Health & Fitness (205)
WASHINGTON (AP) -- Consumers anxious over tight insurance deadlines and lingering computer problems during the holidays will get extra time to pay their premiums under President Barack Obama's health care law, insurers announced Wednesday.
The board of the industry's biggest trade group - America's Health Insurance Plans - said consumers who select a plan by Dec. 23 will now have until Jan. 10 to pay their first month's premium. That's 10 extra days beyond a New Year's Eve deadline set by the government.
The voluntary move comes as insurers and the government try to head off anticipated problems around the first of the year, when new coverage options for the uninsured take effect under Obama's law, and when several million people whose existing policies were canceled must switch to new plans.
Expect even bigger political trouble for the president if consumers who made a good-faith effort to get covered through the government's balky website show up at the pharmacy and can't get prescriptions filled, or if they turn up in the emergency room and there's no record that they are enrolled. The stakes would be higher this time because someone's health could be jeopardized.
The administration applauded the industry decision. It will "ultimately make it easier for consumers to enroll" through the new online insurance markets, said Health and Human Services spokeswoman Joanne Peters. The federal HealthCare.gov website is now working reasonably well, but insurers still report accuracy problems with enrollment information the government is sending about their new customers.
Karen Ignagni, CEO of the industry group, said the decision was taken "to give consumers greater peace of mind about their health care coverage." AHIP represents about 95 percent of the industry, including the major national carriers and nearly all the BlueCross BlueShield plans.
There may be a few insurers who do not follow the group's lead, so consumers are advised to check with their carrier. Consumers must pay their first month's premium on time for coverage to take effect.
The move burnishes the industry's image and has no real downside, said Dan Mendelson, CEO of Avalare Health, a market analysis firm. "It's useful for the consumer and not a problem for the plans," he said.
Insurers will still get paid for January. "They can book the revenue, and they don't need to worry about the cash flow," Mendelson said.
But the announcement does more than grant extra time. It also reduces the risk that consumers switching plans could suffer an interruption in coverage because of the technology woes encountered by the federal sign-up system, and some state-run websites.
That's particularly important for at least 4 million people whose existing individual plans were canceled because they did not meet standards under Obama's law. Disruptions in coverage for those consumers could have major political consequences for Obama and beleaguered HHS Secretary Kathleen Sebelius.
Back in 2009, Obama had promised that people who liked their insurance would be able to keep it under his health overhaul plan. But that guarantee was shredded by the wave of cancellation notices, which crested right around the same time that HealthCare.gov was refusing to function for millions of potential customers. Obama's poll ratings took a nosedive.
Under the industry announcement, consumers still must select a plan by Dec. 23 - next Monday.
But instead of having to pay their first month's premium by New Year's Eve, they now have until Jan. 10. That would let them have coverage retroactive to Jan. 1. Patients who get a pharmacy or medical bill during that period can later submit it to the insurance company for payment.
Insurers have complained that a significant number of the enrollments they have gotten from HealthCare.gov have problems that could prevent a consumer from getting covered on Jan. 1. That includes missing or incomplete information, duplicative entries and garble. The administration says its technical experts are aggressively tackling the problems, and that errors have been cut dramatically. But insurers say useless or corrupted files are still getting through. Government and industry are working together to clean up the records.
Without the extra time granted Wednesday, a consumer who paid in early January would have had to wait until Feb. 1 for coverage.
BEIJING (AP) -- Chinese authorities said Wednesday that a 73-year-old Chinese woman died after being infected with a bird flu strain that had sickened a human for the first time, a development that the World Health Organization called "worrisome."
China's Center for Disease Control and Prevention confirmed the woman in the city of Nanchang had been infected by the H10N8 bird flu virus, a strain that had not previously been found in people, the Jiangxi province health department said on its website.
This is the second new bird flu strain to emerge in humans this year in China. In late March, the H7N9 bird flu virus broke out, infecting 140 people and killing 45, almost all of them on the mainland. The outbreak was controlled after the country closed many of its live animal markets - scientists had assumed the virus was infecting people through exposure to live birds.
Timothy O'Leary, spokesman for the World Health Organization's regional office in Manila, said WHO officials were working closely with Chinese authorities to better understand the new virus. He said though its source remains unknown, birds are known to carry it and it would not be surprising if another human case was detected.
"It's worrisome any time a disease jumps the species barrier from animals to humans. That said, the case is under investigation (by Chinese authorities) and there's no evidence of human-to-human transmission yet," O'Leary said by phone.
