Archive for Aunt Agatha

Hmm, What Good Is Health Insurance If You Can’t Afford To See A Doc?

queries the NY Times

We. Told. You. So. (I know that’s ugly, but it feels so damn good).

Patricia Wanderlich got insurance through the Affordable Care Act this year, and with good reason: She suffered a brain hemorrhage in 2011, spending weeks in a hospital intensive care unit, and has a second, smaller aneurysm that needs monitoring.

But her new plan has a $6,000 annual deductible, meaning that Ms. Wanderlich, who works part time at a landscaping company outside Chicago, has to pay for most of her medical services up to that amount. She is skipping this year’s brain scan and hoping for the best.

“To spend thousands of dollars just making sure it hasn’t grown?” said Ms. Wanderlich, 61. “I don’t have that money.”

About 7.3 million Americans are enrolled in private coverage through the Affordable Care Act marketplaces, and more than 80 percent qualified for federal subsidies to help with the cost of their monthly premiums. But many are still on the hook for deductibles that can top $5,000 for individuals and $10,000 for families — the trade-off, insurers say, for keeping premiums for the marketplace plans relatively low. The result is that some people — no firm data exists on how many — say they hesitate to use their new insurance because of the high out-of-pocket costs.

Insurers must cover certain preventive services, like immunizations, cholesterol checks and screening for breast and colon cancer, at no cost to the consumer if the provider is in their network. But for other services and items, like prescription drugs, marketplace customers often have to meet their deductible before insurance starts to help.

We solved nothing. We were assured that 30 million people would have health care insurance – real number 7.3 million. And it turns out that a good chunk of those can’t afford to use it at all. We made it worse. And what will the Left want to do next?

Single Payer. Bank on it.

– Aggie

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Obama Cancels Fundraiser!!!

This is a first.

President Obama won’t be traveling to New Jersey and Connecticut later today, as he had been planning to do. There he was going to raise money for Democrats up for reelection in November. Instead, Obama is going to be hosting Cabinet members for a meeting on Ebola.

White House aide Dan Pfeiffer tweets: “Later this afternoon,POTUS will convene a meeting at the White House of cabinet agencies coordinating the government’s Ebola response.”

Why bother, Barry?

– Aggie

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Whoopsie

Ebola patient flew day before reporting symptoms.

Don’t you hate it when that happens?

The second health-care worker diagnosed with Ebola in Texas flew between Cleveland and Dallas hours before she reported symptoms to state health workers, U.S. health officials said today.

The caregiver caught the deadly virus while treating patient Thomas Eric Duncan at Texas Health Presbyterian Hospital in Dallas this month. She flew to Dallas on Frontier Airlines flight 1143 the night of Oct. 13, according to a e-mailed statement by the U.S. Centers for Disease Control and Prevention. She then reported symptoms the next morning.

“Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers,” the agency said. The plane had 132 passengers, the CDC said.

Reaching out, eh? I feel sick just thinking about those poor people.

– Aggie

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White House BS

– Aggie

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Boston Rules.

Giant leap forward in treatment of juvenile diabetes

IN WHAT MAY LEAD to the biggest breakthrough in the treatment of Type 1 diabetes in three decades, Xander University Professor Douglas Melton and colleagues have figured out the complex series of steps necessary to turn stem cells into beta cells. Beta cells are the sugar-sensing, insulin-secreting cells of the pancreas that are missing in Type 1 diabetics, casualties of the body’s own immune attack on itself.

Scientists first discovered in the 1920s that insulin is the necessary substance most diabetics lack. For decades thereafter, physicians purified the protein from animals and injected it into patients as a treatment. In 1978, the gene for human insulin was cloned, says Melton, leading in the early 1980s to what is now a major industry: the production of injectable human insulin. “While there have been continual improvements in the types of insulins—long and short-acting—fundamentally since the 1980s, there have been no advances other than providing insulin to inject into patients,” Melton explains. “This is a kind of life-support for diabetics. It doesn’t cure the disease and leads to devastating and very costly complications…such as heart failure and peripheral neuropathy, and other unpleasant consequences of patients not being able to accurately control their blood sugars or their metabolism.”

“We wanted to replace insulin injections” with “nature’s own solution,” says Melton, who has been a leading scientist in and advocate for the field of stem-cell biology ever since he switched from studying developmental biology in frogs after his young son, and later his daughter, were diagnosed with Type 1 diabetes.

He is now co-director of the Harvard Stem Cell Institute (HSCI) and co-chair of the Harvard department of stem cell and regenerative biology (in the Faculties of Medicine and of Arts and Sciences).

