Cultivating peace

Smoke some weed. Feel a little better. From the FD

Viagra best price

Can’t see the audio viagra best price player?. Click here to listen on SoundCloud.Five days after the election was called for President-elect Joe Biden, President Donald Trump has not conceded — and instead ordered his administration not to begin the transition of power. That could have serious ramifications for health care, particularly as nearly every state is experiencing a spike in viagra best price erectile dysfunction treatment cases.One piece of good news is that early results for a erectile dysfunction treatment made by Pfizer look promising.

But that treatment, even if it is approved soon, won’t likely be ready for wide distribution for several months.And for the third time in eight years, the Supreme Court heard a case that could invalidate the Affordable Care Act. Judging from the oral arguments, though, it appears the justices are likely to leave most or even all of the law intact.This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Stephanie Armour of The Wall Street Journal and Shefali Luthra of the 19th News. Email Sign-Up Subscribe to California viagra best price Healthline’s free Daily Edition.

Among the takeaways from this week’s podcast:The transition teams advising Biden cannot officially contact current government officials. But many team members have long-standing relationships with people in the government and were talking to those officials before the viagra best price election, so they have a good sense of what is happening in the administration.The viagra further complicates the handoff. The new administration will need to hit the ground running to distribute any erectile dysfunction treatment, so communication with Trump administration officials would be beneficial for the Biden team.Two members of Biden’s erectile dysfunction treatment task force, Drs.

Vivek Murthy, former surgeon general, and David Kessler, former commissioner of the Food and Drug Administration, have been briefing the former vice president since March on the threats of the erectile dysfunction.Since Democrats may not control the Senate — and if they do have control, it will be by the slimmest majority — Biden may be forced to make changes to health policy through executive actions and regulations. That will limit his ambitions.Still, even these smaller moves can viagra best price have major results, such as allowing Planned Parenthood to again participate in federal health programs to expand the number of providers from which low-income women can seek care.The Pfizer treatment requires extremely cold temperatures for storage, complicating the logistics for distribution. It is an obstacle but not an insurmountable one for most areas in this country.Supreme Court justices signaled this week they might not strike the Affordable Care Act in its entirety.

Several of the conservatives, including Justice Brett Kavanaugh, who was appointed by President Donald Trump, suggested that any ruling that the mandate to have insurance is unconstitutional does not have to doom the rest of the law.Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:Julie Rovner. KHN and The Washington Post’s “In Medical Schools, Students viagra best price Seek Robust and Mandatory Anti-Racist Training,” by Elizabeth LawrenceJoanne Kenen. KHN’s “Trump’s Anti-Abortion Zeal Shook Fragile Health Systems Around the World,” by Sarah VarneyStephanie Armour.

KHN’s “Biden Plan to Lower Medicare Eligibility Age to 60 viagra best price Faces Hostility From Hospitals,” by Phil GalewitzShefali Luthra. Stat News’ “With a Meteoric Rise in Deaths, Talk of Waves Is Misguided, Say erectile dysfunction treatment Modelers,” by Elizabeth CooneyTo hear all our podcasts, click here.And subscribe to What the Health?. on iTunes, Stitcher, Google Play, Spotify, or Pocket Casts.

This story was produced by Kaiser Health News, viagra best price an editorially independent program of the Kaiser Family Foundation. Related Topics Courts Elections Insurance Multimedia Public Health The Health Law Biden Administration erectile dysfunction treatment KHN's 'What The Health?. ' Podcasts Trump Administration treatmentsDrugmaker Pfizer is expected to seek federal permission to release its erectile dysfunction treatment by the end of November, a move that holds promise for quelling the viagra, but also sets up a tight time frame for making sure consumers understand what it will mean to actually get the shots.

This treatment, and likely most others, will require two doses to work, injections that viagra best price must be given weeks apart, company protocols show. Scientists anticipate the shots will cause enervating flu-like side effects — including sore arms, muscle aches and fever — that could last days and temporarily sideline some people from work or school. And even if a treatment proves 90% effective, the rate Pfizer viagra best price touted for its product, 1 in 10 recipients would still be vulnerable.

That means, at least in the short term, as population-level immunity grows, people can’t stop social distancing and throw away their masks. Left out so far in the push to develop treatments with unprecedented speed has been a large-scale plan to communicate effectively about those issues in advance, said Dr. Saad Omer, director viagra best price of the Yale Institute for Global Health.

€œYou need to be ready,” he said. €œYou can’t look for your communication materials the day after the treatment is authorized.” Omer, who declined to comment on reports he’s being considered for a post in the new administration of President-elect Joe Biden, called for the rollout of a robust messaging campaign based on the best scientific evidence about treatment hesitancy and acceptance. The Centers viagra best price for Disease Control and Prevention has created a strategy called “Vaccinate with Confidence,” but it lacks the necessary resources, Omer said.

€œWe need to communicate, and we need to communicate effectively, and we need to start planning for this now,” he said. Such broad-based outreach will be necessary in a country viagra best price where, as of mid-October, only half of Americans said they’d be willing to get a erectile dysfunction treatment. Initial doses of any treatment would be limited at first, but experts predict they may be widely available by the middle of next year.

Discussing potential side effects early could counter misinformation that overstates or distorts the risk. €œThe biggest tragedy would be if we have a safe and effective treatment that people are hesitant to get,” said Dr viagra best price. Preeti Malani, chief health officer and a professor of medicine at the University of Michigan in Ann Arbor.

Pfizer and its partner, the German firm BioNTech, on Monday said their treatment appears to protect 9 in 10 people from getting erectile dysfunction treatment, although they didn’t release underlying data. It’s the first of four erectile dysfunction treatments in large-scale efficacy viagra best price tests in the U.S. To post results.

Data from early trials of several erectile dysfunction treatments suggests that consumers will need to be viagra best price prepared for side effects that, while technically mild, could disrupt daily life. A senior Pfizer executive told the news outlet Stat that side effects from the company’s erectile dysfunction treatment appear to be comparable to standard adult treatments but worse than the company’s pneumonia treatment, Prevnar, or typical flu shots. The two-dose Shingrix treatment, for instance, which protects older adults against the viagra that causes painful shingles, results in sore arms in 78% of recipients and muscle pain and fatigue in more than 40% of those who take it.

Prevnar and common flu shots can cause injection-site pain, aches viagra best price and fever. €œWe are asking people to take a treatment that is going to hurt,” said Dr. William Schaffner, a professor of preventive medicine and health policy at Vanderbilt University Medical Center.

€œThere are lots of sore arms and substantial numbers of people who feel crummy, with headaches and muscle pain, for a day or two.” Persuading people who experience these symptoms to return in three to four weeks for a second dose — and a second round of flu-like symptoms — could be a tough sell, viagra best price Schaffner said. How public health experts explain such effects is important, Omer said. €œThere’s evidence that suggests that if you viagra best price frame pain as a proxy of effectiveness, it’s helpful,” he said.

€œIf it’s hurting a little, it’s working.” At the same time, good communication will help consumers plan for such effects. A erectile dysfunction treatment is expected to be distributed first to health care staffers and other essential workers, who may not be able to work if they feel sick, said Dr. Eli Perencevich, a professor of internal medicine and viagra best price epidemiology at the University of Iowa Health Care.

€œA lot of folks don’t have sick leave. A lot of our essential workers don’t have health insurance,” he said, suggesting that essential workers should be granted three days of paid leave after they’re vaccinated. €œThese are the things a well-functioning government should provide for to get our economy going again.” Making sure consumers know viagra best price that a erectile dysfunction treatment likely will require two doses — and that it could take a month for full effectiveness to kick in — is also crucial.

The Pfizer phase 3 trial, which has enrolled nearly 44,000 people, started in late July. Participants received viagra best price a second dose 21 days after the first. The reported 90% efficacy was measured seven days after the second dose.

Communicating effectively will be vital to ensuring that consumers follow through with the shots and — assuming several treatments are approved — that their first and second doses are from the same maker. Until full protection kicks in, Omer said, people should continue to take measures viagra best price to protect themselves. Wearing masks, washing hands, social distancing.

It’s important to let people know that taking appropriate action now will pay off later. €œIf we just viagra best price show them the tunnel, not the light, then that results in this mass denial,” he said. €œWe need to say, ‘You’ll have to continue to do this in the medium term, but the long term looks good.” The best communication can occur once full data from the Pfizer trial and others are presented, noted Dr.

Paul Offit, a vaccinologist at the Children’s Hospital of Philadelphia who sits on the federal Food viagra best price and Drug Administration’s advisory board considering erectile dysfunction treatments. €œWhen you look at those data, you can more accurately define what groups of people are most likely to have side effects, what the efficacy is, what we know about how long the efficacy lasts, what we know about how long the safety data have been tested,” he said. €œI think you have to get ready to communicate that.

You can start getting ready now.” This story was produced by Kaiser Health News, an editorially viagra best price independent program of the Kaiser Family Foundation. JoNel Aleccia. jaleccia@kff.org, @JoNel_Aleccia Related Topics Contact Us Submit a Story Tip.

What color is viagra

	Viagra	Extra super avana	Caverta	Cenforce
Price	11h	17h	4h	16h
Best way to use	Yes	No	Online	No
Where to get	Consultation	One pill	One pill	Ask your Doctor

Joel Ernst, MD, professor of medicine what color is viagra and chief of the division of experimental can you buy viagra without a prescription medicine, UCSF School of Medicine, San Francisco. Santosha Vardhana, MD, PhD, assistant professor of medicine and attending physician, Memorial Sloan Kettering Cancer Center, New York. Nicolas Vabret, PhD, assistant professor of medicine, Icahn School of Medicine at Mount Sinai, New what color is viagra York. Medline Plus.

"Immune response." Journal of Experimental Medicine. "The many faces of the anti-erectile dysfunction treatment immune what color is viagra response." UCSF. "Ask the Expert. Seeking Immunity Against erectile dysfunction treatment." La Jolla Institute for Immunology.

"T Cells what color is viagra Take the Lead in Controlling erectile dysfunction and Reducing erectile dysfunction treatment Severity." Cell. "Antigen-Specific Adaptive Immunity to erectile dysfunction in Acute erectile dysfunction treatment and Associations with Age and Disease Severity." Immunity. "Immunology of erectile dysfunction treatment. Current State of what color is viagra the Science." The Lancet Infectious Diseases.

"Genomic evidence for re with erectile dysfunction. A case study," and "What res mean for COVI-19." Johns Hopkins erectile dysfunction Resource Center. The Lancet what color is viagra Infectious Disease. "Longitudinal antibody and T cell responses in Ebola viagra disease survivors and contacts.

An observational cohort study." mBio. "Decline of Humoral Responses against erectile dysfunction what color is viagra Spike in Convalescent Individuals." Science Immunology. €œPersistence and decay of human antibody response to the receptor binding domain of erectile dysfunction spike protein in erectile dysfunction treatment patients.” BRO News. €œerectile dysfunction treatment re tracker.”By Steven Reinberg HealthDay Reporter FRIDAY, Oct.

23, 2020 (HealthDay News) -- Kids growing up in poverty show the effects of being poor as early as age 5 -- especially those who are what color is viagra Black, a new study suggests. The research adds to mounting evidence that children of Black parents who are also poor face greater health inequities than whites. "Our findings underscore the pronounced racialized disparities for young children," said lead author Dr. Neal Halfon, director of the Center what color is viagra for Healthier Children, Families and Communities at the University of California, Los Angeles.

For the study, teachers administered a standardized test to measure physical, social, emotional and language development of kindergarteners in 98 school districts across the United States. More than 185,000 kids took the test from 2010 to 2017. Analyzing the data, the researchers found that 30% of the poorest children were what color is viagra vulnerable in one or more areas of health development, compared with 17% of children from wealthier areas. These differences in vulnerability varied among from different ethnic and racial groups.

Black children were at the highest what color is viagra risk, followed by Hispanic children. Asian children were at the lowest risk. The difference between Black children and white children was most striking at the higher socioeconomic levels and tended to narrow for kids from lower-income areas. The disparities can have a profound effect on kids' long-term development and lead to higher rates diabetes, heart disease, drug use, mental what color is viagra health disorders and dementia, the researchers said.

"Many other studies have highlighted patterns of income and racial inequality in health and educational outcomes. What this study shows is that these patterns of inequality are clearly evident and measurable before kids start school," Halfon said in a university news release. The findings were published in the October what color is viagra issue of the journal Health Affairs. WebMD News from HealthDay Copyright © 2013-2020 HealthDay.

All rights reserved.By Steven Reinberg HealthDay Reporter FRIDAY, Oct. 23, 2020 what color is viagra (HealthDay News) -- As most of America prepares for the Nov. 1 return of standard time, 63% want one fixed, year-round time, a new survey finds. "Evidence of the negative impacts of seasonal time changes continue to accumulate, and there is real momentum behind the push to end seasonal time changes," said Dr.

Kannan Ramar, president of the American Academy of Sleep Medicine (AASM), which favors a fixed, nationwide what color is viagra time. A recent position statement from AASM said public health and safety would benefit if seasonal time changes were eliminated. It called for permanent use of standard time, which it said more closely aligns with the daily rhythms of the body's internal clock. More than 20 organizations have endorsed the what color is viagra statement.

They include the National Safety Council, the National Parent Teacher Association and the World Sleep Society. AASM noted that time changes increase the risk of stroke, hospital admissions and sleep loss, and also add to inflammation, one of the body's responses to stress. Researchers recently reported an 18% increase in adverse medical events due to human error in the week what color is viagra after switching to daylight saving time in the spring. "Permanent, year-round standard time is the best choice to most closely match our circadian sleep-wake cycle," said Dr.

M. Adeel Rishi, a specialist in sleep medicine at what color is viagra the Mayo Clinic in Eau Claire, Wisc. "Daylight saving time results in more darkness in the morning and more light in the evening, disrupting the body's natural rhythm." To make the most of the hour gained from the switch to standard time on Nov. 1, the AASM recommends.

Going to bed at your what color is viagra usual time. Setting your clocks back one hour just before getting into bed. Waking up at your regular time. Noting how what color is viagra much better you feel after an extra hour of sleep and make it a goal to get enough sleep each day.

WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.Oct what color is viagra. 22, 2020 -- Being sick with erectile dysfunction treatment for more than four weeks, so-called "long erectile dysfunction treatment," affects older people, women and those with a wide range of symptoms in the first week of their illness most, British researchers report. About 5% of those with erectile dysfunction treatment will have symptoms for eight weeks or more, according to the preprint analysis of data, CNN reported Wednesday.

The researchers identified two groups what color is viagra of long erectile dysfunction treatment sufferers. One had mostly respiratory symptoms, such as a cough and shortness of breath, plus fatigue and headaches. The other group had symptoms in many parts of the body, such as heart palpitations, gut issues, pins and needles or numbness, and brain fog. "It's important we use the knowledge we have gained from the first wave in the viagra to reduce the long-term impact of what color is viagra the second.

This should pave the way for trials of early interventions to reduce the long-term effects," researcher Dr. Claire Steves, a clinical academic at King's College London, said in a statement. Long erectile dysfunction treatment sufferers were twice as likely to have a relapse after they recovered, compared with what color is viagra those who had short erectile dysfunction treatment (16% versus 8%). About 22% of adults older than 70 with erectile dysfunction treatment developed long erectile dysfunction treatment, compared with about 1 in 10 of those aged 18 to 49, the study found.

Women were also more likely to suffer from long erectile dysfunction treatment than men -- 15% versus 10%. But that only applied to younger patients, what color is viagra CNN reported. Also, those who developed long erectile dysfunction treatment were slightly heavier than those with short erectile dysfunction treatment and those with asthma were more likely to develop long erectile dysfunction treatment, but there were no clear links to other health conditions, the researchers added. ----- WebMD News from HealthDay Copyright © 2013-2020 HealthDay.

All rights reserved.By Steven Reinberg HealthDay Reporter THURSDAY, Oct what color is viagra. 22, 2020 (HealthDay News) -- Hispanic mothers-to-be in the southern United States are almost twice as likely to have erectile dysfunction treatment as non-Hispanic women, a new study finds. The researchers also found that those with government health insurance were more likely to test positive for the erectile dysfunction than women with private insurance. For the study, pregnant women were routinely tested what color is viagra for erectile dysfunction treatment as they went to a Houston hospital for delivery, said researcher Dr.

