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Health Care Tag

It is ironic that the success of modern vaccination programs against ancient scourges such as measles has been part of the reason parents today are so ignorant about what these diseases can do. A recent outbreak in California has demonstrated the effects of this lack of knowledge:
Researchers have found that past outbreaks of vaccine-preventable diseases are more likely in places where there are clusters of parents who refuse to have their children vaccinated... In California, vaccine exemptions have increased from 1.5 percent in 2007 to 3.1 percent in 2013, according to an analysis by the Los Angeles Times.
That's a surprisingly large number---but hey, this is California:
Researchers have found that those who refuse vaccines tend to share similarities. "In general, they’re upper-middle to upper class, well-educated — often graduate school-educated — and in jobs in which they exercise some level of control," Offit said. "They believe that they can google the word vaccine and know as much, if not more, as anyone who’s giving them advice."
An enormous amount of damage was also done by fraudulent science in the guise of an influential 1998 article in Lancet claiming a link between vaccines and autism, that has since been proven to be a fraud and retracted. But the study's author, Andrew Wakefield, couldn't have done it alone:

I recently reported on the chikungunya virus that is raging in South America. There are concerns that Florida could be the next epicenter of the epidemic.
Thanks to climate change and globalization, the Keys are also increasingly home to killer tropical diseases such as dengue fever and chikungunya spread by Aedes aegypti, a tiger-striped mosquito that originated in Africa. Just last year, a few dozen people in the Sunshine State were infected with these formerly exotic illness as they made their up the Gulf Coast. “The threat is greater than I’ve seen in my lifetime,” Walter Tabachnick, director of the Florida Medical Entomological Laboratory, said last year. “Sooner or later, our mosquitoes will pick it up and transmit it to us. That is the imminent threat.”
One could quibble as to if the cause of the increase, but the threat is increasingly concerning public health officials no matter the reason. In response, one British research and development firm is trying to obtain approval from the US Food and Drug Administration to run an experiment in the Florida Keys...involving the release of millions of genetically modified mosquitoes:
Enter Oxitec, a British biotech firm launched by Oxford University researchers. They patented a method of breeding Aedes aegypti with fragments of proteins from the herpes simplex virus and E. coli bacteria as well as genes from coral and cabbage. This synthetic DNA has been used in thousands of experiments without harming lab animals, but it is fatal to the bugs, killing mosquito larvae before they can fly or bite. Oxitec's lab workers manually remove modified females, aiming to release only males, which feed on nectar and don't bite for blood like females do. The modified males then mate with wild females whose offspring die, reducing the population. ...Company spokeswoman Chris Creese said the test will be similar in size to Oxitec's 2012 experiment in the Cayman Islands, where 3.3 million modified mosquitoes were released over six months, suppressing 96 percent of the targeted bugs. Oxitec says a later test in Brazil also was successful, and both countries now want larger-scale projects.

Since I last reported on the Disneyland Measles Outbreak, the number of infected people in California has expanded to 68 and has prompted a warning from a state official.
It’s really difficult to tell now when the last day of exposure might be,” said Dr. Gil Chavez, deputy director of the state’s Center for Infectious Diseases. “For the time being, if you are not vaccinated or if you have an infant who is too young to be vaccinated, you should avoid going to Disneyland.” In all, 59 measles cases have been confirmed statewide, including 13 in San Diego County. Disneyland is associated with 41 of those patients, including five of the park’s employees. Disneyland did not respond directly to the Wednesday recommendation from public-health officials. It referred journalists to a recent statement made by Dr. Pamela Hymel, the park’s chief medical officer, that said Disney was notified of the outbreak on Jan. 7. The company has offered vaccinations and immunity tests to its workers. “Cast members who may have come in contact with those who were positive are being tested for the virus. While awaiting results, they have been put on paid leave until medically cleared,” Hymel said.
I was mulling the idea of taking advantage of the situation, as my family is up-to-date on its vaccinations. However, concerns are increasing about the number of vaccinated individuals becoming ill with the disease. Some medical experts have also expressed concern about the five patients who contracted measles despite being fully vaccinated.

