Monthly Archives: October 2016

Florida Derail Healthcare Reform

With Monday’s ruling by a federal judge that the healthcare reform law is unconstitutional, legal experts foresee a showdown in the Supreme Court, where the outcome could go either way.

Judge Roger Vinson, of the U.S. District Court for the Northern District of Florida, in Pensacola, on Monday ruled that the healthcare reform law is unconstitutional, siding with the 26 states that sued to block enforcement of the Affordable Care Act (ACA).

That makes four total rulings on the law: two that upheld the law, one that struck down the individual mandate portion of the law, and Monday’s decision, which struck down the law in its entirety. Another 12 courts have dismissed the case.

“All of these cases are merely station stops on the way to the Supreme Court,” Dr. Daniel Blumenthal, a community health professor at Morehouse School of Medicine in Atlanta, told ABC News/MedPage Today in an e-mail.

The ruling by Vinson is the harshest legal action yet against the ACA because, unlike the recent decision by a Virginia judge stating that the individual mandate portion of the ACA violates the Constitution, Vinson ruled the entire law “void” because the individual mandate provision can’t be separated out from the rest of the law.

The individual mandate — which requires everyone to buy insurance by 2014 or else pay a penalty — exceeds Congress’ authority under the Commerce Clause of the Constitution, which regulates interstate commerce, Vinson wrote in his decision.

Vinson agreed with the states involved in the lawsuit that the government cannot force individuals to participate in the stream of commerce — in this case, the health insurance market.

The federal government responded that at some point, every U.S. citizen will seek medical care, and if that person chooses to not have insurance, the cost of his or her medical care is passed on to those with insurance. Thus, a choice to not participate in the commerce of healthcare doesn’t actually exist.

Many legal and health policy experts say the Florida case is the most likely of the reform cases to make its way to the Supreme Court.

An ounce of prevention being worth

When you were little, your parents probably made sure you had an annual checkup with your doctor. But as you’ve grown older, you may have gotten out of this habit.

Health professionals stress that these regular exams are important to help identify risk factors and problems before they become serious. If diseases are caught early, treatments are usually much more effective. Ultimately, having a regular doctor’s visit will help you live a long and healthy life.

Doctor’s Visit: The Prevention Checkup

Depending on your age, sex, and family medical history, a checkup with your doctor may include:

  • Blood, urine, vision, and hearing tests to evaluate your overall health
  • Assessments of your blood pressure, cholesterol level, and weight
  • A discussion about your diet and exercise habits and any tobacco, drug, and alcohol use
  • Immunizations and booster shots
  • Screenings to assess your risk of developing certain diseases, including diabetes (if you already have high blood pressure or high cholesterol) and cancer
  • Depending on your age and sexual lifestyle, testing for STDs and possibly HIV
  • Starting at age 50, or younger if you have a family history, a screening test for colorectal cancer
  • A discussion about depression and stress to evaluate your mental health

Doctor’s Visit: Concerns for Men

For men, in addition to checking weight, high blood pressure, and other basics, your doctor’s visit may specifically include:

  • Starting at age 50, or younger if you have a family history, a rectal exam to check for abnormal bumps in the prostate and a prostate specific antigen (PSA) blood test to screen for prostate cancer
  • Between the ages of 65 and 75 if you have ever smoked cigarettes, an abdominal exam to check for an enlargement in your aorta; an abdominal aortic aneurysm, a weakness in the lining of the aorta (a large blood vessel in your chest and abdomen), can develop with age and become a life-threatening problem.

Strikes Down Health Reform Law

A federal judge ruled Monday that the new U.S. health-care reform law is unconstitutional, saying the federal government has no authority to require citizens to buy health insurance.

That provision is a cornerstone of the new legislation, signed into law in March by President Barack Obama.

The judge’s decision was not unexpected, and both supports and opponents of the legislation anticipate the validity of the new health law ultimately will be decided by the U.S. Supreme Court.

The ruling was handed down by U.S. District Judge Henry E. Hudson, a Republican appointed by President George W. Bush who had seemed sympathetic to the state of Virginia’s case when oral arguments were heard in October, the Associated Press reported.

Last week, White House officials said a negative ruling would not affect the implementation of the law because its major provisions don’t take effect until 2014, the AP reported.

Virginia Attorney General Kenneth Cuccinelli, a Republican, had filed a lawsuit in defense of a new Virginia law barring the federal government from requiring state residents to buy health insurance. He argued that it is unconstitutional for the federal law to force citizens to buy health insurance and to assess a penalty if they don’t.

The U.S. Justice Department said the insurance mandate falls within the scope of the federal government’s authority under the Commerce Clause. But Cuccinelli said deciding not to buy insurance is an economic matter outside the government’s domain.

By 2019, the law will expand health insurance access to 94 percent of non-elderly Americans. Advocates say that between now and then, it will also provide Americans with many new rights and protections.

Key provisions include:

  • Health plans may no longer deny coverage to people based on pre-existing health conditions.
  • Health plans that cover dependents must permit children to stay on a parent’s family policy until age 26.
  • Insurers may no longer place lifetime dollar limits on essential benefits.
  • New health plans must offer preventive services such as mammograms and colon cancer screenings without charging a deductible, co-payment or coinsurance. (This provision does not apply to existing plans that are “grandfathered.”)

Talk Help Ease Chronic Fatigue

Patients with chronic fatigue syndrome who participated in programs aimed at helping them overcome their symptoms — a combination of exercise and counseling — improved more than those whose treatment was intended to help them adapt to the limitations of the disease, a large randomized trial found.

Mean fatigue scores among patients treated with graded exercise therapy — a tailored program that gradually increases exercise capacity — were 3.2 points lower than scores in patients who received specialist medical care alone, according to Dr. Peter D. White, of Queen Mary University of London, and colleagues.

Furthermore, fatigue scores were lower by 3.4 points among patients receiving cognitive behavioral therapy, in which a therapist works with the patient to understand the disease, alleviate fears about activity, and help overcome obstacles to functioning.

In contrast, among patients who were treated with a program known as adaptive pacing therapy, which emphasizes energy limitations and avoidance of excess activity, scores differed by only 0.7 points the researchers reported online in The Lancet.

In a press briefing describing the study findings, co-investigator Dr. Trudie Chalder, of King’s College London, said, “We monitored safety very carefully, because we wanted to be sure we weren’t causing harm to any patients.”

“The number of serious adverse events was miniscule,” she added.

Another co-investigator, Dr. Michael Sharpe, of the University of Edinburgh, commented that a difficulty in the management of chronic fatigue syndrome has been ambiguity — about the causes and whether these treatments recommended by NICE actually are effective.

“The evidence up to now has suggested benefit, but this study gives pretty clear-cut evidence of safety and efficacy. So I hope that addresses the ambiguity,” Sharpe said during the press briefing.

4 Ways to Save Energy With Chronic Fatigue Syndrome

However, the investigators conceded that the beneficial effects of these treatments were only moderate, with less than one-third of participants being within normal ranges for fatigue and functioning, and only about 40 percent reporting that their overall health was much better or very much better.

“Our finding that studied treatments were only moderately effective also suggests research into more effective treatments is needed,” they wrote.