Dr. Evans Leads Charge Against Disparities in Healthcare

As the founder and CEO/President of Community Wellness Centers of America LLC (CWCOA) and Equinox Electronic Medical Records (EMR), Dr. Robert Evans is working towards organizing and delivering required healthcare services in under-served communities that otherwise would be neglected.

As a medical physician and long time community activist, Dr. Evans understands the resources and programs required to address chronic illnesses through preventive programs, which are often absent from minority communities.

Dr. Evans has developed his companies with a primary mission to deliver state-of-the-art health programs and services, improve healthcare outcomes in underserved communities, and collaborate with hospital systems, physicians, and ancillary healthcare services. All of these steps will help to create a coordinated healthcare delivery system to provide equality in healthcare for residents through increased emphasis on prevention.

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Is Your Doctor Getting Drug Kickbacks?

Doctors are making money – LOTS of money for prescribing drugs to you and your family. Chemotherapy kickbacks are the worst. How much are they getting? Check out the detailed infographic below for the shocking statistics. This revenue windfall absolutely has the potential to sway prescribing decisions. Any doctor who claims otherwise is in La La Land.

The practice of drug kickbacks to doctors is a big reason for the the ever increasing prices of drugs and the huge problem of drug affordability.

Laws that will took effect in 2013 required all pharmaceutical companies to disclose their payments to doctors.  This is not enough, however, as doctors asked about their drug kickbacks usually report biased information that their patients readily believe.
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CVS Is Said to Be in Talks to Buy Aetna in Landmark Acquisition

In addition to its pharmacies, where it runs walk-in clinics, CVS is one of the nation’s top three pharmacy benefit managers. CreditChristian Hansen for The New York Times

CVS Health, the giant drugstore chain that also runs walk-in clinics and a pharmacy benefit business, is in talks to buy Aetna, one of the nation’s largest health insurance companies, according to people briefed on the talks.

Negotiations between the two companies could still fall apart, these people say. But if consummated, the deal could be worth more than $60 billion based on Aetna’s current market value, which would make it one of the largest corporate acquisitions this year and one of the largest in the history of the health industry.

The proposed combination reflects the blurring of traditional boundaries in health care, as established companies seek to find their footing in a rapidly changing environment. Congress is deadlocked over the future of the Affordable Care Act, and employers and consumers are struggling to contain rising medical costs, particularly skyrocketing drug prices.

“I think this deal has been a long time coming,” said Adam J. Fein, president of Pembroke Consulting, a management advisory and business research company. “CVS has been positioning itself as a health care company and not a pharmacy for a long time.”

The negotiations are also taking place as the online retail giant Amazon encroaches on the turf of well-established players — and the pharmacy business could be next. In industries ranging from book sales to groceries to television programming, Amazon has displaced stalwarts that had enjoyed decades of limited competition and rarely interrupted growth.

The talks between CVS and Aetna appear to be in part an attempt to fend off a move by Amazon into the drug-selling business — or at least to insulate the companies in case Amazon does invade. Signs are emerging that Amazon has designs on the pharmacy industry, with The St. Louis Post-Dispatch reporting on Thursday that Amazon had gained licenses in 12 states to become a wholesale prescription drug distributor.

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How Do People Die From Diabetes?

Photo

CreditStuart Bradford

(original article)

Q. How do people die from diabetes?

A. People who have diabetes cannot regulate their blood sugar levels and if the disease isn’t tightly controlled, blood sugar can spike to abnormally high levels, a condition called hyperglycemia, or dip below normal, a condition called hypoglycemia. Both conditions are potentially life-threatening and can lead to coma and death if not promptly treated.

But complications resulting from the disease are a more common cause of death. Heart disease strikes people with diabetes at significantly higher rates than people without diabetes, “and we don’t fully know why,” said Dr. Robert Gabbay, chief medical officer at Joslin Diabetes Center in Boston. People with diabetes develop heart disease at younger ages and are nearly twice as likely to die of heart attack or stroke as people who do not have diabetes.

