Friday, January 31, 2014

Are CT Scans Giving Us Cancer

CTs, once rare, are now routine. One in 10 Americans undergo a CT scan every year, and many of them get more than one. This growth is a result of multiple factors, including a desire for early diagnoses, higher quality imaging technology, direct-to-consumer advertising and the financial interests of doctors and imaging centers. CT scanners cost millions of dollars; having made that investment, purchasers are strongly incentivized to use them. 

While it is difficult to know how many cancers will result from medical imaging, a 2009 study from the National Cancer Institute estimates that CT scans conducted in 2007 will cause a projected 29,000 excess cancer cases and 14,500 excess deaths over the lifetime of those exposed. Given the many scans performed over the last several years, a reasonable estimate of excess lifetime cancers would be in the hundreds of thousands. 

In a 2011 report sponsored by Susan G. Komen, the Institute of Medicine concluded that radiation from medical imaging, and hormone therapy, the use of which has substantially declined in the last decade, were the leading environmental causes of breast cancer, and advised that women reduce their exposure to unnecessary CT scans.

Read a New York times op-ed piece that discusses this issue at http://www.nytimes.com/2014/01/31/opinion/we-are-giving-ourselves-cancer.html?partner=rss&emc=rss


William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www.wombacherlaw.com
 
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Wednesday, January 22, 2014

Mining for Medical Data from Electronic Medical Records

“A major cost driver for our health care system is the price of drugs, and the biggest driver of those costs is the expense of clinical trials,” says Atul Butte, M.D., Ph.D., who led the research teams at Stanford. Based on their findings, Dr. Butte explains that applying big-data tools to publicly available records is already cutting down the time and money needed to translate a laboratory finding into a successful drug treatment from “a decade or more and $1 billion, to roughly one to two years and about $100,000.” However, researchers need access to more data to continue this success.

Scientists there have identified potential new uses for these old drugs by scanning thousands of gene profiles stored in publicly available databases.Pooling and analyzing vast amounts of information can reveal previously unseen patterns and trends that aren’t apparent in smaller studies. By systematically using a number-crunching algorithm that grouped illnesses by how they changed gene activity, and then matching them with medications that blocked these pathways, researchers came up with these seemingly quirky pairings of diseases and drugs — which they are now testing on humans.

Read more about this in an article in The Atlantic which can be found at http://www.theatlantic.com/sponsored/cvs-innovation-care/2013/12/health-cares-big-data-mandate/78/

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www.wombacherlaw.com
 
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Tuesday, January 14, 2014

Health Law Adds Coverage For Services Needed By People With Developmental Disabilities

A little remarked upon requirement in the health law expands treatments for people with cerebral palsy, autism and other developmental disabilities. But some advocates and policy experts are concerned that insurers may find ways to sidestep the new requirement.

The health law requires that individual and small group plans sold on or off the health insurance marketplaces cover 10 essential health benefits, including “rehabilitative and habilitative services and devices.”

But before the health law passed, coverage of similar services for habilitative purposes—that is, to help people learn or maintain functional skills, rather than regain them—was often excluded.

But advocates fear that insurers may avoid providing benefits to the extent needed by people, many of them children born with serious developmental problems that require life-long care. That’s because instead of clearly defining habilitative services and spelling out what must be covered in individual and small group plans under the law, the Department of Health and Human Services permitted states and insurers to decide. 

Read more about this at the Kaiser Health News website in its January 14,2014 .

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www.wombacherlaw.com
 
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.







Monday, January 13, 2014

Cognitive training shows staying power

Training to improve cognitive abilities in older people lasted to some degree 10 years after the training program was completed, according to results of a randomized clinical trial supported by the National Institutes of Health. 

The report, from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, appears in the January 2014 issue of the Journal of the American Geriatrics Society. The project was funded by the National Institute on Aging (NIA) and the National Institute of Nursing Research (NINR), components of the NIH.

“Previous data from this clinical trial demonstrated that the effects of the training lasted for five years,” said NIA Director Richard J. Hodes, M.D. “Now, these longer term results indicate that particular types of cognitive training can provide a lasting benefit a decade later. They suggest that we should continue to pursue cognitive training as an intervention that might help maintain the mental abilities of older people so that they may remain independent and in the community.”

