Macron announces changes to France’s health care system

PARIS  — French President Emmanuel Macron on Tuesday unveiled plans to make France’s health care system, considered one of the best in the world, more efficient and sustainable for the next 50 years.

Macron announced organizational changes at hospitals, in the recruitment of doctors, and a better use of digital technologies to provide health care to patients across the country, regardless of where they live.


Macron said “a lot of our neighbors envy the excellence of our health care system. We are attached to our model which associates hospital medicine — public and private — and private medical practice.”

France came out number 1 in a World Health Organization report comparing 191 countries in 2000.

But the country’s health care system is struggling with increasing costs and lack of doctors in some rural region and poor neighborhoods.

One short-term measure consists in hiring 400 family doctors — paid by the state— in so-called “medical deserts.”

The current rule that sets quotas on the number of students in medicine, dentistry and pharmacy will be abolished in 2020.

Hospitals will be classified into in three categories: local health care, specialized care and ultra-specialized care — each focusing on its priorities, to optimize patient care.

Private doctors and other health care professionals will be required in the coming years to organize themselves into “communities” to be able to respond to daily emergency calls from 8 a.m. to 8 p.m. every day in their geographic area — leaving hospitals for only the most serious cases.

The set of measures is estimated to cost 3.4 billion euros ($4 billion) by 2022.

“My ambition is clear: I want what we call the health care system to be one of the pillars of the welfare state of the 21st century,” Macron said. “A health care system that prevents and protects against today’s and tomorrow’s health risks.”

France’s health care system involves a state-funded health insurance that reimburses patients for most medical interventions and medicines prescribed by a doctor.

France’s health insurance budget in 2018 is 195.2 billion euros ($229 billion) — financed by taxes.

In addition, the French can also apply to private insurance to increase their health coverage. /ee

source: newsinfo.inquirer.net

Kids get more cavities when they live with smokers, says Japan study

Young children are much more likely to get cavities if they live in a household with smokers, a Japanese study suggests.

Compared to children in non-smoking households, kids living with smokers were more than twice as likely to have cavities at age three.

Even when smokers in the home didn’t light up near the children, these three-year-olds were 50 percent more likely to have cavities than kids who didn’t live with smokers, the study found.

The findings should give parents another reason to quit smoking, and another way for health care providers to talk to them about cessation, said senior author Koji Kawakami, a researcher at Kyoto University in Japan.

“Education on the harm of secondhand smoke might increase if dentists became aware of the risk of [cavities] as well as tobacco consumption of their clients,” Kawakami said by email.

To understand the connection between secondhand smoke and cavities, Kawakami and colleagues examined data on almost 77,000 children born between 2004 and 2010 in Kobe City, Japan.

To be included in the study, children needed data on household smoking status when they were infants, as well as records from dental exams done at 18 months and three years.

Overall, about 55 percent of the children lived in households with smokers, but only about 7 percent had people who smoked around them instead of lighting up somewhere away from the kids.

By age three, 14 percent of the kids in non-smoking households had cavities, compared with 20 percent of children who had smokers in the home who tried not to use cigarettes in their presence, and 28 percent of kids who were directly exposed to the smoke.

Children of women who smoked during pregnancy didn’t appear to have an increased risk for cavities, the authors reported in the medical journal BMJ.

One limitation of the study is that it relied on mothers to honestly report smoking in the home on questionnaires, the authors acknowledge. In particular, women may have underreported smoking during pregnancy.

In addition, because the study was observational, and didn’t randomly assign groups of children to live with or without smokers, the findings can’t prove that smoke exposure causes cavities.

Two things in Japan—lack of fluoride in the water and less sugar in a typical diet—might make results for these children different than what researchers might see in the US and other countries, where children consume more sweets and have fluoride-enhanced drinking water, the authors also note.

But the connection between cigarette exposure and cavities is strong enough that the US Surgeon General has warned that secondhand smoke may be associated with an increased risk of tooth decay in children.