Beth Pineles. "It's important to test everyone because if you only test people who are symptomatic, you'll get a lot more people who test positive," explained Pineles, a maternal-fetal medicine fellow with McGovern Medical School at University of Texas Health Science Center at Houston (UT Health). "Universal testing allows you to get an unbiased estimate of who is being infected, and our study found that Hispanic women were much more likely to what color is viagra have the viagra," Pineles said in a UT Health news release. The researchers collected data on more than 900 Hispanic, Black, Asian and white patients.

Among Hispanic women, nearly 11% tested positive for erectile dysfunction treatment, compared with 5.5% of non-Hispanic patients, the findings showed. "Although this study didn't dive into the why behind Hispanic patients being what color is viagra more likely to contract erectile dysfunction treatment, research seems to point to more social and cultural reasons versus any type of genetic disposition," Pineles said. "It's too early in the viagra to know for sure, but some studies have looked at factors like neighborhood crowding, number of people living in the household, and having essential jobs instead of being able to stay home and social distance," Pineles added. As for insurance, 9.5% of patients with public insurance (such as Medicaid) had erectile dysfunction treatment, versus 2.5% of patients with private insurance, the researchers found.

Dr. Jacqueline Parchem is an assistant professor in the department of obstetrics, gynecology and reproductive sciences at the medical school. "One strength of our study is that the obstetric population in Houston is incredibly diverse, so we were able to examine outcomes for groups that are often underrepresented," she said..

Joel Ernst, http://abelvettes.com/?p=1 MD, professor of medicine and chief of the division viagra best price of experimental medicine, UCSF School of Medicine, San Francisco. Santosha Vardhana, MD, PhD, assistant professor of medicine and attending physician, Memorial Sloan Kettering Cancer Center, New York. Nicolas Vabret, PhD, assistant professor of medicine, Icahn School of Medicine viagra best price at Mount Sinai, New York. Medline Plus. "Immune response." Journal of Experimental Medicine.

"The many faces of the anti-erectile dysfunction treatment immune viagra best price response." UCSF. "Ask the Expert. Seeking Immunity Against erectile dysfunction treatment." La Jolla Institute for Immunology. "T Cells Take the Lead viagra best price in Controlling erectile dysfunction and Reducing erectile dysfunction treatment Severity." Cell. "Antigen-Specific Adaptive Immunity to erectile dysfunction in Acute erectile dysfunction treatment and Associations with Age and Disease Severity." Immunity.

"Immunology of erectile dysfunction treatment. Current State of the Science." viagra best price The Lancet Infectious Diseases. "Genomic evidence for re with erectile dysfunction. A case study," and "What res mean for COVI-19." Johns Hopkins erectile dysfunction Resource Center. The viagra best price Lancet Infectious Disease.

"Longitudinal antibody and T cell responses in Ebola viagra disease survivors and contacts. An observational cohort study." mBio. "Decline of Humoral Responses viagra best price against erectile dysfunction Spike in Convalescent Individuals." Science Immunology. €œPersistence and decay of human antibody response to the receptor binding domain of erectile dysfunction spike protein in erectile dysfunction treatment patients.” BRO News. €œerectile dysfunction treatment re tracker.”By Steven Reinberg HealthDay Reporter FRIDAY, Oct.

23, 2020 (HealthDay News) -- Kids growing up in poverty viagra best price show the effects of being poor as early as age 5 -- especially those who are Black, a new study suggests. The research adds to mounting evidence that children of Black parents who are also poor face greater health inequities than whites. "Our findings underscore the pronounced racialized disparities for young children," said lead author Dr. Neal Halfon, director of the Center for Healthier Children, Families and viagra best price Communities at the University of California, Los Angeles. For the study, teachers administered a standardized test to measure physical, social, emotional and language development of kindergarteners in 98 school districts across the United States.

More than 185,000 kids took the test from 2010 to 2017. Analyzing the data, the researchers found that 30% viagra best price of the poorest children were vulnerable in one or more areas of health development, compared with 17% of children from wealthier areas. These differences in vulnerability varied among from different ethnic and racial groups. Black children were at the highest risk, followed by viagra best price Hispanic children. Asian children were at the lowest risk.

The difference between Black children and white children was most striking at the higher socioeconomic levels and tended to narrow for kids from lower-income areas. The disparities can have a profound effect on kids' long-term development and lead to viagra best price higher rates diabetes, heart disease, drug use, mental health disorders and dementia, the researchers said. "Many other studies have highlighted patterns of income and racial inequality in health and educational outcomes. What this study shows is that these patterns of inequality are clearly evident and measurable before kids start school," Halfon said in a university news release. The findings were published in the October issue of viagra best price the journal Health Affairs.

WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.By Steven Reinberg HealthDay Reporter FRIDAY, Oct. 23, 2020 (HealthDay News) viagra best price -- As most of America prepares for the Nov. 1 return of standard time, 63% want one fixed, year-round time, a new survey finds. "Evidence of the negative impacts of seasonal time changes continue to accumulate, and there is real momentum behind the push to end seasonal time changes," said Dr.

Kannan Ramar, president of the American Academy of Sleep Medicine (AASM), which favors a fixed, nationwide viagra best price time. A recent position statement from AASM said public health and safety would benefit if seasonal time changes were eliminated. It called for permanent use of standard time, which it said more closely aligns with the daily rhythms of the body's internal clock. More than 20 organizations have endorsed the viagra best price statement Continue Reading. They include the National Safety Council, the National Parent Teacher Association and the World Sleep Society.

AASM noted that time changes increase the risk of stroke, hospital admissions and sleep loss, and also add to inflammation, one of the body's responses to stress. Researchers recently reported an 18% increase in adverse medical events due to human error viagra best price in the week after switching to daylight saving time in the spring. "Permanent, year-round standard time is the best choice to most closely match our circadian sleep-wake cycle," said Dr. M. Adeel Rishi, a specialist viagra best price in sleep medicine at the Mayo Clinic in Eau Claire, Wisc.

"Daylight saving time results in more darkness in the morning and more light in the evening, disrupting the body's natural rhythm." To make the most of the hour gained from the switch to standard time on Nov. 1, the AASM recommends. Going to viagra best price bed at your usual time. Setting your clocks back one hour just before getting into bed. Waking up at your regular time.

Noting how much better you feel after an extra hour of sleep and make it viagra best price a goal to get enough sleep each day. WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights viagra best price reserved.Oct. 22, 2020 -- Being sick with erectile dysfunction treatment for more than four weeks, so-called "long erectile dysfunction treatment," affects older people, women and those with a wide range of symptoms in the first week of their illness most, British researchers report. About 5% of those with erectile dysfunction treatment will have symptoms for eight weeks or more, according to the preprint analysis of data, CNN reported Wednesday.

The researchers identified two groups of long erectile dysfunction treatment sufferers viagra best price. One had mostly respiratory symptoms, such as a cough and shortness of breath, plus fatigue and headaches. The other group had symptoms in many parts of the body, such as heart palpitations, gut issues, pins and needles or numbness, and brain fog. "It's important we use the knowledge we have viagra best price gained from the first wave in the viagra to reduce the long-term impact of the second. This should pave the way for trials of early interventions to reduce the long-term effects," researcher Dr.

Claire Steves, a clinical academic at King's College London, said in a statement. Long erectile dysfunction treatment sufferers were twice as likely to have a relapse after they viagra best price recovered, compared with those who had short erectile dysfunction treatment (16% versus 8%). About 22% of adults older than 70 with erectile dysfunction treatment developed long erectile dysfunction treatment, compared with about 1 in 10 of those aged 18 to 49, the study found. Women were also more likely to suffer from long erectile dysfunction treatment than men -- 15% versus 10%. But that only applied to younger viagra best price patients, CNN reported.

Also, those who developed long erectile dysfunction treatment were slightly heavier than those with short erectile dysfunction treatment and those with asthma were more likely to develop long erectile dysfunction treatment, but there were no clear links to other health conditions, the researchers added. ----- WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.By Steven Reinberg HealthDay viagra best price Reporter THURSDAY, Oct. 22, 2020 (HealthDay News) -- Hispanic mothers-to-be in the southern United States are almost twice as likely to have erectile dysfunction treatment as non-Hispanic women, a new study finds. The researchers also found that those with government health insurance were more likely to test positive for the erectile dysfunction than women with private insurance.

For the viagra best price study, pregnant women were routinely tested for erectile dysfunction treatment as they went to a Houston hospital for delivery, said researcher Dr. Beth Pineles. "It's important to test everyone because if you only test people who are symptomatic, you'll get a lot more people who test positive," explained Pineles, a maternal-fetal medicine fellow with McGovern Medical School at University of Texas Health Science Center at Houston (UT Health). "Universal testing allows you to get an unbiased estimate of who is being infected, and our viagra best price study found that Hispanic women were much more likely to have the viagra," Pineles said in a UT Health news release. The researchers collected data on more than 900 Hispanic, Black, Asian and white patients.

Among Hispanic women, nearly 11% tested positive for erectile dysfunction treatment, compared with 5.5% of non-Hispanic patients, the findings showed. "Although this study didn't dive into the why behind Hispanic patients being more likely to contract erectile dysfunction treatment, research seems to point to more social viagra best price and cultural reasons versus any type of genetic disposition," Pineles said. "It's too early in the viagra to know for sure, but some studies have looked at factors like neighborhood crowding, number of people living in the household, and having essential jobs instead of being able to stay home and social distance," Pineles added. As for insurance, 9.5% of patients with public insurance (such as Medicaid) had erectile dysfunction treatment, versus 2.5% of patients with private insurance, the researchers found. Dr.

Jacqueline Parchem is an assistant professor in the department of obstetrics, gynecology and reproductive sciences at the medical school. "One strength of our study is that the obstetric population in Houston is incredibly diverse, so we were able to examine outcomes for groups that are often underrepresented," she said..

What may interact with Viagra?

Do not take Viagra with any of the following:

• cisapride
• methscopolamine nitrate
• nitrates like amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin
• nitroprusside
• other sildenafil products (Revatio)

Viagra may also interact with the following:

• certain drugs for high blood pressure
• certain drugs for the treatment of HIV or AIDS
• certain drugs used for fungal or yeast s, like fluconazole, itraconazole, ketoconazole, and voriconazole
• cimetidine
• erythromycin
• rifampin

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Otc viagra

The Solidarity Therapeutics Trial, overseen by the World Health Organization (WHO), shows that medications otc viagra Remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon, repurposed to treat new erectile dysfunction s, “appeared to have little or no effect on 28-day mortality or the in-hospital course of erectile dysfunction treatment among hospitalized patients”, Propecia price south africa WHO said in a statement on Friday. The study, which began in March and spans more than 30 countries, looked at the effects of these treatments on overall mortality, initiation of ventilation, and duration of hospital stay in hospitalized individuals. Other uses of the drugs, for example in treatment of patients in the community or for prevention, would have to be examined using different trials, the WHO explained.

Associated blood pressure otc viagra risks In a related announcement, the UN health agency said that erectile dysfunction treatment had also highlighted the increased vulnerability of people with high blood pressure to the erectile dysfunction. The warning is based on data from more than 120 countries showing significant erectile dysfunction treatment-related disruption to treatment for people suffering from chronic health conditions, with findings showing these patients make up 50 to 60 per cent of all deaths from erectile dysfunction treatment. Dr.

Bente Mikkelsen, Director of WHO’s Department of Noncommunicable Diseases, said that more than otc viagra 1.13 billion people around the world suffer from hypertension. Of this number, 745,800,000 live in low and middle-income countries and 80 per cent of these nations have fewer than 50 per cent of people on treatment. Many unaware they are sick On average, one in four men suffer from the condition, compared with one in five women, according to WHO data.

In addition, two in five people are not aware that they otc viagra even have hypertension. €œWhen it comes to erectile dysfunction treatment and hypertension, the 122 countries that have reported tells us that in over 50 per cent of the countries their health care services is disrupted fully or partially…In addition, we see a high number of fatalities”, Dr. Mikkelsen told journalists in Geneva.

Noting that global figures have yet to be calculated, she added that for those countries where data was available, “we see in the range of 50, 60 per cent of the people that are severely ill and otc viagra die in hospitals from erectile dysfunction treatment have hypertension, diabetes”, and other non-communicable diseases. viagra resurgence Highlighting how the viagra has made a resurgence in many countries across all continents after the easing of restrictions, and the additional health threat posed by the impending influenza season in the global north, the WHO official appealed to governments everywhere to address hypertension urgently. She also cited growing evidence that poor and salty diets along with rising inactivity, have contributed to worsening hypertension rates globally.

To coincide with World Hypertension Day on 16 October, Dr Mikkelsen unveiled a series of recommendations and products developed by otc viagra the WHO to promote action on hypertension “during and beyond the viagra”. By doing so, health authorities can help people to keep their blood pressure under control and prevent stroke, heart attack, and kidney damage, the WHO believes. The new protocols are based on successful patient blood pressure management in 18 countries involving more three million people.

Today, only 20 per otc viagra cent of the world’s nations are on track to reduce hypertension by 25 per cent by 2025, a global target set by the World Health Assembly in 2013, according to the UN health agency.Dr. Hans Henri P. Kluge said the tightening up of restrictions by governments is “absolutely necessary” as the disease continues to surge, with “exponential increases” in cases and deaths.

€œThe evolving epidemiological situation in Europe raises otc viagra great concern. Daily numbers of cases are up, hospital admissions are up, erectile dysfunction treatment is now the fifth leading cause of death and the bar of 1,000 deaths per day has now been reached,” he reported. Cases reach record highs Dr.

Kluge said overall, Europe has otc viagra recorded more than seven million cases of erectile dysfunction treatment, with the jump from six million taking just 10 days. This past weekend, daily case totals surpassed 120,000 for the first time, and on both Saturday and Sunday, reaching new records. However, he stressed that the region has not returned to the early days of the viagra.

€œAlthough we record otc viagra two to three times more cases per day compared to the April peak, we still observe five times fewer deaths. The doubling time in hospital admissions is still two to three times longer,” he said, adding “in the meantime, the viagra has not changed. It has not become more nor less dangerous.” Potential worsening a reality Dr.

Kluge explained that one reason for the higher case rates is increased erectile dysfunction treatment testing, otc viagra including among younger people. This population also partly accounts for the decreased mortality rates. “These figures say that the epidemiological curve rebound is so far higher, but the slope is lower and less fatal for now.

But it has otc viagra the realistic potential to worsen drastically if the disease spreads back into older age cohorts after more indoor social contacts across generations,” he warned. Looking ahead, Dr. Kluge admitted that projections are “not optimistic”.

Reliable otc viagra epidemiological models indicate that prolonged relaxing of policies could result in mortality levels four to five times higher than in April, with results visible by January 2021. He stressed the importance of maintaining simple measures already in place, as the modelling shows how wearing masks, coupled with strict control of social gathering, may save up to 281,000 lives across the region by February. This assumes a 95 per cent rate for mask use, up from the current rate, which is less than 60 per cent.

Restrictions ‘absolutely necessary’ “Under proportionately more stringent scenarios, the model is reliably much more optimistic, still with slightly higher levels of morbidity and mortality than in the otc viagra first wave, but with a lower slope – as if we should rather expect a higher and longer swell instead of a sharp peak, giving us more reaction time,” said Dr. Kluge. “These projections do nothing but confirm what we always said.

The viagra otc viagra won’t reverse its course on its own, but we will.” The WHO bureau chief underlined the importance of targeted national responses to contain erectile dysfunction treatment spread. €œMeasures are tightening up in many countries in Europe, and this is good because they are absolutely necessary,” he said. €œThey are appropriate and necessary responses to what the data is telling us.

Transmission and sources of contamination occur in homes and indoor public places, and within communities poorly complying with self-protection measures.”.

The Solidarity Therapeutics Trial, overseen by the viagra best price World Health Organization (WHO), shows that medications Remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon, repurposed to treat new erectile dysfunction s, “appeared to have little or no effect on 28-day mortality or the in-hospital course of erectile dysfunction treatment among hospitalized patients”, WHO said in a statement on Friday. The study, which began in March and spans more than 30 countries, looked at the effects of these treatments on overall mortality, initiation of ventilation, and duration of hospital stay in hospitalized individuals. Other uses of the drugs, for example in treatment of patients in the community or for prevention, would have to be examined using different trials, the WHO explained. Associated blood pressure risks In a related announcement, the UN health agency said that erectile dysfunction treatment had also highlighted the increased vulnerability of people with high blood viagra best price pressure to the erectile dysfunction. The warning is based on data from more than 120 countries showing significant erectile dysfunction treatment-related disruption to treatment for people suffering from chronic health conditions, with findings showing these patients make up 50 to 60 per cent of all deaths from erectile dysfunction treatment.

