By Scott Hensley

It's taken as self-evident that catching a disease early is always better than finding out about it late. But that dogma can be dead-wrong, according to an analysis of data on prostate cancer and the blood test used to screen for the disease.

A PSA test can detect a prostate cancer like this one, but it can't tell which form it is. As a result, physicians order treatment that's unneccessary, but with considerable side effects. (Visuals Unlimited/Corbis)

Widespread use of the PSA test in the U.S. began in 1986, and since then, it's led to the diagnosis of prostate cancer in 1.3 million men. The biggest jump in diagnosis occurred in men younger than 50, and more than 1 million were treated for the illness.

Problem is the "vast majority of these additional men did not benefit from early detection," according to the analysis published in the current Journal of the National Cancer Institute.

In other words, despite the 1.3 million diagnoses, only 56,000 deaths were averted.

Huh? The conundrum for screening is that so many prostate cancers detected by PSA never pose a health problem because they grow so slowly. A man dies of something else first. The most deadly forms of prostate cancer can progress so rapidly that even a positive PSA test doesn't necessarily help.

Continue reading "Study: Prostate Cancer Test Leads To Overtreatment" >

By April Fulton

As the new school year begins and efforts to slow the spread of H1N1 are ramping up, CDC is trying to make the messages fun but effective. It just named the top ten finalists in its public contest for the best flu prevention PSA. There are some pretty creative entries.

Don't want to wash your hands? Try going to the bathroom in a hazmat suit like this guy.

Another entry suggests touching your mouth without washing your hands is akin to giving a cat a good scratch with a toothbrush that has just cleaned an ATM keypad and a car door handle. This to the strains of a Bach concerto, no less.

Continue reading "Fight-The-Flu Contest Finds Funnybone" >

By Scott Hensley

Cardiologists from around the world have descended on Barcelona for Europe's biggest meeting on heart disease. There have been lots of headlines about two new drugs to prevent blood clots.

Heart attack prevention remains a challenge. (iStockphoto.com)

But we were struck by comments at a kickoff press conference from Roberto Ferrari, president of the European Society of Cardiology, who said advances in heart treatments account for seven of the 10 years of additional life that adults today can expect compared with folks 30 or 40 years ago.

He threw down the gauntlet for his cancer colleagues, whose work, he said, has added only 2.4 months of life over the same period. "In cardiology, we have been extremely good," he bragged. "It is now difficult to die from a myocardial infarction," or a heart attack. He told MedPage Today his claims are based on published data.

Continue reading "Heart Doctors Want Credit For Your Health" >

By Scott Hensley

Hey, Alvaro Uribe, next time you feel the flu bug coming on, you might consider Skype instead of rubbing your infected shoulders with those of other world leaders.

Colombia's Uribe talks to the press in Argentina. (Daniel Garcia/Getty Images)

Colombian President Uribe started feeling sick on Friday just as a summit of South American presidents was getting rolling in Argentina, the Associated Press reported. "During a public event on Saturday, he was sneezing and had a fever and aching muscle," says the Guardian.

On Sunday, after he got home, the 57-year-old was a confirmed swine flu case. Colombia's foreign ministry is calling leaders in other countries who came into contact with Uribe. At the meeting he defended his country's increasingly close military ties with the US.

Continue reading "Colombia's Uribe Falls Ill With Swine Flu" >

By Scott Hensley

It's time for President Obama to reveal his health cards, say some longtime supporters and even a few Republicans.

Obama returns from vacation to find health-care overhaul stalled. (Mandel Ngan/Getty Images)

A key Senate committee's failure to produce a health bill before the August recess, an onslaught of criticism at town hall meetings and slipping poll numbers have put in peril the president's goal of remaking the nation's health-care system.

What's a president to do? Propose his own legislation instead of standing back and cheering on Democratic proxies. "Obama's approval numbers would jump 10 points if Americans knew he was fully in charge," writes Bob Dole, retired Republican senator, in the Washington Post. If Obama introduces an explicit proposal of his own, Dole expects a few Republicans might even support planks of the plan.

Continue reading "Showtime For Health Care" >

By Joanne Silberner

Depression doesn't carry the stigma it once did, but it is still tough to get people to talk openly about their personal experiences.

Depression hurts, and it's still hard for families to talk about. (iStockphoto.com)

I've been doing stories on mental illness for 15 years. When I started, very few people wanted to talk to a radio reporter about it. It's hard to be anonymous on the radio -- even if we change a name, which we only do under limited circumstances and with full disclosure -- the voice is still recognizable.

Back then, many people didn't want to talk about depression because they saw it as a weakness, not an illness.

Continue reading "Depression And Families' Fear Of Being Labeled" >

By Scott Hensley

It has come to this: you'll probably have to run a genetic test on the seafood special to make sure the fish you ordered is the fish you got.

They sure look like red snapper. (Justin Sullivan / Getty Images)

Restaurants all over the country are substituting cheaper fish, like catfish, for more expensive species like grouper and red snapper. But the sneaky chefs are no match for Mahmood Shivji, a conservation biologist at the Guy Harvey Research Institute in Fort Lauderdale, Fla.

He's used DNA tests to identify the fish in 150 samples from across the country and discovered bait-and-switch menus are common. Only one of 15 samples of fish billed as red snapper at Kansas City restaurants was legit, he tells NPR's Robert Siegel on Friday's All Things Considered.

Continue reading "Fish Detective Busts Restaurant Switcharoos" >

By Julie Rovner

The deaths of Senator Edward Kennedy this week and his sister Eunice Shriver two weeks earlier have brought floods of stories about their work helping people in all walks of life. But less attention has been paid to their devotion to animals.

Sen. Edward Kennedy walking to a press briefing with Splash in 2001. (Alex Wong/Getty Images)

I can attest to the latter personally. I, like many Capitol Hill reporters, was the target of quite a few saliva-laden tennis balls courtesy of Splash, the senator's Portuguese Water Dog and a fixture at news conferences and briefings in Kennedy's hideaway office.

As a child I remember visiting Timberlawn, then the Shriver estate in Montgomery Country Maryland. It was crawling with dogs and horses--right in the middle of North Bethesda. I couldn't have been more jealous of Maria, about a year my senior, because she had her own pony basically in her backyard.

Continue reading "Kennedy Legacy Extends To Animals, Too" >

By Scott Hensley

Seems like Americans are waking up to swine flu's likely return. Sort of.

Ready for H1N1? (CDC)

A third of people think swine flu will infect them or family members, compared with just one in five who felt that way in May, says a USA Today/Gallup poll conducted Wednesday.

Most people--55 percent--now say they'll get immunized once a vaccine is available, up 9 percent from a few months ago.

Still, the public perceptions are at odds with government projections of the risks--as many as half of Americans could come down with swine flu this fall and winter. Some 1.8 million may need hospital care.

Continue reading "Americans Worry More About Swine Flu" >

By Scott Hensley

A creepy crawley critter in your basement or proposals to overhaul health care can be downright frightening.

Joseph LeDoux (left) and the Amygdaloids.(William Chang)

And as NPR's Julie Rovner reports, opponents have been using scare tactics to fight changes to the American health-care system for just about as long as people have been trying to give it a makeover.

It turns out the foes of change are pretty smart because fear works. "Once fear is aroused and in your brain, it tends to take over and dominate," explains Joseph LeDoux, a New York University neuroscientist. It's also contagious.

But LeDoux, who's written tons of academic papers and several books on how the brain works, has his own viral way of spreading the science of the brain: rock music. He leads a band called the Amygdaloids, named for the almond-shaped region of the brain instrumental in the fear response.

The group of New York University researchers specializes in a genre they've dubbed "Heavy Mental," and has even played Madison Square Garden. OK, so it was for an NYU graduation ceremony. Still, pretty impressive.

Continue reading "Fear Factor: Don't Let NYU Prof Scare You" >

By Scott Hensley

A key concession made by House negotiators to persuade conservative Democrats to support a public option as part of health overhaul is in jeopardy.

Sometimes mistaken for a health co-op. (iStockphoto.com)

Rep. Pete Stark (D-Calif.) wants the government to use Medicare rates to pay doctors and hospitals under a government-sponsored insurance alternative. That could scotch an agreement with so-called Blue Dog Democrats, who pushed for the feds to negotiate how much health-care providers would be paid by a public plan.

"I think most of us agree that we pay too much to providers now," Stark told reporters on a conference call, according to a report by Modern Healthcare. Doctors and hospitals probably wouldn't, having argued for a long time that Medicare is too stingy.

Continue reading "House Dems Want Medicare Rates For Public Plan" >

By Scott Hensley

Four years after Hurricane Katrina unleashed furious flooding on New Orleans, we get an in-depth reconstruction of the fateful decisions made at a hospital cut off during the storm's aftermath.

With power out and rescuers slow in coming, doctors and nurses at Memorial Medical Center struggled to care for patients, many of them on ventilators. Forty-five patients died. Questions remain about the responsibility health-care workers had in the deaths of some patients who received injections of morphine and sedatives.

