended public school outside Denver from kindergarten through fourth grades. He was given specialized instruction to deal with his learning and behavioral issues.

But Endrew's parents decided to send him to private school in 2010 after complaining about his lack of progress. They asked the school district to reimburse them for his tuition — about $70,000 a year — on the basis that public school officials weren't doing enough to meet their son's needs.

The Colorado Department of Education denied their claim, saying the school district had met the minimum standards required under the law. The federal appeals court in Denver upheld that decision, ruling that the school district satisfied its duty to offer more than a "de minimis" effort.

Disability advocacy groups cheered the ruling, saying it raises the expectations for learning-disabled students.

"It is now clear that schools must provide students with disabilities the supports they need to help them achieve meaningful and substantive educational goals," said Ira Burnim, legal director at the Bazelon Center for Mental Health Law.

Francisco Negron, general counsel of the National School Boards Association, said the court had issued a "measured" decision "that isn't really upsetting the apple cart." He said it would lead to schools more carefully tracking the progress of special needs students. But he praised the court for saying it would defer to the judgment of educational officials.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Timothy D. Easley, File]]>
<![CDATA[Baby Born With 4 Legs, 2 Spines Survives Risky Surgery]]>Tue, 21 Mar 2017 16:59:39 -0400http://media.nbcnewyork.com/images/213*120/dominique+2.jpg

A 10-month-old baby born with four legs and two spines is recovering well after undergoing a complex and risky medical procedure in Chicago, doctors say.

Young Dominique came to Chicago from the Ivory Coast in West Africa with an extremely rare parasitic conjoined twin.

Doctors say the bottom half of her not-fully-developed twins’ body was protruding from the infant’s neck and back.

“It’s very rare because it was attached at the back of her spine,” said Dr. John Ruge, a pediatric neurosurgeon. “It was as if the twin from the waist down had been attached to the back of Dominique’s neck and there was a pelvis and bladder and functional legs that moved and feet coming out the back of Dominique’s neck. This was very dangerous for Dominique.”

Ruge said the parasitic twin caused Dominique’s heart and lungs to do the work for two bodies and could have ultimately paralyzed her.

The child was brought to Chicago in February with the help of an organization called Children’s Medical Missions West and has been living with a host family while doctors at Advocate Children’s Hospital meticulously studied her case.

“It’s really hard to even put a number on how rare it is,” said Dr. Robert Kellogg.

Despite her condition, her host family said the child had a bubbly personality and was a “very happy baby” when she arrived in the U.S.

“If you can say love at first sight I think that’s true for us,” said Nancy Swabb, who has been caring for Dominique since her arrival.

The Swabbs said the decision to take in the child was made quickly, with Dominique arriving at their home about a week after they learned of her case.

“I saw a picture of Dominique with her extra limbs and one concern that we had before we met her was what can she wear?” Swabb said.

The family later learned Dominique had difficulties balancing and sitting up because of the added weight from the extra limbs.

After weeks of planning, on March 8, Dominique underwent a six-hour surgery that involved five surgeons and 50 clinicians.

“The surgery went very well,” said Kellogg. “There were no complications. We expect her to make a full recovery and live an essentially normal life from here on.”

Dominique continues to recover at her host family’s Edgebrook home. Doctors say once the recovery process is complete, the infant can return home to her family in Africa.

“She is about 2 pounds lighter and she sits up and she’s raising her hands and she reaches for things and she’s doing really well,” Swabb said.

Doctors said Dominique is now “essentially a normal baby” and are confident she can go on to live a healthy life.

“I think it is very unique but it was a unique child that brought us together,” Kellogg said.



Photo Credit: Advocate Children's Hospital
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<![CDATA[Here Are the Republicans Who May Reject Health Care Bill]]>Tue, 21 Mar 2017 17:25:59 -0400http://media.nbcnewyork.com/images/213*120/649341198-GOP-Health-Care-Bill.jpg

President Donald Trump campaigned on the promise to repeal the Affordable Care Act, also known as Obamacare, and replace it with "something terrific." Now, House Republicans are in danger of losing a vote on their health care bill, the American Health Care Act — a defeat that would cause setbacks for the party and for the president.

According to a tally by NBC News, as of Tuesday afternoon at least 25 Republicans have said they will vote against or are leaning toward voting against the bill. Voting is expected to occur Thursday.

Republican leadership has been busy trying to secure the 216 votes needed to pass the bill, which means they can lose the support of only 21 Republicans. After traveling to Capitol Hill Tuesday morning in an attempt to close the deal, Trump has invited about nine moderate, undecided Republicans to the White House Tuesday afternoon in another attempt at persuasion.



Photo Credit: Chip Somodevilla, Getty Images]]>
<![CDATA[FDA: Breast Implants Can Cause Rare Form of Cancer]]>Tue, 21 Mar 2017 16:03:40 -0400http://media.nbcnewyork.com/images/213*120/implants-new.jpg

Breast implants can cause a rare form of cancer that may have killed at least nine people, the Food and Drug Administration said Tuesday, NBC News reported.

The cancer is called anaplastic large cell lymphoma (ALCL) and the FDA is checking into more than 350 reports linking it with both silicone and saline breast implants.

ALCL, which is a type of non-Hodgkin's lymphoma, can take about 10 years to develop on average after the implant first goes in and usually stays in the area right around the implant, World Health Organization researchers reported last year in the journal Blood. But it can break out and spread.

"All of the information to date suggests that women with breast implants have a very low but increased risk of developing ALCL compared to women who do not have breast implants," the FDA said in a statement.



Photo Credit: Getty Images]]>
<![CDATA[Infant Mortality Rates Fall 15 Percent in US]]>Tue, 21 Mar 2017 13:58:57 -0400http://media.nbcnewyork.com/images/213*120/babypacifier_1200x675.jpg

Fewer babies are dying in the United States than a decade ago, according to NBC News.

The U.S. infant mortality rate, which is higher than in other developed countries, is down 15 percent over the last 10 years, federal researchers reported Tuesday.

"Infant mortality is considered a basic measure of public health for countries around the world," wrote Anne Driscoll and T.J. Mathews of the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.

Researchers pointed to a high teenage pregnancy rate in the U.S. compared to other countries as one of several factors behind the comparatively high rate of babies dying. Teenagers are more likely to have small and premature babies.



Photo Credit: Getty Images/Tetra images RF, File]]>
<![CDATA[Trump to GOP: Pass Health Care Bill or Seal Your Fate]]>Tue, 21 Mar 2017 21:06:52 -0400http://media.nbcnewyork.com/images/213*120/Trump-Price-AHCA.jpg

Time for talk running out, President Donald Trump on Tuesday warned wavering House Republicans that their jobs were on the line in next year's elections if they failed to back a GOP bill that would overhaul Barack Obama's Affordable Care Act.

The countdown quickened toward an expected vote Thursday on legislation undoing much of the law that provided health coverage to some 20 million Americans. Trump huddled behind closed doors with rank-and-file Republicans just hours after GOP leaders unveiled changes intended to pick up votes by doling out concessions to centrists and hardliners alike.

"If we fail to get it done, fail to (meet) the promises made by all of us, including the president, then it could have a very detrimental effect to Republicans in '18 who are running for re-election," said Rep. Mike Conaway, R-Texas. "If it fails, then there will be a lot of people looking for work in 2018."

Trump's message to Republicans: "If you don't pass the bill there could be political costs," said Rep. Walter Jones, R-N.C.

The outlook for House passage remains dicey even with the revisions.

The GOP bill would scale back the role of government in the private health insurance market, and limit future federal financing for Medicaid. It would also repeal tax cuts on the wealthy that Democrats used to pay for Obama's coverage expansion. Fines enforcing the Obama-era requirement that virtually all Americans have coverage would be eliminated.

The nonpartisan Congressional Budget Office estimates that 24 million fewer people will have health insurance in 2026 under the GOP bill.

Trump warned House Republicans they'd seal their political doom if they waver, with the party potentially losing majority control of the House. Still, several conservatives were steadfast in their opposition even after the session with Trump and the leadership's changes.

"The president wouldn't have been here this morning if they have the votes," said Rep. Rod Blum, R-Iowa, a member of the Freedom Caucus who complained that the GOP bill leaves too much government regulation in place.

Rep. Don Bacon, R-Neb., said he was convinced to back the bill in part by Trump's urging and the changes.

"I think a vote 'no' is a vote for Obamacare," Bacon said. "We can vote for this, and continue to make it better. I intend to vote 'yes' Thursday."

Speaker Paul Ryan, R-Wis., told reporters that if Republicans pass the legislation, "people will reward us. If we don't keep our promise, it will be very hard to manage this."

If the bill advances, prospects are uncertain in the Senate, where Republicans hold a slim majority. Six GOP senators have expressed deep misgivings including Tom Cotton of Arkansas, who said Tuesday he cannot support the House bill.

In an Associated Press interview, Senate Majority Leader Mitch McConnell, R-Ky., signaled he'd use Trump's clout to pressure unhappy Republicans in his chamber. McConnell said he's optimistic that in the end no Republican senator will want to be held responsible for "Obamacare's" survival.

"I would hate to be a Republican whose vote prevented us from keeping the commitment we've made to the American people for almost 10 years now," McConnell said.

The House GOP bill would end Obama-era subsidies based on peoples' incomes and the cost of insurance. A Medicaid expansion to 11 million more low-income people would disappear.

Instead, the bill would provide tax credits based chiefly on age to help people pay premiums. But insurers could charge older consumers five times the premiums they charge younger people instead of Obama's 3-1 limit, and would boost premiums 30 percent for those who let coverage lapse.

The revisions by House GOP leaders to round up votes come at a cost — literally. Congressional budget experts had projected that the original bill would cut federal deficits by $337 billion over a decade. But that amount is dwindling as top Republicans dole out provisions helping older and disabled people.

To address criticism that the bill would leave many older people with higher costs, GOP leaders have taken an unusual approach. They added language paving the way for the Senate, if it chooses, to make the bill's tax credit more generous for people age 50-64. Republicans said the plan sets aside $85 billion over 10 years for that purpose. And the income tax threshold for deducting medical expenses would be lowered to 5.8 percent, from the current 10 percent.

The leaders' proposals would accelerate the repeal of tax increases Obama imposed on higher earners, the medical industry and others.

On Medicaid, the changes would provide higher federal payments to help states care for older and disabled beneficiaries. States would be able to impose work requirements for able-bodied adults. But the bill would still limit future federal financing for Medicaid, seen by many state officials as a cost shift.

In a bid to cement support from upstate New Yorkers, the revisions would also stop that state from passing on over $2 billion a year in Medicaid costs to upstate counties, though it exempts Democratic-run New York City from that protection.

Democrats remain solidly opposed to the GOP repeal effort.

Rep. Chris Collins, R-N.Y., said Trump told Republicans he would campaign for them if they backed the bill.

Associated Press reporters Matthew Daly, Kevin Freking, Richard Lardner, Stephen Ohlemacher in Washington and Thomas Beaumont in Iowa contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: J. Scott Applewhite, AP]]>
<![CDATA[Trump Goes Outside DC for Support on Revised GOP Health Bill]]>Tue, 21 Mar 2017 00:45:42 -0400http://media.nbcnewyork.com/images/213*120/tru1AP_17080015521172.jpg

President Donald Trump is deploying an outside and inside strategy to fulfill his campaign promise to repeal and replace "Obamacare," seeking support beyond Washington before making an in-person pitch on Capitol Hill. Top House Republicans unveiled proposed changes in their legislation in hopes of winning support, three days before the big House vote.

Trump rallied supporters Monday night in Louisville, Kentucky, alongside Senate Majority Leader Mitch McConnell, R-Ky., after meetings and phone calls in Washington aimed at steadying the troubled legislation designed to erase President Barack Obama's signature health care law. He planned to court House Republicans on Tuesday.

"We want a very big tax cut, but cannot do that until we keep our promise to repeal and replace the disaster known as 'Obamacare,'" Trump told the crowd of thousands in Louisville. "This is our long-awaited chance to finally get rid of 'Obamacare.' It's a long-awaited chance. We're going to do it," he said.

With their showpiece bill revamping the 2010 health care law at stake, House GOP leaders released 43 pages of revisions to the legislation in hopes of rounding up votes.

The measure would pave the way for the Senate, if it chooses, to make the bill's tax credit more generous for people age 50 to 65. Details in the documents released were unclear, but one GOP lawmaker and an aide said the language sets aside $85 billion over 10 years for that purpose.

The measure would also accelerate the repeal of tax increases on higher earners, the medical industry and others to this year instead of 2018. It would be easier for people to deduct expenses from their taxes, and older and disabled Medicaid beneficiaries would get larger benefits.

It would also curb future Medicaid growth and let states impose work requirements on some recipients.

Many GOP opponents were unhappy that nonpartisan analysts said their party's legislation would drive up costs for older people. The leaders' changes were aimed at addressing those concerns.

Trump resumed his campaign-style events at the start of a consequential week for his young presidency. Confirmation hearings for his nominee for the Supreme Court, Judge Neil Gorsuch, opened Monday before the Senate Judiciary Committee. The House was expected to vote Thursday on the GOP-backed health care bill.

Trump's Louisville rally, his third since his inauguration, followed a daylong congressional hearing in which FBI Director James Comey acknowledged for the first time that the agency was investigating whether Trump's campaign colluded with Russian officials seeking to influence the 2016 campaign.

Many hard-line conservatives have pushed for a more complete repeal of Obama's law, including its requirement that policies cover a long list of services, which they say drives up premiums. They also complain that the GOP bill's tax credits create an overly generous benefit the federal government cannot afford.

Moderate Republicans, meanwhile, have said the tax credits are too limited and would hurt low earners and older patients. They also worry the plan would leave too many people uninsured, pointing to a nonpartisan Congressional Budget Office analysis that estimated 24 million people would lose coverage over 10 years.

At the rally, Trump suggested he wasn't wedded to the current version of bill. "We're going to negotiate. And it's going to go to the Senate and back and forth," he said, assuring that the "end result is going to be wonderful and it's going to work great."

The White House was trying to win over conservatives who are part of the House Freedom Caucus, including the group's chairman, Rep. Mark Meadows, R-N.C. Meadows joined two Senate conservatives, Ted Cruz of Texas and Mike Lee of Utah, for a weekend meeting at Trump's Florida estate, Mar-a-Lago, with top White House aide Steve Bannon and other White House officials.

The rally Monday night was the Trump administration's second high-profile event in Kentucky in 10 days and took the president to the home state of one of the most outspoken critics of the plan, Sen. Rand Paul, R-Ky. Vice President Mike Pence was in Louisville earlier this month to build support for the Trump-backed bill.

Paul said Monday to a group of Louisville business leaders that he hoped the Republican bill would fail so that "true negotiations" could begin. The senator, who was re-elected last year, has dismissed it as "Obamacare lite" and asserted that the bill had no chance of becoming law.

Paul was not attending the rally, saying he planned to fly back to Washington to continue building a coalition to defeat the plan.

But Trump called him out nonetheless, saying he hoped Paul would come onboard.

"I happen to like a lot Sen. Rand Paul. I do," Trump said. "He's a good guy. And I look forward to working with him so we can get this bill passed, in some form, so that we can pass massive tax reform, which we can't do until this happens. So we gotta get this done."

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Already in Peril, Rural Hospitals Unsure on Health Care Bill]]>Mon, 20 Mar 2017 12:31:57 -0400http://media.nbcnewyork.com/images/213*120/ruralhospital_Georgia_1200x675.jpg

Talmadge Yarbrough had just sat down at his desk and opened a box of pecans when he let out a gasp that could have been his last breath. He'd gone into cardiac arrest in his office, a co-worker called 911, and an ambulance drove him two miles to the small hospital that serves this rural community in southeast Georgia.

"I would have never lasted to get to Savannah or Statesboro," Yarbrough said of the biggest cities near Claxton — each 30 to 60 miles away. "I firmly believe if that hospital wasn't here, I wouldn't be here."

But like Yarbrough, the 10-bed Evans Memorial Hospital has fought to survive. That story is reflected nationwide — rural hospitals have long struggled, with patients who are older, suffer from chronic illnesses, and face few insurance options, if they're insured at all. Most rural hospitals have a higher-than-normal percentage of Medicaid patients; expected cuts to the federal program for low-income residents will affect facilities everywhere, but experts and administrators are particularly worried about rural areas. Still more rural patients are on Medicare, for those 65 and older, but both programs' reimbursements are lower than the cost of care.

Now, as Republicans in Washington put forward long-anticipated plans to get rid of President Barack Obama's Affordable Care Act, rural hospitals and communities are watching the debate closely. But if they didn't fare too well under the ACA, many question whether they'd be better off under the plan backed by President Donald Trump.

At Evans Memorial, many blue-collar workers are unable to afford insurance but are too well-off for Medicaid, said chief financial officer John Wiggins. Such uninsured patients are perhaps the No. 1 problem for rural hospitals: Evans Memorial has been saddled with $3 million or more in unpaid medical bills in recent years.

But the hospital can't and won't turn away the uninsured — federal law prohibits it in emergencies. Recently, Dr. Kyle Parks performed an urgent gallbladder operation on an uninsured woman. "It is what we've always done — we take care of people, payer or no payer," Parks said. "But we're fighting a struggle to keep our little hospital open."

Evans Memorial, which opened in 1968, has managed to keep operating by seeking new revenue — for example, a new wing for dementia patients scheduled to open soon. But the hospital was in the red for four years before finding itself $50,000 in the black this year.

"We do not have fear of the doors closing, but we remember those days and we never get comfortable," said Nikki NeSmith, the CEO who doubles as chief nursing officer, in part to cut costs. "I don't think we'll be in that comfortable position anytime soon."

Meantime, other rural hospitals have shuttered — 80 since 2010, mostly in the South and Midwest, according to the North Carolina Rural Health Research Program. A wave of closures also hit in the 1980s and early '90s with changes in Medicare reimbursement, though Congress eventually increased that.

At Evans Memorial, about half the patients are covered by Medicare; 10 percent are on Medicaid. An uneven, state-by-state expansion of Medicaid has been a problem there and elsewhere. Georgia's among 19 states that didn't expand the program under the ACA. It's never been a popular proposal in rural Georgia, where Trump saw his strongest support in the state. But Evans CFO Wiggins said many of his uninsured patients would have qualified under an expansion.

The ACA was intended to slash the number of uninsured patients seeking care they could never afford at hospitals. It succeeded in rural areas, where overall the rate of uninsured people fell by 8 percent since full implementation of the law in 2014, said Brock Slabach, of the National Rural Health Association. But it fell more in urban areas, in part because of the dearth of choices in the exchanges set up under the ACA. Thirty to 40 percent of rural communities have only one company from which to pick.

Snap Lewis has been selling property and casualty insurance in Claxton for nearly four decades, and he said even he couldn't find affordable coverage after the ACA was implemented. He took a part-time job driving a school bus, with health benefits. He wakes up at 4:45 a.m. for his morning route, then heads to his insurance office at 8. He's back on a bus at 2 p.m. for his after-school route, and then sells insurance for another hour or so.

"I thought it was a very good plan," Lewis said, "if you can stand the hours."

But not all rural residents can — and many can't find jobs with insurance at all. At Evans Memorial, 10 percent of patients are uninsured.

Beyond the insurance, Medicare and Medicaid problems, rural hospitals face death by a thousand paper cuts: a nationwide trend toward outpatient care, trouble recruiting staff, industry consolidation, low-patient volume, and a preference by private-insurance clients for newer hospitals.

When rural hospitals are forced to close, the effects reverberate, a 2016 Kaiser Family Foundation study shows. Such hospitals are often the community's largest employer, leading to job losses. Doctors and others leave the area. Closures also make it hard to attract outside employers or investors who want quick access to emergency rooms.

And for many rural health care workers, the GOP's new plan isn't calming nerves. At Evans Memorial, administrators say they haven't heard much in the proposal that sounds beneficial — besides perhaps the chance to allow Americans to shop for insurance across state lines. But officials recognize the tough task legislators have.

"I wouldn't want to be in a position where I needed to say, 'Here's what we need to do to fix it,'" said Parks, the hospital's surgeon. "Because I honestly don't know what that would be." 

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[How Do Insurers Decide What Medicines to Pay For?]]>Sat, 18 Mar 2017 02:26:17 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-102897463.jpg

How do insurance companies decide what medicines to pay for and when to pay for them?

Insurers and other payers look first at how well the drug works — not its cost — when they decide whether to cover the latest treatments, according to the nation's largest pharmacy benefits manager, Express Scripts.

The price patients eventually pay gets determined later, when an insurance company or pharmacy benefits manager decides where a drug fits on a list of covered treatments called a formulary.

The cost of prescription drugs has become a growing source of concern with doctors and patients, but it's not a factor considered by an independent committee used by Express Script to determine coverage of a new drug, Chief Medical Officer Dr. Steve Miller said.

That committee — 15 doctors and a pharmacist — reviews the information that federal regulators used to approve a drug and then decides whether it should be covered.

Some payer coverage decisions come with qualifications like a requirement that patients meet specific criteria or try other treatments first. That can limit patient access. Doctors say some patients have had trouble getting a new cholesterol-lowering drug, Repatha, that costs $14,000 a year, because of the restrictions.

Insurers largely use pharmacy benefits managers to set up the lists that determine how much a patient ends up paying. Some lists are divided into tiers, with drugs on the bottom generally being generic or least expensive. Those on the highest tier might include specialty medicines that could cost the patient hundreds of dollars even with coverage.

Whether a drug even gets on the list can depend on whether a similar medicine is already in the market. When the ground-breaking hepatitis C treatments Sovaldi and Harvoni from Gilead Sciences debuted a few years ago, Express Scripts had to include them. They cost more than $80,000 for a course of treatment, but the drugs essentially cure a debilitating disease and they had no competition.

But once the drugmaker AbbVie produced a third option, Viekira Pak, with a similar cure rate, Express Scripts was able to negotiate a price discount and switched to covering only Viekira Pak.

The nation's two largest pharmacy benefits managers, Express Scripts and CVS Health Corp., both say they cover Repatha.

Copyright Associated Press / NBC New York



Photo Credit: Joe Raedle/Getty Images]]>
<![CDATA[New Drug Cuts Cholesterol by Half]]>Fri, 17 Mar 2017 17:11:35 -0400http://media.nbcnewyork.com/images/213*120/NC_cholesteroldrug0317_1500x845.jpg

A new drug proven to slash bad cholesterol by more than half of a patient's initial level may prove to be a boon to those worried about heart attacks and strokes. Repatha, a drug that could lower the risk of heart attack or strokes by 20 percent, is a $14,000 a month drug that is injected once or twice a month - a price point health insurance companies may not approve of.]]>
<![CDATA[Jurors Begin Deliberations in Deadly Meningitis Outbreak Trial]]>Fri, 17 Mar 2017 16:07:37 -0400http://media.nbcnewyork.com/images/213*120/AP_17075485521393.jpg

Jurors began deliberations Friday in the trial of a former executive charged in a 2012 U.S. meningitis outbreak that killed 64 people and injured about 700 others in 20 states.

No verdict was reached Friday, and the jury will return to court on Monday morning.

Barry Cadden, the co-founder and former president of the New England Compounding Center, is charged in a massive racketeering indictment with second-degree murder in the deaths of 25 people, as well as fraud and other charges.

During closing arguments on Thursday, Assistant U.S. Attorney Amanda Strachan told the jury that Cadden ran the company in an "extraordinarily dangerous" way, leading to contaminated steroids being shipped around the country, where doctors - trusting they were safe - injected them into patients who then became sick or died.

"It was preventable, but it happened because this man - Barry Cadden - decided to put profits before patients," Strachan said.

She said Cadden cut corners and failed to follow industry regulations for cleanliness and sterility in the so-called "clean rooms" at NECC, where drugs were manufactured. She said NECC did not sterilize drugs long enough, didn't test large enough samples and shipped out drugs before receiving the results of sterility tests.

Cadden's lawyer, Bruce Singal, told jurors that Cadden is not responsible for the deaths.

"As horrible as each of these stories is, there is nothing that shows that Mr. Cadden did something that the government can link to the death of that person," Singal said.

Singal said Glenn Chin, the supervisory pharmacist, was responsible for the day-to-day operations in the clean rooms and repeatedly allowed employees to cut corners, going against instructions from Cadden to "do it right." Chinn, who faces similar charges, is expected to go on trial after Cadden. He has pleaded not guilty.

Singal said prosecutors have "massively piled on" and appealed to the jurors' emotions to try to convict Cadden of murder.

"This is indeed a tragic death case, but it is not a murder case, and there is a big, big difference between the two," Singal said.

Copyright Associated Press / NBC New York



Photo Credit: Steven Senne/AP]]>
<![CDATA[Baby Given Police Escort in Snowstorm 'Resting Comfortably']]>Fri, 17 Mar 2017 12:08:07 -0400http://media.nbcnewyork.com/images/213*120/The+Gingerlowskis.jpg

A 23-month-old Mount Pocono, Pennsylvania, boy who was escorted by snowplows and state troopers for an emergency procedure during this week's snowstorm was resting comfortably Friday in a hospital. 

Bentley Gingerlowski has a rare congenital heart defect and on Tuesday he needed an emergency treatment. But it was at the height of a powerful snowstorm and the doctors equipped to do the procedure were 80 miles from where the boy was staying to Geisinger Medical System's Janet Weis Children's Hospital in Danville, Pennsylvania.

That's when seemingly the best of Pennsylvania's emergency personnel kicked in and provided a special escort in the blinding snow.  

The National Guard and Pennsylvania State Police teamed up with PennDOT.

Even Gov. Tom Wolf said state snowplows and troopers got the boy from Mt. Pocono Medical Center in East Stroudsburg to Geisinger.

“We’re very grateful for each and every member of the team who provided service to get our son here safely,” said mom Nicole Gingerlowski, adding that Geisinger medical personnel helped coordinate the emergency transport.