“This study simply adds to the body of evidence that associates secondhand smoke and an increased risk of tooth decay among children,” said Jonathan Shenkin, a researcher in pediatric dentistry at Boston University and a spokesperson for the American Dental Association.

“Tooth decay is the most common chronic disease in childhood,” Shenkin, who wasn’t involved in the study, said by email. For parents, “knowing they can protect their children against pain and suffering will hopefully be a strong motivator to quit smoking.” — Reuters -

How To Find Kids Affordable Health Insurance

Unless we are eligible for an excellent employer-sponsored group health insurance package, health insurance can sometimes be anything but affordable. When this is the case, many of us opt not to purchase health insurance for ourselves. We rationalize not purchasing health insurance by telling ourselves there are mouths to feed, bodies to clothe, and other bills to be paid.

Denying ourselves health insurance is not wise; however, denying our kids health insurance is even worse. Kids’ health needs even more attention than our health. For example, kids need immunizations to help them ward off infections and diseases and grow healthy and strong. Kids need special attention to help them learn to practice good dental care habits and nutritional ways of life. Plus, a bout of the flu, which usually means lots of rest and chicken soup for adults, could be much more serious for kids.

Do, how can we find affordable health insurance for our kids especially if we can not seem to afford it for ourselves?

The best option is to contact our state’s department of insurance. Many states in America provide at least one kind of state-sponsored health care program for individuals who can’t otherwise find affordable health insurance. Even better news is that most states in America provide kid-specific state-sponsored health care programs for kids with parents who can’t otherwise find affordable health insurance for them.

Health care provided by state-sponsored affordable health insurance for kids includes all or any combination of the following: regular check-ups and hospital visits, immunizations, X-rays, lab work, prescription medications, and even dental care.

There may be days when obtaining affordable health insurance for yourself seems impossible, but finding kids affordable health insurance is always possible. Just pick up the phone and call your state’s department of insurance. Or, check their Web sites for more information. Find affordable health insurance for your kids; make sure they grow up safe, healthy, and happy.

source: wikipresidency.com

Lupus: When your immune system attacks you

MANILA -- Lupus is an uncommon disease that attacks a person's immune system.

In an interview on radio dzMM's "Magandang Gabi Dok," Dr. Michael Salvador, a rheumatologist, explains what lupus is and how it can be controlled.

An autoimmune disease, systemic lupus erythematosus causes a person's immune system to fight against itself.

"Iyung sarili mong immune system na dapat kumakalaban sa virus, sa sakit, kinakalaban ang sarili mong katawan," he said.

Some of the common symptoms of lupus are rashes that appear on the face and body, falling hair, fever, and mouth sores.

Lupus also causes chronic inflammation in the organs such as the kidneys, lungs, the heart, and even the brain.

"Systemic disease siya, so ibig sabihin lahat ng organs maaring maapektuhan."

According to Salvador, lupus affects women from 15 to 35 years old, with 29 as the most common age.

How it can be detected

The problem with most patients, said Salvador, is that they disregard the sysmptoms, leading to the late detection of the disease.

"Madalas hindi agad nade-detect. Akala nila rashes lang, fever lang, iyun pala lupus na."

Patients have to undergo a blood test and a urinalysis for the disease to be detected.

In some cases, when symptoms are overt, doctors can easily detect the disease.

"Kapag may 'butterfly' rash, o rash na mukhang butterfly sa may mukha, sumasakit ang joints. Tinitingnan din natin kung may singaw sa bibig, symptom ng lupus yun."

However, if internal organs are affected, symptoms may not be physically manifested on the skin.

Salvador added that the cause of the disease remains unknown.

"Marami nang research, maraming studies. May mga findings na maaring genetic ang lupus, maari ding caused by environmental factors like ulraviolet (UV) light, smoking."

There are times that lupus is detected later on in the patient's life, but there are also children aged four or five who have lupus.

There are some factors that trigger the disease, such as exposure to sunlight, viral infections such as colds and flu, as well as stress.

