The virtual doctor is in: Contactless consultations in the time of COVID-19

MANILA -- Her finger painful and swollen, Yazhmin Malajito tapped on her smartphone for a cure, mindful that she needs to stay at home due to the coronavirus pandemic. In a few minutes, a doctor told her exactly what she needed to do.

The doctor on the app sent a prescription for antibiotics via email and instructed her to go to the hospital for a minor procedure. The 23-year-old copywriter recalled opening the app at around 10:30 p.m. and had a response from a nurse in 10 minutes.

"Di ko na kaya ‘yung pain at iba na appearance ng finger ko. I wanted to go to a hospital kahit risky, but I remembered an email from our HR about this virtual doctor nga,” Malajito said.

(I can't take the pain anymore and my finger's appearance is different)

"Parang nasa ospital lang, except walang personal interaction (it was just like I was in a hospital, except there was no personal interaction)," she said.

Like groceries, food and services affected by the lockdown, healthcare is being delivered online, offering millions under home quarantine to see a doctor, albeit on their smartphones.

Malajito said the online consult cost P450 and it was covered by her health card.

VIRTUAL DOCTORS

Despite being around for years, apps that offer virtual consultations gained wider traction due to the Luzon lockdown, MEDIFI CEO and co-founder Jay Fajardo told ABS-CBN News.

MEDIFI, a telehealth platform that connects doctors and patients remotely, was launched in 2015 to relieve the "overburdened" healthcare system. It's new version went online last November 2019, Fajardo said.

Users and doctors on the platform grew "exponentially" after the enhanced community quarantine was announced, he said. The app now has 1,280 doctors and 6,261 patients with over 300 daily sign-ups.

Currently, the app caters to over 120 consultations per day, he said.

"The benefits of telehealth, which had so far been mere theoretical in the past 5 years, were now made apparent by the limits a total lockdown posed on traditional doctor patient consultations," Fajardo said.

"We did indeed experience an exponential surge because of the quarantine," he added.

Patients need to choose a doctor on the app based on specialization and their consultation fees. Once confirmed, virtual consultations can be done through chat and video calls with media, document sharing and e-prescriptions, Fajardo said.

"By being able to choose the doctors based on their economic capacity, we’re able to serve a wider market, even those who have long been hesitant to tap healthcare services because of cost," he said.

There has been a surge in use by millennials like Malajito, which could be due to their "being in the sweet spot of being the market for healthcare while possessing progressive attitudes toward technology," Fajardo said. 

The app has seen higher volumes of requests for Pediatrics and OB-Gyn consultations, Fajardo said.

Although there is a confidentiality clause, they observed requests for pulmonary specialists which could be triggered by respiratory illnesses related to COVID-19, he said.

It took a coronavirus pandemic for Malajito and for the other Filipinos to trust virtual consultations.

"Nakakakaba kasi (it's scary) what if the doctor didn't really understand my problem? What if photos weren't enough? Swerte lang 'yung condition ko in a way kasi pwedeng mapicturan...Super thankful for these apps and the frontliners behind them. They're medical professionals after all," she said.

Due to e-commerce and online payments, more and more Filipinos are becoming confident to use telehealth services, Fajardo said. 

"The key word now is convenience and the time is right for MEDIFI to provide the same experience as these services, with a keen focus on healthcare," Fajardo said.

source: news.abs-cbn.com

US stocks week ahead: Healthcare draws election-year worry

NEW YORK - With another election year looming, investors in the healthcare sector are wary the coming months could reopen wounds suffered during the 2016 US presidential race.

Healthcare becoming as a hot an issue in the 2018 midterm elections as it was 2 years earlier could threaten the sector. A big risk stems from voters giving majorities to Democrats in the US Senate and House of Representatives, in a rejection of President Donald Trump's Republican party.

Investors worry that shift would pressure the industry, including through a greater focus on prescription drug prices, even if Trump's grip on the presidency tempers any regulatory changes.

In 2016, similar scrutiny had plagued the healthcare sector, particularly pharmaceutical and biotechnology shares.

“If we woke up tomorrow and it was a given fact (the Democrats) were going to take over the House and the Senate, healthcare would be one of the worst-performing sectors of the market,” said Walter Todd, chief investment officer at Greenwood Capital Associates in Greenwood, South Carolina.

Momentum behind such a shift appears to be building after Democrat Doug Jones on Tuesday won a special Senate election in Alabama that will cut the Republicans' Senate edge to 51 seats against 49 Democrat seats.

Even so, healthcare shares would likely stand up better to election risk in 2018 than they did to the scrutiny of the sector in 2016.

For one, the sector is cheaper relative to the broader market following 2016's struggles. Investors also say it could benefit from a potential boost in merger activity if drugmakers and other multinational companies bring back cash held overseas under the tax overhaul bill moving through U.S. Congress.

The stocks also may be less vulnerable now to news about high drug prices and other healthcare developments, having already weathered those headlines in 2016, investors say.

And some investors are also less concerned that healthcare will be a significant topic on the campaign trail this time around, given other issues that have come to the forefront since Trump's election.

"I think there will be fears. Do they come in March? Do they come in May? I don’t know when they come, but yes there will be fears of the election," said Teresa McRoberts, a portfolio manager who focuses on healthcare at Fred Alger Management in New York.

Still, McRoberts added: "The downside in the group – it’s hard for me to see that it is going to be as much as it was in ’16.”

Healthcare shares had struggled for most of 2016, undermined by investor fears about new drug pricing rules or other regulations, especially should Democratic presidential candidate Hillary Clinton have won.

The sector declined 4.4 percent that year, making it the worst performer of all major sectors, while the overall S&P 500 rose 9.5 percent. Biotech and pharmaceutical shares were hit particularly hard.

Healthcare's underperformance in 2016 was its worst since 1999, and its worst in an election year since 1992.

On balance, however, midterm election years have treated healthcare stocks well.

According to Thomson Reuters data dating back to 1990, the sector's annual performance on average topped the broad S&P 500 by 2.7 percentage points. But in the 7 midterm years over that time, it outperformed by 6.2 percentage points on average, with the sector outperforming in 5 of those years.

To be sure, certain healthcare issues, including the cost of medicine, have drawn broad attention as a populist issue, including from some Republicans like Trump himself.

But Democrats as a whole are seen as more likely to push for changes, such as the ability for the US government to negotiate drug prices through the Medicare health program.

"If the 2018 elections were to see a change of leadership ... then I think the drug pricing issue would be very much back in the picture for all of the pharmaceutical and biotech companies,” said George Strietmann, portfolio manager with Cincinnati investment advisory firm Bahl & Gaynor.

Healthcare stocks rebounded by 21.5 percent so far in 2017, but that was nearly matched by the 19.3 percent rise for the S&P 500.

The sector, at 16.4 times forward earnings estimates, trades at a roughly 10 percent discount to the 18.2 price-to-earnings ratio for the S&P 500, according to Thomson Reuters Datastream.

That stands out especially when compared with the sector's nearly 18 percent premium to the S&P 500, historically, as well as its 4 percent premium in late 2015, before election-related concerns spiked.

“It’s still reasonably cheap," said Nathan Thooft, co-head of global asset allocation, Manulife Asset Management in Boston, which is overweight the healthcare sector.

Healthcare becoming a campaign issue is "definitely a risk," Thooft said. "I just don’t think it’s going to be the prominent debate of the midterm election.”

source: news.abs-cbn.com

Short on staff: Nursing crisis strains U.S. hospitals

MORGANTOWN, West Virginia - A shortage of nurses at U.S. hospitals hit West Virginia’s Charleston Area Medical Center at the worst possible time.

The non-profit healthcare system is one of the state’s largest employers and sits in the heart of economically depressed coal country. It faces a $40 million deficit this year as it struggles with fewer privately insured patients, cuts in government reimbursement and higher labor costs to attract a shrinking pool of nurses.