On Friday, Bentley was "resting comfortably" with his parents, Nicole and Brian, the hospital said in a statement.

“To finally get here was a relief,” Nicole said. “To see your son that way was scary. He’s always been a fighter, but not knowing what would happen to him really was the scariest part.”

His parents rushed him to a nearby hospital initially because of a low platelet condition that caused external bleeding, the hospital said. The life-threatening condition has been stabilized, according to Geisinger, where Bentley was born.

The storm dropped more than 20 inches of snow and sleet in parts of northeastern Pennsylvania.

Copyright Associated Press / NBC New York



Photo Credit: Geisinger Medical System
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<![CDATA[Cholesterol Drug Cuts Heart Risks, Spurs New Debate on Cost ]]>Fri, 17 Mar 2017 10:29:28 -0400http://media.nbcnewyork.com/images/213*120/repatha_cholest_prescription_1200x675.jpg

A long-acting cholesterol medicine cut the risk of having a heart attack or some other serious problems by 15 to 20 percent in a big study that's likely to spur fresh debate about what drugs should cost.

Statins such as Lipitor and Crestor are cheap and lower LDL or bad cholesterol, but some people can't tolerate or get enough help from them. The new drug, Amgen's Repatha, is given as a shot once or twice a month and is part of a novel class of medicines that drop LDL to unprecedented levels.

It costs more than $14,000 a year, and insurers have balked at paying without proof that it lowers heart risks, not just the cholesterol number. The new study gives that evidence, but the benefit is not as great as some doctors had hoped.

For every 200 people treated with Repatha for roughly two years, three fewer people would suffer a heart attack, stroke or heart-related death. But looked at by themselves, deaths were not reduced by the drug.

"That's a big benefit," said Dr. Marc Sabatine, the study leader, from Brigham and Women's Hospital in Boston. For millions of people with heart disease or high risk for it like those in the study, "it's worth it to be on this medicine."

But Dr. Donald Lloyd-Jones, preventive medicine chief at Northwestern University and an American Heart Association spokesman, called the results modest and "not quite what we hoped or expected."

Dr. Mark Hlatky, a Stanford University cardiologist and cost effectiveness researcher, said, "people were hoping for a breakthrough, a lot bigger result than 20 percent."

For patients like Susan Goodreds, whose insurance copay for Repatha is $356 a month, it's not an easy choice.

"It's an expensive, expensive drug," the 74-year-old Florida woman said. "You have to make some real decisions about whether to stay on it."

The results were published Friday by the New England Journal of Medicine and discussed at an American College of Cardiology conference.

Repatha and a similar drug, Praluent, called PCSK9 inhibitors, were approved in 2015 for people with inherited risk for high cholesterol, or heart disease that had already caused a problem such as a heart attack. The study tested Repatha in more than 27,500 people like this who had LDL above 70 (the recommended upper limit for such patients) despite maximum statin use.

After about two years, Repatha, used along with statins, reduced LDL from a median of 92 to 30. It also proved safe — side effects were similar to those from a dummy drug.

Repatha cut by 20 percent the combined risk of having either a heart attack, stroke or a heart-related death. That happened to nearly 6 percent of people on Repatha versus more than 7 percent on the dummy drug. The benefit grew with longer use, and was 25 percent the second year, said Sabatine, who consults for Amgen and other drugmakers.

The drug cut by 15 percent a broader set of problems — the ones above plus hospitalization for chest pain or an artery-opening procedure. Nearly 10 percent of folks on Repatha had one versus more than 11 percent on the dummy drug.

This last result is something insurers care about — preventing costly health care.

"That's the biggest issue — whether they're worth all the money," Hlatky said of the drugs. If they cost 50 times as much as statins, "are they 50 times better? I don't think so."

For now, "we should still probably reserve these for the highest risk patients where statins are not doing a good enough job — at least at the price they are currently offered," said Lloyd-Jones.

Amgen said the drug's value justifies its cost, and offered more deals for insurers, including refunds for people who have a heart attack or stroke after using Repatha for at least six months.

Dr. Seth Baum, president of the American Society for Preventive Cardiology, said records from IMS Health, an information services company, show 83 percent of patients had claims rejected in the first year Repatha and Praluent were sold, and 26 percent of them won on appeal.

They include his patient, Goodreds, who was denied for seven months despite high genetic risk and a heart bypass.

"It's hard not to give that drug" to patients now that a benefit has been shown, said Baum, who consults for Amgen and Praluent's makers — Regeneron Pharmaceuticals Inc. and Sanofi SA.

A study testing whether Praluent also lowers heart risks will wrap up later this year. The companies also are in a patent war over the drugs.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Falls Are Taking a Huge and Rising Toll on Elderly Brains]]>Thu, 16 Mar 2017 18:06:13 -0400http://media.nbcnewyork.com/images/213*120/elderly_people_1200x675.jpg

Elderly people are suffering concussions and other brain injuries from falls at what appear to be unprecedented rates, according to a new report from U.S. government researchers.

The reason for the increase isn't clear, the report's authors said. But one likely factor is that a growing number of elderly people are living at home and taking repeated tumbles, said one expert.

"Many older adults are afraid their independence will be taken away if they admit to falling, and so they minimize it," said Dr. Lauren Southerland, an Ohio State University emergency physician who specializes in geriatric care.

But what may seem like a mild initial fall may cause concussions or other problems that increase the chances of future falls — and more severe injuries, she said.

Whatever the cause, the numbers are striking, according to the new report released Thursday by the Centers for Disease Control and Prevention.

One in every 45 Americans 75 and older suffered brain injuries that resulted in emergency department visits, hospitalizations, or deaths in 2013. The rate for that age group jumped 76 percent from 2007. The rate of these injuries for people of all ages rose 39 percent over that time, hitting a record level, the CDC found.

The report, which explored brain injuries in general, also found an increase in brain injuries from suicides and suicide attempts, mainly gunshot wounds to the head. Brain injuries from car crashes fell.

But the elderly suffered at far higher rates than any other group.

It's well known that falls among the elderly are common. Older people are more likely to have impaired vision, dizziness and other de-stabilizing health problems, and are less likely than younger people to have the strength and agility to find their feet once they begin to lose their balance. The CDC had already reported that falls were the top cause of injuries and deaths from injury among older people; an estimated 27,000 Americans die each year from falls.

But even experts on elderly falls said the new numbers were striking.

Health officials have been increasing their focus on brain injuries among all ages, especially younger people. CDC investigators thought the overall rise in brain injuries might be mainly caused by rising awareness of sports-related head injuries in kids and young adults, and more diagnosis of injuries in that group that in the past were not recorded.

"But when we dug a little bit more into the numbers, we found the larger driver is older adult falls," said the CDC's Matt Breiding, a co-author of the new report.

The toll from elderly falls has been under-recognized by physicians and by seniors themselves, Southerland said. When falls do occur, older people tend to downplay it, she said.

But one fall can quickly lead to others. In a study published last year, Southerland and other Ohio State researchers found that more than a third of older adults with minor head injuries end up back in the ER within 90 days.

Even when they see a doctor, the future risk may be missed. In hospital emergency departments, it's not unusual for a 25-year-old athlete who fell on his head to get a more thorough evaluation for concussion than an elderly retiree, said Southerland, who is trying to develop a standard for assessing concussions in geriatric ER patients.

___

Online:

CDC report: http://tinyurl.com/gm5kuf3

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Critics Warn 'Phase 2' Won’t Save Health Care Plan]]>Wed, 15 Mar 2017 19:12:06 -0400http://media.nbcnewyork.com/images/213*120/paulryan_healthcare_1200x675.jpg

Things aren't looking great for the Republican health care bill after the Congressional Budget Office estimated it would lead to 24 million more people without insurance and skyrocketing costs for older customers, NBC News reported.

But the White House and GOP leaders say that's only part of the story. 

The Republicans' "American Health Care Act" is only "Phase One" of their plan. In "Phase Two," the White House will lower premiums with tweaks to regulations. In "Phase Three," they'll pass new legislation to fill in gaps that can't be addressed through the budget process.

"The fact of the matter is with our whole plan every single American will have access to coverage," Health and Human Services Secretary Tom Price said on the "Today" show.



Photo Credit: Getty Images]]>
<![CDATA[Mental Health Groups Worry New GOP Plan Will End Coverage]]>Wed, 15 Mar 2017 13:19:32 -0400http://media.nbcnewyork.com/images/213*120/naloxone-kit.jpg

Mental health groups say the new GOP health care bill would terminate mental health care and efforts to combat the opioid crisis, NBC News reported.

The Congressional Budget Office released a report on the bill on Monday, stating that billions of dollars would be saved in federal health spending, by way of cutting $880 billion from Medicaid. In addition to health groups, parents of children with special needs are also rallying against the proposed plan.

“Medicaid is the single largest payer of mental health and addiction treatment services in the country, paying 25 percent of all mental health and 20 percent of all addiction care,” the National Council for Behavioral Health said in a statement.

Without Medicaid’s subsidies, said Linda Rosenberg, president and CEO of the council, people could wind up “homeless, in jail or dead.”

Health and Human Services Secretary Tom Price said that the bill does not intend to leave states out in the cold in combating the opioid epidemic.



Photo Credit: Getty Images]]>
<![CDATA[Over 12M Signed Up for 'Obamacare' This Year: Gov't Report]]>Wed, 15 Mar 2017 17:59:18 -0400http://media.nbcnewyork.com/images/213*120/pryan-acha.jpg

A substantial 12 million people have enrolled for coverage this year under the very health care statute that President Donald Trump and the Republican Congress want to erase, the government said Wednesday.

With a crunch-time House vote on a GOP bill replacing that law planned for next week, Vice President Mike Pence ensured conservative lawmakers that the administration was open to changes.

Pence's trip to the Capitol, and an evening all-hands meeting of House Republicans to count votes, came as GOP leaders strained to win backing for besieged legislation that's uniformly opposed by Democrats. The bill would strike down much of former President Barack Obama's 2010 overhaul and reduce the federal role, including financing, for the nation's health care consumers.

"Where is the sweet spot, that's what we're working on," said Rep. Barry Loudermilk, R-Ga., among the conservatives who met with Pence. He said the vice president's pitch was: "The process is open, we're still working on it, bring your ideas forward and let's get a bill done."

With opposition from conservative and moderate GOP lawmakers endangering the measure in the House and Senate, President Donald Trump was expected to urge lawmakers to back the bill in remarks in Nashville, Tennessee. Health secretary Tom Price was using phone calls to lobby Republican governors, some of whom — with home-state GOP members of Congress — oppose the bill's phaseout of Obama's expansion of Medicaid to 11 million additional lower-income Americans.

Underscoring GOP leaders' push-and-pull problem, around 60 conservatives who met with Pence proposed revisions in the other direction, including a hastening of the Medicaid expansion phaseout to 2018 instead of the legislation's 2020.

"He gave us a lot of hope," said Rep. Mark Walker, R-N.C., leader of the group that met with Pence.

The White House, GOP leaders and rank-and-file lawmakers were negotiating over modifications that could be made when the bill reaches the House floor. On CNN, House Speaker Paul Ryan, R-Wis., said changes might give states more "flexibility" to oversee Medicaid.

In the Senate, the GOP's 52-48 edge and widespread dissension leaves leaders little leeway. Sen. Charles Grassley, R-Iowa, expressed worries about higher costs on seniors and predicted the Senate would reject the bill without changes.

Conservatives want deeper cuts in the overall Medicaid program than the Republican bill plans and a work requirement for able-bodied constituents. They're also seeking less generous tax credits for people's health care costs and elimination of Obama's insurance requirements, including mandatory coverage of specified services like drug counseling.

Every one of those proposals would endanger support from moderates.

"This is going to take a lot of political capital from the president" and congressional leaders, said Rep. Dennis Ross, R-Fla.

The bill would enfeeble Obama's individual mandate — the requirement that Americans buy coverage — by abolishing the tax fine on violators. It would end subsidies that help low-income people with high insurance premiums the most and replace them with tax credits that are bigger for older people. It would cut Medicaid, repeal the law's tax increases on higher earning Americans and allow 30 percent higher premiums for consumers who let coverage lapse.

The latest government sign-up numbers missed Obama's target of 13.8 million people for 2017. The figures represent initial enrollment, and there's usually significant attrition over the course of a year.

Nonetheless, experts said the report undercuts Republican claims that the health law's insurance markets are teetering toward collapse, which they say makes repealing the law crucial.

"While there's a big debate in Washington about the future of the Affordable Care Act, the law remains in place for now and is covering millions of people," said the nonpartisan Kaiser Family Foundation's Larry Levitt, using the formal name of Obama's statute.

The official national figure of 12.2 million excludes 765,000 people signed up under a related Obama-era law used by New York and Minnesota.

The Centers for Medicare and Medicaid Services released the figures a day before the House Budget Committee plans to advance the GOP bill in a potentially tight vote. The committee can't make significant changes, but Republicans were expected to approve non-binding suggestions to nail down votes.

GOP support became scarcer when the nonpartisan Congressional Budget Office found this week that the legislation would push 24 million Americans off coverage in a decade and shift out-of-pocket costs toward lower income, older people. That's 4 million more than the 20 million who've gained either Medicaid or insurance coverage under Obama's law.

Hundreds of conservative activists rallied outside the Capitol in sub-freezing weather to call on congressional leaders and Trump to abandon the GOP bill and fully repeal Obama's law. The rally was organized by FreedomWorks, a conservative group backed by the billionaire Koch brothers.

"They're telling us that you campaigned for Obamacare light and you want partial repeal!" said Sen. Rand Paul, R-Ky., among conservative lawmakers who say the House GOP bill is too timid.

"No!" the crowd replied.

Nevada GOP Gov. Brian Sandoval, who expanded Medicaid coverage to over 300,000 additional people in his state, said in a phone call, Price promised "flexibility" in administering the program.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File]]>
<![CDATA[GOP Leaders Acknowledge Health Bill Changes, May Delay Vote ]]>Wed, 15 Mar 2017 21:28:17 -0400http://media.nbcnewyork.com/images/213*120/AP_17068637615881-paul-ryan-american-health-care-act.jpg

Their health care overhaul imperiled from all sides, the White House and top House Republicans acknowledged Wednesday they would make changes to the legislation in hopes of nailing down votes and pushing the party's showpiece legislation through the chamber soon.

House Speaker Paul Ryan, R-Wis., declined to commit to bringing the measure to the House floor next week, a fresh indication of uncertainty. Republican leaders have repeatedly said that was their schedule, but opposition mushroomed after a congressional report concluded this week that the measure would strip 24 million people of coverage in a decade.

Ryan told reporters that GOP leaders could now make "some necessary improvements and refinements" to the legislation, reflecting an urgency to buttress support. The measure would strike down much of former President Barack Obama's 2010 overhaul and reduce the federal role, including financing, for health care consumers and is opposed uniformly by Democrats.

"We're going to arbitrate, we're all going to get together, we're going to get something done," President Donald Trump promised a crowd at a rally in Nashville.

At an all-hands meeting Wednesday evening of House GOP lawmakers, Vice President Mike Pence and party leaders urged their rank-and-file to unite behind the legislation.

"'It's our job to get it out of here and get it to the Senate,'" Pence told the Republicans, according to Rep. Dennis Ross, R-Fla. That would let Trump pressure "Democrats in these red states to come on board,'" Ross said, referring to Republican-leaning states where Democratic senators face re-election next year.

Health secretary Tom Price was using phone calls to lobby Republican governors, some of whom — with home-state GOP members of Congress — oppose the bill's phase out of Obama's expansion of Medicaid to 11 million additional lower-income Americans.

Amid the maneuvering, a government report said more than 12 million people have signed up for coverage this year under the very statute that President Donald Trump and congressional Republicans want to repeal. That figure underscored the potential political impact of the GOP's next move.

Pence met repeatedly with House Republicans but rebels still abounded. Conservatives were unhappy the measure doesn't erase enough of Obama's law while at the other end of the party's spectrum, moderates were upset the bill would strip millions of health coverage.

"Oh heck, yes," said one conservative leader, Rep. Jim Jordan, R-Ohio, asked if the GOP legislation needed changes to win his support.

Conservatives want to end Obama's expansion of Medicaid to 11 million additional low-income people next year, not 2020 as the bill proposes. They say a GOP proposed tax credit to help people pay medical costs is too generous, and they want to terminate all of Obama's insurance requirements, including mandatory coverage of specified services like drug counseling.

Underscoring the push-pull problem GOP leaders face in winning votes, moderates feel the tax credits are too stingy, especially for low earners and older people. They oppose accelerating the phaseout of the Medicaid expansion and are unhappy with long-term cuts the measure would inflict on the entire program.

Terminating the Medicaid expansion in 2020 and not 2018 "is sacrosanct to me," said moderate Rep. Tom MacArthur, R-N.J.

In a new complication, Sen. Charles Grassley, R-Iowa, said the measure lacked the votes to pass in the Senate, where Republicans hold a precarious 52-48 majority. That left House members angry over being asked to take a politically risky vote for legislation likely to be altered.

Moderates "don't like the idea of taking a vote in the House that may go nowhere in the Senate," said Rep. Charlie Dent, R-Pa.

The bill would enfeeble Obama's individual mandate, the requirement that Americans buy coverage, by abolishing the tax fine on violators. It would end subsidies that help low-income people with high insurance premiums the most and replace them with tax credits that are bigger for older people. It would cut Medicaid, repeal the law's tax increases on higher earning Americans and require 30 percent higher premiums for consumers who let coverage lapse.

GOP support became scarcer when the nonpartisan Congressional Budget Office projected the legislation would push 24 million Americans off coverage in a decade and shift out-of-pocket costs toward lower income, older people. That' surpasses the 20 million who've gained Medicaid or insurance coverage under Obama's law.

Hundreds of conservative activists rallied outside the Capitol in sub-freezing weather to call on congressional leaders and Trump to abandon the GOP bill and fully repeal Obama's law. The rally was organized by FreedomWorks, a conservative group backed by the billionaire Koch brothers.

The 2017 government sign-up numbers missed Obama's target of 13.8 million people. Experts said the figures undercut Republican claims that the health law's insurance markets are teetering toward collapse.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Loud Sound May Pose More Harm Than We Thought]]>Tue, 14 Mar 2017 14:30:36 -0400http://media.nbcnewyork.com/images/213*120/ear_noise_1200x675.jpg

Matt Garlock has trouble making out what his friends say in loud bars, but when he got a hearing test, the result was normal. Recent research may have found an explanation for problems like his, something called "hidden hearing loss."

Scientists have been finding evidence that loud noise — from rock concerts, leaf blowers, power tools and the like — damages our hearing in a previously unsuspected way. It may not be immediately noticeable, and it does not show up in standard hearing tests.

But over time, Harvard researcher M. Charles Liberman says, it can rob our ability to understand conversation in a noisy setting. It may also help explain why people have more trouble doing that as they age. And it may lead to persistent ringing in the ears.

The bottom line: "Noise is more dangerous than we thought."

His work has been done almost exclusively in animals. Nobody knows how much it explains hearing loss in people or how widespread it may be in the population. But he and others are already working on potential treatments.

To understand Liberman's research, it helps to know just how we hear. When sound enters our ears, it's picked up by so-called hair cells. They convert sound waves to signals that are carried by nerves to the brain. People can lose hair cells for a number of reasons — from loud noise or some drugs, or simple aging — and our hearing degrades as those sensors are lost. That loss is what is picked up by a standard test called an audiogram that measures how soft a noise we can hear in a quiet environment.

Liberman's work suggests that there's another kind of damage that doesn't kill off hair cells, but which leads to experiences like Garlock's.

A 29-year-old systems engineer who lives near Boston, Garlock is a veteran of rock concerts.

"You come home and you get that ringing in your ears that lasts for a few days and then it goes away," he said.

But after he went to Las Vegas for a friend's birthday, and visited a couple of dance clubs, it didn't go away. So he had the audiogram done, in 2015, and his score was normal.

Last fall, he came across a news story about a study co-authored by Liberman. It was a follow-up to Libermans' earlier work that suggests loud noise damages the delicate connections between hair cells and the nerves that carry the hearing signal to the brain.

The news story said this can cause not only persistent ringing in the ears, but also a lingering difficulty in understanding conversations in background noise. After the Vegas trip, Garlock sensed he had that problem himself.

"I notice myself leaning in and asking people to repeat themselves, but I don't notice anybody else doing that," he said.

Garlock emailed one of Liberman's colleagues and volunteered for any follow-up studies.

It's hard to be sure that Garlock's situation can be explained by the research. But the seeming contradiction of hearing problems in people with perfect hearing tests has puzzled experts for years, says Robert Fifer of the University of Miami's Mailman Center for Child Development.

He's seen it in Air Force personnel who worked around airplanes and in a few music-blasting adolescents.

"We didn't have a really good explanation for it," said Fifer, who's an official of the American Speech-Language-Hearing Association.

But the work by Liberman and others helps solve the mystery, he said.

The connections between hair cells are called synapses, and a given hair cell has many of them. Animal studies suggest you could lose more than half of your synapses without any effect on how you score on an audiogram.

But it turns out, Liberman says, that losing enough synapses erodes the message the nerves deliver to the brain, wiping out details that are crucial for sifting conversation out from background noise. It's as if there's a big Jumbotron showing a picture, he says, but as more and more of its bulbs go black, it gets harder and harder to realize what the picture shows.

The study Garlock noticed is one of the few explorations of the idea in people. Researchers rounded up 34 college students between ages 18 and 41 who had normal scores on a standard hearing test. The volunteers were designated high-risk or low-risk for hidden hearing loss, based on what they said about their past exposure to loud noise and what steps they took to protect their hearing,

The higher-risk group reported more difficulty understanding speech in noisy situations, and they scored more poorly on a lab test of that ability. They also showed evidence of reduced function for hearing-related nerves.

It's a small study that must be repeated, Liberman says, but it adds to evidence for the idea.

One encouraging indication from the animal studies is that a drug might be able to spur nerves to regrow the lost synapses, said Liberman, who holds a financial stake in a company that is trying to develop such treatments.

In the meantime, he says, the work lends a new urgency to the standard advice about protecting the ears in loud places.

"It isn't awesome to have your ears ringing. It's telling you (that) you did some damage," he said.

Liberman's own hearing scores are pretty good, but at age 65, he sometimes can't understand his kids in a loud setting. He figures some of that may be from his years of handyman chores, like using a belt sander or a table saw.

"I wear earplugs when I mow the lawn now."

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File]]>
<![CDATA[Texas Effort to Replace Planned Parenthood Stumbles]]>Tue, 14 Mar 2017 08:15:31 -0400http://media.nbcnewyork.com/images/180*120/GettyImages-499277954.jpg

In pushing a replacement for the Affordable Care Act that cuts off funds for Planned Parenthood, Republicans are out to reassure women who rely on the major health care organization that other clinics will step up to provide their low-cost breast exams, contraception and cancer screenings.

Texas is already trying to prove it. But one big bet is quietly sputtering, and in danger of teaching the opposite lesson conservatives are after.

Last summer, Texas gave $1.6 million to an anti-abortion organization called the Heidi Group to help strengthen small clinics that specialize in women's health like Planned Parenthood but don't offer abortions. The goal was to help the clinics boost their patient rolls and show there would be no gap in services if the nation's largest abortion provider had to scale back.

The effort offered a model other conservative states could follow if Republicans make their long-sought dream of defunding Planned Parenthood a reality under President Donald Trump. Several states are already moving to curtail the organization's funds.

But eight months later, the Heidi Group has little to show for its work. An Associated Press review found the nonprofit has done little of the outreach it promised, such as helping clinics promote their services on Facebook, or airing public service announcements. It hasn't made good on plans to establish a 1-800 number to help women find providers or ensure that all clinics have updated websites.

Neither the group nor state officials would say how many patients have been served so far by the private clinics.

The Heidi Group is led by Carol Everett, a prominent anti-abortion activist and influential conservative force in the Texas Legislature.

In a brief interview, Everett said some of the community clinics aren't cooperating despite her best efforts to attract more clients.

"We worked on one Facebook site for three months and they didn't want to do it. And we worked on websites and they didn't want to do it," Everett said of the clinics. "We can't force them. We're not forcing them."

Everett said that advertising she planned was stalled by delays in a separate $5.1 million family planning contract.

Everett proposed helping two dozen selected clinics serve 50,000 women overall in a year, more than such small facilities would normally handle. Clinic officials contacted by the AP either did not return phone calls or would not speak on the record.

The Texas Health and Human Services Commission, which awarded the funding to the Heidi Group, acknowledged the problems. Spokeswoman Carrie Williams said in an email that the agency had to provide "quite a bit" of technical support for the effort and make many site visits. She disputed that the contract funding has been as slow as Everett alleged.

"The bottom line is that we are holding our contractors accountable, and will do everything we can to help them make themselves successful," she said.

In August, the state had lauded Everett's pitch for taxpayer funds as "one of the most robust" received.

Planned Parenthood and its supporters say the failures show the risks of relying on unproven providers to serve low-income women, and that Republicans' assurances about adequate care are only political rhetoric.

"Every time they try to relaunch one of these women's health programs, without some of the most trusted providers in women's health, every single time they come up short," said Sarah Wheat, a Planned Parenthood spokeswoman in Texas. "And they show their lack of understanding and respect for what women need."

On Tuesday, the nonpartisan Congressional Budget Office estimated that 15 percent of low-income people in rural or underserved areas would lose access to care if Planned Parenthood loses funding. The analysis also projected several thousand more births in the Medicaid program in the next year.

The Heidi Group is an evangelical nonprofit that started in the 1990s and is best known for promoting alternatives to abortion. It operates with a relatively small budget, taking in about $186,000 in grants and donations in 2015, according to tax records, and had not been doing patient care.

State officials say the year-old women's health program includes about 5,000 providers. Planned Parenthood and other abortion providers are banned from participation.

