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Preview: Seattle Post-Intelligencer: Health and Fitness

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Anorexic, bulimic woman who fought force-feeding dies at 30

Wed, 22 Feb 2017 17:46:23 UT

The state attorney general's office argued she was not mentally competent because of chronic depression. The attorney general's office said the woman's depression could be treated using an experimental drug. Armstrong cited previous "landmark" cases where patients, their families, physicians, and their institutions were found to be "proper cooperators" in making difficult medical decisions.



Health care's future: Turning patients into savers, shoppers

Wed, 22 Feb 2017 17:02:47 UT

The idea is that when your money is on the line — and not the insurance company's — you'll look for the best value and do your part to curb national health care spending. The Affordable Care Act's fate is up in the air as President Donald Trump and Congress weigh plans to overhaul the law. While much remains unknown, Republicans indicated last week that they will encourage wider use of insurance that comes with a health savings account aimed at pushing patients to save and shop for care. To ease that pain, health savings accounts, or HSAs, let customers set aside money before taxes, and some offer the chance to invest the balance in mutual funds like a retirement account. While these plans may help patients save on doctor visits, they do little to curb spending on the priciest care like major surgeries. Nieves-Taranto said he also has become a discerning shopper, favoring cheaper retail clinics over a doctor's office for routine care. People with low incomes may not benefit from the tax breaks the accounts offer, and they also might struggle to keep money in their accounts especially if the government doesn't help stock them. Researchers also saw an initial drop in prescriptions and use of preventive care like flu shots or breast cancer screenings after workers were introduced to coverage with an HSA.



New trauma unit to help former Islamic State sex slaves

Wed, 22 Feb 2017 16:32:29 UT

New trauma unit to help former Islamic State sex slaves DOHUK, Iraq (AP) — After their rape and torture by Islamic State extremists for months or years, Yazidi women face ongoing suffering from psychological trauma even if they do manage to escape. [...] a lack of psychiatrists and other mental health specialists in northern Iraq meant that many Yazidi women — a minority singled out for especially harsh treatment by IS — got little or no help. The training center is the next phase of an ambitious project funded by the wealthy German state of Baden Wuerttemberg that brought 1,100 women who had escaped Islamic State captivity, primarily Yazidis, to Germany for psychological treatment. The program will train local mental health professionals to treat people like Perwin and thousands of Yazidi women, children and other Islamic State victims. About 1,900 Yazidis have escaped the clutches of IS, but more than 3,000 other women and children are believed to still be held captive, pressed into sexual slavery and subjected to horrific abuse. The U.S., Iraq, Britain, France and Australia flew in water and other supplies, until Kurdish fighters eventually opened a corridor to allow some of them to reach safety. Casualty estimates vary widely, but the United Nations has called the Islamic State assault genocide, saying the Yazidis' "400,000-strong community had all been displaced, captured or killed."



'It saved my life': Talk of Obamacare repeal worries addicts

Wed, 22 Feb 2017 13:55:40 UT

In Kentucky, which has been ravaged worse than almost any other state by fentanyl, heroin and other drugs, Tyler Witten went into rehab at Medicaid's expense after the state expanded the program under a provision of the act. [...] he had been addicted to painkillers for more than a decade. Addicts and mentally ill people who gained access to treatment programs for the first time are worried about how that might change as President Donald Trump and Republicans in Congress try to make good on their promise to repeal and replace "Obamacare." Repeal could end coverage for 1.8 million people who have undergone addiction or mental health treatment and could cut $5.5 billion in spending on such services, said Richard Frank, a health economist at Harvard Medical School. Some GOP governors insist addicts have nothing to fear from repeal because, they say, Medicaid will continue to pay for treatment. Marquitta Nelson, a 60-year-old homeless Chicagoan with severe depression, is getting psychiatric care and treatment for asthma, arthritis and other conditions since she obtained Medicaid coverage under the health law expansion. For those buying insurance in the marketplace, many plans still exclude or limit residential treatment and clinics that dispense methadone, which is used to treat addictions to heroin and painkillers.



Health law created winners and losers when buying insurance

Wed, 22 Feb 2017 08:57:27 UT

Known as the ACA, the law rewrote the rules for people buying their own health insurance, creating winners and losers. [...] other consumers who also buy their own insurance and don't qualify for financial help feel short-changed by Obama's law. Consumers who didn't qualify for government financial help wound up bearing the full cost of premiums. If Trump and congressional Republicans aren't careful, their actions could stoke fresh grievances without solving longstanding problems of access and cost. If Republicans take away his subsidy, "I would have to change careers and find a job that offered health insurance," he said. The Congressional Budget Office estimates that the pool of people buying individual health insurance is basically split down the middle among subsidized customers like Schwarz and those who get no help, like Dorsch. Republican proposals to tie tax credits to age, not income, would help Dorsch. Caroline Pearson, of the consulting firm Avalere Health, studied consumers on government marketplaces like HealthCare.gov — where nearly 90 percent get subsidies — and compared them with those who purchase directly from an insurer and pay full cost. For those with a standard plan, per-person medical claims averaged $376 per month in 2015, compared to $312 for unsubsidized customers who bought policies directly from an insurer.



Experts: Science behind 'abortion reversal' is flawed

Wed, 22 Feb 2017 06:31:06 UT

CHICAGO (AP) — Lawmakers in several states are considering requirements for doctors to inform women seeking medical abortions about an unproven procedure called "abortion reversal." The procedure involves shots of the hormone progesterone given if a woman changes her mind after the first step of a medical abortion. Since 2015, Arkansas and South Dakota have enacted laws requiring doctors to tell women about it. About a third of women who seek abortions in early pregnancy choose medical abortions because they want a less invasive procedure than a surgical abortion. Progesterone is legitimately used to prevent preterm birth in women who are at risk of early delivery. The clinic "offers true reproductive health care and abortion alternatives to women," the website says. Delgado published a paper in 2012 about six women who had taken mifepristone, the first medication in the two-part medical abortion, then had a series of progesterone shots. Progesterone shots are generally safe but can cause swelling, irritation and other side effects.



State lawmakers channel grief into fight against opioids

Wed, 22 Feb 2017 01:38:13 UT

A Minnesota state senator whose daughter died of a heroin overdose in a Burger King parking lot — a friend hid the needles instead of calling for help — spearheaded a law that grants immunity to 911 callers. The lawmakers' personal stories have lent weight to the effort to combat what public health officials have deemed a full-blown epidemic that is fast approaching the severity of the AIDS outbreak of the 1980s and '90s. More than 52,000 people died of a drug overdose in 2015, and roughly two-thirds of them had used prescription opioids like OxyContin or Vicodin or illegal drugs like heroin, according to the Centers for Disease Control and Prevention. A joint investigation by The Associated Press and the Center for Public Integrity last fall found that pharmaceutical companies and allied groups spent more than $880 million nationwide on lobbying and campaign contributions from 2006 through 2015. The industry group Pharmaceutical Research and Manufacturers of America said in a statement Tuesday that it is "committed to helping combat misuse and abuse" of prescription drugs. New Jersey Gov. Chris Christie has devoted his final year in office to curbing his state's rapidly growing heroin and prescription drug epidemic, citing the case of a friend from law school who was found dead with a painkiller bottle at his side.