Over a single 8-month period, seven infants were admitted to Monroe Carell Jr. Children’s Hospital at Vanderbilt for treatment of either cranial or intestinal hemorrhaging due to vitamin K deficiency bleeding (VKDB)…
That report prompted researchers in Canada to investigate local vitamin K refusal rates and predictors.
Of the 214,061 children born in Alberta, Canada, from 2006 to 2011, 0.3% had parents who declined the vitamin K injection after birth, Shannon E. MacDonald, PhD…and colleagues wrote in Pediatrics.
In 2006, the vitamin K refusal rate was 0.21%, but by 2012, that rate increased to 0.39% (P<0.001) of live births.
The highest rates of vitamin K refusal occurred in parents who also refused recommended vaccines throughout the first 15 months of life…
The vitamin K refusal rate for parents who delivered in a hospital was very low, 0.2%, compared with parents who had planned home deliveries, 14.5%…and parents who delivered at a birthing center, 10.7%…
The study authors suggested parental decisions to refuse vitamin K were linked to lack of education and misinformation based on two studies from the 1990s (Golding et al.), which suggested vitamin K injections could increase the chances of developing childhood cancer. Those study results, the Canadians said, were since found to be inaccurate…
Refusal rates have increased in Texas, too. At Texas Children’s Pavilion for Women, Tiffany McKee-Garrett said that when parents refuse, they team up with the parents’ primary care provider to counsel the family extensively and provide the parents with written materials to educate them about vitamin K.
RTFA for details of other regional studies.
I know I get too cranky for some folks; but, what kind of parent is so dedicated to 14th Century dogma that they’re ready and willing to accept the prattle from long-discredited studies – generally from some 3rd or 4th-hand source – instead of taking the time to read a little science about disease prevention, proven health maintenance.
Rather, they risk the lives of their newborn in pursuit of purity of their soul. No sense or balance IMHO.
States that aren’t expanding Medicaid are leaving a total of $423 billion in federal funds on the table over the next decade.
States do have to spend a bit of their own money to get the federal dollars. While the federal government covers the full cost of Medicaid expansion through 2016, states have to kick in a small portion (5 percent) beginning in 2017. The state’s contribution ultimately rises to 10 percent by 2020.
The Urban Institute, who crunched the numbers behind this map, finds that the states currently not expanding Medicaid would have to spend $31.6 billion over the next decade if they opt-in. That is definitely real money — but also less than a tenth of the amount they’re losing out on by passing up the expansion.
Almost all these states have Republican governors and Republican-conrolled legislatures. Proving once again idjits elect idjits – or liars.
As for sloganeering — it’s obvious Republicans have as much concern for people needing healthcare as they do for people needing jobs. Lots of talk – but, won’t do a damned thing to help out.
More than half of U.S. hospitals were on the hook to meet a new set of “meaningful use” of electronic health records criteria — known as the stage 2 criteria — by the end of the fiscal year that ended in July. The new study’s data, which was gathered in late 2013, suggests that many may have missed the milestone. At the time, only 5.8 percent of those hospitals were on track to adopt all 16 of the stage 2 meaningful use goals.
Hospitals that bill the Medicare program and didn’t meet the criteria in fiscal year 2014 will be subject to financial penalties in fiscal year 2015…
The criteria, set forth by the Centers for Medicare and Medicaid, include relatively easy items such as using electronic health records to enter orders for medication as well as lab and radiology tests, to chart patients’ vital signs and to record patient demographics. More difficult activities include sharing electronic health record data with patients online, sharing electronic data with other providers who care for the same patients and submitting electronic data to vaccine registries…
The criteria are the second tier of compliance with the 2009 Health Information Technology for Economic and Clinical Health Act, also known as HITECH. The act requires hospitals to move from paper to electronic recordkeeping. At first, only a basic set of criteria is required, but once a hospital starts down the path, it must meet higher benchmarks at scheduled dates. The more than half of hospitals that were scheduled to meet the stage 2 meaningful use criteria in 2014 were the first wave to begin adopting digital medical records.
The study determined that the number of hospitals adopting electronic health records continues to rise steeply. Nearly 60 percent of hospitals now have at least a basic system. And 90 percent of those were on track to achieve many of the 16 core criteria.
The study suggests that, where hospitals are not able to meet criteria, they aren’t always to blame. Vendors must upgrade their products to make necessary functions available to meet the criteria. These challenges, however, appear to be concentrated in specific types of hospitals.
“Policymakers may want to consider new targeted strategies to ensure that all hospitals move toward meaningful use of electronic health records,” Adler-Milstein said. “We found that rural and small hospitals lag behind, suggesting a need to expand federal efforts to help these institutions select, purchase, implement and successfully use electronic health records in ways that earn them incentive payments and enable them to engage in new care delivery and payment models.”