In the new case, the Jiangxi health department said the woman had severe pneumonia before dying Dec. 6 in a hospital in Nanchang.
She had suffered high blood pressure, heart disease and other underlying health problems that lowered her immunity, the health department said. Her medical history showed that she had been in contact with live poultry.
The health department said "no abnormalities" have been found in people who had close contact with her. It did not say if they had been tested or quarantined, though China has in previous outbreaks taken those measures.
Experts are cautious when it comes to bird flu viruses infecting humans. They have been closely watching the H5N1 bird flu virus, which has killed 384 people worldwide since 2003. The virus remains hard to catch with most human infections linked to contact with infected poultry, but scientists fear it could mutate and spread rapidly among people, potentially sparking a pandemic.
WASHINGTON (AP) -- After more than 40 years of study, the U.S. government says it has found no evidence that common anti-bacterial soaps prevent the spread of germs, and regulators want the makers of Dawn, Dial and other household staples to prove that their products do not pose health risks to consumers.
Scientists at the Food and Drug Administration announced Monday that they are revisiting the safety of triclosan and other sanitizing agents found in soap in countless kitchens and bathrooms. Recent studies suggest triclosan and similar substances can interfere with hormone levels in lab animals and spur the growth of drug-resistant bacteria.
The government's preliminary ruling lends new support to outside researchers who have long argued that the chemicals are, at best, ineffective and at worst, a threat to public health.
"The FDA is finally making a judgment call here and asking industry to show us that these products are better than soap and water, and the data don't substantiate that," said Stuart Levy of the Tufts University School of Medicine.
While the rule only applies to personal hygiene products, it has implications for a broader $1 billion industry that includes thousands of anti-bacterial products, including kitchen knives, toys, pacifiers and toothpaste. Over the last 20 years, companies have added triclosan and other cleaners to thousands of household products, touting their germ-killing benefits.
Under a proposed rule released Monday, the agency will require manufacturers to prove that anti-bacterial soaps are safe and more effective than plain soap and water. Products that are not shown to be safe and effective by late 2016 would have to be reformulated, relabeled or removed from the market.
"I suspect there are a lot of consumers who assume that by using an anti-bacterial soap product, they are protecting themselves from illness, protecting their families," said Sandra Kweder, deputy director in the FDA's drug center. "But we don't have any evidence that that is really the case over simple soap and water."
A spokesman for the cleaning product industry said the FDA already has "a wealth of data" showing the benefits of anti-bacterial products.
Monday's action affects virtually all soap products labeled anti-bacterial, including popular brands from CVS, Bath and Body Works, Ajax and many other companies.
The rule does not apply to hand sanitizers, most of which use alcohol rather than anti-bacterial chemicals.
An FDA analysis estimates it will cost companies $112.2 million to $368.8 million to comply with the new regulations, including reformulating some products and removing marketing claims from others.
The agency will accept data from companies and researchers for one year before beginning to finalize the rule.
The proposal comes more than four decades after the FDA began evaluating triclosan, triclocarban and similar ingredients. The government only agreed to publish its findings after a three-year legal battle with the Natural Resources Defense Council, an environmental group that accused the FDA of delaying action on potentially dangerous chemicals.
Triclosan is found in an estimated 75 percent of anti-bacterial liquid soaps and body washes in the U.S. More than 93 percent of anti-bacterial bar soaps also contain triclosan or triclocarban, according to the FDA.
Some consumers said the FDA ruling would have little effect on their buying habits, since they already avoid anti-bacterial soaps and scrubs.
"The regular soap works fine for me. And if I was to think about it, I would guess that those anti-bacterial soaps probably have more toxins," said Marco Cegarra, of Fort Lauderdale, Fla.
Diane McLean, of Washington, D.C., thought the soaps always "seemed like a bad idea" because of concerns about creating drug-resistant bacteria.
The FDA was asked to investigate anti-bacterial chemicals in 1972 as part of a law designed to set guidelines for dozens of common cleaners. But the guidelines got bogged down in years of regulatory delays and missed deadlines. The agency published a preliminary draft of its findings in 1978, but never finalized the results until Monday.
Most of the research surrounding triclosan's safety involves laboratory animals, including studies in rats that showed changes in testosterone, estrogen and thyroid hormones. Some scientists worry that such changes in humans could raise the risk of infertility, early puberty and even cancer.
FDA scientists stressed Monday that such studies are not necessarily applicable to humans, but the agency is reviewing their implications.