To keep its operations intact, Charleston Medical is spending this year $12 million on visiting or “travel” nurses, twice as much as three years ago. It had no need for travel nurses a decade ago.

“I’ve been a nurse 40 years, and the shortage is the worst I’ve ever seen it,” said Ron Moore, who retired in October from his position as vice president and chief nursing officer for the center. Charleston Area Medical’s incentives include tuition reimbursement for nursing students who commit to work at the hospital for two years.

“It’s better to pay a traveler than to shut a bed,” he said.

Hospitals nationwide face tough choices when it comes to filling nursing jobs. They are paying billions of dollars collectively to recruit and retain nurses rather than risk patient safety or closing down departments, according to Reuters interviews with more than 20 hospitals, including some of the largest U.S. chains.

In addition to higher salaries, retention and signing bonuses, they now offer perks such as student loan repayment, free housing and career mentoring, and rely more on foreign or temporary nurses to fill the gaps.

The cost nationwide for travel nurses alone nearly doubled over three years to $4.8 billion in 2017, according to Staffing Industry Analysts, a global advisor on workforce issues.

The burden falls disproportionately on hospitals serving rural communities, many of them already straining under heavy debt like the Charleston Area Medical Center.

These hospitals must offer more money and benefits to compete with facilities in larger metropolitan areas, many of them linked to well-funded universities, interviews with hospital officials and health experts show.

Along West Virginia’s border with Pennsylvania, university-affiliated J.W. Ruby Memorial Hospital in Morgantown is spending $10.4 million in 2017 compared with $3.6 million a year earlier to hire and retain nurses.

But these costs are part of the facility’s expansion this year, including adding more than 100 beds as it grows programs and takes over healthcare services from smaller rural providers that have scaled back or closed.

J.W. Ruby, the flagship hospital for WVU Medicine, offers higher pay for certain shifts, tuition reimbursement, $10,000 signing bonuses and free housing for staff who live at least 60 miles away.

Next year, the hospital is considering paying college tuition for the family members of long-time nurses to keep them in West Virginia.

“We’ll do whatever we need to do,” said Doug Mitchell, vice president and chief nursing officer of WVU Medicine-WVU Hospitals.

NOT LIKE OTHER SHORTAGES

A major driver is the aging of the baby boomer generation, with a greater number of patients seeking care, including many more complex cases, and a new wave of retirements among trained nurses.

Industry experts, from hospital associations to Wall Street analysts, say the crisis is harder to address than in the past. A faculty shortage and too few nursing school slots has contributed to the problem.

Hospitals seek to meet a goal calling for 80 percent of nursing staff to have a four-year degree by 2020, up from 50 percent in 2010. They also face more competition with clinics and insurance companies that may offer more flexible hours.

Healthcare experts warn that the shortfall presents risks to patients and providers. Research published in August in the International Journal of Nursing Studies found that having inadequate numbers of registered nurses on staff made it more likely that a patient would die after common surgeries.

UAB Hospital in Birmingham, Alabama, has invested millions to attract nurses, but still has 300 jobs to fill. At times, nursing vacancy rates in some of its departments has hit 20 percent or higher.

“We’ve rarely canceled a surgery or closed a bed because of lack of staffing,” said Terri Poe, chief of nursing at the hospital, the state’s largest, which serves many low income and uninsured residents.

Last year, the medical center covered nearly $200 million in unreimbursed medical costs for patients. It spent $4.5 million for visiting nurses during fiscal 2016, including $3 million for post-surgery services, compared with $858,000 in 2012.

Healthcare labor costs typically account for at least half of a facility’s expenses. They jumped by 7.6 percent nationally last year, after climbing at a rate closer to 5 percent annually in recent years, said Beth Wexler, vice president non-profit healthcare at Moody‘s. The spending has proven a boon for medical staffing companies like AMN Healthcare and Aya Healthcare.

Missouri’s nursing shortage reached a record high in 2017, with almost 16 percent - or 5,700 - of positions vacant, up from 8 percent last year. Thirty-four percent of Missouri registered nurses are 55 or older.

“Our biggest challenge is getting the pipeline of experienced nurses,” said Peter Callan, director of talent acquisition and development at the University of Missouri Health Care in Columbia, which is expanding. “There are fewer and fewer as people retire.”

Last year, the academic medical center hired talent scouts to identify candidates, Callan said. It spends $750,000 a year on extras to attract and keep nurses, including annual $2,000 bonuses to registered nurses who remain in hard-to-fill units and up to five years of student loan repayment assistance. It offers employee referral bonuses and a chance to win a trip to Hawaii.

Smaller hospitals find it much harder to compete in this climate. More than 40 percent of rural hospitals had negative operating margins in 2015, according to The Chartis Center for Rural Health.

In rural Missouri, 25-bed Ste. Genevieve County Memorial Hospital had to offer signing bonuses, tuition reimbursement and pay differentials when staffing is “critically low” in units such as obstetrics.

They haven’t closed beds, but have hired less experienced nurses, raised salaries and turned away at least one patient who would have been in its long term care program.

“We’ve had to try whatever it takes to get nurses here,” said Rita Brumfield, head of nursing at the hospital. “It’s a struggle every day to get qualified staff.”

To see the entire graphic on the U.S. nursing shortage, click tmsnrt.rs/2xQ9Y0K

source: news.abs-cbn.com

Trump rolls back Obamacare provision for free birth control

U.S. President Donald Trump's administration annulled on Friday an Obamacare provision that obliged employer health plans to pay for contraception, potentially stripping free birth control from millions of women.

The move extends to all commercial enterprises an exemption already given to religious institutions.

Rights groups erupted in anger and the American Civil Liberties Union threatened a lawsuit, but the White House called it a matter of religious freedom.


The ruling expands "exemptions to protect moral convictions for certain entities and individuals whose health plans are subject to a mandate of contraceptive coverage" under Obamacare, a note published by the U.S. Department of Health and Human Services said.

Millions of American women who had the cost of contraception reimbursed could be affected by the Trump administration's decision, which conservative groups had been seeking since Obamacare began.

Challenges to Obamacare had reached the US Supreme Court, which in 2014 ruled that family-owned private companies could choose not to provide contraceptive coverage to female employees on religious grounds.

In May, Trump signed a decree on religious liberty ordering his administration to take account of objections of conscience on matters of contraception.

Obamacare is the common name for the Affordable Care Act, health reforms that took effect under former President Barack Obama in 2010. It allowed millions of uninsured people to get health insurance.

The powerful American Civil Liberties Union said on Twitter that it is "suing the Trump administration to block new rules allowing employers to deny insurance coverage for birth control."

Planned Parenthood, also on Twitter, said the new rule "puts our birth control coverage at risk."

The non-profit health organization, targeted for cuts by Trump's administration because it provides abortion services, added that the decision on contraception coverage "shows the Trump admin's disdain for women's health & lives."

Bernie Sanders, who sought the Democratic nomination for president in last November's election, called the new rule sexist.

"It's the latest display of Republicans' total disdain for women's ability to control their own lives," he said.

But the White House framed it as an issue of religious liberty and asserted that the law was on its side.

"The president believes that the freedom to practice one's faith is a fundamental right in this country and that's all today was about," White House press secretary Sarah Huckabee Sanders told reporters.

"I don't understand why that should be an issue. The Supreme Court has validated this decision, certainly many times over and the president is somebody who believes in the constitution," Sanders said.

Repealing Obamacare was one of Trump's most strident campaign promises. He described Obamacare as a "total disaster," but his Republican Party has failed in efforts to repeal the health reforms.

source: news.abs-cbn.com

US House passes Obamacare repeal in win for Trump

The US House of Representatives on Thursday narrowly passed a Republican effort to repeal and replace Obamacare, delivering a welcome victory to President Donald Trump after early legislative stumbles.

