Tag Archives: health

Mayo Clinic faces questions over CEO’s ‘prioritized’ patients remark

Mayo Clinic is facing questions from the state of Minnesota after its CEO told employees that if patient conditions are equal, its hospitals should prioritize privately insured patients over those under government-subsidized programs such as Medicaid.

John Noseworthy’s comments were made late last year in a videotaped speech to staff but surfaced only this week after a transcript of his speech was obtained by the Star Tribune newspaper.

The Mayo Clinic has verified the transcript is accurate.

Noseworthy said in a statement that medical need will always be the top factor in scheduling an appointment.

“In an internal discussion I used the word ‘prioritized’ and I regret this has caused concerns that Mayo Clinic will not serve patients with government insurance. Nothing could be further from the truth,” he said, adding that the hospital is committed to serving patients with government insurance.

“Changing demographics, aging of Americans and budgetary pressures at state and federal government pose challenges to the fiscal sustainability in healthcare today,” he said. “While these discussions are uncomfortable, they are critical for us to be able to meet the needs of all of our patients.”

Minnesota Department of Human Services Commissioner Emily Piper said she was surprised and concerned by Noseworthy’s earlier comments and has questions about what they really mean and how Noseworthy’s directive would be carried out.

The department is looking into whether there are possible violations of civil and human rights laws.

The agency also is reviewing its contracts with Mayo Clinic to ensure the hospital is meeting its obligations to serve patients in public programs.

Last year, Noseworthy told staff that when Mayo Clinic has expertise that can’t be found elsewhere, it will always take patients, regardless of how they are paying for care.

“We’re asking. if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal, that we prioritize the commercial insured patients enough so . we can be financially strong at the end of the year to continue to advance our mission,” Noseworthy said in the transcript.

Mayo Clinic spokeswoman Duska Anastasijevic said the speech stressed the need to increase privately insured patients, but not at the expense of government insured patients.

Mayo Clinic said about half of the services it provides go toward those enrolled in government programs. The clinic said it provided $629.7 million in care to people in need in 2016, including $546.4 million that wasn’t covered by Medicaid or other programs for the uninsured or underinsured.

The statement said that as Mayo’s percentage of publicly funded patients has grown, to now roughly 50 percent, the health system is working to increase commercially insured patients.

“To fund its research and education mission, Mayo needs to support its commercial insurance patient numbers in order to continue to subsidize the care of patients whose insurance does not cover the cost of their care,” the statement said.

Piper said Noseworthy’s statements do not reflect routine hospital practices and she found them to be troubling.

As Human Services commissioner, Piper is focused on ensuring access to health care for those enrolled in public programs. She said providers have to follow the law and uphold agreements to provide such care. She said that in her view, nothing that is happening with the health care law on the federal level changes those requirements.

“Health insurance coverage for health insurance coverage’s sake is not the end goal,” she said. “It’s access _ that’s what’s important.”

Anastasijevic said Minnesota Medicaid patients are and will continue to be scheduled the same as patients with commercial insurance.

WalletHub: Milwaukee in top 10 cities most affected by ‘Trumpcare’

Source: WalletHub

With the average health-insurance premium estimated to rise 15-20 percent in the next two years and federal tax credits expected to decrease under the recently proposed American Health Care Act, the personal-finance website WalletHub conducted an in-depth analysis of cities most affected by the GOP health plan, which it referred to as “TrumpCare.”

To gauge the impact of the Republican-proposed health plan on people who buy their own insurance, WalletHub’s analysts compared 457 U.S. cities based on the differences in premium subsidies that the average household would receive under “Obamacare” and “Trumpcare.”

The impact on Milwaukee:
 

  • Average Obamacare Premium Subsidy: $5,707
  • Average Trumpcare Premium Subsidy: $5,000
  • Subsidy Difference: -$707
  • Milwaukee ranks 78th most affected overall and 10th most affected among large cities.

On the web

https://wallethub.com/edu/cities-most-affected-by-trumpcare/33588/

Wisconsin League of Conservation Voters: Leading on Lead testimony

The Wisconsin League of Conservation Voters offered testimony in support of Senate Bill 48, or the “Leading on Lead” bill, at a public hearing in front of the Senate Natural Resources and Energy Committee.

The bill, introduced by Committee Chair Sen. Rob Cowles, aims to provide communities new tools to assist homeowners in replacing lead pipes.

League legislative director Jennifer Giegerich issued the following testimony to the committee:

We know at least 81 water systems in Wisconsin have tested for unsafe levels of lead. We also know that between 1996 and 2016 more than 200,000 children were diagnosed as being lead-poisoned.

