New Year, New Health Care Provisions: What You Can Expect

Photo Courtesy - Getty Images(WASHINGTON) -- The new year brings new changes in the U.S. health care system.

Although most of the new provisions that will roll out next week as part of the Affordable Care Act apply mainly to insurers, they will have a direct impact on consumers too.

Here's a look at some of the changes Americans can expect starting Jan. 1, 2011.

One provision that triggered particular controversy earlier this year was end-of-life counseling, which the federal government will pay for starting Jan. 1.

The White House points out that the option will now be covered as part of the new annual wellness visit created by the Affordable Care Act.

The provision has revived discussion of "death panels" -- a term first coined by Betsy McCaughey, a Republican health policy expert and the former lieutenant governor of New York -- which was widely used by former Alaska Gov. Sarah Palin. The provision could be one of the targets for repeal or defunding in the new Congress.

Pharmaceutical manufacturers will have to provide a 50 percent discount on brand-name prescription drugs to older Americans who fall into the "doughnut hole," the out-of-pocket expenses Medicare recipients have to pay once their prescription drug costs reach $2,830.

The "doughnut hole" will eventually be phased out so that enrollees in the Medicare Part D drug coverage program will be responsible only for 25 percent of their prescription drug costs by 2020.

In 2010, elderly Americans who fell into the gap received a $250 rebate check.

There will be a 10 percent Medicare bonus payment for primary care services and a 10 percent Medicare bonus payment to some surgeons in specialties with fewer doctors.

That component of the health care bill lasts until Dec. 31, 2015.

The new law eliminates any cost sharing Medicare beneficiaries need to pay for preventive care and waives the deductible for colorectal cancer screening tests.

A 15-member, independent advisory board will be established to study how to reduce Medicare spending if it exceeds targeted growth rates.

Under the new law, insurance companies serving the large group market will have to devote 85 percent of every dollar to patient care and improving quality of care, instead of such expenses as overhead costs, executive salaries or dividends for shareholders. For those serving small business and individuals, that has to amount to 80 percent of every dollar.

If insurance companies fail to meet these standards, they will have to provide rebates to consumers.

The medical loss ratio -- the ratio of medical expenses to administrative spending -- came under fire last year when some companies, such as McDonald's, reportedly threatened to drop limited coverage plans because of the new standards.

A new program will go into effect that will provide matching federal funds for long-term care services under Medicaid. The federal government will also provide funds for home health care and attending services for people with disabilities.

The Medicaid expansion under the new health care law has met with resistance from many state governments that say it puts additional burdens on them at a time when they're struggling with budget deficits.

Copyright 2010 ABC News Radio


French Model Isabelle Caro's Death Highlights Tough Personal Battles Against Anorexia

Photo Courtesy - Getty Images(TOKYO) -- Isabelle Caro, a French model featured in an anti-anorexia advertising campaign, died at age 28 from unknown causes. Caro actually died last month, but the news wasn't made public until this week.

Caro suffered from anorexia from the time she was a teenager and made her struggle public in 2007 when she appeared in an ad for an Italian designer showing her naked, emaciated frame with the words "No. Anorexia."

Caro chronicled her battle with anorexia on her blog. In a magazine interview she published on her blog, she said her reason for making the ad was to draw attention to how debilitating the disease can be.

"I wanted to show, in its raw state, the full horror of anorexia," Caro said in a quote translated from French.

Specialists who treat eating disorders say Caro's untimely death sends the message she wanted to send to others while she was alive.

"I think it is so important that a high-profile death remind us of all of the less high-profile people who are struggling and dying," said Cynthia Bulik, director of the UNC Eating Disorders Program at The University of North Carolina at Chapel Hill.

Bulik and other experts say anorexia and other eating disorders are physically and mentally devastating. Treatment can be very intense and very difficult, and part of the challenge is that little is known about what causes the distorted body image that is characteristic of these disorders.

Caro talked about the serious physical toll anorexia took on her body. During one hospital stay, she was so sick she fell into a coma.

"If people are trying to control their weight using devious means, they can kill themselves if they purge themselves, take laxatives or starve themselves," said Dr. Richard Pesikoff, a professor of psychiatry at Baylor College of Medicine in Houston. "If you vomit up potassium, your potassium levels drop. Then you get cardiac arrhythmia, and multiple vomiting can lead to cardiac arrest and death."

"Anorexia nervosa is a serious biologically based mental illness with the highest mortality rate of any psychiatric disorder," said Bulik.

Treatment generally involves a team of specialists, including psychiatrists, psychotherapists, pediatricians or other general practitioners, and others. The intensity of treatment depends on how severe a person's illness is.

Because there are so many physical and psychological factors involved in anorexia and other eating disorders, recovery can be difficult.

