RI ARA March 31, 2019 E-Newsletter by RI ARA

Publication 2019 Issue 14 Published in house by the RI ARA

March 31, 2019 E-Newsletter

It just became easier for employers to dump retirees' pensions Traditional pensions are disappearing in America, and the federal government just made it easier for employers to get rid of them. With no fanfare in early March, the Treasury Department issued a notice that allows employers to buy out current retirees from their pensions with a one-time lump sum payment. The decision reverses Obamaera guidance, issued in 2015, that had effectively banned the practice after officials determined that lump-sum payments often shortchanged seniors. Now, advocates for the elderly worry that millions of people receiving monthly pension checks could be at risk.

"Permitting plans — for their own financial benefit — to replace joint and survivor or other annuities with lump-sum payments will reduce the retirement security of both workers and their spouses," AARP Legislative Counsel David Certner said. Since the 1980s, employers have shifted away from offering defined-benefit pensions, which provide a guaranteed monthly income for as long as someone lives in retirement. Instead, employers now favor 401(k) accounts, a finite pot of money that becomes available at age 59.5.

Traditional pensions are disappearing in America, and the federal government just made it easier for employers to get rid of them. With no fanfare in early March, the Treasury Department issued a notice that allows employers to buy out current retirees from their pensions with a one-time lump sum payment. The decision reverses Obamaera guidance, issued in 2015, that had effectively banned the practice after officials determined that lump-sum payments often shortchanged seniors. Now, advocates for the elderly

worry that millions of people receiving monthly pension checks could be at risk. "Permitting plans — for their own financial benefit — to replace joint and survivor or other annuities with lump-sum payments will reduce the retirement security of both workers and their spouses," AARP Legislative Counsel David Certner said. Since the 1980s, employers have shifted away from offering defined-benefit pensions, which provide a guaranteed monthly income for as long as someone lives in retirement. Instead, employers now favor 401(k) accounts, a finite pot of money that becomes available at age 59.5….Read More

Trump Administration Says Entire Affordable Care Act Should Be Repealed In a significant shift, the Trump administration says the entirety of the Affordable Care Act should be struck down in the courts. Previously, the administration had pushed to remove the law's protections for people with pre-existing conditions but had not argued in court that the whole law should be struck down. The change was announced in a two-sentence letter from the Department of Justice to the 5th Circuit Court of Appeals, which said that the ruling made in December by a district court judge in Texas "should be affirmed." In that case, District Judge Reed O'Connor declared the ACA unconstitutional. He ruled that a 2017 change in

federal tax law eliminating the penalty on uninsured people invalidated the entire health care law. "The Department of Justice has determined that the district court's comprehensive opinion came to the correct conclusion and will support it on appeal," Justice Department spokeswoman Kerri Kupec said in a statement. The letter said the DOJ will further explain its position in a brief to be filed later. The Justice Department's letter won't change anything yet for the law, also known as Obamacare. Coverage for those who have insurance through the ACA — more than 10 million

people through Medicaid expansion, and nearly 12 million more through ACA exchanges — stays the same for now. The case will continue to wind through the courts and is likely to end up before the Supreme Court. If the case does land at the Supreme Court, it would be the third time that the court would rule on a constitutional question related to the ACA. The court upheld the law in 2012 and rejected a challenge to it in 2015. Meanwhile, a group of Republican state attorneys general is fighting to have the law repealed, while a group of Democratic state attorneys

general is arguing to keep the law in place. In addition to the law's bestknown aspects — the exchanges and the federal requirement to buy health insurance — the ACA touches every part of the health care system, from how Medicare pays doctors to the Medicaid expansion that has covered millions of low-income people to whether restaurants have to post nutrition information. Hospitals would have to develop new payment systems, and an entire section of the insurance industry would go away. This would also affect the “Donut Hole” for retirees and senior citizens on Medicare with Part D, Prescriptions.