Following weeks of in-party feuding and mounting pressure from the White House, lawmakers voted 217 to 213 to pass a bill dismantling much of Barack Obama's Affordable Care Act and allowing US states to opt out of many of the law's key health benefit guarantees.

Some 20 Republicans voted in opposition, along with all Democrats, in the most contentious congressional vote of Trump's young presidency.

Eyeing a victory, a jubilant Trump tweeted during the vote that, if successful, Republicans would gather for "big press conference at the beautiful Rose Garden of the White House" immediately afterwards.

The bill's passage is a conservative dream seven years in the making: doing away with a reform which Republicans accuse of sending health premiums soaring while reducing options for millions of Americans.

An earlier version of the plan to repeal Obamacare collapsed in March, torpedoed by opposition from both moderates and conservatives in the Republican party -- and dealing the president one of the most stinging setbacks since he took office.

In extraordinary scenes in the House chamber, Republicans clapped and cheered while Democrats shouted their disapproval.

"We can continue with the status quo or we can put this collapsing law behind us. End this failed experiment," House Speaker Paul Ryan declared on the House floor.

"This bill delivers on the promises that we have made to the American people," Ryan said, referring to the relentless campaign pledges by most Republicans, including Trump last year, to do everything they could to repeal and replace the reforms that came into law in 2010.

"A lot of us have been waiting seven years to cast this vote," added.

Uphill battle in Senate

Republican leadership endured strong criticism from Democrats and several Republicans for rushing the legislation through without extended debate.

The measure now heads to the US Senate, where it faces an uphill battle.

"Where's the score?" Democrats hollered, referring to the lack of a budget office estimate of the legislation's cost for the federal government.

Republicans including Trump had campaigned relentlessly on the pledge to dismantle the 2010 reforms.

Democrats counter that Obamacare, as it is known, helped 20 million Americans gain health coverage and saved thousands of lives by barring insurers from denying policies to people with pre-existing conditions.

The American Medical Association issued a scathing rebuke of the latest Republican effort, warning that it would lead millions of Americans to lose their health care.

The Republican party leadership apparently won over enough skeptical members with an amendment that adds $8 billion over five years to help cover insurance costs for people with pre-existing conditions.

Several medical experts and health groups publicly ridiculed the amendment, saying it falls woefully short of the hundreds of billions of dollars likely needed to help control health costs for the sick under the new bill.

source: news.abs-cbn.com

Republicans fail to repeal Obamacare

WASHINGTON - President Donald Trump suffered a stunning political setback on Friday in a Congress controlled by his own party when Republican leaders pulled legislation to overhaul the U.S. healthcare system, a major 2016 election campaign promise of the president and his allies.

Republican leaders of the House of Representatives pulled the legislation due to a shortage of votes despite desperate lobbying by the White House and its allies in Congress, ensuring that Trump's first major legislative initiative since taking office on Jan. 20 ended in failure.

House Republicans had planned a vote on the measure after Trump late on Thursday cut off negotiations with Republicans who had balked at the plan and issued an ultimatum to vote on Friday, win or lose.

Republican moderates as well as the most conservative lawmakers had objected to the legislation. The White House and House leaders were unable to come up with a plan that satisfied both moderates and conservatives, despite Trump's vaunted image as a deal maker.

"We learned a lot about loyalty. We learned a lot about the vote-getting process," Trump told reporters at the White House, although he sought to shift the blame to the Democrats, who were unified in their opposition, even though his party controls the White House, the House and the Senate.

Amid a chaotic scramble for votes, House of Representatives Speaker Paul Ryan, who championed the bill, met with Trump at the White House before the bill was pulled from the House floor after hours of debate. Ryan said he recommended that the legislation be withdrawn from the House floor because he did not have the votes to pass it, and that Trump agreed.

"There were things in this bill that I didn't particularly like," Trump added, without specifying what those were, but expressed confidence in Ryan's leadership.

"Perhaps the best thing that could happen is exactly what happened today, because we'll end up with a truly great healthcare bill in the future after this mess known as Obamacare explodes," Trump said.

Friday's events cast doubt on whether Ryan can get major legislation approved by fractious Republican lawmakers.

"I will not sugarcoat this. This is a disappointing day for us," Ryan said at a news conference, adding that his fellow Republicans are experiencing what he called "growing pains" transitioning from an opposition party to a governing party.

"Doing big things is hard," Ryan added, noting that he got close but failed to muster the 216 votes needed to pass it.

Ryan said he did not know what the next steps would be on healthcare, but called Obamacare so flawed that it would be hard to prop up.

Without the bill's passage in Congress, Democratic former President Barack Obama's signature domestic policy achievement, the 2010 Affordable Care Act - known as Obamacare - remains in place despite seven years of Republican promises to dismantle it.

Repealing and replacing Obamacare was a top campaign promise by Trump in last year's presidential election, as well as by most Republican candidates, "from dog-catcher on up," as White House spokesman Sean Spicer put it during a briefing on Friday.

AGENDA AT RISK

The House failure to pass the measure called into question Trump's ability to get other key parts of his agenda, including tax cuts and a boost in infrastructure spending, through Congress.

News that the bill had been pulled before a final vote was greeted initially with a small sigh of relief by U.S. equity investors, who earlier in the week had been fretful that an outright defeat would damage Trump's other priorities, such as tax cuts and infrastructure spending.

Benchmark U.S. stock market indexes ended the session mixed after rallying back from session lows following the news. The S&P 500 Index ended fractionally lower, the blue chip Dow Jones Industrial Average slipped about 0.3 percent and the Nasdaq Composite Index rose about 0.2 percent.

The dollar also strengthened modestly on the news and U.S. Treasury bond yields edged up from session lows.

"There's nobody that objectively can look at this effort and say the president didn't do every single thing he possibly could with this team to get every vote possible," Spicer told reporters before the legislation was pulled.

Trump already has been stymied by federal courts that blocked his executive actions barring entry into the United States of people from several Muslim-majority nations. Some Republicans worry a defeat on the healthcare legislation could cripple his presidency just two months after the wealthy New York real estate mogul took office.

In a blow to the bill's prospects, House Appropriations Committee Chairman Rodney Frelinghuysen announced his opposition, expressing concern about reductions in coverage under the Medicaid insurance program for the poor and the retraction of "essential" health benefits that insurers must cover.

"We need to get this right for all Americans," Frelinghuysen said.

Republican Representative Dana Rohrabacher said before the bill was pulled that voting it down would be "neutering Trump" while empowering his opponents.

"You don't cut the balls off a bull and then expect that he can go out and get the job done," Rohrabacher told Reuters. "This will emasculate Trump and we can't do that. ... If we bring this down now, Trump will have lost all of his leverage to pass whatever bill it is, whether it's the tax bill or whatever reforms that he wants."

Trump and House Republican leaders could not afford to lose many votes in their own party because Democrats were unified in opposition, saying the bill would take away medical insurance from millions of Americans and leave the more-than-$3 trillion U.S. healthcare system in disarray.

Republican supporters said the plan would achieve their goal of rolling back the government's "nanny state" role in healthcare.

Obamacare boosted the number of Americans with health insurance through mandates on individuals and employers, and income-based subsidies. About 20 million Americans gained insurance coverage through the law.

The nonpartisan Congressional Budget Office said under the Republican legislation 14 million people would lose medical coverage by next year and more than 24 million would be uninsured in 2026.

Days of negotiations involving Republican lawmakers and the White House led to some changes in the bill but failed to produce a consensus deal.