Did cancer surgeon Anna Maria Pou go too far, hastening the death of four patients, or was she seeking to relieve their suffering? In 2007, a grand jury declined to indict her and two nurses on murder charges brought by a local prosecutor.

Pro Publica reporter Sheri Fink, a physician, explores the controversial events in a piece being published in Sunday's New York Times Magazine and available online now. In the video below, she talks about why the story still matters.

Continue reading "Hard Choices At New Orleans Hospital After Katrina" >

By Scott Hensley

Lots more rumbling about swine flu today.

Back to school with swine flu. (CDC)

It's the first week of school at Texas Christian University in Fort Worth, and more than three dozen students have come down with flu-like symptoms. Ten people were found to have swine flu and got treated with Tamiflu, the university said the other day.

Classes go on at the 8,700-student institution. "So far, flu cases are mild and most students are recovering within two to four days of illness onset," TCU said on a swine flu page recently added to its Web site.

Continue reading "Swine Flu Hits Texas Christian Univ., New Zealand " >

By Richard Knox

In his full-bore battle against brain cancer, Sen. Edward M. Kennedy resorted to treatment many consider experimental -- proton beam radiation therapy.

Sen. Kennedy returns to Senate last year after treatment for brain cancer. (Alex Wong/Getty Images)

Medicare pays for it. But his death leaves open a slew of questions about the costly treatment, which delivers high doses of radiation to tumor cells while largely sparing healthy tissue from damage.

Did it do him any good? Should Medicare (or private insurers) pay for the unproven treatment? And most politically fraught, should Kennedy's legacy issue -- universal health care -- include a mechanism for sorting out what new treatments are worth paying for, and when?

Continue reading "When Is Proton Beam Therapy Worthwhile?" >

By Scott Hensley

If you ask around, you'll probably find that most people you know have had an X-ray, CT scan or other test that exposed them to radiation in the last few years.

(CarbonNYC/Flickr)

Some researchers crunched numbers from insurance claims during a three-year period ending in 2007 and determined more than two-thirds of people had at least one scan involving radiation, and they didn't even count dental X-rays.

That's a lot of scans and, potentially, a lot of radiation, which boosts the risk of cancer over time. Factor in the doses, and about 4 million people between 18 and 64 are exposed to "high" or "very high" levels of radiation each year, the authors of the study published in current New England Journal of Medicine conclude.

Continue reading "Heart Stress Tests Pump Up Radiation Dose" >

By Scott Hensley

Price cuts weren't enough to persuade Britain's arbiter of medical treatments to recommend coverage for some expensive new medicines for kidney cancer by the country's health service.

(Wikimedia Commons)

The UK's National Institute for Health and Clinical Excellence, concluded the evidence of patient benefit wasn't strong enough to justify the expense of Bayer's Nexavar, Wyeth's Torisel and Roche's Avastin, or to expanding coverage for Pfizer's Sutent as a back-up when other kidney cancer treatments fail. The makers of the drugs had appealed an earlier decision that went against them.

NICE is sometimes held up as an example of how the US might approach the systematic evaluation of new treatments to decide which ones are worth paying for--and which aren't. But critics of NICE, as well as its general approach, fault the decisions as bureaucratic rationing that fails to adequately consider the desires of individual patients.

Continue reading "UK's Health Service Restricts Kidney Cancer Drugs" >

By Scott Hensley

With the federal deficit already measured in the trillions of dollars, it's not easy to grab people's attention with projections of deeper red ink.

Budget director Orszag testifies at a June hearing. (Mark Wilson/Getty Images)

But then came a White House forecast Tuesday that said the budget shortfall over the next decade is expected to top $9 trillion, nearly $2 trillion more than a prediction made earlier this year.

Right now the government is borrowing a ton to repair the country's financial system and to stimulate the economy. Tax revenue is also way down. But increases in spending on health loom large in the years to come.

Continue reading "Health Care: The Ultimate Budget Buster" >

By Julie Rovner

Sen. Kennedy presides over confirmation hearing for HHS Secretary Sebelius in March. (Chip Somodevilla / Getty Images)

With the death of Senator Edward Kennedy, there's the obvious question of who will fill what was known for six decades in Massachusetts as the "Kennedy seat."

But when it comes to health policy, the more pressing question may be who takes over for him as chair of one of the pivotal panels in the Senate -- the Health, Education, Labor and Pensions Committee?

That's the platform Kennedy used to launch bills to prevent and treat AIDS and HIV; to boost education funding, and to protect the rights of those with disabilities, among dozens and dozens of others.

Continue reading "Who Will Assume Kennedy's Health Role In Senate?" >

By Scott Hensley

Sen. Edward M. Kennedy of Massachusetts succumbed to brain cancer Tuesday night.

Click on the image for a timeline of Kennedy's life. (Saul Loeb / Getty Images)

The 77-year-old legislative giant died just as his great hope for an expansion of health care to serve all Americans is as close to being realized as at any point in his long life.

Kennedy called universal, decent-quality health care for Americans "the cause of my life." Just a month ago, writing in Newsweek, he affirmed his belief that "quality care shouldn't depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to."

Continue reading "Kennedy Dies; Universal Care Dream Lives On" >

By Scott Hensley

Your already expensive health coverage is about to get even more costly.

(iStockphoto.com)

Big insurers surveyed by Aon Consulting figure the cost of health coverage provided by employers will rise more than 10 percent between spring of this year and next.

Your boss might make you pay more to get coverage, reduce your benefits or dole out a smaller raise (if anybody even gets those anymore).

Continue reading "Employer Health Insurance Costs Keep Rising" >

By Scott Hensley

It's a real challenge developing better drugs for loads of common conditions because there are already so many effective treatments.

Active or inert? (iStockphoto.com)

But another problem that might surprise you is that placebos, the dummy pills that are the gold standard for comparison in drug studies, seem to be getting more powerful. A provocative piece in Wired describes the evolving science behind placebos and the relatively recent finding that patients' response to sugar pills in many studies appears stronger than it used to be.

Psychiatrist and drug researcher William Potter, now at Merck, found that antidepressants, including Prozac, were more likely to fail when compared to placebos in trials conducted recently than in studies a decade earlier. Results also varied by location and according to doctors' subjective interpretation of supposedly standardized measures of response.

Continue reading "Placebo Power Grows, Perplexing Big Pharma" >

By Scott Hensley

Make room, salt and cholesterol, sugar is now an official bad guy for your heart.

Skip soda to help your heart.(Justin Sullivan/Getty Images)

The American Heart Association says it's time to say no to your sweet tooth and cut your sugar intake. For most women, no more than 100 calories a day should come from sugar added to food and drink, about six teaspoons. For men, the heart experts recommend no more than 150 calories a day, about nine teaspoons. Right now, the average American consumes a little over 22 teaspoons of added sugar a day.

The thinking behind the recommendations, published online Monday, boils down to simple arithmetic. Americans are taking in 150 to 300 more calories a day than they did 30 years ago. We're not doing more to burn those calories, so it's pretty likely that extra sugar is at least part of the reason Americans are so much fatter today, the AHA concludes.

Continue reading "Sugar Elbows On To Heart Health Hit List" >

By Richard Knox

Federal health officials are unsettled. They're losing sleep over what swine flu might do this fall. But most Americans wonder what all the fuss is about.

This little bug has federal officials worried. (CDC)

What keeps Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, up at night? "Are we prepared if we have to surge up our ventilator capacity," he answered during a meeting with journalists at the CDC headquarters in Atlanta Monday.

Some of President Obama's top science advisers told him this month that half (or more) of the nation's mechanical ventilators may be needed by young flu victims. As many as 1.8 million Americans may be hospitalized because of the H1N1 virus. Some 300,000 patients may need intensive care, putting a strain on a limited hospital resource.

But ordinary Americans aren't staying up nights worrying about the pandemic.

Continue reading "Swine Flu, Complacency And Sleepless Nights" >

By Scott Hensley

If you can't get enough controversy over the government's role in end-of-life planning, there's a new brouhaha. The Department of Veterans Affairs is being criticized for a booklet that aims to help vets come up with a living will.

Cover shot of VA handbook.

NPR's Joe Shapiro reports on Monday's All Things Considered that some veterans seem to support the effort nonetheless. "It's a tempest in a teapot as far as I'm concerned, personally," says Dave Autry, a spokesman for the group Disabled American Veterans, meeting in Denver now.

The VA booklet, "Your Life, Your Choices," was still available online when we checked this afternoon. One of the controversial parts is a checklist on page 21 that asks people to rate how they would feel about living in a wheelchair, being unable to recognize friends and family, and unable to "shake the blues."

Continue reading "VA Catches Flak For End-Of-Life Guide" >

By Scott Hensley

These days just about everyone says data should drive decisions in health care. Results would be better and costs might just be lower.

