Tag Archives: federal

5 reasons the government is not prepared to handle ObamaCare

The recent turn of events with the Obama Administration and a lack of transparency are a significant red flag to the impending catastrophe of how the proposed changes under the Affordable Care Act could be the next ensuing disaster. 1. Is the IRS capable of fairly enforcing penalties? A major part of the Affordable Care Act is providing insurance for those who don’t have it, or can’t afford it.  The assumption, originally, was that savings would be obtained by coaxing individuals to buy insurance sooner, and prevent the rising cost of catastrophic illness. The hope was that individuals would feel the pain of a financial penalty, enforced by the IRS, and hence opt-in for insurance as opposed to paying the fine.   But recent events, and the follies of the IRS, in using their authority to overstep the boundaries of fairness and jurisdiction, should cause concern.  How effective and unbiased can the IRS truly be in accurately indentifying those individuals who have not complied with the law and enforcing the penalties? …

Ultra-low salt intake may not boost health, U.S. panel says

Americans at high risk for heart problems who have been told for years to sharply cut salt from their diet may not actually benefit from ultra-low sodium diets and could even face some harm, an independent panel of health experts said on Tuesday. The influential Institute of Medicine, in a report to U.S. health officials, reviewed the latest data on the link between salt intake and health. While blacks, diabetics and others more likely to have heart problems are urged to slash their salt intake, the IOM review showed there was limited evidence such a diet helped, and that too little salt might increase the risk of heart trouble. “The evidence on both the benefit and harm is not strong enough to indicate that these subgroups should be treated differently from the general U.S. population,” the panel wrote. That suggests higher-risk populations may not need such a drastic reduction of salt in their diets and that other steps to curb heart disease risk may be needed. Americans are still consuming far too much salt, the IOM experts said. On average, U.S. adults eat about 1.5 teaspoons of salt over the course of the day, or about 3,400 milligrams. Federal guidelines recommend that healthy people consume no more than 2,300 milligrams daily. But the latest data calls into question whether individuals with higher risk factors for heart disease or stroke should limit their daily intake to 1,500 milligrams, as the government recommends. Brian Strom, the panel's chairman and a public health professor at the University of Pennsylvania, said the newest studies back the known benefits of “reducing sodium from very high intake levels to moderate levels.” “But they also suggest that lowering sodium intake too much may actually increase a person's risk of some health problems,” he said, including heart ailments. Still, the studies are limited and in some cases flawed, so more research is needed, the IOM panel told the Centers for Disease Control and Prevention, which requested the report. Health advocates including the American Heart Association were quick to dismiss the findings, saying the recent studies reviewed by IOM focused on sick patients and not the majority of Americans, most of whom eat too much salt. “The bottom line for consumers is still: cut back on sodium,” said the Center for Science in the Public Interest's (CSPI) Bonnie Liebman. 'IT'S PRETTY TOUGH' The problem is not just food loaded with salt. It's also that Americans eat a lot of food that contains lower amounts of salt, such as bread and pasta, without realizing their sodium content. Health officials have called for Americans to take various steps to cut back, such as asking for no-salt dishes in restaurants and eating more naturally low-salt foods like fruits and vegetables. Health advocates said the IOM's review was beside the point given the high levels of sodium that still plague U.S. foods. It's almost impossible to ingest just 1,500 milligrams a day, said Liebman, director of nutrition for CSPI. “Virtually any meal at any restaurant would give you at least half-a-day's worth of sodium, maybe a whole day's worth, maybe more,” Liebman said. “You'd have to make everything from scratch. ... It's pretty tough.” Consumer groups and some lawmakers have for years called on the U.S. Food and Drug Administration to set federal salt levels for food, a recommendation that the IOM backed in 2010. In New York City, health officials have been working with restaurants and food companies to voluntarily remove salt from everyday foods. A trio of studies published on Monday found that smaller restaurants still load their food with salt even as national chains and food manufacturers have cut back.  The FDA, in a statement, said it was reviewing the IOM's report, calling it consistent with its “efforts to work toward achievable and reasonable voluntary reductions in the sodium content of the U.S. food supply.” IOM was not asked to review current federal salt intake guidelines, which were issued in 2010. U.S. health officials are expected to revise the guidelines on salt and other nutrients in 2015.source : http://www.foxnews.com/health/2013/05/15/ultra-low-salt-intake-may-not-boost-health-us-panel-says/