People with Type 2 diabetes, which is the more common form of the disease, are more likely to have elevated cholesterol, high blood pressure and obesity, Dr. Gabbay said, all risk factors for cardiovascular disease. “The good news,” he said, “is that a lot of treatments, like those for lowering cholesterol, are even more effective at lowering risk in people with diabetes than in people without.” Some new classes of diabetes medications used for Type 2 diabetes have also been shown to reduce cardiovascular risk, he said.

People with Type 1 diabetes are also at increased risk for heart disease, though the reasons are less clear.

Both types of diabetes can also lead to other long-term complications, like kidney disease, that may result in premature death. Problems like vision loss, nerve damage and infections that may lead to amputations can increase the likelihood of injuries and accidents. Good disease management starting early in the disease process helps people avoid some of these complications, Dr. Gabbay said.

Do you have a health question? Ask Well

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America’s 8-Step Program for Opioid Addiction

CreditAnthony Russo

(original article)

Opioid addiction has developed such a powerful grip on Americans that some scientists have blamed it for lowering our life expectancy.

Drug overdoses, nearly two-thirds of them from prescription opioids, heroin and synthetic opioids, killed some 64,000 Americans last year, over 20 percent more than in 2015. That is also more than double the number in 2005, and nearly quadruple the number in 2000, when accidental falls killed more Americans than opioid overdoses.

The President’s Commission on Combating Drug Addiction and the Opioid Crisis said in July that its “first and most urgent recommendation” was for President Trump to declare a national emergency, to free up emergency funds for the crisis and “awaken every American to this simple fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon will.” The commission’s final report is due out in a month.

Mr. Trump has not declared an emergency, and “bold” would not describe the steps the White House has taken so far. The president’s 2018 budget request increases addiction treatment funding by less than 2 percent, even including $500 million already appropriated by Congress in 2016 under the 21st Century Cures Act.

Families across the United States are demanding that more be done to end the despair and devastation of addiction. Here are eight steps to take — now. They include some of the recommendations of the president’s commission.

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Hospitals in the ER: Resuscitating NY’s public health system

Not Released (NR)

A costly system

(BAONA/GETTY IMAGES/ISTOCKPHOTO)

A new physician will shortly be attending at the city’s financially hemorrhaging public hospital system, and not a moment too soon. Dr. Mitch Katz, late of Los Angeles, must act aggressively to save New York Health + Hospitals — not by funneling ever more money into a failing model, but by transforming the way hidebound institutions deliver care.From Bellevue to Woodhull, the network of 11 hospitals and myriad community clinics is in deep, deep trouble.

Patients are fleeing as people newly covered under the Affordable Care Act make appointments elsewhere.

That leaves the public hospital system and its 45,000 employees increasingly caring for the uninsured and chronically sick, notably undocumented immigrants and people with severe mental illness.

Resulting budget deficits exceed $1 billion a year and growing. Those would be far worse if not for massive recent infusions of cash from the mayor and City Council and the system’s takeover of jail health care, together amounting to $1.8 billion a year.

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Bring On the Exercise, Hold the Painkillers

Phys Ed
By GRETCHEN REYNOLDS

Taking ibuprofen and related over-the-counter painkillers could have unintended and worrisome consequences for people who vigorously exercise. These popular medicines, known as nonsteroidal anti-inflammatory drugs, or NSAIDs, work by suppressing inflammation. But according to two new studies, in the process they potentially may also overtax the kidneys during prolonged exercise and reduce muscles’ ability to recover afterward.

Anyone who spends time around people who exercise knows that painkiller use is common among them. Some athletes joke about taking “vitamin I,” or ibuprofen, to blunt the pain of strenuous training and competitions. Others rely on naproxen or other NSAIDs to make hard exercise more tolerable.

NSAID use is especially widespread among athletes in strenuous endurance sports like marathon and ultramarathon running. By some estimates, as many as 75 percent of long-distance runners take ibuprofen or other NSAIDs before, during or after training and races.