When the spread of Ebola in this country was of paramount concern, President Obama hired an "Ebola Czar." Now, as more and more school districts are giving Michelle Obama's signature school lunch program a double F minus, she has tapped a new "Food Czar".
First lady Michelle Obama on Thursday announced the new White House senior policy adviser for nutrition policy and director of the “Let’s Move!” campaign, a driving force behind controversial changes to school lunches. Debra Eschmeyer, who founded the FoodCorps service program designed to teach cafeteria workers about nutrition, will fill the role vacated by Sam Kass.
Even better news! Eschmeyer is a self-avowed Food Justice Warrior!
First Lady Michelle Obama named the new Executive Director of Let’s Move on Thursday, Debra Eschmeyer, a self-described “food justice” activist who believes that all aspects of food production and consumption should be “shared fairly.” Eschmeyer, who grew up on a dairy farm in Ohio and is now an organic vegetable farmer, previously campaigned for “school lunch reform” and has been involved in anti-obesity and school gardening initiatives. Eschmeyer was asked in an interview in May 2011 what her definition of “food justice” is. “I was an editor of ‘Food Justice’ (the new book by Robert Gottlieb and Anupama Joshi) so I spent several years thinking about the definition,” she said. “Food justice seeks to ensure that the benefits and risks of where, what, and how food is grown, produced, transported, distributed, accessed, and eaten are shared fairly.” “It represents a transformation of the current food system, including but not limited to eliminating disparities and inequities,” Eschmeyer added.

Single payer activists disrupted the inauguration of Vermont Governor Peter Shumlin this weekend. Somewhere between November and now, we forgot to tell them that even though a Democrat won the election, they lost. Mike Donoghue of the Burlington Free Press:
Police ID 29 arrested at Statehouse protest The Vermont State Police have identified the 29 protesters arrested on suspicion of unlawful trespass for ignoring orders to leave the Statehouse following a sit-in Thursday in Montpelier. James Haslam, executive director of the Vermont Workers' Center and the organizer of the sit-in protest over single-payer health care on the day of Gov. Peter Shumlin's inauguration, was not among them. "I had some commitments in the morning to deliver two little kids to school. Family comes first," Haslam told the Burlington Free Press. Haslam, who kept his distance, said others were prepared to be arrested. For his part, Shumlin said he was disappointed some protesters tried to interrupt his inaugural address, but was bothered more that the demonstrators disrupted the final benediction by the Rev. Robert Potter of the Peacham Congregational Church. "I found it heartbreaking," he said.
The incident was caught on video, watch it below.

I thought it would be an excellent time as I recover from my bout with the flu to check in on the state of my state...and it looks like the diagnosis is poor---especially if you own a small business in California, as a leading health insurance provider is hiking rates:
Health insurance giant Aetna Inc. is imposing excessive rate hikes on more than 5,000 small employers, according to California's insurance commissioner. Commissioner Dave Jones lashed out Thursday at the third-largest U.S. health insurer for raising premiums as much as 20% on some small businesses starting Jan. 1. The average increase of 10.7% will cost small employers and their workers $23.5 million in excessive premiums, according to the state. ...Aetna said its rate increase was justified based on the expected medical costs for employers. The Hartford, Conn., insurer rejected the state's request for a lower increase. The state said a 2.6% increase was more appropriate for this group of 64,000 employees and dependents.
While the finger is being pointed at the "evil insurance company", an analysis by Cal Watchdog's James Poulos shows that Obamacare (i.e., Affordable Care Act) is most likely the root cause.
...From a bird’s-eye view, however, some analysts have pointed out that Aetna’s rate increases are a rational result of the market distortions created by the ACA’s regulatory framework. As Scott Gottlieb argued at Forbes, “Obamacare was designed with the goal of commoditizing health insurance. The belief was that competition between plans would turn largely on premiums and cost sharing. This was seen as a way to hold down prices.” What happened instead, Gottlieb explained, was that pushing down on competition in the areas of networks and care delivery discouraged competition between “different benefit packages and plan designs.” In other words, the big, established coverage providers discovered they could create many variations on very similar benefit packages. In a free market for health care, different plans would differ in their benefit packages as well — giving small business owners, for instance, greater options around not just scope of coverage but cost of coverage. Instead, the ACA has dramatically narrowed their available coverage, leaving business owners with little alternative to Aetna’s hiked rates.