What Melton reports in the journal Cell on October 9 is that his lab, including co-first authors Felicia W. Pagliuca, Jeff Millman, and Mads Gurtler (as well as a Harvard undergraduate and others), have succeeded in developing a procedure for making hundreds of millions of pancreatic beta cells in vitro. These cells, Melton explains, “read the amount of sugar in the blood, and then secrete just the right amount insulin in a way that is so exquisitely accurate that I don’t believe it will ever be reproduced by people injecting insulin or by a pump injecting that insulin.”

The cells share key traits and markers characteristic of beta cells with those from healthy individuals, including the packaging of the insulin they secrete in granules. In diabetic mice, they cure diabetes right away, in fewer than 10 days, Melton reports.

The challenge of creating such cells was described in this magazine in 2004:

Type 1 diabetes, the problem that concerns Melton, is well-suited to stem-cell therapy. It involves a single cell type, the beta cell, that is either missing or present in numbers too low to regulate blood-sugar levels. “If you could place that cell type back into a person [so] that it was not subjected to autoimmune attack, where it could be healthy and thrive, even outside the context of the pancreas, then you could cure diabetes.” One current therapy for Type 1 diabetes — the Edmonton protocol—involves injecting beta cells from three cadavers into a patient’s vein; the cells seed the liver and work from within that organ. But nonsteroidal immunosuppressants are required to control both autoimmune attacks and rejection of the foreign cells by the patient’s body. Nevertheless, a first test of beta cells created through directed differentiation of human [embryonic stem] cells might be to use them in the Edmonton protocol. The next step might be to create a device—beta-cell tissue grown on a synthetic three-dimensional biomatrix—and encapsulate it in a Gore-Tex-like membrane that would allow glucose and insulin, but not immune cells, to pass through.

But the how of creating beta cells from embryonic stem (ES) cells—directing the process of differentiation in either embryonic stem cells or induced pluripotent stem cells (derived from adult cells) to make any specific cell type, for that matter—has eluded scientists for more than a decade. Recapitulating the normal development program in a petri dish has proven extremely complicated, because a protein signal that has a certain effect at one stage of the process—guiding an ES cell to become, for example, one of the embryonic “germ layers” such as endoderm (from which the gut, liver, and pancreas develop)—might have an entirely different effect at a later stage, or in a higher concentration, or within a different environmental niche in the body.

The discovery reported today in Cell was thus not the result of serendipitous biological code-breaking, says Melton, but rather of “hard work.” “What we did to solve this problem is study all the genes that come on and go off during the normal development of a beta cell in mice and in frogs and in the human material that we could get access to. Once we knew which genes come on and go off, we then had to find a way to manipulate their activity…with inducing agents.” Melton and his team tested hundreds of combinations of small chemicals and growth factors before hitting on a six-step procedure in which two or three factors are added at each step, and in which the factor, its concentration, and the duration of its application all mattered.

The result was a scalable differentiation protocol that will be usable in industrial production of beta cells. “We are very excited about this,” Melton says, because “it provides for Type 1 diabetics, in my view, half of the solution to their problem”: victims lack beta cells, and have an immune system that attacks and kills those cells. “So problem one is replacing [beta cells], and these cells are suitable for that kind of replacement” in combination with some kind of immune protection.

Melton thanked not only the 50 or more students who have worked on this problem in his lab during the past 15 years, but also the philanthropists (including the Juvenile Diabetes Research Foundation, the Helmsley Trust, numerous donors to the Harvard Stem Cell Institute, the National Institutes of Health, the JPB Foundation, and Mike and Amy Barry) who supported it, especially during the period when government restrictions made work with human embryonic stem cells nearly impossible.

How soon could a transplant therapy protocol be ready for type 1 diabetics?
“PATIENTS ASK when these cures are coming,” Melton said in a conference call with reporters, “and none of them touch me more than my own children, who ask me that all the time. I would say this. We now know we can make these cells. We have to transfer the protocol to what is called GMP, good manufacturing practice, so that it can be compliant with the very reasonable FDA regulations. So the protocol has to be done with highly purified factors. That is likely to take us about a year. And then…we have to choose the method for Type 1 diabetes that will allow us to put the cells in the patients and protect them from an immune attack.”

While that could be achieved with immunosuppressants, Melton favors an encapsulation device and cited an “encouraging collaboration” with the lab of Daniel Anderson [Goldblith professor of applied biology at MIT’s Koch Institute for Integrative Cancer Research], who has developed a chemically modified alginate that coats and protects islets, clusters of beta cells. Melton estimates that an encapsulation device would be about the size of a credit card.

