Christian health cost sharing ministries offer no guarantees

Eight-year-old Blake Collie was at the swimming pool when he got a frightening headache. His parents rushed him to the emergency room only to learn he had a brain aneurysm. Blake spent nearly two months in the hospital.

His family did not have traditional health insurance. “We could not afford it,” said his father, Mark Collie, a freelance photographer in Washington, North Carolina.

Instead, they pay about $530 a month through a Christian health care sharing organization to pay members’ medical bills. But the group capped payments for members at $250,000, almost certainly far less than the final tally of Blake’s mounting medical bills.

“Just trust God,” the nonprofit group, Samaritan Ministries, in Peoria, Illinois, said in a statement about its coverage, and advises its members that “there is no coverage, no guarantee of payment.”

More than 1 million Americans, struggling to cope with the rising cost of health insurance, have joined such groups, attracted by prices that are far lower than the premiums for policies that must meet strict requirements, like guaranteed coverage for preexisting conditions, established by the Affordable Care Act. The groups say they permit people of a common religious or ethical belief to share medical costs, and many were grandfathered in under the federal health care law mainly through a religious exemption.

These Christian nonprofit groups offer far lower rates because they are not classified as insurance and are under no legal obligation to pay medical claims. They generally decline to cover people with preexisting illnesses. They can set limits on how much their members will pay, and they can legally refuse to cover treatments for specialties like mental health.

“Nothing is guaranteed,” said Dr. Carolyn McClanahan, a physician who is also a financial planner in Jacksonville, Florida. “You have to depend on the largess of the program.”

The main requirement for membership is adherence to a Christian lifestyle. And the alternative sharing plans keep flourishing, especially now that the Trump administration has relaxed rules to permit alternatives to the ACA that don’t provide such generous coverage.

But state regulators in New Hampshire, Colorado and Texas are beginning to question some of the ministries’ aggressive marketing tactics, often using call centers, and said in some cases people who joined them were misled or did not understand how little coverage they would receive if they or a family member had a catastrophic illness.

On Monday, Washington state fined one of the larger health-sharing ministries, Trinity Healthshare, $150,000 and banned it from offering its product to state residents because it was operating as an unauthorized insurer.

In December, Nevada insurance regulators warned consumers to beware of these plans. “They may seem enticing because they may be cheap, look and sound like they are in compliance with the Affordable Care Act (‘ACA’), when in reality these plans are not even insurance products,” the department said.

The Texas attorney general brought a lawsuit last summer against Aliera Healthcare, which marketed Trinity’s ministry program, to stop it from offering “unregulated insurance products to the public.” The Houston Chronicle featured one couple who was left with more than $100,000 in unpaid medical bills. Trinity said most members are satisfied with its services.

Aliera, which says it has stopped offering its plans in Texas, said it is working with regulators to resolve their concerns. The company says it has taken steps to make sure its customers are not confused about what they are buying.

Because the groups are not technically considered insurance, they operate with no government oversight. “Regulators haven’t been willing to assert any control or regulatory authority over these plans,” said Katie Keith, who serves as a consumer representative to the National Association of Insurance Commissioners and teaches health law at Georgetown University. “They feel their hands are tied. At the end of the day, it’s not insurance.”

Families who have joined the groups recount winding up with medical bills not covered by the ministries, with no legal way to appeal decisions to reject coverage for care. Some groups ask their members to push hospitals and doctors to write off their bills rather than use members’ money to pay their expenses.

“These plans offer a false sense of security,” said Jenny Chumbley Hogue, who runs an insurance agency in north Dallas. She refuses to offer them to her clients.

Several states have taken action against one ministry they say has deceived people about what they are buying. “The nature of what we’re hearing from consumers around the state is absolutely heart breaking,” said Kate Harris, chief deputy insurance commissioner in Colorado, one of the states that is trying to prevent the ministry from operating there.

But health share ministries have become particularly attractive to people like the Collie family who don’t qualify for a federal subsidy and can’t afford an ACA plan. Even though premiums in the ACA market have stabilized, critics of the law insist people need alternatives. “That’s the real driver behind the growth,” said Dr. Dave Weldon, a former Republican congressman from Florida who is president of the Alliance of Health Care Sharing Ministries, which represents the two largest groups.

When Dan Plato left his job to become self-employed as a consultant, he discovered that an ACA policy for 2018 would cost his family around $1,300 a month. “It was very expensive and beyond our needs,” he said. Membership in Liberty Healthshare, a ministry established by Mennonites in Canton, Ohio, was less than half the price, according to Plato, who blogged about his experience.

But some Liberty members reported trouble getting their medical bills covered. Plato says a small bill for flu shots went unpaid and ended up in collection. At the end of the year, he was left wondering if Liberty would be able to cover the family in the event of a serious medical emergency. “It’s not something we could trust in that situation,” said Plato, who switched to one of the plans offered by United Healthcare also exempt from the ACA rules for 2019.

Robyn Lytle, who works as an event planner in Chicago, joined Liberty for 2018, only to find that her daughter’s medical tests were never paid for. “It’s been a year and half, and I’ve been sent to collection,” said Lytle, who says Liberty had covered some of her family’s other expenses. She switched to an ACA plan for 2019.

Liberty Healthshare declined to comment.

Other people complain that the ministries can be vague about coverage. Greg Snider and his wife joined Medi-Share, the program offered by Christian Care Ministry. Based in West Melbourne, Florida. Medi-Share says it has more than 400,000 members across the country.

Snider said he had just dropped traditional coverage when his wife was diagnosed with a heart condition, but he says he was assured by Medi-Share that her care could still be covered. She underwent surgery last year to address an abnormal heart rhythm. “After the procedure, the bills start rolling in,” Snider said, including $177,000 for the surgery alone.

Snider says Medi-Share urged him to plead with the hospital after determining he would owe more than $100,000. He said he had assumed the $800 a month he paid into a pool would help cover the expenses. After he tweeted his frustrations, the ministry told him that he would owe only $1,500 for the surgery because the hospital had forgiven the rest, he said. He now owes thousands of dollars in related medical bills and is unsure of their status.

If Medi-Share decides not to pay, Snider knows he has little recourse: “It is completely and solely up to them.” He has since gotten a job where he is covered under his employer.

Medi-Share says that more than 80% of the $774 million it collected last year went to members’ medical bills. “We take great care to ensure prospective members understand what is considered a preexisting condition and what is eligible for sharing,” it said.

It does its part to reduce medical spending, it says, through negotiating with doctors and hospitals and claims it saved members more than $500 million last year. “We consider this process to be one way in which we contribute to the overall objective of reducing medical costs,” the ministry said in a statement.

Medi-Share says it has an extensive network of more than 700,000 providers. But even if a member goes to an in-network provider, the ministry may still decide not to pay the bill. “Fundamentally, we have found that there is often a lack of understanding of what is covered,” said Brendan Miller, an executive with MultiPlan, which arranges networks for Medi-Share as well as insurers.

That uncertainty has led some hospitals and doctors in the MultiPlan network to refuse to treat ministry patients rather than absorb unpaid costs.

Colorado is one of several states, including Washington, Texas and New Hampshire, that are trying to stop Trinity Healthshare, and its administrator, Aliera Healthcare, from operating in their states because they say the ministry is misleading its residents.

In a statement, Aliera said “it’s deeply disappointing to see state regulators working to deny their residents access to more affordable alternatives offered by health care sharing ministries.”

Trinity says its website makes clear that the ministry does not offer health insurance.

Regulators also worry about these plans siphoning off healthy individuals from the ACA marketplaces, leading to higher premiums for Obamacare policies.

“The ministries have been very concerned about bad actors invading this space,” said Weldon, the alliance president, who says his members are very clear that they are not insurance companies. “They all operate call centers, and they all bend over backward to inform people inquiring that it is not insurance,” he said.

In the case of Samaritan, which says it covers 271,000 people, the ministry pointed to its Save to Share program, where members can contribute extra to cover more of their bills.

With Blake’s bills likely to far exceed the cap — Collie has not yet tallied them yet — he created a GoFundMe account to help pay for his son’s care.

Collie says the ministry remains a viable alternative, noting it paid for numerous medical bills before his son’s hospitalization. “Every single person has prayed for me and my family,” he said. But he was enormously relieved when he found out recently his son qualified for Medicaid, the state-federal insurance program, and will cover the boy’s full medical care.

In some states, officials are starting to consider requiring the groups to register, to obtain more information for consumers.

Peter V. Lee, a former Obama administration official who now runs the California ACA marketplace, said ministries should be subject to some oversight, including disclosure of how much of the money collected is spent on care.

“There should not be a religious exemption for transparency — where the money goes and if it will be there if consumers need it,” he said.

California is also requiring brokers, who are paid hefty commissions by some of the ministries to enroll members, to make sure their clients understand they are not buying insurance.

Some ministries, like Samaritan, say they do not use brokers or agents. “We also have never, nor will we ever, use insurance agents or brokers to sell Samaritan because we don’t want people to confuse us with insurance,” it said.

This content was originally published here.

‘It’s okay not to be okay’: Café offers mental health help, supports suicide prevention

CHICAGO — While the coffee is good, “Sip of Hope” serves up much more than a cup of joe on the Northwest Side.

Through a partnership with Dark Matter Coffee, the café donates 100% of its proceeds to mental health education and suicide prevention.

“It doesn’t matter who you are or where you come from… five out of five people have good days and bad days,” owner Johnny Boucher said. “It’s okay not to be okay.”

Nationwide, suicide rates are the highest recorded in 28 years. Boucher opened Sip of Hope in honor of those who will never get the chance to pull up a chair.

“I personally have lost 16 people to suicide and the overarching issue they all faced was silence,” Boucher said.

His antidote is a place to talk through dark moments without judgement, a cafe serving up a cup of joe and compassion.

“The goal is always to meet people where they’re at and not where we expect them to be,” Boucher said. “You can talk to our baristas because they’re trained in mental health first aid.”

And on top of that, the coffee is great.

Ryan Shannon is now a regular. The Navy veteran says to him depression equaled weakness.

“I came home and I wasn’t the same,” Shannon said. “My leg and traumatic brain injury really took a toll.”

The former collegiate athlete found himself not only unable to stand, but also unwilling to find his way back. He says he wrote a suicide note and had a plan, but it was his wife who saved him that day.

He said she saved his life simply by listening and showing him he’s not alone.

Since then, Shannon has gone on to clean up in adaptive sports, winning a gold medal in Warrior Games, silver in track and finish his MBA.

“I still have bad days but… I now understand you can climb back out of it. You’re not in a dark room alone. There’s a lot of people out there that care,” Shannon said.

And at Sip of Hope, there’s a seat for anyone in need of more than a strong cup of coffee to make it through their day.

“In a country where we talk about building more walls, we need to build more tables and seats,” Boucher said.

If you or someone you know needs help, the National Suicide Prevention Lifeline offers crisis counseling free of charge every day of the year- at 1-800-273-8255, or text the word “home” to 741741.

This content was originally published here.

U.S. health system costs four times more to run than Canada’s single-payer system

In the United States, a legion of administrative healthcare workers and health insurance employees who play no direct role in providing patient care costs every American man, woman and child an average of $2,497 per year.

Across the border in Canada, where a single-payer system has been in place since 1962, the cost of administering healthcare is just $551 per person — less than a quarter as much.

That spending mismatch, tallied in a study published this week in the Annals of Internal Medicine, could challenge some assumptions about the relative efficiency of public and private healthcare programs. It could also become a hot political talking point on the American campaign trail as presidential candidates debate the pros and cons of government-funded universal health insurance.

Progressive contenders for the Democratic nomination, including Sen. Bernie Sanders of Vermont and Sen. Elizabeth Warren of Massachusetts, are calling for a “Medicare for All” system. More centrist candidates, including former Vice President Joe Biden and former South Bend, Ind., Mayor Pete Buttigieg, have questioned the wisdom of turning the government into the nation’s sole health insurer.

It’s been decades since Canada transitioned from a U.S.-style system of private healthcare insurance to a government-run single-payer system. Canadians today do not gnash their teeth about co-payments or deductibles. They do not struggle to make sense of hospital bills. And they do not fear losing their healthcare coverage.

To be sure, wait times for specialist care and some diagnostic imaging are often criticized as too long. But a 2007 study by Canada’s health authority and the U.S. Centers for Disease Control and Prevention found the overall health of Americans and Canadians to be roughly similar.

Some Canadians purchase private supplemental insurance, whose cost is regulated. Outpatient medications are not included in the government plan, but aside from that, coverage of “medically necessary services” is assured from cradle to grave.

The cost of administering this system amounts to 17% of Canada’s national expenditures on health.

In the United States, twice as much — 34% — goes to the salaries, marketing budgets and computers of healthcare administrators in hospitals, nursing homes and private practices. It goes to executive pay packages which, for five major healthcare insurers, reach close to $20 million or more a year. And it goes to the rising profits demanded by shareholders.

Administering the U.S. network of public and private healthcare programs costs $812 billion each year. And in 2018, 27.9 million Americans remained uninsured, mostly because they could not afford to enroll in the programs available to them.

“The U.S.-Canada disparity in administration is clearly large and growing,” the study authors wrote. “Discussions of health reform in the United States should consider whether $812 billion devoted annually to health administration is money well spent.”

The new figures are based on an analysis of public documents filed by U.S. insurance companies, hospitals, nursing homes, home-care and hospice agencies, and physicians’ offices. Researchers from Hunter College, Harvard Medical School and the University of Ottawa compared those to administrative costs across the Canadian healthcare sector, as detailed by the Canadian Institute for Health Information and a trade association that represents Canada’s private insurers.

Compared to 1999, when the researchers last compared U.S. and Canadian healthcare spending, the costs of administering healthcare insurance have grown in both countries. But the increase has been much steeper in the United States, where a growing number of public insurance programs have increased their reliance on commercial insurers to manage government programs such as Medicare and Medicaid.

As a result, overhead charges by private insurers surged more than any other category of expenditure, the researchers found.

In U.S. states that have retained full control over their Medicaid programs, the growth of administrative costs was negligible, they reported. (The same was true for Canada’s health insurance program.) But in states that shifted most of their Medicaid recipients into private managed care, administrative costs were twice as high.

America’s Health Insurance Plans, a group representing private health insurance companies, said administrative practices shouldn’t be blamed for escalating the cost of care in the United States.

“Study after study continues to demonstrate the value of innovative solutions brought by the free market,” AHIP said in a statement. “In head-to-head comparisons, the free market continues to be more efficient than government-run systems.”

AHIP cited a recent report by the Medicare Payment Advisory Commission (MedPAC), an independent body that advises Congress. The report showed that Medicare Advantage plans — which are privately administered — deliver benefits at 88% of the cost of traditional Medicare.

Even so, the study authors concluded that if the U.S. healthcare system could trim its administrative bloat to bring it in line with Canada’s, Americans could save $628 billion a year while getting the same healthcare.

“The United States is currently wasting at least $600 billion on healthcare paperwork — money that could be saved by going to a simple ‘Medicare for All’ system,” said senior author Dr. Stephanie Woolhandler, a health policy researcher at Hunter College and longtime advocate of single-payer systems.

That sum would be more than enough to extend coverage to the nation’s uninsured, she said.

This content was originally published here.

There’s an updated Annual Health and Medical Record to use for 2020

Every few years, the BSA updates its Annual Health and Medical Record after consulting with health care professionals, Scout executives, council and camp health officers and other experts to ensure it is up-to-date and helpful.

This was one of those years, meaning a new form is available for everyone to use for 2020. Your AHMR is valid through the end of the 12th month after the date it was administered by your medical provider. For example, if you got your physical on Nov. 3, 2019, it’s valid until Nov. 30, 2020.

Next year will be a transition year, so you can use either the old or new form, but everyone in all Scouting programs must use the updated AHMR form starting Jan. 1, 2021. The old form will be obsolete at that date. So, the BSA recommends using the new form on your next physical exam or if you’re a new participant in 2020.

Since at least the 1930s, the BSA has required the use of standardized health and medical information. The last time this form was updated was in 2014. The changes made this year were minor, such as some conditions listed in the health history section.

You can download the new form here. The Annual Health and Medical Record is required for Scouts and adult leaders who want to go on Scouting events, campouts and high-adventure trips. Note that there are different parts to the AHMR:

  • Part A is an informed consent, release agreement and authorization that needs to be signed by every participant (or a parent and/or legal guardian for all youth under 18).
  • Part B is general information and a health history.
  • Part C is your pre-participation physical exam completed by a certified and licensed health care provider.

Which part must be completed?

  • For all Scouting events: Part A and B. Give the completed forms to your unit leader. This applies to all participants for all activities, day camps, local tours and weekend camping trips less than 72 hours.
  • For events or camps: Part A, B and C. A pre-participation physical is needed for resident, tour, or trek camps or for a Scouting event of more than 72 hours, such as Wood Badge and NYLT. The exam needs to be completed by a certified and licensed physician (M.D. or D.O.), nurse practitioner or physician assistant. If your camp has provided you with any supplemental risk information, or if your plans include attending one of the four national high-adventure bases, share the venue’s risk advisory with your medical provider when you are having your physical exam.
  • For high-adventure trips: Part A, B and C. Plus, each of the four national high-adventure bases (Florida Sea Base, Northern Tier, Philmont and the Summit Bechtel Reserve) has provided a supplemental risk advisory that explains in greater detail some of the risks inherent in that program. Please review these as some Scouts or leaders may not be physically or mentally able to handle the trek. Others arrive at a high-adventure base without discussing that base’s risk factors with their health care provider, meaning they have missing info at check-in that can slow down the process.

How do I fill it out?

Please review and complete the AHMR fully and carefully. If you have any questions how to review it, read this BSA Safety Moment or look at these frequently asked questions. Remember, these completed forms must be secure, so they are not to be digitized, scanned, emailed or stored electronically by unit leaders.

This content was originally published here.

Bernie Vows to Raise Taxes On Everybody Making Over $29,000 to Fund Gov’t-Run Health Care

The following article, Bernie Vows to Raise Taxes On Everybody Making Over $29,000 to Fund Gov’t-Run Health Care, was first published on Flag And Cross.

During a speech in New Hampshire, 2020 Democrat Socialist presidential candidate Bernie Sanders (VT) told his fans how he plans to not only ruin their lives but the lives of every single person in America – legal or illegal.

Bernie noted, “What we will do is have a 4% tax on income exempting the first $29,000.” He then added, “You’re better at arithmetic than I am. Because what that means is if you are that average family in the middle who makes $60,000 a year, that means we’re gonna tax you on $31,000 at 4%.

The more Bernie talks, the more likely voters are to flock to President Trump next November.

At the end of the day, is a man who recently suffered a heart attack physically fit to deal with the rigors of being president of the United States on a day-to-day basis? The answer should be obvious.

Nope.

Bernie’s heart failing him is a lot like Hillary Clinton’s fainting spells back in 2016. Both instances showed the nation that neither far-left radical was prepared to handle the duties of office.

During a recent interview with a left-wing outlet, the embattled Democrat Socialist made it clear to those who weren’t yet aware: he is not a capitalist. Funny enough, though, Bernie says equally far-left radical 2020 candidate Elizabeth Warren is a capitalist.

Hmm.

From Free Beacon:

Appearing on ABC’s This Week, Sanders said that Warren considers herself a “capitalist through her bones,” while he does not.

[…]

Warren has become the 2020 Democratic frontrunner while largely allying herself with Sanders on issues of health care and tax policy. Sanders, who has struggled to differentiate himself from Warren, said he is the only candidate who will take on systemic corruption.

Sanders opined, “I am, I believe, the only candidate who’s going to say to the ruling class of this country, the corporate elite, ‘enough, enough with your greed and with your corruption.’” We need real change in this country.

It physically hurts to read this tweet from Bernie Sanders.

But you have to see it.

LOOK:

Maybe I’m old fashioned. But I believe we should have a president who believes in the United States Constitution.

Maybe I’m old fashioned. But I believe we should have a president who believes in the United States Constitution.

— Bernie Sanders (@BernieSanders) October 6, 2019

That’s rich coming from a man who literally wants to tear America apart.

Continue reading: Bernie Vows to Raise Taxes On Everybody Making Over $29,000 to Fund Gov’t-Run Health Care

This content was originally published here.

starsis applies terrazzo furniture to orthodontist surgery in south korea

in the south korean city of hwaseong-si, design studio starsis has realized the interior of an orthodontist practice. characterized by bright spaces and a rich material palette, the project has been formed by the architect to perfectly fit the needs and background of the client while creating a tranquil environment for awaiting customers.

all images © hong seokgyu

when approaching the design, starsis took inspiration from teeth and the layout of the human jaw to create a plan from rounded, overlapping shapes. after applying this idea to the architecture, it resulted in an internal space in which the oval forms overlap. by limiting straight lines and placing curves inside the tight space, the organic aesthetic is maximized, creating a soft and friendly atmosphere within the orthodontist surgery.

the reception desk and hardwood shelves made from terrazzo, viewed from the waiting area

the interior is defined by white walls lit with warm-colored lights, terrazzo furniture, wooden fittings built into the walls and plants full of lush greenery to provide a sense of ease and relaxation for those who visit the practice for treatment. these materials are combined by the steel furniture, which is finished with paint and placed above the terrazzo floor in perfect harmony.

the entrance viewed from the corridor, and wooden and steel furniture for waiting customers

the furniture and reception desk viewed through the glass window

the wall with the reception desk and hardwood shelves made from terrazzo

the walls are 3.7m high and made of steel for solidity

there is an inspection room, a corridor and a powder room

the triage room viewed through the glass where the floor and walls are finished with 50 x 50mm white tiles

the corridor leading to the examination room

the corridor leading to the consulting office and photography room

on the wall there is built-in furniture where examination instruments can be placed and stored

steel pillars with sketches of spatial symbols and geometric shapes

project info:

project name: malocclusion ; offbeat teeth

location: 127-5, dongtansunhwan-daero, hwaseong-si, gyeonggi-do, south korea

total area: 2198.31 ft2 (204.23 m2)

designboom has received this project from our ‘DIY submissions‘ feature, where we welcome our readers to submit their own work for publication. see more project submissions from our readers here.

edited by: lynne myers | designboom

This content was originally published here.

Canadian Man Accused Of Unauthorized Horse Dentistry: ‘A Display of Lawless Bravado’

A Canadian man is facing a lifetime ban on practicing veterinary medicine after accusations he’s been performing unauthorized horse dentistry.

The Manitoba Veterinary Medical Association (MVMA) is seeking a permanent injunction against Kelvin Brent Asham, accused of treating horses—including giving one horse a sedative—without veterinary certification.

An investigator described Asham’s actions as “a display of lawless bravado,” according to court documents.

The MVMA says it’s been trying to stop Asham for the past three years: It first became aware of his activities in 2015, when a complaint was filed about a 16-year-old gelding he had treated. Asham sedated the horse, filed down its teeth—a process known as “floating”—pulled one tooth and tried to extract another.

horse teeth dentist
The sharp edges of horses’ teeth occasionally needs to be filed down to save the horse from pain when eating or holding a bit in its mouth. The term “floating” comes from the file used in the process, known as a “float.”
Anna Elizabeth/Getty

Leon Flannigan, an animal protection officer in Manitoba, investigated the claims and determined the horse had suffered “irreparable damage.” In an affidavit, Flannigan said he’d met with Asham in 2016 at a Tim Horton’s donut shop in Selkirk. Asham allegedly told Flannigan he’d been floating horse teeth since 1996 and had performed the procedure on four other horses owned by the same person as the gelding.

Asham also told Flannigan that most vets float teeth improperly, and that he had different tools than vets use. “Off the record, I do thousands of horses,” Asham allegedly told Flannigan. “I do a good job. I am willing to fight this in court.”

This incident caused the MVMA to send Asham a cease-and-desist letter in 2017, as he is not a licensed veterinarian.

But last year, the MVMA found out that Asham was still working as a equine dentist and was recommended on Facebook. The MVMA hired private investigator Russ Waugh to go undercover and try to hire Asham.

According to Waugh’s affidavit, Asham told him the horse Waugh brought in could be treated for $200 CAD (about $150), the average price for floating teeth. After the investigation, the MVMA filed suit against Asham, asking a judge to ban Asham from acting as a vet.

“By engaging in the unauthorized practice of veterinary medicine, the respondent effectively declares himself to be outside the law,” writes Robert Dawson, an attorney for the association.

This isn’t Asham’s first run-in with the law: In December 2001, the then-37-year-old was arrested after admitting to carrying 10 one-kilogram bricks of cocaine in his truck. Asham and Barry Vaughan Hancock, who was also in the truck when it was pulled over, were each charged with possession of cocaine for the purposes of trafficking.

At the time, Hancock was an equine dentist.

This content was originally published here.

Viral video shows British people shocked as they guess costs of US health care | TheHill

A now-viral video shows British people appearing shocked at the cost in the United States for essential health care services like delivering a baby or purchasing an inhaler or an Epi Pen. 

The U.K.-based political news site JOE shared the video on Twitter Tuesday and it has garnered over 15 million views and more than 50,000 likes. It shows one person going up to multiple British people and asking how much they think essential health services might cost on the U.S.

“Ambulance call out, how much do you think that costs?” the questioner asks one man.

“Zero payment,” the man responds.

“For real?” He asks after the questioner revealed that receiving medical care in an ambulance can cost $2,500.

The questioner asked one woman how much she thinks a single inhaler would cost. When the questioner told her it can cost $250 to $300 dollars, she responded “For an inhaler? Man, so if you’re poor you’re dead?” 

Ambulance call out? $2,500. Childbirth? $30,000.

Our NHS is not for sale, @realDonaldTrump pic.twitter.com/q9z4r6Ni6g

— PoliticsJOE (@PoliticsJOE_UK)

When he told the same woman that an Epi Pen cost more than $250, she responded “shut the fridge,” looking shocked when the questioner revealed that the life-saving medicine can cost more than $600.

“You have to pay to do that?” the woman asked after the questioner said hospitals can charge for skin-to-skin contact between a mother and baby after a person gives birth. “To hold my own child that I’ve been carrying inside of my womb?”

“I’m genuinely speechless,” she continued. When asked what she thinks about the people profiting off of the medical industry in the U.S., she responded, “You’re bastards.” 

Another woman looked aghast when the questioner revealed that giving birth in a hospital can cost $10,000, and an IUD contraceptive device can cost $1,300. The woman called the National Health Service in the United Kingdom “Literally the gift that keeps on giving.”

“Literally, literally people are so dumb for taking advantage of it, and I don’t want it to change,” she said. 

Earlier this year, President TrumpDonald John TrumpTop Democrat: ‘Obstruction of justice’ is ‘too clear not to include’ in impeachment probe Former US intel official says Trump would often push back in briefings Schiff says investigators seeking to identify who Giuliani spoke to on unlisted ‘-1’ number MORE walked back comments he made that the NHS should be included in trade talks between the U.S. and the U.K., telling Piers Morgan that he doesn’t “see it being on the table.”

Trump again told reporters Tuesday that “If you handed [the NHS] to us on a silver platter, we want nothing to do with it,” Fox News reported.

This content was originally published here.

Important Studies on Opioid Prescribing: Implications for Dentistry – TeethRemoval.com

Recently on this site several articles have appeared discussing opioid prescribing after wisdom teeth removal see for example the posts Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal? and Opioid Prescriptions From Dental Clinicians for Young Adults and Subsequent Opioid Use and Abuse. Very recently several interesting studies regarding opioid prescribing have published.

The first study is titled “Trends in Opioid Prescribing for Adolescents and Young Adults in Ambulatory Care Settings” written by Hudgins et al. appearing in Pediatrics in June 2019 (vol.143, no. 6, e20181578). The article explored opioid prescribing for adolescents (ages 13 to 17) and young adults (ages 18 to 22) receiving care in emergency departments and outpatient clinics. Data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) and National Ambulatory Medical Care Survey (NAMCS) over the time period from January 1, 2005, to December 31, 2015 was used. It was found the most common conditions associated with opioid prescribing among adolescents visiting emergency departments was dental disorders (59.7%), clavicle fractures (47%) and ankle fractures (38.1%) and among young adults visiting emergency departments was dental disorders (57.9%), low back pain (38%), and neck sprain (34.8%). Thus in both cases when someone ages 13 to 22 goes to an emergency department because of a dental disorder they are nearly 60% likely to leave with an opioid prescription. Studies suggest that adolescents and young adults are the most likely to misuse and abuse opioid medications. Thus the authors imply it is possible that many of these opioids being prescribed for dental disorders are being used for non medical use.

An accompanying commentatory of the article by Hudgins also provides additional insights into the article titled “Opioids and the Urgent Need to Focus on the Health Care of Young Adults” written by Callahan also appearing in Pediatrics in June 2019 (vol. 143, no. 6, e20190835). Callahan says that research looking at young adults is often not available as they often get grouped into adolescents in studies. Callahan states:

“Efforts to improve research and health care for young adults are further hindered by (1) the lack of a consensus definition of young adulthood, (2) the false perception that young adults are healthy, (3) fragmented health insurance coverage during young adulthood, and (4) little organized advocacy on behalf of young adults.”

Callahan thus calls for more research tailored to young adults. Young adults are of course a target demographic for wisdom teeth surgery.

The second study is titled “Comparison of Opioid Prescribing by Dentists in the United States and England” written by Suda et al. appearing in JAMA Network Open in 2019 (vol. 2, no. 5,e194303). The article explored opioid prescribing differences by dentists in the United States of America and England. The authors looked at data from IQVIA LRx in the U.S. and the NHS Digital Prescription Cost Analysis in England. The authors found in 2016 dentists prescribed more than 11,440,198 opioid prescriptions in the U.S. and 28,082 opioid prescriptions in England. Dental prescriptions for opioids were 37 times greater in the US than in England. In the U.S. various opioids were prescribed including hydrocodone-based opioids (62.3% of time), codeine (23.2% of the time), oxycodone (9.1% of the time), and tramadol (4.8% of the time) whereas in England only the codeine derivative dihydrocodeine was prescribed. The authors state:

“The significantly higher opioid prescribing occurs despite similar patterns of receiving dental care by children and adults, no difference in oral health quality indicators, including untreated dental caries and edentulousness, and no evidence of significant differences in patterns of dental disease or treatment between the 2 countries.”

The authors in the article by Suda point out that the patients included in the study from England were limited to receiving medications from the U.K.’s National Health Service. However they feel that their study shows that U.S. dentists prescribe too many opioids and this practice is contributing to the opioid epidemic in the U.S.

In both studies above it seems that the authors feel that patients in the U.S. are receiving too many opioids for dental related issues and that other medications that can provide pain relief should be given. When opioids are given they should be prescribed in the shortest duration necessary to deal with the expected amount of pain the patient is dealing with. However, a limitation of both studies is the authors were unable to assess the appropriateness of the opioid prescriptions given.

This content was originally published here.

Health officials warn Denver airport travelers of potential measles exposure after 3 children hospitalized

Three children visiting Colorado have been hospitalized with measles, leading health officials to warn people who traveled through Denver International Airport earlier this week that they are at risk for the highly contagious disease.

The children tested positive after traveling to a country with an ongoing measles outbreak. They did not have the MMR — or measles, mumps and rubella — vaccine, according to a news release from Tri-County Health Department, which covers Adams, Arapahoe and Douglas counties.

The Centers for Disease Control and Prevention considers three or more cases of measles “linked in time and place” to be an outbreak. However, Tri-County Health spokesman Gary Sky said the department doesn’t consider this to be an outbreak because the patients are related.

Health officials said individuals who visited these locations may have been exposed to measles:

  • Denver International Airport between 1:15 and 5:45 p.m. Dec. 11
  • Children’s Hospital Colorado’s Anschutz Campus Emergency Department between 1 and 7:30 p.m. Dec. 12

Local health officials have not said where the family was traveling from. But the news of the measles cases in Colorado comes the same day that health officials in California warned about exposure from patients who traveled through Los Angeles International Airport.

It’s unclear how many people are at risk of exposure.

Officials at Denver International Airport said they do not know how many people potentially came in contact with the children. Roughly 179,000 people passed through the airport via departing, arriving or connecting flights on Dec. 11, said airport spokeswoman Emily Williams.

Health officials are contacting people who are believed to be at risk for measles, including those who visited Children’s Hospital on Dec. 12. The Tri-County Health Department will likely contact “well over 100” people in its investigation, said Dr. Bernadette Albanese, a medical epidemiologist.

“We’re doing this investigation for a reason, and that reason is precisely to prevent secondary spread — and having a non-ideal vaccination rate in Colorado isn’t helping matters,” she said.

There is no ongoing risk of exposure at these two locations, however, travelers should be on the lookout for measles symptoms, which can develop seven to 21 days after contact, the news release said.

Measles has various symptoms including high fever, cough, runny nose, watery eyes and a rash. The illness can lead to pneumonia and swelling of the brain, according to the Centers for Disease Control and Prevention.

Measles is highly contagious and up to 90% of people close to a person with the illness become infected if they are not immune, according to the CDC.

Representatives of the Colorado Department of Public Health and Environment and Children’s Hospital Colorado declined to discuss the measles cases and deferred questions to Tri-County Health Department.

Several measles outbreaks have occurred across the United States this year, but until now there was only one case reported in Colorado. In January, a Denver resident was placed in isolation and treated for the respiratory illness.

But health experts have warned that Colorado’s low vaccination rate makes communities here vulnerable to an outbreak. The immunization rate for the MMR shot was 87.4% during the 2018-19 school year, meaning the state doesn’t meet the threshold needed to protect a community from a measles outbreak.

The state’s low vaccination rate has come under scrutiny this year and a bill to make it harder to opt out of such shots was debated by legislators before it failed. Gov. Jared Polis has said he’s “pro-choice” when it comes to vaccinations. He said believes the solution to raise the low immunization rate is through education and access rather than eliminating nonmedical exemptions.

If a person has symptoms that could be measles they should call their doctor’s office or a hospital first, the news release said.

Due to incorrect information from a health official, this story originally mischaracterized the measles cases at Denver International Airport as an outbreak.

This content was originally published here.