On a conference call with journalists, Kweder noted that the government's National Toxicology Program is already studying whether daily skin exposure to hormone-altering chemicals could lead to cancer.
Other experts are concerned that routine use of anti-bacterial chemicals such as triclosan contributes to the emergence of drug-resistant germs, or superbugs, that render antibiotics ineffective.
In March 2010, the European Union banned the chemical from all products that come into contact with food, such as containers and silverware.
A spokesman for the American Cleaning Institute, a soap cleaning product trade organization, said the group will submit new data to regulators, including studies showing that company products do not lead to antibiotic resistance.
"We are perplexed that the agency would suggest there is no evidence that anti-bacterial soaps are beneficial," said Brian Sansoni. "Our industry sent the FDA in-depth data in 2008 showing that anti-bacterial soaps are more effective in killing germs when compared with non-anti-bacterial soaps."
The group represents manufacturers including Henkel, Unilever and Dow Chemical Co.
ELMHURST, Ill. (AP) -- World leaders set a goal for a cure or treatment for dementia by 2025 at the recent G8 summit in London.
But for now, caregiving is among the most pressing issue for people with Alzheimer's and other forms of dementia.
The Chicago-based Alzheimer's Association says there are an estimated 15 million caregivers in the United States. And as baby boomers age and live longer, those numbers are expected to grow.
Katie Halloran, a 29-year-old teacher from suburban Chicago, is one of those caregivers.
She races home each day to her 62-year-old father Mike, who has Alzheimer's, to take over for his paid caregiver. As his condition worsens, she and her siblings are considering full-time care - a move Katie dreads.
SAN ANTONIO (AP) -- Tens of thousands of women each year might be able to skip at least some of the grueling treatments for breast cancer - which can include surgery, heavy chemo and radiation - without greatly harming their odds of survival, new research suggests.
The research is aimed at curbing overtreatment, a big problem in cancer care. Treatments help many women beat the disease, but giving too many or ones that aren't really needed causes unnecessary expense, trauma and lifelong side effects, such as arm swelling and heart troubles. Radiation can even raise the risk of new cancers.
Several studies presented Wednesday at the San Antonio Breast Cancer Symposium, an international conference on the disease, identify groups of patients who might be able to safely forgo certain treatments.
One found that many older women can skip radiation after surgery for early-stage tumors. Two others suggest that surgery may not help patients whose cancer has already spread widely. A fourth study tested a "light chemo" combination that could become a new standard of care.
The trend is "less and less therapy" for certain cancer types, said one conference leader, Dr. C. Kent Osborne of Baylor College of Medicine.
Breast cancer is already widely spread in 5 to 20 percent of newly diagnosed patients, and at that point is usually incurable. The main treatment is chemotherapy or hormone treatments that attack cancer throughout the body. Sometimes doctors also remove the breast tumor in hope of prolonging survival, but this has not been put to a hard test.
Dr. Rajendra Badwe, director of the Tata Memorial Hospital in Mumbai, India, led a study of 350 women with widely spread cancers that had shrunk after initial chemotherapy. Half were given surgery to remove the breast or the lump plus any cancerous lymph nodes. The rest did not have surgery.
After about two years, 40 percent of both groups were alive, suggesting that medicines are enough and that these women can be spared the ordeal of having all or part of a breast removed.
A second study by Dr. Atilla Soran of the University of Pittsburgh Medical Center of nearly 300 women in Turkey also suggests surgery is not helping, though there were hints that some groups did better or worse. Surgery seemed to help if cancer had spread just to bone, and it appeared to do harm if it had spread to the liver or lungs.
"These are incredibly important, big-deal studies," said Dr. Claudine Isaacs, a breast specialist at Georgetown University's Lombardi Comprehensive Cancer Center. Many doctors jumped on earlier, less rigorous studies and advised women to have surgery, and this should be a warning against that, she said.
The results also may spur interest in a U.S. study on the topic. Dr. Seema Khan of Northwestern University in Chicago has had so much trouble recruiting participants that she lowered her goal and may not be able to answer the question.
"There's a huge amount of bias" among doctors and patients about what is best, she said.
Most breast cancers are found at an early stage, and many women are treated with surgery followed by hormones or chemotherapy, plus radiation. But cancer medicines have gotten so good at lowering the risk of a recurrence that doctors wonder whether the radiation is still needed. It can cause heart and other problems, especially in older women, and three or four weeks of daily treatments can be a burden.