Salvador said symptoms vary from one patient to another and no two lupus patients are alike.

Treatment

Salvador explained that the treatment of lupus depends on the organ severely affected.

"Depende rin kung anong organs ang naapektuhan, doon nakabase ang treatment."

Patients are given high-dose steroids and immunosuppresants.

However, as steroids have many side effects, Salvador explained that they avoid putting a patient on steroids for a prolonged period.

"Kapag mas active ang sakit, mas mataas ang dosage ng steroids. Kapag na-control na ang sakit, binababaan na namin ang dosage."

"Sometimes, the disease activity is so low na hindi na kailangan ng steroids," he added.

Unfortunately, most lupus patients would have to take medication for life.

Salvador reminded people not to be depressed once they are diagnosed with lupus, as the disease has a 90% survival rate.

Myths

There are a lot of myths about lupus, and Salvador clarified that although lupus is a serious disease, it is not very deadly.

It is also different from cancer. It is not contagious as well.

source: www.abs-cbnnews.com

TVs, cars, computers linked to obesity in poor nations

WASHINGTON - In low-income countries, people with cars, televisions and computers at home are far more likely to be obese than people with no such conveniences, researchers said Monday.

Eating more, sitting still and missing out on exercise by driving are all likely reasons why people with these modern-day luxuries could be gaining weight and putting themselves at risk for diabetes, researchers said.

The findings in the Canadian Medical Journal suggest extra caution is needed to prevent health dangers in nations that are adopting a Western lifestyle.

"With increasing uptake of modern-day conveniences -- TVs, cars, computers -- low and middle income countries could see the same obesity and diabetes rates as in high income countries that are the result of too much sitting, less physical activity and increased consumption of calories," said lead author Scott Lear of Simon Fraser University.

"This can lead to potentially devastating societal health care consequences in these countries."

The same relationship did not exist in developed nations, suggesting the harmful effects of these devices on health are already reflected in the high obesity and diabetes rates.

The study included nearly 154,000 adults from 17 countries across the income spectrum, from the United States, Canada and Sweden to China, Iran, India, Bangladesh and Pakistan.

Televisions were the most common electronic device in developing countries -- 78 percent of households had one -- followed by 34 percent that owned a computer and 32 percent with a car.

Just four percent of people in low-income countries had all three, compared to 83 percent of people in high-income countries.

Those that did have electronics were fatter and less active than those that did not.

People with all three were almost a third less active, sat 20 percent more of the time and had a nine-centimeter (3.5 inches) increase in waist circumference, compared to those that owned none of the devices.

The obesity prevalence in developing countries rose from 3.4 percent among those that owned no devices to 14.5 percent for those that owned all three.

In Canada, about 25 percent of the population is obese and in the United States, about 35 percent of people are obese.

"Our findings emphasize the importance of limiting the amount of time spent using household devices, reducing sedentary behavior and encouraging physical activity in the prevention of obesity and diabetes," said the study.  — Agence France-Presse

source: gmanetwork.com

Braces help avoid surgery in teens with scoliosis

NEW YORK - In the first large-scale test of whether wearing a brace helps to prevent an already-curved childhood spine from twisting further, bracing was nearly twice as effective as a watch-and-wait approach at preventing kids from needing corrective surgery.

But the study also found that too many children with scoliosis are being given a brace when they don't need one. Data from the new research may help doctors identify which children need to wear the brace and when it is better to just keep tabs on the child.

The study "really answers the question that parents raise—'If you're going to prescribe a brace for my child, does it work?'" said Dr. Stuart Weinstein, lead author of the study, which was published online by the New England Journal Medicine and reported Thursday at the Scoliosis Research Society's annual meeting in Lyon, France. "The answer is that braces have a very high success rate," he told Reuters Health.

"We also found that the longer the child wore the brace, the more likely you were to achieve success," he said. "Children who wore it more than 13 hours a day had a 90 percent to 93 percent chance of success for avoiding having the curve progressing to a surgical threshold."