Dr. Bente Mikkelsen, Director of WHO’s Department of Noncommunicable Diseases, said that more than 1.13 billion people around the world viagra best price suffer from hypertension. Of this number, 745,800,000 live in low and middle-income countries and 80 per cent of these nations have fewer than 50 per cent of people on treatment. Many unaware they are sick On average, one in four men suffer from the condition, compared with one in five women, according to WHO data. In addition, viagra best price two in five people are not aware that they even have hypertension.

€œWhen it comes to erectile dysfunction treatment and hypertension, the 122 countries that have reported tells us that in over 50 per cent of the countries their health care services is disrupted fully or partially…In addition, we see a high number of fatalities”, Dr. Mikkelsen told journalists in Geneva. Noting that global figures have yet to be viagra best price calculated, she added that for those countries where data was available, “we see in the range of 50, 60 per cent of the people that are severely ill and die in hospitals from erectile dysfunction treatment have hypertension, diabetes”, and other non-communicable diseases. viagra resurgence Highlighting how the viagra has made a resurgence in many countries across all continents after the easing of restrictions, and the additional health threat posed by the impending influenza season in the global north, the WHO official appealed to governments everywhere to address hypertension urgently. She also cited growing evidence that poor and salty diets along with rising inactivity, have contributed to worsening hypertension rates globally.

To coincide with World Hypertension Day on 16 October, Dr Mikkelsen unveiled viagra best price a series of recommendations and products developed by the WHO to promote action on hypertension “during and beyond the viagra”. By doing so, health authorities can help people to keep their blood pressure under control and prevent stroke, heart attack, and kidney damage, the WHO believes. The new protocols are based on successful patient blood pressure management in 18 countries involving more three million people. Today, only 20 per cent of the world’s nations are on track to reduce hypertension by 25 per cent by 2025, a global target viagra best price set by the World Health Assembly in 2013, according to the UN health agency.Dr. Hans Henri P.

Kluge said the tightening up of restrictions by governments is “absolutely necessary” as the disease continues to surge, with “exponential increases” in cases and deaths. €œThe evolving epidemiological viagra best price situation in Europe raises great concern. Daily numbers of cases are up, hospital admissions are up, erectile dysfunction treatment is now the fifth leading cause of death and the bar of 1,000 deaths per day has now been reached,” he reported. Cases reach record highs Dr. Kluge said overall, viagra best price Europe has recorded more than seven million cases of erectile dysfunction treatment, with the jump from six million taking just 10 days.

This past weekend, daily case totals surpassed 120,000 for the first time, and on both Saturday and Sunday, reaching new records. However, he stressed that the region has not returned to the early days of the viagra. €œAlthough we record two to three times more cases per day compared to the April peak, we viagra best price still observe five times fewer deaths. The doubling time in hospital admissions is still two to three times longer,” he said, adding “in the meantime, the viagra has not changed. It has not become more nor less dangerous.” Potential worsening a reality Dr.

Kluge explained that one reason for viagra best price the higher case rates is increased erectile dysfunction treatment testing, including among younger people. This population also partly accounts for the decreased mortality rates. “These figures say that the epidemiological curve rebound is so far higher, but the slope is lower and less fatal for now. But it has the realistic potential to worsen drastically if the disease spreads back into older viagra best price age cohorts after more indoor social contacts across generations,” he warned. Looking ahead, Dr.

Kluge admitted that projections are “not optimistic”. Reliable epidemiological models indicate that prolonged relaxing of policies could result in mortality levels four to five times higher than in viagra best price April, with results visible by January 2021. He stressed the importance of maintaining simple measures already in place, as the modelling shows how wearing masks, coupled with strict control of social gathering, may save up to 281,000 lives across the region by February. This assumes a 95 per cent rate for mask use, up from the current rate, which is less than 60 per cent. Restrictions ‘absolutely necessary’ “Under proportionately more stringent scenarios, the model is reliably much more optimistic, still with slightly higher levels of morbidity and mortality than in the first wave, but with a lower slope – as if we should rather expect a viagra best price higher and longer swell instead of a sharp peak, giving us more reaction time,” said Dr.

Kluge. “These projections do nothing but confirm what we always said. The viagra won’t reverse its course on its viagra best price own, but we will.” The WHO bureau chief underlined the importance of targeted national responses to contain erectile dysfunction treatment spread. €œMeasures are tightening up in many countries in Europe, and this is good because they are absolutely necessary,” he said. €œThey are appropriate and necessary responses to what the data is telling us.

Transmission and sources of contamination occur in homes and indoor public places, and within communities poorly complying with self-protection measures.”.

Viagra medical name

€œDid you https://eu.cubcadet.com/seroquel-pill-cost/ think we viagra medical name wouldn’t notice?. € an older woman says, speaking into the camera. €œYou thought you could sneak viagra medical name this through?. € an older man later adds. Others warn that Washington is “messing with” their Medicare Advantage health coverage and trying to raise their premiums.

But viagra medical name the television ad, paid for by Better Medicare Alliance, a research and advocacy group for Medicare Advantage plans, doesn’t spell out what cuts congressional lawmakers might be trying to slip past unsuspecting seniors. Concerned that viewers could be confused and alarmed about coverage changes, we asked the Better Medicare Alliance for specifics about the sneaky moves the organization aims to alert people to. It’s not just one ad. The organization has launched a $3 viagra medical name million TV, radio and online advertising campaign, according to advertising tracker AdImpact. In response, the group offered this emailed comment from its president and CEO, Mary Beth Donahue.

€œBetter Medicare Alliance is airing messages encouraging Congress to guard against cuts to seniors’ Medicare Advantage coverage, whether through benchmark policies in the reconciliation bill or other avenues.” While still light on specifics, Donahue’s comment offered an important detail not mentioned in the ad. The group is concerned about viagra medical name coverage cutbacks through “benchmark policies in the reconciliation bill.” Now we were getting somewhere. In the Democrats’ climate and social-spending bill being hammered out in Congress, one key health care proposal would add dental, hearing and vision coverage to the traditional Medicare program. The provision, viagra medical name championed by Sen. Bernie Sanders (I-Vt.), is estimated to cost $350 billion over 10 years.

As Democrats have labored to winnow their $3.5 trillion social-spending bill to make it palatable to moderates in the party, it’s unclear whether the Medicare benefits expansion will make it into the final version. Assuming it does, here’s where viagra medical name benchmark calculations, and presumably the Better Medicare Alliance’s concerns, come into play. Traditional Medicare vs. Medicare Advantage First, some background. Most Medicare beneficiaries are viagra medical name in the so-called traditional Medicare program, in which members generally pay 20% of the cost of medical services after meeting a deductible.

A separate plan covers prescription drugs. Enrollees can visit any doctor, hospital or other medical provider participating in the program, the vast majority of whom do nationwide. Many beneficiaries buy supplemental Medigap policies that cover their viagra medical name cost-sharing obligations and fill in other financial gaps. However, a growing number of Medicare beneficiaries — more than 26 million, or 42% of Medicare enrollees — are in Medicare Advantage plans. Cost sharing is generally lower in these private-sector managed-care plans than in traditional Medicare, but the networks of doctors and hospitals are smaller, too.

Many Medicare Advantage viagra medical name plans offer supplemental benefits such as dental, vision and hearing coverage, although the level of coverage varies widely. €œTraditional Medicare is a lousy program, and that’s why Medicare Advantage has really taken off over the last five or 10 years,” said Joseph Antos, a senior fellow at the American Enterprise Institute. €œMedicare Advantage looks like the coverage you used to have [before joining viagra medical name Medicare] and there [isn’t] confusing cost sharing that most people don’t understand. Whereas with traditional Medicare, there are different deductibles and holes in coverage.” The Benchmark The federal Medicare program pays Medicare Advantage plans a set amount per member. Medicare Advantage health plans submit bids annually to federal officials that reflect how much they estimate it will cost to provide a package of benefits covering hospitalization (Medicare Part A) and outpatient services (Medicare Part B) to enrollees.

Those bids are compared against a “benchmark,” which is based on the average spending per beneficiary in the traditional Medicare program, with geographic adjustments viagra medical name. Plans that bid below the benchmark, as most do, receive a rebate they can use to reduce beneficiary cost sharing, subsidize premiums or pay for supplemental benefits like dental, vision and hearing. The Benchmark Controversy Groups like the Better Medicare Alliance say they support providing dental, hearing and vision coverage to all Medicare beneficiaries. But they’re worried that congressional leaders won’t factor the cost of new traditional viagra medical name Medicare benefits into the benchmark, resulting in lower rebates from the program, which could threaten other supplemental benefits that Medicare Advantage members enjoy, such as meals and transportation services, gym memberships and in-home care. It’s not evident that lawmakers are considering excluding the benefit from the benchmark, however.

€œI feel like this is the industry flexing its muscles and sending loud signals, but it’s not clear that Congress has any intention to modify payments as part of this legislation,” said Tricia Neuman, executive director of the program on Medicare policy at KFF. Still, excluding the new benefits from viagra medical name the Medicare benchmark has generated interest as one way to pay for the pricey new benefits. According to one analysis, excluding the cost of the new benefits from the benchmark would reduce the fiscal cost by an estimated 41%, compared with a scenario that included the cost in the benchmark. €œThis is because federal payments to [Medicare Advantage] plans would rise only modestly if the benchmarks excluded the new benefits, whereas they would rise substantially if the benchmarks included them,” according to the analysis by Matthew Fiedler, a fellow at the USC-Brookings Schaeffer Initiative for Health Policy. Since rebates would fall, Medicare Advantage plans would have less to spend on viagra medical name supplemental benefits.

But dental, vision and hearing would no longer be considered supplemental and would need to be incorporated into plans’ estimate of regular Medicare coverage costs, Fiedler noted. That shift would mean that the rebate dollars that plans currently devote to dental, vision and hearing could be used for other supplemental benefits, which could shield those other benefits from substantial viagra medical name reductions, Fiedler said. An analysis commissioned by AHIP, an industry group, estimated that incorporating a dental, vision and hearing benefit without adjusting the benchmark would have a substantial impact, resulting in a 48% decline in the national average rebate amount, or $58 per member per month. No Sympathy Critics of the Medicare Advantage program have long argued that the government is too generous in paying the private plans. When the Medicare program began incorporating private plans in the 1970s, viagra medical name part of the rationale was that the private plans could provide care more efficiently and save the program money.

That hasn’t happened. In a June report to Congress, the Medicare Payment Advisory Commission estimated that the government pays 4% more for beneficiaries enrolled in Medicare Advantage than for those in traditional Medicare. MedPAC recommended a 2% reduction in capitated payments viagra medical name to Medicare Advantage plans. In addition, in a September report, the Office of Inspector General for the Department of Health and Human Services found that 20 of 162 Medicare Advantage companies used patient chart reviews and health risk assessments to boost their payments disproportionately compared with their enrollment size. Losing Their Competitive Advantage A big selling point for Medicare Advantage plans has been that they provide coverage for valuable benefits that the traditional Medicare program does not.

In 2021, 94% of Medicare Advantage enrollees in individual plans are in plans with some level of dental viagra medical name coverage, according to an analysis by KFF. (KHN is an editorially independent program of KFF.) But “some” coverage doesn’t necessarily mean comprehensive coverage. In a separate analysis, KFF found that Medicare beneficiaries faced high out-of-pocket costs for dental and hearing services, no matter what type of plan they had. In 2018, average out-of-pocket viagra medical name spending on dental care for traditional Medicare enrollees was $992. Medicare Advantage members spent modestly less out-of-pocket.

$766. In 2010, when the Affordable Care Act reduced Medicare Advantage plan payments to bring them in line with traditional Medicare, some in the industry predicted plans would pull out and benefits would be cut. That didn’t happen. €œThe truth is Medicare Advantage has grown rapidly since then and extra benefits have proliferated,” Neuman said. So, if the payment methodology changes because of the addition of dental, hearing and vision benefits, “it’s hard to say what would really happen.” Michelle Andrews.

andrews.khn@gmail.com, @mandrews110 Related Topics Contact Us Submit a Story TipThe federal government’s effort to penalize hospitals for excessive patient readmissions is ending its first decade with Medicare cutting payments to nearly half the nation’s hospitals. In its 10th annual round of penalties, Medicare is reducing its payments to 2,499 hospitals, or 47% of all facilities. The average penalty is a 0.64% reduction in payment for each Medicare patient stay from the start of this month through September 2022. The fines can be heavy, averaging $217,000 for a hospital in 2018, according to Congress’ Medicare Payment Advisory Commission, or MedPAC. Medicare estimates the penalties over the next fiscal year will save the government $521 million.

Thirty-nine hospitals received the maximum 3% reduction, and 547 hospitals had so few returning patients that they escaped any penalty. An additional 2,216 hospitals are exempt from the program because they specialize in children, psychiatric patients or veterans. Rehabilitation and long-term care hospitals are also excluded from the program, as are critical access hospitals, which are treated differently because they are the only inpatient facility in an area. Of the 3,046 hospitals for which Medicare evaluated readmission rates, 82% received some penalty, nearly the same share as were punished last year. The Hospital Readmissions Reduction Program (HRRP) was created by the 2010 Affordable Care Act and began in October 2012 as an effort to make hospitals pay more attention to patients after they leave.

Readmissions occurred with regularity — for instance, nearly a quarter of Medicare heart failure patients ended up back in the hospital within 30 days in 2008 — and policymakers wanted to counteract the financial incentives hospitals had in getting more business from these boomerang visits. MedPAC has found readmission rates declined from 2008 to 2017 after the overall health conditions of patients were taken into account. Heart failure patient readmission rates dropped from 24.8% to 20.5%, heart attack patient rates dropped from 19.7% to 15.5%, and pneumonia patient rates decreased from 20% to 15.8%, according to the most recent MedPAC analysis. Readmission rates for chronic obstructive pulmonary disease, hip and knee replacements, and conditions that are not tracked and penalized in the penalty program also decreased. €œThe HRRP has been successful in reducing readmissions, without causing an adverse effect on beneficiary mortality,” MedPAC wrote.

The commission added that untangling the exact causes of the readmission rates was complicated by changes in how hospitals recorded patient characteristics in billing Medicare and an increase in patients being treated in outpatient settings. Those factors made it difficult to determine the magnitude of the readmission rate drop due to the penalty program, MedPAC said. The current penalties are calculated by tracking Medicare patients who were discharged between July 1, 2017, and Dec. 1, 2019. Typically, the penalties are based on three years of patients, but the Centers for Medicare &.

Medicaid Services excluded the final six months in the period because of the chaos caused by the viagra as hospitals scrambled to handle an influx of erectile dysfunction treatment patients. Jordan Rau. jrau@kff.org, @JordanRau Related Topics Contact Us Submit a Story TipUnder programs set up by the Affordable Care Act, the federal government cuts payments to hospitals that have high rates of readmissions and those with the highest numbers of s and patient injuries. For the readmission penalties, Medicare cuts as much as 3 percent for each patient, although the average is generally much lower. The patient safety penalties cost hospitals 1 percent of Medicare payments over the federal fiscal year, which runs from October through September.

Maryland hospitals are exempted from penalties because that state has a separate payment arrangement with Medicare.Below are look-up tools for each type of penalty. You can search by hospital name or location, look at all hospitals in a particular state and sort penalties by year. Jordan Rau. jrau@kff.org, @JordanRau Related Topics Cost and Quality Health Industry Medicare States The Health Law CMS Hospitals RatingsCaitlin Wells Salerno knew that some mammals — like the golden-mantled ground squirrels she studies in the Rocky Mountains — invest an insane amount of resources in their young. That didn’t prepare her for the resources the conservation biologist would owe after the birth of her second son.

Wells Salerno went into labor on the eve of her due date, in the early weeks of erectile dysfunction lockdowns in April 2020. She and her husband, Jon Salerno, were instructed to go through the emergency room doors at Poudre Valley Hospital in Fort Collins, Colorado, because it was the only entrance open. Despite the weird erectile dysfunction treatment vibe — the emptiness, the quiet — everything went smoothly. Wells Salerno felt well enough to decline the help of a nurse offering to wheel her to the labor and delivery department. She even took a selfie, smiling, as she entered the delivery room.

€œI was just thrilled that he was here and it was on his due date, so we didn’t have to have an induction,” she said. €œI was doing great.” Gus was born a healthy 10 pounds after about nine hours of labor, and the family went home the next morning. Wells Salerno expected the bill for Gus’ birth to be heftier than that for her first child, Hank, which had cost the family a mere $30. She was a postdoctoral fellow in California with top-notch insurance when Hank was born, about four years earlier. They were braced to pay more for Gus, but how much more?.