Federal dollars comprise nearly half of the Planned Parenthood's annual billion-dollar budget, and although government funds don't pay for abortions, the organization is reimbursed by Medicaid for non-abortion services that it says the vast majority of clients receive. Missouri is planning to reject federal funding just to keep some of it away from Planned Parenthood, and Iowa is also considering giving up millions in federal Medicaid dollars to create a state-run family planning program that excludes abortion providers.

U.S. House Republicans' health care bill would freeze funding to Planned Parenthood for one year. House Speaker Paul Ryan has suggested other clinics will pick up the slack.

"It ends funding to Planned Parenthood and sends money to community centers," Ryan said last week.

Democrats argue that other clinics are already overloaded and wouldn't be able to meet increased demand.

After Texas state funding was cut off to abortion providers in 2011, 82 family planning clinics closed in the state, a third of which were Planned Parenthood affiliates. A state report later found that 30,000 fewer women were served through a Texas women's health program after the changes. Planned Parenthood now has 35 clinics in Texas and served more than 126,000 individual patients last year, including those seeking abortions. The state has provided no estimates of low-income women served by other clinics.

Asked whether the Heidi Group would meet the patient targets in her contract, Everett said her own goal was to serve 70,000 women.

However, "it's not as easy as it looks because we are not Planned Parenthood. We are working with private physicians and providers," Everett said after leaving a committee hearing this week at the Texas Capitol. She said the clinics she is working with are busy seeing 40 to 50 women a day. "They don't have time to go out and do some of the things that we would really like to help them do. But we're there if they want to. And we're there when the need it. And we're in their offices and we're helping them."

She had been at the Capitol to support a bill that would require abortion clinics to bury or cremate fetal remains.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File]]>
<![CDATA[City Sues Drugmaker for Letting OxyContin Flood Black Market]]>Tue, 14 Mar 2017 11:45:36 -0400http://media.nbcnewyork.com/images/213*120/AP_16273781823723oxy.jpg

As deaths from painkillers and heroin abuse spiked and street crimes increased, the mayor of Everett took major steps to tackle the opioid epidemic devastating this working-class city north of Seattle.

Mayor Ray Stephanson stepped up patrols, hired social workers to ride with officers and pushed for more permanent housing for chronically homeless people. The city says it has spent millions combating OxyContin and heroin abuse — and expects the tab to rise.

So Everett is suing Purdue Pharma, maker of the opioid pain medication OxyContin, in an unusual case that alleges the drugmaker knowingly allowed pills to be funneled into the black market and the city of about 108,000. Everett alleges the drugmaker did nothing to stop it and must pay for damages caused to the community.

Everett's lawsuit, now in federal court in Seattle, accuses Purdue Pharma of gross negligence and nuisance. The city seeks to hold the company accountable, the lawsuit alleges, for "supplying OxyContin to obviously suspicious pharmacies and physicians and enabling the illegal diversion of OxyContin into the black market" and into Everett, despite a company program to track suspicious flows.

"Our community has been significantly damaged, and we need to be made whole," said Stephanson, who grew up in Everett and is its longest-serving mayor, holding the job since 2003.

He said the opioid crisis caused by "Purdue's drive for profit" has overwhelmed the city's resources, stretching everyone from first responders to park crews who clean up discarded syringes. The lawsuit doesn't say how much money the city is seeking, but the mayor says Everett will attempt to quantify its costs in coming months.

Connecticut-based Purdue Pharma says the lawsuit paints a flawed and inaccurate picture of the events that led to the crisis in Everett.

"We look forward to presenting the facts in court," the company said in a statement.

Purdue said it is "deeply troubled by the abuse and misuse of our medication," and noted it leads the industry in developing medicines with properties that deter abuse, even though its products account for less than 2 percent of all U.S. opioid prescriptions.

In 2007, Purdue Pharma and its executives paid more than $630 million in legal penalties to the federal government for willfully misrepresenting the drug's addiction risks. The same year, it also settled with Washington and other states that claimed the company aggressively marketed OxyContin to doctors while downplaying the addiction risk. As part of that settlement, it agreed to continue internal controls to identify potential diversion or abuse.

While numerous individuals and states have sued Purdue, this case is different because Everett is getting at the results of addiction, said Elizabeth Porter, associate law professor at the University of Washington.

She thinks Everett may have a shot at winning, though it will have to overcome some legal burdens, including showing that diverted OxyContin from rogue doctors and pharmacies was a substantial factor in the city's epidemic.

Stephanson said he was "absolutely outraged" after the Los Angeles Times reported last summer it found Purdue had evidence that pointed to illegal trafficking of its pills but in many cases did nothing to notify authorities or stop the flow. That newspaper investigation prompted the city's lawsuit.

In response to the newspaper's reporting, Purdue said in a statement that in 2007, it provided LA-area law enforcement information that helped lead to the convictions of the criminal prescribers and pharmacists referenced by the Los Angeles Times. The company also pointed to court documents that showed a wholesaler alerted the Drug Enforcement Administration about suspicious activity at a sham clinic noted in the newspaper's story.

Still, Everett contends Purdue created a market for addicts that didn't exist until the company let its pills flood the streets.

The region saw two spikes in overdose deaths: first from OxyContin and other opioid painkillers in 2008 and then, after the drug was reformulated in 2010, a spike from heroin as people switched to a potent but cheaper alternative, officials said.

The city contends Purdue's wrongful conduct fueled a heroin crisis in Everett. Between 2011 and 2013, nearly one in five heroin-related deaths in Washington state occurred in the Everett region.

In response to the drug epidemic, Everett last year began sending social workers on routine patrols with police officers. Sgt. Mike Braley says the community outreach and enforcement team strikes a balance between enforcement and connecting people to addiction treatment, mental health and other services.

"We understand that we can't arrest our way out of problems that addiction is causing our city," Braley said.

Sometimes it takes many follow-ups and hours of handholding to get people help. On their first stop one morning, Braley and his team check under a street overpass, a popular hangout for addicts. They find plenty of needles, drug packaging and mounds of garbage but none of the people they had encountered there recently.

They swing by a woody vacant piece of city property to follow up with a homeless man who told social workers he was on a housing list. He previously was reluctant to talk but opens up this time.

Social worker Kaitlyn Dowd offers to check on the man's housing status with a local nonprofit provider and then punches her number into a cellphone he recently got.

"You can call me, and I have your number," she tells him.

Social worker Staci McCole said they come across many cases where highly functioning residents were introduced to opiates or heroin. "So many of these people — somehow it's taken a hold of them, and their lives now have forever changed," she said.

Copyright Associated Press / NBC New York



Photo Credit: Toby Talbot/AP, File]]>
<![CDATA[Baby Injuries Rise in Common Infant Products]]>Mon, 13 Mar 2017 19:55:47 -0400http://media.nbcnewyork.com/images/213*120/BabyInjuries0310_MP4-148944776988400001.jpg

A new study finds a growing number of young children are being injured while using infant products like carriers, strollers and cribs. Researchers at Nationwide Children's Hospital in Columbus, Ohio, looked at the number of kids across the country under age 3 who had to go to an emergency room after such an injury. "There's an average of 128 a day, or about one every eight minutes," says Tracy Meahn of the Center for Injury Research and Policy. "And the concerning thing is that these numbers are going up."



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<![CDATA[What the Budget Analysts Say About GOP Health Care Bill]]>Mon, 13 Mar 2017 19:07:52 -0400http://media.nbcnewyork.com/images/213*120/understand-gop-health-care-replacement.jpg

The Republican bill to replace major portions of Barack Obama's health care law and restructure Medicaid would leave 24 million people uninsured over the next decade, according to projections from the Congressional Budget Office. A look at what the CBO said Monday in its estimates of the House GOP plan that's backed by President Donald Trump:

— The bill would reduce the deficit by $337 billion over a decade. The largest savings would come from reductions in money for Medicaid, the federal-state health care program for low-income Americans, and elimination of the Affordable Care Act's subsidies for non-group health insurance.

— Fourteen million more people would be uninsured next year. That increase would include 6 million who don't get coverage on the individual market, some 5 million people under Medicaid and about 2 million with employment-based coverage.

— The CBO estimates that the number of uninsured would rise to 21 million in 2020 and 24 million in 2026. Much of the increase in uninsured would be due to changes in Medicaid enrollment as states end their expansion of eligibility.

— In 2026, an estimated 52 million people would be uninsured compared with 28 million under Obama's law.

— Average premiums in the insurance market for individuals would rise in 2018 and 2019 by 15 percent to 20 percent, compared with current law, because Republicans would eliminate the penalties designed to induce people to buy insurance coverage, leading to higher costs for those who remain.

— Beginning in 2020, premiums would begin to fall in comparison with current law, and by 2026 average premiums for people buying individual coverage would be roughly 10 percent lower than current law. However, premiums would vary significantly for people of different ages because of a change Republicans would make allowing old people to be charged more for insurance coverage, compared with young people, than allowed under Obama's law.

— The GOP health care bill prohibits funds for Planned Parenthood for one year, and the CBO estimates the number of births in the Medicaid program would increase by several thousand.

Copyright Associated Press / NBC New York

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<![CDATA[Cardboard Boxes as Cribs? Safety Sleep Program Expands]]>Sat, 11 Mar 2017 13:29:47 -0400http://media.nbcnewyork.com/images/213*120/AP_17065757102076-Baby-Box-SIDS-SUIDS.jpg

Cardboard boxes certainly aren't new technology. But when they're linked to a practice that started in Finland decades ago to help babies sleep safely, they're taking on a new purpose as so-called baby boxes make their way to the U.S.

Parents are beginning to take baby boxes home from hospitals along with their newborns. A Los Angeles-based company has partnered with health officials to give the boxes away for free and an online initiative offers advice aimed at reducing sudden unexpected infant deaths. New Jersey and Ohio were the first to participate statewide in the program.

"To new moms: (SUID) was one of my biggest fears and then it happened,'' said 35-year-old Chauntia Williams, of Maple Heights, Ohio.

Williams is an advocate for safe sleeping and the boxes after she unexpectedly lost her 33-day-old daughter Aaliyah nine years ago. Williams said her daughter went to sleep in a crib with cushiony bumpers, stuffed animals and an added blanket beneath the fitted sheet and never woke up. She said the coroner determined the bedding caused the death.

She now uses a box with her son, Bryce, though he's getting a little too big for it. Her message to new parents: Educate yourselves on safe sleep habits.

"Open your mouth and say I'm concerned about this so you can get the assistance,'' Williams said.

Sudden unexpected infant death is a broad category that includes sudden infant death syndrome and accidental suffocation and strangulation that could come from overcrowded bassinets or cribs. The boxes aren't the only option for safe sleeping, of course, but health officials say they're a useful part of a broader safe-sleep education program.

Ohio on Wednesday joined New Jersey in offering the cardboard boxes, which double as bassinets, for free. Each box comes filled with a mattress, fitted sheet, onesie and diapers.

The Baby Box Co. is also handing out the boxes in Minneapolis, Phoenix and San Francisco, with the goal of expanding to all 50 states. The for-profit company also operates in Canada, Ireland and the United Kingdom. Baby Box University, a nonprofit, maintains a website that coordinates the educational component of the program.

The idea for baby boxes started in Finland in the 1930s, and is tied to a sharp drop in sudden infant deaths, according to Dr. Kathryn McCans, a pediatrician who chairs New Jersey's Child Fatality and Near Fatality Review Board. The boxes provide a clutter-free sleep space that has been shown to reduce accidental and unexpected deaths, she said.

The Centers for Disease Control and Prevention says the U.S. rate of sudden unexpected infant deaths has been declining since the 1990s when public health officials began recommending parents put infants to sleep on their backs. About 3,700 sudden unexpected infant deaths were reported in the country in 2015.

The boxes are a new idea for many Americans.

"The thought of putting the baby in a box, I was like 'wow that's weird,''' said Dolores Peterson, of Camden, New Jersey, who became a first-time mom recently and was among the first to bring home a box.

Peterson's daughter, Ariabella, just turned 3 months old. She said the program was eye-opening for how much information she learned about how to prevent sudden unexpected infant death.

McCans says the complimentary items like diapers and onesies are nice, but the more important objective behind the boxes is bringing down infant deaths and grounding parents on safe sleep practices: Place babies on their backs to sleep; don't use bumpers in cribs; keep stuffed animals and blankets out of infants' sleep spaces; avoid sleeping in the same bed as infants.

"No one brings their baby into bed with them because they want their baby to die,'' she said. "They do it because they want to be nurturing and they are, but it's not safe.''

To get the boxes, prospective moms can register through babyboxuniversity.com, watch a handful of videos on sleep safety and pass a quiz. Parents can then take their digital or printed-out certificates to a participating hospital for their boxes. The boxes can also be sent in the mail, if a nearby hospital is not designated as a distribution center.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Hospitals Worry About Caring for Newly Uninsured in GOP Plan]]>Sun, 12 Mar 2017 22:07:27 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-600361148.jpg

When Colorado expanded Medicaid coverage under former President Barack Obama's health care law, the largest provider in the Denver region hired more than 250 employees and built a $27 million primary care clinic and two new school-based clinics.

Emergency rooms visits stayed flat as Denver Health Medical Center directed many of the nearly 80,000 newly insured patients into one of its 10 community health centers, where newly hired social workers and mental health therapists provided services for some of the county's poorest residents. Demand for services at the new primary care clinic was almost immediate.

The hospital system, like others around the country, now is facing enormous uncertainty under the health care overhaul proposed by congressional Republicans.

The GOP plan would scale back the Medicaid expansion and take away direct federal subsidies to help consumers pay their health insurance premiums, replacing them with age-adjusted tax credits.

Denver Health could see revenue losses between $50 million and $85 million by 2020, which is between 5 and 9 percent of their annual revenue, according to the hospital's chief financial officer. Adding to the financial anxiety is that Denver Health and many other hospital systems and medical providers across the country still would be required to care for many of the same patients, even if they lost their health coverage. That would leave hospitals, state and local governments, or privately insured patients to foot the bill.

"If it's full removal of Medicaid expansion, we would have to make cuts on our system, and I really think that those cuts would roll back our progress and could paradoxically increase the cost of care by driving care back to where it shouldn't be — in the emergency rooms," said Dr. Bill Burman, interim chief executive for Denver Health.

Similar sentiments are being shared by hospital CEOs across the country as President Donald Trump and congressional Republicans make good on their promise to undo the Affordable Care Act.

The Republican plan would limit the amount of federal money available to states that opted to expand Medicaid, the state-federal program that provides health coverage to the poor and lower-income people. It also would overhaul the framework of Medicaid generally so that in the future states would receive a limited amount per person based on enrollment and costs. Health care advocates have said such a change would mean less Medicaid money for the states.

The Republican proposal would boost one revenue stream for hospitals that had been cut under Obama's plan — a pool of money helping hospitals that care for a disproportionately high share of uninsured patients. But hospital CEOs say that money will not come close to making up for the revenue lost if large numbers of people lose their health coverage.

The American Hospital Association, which represents nearly 5,000 institutions nationwide and the Catholic Health Association of the United States, the nation's largest not-for-profit health provider, wrote Congress warning that the bill would lead to significant cuts in a program that provides services to the most vulnerable.

"We are likely looking at situations where hospitals would close down service lines, shorten clinic hours and lay off staff," said Beth Feldpush, a senior vice president at America's Essential Hospitals.

The Affordable Care Act sought to get more people covered and give them access to primary care doctors, theoretically increasing the number of paying customers for hospital systems while diverting those people away from emergency rooms where they are more expensive to treat. About 22 million people have gained coverage through Medicaid and by buying private health insurance in the government-sponsored marketplaces that offer plans with subsidized premiums.

The national uninsured rate is below 9 percent, a historic low.

Moody's Investors Service said it expects that the legislation's provision to cap federal Medicaid payments to the states, starting in 2020, will cause states to reduce payments to hospitals. The legislation also would saddle hospitals with more unpaid bills and uninsured patients, particularly older ones who could now face much-higher premiums, according to Moody's.

"We believe that the effect of older enrollees losing coverage will outweigh the positive effect of younger people gaining coverage, given that older people have greater health care needs and as they lose coverage, hospitals would incur greater uncompensated care and bad-debt costs," the report states.

S&P Global Ratings wrote that the bill would add to existing stresses on hospitals, including rising costs for salaries and prescription drugs.

NYC Health + Hospitals, the largest public health system in the country that serves mostly low-income people, made a rare decision to create its own insurance plans to help maximize revenue in the changing health climate. One of its plans, granted under the Affordable Care Act, offered premiums of $20 or less per month to 70,000 low-income enrollees. An additional 96,000 people gained coverage in another insurance plan under Medicaid expansion.

One plan would be eliminated entirely under the bill and tens of thousands would lose coverage on the other under the Republican bill.

Stanley Brezenoff, the health system's interim president, says it's "particularly appalling" for the expanded Medicaid patients who spent years going without insurance. Many of them have substantial medical needs and finally were able to get into a routine of receiving regular medical care.

"It is a brutal assault on the health care system, especially as it applies to the people in greatest need with historically the least access to care," he said.

Rural hospitals are particularly at risk.

One of the most likely ways hospitals will make up for revenue losses is by increasing the amount they charge privately insured patients. But rural hospitals have less bargaining power to negotiate rates with insurers because they have such a small number of insured patients to begin with, said Bruce Rueben, president of the Florida Hospital Association.

At Jackson Health, a 100-bed hospital in rural Marianna in the Florida Panhandle, 90 percent of patients are receiving charity care because they are uninsured or on Medicaid. They are the working poor who make too little to qualify for subsidies under Affordable Care Act plans and too much to qualify for Medicaid under Florida's stringent standards, where you must be a pregnant woman, child or disabled for the most part to qualify.

Nearly 60 percent of the hospital's patients work in agriculture, growing peanuts and fresh produce. Emergency room visits there continue to creep up every year by 2 to 3 percent, said chief financial officer Kevin Rovito.

"If they keep cutting the reimbursements for the hospital one way or another and we do disappear, then where are these patients going to go?" he said.

Copyright Associated Press / NBC New York



Photo Credit: Joe Raedle/Getty Images]]>
<![CDATA[Pence Appeals for Complete GOP Support for Health Overhaul ]]>Sat, 11 Mar 2017 19:32:55 -0400http://media.nbcnewyork.com/images/213*120/AP_17061754105215-Pence.jpg

Vice President Mike Pence appealed for total GOP congressional support for a White House-backed health overhaul during a brief visit Saturday to Kentucky, where the Republican governor and junior senator are among the plan's skeptics.

"This is going to be a battle in Washington, D.C. And for us to seize this opportunity to repeal and replace Obamacare once and for all, we need every Republican in Congress, and we're counting on Kentucky," Pence said at an energy company where business leaders had gathered.

He said President Donald Trump would lean on House Republicans — including two Kentucky lawmakers in the audience, Reps. Andy Barr and Brett Guthrie — to vote to replace former President Barack Obama's law.

Pence's trip was part of an effort to reassure conservatives who have raised objections to the House plan. In a sign of the high stakes, Pence's motorcade passed a long line of demonstrators who chanted, "Save our care."

Almost at the time Pence landed in Louisville, Trump tweeted: "We are making great progress with health care. ObamaCare is imploding and will only get worse. Republicans coming together to get job done!"

The former Indiana governor has been the chief salesman for Trump's push to jettison the Affordable Care Act. The House is expected to vote on the bill in less than two weeks, but faces resistance from critics within the GOP, including Kentucky Sen. Rand Paul, who has called the initial draft "Obamacare Lite."

Even before the legislation was released, Paul placed a copy machine outside the room where House Republicans were drafting the bill and asked for a copy — all to draw attention to the secrecy of the plan.

GOP Gov. Matt Bevin has said his state cannot afford to pay for a growing Medicaid program, which has cost Kentucky millions more than initially expected and now covers more than 25 percent of the state's population. He has dismantled Kentucky's state-based exchange but indicated he would not favor eliminating the federal health insurance exchange.

Bevin told reporters Friday that, like Paul, he was not impressed with the initial proposal in the House.

But on Saturday he said that while there were different views on how to change the law, "ultimately these differences of opinion will be rectified." He said all could agree that "change has to come — the system is broken."

"Now I know that not every politician in Kentucky supports our plan," Pence said, mentioning former Democratic Gov. Steve Beshear but neither Paul nor Bevin.

After greeting Pence at the airport, Bevin and his children and their friend got an impromptu tour of Air Force Two, and Pence later told business leaders: "I was for Matt Bevin before it was cool."

Democrats have praised Beshear's use of the health care law to drive down the state's uninsured rate and his smooth rollout of kynect, the state-run exchange, even while Obama struggled with the national release of healthcare.gov.

The event at the Harshaw Trane facility was in the hometown of Senate Majority Leader Mitch McConnell, R-Ky., whom Pence praised as "a true friend to me, to our president, and to the people of America."

McConnell, however, did not attend due to a scheduling conflict.

Copyright Associated Press / NBC New York



Photo Credit: John Minchillo, AP (File)]]>
<![CDATA[Feel Stressed? Stop Checking Your Phone, Study Says]]>Fri, 10 Mar 2017 20:23:11 -0400http://media.nbcnewyork.com/images/213*120/SmartphoneStress0309a_MP4-148918974502400001.jpg

A recent study finds mobile users who check their phones frequently feel more stressed. According to the American Psychological Association, we are a nation of "constant checkers" and it's taking a toll. Some experts consider this a behavioral addiction.
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<![CDATA[Doctors Remove 140-Pound Tumor From Pa. Woman]]>Fri, 10 Mar 2017 16:34:13 -0400http://media.nbcnewyork.com/images/213*120/Mary+140LB+Tumor+BEFORE+AFTER+pic.jpg

Mary Clancey said she was resigned to being a "fat little old lady." Over 15 years, she kept getting bigger despite dieting. But with her health deteriorating, her son persuaded her to go to the hospital.

What doctors found astounded them: A cyst in one of her ovaries had grown into a 140-pound tumor.

Doctors at Lehigh Valley Health Network in Allentown removed the cancerous, Stage 1 mass in a five-hour operation on Nov. 10.

Clancey weighed 365 pounds heading into the operation. After five hours in surgery, she lost 180 pounds of tumor and tissue, about half her weight, the doctors said.

"You can't imagine in your wildest dreams something that huge," she told NBC10.

As she was gaining weight, Clancey, 71, of St. Clair, Pennsylvania, said doctors told her just to watch what she ate. At just over 5 feet tall, she said she felt destined to become "a short round, fat little old lady."

The tumor didn't really cause her pain. "It just made itself comfortable in there," she said.

But by the time she went to the hospital, it had become difficult for her to walk and even stand.

Dr. Richard Boulay, who performed the operation, said the mass was so big it didn't even fit in the picture taken by a CT scan.

"It was slowly killing her," Bouley said Thursday during a news conference at the hospital.

To help in the removal of the tumor, a second table had to be moved next to the one on which Clancey was lying so the mass could be rolled out without it rupturing, The Morning Call reported.

Made up predominantly of water, the tumor was "slippery and nasty," Boulay said.

After nearly a month in recovery, Clancey is back home, working to regain her balance as a lighter woman.

She weighs less than 150 pounds and said she feels great.

Doctors said tests show she is cancer-free and does not need further treatment, The Call reported.

Copyright Associated Press / NBC New York

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<![CDATA[Under New Rules, Rookie Doctors Can Work 24-Hour Shift]]>Fri, 10 Mar 2017 14:18:37 -0400http://media.nbcnewyork.com/images/213*120/Doctor+Generic1.jpg

Rookie doctors can work up to 24 hours straight under new work limits taking effect this summer — a move supporters say will enhance training and foes maintain will do just the opposite.

A Chicago-based group that establishes work standards for U.S. medical school graduates has voted to eliminate a 16-hour cap for first-year residents. The Accreditation Council for Graduate Medical Education announced the move Friday as part of revisions that include reinstating the longer limit for rookies — the same maximum allowed for advanced residents.

An 80-hour per week limit for residents at all levels remains in place under the new rules.

Dr. Anai Kothari, a third-year resident on a council panel that recommended the changes, says he only occasionally works 24-hour shifts. The extra hours give him time to finish up with patients instead of being sent home in the middle of a case, said Kothari, who works at Loyola University Medical Center near Chicago.

But first-year resident Dr. Samantha Harrington thinks it will endanger the safety of residents and patients.

Harrington says her 14-hour shifts this winter at Cambridge Hospital near Boston are already plenty long. To stay awake while driving home after work, she sometimes rolls down the window to let the freezing air blast her in the face.

Harrington says the grueling hours are "based on a patriarchal hazing system," where longtime physicians think "'I went through it, so therefore you have to go through it too.'" She is a member of the Committee of Interns and Residents, a union group that opposes the work-shift changes. So does the American Medical Student Association.

Dr. Kelly Thibert, the group's president, says putting a 16-hour cap on all residents' work shifts would be a safer way to even the playing field.

There are more than 120,000 U.S. doctors-in-training including rookies.

The accreditation council has for years wrestled with ensuring that doctors are adequately trained but not over-worked.

The 1984 death of an 18-year-old college student in a New York hospital while under the care of medical residents working long hours put a national spotlight on the issue. Medication error and inadequate supervision were cited in that case, which prompted a lengthy investigation and state limits for residents' work hours.

In 2003, the council implemented national standards that established the 24-hour shift cap and 80-hour work week for all residents. After an Institute of Medicine report raised additional safety concerns about sleep-deprived residents, the council in 2010 shortened work shift caps for first-year residents to 16 hours and strongly recommended "strategic napping."

Critics of the shorter limit said it short-changed rookie doctors. Dr. Karl Bilimoria, a Northwestern University surgery professor, said some residents have complained that they've had to leave work in the middle of surgeries.