Overdue. Way overdue. One of the best things we can thank Obama for – at two levels.
I really enjoy being able to access my medical records, diagnoses and communications – and love seeing them available between my physicians. Two of the four physicians on my Medicare chart are there: my GP and my eye doctor. Mostly just annual checkups; but, I’m glad they can see other’s work. The other two have just as perfunctory a relationship – and I’m confident they’ll soon be on board.
The best reason in the world to get hospitals into the mix makes me feel great – as a cynical geek. Because computational analysis is turning up crooked hospitals, administrators and healthcare conglomerates all over the country. And I love it.
When a hospital’s billing practices distort general rules of practice – it shows up. When a hospital is requesting ten times the national/regional average of one kind of profit center test – it shows up. Etc.
Like I said. Overdue.
Ezekial Emanuel, one of the architects of both health plans
The death rate in Massachusetts dropped significantly after it adopted mandatory health care coverage in 2006, a study released Monday found, offering evidence that the country’s first experiment with universal coverage — and the model for crucial parts of President Obama’s health care law — has saved lives, health economists say.
The study tallied deaths in Massachusetts from 2001 to 2010 and found that the mortality rate — the number of deaths per 100,000 people — fell by about 3 percent in the four years after the law went into effect. The decline was steepest in counties with the highest proportions of poor and previously uninsured people. In contrast, the mortality rate in a control group of counties similar to Massachusetts in other states was largely unchanged.
A national 3 percent decline in mortality among adults under 65 would mean about 17,000 fewer deaths a year…
Massachusetts is whiter and more affluent than most states, and has more doctors per capita and fewer uninsured people. But researchers said that the state’s health insurance law nevertheless amounted to the best natural experiment the country has had for testing the effects of a major insurance expansion on a large population.
In Suffolk County, which includes Boston, the death rate for adults under 65 dropped by about 7 percent from 2005 to 2010, the study’s authors said.
There have been patchy efforts to boost coverage for the poor in states like Arizona, Maine and New York, but Massachusetts is the only state to fully overhaul its health system to cover almost everybody…
David O. Meltzer, a health economist from the University of Chicago, who was not involved in the study, said one of the study’s strengths was its size. It looked at four million people in Massachusetts — the entire population age 20 to 64 — and compared them with more than 44 million people in control counties…
The biggest declines happened for conditions that are more likely to be deadly if not caught early — for example, infections from complications of diabetes, heart attacks and cancer.
Americans continue to amaze the rest of the industrialized world. The rate at which we catch on to real social and economic benefits truly lags any sort of common sense. Here we are adopting a half-Republican version of the National Health Service folks in the UK have had for over 60 years. My kin in the Great White North have had the more advanced Canadian version for 30 years.
About the only thing we manage to achieve is higher salaries for doctors and hospital administrators. And insurance company executives.
Of course, we have a surplus of priests, politicians and pundits who tell us we are committing an unholy act by improving health care for all. OTOH, when we have the same number of years to evaluate the single payer system starting up in Vermont, I’ll wager we will find the benefits even more cost effective and achieving similar or better results. The rest of us will continue to ignore the naysayers.
Voters…are returning to faith in cradle to grave welfare after eight years of center-right Prime Minister Fredrik Reinfeldt, who cut income, wealth and corporate taxes. Sweden’s tax burden has fallen by four percentage points of GDP – now lower than France.
In the eyes of many Swedes, the welfare state withered. Sickness and unemployment benefits were cut. Private firms started to run tax-funded schools and hospitals. But a tipping point may have come as a September general election approaches – and many now point to a U-turn…
By any standards, Sweden is healthy. Its public debt is around 40 percent of GDP, half of Germany’s.
But Sweden has one of the world’s most generous welfare states – like subsidized child care with up to 480 days of parental leave per child. Its Nordic model depends on keeping to a strict national bookkeeping unusual in much of Europe…
At the same time as demands grow for more spending on schools and hospitals, Sweden’s public finances have worsened. The country may now be heading for years of rising tax burdens if it wants to keep its public finances in order.
Flush from income tax cuts, middle classes have also enjoyed cheap loans and a property boom. As wealth grew – with clusters of Michelin star restaurants in Stockholm – Sweden remained one of the few economies in Europe with the top AAA credit rating. It also has the fastest growing economic inequality of any OECD nation…
The U.S. has been in a jobs emergency since at least 2008. The cause of the crisis…isn’t mysterious, and neither are the solutions. We could invest in infrastructure to create construction jobs. We could give tax breaks to employers who hire new workers. We could restore the payroll tax cut to workers so they have more money to spend. We could help state and local governments hire back some of the employees they laid off during the recession. Macroeconomic Advisers, an economic consulting firm, found that the American Jobs Act, which contained many of these policies, would have created 2 million jobs.