But in recent years, there have been hints that NSAIDs might not have the effects in athletes that they anticipate. Some studies have found that those who take the painkillers experience just as much muscle soreness as those who do not.

A few case studies also have suggested that NSAIDs might contribute to kidney problems in endurance athletes, and it was this possibility that caught the attention of Dr. Grant S. Lipman, a clinical associate professor of medicine at Stanford University and the medical director for several ultramarathons.

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For Millions, Life Without Medicaid Services Is No Option

By ABBY GOODNOUGH

TUSCALOOSA, Ala. — Frances Isbell has spinal muscular atrophy, a genetic disorder that has left her unable to walk or even roll over in bed. But Ms. Isbell has a personal care assistant through Medicaid, and the help allowed her to go to law school at the University of Alabama here. She will graduate next month.

She hopes to become a disability rights lawyer — “I’d love to see her on the Supreme Court someday,” her aide, Christy Robertson, said, tearing up with emotion as Ms. Isbell prepared to study for the bar exam in her apartment last week — but staying independent will be crucial to her professional future.

“The point of these programs is to give people options and freedom,” said Ms. Isbell, 24, whose family lives a few hours away in Gadsden.

The care she gets is an optional benefit under federal Medicaid law, which means each state can decide whether to offer it and how much to spend. Optional services that she and millions of other Medicaid beneficiaries receive would be particularly at risk under Republican proposals to scale back Medicaid as part of legislation to repeal and replace the Affordable Care Act.

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$45 Billion to Fight Opioid Abuse? That’s Much Too Little, Experts Say

By ABBY GOODNOUGH

WASHINGTON — The Senate leadership’s efforts to salvage the Republican health care bill have focused in part on adding $45 billion for states to spend on opioid addiction treatment.

That is a big pot of money. But addiction specialists said it was drastically short of what would be needed to make up for the legislation’s deep cuts to Medicaid, which has provided treatment for hundreds of thousands of people caught up in a national epidemic of opioid abuse.

The new money would most likely flow to states in the form of grants over 10 years, averaging out to $4.5 billion per year. With hundreds of people dying every week from overdoses of heroin, fentanyl and opioid painkillers, some specialists say a fixed amount of grant money is simply inadequate compared with the open-ended funding stream that Medicaid provides to treat all who qualify for the coverage.

“When it comes to other illnesses like breast cancer or heart disease, we’d never rely solely on grants for treatment — because we know that grants are not substitutes for health coverage,” said Linda Rosenberg, president and chief executive of the National Council for Behavioral Health, which represents treatment providers. “Addiction is no different.”

The Affordable Care Act vastly expanded access to addiction treatment by designating those services as “essential benefits.” That means they had to be covered through both an expansion of Medicaid to far more low-income adults and the marketplaces set up under the law for people to buy private plans. Both the House and Senate health bills would effectively end the expansion and cap federal Medicaid spending, resulting in the loss of coverage for millions of people, according to the Congressional Budget Office.

According to the National Household Survey on Drug Use and Health, there were roughly 1.35 million low-income Americans in 2015 with an opioid use disorder. Only 25 percent of those people get treated in a year, although the Affordable Care Act’s expansion of health insurance coverage has provided more resources for closing the treatment gap.

Richard G. Frank, a health economics professor at Harvard Medical School, has estimated that last year, people who enrolled in expanded Medicaid incurred about $4.5 billion in costs for mental health and addiction treatment. But in an updated analysis this month, Mr. Frank, who worked for the Obama administration during the rollout of the Affordable Care Act, calculated it would cost $14 billion in the first year and more than $183 billion over a decade to treat addiction and related illnesses in low-income people who would lose coverage under the Republican plan.

“Medicaid spending contracts and expands based on need as well as new treatment options,” Mr. Frank wrote in his analysis. “That means that funding is there for people and states when they need it the most. For example, the opioid epidemic will likely continue to morph and require different interventions of care should new synthetic drugs cause different health problems.”