Although the media has recently been less focused on Ebola, the disease is still impacting Africa and the death count now tops 7000. Meanwhile, a new epidemic of a disease that was once thought well-contained by vaccinations may be occurring in my home state of California. The number of cases of whooping cough (pertussis) has skyrocketed this year.
Nearly 10,000 cases have been reported in the state so far this year, and babies are especially prone to hospitalization or even death. ...Whooping cough is cyclical in nature and tends to peak every three to five years. The last outbreak of the disease in California was in 2010. But doctors are discovering that immunity from the current vaccine may be wearing off on a similar timeline. Medical recommendations suggest booster shots after eight years, but doctors are seeing kids who received a booster three years ago getting sick. Public health officials are considering an update to the recommendations to account for the dip in immunity seen after three years. Plus, many kids in some areas aren't getting vaccinated at all. The highest rates of whooping cough are found in the Bay Area counties of Sonoma, Napa and Marin, which also have some of the highest rates of parents who opt out of vaccinating their children. Doctors believe these kids are the root of the current and recent epidemics.
Whooping cough feels like a cold at first, but an intense cough that develops later can produce a "whooping" sound. The disease is caused by the bacterium Bordetella pertussis. It can be treated with antibiotics, but the drugs may not be effective when the illness is in the severe coughing stages. Whooping cough can last for weeks and is especially dangerous to infants under 1 year. California isn't the only state seeing jumps in pertussis infections.

Vermont appears to have given up on single-payer health insurance, having run out of other people's money before the program even began. If leftist Vermont can't make it work, does that mean the drive for single-payer has been abandoned? One might think so, but not so fast. Perhaps the time just isn't right:
“It is not the right time for Vermont” to pass a single-payer system, [Vermont Governor] Shumlin acknowledged in a public statement ending his signature initiative. He concluded the 11.5 percent payroll assessments on businesses and sliding premiums up to 9.5 percent of individuals’ income “might hurt our economy.”
Will there ever be a "right time"?:
“If cobalt blue Vermont couldn’t find a way to make single-payer happen, then it’s very unlikely that any other state will,” said Jack Mozloom, spokesman for the National Federation of Independent Business. “There will never be a good time for a massive tax increase on employers and consumers in Vermont, so they should abandon that silly idea now and get serious,” Mozloom added.
Mozloom aside, the left will never stop trying. Never:

The ultra-liberal state of Vermont never liked Obamacare but not for the reasons most Americans object to the law. Vermont felt it didn't go far enough and was determined to establish its own single payer system. As of this week, that plan is dead. Sarah Wheaton of Politico:
Why single payer died in Vermont Vermont was supposed to be the beacon for a single-payer health care system in America. But now its plans are in ruins, and its onetime champion Gov. Peter Shumlin may have set back the cause. Advocates of a “Medicare for all” approach were largely sidelined during the national Obamacare debate. The health law left a private insurance system in place and didn’t even include a weaker “public option” government plan to run alongside more traditional commercial ones. So single-payer advocates looked instead to make a breakthrough in the states. Bills have been introduced from Hawaii to New York; former Medicare chief Don Berwick made it a key plank of his unsuccessful primary race for Massachusetts governor. Vermont under Shumlin became the most visible trailblazer. Until Wednesday, when the governor admitted what critics had said all along: He couldn’t pay for it.
Advocates of a single payer healthcare system may not realize just how bad this news is for them. Vermont was their best shot. John Fund of National Review noted this:
Health-care experts from outside Vermont point out some of the implications. “It’s a very liberal state, and its leaders spent years trying to design a system that would work,” Grace-Marie Turner of the Galen Institute observes. “If Vermont can’t make it work, single-payer can’t work anywhere in the country where the economy has free and competitive markets. It’s more evidence that centralized government health care is simply not workable in America.”
All is not lost for the Green Mountain state. One of their senators might even run for president.

It looks like a mumps outbreak has body-checked the National Hockey League!
This is the most baffling sports medicine story of the year: Thirteen NHL players and two referees have been diagnosed with mumps—a potentially severe and exceedingly viral infection that classically causes fever, body aches, malaise, and in about half of cases, parotitis (a painful swelling of the salivary glands). It's gotten so bad in the NHL that Sidney Crosby set off a mumps alert last week when he spoke to reporters with a welt on his face. (On Sunday, the Penguins confirmed Crosby does indeed have the disease.) So what's going on? The story of this outbreak appears to have begun in early November, when Anaheim Ducks defenseman Francois Beauchemin noticed a swelling in his jaw after a game against the Arizona Coyotes on November 7th. A few hours later, he developed a fever, chills, muscle aches, and lost his appetite. Four days later, he was ten pounds lighter. By then, the virus was spreading around the Ducks locker room. Three of his teammates would catch the disease before it leapt to other teams: the New Jersey Devils, New York Rangers, and the Minnesota Wild, where five players came down with mumps, including all-star defenseman Ryan Suter. "Ten percent of our team population contracted it," Minnesota Wild general manager Chuck Fletcher recently said. "As far as I know, everybody received the immunization when they were young." If that's true, what's the explanation? We know that the mumps vaccine unquestionably works—cases in the United States declined by 99 percent following its introduction in 1967—so why is an outbreak in hockey happening now?
CBS This Morning reviews the story:

The administration is still trying to convince us that Obamacare is a good thing:
On Dec. 3, federal actuaries released data showing that health spending inched up only 3.6 percent in 2013. Marilyn Tavenner, the head of Medicare and Medicaid, boasted that it’s “evidence that our efforts to reform the health-care-delivery system are working.” Sorry, not true. That 3.6 percent figure is an improvement only by a hair. The real slowing of health care spending started way back in 2009...long before ObamaCare even passed. Health spending slowed to a comfortable 3.8 percent rise that year, and stayed at that slow pace in 2010. Not that the president acknowledged that health spending was growing at the slowest rate in a half-century. To pass his health bill, he needed a crisis. So he and then-Secretary of Health and Human Services Kathleen Sebelius repeatedly lied, warning that costs were “skyrocketing,” spending was “spiraling” out of control... On Dec. 2, Health and Human Services Secretary Sylvia Burwell announced “demonstrable progress” in making hospital care safer. Her report claims that some 50,000 fewer patients died from bed sores, infections, medication errors, falls and other mishaps from 2010 to 2013, largely due to new payment incentives and a patient safety program in ObamaCare. That happy claim was repeated verbatim by many media outlets. Not so fast, say patient safety experts who actually read the report...
There's another much more subtle lie inherent in the administration's claims, which is the assumption that if an effect follows an event, the effect is caused by that event. That sort of "lie" is hardly limited to the Obama administration or Obamacare, of course. It's a common problem with a great deal of social science and medical research that relies on correlations, and where rigorous controls are impossible with the human subjects involved.

Some good news from the frontlines related to our battle with Ebola: The outbreak is now "stable" in Guinea, according to the World Health Organization.
There were still some flare ups in the south-east, but things were improving in other prefectures, WHO co-ordinator Dr Guenael Rodier told the BBC. More than 5,400 people have died in the latest outbreak, with Guinea, Sierra Leone and Liberia the worst hit. The outbreak can be ended by mid-2015 if the world speeds up its response, UN Secretary General Ban Ki-moon has said.
Although the rate of new cases shows signs of decreasing in parts of West Africa, Mali - where six people have died and a seventh case has been reported - is now of concern. Additionally, the United Nations Ebola Emergency Response Mission has formally announced that it will not meet its self-imposed December 1st deadline of containment.
The mission set the goal in September, seeking to have 70 percent of Ebola patients under treatment and 70 percent of Ebola victims safely buried. That target will be achieved in some areas, head of UNMEER Anthony Banbury told Reuters news agency, citing progress in Liberia. "We are going to exceed the December 1 targets in some areas. But we are almost certainly going to fall short in others. In both those cases, we will adjust to what the circumstances are on the ground," he said in an interview.

As Ebola continues to rage in Africa, one key person seems to be missing in action: Ron Klain, Ebola Czar.
Ebola was on the top of everyone’s minds five weeks ago, but now that it’s largely disappeared from the mainstream media, it continues to fade into the background in this country. But the fact remains: Ebola continues to kill hundreds of people in Africa. Ebola continues to destroy families and leave many children without parents. It was sad for me to hear about the passing of a surgeon – who was a citizen of Sierra Leone and a permanent resident of the U.S. – on Monday. From what I know, he was a dedicated health care professional who did his best to keep his patients safe and alive. But what is sadder to me is that our Ebola czar, Ron Klain, did not have the courage to publicly come out and offer a statement in regards to the death of this physician, and also has failed in keeping the American public informed about the progress in this Ebola war.
I would have expected a political operative such as Klain to at least try to "message" us. Hopefully, we won't discover videos of him calling Americans stupid for being concerned about a potential pandemic..after being paid millions in taxpayer dollars for questionably professional services. However, at least Ebola did attract some mainstream media coverage. That differs from Enterovirus-D68, which has swept through the country and has sent hundreds of American children into emergency rooms with respiratory distress. There has been very limited, local coverage. One of the few who took up the story is Sharryl Attkisson, who now reports that 12 deaths have now been linked to this pathogen.