The results were so pronounced, the test of 242 youngsters in the U.S. and Canada was halted early.

"It certainly reinforces our present approach to bracing in these at-risk adolescents," Dr. Allan Beebe, an orthopedic specialist at Nationwide Children's Hospital in Columbus, Ohio, who was not connected with the research, told Reuters Health in an email. "This study appears to be better science" than the previous research on bracing.

About 2 to 3 percent of children have some degree of spine curvature, but only 0.3 to 0.5 percent have progressively worsening curves that make them candidates for treatment aimed at avoiding the need for surgery.

Once the spinal curve gets beyond 50 degrees, there's a high risk it will continue worsening into adulthood unless corrected surgically. So treating the problem early is preferable, and less expensive.

Weinstein and his colleagues point out in their report that there were more than 3,600 spinal surgeries to correct adolescent scoliosis in the U.S. in 2009. At a total cost of $514 million, the procedure "ranked second only to appendicitis" for children 10 to 17 years old.

"Bracing has been the standard method of trying to protect patients from needing surgery ever since a brace was developed in the 1940s, said Weinstein, of the University of Iowa. "But it was never really proven if it was effective. There was never a randomized trial where some children were braced and some weren't. The data were inconsistent."

The original plan for the study was to randomly assign some children to a brace and to simply watch others to see whether the curve of the spine became too severe. In either case, progression of the curve to 50 degrees or more indicated that the assigned treatment had not worked.

But many parents had strong feelings about how they wanted their child treated and declined to allow a treatment to be randomly selected for them. So the research team let those parents choose a treatment; 70 percent chose a brace.

"The interesting fact was that when you looked at both the randomized children and those who chose their preference, bracing produced an overwhelming 72 percent success rate when it came to preventing the need for surgery," Weinstein said. The success rate in the observation group was 48 percent.

The success rate among children randomly assigned to bracing was even higher, at 78 percent.

A temperature sensor logged the amount of time the child wore the brace.

"The study provided pretty overwhelming evidence that braces are effective," Weinstein said.

But it was also clear from the results that many bracing treatments are unnecessary.

Nearly half of the participants in the watch-and-wait group during the trial did not have curve progression to the point of needing surgery. The same was true for 41 percent of kids in the bracing group who actually spent very little time wearing their braces.

"We're unnecessarily bracing two patients to get the one patient who actually needs it. We are still overtreating patients," Weinstein said.

A further analysis of the data might prevent some of that unnecessary treatment, he said.

"We will probably, in the next year or so, be analyzing all the factors so we can hone down better who the ideal candidate for bracing is," Weinstein said. — Reuters

source: gmanetwork.com

Take Care When Hiring an Adult Caregiver

When her 90-year-old father wanted to remain active and continue living in his own Los Angeles-area home, Tobi Rosen hired a caregiver with the help of a care manager from the geriatric care management firm LivHome. Rosen says she chose to go with a professional after taking care of her father herself. "Once we hired the caregiver, my dad and I had a better, more rewarding relationship," says Rosen.

Rosen says the agency helped her find the right person to assist with shopping, meal preparation, personal care and transportation. What made it even more rewarding was the relationship that developed between her father and his caregiver.

"They became instant friends, buddies and companions. I know my dad's life was enriched because of his caregiver," she says.

Recent estimates from a Pew Research Center study place the amount of individuals in this country who serve as caregivers for other adults at about 24%. That means nearly one-fourth of adult Americans take care of a parent or other elderly relative or their spouse. The typical family caregiver is a college-educated woman between the ages of 30 and 49, but other demographic distinctions such as income, employment and marital status don't seem to make much of a difference.

As baby boomers age, the number of adults who need some type of assistance will continue to rise. That leaves families facing difficult decisions, such as: Will you (and do you want to) provide this care yourself? Many will choose to hire a caregiver through a geriatric care manager, or GCM, or by finding someone on their own.
Types of Caregivers

Deciding to hire home-based care for an elderly relative is a deeply complex decision based on multiple considerations: your proximity to the relative in question, budget, the care available and personal preferences. But experts say you should also remember that not everyone has the same needs.