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/

National Cross-Sector Coalition Calls for Federal Solutions to Stem Rising Prescription Costs Twelve organizations representing health care consumers, labor unions and health care providers, formally launched the Coalition for Fair Drug Prices. The diver sity of groups is historically symbolic, and demonstrates a collective desire to hold policymakers accountable for reining in high and rising prescription drug prices. As part of its launch, the Coalition hosted a media briefing where it released its Statement of Principles for prescription drug policy. Families USA executive director, Frederick Isasi, and AFL-CIO president Richard Trumka spoke at the briefing. Isasi said, “We and our partners are extremely proud to confront the true crux of America’s prescription drug pricing crisis — patent and

market exclusivity abuses that allow pharmaceutical companies to set astronomically high prices that our families can’t afford and that often have no relationship to value or health. Congress created the laws that many pharmaceutical companies are abusing, and they must fix this problem. Now. Making matters worse, tax payers fund basic research and development but taxpayers often can’t access, or afford the drugs their hard-earned money helped to create.” According to results from a February 2019 Kaiser Family Foundation survey, nearly 3 in 10 people across the country skip doses or forgo filling prescriptions altogether due to high costs. The

prescription drug crisis puts families at risk for poor health outcomes and threatens their financial stability. What’s more, the survey found that across party lines — and by wide margins — Americans support serious action to reduce drug prices, including allowing the government to negotiate prices with drug companies. While the Coalition for Fair Drug Prices is supportive of initial efforts Congressional committees have taken this year to address exorbitant prescription drug prices, those efforts are not enough. Families and health care consumers across America want and deserve meaningful reforms that target and reduce the underlying prices of drugs

so they are not forced to choose between their health and financial security to get the medication they need. “Unreasonably high drug prices and unjustified price increases do not happen by chance. They are the result of deliberate policy decisions made in Washington,” said AFL-CIO President Richard Trumka. “Patients at the pharmacy counter, workers at the bargaining table and their health plans negotiating with drug companies are all forced to pay the price. That’s why working people are joining with other health care advocates to change the rules so families can get the lifesaving drugs they need at fair prices.” Visit the coalition page. Read the Statement of Principles.

Electronic Health Records Can Be Useful for Patients, but Concerns Remain Electronic Health Records (EHRs) allow providers and hospitals to input information about a patient’s health, diagnoses, and treatments into a computer system. These records can, when used correctly, help physicians keep track of patient histories and preferences and improve quality of care. They also give patients more access to their own data, increasing their ability to seek second opinions, better understand their health issues, and make corrections where needed. The use of EHRs has exploded in recent years, with 9% of hospitals using them in 2008 and 96% today. But what does the public think about EHRs? This week, the Kaiser Family Foundation (KFF) released a data note about public experiences with and views on EHRs.

Based on polling information collected in the January 2019 KFF Health Tracking Poll, it shows that there is widespread exposure to EHRs but varying levels of concern about their use. According to the KFF data, in 2009, 46% of the public reported that their providers used computer-based medical records. That number has gone up to 88%. Large shares of that 88% say this has made their interactions with their providers the same (45%) or better (44%), and similar shares (47%) say that the quality of care they have received has stayed the same or improved. At the same time, a significant share of the public (45%) is very or somewhat concerned that errors in the EHRs may hurt

their care. Even more (54%) are worried about their privacy. As the public perception on EHRs has evolved, a recent article from Kaiser Health News shows that so too has the industry assessment—and that the potential of EHRs has not yet been fully realized. Rather than the envisioned electronic ecosystem of information, today the nation’s EHR system largely remains a disconnected patchwork of information. Further, widespread data-entry errors, clinical mistakes, and software glitches may be putting patient safety at risk. The article also illustrates where the federal government has encouraged EHR use without always creating the right environment to ensure these systems are designed and

used properly. Despite these challenges, there is still great promise in EHRs for patients and providers. Medicare Rights supports the use of quality EHR systems with the robust oversight and transparency necessary to find and correct software problems, misuse, and privacy violations. In particular, we encourage timely access for Medicare beneficiaries to their own health records. As with all electronic tools, EHRs can speed up processes and add convenience and accuracy, but only when held to a high standard. Read more from Kaiser Family Foundation on public perceptions of EHR use. Read more from Kaiser Health News for more on problems in some EHR systems.

