Sunday, June 30, 2013

As Doctors Leave Syria, Public Health Crisis Looms

Listen to the Story 4 min 54 sec Playlist Download Transcript   Enlarge image i

Refugees fill cans with water inside a camp in Baalbek, Lebanon, for Syrians who have fled the fighting in their country.

Spencer Platt/Getty Images

Refugees fill cans with water inside a camp in Baalbek, Lebanon, for Syrians who have fled the fighting in their country.

Spencer Platt/Getty Images

The death toll in Syria's ongoing civil war may now be as high as 100,000. As the violence mounts, another emergency is looming: a public health crisis across the region.

That's the conclusion of a new study published by the British medical journal The Lancet. Syria's health care system is near collapse. Outbreaks of disease are on the rise in the country, and refugees sheltered beyond the border are also at great risk.

One medical clinic in a poor neighborhood in Beirut is always busy. The two-story building is up a narrow street of cinder-block homes. Syrian refugees have moved in, adding to the crowding and the caseload, Dr. Abdul Kader Abbas says. He says he's treated 758 Syrian families here � many already sick when they arrived in this densely packed neighborhood.

"With the additional numbers," Abbas says, "we are afraid that any disease could spread easily in such circumstances." That's the same warning spelled out in the latest Lancet report.

Seventy percent of Syria's medical professionals have fled the country. Public health researchers Dr. Adam Coutts and Dr. Fouad Fouad say there has been a dramatic rise in communicable disease.

For example, Coutts says, there were 7,000 cases of measles in northern Syria in the past few months after a vaccination program was disrupted by war, and the list is growing to include TB, leishmaniasis, typhoid and cholera, which will come up during the summer months.

Leishmaniasis is spreading so fast among the displaced people inside of Syria that it is now called the "Aleppo boil" � for the running skin sores transmitted by sand fleas. Fouad says with the collapse of Syria's health care system, many Syrians have not had any medical care or medicine for more than two years.

When you consider chronic diseases like diabetes, Type 1 and 2, and cancer, Fouad says, you start to see that more people are dying of disease rather than war.

Disease moves easily across boundaries along with the refugees. Coutts and Fouad warn this could lead to a public health crisis for the entire region. By the end of this year, the Syrian refugee population is expected to reach more than 3 million.

In Jordan, the patient load in hospitals has jumped 250 percent in the past five months. Lebanon's health system is under strain with more registered refugees than any of its neighbors.

Parallels War Correspondent's Unflinching 'Diary Of A Very Bad Year'

"With this huge influx of refugees now in Lebanon," Fouad says, "the number will come to change the whole system."

One expected change is in the school system. U.N. officials estimate that when school starts in the fall, Syrians will outnumber Lebanese kids in the country's public schools. That worries Hayda Mohammed Al Jeeshi, the nurse at the health care center.

She says many Syrian kids missed childhood vaccinations before they fled to Lebanon and that puts Lebanese children at much greater risk. The measles outbreak that started in northern Syria is now showing up among the refugee community in Lebanon.

Scrambling to care for one of the world's largest refugee populations is another burden of the Syrian war. The U.S. government has upped its contribution to host countries to more than $800 million, with an additional $300 million pledged this month for food, shelter and health care.

"Diseases don't care whether you're for Assad, or against Assad, or uninterested in politics," says Anne Richard, the U.S. assistant secretary of state for refugees, who was in Lebanon this week. "It strikes everyone, as an equal opportunity."

Share Facebook Twitter Google+ Email Comment More From Middle East Lack In Leadership Hurts Palestinian Peace ProspectsNewsAmerican Killed At Protest In Egypt ID'd As Kenyon StudentEgyptian Protests Grow ViolentAs Doctors Leave Syria, Public Health Crisis Looms

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Tuesday, June 25, 2013

Top Medicare Prescribers Rake In Speaking Fees From Drugmakers

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Monday, June 24, 2013

Depression May Increase The Risk Of Dementia Later On

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Saturday, June 22, 2013

Political Fight Jeopardizes Medicaid In Mississippi

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Thursday, June 20, 2013

Universal Healthcare and Economic Freedom Go Hand-in-Hand

One of the most pernicious myths of the past half century is that guaranteeing healthcare for all Americans would strike a mortal blow against this country’s system of free enterprise.