Results of the cognitive tests after 10 years show that 73.6 percent of reasoning-trained participants were still performing reasoning tasks above their pre-trial baseline level compared to 61.7 percent of control participants, who received no training and were only benefiting from practice on the test. This same pattern was seen in speed training: 70.7 percent of speed-trained participants were performing at or above their baseline level compared to 48.8 percent of controls. There was no difference in memory performance between the memory group and the control group after 10 years. 

Read more about this at the National Institutes of Health website http://www.nih.gov/news/health/jan2014/nia-13.htm


William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www.wombacherlaw.com
 
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.


Thursday, January 9, 2014

Brain Dead v Vegetative State

In one way, the cases are polar opposites: the parents of Jahi McMath in Oakland, Calif., have fought to keep their daughter connected to a ventilator, while the parents and husband of Marlise Muñoz in Fort Worth, Tex., want desperately to turn the machine off. In another way, the cases are identical: both families have been shocked to learn that a loved one was declared brain-dead — and that hospital officials defied the family’s wishes for treatment.

“These cases are quite different from those we’ve known in the past,” like Karen Ann Quinlan, Nancy Cruzan or Terri Schiavo, said Dr. Joseph J. Fins, director of the medical ethics division at NewYork-Presbyterian/Weill Cornell hospital. He explained: “Those patients could all breathe without a ventilator. They were in a vegetative state, not brain-dead, and that distinction makes all the difference.”

A person who has received a brain-death diagnosis cannot breathe on his or her own and is legally dead, in all 50 states. In two states, New York and New Jersey, hospitals must take into account the family’s religious or moral views in deciding how to proceed in such cases. In all others, including California and Texas, hospitals are not required to consult the family in how to terminate care.

The two cases are poignant in part because of a biological quirk of the body: The patients’ hearts continue to beat. Hearts have their own pacemaker, and with ventilation, the heart can continue to beat for days, even up to a week. But with more aggressive care, it can last months and longer after brain death, experts say, depending on the health of the patient and how much treatment is provided.  

Read about the tests that doctors perform to determine brain death. See the New York Times at

William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www.wombacherlaw.com
 
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Saturday, January 4, 2014

Brain Dead---Using medical technology is easy--turning it off is a Mom's nightmare

It has become an anguished fight over the fate of a 13-year-old girl who, though pronounced legally dead by doctors, remains alive in the opinion of her religious parents. The girl, Jahi McMath, was declared brain-dead after complications from surgery on Dec. 9 at Children’s Hospital Oakland, which wanted to remove her from a ventilator. But her heart continues to beat, and her family protested the removal in court, so she has remained connected to the machine.

Nailah Winkfield, the girl’s mother, said she was hopeful that Friday’s agreement would facilitate her daughter’s move.“I believe in God, and I believe that if he wanted her dead, he would have taken her already,” Ms. Winkfield, a Baptist, said by phone. “Her heart is beating, her blood is flowing. She moves when I go near her and talk to her. That’s not a dead person.”

The hospital determined two days later that the girl was legally dead, and later sought to remove the ventilator. The family objected, asserting that the heartbeat was proof that she remained alive. In a document filed in Federal Court, the family’s lawyer stated that the girl’s parents are “Christians with firm religious beliefs that as long as the heart is beating, Jahi is alive.”Doctors who have examined the girl, including a court-appointed neurologist, have all declared her brain-dead.

Under the agreement reached Friday, the hospital will release the girl to the Alameda County coroner, a move that will officially classify the girl as dead, before the family can transfer Jahi elsewhere.
The agreement does not require the hospital to perform the procedures that will help the girl’s heart to keep beating during the transfer, or to allow an outside doctor to carry them out on hospital premises, as Mr. Dolan had requested.

Lt. Riddic Bowers of the Alameda County Coroner’s Bureau said that once the bureau issued a death certificate and a release form, a deceased person’s relatives were free to dispose of the body according to their wishes.David Magnus, director of the Stanford Center for Biomedical Ethics, said it was unlikely that a long-term care facility would accept a patient who has been issued a death certificate.“There’s no reported case of a correct diagnosis of brain death where anybody comes back,” he said. He added that while death occurs after an hour because of a lack of blood flowing into the brain, Jahi has not had blood flowing into her brain since at least Dec. 12. 


William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.