But in recent years, these policies have been either blocked or canceled by congressional Republicans. They fought Democrats to scuttle the American Jobs Act and allow the payroll tax break and long-term unemployment benefits to expire. Creating jobs, they argued, was neither feasible nor affordable.
That’s the proper context in which to view this week’s hysteria about Obamacare. The nonpartisan Congressional Budget Office just released updated estimates for the health law. It found that the disastrous rollout last fall put Obamacare behind schedule — on track to insure 2 million fewer people than projected by the end of 2014. On the other hand, it also found that insurance premiums were about 15 percent lower than projected, and that the law would cost less than previously estimated. It found that the risk corridors designed to safeguard insurance companies from the effects of acquiring too many high-risk customers — which Republicans have been calling an “insurer bailout” — will actually yield $8 billion in net payments from insurers to the federal government.
The finding that made the news, however, concerned the Affordable Care Act’s long-term effect on labor supply. In past reports, the CBO has estimated that the law will, on net, lead some people to drop out of the labor market or cut back on their hours because their health insurance is no longer tied to their job. Imagine a 62-year-old who would like to shift to part-time work but can’t because he can’t afford — or, due to pre-existing conditions, wouldn’t even be sold — insurance on the individual market. Now, because Obamacare has made that insurance affordable and available, he can — and will. As a result, his work hours will be (voluntarily) reduced…
Whether this is good or bad depends on your views about human flourishing. Lower labor-force participation is bad for economic growth. On the other hand, the point of life is not for everyone to work every possible hour until they die. Workers should be able to choose to leave their jobs or cut their hours without worrying that their families won’t survive a medical emergency. In addition, as the Urban Institute’s Donald Marron tweeted, “employers will be competing harder for workers,” which will push wages to rise for everyone remaining in the workforce…
Policies don’t exist in vacuums. By untying the link between employment and health care, the Affordable Care Act reduces the incentive to work. But there are ways to increase incentives to work without making people dependent on their jobs for health insurance. We can help people without taking away their health care.
So here’s a simple proposal. Repeal of the Affordable Care Act would cost hundreds of billions of dollars over the next few decades because of the law’s spending cuts and new revenue. So instead of repeal, how about if Congress devotes that same amount of money to policies to increase employment now. Republicans could even dictate that all the money flow to targeted tax cuts.
Ezra Klein politely suggests the Republicans are hypocrites. He’s wasting politeness on the crudest, least responsible clot of scumsuckers ever seated beneath the moldy dome of Congress.
Republicans denied playing a part in Wall Street’s crash and burning. They tried as hard as possible to avoid any cooperation on essential economic remedies. Every year since the beginning of the worst economic failure since Herbert Hoover was president – their mantra has been “Jobs, jobs, jobs” – while blocking any reasonable attempt to assist jobs creation.
They stuck to dribble-down economics with a 100% record of failure and spent most of their casual time inside the Capitol waging war on women, reproductive rights, working as hard as possible to rescue their mates in the insurance cartels from bona fide national healthcare, committed to every possible delay in the expansion of civil rights. And, of course, hoping to start the occasional war.
Now, once again, they say they are worried about jobs for working class America. If I was a fire-and-brimstone Christian I wouldn’t stand outdoors next to a Republican for fear of being struck by lightning.
Why, yes – I have a master’s degree in education
The fastest-growing jobs in the United States through 2017 are expected to be those requiring an advanced education, a study released Thursday found.
The report compiled by CareerBuilder and Economic Modeling Specialists International, says job creation will accelerate from 2013 to 2017 compared with 2009 to 2013, gaining 4.4 percent compared with 3.5 percent.
Jobs requiring an associate degree or a master’s degree are expected to grow 8 percent, the report says, while jobs requiring a bachelor’s degree — which generally takes four years and falls between associates and master’s degrees — are expected to grow 6 percent.
Jobs that require “short-term, on-the-job training trail at 4 percent,” the study projects.
In a list of jobs expected to grow 8 percent or more through 2017, personal care and home health aides top the list with growth expected at 21 percent.
Jobs for market research analyst and marketing specialists are expected to grow 14 percent, as are jobs for medical secretaries.
Jobs for emergency medical technicians and paramedics are projected to grow 13 percent, while jobs for software developers are projected to rise 11 percent.