Then the bill came. The Patient. Caitlin Wells Salerno, a conservation biologist at Colorado State University and a principal investigator at Rocky Mountain Biological Laboratory. She is insured by Anthem Blue Cross Blue Shield through her job. When Wells Salerno went into labor in April 2020, she and husband Jon were told to go through a Fort Collins, Colorado, hospital’s emergency room doors because it was the only entrance open.

Their medical bill later included a $2,755 charge for Level 5 emergency services.(Rae Ellen Bichell / KHN) Medical Service. A routine vaginal delivery of a full-term infant. Total Bill. $16,221.26. The Anthem BCBS negotiated rate was $14,550.

Insurance paid $10,940.91 and the family paid the remaining $3,609.09 to the hospital. Service Provider. Poudre Valley Hospital in Fort Collins, Colorado, operated by UCHealth, a nonprofit health system. What Gives. In a system that has evolved to bill for anything and everything, a quick exam to evaluate labor in a small triage room can generate substantial charges.

The total bill was huge, but what really made Wells Salerno’s eyes pop was a line for the highest level of emergency services. It didn’t make any sense. Was it for checking in at the ER desk, as she’d been instructed to?. She recalls going through security there on her way to labor and delivery, yet there was a $2,755 charge for “Level 5” emergency department services — as if she had received care there like a patient with a heart attack or fresh from a car wreck. It is the biggest item on the bill other than the delivery itself.

Dr. Renee Hsia, a professor of emergency medicine and health policy at the University of California-San Francisco and a practicing ER doctor, said Level 5 charges are supposed to be reserved for serious cases — “a severe threat to life, or very complicated, resource-intense cases” — not for patients who can walk through a hospital on their own. Emergency room visits are coded from Level 1 to Level 5, with each higher level garnering more generous reimbursement, in theory commensurate with the work required. But over the past 20 years, hospitals and doctors have learned there’s great profit in upcoding visits. After all, the insurer isn’t in the exam room to know what transpired.

An investigation by the Center for Public Integrity found that between 2001 and 2008 the number of Level 4 and 5 visits for patients who were sent homefrom the ER nearly doubled to almost 50% of visits. In Colorado, the Center for Improving Value in Health Care looked at emergency visit billing from 2009 to 2016 and found that the percentage of emergency visits coded as Level 5 steadily grew from 23% to 34% for patients with commercial insurance. After repeated calls questioning the line item on her bill, Wells Salerno eventually got a voicemail from the billing department, which she shared with KHN, explaining that “the emergency room charge is actually the OB triage little area before they take you to the labor and delivery room.” Wells Salerno was in good enough shape during labor to snap this selfie with husband Jon on entering the delivery room. So when the hospital bill came with a charge for emergency services, the couple thought it had to be a mistake. (Caitlin Wells Salerno) Even though Gus Salerno’s birth was smoother and faster than his brother’s, it was much more expensive.

(Jon Salerno) A customer service representative later explained it was for services given there when a nurse placed an IV for antibiotics, and her doctor checked her dilation and confirmed her water had broken — although none of that was performed in the Emergency Department. And those services, performed before every delivery, are traditionally not billed separately — and are routine, not emergency, procedures. Some hospitals provide that package of services via an “obstetrical emergency department.” OB-EDs are licensed under the main Emergency Department and typically see patients who are pregnant, for anything from unexplained bleeding to full-term birth. They bill like an ER, even if they aren’t physically located anywhere near the ER. Health care staffing company TeamHealth — owned by the investment company Blackstone, and known for marking up ER bills to boost profit — essentially says an OB-ED can be as simple as a rebranded obstetrical triage area.

In a white paper, the company said an OB-ED is an “entrepreneurial approach to strengthening hospital finances” because with “little to no structural investment” it allows hospitals to “collect facility charges that are otherwise lost in the obstetrical triage setting.” The OB Hospitalist Group, which is owned by a private equity company, markets a tool to help OB-EDs calculate levels of emergency care. In a case study, OB Hospitalist Group reported that hospitals “leave a lot of money on the table” by billing OB-ED visits as Level 1 and 2 emergencies when they could be considered Level 4 emergencies. An Arizona facility said its revenue increased $365,000 per quarter after turning their obstetric triage area into an OB-ED. Poudre Valley Hospital’s website doesn’t list “OB-ED” as part of the facility’s offerings, though UCHealth documents do reference OB-ED beds in other facilities. KHN spoke with four other women who, after giving birth at Poudre Valley in 2020 and 2021, received ER charges on their bills after healthy births.

They had no clue they had received emergency services. One wrote a warning note on Facebook to other area moms after getting a whopping charge — for the 10 minutes she spent in the triage room, while fully dilated and in active labor. In Wells Salerno’s case, UCHealth and her insurer have an agreement that Anthem BCBS pays a lump sum for vaginal delivery, rather than paying for line items individually. €œBeing seen there in OB-ED did not impact this bill whatsoever,” said Dan Weaver, a spokesperson with UCHealth. But in one of the other moms’ cases, it did.

The hospital received $1,500 from the insurer for that charge, and the mom was on the hook for an additional $375 for coinsurance. Ge Bai, a professor of accounting and health policy at Johns Hopkins University, said it’s a “questionable” billing practice, and one that can matter to those who don’t have the same kind of insurance as Wells Salerno, or have none at all. Dr. Mark Simon, chief medical officer with OB Hospitalist Group, said OB-EDs can help women avoid being admitted to the hospital too early in labor, ensuring timelier, more appropriate care. UCHealth’s Weaver said they can also help pregnant patients with actual emergencies like preterm labor, preeclampsia or vaginal bleeding get quick care from specialists available 24/7, often without having to be admitted to the hospital.

But at hospitals like Poudre Valley, healthy women having healthy births also get routine “OB-ED” treatment, without their knowledge. Weaver said the only time someone in labor would not go through the OB-ED — and therefore the only time they would not receive the emergency charge — is if they have a scheduled induction or cesarean section or are directly admitted from a provider’s office. Hsia, the UCSF researcher and ER doctor, is unconvinced. €œIf they’re actually going to charge a special fee that you didn’t get directly admitted from your physician, that’s absolutely ridiculous.” Wells Salerno’s “OB-ED” exam was performed by her clinician, but the OB-ED charge still showed up on her bill. Despite the hospital’s strange early-viagra atmosphere, Wells Salerno’s delivery went smoothly and son Gus was born a healthy 10 pounds.

The family went home the next morning.(Rae Ellen Bichell / KHN) Resolution. After trying to determine that the charge wasn’t a mistake, Wells Salerno eventually threw in the towel and paid the bill. €œI was at a very vulnerable time during pregnancy and immediately postpartum,” she said. €œI just felt like I had kind of been taken advantage of financially at a time when I couldn’t muster the energy to fight back.” The fact that two healthy brothers could come with such different price tags isn’t surprising to Dr. Michelle Moniz.

€œThere is no clinical reason that we have this level of variation,” said Moniz, assistant professor of obstetrics and gynecology at the University of Michigan and its Institute for Healthcare Policy and Innovation. Her research shows that people with private insurance pay anywhere from nothing to $10,000 for childbirth. €œYou don’t get what you pay for,” said Wells Salerno, who maintains that — despite their price difference — both of her children are equally “awesome.” Data from the Colorado Division of Insurance shows that Poudre Valley typically received about $12,000 for similar births in 2020, about 43% more than the typical Colorado hospital. So the more than $14,000 Wells Salerno and her insurer paid is very high. The Takeaway.

Anything in our health system labeled as an emergency room service likely comes with a big additional charge. Expectant parents should be aware that OB-EDs are a relatively new feature at some hospitals. Ask whether your hospital has that kind of charge and how it will affect your bill. Ahead of time, ask both the hospital and your insurer how much the birth is expected to cost. In Colorado, the Center for Improving Value in Health Care offers a price comparison tool for common medical procedures, including vaginal delivery.

If you do require a genuine ER encounter, look at your bill to see how it was coded, Levels 1 to 5 — and protest if your visit was misrepresented. Ask, “Has this bill been upcoded?. € You are the only one who knows how much time you spent with a medical provider and how much care was given. Here’s a chart that will help with the proper definition of each level. Know that victory is possible.

At least one mom won the battle and got the emergency charge removed from her Poudre Valley Hospital birth bill. It took hours on the phone with UCHealth, a lot of confidence and countless repetitions of the birth story — and how an emergency charge for a routine delivery just didn’t, and doesn’t, make sense. Bill of the Month is a crowdsourced investigation by KHN and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us?. Tell us about it!.

Rae Ellen Bichell. rbichell@kff.org, @raelnb Related Topics Contact Us Submit a Story TipThe Biden administration and Congress are embroiled in high-stakes haggling over what urgent priorities will make it into the ever-shrinking social spending bill. But for the pharmaceutical industry there is one agenda. Heading off Medicare drug price negotiation, which it considers an existential threat to its business model. The siren call to contain rising drug costs helped catapult Democrats to power, and the idea is popular among voters regardless of their politics.

Yet granting Medicare broad authority to intervene in setting prices has nonetheless divided the party. And so, as it normally does, the drug industry gave generously to members of Congress, according to new data from KHN’s Pharma Cash to Congress database. Contributions covering the first half of this year show that some of its biggest donations were delivered with surgical-strike precision to sympathetic or moderate Democratic lawmakers the industry needs to remain in its corner. Campaign donations to members of Congress — which must be reported to the Federal Election Commission — are the tip of the iceberg, signaling far greater activity in influence peddling that includes spending millions on lobbying activities and advertising campaigns. Unusually, in the first half of this year Republicans and Democrats in Congress were virtually neck and neck in pulling in drug industry money, according to a KHN analysis of campaign contributions.

In prior years, Republicans dominated giving from that sector, often by huge margins. Pharmaceutical companies and their lobbying groups gave roughly $1.6 million to lawmakers during the first six months of 2021, with Republicans accepting $785,000 and Democrats $776,200, the Pharma Cash to Congress database shows. Since the 2008 cycle, the industry has generally favored Republicans. The exception was 2009-10, the last time Democrats controlled both chambers of Congress and the White House. Democrats again narrowly hold both the House and Senate, and political scientists and other money-in-politics experts said the contributions likely reflect who is in power, which lawmakers face tougher reelection bids next year, and who has outsize sway over legislation affecting the industry’s bottom line.

Several pharmaceutical companies paused contributions to Republican lawmakers who voted against certifying the results of the 2020 election, blunting the GOP’s total fundraising haul and overall industry giving compared with other years. The drug industry’s campaign contributions are markedly strategic, said Steven Billet, an associate professor at the Graduate School of Political Management at George Washington University. €œThis is a really well-organized commercial sector,” Billet said. €œIf I’m one of these PACs, I’ve surveyed the landscape at the front end of the process, decided on our agenda and budget, and figured out who I may be able to get to and who I wouldn’t be able to get to.” Of the top 10 recipients of funding, Republican lawmakers accounted for six. Democrats, four.

Rep. Scott Peters (D-Calif.) received the most money of any member of Congress, with $63,900 in contributions in the first half of the year. Peters, whose San Diego-area district includes multiple drug companies, has consistently accepted money from drugmakers since he took office in 2013, according to KHN’s database. Right behind Peters was Rep. Cathy McMorris Rodgers (R-Wash.), who received $50,000 from the industry in the first six months of 2021.

McMorris Rodgers was chosen this year to be the most senior Republican on the House Energy and Commerce Committee, which has significant influence on pharmaceutical issues. Peters sits on the same committee. €œThey’re typically going to saturate the committees that are relevant to their industry,” said Nick Penniman, CEO of Issue One, a nonprofit that advocates reforming money’s influence in politics. Next in line was Sen. Robert Menendez (D-N.J.), who accepted $49,300, the most of any senator this year despite not facing reelection until 2024.

The vote of Menendez, a longtime ally of the industry, would be crucial for Democrats to pass any proposal giving the government greater control over drug prices. The pharmaceutical industry is a major employer in New Jersey, home to headquarters of behemoths like Johnson &. Johnson, Merck, Novo Nordisk and Sanofi. Menendez said he’s waiting to see the proposal, “which I expect will include language to allow Medicare to negotiate drug prices.” “The focus of any proposal must be lowering patient costs,” he said, “and that will drive my analysis.” Among other moderate Democrats is Sen. Kyrsten Sinema (D-Ariz.), whose vote also is critical to passage.

She received $108,500 in pharma contributions in 2019-20, according to the KHN database. However, in the first half of this year, she received only $8,000. She has not said publicly where she stands on the current pricing proposal. As Billet sees it, the pharmaceutical industry knew allowing Medicare to negotiate drug prices would likely be on the table, and drug companies shored up members, such as Peters and Menendez, who have sided with them in the past. Plus, “right now, the Democrats are driving the train, and because of that they’re going to get a few more contributions,” Billet added.

Peters received funds from nearly two dozen companies or industry groups, including Eli Lilly, Takeda Pharmaceutical, Pfizer, Merck, GlaxoSmithKline, EMD Serono and Amgen. Menendez’s donors included Boehringer Ingelheim, Sanofi, Pfizer, Merck, Gilead Sciences, Eli Lilly, Teva and Novo Nordisk. A spokesperson for Peters did not respond to request for comment. Controlling drug prices has broad support among adults regardless of political party, according to polling from KFF (KHN is an editorially independent program of KFF). But facing industry opposition, Democrats have yet to agree on a plan as lawmakers weigh which policies make it into a massive domestic spending bill to expand the social safety net and address climate change.

Central to the industry’s argument is that greater government intervention in setting prices would harm new drug development. However, drug pricing experts generally say this argument is overblown. Republicans remain unanimously opposed, which means Senate Democrats can’t afford any defections to advance legislation. Fourth in industry contributions was Sen. Catherine Cortez Masto (D-Nev.), a freshman lawmaker on the powerful Senate Finance Committee, which oversees legislation pertaining to federal health programs like Medicare.

Cortez Masto received $46,000, with cash flowing in from companies like Eli Lilly, Merck, Pfizer, Johnson &. Johnson and Mallinckrodt Pharmaceuticals, the latter of which filed for bankruptcy in 2020 after being swamped with litigation over its alleged role in the opioid crisis. One of her recent aides, Eben DuRoss, was hired as a lobbyist this year by the Pharmaceutical Research and Manufacturers of America, or PhRMA, federal disclosures show. Cortez Masto is up for reelection next year in a battleground state that’s been competitive between Republicans and Democrats in recent elections. She was narrowly elected in 2016, and recent polling showed she held a small lead against her expected Republican challenger in 2022, former Nevada attorney general Adam Laxalt.

But her contributions dwarf those of other Senate Democrats in close races. For example, in the first half of this year, Sen. Maggie Hassan (D-N.H.), who also sits on the Senate Finance Committee, reported having accepted $6,000. Two other lawmakers in competitive seats, Sen. Raphael Warnock (D-Ga.) and Sen.

Mark Kelly (D-Ariz.), didn’t receive funding from the pharmaceutical sector. Sarah Bryner, research director of OpenSecrets, a nonprofit that tracks money in politics, noted several reasons Cortez Masto would pull in more money. In addition to her committee seat and competitive race, politically she’s more moderate than progressive lawmakers who have been bigger agitators against the drug industry. €œShe’s not seen as an extremist, which is the kind of person who would typically take in more money” from political action committees, Bryner said. Cortez Masto was also a recent past chair of the Democratic Senatorial Campaign Committee and therefore heavily involved in the party’s national fundraising efforts to preserve Democrats’ Senate majority.

Those relationships with corporate and other donors could be leveraged for her own race, Bryner said. €œOnce you’ve made all the relationships, it’s not like they just disappear,” she said. Still, the freshman Democrat has openly supported allowing Medicare to negotiate prescription drug prices, in contrast to Menendez, who voted against the idea in 2019. The Nevada senator recently told KHN that she “absolutely” backs the policy and that the pharma cash flowing into her campaign coffers doesn’t influence her decisions. €œI’ve already supported it in Finance and actually voted to pass legislation to do just that,” Cortez Masto said.

€œWe need to reduce the health care costs for so many in this country, and that’s what I’m focused on doing, including reducing prescription drug costs.” Peters — who unseated a Republican in 2012 — was one of four moderate House Democrats who in September voted against a plan to give Medicare broad authority to negotiate prescription drug prices. They backed a narrower alternative that includes caps on out-of-pocket spending and limits the scope of Medicare’s negotiating authority to a smaller set of medications. The money Peters and McMorris Rodgers got from drugmakers ($63,900 and $50,000, respectively) significantly jumped from the same periods in past cycles. In the first half of 2019, Peters received $19,500, and during those same quarters in 2017 he got $36,000. McMorris Rodgers’ haul for the first six months of 2019 was $2,500, and two years earlier it was $3,000.