The House plan would rescind a range of taxes created by Obamacare, end a penalty on people who refuse to obtain health insurance, end Obamacare's income-based subsidies to help people buy insurance while creating less-generous age-based tax credits

It also would end Obamacare's expansion of the Medicaid state-federal insurance program for the poor, cut future federal Medicaid funding and let states impose work requirements on some Medicaid recipients.

House leaders agreed to a series of last-minute changes to try to win over disgruntled conservatives, including ending the Obamacare requirement that insurers cover certain "essential benefits" such as maternity care, mental health services and prescription drug coverage.

source: news.abs-cbn.com

US health care vote postponed in blow to Trump

WASHINGTON - US President Donald Trump's bid to repeal his predecessor's signature health care law suffered a bitter blow Thursday, as opposition from within his Republican Party forced the delay of a crucial vote in Congress.

"No vote tonight," a House leadership source told AFP, signaling a stunning political setback for Trump -- who prides himself on his deal-making skills -- to win sufficient support for a Republican bill repealing and replacing Obamacare.

The president and his lieutenants repeatedly voiced optimism about the bill's prospects and said they had made progress in convincing doubters to join his camp in dismantling the Affordable Care Act.

But the votes for Trump's plan -- dubbed the American Health Care Act -- weren't there.

"I am still a no at this time. I am desperately trying to get to yes," said Mark Meadows, chairman of the conservative House Freedom Caucus, whose members have demanded major changes to the plan before giving their blessing.

While Meadows sought to portray optimism about the process, he revealed the width of the gap between Trump and plan opponents.

"At this point, we are trying to get another 30 to 40 votes that are currently in the 'no' category to 'yes,'" Meadows said after meeting with his caucus.

"Once we do that, I think we can move forward to passing it on the House floor."

House Republicans were preparing to head into a closed-door conference at 7 p.m. (2300 GMT) to thrash out their differences and perhaps come to agreement on a way to bring enough Republicans on board.

A White House official said the expectation was for a vote Friday, and downplayed suggestions that Trump had failed to close the deal, claiming the delay did not spell doom for the measure.

"The vote will be in the morning to avoid voting at 3 am," the official said.

"We feel this should be done in the light of day, not in the wee hours of the night and we are confident the bill will pass in the morning," the official said.

That schedule was reiterated by House Majority Leader Kevin McCarthy after the vote's postponement.

But with negotiations unable to provide the necessary breakthrough, nighttime debate is likely to be intense as the two sides seek an elusive compromise.

Failure to work out their differences would mark a humiliating defeat for Trump's biggest legislative battle to date.

DIVISION

Republicans have spent years railing against the Affordable Care Act, branding it an example of Democrats pushing for socialized medicine.

But seven years to the day since Barack Obama signed his landmark reforms into law, House Republican leaders were unable to present a united front within their own ranks for the alternative.

With Democrats opposed to Trump's effort to rip out his predecessor's crowning domestic achievement, and his own party's right flank in revolt, the White House and Republican leaders have been burning the midnight oil to find ways to make the bill palatable to enough conservatives without angering moderates.

Confidence by the White House appeared to highlight the disconnect between Trump's team and rank-and-file conservatives.

Asked Thursday whether House Speaker Paul Ryan might delay the vote, White House spokesman Sean Spicer said "nothing leads me to believe that that's the case."

A few hours later, the vote was postponed.

Many conservatives say their party's plan is still too costly for the government.

They have said they want to repeal health benefits that all insurance policies must pay for under Obamacare -- including maternity care, emergency room visits, and preventive care like screenings and vaccines -- arguing they have driven up costs.

LIMITING DEFECTIONS

The House Freedom Caucus, about 30 lawmakers who are heirs apparent to the ultra-conservative Tea Party movement, have dubbed the new bill "Obamacare Lite," as it will only reduce, not eliminate, health coverage subsidies by replacing them with refundable tax credits.

At the other end of the spectrum, some Republican moderates also worry their constituents would no longer be able to afford health insurance under the new plan.

A nonpartisan congressional budget estimate says it would lead 14 million Americans to lose their coverage from next year.

The Democratic minority is prepared to vote against it as a bloc, so Republican leaders need to limit defections to fewer than 22 out of their party's 237 representatives among the House's 430 current members.

Further pressuring recalcitrant Republicans, Trump tweeted out messages to his tens of millions of followers urging them to contact their local lawmakers in support of the plan.

Congressman Thomas Massie said the arm-twisting would not work on him.

"I'm still opposed to the bill," the Kentucky Republican told MSNBC. "I think it's worse than Obamacare."

Obama himself weighed in Thursday on the law's anniversary, saying the reform that has helped 20 million people get coverage should be improved, not pulled out by its roots.

"We should start from the baseline that any changes will make our health care system better, not worse for hardworking Americans. That should always be our priority," Obama said in a statement.

source: news.abs-cbn.com

How much does a dental assistant school cost?

The cost of dental assistant schools vary by state. Let’s say you were to complete either an 11 month, full-time, or 22 month, part-time curriculum that consisted of 42 units. You’re looking at a tuition that can be anywhere between $850 dollars to $7,560. This all depends on the average unit cost.

For example, one school could charge about $20 per unit for a certificate course which will allow you to become a dental assistant. This makes the cost of the program about $850. Keep in mind that some dental assistant colleges may cost more, and this does not include any additional costs.

Registration fees can cost up to $60, lab fees can cost up to $500, and books and supplies can cost up to $1,600. After your training is complete you will also have to take the certification exam, which costs $125. These additional fees should be taken into consideration when selecting a dental assistant school. Prices and expenses vary by state. Another option may be to look into online colleges. With additional costs included, you’re looking at a total cost between $3,000 and $9,000.


Many dental assistant schools will allow you to pay for tuition through payment plans and loans. The American Dental Assistants Association also offers an annual scholarship to qualified candidates.

Doing a college search for dental assistant schools or dental assistant colleges? Check out popular Texas healthcare colleges or a college in any other state of your choosing. Looking for online colleges? You can search for online degrees too. For additional information, use US College Search or find us on Facebook and Twitter as well as searching by zip code.

source: uscollegesearch.org

5 ways to promote wellness in your franchise

The working population in the Philippines is facing a huge problem: there is now a segment of the working population called "Generation O" (overweight, overworked and overstressed).

This is partly due to employees becoming more and more sedentary, chained to their desks for most of their waking hours.

As Coach Chappy of 360 Fitness Club said in The Wellness Report 2013, "With the automation of almost everything, we simply don't move as much as we used to."

 Thus, health risks such as cardiovascular disease, diabetes and other chronic illnesses are now affecting even younger employees. With the rise in these common workplace issues comes higher healthcare costs. All employers understand that prevention is always better than cure. This is why a plan of action needs to take place.

Investing in wellness programs have proven to lower healthcare costs and more importantly, boost overall productivity. Franchise owners know that wellness programs can help increase employee and franchisee engagement, energy and morale in the workplace.

These intangibles greatly affect employee's buy-in to the company, buy-in to his or her role, and boosts overall productivity, in the end contributing improvements in bottom line.

But the question is where to start? Coach Chappy from 360 Fitness Club gives five steps that can help you in promoting wellness for your franchise business:

1. Create a survey

Find out what your employees want to experience or learn about. It may be group exercise classes, gym membership discounts, outdoor team building fitness activities or education on nutrition. It is important that before you implement a program, you know what your employees’ interests and needs are.

2. Invest in talks or workshops

Focus on education first before implementing activities. By investing in talks and workshops, you can give your employees a platform to understand the benefits of exercise, nutrition and healthy living, creating awareness and their buy in to programs which will be implemented.

3. Have regular activities

Help your employees build the fitness habit by holding regular activities that are suitable for everyone. By giving them options and different activities, you can target a larger group of people for your wellness program. whether it be a mind-body workout like yoga or a more intense circuit training, make sure options are available for them which they can join consistently.