Just as the last remaining US patient with Ebola, Dr. Craig Spencer, is released from New York's Bellevue Hospital, comes a report that another tropical disease, deemed "the new AIDS," has already infected 300,000 people and is poised to strike more.
Over 300,000 Americans have already been infected with the potentially fatal 'kissing bug disease' called Chagas but U.S. healthcare workers lack of knowledge about the illness is letting many cases of the parasite unnoticed. Some doctors are calling it the 'new AIDS' because of the way it develops. Researchers who gathered on Tuesday at the annual American Society of Tropical Medicine and Hygiene meeting in New Orleans said that if caught early the disease can be cured however sometimes the disease can be asymptomatic and there is a dearth in medication for the condition. The CDC reports that the initial symptoms of the disease caused by a parasite, Trypanosoma cruzi, which is spread through the feces of kissing bugs includes fever, fatigue, body aches, rash, diarrhea and vomiting. One of the first visual signs can be a skin lesion or a purplish swelling of the lid of one eye.
More details are offered in an IN News Report:

Kaci Hickox is back home in Maine. But she's as defiant as ever:
Kaci Hickox, the nurse who was quarantined at a New Jersey hospital despite exhibiting no Ebola symptoms after arriving from West Africa, won't follow the quarantine imposed by Maine officials, her attorney said tonight. "Going forward she does not intend to abide by the quarantine imposed by Maine officials because she is not a risk to others," her attorney Steven Hyman said. "She is asymptomatic and under all the protocols cannot be deemed a medical risk of being contagious to anyone." Hickox will abide by all the self-monitoring requirements of the Centers for Disease Control and Prevention and the state of Maine, Hyman said.
But I wonder how many people in Fort Kent, Maine are going to be eager to attend her "Welcome home, Kaci" party? Now that Christie has washed his hands (metaphorically speaking) of Hickox---which is beginning to look more and more like a savvy decision---what will LePage of Maine do? Treat her with kid gloves, perhaps:
Maine requires that health care workers such as Hickox who return to the state from West Africa will remain under a 21-day home quarantine, with their condition actively monitored, Gov. Paul R. LePage said in a statement. "We will help make sure the health care worker has everything to make this time as comfortable as possible," he said.
The comments to the linked article are uniformly angry. Typical is this: "She makes it REALLY easy to hate her." And that's among the nicer ones. From some of the statements in this article, however, it sounds like Maine may be ready for a legal battle with Hickox:

While all the Ebola-stricken patients in America seem to be on the road to recovery, with the tragic exception of patient zero Thomas Duncan, Enterovirus-D68 is reported to have claimed its 8th victim:
The U.S. death toll from the mysterious Enterovirus D-68 continues to rise. The latest CDC update on the current outbreak of the polio-like Enterovirus D-68 states that it has now been detected “in specimens from eight patients who died and had samples submitted for testing.” That’s one more death than was disclosed in last week’s update. The CDC account does not provide any information as to where the patient died and does not disclose his/her name, age or other details. According to the latest weekly update from CDC, 167 more people have been sickened with EV-D68 in the past week: a total of 973 patients in 47 states and the District of Columbia. That’s up from last week’s total of 796 people in 46 states.
Two new cases have just been reported in North Florida.
Unlike the popular saying, if it quacks like a duck, then it probably is a duck. Health department workers tell us Enterovirus D-68 is a lot like having the common cold, except it isn't. ...Elmira Warren a Gainesville resident said, "I am concerned, I think it's important for us to be in touch with our bodies and if we have any type of symptoms that may be similar to that we should see our physicians."
And Arizona reports its first confirmed case, but many other cases are awaiting the results of testing to determine of they are related to infection with this pathogen.

Tech giants Facebook and Apple have come up with a plan to keep their female employees happy and on the job---subsidized egg freezing. Both companies have a reputation for offering posh work environments and cadillac health care plans, but the new program seeks to invest up to $20,000 in benefits to help their employees pay for fertility treatments, sperm donation, and most controversially, egg freezing. Reactions have been mixed, and there doesn't seem to be a clear consensus as to is on board with egg freezing as an option for young professional women: Via AP's Big Story:
"Anything that gives women more control over the timing of fertility is going to be helpful to professional women," said Shelley Correll, a sociology professor and director of the Clayman Institute for Gender Research at Stanford University. "It potentially addresses the conflicts between the biological clock and the clockwork of women's careers: The time that's most important in work, for getting your career established, often coincides with normal fertility time for women. This can potentially help resolve that by pushing women's fertility into the future." ... As more women wait longer to have their first child, the number of women choosing to freeze their eggs has grown "exponentially," said Dr. Alan Copperman, a fertility specialist at Mount Sinai Hospital. They are also doing it at a younger age, which means healthier and more viable eggs.
Interviews conducted by the Daily Mail tell a different story, and raise concerns about the message this could be sending to women who want both a career and a family: