Monday, February 8, 2016

Brown Nearing MCO Tax Deal With Health Plans -

The unforseen effects of the Affordable 
Care Act

California lawmakers could vote this week on a proposal to restructure a tax on health care plans in order to avert a potential $1 billion state budget hole.
This “managed care organization” (MCO) tax brings in federal funds for Medi-Cal, California’s health care program for the poor. The federal government say the state’s current structure is no longer acceptable – and must be fixed by the end of June for the state to keep getting the money.
So Gov. Jerry Brown and health plans have been negotiating for months – and now talks are in the final stages.
Any deal would require Republican votes to pass the Legislature. There are signs that the votes could be there for the right deal as long as it's “revenue neutral“ – that is, the federal funds offset any tax liability to the health plans so the insurance companies don’t pass costs on to the rest of us.
A deal would also likely include funding increases for in-home care for the elderly and disabled (known as in-home supportive services or IHSS), and programs that benefit people with developmental disabilities.

Brown Nearing MCO Tax Deal With Health Plans -

Saturday, February 6, 2016

The Silence Around Stillbirth is Unspeakable

7,200 lives are lost every day to stillbirths. Imagine if we could reduce that number and stop this epidemic 
Almost 2·6 million babies are stillborn worldwide every year. That’s roughly the population of Rome, wiped out. Yet we still don’t talk openly about stillbirth. Vulnerable girls and women are often left to suffer in silence. It only perpetuates the stigma when they have little to no information on the topic. More must be done to cut through the sociocultural, religious, and health barriers that inhibit open dialogue.

A healthy pregnancy should be a universal right. Millions of women worldwide are still denied access to basic education about pregnancy and stillbirth. Education must include information about sexual health, birth control and treatable diseases, as well as the risks associated with smoking, obesity, and pregnancy in later life.

Skilled health professionals matter. Their care is vital for all expectant mothers. Yet they are in short supply. We must value health workers, including skilled birth attendants, in order to succeed–boost their numbers, increase access to quality training, give them a visible community presence, and remove the barriers to access.  

 1·3 million of the 2·6 million stillborn babies started labour alive

Monday, February 1, 2016

Where the Leading Presidential Candidates Stand on Healthcare

Much of the presidential candidates’ discussions of healthcare center on Obamacare, but there are other key issues affecting the health of the country.

Ballotpedia is a one stop source for the 2016 candidate's position on health care and the affordable care act.

                                                  The Candidates:  Democratic

Not only are most people confused  about what the Affordable Care has done to the health system, another challenge is to understand and differentiate what the 2016 Presidential candidate's platform say about further health reform.  Bear in mind, positions will change, and  be subject to congressional actions.

                                                  The Candidates:Republican

This Health  Train Express post hopes to offer some framework for their stances. The myriad proposals and the short term effects of the Affordable Care Act add to the confusion.

Voters have many interests, besides health reform, terrorism, immigration, economy, police abuse, gun control all of which are considerable.

Where the Leading Presidential Candidates Stand on Healthcare

Thursday, January 28, 2016

RunawayRx_Costs While_You_Were_Out_

There appears to be significant profiteering by some unscrupulous investors. One particularly egregious event was an enormous increase in the cost of some drugs (5,000%) by Turing Pharmaceuticals. Turing Pharmaceuticals acquired the rights to Daraprim in August. 

The drug treats toxoplasmosis, a parasitic affliction that affects people with compromised immune systems.
After Turing's acquisitiona dose of Daraprim in the US increased from $13.50 (£8.70) to $750.The pill costs about $1 to produce, but Mr Shkreli, a former hedge fund manager, said that does not include other costs like marketing and distribution, which have increased dramatically in recent years. Mr Shrell, it should be noted has been indicted for security fraud in an unrelated situation.
This indictment had nothing to do with the pharmaceutical furor. and 
revolved around a different alleged incident ( Ponzi Scheme.)

While the specifics of this case are unique and skewed significantly, 
other Pharma companies are increasing prices to offset hard bargaining
by health plans and CMS in the wake of the Affordable Care Act.

Health financing, like other industries has it's "bad boys" and it deserves 
careful scrutiny to guard against rampant raping of the federal and state 

Despite over-regulation and micro management of changes fostered by 
the affordable care act, profiteers and adventurers find ways to bilk the 
“Some of these companies seem to act more like hedge funds than traditional pharmaceutical companies”
Meanwhile:The California Legislature has passed AB 463,

Pharmaceutical Cost Transparency Act of 2015 2016

 The Legislature finds and declares all of the following:
(a) It is the intent of the Legislature to make information available to the public about the cost of ultra-high-priced pharmaceuticals, in order to make pharmaceutical pricing as transparent as the pricing in other sectors of the health care industry.
(b) To fulfill this goal, the Legislature finds that there should be annual cost reporting on the most expensive drugs that would be of use by policymakers, government agencies, and others to understand costs for these important products.
 (a) Each manufacturer of a prescription drug, made available in California, that has a wholesale acquisition cost (WAC) of ten thousand dollars ($10,000) or more annually or per course of treatment, shall file a report pursuant to this section on the costs for each qualifying drug.  Further details here

Runaway Prescription Costs

Wednesday, January 27, 2016

Today is Cystic Fibrosis Awarenes day in the U.S.

While there have been great advances in survival there is still no cure. This leads to a longer life of suffering. Please donate generously to the Cystic Fibrosis Foundation.

Monday, January 25, 2016

Is There a Doctor in the Marriage? - The New York Times

Women who are not married to a doctor often equate being a physician with other professionals. Marriage is one of those things.

Having a spouse as a physician requires a mate who can be largely independent with short periods of intimacy and companionship.  While there are some specialties that insulate  physician marriages from clinical demands, such as pathology, dermatology  and a few others, most doctors become focused on patient care either by an innate sense of duty, moral standards, or the induced habit by repetition of answering all calls during training.

Fortunately for many, actual independent clinical practice is not usually as demanding, although the stress level rises substantially when the final decision rests upon them.  It is also the time when physicians begin to pay their own medical malpractice premiums...a certain indicator of medical liability.

Is There a Doctor in the Marriage?

Six weeks after our wedding, my husband and I were flying back to New
Orleans, where we live. As soon as we reached cruising altitude, his
head tilted forward in sleep.

The previous year had been the hardest stretch of his medical training. As a
third-year resident in internal medicine, he often worked 30-hour
shifts. When he came home, he’d still have notes to dictate. I’d
frequently find him snoozing in an armchair with the light still on. A
few hours later, he’d wake and go back to work.“I’m trying to survive,” he told me when I complained about how work consumed him. “I’m doing the best I can.”When we first met, I fell in love with his playfulness as much as his passion. He belonged to an improv comedy group and kept me up talking in
funny voices and telling me what he loved about medicine.

Our personal life is private, but his professional life is public

Modern Love


Is There a Doctor in the Marriage? - The New York Times

Health and the Weather

Mental health professionals have labelled some depressions as seasonal affective disorder (SAD), an appropriate acronym  for depression related to seasons. The term is most often linked to depression occuring in winer when days are short, thereby decreasing the amount of time when visible light and other components of the electro-magnetic spectrum are a low levels.

 However visible light is only one part of the electromagnetic spectrum which fall upon us.  Ranging from the  low infrared through the visible spectrum (R,G,B,V) and into the ultraviolet, radio frequency, x-ray and beyond, including cosmic rays (solar flares-coronal mass ejections). Some or all of these may effect our psyche.
        Solar X-rays
Coronal Mass Ejections 

A sense of wellness is often associated with being at the beach or in elevated topography, which is associated with + ions.

Magnetic forces which may alter our mental, physical health or spiritual well being is proposed for wearing magnetic bracelets, rings or necklaces.

NOAA has developed sensitive measuring equipment to monitor space weather.

Window to the Universe

Space weather can be found either at:  or