However, Menendez received more funding in the first half of 2019 ($52,000) than this year. That some drugmakers — including Pfizer, Johnson &. Johnson, Gilead and Eli Lilly — as well as PhRMA and the Biotechnology Innovation Organization, another lobbying group for the industry, paused contributions to Republicans after the events of Jan. 6 seems at least in part to account for overall pharma contributions dropping in comparison with other years. In the first half of 2019 drugmakers gave $3.7 million, and in the first half of 2017 they gave about $4.4 million, versus 2021’s $1.6 million.

However, other drug company PACs and their industry groups kept up contributions or failed to void checks they’d issued to those who refused to certify the election results, according to a KHN analysis of the FEC data. They include Merck, Novo Nordisk, GlaxoSmithKline, AstraZeneca, Genentech, Boehringer Ingelheim, Amgen, Teva, EMD Serono and the Association for Accessible Medicines, which all gave $1,000 or more to at least one of the 147 Republicans who voted to overturn the election results. Direct contributions to lawmakers’ political accounts are only one way for the industry to channel cash to Congress. Companies also give money to trade associations and 501(C)(4)s, which are nonprofits that often function as “dark money” groups because they are not required to disclose their donors. €œWe know that they’re giving.

They didn’t stop giving. Their giving went underground,” said Carlos Holguin, research director for the Center for Political Accountability, a nonprofit that tracks money in politics. Groups also funnel money into advertising — in September, PhRMA announced a seven-figure ad campaign opposing Democrats’ drug pricing plan — or into advocacy groups from which it may eventually trickle down to political candidates. Another factor?. Hail Mary erectile dysfunction treatments, developed and distributed in record time, that may have shored up goodwill with lawmakers.

Or that, despite everything lawmakers have said about lowering drug costs, the industry suspects drug pricing legislation will stall once again and don’t want to spend their political capital on the issue. €œI think, frankly, drugmakers know they’ve won the match when it comes to drug pricing. This whole question of the cost of pharmaceuticals, it has come up for literally decades now and they have successfully shut it down, year after year,” Penniman said. €œAt a certain point, they know they have driven the nail far enough in the wood and they don’t need to do much more.” Victoria Knight. vknight@kff.org, @victoriaregisk Rachana Pradhan.

rpradhan@kff.org, @rachanadixit Elizabeth Lucas. elucas@kff.org, @eklucas Related Topics Contact Us Submit a Story Tip.

€œDid you think viagra best price https://eu.cubcadet.com/seroquel-pill-cost/ we wouldn’t notice?. € an older woman says, speaking into the camera. €œYou thought you could sneak this through? viagra best price.

€ an older man later adds. Others warn that Washington is “messing with” their Medicare Advantage health coverage and trying to raise their premiums. But the viagra best price television ad, paid for by Better Medicare Alliance, a research and advocacy group for Medicare Advantage plans, doesn’t spell out what cuts congressional lawmakers might be trying to slip past unsuspecting seniors.

Concerned that viewers could be confused and alarmed about coverage changes, we asked the Better Medicare Alliance for specifics about the sneaky moves the organization aims to alert people to. It’s not just one ad. The organization has launched viagra best price a $3 million TV, radio and online advertising campaign, according to advertising tracker AdImpact.

In response, the group offered this emailed comment from its president and CEO, Mary Beth Donahue. €œBetter Medicare Alliance is airing messages encouraging Congress to guard against cuts to seniors’ Medicare Advantage coverage, whether through benchmark policies in the reconciliation bill or other avenues.” While still light on specifics, Donahue’s comment offered an important detail not mentioned in the ad. The group is concerned about coverage viagra best price cutbacks through “benchmark policies in the reconciliation bill.” Now we were getting somewhere.

In the Democrats’ climate and social-spending bill being hammered out in Congress, one key health care proposal would add dental, hearing and vision coverage to the traditional Medicare program. The provision, championed by Sen viagra best price. Bernie Sanders (I-Vt.), is estimated to cost $350 billion over 10 years.

As Democrats have labored to winnow their $3.5 trillion social-spending bill to make it palatable to moderates in the party, it’s unclear whether the Medicare benefits expansion will make it into the final version. Assuming it does, here’s where viagra best price benchmark calculations, and presumably the Better Medicare Alliance’s concerns, come into play. Traditional Medicare vs.

Medicare Advantage First, some background. Most Medicare beneficiaries are in the viagra best price so-called traditional Medicare program, in which members generally pay 20% of the cost of medical services after meeting a deductible. A separate plan covers prescription drugs.

Enrollees can visit any doctor, hospital or other medical provider participating in the program, the vast majority of whom do nationwide. Many beneficiaries buy supplemental Medigap policies that cover their cost-sharing viagra best price obligations and fill in other financial gaps. However, a growing number of Medicare beneficiaries — more than 26 million, or 42% of Medicare enrollees — are in Medicare Advantage plans.

Cost sharing is generally lower in these private-sector managed-care plans than in traditional Medicare, but the networks of doctors and hospitals are smaller, too. Many Medicare Advantage plans offer supplemental benefits such as dental, vision and hearing coverage, although the level of coverage viagra best price varies widely. €œTraditional Medicare is a lousy program, and that’s why Medicare Advantage has really taken off over the last five or 10 years,” said Joseph Antos, a senior fellow at the American Enterprise Institute.

€œMedicare Advantage looks like the coverage you used to have [before joining Medicare] and there [isn’t] confusing cost viagra best price sharing that most people don’t understand. Whereas with traditional Medicare, there are different deductibles and holes in coverage.” The Benchmark The federal Medicare program pays Medicare Advantage plans a set amount per member. Medicare Advantage health plans submit bids annually to federal officials that reflect how much they estimate it will cost to provide a package of benefits covering hospitalization (Medicare Part A) and outpatient services (Medicare Part B) to enrollees.

Those bids are compared against a “benchmark,” which is based on the average spending viagra best price per beneficiary in the traditional Medicare program, with geographic adjustments. Plans that bid below the benchmark, as most do, receive a rebate they can use to reduce beneficiary cost sharing, subsidize premiums or pay for supplemental benefits like dental, vision and hearing. The Benchmark Controversy Groups like the Better Medicare Alliance say they support providing dental, hearing and vision coverage to all Medicare beneficiaries.

But they’re worried that congressional leaders won’t factor the cost of new traditional Medicare benefits into the benchmark, resulting in lower rebates from the program, which could threaten other supplemental benefits that Medicare Advantage members enjoy, such as meals and transportation services, gym memberships viagra best price and in-home care. It’s not evident that lawmakers are considering excluding the benefit from the benchmark, however. €œI feel like this is the industry flexing its muscles and sending loud signals, but it’s not clear that Congress has any intention to modify payments as part of this legislation,” said Tricia Neuman, executive director of the program on Medicare policy at KFF.

Still, excluding the new benefits from the Medicare benchmark has generated interest as one way to pay viagra best price for the pricey new benefits. According to one analysis, excluding the cost of the new benefits from the benchmark would reduce the fiscal cost by an estimated 41%, compared with a scenario that included the cost in the benchmark. €œThis is because federal payments to [Medicare Advantage] plans would rise only modestly if the benchmarks excluded the new benefits, whereas they would rise substantially if the benchmarks included them,” according to the analysis by Matthew Fiedler, a fellow at the USC-Brookings Schaeffer Initiative for Health Policy.

Since rebates would fall, Medicare Advantage plans would have less to viagra best price spend on supplemental benefits. But dental, vision and hearing would no longer be considered supplemental and would need to be incorporated into plans’ estimate of regular Medicare coverage costs, Fiedler noted. That shift would mean that the rebate dollars that plans currently devote to dental, vision and hearing could be used for other supplemental benefits, which could shield those other benefits from viagra best price substantial reductions, Fiedler said.

An analysis commissioned by AHIP, an industry group, estimated that incorporating a dental, vision and hearing benefit without adjusting the benchmark would have a substantial impact, resulting in a 48% decline in the national average rebate amount, or $58 per member per month. No Sympathy Critics of the Medicare Advantage program have long argued that the government is too generous in paying the private plans. When the Medicare program began incorporating private plans viagra best price in the 1970s, part of the rationale was that the private plans could provide care more efficiently and save the program money.

That hasn’t happened. In a June report to Congress, the Medicare Payment Advisory Commission estimated that the government pays 4% more for beneficiaries enrolled in Medicare Advantage than for those in traditional Medicare. MedPAC recommended a 2% reduction in capitated viagra best price payments to Medicare Advantage plans.

In addition, in a September report, the Office of Inspector General for the Department of Health and Human Services found that 20 of 162 Medicare Advantage companies used patient chart reviews and health risk assessments to boost their payments disproportionately compared with their enrollment size. Losing Their Competitive Advantage A big selling point for Medicare Advantage plans has been that they provide coverage for valuable benefits that the traditional Medicare program does not. In 2021, 94% of Medicare viagra best price Advantage enrollees in individual plans are in plans with some level of dental coverage, according to an analysis by KFF.

(KHN is an editorially independent program of KFF.) But “some” coverage doesn’t necessarily mean comprehensive coverage. In a separate analysis, KFF found that Medicare beneficiaries faced high out-of-pocket costs for dental and hearing services, no matter what type of plan they had. In 2018, average out-of-pocket spending on dental care for traditional Medicare viagra best price enrollees was $992.

Medicare Advantage members spent modestly less out-of-pocket. $766. In 2010, when the Affordable Care Act reduced Medicare Advantage plan payments to bring them in line with traditional Medicare, some in the industry predicted plans would pull out and benefits would be cut.

That didn’t happen. €œThe truth is Medicare Advantage has grown rapidly since then and extra benefits have proliferated,” Neuman said. So, if the payment methodology changes because of the addition of dental, hearing and vision benefits, “it’s hard to say what would really happen.” Michelle Andrews.

andrews.khn@gmail.com, @mandrews110 Related Topics Contact Us Submit a Story TipThe federal government’s effort to penalize hospitals for excessive patient readmissions is ending its first decade with Medicare cutting payments to nearly half the nation’s hospitals. In its 10th annual round of penalties, Medicare is reducing its payments to 2,499 hospitals, or 47% of all facilities. The average penalty is a 0.64% reduction in payment for each Medicare patient stay from the start of this month through September 2022.

The fines can be heavy, averaging $217,000 for a hospital in 2018, according to Congress’ Medicare Payment Advisory Commission, or MedPAC. Medicare estimates the penalties over the next fiscal year will save the government $521 million. Thirty-nine hospitals received the maximum 3% reduction, and 547 hospitals had so few returning patients that they escaped any penalty.

An additional 2,216 hospitals are exempt from the program because they specialize in children, psychiatric patients or veterans. Rehabilitation and long-term care hospitals are also excluded from the program, as are critical access hospitals, which are treated differently because they are the only inpatient facility in an area. Of the 3,046 hospitals for which Medicare evaluated readmission rates, 82% received some penalty, nearly the same share as were punished last year.

The Hospital Readmissions Reduction Program (HRRP) was created by the 2010 Affordable Care Act and began in October 2012 as an effort to make hospitals pay more attention to patients after they leave. Readmissions occurred with regularity — for instance, nearly a quarter of Medicare heart failure patients ended up back in the hospital within 30 days in 2008 — and policymakers wanted to counteract the financial incentives hospitals had in getting more business from these boomerang visits. MedPAC has found readmission rates declined from 2008 to 2017 after the overall health conditions of patients were taken into account.

Heart failure patient readmission rates dropped from 24.8% to 20.5%, heart attack patient rates dropped from 19.7% to 15.5%, and pneumonia patient rates decreased from 20% to 15.8%, according to the most recent MedPAC analysis. Readmission rates for chronic obstructive pulmonary disease, hip and knee replacements, and conditions that are not tracked and penalized in the penalty program also decreased. €œThe HRRP has been successful in reducing readmissions, without causing an adverse effect on beneficiary mortality,” MedPAC wrote.

The commission added that untangling the exact causes of the readmission rates was complicated by changes in how hospitals recorded patient characteristics in billing Medicare and an increase in patients being treated in outpatient settings. Those factors made it difficult to determine the magnitude of the readmission rate drop due to the penalty program, MedPAC said. The current penalties are calculated by tracking Medicare patients who were discharged between July 1, 2017, and Dec.

1, 2019. Typically, the penalties are based on three years of patients, but the Centers for Medicare &. Medicaid Services excluded the final six months in the period because of the chaos caused by the viagra as hospitals scrambled to handle an influx of erectile dysfunction treatment patients.

Jordan Rau. jrau@kff.org, @JordanRau Related Topics Contact Us Submit a Story TipUnder programs set up by the Affordable Care Act, the federal government cuts payments to hospitals that have high rates of readmissions and those with the highest numbers of s and patient injuries. For the readmission penalties, Medicare cuts as much as 3 percent for each patient, although the average is generally much lower.

The patient safety penalties cost hospitals 1 percent of Medicare payments over the federal fiscal year, which runs from October through September. Maryland hospitals are exempted from penalties because that state has a separate payment arrangement with Medicare.Below are look-up tools for each type of penalty. You can search by hospital name or location, look at all hospitals in a particular state and sort penalties by year.

Jordan Rau. jrau@kff.org, @JordanRau Related Topics Cost and Quality Health Industry Medicare States The Health Law CMS Hospitals RatingsCaitlin Wells Salerno knew that some mammals — like the golden-mantled ground squirrels she studies in the Rocky Mountains — invest an insane amount of resources in their young. That didn’t prepare her for the resources the conservation biologist would owe after the birth of her second son.

Wells Salerno went into labor on the eve of her due date, in the early weeks of erectile dysfunction lockdowns in April 2020. She and her husband, Jon Salerno, were instructed to go through the emergency room doors at Poudre Valley Hospital in Fort Collins, Colorado, because it was the only entrance open. Despite the weird erectile dysfunction treatment vibe — the emptiness, the quiet — everything went smoothly.

Wells Salerno felt well enough to decline the help of a nurse offering to wheel her to the labor and delivery department. She even took a selfie, smiling, as she entered the delivery room. €œI was just thrilled that he was here and it was on his due date, so we didn’t have to have an induction,” she said.

€œI was doing great.” Gus was born a healthy 10 pounds after about nine hours of labor, and the family went home the next morning. Wells Salerno expected the bill for Gus’ birth to be heftier than that for her first child, Hank, which had cost the family a mere $30. She was a postdoctoral fellow in California with top-notch insurance when Hank was born, about four years earlier.

They were braced to pay more for Gus, but how much more?. Then the bill came. The Patient.

Caitlin Wells Salerno, a conservation biologist at Colorado State University and a principal investigator at Rocky Mountain Biological Laboratory. She is insured by Anthem Blue Cross Blue Shield through her job. When Wells Salerno went into labor in April 2020, she and husband Jon were told to go through a Fort Collins, Colorado, hospital’s emergency room doors because it was the only entrance open.

Their medical bill later included a $2,755 charge for Level 5 emergency services.(Rae Ellen Bichell / KHN) Medical Service. A routine vaginal delivery of a full-term infant. Total Bill.

$16,221.26. The Anthem BCBS negotiated rate was $14,550. Insurance paid $10,940.91 and the family paid the remaining $3,609.09 to the hospital.

Service Provider. Poudre Valley Hospital in Fort Collins, Colorado, operated by UCHealth, a nonprofit health system. What Gives.

In a system that has evolved to bill for anything and everything, a quick exam to evaluate labor in a small triage room can generate substantial charges. The total bill was huge, but what really made Wells Salerno’s eyes pop was a line for the highest level of emergency services. It didn’t make any sense.

Was it for checking in at the ER desk, as she’d been instructed to?. She recalls going through security there on her way to labor and delivery, yet there was a $2,755 charge for “Level 5” emergency department services — as if she had received care there like a patient with a heart attack or fresh from a car wreck. It is the biggest item on the bill other than the delivery itself.

Dr. Renee Hsia, a professor of emergency medicine and health policy at the University of California-San Francisco and a practicing ER doctor, said Level 5 charges are supposed to be reserved for serious cases — “a severe threat to life, or very complicated, resource-intense cases” — not for patients who can walk through a hospital on their own. Emergency room visits are coded from Level 1 to Level 5, with each higher level garnering more generous reimbursement, in theory commensurate with the work required.