The threat is real and it can be devastating. Lead – even in the smallest amounts – interferes with the synapses in a child’s brain. This damage manifests as decreased IQ, learning disability, and behavior dysfunction.

Lead leaches into water via lead water mains, lead laterals, old pipes, solder, and fixtures. The threat increases when municipalities replace pipes on public property and homeowners don’t replace them on their property. That’s because more lead is released into the drinking water supply when new lead-free pipes are soldered onto older lead pipes. Currently, water utilities have little flexibility to help homeowners replace lead pipes in their homes and on their property.

This bill would give communities the tools necessary to help get rid of these toxic lead pipes, allowing them to provide greater financial assistance to homeowners replacing them.

We again thank Sen. Cowles for his leadership on this issue and urge members of the committee to support SB 48.

CDC: Number of new HIV infections falls in United States

The United States is seeing a strong and steady decline in the number of new HIV infections.

However, there was a 35 percent increase among gay and bisexual men ages 25-34.

The U.S. Centers for Disease Control and Prevention, which uses blood test results to help date infections, says new HIV infections dropped by nearly 18 percent over six years.

The trend suggests stepped-up efforts to diagnose and treat infections are paying off.

The CDC found that between 2008 and 2014, new infections fell:

  • 18 percent in the overall population, from 45,700 to 37,600.
  • 36 percent among heterosexuals.
  • 56 percent among people who inject drugs.

Two-thirds of the people diagnosed with HIV each year are gay and bisexual men. The CDC saw substantial declines in new infections in very young and in middle-aged men in this group.

However, there was a 35 percent increase in men ages 25 to 34.

The CDC also estimated annual HIV infections in 35 states and reported no state saw an increase.

Seven states showed significant decreases — Georgia, Illinois, Maryland, Pennsylvania, New York, North Carolina and Texas.

Reducing food waste is good for the Earth AND your wallet

Remember how it was when you were a kid sitting at the kitchen table and your mother served up a healthy helping of rutabagas? Gross, right?

You slipped them to the family dog or spooned them into a napkin to get them out of sight. But there was no fooling Mom. Your failed sleight-of-hand resulted in a guilt trip and membership in the Clean Your Plate Club.

Fast-forward to today and you’ll find that wasting food has costly consequences extending well beyond your plate.

“Getting food from the farm to our fork eats up 10 percent of the total U.S. energy budget, uses 50 percent of U.S. land and swallows 80 percent of all freshwater consumed in the United States. Yet 40 percent of food in the United States goes uneaten,” according to the Natural Resources Defense Council.

The environmental advocacy group says that cutting food waste by just 15 percent would help feed more than 25 million people a year “at a time when 1 in 6 Americans lack a secure supply of food to their tables.”

Alice Henneman, an extension educator with the University of Nebraska-Lincoln, puts it another way: “Food tossed is money lost.”

Food rots when dumped in a landfill, and produces methane, a greenhouse gas said to contribute to climate change. Food wasted in stores and restaurants cuts into profits.

But incentives have been introduced to reduce food waste, many of them financial.

“Tax benefits are available for restaurants and stores for donating food,” Henneman said. “People are buying ‘ugly food and vegetables,’ or produce that is misshapen in appearance, in stores because stores are offering them at a discount.”

Michigan State University has been aggressive about fighting food waste in its 10 dining halls, where more than 30,000 meals are served daily.

“Food is expensive,” said Carla Iansiti, sustainability projects manager for MSU’s Culinary Services. “We train our staff members to get the most volume out of their product, only cut what you need for a recipe and be creative about using all the products.”

The university remodeled several of its dining halls to be trayless and stocked them with smaller dishes. “It makes a difference with smaller plates and fewer plates, and people always have the option to come back for more,” Iansiti said.

Additional tips for minimizing food waste:

• Think landfill diversion. Compost your leftovers for better crop or garden production, or mix them with animal feed. Freeze or can surplus garden produce or donate it to a food bank.

• There is value in sizing. Buy things that won’t spoil in quantity.

• Check your garbage. Cook dishes that have proven popular and don’t end up being thrown out.

• Buy often and buy fresh, eating as much as you can before it goes bad. Shop your refrigerator before purchasing more.

• Practice portion control. Share rather than discard leftovers. Ask for a sample when dining out if you’re uncertain about ordering something. Don’t rush through meals.

• Plan “cook-it-up” menus. Check expiration dates and move older food products toward the front of your shelves so they can be used first.

On the Web

For more about reducing food waste, see this Natural Resources Defense Council issue paper.