Bilimoria led a study published last year suggesting that first-year residents could work longer without endangering patient safety or their own well-being. The research was among published findings that helped persuade panel to recommend lifting the 16-hour cap. The council's board approved the recommendation in a vote last month. The group delayed announcing the vote until its annual education conference, which ends Sunday in Orlando, Florida.

"We all agree that nobody wants tired physicians" said Dr. Rowen Zetterman, board chairman.

He said the new rules give training programs more flexibility, help eliminate abrupt handoffs of patients and will enhance teamwork among new doctors and their supervisors. The rules say rookie doctors must have supervisors nearby, and those more experienced doctors can step in if a new resident is exhausted, Zetterman said.

U.S. doctor training generally includes an undergraduate science-related degree followed by four years of medical school. After that, newly minted doctors pursue several years of on-the-job training as medical residents, usually in hospitals. Fellowships or extra training in medical specialties may follow after that.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/File]]>
<![CDATA[Women's Health Services Face Cuts in GOP Bill]]>Fri, 10 Mar 2017 08:48:06 -0400http://media.nbcnewyork.com/images/213*120/650498064-Paul-Ryan-American-Health-Care-Act.jpg

Women seeking abortions and some basic health services, including prenatal care, contraception and cancer screenings, would face restrictions and struggle to pay for some of that medical care under the House Republicans' proposed bill.

The legislation, which would replace much of former President Barack Obama's health law, was approved by two House committees on Thursday. Republicans are hoping to move quickly to pass it, despite unified opposition from Democrats, criticism from some conservatives who don't think it goes far enough and several health groups who fear millions of Americans would lose coverage and benefits.

The bill would prohibit for a year any funding to Planned Parenthood, a major provider of women's health services, restrict abortion access in covered plans on the health exchange and scale back Medicaid services used by many low-income women, among other changes.

Washington Sen. Patty Murray, the top Democrat on the Health, Labor, Education and Pensions Committee, said the legislation is a "slap in the face" to women. She said it would shift more decisions to insurance companies.

"You buy it thinking you will be covered, but there is no guarantee," Murray said.

House Republican leaders said the bill, which is backed by President Donald Trump, will prevent higher premiums some have seen under the current law and give patients more control over their care.

"Lower costs, more choices not less, patients in control, universal access to care," House Speaker Paul Ryan, R-Wis., said Thursday.

The abortion restrictions and cuts to women's health care could draw opposition from some Republican women.

Sens. Lisa Murkowski of Alaska and Susan Collins of Maine have both said that a prohibition on Planned Parenthood funding shouldn't be part of the bill. Last month, before the legislation was released, Murkowski told the Alaska state legislature that she doesn't believe that taxpayer money should go toward abortions but added, "I will not vote to deny Alaskans access to the health services that Planned Parenthood provides."

Support from Collins and Murkowski will be crucial once the bill moves to the Senate, since there are 52 Republicans and the GOP will need 50 votes to pass it.

Here's a look at how the bill would affect women's health care:

PLANNED PARENTHOOD
Republicans have tried for years to block federal payments to the group, but weren't able to do so with Democrat Barack Obama in the White House. Now that Republican Donald Trump is president, they are adding the one-year freeze in funding to their bill.

Most GOP lawmakers have long opposed Planned Parenthood because many of its clinics provide abortions. Their antagonism intensified after anti-abortion activists released secretly recorded videos in 2015 showing Planned Parenthood officials discussing how they sometimes provide fetal tissue to researchers, which is legal if no profit is made.

Federal dollars comprise nearly half of the group's annual billion-dollar budget. Government dollars don't pay for abortions, but the organization is reimbursed by Medicaid for other services, including birth control, cancer screenings and treatment of sexually transmitted diseases. The group has said the vast majority of women seek out those non-abortion services.

Ryan boasted this week that the bill is a "conservative wish list," as it "ends funding to Planned Parenthood and sends money to community centers." Democrats argue that many of the other clinics are already overloaded and would not be able to meet the increased demand for screenings and other services.

ABORTION COVERAGE
Under Obama's health law, health plans on the exchange can cover elective abortions, but they must collect a separate premium to pay for them so it's clear that no federal funds are used. The GOP bill would go further, prohibiting the use of new federal tax credits to purchase any plan that covers abortions.

That could make it more difficult for women covered under the federal exchange to find a plan that covers abortions at all, because many companies may just drop the abortion coverage if it disqualifies the entire plan from the tax credits.

Massachusetts Rep. Joe Kennedy, a Democrat, said during the Energy and Commerce Committee's debate on the bill Thursday that he is concerned those prohibitions will extend to hospitals that do abortions, as well.

MEDICAID AND 'ESSENTIAL HEALTH BENEFITS'
The bill would phase out the current law's expanded Medicaid coverage for more low-income people that 31 states accepted, which is almost completely financed by federal funds. That could affect women's health care services, including mammograms and prenatal care, for those who would lose that coverage. The legislation also repeals the requirement that state Medicaid plans must provide "essential health benefits" that are currently required, including pregnancy, maternity and newborn care for women.

The legislation will still require that private health plans fund the essential health benefits, but those insurers will have more leeway as to how much is covered.

Rep. John Shimkus, R-Ill., complained during the committee debate about the current law's requirements that certain services be covered.

"What about men having to purchase pre-natal care?" Shimkus said in response to a question from a Democrat who asked him what mandates he was concerned about. "Is that not correct? And should they?"

Associated Press writer Ricardo Alonso-Zaldivar contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Bottled Water Beats Soda as No. 1 Drink in US: Industry Analyst]]>Fri, 10 Mar 2017 08:10:20 -0400http://media.nbcnewyork.com/images/213*120/634599298-bottled-water-generic.jpg

An industry tracker says bottled water overtook soda as the No. 1 drink in the U.S. by sales volume last year.

Bottled water has been enjoying growth for years, while sales of traditional sodas have declined. Research and consulting firm Beverage Marketing Corp. says Americans drank an average of 39.3 gallons of bottled water in 2016, and 38.5 gallons of carbonated soft drinks. In 2015, bottled water was at 36.5 gallons while soda was at 39 gallons.

Other industry trackers define categories differently, so may see the cross at different times. Beverage Marketing includes sparkling waters in bottled waters and excludes energy drinks in sodas. Another tracker, Beverage Digest, says by its metrics bottled water will surpass soda this year.

The estimates don't include tap water.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File]]>
<![CDATA[GOP Health Bill Would Cut CDC's $1B Disease Fighting Fund]]>Fri, 10 Mar 2017 06:49:14 -0400http://media.nbcnewyork.com/images/213*120/cdcGettyImages-456691988.jpg

A proposal to replace the Obama health care law would cut out a pillar of funding for the nation's lead public health agency, and experts say that would likely curtail programs across the country to prevent problems like lead poisoning and hospital infections.

The Republican bill calls for the elimination of a $1 billion-a-year fund created for the Centers for Disease Control and Prevention by the Affordable Care Act in 2010. The fund's goal: Pay for public health programs designed to prevent illness and, therefore, reduce health care costs.

Bureaucracy-slashing bills are nothing new in Washington, and many never pass. Introduced this week, the GOP's plan to overhaul former President Barack Obama's health care law is being hashed out in the House of Representatives before it goes to the Senate.

But some health experts say what's being discussed now is far graver than the funding debates seen in other years.

The results "will be a major turning point" in how the nation promotes health and addresses health care needs, said John Auerbach, president of Trust for America's Health, a Washington-based public health research and advocacy organization.

Some Republican legislators have championed the demise of the fund, equating it to a "slush fund." They say they want more control over how public health funds are spent.

"We shouldn't cede that to the executive branch," said U.S. Rep. Andy Harris, a Maryland Republican who is an anesthesiologist. He sits on the House appropriations subcommittee that oversees health spending.

CDC officials declined to comment Thursday about the possibility of losing the fund.

"Until we know more about the final budget, we can't say how we'll be affected," said agency spokeswoman Kathy Harben.

The CDC's total budget is around $11.8 billion, but about a third of that is for specific projects mandated by Congress. Those programs, for example, pay for vaccines for poor children and monitor the health of survivors of the 9/11 World Trade Center disaster.

What's left is the core of the agency's budget. The Atlanta-based agency has received the special funding for seven years, and currently it accounts for about 12 percent, or about $900 million, of the core budget, according to the CDC.

Much of the money is passed on to state and local health departments. That funding bolsters vaccination programs, upgrades state laboratories that monitor for Zika and other infectious diseases and pays for a push to reduce infections spread in hospitals. It supports programs to save people from diabetes, cancer, heart disease and stroke. And it completely finances the CDC's lead poisoning prevention program.

"The elimination of the fund would be devastating to state and local health departments," said Laura Hanen, chief of government affairs for the National Association of County and City Health Officials.

Those health departments lost local funding during and after the 2007-2009 recession, said Michael Fraser of the Association of State and Territorial Health Officials. Today, the average state health department gets about 55 percent of its budget from federal money. In some states, it's as much as 75 percent, he said.

Harris, the Maryland Republican, said that federal budget constraints mean that at some point more public health costs are going to shift to the states. Local public health officials and advocates "are not lobbying their legislatures adequately," he said.

But eliminating the fund "will create a hole that states won't be able to fill," said Fraser.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[California Lawmakers Want to Repeal HIV Criminalization Laws]]>Thu, 09 Mar 2017 19:59:10 -0400http://media.nbcnewyork.com/images/160*128/AP_17068048820399.jpg

Exposing a person to HIV is treated more seriously under California law than infecting someone with any other communicable disease, a policy some lawmakers say is a relic of the decades-old AIDS scare that unfairly punishes HIV-positive people based on outdated science.

Several lawmakers are promoting a bill by state Sen. Scott Wiener, D-San Francisco, that would make it a misdemeanor instead of a felony to intentionally expose someone to HIV, the virus that causes the immune system-weakening disease AIDS. The change would treat HIV like other communicable diseases under California law.

Under current law, if a person who knows they are infected with HIV has unprotected sex without telling their partner they have the virus, they can be convicted of a felony and face years of jail time. Intentional transmission of any other communicable disease, even a potentially deadly condition like hepatitis, is a misdemeanor.

"These laws were passed at the height of the HIV/AIDS epidemic when there was enormous fear and ignorance and misinformation around HIV," Wiener said. "It's time for California to lead and to repeal these laws to send a clear signal that we are going to take a science-based approach to HIV not a fear-based approach."

Wiener's bill, SB239, would also repeal California laws that require people convicted of prostitution for the first time to be tested for AIDS and that increase penalties for prostitution if the sex worker tested positive for AIDS in connection with a previous conviction.

The original laws were passed during the 1980s and 1990s based on incomplete and outdated science, said Dr. Edward Machtinger, director of the Women's HIV Program at the University of California, San Francisco. Transmission rates are much lower than people believed when the laws were enacted. Modern treatment dramatically reduces the effects of the virus and chances for transmission, he said.

Although modern treatments are highly effective, the current laws deter people from getting tested for HIV and seeking treatment, Wiener said.

Between 1988 and 2014, at least 800 people were arrested, charged or otherwise came into contact with the criminal justice system related to their HIV status, according to a study conducted at the University of California, Los Angeles. The study found "HIV criminalization" laws disproportionately affected women and people of color.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[New Tech Could Change Food Nutrition Labels ]]>Wed, 08 Mar 2017 16:54:08 -0400http://media.nbcnewyork.com/images/213*120/NC_labels0307_1500x845.jpg

New smart glasses developed by researchers at Colorado State University could change how food labels are printed on boxes and cans in your local grocery store. The FDA is looking to roll out this new tech by 2018.]]>
<![CDATA[Industry Groups Oppose GOP Health Bill, Ryan Seeks Unity ]]>Thu, 09 Mar 2017 01:47:49 -0400http://media.nbcnewyork.com/images/213*120/649341198-GOP-Health-Care-Bill.jpg

Hospitals, doctors and consumer groups mounted intensifying opposition to the Republican health care bill as GOP leaders labored Wednesday to rally a divided party behind their high-stakes overhaul drive. Lawmakers cast Congress' initial votes on the legislation as House Speaker Paul Ryan praised the proposal as "what good, conservative health care reform looks like."

The American Medical Association, the American Hospital Association and AARP, the nation's largest advocacy group for older people, were arrayed against the GOP measure. Seven years ago their backing was instrumental in enacting President Barack Obama's health care statute, which President Donald Trump and congressional Republicans are intent on erasing.

The hospitals — major employers in many districts — wrote lawmakers complaining about the bill's cuts in Medicaid and other programs and said more uninsured Americans seem likely, adding, "We ask Congress to protect our patients." Groups representing public, children's, Catholic and other hospitals also expressed opposition.

America's Health Insurance Plans, representing insurers, praised GOP provisions like erasing health industry taxes but warned that proposed Medicaid changes "could result in unnecessary disruptions in the coverage and care beneficiaries depend on."

In epic sessions that stretched past midnight into Thursday morning, leaders began pushing the legislation toward passage by two House committees — Ways and Means, and Energy and Commerce.

GOP leaders faced rebellion within their own ranks, including from conservative lawmakers and outside conservative groups. Top Republicans knew if the upheaval should snowball and crush the legislation it would be a shattering defeat for Trump and the GOP, so leaders hoped approval by both House committees would give them momentum.

In words aimed at recalcitrant colleagues, Ryan, R-Wis., told reporters: "This is what good, conservative health care reform looks like. It is bold and it is long overdue, and it is us fulfilling our promises." The last was a nod to campaign pledges by Trump and many GOP congressional candidates.

Outnumbered Democrats used the panels' meetings for political messaging, futilely offering amendments aimed at preventing the bill from raising deficits, kicking people off coverage or boosting consumers' out-of-pocket costs. They tried unsuccessfully to insert language pressuring President Donald Trump to release his income tax returns, and failed to prevent Republicans from restoring insurance companies' tax deductions for executive salaries above $500,000 — a break Obama's law killed.

There were signs of growing White House engagement, and perhaps progress.

Trump met at the White House late Wednesday with leaders of six conservative groups that have opposed the GOP legislation, and several voiced optimism afterward.

"I'm encouraged that the president indicated they're pushing to make changes in the bill," said David McIntosh, head of the Club for Growth, though he provided no specifics.

Underscoring Trump's potential impact, Energy and Commerce Chairman Greg Walden, R-Ore., said of GOP holdouts, "A lot of them, they maybe haven't felt the inertia that comes with Air Force One landing in their district."

The legislation would defang Obama's requirement that everyone buy insurance — a provision deeply disliked by Republicans — by repealing the tax fines imposed on those who don't. That penalty has been a stick aimed at pressing healthy people to purchase policies. The bill would replace income-based subsidies Obama provided with tax credits based more on age, and insurers would charge higher premiums for customers who drop coverage for over two months

The extra billions Washington has sent states to expand the federal-state Medicaid program would begin ending in 2020, and spending on the entire program would be capped at per-patient limits. Around $600 billion in 10-year tax boosts that Obama's statute imposed on wealthy Americans and others to finance his overhaul would be repealed. Insurers could charge older customers five times more than younger ones instead of the current 3-1 limit, but would still be required to include children up to age 26 in family policies, and they would be barred from imposing annual or lifetime benefit caps.

"We will answer President Trump's call to action," said Ways and Means Chairman Kevin Brady, R-Texas, adding later, "Relief is on the way."

Democrats said the Republicans would yank health coverage from many of the 20 million Americans who gained it under Obama's statute, and drive up costs for others because the GOP tax breaks would be skimpier than existing subsidies. And they accused Republicans of hiding bad news by moving ahead without official estimates from the nonpartisan Congressional Budget Office on the bill's cost to taxpayers and anticipated coverage.

"The bill sabotages the marketplaces where close to 10 million Americans today get coverage and starts a death spiral from which we will never recover," said Ways and Means' top Democrat, Richard Neal of Massachusetts.

On the Republican side, conservatives in particular were up in arms, saying the tax credits would be too expensive and the phase-out of Obama's Medicaid expansion too slow. One conservative group, FreedomWorks, was launching digital and social media ads opposing the legislation, while others like Americans for Prosperity, backed by the wealthy Koch brothers, were working against the legislation.

Numerous GOP centrists and governors were also antagonistic, worried their states could lose Medicaid payments and face higher costs for hospitals having to treat growing numbers of uninsured people.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Pot for Pets: Owners Treating Sick Animals With Cannabis]]>Wed, 08 Mar 2017 08:09:31 -0400http://media.nbcnewyork.com/images/213*120/AP_17047766471893-Cannabis-extract-pets.jpg

Michael Fasman's 12-year-old dog, Hudson, limps from pain caused by arthritis and an amputated toe, but Fasman doesn't want to give her painkillers because "they just knock her out."

So the San Francisco resident has turned to an alternative medicine that many humans use to treat their own pain and illness: marijuana.

On a recent morning, Fasman squeezed several drops of a cannabis extract onto a plate of yogurt, which the Portuguese water dog lapped up in seconds. It's become part of Hudson's daily routine.

"We think it's really lifted her spirits and made her a happier dog," Fasman said. "It's not that she's changed. She's just back to her good old self."

As more states legalize marijuana for humans, more pet owners are giving their furry companions cannabis-based extracts, ointments and edibles marketed to treat everything from arthritis and anxiety to seizures and cancer.

Most of these pet products, which aren't regulated, contain cannabidiol or CBD, a chemical compound found in cannabis that doesn't get pets or humans high. They contain little or no tetrahydrocannabinol or THC, the cannabis compound known for its psychoactive effects.

But veterinarians say there isn't enough scientific data to show cannabis is safe and effective for treating animals. Although medical marijuana is legal in 28 states, it remains illegal under federal law, so there has been relatively little research into its potential medical benefits for humans or animals.

Veterinarians in California and other states are legally barred from prescribing or recommending cannabis. They risk losing their veterinary licenses if they do.

"Our hands really are tied," said Ken Pawlowski, president of the California Veterinary Medical Association. "Definitely we're getting more questions from clients asking about it for their pets, but unfortunately we don't have any answers for them."

Karl Jandrey, a veterinarian who teaches at the University of California, Davis, said he tells his clients they "use them at their own risk with the potential to spend money for no improvement, or a risk of adverse side effects."

Despite the lack of scientific data or veterinary guidance, many pet owners are convinced cannabis has improved their animals' health and well-being, based on their own observations.

Lynne Tingle, who runs a pet adoption center and animal sanctuary, regularly gives cannabis edibles and topical ointments to older dogs with health or behavior issues, including her own elderly dogs Chorizo and Alice.

"You just see a real difference in their spirit. They're just not in pain, so they're happier and they're moving better," said Tingle, who founded the Richmond-based Milo Foundation. "They just get a new lease on life."

San Francisco-based TreatWell Health is one of a growing number of companies marketing cannabis products for pets despite questions over their legality.

TreatWell sells cannabis tinctures — extracted from marijuana plants in Humboldt County — that can be added to food or dropped directly into an animal's mouth. Co-founder Alison Ettel works directly with clients and their pets, recommending different formulations based on the animals' ailments.

TreatWell pet tinctures can help treat anxiety, poor appetite, pain, inflammation and seizures, as well as kidney and liver problems, cancer and glaucoma, according to its website. They also are used in end-of-life care.

"What we find is a lot of the animals are coming to us when there are no other options and pharmaceuticals haven't worked for that animal," Ettel said. "They're at that last resort, and cannabis is really good for those types of situations."

Barbara Stein is one of TreatWell's most enthusiastic customers. She said the cannabis tinctures helped treat anxiety and digestive problems in her 13-year-old cat, Willie. And she believes the drug helped Willie's sister Prudence maintain her weight and stay comfortable when she was battling cancer.

Stein, a retiree who lives in the San Francisco Bay Area city of Concord, said she got a medical marijuana card so she could buy cannabis for her cats. She has since recommended cannabis to many friends with aging and sick pets.

"All I know is that none of the traditional medications she got from the vet worked, but the cannabis did," Stein said. "I swear by the stuff."

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[How GOP Plans to Make Health Care Plan Into Law: Analysis]]>Wed, 08 Mar 2017 05:17:06 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-649341364.jpg

After more than 60 votes and seven years of promises, Republicans offered their long-awaited plan to repeal and replace the Affordable Care Act.

Now, the real work begins. Republicans must navigate a complicated path to turn their 123-page proposal from legislation to law.

A look at the process and the politics:

WHAT HAPPENS NEXT?
Republicans have set an aggressive timetable for moving the bill.

Two House committees — Ways and Means and Energy and Commerce — plan to take up the legislation on Wednesday. Republican leaders hope the committees will approve the measure this week, allowing the full House to pass the bill before lawmakers leave for the spring recess in early April.

The legislation will then move to the Senate, where a tighter Republican majority makes the outlook even more uncertain.

Normally, legislation requires 60 votes to pass the Senate. But because Republicans hold just 52 seats, they plan to use a budget maneuver known as reconciliation to pass the bill on a simple majority.

Even that may be difficult. Senate rules require that any bill passed by reconciliation cannot increase the deficit over the long term.

Republicans said on Tuesday that they'd not received official estimates on the costs of bill from the Congressional Budget Office.

Senate Majority Leader Mitch McConnell, R-Ky., said on Tuesday he wants to pass the bill before the April recess, sending it to President Donald Trump for his signature. President Barack Obama signed the health care bill 14 months after entering office.

A TIGHT MARGIN?
How the congressional process unfolds will depend on how Republicans maneuver through some complicated intra-party politics.

Conservative Republicans are worried about the cost of the overhaul, fearing the GOP would essentially be replacing one mandatory federal program with another.

Sens. Rand Paul of Kentucky, Mike Lee of Utah and Ted Cruz of Texas, dubbed an early draft "Obamacare Lite." On Tuesday, influential conservative groups — Heritage Action, FreedomWorks, the Club for Growth, Americans for Prosperity, and Freedom Partners — came out against the proposal.

Moderate lawmakers, meanwhile, fear their constituents could lose access to health care.

On Monday, Republican senators from Ohio, West Virginia, Colorado and Alaska signed a letter saying the House bill didn't sufficiently protect "the country's most vulnerable and sickest" in 31 states that accepted federal dollars to expand Medicaid coverage under the law.

Provisions to reverse taxes on the wealthy and deny federal funding for one year to Planned Parenthood, a major provider of women's health services, could also open swing state lawmakers to criticism.

Democrats, under pressure from their base to resist every part of Trump's agenda, are expected to lend little help.

With no Democratic support, Republicans can't lose more than two votes in the Senate and 21 in the House.

That's a margin that makes even some top Republicans admit their party has little wiggle room.

"I am going to be very anxious to hear how we get to 51 votes and how the House gets to 218," Missouri Sen. Roy Blunt, vice chairman of the Senate GOP, told reporters on Tuesday.

Copyright Associated Press / NBC New York



Photo Credit: Chip Somodevilla/Getty Images]]>
<![CDATA[Sleepy Students Allowed to Nap at Some NM Schools]]>Tue, 07 Mar 2017 16:46:57 -0400http://media.nbcnewyork.com/images/213*120/470425888-pillow-generic.jpg

A handful of high schools in New Mexico are letting their students sleep in school, NBC News reported.

Not during class, though. The schools in Las Cruces are letting students take 20-minute naps between classes in sleeping pods, so they can focus better on their education.

"They wouldn't be listening, they wouldn't be paying attention" if students weren't getting enough sleep, said New Mexico State University sleep researcher Linda Summers.

Teens need a lot of sleep but get little. The National Institutes of Health recommends they get 9-10 hours every night, but only a third of teens are sleeping even 8 hours.



Photo Credit: Getty Images/iStockphoto]]>
<![CDATA[Conservative Groups Give 'RyanCare' Negative Reviews]]>Tue, 07 Mar 2017 19:13:22 -0400http://media.nbcnewyork.com/images/213*120/649197060-American-Health-Care-Act-Brady.jpg

The reviews are starting to come in on the Republican plan to replace the Affordable Care Act, also known as "ObamaCare," and aside from the Trump administration, they aren't very good to start out. 

Major conservative lobbying groups have registered their displeasure with the bill, deeming it "Obamacare-lite," "Obamacare 2.0" and "RyanCare." It's been criticized by some key members of the party in Congress, not to mention Democrats.

The 100-page bill would eliminate the Affordable Care Act's mandate requiring Americans to buy health insurance, the fines imposed on those who don't carry health insurance and Medicaid expansion for some beneficiaries after 2019, among other changes.

It was rolled out by House Republicans Monday, and the Trump administration threw its support behind the bill Thursday, with the president calling it "wonderful" in an early morning tweet. 

But that was before statements started coming in from influential groups like Americans for Prosperity and Club for Growth. Here are selections from their statements, which all registered opposition to the bill:

  • "As the bill stands today, it is Obamacare 2.0. Passing it would be making the same mistake that President Obama, Harry Reid, and Nancy Pelosi made in 2010. Millions of Americans would never see the improvements in care they were promised, just as Obamacare failed to deliver on its promises." –letter from Koch brothers-affiliated Freedom Partners and Americans for Prosperity
  • "Republicans should be offering a full and immediate repeal of Obamacare's taxes, regulations, and mandates, an end to the Medicaid expansion, and inclusion of free-market reforms, like interstate competition." –Club for Growth president David McIntosh, in a letter calling the bill "RyanCare"
  • "Many Americans seeking health insurance on the individual market will notice no significant difference between the Affordable Care Act (i.e., Obamacare) and the American Health Care Act. That is bad politics and, more importantly, bad policy." –American Heritage Action CEO Michael A. Needham

Those comments were echoed by some influential GOP lawmakers, including Kentucky Sen. Rand Paul and Utah Sen. Mike Lee. 

"The House leadership plan is Obamacare Lite. It will not pass. Conservarives (sic) are not going to take it. #FullRepeal," Paul tweeted.

"We don't know how many people would use this new tax credit, we don't know how much it will cost, and we don't know if this bill will make health care more affordable for Americans," Lee said at a news conference.

Four other Republican senators, from Ohio, West Virginia, Colorado and Alaska, took issue with the way the new bill affects Medicaid funding, arguing that while Obamacare needs to be replaced, this replacement "does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states."

Notes of caution also came from GOP governors, the Associated Press reported, with Ohio Gov. John Kasich arguing that phasing out expanded Medicaid coverage without a viable alternative is "counterproductive" and Gov. Bruce Rauner of Illinois' saying he was "very concerned" that people will be "left in the lurch" under the House GOP plan.

Members of the administration sought to assure the party, and the American people, that the bill was strong and would pass.

"This is the beginning of the process and we look forward to working with them and others," Health and Human Services Secretary Tom Price said, when asked about the opposition of conservative groups.

Price said the bill was following the principles of affordability, accessibility, quality care, incentivizing innovation, and empowering patients.

Trump tweeted Tuesday morning that interstate competition was coming in another phase of the health care rollout, which members of the administration echoed later. 

White House budget chief Mick Mulvaney said he was sure the bill will bring "tremendous long-term savings" by giving states more control over Medicaid.

The nonpartisan Congressional Budget Office hasn't yet determined the cost of the new health care bill.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Fewer Heavy Americans Are Trying to Lose Weight: Study]]>Tue, 07 Mar 2017 13:12:26 -0400http://media.nbcnewyork.com/images/213*120/OBESITY_AP_16195512447159.jpg

Fewer overweight Americans have been trying to lose weight in recent years, and researchers wonder if fat acceptance could be among the reasons.

The trend found in a new study occurred at the same time obesity rates climbed.

"Socially accepted normal body weight is shifting toward heavier weight. As more people around us are getting heavier, we simply believe we are fine, and no need to do anything with it," said lead author Dr. Jian Zhang, a public health researcher at Georgia Southern University.

Another reason could be people abandoning efforts to drop pounds after repeated failed attempts, Zhang said.

The researchers analyzed U.S. government health surveys over nearly two decades from 1988 through 2014. The surveys involved in-person physical exams and health-related questions including asking participants if they'd tried to lose weight within the past year. More than 27,000 adults aged 20 to 59 were included. They were not asked to explain their answers.

In the early surveys, about half the adults were overweight or obese. Those numbers climbed to 65 percent by 2014. But the portion of overweight or obese adults who said they were trying to slim down fell from 55 percent to 49 percent in the study.

Body mass index, a measure of height and weight, determines weight status. Those with a BMI of 25 to 29 are considered overweight; 30 and above is obese. A BMI of 30 generally reflects being about 50 pounds above your ideal weight.

The study results were published Tuesday in the Journal of the American Medical Association.

Dr. Scott Kahan, director of a weight-loss clinic in Washington, said the study is important and echoes previous research. He acknowledged that it has become more acceptable in some circles to be overweight, but that many patients still feel stigmatized. He said many come to his center after repeated attempts to lose weight and some give up for a while out of frustration.

The study found obesity was most common among black women — 55 percent were obese in the most recent survey years, and there was a big decline in black women trying to lose weight. Whether that's because of fat acceptance, dieting frustration or other reasons is not known.

Zhang said there's a positive side to fat acceptance, if it means people feel less ridiculed for their weight. But obesity can increase risks for heart disease, diabetes, cancer and other ailments.

The findings "are a very serious concern," he said.

"We should forget the words 'fat' or 'obesity,'" Zhang said, adding that a healthy lifestyle may be an effective way to help people lose weight.

Copyright Associated Press / NBC New York



Photo Credit: AP, file]]>
<![CDATA[GOP Congressman Suggests Buying Health Care, Not Phone]]>Tue, 07 Mar 2017 12:39:40 -0400http://media.nbcnewyork.com/images/180*120/trump-rechazo-10.jpg

Rep. Jason Chaffetz advised consumers concerned about changes to the health care system under the long-awaited Republican health care plan that they may want to choose between to putting money aside for their health instead of "getting that new iPhone."

The Utah Republican soon walked his comment back as not perfectly phrased, but it had already sparked ridicule on social media, from citizens who have paid far more than the cost of an iPhone for health care to a Senate Democrat who said Chaffetz's own phone and health care plan are funded by low-income taxpayers.

The plan, announced Monday, puts more emphasis on health savings accounts at the expense of former President Barack Obama's Affordable Care Act, which offers more generous subsidies of insurance premiums.

To make his point, on CNN's "New Day," Chaffetz advised consumers that "Americans have choices" and they'll have to make one on for their health.

"And so maybe rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on, maybe they should go and invest in their own health care," he said.

Later, Chaffetz responded went on Fox News to say "maybe I didn't say as smoothly as I possibly could, but people need to make a conscious choice and I believe in self-reliance."

Many people who reacted to his comments online pointed out that health care is often much more expensive than the roughly $600 cost of an iPhone.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File
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<![CDATA[Travel Order Could Hit Doctor Supply in Trump Territory: Researchers]]>Tue, 07 Mar 2017 11:17:31 -0400http://media.nbcnewyork.com/images/213*120/AP_17060083101353.jpg

President Donald Trump's new executive order suspending new visas to the United States for people from six Muslim-majority nations could reduce the number of doctors in areas that voted Trump into office, NBC News reported.

Researchers at Harvard Medical School and MIT looked at data about physicians from those countries in the U.S. and found that swaths of Appalachia and the Rust Belt could be disproportionately affected.

Residency programs are a pathway for foreign-born doctors to become physicians in the U.S. Many work in rural and low-income areas, where they have played a critical role in preventing doctor shortages.

As many as several hundred doctors will be affected by the order, unable to begin medical residencies this year unless granted waivers, Atul Grover, executive vice president of The Association of American Medical Colleges, told NBC News.



Photo Credit: Pablo Martinez Monsivais/AP]]>
<![CDATA[Trump Offers Planned Parenthood Funds If It Stops Abortions]]>Tue, 07 Mar 2017 07:38:58 -0400http://media.nbcnewyork.com/images/180*120/GettyImages-499277954.jpg

President Donald Trump has offered to maintain federal funding for Planned Parenthood if the group stops providing abortions. Its president spurned the proposal and noted that federal money already is not allowed to be used for abortion.

Trump confirmed Monday there had been discussions after The New York Times inquired about what it described as an informal proposal. In a statement to the newspaper, Trump said polling shows most Americans oppose public funding for abortion.

"As I said throughout the campaign, I am pro-life and I am deeply committed to investing in women's health and plan to significantly increase federal funding in support of nonabortion services such as cancer screenings," he said.

Trump added: "There is an opportunity for organizations to continue the important work they do in support of women's health, while not providing abortion services." 

Planned Parenthood Federation of America President Cecile Richards said in response: "We will always stand for women's ability to make decisions about their health and lives, without interference from politicians in Washington, D.C."

Anti-abortion activists want the federal government to cut off all federal funding to Planned Parenthood. Nearly $400 million in Medicaid money goes to the group and pulling it back would result in roughly 400,000 women losing access to care, according to the nonpartisan Congressional Budget Office.

In one of his first acts as president, Trump banned U.S. funding to international groups that perform abortions or even provide information about abortions.

Vice President Mike Pence strongly opposes abortion, citing his Roman Catholic beliefs, and the newly confirmed health secretary, Tom Price, has supported cutting off taxpayer money to Planned Parenthood.

Copyright Associated Press / NBC New York



Photo Credit: Andrew Burton, Getty Images (File)]]>
<![CDATA[DNA Scan Uncovers 18 Genes Newly Associated With Autism]]>Mon, 06 Mar 2017 19:22:31 -0400http://media.nbcnewyork.com/images/213*120/DNA+Generic+Double+Helix.jpg

A new genetic analysis has uncovered 18 genes associated with autism, NBC News reported.

The study observed people with autism and their relatives, and found that people with autism often had dozens of mutations that could have caused their symptoms. There was an average of 73 unique mutations, according to the team at Autism Speaks.

The study adds to evidence that autism is a condition caused by genetics, and that each person with autism has his or her own pattern of DNA changes. The 18 genes that were identified have not been previously linked with autism, however, they are all involved in brain cell communications.



Photo Credit: AP]]>
<![CDATA[Birth Defects Rise 20 Times in Zika-Affected Pregnancies: CDC ]]>Fri, 03 Mar 2017 09:10:15 -0400http://media.nbcnewyork.com/images/213*120/pregnant+woman+generic1.jpg

Babies in Zika-affected pregnancies in the United States are about 20 times more likely to have birth defects compared with the proportion of pregnancies seen in 2013-2014, before Zika was introduced into the Americas, according to the Centers for Disease Control and Prevention.

The types of birth defects associated with Zika include brain abnormalities and/or microcephaly, neural tube defects and other early brain malformations, eye defects and other central nervous system problems.

Those defects were seen in about three of every 1,000 births in 2013-2014 in the U.S., but in 2016, the proportion of infants with these same types of birth defects born to women with Zika virus infection during pregnancy rose to about 6 percent, or nearly 60 of every 1,000 completed pregnancies with Zika infections, according to a CDC report. 

These findings demonstrate the importance of having monitoring systems that collect data on birth defects, as well as why pregnant women and their partners should be educated about them, doctors say.

"There's been such a massive improvement in taking care of these birth defects, that, however terrifying it is, it's important for mothers to get their follow-up appointments and their doctors, and make sure they're delivering in a center where people know how to take care of the defects," says Dr. Tala Nasr, a neonatologist the Pediatrix Group at Medical City Children's Hospital in Dallas.

The CDC researchers analyzed 2013-2014 data from three birth defect surveillance programs in the United States (in Massachusetts, North Carolina and Georgia) to provide the baseline frequency for Zika-related birth defects. To assess the effect of Zika virus infection during pregnancy, the scientists compared that 2013-2014 baseline number with previously published numbers among pregnancies with Zika virus infection from the U.S. Zika Pregnancy Registry (USZPR) from 2016.

They identified 747 infants and fetuses with one or more of these defects from programs in Massachusetts, North Carolina and Georgia from 2013-2014. Brain abnormalities and/or microcephaly were the most frequent conditions reported.

Data from the USZPR identified 26 infants and fetuses with these same birth defects among the 442 completed pregnancies of women with possible Zika infection from January through September 2016.

Studies have shown that Zika's arrival to Brazil at least doubled the birth defect rate there, even though the mosquito-borne virus only seriously affected small areas, NBC News reported.



Photo Credit: NBC 5 News]]>
<![CDATA[About 680,000 Baby Rattles Recalled Over Choking Hazard]]>Fri, 03 Mar 2017 08:40:01 -0400http://media.nbcnewyork.com/images/213*120/baby-rattle-recall.jpg

Hundreds of thousands of baby rattles made by Kids II have been recalled due to the possibility that small beads can pose a choking hazard if part of the rattles break.

Kids II has received 42 reports of the plastic disc that contains the beads breaking in Oball Rattles. Three children were reported to be gagging, according to the U.S. Consumer Product Safety Commission, and two other children were reported to have the beads in their mouths.

The CPSC advises that consumers take the rattles away from children and contact Oball for a full refund.

The full recall affects about 680,000 rattles sold nationwide at Target, Walgreens and Walmart, as well as online at several retailers, between January 2016 and February 2017.

The recalled rattles are four-inch-wide pink, blue, green and orange balls with about two dozen finger holes and clear plastic discs that contain beads.

They can be identified by model number 81031, but only rattles with certain date codes — T0486, T1456, T2316, T2856 and T3065 — are included in the recall. The date codes can be found on a small triangle on the inner surface of the rattle.

For more information, contact Kids II at 877-243-7314 from 8 a.m. to 5 p.m. ET Monday through Friday or visit www.kidsii.com and click on "recalls" at the bottom of the page.



Photo Credit: CPSC]]>
<![CDATA[Click for Candy: How Online Retailers Boost Impulse Buys]]>Wed, 01 Mar 2017 13:17:25 -0400http://media.nbcnewyork.com/images/213*120/adtargetingforonlineshopping.jpg

Supermarket layouts are carefully calibrated to tempt people into impulsive purchases, and now food makers are trying to adapt their strategies as people do more of their shopping online.

Part of the worry for companies is that shoppers won't get to see their products as they would at a store, where people often decide they want an item only after walking past it on shelves or in displays . When shoppers order from a website, the thinking is that they aren't as susceptible to tossing extra goodies into their carts.

"They don't buy so many Snickers and Skittles online as they would in the store," said David Ciancio, head of North American marketing at dunnhumby, a shopping analytics company.

So companies are using targeted ads, like to frequent cookie buyers, or suggesting add-ons like gum if someone is just short of getting free shipping. It's still a relatively new arena for packaged food makers, with less than 2 percent of groceries being purchased online, but that figure is expected to keep growing. Here's some of what customers might encounter.

OFFERS THAT PIGGYBACK ON DELIVERIES

A shopper who's just shy of the minimum order necessary to get free delivery might see a selection of traditional checkout lane "impulse products" that would get them to the threshold.

That's what candy maker Mars says it did in China, under a partnership with online retail giant Alibaba that helped it sell more gum. Mars said the array of impulse products presented to each shopper was determined by an algorithm, which drew from about 500 options.

Andrew Clarke, chief marketing officer for Mars, said the company's gum was a good fit because gum is such a "highly impulsive" purchase.

KITCHEN HELPERS

People who might be searching for dinner ideas could see promotions for recipes or preparation tips.

General Mills, for instance, says it promotes "how to" cooking videos featuring its products on grocery sites. So if someone was shopping for chicken on Amazon Fresh, the company said a video for tacos recipes with its Old El Paso products might pop up in an area that suggests additional items.

Last year, Hershey also started offering dessert recipes featuring its chocolates through online meal-kit company Chef'd. The company said it was a way to test and learn about ways to expand sales online, with grocery shopping increasingly becoming about "meal inspiration."

A CLICK FOR COOKIES

Candy and cookie makers are trying to tap into people's impulsive tendencies online the same way they do in stores.

Mondelez uses "big data" to follow people it knows are "Oreo users" with targeted ads, said Tim Cofer, the company's chief growth officer. And the ads are tailored depending on whether people are thought to be frequent buyers or "lapsed users," he said.

Last year, Mondelez also started putting a "shop now" button in the ads on various sites that took them to Amazon where they could buy Oreos.

THE RIGHT MIX

Shoppers might see different products or package sizes online than they would in stores.

On Amazon, for instance, Mondelez said it takes into account that people who aren't Prime members might be looking for larger package sizes that will qualify them for free delivery. Offering the right packages helps ensure the product is purchased frequently, the company said, which turn helps it move up in the search rankings on sites.

Mars also said it created five larger packs for its chocolates for Amazon.

Plus, stores have a finite amount of space, meaning only the most popular items get stocked. Online, Campbell Soup said, its more obscure items, such as Spaghetti-Os with Sliced Franks, have found a receptive audience.

Copyright Associated Press / NBC New York



Photo Credit: Getty]]>
<![CDATA[Colon, Rectal Cancer on the Rise for Millennials ]]>Tue, 28 Feb 2017 19:03:17 -0400http://media.nbcnewyork.com/images/213*120/NC_cancer0228_1500x845.jpg

A new study by the American Cancer Society is showing a shocking increase in cancer among millennials. People in their 20s and 30s have double the risk of being diagnosed with colon cancer, as well as quadruple the risk for rectal cancer as their parents' generation did at the same age. ]]>
<![CDATA[New Help for That Bane of Middle-Age: Blurry Close-Up Vision]]>Tue, 28 Feb 2017 12:39:49 -0400http://media.nbcnewyork.com/images/213*120/eye-surgery.jpg

An eye implant that takes about 10 minutes to put in place is the newest surgical repair for the blurry close-up vision that is a bane of middle age.

Dr. Shilpa Rose says the Raindrop inlay won't restore vision you had in your 20s. But the Washington ophthalmologist says it decreases the need for reading glasses to send texts or read email.

Nearly everybody will experience presbyopia at some point, usually starting in the mid-40s.

While surgery always carries some risk, corneal inlays implanted into the eye's clear front surface are getting attention because they're removable if necessary.

Dr. Deepinder K. Dhaliwal of the University of Pittsburgh Medical Center says patients have to remember it's not one and done, but requires post-surgical exams and care.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Gene Therapy to Fight a Blood Cancer Succeeds in Major Study]]>Tue, 28 Feb 2017 12:44:48 -0400http://media.nbcnewyork.com/images/213*120/cancer6.jpg

An experimental gene therapy that turns a patient's own blood cells into cancer killers worked in a major study, with more than one-third of very sick lymphoma patients showing no sign of disease six months after a single treatment, its maker said Tuesday.

In all, 82 percent of patients had their cancer shrink at least by half at some point in the study.

Its sponsor, California-based Kite Pharma, is racing Novartis AG to become the first to win approval of the treatment, called CAR-T cell therapy, in the U.S. It could become the nation's first approved gene therapy.

A hopeful sign: the number in complete remission at six months — 36 percent — is barely changed from partial results released after three months, suggesting this one-time treatment might give lasting benefits for those who do respond well.

"This seems extraordinary ... extremely encouraging," said one independent expert, Dr. Roy Herbst, cancer medicines chief at the Yale Cancer Center.

The worry has been how long Kite's treatment would last and its side effects, which he said seem manageable in the study. Follow-up beyond six months is still needed to see if the benefit wanes, Herbst said, but added, "this certainly is something I would want to have available."

The therapy is not without risk. Three of the 101 patients in the study died of causes unrelated to worsening of their cancer, and two of those deaths were deemed due to the treatment.

It was developed at the government's National Cancer Institute and then licensed to Kite. The Leukemia and Lymphoma Society helped sponsor the study.

Results were released by the company and have not been published or reviewed by other experts. Full results will be presented at the American Association for Cancer Research conference in April.

The company plans to seek approval from the U.S. Food and Drug Administration by the end of March and in Europe later this year.

The treatment involves filtering a patient's blood to remove key immune system soldiers called T-cells, altering them in the lab to contain a gene that targets cancer, and giving them back intravenously. Doctors call it a "living drug" — permanently altered cells that multiply in the body into an army to fight the disease.

Patients in the study had one of three types of non-Hodgkin lymphoma, a blood cancer, and had failed all other treatments. Median survival for such patients has been about six months.

Kite study patients seem to be living longer, but median survival isn't yet known. With nearly nine months of follow-up, more than half are still alive.

Six months after treatment, 41 percent still had a partial response (cancer shrunk at least in half) and 36 percent were in complete remission (no sign of disease).

"The numbers are fantastic," said Dr. Fred Locke, a blood cancer expert at Moffitt Cancer Center in Tampa who co-led the study and has been a paid adviser to Kite. "These are heavily treated patients who have no other options."

One of his patients, 43-year-old Dimas Padilla of Orlando, was driving when he got a call saying his cancer was worsening, chemotherapy was no longer working, and there was no match to enable a second try at a stem cell transplant.

"I actually needed to park ... I was thinking how am I going to tell this to my mother, my wife, my children," he said. But after CAR-T therapy last August, he saw his tumors "shrink like ice cubes" and is now in complete remission.

"They were able to save my life," Padilla said.

Of the study participants, 13 percent developed a dangerous condition where the immune system overreacts in fighting the cancer, but that rate is lower than in some other tests of CAR-T therapy. The rate fell during the study as doctors got better at detecting and treating it sooner.

Roughly a third of patients developed anemia or other blood-count-related problems, which Locke said were easily treated. And 28 percent had neurological problems such as sleepiness, confusion, tremor or difficulty speaking, but these typically lasted just a few days, Locke said.

"It's a safe treatment, certainly a lot safer than having progressive lymphoma," and comparable to combination chemotherapy in terms of side effects, said the cancer institute's Dr. Steven Rosenberg, who had no role in Kite's study. The first lymphoma patient Rosenberg treated this way, a Florida man, is still in remission seven years later.

There were no cases of swelling and fluid in the brain in this or any other study testing Kite's treatment, company officials said. That contrasts with Juno Therapeutics, which has had a CAR-T study put on hold twice after five patient deaths due to this problem.

Company officials would not say what the treatment might cost, but other types of immune system therapies have been very expensive. It's also being tested for some other types of blood cancer. 

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Trans Students Face ‘Detrimental’ Health Effects: Experts]]>Sun, 26 Feb 2017 04:55:37 -0400http://media.nbcnewyork.com/images/213*120/AP_17055026714973.jpg

LGBTQ advocates say President Donald Trump sent a worrying message when his administration withdrew Obama administration guidance on transgender student protections in public schools.

"It makes me feel unimportant. It makes me feel angry. It makes me feel invisible," 16-year-old transgender student Grace Dolan-Sandrino told NBC Out.

The American Academy of Pediatrics was one of many health organizations that released a statement opposing the White House's decision.

"Policies excluding transgender youth from facilities consistent with their gender identity have detrimental effects on their physical and mental health, safety and well-being," the statement read.

According to the 2015 U.S. Transgender Survey, 40 percent of respondents reported attempting suicide in their lifetimes, nearly nine times the rate in the U.S. population.



Photo Credit: Kathy Willens, AP (File)]]>
<![CDATA[Study Builds Case Linking Autism, Infections During Pregnancy]]>Thu, 23 Feb 2017 08:14:39 -0400http://media.nbcnewyork.com/images/180*120/embarazo22588.jpg

Women with active genital herpes infections early in their pregnancy were twice as likely to have a child with autism than women who did not, according to a study released Wednesday.

NBC News reported that the study, published in the journal mSphere, adds to evidence that some cases of autism may be caused by the mother's immune response to infections.

The team from Columbia University and the Norwegian Institute of Public Health believe that the mother's reaction to herpes infection may be crossing the placenta and affecting the fetus' developing brain. A 2013 study found a similar rise in autism rates in pregnant women who had flu.

"We are now looking at other triggers. We think that a wide range of different types of infections can cause this," said Dr. Ian Lipkin, a Columbia epidemiologist and infectious disease expert who oversaw the research.



Photo Credit: Media for Medical/UIG via Getty Images]]>
<![CDATA[Texas Can't Cut Planned Parenthood]]>Tue, 21 Feb 2017 21:59:28 -0400http://media.nbcnewyork.com/images/213*120/mv+planned+parenthood.jpg

A federal judge ruled Tuesday that Texas can't cut off Medicaid dollars to Planned Parenthood over secretly recorded videos taken by anti-abortion activists in 2015 that launched Republican efforts across the U.S. to defund the nation's largest abortion provider.

An injunction issued by U.S. District Sam Sparks of Austin comes after he delayed making decision in January and essentially bought Planned Parenthood an extra month in the state's Medicaid program.

Texas is now at least the sixth state where federal courts have kept Planned Parenthood eligible for Medicaid reimbursements for non-abortion services, although a bigger question remains over whether President Donald Trump will federally defund the organization.

Sparks' decision preserves what Planned Parenthood says are cancer screenings, birth control access and other health services for nearly 11,000 low-income women. Texas originally intended to boot Planned Parenthood in January but Sparks told the state to wait pending his ruling.

Arkansas, Alabama, Kansas, Mississippi and Louisiana have also had similar efforts blocked.

Like in those states, Texas health officials accused Planned Parenthood officials of making misrepresentation to investigators following the release of secretly recorded and heavily edited videos by an anti-abortion group last year. Investigations by 13 states into those videos have concluded without criminal charges, and Planned Parenthood officials have denied any wrongdoing.

A Houston grand jury indicted two activists behind the videos over how they covertly gained access inside a Planned Parenthood clinic, but a judge later dismissed the charges.

Planned Parenthood serves only a fraction of the 4.3 million people enrolled in Medicaid in Texas.

Anti-abortion activists emboldened by a new Trump administration are looking for the federal government to cut off all federal funding to Planned Parenthood. That would cut nearly $400 million in Medicaid money to the group and result in roughly 400,000 women losing access to care, according to the nonpartisan Congressional Budget Office.

In one of his first acts as president, Trump last month banned U.S. funding to international groups that perform abortions or even provide information about abortions. Vice President Mike Pence strongly opposes abortion, citing his Catholic beliefs, and the newly confirmed health secretary, Tom Price, has supported cutting off taxpayer money to Planned Parenthood.

Copyright Associated Press / NBC New York



Photo Credit: NBC Bay Area (File)]]>
<![CDATA[Rise in Premiums Lays Bare 2 Americas on Health Care]]>Tue, 21 Feb 2017 14:58:35 -0400http://media.nbcnewyork.com/images/213*120/Obamacare-Website-AP_249581118509.jpg

Michael Schwarz is a self-employed business owner who buys his own health insurance. The subsidized coverage "Obamacare" offers provides protection from life's unpredictable changes and freedom to pursue his vocation, he says.

Brett Dorsch is also self-employed and buys his own health insurance. But he gets no financial break from the Affordable Care Act. "To me, it's just been a big lie," Dorsch says, forcing him to pay more for less coverage.

Schwarz and Dorsch represent two Americas, pulling farther apart over former President Barack Obama's health care law. Known as the ACA, the law rewrote the rules for people buying their own health insurance, creating winners and losers.

Those with financial subsidies now fear being harmed by President Donald Trump and Republicans intent on repealing and replacing the ACA. But other consumers who also buy their own insurance and don't qualify for financial help feel short-changed by Obama's law. They're hoping repeal will mean relief from rising premiums.

The ACA sought to create one big new market for individual health insurance in each state. It required insurers to accept all customers, regardless of medical problems. And it provided subsidies to help low- and moderate-income people afford premiums.

These newly vested ACA customers joined consumers already in the market, to make a new insurance pool. Policies offered to all had to be upgraded to meet new federal standards for comprehensive benefits, raising premiums. And many of the new customers turned out to be sicker than insurers expected, pushing rates even higher.

Consumers who didn't qualify for government financial help wound up bearing the full cost of premiums. They also faced the law's new requirement to carry health insurance or risk fines.

"One (group) is angry and one is incredibly grateful," said Robert Blendon of the Harvard T.H. Chan School of Public Health. If Trump and congressional Republicans aren't careful, their actions could stoke fresh grievances without solving longstanding problems of access and cost.