4. Come up with a theme

You might need to have a theme or a goal-oriented program in order to retain employee engagement. If you offer monotonous programs or the same thing every month, you might lose the interest of your employees. Keep them interested in the wellness activities by offering inter-department fitness Olympics, fitness relays and biggest loser programs, for example.

5. Monitor progress

Let your employees know that you care about their health and well-being by monitoring their progress and improvement. By tracking their results, they will also be more motivated to get involved in fitness activities and it will also encourage accountability. It is important that you always encourage wellness throughout the workplace so that employees will stay motivated.

When you look after your employees’ health and well-being, you are also taking care of your bottom line. Healthy and happy employees create a more fun, energetic and productive workplace.

source: www.abs-cbnnews.com

Pfizer set to buy Allergan for more than $150 billion - sources

Pfizer Inc. secured formal board approval on Sunday for its acquisition of Botox maker Allergan Plc for more than $150 billion (99 billion pounds), a deal that will create the world's biggest drug maker, according to people familiar with the matter.

The deal, the largest ever in the healthcare sector, will be announced on Monday and is sure to draw political ire in a U.S. presidential election year because Pfizer would redomicile to Ireland, where Allergan is registered, in a so-called "inversion" that would slash its corporate tax rate.

It will also reignite debate in the pharmaceutical industry over the role of research and development, with Allergan Chief Executive Brent Saunders, a prolific dealmaker and a skeptic of in-house drug discovery, joining the combined company in a position to influence its strategy.

The deal would involve Pfizer paying with 11.3 of its shares for each Allergan share, the people said. There will also be a small cash component, accounting for less than 10 percent of the value of the deal, the people said.

Pfizer's Chief Executive Ian Read, 62, will be CEO of the combined company, with Allergan's CEO Brent Saunders, 45, serving in a very senior role focused on operations and the integration, the people added.

Saunders will also have a seat on the combined company's board, one of the people said.

The sources asked not to be identified because the terms of the deal are not yet public. Pfizer and Allergan declined to comment.

COLOSSUS

The deal would create a pharmaceutical colossus with annual sales of more than $60 billion, putting the merged group well ahead of No. 2 U.S. drugmaker Merck & Co (MRK.N), which has annual sales of about $40 billion.

Widely used Pfizer drugs such as Lipitor, Viagra and nerve pain treatment Lyrica would be brought together with Allergan's Namenda memory loss treatment, Restasis dry eye medication and other leading eye-care brands.

It would be the biggest merger of the year, topping beer maker Anheuser-Busch InBev's (ABI.BR) proposed $107 billion takeover of SABMiller Plc (SAB.L). And it would realize Read's longtime ambition of an inversion deal that would get Pfizer out from under the 35 percent U.S. corporate tax rate, among the world's highest. The tax rate in Ireland is 12.5 percent.

Pfizer’s talks with Allergan come more than a year after the U.S. firm abandoned a bid to acquire AstraZeneca (AZN.L) and move its tax headquarters to Britain.

The U.S. Treasury last year, and again last week, updated its rules on inversions to make it harder for companies to avoid U.S. taxes by moving overseas. But experts have said these moves would do little to prevent Pfizer from inverting.

Although Pfizer has decried the high U.S. corporate tax rate, it has minimized its U.S. taxes for years by selling its drug patents to overseas subsidiaries and then using them to make drugs that are sold back to U.S. affiliates. While generating big profit margins for its overseas arm, the practice has allowed Pfizer to report losses on its higher-taxed U.S. business in each of the past five years.

Many industry analysts and investors believe Pfizer could be bulking up with Allergan's fast-growing brands as a prelude to splitting by 2017 into two companies - one selling high-margin branded drugs and one selling inexpensive generics that have dragged down Pfizer results over the past few years.

Read, a trained accountant, has said Pfizer could decide on such a split by late 2016, after it completes separate financial analyses of the two businesses.

Pfizer's $15 billion purchase earlier this year of hospital products maker Hospira, which sells generic injectable drugs and is developing biosimilar versions of top-selling biotech medicines, was widely seen as a move to make its generics business more attractive ahead of a sale.

Allergan has agreed to sell its own wide array of generics by early next year to Israeli drugmaker Teva Pharmaceutical Industries Ltd (TEVA.TA) for $40.5 billion.

Speculation has been rife on Wall Street whether Read or Saunders would take the helm of the combined company, and whether Saunders would be content to play second fiddle to Read, who became Pfizer CEO in 2010 after more than 30 years with the company.

Saunders has had a meteoric rise in the industry over the past five years, turning around eye-care company Bausch & Lomb and also leading Forest Laboratories and Swiss drugmaker Actavis, which took the Allergan name after acquiring it this year.

Earlier, he won plaudits for helping Schering-Plough overcome serious quality-control problems and then leading its integration with Merck & Co.

Due to his rapid ascent and moves, Saunders has not presided over start-to-finish development of a drug, a process that can take 12 years or longer.

And unlike large drugmakers who conduct costly discovery research, Saunders has said that it makes more sense economically to acquire medicines that have already shown promise in human trials.

But in a recent interview, Saunders said he would be willing to put a higher emphasis on drug discovery if it makes sense for his company.

Pfizer shares closed little changed on Friday at $32.18, while Allergan's rose 3.4 percent to $312.46, both on the New York Stock Exchange.

source: www.abs-cbnnews.com

Fil-Ams getting health insurance as Obamacare deadline nears

NEW YORK – March 31 is a deadline that will cost you $95 if you don’t have health insurance and it's a fine that will cost you even more next year.

The Patient Protection and Affordable Care Act or more commonly known as Obamacare is a federal law enacted to increase the quality and affordability of health insurance.

It's meant to lower the rate of the uninsured by expanding public and private insurance coverage and reducing the costs of healthcare for individuals and the government.

New York's Office of Citiwide health outreach specialist Iman James said, "Don't wait until March 30th because they might ask for income verification or they may ask you to verify your identity and that might take longer and you might miss that open enrollment date."

US Department of Health officials said you don't have to enroll in plans in the marketplace if you already have health insurance coverage through your employer.

But if an individual is unemployed, or if their health insurance premium costs are equal to or greater than 10 percent of their personal or household income, they may be eligible for free public insurance or lower cost health insurance.

New York resident John Mallonga said he is young, in good health and he feels that he doesn’t really need to spend for health insurance at this time.

While the penalty is not his main concern, he said it doesn’t hurt to start looking into the cheapest available private insurance he could get at the Obamacare Market Place.

Mallonga said, "I just think that Affordable Care Act is a good proposition for the whole country so it will be better for us in the long run. The truth is, all of us should be covered.”

Meantime, Jen Furer and her husband are self-employed, running a consulting company that makes more than $126,000 a year.

Pre-Obamacare, she said, for a family of six, they pay nearly $17,000 a year for premium health insurance plan.

"No Deductibles, very minimal co-payment and I could go to any specialist that I want. When Obamacare kicked in starting this year, I was informed that my plan was increasing to $33,000," Furer said.

Furer said under Obamacare, their consulting firm no longer qualifies as small business without having a single paid employee.

She pointed out that if their income stayed below $120,000 annually, she would have qualified for a tax subsidy of $8,376.

Obamacare experts advise Furer to look into other ways to insure her family with the help of navigators who could guide her through her family’s healthcare needs.

Navigator Caitlin O’Brian said, "If you have four kids, I'd have you come see a navigator, instead of just doing it on the website because there are lots of other things that you can do to kind of tweak it."