Some people require only a little help with housekeeping and transportation. Others need companionship, assistance with medication and help with meals and personal care. Still others must have ongoing medical attention. Although a caregiver's duties will vary from case to case, below are a few of the more common levels of caregiving.

    Housekeeper: Cleans and cares for the home.
    Personal care worker: Keeps house, but also assists with meals and possibly medication reminders. Can help with driving and doctor's visits.
    Certified nursing assistant or home health aide: Provides personal care assistance such as bathing and dressing, administering medications, supervising light exercise and monitoring health.
    Skilled care: Monitors physical condition and assists with physical therapy, wound management and other medical needs.

Where to Look for a Caregiver

Judson Kramer, a Santa Monica, Calif., graphic artist who works part time as a caregiver, started with an agency because he needed the extra money. Kramer stays with it because he likes his clients, though he admits it's taxing.

"The first year to two years were very draining," he says.

Caregiver burnout is a frequent complaint that's also shared by family members. Ruth Johnson, a North Carolina-based newspaper columnist, says both of her elderly parents required help. Johnson chose to take care of one parent on her own, but she hired a caregiver the second time around. Neither solution was perfect, but she says careful applicant screening is essential.

"You've got to have references and check them out," she says. Johnson says she's surprised at how many people hire caregivers without due diligence.

"I've known a lot of caregivers, and it's a revolving door out there. You really have to be careful; it's not a job that always attracts the best people," she says.

Where can you find caregivers? Experts point to these resources:

    Newspaper ads.
    Online job boards such as Care.com.
    Craigslist.
    Word of mouth (try asking around your church, at your job, etc.).
    Your state employment office.
    Temporary job agencies.
    A senior's doctor's office.

The Hiring Process

Experts say once you begin the hiring process you should remember not to divulge personal information about yourself or the potential client until you've thoroughly checked out potential caregivers. Here's a checklist to help in the initial hiring phase and early employment:

    Check applicants' identification -- don't hire anyone who can't give you a valid ID.
    Check references, run a background check and secure a criminal history and driver's record. You can sometimes do this at your local courthouse or pay a small fee to online services.
    Make copies of certifications to keep on hand.
    Talk to the elderly person's insurance company and make sure his or her homeowners insurance will cover the caregiver (for both in-home accidents and driving).
    Put rare art, expensive jewelry, guns and other valuable items in secure storage.
    Have mail diverted from the home to a secure location in order to monitor what's coming in, if necessary. This can protect an elderly person with dementia from scams.
    Keep a tight rein on finances. In particular, prevent access to credit cards and bank accounts.
    Make arrangements for regular consultations with the caregiver, and put a backup plan in position in case the caregiver doesn't work out or can't come in as scheduled.
    Try to include the elderly person in as much of the process as possible.
    Make frequent, unexpected visits to the home or have another person do so.

Hiring a Care Manager

The case for care management can be strong, but it's also costly. Care managers generally charge by the hour and some hourly fees can run upward of $100. However, hiring a manager can ensure higher quality.

Suzanne Modigliani, a GCM in the Boston area, says she starts by assessing a person's needs, then looks for the right person to meet them. "We strive to make a good match and then we troubleshoot case issues," says Modigliani.

The benefits of hiring a GCM are many: The manager or company has a backup system, so if a caregiver can't come in, another can be sent. They check references and backgrounds and supervise the workers. And they handle liability issues.

Bunni Dybnis, a licensed marriage and family therapist who has worked exclusively in the field of aging for the past 20 years and is a member of the National Association of Professional Geriatric Care Managers, says the most important part of hiring a caregiver is to first know what you need.

"Everybody's going to be different, and probably 65 (percent) to 70% of those who need caregivers will have dementia, which brings a whole different light to it," says Dybnis.

Copyright 2013, Bankrate Inc.

source: foxbusiness.com