The final job with double-digit growth expected is medical assistants, with growth of 10 percent predicted, CareerBuilder said…
The top 18 include, in descending order, registered nurses, network and computer systems administrators, pharmacy technicians, landscapers, and social and human services assistants, all expected to grow 9 percent, and computer systems analysts, management analysts, cooks, insurance agents, nursing assistants, licensed practical and licensed vocational nurses and food preparation workers and servers, including fast-food, the report said.
Middle-aged? Stick to figuring out ways to survive. Sooner or later the cost of living will begin to accelerate to match the increases of those with growing income. If you want longer-term worries consider your kids and grandkids. The quality of K-12 education ain’t especially getting better inside the United States. Compared to other literate nations and competing with them for jobs, we’re in a deeper hole that’s on the way to becoming downright subterranean.
While there’s no shortage of pundits who finished their college years before malaise and a matching decline set in – they continue to praise the value of our advanced education. That will continue to sort out with underfunded public schools getting more and more of the student base and giving back less in return. Or so it seems.
Seven months pregnant, at a time when most expectant couples are stockpiling diapers and choosing car seats, Renée Martin was struggling with bigger purchases.
At a prenatal class in March, she was told about epidural anesthesia and was given the option of using a birthing tub during labor. To each offer, she had one gnawing question: “How much is that going to cost?”
Though Ms. Martin, 31, and her husband, Mark Willett, are both professionals with health insurance, her current policy does not cover maternity care. So the couple had to approach the nine months that led to the birth of their daughter in May like an extended shopping trip though the American health care bazaar, sorting through an array of maternity services that most often have no clear price and — with no insurer to haggle on their behalf — trying to negotiate discounts from hospitals and doctors…
When she became pregnant, Ms. Martin called her local hospital inquiring about the price of maternity care; the finance office at first said it did not know, and then gave her a range of $4,000 to $45,000. “It was unreal,” Ms. Martin said. “I was like, How could you not know this? You’re a hospital.”
Midway through her pregnancy, she fought for a deep discount on a $935 bill for an ultrasound, arguing that she had already paid a radiologist $256 to read the scan, which took only 20 minutes of a technician’s time using a machine that had been bought years ago. She ended up paying $655. “I feel like I’m in a used-car lot,” said Ms. Martin, a former art gallery manager who is starting graduate school in the fall.
Like Ms. Martin, plenty of other pregnant women are getting sticker shock in the United States, where charges for delivery have about tripled since 1996, according to an analysis done for The New York Times by Truven Health Analytics. Childbirth in the United States is uniquely expensive, and maternity and newborn care constitute the single biggest category of hospital payouts for most commercial insurers and state Medicaid programs. The cumulative costs of approximately four million annual births is well over $50 billion.
And though maternity care costs far less in other developed countries than it does in the United States, studies show that their citizens do not have less access to care or to high-tech care during pregnancy than Americans.
RTFA. It’s long, detailed, and scary.
When Dwight Eisenhower left office as president he warned of the political power of the military-industrial complex. Well, they ended up owning enough of Congress that they suck down the lion’s share of our non-insurance federal budget. That leaves what is now being called the medical-industrial complex. And between insurance companies, pharmaceutical manufacturers, healthcare providers and hospitals they seem bound and determined to take the rrest of that budget – and our life savings.
A group of 18 doctors, researchers and public health experts have jointly urged the Food and Drug Administration…to take action on energy drinks to protect adolescents and children from the possible risks of consuming high amounts of caffeine.
“There is evidence in the published scientific literature that the caffeine levels in energy drinks pose serious potential health risks,” the doctors and researchers wrote.In their letter to Dr. Margaret A. Hamburg, the F.D.A. commissioner, the group argued that energy drink makers had failed to meet the regulatory burden placed on them to show that the ingredients used in their beverages were safe, specifically where children, adolescents and young adults are concerned. As a result, the group urged the F.D.A. to restrict caffeine content in the products and to require manufacturers to include caffeine content on product labels…
Less is known about the safe level of caffeine for a young teenager, experts say, apart from the fact that it is considered to be lower than for an adult. In their letter Tuesday to Dr. Hamburg, the group of researchers and scientists also pointed out that makers of energy drinks aggressively marketed their products to young teenagers and urged them to consume the drinks quickly. Including mixing them with booze!
In recent years, the number of reported emergency-room visits in which an energy drink was cited as the primary cause of a health problem, or a contributing factor, has grown sharply. In 2011, there were 20,783 such visits, compared with 10,068 in 2007. Problems typically linked to excessive caffeine consumption can include anxiety, headaches, irregular heartbeats and heart attacks.
Probably overdue. At least until and unless reasonable research indicates otherwise. Think we can count on the FDA to encourage that?