30 Years of Getting Medicare Right decades—and we will continue educational resources for this critical work into our 30th people with Medicare, their year and as long as our services families and caregivers, and are needed. the professionals who serve Since our inception, Medicare them, including Medicare This year is a significant Rights has: Interactive Pro and milestone for the Medicare the Medicare  Answered millions of Rights Center as we celebrate Minute program. questions on our free, our 30th anniversary! national consumer helpline,  Stood firm to protect and Thanks to our dedicated and through our online strengthen the Medicare supporters, we have worked to reference tool, Medicare program for those who rely ensure access to affordable on it today, and for those Interactive. health care for older adults and  Created user-friendly who are counting on it for people with disabilities for three tomorrow.

In 2019, we are celebrating Medicare Rights’ history and how far we’ve come. Throughout the year, we’ll be in touch with opportunities to commemorate “30 Years of Getting Medicare Right.” In the meantime, you can stay connected with Medicare Rights by subscribing to our free email newsletters and following us on Facebook and Twitter .

KFF Brief Highlights Financial Burden of Part D Specialty Drugs While Medicare Part D has made prescription drugs more affordable for people with Medicare, many beneficiaries continue to face affordability challenges, in part because there is no hard cap on out-of-pocket spending under Part D. A new resource from the Kaiser Family Foundation examines the financial burden this places on Part D enrollees who rely on high-cost medications. There are several different phases of part D coverage that beneficiaries pass through during the year. In each, the beneficiary pays a different percentage of the total cost of the needed medication. This

structure puts Part D enrollees without low income subsidies who rely on specialty tier drugs—which Medicare defines as drugs that cost more than $670 per month in 2019—at particularly high risk of facing significant out-of-pocket costs. In the initial coverage period, Part D plans are allowed to charge between 25% and 33% coinsurance for specialty tier drugs before enrollees reach the coverage gap, where they pay 25% for all brands. Once a beneficiary reaches the annual total out-of-pocket threshold ($5,100 in 2019) they move into the catastrophic coverage phase,

where they stay for the remainder of the year. During this period, enrollees pay lower coinsurance (5%) for their covered drugs. However, for individuals who take highpriced medications, this relatively small percentage can translate into significant out-ofpocket costs. According to the Kaiser Family Foundation, in 2019 the cost of certain specialty-tier drugs in the catastrophic phase alone is over $5,000. Because there is no hard cap on spending in the Part D benefit, enrollees who need expensive medications can face

substantial out-of-pocket costs—which may lead to unfilled prescriptions, poor medication adherence, and worse outcomes. Medicare Rights continues to support improvements to Part D that will improve beneficiary access and affordability, including establishing an out-ofpocket cap. We look forward to working with our partners and policymakers to address the issue of high and rising prescription drug prices for people with Medicare and

their families.

Read the report, The Out-ofPocket Cost Burden for Specialty Drugs in Medicare Part D in 2019

States Push For Caregiver Tax Credits Gloria Brown didn’t get a good night’s sleep. Her husband, Arthur Brown, 79, has Alzheimer’s disease and had spent most of the night pacing their bedroom, opening and closing drawers, and putting on and taking off his jacket. So Gloria, 73, asked a friend to take Arthur out for a few hours one recent afternoon so she could grab a much-needed nap. She was lucky that day because she didn’t need to call upon the home health aide who comes to their house twice a week.

The price of paying for help isn’t cheap: The going rate in the San Francisco Bay Area ranges from $25 to $35 an hour. Gloria Brown estimates she has spent roughly $72,000 on caregivers, medications and supplies since her husband was diagnosed four years ago. “The cost can be staggering,” said state Assemblyman Jim Patterson (R-Fresno), author of a bill that would give family caregivers in California a tax

credit of up to $5,000 annually to help offset their expenses. A 2016 study by AARP found that the average caregiver spends $6,954 a year on out-of-pocket costs caring for a family member. The expenses range from $7 for medical wipes to tens of thousands of dollars to retrofit a home with a walk-in shower or hire outside help. AARP, a lobbying organization for people 50 and older, is pushing similar bills in

at least seven other state legislatures this year, said Elaine Ryan, the group’s vice president of State Advocacy and Strategy Integration. Arizona, Illinois, Nebraska, New Jersey, New York, Rhode Island and Wisconsin are considering legislation, and AARP expects measures also to be introduced in Florida, Massachusetts and Ohio. In Wisconsin, two Republicans and two Democrats are behind that state’s tax credit measure….Read More