The deadline to find a healthcare plan using the Market Place is on March 31. Obamacare experts told people not to wait until the last minute to get insured to avoid various penalties.

source: www.abs-cbnnews.com

Choosing a Medicare Plan Is Really Not That Puzzling As It Seems

With so many choices available along with recent alterations involved in the Medicare, some people find it very confusing. And for those who are new to the elderly care all these words Medicare, Medicaid, Supplement Plans, Advantage Plans can be highly bewildering. However, you don’t need to feel intimidated by these insurance plans because they are not as confusing as they seem.

Many people avoid the discussion of Medicare plans as they find it overwhelming and even mentally exhausting to understand how to pick the right plan. The decision making process will become very easy for you after reading this article.

When can you make the changes in your Medicare Plans?

Every year between November 15 and December 31 you get the opportunity to make changes in your Medicare plans. You can choose more cost effective plans for the coming year during this time, which comes only once every year. As soon as the November month starts, many people start discussing about the Medicare plans. The ubiquitous conundrum is almost palpable and one question that everybody has in mind is “do I stick to my plan or make changes and go for another plan?” You are not required to take this decision all alone, and you must take the help of an experienced and licensed insurance agent in your local area to take such decisions. It is advisable to seek help of an agent that specializes in Medicare supplement plans, so that you get the right guidance.

What are your choices during this period?

1. You can stick to your original Medicare Plans which offers hospital insurance (Part A) and medical insurance (Part B). Along with this original Medicare you can take prescription drug insurance (Part D).

2. Again you can stick with your original Medicare where, in Part A you get coverage for hospital care and hospice and in part B you get coverage for medical facilities such as blood and ambulance. To this you can add a supplement plan and Part D – Prescription drug plan.

3. Your third choice is you can get Medicare supplement plans which are provided by private insurance companies. There are currently 10 supplement plans available namely A, B, C, D, F, G, K, L, M and N. All these plans provide exactly the same coverage and it does not really matter from which company you buy them.

4. You also have an option of going for Medicare Advantage plan which is known as Part C. With this option you get covered for vision, hearing, dental, Gym and nutritional supplements.

Which one of these options is good for you?




With so many options available a person is bound to be puzzled and confused as in which plan to choose to get the maximum benefit. Moreover, the insurance need of every individual is unique so you cannot just go for the same package as your friend. But like I have mentioned earlier in the article you must take help of a qualified and reputed insurance agent to decide what is best for you or your parents. However, answers to certain questions like do you prefer to see the doctor of your choice? Do you travel overseas a lot? How important is gym membership or dental care to you? Can help you decide which plan is best suitable to you.

Conclusion:

In the end all I have to say if you must enroll into Medicare as soon as the opportunity opens up for you, else you will have to pay more and suffer the penalty later on. Also remember you are not alone in this process and taking help from an agent will definitely be beneficial.

source: 20smoney.com

Drugmakers report US shortages of flu vaccine, Tamiflu

This year's U.S. flu season has created shortages of the Tamiflu treatment for children and of the most widely used flu vaccine, their manufacturers said.

Roche Holding AG told Reuters late on Wednesday that it had a shortage of the liquid form of Tamiflu, given to children who already have the flu to slow or stop symptoms. A spokeswoman for the U.S. Food and Drug Administration confirmed that there have been supply interruptions in some locations.

Roche said it told wholesalers and distributors in recent weeks that temporary delays in shipments were imminent. In the meantime, pharmacists can make a substitute by dissolving Tamiflu capsules in a sweet liquid, according to Tara Iannuccillo, spokeswoman for Roche's Genentech unit, which makes Tamiflu.

Sanofi SA, the largest flu vaccine provider in the United States, said on Thursday it had sold out of four of the six different dosages of Fluzone seasonal flu vaccine due to unanticipated late-season demand. The vaccine is made in different sized vials and pre-filled syringes.

"At this point we are not able to make any more vaccine because we are gearing up for next year's vaccine," said Michael Szumera, a spokesman for Sanofi.

Most of the United States is nearing peak levels seen during moderately severe flu seasons, according to the Centers for Disease Control in Atlanta. As of last Friday, the percentage of people seeing health care providers for influenza had increased for the previous four consecutive weeks to 5.6 percent. That compares with 2.2 percent the previous year, when flu was mild.

"We are hearing of spot shortages. Given the time in our flu season, it isn't surprising. People who haven't been vaccinated and want to get the vaccine may have to look in several places for it," CDC spokesman Tom Skinner said on Thursday.

It is not unusual to run out mid-season during a moderate to severe season, which is what this year looks like, he said.

It is definitely not too late to receive the seasonal flu vaccine, said epidemiologist Craig Roberts, a physician assistant at University Health Services at the University of Wisconsin, Madison. The 42,000-student campus gave 10,000 flu shots before the holiday break in December and has 5,000 more in stock. "We'll be offering walk-in shots" once the students return around January 22, he said, "which we haven't done in January before. We also sent out a mass e-mail asking students to get the shot at home if they can."

The vaccines that are available this year are a fairly good match to the strains of the flu that are circulating, Skinner said. It takes about two weeks for the vaccines to provide protection.

Manufacturers planned to produce 137 million doses of the vaccine and as of late last year, 112 million people had been vaccinated, the CDC said.

Sanofi produced 60 million of those doses and GlaxoSmithKline PLC had planned to make 25 million doses.

A spokesman for GlaxoSmithKline said on Thursday it expected to have the vaccine available until mid-February.

Novartis, AstraZeneca Plc, ID Biomedical Corp of Quebec and CSL Biotherapies are also authorized to sell flu vaccines in the United States. ID Biomedical's product is distributed by Glaxo, while Merck & Co distributes the CSL Biotherapies vaccine.

AstraZeneca's MedImmune unit sells FluMist, an intranasal spray approved for people aged 2 to 49. Tara Mullins, an outside spokesperson for MedImmune, declined to provide details about demand for and available supply of FluMist.

Karen Andersen, an analyst with Morningstar, said Tamiflu sales would likely more than double to about $750 million this year from about $350 million in the 2011-2012 flu season. Tamiflu demand could boost overall Roche revenue this year by about 1 percent, but she said that would be a "small positive impact" for the company.

Tamiflu sales peaked at $3 billion in 2009, when governments stockpiled the product in case of a global epidemic of avian flu that never materialized.

WALGREENS FLU SHOTS UP

Walgreen Co, which provides flu shots in some of its pharmacy locations, said on Wednesday it had given 5.7 million doses so far this flu season, up from 5.3 million a year ago.

"We've kept our reimbursement rates the same, so we are making a consistent level of profitability on flu shots," Walgreens President of Pharmacy, Health and Wellness Kermit Crawford said after the company's annual shareholder meeting in Chicago. Walgreens is the largest distributor of flu vaccines in the United States other than the government.

Walgreens is reimbursed by health insurers such as UnitedHealth Group, Wellpoint Inc. and Aetna Inc., whose profitability can be hurt by the flu because of reimbursements to pharmacies, doctors and other providers for vaccines and treatments.

One small insurer, Centene Corp., in December cut back on its earnings estimates for 2012 because its managed care business in Texas and Kentucky, where the flu was active early in the season, had increased its medical costs.

Aetna said this week it has seen a spike in flu cases this year but it is not resulting in more inpatient admissions and it is budgeting about $40 million to $50 million for a normal flu season. That compares with $100 million it spent during the flu season in 2009.

"We don't see this flu season, even at its worst, getting close to that number," Aetna CEO Mark Bertolini said during Tuesday's J.P. Morgan Healthcare conference in San Francisco.

Jason Gurda, an analyst at Leerink-Swann in healthcare equity research, said in a research report this week that 2,255 flu-related hospitalizations have been reported since Oct. 1, 2012, up 735 from the previous week but below the 6,896 hospitalizations in the 2009-2010 season.