Public health experts are concerned that grants aimed at treatment and recovery would not address a multitude of other physical health problems associated with addiction. One glaring example is hepatitis C, a blood-borne virus endemic among people who use needles to inject illicit drugs. Treatment is extremely expensive, but Medicaid has expanded access to it in many states. Many addicts also suffer from diabetes and other chronic conditions, or get endocarditis, a serious heart infection connected to intravenous drug use.

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The U.S. spends more on health care than any other country. Here’s what we’re buying.

December 27, 2016
American health-care spending, measured in trillions of dollars, boggles the mind. Last year, we spent $3.2 trillion on health care — a number so large that it can be difficult to grasp its scale.A new study published in the Journal of the American Medical Association reveals what patients and their insurers are spending that money on, breaking it down by 155 diseases, patient age and category — such as pharmaceuticals or hospitalizations. Among its findings:

  • Chronic — and often preventable — diseases are a huge driver of personal health spending. The three most expensive diseases in 2013: diabetes ($101 billion), the most common form of heart disease ($88 billion) and back and neck pain ($88 billion).
  • Yearly spending increases aren’t uniform: Over a nearly two-decade period, diabetes and low back and neck pain grew at more than 6 percent per year — much faster than overall spending. Meanwhile, heart disease spending grew at 0.2 percent.
  • Medical spending increases with age — with the exception of newborns. About 38 percent of personal health spending in 2013 was for people over age 65. Annual spending for girls between 1 and 4 years old averaged $2,000 per person; older women 70 to 74 years old averaged $16,000.

The analysis provides some insight into what’s driving one particularly large statistic: Within a decade, close to a fifth of the American economy will consist of health care.

“It’s important we have a complete landscape when thinking about ways to make the health care system more efficient,” said Joseph Dieleman, an assistant professor at the Institute for Health Metrics and Evaluation at the University of Washington who led the work.
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Scientists are bewildered by Zika’s path across Latin America

October 25 at 3:24 PM (original post)

Nearly nine months after Zika was declared a global health emergency, the virus has infected at least 650,000 people in Latin America and the Caribbean, including tens of thousands of expectant mothers.

But to the great bewilderment of scientists, the epidemic has not produced the wave of fetal deformities so widely feared when the images of misshapen infants first emerged from Brazil.

Instead, Zika has left a puzzling and distinctly uneven pattern of damage across the Americas. According to the latest U.N. figures, of the 2,175 babies born in the past year with undersize heads or other congenital neurological damage linked to Zika, more than 75 percent have been clustered in a single region: northeastern Brazil.

The pattern is so confounding that health officials and scientists have turned their attention back to northeastern ­Brazil to understand why Zika’s toll has been so much heavier there. They suspect that other, underlying causes may be to blame, such as the presence of another ­mosquito-borne virus like chikungunya or dengue. Or that environmental, genetic or immunological factors combined with Zika to put mothers in the area at greater risk.

“We don’t believe that Zika is the only cause,” Fatima Marinho, director of the noncommunicable disease department at Brazil’s Ministry of Health, said in an interview.

Brazilian officials were bracing for a flood of fetal deformities as Zika spread this year to other regions of the country, Marinho said. However, “we are not seeing a big increase.”

Researchers and health officials remain cautious about the lower-than-expected numbers. The latest studies have found more evidence than ever that the virus can inflict severe damage on the developing infant brain, some of which may not be evident until later in childhood.

How the Zika virus affects an infant’s brain

But researchers so far have learned a lot more about Zika’s potential to do harm than its likelihood of doing so.

Scientists at the U.S. Centers for Disease Control and Prevention are closely watching Puerto Rico, which has reported more than 26,800 cases of Zika. More than 7,000 pregnant women could be infected by the end of the year, according to the CDC.

But although the outbreak has spread this year to more than 50 nations and territories across the Western Hemisphere, U.N. data shows just 142 cases of congenital birth defects linked to Zika so far outside Brazil.
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