Friday, January 3, 2014

Mental Illness can create a higher risk for substance abuse

People with severe mental illness such as schizophrenia or bipolar disorder have a higher risk for substance use, especially cigarette smoking, and protective factors usually associated with lower rates of substance use do not exist in severe mental illness, according to a new study funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

In the current study, 9,142 people diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features, and 10,195 controls matched to participants according to geographic region, were selected using the Genomic Psychiatry Cohort program. Mental disorder diagnoses were confirmed using the Diagnostic Interview for Psychosis and Affective Disorder (DI-PAD), and controls were screened to verify the absence of schizophrenia or bipolar disorder in themselves or close family members. The DI-PAD was also used for all participants to determine substance use rates.

Compared to controls, people with severe mental illness were about 4 times more likely to be heavy alcohol users (four or more drinks per day); 3.5 times more likely to use marijuana regularly (21 times per year); and 4.6 times more likely to use other drugs at least 10 times in their lives. The greatest increases were seen with tobacco, with patients with severe mental illness 5.1 times more likely to be daily smokers. This is of concern because smoking is the leading cause of preventable death in the United States.

Read about this on the NIH website and read the article at http://archpsyc.jamanetwork.com/article.aspx?articleid=1790914#Abstract


William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.


Thursday, January 2, 2014

Medicare pricing drives high health-care costs

For virtually every procedure and service — from routine colonoscopies to brain surgery and hospice care — Medicare comes up with a dollar figure that the government considers a fair price. But economists are finding that, largely because of the program’s vast scale, Medicare prices substantially shape what all Americans pay for health care. 

“Our results suggest that Medicare’s decisions are far more influential than you may imagine,” said Joshua Gottlieb, an economist at the University of British Columbia. His research shows that a $1 change in the price that Medicare pays yields a $1.30 change in what private insurers pay. What happens if the government gets those prices wrong? In the past year, a Washington Post investigation has shown that Medicare prices are sometimes based on faulty premises, offer perverse incentives for unnecessary care and provide widely varying amounts for equivalent drugs.

“It’s a very big problem — Medicare pays too much for a lot of stuff it buys,” said Bruce Vladeck, who headed Medicare under President Bill Clinton. “If you had better pricing policy, a whole lot of hysteria about long-term insolvency of Medicare would go away.”

“Medicare is a wonderful program, but behaviorally, because of the price-fixing, it’s a mess,” said Tom Scully, who was Medicare chief during the George W. Bush administration and is now a partner in a private-equity firm that invests in health care.

Economists believe that the Medicare prices are even more important than that massive scale suggests, because in the absence of a traditional market for medical services, the Medicare prices form the foundation for private insurers, as well.

That is partly because Medicare is such a huge player in the market, accounting for more than a fifth of the money spent on personal health care. But there is a second, possibly more important impetus: Because of the complexity of modern medicine, setting prices is an arduous, time-consuming task. Insurers save money by letting Medicare do the work.

Read more about this in the Washington Post at http://www.washingtonpost.com/business/economy/medicare-pricing-drives-high-health-care-costs/2013/12/31/24befa46-7248-11e3-8b3f-b1666705ca3b_story.html


William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.

Wednesday, January 1, 2014

Medicare to Cover More Mental Health Costs

For decades, older adults with depression, anxiety and other psychological conditions have received unequal treatment under Medicare. The program paid a smaller share of the bill for therapy from psychiatrists, psychologists or clinical social workers than it did for medical services. And Medicare imposed strict lifetime limits on stays in psychiatric hospitals, although no such limits applied to medical care received in inpatient facilities.

On Jan. 1, that process will be complete, and for the first time since Medicare’s creation seniors who seek psychological therapy will be responsible for 20 percent of the bill while Medicare will pay 80 percent, the same percentage it covers for most medical services. (Payment kicks in once someone exhausts an annual deductible — $147 next year.)

But parity under Medicare remains incomplete, and hurdles still stand in the way of older adults receiving services. A 190-day lifetime limit on inpatient services at psychiatric hospitals is the most notable example. There is no similar cap on any other inpatient medical services provided through Medicare.

Read more about this in the New York Times blog by Judith Graham.


William Wombacher, your Central Illinois Certified Elder Law Attorney (CELA) and Social Security Disability Specialist. I'll help you!   www..wombacherlaw.com
 
Serving Peoria, East Peoria, Peoria Heights, Pekin, Dunlap, Chillicothe, Morton, Washington, Metamora, Canton, Galesburg, Lacon, Henry, Bloomington, Normal and surrounding cites and counties of Peoria, Tazewell, Woodford, Fulton and  Knox Counties in Central Illinois.