But over the past 20 years, hospitals and doctors have learned there’s great profit in upcoding visits. After all, the insurer isn’t in the exam room to know what transpired. An investigation by the Center for Public Integrity found that between 2001 and 2008 the number of Level 4 and 5 visits for patients who were sent homefrom the ER nearly doubled to almost 50% of visits.

In Colorado, the Center for Improving Value in Health Care looked at emergency visit billing from 2009 to 2016 and found that the percentage of emergency visits coded as Level 5 steadily grew from 23% to 34% for patients with commercial insurance. After repeated calls questioning the line item on her bill, Wells Salerno eventually got a voicemail from the billing department, which she shared with KHN, explaining that “the emergency room charge is actually the OB triage little area before they take you to the labor and delivery room.” Wells Salerno was in good enough shape during labor to snap this selfie with husband Jon on entering the delivery room. So when the hospital bill came with a charge for emergency services, the couple thought it had to be a mistake.

(Caitlin Wells Salerno) Even though Gus Salerno’s birth was smoother and faster than his brother’s, it was much more expensive. (Jon Salerno) A customer service representative later explained it was for services given there when a nurse placed an IV for antibiotics, and her doctor checked her dilation and confirmed her water had broken — although none of that was performed in the Emergency Department. And those services, performed before every delivery, are traditionally not billed separately — and are routine, not emergency, procedures.

Some hospitals provide that package of services via an “obstetrical emergency department.” OB-EDs are licensed under the main Emergency Department and typically see patients who are pregnant, for anything from unexplained bleeding to full-term birth. They bill like an ER, even if they aren’t physically located anywhere near the ER. Health care staffing company TeamHealth — owned by the investment company Blackstone, and known for marking up ER bills to boost profit — essentially says an OB-ED can be as simple as a rebranded obstetrical triage area.

In a white paper, the company said an OB-ED is an “entrepreneurial approach to strengthening hospital finances” because with “little to no structural investment” it allows hospitals to “collect facility charges that are otherwise lost in the obstetrical triage setting.” The OB Hospitalist Group, which is owned by a private equity company, markets a tool to help OB-EDs calculate levels of emergency care. In a case study, OB Hospitalist Group reported that hospitals “leave a lot of money on the table” by billing OB-ED visits as Level 1 and 2 emergencies when they could be considered Level 4 emergencies. An Arizona facility said its revenue increased $365,000 per quarter after turning their obstetric triage area into an OB-ED.

Poudre Valley Hospital’s website doesn’t list “OB-ED” as part of the facility’s offerings, though UCHealth documents do reference OB-ED beds in other facilities. KHN spoke with four other women who, after giving birth at Poudre Valley in 2020 and 2021, received ER charges on their bills after healthy births. They had no clue they had received emergency services.

One wrote a warning note on Facebook to other area moms after getting a whopping charge — for the 10 minutes she spent in the triage room, while fully dilated and in active labor. In Wells Salerno’s case, UCHealth and her insurer have an agreement that Anthem BCBS pays a lump sum for vaginal delivery, rather than paying for line items individually. €œBeing seen there in OB-ED did not impact this bill whatsoever,” said Dan Weaver, a spokesperson with UCHealth.

But in one of the other moms’ cases, it did. The hospital received $1,500 from the insurer for that charge, and the mom was on the hook for an additional $375 for coinsurance. Ge Bai, a professor of accounting and health policy at Johns Hopkins University, said it’s a “questionable” billing practice, and one that can matter to those who don’t have the same kind of insurance as Wells Salerno, or have none at all.

Dr. Mark Simon, chief medical officer with OB Hospitalist Group, said OB-EDs can help women avoid being admitted to the hospital too early in labor, ensuring timelier, more appropriate care. UCHealth’s Weaver said they can also help pregnant patients with actual emergencies like preterm labor, preeclampsia or vaginal bleeding get quick care from specialists available 24/7, often without having to be admitted to the hospital.

But at hospitals like Poudre Valley, healthy women having healthy births also get routine “OB-ED” treatment, without their knowledge. Weaver said the only time someone in labor would not go through the OB-ED — and therefore the only time they would not receive the emergency charge — is if they have a scheduled induction or cesarean section or are directly admitted from a provider’s office. Hsia, the UCSF researcher and ER doctor, is unconvinced.

€œIf they’re actually going to charge a special fee that you didn’t get directly admitted from your physician, that’s absolutely ridiculous.” Wells Salerno’s “OB-ED” exam was performed by her clinician, but the OB-ED charge still showed up on her bill. Despite the hospital’s strange early-viagra atmosphere, Wells Salerno’s delivery went smoothly and son Gus was born a healthy 10 pounds. The family went home the next morning.(Rae Ellen Bichell / KHN) Resolution.

After trying to determine that the charge wasn’t a mistake, Wells Salerno eventually threw in the towel and paid the bill. €œI was at a very vulnerable time during pregnancy and immediately postpartum,” she said. €œI just felt like I had kind of been taken advantage of financially at a time when I couldn’t muster the energy to fight back.” The fact that two healthy brothers could come with such different price tags isn’t surprising to Dr.

Michelle Moniz. €œThere is no clinical reason that we have this level of variation,” said Moniz, assistant professor of obstetrics and gynecology at the University of Michigan and its Institute for Healthcare Policy and Innovation. Her research shows that people with private insurance pay anywhere from nothing to $10,000 for childbirth.

€œYou don’t get what you pay for,” said Wells Salerno, who maintains that — despite their price difference — both of her children are equally “awesome.” Data from the Colorado Division of Insurance shows that Poudre Valley typically received about $12,000 for similar births in 2020, about 43% more than the typical Colorado hospital. So the more than $14,000 Wells Salerno and her insurer paid is very high. The Takeaway.

Anything in our health system labeled as an emergency room service likely comes with a big additional charge. Expectant parents should be aware that OB-EDs are a relatively new feature at some hospitals. Ask whether your hospital has that kind of charge and how it will affect your bill.

Ahead of time, ask both the hospital and your insurer how much the birth is expected to cost. In Colorado, the Center for Improving Value in Health Care offers a price comparison tool for common medical procedures, including vaginal delivery. If you do require a genuine ER encounter, look at your bill to see how it was coded, Levels 1 to 5 — and protest if your visit was misrepresented.

Ask, “Has this bill been upcoded?. € You are the only one who knows how much time you spent with a medical provider and how much care was given. Here’s a chart that will help with the proper definition of each level.

Know that victory is possible. At least one mom won the battle and got the emergency charge removed from her Poudre Valley Hospital birth bill. It took hours on the phone with UCHealth, a lot of confidence and countless repetitions of the birth story — and how an emergency charge for a routine delivery just didn’t, and doesn’t, make sense.

Bill of the Month is a crowdsourced investigation by KHN and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us?. Tell us about it!.

Rae Ellen Bichell. rbichell@kff.org, @raelnb Related Topics Contact Us Submit a Story TipThe Biden administration and Congress are embroiled in high-stakes haggling over what urgent priorities will make it into the ever-shrinking social spending bill. But for the pharmaceutical industry there is one agenda.

Heading off Medicare drug price negotiation, which it considers an existential threat to its business model. The siren call to contain rising drug costs helped catapult Democrats to power, and the idea is popular among voters regardless of their politics. Yet granting Medicare broad authority to intervene in setting prices has nonetheless divided the party.

And so, as it normally does, the drug industry gave generously to members of Congress, according to new data from KHN’s Pharma Cash to Congress database. Contributions covering the first half of this year show that some of its biggest donations were delivered with surgical-strike precision to sympathetic or moderate Democratic lawmakers the industry needs to remain in its corner. Campaign donations to members of Congress — which must be reported to the Federal Election Commission — are the tip of the iceberg, signaling far greater activity in influence peddling that includes spending millions on lobbying activities and advertising campaigns.

Unusually, in the first half of this year Republicans and Democrats in Congress were virtually neck and neck in pulling in drug industry money, according to a KHN analysis of campaign contributions. In prior years, Republicans dominated giving from that sector, often by huge margins. Pharmaceutical companies and their lobbying groups gave roughly $1.6 million to lawmakers during the first six months of 2021, with Republicans accepting $785,000 and Democrats $776,200, the Pharma Cash to Congress database shows.

Since the 2008 cycle, the industry has generally favored Republicans. The exception was 2009-10, the last time Democrats controlled both chambers of Congress and the White House. Democrats again narrowly hold both the House and Senate, and political scientists and other money-in-politics experts said the contributions likely reflect who is in power, which lawmakers face tougher reelection bids next year, and who has outsize sway over legislation affecting the industry’s bottom line.

Several pharmaceutical companies paused contributions to Republican lawmakers who voted against certifying the results of the 2020 election, blunting the GOP’s total fundraising haul and overall industry giving compared with other years. The drug industry’s campaign contributions are markedly strategic, said Steven Billet, an associate professor at the Graduate School of Political Management at George Washington University. €œThis is a really well-organized commercial sector,” Billet said.

€œIf I’m one of these PACs, I’ve surveyed the landscape at the front end of the process, decided on our agenda and budget, and figured out who I may be able to get to and who I wouldn’t be able to get to.” Of the top 10 recipients of funding, Republican lawmakers accounted for six. Democrats, four. Rep.

Scott Peters (D-Calif.) received the most money of any member of Congress, with $63,900 in contributions in the first half of the year. Peters, whose San Diego-area district includes multiple drug companies, has consistently accepted money from drugmakers since he took office in 2013, according to KHN’s database. Right behind Peters was Rep.

Cathy McMorris Rodgers (R-Wash.), who received $50,000 from the industry in the first six months of 2021. McMorris Rodgers was chosen this year to be the most senior Republican on the House Energy and Commerce Committee, which has significant influence on pharmaceutical issues. Peters sits on the same committee.

€œThey’re typically going to saturate the committees that are relevant to their industry,” said Nick Penniman, CEO of Issue One, a nonprofit that advocates reforming money’s influence in politics. Next in line was Sen. Robert Menendez (D-N.J.), who accepted $49,300, the most of any senator this year despite not facing reelection until 2024.

The vote of Menendez, a longtime ally of the industry, would be crucial for Democrats to pass any proposal giving the government greater control over drug prices. The pharmaceutical industry is a major employer in New Jersey, home to headquarters of behemoths like Johnson &. Johnson, Merck, Novo Nordisk and Sanofi.

Menendez said he’s waiting to see the proposal, “which I expect will include language to allow Medicare to negotiate drug prices.” “The focus of any proposal must be lowering patient costs,” he said, “and that will drive my analysis.” Among other moderate Democrats is Sen. Kyrsten Sinema (D-Ariz.), whose vote also is critical to passage. She received $108,500 in pharma contributions in 2019-20, according to the KHN database.

However, in the first half of this year, she received only $8,000. She has not said publicly where she stands on the current pricing proposal. As Billet sees it, the pharmaceutical industry knew allowing Medicare to negotiate drug prices would likely be on the table, and drug companies shored up members, such as Peters and Menendez, who have sided with them in the past.

Plus, “right now, the Democrats are driving the train, and because of that they’re going to get a few more contributions,” Billet added. Peters received funds from nearly two dozen companies or industry groups, including Eli Lilly, Takeda Pharmaceutical, Pfizer, Merck, GlaxoSmithKline, EMD Serono and Amgen. Menendez’s donors included Boehringer Ingelheim, Sanofi, Pfizer, Merck, Gilead Sciences, Eli Lilly, Teva and Novo Nordisk.

A spokesperson for Peters did not respond to request for comment. Controlling drug prices has broad support among adults regardless of political party, according to polling from KFF (KHN is an editorially independent program of KFF). But facing industry opposition, Democrats have yet to agree on a plan as lawmakers weigh which policies make it into a massive domestic spending bill to expand the social safety net and address climate change.

Central to the industry’s argument is that greater government intervention in setting prices would harm new drug development. However, drug pricing experts generally say this argument is overblown. Republicans remain unanimously opposed, which means Senate Democrats can’t afford any defections to advance legislation.

Fourth in industry contributions was Sen. Catherine Cortez Masto (D-Nev.), a freshman lawmaker on the powerful Senate Finance Committee, which oversees legislation pertaining to federal health programs like Medicare. Cortez Masto received $46,000, with cash flowing in from companies like Eli Lilly, Merck, Pfizer, Johnson &.

Johnson and Mallinckrodt Pharmaceuticals, the latter of which filed for bankruptcy in 2020 after being swamped with litigation over its alleged role in the opioid crisis. One of her recent aides, Eben DuRoss, was hired as a lobbyist this year by the Pharmaceutical Research and Manufacturers of America, or PhRMA, federal disclosures show. Cortez Masto is up for reelection next year in a battleground state that’s been competitive between Republicans and Democrats in recent elections.

She was narrowly elected in 2016, and recent polling showed she held a small lead against her expected Republican challenger in 2022, former Nevada attorney general Adam Laxalt. But her contributions dwarf those of other Senate Democrats in close races. For example, in the first half of this year, Sen.

Maggie Hassan (D-N.H.), who also sits on the Senate Finance Committee, reported having accepted $6,000. Two other lawmakers in competitive seats, Sen. Raphael Warnock (D-Ga.) and Sen.

Mark Kelly (D-Ariz.), didn’t receive funding from the pharmaceutical sector. Sarah Bryner, research director of OpenSecrets, a nonprofit that tracks money in politics, noted several reasons Cortez Masto would pull in more money. In addition to her committee seat and competitive race, politically she’s more moderate than progressive lawmakers who have been bigger agitators against the drug industry.

€œShe’s not seen as an extremist, which is the kind of person who would typically take in more money” from political action committees, Bryner said. Cortez Masto was also a recent past chair of the Democratic Senatorial Campaign Committee and therefore heavily involved in the party’s national fundraising efforts to preserve Democrats’ Senate majority. Those relationships with corporate and other donors could be leveraged for her own race, Bryner said.

€œOnce you’ve made all the relationships, it’s not like they just disappear,” she said. Still, the freshman Democrat has openly supported allowing Medicare to negotiate prescription drug prices, in contrast to Menendez, who voted against the idea in 2019. The Nevada senator recently told KHN that she “absolutely” backs the policy and that the pharma cash flowing into her campaign coffers doesn’t influence her decisions.

€œI’ve already supported it in Finance and actually voted to pass legislation to do just that,” Cortez Masto said. €œWe need to reduce the health care costs for so many in this country, and that’s what I’m focused on doing, including reducing prescription drug costs.” Peters — who unseated a Republican in 2012 — was one of four moderate House Democrats who in September voted against a plan to give Medicare broad authority to negotiate prescription drug prices. They backed a narrower alternative that includes caps on out-of-pocket spending and limits the scope of Medicare’s negotiating authority to a smaller set of medications.

The money Peters and McMorris Rodgers got from drugmakers ($63,900 and $50,000, respectively) significantly jumped from the same periods in past cycles. In the first half of 2019, Peters received $19,500, and during those same quarters in 2017 he got $36,000. McMorris Rodgers’ haul for the first six months of 2019 was $2,500, and two years earlier it was $3,000.

However, Menendez received more funding in the first half of 2019 ($52,000) than this year. That some drugmakers — including Pfizer, Johnson &. Johnson, Gilead and Eli Lilly — as well as PhRMA and the Biotechnology Innovation Organization, another lobbying group for the industry, paused contributions to Republicans after the events of Jan.

6 seems at least in part to account for overall pharma contributions dropping in comparison with other years. In the first half of 2019 drugmakers gave $3.7 million, and in the first half of 2017 they gave about $4.4 million, versus 2021’s $1.6 million. However, other drug company PACs and their industry groups kept up contributions or failed to void checks they’d issued to those who refused to certify the election results, according to a KHN analysis of the FEC data.

They include Merck, Novo Nordisk, GlaxoSmithKline, AstraZeneca, Genentech, Boehringer Ingelheim, Amgen, Teva, EMD Serono and the Association for Accessible Medicines, which all gave $1,000 or more to at least one of the 147 Republicans who voted to overturn the election results. Direct contributions to lawmakers’ political accounts are only one way for the industry to channel cash to Congress. Companies also give money to trade associations and 501(C)(4)s, which are nonprofits that often function as “dark money” groups because they are not required to disclose their donors.

€œWe know that they’re giving. They didn’t stop giving. Their giving went underground,” said Carlos Holguin, research director for the Center for Political Accountability, a nonprofit that tracks money in politics.

Groups also funnel money into advertising — in September, PhRMA announced a seven-figure ad campaign opposing Democrats’ drug pricing plan — or into advocacy groups from which it may eventually trickle down to political candidates. Another factor?. Hail Mary erectile dysfunction treatments, developed and distributed in record time, that may have shored up goodwill with lawmakers.