Consider what happened to Schwarz and Dorsch this year, as premiums for a standard plan through HealthCare.gov jumped an average of 25 percent.

Schwarz and his wife are in their mid-20s and live in Tampa, Florida. He has his own commercial photography business and she's pursuing a graduate degree in speech-language pathology.

The sticker price of their HealthCare.gov policy went up about 20 percent, but what they pay monthly is about $115 lower than last year. Not only did their subsidy cover the rise in premium, they're also getting more help because their income went down when Schwarz's wife returned to school full time.

"Being uninsured is not an option," said Schwarz. If Republicans take away his subsidy, "I would have to change careers and find a job that offered health insurance," he said.

Dorsch and his wife live in Wilmington, Delaware, and are in their mid-50s. He has a wholesale business supplying electronics to retail stores and has been buying his own health insurance for years. He gets no financial help from the ACA.

Dorsch said their insurance company wanted to raise the monthly premium to $2,050, or nearly $25,000 a year. They settled for a skimpier plan that still costs $1,350 a month and has a very high deductible.

"In four years my health insurance has more than doubled and I have less coverage," said Dorsch. "It's ludicrous."

He voted for Trump. "He saw the reality that Obamacare has been a nightmare for most Americans, unless you are poor or in a very difficult situation," said Dorsch.

The Congressional Budget Office estimates that the pool of people buying individual health insurance is basically split down the middle among subsidized customers like Schwarz and those who get no help, like Dorsch.

Republican proposals to tie tax credits to age, not income, would help Dorsch. But they may not be generous enough for Schwarz.

"It's trying to find the way to help the one without hurting the other that's really tricky," said Nicholas Moriello, a health insurance broker from Newark, Delaware. "If we had a way to help the person whose premium has become unaffordable without hurting the person we are currently subsidizing."

Caroline Pearson, of the consulting firm Avalere Health, studied consumers on government marketplaces like HealthCare.gov — where nearly 90 percent get subsidies — and compared them with those who purchase directly from an insurer and pay full cost.

Among Avalere's findings:

  • The majority of consumers in the government marketplaces live in lower-income neighborhoods with high unemployment. However, among those who purchase directly from an insurer, about 30 percent live neighborhoods with a median income of $100,000 or more.
  • Consumers in the subsidized market are generally costlier to cover. For those with a standard plan, per-person medical claims averaged $376 per month in 2015, compared to $312 for unsubsidized customers who bought policies directly from an insurer.
  • The subsidized market is important in states that voted for Trump. In Florida, for example, 70 percent of individual policyholders purchase through HealthCare.gov.

"Obamacare helped a lot of lower-income people with high health needs who previously couldn't afford insurance," said Pearson. "It overlooked the fact that there are a lot of people who are relatively healthy and who didn't want the increased benefits. More sick people drove up premiums, which is resulting in some people feeling like they are worse off."

Copyright Associated Press / NBC New York



Photo Credit: AP, File]]>
<![CDATA[NIH Testing Mosquito Saliva Vaccine as Way to Fight Illness]]>Tue, 21 Feb 2017 14:28:22 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-543392276-Mosquito.jpg

Wanted: 60 people willing to be bitten by mosquitoes to test a new kind of vaccine — one that acts against the bugs' saliva.

Rather than separate vaccines against Zika or other mosquito-borne diseases, the new approach aims to protect against multiple infections by triggering the immune system to rev up in response to the bite itself.

The National Institutes of Health is recruiting volunteers for a safety study of the experimental vaccine, being developed by two London companies.

Researchers at NIH's National Institute of Allergy and Infectious Diseases will give volunteers either vaccine or dummy shots. The volunteers must return later to NIH's Bethesda, Maryland, hospital to be bitten by mosquitoes through a special netted device. The mosquitoes are infection-free; researchers will track the volunteers' immune responses.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File]]>
<![CDATA[Face Transplant Links Men Touched by Tragedy]]>Tue, 21 Feb 2017 11:31:54 -0400http://media.nbcnewyork.com/images/213*120/AP_17045844162882-s.jpg

He'd been waiting for this day, and when his doctor handed him the mirror, Andy Sandness stared at his image and absorbed the enormity of the moment: He had a new face, one that had belonged to another man.

His father and his brother, joined by several doctors and nurses at Mayo Clinic, watched as he studied his swollen features. He was just starting to heal from one of the rarest surgeries in the world — a face transplant, the first at the medical center. He had the nose, cheeks, mouth, lips, jaw, chin, even the teeth of his donor. Resting in his hospital bed, he still couldn't speak clearly, but he had something to say.

He scrawled four words in a spiral notebook:

"Far exceeded my expectations," he wrote, handing it to Dr. Samir Mardini, who read the message to the group.

"You don't know how happy that makes us feel," Mardini said, his voice husky with emotion as he looked at the patient-turned-friend he had first met nearly a decade earlier.

The exchange came near the end of an extraordinary medical journey that revolved around two young men. Both were rugged outdoorsmen and both just 21 when, overcome by demons, they decided to kill themselves: One, Sandness, survived but with a face almost destroyed by a gunshot; the other man died.

Their paths wouldn't converge for years, but when they did — in side-by-side operating rooms — one man's tragedy offered hope that the other would have a second chance at a normal life.

__

It was two days before Christmas in 2006 when Andy Sandness reached a breaking point.

He'd been sad and drinking too much at that time. That night after work while "super, super depressed," he grabbed a rifle from a closet. He stared at it for a while, then put a round in the chamber. He positioned the barrel beneath his chin, took a deep breath and pulled the trigger.

Instantly, he knew he'd made a terrible mistake. When the police arrived, an officer who was a friend cradled him in his arms as Sandness begged, "Please, please don't let me die! I don't want to die!"

He was rushed from his home in eastern Wyoming, treated at two hospitals, then transferred to Mayo Clinic. When he woke, his mother was holding his hand. She'd always been a strong woman but that day, her face was a portrait of unfathomable pain. The bullet had obliterated his mouth, so he motioned for a pen and paper.

"I'm sorry," he wrote.

"I love you," she replied. "It's OK." But all Sandness could think about was how he'd hurt his family — and just wonder what was next.

The answer came quickly when he met Mardini, a plastic surgeon whose specialty is facial reconstruction. As a newcomer at Mayo, the doctor was on call Christmas Eve. Over the next few days, he reassured Sandness that he'd fix his face as best he could.

"I just need you to be strong and patient," he said.

It would take time and much surgery. And despite their skills, the doctors couldn't miraculously turn him back into that guy with the orthodontist-perfected smile.

Sandness couldn't bear to see himself, so he covered his hospital room mirror with a towel. He had no nose and no jaw. He'd shot out all but two teeth. His mouth was shattered, his lips almost nonexistent. He'd lost some vision in his left eye. He needed breathing and feeding tubes at first.

Mardini and his team removed dead tissue and shattered bones, then connected facial bones with titanium plates and screws. They reconstructed his upper jaw with bone and muscle from the hip; they transferred bone and skin from a leg to fashion the lower jaw. They used wires and sutures to bring together his eyelids, which had been spread apart by the powerful blast.

They made progress, even if it didn't always look that way.

After about eight surgeries over 4½ months, Sandness returned home to Newcastle, Wyoming, a hamlet of 3,200, where friends and family embraced him. He worked at a lodge, in the oil fields and as an electrician's apprentice.

But his world had shrunk. When he ventured to the grocery store, he avoided eye contact with children so he wouldn't scare them. Occasionally, he heard them ask their mothers why he looked that way.

He sometimes lied when folks asked what had happened. "I would tell them it was a hunting accident," he says. "I felt like they didn't need to know."

He had almost no social life; on a rare night out to shoot pool, a guy taunted him about his appearance. He retreated to the hills, where he could hunt elk and fish walleye, unseen.

"Those were real tough times for him,' says his father, Reed. "He was insecure. Who wouldn't be?"

Sandness learned to adapt. His mouth was about an inch wide — too small for a spoon — so he tore food into bits, then sucked on them until he could swallow the pieces. He wore a prosthetic nose but it constantly fell off outdoors; he carried glue to reattach it. It discolored often, so he had to paint it to match his skin.

"You never fully accept it," he says. "You eventually say, 'OK, is there something else we can do?'"

There was, but the prospect of 15 more surgeries Mardini had mapped out scared him. He didn't want more skin grafts, more scars or dental implants. Even then, he'd still look deformed.

Over the next five years, Sandness made yearly visits to Mayo. Then in spring of 2012, he received a life-changing call.

Mardini told him it looked like Mayo was going to launch a face transplant program and Sandness might be an ideal patient. The doctor had already begun traveling to France, Boston and Cleveland to meet doctors who'd done face transplants.

Mardini tried to temper his patient's enthusiasm. "Think very hard about this," he said. Only about two dozen transplants have been done around the world, and he wanted Sandness to understand the risks and the aftermath: a lifelong regimen of anti-rejection drugs.

But Sandness could hardly contain himself. "How long until I can do this?" he asked.

He followed Mardini's advice to research the surgery. It was far more complicated than he'd imagined, but he was undeterred.

"When you look like I looked and you function like I functioned, every little bit of hope that you have, you just jump on it," he says, "and this was the surgery that was going to take me back to normal."

___

Three more years passed as Sandness waited.

By then, Mayo Clinic had completed a long internal review to get the face transplant program approved. Sandness had to undergo a rigorous psychiatric and social work evaluation to address, among other things, a key question: Should this surgery be performed on someone who'd attempted suicide?

Several factors were in his favor: His resilience and motivation, a strong support network of family and friends, a long-standing rapport with Mardini and a gap of several years since the shooting.

"I don't think there's anybody who doesn't deserve a second chance," Mardini says.

Asked by the doctors what he expected from the transplant, to make sure he had realistic goals, Sandness said he wanted a working nose, the ability to bite, swallow, chew, and to "get good stares as opposed to bad stares."

These incremental steps benefited everyone, says Dr. Hatem Amer, Mayo's medical director of reconstructive transplantation.

"He wasn't rushing us, and we weren't rushing him," he says. "He really understood what he was embarking upon."

Sandness says he was concerned both about the possibility of rejection and potential side effects of anti-rejection drugs, including skin cancer, infection, diabetes and weakening of the bones.

Mardini and his team devoted more than 50 Saturdays over 3½ years to rehearsing the surgery, using sets of cadaver heads to transplant the face of one to the other. They used 3-D imaging and virtual surgery to plot out the bony cuts so the donor's face would fit perfectly on Sandness.

In January 2016, Sandness' name was added to the waiting list of the United Network for Organ Sharing.

Mardini figured it would take up to five years to find the right donor: a man with matching blood and tissue types, roughly the same size as Sandness, within a 10-year age range and a close skin tone.

But just five months later, Mardini got a call: There might be a donor. He phoned Sandness, cautioning it was just a possibility.

The next day, Mardini got the final word: The donor's family had said OK.

___

The decision came from a 19-year-old newlywed mourning the sudden loss of her husband.

In early June, Calen "Rudy" Ross fatally shot himself in the head. His devastated widow, Lilly, was eight months pregnant.

Despite her grief, she was committed to carrying out her husband's wishes: On his driver's license, Ross, who lived in Fulda, Minnesota, had designated he wanted to be an organ donor. Lilly met with a coordinator from LifeSource, a nonprofit group that works with families in the upper Midwest to facilitate organ and tissue donation.

Since Ross had been healthy and just 21, his heart, lungs, liver and kidneys could be donated. But additional screening determined he could do even more: He was a good match for a man awaiting a face transplant at Mayo Clinic.

In a second conversation, LifeSource broached the idea to Lilly.

"I was skeptical at first," she says. "I didn't want to walk around and all of a sudden see Calen." She was reassured the donor had his own eyes and forehead and would not be recognizable as her husband. After consulting with her husband's best friend, she gave her consent.

A CT scan, other tests and a photo sent to Mardini by LifeSource confirmed the two men were a good match. Mardini said when the doctors studied Ross' photo, "we got chills when we actually saw how close they were in hair color, skin — just the overall look. It could be his cousin."

Late on June 16, Sandness was wheeled into surgery, accompanied by Mardini, who was showing him photos of his two small children. Over the years, the two say they've become as close as brothers.

"There was not a second of doubt that everything was going to go well," Sandness says.

"Everybody went into this totally knowing their role, knowing what to expect," Mardini recalls. "Every step has been thought out 1,000 times."

Mardini had a parting message: "We're looking forward to seeing you with a new face."

In adjoining operating rooms, some 60 surgeons, nurses, anesthesiologists and others had gathered for what would be a 56-hour marathon.

__

The surgery that started shortly before midnight Friday was over early Monday morning.

It took about 24 hours to procure the donor's face, which involved taking bone, muscle, skin and nerves, and almost the same time to prepare Sandness. His entire face was rebuilt below his eyes, taking an additional 32 hours. The medical team rotated, many taking four-hour breaks through the weekend.

One of the most intricate parts of the surgery was identifying facial nerve branches on both men and stimulating them with an electric current to determine their function. That allowed doctors to make the correct transfers, so when Sandness thinks about smiling or closing his eyes, for example, those movements actually happen.

After the surgery ended, Mardini proclaimed it "a miracle."

Sandness, who was sedated for several days, wasn't allowed to see himself immediately. His room mirror and cell phone were removed. His father, Reed, served as his eyes.

"I said, 'Andy, I've never lied to you. I'm telling you you're going to be happy with what you see,'" he recalls. "He was quizzing me and the nurses all the time."

Three weeks later, when he finally did see his face — a scene captured on a Mayo video — his father says it "was just a real tearful, hard-to-hold-back time ... beyond our wildest dreams."

Sandness was overwhelmed. "Once you lose something that you've had forever, you know what it's like not to have it," he says. "And once you get a second chance to have it back, you never forget it."

Just having a nose and mouth are blessings, he says. "The looks are a bonus."

Months earlier, both he and Lilly Ross had expressed interest in learning about each other. She particularly wanted him to know about her husband, an adventurous, spontaneous guy.

Last fall, she wrote to Sandness and the five others who received her husband's organs. She described Ross, her high school sweetheart, as a "giving person" who loved hunting, trapping and being with his dog, Grit. "I am filled with great joy knowing that he was able to give a little of himself to ensure a better quality of life for someone else," she wrote.

As for the face transplant, she thought of her baby son when she agreed to it. "The reason that I decided to ... go through with it was so that I can later down the road show Leonard what his dad had done to help somebody," she said in a video produced by LifeSource.

Lilly was given photos of Sandness before and after the transplant. That's when she learned of uncanny similarities between the two men — not just their passion for the outdoors, but the way they stood in their hunting photos. "It was amazing how good he looked and how well he's doing,'" she says of Sandness. "I'm excited for him that he's getting his life back."

She also noticed one small detail — a small bare patch in the middle of his bearded chin, just as on her husband's face.

Both she and Sandness hope to meet one day. For now, he wrote her a letter of appreciation. Referring to her husband's favorite things, he said: "He's still going to continue to love hunting and fishing and dogs — through me."

___

Andy Sandness can pinpoint the day he looked normal.

About three months after the transplant, he was in an elevator when a little boy glanced at him, then turned to his mother without appearing scared or saying anything. "I knew then," he says, "that the surgery was a success."

Last December, he had follow-up surgery to tighten skin on his face and neck and build up bone around his eyes so they're not so recessed.

His facial muscles are growing stronger. He received speech therapy to learn to use his tongue in a new mouth and jaw, and enunciate clearly.

He's thrilled to smell again, breathe normally and be eating foods that were off-limits for a decade: apples, steak and pizza that he shared with his doctors.

His transformation isn't just visible. After the shooting, he says, when he dreamed, he still had his old face. Now, his new face appears in his dreams.

Sandness, now 31, plans to return to Wyoming, work as an electrician and, he hopes, marry and have a family someday.

For now, he savors his anonymity. Recently, he attended a Minnesota Wild game. He bought some popcorn. He watched some hockey. He didn't see any stares or hear any whispers.

He was, as he says, "just another face in the crowd." Just thinking about that makes him smile. 

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Drugs Vanish at Some VA Hospitals: AP]]>Mon, 20 Feb 2017 16:52:53 -0400http://media.nbcnewyork.com/images/213*120/AP_17048604060654-shulkin.jpg

Federal authorities are stepping up investigations at Department of Veterans Affairs medical centers due to a sharp increase in opioid theft, missing prescriptions or unauthorized drug use by VA employees since 2009, according to government data obtained by The Associated Press.

Doctors, nurses or pharmacy staff at federal hospitals — the vast majority within the VA system — siphoned away controlled substances for their own use or street sales, or drugs intended for patients simply disappeared.

Aggravating the problem is that some VA hospitals have been lax in tracking drug supplies. Congressional auditors said spot checks found four VA hospitals skipped monthly inspections of drug stocks or missed other requirements. Investigators said that signals problems for VA's entire network of more than 160 medical centers and 1,000 clinics, coming after auditor warnings about lax oversight dating back to at least 2009.

"Drug theft is an area of concern," Jeffrey Hughes, the VA's acting assistant inspector general for investigations, told the AP. He said the monthly inspections could help the VA uncover potential discrepancies and root out crime.

Both the inspector general's office and the Drug Enforcement Administration said they have increased scrutiny of drug thefts from the VA, with the DEA reporting more criminal investigations.

It's not clear if the problem is worse at the VA than at private facilities, where medical experts and law enforcement officials say drug theft is also increasingly common in a time of widespread opioid abuse in the U.S. But the VA gets special scrutiny from lawmakers and the public, given Americans' esteem for ex-servicemembers served by the agency and because of past problems at the VA, especially a 2014 wait-time scandal in which some patients died.

"Those VA employees who are entrusted with serving our nation's wounded, ill and injured veterans must be held to a higher standard," said Joe Davis, spokesman for Veterans of Foreign Wars.

The drug thefts will be among the challenges facing newly confirmed VA Secretary David Shulkin, who served as the department's undersecretary of health while the drug problem was growing. At his confirmation hearing this month, Shulkin said he was proud that the VA identified the opioid addiction problem before others did and "recognized it as a crisis and began to take action."

Still, the VA acknowledges it has had problems keeping up with monthly inspections and said it was taking steps to improve training. It also said it was requiring hospitals to comply with inspection procedures and develop plans for improvement.

It did not respond to AP requests made three weeks ago to provide a list of VA facilities where drugs had been reported missing or disciplinary action was taken, saying it was still compiling the information.

Reported incidents of drug losses or theft at federal hospitals jumped from 272 in 2009 to 2,926 in 2015, before dipping to 2,457 last year, according to DEA data obtained by AP. "Federal hospitals" include the VA's more than 1,100 facilities as well as seven correctional hospitals and roughly 20 hospitals serving Indian tribes.

The inspector general's office estimates there are nearly 100 open criminal probes involving theft or loss of VA controlled substances.

Three VA employees were charged this month with conspiring to steal prescription medications including opioids at the Little Rock, Arkansas, VA hospital. The inspector general's office says a pharmacy technician used his VA access to a medical supplier's web portal to order and divert 4,000 oxycodone pills, 3,300 hydrocodone pills and other drugs at a cost to the VA of $77,700 and a street value of $160,000.

Christopher Thyer, the U.S. attorney overseeing the case, said the employees were abusing their position to steal from taxpayers and "poison the communities we live in with dangerous drugs."

The drug thefts from VA also raise the possibility that patients will be denied medication they need or that they will be treated by drug-impaired staff.

In one case, a former VA employee in Baltimore pleaded guilty on charges that he injected himself with fentanyl intended for patients heading into surgery, then refilled the syringes with saline solution. Patients received solution tainted with the Hepatitis C virus carried by the employee.

Dr. Dale Klein, a VA pain management specialist, said some of his patients suspected they weren't getting the drugs they needed, including one patient with an amputated leg who had to do without morphine because a VA pharmacy said it did not have enough in supply.

Klein, who is part of a whistleblowers network called VA Truth Tellers, ran a VA pain clinic from 2015 to 2016 and has filed a retaliation claim against VA, saying the VA restricted his work after he voiced complaints. The VA has said it was looking into the claims.

Klein described several of VA's inventory lists as inconsistent or a "slapdash rush job." That concern was underscored by the findings from the Government Accountability Office, released last week, that drug stockpiles were not always being regularly inspected. Klein's attorney, Natalie Khawam, says she's heard similar complaints from other clients at their VA hospitals.

The GAO review, covering January 2015 to February 2016, found the most missed inspections at VA's hospital in Washington, D.C., according to a government official familiar with confidential parts of the audit. Monthly checks were missed there more than 40 percent of the time, mostly in critical patient care areas, such as the operating room and intensive care units. That adds to the risk of veterans not receiving their full medications.

The Washington hospital also missed inspections of the facility's pharmacy for three straight months, violating VA policy, according to the official, who insisted on anonymity to reveal findings that weren't public. In the last year, the hospital had at least five incidents of controlled substances that were "lost" or otherwise unaccounted for, according to the DEA.

Other problems were found in VA hospitals in Seattle, Milwaukee and Memphis, Tennessee. Milwaukee had the fewest, which the GAO attributed to a special coordinator put in place to ensure inspection compliance.

Responding to the findings, the House Veterans Affairs Committee planned a hearing on the inspection issue. Its chairman, Rep. Phil Roe, a physician, said failing to follow protocol is serious and "should not be tolerated within VA."

Copyright Associated Press / NBC New York



Photo Credit: AP, Carolyn Kaster]]>
<![CDATA[Gore: Climate Change Poses Dangerous Health Consequences]]>Thu, 16 Feb 2017 17:16:56 -0400http://media.nbcnewyork.com/images/213*120/AP_17047583778829-gore.jpg

Former Vice President Al Gore on Thursday said more attention must be paid to the dangerous health consequences of climate change, and he called on scientists, health officials and health care providers to work together to find solutions to the crisis.

Gore made the comments Thursday during the Health and Climate Meeting at The Carter Center in Atlanta. Gore helped organize the conference after the Centers for Disease Control and Prevention abruptly canceled its own conference on climate change and health.

A number of CDC employees were attending, however, including Patrick Breysse, who leads the agency's efforts to investigate the relationship between environmental factors and health. CDC spokeswoman Kathy Harben said Breysse was there to represent the CDC but that some agency officials were attending on their own time.

Officials from the U.S. Environmental Protection Agency, the National Institutes of Health and the National Oceanic and Atmospheric Administration were also attending.

Public health experts have long said that climate change is a man-made problem that contributes to a range of health issues and illnesses, including heat stroke, respiratory illness and diseases spread by tropical insects.

The problems are already here, the Noble Peace Prize Winner said in his keynote speech, noting infectious diseases like zika are now spreading to areas where they previously were not found.

"It's hard to focus on some of these horrific consequences of the climate crisis on health, but hope is justified," Gore said. "We are going to win this.”

Gore also said the effects of climate change are falling hardest on the poor. Outbreaks of cholera, an acute intestinal illness caused by ingesting infected food and water, have in recent years struck places like Haiti and Niger. Cholera causes severe diarrhea and can lead to death by dehydration, sometimes within hours.

"Cholera likes warmer water," Gore said. "There are lots of examples of temperature spikes with water that had high levels where cholera becomes much worse and much worse of a problem."

In 2012, President Donald Trump tweeted that the concept of global warming was created by the Chinese to make U.S. manufacturing noncompetitive. He later said he was joking, but during the presidential campaign referred to global warming as "a hoax."

Oklahoma Attorney General Scott Pruitt, Trump's pick to head the Environmental Protection Agency, has been met with opposition from environmental groups and some Republicans on Capitol Hill.

Republican Sen. Susan Collins of Maine said Wednesday that she's going to vote against Pruitt because she has "significant concerns" over his active opposition to EPA policy and his lawsuits against the agency on policies important to Maine.

"We are now facing a new headwind," Gore said of the situation in Washington. " ... This is not the first time that there has been an unexpected obstacle. We will win this."

Copyright Associated Press / NBC New York



Photo Credit: AP, Alex Sanz]]>
<![CDATA[China Carfentanil Ban a 'Game-Changer' in US Opioid Epidemic]]>Thu, 16 Feb 2017 11:10:40 -0400http://media.nbcnewyork.com/images/213*120/DEA-Badge-Generic.jpg

So deadly it's considered a terrorist threat, carfentanil has been legal in China— until now. Beijing is banning carfentanil and three similar drugs as of March 1, China's Ministry of Public Security said Thursday, closing a major regulatory loophole in the fight to end America's opioid epidemic.

"It shows China's attitude as a responsible big country," Yu Haibin, the director of the Office of the National Narcotics Control Committee, told the Associated Press. "It will be a strong deterrent."

He added that China is actively considering other substances for sanction, including U-47700, an opioid marketed as an alternative to banned fentanyls. China said the March 1 ban will also apply to carfentanil's less-potent cousins furanyl fentanyl, acryl fentanyl and valeryl fentanyl.

The U.S. Drug Enforcement Administration called China's move a potential "game-changer" that is likely to have a big impact in the U.S., where opioid demand has driven the proliferation of a new class of deadly drugs made by nimble chemists to stay one step ahead of new rules like this one. After China controlled 116 synthetic drugs in October 2015, seizures in the United States of compounds on that list plunged.

"It's a substantial step in the fight against opioids here in the United States," said Russell Baer, a DEA special agent in Washington. "We're persuaded it will have a definite impact."

Legally used as an anesthetic for elephants and other large animals, carfentanil burst into the North American drug supply last summer, causing hundreds of unsuspecting drug users to overdose. The DEA confirmed more than 400 seizures of carfentanil across eight U.S. states from July through October. So lethal an amount smaller than a poppy seed can kill a person, carfentanil was researched for years as a chemical weapon and used by Russian forces to subdue Chechen separatists at a Moscow theater in 2002.

New data from DEA laboratories suggests the supply of furanyl fentanyl is now surging. DEA labs identified 44 samples of furanyl fentanyl in the last three months of 2016, up three-fold from the prior quarter.