What to do for an aching back? (iStockphoto.com )

Take, for instance, Joshua Hirsch, an interventional radiologist at Massachusetts General Hospital who tells the Boston Globe, "I bow at the altar of evidence-based medicine."

Yet, he still recommends vertebroplasty, an injection of glue to relieve pain from cracked backbones, despite recent studies that showed the minimally invasive procedure was no better than a shot of Novocain.

Continue reading "Who Says How Much Evidence Is Enough?" >

By Scott Hensley

In the demimonde of health wonks, there's a special place for Paul Starr, the Princeton academic whose history of the American health system more than 25 years ago still seems fresh today.

Is health overhaul a "gateway drug" to government domination? (/kallu/Flickr)

Over the weekend, Starr brought some historical perspective to the current debate over health overhaul to NPR's On The Media. Opposition to some form of universal health coverage for American is as old as efforts to make it happen.

Around World War I, the plans foundered as opponents murmuring about an association with Germany, Starr tells On The Media co-host Bob Garfield. FDR chose to skip universal coverage as part of the package that created Social Security rather than do battle with the American Medical Association.

Then, there's an embalmed Lenin, who opponents trotted out to torpedo President Truman's push for national health insurance in 1945.

Continue reading "The Scary History Of Failed Health Overhauls" >

By Allison Aubrey

Stop jogging and start sprinting--for a few seconds. ( John Poole/NPR)

I was getting bored with my tired old morning jog. My pace was slow and steady. And, perhaps most boring of all, I didn't seem to be getting any fitter, despite sticking to my running routine.

Now I've figured out why. I needed to add a little sprinting to the mix. On Monday's Morning Edition, I look at the science behind interval training.

Interval training has been the buzz for a while now, but I'd always pooh-poohed it. After all, I'm not looking to make the track team. Why bother with the fast stuff?

Continue reading "Running Hard, But For Just A Few Seconds" >

By Scott Hensley

Take a look way back in the corner of a town hall meeting on health overhaul and you might just find someone who works for an insurance company.

Pick me. (iStockphoto.com)

Thousands of insurance workers, some armed with tips from a trade group, have been trooping to the meetings to politely make the case for their beleaguered industry.

Maybe that's why we hadn't noticed them until the Wall Street Journal wrote about them today.

Take Lary Loew of Wheeling, W.Va., who turned out for Rep. Alan Mollohan's (D., W.Va.) meeting there a little over a week ago. Loew runs an employee benefits company in town and told the Journal he showed up because "my whole industry is being threatened."

Continue reading "Insurance Workers Pipe Up At Town Halls" >

By Scott Hensley

We remember lo those many years ago when a New England governor, who was also a doctor, started making noise about running for president and improving health care.

Howard Dean has high hopes for health care. (Win McNamee/Getty Images )

Howard Dean made it the top of the Democratic Party, though he never got to live at 1600 Pennsylvania Avenue. Still, the former Vermont governor can't stop talking about health care. He's even got a book out on the subject.

These days he's on the stump to save the public option, a government-sponsored health plan that the administration wavered on then seems to have embraced again--maybe.

Why does the country need a public alternative? "The fact is that only Medicare has controlled costs better than the private sector," Dean tells All Things Considered's Robert Siegel on Friday. "Now Medicare doesn't do a terribly great job of controlling costs, but they do a much better job than private health insurance does."

Continue reading "Howard Dean Stumps For The Public Option" >

A little dab of painkilling ibuprofen will not do you.

That better not have any ibuprofen in it. (iStockphoto.com)

We've didn't even know you could rub the medicine on a sore spot, but evidently a bunch of companies have been making mixtures of ibuprofen and other ingredients for use on the skin.

Only problem is the Food and Drug Administration never said that was OK. So the agency warned eight companies they're out of line for selling the topical ibuprofen and told them to stop.

Continue reading "FDA Nixes Ibuprofen Creams" >

By Scott Hensley

South African runner Caster Semenya celebrates victory. (Olivier Morin/ AFP/Getty Images)

A victory that should have brought unalloyed joy to South African runner Caster Semenya has been marred by doubts about her gender.

She trounced the competition to win the 800-meter race at the World Athletics Championship in Berlin Wednesday. But is the 18-year-old a woman?

Her family says the accusations by rivals are ludicrous. But the International Association of Athletic Federations has asked Semenya to be tested, and the results may take months, the Los Angeles Times reports. A group of specialists will assess Semenya, the BBC reports, with the tests going far beyond a simple genetic check.

Suspicions fueled by Semenya's appearance and athletic performance have dogged her for years. A principal at a school she attended told the Star of South Africa, "Some schools, suspecting that she was not a girl, even demanded that her status be checked. But each time they returned from the toilet, she would be cleared and the competition would resume."

Continue reading "Gender Questions Hover Over Champion Runner" >

By Richard Knox

With August waning and an expected resurgence of swine flu on the horizon, health officials from developing countries are meeting in Beijing today. They're deeply worried about the next phase of the flu pandemic, judging from an Associated Press report.

How often will this happen for swine flu?(iStockphoto.com)

The WHO's director for the Western Pacific region, Dr. Shin Young-soo, told the Beijing meeting that soon many countries will see cases of swine flu double every three to four days for several months. "At a certain point, there will seem to be an explosion in case numbers," Shin says.

The most urgent problem is the paucity of swine flu vaccine for developing countries, says Dr. Keiji Fukuda, the World Health Organization's flu chief. The WHO convened the Beijing meeting.

Continue reading "Swine Flu Vaccine Shortage Looms For Developing World" >

If you ever wondered what difference a system of electronic medical records might make in everyday care, stop at Chicago's Mount Sinai Hospital as Vice President Joe Biden did yesterday.

Click here for $1.2 billion in aid for computerized records. (Scott Olson/Getty Images)

A trauma nurse at the hospital told Biden (pictured) she and the doctors there commonly check patients for scars to piece together medical histories because accessing records quickly is difficult or impossible, the Chicago Tribune reports.

A scar might tell them the patient has had an appendectomy. But nobody thinks this is right way to run a hospital, and the nurse welcomed the $1.2 billion in federal funds for modernizing record keeping that Biden said will become available in 2010. "We become people who put puzzles together," she said. "We need this to communicate."

Continue reading "Without Medical Records, Scars Reveal Patients' Histories" >

By Scott Hensley

The insurance industry has become the beleaguered bogeyman of health overhaul. But would the changes proposed so far be so bad for the companies?

WellPoint CEO Angela Braly (WellPoint)

Sure, insurers have resisted a government-sponsored health option that the Obama administration has advanced as a way to keep costs down and competition up. Karen Ignagni, head of the trade group America's Health Insurance Plans, told All Things Considered's Robert Siegel the other day that a government plan could become just another way to shift costs to those with private insurance.

Lately the odds seem dim a public option will become reality, while measures that would extend insurance coverage to tens of millions of people are going strong. AHIP says it supports universal coverage, including a personal mandate to make sure everyone buys in.

Sounds like good business, right? That's what Morning Edition co-host Steve Inskeep asks Angela Braly, CEO of WellPoint, the largest private insurer as measured by the number of people it covers. Actually, in search of an answer, he puts the question to her again and again.

Continue reading "Could Health Overhaul Be Insurers' Windfall?" >

By Scott Hensley

Forget car exhaust, power plant smokestacks and factory fumes. You may be polluting your own home by burning candles.

Hazardous to your health? (iStockphoto.com)

The neighborhood around NPR HQ in Washington is crawling with chemists attending a big meeting of the American Chemical Society this week, and we lured two of them over to our cubicle to talk about their fascination with burning candles in the lab.

Ruhullah Massoudi, a chemistry professor at South Carolina State University, and undergrad Amid Hamidi found that candles made with paraffin, a waxy ingredient derived from petroleum, gave off a variety of nasty chemicals, including toluene, alkanes (think propane, methane and stuff like that), and alkenes (like the alkanes but with at least a double bond thrown in).

Sorry for the walk down organic chemistry lane but being around all these chemists rubbed off on us.

Continue reading "Candlelight, Toluene And You" >

By Scott Hensley

Chicago politics has always been a contact sport.

But even congressional tough guy Dan Rostenkowski, the Windy City pol who ruled the powerful House Ways and Means Committee for years, didn't know what hit him two decades ago, when irate senior citizens descended upon his car after a town hall meeting to discuss a law that made some of the biggest changes to Medicare since it was established in 1965.

Some hold up the historic confrontation as a cautionary tale for the Obama administration and congressional Democrats seeking to remake health care. Another take, the public won't support change that involves too many compromises.

Continue reading "Golden Oldie: Seniors Protest Health Overhaul In 1989" >

By Scott Hensley

Sen. Ted Kennedy makes plans for a successor. (Saul Loeb/Getty Images)

For President Obama to pull off a health overhaul, he's going to need every vote he can get in the Senate. And no vote would mean more than one cast by Ted Kennedy, the Massachusetts Democrat who has been the acknowledged master of health policy in the august chamber for decades.