That claim has been made endlessly in the context of the Affordable Care Act, and Obamacare critics are now ramping up their predictions of doom as implementation of the law grows near.

But as Robert Frank explained this weekend in the New York Times, the lived experience of other countries like Sweden with national healthcare systems doesn’t bear out the fears.

In fact, you don’t need to take the word of a progressive economist like Frank on this point. The Heritage Foundation’s research indicates the same thing.

Consider Heritage’s “Index of Economic Freedom,” which measures how friendly countries are to business, investors, and property rights.

The countries that rank the highest on the list are: Hong Kong, Singapore, Australia, New Zealand, Switzerland, Canada, Chile, Mauritius, Denmark, and the United States.

Of those ten countries, nearly every one has a universal healthcare system or mandates that individuals pay into medical savings accounts. Australia and Canada both have single-payer systems. Denmark’s system is pretty much government controlled. Switzerland’s system is similar in many ways to Obamacare. Among the top twenty nations on the list are Ireland, the U.K., Germany, Sweden, and Finland — other countries that also have universal healthcare systems.

There are some good reasons why such systems might go hand-in-hand with economic freedom. For one thing, as Robert Frank noted, these systems help keep down healthcare costs:

The United States spends more than $8,000 a person per year on health care, well more than twice what Sweden spends. Yet health outcomes are far better in Sweden along virtually every dimension.

Lower healthcare costs mean that business and individuals can channel more money into productive uses that foster a vibrant and globally competitive market economy.

Universal healthcare systems also make it easier for people to be entrepreneurs or self-employed. While we think of the United States as a place where people are uniquely likely to strike out on their own, this is largely a myth. The U.S. actually has a much lower self-employment rate than most developed countries. Australians, Brits, Germans, Swedes, and so on all are more likely to work for themselves than Americans.

It’s hard to say how much universal healthcare insurance determines self-employment rates, but common sense suggests you’re more likely to go out on your own if you’re not worried about losing your health insurance.

Now, does all this mean that Obamacare will produce more economic freedom in America? Not necessarily. Ironically, government run healthcare system are better for free enterprise than those — like the ACA — which impose mandates on employers.

I say ironically because, of course, such a truly “socialized” system was off the table during the healthcare debate thanks opposition by supposed defenders of economic freedom.

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Wednesday, June 19, 2013

House Passes Bill That Would Ban Abortions After 20 Weeks

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Vaccine Against HPV Has Cut Infections In Teenage Girls

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Monday, June 17, 2013

FTC Can Sue Firms In 'Pay For Delay' Drug Deals, Court Rules

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Saturday, June 15, 2013

Commentary: On Being Young and Wanting Health Insurance

Ed. note: This blog was first published on BET. You can see the original post here.

I'm a 24-year-old server and bartender in Philadelphia, an uncle, and a father figure to my sister's three children. And I'm one of the millions of young Americans who can't afford health insurance.

Until recently, that never struck me as a big deal. �When you're young and healthy, you don't really think about health insurance-or at least you don't think about it until something goes wrong and you need it.

Not too long ago, I hurt my foot pretty badly, and thought that I may have fractured a bone.� It was the sort of injury that if I had insurance I would've gotten checked out, but since I wasn't covered and couldn't afford to go see a doctor, I ended up just working through the pain.

That experience made me think about the consequences that a really serious accident could have on the rest of my life.� Without insurance, one injury could just turn my future upside down.

That's why I'm looking forward to the new Health Insurance Marketplaces being created thanks to the health care law.� This October, I'll be one of the people checking out affordable health plans on HealthCare.gov.� I'll figure out which plan is the best fit for me and for my wallet, and I'll find out if I can get additional help covering costs from the new tax credits the law is making available.

Having health insurance is all about peace of mind-it means somebody's got your back in case anything happens to you.� And having that worry off my shoulders is going to make things so much easier for me as I work toward my goals, whether that ends up meaning going back to school or maybe looking for a better job.