Dr. Ian Kunkler of the University of Edinburgh in Scotland led a study of 1,326 patients 65 or older with early-stage cancers whose growth was driven by hormones. This is the most common form of the disease and the age group that accounts for most cases. Half were given radiation and half skipped it.
After five years, roughly 96 percent of both groups were alive, and most deaths were not from breast cancer. About 1 percent of those given radiation had cancer recur in the treated breast versus 4 percent of those who skipped radiation.
For every 100 women given radiation, "one will have a recurrence anyway, four will have a recurrence prevented, but 95 will have had unnecessary treatment," Kunkler said. Since radiation did not affect survival or the risk of cancer spreading, skipping it "is a reasonable option."
Doctors are unsure how to treat women with small tumors involving the gene that the drug Herceptin targets. Those tumors are low risk because they're still confined to the breast, but high risk because the gene is thought to make them more aggressive. Some women get heavy-duty chemo, including drugs that can damage the heart.
Dr. Eric Winer of the Dana-Farber Cancer Institute in Boston led a study of 406 women given "light chemo" - paclitaxel plus Herceptin for 12 weeks, followed by nine months of Herceptin alone. More than three years later, only four had cancer recur in the same breast, and two had recurrences in other places.
"This is likely to become a new standard," Winer said.
The cancer conference is sponsored by the American Association for Cancer Research, Baylor and the UT Health Science Center.
Marilynn Marchione can be followed at HTTP://TWITTER.COM/MMARCHIONEAP
JEFFERSON CITY, Mo. (AP) -- The slow rollout of a new federal health insurance marketplace may be deepening differences in health coverage among Americans, with residents in some states gaining insurance at a far greater rate than others.
The demarcation may be as simple as Democrat and Republican.
Newly released federal figures show more people are picking private insurance plans or being routed to Medicaid programs in states with Democratic leaders who have fully embraced the federal health care law than in states where Republican elected officials have derisively rejected what they call "Obamacare."
On one side of the political divide are a dozen mostly Democratic leaning states, including California, Minnesota and New York. They have both expanded Medicaid for lower-income adults and started their own health insurance exchanges for people to shop for federally subsidized private insurance.
On the other side are two dozen conservative states, such as Texas, Florida and Missouri. They have both rejected the Medicaid expansion and refused any role in running an online insurance exchange, leaving that entirely to the federal government.
The new federal figures, providing a state-by-state breakdown of enrollment in the new health care program through November, showed that the political differences among leaders over the initiative are turning into differences in participation among the uninsured.
Even though many conservative states have higher levels of poverty and more people without health coverage, fewer of them may receive new insurance, said Dylan Roby, an assistant public health professor at the Center for Health Policy Research at the University of California, Los Angeles.
With the patchwork implementation of the federal health care law, "the gap will exacerbate," Roby said
The U.S. Health and Human Services Department reported this week that 364,682 people had signed up for private coverage through the new health insurance marketplaces as of Nov. 30 and an additional 803,077 had been determined eligible for Medicaid.
But the rate of residents gaining health coverage was more than three times as great in the states embracing the federal health care law than in those whose leaders have resisted it.
In the dozen states embracing the overhaul, more than 50 percent of those who applied for coverage picked an insurance plan or were eligible for Medicaid. That rate was barely 15 percent in the two dozen states that aren't cooperating in the implementation of the federal health care law.
"It's very frustrating," said U.S. Sen. Claire McCaskill, a Missouri Democrat who voted for the federal law only to see it twice rebuffed in a statewide vote and repeatedly rejected by her home state's Republican-led state Legislature.
"The political point has trumped the services that Missourians need," McCaskill said.
In Texas, which has the highest rate of uninsured residents in the U.S., the GOP-controlled state Legislature opted not to create a state-run insurance marketplace and Republican Gov. Rick Perry also declined to expand Medicaid to cover more of the working poor. As of the end of November, just 14,000 Texans had signed up for insurance through the federally run marketplace and fewer than 17,000 of the nearly 245,000 applicants on the exchange had been determined to be eligible for Medicaid.
State Rep. Trey Martinez Fischer, a Democrat from San Antonio who chairs the Mexican American Legislative Caucus, said he nonetheless remains optimistic about the meager numbers.
"To know that there are people who, despite those odds, are still enrolling is encouraging," Fischer said.
In California, which also has a high uninsured rate, more than 107,000 people had picked an insurance plan through the state-run marketplace as of the end of November, and nearly 182,000 others had been determined eligible for Medicaid. That means nearly two-thirds of the 448,133 individuals who applied through the insurance exchange could gain some sort of coverage.