Getting Medicare Right in 2019 There are changes to Medicare costs and coverage options every year, and it’s difficult for consumers and professionals alike to keep up with what’s new and how it will affect them or their clients. As the Centers for Medicare & Medicaid Services rolls out these changes, the Medicare Rights Center’s education team gets to work right away translating complex legal language into consumerfriendly resources. The new year presented several important changes that

could be overwhelming for people with Medicare, including updates to Medicare enrollment periods. The education staff revised Medicare Rights’ print and online materials to reflect these changes, including Medicare Interactive (MI). Internal trainings by the education team were essential to ensuring Medicare Rights’ client services staff was prepared for

questions about Medicare in 2019. Once the staff was updated, they trained the helpline volunteers to make sure they had clear, accurate information, too. The education team also prepared professionals for what Medicare changes could mean for their clients. After rerecording audio and updating visual content, the education staff published updates to MI Pro, Medicare Rights’ online

curriculum. Medicare Rights also updated the version of MI Pro used by State Health Insurance Assistance Program (SHIP) counselors across the United States. Medicare Rights recently developed and hosted a webinar, “What’s New in Medicare for 2019?” to discuss these changes in an engaging format. Anyone interested in learning more about this year’s changes can purchase a recording of the webinar on Medicare Interactive.

Purdue Pharma to settle historic Oklahoma opioid lawsuit Purdue Pharma has agreed to settle a historic lawsuit brought by the Oklahoma attorney general who accused the OxyContin maker of aggressively marketing the opioid painkiller and fueling a drug epidemic that left thousands dead in the state, a source familiar with the case tells CNN. The settlement which was first reported by Reuters, comes after Purdue fought the attorney general in court, seeking to delay the start of the trial, which is scheduled for May 28. The source would not say

whether other drugmakers named in the suit would follow Purdue's lead. A spokesman for Oklahoma Attorney General Mike Hunter declined to comment. The attorney general has planned a news conference for Tuesday afternoon in Tulsa. In an email Tuesday, Bob Josephson, Purdue Pharma executive director of communication said, "We are not commenting at this time." The suit was brought by Hunter against some of the nation's

leading makers of opioid pain medications, alleging that deceptive marketing over the past decade fueled the epidemic in the state. Hunter has said the defendants -- Purdue Pharma, Johnson & Johnson, Teva Pharmaceuticals, Allergan and others -- deceived the public into believing that opioids were safe for extended use. On Monday, the Oklahoma Supreme Court rejected the drugmakers' appeal to delay the

trial for 100 days. The drugmakers have denied the allegations and maintained their marketing was appropriate. Thirty-six states have brought cases against Purdue and other opioid drugmakers. Oklahoma was the first state set for trial, and court observers have been watching the case closely for precedent. The Oklahoma trial was set to be the first in the nation to go before a jury that could determine pharmaceutical companies' role in the nation's opioid epidemic and whether Big Pharma should pay for it.

Federal Judge Again Blocks Medicaid Work Requirements For a second time in nine months, the same federal judge has struck down the Trump administration’s plan to force some Medicaid recipients to work to maintain benefits. The ruling Wednesday by U.S. District Judge James Boasberg blocks Kentuckyfr om implementing the work requirements and Arkansas from continuing is program. More than 18,000 Arkansas enrollees have lost Medicaid coverage since the state began the mandate last summer. Boasberg said that the

approval of work requirements by the Department of Health and Human Services “is arbitrary and capricious because it did not address … how the project would implicate the ‘core’ objective of Medicaid: the provision of medical coverage to the needy.” The decision could have repercussions nationally. The Trump administration has approved a total of eight states for work requirements, and seven more states are pending. Still, health experts say it’s likely the decision won’t stop

the administration or conservative states from moving forward. Many predict the issue will ultimately be decided by the Supreme Court. Kentucky Gov. Matt Bevin, a Republican, has threatened to scrap the Medicaid expansion unless his state is allowed to proceed with the new rules, a move that would drop more than 400,000 new enrollees. He said the work requirement will help move some adults off the program so the state has enough money to help other enrollees. Bevin, who is running for re-

election this fall, had threatened to end the Medicaid expansion during his last campaign but backed off that pledge after his victory. Kentucky had been slated to begin its work requirement next Monday, but current provisions will instead stay in place, according to Adam Meier, who heads up the state’s Medicaid program. He said officials there believe they have “an excellent record for appeal and are currently considering next steps.”...Read More

Administration proposes cutting Medicare drug coverage A few months ago, the Trump administration proposed cutting the prescription drugs Medicare covers in order to rein in Medicare Part D spending. It argued that if insurers did not have to cover all drugs in protected classes they would have more leverage to negotiate lower prices. But, allowing insurance companies the discretion to decide whether to cover certain prescription drugs in protected classes is bad policy. It is fair to assume that commercial health insurers will promote their business interests over the interests of their enrollees. For that reason alone, the Administration is proposing the wrong policy to rein in drug costs. It easily could hurt patients. The federal government has no control over the deals the Medicare Part D insurers negotiate. In some cases, insurers steer enrollees

to higher-cost drugsbecause it is in their financial interest to do so. And, sometimes higher-cost drugs offer less value than lower-cost drugs. Insurers care about which drugs will deliver them more profits. The best way to ensure fair drug prices in Medicare, as well as for all Americans, is for the federal government to use its leverage to regulate prescription drug prices, as every other wealthy country does. And, Senator Sanders has introduced such a bill. It would set drug prices in the US at the same level as other wealthy countries. Of course, Pharma opposes the administration’s proposal because it fears any possible cuts to its revenue. Kaiser Health News reports that the pharmaceutical industry is funding half of the patient advocacy groups opposing the administration’s proposal and

sponsoring ads against it. In this case, it appears that Pharma’s interests are aligned with the interests of people with Medicare. Pharmaceutical companies support and count on patient advocacy groups to ensure that the government protects their interests–high-priced drugs covered by Medicare and Medicaid. The patient advocacy groups are consciously or unconsciously influenced by the grants they receive. The American Cancer Society Cancer Action Network, along with 56 other groups, oppose the Administration’s proposal, claiming it’s an access issue. (NB: While it is an access issue, these disease groups rarely if ever support proposals to rein in drug prices even though high prices also undermine access.) The Administration suggests in its proposal that if a lowercost prescription drug doesn’t

work, the Medicare Part D insurer should pay for the higher-priced prescription drug. But, insurers could start the patient on the lower-cost drug and decide not to switch the patient over to the more expensive drug if it’s not in the insurer’s financial interest to do so. Who knows what the insurers will do with their power if the administration’s proposal goes through? Moreover, the Administration’s proposal could allow insurers to keep some super-high-priced drugs off a formulary altogether. Rachel Sachs, a health care law professor explains that the proposal gives Part D insurers negotiating power they do not otherwise have over drug costs. That is true. But, she also recognizes that if negotiations fail, some drugs in a protected class may not be covered. And, that’s bad policy. If you want Congress to rein in drug prices, please sign this petition.

Judge finds UnitedHealth illegally denied care to thousands CNN reports that UnitedHealth was found to have illegally denied care to thousands of its members. Policymakers in Washington should take note of the risk commercial health insurers may pose to Americans and question their viability. Why do the politicians behave as if they are fenced in? Judge Spiro of the US District Court for the Northern District of California has yet to set the punishment. What is clear, however, is that UnitedHealth— the largest mental health insurer—established mental health coverage guidelines that wrongfully and systematically denied its enrollees benefits to which they were entitled. It illegally denied its enrollees

access to needed care–in this case, mental health care. The judge also found that UnitedHealth’s medical directors were misleading in their sworn testimony. Most important, the judge found that UnitedHealth focused on cost-cutting over appropriate treatment. Cost-cutting through wrongful delays and denials of care appears to be widespread in commercial health plans. See this report from the Government Accountability Office. If United Health’s medical directors are wrongly denying mental health care, isn’t it reasonable to assume that its

medical directors are wrongly denying other needed care? There’s good reason to believe that the wrongful denials affect not only the 50,000 enrollees needing mental health care but the hundreds of thousands of enrollees needing other care. United Health’s medical directors are supposed to adhere to particular effective treatment guidelines for people with mental health issues. They did not. As a result, these patients received a lower level of care than appropriate, putting them at risk of worse health outcomes. Now, UnitedHealth and other commercial insurers are trying to keep CMS from getting

more patient encounter data from people enrolled in their Medicare Advantage plans. This data could help show whether enrollees are getting needed care or going without it. So, naturally, the insurers want to keep it from government scrutiny. Taxpayer dollars pay for this care; the public should be able to see what it is paying for. The lack of accountability in the commercial health insurance system is untenable. It’s one of the key reasons that we pay more for our health care and get poorer health outcomes than people in other wealthy countries with government-administered health care, We need Medicare for All.