Kennedy, ailing with brain cancer, is trying to make sure that if he's not around to vote for Obama's plan someone else will be.

The Boston Globe reports Kennedy sent a letter to Massachusetts Governor Deval Patrick and leaders of the state legislature asking them to change a 2004 law that would leave the seat empty, in the event of his death, until a special election can be held.

Continue reading "Kennedy Seeks Quick Senate Replacement" >

By Joseph Shapiro

Life expectancy in the United States has reached an all-time high: 77.9 years. But before you celebrate, consider this: People in more than two dozen countries claim a longer life expectancy than us.

The new statistics come from the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. Men now have a life expectancy of 75.3 years. For women, it's 80.4 years.

The numbers are for the year 2007, and are based on 90 percent of death certificates in the United States.

Continue reading "U.S. Life Expectancy Hits Record High" >

Can't the politicians just get along? Americans are cranky about the lack of cooperation between the president and Republican leadership, according to poll data just out from the Pew Research Center for the People & the Press.

Survey says. (iStockphoto.com)

Some 63 percent of Americans think President Barack Obama and GOP leaders aren't getting the job done when it comes to working together on the nation's biggest problems, according to a survey conducted during the week ending August 17. In June, only 50 percent thought the two camps weren't cooperating.

Health care overhaul a problem? Could be. Overall, the Pew data show that 39 percent of Americans would be pleased or happy if proposals from Obama and Congress became law, about neck and neck with the 40 percent who would be disappointed or angry about that outcome.

Continue reading "Americans See Parties Deadlocked On Big Issues" >

By Joanne Silberner

There's one thing no one can accuse the government of doing: neglecting swine flu.

Stay out of my cubicle. (CDC)

Last week the administration issued guidelines for how schools should deal with the likely imminent return of the H1N1 virus. Now the feds have released guidelines for businesses. Coming soon: advice for colleges and universities.

One of the tips for employers is to ease up on sick-leave rules. Employees shouldn't feel that taking sick days will cost them their jobs.

Continue reading "On-The-Job Advice For Swine Flu" >

By Scott Hensley

If you thought Democrats have put health insurers in a bad light lately, just wait until the industry responds to letters from Reps. Henry Waxman (D-Calif.) and Bart Stupak (D-Mich.).

Rep. Waxman wants answers. (Saul Loeb/Getty Images)

The congressmen want to know which insurance company execs are making more than $500,000 a year, all sorts of details about their compensation and how it's determined, and what the companies are spending on conferences and retreats.

Remember all the fun AIG had explaining its spending after taking billions of dollars in a federal bailout?

The Wall Street Journal reported on the letters and posted a copy of one here.

Continue reading "Congressmen Want Info On Insurers' Spending On Exec Pay, Retreats" >

By Scott Hensley

We may have a new benchmark for raucousness at congressional town hall meetings.

Rep. Frank faces tough town hall. (Associated Press)

Rep. Barney Frank, the loquacious Massachusetts Democrat, faced a very tough crowd at a senior center in the coastal town of Dartmouth Tuesday.

A flash point came when some in the crowd compared President Obama's plans for health overhaul to something from the Nazi era, complete with posters showing President Obama with a Hitler-style mustache.

"On what planet do you spend most of your time?" Frank asked a woman, who wanted Frank to explain his support for what she called a Nazi policy, the Associated Press reported. "Ma'am, trying to have a conversation with you would be like trying to argue with a dining room table. I have no interest in doing it."

Listen to the question and Frank's tart response:

Continue reading "Barney Frank Unleashed At Town Hall" >

By Scott Hensley

Senator Chuck Grassley is chasing ghosts.

Any NIH funds back there? ( piccadillywilson/Flickr)

The Iowa Republican, who's been a bulldog on conflicts of interest in academic medicine, has asked the National Institutes of Health to tell him what it's doing about ghostwriting by NIH-funded researchers. You can read the letter, obtained by NPR, here.

The New York Times reports again this morning on the common practice of drugmakers arranging for the publication of favorable articles in medical journals under the names of prominent doctors. Companies paid by drugmakers draft the articles, find willing doctors to lend their names and prestige, and then submit them to journals. The financial arrangements often remain hidden.

Continue reading "Grassley Presses NIH On Drug Company Ghostwriting" >

We haven't had a discussion with our family doctor about end-of-life planning. But if he were half as soothing as David Casarett, a palliative medicine specialist who talked Tuesday with All Things Considered's Melissa Block, maybe we wouldn't mind.

Dr. David Casarett

How does one of these chats get started? No scary death panel to confront. "Usually I try to begin these conversations by talking about patients' hopes and fears," Casarett explains. "What's important to people? What they would like their future to look like? What they're afraid of? What they'd like to avoid?"

So what about all this death panel talk and the notion that health overhaul would put the government into the euthanasia business? Casarett says he's "still mystified" that allowing Medicare to pay for end-of-life counseling somehow got twisted into death panels deciding when to pull the plug.

Continue reading "A Chat Now Could Mean More Control At Life's End" >

By Scott Hensley

When it comes to health-care safety nets, one of the oldest and leakiest is COBRA, the 1986 law that allows workers to continue their employer-sponsored health insurance for a while after they leave their companies.

COBRA subsidies take a bite out of costs. (Adek Berry/Getty Images)

But there has been a big catch--the price. Historically, COBRA has required people pay the full premium for the coverage plus a 2 percent administrative fee. Somebody who just lost a job isn't likely to have oodles of spare cash to do that.

Enter the federal stimulus package, which starting on February 17, added a 65% government subsidy for COBRA coverage for laid-off workers. More than 14 million people are eligible for the sweetened benefit, and lots of them are using it, according to an analysis by Hewitt Associates, the human resources consultants.

Continue reading "COBRA Jumps After Subsidies Kick In" >

By Scott Hensley

If you think health-care overhaul is hopelessly complicated, maybe a flowchart will help.

A blueprint for what the proposed changes to the health system would mean for you was laid out by The Nation's Washington editor Chris Hayes during a Q&A session at a recent Netroots Nation conference.

Then Nicholas Beaudrot, blogging at Donkeylicious, turned Hayes's rat-tat-tat breakdown into a graphic. Click on the snapshot image or here to see an enlarged version that you can actually read.

A picture of health--overhauled. (niq77174/Flickr)

We've got our own nifty guide to what the overhaul might mean for you. Check out the interactive package from NPR's Richard Knox to step through the options.

Continue reading "Health Overhaul Boiled Down To A Flowchart" >

By Scott Hensley

If you were thinking about writing the White House to report some cockamamie criticism of Obama's plans for health overhaul, you may need to update your address book.

(iStockphoto.com)

The Wall Street Journal reports the administration deep-sixed a controversial email account to collect tips on disinformation about health reform.

In a blog post early this month, the White House said the mailbox was established because it just couldn't keep track of all the rumors. "If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov," the post advised.

Continue reading "White House Shutters Email Tip Box" >

By Richard Knox

What killed Wolfgang Amadeus Mozart at the age of 35?

German stamp marking 200th anniversary of Mozart's death. (Wikimedia Commons )

Historians and medical experts have debated the question for nearly 218 years. A European group now has evidence the prodigious composer was the victim of a strep outbreak.

The researchers looked at causes of death in Vienna in the winter of 1791 -- Mozart died on December 5 of that year -- and during the same period in the adjacent years.

In the year of Mozart's death, there was a sudden spike in deaths from edema, or abnormal fluid buildup. At the time, about a quarter of the deaths in younger Viennese men were from this cause.

Continue reading "Strep Infection May Have Felled Mozart" >

By Joe Neel

Washington isn't a swamp. It's a schoolyard. And the House GOP leader is accusing another powerful Republican of cutting a deal with a schoolyard bully.

In this case, the bully is President Obama and the powerful Republican is Billy Tauzin, former chairman of one of the key House committees that oversees health care and now the head of the Pharmaceutical Research and Manufacturers of America.

"The simple truth is, two wrongs don't make a right," House GOP leader John Boehner writes in a scathing letter to Tauzin, obtained by NPR. "When a bully asks for your lunch money," Boehner continues, "you may have no choice but to fork it over."

"But cutting a deal with the bully is a different story, particularly if the 'deal' means helping him steal others' money as the price of protecting your own," Boehner writes.

And that was just how the letter opened. Full text here

Continue reading "Boehner Says Old GOP Pal Aiding Schoolyard Bully" >

by April Fulton

Watching the waves break on the rocks off the North Coast of the Dominican Republic was one of my favorite memories of my recent vacation. But as I trodded back into the office today, I wondered, how do I keep that vacation feeling going while I'm back to reality, staring at my computer screen?

Vacation zen, Dominican Republic style. (Dan Katz)

Vacations are good for us. The more leisure time we fill with non-work activities, the healthier we feel, Karen Matthews of the University of Pittsburgh's Mind-Body Center tells NPR's Brenda Wilson on Morning Edition today. But their effects tend to fade within a day or two, research shows.