Just because I'm young and healthy now doesn't mean I shouldn't be looking out for my future.� That's why I'll be visiting the Marketplace on October 1 to choose a health insurance plan.

You can learn more about the Marketplace and what you need to do to prepare for October.

Friday, June 14, 2013

New York Hospitals Shelve Rivalries For Proton Beam Project

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Thursday, June 13, 2013

Judge Reluctantly Approves Government Plan For Morning-After Pill

More From Shots - Health News HealthHaiti Moves A Step Closer Toward Eradicating ElephantiasisShots - Health NewsSupreme Court Gene Ruling Splits Hairs Over What's 'Natural'HealthJudge Reluctantly Approves Government Plan For Morning-After PillHealthPrevention Pill Cuts HIV Risk For Injecting Drug Users

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Prevention Pill Cuts HIV Risk For Injecting Drug Users

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Monday, June 10, 2013

African-Americans Remain Hardest Hit By Medical Bills

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African-Americans Remain Hardest Hit By Medical Bills

More From Shots - Health News HealthConcussion Prescription: A Year On The Bench For Youngsters?HealthTriple Threat: Middle East Respiratory Virus And 2 Bird FlusHealthDesignated Drivers Often Fail To Abstain From DrinkingHealthAfrican-Americans Remain Hardest Hit By Medical Bills

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Sunday, June 9, 2013

'Not Fighting For Just Sarah': Rating Transplant Priorities

Listen to the Story 11 min 30 sec Playlist Download Transcript   Enlarge image i

Sarah Murnaghan, center, on May 30 as she and her parents marked the 100th day of her stay in Children's Hospital of Philadelphia. Her father, Fran, is at left. Her mother, Janet, is at right.

Murnaghan family/AP

Sarah Murnaghan, center, on May 30 as she and her parents marked the 100th day of her stay in Children's Hospital of Philadelphia. Her father, Fran, is at left. Her mother, Janet, is at right.

Murnaghan family/AP

Sarah Murnaghan's spirit can be summed up by her personalized Monopoly character: a three-legged silver pig that can stand on its own.

"Everybody sort of expects her to decline here, and she does, but she fights back every time," says her mother, Janet.

Sarah, who has cystic fibrosis, has a reason to keep fighting: She's another step closer to getting a lung transplant. Sarah has been waiting for a year and a half, and doctors say she could die soon without a transplant.

The current system puts children at the bottom of the list for adult lungs. While they are eligible for child donor lungs, those are harder to come by. Wednesday, Judge Michael Baylson ruled that Sarah could be moved up on the adult list, and considered for a new set of adults lungs based on her need, not her age.

Sarah's family has new hope. Janet Murnaghan says Sarah's heart is under a lot of strain, but she's still a good transplant candidate. Now they're waiting for a match.

The case has triggered a swell of emotions, along with a wave of arguments criticizing and defending the current organ allocation system.

Setting Priorities

Janet Murnaghan says her family's legal fight for Sarah is one path toward revising the transplant selection process. "We're not fighting for just Sarah," she tells Tess Vigeland, guest host of weekends on All Things Considered. "There is a system here that is letting children die. The system needs to be fairer."

Murnaghan says adults are favored over children, even if that wasn't the original intention. She believes there shouldn't be an age cutoff at all � that organs should be given based on doctors' recommendations.

So how are those decisions made?

The first thing to note is that there just aren't enough organs available. More than 100,000 people are on the list for a new organ, according to the Organ Procurement and Transplantation Network, a nonprofit contracted by the federal government to regulate transplants in the U.S. And 18 die each day while still waiting.

Given the constraints, selecting an organ recipient comes down to priorities. Bioethicist Art Caplan says there are a number of factors that determine where you land on the waitlist, including: blood type, immune system, who's the sickest and who has the greatest need.

"Among that group, the system then starts to say, 'Who's going to do best? Who will survive with the greatest chance of living and living long? And then beyond that, you're starting to look at things like geography [to find out how far the organ needs to travel]," he says.

The under-12 rule evolved, Caplan says, from the medical complications that come with putting an adult organ in a child.