Though Beijing has said U.S. assertions that China is the top source of fentanyls lack evidence, the two countries have deepened cooperation as the U.S. opioid epidemic intensifies. Beijing already regulates fentanyl and 18 related compounds, even though they are not widely abused domestically. Since 2016, China has arrested dozens of synthetic drug exporters, destroyed eight illegal labs and seized around 2 tons of new psychoactive substances, according to the Office of the National Narcotics Control Committee.

But the battle against rapidly evolving synthetic drugs is complicated by the deeply global nature of the narcotics trade and the deeply national nature of law enforcement. Some online drug vendors host their websites on servers abroad to thwart police. All benefit by submerging their illicit packages in the vast tides of legitimate commerce shipped or sent by courier from China.

One example of the kind of global coordination needed to take down synthetic drug barons is the case of Zhang Lei, whom the U.S. Treasury Department designated a drug kingpin in 2014. China shared 4,221 clues with 58 countries and areas in the hunt for Zhang, Chinese drug control authorities said Thursday. Zhang was sentenced to 14 years in Chinese prison last year, according to one of his lawyers, Fan Renzhong.

In October, the AP identified 12 Chinese companies willing to export carfentanil around the world for a few thousand dollars a kilogram (2.2. pounds), no questions asked. That same month China began evaluating whether to ban carfentanil and the three other drugs. Usually, the process can take nine months. This time, it took just four. Good international cooperation and effective early warning systems to track the emergence of novel drugs helped speed the process, Chinese drug control officials said Thursday.

China's action is "a hopeful sign of political and strategic law enforcement cooperation," said Jeremy Douglas, a regional representative for the U.N. Office on Drugs and Crime in Bangkok. "But having legislation is a first step. The law will need to be enforced effectively."

Offers for carfentanil from Chinese vendors were scarce Thursday, but the AP quickly secured five offers to export furanyl fentanyl to the United States. Some vendors also pushed U-47700.

"One news I just got is that the carfentanil and furanyl fentanyl etc opioid analogs will be controlled in China on March 1 effective," one vendor called Ete wrote in an email. "So if you need them pls make it before that day. After that day it will be unavailable."

The vendor did not immediately respond to a request for comment from AP.

Associated Press researcher Fu Ting contributed to this report from Shanghai.

Copyright Associated Press / NBC New York



Photo Credit: NBC San Diego, File]]>
<![CDATA[Would You Let Someone Who's Not a Dentist Pull Your Teeth?]]>Thu, 16 Feb 2017 11:43:30 -0400http://media.nbcnewyork.com/images/213*120/AP_17046749125354-dentist.jpg

Need a tooth pulled or a cavity filled? Forget the dentist. A number of states are allowing or considering letting "dental therapists," professionals with a lower level of training, do the job.

In dozens of countries and a handful of U.S. states, dental therapists also sometimes called advanced dental hygiene practitioners help fill gaps in access to oral care for low-income, elderly and disabled people, and in rural areas where few dentists practice, according to many public health advocates.

In Massachusetts, a group that lobbies on behalf of dentists has for the first time signaled a willingness to embrace the concept, though its proposal is viewed as unnecessarily restrictive by sponsors of a competing bill in the Legislature.

Dentists have long opposed the midlevel position, citing concerns over safety and supervision.

"We are not a silver bullet for helping access to dental care, but we are a great tool," said Christy Jo Fogarty, a dental therapist in Minnesota, which in 2009 became the first state to broadly authorize and establish educational and training criteria for therapists. Often compared to a nurse practitioner, the therapist can perform more common procedures than dental hygienists, while leaving more complex tasks to licensed dentists.

Fogarty, a dental hygienist for 13 years before training to become a dental therapist, said her work includes fillings, temporary crowns and extractions. She regularly provides care in schools, Head Start centers and other community settings without a dentist physically present.

"We have kids who don't have to go to an emergency room for a toothache anymore," said Fogarty, one of more than 60 therapists in Minnesota.

In Massachusetts, with a higher rate of dentists per 100,000 residents than any other state, there were more than 36,000 visits to emergency rooms in 2014 for "preventable oral health" issues, costing the health care system as much as $36 million, according to an estimate by the state's Health Policy Commission.

Dentists often do not accept Medicaid because of low reimbursement rates, and dental procedures covered by the government insurance program vary from state to state.

"I can't tell you how many times I had to take my kids to an emergency room because of an abscessed tooth," said Maura Sullivan, who works for The Arc of Massachusetts, a group that advocates for people with disabilities and supports dental therapists. She said she struggled for years to find preventative dental care for her two sons, both with autism, in part because many dentists in her area would not accept Medicaid disability benefits.

Alaska has allowed dental therapists to work in tribal areas since 2004, and two other New England states, Maine in 2014 and Vermont in 2016, have since joined Minnesota in authorizing statewide programs. Proposals also are being considered in Arizona, Connecticut, Kansas, Maryland, Michigan, New Hampshire, New Mexico, North Dakota, Ohio and Texas. One recent North Dakota study found that Medicaid recipients suffered disproportionately from tooth decay and tooth loss, and conditions such as severe gingivitis.

Massachusetts dentists broke from the American Dental Association, a national organization that opposes the midlevel position, by filing a bill in January that would allow limited use of public health dental practitioners as part of a broader approach to improved oral health care.

"They could do any procedure that a dental hygienist can do, but if there is anything beyond that scope, it should be under direct supervision, which means a dentist needs to be there at the facility in case they develop a problem with an extraction or something like that," said Raymond Martin, president of the Massachusetts Dental Society.

The legislation would require practitioners to have at least two years of post-graduate level training and restrict them to serving only Medicaid patients or residents of "underserved" counties with a documented shortage of dentists.

Under a separate bill backed by Pew Charitable Trusts and other advocacy groups, dental therapists would work collaboratively with dentists but would be allowed to perform procedures under "general" rather than direct supervision — meaning a dentist would not have to be physically present. The measure would not specify the level of education for therapists but requires them to meet standards of a national dental accrediting commission.

Copyright Associated Press / NBC New York



Photo Credit: AP, Dawn Villella]]>
<![CDATA[Brain Scans May Detect Signs of Autism in Infants]]>Wed, 15 Feb 2017 21:57:36 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-5248112111.jpg

It may be possible to detect autism in babies before their first birthdays, a much earlier diagnosis than ever before, a small new study finds.

Using magnetic-resonance imaging scans, researchers at the University of North Carolina were able to predict — with an 80 percent accuracy rate — which babies who had an older sibling with autism would be diagnosed with the disorder, NBC News reported.

The brain imaging scans, taken at 6 months, at 12 months and again at 2 years, showed significant growth in brain volume during the first year in babies who would later meet the criteria for autism, such as not making eye contact, delaying speech or other displaying other developmental delays.

Parents who have a child with autism have a 2 percent to 18 percent increased risk of having a second child who is also affected, according to the Centers for Disease Control and Prevention.



Photo Credit: Sally Anscombe/Getty Images]]>
<![CDATA[South Florida Company Turns Cobra Venom Into Healing Treatment]]>Wed, 15 Feb 2017 20:42:41 -0400http://media.nbcnewyork.com/images/213*120/021417+cobra+venom.jpg

When you think about Cobra venom, eventual death comes to mind. A South Florida company is changing the perception of the deadly venom.

Nutra Pharma Corp., a biotechnology company specializing in the acquisition, licensing and commercialization of pharmaceutical products and technologies,  has turned the toxin in the venom into treatment for pets and people.

The treatment fills medicine bottles at the facility in Plantation.

Tom Crutchfield, a herpetologist, says there’s really no need to be afraid of this potentially deadly snake.

“I always knew they were special even as a kid, because when I was a kid everybody hated snakes,” said Crutchfield.

He raises and handles the slithering creatures in his farm in Homestead.

Twice a month, Crutchfield milks the venom that will be used to help people and pets with chronic pain.

“The biodiversity on this planet never ceases to amaze me. And, the more we look, the more we find, the more medicines we find when we look at venoms and poisons and things like that. It’s amazing,” said Crutchfield.

The venom is taken to the Nutra Pharma lab, where it undergoes a process converting it from fluid to powder.

The product is then sold and marketed as Nyloxin, selling for $24.95.

“All the principle work has been in humans. So, the Nyloxin product is amazing. It’s non-addictive, no opiate, non-narcotic. In the last model, it outperformed morphine. It lasted six hours longer than morphine without any of the side effects,” explained Rik Deitsch, CEO of Nutra Pharma Corp.

Deitsch said the extracted venom is also good for pets. It’s sold as Pet Pain Away.

“The problem with pain medication for dogs and cats is there aren't a lot of choices,” said Deitsch.

The product comes as a spray and topical gel. The South Florida-based company says it has three patents on this specific healing formula.

Nutra Pharma says there are 46 published clinical studies about the product.

Nyloxin and Pet Pain Away are all natural and can also be used for auto immune diseases, viruses and pain. Every time the lab milks a cobra, more than 100 bottles of product are made.



Photo Credit: NBC Miami]]>
<![CDATA[Sore Back? Try Heat and Exercise First, Guidelines Say]]>Tue, 14 Feb 2017 12:56:07 -0400http://media.nbcnewyork.com/images/212*120/Back-Guy.jpg

Prescription drugs should only be a last resort as a treatment for lower back pain, a leading doctors' group said Monday.

NBC News reported on the new guidance from the American College of Physicians, which says doctors should tell patients to try heat wraps and exercise first, then over-the-counter drugs like ibuprofen (Tylenol has been shown to do little for back pain), before they prescribe opioids.

"Given that most patients with acute or subacute low back pain improve over time regardless of treatment, clinicians and patients should select nonpharmacologic treatment with superficial heat massage, acupuncture, or spinal manipulation," the group says in its new guidance, published in the Annals of Internal Medicine.

Among the therapies that may help and have little risk of harm are tai chi, yoga and cognitive behavioral therapy, the group said.



Photo Credit: Getty Images, File]]>
<![CDATA[Aetna, Humana Call Off $34 Billion Deal]]>Tue, 14 Feb 2017 09:50:03 -0400http://media.nbcnewyork.com/images/213*120/AP_16229419820877.jpg

Aetna and Humana called off a $34 billion proposal to combine the two major health insurers after a federal judge, citing antitrust concerns, shot down the deal.

The announcement Tuesday comes several days after another federal judge rejected a tie-up between two other massive insurers. Blue Cross-Blue Shield carrier Anthem is attempting to buy Cigna for $48 billion. Anthem has vowed to appeal that decision.

Aetna, the nation's third largest insurer, had announced its bid for Humana in 2015. The deal would have given Aetna the opportunity to significantly expand its presence in the fast-growing market for Medicare Advantage plans, privately run versions of the federal Medicare program for people who are over 65 or disabled.

But Aetna's attempt to gobble up the nation's fifth largest health insurer brought in the Department of Justice, which sued to block the deal last summer.

U.S. District Judge John Bates wrote in the decision last month that neither new competition nor plans to shed some of the combined company's businesses would be enough to ease antitrust concerns. Federal regulation would likely be "insufficient to prevent the merged firm from raising prices or reducing benefits," Bates ruled.

Aetna Chairman and CEO Mark Bertolini said in a company release Tuesday that "the current environment makes it too challenging to continue pursuing the transaction."

Humana is entitled to a $1 billion breakup fee, which would amount to about $630 million after taxes. The Louisville, Kentucky, insurer says it will announce its 2017 forecast and provide an update on its strategic plan after markets close Tuesday.

Aetna is based in Hartford, Connecticut.

The two deals blocked in federal courts would have melded the nation's five largest insurers into three, with UnitedHealth Group Inc. currently the biggest.

The insurers have argued that growing through acquisitions would allow them to better negotiate prices with pharmaceutical companies, hospitals and doctor groups that also are merging and growing larger. They also expect to cut expenses and add more customers, which helps them spread out the cost of investing in technology to manage and improve care.

Insurers have also said that combining would help them stabilize their business on the Affordable Care Act's public insurance exchanges.

But the American Medical Association said last week, after the Anthem-Cigna deal was shot down, that a merger would have created a health care behemoth too large to regulate and with too much control over the lives of consumers.

Copyright Associated Press / NBC New York



Photo Credit: AP, File]]>
<![CDATA[Firstborns Get Intellectual Advantage Over Siblings: Study]]>Mon, 13 Feb 2017 17:04:28 -0400http://media.nbcnewyork.com/images/160*122/GettyImages-73781080.jpg

Firstborn children are set up for more academic and intellectual success, according to a new study that delved into nearly 40 years of data.

Today.com reported that firstborn babies and toddlers started scoring better on cognitive tests than their younger siblings at the same age, and the advantage continued through their lives.

The study was published in the Journal of Human Resources and based its findings on the Children of the National Longitudinal Survey of the Youth, which included information on thousands of Americans 14-21 years old who were interviewed several times starting in 1979.

“First-time parents tend to want to do everything right and generally have a greater awareness of their interactions with and investments in the firstborn," co-author Jee-Yeon K. Lehmann, an economist at the Analysis Group in Boston, told "Today."



Photo Credit: Getty Images]]>
<![CDATA[Shoveling Snow Can Be Deadly for Men: Study]]>Mon, 13 Feb 2017 15:45:47 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-462353044.jpg

Men are more likely to have a heart attack after a snowfall, probably from shoveling snow, according to Canadian researchers.

NBC News reported that researchers found a slight increase in heart attacks and deaths following a storm in Quebec. With each day of snow, these likelihoods increased. A single day of snowfall raised a man’s risk of heart attack by just less than one percent, the researchers reported in the Canadian Medical Association Journal.

“Men are potentially more likely than women to shovel, particularly after heavy snowfalls,” researchers wrote. “Snow shoveling is a demanding cardiovascular exercise require more than 75 percent of the maximum heart rate, particularly with heavy loads.”

The study found that men were one-third more likely to die after an eight-inch snowfall compared to a dry day. Researchers did not find a similar trend with women.



Photo Credit: Getty Images, File]]>
<![CDATA[Woman Praises 911 Dispatcher]]>Sun, 12 Feb 2017 07:29:37 -0400http://media.nbcnewyork.com/images/258*120/170211-911-dispatcherJPG.JPG

There were happy tears all around Saturday at the Corona Police Department when a woman met the 911 dispatcher who helped save her husband’s life.

On Jan. 21, Carolyn Evans called 911. Her husband, 65-year-old Jeff Evans, had suffered a heart attack and wasn’t breathing.

“His face is turning purple,” Carolyn Evans can be heard saying to the dispatcher in the 911 call.

Elise Rodriguez, the voice on the other end, kept Carolyn Evans calm and walked her through two rounds of CPR until paramedics arrived four minutes later.

“I want you to put the heel of your hand on the breast bone in the center of his chest,” Rodriguez instructed. “I want you to count out loud with me."

Even as the paramedics arrived and continued to administer life-saving care, Evans said Rodriguez deserves tremendous credit.

"She really walked me through the whole thing. I’d never done it,” Evan said. “I’ve been told about it. My daughter told us, but I've never done it. And [Rodriguez] perfectly walked me through it.”

For Rodriguez, it’s all part of the job, but she said it’s nice to hear about the end result and meet Evans’ family.

“When I found out from one of the officers initially on scene that he survived, I was really excited about that,” Rodriguez said. “You always hope for the best, but you have no idea what happens once they've been taken away.”

Jeff Evans had two stints put in and was put into a medically induced coma. But three weeks after his heart attack, he’s recovering well.

On Saturday, Evans, his wife and his 11 grandchildren wanted to thank the dispatchers and first responders who helped make that recovery possible.

“I’m able to read and comprehend,” Jeff Evans said. “It’s a miracle. I don’t understand it, but I’m good.”



Photo Credit: KNBC-TV ]]>
<![CDATA[US Judge Blocks Anthem-Cigna Health Insurance Merger]]>Thu, 09 Feb 2017 05:17:29 -0400http://media.nbcnewyork.com/images/213*120/gavel-generic-stock.jpg

A federal judge on Wednesday rejected Anthem Inc.'s bid to buy rival health insurer Cigna Corp., saying the merger would likely lead to higher costs, less competition and diminished innovation.

U.S. District Judge Amy Berman Jackson said the merger would significantly reduce competition in the already concentrated insurance market, particularly for large national employers. Cigna and Anthem are two of just four insurers selling to companies with 5,000 employees spread across multiple states, and they compete aggressively for business, the judge wrote.

Berman Jackson was unconvinced by Anthem's argument that the merged company could save money for customers by combining the two insurers' different approaches to cost saving. Anthem has negotiated lower payments to doctors and hospitals, while Cigna has higher upfront expenses for wellness in the hopes of reducing future health expenses.

"Eliminating this competition from the marketplace would diminish the opportunity for the firms' ideas to be tested and refined, when this is just the sort of innovation the antitrust rules are supposed to foster," she wrote.

Anthem officials are reviewing the decision, spokeswoman Jill Belcher said. She declined to comment.

Last month, another federal judge rejected Aetna's roughly $34-billion bid to buy rival Humana, citing in part concerns about competition in hundreds of Medicare advantage markets.

Washington, D.C.-based U.S. District Judge John Bates said in an opinion filed Jan. 23 that federal regulation would probably be "insufficient to prevent the merged firm from raising prices or reducing benefits." He added that neither new competitors nor an Aetna plan to sell some of the combined company's business to another insurer, Molina Healthcare Inc., would be enough to ease competitive concerns.

An Aetna spokesman has said the company is strongly considering an appeal.

The Justice Department had sued last summer to block both deals, and the cases went to trial late last year.

The two deals would have consolidated the nation's five largest insurers into three, a list that includes UnitedHealth Group Inc., currently the largest.

The insurers have argued that by getting bigger they will be able to negotiate better prices with pharmaceutical companies, hospitals and doctor groups that also are growing. They also expect to cut expenses and add more customers, which helps them spread out the cost of investing in technology to manage and improve care.

Industry experts have said any consumer impact from these deals would take years to materialize and could lead to savings in some areas, along with higher costs elsewhere.

The American Medical Association cheered the ruling, saying the merger would have created a health care behemoth too big to regulate and with too much control over consumers' lives.

"In a David vs. Goliath battle between consumers and mega insurers, a federal judge today ruled that Anthem's proposed acquisition of Cigna poses a clear and present threat to the quality, accessibility and affordability of health care in the United States," Dr. Andrew Gurman, the AMA president, said in a statement.

Anthem CEO Joseph Swedish also has said the $48-billion Cigna deal would help stabilize pricing in the volatile public exchanges created by the Affordable Care Act. He has said that would enable his company to keep its commitment to the public exchanges, a statement seen by some as a sign that Anthem might slash that business if the deal falls through.

The Indianapolis-based insurer, which sells Blue Cross-Blue Shield coverage in key markets like California and New York, offers plans on exchanges in 14 states and covers 839,000 people.

Many insurers have struggled developing their business on the exchanges. Swedish said on Feb. 1 that his company is waiting to see whether the government can make some sort-term fixes for these markets before it decides how much it will participate next year.

He said Anthem is concerned about a health insurance tax and special enrollment periods that expensive customers use to sign up for coverage only when they need insurance, among other issues.

The Justice Department has pushed aggressively in recent years to block deals in several industries that they say will reduce competition. The Swedish company Electrolux and oil and gas service provider Haliburton both walked away from multi-billion-dollar deals after being sued by regulators.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/iStockphoto]]>
<![CDATA[Clinic Falsely Told Dozens They Had Alzheimer's, Suits Say ]]>Wed, 08 Feb 2017 11:05:40 -0400http://media.nbcnewyork.com/images/213*120/AP_17027638904199-sm.jpg

Shawn Blazsek knew a string of concussions from high school football and boxing was catching up with him. He would go days without sleeping and was forgetting how to tie his shoes. Still, at age 33, he was stunned after being told he had Alzheimer's disease.

He started planning out who would take care of his four kids if something happened to his wife, and thought about how hard it would be for them when he could no longer recognize his family. So he stuffed fistfuls of sleeping pills into a bottle and wrote himself a note, vowing to swallow all of them when he wasn't able to remember the names of his children.

That day never came. Nine months later, he learned that the memory-loss center director who diagnosed him didn't have a medical or psychology license needed to do so. Then another test confirmed he did not have Alzheimer's.

He is one of more than 50 people suing the now-closed clinic's former director and its owner, saying they, too, were told they had Alzheimer's or another form of dementia. Most now know it's not true, while a few are awaiting confirmation.

Some say they spent months undergoing treatment while planning out their final years. Some quit their jobs, sold possessions or took one last special trip. One killed himself.

Blazsek crammed years of fatherly advice into a matter of months, showing his son how to check the oil on a car and teaching his wife about the household finances.

"I was preparing her to be a single mom," he said.

The couple figured he had no more than 10 years to live and even less time before his memory was gone.

"Here I am, thinking I'm going to be a widow at 43. What am I going to do?" said his wife, Jennifer. "Who's going to teach my boys how to shave? Who's going to play ball with them?"

So far, the case has yet to result in any charges against Sherry-Ann Jenkins, who opened the Toledo Clinic Cognitive Center in early 2015 through the Toledo Clinic, a multi-specialty medical center with more than 150 doctors.

Attorneys on both sides would not say whether there is a criminal investigation, although court records indicate the Ohio Medical Board has talked with some of the patients.

The lawsuits say that Jenkins, who has a doctorate degree in physiological science, wasn't authorized to order medical tests and that her husband, a licensed doctor who is a partner in the Toledo Clinic, signed off on the tests and was sometimes listed as the referring physician on billing even though he did not see any of the patients.

An attorney for the couple would not answer questions about the cognitive clinic, which abruptly shut down after about a year in early 2016. Jenkins and her husband did not respond to messages seeking comment.

In court filings responding to the lawsuits, each of which seeks more than $1 million in damages, their attorney did not dispute that Jenkins was unlicensed but denied most of the other allegations.

The former patients have sued the Toledo Clinic, as well, saying it should have known Jenkins lacked the training and credentials to treat and diagnose patients. Michael D'Eramo, chief administrative officer of the Toledo Clinic, said he could not comment.

Some describe her as compassionate and easy to talk with, saying she ended therapy sessions by telling them to give her a hug. At her suggestion, a few patients appeared in articles touting the benefits of her holistic treatments, which included memory games and daily doses of coconut oil. But they also say she fought hard against medication and getting a second opinion.

Nearly all of those diagnosed by Jenkins began seeing her after suffering traumatic brain injuries or worsening cognitive issue. Some, like Blazsek, are continuing treatment with other doctors.

Attorney David Zoll, who is representing those suing Jenkins, said that it's not clear how many patients she saw and that others might not know they were misdiagnosed with Alzheimer's. More than 30 people added their names to the lawsuits late last month.

He said he believes she was motivated by greed, saying several patients were overbilled. The cognitive clinic grew rapidly, he noted.

"Many times she would see the first person and have them bring in their whole family," Zoll said. "And many times she would diagnose the whole family."

Kay Taynor was diagnosed with Alzheimer's on her second visit to Jenkins and then referred five or six friends and family members to her office, including her husband of 48 years. All were told they had the disease, she said, but her husband, Gary, took it hardest.

"He's got a smile that just lights up the room, and I never saw it again," she said. "He just sunk in his chair. To me, he never stood up again. He was never tall again. He gave up."

Gary fell into depression, spending his final weeks sitting in a chair with his hands in his lap until he went into their garage and shot himself in the head, she said. An autopsy did not show any signs of Alzheimer's, she said.

Don Tanner said he, too, felt like taking his own life.

He was sent to the clinic for therapy in February 2015 after suffering a severe brain injury in a fall. The trauma of healing while dealing with the devastating diagnosis of Alzheimer's became unbearable.

"She gave me a death sentence," said Tanner, who told his wife he wanted to jump off a bridge and then thought about wandering off into the marsh behind their home with his gun.

He had seen firsthand how Alzheimer's gradually erodes someone while caring for his dad. He spent many days shaving and dressing his father, who died only months before Tanner's own diagnosis.

"It was just cemented in my mind that I wasn't going to put my family through that," he said.

His wife enlisted their daughters and friends to stay with him while she was at work, fearing what she'd find when she returned. "If he had a bad day, I didn't know where that would send him," said his wife, Monica.

It wasn't until last summer — after the clinic had closed — that a new doctor told him there was no way he had Alzheimer's.

"God must have been on my side, because I didn't go out there and get that damn gun," Tanner said. "But man I thought of it. Something kept telling me it's not there yet."

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Kids Are Trying Potentially Harmful E-Cigarette Hack]]>Tue, 07 Feb 2017 08:25:07 -0400http://media.nbcnewyork.com/images/213*120/AP_34020085243.jpg

As many as a quarter of U.S. kids who are using e-cigarettes may be taking them apart and "dripping" — a method that gives them more vapor but a potentially higher hit of nicotine, researchers reported Monday, according to NBC News.

They recommended more research into whether it's more dangerous for kids, and experts said parents should ask their kids if they've tried it.

"E-cigarettes are also being used for 'dripping,' which involves vaporizing the e-liquid at high temperatures by dripping a couple of drops of e-liquid directly onto an atomizer's coil and then immediately inhaling the vapor that is produced," Dr. Suchitra Krishnan-Sarin of Yale University and colleagues reported in the journal Pediatrics.

"Among 1,080 ever e-cigarette users, 26.1 percent of students reported ever using e-cigarettes for dripping. Reasons for dripping included produced thicker clouds of vapor (63.5 percent), made flavors taste better (38.7 percent), produced a stronger throat hit (27.7 percent)," they added.



Photo Credit: AP Photo/Frank Franklin II]]>
<![CDATA[9.2 Million Signed Up for Obamacare in 2017]]>Fri, 03 Feb 2017 22:35:00 -0400http://media.nbcnewyork.com/images/180*120/Obacare.jpg

Facing higher premiums, less choice and a last-minute advertising pullback, fewer people signed up for coverage this year through HealthCare.gov, according to data from a preliminary government report Friday.