RI ARA HealthLink Wellness News

Alzheimer’s Drug Failure Leaves Scientists Seeking New Direction For years, drugmakers have tried targeting a brain compound called beta amyloid. Not one of those attempts has worked. Drugmakers have tried again and again to treat Alzheimer’s disease by targeting a compound in the brain known as beta amyloid. Again and again, they’ve failed. This week, Biogen Inc. and Eisai Co. joined the ranks of frustrated companies that spent years nurturing expensive, experimental therapies that ultimately fell short. Many scientists and drug developers are now asking whether it could

be time to find another approach to treat the pernicious memory-wasting disease. The brain has been a black box for drug developers, but focusing on beta amyloid has long been viewed as the best hope for treating the mysterious ailment that affects millions of Americans and their families. For many, the hypothesis became an article of faith, motivating billions of dollars in research spending and putting thousands of patients through clinical trials. “It’s not science anymore,”

said George Perry, a biology professor at the University of Texas at San Antonio and a longtime critic of the amyloid theory. “It has turned into a religion.” Biogen and Eisai will discontinue two late-stage trials designed to evaluate the efficacy and safety of the drug, aducanumab, which has cost the partners more than $830 million over the past three years. The results showed that the drug was unlikely to help patients, the companies said in a statement, and the discontinuation wasn’t

related to safety concerns. The companies said they would continue to work together on other Alzheimer’s therapies. Secret Sauce Beta amyloid is a protein that collects in the brain and, in people with Alzheimer’s, clumps into plaques. Drugmakers have pursued the idea that by clearing beta amyloid with drugs, they might stop the disease. But it’s still not known if the protein is the cause of Alzheimer’s, or merely a neurological memorial to damage already done…..Read More

US adults do not consume enough protein, study warns New research in the Journal of Nutrition, Health & Aging reveals that older people in the United States do not consume enough protein. Insufficient protein is a marker of poor diet and health overall, the study also suggests. With age, the human body loses muscle mass. Sarcopenia, or the age-related gradual loss

of muscle function, can slash muscle strength by around 50 percent. Also, loss of muscle mass and strength can lead to poor overall quality of life and increase the risk of falls and fractures in older age. So, as we age, intake of protein becomes increasingly

important. However, few adults consume as much protein as they should, for a variety of reasons. Older people often lose their appetite with age, have lower energy needs, or sometimes eat less due to financial and social difficulties… However, researchers do not

know precisely how much protein older adults consume, so a new study aimed to fill this gap in research. Christopher A. Taylor, Ph.D. — a registered dietitian and associate professor at the Ohio State University in Columbus — is the last and corresponding author of the new study..Read More

Why your gut may hold the key to cardiovascular health New research, which appears in The Journal of Physiology, examines the role that gut bacteria might play in preserving the health of our arteries. An increasing number of studies suggest that the bacteria in our guts hold the key to healthy aging. For instance, a recent conference that Medical News Today reported on featured research in the worm Caenorhabditis elegans. The results suggested that colonizing the gut with specific strains of bacteria, for example, can delay aging and prevent a

host of age-related chronic diseases. Now, research in mice strengthens the idea that gut bacteria mediate the aging process. Specifically, scientists have examined the link between the composition of the gut microbiota in mice and vascular aging. Vienna Brunt, a postdoctoral researcher in the Department of Integrative Physiology at the University of Colorado, Boulder, is the study's lead author. Doug Seals, a professor and the director of the university's Integrative

Physiology of Aging Laboratory, is the senior author. Studying gut bacteria and vascular health Brunt and colleagues administered a "cocktail of broad‐spectrum, poorly absorbed antibiotics" to a group of young mice and a group of old mice. They added the antibiotics to the drinking water of the rodents for a period of 3–4 weeks to suppress their gut microbiota. Next, the researchers examined the health of the rodents' vascular systems by measuring

their arterial stiffness and the health of the endothelium — that is, the layer of cells that line the inside of the arteries. Brunt and her team also examined the rodents' blood samples for markers of inflammation and oxidative stress, such as harmful free radicals. Oxidative stress occurs when the body produces too many free radicals and does not have enough antioxidants to degrade them. Studies indicate that this phenomenon contributes to hypertension, cardiovascular disease, and aging in general. ….Read More

Women who say they were sickened by breast implants demand FDA action: ‘I was not warned.’ Patients urge advisory panel to recommend banning some products and mandating disclosure of more risk information. Women who say they were harmed by breast implants demanded the Food and Drug Administration take new steps to protect consumers, including providing more information about potential risks and banning devices linked to the most serious complications, including cancer. Telling searing stories about broken health, disrupted families and lost careers, the

women pressed an FDA advisory panel to recommend more long-term research, bans or restrictions on certain products and a beefed-up informed consent process so that women have a clear understanding of the risks and benefits of the devices before they opt for surgery. “I was not warned" about the risks of implants, Jamee Cook, an advocate and former ER paramedic, told the FDA’s expert committee. Cook, who lives near Dallas, said that after getting implants in 1998, she

suffered for years from swollen lymph nodes, chronic fatigue, migraines and a lowgrade fever. She said she eventually had the devices removed, after which many, but not all, of her symptoms eased. The FDA said recently it is taking a closer look at implants, which have sparked anger and contention for decades. The agency asked its General and Plastic Surgery Devices Advisory Committee for recommendations on a raft of issues, and Cook’s testimony

was part of a two-day hearing, which continues Tuesday, on the key issues. Several plastic surgeons pleaded with the panel to proceed carefully, saying that implants generally are safe and an important option for women who want breast augmentation or reconstruction after breast cancer surgery. They said that women’s choices should not be curtailed. About 400,000 women a year get implants, 75 percent for cosmetic reasons and the rest for reconstruction after breast-cancer surgery….Read More

What Are Heart Murmurs? How alarmed should you be if your doctor says you have a heart murmur? Not very, absent additional tests that suggest a serious problem, says Dr. Mouin Abdallah, a cardiologist with the Cleveland Clinic. He's also medical director of the clinic's Center for Coronary Artery Disease. Heart murmurs are abnormal sounds emanating from the heart, caused by the turbulence of blood flow as it courses within the organ, Abdallah says. A heart murmur isn't a disorder or a disease, but it

could be a sign of a problem in the organ. For example, it may suggest heart valve disease or a hole in the heart, conditions that would typically require cardiac evaluation and treatment. Or, a heart murmur could be benign and not signal any disease. About 10 percent of the U.S. adult population will have a benign heart murmur at some point in his or her lifetime, Abdallah says. Heart murmurs are more common in children, and pediatricians are trained to

diagnose them to determine which murmurs are benign and which require testing. Many murmurs emanate from a healthy heart, says Dr. Vincent J. Bufalino, president of the Advocate Heart Institute, a system of hospitals in the Chicago area. He's also a spokesman for the American Heart Association. "A number of these are what we call 'innocent' or benign," Bufalino says. "They don't indicate any heart problem. That's pretty

common." It's important to keep in mind that heart murmurs can be related to non-heart-related conditions, like anemia, pregnancy, a high fever or very high thyroid levels, says Dr. Michael Y. Chan, a cardiologist with St. Joseph Hospital in Orange, California. These are the basic types of heart murmurs:  Systolic murmur.  Diastolic murmur.  Continuous murmur. …….Read More

How can social issues affect the life and health of seniors? Social issues can have a significant impact on life and both physical and mental health of seniors. Some of the major contributors to social and psychological problems for seniors are as follows:  Loneliness from losing a spouse and friends  Inability to independently manage regular activities of living  Difficulty coping and accepting physical changes of

aging These factors can have a negative impact on  Frustration with overall health of an older ongoing medical individual. Addressing problems and these psychosocial increasing number of problems is an integral medications component of seniors' Social isolation as complex medical care. adult children are  What are some engaged in their own lives common facts about health in Feeling inadequate from seniors? inability to continue to work Boredom from retirement and  What changes occur in the body as we age? lack of routine activities  What are the most common Financial stresses from the diseases and conditions loss of regular income

seniors face as they age?