The Financial Factor

Caplan says, generally, the system "does a good job in trying to let medical factors and objective factors drive the distribution of organs.

"What isn't a good situation is admission to the transplant centers. One of the first tests that everybody does is a very thorough wallet biopsy," he says. "So the ability to pay counts. ... It's a major driver in access to transplants."

Dr. John Roberts, chairman of the transplant network's executive committee, disagrees with Caplan's assessment.

"I think there are people who have a harder time getting referred for a transplant, but I don't think it's necessarily an insurance, 'wallet biopsy' approach," he says.

He says Medicaid will cover transplantation for low-income patients, but not in every state. Transplants easily run hundreds of thousands of dollars, some even hitting seven figures.

Roberts says it's the post-surgery costs that can create the biggest financial hurdle for patients. "The medications are lifelong, and they are expensive," he says.

'No Great Solution'

As a result of the judge's decision, the allocation system is under review. Roberts says that doesn't mean change is inevitable, but he certainly has received a lot of feedback.

"I received I think almost 50,000 emails now from people that are concerned about whether or not we are giving children high enough priority for all organs," he says. "And that's sort of a societal decision. There's no great solution here."

What Roberts is concerned about is having transplant allocation decided by political or judicial systems working on behalf of specific children who have access to lawyers or the media. "On some level, we can't make a decision child by child," he says.

So far, the federal judge in Pennsylvania has ruled in favor of two children, putting both on the older-than-12 waitlist for lung transplants.

"I surely understand the judge," Roberts says. "He doesn't want to make a decision that the [organ transplant network] has to make of: this child is in a situation with a lot of other children, and how that is going to affect the other children. He's making a decision for the child that's in front of him."

'Just A Chance'

Now, Janet Murnaghan is looking at the child in front of her. She's not sure "optimistic" is the right word to describe how her family's feeling.

"I don't know what's going to happen in 10 days, and we still have a kid who's really seriously ill. And we have a kid who may not make it 10 days. I don't know," she says.

"I would just say, for the first time in a little while here, we have hope that she has a chance. Just a chance."

Share Facebook Twitter Google+ Email Comment More From Law Same-Sex Marriage And The Supreme CourtSame-Sex Couple Seeks Immigration Relief From High CourtU.S.Toll In Santa Monica Shooting Rises To Six, Including Gunman'Not Fighting For Just Sarah': Rating Transplant PrioritiesU.S.Police: Gunman Had Attended Santa Monica College

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'Not Fighting For Just Sarah': Rating Transplant Priorities

Listen to the Story 11 min 30 sec Playlist Download Transcript   Enlarge image i

Sarah Murnaghan, center, on May 30 as she and her parents marked the 100th day of her stay in Children's Hospital of Philadelphia. Her father, Fran, is at left. Her mother, Janet, is at right.

Murnaghan family/AP

Sarah Murnaghan, center, on May 30 as she and her parents marked the 100th day of her stay in Children's Hospital of Philadelphia. Her father, Fran, is at left. Her mother, Janet, is at right.

Murnaghan family/AP

Sarah Murnaghan's spirit can be summed up by her personalized Monopoly character: a three-legged silver pig that can stand on its own.

"Everybody sort of expects her to decline here, and she does, but she fights back every time," says her mother, Janet.

Sarah, who has cystic fibrosis, has a reason to keep fighting: She's another step closer to getting a lung transplant. Sarah has been waiting for a year and a half, and doctors say she could die soon without a transplant.

The current system puts children at the bottom of the list for adult lungs. While they are eligible for child donor lungs, those are harder to come by. Wednesday, Judge Michael Baylson ruled that Sarah could be moved up on the adult list, and considered for a new set of adults lungs based on her need, not her age.

Sarah's family has new hope. Janet Murnaghan says Sarah's heart is under a lot of strain, but she's still a good transplant candidate. Now they're waiting for a match.

The case has triggered a swell of emotions, along with a wave of arguments criticizing and defending the current organ allocation system.

Setting Priorities

Janet Murnaghan says her family's legal fight for Sarah is one path toward revising the transplant selection process. "We're not fighting for just Sarah," she tells Tess Vigeland, guest host of weekends on All Things Considered. "There is a system here that is letting children die. The system needs to be fairer."