Or that, despite everything lawmakers have said about lowering drug costs, the industry suspects drug pricing legislation will stall once again and don’t want to spend their political capital on the issue. €œI think, frankly, drugmakers know they’ve won the match when it comes to drug pricing. This whole question of the cost of pharmaceuticals, it has come up for literally decades now and they have successfully shut it down, year after year,” Penniman said.

€œAt a certain point, they know they have driven the nail far enough in the wood and they don’t need to do much more.” Victoria Knight. vknight@kff.org, @victoriaregisk Rachana Pradhan. rpradhan@kff.org, @rachanadixit Elizabeth Lucas.

elucas@kff.org, @eklucas Related Topics Contact Us Submit a Story Tip.

Viagra no prescription

A New York teacher has been generic viagra prices arrested and accused of raping viagra no prescription a 15-year-old student in 2013. Long Island resident Timothy Harrison, age 46, of Oak viagra no prescription Beach, was arrested on Thursday, March 3, and charged with two counts of third-degree rape and one count of third-degree criminal sexual act, according to the Suffolk County Police Department.Harrison was arrested during a traffic stop at about 7:40 a.m. On the Robert Moses Causeway at Route 27A in West Islip, police said. Administrators from the Babylon Union viagra no prescription Free School District contacted police in October 2021 about allegations of misconduct involving district staff, prompting detectives to begin the investigation. In November 2021, a viagra no prescription woman told investigators she had a sexual relationship with Harrison in 2013 when she was 15 years old and he was 38, police reported.

His arraignment is scheduled for Friday, March 4, police said. Police asked anyone who look these up believes viagra no prescription they may be a victim of Harrison to call detectives at 631-852-8791. Click here to sign up for Daily Voice's free daily emails and news alerts.The student section for a Hudson Valley high school playoff game will be quiet for an upcoming semifinal matchup after there were reportedly racist taunts lobbied at student-athletes. During the quarterfinal matchup between Dutchess County-based Our Lady of Lourdes High School in Poughkeepsie and the Ossining High School girls basketball team, there were reports of alleged racist comments made toward players, prompting a swift response from education officials in the region.In response, Our Lady of Lourdes Athletic Director Bill Kyle issued an alert to the community advising that they will be limiting spectators to viagra no prescription four family members for players for each team, and no students will be permitted for their scheduled game on Thursday, March 3 against Roy C. Ketcham in the Section 1 Class AA semifinal.According to reports, during the Warriors’ win over Ossining, some hecklers were offensively shouting the name of Mexican food at a Hispanic player as she shot free throws.Our Lady of Lourdes President Catherine Merryman was quick to issue a scathing statement viagra no prescription following the reported incident.“Racism is contrary to the teachings of the Catholic Church and contrary to the values of all Catholic schools, including Our Lady of Lourdes,” she stated.

"We have and will continue to hold our entire school community, including our students, to the highest standards of behavior."Section 1 officials also issued their own statement following the racially-charged taunts.“The Section will not tolerate negative statements or actions, inclusive of racial or discriminatory comments or slurs," Section 1 Executive Director Todd Santabarbara said. "The organization firmly believes in viagra no prescription the values that athletics can bring to student-athletes and their communities. These values can only exist in an environment absent of discrimination and hate.” Click here to sign up for Daily Voice's free daily emails and news alerts..

A New http://whiterockboatclub.com/fall-sailing-is-phenomenal/ York teacher has been viagra best price arrested and accused of raping a 15-year-old student in 2013. Long Island resident Timothy Harrison, age 46, of Oak Beach, was arrested on Thursday, March 3, and charged with two counts of third-degree rape and one count of third-degree criminal sexual act, according to the Suffolk County Police Department.Harrison was arrested during a traffic stop at viagra best price about 7:40 a.m. On the Robert Moses Causeway at Route 27A in West Islip, police said. Administrators from the Babylon Union Free School District contacted police viagra best price in October 2021 about allegations of misconduct involving district staff, prompting detectives to begin the investigation. In November 2021, a woman told investigators she had a sexual relationship with Harrison in 2013 when she viagra best price was 15 years old and he was 38, police reported.

His arraignment is scheduled for Friday, March 4, police said. Police asked anyone viagra best price who believes they may be a victim get viagra online of Harrison to call detectives at 631-852-8791. Click here to sign up for Daily Voice's free daily emails and news alerts.The student section for a Hudson Valley high school playoff game will be quiet for an upcoming semifinal matchup after there were reportedly racist taunts lobbied at student-athletes. During the quarterfinal matchup between Dutchess County-based Our Lady of Lourdes High School in Poughkeepsie and the Ossining High School girls basketball team, there were reports of alleged racist comments made toward players, prompting a viagra best price swift response from education officials in the region.In response, Our Lady of Lourdes Athletic Director Bill Kyle issued an alert to the community advising that they will be limiting spectators to four family members for players for each team, and no students will be permitted for their scheduled game on Thursday, March 3 against Roy C. Ketcham in the Section 1 Class AA semifinal.According to viagra best price reports, during the Warriors’ win over Ossining, some hecklers were offensively shouting the name of Mexican food at a Hispanic player as she shot free throws.Our Lady of Lourdes President Catherine Merryman was quick to issue a scathing statement following the reported incident.“Racism is contrary to the teachings of the Catholic Church and contrary to the values of all Catholic schools, including Our Lady of Lourdes,” she stated.

"We have and will continue to hold our entire school community, including our students, to the highest standards of behavior."Section 1 officials also issued their own statement following the racially-charged taunts.“The Section will not tolerate negative statements or actions, inclusive of racial or discriminatory comments or slurs," Section 1 Executive Director Todd Santabarbara said. "The organization firmly viagra best price believes in the values that athletics can bring to student-athletes and their communities. These values can only exist in an environment absent of discrimination and hate.” Click here to sign up for Daily Voice's free daily emails and news alerts..

Teva generic viagra cost

Latest Alzheimer's News teva generic viagra cost THURSDAY, Nov. 18, 2021 (HealthDay News) Neurologists must make sure Alzheimer's patients and their families understand that the controversial drug aducanumab does not restore mental function, the American Academy of Neurology (AAN) said in new position statement that includes ethical guidelines. "Aducanumab is not a cure for Alzheimer's disease, yet since it has been teva generic viagra cost approved by the [U.S.

Food and Drug Administration], patients are asking their doctors if this is an option for them," said statement author Dr. Winston Chiong, an associate professor at the University of California San Francisco and member of the AAN's Ethics, Law and Humanities Committee. "This is a high-cost drug that teva generic viagra cost was approved by the FDA without convincing evidence of benefits and with known harms, so the purpose of this position statement is to offer ethical guidance on how neurologists can help patients make informed decisions about this treatment," Chiong said in an AAN news release.

The U.S. Food and Drug Administration approved aducanumab (brand name. Aduhelm) based teva generic viagra cost on two studies that were both stopped early because the drug showed no benefits for patients.

The statement explained that a later analysis of data from one of those studies suggested a small benefit, while the other still showed no benefit. The statement noted that while aducanumab reduces the beta-amyloid plaques in the brain that are markers of teva generic viagra cost Alzheimer's, it's unclear whether that provides any meaningful benefits to patients. There isn't sufficient evidence to offer the drug to patients with moderate or advanced dementia, or to those without evidence of beta-amyloid in the brain, according to the position statement published Nov.

17 in the journal Neurology. It also said the drug carries a risk of brain inflammation and brain bleeds, which occurred in a third of patients in the studies who received the dose approved by teva generic viagra cost the FDA. The statement said neurologists must inform patients and families about the drug's potential risks of and the need for more frequent monitoring with MRI scans.

Another issue is the lack of racial and ethnic diversity in the clinical trials of aducanumab. Patients in racial and ethnic teva generic viagra cost minorities need to be told about the lack of safety and effectiveness data for them, the statement said. In addition, it warned that pricing and insurance coverage of the drug may cause financial harm to patients and their families.

Aducanumab is priced at $56,000 a teva generic viagra cost year. But the costs of infusing the drug, repeated imaging and medical management may push annual costs to more than $100,000. Medicare generally covers 80%, so patients and families must be told that the full cost of treatment may not be covered, the statement advised.

The statement said another concern is that availability of aducanumab may teva generic viagra cost lead to lower patient enrollment in clinical trials of more effective treatments. More information The U.S. National Institute on Aging has more about Alzheimer's disease treatment.

SOURCE. American Academy of Neurology, news release, Nov. 17, 2021 Robert Preidt Copyright © 2021 HealthDay.

All rights reserved. QUESTION One of the first symptoms of Alzheimer's disease is __________________. See AnswerLatest erectile dysfunction News FRIDAY, Nov.

19, 2021 (HealthDay News) The first known person with erectile dysfunction treatment was a vendor in a large seafood market in Wuhan, China, claims an American scientist whose findings challenge the World Health Organization's conclusion that the first patient was an accountant who lived miles from the market. Michael Worobey, a University of Arizona expert in tracing the evolution of viagraes, examined a number of sources of information and discovered discrepancies in the WHO's timeline for the start of the viagra. The vendor's links to the Huanan Seafood Wholesale Market and a new analysis of the earliest hospitalized patients' connections to the market strongly suggest that's where the viagra began, according to Worobey, whose findings were published Thursday in the journal Science.

"In this city of 11 million people, half of the early cases are linked to a place that's the size of a soccer field," Worobey told The New York Times. "It becomes very difficult to explain that pattern if the outbreak didn't start at the market." While a number of experts agree with Worobey's conclusion, some say he doesn't provide definitive proof of how the viagra began. "I don't disagree with the analysis," Jesse Bloom, a virologist at the Fred Hutchinson Cancer Research Center in Seattle, told the Times.

"But I don't agree that any of the data are strong enough or complete enough to say anything very confidently, other than that the Huanan Seafood Market was clearly a super-spreading event." Studies of the viagra' genome -- including one conducted by Worobey himself -- suggest that the first occurred in about mid-November 2019, weeks before the market vendor got sick, the Times reported. The viagra likely infected a "patient zero" sometime before the vendor became ill and then started to spread widely at the market, some have suggested. While Worobey's paper will rekindle debate over whether the viagra resulted from animal-to-human transfer, it likely won't settle the issue.

"He has done an excellent job of reconstructing what he can from the available data, and it's as reasonable a hypothesis as any," Dr. W. Ian Lipkin, a virologist at the Mailman School of Public Health at Columbia University, told the Times.

"But I don't think we're ever going to know what's going on, because it's two years ago and it's still murky." More information Visit the U.S. Centers of Disease Control and Prevention for more on erectile dysfunction. SOURCE.

The New York Times Robert Preidt and Robin Foster Copyright © 2021 HealthDay. All rights reserved.Latest Infectious Disease News FRIDAY, Nov. 19, 2021 (HealthDay News) There was no smallpox viagra in frozen vials recently discovered at a treatment research facility in Pennsylvania, the U.S.

Centers for Disease Control and Prevention said Thursday. Instead of the variola viagra that causes smallpox, lab tests showed that the vials contained vaccinia, the viagra used in smallpox treatment, according to the agency. On Nov.

15, federal officials were alerted that the vials were found by a laboratory worker while cleaning out a freezer in the facility. The vials were sent on Nov. 18 to the CDC.

Before smallpox was declared eradicated in 1980 by the World Health Organization, the easily transmitted viagra infected up to 15 million people a year and killed about 30% of them, CNN reported. The last known outbreak in the United States was in 1947. In 2014, employees of the National Institutes of Health (NIH) found six vials of smallpox in an unused storage room as they packed up a lab at the NIH's Bethesda, Md., campus to move it.

Two of the vials contained viable viagra. The CDC said at the time there was no evidence anyone had been exposed to the contents of any of the vials. There's disagreement among governments about whether to keep samples of smallpox or to destroy all known copies.

Routine vaccination for smallpox stopped in 1972, but military personnel and some researchers still get vaccinated, CNN reported. The CDC recommends that people who need long-term protection get smallpox boosters every 3-5 years, although at least one study found the treatment might protect recipients for life. More information Visit the U.S.

Centers for Disease Control and Prevention for more on smallpox. SOURCE. U.S.

Centers for Disease Control and Prevention. CNN Robert Preidt Copyright © 2021 HealthDay. All rights reserved.

SLIDESHOW Bacterial s 101. Types, Symptoms, and Treatments See SlideshowLatest Migraine News By Robert Preidt and Ernie Mundell HealthDay ReportersTHURSDAY, Nov. 19, 2021 – People who live with chronic migraines suffer intense throbbing and pulsing, sensitivity to light and sound, nausea and vomiting.

Could a plant-based diet, credited with a variety of positive health impacts, also help ease these chronic symptoms?. It might. Researchers in New York have published a case study of one man with severe chronic migraines who had tried everything to curb them, and then switched to a plant-based diet -- loaded with a lot of dark green leafy vegetables.

He quickly found significant relief from the headaches, doctors reported online Nov. 18 in the journal BMJ Case Reports. "This report suggests that a whole food plant-based diet may offer a safe, effective and permanent treatment for reversing chronic migraine," wrote a team led by Dr.

David Dunaief, who specializes in nutritional medicine and has a private practice in East Setauket, N.Y. One expert in migraine who wasn't connected to the study was cautiously optimistic about the findings. "It is hard to make much from one case report, [but] it does illustrate the importance of all of these non-pharmacological, evidence-based treatments," said Dr.

Noah Rosen. He directs Northwell Health's Headache Center in Great Neck, N.Y. As the researchers noted, more than 1 billion people worldwide have migraines, defined as one-side, pulsating headaches, sometimes with a variety of other symptoms, that last between four and 72 hours.

Some migraines are episodic, meaning they happen fewer than 15 days per month. Others are chronic, with 15 or more migraine days per month plus migraine features on eight days per month. To be considered successful, migraine treatment must cut the frequency and length of the attacks in half or improve symptoms.

The 60-year-old man whose experiences are detailed in the report had endured severe migraine headaches without aura for more than 12 years. Six months before his clinic referral, his migraines had become chronic, occurring anywhere from 18 to 24 days each month.He had tried a number of potential fixes, including the prescribed medications zolmitriptan and topiramate. He also cut out potential 'trigger' foods, including chocolate, cheese, nuts, caffeine, and dried fruit.

Beyond this, the man also tried yoga and meditation to curb the attacks. None of those interventions had worked.The man described the pain as throbbing, starting suddenly and intensely in the forehead and temple on the left side of his head. His migraines usually lasted 72 hours and also included sensitivity to light and sound, nausea and vomiting.

His pain severity was 10 to 12 out of a scale of 10.He didn't have high levels of systemic inflammation but had a normal level of beta carotene in his blood, possibly because he ate sweet potatoes daily. Sweet potatoes are relatively low in food nutrients known as carotenoids, which carry anti-inflammatory and antioxidant properties, the authors explained. Leafy greens such as spinach, kale and watercress do contain high levels of carotenoids, however.

So, Rosen's team advised the man to adopt the Low Inflammatory Foods Everyday (LIFE) diet. It's a nutrient-dense, whole food, plant-based diet. The regimen advocates eating at least five ounces by weight of raw or cooked dark green leafy vegetables every day, drinking one 32-ounce daily green LIFE smoothie, and limiting intake of whole grains, starchy vegetables, oils, and animal protein, particularly dairy and red meat.After two months on the diet, the man said his migraines had been dramatically reduced -- to just one migraine day per month, and even that headache was less severe.

SLIDESHOW 16 Surprising Headache Triggers and Tips for Pain Relief See Slideshow At the same time, his blood tests showed a substantial rise in beta-carotene levels. Soon, the man stopped taking all his migraine meds. His migraines stopped completely after three months and haven't returned in 7 1/2 years.The man was allergic, and previously published research suggests that better control of allergies may also lead to fewer migraine headaches.

In this case, the man's allergy symptoms also improved -- to the point that he no longer needed to use seasonal medication.He was also HIV-positive, and HIV has been linked to a heightened risk of migraines. It is possible that the man's HIV status and antiretroviral drugs had contributed to his symptoms, the authors said, though it wasn't possible to study this further without stopping the antiretroviral treatment."While this report describes one very adherent patient who had a remarkable response, the LIFE diet has reduced migraine frequency within 3 months in several additional patients," Dunaief added. For his part, Rosen said that "the role of proper diet and migraine has had a few studies demonstrating benefit." Being properly hydrated, eating a healthy "low-glycemic" diet and getting lots of omega 3 fatty acids (such as are found in oily fish) have all been shown to have a positive effect on curbing migraines, he said.