Continue reading "How To Extend The Vacation Zen" >

By Scott Hensley

The National Health Service in the U.K. has become a punching bag for some critics of proposals to remake the U.S. health-care system.

(iStockphoto.com)

Among the inflammatory charges, Sen. Edward Kennedy wouldn't have received state-of-the-art care for his brain tumor in a place like Great Britain because health overseers would have found extending the life of the 77-year-old unworthy of the expense.

"Well, I'm sorry to say that's the most ludicrous thing that I've heard," Ara Darzi, a surgeon and former minister of health, tells Steve Inskeep on Tuesday's Morning Edition. It's an example, Darzi says, of the "lies that have been used to set fear against reform."

Continue reading "Britain's Health System Defended" >

By Scott Hensley

The only co-op we have any experience with is the New York variety for apartment living. Even in the little Brooklyn building where we used to kick back, the vetting process for prospective shareholders was daunting, including in our case a separate interview of our dog. She passed.

A pediatrician from Group Health Cooperative checks a patient. (Stephen Brashear/GroupHealth)

So what's the deal with these health co-ops, suddenly the hot alternative to the administration's controversial proposal for a government-sponsored public plan in health overhaul? We point you to a prescient piece from late June by NPR's Joanne Silberner.

She took a look at HealthPartners, a Minnesota-based co-op with 1.25 million members. The folks insured by HealthPartners also own the non-profit company. Any money left over each year gets plowed back into care.

Continue reading "Health Co-Ops Explained" >

By Scott Hensley

Life would be so much easier if you could get a shot as a youngster that would protect you against flu for decades.

Let's just do this once.

(iStockphoto.com)

The wily flu bugs change so fast, though, that traditional vaccines need to be tailor-made for each flu season. Even then, they often miss the mark.

The Baltimore Sun's Stephanie Desmon writes researchers are making progress on a universal flu vaccine that would work against all sorts of flu viruses, though a version suitable for humans still seems a long way off.

Continue reading "One Shot Fit For All Flu" >

By Scott Hensley

Maybe the public option was just a stalking horse all along.

Sen. Conrad says it's time to stop chasing the public-option rabbit. (iStockphoto.com)

On the defensive about plans to overhaul health care, the Obama administration signaled over the weekend it might forgo a government-sponsored insurance option to get a deal done.

The whole idea of a public insurance option offered was to keep the for-profit companies honest in a revamped insurance marketplace.

Health and Human Services Secretary Kathleen Sebelius told CNN on Sunday that a public plan was "not the essential element," in a health overhaul.

The shift may win some converts but may also alienate some of the bedrock supporters on the left. Former Democratic National Committee Chairman Howard Dean is busy defending the public option, saying, "You can't really do health reform without it."

Continue reading "Public Option On Life Support" >

By Deborah Franklin

To spot a cross-cultural difference in the way people read facial expressions, look no further than the standard emoticons that pepper email in the west versus East Asia.

"Happy" in the west is :-) but in the east is (^_^), points out University of Glasgow psychologist Rachael Jack. "Sad" in the west is :-(. In the east sad is (;_;) or (T_T). "Surprise" in the west is :-o but in the east is (o.o).

What's this man saying with his eyes? (iStockphoto.com)

The eyes are key to the Japanese icons, Jack and other researchers have noted, while the western emoticons are all about the mouth.

In a little study published in the new issue of Current Biology, Jack and some colleagues found that the same East/West "cultural accent" shapes the way people read real faces, too.

Continue reading "Disgust or Anger? Some Looks Don't Translate" >

By Scott Hensley

We always thought the Senate was the place for civil discourse on the issues of the day. Maybe it still is. But when senators start arguing about health care and death panels on Twitter, all bets are off.

Death panel became the shorthand for claims by opponents of health overhaul that a provision in a House bill on end-of-life counseling would lead to government-ordered euthanasia.

Senator Chuck Grassley, an Iowa Republican, is clearly ticked off at the recently ex-GOPer Arlen Specter, the senior senator from Pennsylvania. Just a little while ago Grassley fired this salvo Specter's way:

Continue reading "Specter And Grassley Tweet Tough On Death Panels" >

By Scott Hensley

If you want to take the temperature of health overhaul, check out the polls.

Time to see the polling doctor. (iStockphoto.com)

The Marist Poll is out with numbers this morning that show President Obama has a lot of work left to do if he hopes to remake the country's health-care system.

Forty-five percent of American voters disapprove of how Obama is handling health care, compared with 43 percent who give him a thumbs-up. That's a dead heat, considering the +/- 3.5 percent margin of error in the poll.

Continue reading "Polls Show Tough Fight For Health Overhaul" >

By Scott Hensley

For women diagnosed with early stage breast cancer, getting an MRI before surgery increases the odds an operation will be more extensive without any proven survival benefit over less invasive approaches, argues an analysis just published online by CA: A Cancer Journal for Clinicians from the American Cancer Society.

MRI of cancerous breast. (Mitchell D. Schnall via National Cancer Institute)

Women who get a pre-operative MRI are more likely to get a mastectomy instead of breast-preserving treatment (lumpectomy and radiation therapy) that has equal or better long-term success. As a result, says Daniel Hayes, a breast cancer specialist at the University of Michigan who co-wrote the analysis, "MRI has led to worse outcomes for patients rather than better ones."

MRI is better at picking up some things than mammography, Hayes concedes, but the expensive imaging tool "is probably finding cancers that radiation gets rid of anyway." For the typical woman, his advice: don't bother.

Continue reading "MRI Brings Little Value Before Breast Cancer Surgery" >

By Deborah Franklin

Sure, they're cute and clever. But, as if the risk of rabies weren't bad enough, some masked critters are loaded with raccoon roundworms that can find their way into humans -- most notably toddlers -- where the parasites can burrow into the eyes or brain, causing blindness, convulsions and even death.

So young. So cute. So chock-full of parasites. (iStockphoto.com)

A recent survey of 119 backyards in suburban Chicago turned up "raccoon latrines" in roughly half. Raccoons tend to choose elevated spots for doing their business -- decks, patios, woodpiles, flat roofs and playhouses.

Wheaton College ecologist Kristen Page and her students found that scat from 21 such spots was heavily contaminated with the worrisome roundworm Baylisascaris procyonis.

Continue reading "Don't Mess With Raccoons" >

By Scott Hensley

Change insurance plans, move or learn that you have a tough health challenge that requires a specialist, and you'll be hunting for a doctor.

Who's better?

iStockphoto.com

But how to decide which one to see? It's one of the hardest choices a person has to make because there's so little information to go on.

Most people we know ask their friends and colleagues for advice. In a pinch, you may end up singing "eeny, meeny, miny, moe" as you leaf through your insurer's directory of approved doctors.

Continue reading "New Online Help For Finding A Doctor" >

By Scott Hensley

Grand Junction, Colo., a cost-quality leader. (Eleaf/Flickr)

Let's call them the Four Horsemen of Health Care Improvement:

Atul Gawande, the surgeon and embarrassingly talented journalist; Donald Berwick, an indefatigable campaigner for better health quality; Elliott Fisher, a bigwig with the indispensable Dartmouth Atlas; and, Mark McClellan, the doctor-economist who oversaw the addition of a drug benefit to Medicare.

Forget the naysayers who proclaim that it's impossible to remake our health system to deliver better care at a lower cost, these four doctors write in the New York Times. It's happening already.

In 74 places (hospital referral regions, for the wonks out there) around the country, per capita Medicare costs are low or declining and the quality of care is above average.

Continue reading "Getting Health Care Right" >

By Scott Hensley

Dental patients at a free health clinic at the Forum arena in Inglewood, Calif. (John Moore/Getty Images)

As the debate over the administration's plan to remake health care rages on, some folks are taking direct action to bring medical help to the uninsured.

Remote Area Medical, an aid outfit that got its start helping villagers in the Amazon Rainforest, is running a free, eight-day-long clinic in Los Angeles for people in need.

Hundreds of people started lining up Monday for a chance to get their teeth fixed, eyes checked and various other maladies cared for at the clinic, which opened Tuesday.

Continue reading "Los Angelenos Flock To Free Health Clinic" >

By Scott Hensley

In 1996, California voters decided that it was time to make marijuana available to people whose doctors determined it could help them.

Get your pot here. (Amy Walters/NPR)

Fast forward to today, and as NPR's Richard Gonzales reports, there are an awful lot of seemingly healthy Californians buying marijuana from storefront dispensaries made possible by the legal change.

The medical marijuana trade is booming, with pot stores outnumbering McDonalds or Starbucks outlets by at least 2 to 1 in some parts of Los Angeles.

Scott Imler, a Methodist minister from West Hollywood who co-wrote Proposition 215 that opened the door for medical pot, tells Gonzales the law has been subverted. "What we have is de-facto legalization."