He said that could have a "modestly positive impact" on first-quarter volumes for hospitals and said that many companies, including HCA Holdings and Tenet Healthcare, had hospitals in the states most affected so far.

source: abs-cbnnews.com

Hobby Lobby to defy law on contraception insurance coverage

After losing a last-minute appeal to the Supreme Court, craft stores chain Hobby Lobby said it would defy a federal healthcare mandate requiring employers to provide their workers with insurance that covers emergency contraceptives.

The Oklahoma City-based chain, owned by a conservative Christian family, had applied to the high court to block a part of the federal healthcare law ordering companies to offer insurance that covers contraceptive drugs, including the so-called morning-after pill.

After the court refused to block the mandate, a lawyer for Hobby Lobby said the Green family, which also has holdings in Mardel Inc., a seller of religious books, would nonetheless refuse to provide health coverage for contraception it considers to be abortion-inducing.

Hobby Lobby and Mardel could be fined as much as $1.3 million a day starting Tuesday.

"They're not going to comply with the mandate," said Kyle Duncan, general counsel of the Becket Fund for Religious Liberty, which represents Hobby Lobby. "They're not going to offer coverage for abortion-inducing drugs in the insurance plan."

His comments were issued in a statement.

In the lawsuit, the Green family said certain types of contraception, such as the morning-after pill and the week-after pill, violated family members' religious beliefs against abortion.

The morning-after pill has spurred heated debate, especially among politicians, on whether using it constitutes abortion. The National Institutes of Health says on its website that the pills most likely work by preventing pregnancy "in the same way as regular birth control pills."

source: latimes.com

Health IT Is a Small, But Significant Part of Health Reform

Proponents of government health IT programs may breathe a little easier after the U.S. Supreme Court upheld almost all of President Obama’s landmark healthcare reform law.

Most efforts to give hospitals and doctors the latest IT tools are rooted in 2009 stimulus laws that predate Obama’s Affordable Care Act (ACA). Had the law been overturned, it would likely have been no more than a speed bump for health IT.

Supporters of the wide range of health IT, from digital records to electronic information exchanges, say the reforms in the ACA are critical to creating a health care system where the latest technology flourished.

“In addition to health insurance reforms, expansion of Medicaid eligibility and the creation of health insurance exchanges, the ACA includes a number of improvements dependent on or related to health IT capabilities including, electronic health information exchange (HIE); new methods to reimburse expenses based on quality of care, operating rules and standards; and health IT workforce development,” all of which would have been lost if the law had been overturned, according to the Healthcare Information and Management Systems Society.

In March, Sheldon Whitehouse, D-R.I., released a report noting that the ACA included provisions that expanded some earlier health IT programs to encourage adoption of the latest technology. As Whitehouse observed in the report, health IT is an integral part of the broader healthcare system.

“These areas are not separate silos; progress in each area will influence, and be influenced by, progress in others,” he wrote.

That was a sentiment echoed by National Coordinator for Health Information Technology Farzad Mostashari, who told reporters earlier this month he wasn’t worried about what effect the Supreme Court’s ruling could have on health IT. “What worries me is people not having health insurance,” he said.

article source: mashable.com

Fewer antibiotics prescribed for children

The number of antibiotic prescriptions for kids declined 14% from 2002 to 2010, but antibiotics remain the most frequently prescribed drugs for pediatric patients, a federal analysis finds.

Antibiotics accounted for about a quarter of all pediatric prescriptions; amoxicillin leads the list.

Overall, 263.6 million prescriptions were written for patients 17 and under in 2010, down 7% from 2002, finds the analysis of prescription claims databases by Food and Drug Administration researchers, published today in the journal Pediatrics. By comparison, 3.3 billion were dispensed for ages 18 and up, 22% more than in 2002.

The medical community has made "an enormous effort to decrease antibiotic use" for kids in the past decade "by educating parents about the futility of treating viral infections with antibiotics" and about antibiotic resistance, the FDA study says.

Those efforts "are succeeding to some extent," but this study and others show antibiotic overuse "is still a big problem," says Adam Hersh, assistant professor of pediatric infectious diseases at the University of Utah. He says overuse of azithromycin and other broad-spectrum antibiotics "is contributing to the epidemic of antibiotic-resistant infections."

Other drug categories down from 2002-2010 were allergy medications (61%); pain (14%); and cough/cold without expectorant (42%). But prescriptions increasing include corticosteroids for asthma (14%); contraceptives (up 93%, possibly because of secondary uses, such as acne) and attention deficit hyperactivity disorder (46%).

"It's good news that cough and cold prescriptions are down, given that they don't work and can have serious side effects," says Danny Benjamin, a professor of pediatric medicine at Duke University. In 2008, the FDA advised against them for the youngest children. But he says the rise in prescriptions for ADHD and off-label use of proton pump inhibitors for certain gastrointestinal disorders is worrisome. Safety of long-term ADHD drugs is unknown, he says. The study cites 358,000 outpatient prescriptions for lansoprazole (Prevacid) for infants, despite labeling that it is not effective in babies under 1 year.

source: USA TODAY

Technology helps boost medical research, diagnostics and treatment

MANILA, Philippines - Bienvenida Cabezon, a physician who works at the municipal health office of Capas, Tarlac, has never touched a computer. In fact she dreads operating one for fear that she may press the wrong button.

With no single computer in her office and with practically everyone being computer illiterate, Dr. Cabezon and her colleagues record patients’ information on paper and submit records to the provincial health office. All records are put on file and tediously submitted as people riding motorcycles and jeepneys deliver them.

With records from these community-based units becoming the bases for the country’s national health indicators, one can only surmise how technology, or the lack of it, has affected the country’s policy-making and healthcare delivery.

The province of Tarlac hopes to change that as it becomes the country’s first local government unit to use 3G wireless technology and store medical health information of patients that can be easily accessed by healthcare providers and policy-makers.

Through a project called Wireless Access for Health (WAH), a government-private sector collaboration that started in 2009, Tarlac hopes to computerize its database of patient information in all of its 38 provincial health clinics by end of this year.

The project was introduced by US-based Quallcomm Inc., a world leader in 3G and next-generation mobile technologies, and SMART Communications, and supported by the Department of Health, University of the Philippines, United States Agency for International Development, and the provincial government of Tarlac. It uses a software called Community Health Information Tracking System (CHITS) developed by UP in computerizing patients records.

The records are transmitted to the Philippine Field Health Service Information System that is the government’s major resource for managing public health data. FHIS data is used for policy analysis and planning at all levels of the public health system.

Dr. Cabezon admits it was not easy for her and her colleagues to adjust to technology but have realized its importance in managing patients’ records and healthcare delivery. “When we were first introduced to it, we were all hesitantn,” she said, speaking in Filipino. “If the WAH didn’t come into our lives, I wouldn’t know how to log in or log out,” she quipped.

As of April this year, more than 109,000 patient consultations have been recorded using WAH as a result of improved record searching that has reduced securing patient information in Tarlac, from five minutes to a few seconds.

Mayor Miguel Rivilla of the municipality of Panuqui said the introduction of WAH has helped the municipal government to secure reliable data from the communities and get first-hand information on health indicators. He admitted that “bad record keeping” affected healthcare delivery in his area during a dengue epidemic last year.

Dr. Soe Nyunt-U, country representative of the World Health Organization, said the absence of a real time national health database in the Philippines even affects the WHO’s work in coming up with its country report.

Soe noted that delays in reporting happen in the Philippines as healthcare information is taken from barangay health units that get transmitted to rural health units, city and health offices, regional offices, before data reaches the national government.

“It’s not surprising to find a report coming out from a particular program with information 2 or three years late. Of course we can’t afford to wait so we have to make use of estimation methodology in getting those information reported and sometimes also make use of surveys,” he told Interaksyon.com.