Beyond food, getting good sleep, regular exercise and psychological interventions such as "cognitive behavioral therapy, mindfulness and progressive muscle relaxation" may also help, Rosen said. More information Find out more about migraines at the American Migraine Foundation. SOURCE.

BMJ Case reports, news release, Nov. 18, 2021 Copyright © 2021 HealthDay. All rights reserved.

From Migraines and Headaches Resources Featured Centers Health Solutions From Our SponsorsLatest Asthma News FRIDAY, Nov. 19, 2021 (HealthDay News) While climate change gets a lot of notice for its numerous negative impacts around the globe, children's allergies may not be among them. Despite climate change, with the longer growing seasons and larger pollen loads that are attributed to it, more than 5,800 children in the Los Angeles area with asthma did not have an increase in allergic sensitization or allergy diagnosis over a 15-year period, a new study showed.

The findings were presented earlier this month at an annual meeting of the American College of Allergy, Asthma and Immunology. "We were somewhat surprised at the results as we expected there would be an increase in the number of kids with asthma who were sensitized to pollen and other allergens," said principal investigator Dr. Kenny Kwong, a Los Angeles-based allergist.

"Between 80%-90% of children with asthma have allergy triggers, which is why it's important for children with asthma to be tested for allergies," he said in a meeting news release. "Allergy triggers can cause asthma flares in children." When people's immune systems become sensitized to an allergen, those patients will likely develop symptoms of an allergy each time they are exposed to that same allergen, which for others is harmless. "Although temperatures have been rising and pollen loads increasing, if someone is not genetically predisposed to allergies, they are not likely to be sensitized to more allergens," said allergist and study co-author Dr.

Lyne Scott, an associate professor of pediatrics at USC's Keck School of Medicine. "The growing season is year-round in L.A. And people with allergies who are already sensitized to pollens suffer more intensely when the growing season is longer, or the air quality isn't good," Scott said in the release.

"It is important to remember that sensitization does not equate to severity so those with allergies may have worse symptoms." The study followed 5,874 kids with asthma in Los Angeles for 15 years, who underwent more than 123,200 skin prick tests to dust mites, cats, dogs, cockroaches, tree pollen, grass pollen and weed pollen. All the patients had been diagnosed with asthma and allergic rhinitis by an asthma specialist using history, physical examination and spirometry when it was age-appropriate. The researchers found no increase in allergic sensitization or allergy diagnosis among the children.

The findings were also published recently in the journal Annals of Allergy, Asthma and Immunology. More information The U.S. National Library of Medicine has more on seasonal allergies.

SOURCE. American College of Allergy, Asthma and Immunology, news release, Nov. 5, 2021 Cara Murez Copyright © 2021 HealthDay.

All rights reserved. SLIDESHOW What is Asthma?. Asthma Myths Debunked See Slideshow.

Latest Alzheimer's News THURSDAY, viagra best price Nov. 18, 2021 (HealthDay News) Neurologists must make sure Alzheimer's patients and their families understand that the controversial drug aducanumab does not restore mental function, the American Academy of Neurology (AAN) said in new position statement that includes ethical guidelines. "Aducanumab is not a cure for Alzheimer's disease, yet since it viagra best price has been approved by the [U.S.

Food and Drug Administration], patients are asking their doctors if this is an option for them," said statement author Dr. Winston Chiong, an associate professor at the University of California San Francisco and member of the AAN's Ethics, Law and Humanities Committee. "This is a high-cost drug that was approved by the FDA without convincing evidence of benefits and with known harms, so the purpose of this position statement is to offer ethical guidance on how neurologists can help patients make informed decisions about this treatment," Chiong said in an AAN viagra best price news release.

The U.S. Food and Drug Administration approved aducanumab (brand name. Aduhelm) based viagra best price on two studies that were both stopped early because the drug showed no benefits for patients.

The statement explained that a later analysis of data from one of those studies suggested a small benefit, while the other still showed no benefit. The statement noted viagra best price that while aducanumab reduces the beta-amyloid plaques in the brain that are markers of Alzheimer's, it's unclear whether that provides any meaningful benefits to patients. There isn't sufficient evidence to offer the drug to patients with moderate or advanced dementia, or to those without evidence of beta-amyloid in the brain, according to the position statement published Nov.

17 in the journal Neurology. It also said the drug carries a risk of brain inflammation and brain bleeds, which occurred in a third of patients viagra best price in the studies who received the dose approved by the FDA. The statement said neurologists must inform patients and families about the drug's potential risks of and the need for more frequent monitoring with MRI scans.

Another issue is the lack of racial and ethnic diversity in the clinical trials of aducanumab. Patients in racial and ethnic minorities need to be told about the lack of viagra best price safety and effectiveness data for them, the statement said. In addition, it warned that pricing and insurance coverage of the drug may cause financial harm to patients and their families.

Aducanumab is priced at $56,000 a viagra best price year. But the costs of infusing the drug, repeated imaging and medical management may push annual costs to more than $100,000. Medicare generally covers 80%, so patients and families must be told that the full cost of treatment may not be covered, the statement advised.

The statement said another concern is that availability of aducanumab may lead to lower patient enrollment in clinical viagra best price trials of more effective treatments. More information The U.S. National Institute on Aging has more about Alzheimer's disease treatment.

SOURCE. American Academy of Neurology, news release, Nov. 17, 2021 Robert Preidt Copyright © 2021 HealthDay.

All rights reserved. QUESTION One of the first symptoms of Alzheimer's disease is __________________. See AnswerLatest erectile dysfunction News FRIDAY, Nov.

19, 2021 (HealthDay News) The first known person with erectile dysfunction treatment was a vendor in a large seafood market in Wuhan, China, claims an American scientist whose findings challenge the World Health Organization's conclusion that the first patient was an accountant who lived miles from the market. Michael Worobey, a University of Arizona expert in tracing the evolution of viagraes, examined a number of sources of information and discovered discrepancies in the WHO's timeline for the start of the viagra. The vendor's links to the Huanan Seafood Wholesale Market and a new analysis of the earliest hospitalized patients' connections to the market strongly suggest that's where the viagra began, according to Worobey, whose findings were published Thursday in the journal Science.

"In this city of 11 million people, half of the early cases are linked to a place that's the size of a soccer field," Worobey told The New York Times. "It becomes very difficult to explain that pattern if the outbreak didn't start at the market." While a number of experts agree with Worobey's conclusion, some say he doesn't provide definitive proof of how the viagra began. "I don't disagree with the analysis," Jesse Bloom, a virologist at the Fred Hutchinson Cancer Research Center in Seattle, told the Times.

"But I don't agree that any of the data are strong enough or complete enough to say anything very confidently, other than that the Huanan Seafood Market was clearly a super-spreading event." Studies of the viagra' genome -- including one conducted by Worobey himself -- suggest that the first occurred in about mid-November 2019, weeks before the market vendor got sick, the Times reported. The viagra likely infected a "patient zero" sometime before the vendor became ill and then started to spread widely at the market, some have suggested. While Worobey's paper will rekindle debate over whether the viagra resulted from animal-to-human transfer, it likely won't settle the issue.

"He has done an excellent job of reconstructing what he can from the available data, and it's as reasonable a hypothesis as any," Dr. W. Ian Lipkin, a virologist at the Mailman School of Public Health at Columbia University, told the Times.

"But I don't think we're ever going to know what's going on, because it's two years ago and it's still murky." More information Visit the U.S. Centers of Disease Control and Prevention for more on erectile dysfunction. SOURCE.

The New York Times Robert Preidt and Robin Foster Copyright © 2021 HealthDay. All rights reserved.Latest Infectious Disease News FRIDAY, Nov. 19, 2021 (HealthDay News) There was no smallpox viagra in frozen vials recently discovered at a treatment research facility in Pennsylvania, the U.S.

Centers for Disease Control and Prevention said Thursday. Instead of the variola viagra that causes smallpox, lab tests showed that the vials contained vaccinia, the viagra used in smallpox treatment, according to the agency. On Nov.

15, federal officials were alerted that the vials were found by a laboratory worker while cleaning out a freezer in the facility. The vials were sent on Nov. 18 to the CDC.

Before smallpox was declared eradicated in 1980 by the World Health Organization, the easily transmitted viagra infected up to 15 million people a year and killed about 30% of them, CNN reported. The last known outbreak in the United States was in 1947. In 2014, employees of the National Institutes of Health (NIH) found six vials of smallpox in an unused storage room as they packed up a lab at the NIH's Bethesda, Md., campus to move it.

Two of the vials contained viable viagra. The CDC said at the time there was no evidence anyone had been exposed to the contents of any of the vials. There's disagreement among governments about whether to keep samples of smallpox or to destroy all known copies.

Routine vaccination for smallpox stopped in 1972, but military personnel and some researchers still get vaccinated, CNN reported. The CDC recommends that people who need long-term protection get smallpox boosters every 3-5 years, although at least one study found the treatment might protect recipients for life. More information Visit the U.S.

Centers for Disease Control and Prevention for more on smallpox. SOURCE. U.S.

Centers for Disease Control and Prevention. CNN Robert Preidt Copyright © 2021 HealthDay. All rights reserved.

SLIDESHOW Bacterial s 101. Types, Symptoms, and Treatments See SlideshowLatest Migraine News By Robert Preidt and Ernie Mundell HealthDay ReportersTHURSDAY, Nov. 19, 2021 – People who live with chronic migraines suffer intense throbbing and pulsing, sensitivity to light and sound, nausea and vomiting.

Could a plant-based diet, credited with a variety of positive health impacts, also help ease these chronic symptoms?. It might. Researchers in New York have published a case study of one man with severe chronic migraines who had tried everything to curb them, and then switched to a plant-based diet -- loaded with a lot of dark green leafy vegetables.

He quickly found significant relief from the headaches, doctors reported online Nov. 18 in the journal BMJ Case Reports. "This report suggests that a whole food plant-based diet may offer a safe, effective and permanent treatment for reversing chronic migraine," wrote a team led by Dr.

David Dunaief, who specializes in nutritional medicine and has a private practice in East Setauket, N.Y. One expert in migraine who wasn't connected to the study was cautiously optimistic about the findings. "It is hard to make much from one case report, [but] it does illustrate the importance of all of these non-pharmacological, evidence-based treatments," said Dr.

Noah Rosen. He directs Northwell Health's Headache Center in Great Neck, N.Y. As the researchers noted, more than 1 billion people worldwide have migraines, defined as one-side, pulsating headaches, sometimes with a variety of other symptoms, that last between four and 72 hours.

Some migraines are episodic, meaning they happen fewer than 15 days per month. Others are chronic, with 15 or more migraine days per month plus migraine features on eight days per month. To be considered successful, migraine treatment must cut the frequency and length of the attacks in half or improve symptoms.

The 60-year-old man whose experiences are detailed in the report had endured severe migraine headaches without aura for more than 12 years. Six months before his clinic referral, his migraines had become chronic, occurring anywhere from 18 to 24 days each month.He had tried a number of potential fixes, including the prescribed medications zolmitriptan and topiramate. He also cut out potential 'trigger' foods, including chocolate, cheese, nuts, caffeine, and dried fruit.

Beyond this, the man also tried yoga and meditation to curb the attacks. None of those interventions had worked.The man described the pain as throbbing, starting suddenly and intensely in the forehead and temple on the left side of his head. His migraines usually lasted 72 hours and also included sensitivity to light and sound, nausea and vomiting.

His pain severity was 10 to 12 out of a scale of 10.He didn't have high levels of systemic inflammation but had a normal level of beta carotene in his blood, possibly because he ate sweet potatoes daily. Sweet potatoes are relatively low in food nutrients known as carotenoids, which carry anti-inflammatory and antioxidant properties, the authors explained. Leafy greens such as spinach, kale and watercress do contain high levels of carotenoids, however.

So, Rosen's team advised the man to adopt the Low Inflammatory Foods Everyday (LIFE) diet. It's a nutrient-dense, whole food, plant-based diet. The regimen advocates eating at least five ounces by weight of raw or cooked dark green leafy vegetables every day, drinking one 32-ounce daily green LIFE smoothie, and limiting intake of whole grains, starchy vegetables, oils, and animal protein, particularly dairy and red meat.After two months on the diet, the man said his migraines had been dramatically reduced -- to just one migraine day per month, and even that headache was less severe.

SLIDESHOW 16 Surprising Headache Triggers and Tips for Pain Relief See Slideshow At the same time, his blood tests showed a substantial rise in beta-carotene levels. Soon, the man stopped taking all his migraine meds. His migraines stopped completely after three months and haven't returned in 7 1/2 years.The man was allergic, and previously published research suggests that better control of allergies may also lead to fewer migraine headaches.

In this case, the man's allergy symptoms also improved -- to the point that he no longer needed to use seasonal medication.He was also HIV-positive, and HIV has been linked to a heightened risk of migraines. It is possible that the man's HIV status and antiretroviral drugs had contributed to his symptoms, the authors said, though it wasn't possible to study this further without stopping the antiretroviral treatment."While this report describes one very adherent patient who had a remarkable response, the LIFE diet has reduced migraine frequency within 3 months in several additional patients," Dunaief added. For his part, Rosen said that "the role of proper diet and migraine has had a few studies demonstrating benefit." Being properly hydrated, eating a healthy "low-glycemic" diet and getting lots of omega 3 fatty acids (such as are found in oily fish) have all been shown to have a positive effect on curbing migraines, he said.

Beyond food, getting good sleep, regular exercise and psychological interventions such as "cognitive behavioral therapy, mindfulness and progressive muscle relaxation" may also help, Rosen said. More information Find out more about migraines at the American Migraine Foundation. SOURCE.

BMJ Case reports, news release, Nov. 18, 2021 Copyright © 2021 HealthDay. All rights reserved.

From Migraines and Headaches Resources Featured Centers Health Solutions From Our SponsorsLatest Asthma News FRIDAY, Nov. 19, 2021 (HealthDay News) While climate change gets a lot of notice for its numerous negative impacts around the globe, children's allergies may not be among them. Despite climate change, with the longer growing seasons and larger pollen loads that are attributed to it, more than 5,800 children in the Los Angeles area with asthma did not have an increase in allergic sensitization or allergy diagnosis over a 15-year period, a new study showed.

The findings were presented earlier this month at an annual meeting of the American College of Allergy, Asthma and Immunology. "We were somewhat surprised at the results as we expected there would be an increase in the number of kids with asthma who were sensitized to pollen and other allergens," said principal investigator Dr. Kenny Kwong, a Los Angeles-based allergist.

"Between 80%-90% of children with asthma have allergy triggers, which is why it's important for children with asthma to be tested for allergies," he said in a meeting news release. "Allergy triggers can cause asthma flares in children." When people's immune systems become sensitized to an allergen, those patients will likely develop symptoms of an allergy each time they are exposed to that same allergen, which for others is harmless. "Although temperatures have been rising and pollen loads increasing, if someone is not genetically predisposed to allergies, they are not likely to be sensitized to more allergens," said allergist and study co-author Dr.

Lyne Scott, an associate professor of pediatrics at USC's Keck School of Medicine. "The growing season is year-round in L.A. And people with allergies who are already sensitized to pollens suffer more intensely when the growing season is longer, or the air quality isn't good," Scott said in the release.

"It is important to remember that sensitization does not equate to severity so those with allergies may have worse symptoms." The study followed 5,874 kids with asthma in Los Angeles for 15 years, who underwent more than 123,200 skin prick tests to dust mites, cats, dogs, cockroaches, tree pollen, grass pollen and weed pollen. All the patients had been diagnosed with asthma and allergic rhinitis by an asthma specialist using history, physical examination and spirometry when it was age-appropriate. The researchers found no increase in allergic sensitization or allergy diagnosis among the children.

The findings were also published recently in the journal Annals of Allergy, Asthma and Immunology. More information The U.S. National Library of Medicine has more on seasonal allergies.

SOURCE. American College of Allergy, Asthma and Immunology, news release, Nov. 5, 2021 Cara Murez Copyright © 2021 HealthDay.

All rights reserved. SLIDESHOW What is Asthma?. Asthma Myths Debunked See Slideshow.

, so I made a batch of organic hemp infused iced tea & I’ve been starting my days that way. This tea is from @standarddose my new favorite online shop. They have curated an incredible selection of clean and organic products that benefit your skin both internally and externally. I’ve rounded up a few of my favorites in my stories (included the best damn natural deodorant I’ve ever tried). Anyone else on the iced tea kick? #sponsored">

Happy Independence Day. #juneteenth