Continue reading "How Medical Is The Marijuana In California?" >

By Deborah Franklin

All you grown-ups who tsk-tsk heedless teens and others for texting or gabbing on a cellphone while driving should know this:

Even blood pressure meds can impair driving. (iStockphoto.com)

A new survey of drivers 55 and older finds that nearly 70 percent are on a prescription drug that can interfere with driving. And ten percent are on five or more such drugs.

The problem meds aren't restricted to sleeping aids and tranquilizers. Common heart and blood pressure meds like beta-blockers and ACE inhibitors can cause drowsiness and dizziness, as can some allergy drugs, some antidepressants, and medicines that treat swollen prostates or restless leg syndrome. That's just a few.

Continue reading "Older Drivers On Drugs " >

By Joanne Silberner

Of all the criticism leveled at the Food and Drug Administration in recent years, some of the most emotional has focused on patient access to experimental drugs for serious illnesses.

It's a tough spot for the regulators. On one side are desperate and dying patients who feel they have little to lose by trying an unproven drug that could help, even if it might be toxic or eventually turn out to be a dud. If the patients aren't part of drugmakers' clinical tests, though, they're usually out of luck.

On the other side? Well, there's the problem of false hope and the needs of the rest of us, who might like a medicine some day that's been thoroughly tested to determine its effectiveness and shortcomings. If people can get experimental drugs on their own, they may not sign up for clinical trials. And that makes it tough to figure out whether the medications actually work.

Until now, the FDA's rules about so-called "compassionate use" of experimental drugs for patients not in clinical trials have been murky. Now the agency has clarified them, and added a few new conditions.

Continue reading "FDA Makes Rules For Early Access To Experimental Drugs" >

By Scott Hensley

How hard will it be to reconcile the proposals kicking around Capitol Hill to remake health care?

At least for three House bills, the content is about 85% the same, Nancy-Ann DeParle, head of the White House Office of Health Reform, tells Melissa Block, co-host of All Things Considered. "The bills do follow the basic blueprint that the president put forth from his campaign," DeParle says.

In the Wednesday interview, DeParle acknowledges that the 15% of the legislation that's different will take some work to reconcile. Issue No. 1: the fate of the public plan.

She tells Block she's not sure whether a co-op, an alternative getting support in the Senate, would be acceptable to President Obama. We're also not likely to find out the details of what provisions the president supports or rejects until a bill surfaces in conference.

Continue reading "White House's DeParle Updates Health Overhaul" >

By Scott Hensley

The swine flu virus doesn't much care who you are.

Oscar Arias, at a meeting last month, before the swine flu. (Mayela Lopez/Getty Images)

President of Costa Rica? Sorry, gotcha. Oscar Arias, the 68-year-old head of state, was just diagnosed with the illness. Arias is also an asthmatic, which puts him at higher risk for H1N1 infection.

"Apart from the fever and a sore throat, I feel well and in good shape to carry out my work by telecommuting," the 68-year-old said in a widely reported statement.

He'll work from home for a week and is taking Tamiflu to fight the infection.

Continue reading "Costa Rican President Ill With Swine Flu" >

By Scott Hensley

There's been plenty of chatter and misinformation lately about rationing of care under a remade health system.

(iStockphoto.com)

But a Johns Hopkins doctor argues we're already way overdue when it comes to talking frankly about what sorts of care doesn't make sense at the end of life.

For the Wall Street Journal online, Peter Pronovost, a critical care doctor and prominent patient safety researcher, writes about a man hospitalized for more than six months with an antibiotic-resistant infection that seems certain to kill him. The tab: $1.5 million and counting.

Continue reading "Time For Frank Talk In The ICU" >

by Deborah Franklin

It's long been known that some teenagers raid the family medicine cabinet or a friend's locker for legal drugs that will get them high. But a new survey suggests that's not their only prescription drug problem.

What does this coyote know that teen drug users don't? (iStockphoto.com)

Twenty percent of a diverse sampling of teens surveyed in a report in this month's Journal of Adolescent Health say they also bum antibiotics, antidepressants, serious acne meds, and ADHD drugs off each other, as a way of treating their own ailments.

Most don't see warning labels or any instructions that come with the shared pills. And about a third of the kids suffer side effects, says Chris Mayhorn, a North Carolina State University psychologist involved in the research.

Other researchers have studied people selling prescription drugs, but we looked at people with good intentions, trying for instance, to help a friend who lacked money or transportation for a doctor's visit.

Continue reading "Friends Don't Give Friends Prescription Drugs" >

By Scott Hensley

You think your health insurer slaps you with some wild charges? Well, the insurers say take a look at what comes our way from some doctors.

(iStockphoto.com)

The trade group America's Health Insurance Plans released results of a survey of high charges submitted by doctors outside the insurers' approved networks of physicians last year. The snapshot, says AHIP, shows the value of the networks of providers and negotiated rates that insurers put together.

There are some doozies, even after the group says it screened out some of the highest charges that might have been submitted in error.

How about a hip replacement in Arizona for which the doctor charged $17,357 compared with the Medicare fee of $1315.60. Or, take a look at a pricey gallbladder surgery in Colorado: doctor's charge $26,100 versus the usual Medicare fee of $625.94.

Continue reading "Insurers Hit Back At Doctor Charges" >

by Scott Hensley

When Wendell Potter was a high-ranking PR exec at insurance giant Cigna, he was the guy reporters would buttonhole for the company's official answers to questions.

Wendell Potter (Center for Media and Democracy)

The longtime defender of insurers left Cigna last year and has since become one of the industry's toughest critics. In June, for instance, Potter told a Senate committee that insurers were "using fear tactics" to "tar a transparent and accountable -- publicly accountable -- health-care option."

In an interview with NPR's Madeleine Brand on All Things Considered Tuesday, Potter describes his conversion. It happened at a rural Virginia fairground where he saw hundreds of people with little or no insurance waiting in the rain for free medical care provided by an aid group that got started helping people in the Amazon Rainforest.

"I was just absolutely astonished at what I saw. It was almost like being hit by lightning," he tells Brand. "These people were, by and large, waiting to be treated in animal stalls that other volunteers had disinfected a few days before."

Continue reading "Health Insurance Insider Turns On Industry" >

by Scott Hensley

The Commander In Chief will try his hand at selling the administration's plans for remaking the health-care system at a town hall meeting in Portsmouth, N.H., this afternoon.

We'll monitor what President Obama has to say and how the crowd behaves, after so many of these meetings have turned ugly.

Click the "play" button below and our live updates about the event should scroll automatically.

by Scott Hensley

Health and taxes aren't the usual combo of life's inevitabilities.

The loafers lobbyists made famous. (DavidAll06s/Flickr)

But as NPR's Linda Wertheimer reports, the remaking of the federal tax code against long odds in the '80s may tell us something about the prospects for an overhaul of health care.

Two decades ago, Republicans and Democrats each had their reasons for wanting to transform the tax system. President Reagan made lowering taxes his top domestic priority. Democrats, who controlled the House at the time, wanted to close loopholes that favored the wealthy and corporations.

Bill Bradley, then a senator from New Jersey, says that proved a winning formula:

It just made a lot of sense to cut tax rates, who's not for that, and to pay for it by eliminating loopholes that allowed different people making the same income to pay different taxes.

Continue reading "What An '80s Tax Reform Fight Says About Health Legislation Now" >

by Scott Hensley

It's startling fact that about 1 in 100 babies is born with a heart defect. Perhaps even more startling is the lack of appropriate tools at doctors' disposal to fix the problems.

(CarbonNYC/ Flickr)

The Wall Street Journal's Ron Winslow reports on these "neglected patients," thousands of whom need surgery or other interventions each year.

The challenge for doctors is to adapt medical devices and drugs designed for adults to treat youngsters.

Continue reading "Tiny Hearts Need Big Help" >

Would changes being proposed for our health-care system actually lead to government-sponsored euthanasia?

(iStockphoto.com)

Some critics come pretty close to saying so, and comments on the subject by Sarah Palin on Facebook late last week got a lot of folks fired up:

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care.

To set matters straight, the Washington Post's Ezra Klein chatted with Sen. Johnny Isakson, a Georgia Republican who has worked to expand coverage of end-of-life planning. In particular, he supports a voluntary, Medicare-covered counseling session for people with their doctors to discuss end-of-life options. The idea is to make it easier to decide in advance what sorts of care people want and don't want when facing death.

Continue reading "'Death Panels' Debunked: Sen. Johnny Isakson" >

by Deborah Franklin

Will shots against this virus work? Only tests will tell. ( CDC)

Vaccine makers have begun squeezing out the first drops of the new H1N1 flu vaccine and rushing them to several sites around the world for tests of safety and effectiveness in people.

On Monday's All Things Considered, NPR's Joanne Silberner reports from Baltimore on how everything went on their first day -- why 400 people in the city have volunteered to get the experimental injections this week, and what sort of side effects they can expect. She'll be back on Tuesday's Morning Edition with an update on how the pandemic flu spent its summer vacation, and what to expect next month.