Deadly backstreet abortions to rise with Trump restrictions

Thousands of women will die from unsafe abortions and millions will have unwanted pregnancies following President Donald Trump’s decision to ban U.S.-funded groups from discussing abortion, activists said this week.

Trump reinstated the so-called global gag rule, affecting U.S. non-governmental organizations working abroad, to signal his opposition to abortion, which is difficult to access legally in many developing countries due to restrictive laws, stigma and poverty.

“Women will go back to unsafe abortion again,” said Kenyan campaigner Rosemary Olale, who teaches teenage girls in Nairobi slums about reproductive health. “You will increase the deaths.”

The East African nation has one of world’s highest abortion rates and most abortions are unsafe and a leading cause of preventable injury and death among women, government data shows.

Globally, 21.6 million women have unsafe abortions each year, nine out of 10 of which take place in developing countries, according the World Health Organization.

The gag rule, formally known as the Mexico City Policy, prevents charities receiving U.S. funding from performing or telling women about legal options for abortion, even if they use separate money for abortion services, counseling or referrals.

It will hit major reproductive health charities, such as International Planned Parenthood Federation and Marie Stopes International, as the United States is the world’s largest bilateral family planning donor.

Unless it receives alternative funding to support its services, MSI estimates there will be 2.1 million unsafe abortions and 21,700 maternal deaths during Trump’s first term that could have been prevented.

“Abortion is a fundamental right for women and also very necessary public health intervention,” said Maaike van Min, MSI’s London-based strategy director.

MSI has been receiving $30 million per year in U.S. Agency for International Development funding to provide 1.5 million women in more than a dozen countries with family planning services.

It will have to cut these services unless it finds other donors, the charity said.

“Women won’t be able to finish their education (or) pursue the career that they might have, because they don’t have control over their fertility,” said van Min.

“Aid is under pressure everywhere in the world and so finding donors who have the ability to fund this gap is going to be challenging.”

INHUMAN

Women who live in remote areas without government services will suffer most, van Min said, highlighting mothers in Nigeria and Madagascar where MIS has large programs.

“If they don’t now control their fertility, they are at high risk for maternal mortality,” she said. “I remember this lady who had had too many pregnancies and she came up to me … in this village and she was like: ‘Can you make it stop?'”

Other important health services are also likely to be cut, said Evelyne Opondo, Africa director for the Center for Reproductive Rights advocacy group, recalling the large number of facilities that closed down in Kenya after President George W. Bush came to power in 2001 and reinstated the gag rule.

“They refused to adhere to the global gag rule so they lost quite a substantial amount of funding,” she told the Thomson Reuters Foundation in a phone interview.

“They were also forced to drastically reduce other services that they were providing, including for survivors of sexual violence (and) for HIV.”

Abortion rates across sub-Saharan Africa increased during the Bush administration, according to a WHO study.

“It’s really unfortunate that the lives and the health of so many women are subject to the whims of American politics,” Opondo said. “This is really unethical, if not inhuman.”

Reporting by Neha Wadekar; Editing by Katy Migiro and Ros Russell. This report is from Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s rights, trafficking, property rights and climate change. Visit http://news.trust.org to see more stories.

Consumer groups petition fast-food chains to reduce antibiotic use

Consumer health and food safety groups this week called on 16 fast-food restaurants to stop the unnecessary use of antibiotics in their meat and poultry supply.

Medical experts say the overuse of antibiotics in livestock poses a public health threat by increasing the spread of deadly drug-resistant bacteria.

The 16 restaurants petitioned by the organizations received “F” grades for failing to take steps to end the misuse of medical important antibiotics in the Chain Reaction scorecard, a report published by the Center for Food Safety, Consumers Union, Friends of the Earth, NRDC and Food Animals Concerns Trust.

A statement from the coalition this week says Burger King received an F and, despite an announcement in December to make certain changes regarding antibiotics in the chicken supply chain, still lags far behind McDonald’s.

McDonald’s has removed medically important antibiotics from its chicken supply chain, but Burger King has committed to removing only limited group of antibiotics classified as “critically important” to human medicine, by the end of 2017.

“The global increase in antibiotic-resistant infections is a public health disaster, and it is essential that our biggest restaurant chains do their part to address this growing problem right away,” said Cameron Harsh of the Center for Food Safety.

The petition effort is the latest in a series of campaigns intended to pressure such companies as KFC, Olive Garden, Chili’s and Starbucks to help protect public health and animal welfare by committing to meat and poultry raised without routine antibiotics.

The performance of these companies contrasts sharply with nine of the largest chains — including McDonald’s, Wendy’s, Chipotle and Panera, which received passing grades in the report.