Elaine Fuchs, Lancefield professor at Rockefeller University and a Howard Hughes Medical Institute Investigator who is not involved in the work, hailed the discovery as “one of the most important advances to date in the stem-cell field, and I join the many people throughout the world in applauding my colleague for this remarkable achievement. For decades, researchers have tried to generate human pancreatic beta cells that could be cultured and passaged long term under conditions where they produce insulin. Melton and his colleagues have now overcome this hurdle and opened the door for drug discovery and transplantation therapy in diabetes.”

Jose Oberholtzer, associate professor of surgery, endocrinology and diabetes, and of bioengineering at the University of Illinois at Chicago, director of its islet and pancreas transplant program and chief of its division of transplantation, said the work described in today’s Cell “will leave a dent in the history of diabetes. Doug Melton has put in a lifetime of hard work in finding a way of generating human islet cells in vitro. He made it. This is a phenomenal accomplishment.”

What the heck, this is so pleasant I just decided to post it all.

– Aggie

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To Find Out What Your Health Care Will Cost, Wait Until After The Election

I am linking this, but it opens with noise.

Those planning to purchase health insurance on the Obamacare exchange will soon find out how much rates have increased — after the Nov. 4 election.

Enrollment on the Healthcare.gov website begins Nov. 15, or 11 days after the midterm vote, and critics who worry about rising premium hikes in 2015 say that’s no coincidence. Last year’s inaugural enrollment period on the health-care exchange began Oct. 1.

The American public is to stupid, I have to say that they deserve this.

– Aggie

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Rampaging, Mostly Black, Youth, Swarm Kosher Deli In Crown Heights

The Brits have bothered to report this Our own media will not. And the police say that it was not a hate crime, despite the fact that the youth were screaming antisemitic slurs.

NBC reports that owners at the deli, which is a kosher establishment, say that teenagers have come in before yelling antisemitic language.
Police say that there is no indication that the incident was a hate crime and they are not investigating it as one.
When police responded to a call from the deli one 23-year-old man reported being assaulted.
Police have observed the surveillance footage but haven’t been able to identify any suspects.
‘I don’t want to think how it could end if it there wasn’t a few people in the store,’said Klein to dnainfo.com.
‘We’re trying to make a living here and it’s very scary to be insecure,’ he said.
Local leaders, including Borough President Eric L. Adams, are planning to hold a news conference today about the attack.

Here’s the video, which is silent:

Whoops. I won’t post it because it begins with a noisy ad. Turn off your sound and go to the link.

And then, ask yourself this. How many of those youth live off the welfare rolls? Perhaps there should be a law that says that if any member of the household is arrested and convicted, the entire household loses welfare benefits. That might stop this savage behavior.

– Aggie

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How Do We Know He’s Obama?

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Barack Obama: The End Of A Love Affair

Where did it go wrong?

I confess, I am posting this only because I love the title in the British newspaper.

Barack Obama romped to the presidency of the United States in 2008 on a tidal wave of ‘hope and change’. Back then, the financial crisis was raging and US troops were still engaged in combat in Iraq and Afghanistan, but a fresh-faced Mr Obama brimmed with confidence.
He predicted that future generations would look back on his election and see the moment “when the rise of the oceans began to slow and our planet began to heal…when we ended a war and secured our nation and restored our image as the last, best hope on earth.”
Six years later, Mr Obama is weary and greyed and finds his job approval ratings stuck in the low-40s. This October is the 17th consecutive month in which polls show that a majority of Americans disapprove of his leadership.
With November’s mid-term elections less than a month away, even fellow Democrats won’t be seen dead with the man who once transformed their party’s fortunes. Apart from some closed-door fundraisers, Mr Obama is all but invisible on the campaign trail.

BTL readers were never sucked into the charisma of the New Messiah at all, so we know where things went wrong. They went wrong when reality asserted herself, as she always does. Did ObamaCare kill the love affair, or was it the IRS scandal? Benghazi? The crappy economy, 11.4% black unemployment, ISIS, the almost unimaginable arrogance of the President himself? Or was it ennui with his posturing? Are we casting about for a new heartthrob? Elvis has left the building.

I don’t know, and don’t much care. Any time you have a youth movement – and the Obama phenomenon was clearly a youth movement – you have incompetence and you also have fantasy objectives. We got off lucky. Russian communism under Lenin was a youth movement as was the Hitler Movement in Germany a couple decades later. The real question is whether or not we’ve bothered to grow up. I doubt it.