Meanwhile, ATC's Melissa Block talks tonight with Dr. David Fleming, the Director of Public Health for Seattle's King County. Dr. Fleming is charged with getting whatever vaccine is delivered to Seattle in mid-October or so into the arms of nearly a million of his county's 1.8 million residents as quickly as possible.

Continue reading "Swine Flu Prep: Let The Safety Tests Begin" >

By Scott Hensley

Is it too late to have a fact-based discussion about proposals to remake health care? Maybe.

Can you hear me now? (iStockphoto.com)

With the disruption of town hall meetings practically a national sport and "death panels" making the rounds today, the White House launched an online counteroffensive, called "Health Insurance Reform Reality Check."

Before we go any further, can we do a smidge of reality-checking of our own? There's a lot more at stake in the proposals to overhaul health care than just reforming the insurance system. Sure, we know the Dems' talking points emphasize hammering on the insurance industry. Just ask insurance-industry lobbyist Karen Ignagni, as Kaiser Health News did the other day.

But ask doctors, hospitals and drugmakers how much money they might gain or lose under various plans for a taste of the topics beyond strict insurance reform.

Continue reading "Fact-Checking The Health Overhaul Debate: White House Edition" >

By Patricia Neighmond

Is this your idea of a vacation? (b.frahm/ Flickr)

With the economy so crummy, people who need a vacation more than ever are finding it pretty tough to afford one.

So, lots of folks are trying to get away from all it without leaving their own backyard. The goal of these on-the-cheap "staycations," just like a traditional holiday, is a respite from the mundane routine and stress of everyday life.

It can be done, says New York psychiatrist Sudeepta Varma, who advises staycationers to strike a balance between excitement and relaxation.

The research on the health value of vacations, much less staycations, is pretty sparse, though a recent analysis of some published studies showed that the stress-reducing effects of any holiday fades pretty quickly.

Continue reading "Staycationing? Tell Us About It" >

By Scott Hensley

The government estimates as many as 100,000 Americans die each year from preventable mistakes made during medical care.

The sobering figure, cited in an investigation just published by Hearst Newspapers, is even more worrisome when you realize it hasn't budged, despite a landmark report that called for national action a decade ago.

"We didn't show leadership and take charge and do what needed to be done," says Lucian Leape, a doctor, patient-safety advocate and an author of the report, called "To Err Is Human."

Continue reading "Medical Errors Run Rampant Despite Calls For Change" >

By Scott Hensley

If you're perplexed by the automated directory of choices when you call the doctor, you aren't alone.

Yes, even medical professionals get frustrated by the maze of push-button options, which each office seems to organize differently.

Does the doctor's phone service make you see red? (iStockphoto.com)

Can't we just standardize those darned things, asks Graham Walker, a second-year emergency medicine resident, on the Central Line blog from the American College of Emergency Physicians.

Walker, a clever blogger from way back, obviously spends a lot of time working his phone's keypad. We're guessing he crafted his plea for uniformity (written as haiku) while on hold. It begins:

Can we standardize
A doctor's call services?
I am losing it.

Continue reading "Press *9 For Relief From Doctors' Answering Services" >

By Deborah Franklin

U.S. exercise docs were in a huff over the weekend, though it took a little digging to figure out why. Their opening salvo, in a Friday press release from the American College of Sports Medicine, began:

Are they dropping pounds or just revving their appetites? (iStockphoto.com)

"Leading experts in exercise and weight management have taken strong exception to assertions that exercise can inhibit weight loss by over-stimulating the appetite."

Huh? What assertions?

Though the press release never mentions any publication by name, apparently what had the fitness buffs hopping mad (stair-stepping mad?) was this week's Time cover story and ensuing blog buzz on the limits of exercise in curbing obesity.

Continue reading "The Big Fat Lies Of Exercise" >

By Scott Hensley

Coming soon to a TV near you: a wave of ads bankrolled by drug companies in support of health overhaul.

Don't adjust your set--those ads are from the drug industry. (iStockphoto.com)

The drug industry, already a big spender on commercials for its medicines, is a seemingly unlikely patron for the planned ad blitz, which could cost $150 million or more, the Associated Press reported over the weekend.

The ads would bolster the administration's plans to remake health care and expand insurance coverage to nearly 50 million people.

To put the size of the ad campaign in perspective, the New York Times points out that Sen. John McCain spent $126 million on ads in his bid for the presidency. In the end, the drug industry ad spending could wind up within spitting distance of the $236 million shelled out for campaign ads by Team Obama.

Continue reading "Drugmakers To Put Advertising Oomph Behind Overhaul" >

A really, really tight shot of a blood clot. (Courtesy Andre E.X. Brown, Rustem I. Litvinov, Dennis E. Discher, Prashant K. Purohit, John W. Weisel, University of Pennsylvania / Science)

by Deborah Franklin

This scanning electron micrograph of a blood clot -- taken from the coronary artery of somebody who had a heart attack -- might be scary if it weren't so cool.

It's a colorized portrait from University of Pennsylvania researchers reporting in this week's Science. Their study details the role a versatile molecule called fibrin plays in sealing off a wound or, in the case of a heart attack, blocking a blood vessel.

Look closely: The brown mesh is a wiry web of fibrin molecules. Strengthened by the purple-grey platelets, the fibrin mesh bends and stretches without breaking to catch red blood cells and infection-fighting white blood cells (tinted green in the photo) like fish in a net. Where does that flexibility come from?

The Penn study suggests the key is the way each molecule unfolds when tugged, exposing hidden inner parts of the fibrin string that then actively expel water. "That's how the whole clot volume decreases about ten-fold with three-fold stretching," says Penn biologist John Weisel. It's this molecular unfolding, the scientists write, "that allows clots to stretch so far."

by Deborah Franklin

Let's say you're sick and tired after weeks of traveling and find yourself with a worsening kidney infection, wandering the hospital halls looking for the nephrology clinic....in rural Uzbekistan. Or any place else where you don't speak the language, and can't puzzle out the words.

Hospital signs could be clearer. (Courtesy University of Cincinnati)

Or, let's just say that, like about half of all American adults -- 90 million -- you can't read well enough to navigate an American hospital with written signs.

Pictures could help in both cases, say health literacy experts. But which pictures?

Design students at the University of Cincinnati this week announced they have a few ideas. They've been noodling over how to best represent abstractions like "In-Patient Clinic." How do you best distinguish between the mental health clinic and neurology? (And is that a tube of acne medicine aimed at my eye, or are you just glad to see me?)

(More experimental signs after the jump)

Continue reading "Signs For When Words Fail" >

By Scott Hensley

Just because swine flu crashes a classroom or two doesn't mean the principal should send everyone home.

Swine flu won't spring you from that test. ( CDC)

But to prevent the flu's spread, the Centers for Disease Control and Prevention says adults and kids should stay home for a least a day after their fevers have gone away.

That's some of the advice just released by the CDC for schools and health officials on what to do when swine flu strikes again -- and everyone expects that will happen this fall.

The full set of recommendations, in the works for several months, is fairly tame and reflects the current thinking that so far swine flu doesn't look much worse than seasonal flu.

Continue reading "CDC Advises Calm Course For Schools And Swine Flu" >

By Scott Hensley

When you become FDA commissioner, one of your first jobs is to lay down the law for all the companies, legitimate and otherwise, that make the food, drugs, devices and other health-related products consumed by Americans.

Industry: FDA Commissioner Hamburg is watching you. ( Win McNamee/Getty Images)

Margaret Hamburg, confirmed in May as the 21st head of the agency, mapped out the FDA's role as beat cop in a speech Thursday to a lot of lawyers who represent those firms.

She sounded pretty tough to us. Her prepared text featured the words "enforce" or "enforcement" 39 times.

Most of the details probably aren't that interesting except to legal beagles, but Hamburg talked about setting clearer standards for companies and faster timetables for action that the public may even be able to keep tabs on. Watch the video, if you want the nitty-gritty, including some Q&A.

Continue reading "FDA's Hamburg Talks Tough" >

By Scott Hensley

The cost of health care is a problem almost everywhere. Take a look at France, as the Wall Street Journal does today, and find that some of the cost-control techniques pioneered in the U.S. are now being trotted out there to reduce health spending.

(Al Ianni (Away)/ Flickr)

France has achieved nearly universal coverage for its citizens, but the cost of care is a problem. Health expenditures ran at 11 percent of the French GDP in 2007, the highest figure in Western Europe, though still a long way from the 16 percent spent in the U.S., according to OECD data.

For Americans, the WSJ writes, "The French system's fragile solvency shows how tough it is to provide universal coverage while controlling costs, the professed twin goals of President Barack Obama's proposed overhaul."

One question: What's French for co-pay?

Continue reading "Morning Rounds: Another French Paradox, House Dems Reject Deal & Bad Beef " >

By Scott Hensley

Republican Senator Judd Gregg of New Hampshire figures some sort of health overhaul is inevitable. He just doesn't know if he'll like it.