“KFC and the other restaurants that received failing grades are making our antibiotics crisis worse,” said Jean Halloran, director of food policy initiatives at Consumers Union, the policy division of Consumer Reports. “Antibiotics should only be used to treat disease, not wasted on healthy animals or to compensate for filthy conditions on factory farms. It’s time for restaurants to help protect public health by demanding that their suppliers end the irresponsible use of these important medications.”

“When consumers eat a chicken sandwich they shouldn’t have to worry that doing so is potentially undermining antibiotics. They should just enjoy the sandwich,” said Matthew Wellington, field director of the antibiotics program for U.S. PIRG. “More major chains like KFC need to act on antibiotics. We simply cannot afford to lose the foundations of modern medicine.”

Consumer advocacy and food safety groups say that in the absence of mandatory government regulations on agricultural uses of antibiotics in the United States, restaurants should demonstrate their commitment to public health by ending the misuse of antibiotics in their meat and poultry supply chains.

Some background on the issue…

Most meat served by U.S. chain restaurants comes from animals raised in factory farms. The animals often are fed antibiotics to prevent diseases that occur in crowded, unsanitary living conditions and also to promote faster growth.

According to the U.S. Centers for Disease Control and Prevention, regularly dosing animals with antibiotics contributes to rising cases of infections in humans that are resistant to important medicines.

The spread of resistant pathogens means that infections are harder to treat, require longer hospitalizations, and pose greater risk of death. World Health Organization reports that “antibiotic resistance is one of the biggest threats to global health, food security and development today.”

CDC considers lowering threshold for lead exposure

The CDC is considering lowering its threshold for elevated childhood blood lead levels by 30 percent, a shift that could help health practitioners identify more children afflicted by the heavy metal.

Since 2012, the U.S. Centers for Disease Control and Prevention, which sets public health standards for exposure to lead, has used a blood lead threshold of 5 micrograms per deciliter for children under age 6.

While no level of lead exposure is safe for children, those who test at or above that level warrant a public health response, the agency says.

Based on new data from a national health survey, the CDC may lower its reference level to 3.5 micrograms per deciliter in the coming months, according to six people briefed by the agency.

The measure will come up for discussion at a CDC meeting Jan. 17 in Atlanta.

But the step, which has been under consideration for months, could prove controversial. One concern: Lowering the threshold could drain sparse resources from the public health response to children who need the most help – those with far higher lead levels.

The CDC did not respond to a request for comment.

Exposure to lead — typically in peeling old paint, tainted water or contaminated soil — can cause cognitive impairment and other irreversible health impacts.

The CDC adjusts its threshold periodically as nationwide average levels drop. The threshold value is meant to identify children whose blood lead levels put them among the 2.5 percent of those with the heaviest exposure.

“Lead has no biological function in the body, and so the less there is of it in the body the better,” Bernard M Y Cheung, a University of Hong Kong professor who studies lead data, told Reuters. “The revision in the blood lead reference level is to push local governments to tighten the regulations on lead in the environment.”

The federal agency is talking with state health officials, laboratory operators, medical device makers and public housing authorities about how and when to implement a new threshold.

Since lead was banned in paint and phased out of gasoline nearly 40 years ago, average childhood blood lead levels have fallen more than 90 percent. The average is now around 1 microgram per deciliter.

Yet progress has been uneven, and lead poisoning remains an urgent problem in many U.S. communities.

A Reuters investigation published this month found nearly 3,000 areas with recently recorded lead poisoning rates of at least 10 percent, or double those in Flint, Michigan, during that city’s water crisis.

More than 1,100 of these communities had a rate of elevated blood tests at least four times higher than in Flint.

In the worst-affected urban areas, up to 50 percent of children tested in recent years had elevated lead levels.

The CDC has estimated that as many as 500,000 U.S. children have lead levels at or above the current threshold. The agency encourages “case management” for these children, which is often carried out by state or local health departments and can involve educating families about lead safety, ordering more blood tests, home inspections or remediation.

Any change in the threshold level carries financial implications. The CDC budget for assisting states with lead safety programs this year was just $17 million, and many state or local health departments are understaffed to treat children who test high.

Another concern: Many lead testing devices or labs currently have trouble identifying blood lead levels in the 3 micrograms per deciliter range. Test results can have margins of error.

“You could get false positives and false negatives,” said Rad Cunningham, an epidemiologist with the Washington State Department of Health. “It’s just not very sensitive in that range.”

The CDC doesn’t hold regulatory power, leaving states to make their own decisions on how to proceed. Many have yet to adapt their lead poisoning prevention programs to the last reference change, implemented four years ago, when the level dropped from 10 to 5 micrograms per deciliter. Other states, including Virginia and Maine, made changes this year.