Murnaghan says adults are favored over children, even if that wasn't the original intention. She believes there shouldn't be an age cutoff at all � that organs should be given based on doctors' recommendations.

So how are those decisions made?

The first thing to note is that there just aren't enough organs available. More than 100,000 people are on the list for a new organ, according to the Organ Procurement and Transplantation Network, a nonprofit contracted by the federal government to regulate transplants in the U.S. And 18 die each day while still waiting.

Given the constraints, selecting an organ recipient comes down to priorities. Bioethicist Art Caplan says there are a number of factors that determine where you land on the waitlist, including: blood type, immune system, who's the sickest and who has the greatest need.

"Among that group, the system then starts to say, 'Who's going to do best? Who will survive with the greatest chance of living and living long? And then beyond that, you're starting to look at things like geography [to find out how far the organ needs to travel]," he says.

The under-12 rule evolved, Caplan says, from the medical complications that come with putting an adult organ in a child.

The Financial Factor

Caplan says, generally, the system "does a good job in trying to let medical factors and objective factors drive the distribution of organs.

"What isn't a good situation is admission to the transplant centers. One of the first tests that everybody does is a very thorough wallet biopsy," he says. "So the ability to pay counts. ... It's a major driver in access to transplants."

Dr. John Roberts, chairman of the transplant network's executive committee, disagrees with Caplan's assessment.

"I think there are people who have a harder time getting referred for a transplant, but I don't think it's necessarily an insurance, 'wallet biopsy' approach," he says.

He says Medicaid will cover transplantation for low-income patients, but not in every state. Transplants easily run hundreds of thousands of dollars, some even hitting seven figures.

Roberts says it's the post-surgery costs that can create the biggest financial hurdle for patients. "The medications are lifelong, and they are expensive," he says.

'No Great Solution'

As a result of the judge's decision, the allocation system is under review. Roberts says that doesn't mean change is inevitable, but he certainly has received a lot of feedback.

"I received I think almost 50,000 emails now from people that are concerned about whether or not we are giving children high enough priority for all organs," he says. "And that's sort of a societal decision. There's no great solution here."

What Roberts is concerned about is having transplant allocation decided by political or judicial systems working on behalf of specific children who have access to lawyers or the media. "On some level, we can't make a decision child by child," he says.

So far, the federal judge in Pennsylvania has ruled in favor of two children, putting both on the older-than-12 waitlist for lung transplants.

"I surely understand the judge," Roberts says. "He doesn't want to make a decision that the [organ transplant network] has to make of: this child is in a situation with a lot of other children, and how that is going to affect the other children. He's making a decision for the child that's in front of him."

'Just A Chance'

Now, Janet Murnaghan is looking at the child in front of her. She's not sure "optimistic" is the right word to describe how her family's feeling.

"I don't know what's going to happen in 10 days, and we still have a kid who's really seriously ill. And we have a kid who may not make it 10 days. I don't know," she says.

"I would just say, for the first time in a little while here, we have hope that she has a chance. Just a chance."

Share 1Facebook Twitter Google+ Email Comment More From Law U.S.Toll In Santa Monica Shooting Rises To Six, Including Gunman'Not Fighting For Just Sarah': Rating Transplant PrioritiesU.S.Police: Gunman Had Attended Santa Monica CollegeU.S.Prosecutors Recommend 4 Years For Jesse Jackson Jr.

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Thursday, June 6, 2013

Fat Doctors Make Fat Patients Feel Better, And Worse

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Saturday, June 1, 2013

Survivor Of Boston Marathon Bombings Has Long Road Ahead

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Survivor Of Boston Marathon Bombings Has Long Road Ahead

More From Shots - Health News Health D.C. Agency Approves 2 High-Tech Cancer CentersHealthSurvivor Of Boston Marathon Bombings Has Long Road AheadHealthYoung Women With Breast Cancer Opting For MastectomyHealth CareProton Beam Therapy Sparks Hospital Arms Race

More From Shots - Health News

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Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

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