About 9.2 million people signed up through HealthCare.gov, the insurance marketplace serving most states, said the Health and Human Services department. That's about 500,000 fewer customers than had enrolled last year in those same 39 states, or slippage of around 5 percent.

The report doesn't include figures from 11 states that run their own health insurance markets — including California and New York — so the final national number will be higher. But the preliminary report is being closely watched, because President Donald Trump and the GOP-led Congress have vowed to repeal the Obama-era health law and replace it with a plan yet to emerge.

Insurance markets created by former President Barack Obama's law provide subsidized private coverage for people who don't have access to health care through their jobs. Along with a Medicaid expansion aimed at low-income adults, the Affordable Care Act has helped millions get coverage, reducing the nation's uninsured rate to a historic low of about 9 percent.

But even before Trump's election victory, the ACA's markets were facing double-digit premium increases and a sharp drop in insurer participation. Although most customers receive taxpayer subsidies for their premiums, the increases averaged more than 20 percent nationally and much higher in several states.

The night he was inaugurated, Trump signed an executive order directing his administration to provide relief from "Obamacare." That was interpreted as a signal that officials would waive the law's tax penalties meant to nudge uninsured people to sign up. Then last week the administration pulled back about $5 million in ads that were part of a closing bid to woo the uninsured. Former Obama administration officials cried foul.

Trump administration spokesman Matt Lloyd said Friday that "Obamacare has failed" and the new president looks forward to providing relief through "patient-centered solutions that will work for the American people."

But independent analysts said the report also highlights the challenges that Trump and the GOP Congress will face trying to deliver on their promises without disrupting coverage for millions. That includes many people in states that Trump won in November, among them Florida (1.8 million); Texas (1.2 million); North Carolina (549,000); Georgia (494,000), and Pennsylvania (426,000).

"While enrollment is down, this does not exactly paint a picture of a program collapsing," said Larry Levitt of the nonpartisan Kaiser Family Foundation.

"Enrollment had been tracking on pace with last year, but sign-ups slowed down in the final weeks of open enrollment," said Caroline Pearson of the consulting firm Avalere Health. The controversy over unwinding the health care law may have contributed, she said.

Nonetheless, Pearson said the demand for coverage "remains strong." She added, "Policymakers will need to consider how forthcoming changes will impact those currently purchasing coverage."

Supporters of the health care law, trying to beat back or blunt efforts to repeal it, blamed the Trump administration for the lackluster number.

Ron Pollack, executive director of the advocacy group Families USA, said Trump had tried to "sabotage" enrollment.

"Millions of consumers still got their insurance through the ACA," said Pollack. "The Republican rush to repeal the ACA without a replacement will do real harm to real people."

A final, national enrollment report isn't due until next month. Some of the 11 state-run insurance markets, including California, have extended open enrollment through Saturday. Washington, DC, also runs its own insurance market. HealthCare.gov's sign-up season ended Jan. 31.

Copyright Associated Press / NBC New York



Photo Credit: HealthCare.gov]]>
<![CDATA[Laundry Pod-Linked Eye Injuries Surged in Small Kids: Study]]>Fri, 03 Feb 2017 12:12:11 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-453144893.jpg

Liquid laundry packets are responsible for a surge in eye injuries in young children, according to new medical research.

The pods are already under scrutiny after thousands of incidents of kids mistaking them for toys or candy, the "Today" show reported. But chemical burns to the eyes of preschool-aged kids caused by the packets jumped 32-fold between 2012 and 2015, according to a report published in JAMA Ophthalmology.

The report noted that by the end of 2015, liquid laundry packet-involved eye injuries represented more than one in four chemical eye burns in children 3-4 years old.

An industry group says that voluntary safety standards meant to prevent such injuries were put in place after the period covered in the data.



Photo Credit: Getty Images/iStockphoto]]>
<![CDATA[Insurers Mull Exit From Exchanges or Price Hikes]]>Thu, 02 Feb 2017 17:52:51 -0400http://media.nbcnewyork.com/images/213*120/Obamacare-AP_30213472209.jpg

The Affordable Care Act's insurance exchanges have become too risky for major health insurers, and that's creating further doubt about coverage options consumers might have next year.

Anthem CEO Joseph Swedish said Wednesday his company is waiting to see whether the government makes some short-term fixes to the shaky exchanges before it decides how much it will participate next year. The Blue Cross-Blue Shield carrier is the nation's second largest insurer and sells coverage on exchanges in 14 states.

This is a separate and more immediate concern for consumers beyond whether the ACA will continue to exist. Congressional Republicans and President Donald Trump have vowed to repeal and replace the law. Republicans have promised they won't strand those now covered under the program, but they also haven't detailed their replacement plan.

Even if parts of the law continue to exist in some form, as many expect, the insurance exchanges through which millions have bought coverage are in peril. Swedish told Wall Street analysts during a conference call that if Anthem doesn't see stability in the exchanges heading into next year, "then we will begin making some very conscious decisions with respect to extracting ourselves."

The enrollment window for 2018 coverage is still several months away, but insurers have to decide by this spring whether they will participate.

Aetna, the nation's third largest insurer, said Tuesday that it will announce by April 1 whether it will stay in any of the four states where it currently sells coverage. Aetna said it lost $450 million last year on its ACA-compliant coverage — a big hit from a small slice of its overall business.

The losses that insurers have taken from coverage sold on these state-based exchanges in recent years have already prompted some to scale back their participation or raise rates, often dramatically. The higher prices and dwindling choices have made the markets unappealing for many consumers.

Insurers say they've struggled to attract young, healthy customers to their risk pools to help keep coverage costs in check. They also say they've been hurt by expensive customers who use special enrollment periods to sign up for coverage only when they need help paying big medical bills.

Swedish, the Anthem CEO, said Wednesday that his company has had extensive talks with Congressional leaders. Anthem would like to see fewer special enrollment periods and better verification of patients who are eligible, as well as the repeal of a health insurance tax and other fixes.

"While the direction in Washington has been positive, we still need certainty about short-term fixes in order to determine the extent of our participation in the individual market in 2018," he said.

Separately, Tennessee insurance commissioner Julie McPeak told a US Senate panel Wednesday that Congress needs to send the industry a clear signal by March to avoid disrupting the individual health insurance market for 2018.

"You need to provide some indication to plans as a quickly as possible," she told the Health, Education, Labor and Pensions committee.

Representatives of the U.S. Department of Health and Human Services did not respond Wednesday to requests for comment on the exchanges.

Congress may wind up addressing several insurer concerns, but short-term fixes may not be enough to guarantee 2018 exchange participation, according to Gary Claxton, an insurance expert at the nonprofit Kaiser Family Foundation.

Claxton thinks insurers also will watch closely the debate over the fate of the ACA and, with it, the long-term prospects of the individual insurance market.

"Insurers really have to believe they see a future for a little while longer to continue to invest," he said.

Copyright Associated Press / NBC New York



Photo Credit: ap]]>
<![CDATA[Repeal of Health Law Could Mean Women Pay More For Less]]>Thu, 02 Feb 2017 15:55:20 -0400http://media.nbcnewyork.com/images/180*120/ACA.jpg

From a return to higher premiums based on gender, to gaps in coverage for birth control and breast pumps, experts say women could end up paying more for less if the Obama-era health care law is repealed.

The 2010 law ended a common industry practice of charging women more than men for policies purchased directly from an insurer. It made maternity and newborn care a required benefit for individual health plans. And it set a list of preventive services to be provided at no extra cost to women, including birth control and breast pumps used by nursing mothers. That preventive care requirement also applies to most employer plans.

Nearly half of pregnancies are unplanned, and prior to "Obamacare" some women would get pregnant only to learn that their insurance did not cover maternity and delivery, said Dr. John Meigs, a longtime family practitioner in the small town of Centerville, Alabama.

"A lot of women were delaying their prenatal care until they could figure out what to do," said Meigs, president of the American Academy of Family Physicians. Pregnancy "is one of those things that ought to be covered, because it happens."

Democrats are keying in on the issue as they try to block or blunt the GOP drive to repeal the Affordable Care Act. "We don't want our country going backward when it comes to women's health," said Sen. Patty Murray, ranking Democrat on the Health, Education, Labor and Pensions Committee.

Women are widely seen as having benefited from the health law. In a recent AP-NORC poll, 44 percent said they thought women were better off as a result of the law, while only 24 percent said women were worse off.

"The ACA set minimum levels of benefits that health plans have to cover and many are highly used, or exclusively used by women," said Usha Ranji, a health policy expert with the nonpartisan Kaiser Family Foundation. "Repeal and replace could take away that minimum level of benefits, which includes really commonly used services like contraception and maternity care."

Nashville-based singer Rachel Potter worries about what it could mean for her. She says she was lucky to be covered under the ACA when she unexpectedly became pregnant last year.

Bleeding early on and other complications sent her to the doctor's office frequently.

"We were able to monitor the pregnancy really closely," said Potter. "I was able to go to an amazing OB-GYN and I wouldn't have had access to that care if I had not been on this insurance." Her son Jude was born in December and is already on the road with her.

Potter's medical bill came to more than $40,000, but she only paid about $2,000 of that.

She's now thinking about getting a long-lasting form of birth control while her insurer is still required to cover it at no charge to her. "I don't know the future of the health insurance situation," said Potter.

Five doctor groups representing about 500,000 clinicians on Thursday called for maintaining the ACA's women's benefits, along with other protections. The groups include family physicians, the American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists, the American College of Physicians, and the American Osteopathic Association.

A Trump administration spokesman says speculation about components of an "Obamacare" replacement is premature.

Recently introduced legislation that seeks a middle path on health care would keep some of the Obama-era requirements, but make others a state option.

The bill co-authored by Sen. Susan Collins, R-Maine, would allow states to keep the ACA or substitute an alternative with fewer federal requirements.

Under that approach, insurance plans in states that pick the alternative would not be required to cover maternity and newborn care. However, plans in all states would have to cover the ACA's preventive benefits, including birth control. Collins staff said the draft bill is a starting point.

Some "Obamacare" critics argue that required benefits for women have driven up costs for others, for example young men who don't need maternity care. Other experts say the impact on premiums is modest compared to provisions of the law such as guaranteed coverage for people with medical problems and tighter limits on how much older adults can be charged.

"Relative to other market changes, there is no indication that required coverage for women's health benefits was a primary driver of premium increases," said Caroline Pearson of the consulting firm Avalere Health.

Ranji, of the Kaiser Foundation, says the ACA made significant improvements for women. Before the law:

  • Pregnancy, a prior cesarean-section, a history of domestic violence, or problems with depression could be deemed a pre-existing condition, triggering restrictions on coverage or higher premiums.

  • About one-third of plans on the individual insurance market charged women between the age of 25 and 40 premiums at least 30 percent higher than men of the same age.

  • Only about 12 percent of plans available directly to individuals included maternity care.

  • About 20 percent of women of childbearing age covered by large employers spent some of their own money on birth control pills. Currently it's fewer than 4 percent.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Damian Dovarganes]]>
<![CDATA[Tackle Food Safety: Keep Your Food Safe on Game Day]]>Thu, 02 Feb 2017 15:38:06 -0400http://media.nbcnewyork.com/images/213*120/Screen+Shot+2017-02-02+at+2.25.05+PM.pngThe U.S. Food and Drug Administration released a list of food safety tips for Super Bowl party hosts.]]><![CDATA[Science Could Soon Develop Eggs, Sperm From Skin Cells]]>Thu, 02 Feb 2017 08:46:46 -0400http://media.nbcnewyork.com/images/180*120/170131-babies-mn-1600.jpg

The world is on the brink of another revolution thanks to an emerging technology called in vitro gametogenesis, or IVG, which would allow doctors to develop eggs and sperm from a surprising source: skin cells, NBC News reported.

These reproductive cells could then be used to create fertilized embryos to be implanted into a woman's uterus (or, someday, an artificial womb).

Researchers in Japan created viable eggs from the skin cells of adult female mice, which were then fertilized with naturally derived sperm from male mice.

Using the same process in people isn't exactly feasible, so scientists need to find another way to turn primordial germ cells into mature eggs in vitro.

"It's a technology that will come someday, but the question is when and whether it will be completely safe," says Zev Rosenwaks, director of the Center for Reproductive Medicine at Weill Cornell Medicine in New York.



Photo Credit: Blaine Harrington III/Getty Images]]>
<![CDATA[Tuesday Night Is Deadline for Obamacare Coverage]]>Tue, 31 Jan 2017 09:21:19 -0400http://media.nbcnewyork.com/images/213*120/OBAMACARE_AP_16320806519240.jpg

Overnight Tuesday is the deadline to sign up for coverage under the federal health care law. Even if the ultimate fate of Obamacare is uncertain, there's been no change for this year. About 11.5 million people had enrolled as of Dec. 24.

The deadline is midnight Pacific time in the 39 states served by HealthCare.gov, the government said. States with their own insurance websites may have different deadlines.

Although premiums are up significantly this year, more than 8 in 10 customers get subsidies, and more than half qualify for extra help with deductibles and copays.

President Donald Trump and congressional Republicans have promised to repeal and replace the Obama-era law, but without creating disruptions for millions already covered.

Consumers can enroll online or call 1-800-318-2596.

Copyright Associated Press / NBC New York

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<![CDATA[NJ Health Officials: Infant May Have Spread Measles]]>Tue, 31 Jan 2017 07:24:15 -0400http://media.nbcnewyork.com/images/213*120/measles3.jpg

Health officials in New Jersey say that an infant with measles may have exposed people in Passaic County to the highly contagious disease.

The New Jersey DOH said that the 7-month-old infant traveled internationally before returning to the state in mid-to-late January.

Locations of potential exposure include:

• St. Joseph’s Wayne Hospital, 224 Hamburg Tpke., Wayne, NJ 07470:

o Jan. 21, between 6:50 a.m. and 1 p.m.

• Pediatric Emergency Department at St. Joseph’s Regional Medical Center, 703 Main St., Paterson, NJ 07503:

o Jan. 23, between 6:30 a.m. and 3:45 p.m.

Health officials said that anyone exposed to the infant could develop symptoms as late as Feb. 15.

The infant was recovering at home on Monday. Officials said the case is not related to the Hudson County man who got measles while traveling internationally.

The airborne illness can cause serious complications such as pneumonia and swelling of the brain in 20 percent of patients. Measles symptoms include rash, high fever, cough, runny nose and red, watery eyes.

Health officials say children younger than 5 years old and adults older than 20 are especially at risk. Pregnant women who contract the virus can suffer a miscarriage.

Anyone who hasn't been vaccinated or hasn't had measles is at risk if exposed to the virus, officials said.

For more information on what to do if you've been exposed to measles, take a look at this PDF or visit the state's website to learn more about the illness.

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<![CDATA[Little Girls Doubt That Women Can Be Brilliant, Study Shows]]>Fri, 27 Jan 2017 13:02:57 -0400http://media.nbcnewyork.com/images/213*120/education-nation169271319.jpg

Can women be brilliant? Little girls are not so sure.

A study published Thursday in the journal Science suggests that girls as young as 6 can be led to believe men are inherently smarter and more talented than women, making girls less motivated to pursue novel activities or ambitious careers. That such stereotypes exist is hardly a surprise, but the findings show these biases can affect children at a very young age.

"As a society, we associate a high level of intellectual ability with males more than females, and our research suggests that this association is picked up by children as young 6 and 7," said Andrei Cimpian, associate professor in the psychology department at New York University. Cimpian coauthored the study, which looked at 400 children ages 5-7.

In the first part of the study, girls and boys were told a story about a person who is "really, really smart," a child's idea of brilliance, and then asked to identify that person among the photos of two women and two men. The people in the photos were dressed professionally, looked the same age and appeared equally happy. At 5, both boys and girls tended to associate brilliance with their own gender, meaning that most girls chose women and most boys chose men.

But as they became older and began attending school, children apparently began endorsing gender stereotypes. At 6 and 7, girls were "significantly less likely" to pick women. The results were similar when the kids were shown photos of children.

Interestingly, when asked to select children who look like they do well in school, as opposed to being smart, girls tended to pick girls, which means that their perceptions of brilliance are not based on academic performance.

"These stereotypes float free of any objective markers of achievement and intelligence," Cimpian said.

In the second part of the study, children were introduced to two new board games, one described as an activity "for children who are really, really smart" and the other one "for children who try really, really hard." Five-year-old girls and boys were equally likely to want to play the game for smart kids, but at age 6 and 7, boys still wanted to play that game, while girls opted for the other activity.

"There isn't anything about the game itself that becomes less interesting for girls, but rather it's the description of it as being for kids that are really, really smart."

As a result, believing that they are not as gifted as boys, girls tend to shy away from demanding majors and fields, leading to big differences in aspirations and career choices between men and women. "These stereotypes discourage women's pursuit of many prestigious careers; that is, women are underrepresented in fields whose members cherish brilliance," the authors wrote.

It is still unclear where the stereotypes come from. Parents, teachers and peers and the media are the usual suspects, Cimpian said. But it is evident that action must be taken so that these biases don't curtail girls' professional aspirations. "Instill the idea that success in any line of work is not an innate ability, whatever it is, but rather putting your head down, being passionate about what you are doing," Cimpian said, adding that exposure to successful women who can serve as role models also helps.

Toy companies like Mattel, maker of the Barbie doll, have taken steps to try to reduce gender stereotypes. Mattel's "You can be anything" Barbie campaign tells girls that they can be paleontologists, veterinarians or professors, among other careers. The campaign also holds out the possibility that a girl can imagine herself to be a fairy princess.

Rebecca S. Bigler, professor of psychology at the University of Texas at Austin, described Cimpian's study "as exceptionally nice work." She suggested that the stereotypes develop in early elementary school when students are exposed to famous scientists, composers and writers, the "geniuses" of history, who are overwhelmingly men. Bigler said it is important to combine that knowledge with information on gender discrimination.

"We need to explain to children that laws were created specifically to prevent women from becoming great scientists, artists, composers, writers, explorers, and leaders," Bigler added. "Children will then be ... more likely to believe in their own intellectual potential and contribute to social justice and equally by pursuing these careers themselves."

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/Caiaimage]]>
<![CDATA[NJ Becomes 1st State to Offer New Parents Free ‘Baby Boxes’]]>Fri, 27 Jan 2017 16:57:54 -0400http://media.nbcnewyork.com/images/213*120/baby+box+new+jersey.jpg

New Jersey has become the first state where expectant parents can get a free "Baby Box" for their newborn.

The Baby Box Co. announced the Baby Box University program on Thursday. The global integrated program looks to reduce Sudden Unexpected Infant Death Syndrome (SUIDS) and provide a safe start for newborns in the state by providing their parents with potentially life-saving boxes.

The boxes, which are made from a durable cardboard, can be used as a baby's bed for the first months of life. Inside, the box contains diapers, wipes, and other goodies that are worth about $150. 

Expectant parents in New Jersey just need to complete a short parenting education course online to get their free baby box.

 The Baby

The New Jersey Child Fatality and Near Fatality Review Board (CFNFRB) is supporting the program using a grant from the CDC, which reviews fatalities and near-fatalities of children in order to identify their causes, relationship to governmental support systems, and methods of prevention.

The program will distribute approximately 105,000 Baby Boxes in 2017, according to Baby Box Co.

The use of baby boxes has been credited with helping Finland achieve one of the world’s lowest infant mortality rates.

"I'm grateful to the Child Fatality and Near Fatality Review Board for their efforts to promote infant safe sleep," said Commissioner Allison Blake of the New Jersey Department of Children and Families. "Through greater awareness and education, and by working together, we can make sleep time safe time for babies."

"Every year we review instances in which infants die suddenly and unexpectedly," said CFNFRB chair Kathryn McCans.

"In a significant proportion of these deaths, an unsafe sleep circumstance is a contributing factor. Baby Box University will help families make safe and healthy choices for their children by educating them about simple changes that will decrease the risk that a death will occur due to an unsafe sleep environment or SIDS."

The use of Baby Boxes has been credited with helping Finland achieve one of the world's lowest infant mortality rates. The initiative is credited with helping to decrease Finland's infant mortality rate from 65 deaths for each 1,000 children born in 1938 to 1.3 deaths per 1,000 births in 2013, according to the World Health Organization.

Parents can pick up their baby boxes at Cooper University Healthcare, Southern New Jersey Perinatal Cooperative and other locations. They can also have them delivered to their home.

Here’s how New Jersey parents can get a free baby box:

1. Register for free online at babyboxuniversity.com as a New Jersey resident. Be sure to include your correct contact information, including mailing address.

2. Watch the 10-15 minute New Jersey syllabus at babyboxuniversity.com. After taking a short quiz, you will receive a certificate of completion and be able to select local pick-up or direct delivery of your Baby Box.

3. If you select direct delivery, your Baby Box will ship to the address you provided when you registered on Baby Box University. If you select local pick up, bring your Baby Box University certificate to the closest participating distribution partner to collect your Baby Box.

Copyright Associated Press / NBC New York



Photo Credit: Baby Box Co.]]>
<![CDATA[Gore Revives Climate, Health Summit Canceled by CDC]]>Thu, 26 Jan 2017 23:21:46 -0400http://media.nbcnewyork.com/images/213*120/GettyImages-519674944.jpg

A conference on climate change and health is back on but apparently minus the U.S. government.

Several organizers including former Vice President Al Gore have resurrected the meeting set for next month in Atlanta.

The government's top public health agency had planned the conference with the American Public Health Association (APHA), then canceled it in December without explanation.

The APHA says Gore, one of two keynote speakers, stepped in to help keep the meeting alive, NBC News reported.

"I was minding my own business and he picked up the phone and called me," APHA executive director Dr. Georges Benjamin told NBC News.

The decision to hold the meeting was hatched by Benjamin's group, Gore, the University of Washington and the Harvard Global Health Institute.

The one-day meeting is moving from the Centers for Disease Control and Prevention to the Carter Center. 

"It's going to be on climate and health, and in many ways it's going to be a very different meeting," Benjamin said.

Benjamin said he doesn't know if government officials will attend; many had been scheduled to speak at the conference .

An after-hours message to the CDC was not immediately returned.

A recent report by the U.S. government said global warming is a national public health problem. It said climate change is increasing the risk of respiratory problems and spread of disease from insects.

"Some of these health impacts are already underway in the United States," the report said.

In 2015, an international global health commission organized by the British medical journal Lancet said that hundreds of thousands of lives a year are at stake as global warming "threatens to undermine the last half century of gains in development and global health."

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Scientists Take First Steps to Growing Human Organs in Pigs]]>Fri, 27 Jan 2017 08:12:13 -0400http://media.nbcnewyork.com/images/213*120/pig-embryo-research-salk-institute.jpg

Scientists have grown human cells inside pig embryos, a very early step toward the goal of growing livers and other human organs in animals to transplant into people.

The cells made up just a tiny part of each embryo, and the embryos were grown for only a few weeks, researchers reported Thursday.

Such human-animal research has raised ethical concerns. The U.S. government suspended taxpayer funding of experiments in 2015. The new work, done in California and Spain, was paid for by private foundations.

Any growing of human organs in pigs is "far away," said Juan Carlos Izpisua Belmonte of the Salk Institute in La Jolla, California, an author of the paper in the journal Cell.

He said the new research is "just a very early step toward the goal."

Even before that is achieved, he said, putting human cells in animals could pay off for studies of how genetic diseases develop and for screening potential drugs.

Animals with cells from different species are called chimeras. Such mixing has been done before with mice and rats. Larger animals like pigs would be needed to make human-sized organs. That could help ease the shortage of human donors for transplants.

The Salk team is working on making humanized pancreases, hearts and livers in pigs. The animals would grow those organs in place of their own, and they'd be euthanized before the organ is removed.

Most of the organ cells would be human. By injecting pig embryos with stem cells from the person who will get the transplant, the problem of rejection should be minimized, said another Salk researcher, Jun Wu.

Daniel Garry of the University of Minnesota, who is working on chimeras but didn't participate in the new work, called the Cell paper "an exciting initial step for this entire field."

Here's what the new paper reports:

Scientists used human stem cells, which are capable of producing a wide variety of specialized cells. They injected pig embryos made in the lab with three to 10 of those cells apiece, and implanted the embryos into sows. At three to four weeks of development, 186 embryos were removed and examined.

Less than 1 in every 100,000 embryonic cells was human, which still comes to about a million human cells, Wu said. That contribution is lower than expected, he said, "but we were very happy to see we actually can see the human cells after four weeks of development."

The cells generated the precursors of muscle, heart, pancreas, liver and spinal cord tissue in the embryos. The researchers said they plan to test ways to focus human cells on making specific tissues while avoiding any contribution to the brain, sperm or eggs.

That addresses ethical concerns that the approach could accidentally lead to pigs that gain some human qualities in their brains, or make human egg or sperm.

There was no sign of that in the new research. The government, meanwhile, has signaled that it may lift the federal funding ban soon but impose extra oversight of any proposed work.

A pig might not always have to be brought to term, Belmonte and Wu said. Even a pig fetus might provide human pancreatic cells to treat diabetes, or kidney cells to repair injuries to that organ, they said.

The University of Minnesota's Garry said the research offers some direction about what kind of human stem cells will work best. And it shows a need for boosting the number of human cells that appear in the embryo, he said.

Hiromitsu Nakauchi of Stanford University said his own unpublished experiments with pig and sheep embryos also found a sparse contribution from injected human cells. That's a challenge for making organs, but it might be surmounted by focusing cells on doing that job, he said.

Ethics experts were also impressed by the results. "It really does give a green light to explore more," said Insoo Hyun of Case Western Reserve University in Cleveland.

Hyun said he understood why some people might object on moral grounds to making animals with human organs.

"It seems kind of creepy," he said. But "this is a strategy to help save human lives" and so it is justified if properly done, he said.

Copyright Associated Press / NBC New York



Photo Credit: Salk Institute]]>