"Once someone starts down the slippery slope of starvation, it simply spins out of control," said Bulik. "Even if the person wants to recover, it becomes enormously hard to eat and restore weight. The fear and anxiety underlying anorexia nervosa become paralyzing to recovery."

Caro's long struggle with anorexia emphasizes how pervasive a disease it is.

"Anorexia nervosa is not a phase," said Bulik. "Anorexia nervosa is not a choice. It needs to be taken seriously because, as Isabelle Caro's death underscores, it is serious."

Copyright 2010 ABC News Radio


New Year’s Worst Holiday for Underage Drinking-Related ER Visits

Photo Courtesy -- Getty Images(ROCKVILLE, Md.) – Visits to the emergency room due to underage drinking nearly quadruple on New Year’s Eve according to a new report.

The report out Thursday by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) said that New Year’s-related drinking sent 1,980 underage individuals to the ER in 2009.

The figure is four times greater than the average daily number of people under 21 who make alcohol-related ER visits.

It also beats out other notorious partying holidays such as Fourth of July and Memorial Day weekend.
Copyright 2010 ABC News Radio


'Am I Going to Wake Up?' Scientists Continue to Analyze the Effects of Anesthesia

Photo Courtesy - Getty Images(CAMBRIDGE, Mass.) -- Modern medical advancements could put patients more at ease when going under anesthesia, but scientists are only now researching the effects of the drug on the brain.

A patient’s fear of waking up while under the knife could be calmed by modern developments such as brain monitors that can gauge levels of consciousness. Such developments, however, underscore the complex science of keeping patients free from consciousness and pain without killing them.

The use of general anesthesia is a routine part of surgical operations at hospitals and medical facilities around the world, but the precise biological mechanisms of the drug's effects on the brain are only now being analyzed.

In a review article published this week in the New England Journal of Medicine, scientists have for the first time used a range of disciplines, including neuroscience and sleep medicine, to lay the groundwork for better understanding of how anesthesia actually works.

Armed with the new information, doctors can speak more frankly and knowledgeably to patients.

"The biggest concern among patients is, "Am I going to wake up?" said lead study author Dr. Emery Brown, an anesthesiologist at Massachusetts General Hospital and professor at Massachusetts Institute of Technology. "That happens extremely rarely but it's a fear everyone has. I think the way to assuage the fear is to know what we are doing. But we can't continue to comfort people if it's a black box and I assure you it's not going to go wrong."

Among the most common misconceptions given by doctors to patients regarding anesthesia is the idea that they are being put to sleep. General anesthesia, however, is a reversible coma. Brown said doctors often tell their patients they are putting them to sleep in hopes of scaring them less.

Copyright 2010 ABC News Radio


Nintendo: 3D Game Player Not for Pre-Schoolers

Photo Courtesy - Nintendo(KYOTO, Japan) – Japanese gaming company Nintendo has warned that a new 3D video game player could permanently damage the eyesight of those under age six whose eyes are still developing, reports MedPage Today.

The portable 3D player, 3DS, will be introduced starting in late February. In their warning, Nintendo cited "a potential impact on the growth of children's eyes” when using the device in 3D.

Nintendo suggests that the device be switched to a 2D mode when used by children under six years old.

Copyright 2010 ABC News Radio


Banned at Birth: Maryland Hospital Bars Delivery Room Pictures and Video

Photo Courtesy - Getty Images(HAGERSTOWN, Md.) -- Laurie Shifler, pregnant with her eighth child, is preparing for a birth different from her seven previous experiences after her Maryland hospital banned photography and video in the delivery room until five minutes after the baby is born.

"My family has taken pictures of every single one of my children when they were seconds old. I have pictures of all seven of them on my chest, that new look, that new human being that you just brought into the world," Shifler said.

The hospital, Meritus Medical Center, formerly known as Washington County Hospital, implemented its policy Nov. 1.

"We felt it enabled the physician, midwives and staff to focus on the safety and health of the mom and the newborn and that it still allowed the cutting of the cord and photo opportunities of mom with baby," Mary Stuart Rizk, spokesperson for Meritus Medical Center, said.

The hospital, located in Hagerstown, said that it decided on the policy after surveying several hospitals in the region. Meritus said that the policy does not stem from lawsuits but from concern about mother and child.

Rizk, the hospital spokesperson, said that the hospital has received only one formal complaint since implementing the policy.

"We heard from one expectant mother in late September to complain about the pending policy change," Rizk said. "We have not had a single patient complaint since we implemented the policy on Nov. 1."

But Shifler said that many moms might not be aware of the policy. She found out by accident.

Shifler, the 36-year-old expectant mother, said it's too late to change doctors and hospitals. Her due date is Jan. 13. "I don't even know what the logistics would be with the insurance and just to find someone that would take me at 38 weeks. I've used him [my current doctor] for the last four kids," Shifler said.

She is hoping the hospital will change its stance.