– Aggie

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Pity The Poor Teachers

Philadelphia teachers now have to pay $140/month for health insurance

Philadelphia teachers vowed to fight a sudden move by the district Monday that cancels their union contract and forces them to start paying health premiums of as much as $140 a month.

The teachers union, with about 15,000 members, accused the state-led School Reform Commission of ratcheting up its “war on teachers.”

However, district leaders said there was nothing else to cut after years of funding woes that have prompted nearly $1 billion in cuts that includes the loss of 5,000 positions and the closure of 30 schools. Many Philadelphia schools operate without a nurse or librarian on duty.

“If the contract is blown open, what’s going to happen to things that matter to our kids, (such as) student class size?” said Anissa Weinraub, 34, a high school English teacher who has gone through several layoffs and three forced transfers in nine years. “I’m nervous about what else might be imposed.”

Both Superintendent William R. Hite and Philadelphia Federation of Teachers President Jerry Jordan, along with Mayor Michael Nutter, agreed that the problem lies in the state funding formula for education.

“The cuts by the commonwealth over the last few years have had a devastating financial impact on the school district and the quality of education,” Nutter said. “There’s no debate about that.”

Hite nonetheless backed Monday’s decision, saying the money would yield more than $50 million a year for classroom and other needs.

Philadelphia is one of those cities that likes to put it to businesses. The end game of that sort of thing will always be that businesses find another place to be. The folks left behind might not have the resources to pay taxes. And what do the teachers think that ObamaCare did to the business community? So, as you can tell, Gentle Reader, my heart is bleeding all over the keyboard. One hundred and forty dollars a month is a steal.

– Aggie

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Discouraging.

What have we done to ourselves?

– Aggie

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Leon Panetta Sounding An Awful Lot Like BTL

Obama created a power vacuum

See if any of this sounds familiar:

Americans should be braced for a long battle against the brutal terrorist group Islamic State that will test U.S. resolve — and the leadership of the commander in chief, says Leon Panetta, who headed the CIA and then the Pentagon as Al Qaeda was weakened and Osama bin Laden killed.

“I think we’re looking at kind of a 30-year war,” he says, one that will have to extend beyond Islamic State to include emerging threats in Nigeria, Somalia, Yemen, Libya and elsewhere.

In his first interview about his new book, Worthy Fights: A Memoir of Leadership in War and Peace, Panetta argues that decisions made by President Obama over the past three years have made that battle more difficult — an explosive assessment by a respected policymaker of the president he served.

Even before it’s published Tuesday by Penguin Press, the 512-page book has provoked rebukes at the State Department and by Vice President Biden. But Panetta says he was determined to write a book that was “honest,” including his high regard for the president on some fronts and his deep concern about his leadership on others.

In an interview at his home with Capital Download, USA TODAY’s video newsmaker series, Panetta says Obama erred:

By not pushing the Iraqi government harder to allow a residual U.S. force to remain when troops withdrew in 2011, a deal he says could have been negotiated with more effort. That “created a vacuum in terms of the ability of that country to better protect itself, and it’s out of that vacuum that ISIS began to breed.” Islamic State also is known as ISIS and ISIL.

By rejecting the advice of top aides — including Panetta and then-secretary of State Hillary Rodham Clinton — to begin arming Syrian rebels in 2012. If the U.S. had done so, “I do think we would be in a better position to kind of know whether or not there is some moderate element in the rebel forces that are confronting (Syrian President Bashar) Assad.”

By warning Assad not to use chemical weapons against his own people, then failing to act when that “red line” was crossed in 2013. Before ordering airstrikes, Obama said he wanted to seek congressional authorization, which predictably didn’t happen.

The reversal cost the United States credibility then and is complicating efforts to enlist international allies now to join a coalition against the Islamic State, Panetta says. “There’s a little question mark to, is the United States going to stick this out? Is the United States going to be there when we need them?”

Showing leadership in the fight against ISIS is an opportunity “to repair the damage,” he says. He says it’s also a chance for Obama to get a fresh start after having “lost his way.”

Panetta’s behind-the-scenes account of events during Obama’s first term, including the internal debate over helping Syrian rebels, is consistent with those in memoirs published this year by Hillary Clinton and Robert Gates, whom Panetta succeeded as Defense secretary.

Keep in mind that this guy was head of CIA, head of defense, and likes Obama. And he still sounds like BTL. So I’m taking a victory lap. It would have been better to have been wrong about this dufus, but second best is being right and mocking all the liberals who still refuse to face reality.

– Aggie

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