According to him, the WHO uses alternatives like conducting surveys and partnering with other international organizations to make up for the delays in securing health information from the government. He however admitted that surveys capture only a “small portion” of the population unlike real time data that could have been in place like those in other ASEAN countries such as Thailand and Singapore.

source: interaksyon.com

Prenatal smoking tied to worse asthma in kids

NEW YORK- Children whose mothers smoked during pregnancy may have a tougher time controlling their asthma than other kids do, a new study suggests.

The findings, from a study of nearly 2,500 U.S. kids, add to evidence that prenatal smoking may affect children's future lung health.

There are already plenty of reasons for women to quit smoking during, and ideally before, pregnancy, said lead researcher Sam Oh, of the University of California San Francisco.

This study offers more motivation for women, and for doctors to ask moms and expectant moms about smoking, Oh said in an interview.

"Pregnancy is a great opportunity for smoking cessation," he said.

Smoking during pregnancy is linked to increased risks of miscarriage, low birth weight, certain birth defects and other pregnancy complications.

As for asthma, many studies have found that secondhand smoke may worsen children's asthma symptoms, or possibly raise their risk of developing the lung disease in the first place. The same risks have been linked to moms' prenatal smoking.

But, Oh's team says, it has not been clear how much of an impact prenatal smoking might have on kids' asthma symptoms later in life, independent of any current exposure to secondhand smoke.

HIGHER RISK AMONG POOR MINORITIES

For their study, the researchers focused on 2,481 black and Hispanic kids between the ages of 8 and 17 who all had asthma and were mostly from low-income families.

In the U.S., poor, minority children are at particular risk of asthma. About 16 percent of low-income black children have asthma, versus the national prevalence of 9 percent, according to the U.S. Centers for Disease Control and Prevention.

In this study, almost 19 percent of African-American moms smoked at some point during pregnancy, as did 5.5 percent of Hispanic moms.

Overall, their kids were at greater risk of poor asthma control later in life, even when childhood secondhand-smoke exposure was taken into account -- as well as other factors like a child's age and asthma medication use.

About 30 percent of Hispanic kids and 38 percent of black kids had poorly controlled asthma symptoms -- and the risk was 50 percent for those exposed to smoking in the womb, versus unexposed kids.

"There are measurable effects even years down the road," Oh said.

The findings do not, however, prove that prenatal smoking, itself, causes more-severe asthma symptoms later in life. They can only point to a correlation.

But there is lab research, in animals and human cells, suggesting there could be a direct effect, Oh pointed out.

Fetal exposure to tobacco smoke may, for example, impair early lung development, or have lasting effects on the activity of certain genes.

The bottom line, according to Oh, is that there is already a host of reasons for pregnant women to quit smoking for good, and this may be one more.

"This study provides more impetus for healthcare providers to ask about smoking at each visit," he said.

Some pregnant women may be able to quit with behavioral counseling. In some cases, a doctor may prescribe nicotine replacement therapy or other medication.

source: interaksyon.com

Don't Let Your Bones Break

MANILA, Philippines — Osteoporosis is a hard-hitting bone disease that is currently affecting a great number of Filipinos. While some individuals feel the manifestation of pain, majority of those afflicted by osteoporosis hardly feel a thing. Everything feels normal, only to find out that they are already at risk after undergoing a bone scan. This is why osteoporosis is often called the silent disease – it creeps like a thief in the night, claiming the lives of unsuspecting victims.

Lene Almoniña and her sister Mary Ann Suzon found out that they are at risk of having osteoporosis after undergoing a bone scan analysis conducted by Anlene. Lene, 50, married and with two children, was not aware of her bone condition. Busy running their own business, Lene has her mind on more pressing matters. Besides, she didn’t feel anything wrong with her body.

“Last year, I saw the Anlene Bone Scan booth in a mall and thought I’d have myself checked. It was when I found out that I was in moderate risk of osteoporosis,” Lene recalled.

Mary Ann, on the other hand, already felt pain on her left knee that ran up to her back. She found it difficult to walk at times. At 48 with four children, Mary Ann would commute to work but, lately, would ask her husband to give her a ride because of the pain. When she went to the Anlene Bone Scan activity held in a mall, she learned that she was already under the high risk category.

Mary Ann became alarmed and worried that she might not be able to go to work anymore. It was at this point that she decided to do something about her condition. She followed the advice of the attending nutritionist at the Anlene booth to watch her diet, get some exercise and drink Anlene as a nutrition supplement.

Lene and Mary Ann are just two of the more than one million Filipinos who have benefitted from the Anlene Bone Health Check campaign. Started in 1999, the nationwide caravan has remarkably helped propagate information on the debilitating silent disease. The caravan provides free bone scanning and assessment, and useful pointers on how to address the onset of osteoporosis.

Osteoporosis occurs when the bone mass decreases quicker than the body can replace it, leading to a net loss of bone strength. As a result, a slight bump or fall can result into fracture. It affects all bones in the body but fractures occur mostly on the spine, hips and wrist. Broken bones bring severe pain, and both hip and spine fractures were found to be associated with a higher risk of death – 20 percent of those who suffer hip fracture die within six months after the fracture.

Proper exercise, keeping a healthy lifestyle and regular intake of calcium-rich milk such as Anlene can help prevent osteoporosis. Anlene is the only milk that is clinically proven to reduce bone breakdown within four weeks.

“My condition has improved with the help of Anlene,” shares Mary Ann. “When I had another bone scan assessment last December, I found out that from high risk, I am now down to moderate risk. I can now take long walks and I no longer feel the pain. My target is to further reduce my condition to low risk, of course with the help of Anlene.”

Lene, though her condition remains stable, vows not to put her health at further risk. Aside from taking Anlene, she also gets involved in physical activities such as aerobics and badminton.

“I got scared when I found out I was under the moderate risk category. But with proper diet, the right exercise and regular intake of Anlene, I have stronger bones now,” says Lene.

The Anlene Bone Health Check continues to reach countless Filipinos all over the country. For 2012, the project is aimed at scanning another one million Filipinos, with a total investment amounting to P50 million to roll out the campaign on osteoporosis awareness. The activities are held in various barangays and malls so that more people can have easy access to free bone scanning and assessment. The progam also scans people across Asia, Australia and the Middle East. It is run in partnership with GE Healthcare, a world leader in medical imaging technology.

source: mb.com.ph

Pinay nurses in Austria lauded for contribution to healthcare

Austrian Federal Minister for Labor, Social Affairs and Consumer Protection Rudolf Hundstorfer praised Filipino nurses in Austria for their “very important contribution” to their host country’s healthcare system.

In his remarks during the 10th anniversary of the Philippine Nurses Association Austria on December 3, Hundstorfer "thanked the Filipino nurses in Austria for their very important contribution to the country’s healthcare system," the Department of Foreign Affairs (DFA) said.

Hundstorfer noted that a good healthcare system was "one of the criteria in the 2011 Quality of Living survey set by the global consulting firm Mercer in choosing Vienna as the best place to live in the world for three consecutive years,” the DFA said.

Hundstorfer and Philippine Ambassador Lourdes Yparraguirre were the special guests at the event.

Yparraguirre lauded the nurses for their “hard work, high skills and dedication” that helped open the gates for other nurses from the Philippines to go to Austria.

“Under a bilateral agreement, Filipino nurses came to Austria, first in trickle, then in groups. In virtually every corner of this country, there is nothing but praise for Filipino nurses. And many Austrians who have never heard of the Philippines learn about us through the most positive examples - you! Our nurses overseas are truly some of the best ambassadors of the Filipino people,” she said.

She likewise highlighted the recognition awarded by the City of Vienna to Filipino and Filipino-Austrian nurses and caregivers for their long years of dedicated services to the health sector of Austria.

The DFA said there are about 30,000 Filipino-Austrians in Austria. - VVP, GMA News

source:gmanetwork.com