"A picture at five minutes old versus five seconds old is a whole different picture."

Copyright 2010 ABC News Radio


Holiday Hangover: Alcohol Linked to SIDS Deaths

Photo Courtesy - Getty Images(OAKLAND, Calif.) -- The New Year's Day hangover can be deadly for caregivers who have had a night of heavy drinking and awake to find a lifeless baby in the crib.

More than 2,500 babies a year die from sudden infant death syndrome (SIDS), and now researchers now say there may be an association between those deaths and alcohol.

A University of California study published this month in the journal Addiction found a 33-percent spike in SIDS deaths on Jan. 1.

Alcohol consumption is also at an all-time high during the holidays.

The study, conducted by sociologist David Phillips, concluded that alcohol was a risk factor for SIDS, although it is unclear whether alcohol is an independent risk or occurs only in conjunction with other known risks, such as co-sleeping with the baby.

It concludes that alcohol "impairs parental capacity" and therefore can put a child at risk.

Scientists took into account the normal increase in SIDS deaths that are reported during the winter months, probably because of colds and respiratory infections, as well as using coverings in the crib for warmth.

The study looked at 129,090 SIDS cases from 1973 to 2006 and also tracked alcohol-related motor vehicle accidents among the general population. Both were at an all-time high on New Year's Day.

In addition, the study showed another rise in SIDS deaths right after April 20, a day celebrated by pot smokers and after July 4, also a time of heavy alcohol use. Babies of mothers who drink are also twice as likely to die of SIDS, according to the study.

"It's logical that when women are inebriated the attentiveness to the child is going to be reduced and the likelihood of getting a child in the situation where a parent puts them at risk would be there," said Dr. Michael Malloy, a neonatologist at University of Texas Medical Branch.

Copyright 2010 ABC News Radio


No Link Between Maternal Obesity and Child Behavior

Photo Courtesy -- Getty Images(BRISTOL, England) – A new study claims that the offspring of overweight women are not more prone to behavioral issues such as ADHD as was previously thought.

According to WebMD, researchers at the University of Bristol say they found no substantiated link between maternal pre-pregnancy weight and child behavior, despite initial hints that they may be connected.

“We find little consistent evidence for intrauterine effects of maternal pre-pregnancy overweight on childhood verbal skills, nonverbal skills and behavioral problems,” said researcher Marie-Jo Brion, PhD, of the University of Bristol and colleagues. “Previously reported findings of an association with childhood ADHD and intellectual function is not supported by the present study,” Brion concluded.

The study also showed no link between a father’s weight and cognitive problems in his children. Researchers did point out, however, that obesity in pregnant women can lead to other complications before and after birth.

Copyright 2010 ABC News Radio


Coming Soon: Nutrition Labels on Cuts of Meat

Photo Courtesy - Getty Images(WASHINGTON) -- Nutrition labels, like those found on the backs of cereal boxes and canned goods, will soon be required on cuts of meat.

As reported by USA Today, the U.S. Department of Agriculture is expected to announce the new requirements on Wednesday.  The new labels, which are set to go into effect on Jan. 1, 2012, will list calories, calories from fat, total fat, saturated fat, cholesterol, sodium, protein and vitamins for the slabs of beef, poultry, pork and lamb that are most commonly consumed.

By implementing the labels, federal officials hope Americans will become more health conscious and selective when choosing to buy meats.

Copyright 2010 ABC News Radio


Snow Shoveling May Put Hearts at Risk

Photo Courtesy - Getty Images(NEW YORK) -- As Americans living on the Eastern seaboard break out the snow shovels, doctors are telling them to take special care, and have "great respect" for the dangers of blizzard conditions, both during and after the storm.

Doctors say slips and falls are the most common injuries caused by snow and ice seen in the ER, but they also warn of heart dangers that may come with a snowfall.

"The risk of heart attack is increased by the combination of heavy, upper body exertion and cold weather encountered while shoveling snow," said Dr. William Abraham, director of the division of cardiovascular medicine at Ohio State University.  "People, especially those at risk for coronary heart disease, should avoid heavy exertion in cold weather conditions."

There are two major points that can put people at risk for heart problems when it's cold.

"For one, most people don't realize that, when their hands get cold, it causes blood vessels in the heart to constrict and reduce the blood supply to their heart," said Dr. Randy Zusman, director of the Massachusetts General Hospital Heart Center.

So, if a blood vessel is 20 percent to 30 percent blocked, it can become up to 70 percent to 80 percent blocked due to the constricting walls in the cold weather conditions, said Zusman.

And once the shovel comes out of the garage, things can often get much worse.

"Lifting heavy snow is like heavy weight lifting," said Zusman.  "It puts a strain on the heart, and the blood pressure and heart rate go up in response to it."

Copyright 2010 ABC News Radio

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