 What are lifestyle changes

seniors can make to lead a healthy life as they age?  What role does diet play in senior health?  Is exercise important in health of the elderly?  What are some of the routine medical tests for seniors  What are important safety measures for the elderly?  What is a hospitalist, and where is my regular doctor? ….Read More on each subject

More Older Adults With Joint Replacements Recover At Home, Not Rehab Older adults and their families often wonder: Where’s the best place to recover after a hip or knee replacement — at home or in a rehabilitation facility? Increasingly, the answer appears to be home if the procedure is elective, friends and family are available to help and someone doesn’t have serious conditions that could lead to complications. This trend is likely to accelerate as evidence mounts that recuperating at home is a safe alternative and as hospitals alter medical practices in response to changing Medicare policies. The newest data comes from a March study in JAMA Internal Medicine of 17 million

Medicare hospitalizations of people from 2010 to 2016. All the patients were older adults and went home or to a skilled nursing facility after a medical procedure or a serious illness. Knee and hip replacements were the most common reason for these hospitalizations. People who were sent home with home health care services demonstrated the same level of functional improvement as those who went to a skilled nursing facility (assessments examined their ability to walk and get up and down stairs, among other activities), the study found. And they were no more likely to die

30 days after surgery (a very small percentage in each group). Overall, costs were significantly lower for patients who went home, while hospital readmissions were slightly higher — a possible signal that home health care services needed strengthening or that family caregivers needed better education and training. “What this study tells us is it’s certainly safe to send people home under many circumstances,” said Dr. Vincent Mor, a professor of health services, policy and practice at Brown University’s School of Public Health who

wrote an editorialaccompanying the study. The new report expands on previous research that came to a similar conclusion. In 2017, experts from New York City’s Hospital for Special Surgery published a study that examined 2,400 patients who underwent total knee replacements and were discharged home or to a skilled nursing facility for rehabilitation between May 2007 and February 2011. There were no differences in complication rates at six months or in functional recovery and patient-reported outcomes at two years….Read More

Get tested for glaucoma, save your vision If you’re over 60, you should be getting a comprehensive dilated eye exam at least every two years. This test for glaucoma could help save your vision. Like many people, you’re likely wondering what is glaucoma, what are the symptoms, and who’s at most risk? I can explain. One thing our health care providers always check is our blood pressure. We know that if it’s too high for too long it can lead to heart disease and

stroke. Well, high pressure can occur in our eyeballs too. Like high blood pressure, it can go on for years with no symptoms. Subtle decreases in peripheral (side) vision then occurs. If untreated, it can lead to blindness. The disease of high pressure in the eye is called glaucoma,

and it’s the leading cause of preventable blindness. That’s why it’s important to go for regular eye exams, especially as you get older. And yes, those include the exams where they put in the drops to dilate your eyes and your vision is blurry and you’re sensitive to light for a while after your appointment.

You are especially at risk for glaucoma if you’re AfricanAmerican and over 40, of Mexican heritage and over 60, have a family history of the disease, or have poorly controlled blood pressure or diabetes. Most cases of glaucoma are treatable with eyedrops if diagnosed in time. And, although Medicare does not cover standard vision tests, it does cover the cost of glaucoma screenings.

Earwax can cause hearing loss, if left untreated If you have a problem hearing, it may stem from excess earwax. Kaiser Health News reports that earwax can cause hearing loss in older adults, if left untreated. Excess earwax is more common in older people than in younger people. In addition to conductive hearing loss–preventing sound waves to reach your inner ear– excess earwax can cause tinnitus or ringing in your ears, because earwax blocks the ear canal. It

can also cause vertigo, and even cognitive decline. And, it can increase your risk of falling. What is earwax? It is a sticky substance that mixes with dirt and dust in the air, which protects your ears. For about three in ten older adults, however, it can block the ear canal, posing serious risks.

People in nursing homes are particularly likely to suffer from this blockage or impaction. Many people try to remove excess earwax on their own. That can can bigger problems, pushing the wax deeper into the ear canal. Experts suggest leaving the earwax alone. The National

Institute on Aging recommends mild treatments, such as mineral oil, baby oil, glycerin, or commercial ear drops to soften earwax. Read More on hearing loss below. https://justcareusa.org/heari ng-loss/ https://justcareusa.org/three -things-to-do-to-addresshearing-loss-as-you-get-older/