The U.S. Department of Housing and Urban Development is close to adopting a rule requiring an environmental inspection — and lead cleanup if hazards are found — in any public housing units where a young child tests at or above the CDC threshold.

If the CDC urges public health action under a new threshold, HUD said it will follow through. “The only thing that will affect our policy is the CDC recommendation for environmental intervention,” said Dr. Warren Friedman, with HUD’s Office of Lead Hazard Control and Healthy Homes.

To set the reference value, the CDC relies upon data from the National Health and Nutrition Survey. The latest data suggests that a small child with a blood lead level of 3.5 micrograms per deciliter has higher exposure than 97.5 percent of others in the age group, 1 to 5 years.

But in lead-poisoning hotspots, a far greater portion of children have higher lead levels. Wisconsin data, for instance, shows that around 10 percent of children tested in Milwaukee’s most poisoned census tracts had levels double the current CDC standard.

Some worry a lower threshold could produce the opposite effect sought, by diverting money and attention away from children with the worst exposure.

“A lower reference level may actually do harm by masking reality – that significant levels of lead exposure are still a problem throughout the country,” said Amy Winslow, chief executive of Magellan Diagnostics, whose blood lead testing machines are used in thousands of U.S. clinics.

Shots urged as flu cases rise in Wisconsin

Wisconsin health officials say flu cases are on the rise and they are urging people to take precautions like getting a flu shot.

The Wisconsin Department of Health Services said on Dec. 28 there had been 161 influenza cases so far this season, and 95 hospitalizations, including eight children and 78 adults age 50 and older. Of those hospitalized with influenza, 63 percent were 65 or older.

State Health officer Karen McKeown says getting a flu shot is still one of the best ways to protect yourself and your family and friends from complications of the flu.

McKeown says other steps include practicing good hand-washing hygiene, covering your cough and not sharing drinking cups and straws.

 

Minnesota is leading the rest of country in banning germ-killer triclosan

Minnesota’s first-in-the nation ban on soaps containing the once ubiquitous germ-killer triclosan takes effect Jan. 1, but the people who spearheaded the law say it’s already having its desired effect on a national level.

The federal government caught up to Minnesota’s 2014 decision with its own ban that takes effect in September 2017. Major manufacturers have largely phased out the chemical already, with some products being marketed as triclosan-free.

And it’s an example of how changes can start at a local level.

“I wanted it to change the national situation with triclosan and it certainly has contributed to that,” said state Sen. John Marty, an author of Minnesota’s ban.

Triclosan once was widely used in anti-bacterial soaps, deodorants and even toothpaste. But studies began to show it could disrupt sex and thyroid hormones and other bodily functions, and scientists were concerned routine use could contribute to the development of resistant bacteria. And University of Minnesota research found that triclosan can break down into potentially harmful dioxins in lakes and rivers.

The group Friends of the Mississippi River and its allies in the Legislature, including Marty, got Gov. Mark Dayton to sign a ban in 2014 that gave the industry until Jan. 1, 2017, to comply.

In September, the FDA banned triclosan along with 18 other anti-bacterial chemicals from soaps nationwide, saying manufacturers had failed to show they were safe or more effective at killing germs than plain soap and water. However, the FDA allowed the use of some triclosan products such as Colgate Total toothpaste, saying it’s effective at preventing gingivitis.

Marty and Trevor Russell, the water program director for Friends of the Mississippi River, acknowledged they can’t take direct credit for the FDA’s action because that rulemaking process began in 1978, though it didn’t finalize the rule until after a legal battle with the Natural Resources Defense Council.

However, the Minnesota men hope their efforts helped turn opinions against the chemical and are confident the state’s ban helped prod manufacturers to accelerate a phase-out that some companies such as Procter & Gamble and Johnson & Johnson had already begun.

Most major brands are now reformulated, said Brian Sansoni, spokesman for the American Cleaning Institute, a lobbying group. Soaps containing triclosan on store shelves are likely stocks that retailers are just using up, he said.

Russell noted he recently found Dial liquid anti-bacterial hand soap at two local Wal-Marts, two supermarkets and a Walgreens.

The industry is now submitting data to the FDA on the safety and effectiveness of the three main replacements, benzalkonium chloride, benzethonium chloride and chloroxylenol.

“Consumers can continue to use these products with confidence, like they always have,” Sansoni said.

By going first, Russell said, Minnesota can identify any issues with implementing the ban and share it with the rest of the country.

The Minnesota Department of Health will remind consumers and businesses of the ban’s start.