Federal grants in California have helped finance TV and radio commercials, billboards, bus signs and town hall meetings encouraging people to participate in the new health insurance marketplace.
That sort of promotion has been lacking in many of the states that have refused to run their own insurance marketplaces.
In Missouri, where a law forbids the government from implementing an insurance exchange, a coalition supporting the marketplace delayed its promotional campaign because of the technical troubles that marred the launch of the federal website.
"We didn't want to drive people to a frustrating experience," said Thomas McAuliffe, a policy analyst at the nonprofit Missouri Foundation for Health.
Now, advocates for the federal law face a steep challenge to implore people to sign up by Dec. 23, which is the deadline to be covered by health insurance policies that take effect in January.
"When we look at enrollment numbers, we're obviously going to lag behind, because in many parts of the state there's still a sense that Obamacare is not going to help me - even by the people it's going to help the most," McAuliffe said.
Heather McCabe, an assistant professor of social work at Indiana University-Purdue University Indianapolis, said the low enrollment numbers in many states raise questions about whether people are turned off by the problematic website, don't know they're eligible to use the exchange or have found the policies unaffordable.
"If the answer is that people still don't understand what the exchange is and how to use it, then the answer is we need to do education and help people better access the system," she said. "But if the answer is that the premiums are too high, then we have an issue that's a little more difficult to deal with."
Associated Press writers Will Weissert in Austin, Texas, and Rick Callahan in Indianapolis contributed to this report.
PHILADELPHIA (AP) -- Need a hand lifting something? A robotic device invented by University of Pennsylvania engineering students can help its wearer carry an additional 40 pounds.
Titan Arm looks and sounds like part of a superhero's costume. But its creators say it's designed for ordinary people - those who need either physical rehabilitation or a little extra muscle for their job.
In technical terms, the apparatus is an untethered, upper-body exoskeleton; to the layman, it's essentially a battery-powered arm brace attached to a backpack. Either way, Titan Arm's cost-efficient design has won the team accolades and at least $75,000 in prize money.
"They built something that people can relate to," said Robert Carpick, chairman of Penn's mechanical engineering department. "And of course it appeals clearly to what we've all seen in so many science-fiction movies of superhuman strength being endowed by an exoskeleton."
The project builds on existing studies of such body equipment, sometimes called "wearable robots." Research companies have built lower-body exoskeletons that help paralyzed people walk, though current models aren't approved for retail and can cost $50,000 to $100,000.
The Penn students were moved by the power of that concept - restoring mobility to those who have suffered traumas - as well as the idea of preventing injuries in those who perform repetitive heavy-lifting tasks, team member Nick Parrotta said.
"When we started talking to physical therapists and prospective users, or people who have gone through these types of injuries, we just kept on getting more and more motivated," said Parrotta, now in graduate school at the university.
So for their senior capstone project last year, Parrotta and classmates Elizabeth Beattie, Nick McGill and Niko Vladimirov set out to develop an affordable, lightweight suit for the right arm. They modeled pieces using 3-D printers and computer design programs, eventually making most components out of aluminum, Beattie said.
The final product cost less than $2,000 and weighs 18 pounds - less than the backpack that Beattie usually carries. A handheld joystick controls motorized cables that raise and lower the arm; sensors measure the wearer's range of motion to help track rehab progress.
Since its unveiling, Titan Arm has won the $10,000 Intel Cornell Cup USA and the $65,000 James Dyson Award. The resulting publicity generated a slew of interest from potential users, including grandparents who find it hard to lift their grandchildren.
"We found out that some people can't even lift a cast-iron pan to cook dinner," McGill said.
Experts say the aging population represents a potentially big customer base for exoskeletons, which originally were researched for military applications.
"There is certainly a market, but it's slowly emerging because the systems are not perfect as yet," said Paolo Bonato, director of the Motion Analysis Lab at Spaulding Rehabilitation Hospital in Boston.
Titan Arm's design impressed Yong-Lae Park, an assistant professor of robotics at Carnegie Mellon University in Pittsburgh who watched a video demonstration. He noted, though, that its low cost represent parts only, not the salaries or marketing built into the price of other products.
Park's research is focused on making exoskeletons less noticeable - "more like a Spider-Man suit than an Iron Man suit," he said.
The Titan team hopes to refine its prototype, although three members are now busy with graduate studies at Penn and one is working on the West Coast.
Among the considerations, Parrotta said, are different control strategies and more innovative materials and manufacturing.
And, of course, a second arm.