New approaches give women more options for breast cancer surgery

CHICAGO – & Treating breast cancer almost always involves surgery, and for years the choice was just having the lump or the whole breast removed. Now, new approaches are dramatically changing the way these operations are done, giving women more options, faster treatment, smaller scars, fewer long-term side effects and better cosmetic results. It has led to a new specialty -- “oncoplastic” surgery -- combining oncology, which focuses on cancer treatment, and plastic surgery to restore appearance. “Cosmetics is very important” and can help a woman recover psychologically as well as physically, said Dr. Deanna Attai, a Burbank, Calif., surgeon who is on the board of directors of the American Society of Breast Surgeons. Its annual meeting in Chicago earlier this month featured many of these new approaches. More women are getting chemotherapy or hormone therapy before surgery to shrink large tumors enough to let them have a breast-conserving operation instead of a mastectomy. Fewer lymph nodes are being removed to check for cancer's spread, sparing women painful arm swelling for years afterward. Newer ways to rebuild breasts have made mastectomy a more appealing option for some women. More of them are getting immediate reconstruction with an implant at the same time the cancer is removed rather than several operations that have been standard for many years. Skin and nipples increasingly are being preserved for more natural results. Some doctors are experimenting with operating on breast tumors through incisions in the armpit to avoid breast scars. There's even a “Goldilocks” mastectomy for large-breasted women -- not too much or too little removed, and using excess skin to create a “just right” natural implant. Finally, doctors are testing a way to avoid surgery altogether, destroying small tumors by freezing them with a probe through the skin. “Breast surgery has become more minimalistic,” said Dr. Shawna Willey of Georgetown's Lombardi Comprehensive Cancer Center. “Women have more options. It's much more complex decision-making.” Breast cancer is the most common cancer in women around the world. In the U.S. alone, about 230,000 new cases are diagnosed each year. Most can be treated by just having the lump removed, but that requires radiation for weeks afterward to kill any stray cancer cells in the breast, plus frequent mammograms to watch for a recurrence. Many women don't want the worry or the radiation, and choose mastectomy even though they could have less drastic surgery. Mastectomy rates have been rising. Federal law requires insurers to cover reconstruction for mastectomy patients, and many of the improvements in surgery are aimed at making it less disfiguring. Here are some of the major trends: IMMEDIATE RECONSTRUCTION Doctors used to think it wasn't good to start reconstruction until cancer treatment had ended -- surgery, chemotherapy, radiation. Women would have a mastectomy, which usually involves taking the skin and the nipple along with all the breast tissue, followed by operations months later to rebuild the breast. Reconstruction can use tissue from the back or belly, or an implant. The first operation often is to place a tissue expander, a balloon-like device that's gradually inflated to stretch the remaining skin and make room for the implant. A few months later, a second surgery is done to remove the expander and place the implant. Once that heals, a third operation is done to make a new nipple, followed by tattooing to make an areola, the darkened ring around it. The new trend is immediate reconstruction, with the first steps started at the time of the mastectomy, either to place a tissue expander or an implant. In some cases, the whole thing can be done in one operation. Nationally, about 25 to 30 percent of women get immediate reconstruction. At the Mayo Clinic, about half do, and at Georgetown, it's about 80 percent. SPARING SKIN, NIPPLES Doctors usually take the skin when they do a mastectomy to make sure they leave no cancer behind. But in the last decade they increasingly have left the skin in certain women with favorable tumor characteristics. Attai compares it to removing the inside of an orange while leaving the peel intact. “We have learned over time that you can save skin” in many patients, Willey said. “Every single study has shown that it's safe.” Now they're going the next step: preserving the nipple, which is even more at risk of being involved in cancer than the skin is. Only about 5 percent of women get this now, but eligibility could be expanded if it proves safe. The breast surgery society has a registry on nipple-sparing mastectomies that will track such women for 10 years. “You really have to pick patients carefully,” because no one wants to compromise cancer control for cosmetic reasons, Attai said. “The preliminary data are that nipple-sparing is quite good,” but studies haven't been long enough to know for sure, Willey said. “It makes a huge difference in the cosmetic outcome. That makes the woman's breast recognizable to her.” Dr. Judy Boughey, a breast surgeon at the Mayo Clinic, said the new approach even has swayed patients' treatment choices. “We're seeing women choosing the more invasive surgery, choosing the mastectomy,” because of doctors' willingness to spare skin and nipples, she said. It helped persuade Rose Ragona, a 51-year-old operations supervisor at O'Hare Airport in Chicago. She had both breasts removed on April 19 with the most modern approach: Immediate reconstruction, with preservation of her skin and nipples. “To wake up and just see your breasts there helped me immensely,” she said. She chose to have both breasts removed to avoid radiation and future worry. “I felt it was a safer road to go,” she said. “I can't live the rest of my life in fear. Every time there's a lump I'm going to worry.” FREEZING TUMORS Attai, the California breast surgeon, is one of the researchers in a national study testing cryoablation. The technique uses a probe cooled with liquid nitrogen that turns tumors into ice balls of dead tissue that's gradually absorbed by the body. This has been done since 2004 for benign breast tumors and the clinical trial is aimed at seeing if it's safe for cancer treatment. “The technology is amazing. This is done in the office under local anesthesia, a little skin puncture,” Attai said. In the study, women still have surgery at some point after the freezing treatment to make sure all the cancer is destroyed. If it proves safe and effective, it could eliminate surgery for certain cancer patients. “I'd love to see the day when we can offer women with small breast tumors a completely non-operative approach, and I do think that's coming soon,” Attai said.source : http://www.foxnews.com/health/2013/05/14/new-approaches-give-women-more-options-for-breast-cancer-surgery/