Sen. Gregg bets overhaul is coming. (Getty Images)

"I'm presuming something will pass," Gregg tells NPR's Linda Wertheimer in an interview for Friday's Morning Edition. The president has invested his "status on public policy" in getting legislation through, Gregg explains, "and he has supermajorities in the House and the Senate" to get the job done.

But Gregg, who's not running for reelection, says he's a little worried the plans advancing already are "very far on the liberal side of the agenda" and would eventually lead to a system with the government as the primary insurer.

Continue reading "Gregg Expects Health Overhaul, Like It Or Not" >

By Scott Hensley

Swine flu vaccine is on the way.

( CDC)

Several companies have started human tests of experimental swine flu vaccine, and the first results may be in as soon at the first half of September.

If the data are good, they could be used to win quick licensing approvals from governments around the world. The first doses of vaccine might be ready to roll later that month, with more to come in October.

The World Health Organization's Marie-Paule Kieny, director of vaccine research, told reporters today the studies will help determine the proper dose for a vaccine. The central question: one dose, or two?

Run-of-the-mill seasonal flu vaccination typically takes a single shot. Vaccination against avian flu takes two, Kieny said. The lower the dose, the farther a limited supply of vaccine could stretch.

Continue reading "Swine Flu Vaccine May Debut In September" >

By Scott Hensley

A promise by the pharmaceutical industry to save the nation $80 billion over a decade in exchange for protection from further givebacks under an overhaul of health care just got validated by the White House.

( iStockphoto.com )

The New York Times reports that pharmaceutical companies got spooked by action in the House that would give the feds negotiating authority for drug prices and bigger rebates from the industry.

So the industry got an explicit affirmation of protection from deeper cuts, according to the Times.

Billy Tauzin, head of the trade group PhRMA and the industry's lobbyist-in-chief, explained the quid pro quo -- drugmakers stepped up first with a cost-saving pledge, and, in return, got "a rock-solid deal." A White House official confirmed Tauzin's account to the Times.

But what price lobbying glory?

Continue reading "White House Says A Deal's A Deal With Drug Industry" >

Despite the public rancor over a potential health overhaul, a bipartisan agreement on how to remake the system may not be dead yet. The Washington Post reports that Senate negotiators are making progress on a compromise that would cut about $100 billion from the price tag for expanding health coverage while still getting 94 percent of Americans on insurance rolls.

The Post, citing "participants in the talks," says the latest and still fragile proposal would ditch the public insurance option that the administration has made a top priority and, in a first, "tax health-care benefits under the most generous plans."

Six senators, three Dems and three from the GOP, are supposed to brief President Obama on the state of talks later today, the Post reports.

Continue reading "Morning Rounds: Senate Health Talks, Back Pain & Fat Paint" >

By Scott Hensley

The sheet just got pulled off some of the folks who work behind the scenes to create medical journal articles favorable to drugmakers.

Boo! ( piccadillywilson / Flickr)

The journal PLoS Medicine and the New York Times were able to get a slew of internal company documents collected in litigation over breast cancer risks from a hormone-replacement drug.

The Times explains how Wyeth, maker of Premarin, engaged a third-party firm to "outline articles, draft them and then solicit top physicians to sign their names, even though many of the doctors contributed little or no writing." In all, 26 papers produced this way made it into 18 different journals. Wyeth's role in organizing and paying for the work wasn't disclosed.

You can find the documents posted by the Times here. Zip to page 15, where you'll find some interesting emails between the medical writers, an influential doctor whose name eventually went on an article about treating hot flashes, and the company.

Continue reading "Pharmaceutical Ghostwriters Revealed " >

by Deborah Franklin

News stories have a way of firing up old debates. So maybe it was predictable that scarcely had the feds broken open the money-laundering-kidney-smuggling corruption ring in New Jersey last month, when some economists started clamoring once again to legalize the regulated sale of human organs for transplant. Their basic argument: Banning the legitimate sale of organs merely forces willing sellers and buyers into a dirty and dangerous black market.

The Freakonomics guys weighed in early, with their observation in a New York Times column that "it is hard to find an economist who agrees with this policy" of banning kidney sales. (This follows a previous column last fall, where they noted that many organ donors in the U.S. don't have health insurance).

Dr. Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute, has been widely quoted, too, based on her experience of having to ask a friend for a kidney when her own failed several years ago. Satel wrote a book about it, and the woman who donated the kidney, writer Virginia Postrel, explains her own support of financial reimbursement for traded organs in this month's Atlantic.

Meanwhile, the New Yorker and Mother Jones are weighing in with their own stories about the downside of organ sales. And the Jewish Daily Forward quotes ethicist Art Caplan's central argument against legalization:

The people who sell are almost always incredibly poor. They're usually up to their eyeballs in debt....past the point of desperation. They're not making a calculated decision.

Continue reading "Why Not Buy A Kidney?" >

By Scott Hensley

Well, this didn't take long. The Democratic National Committee has trotted out a Web ad to get the party's supporters to tell Republicans to lay off the public meetings on health-care overhaul.

The ad reprises snippets from some recent confrontations, including a quick shot of protesters at a Philadelphia meeting last weekend that featured some testy exchanges between the audience and Sen. Arlen Specter (D-Penn.) and HHS Secretary Kathleen Sebelius. There's also a cameo appearance by a memo on disruption tactics.

You can find some more details on the Democrats' beefs with the "angry mobs" on the DNC blog here.

But the basic message, as you might expect, is: GOP, call off the dogs. To that end, the spot concludes with the telephone number for the Republican National Committee.

We gave it a try just to see what the RNC had to say and got an automated phone directory. Conveniently enough, the recorded voice prompted us to press 1, if we were calling about the recent DNC ad. Okee dokee. We did, and a few seconds later found ourselves talking with a receptionist at the DNC, who said she's been getting a lot of calls like ours today.

Update: The DNC's Brad Woodhouse said in an email that the call-forwarding option is "a neat trick." But it also shows, he wrote, that "Republicans don't want to have a discussion about the future of health care reform."

The RNC said they'd have something to tell us about this later today.

By Joanne Silberner

Here's a way to make $2,500: Use your creativity and fight the flu at the same time.

How? Enter your own 15-, 30-, or 60-second public service announcement in a contest sponsored by the Department of Health and Human Services.

Right now, HHS is working on lining up celebrity judges. (We hear Paula Abdul may be available.) Closing date to submit videos is August 17.

Be clever. Everyone who watches TV at odd enough hours to catch public service announcements will be watching the winning video.

The contest is part of the government's efforts to educate people about the flu. "We're very concerned about people having accurate information," a senior government official said at a background briefing yesterday.

Continue reading "DIY PSA For H1N1 To Win Cash" >

By Scott Hensley

You may be on summer vacation, but the interest groups looking to make their mark on legislation to overhaul health care are working harder than ever.

No rest for the weary lobbyists. ( Alykat / via Flickr )

The Wall Street Journal reports that delays on Capitol Hill make this month the key time to "snare one-on-one meetings with lawmakers back in their home districts."

Take Tim Trysla, a lobbyist at Alston + Bird. Makers of diagnostic imaging equipment are among his clients. "If you're looking for savings, don't come at us," says Trysla, who has called on 120 legislators, sometimes taking General Electric execs along to make the case for protecting payment for medical scans. (Check out a nifty WSJ interactive graphic on lobbying spending here.)

Continue reading "Morning Rounds: No Rest For Lobbyists, Mass. Rethinks Doctor Pay & FDA Warning" >

By Scott Hensley

What did Health and Human Services Secretary Kathleen Sebelius make of the free-for-all that erupted during a Philadelphia town hall meeting about health care over the weekend?

HHS's Secretary Kathleen Sebelius talks insurance. ( Mark Wilson / Getty Images )

"Democracy is alive and well in Philadelphia," she told All Things Considered co-host Melissa Block this afternoon.

These sorts of meeting have been marked by protests all around the country. Sebelius said she knew this one might have some "interesting dialog" when the audience booed during introductions by the director of the National Constitution Center.

There were many people at the meeting who aimed to "disrupt and and have the opportunity to disengage folks from a conversation about health reform," she said. Take a listen to the interview:

Still, public concerns about a health overhaul aren't just orchestrated, Sebelius acknowledged, telling Block, "I don't think there's any more personal issue to the American people than health care."

Continue reading "HHS's Sebelius: What's Been Lost In The Shouting" >

By Scott Hensley

Forget Norman Rockwell. The town hall meetings that many representatives and senators are holding back in their districts to make the case for a health care overhaul are turning into knockdown-dragouts.

Some of the aggressive questioning, and even heckling, of legislators meeting with constituents across the country appears to be staged. A memo on "best practices" for disrupting town hall meetings has surfaced on the Web.

A conservative group in Connecticut called Right Principles laid out how it "conducted an action" at a town hall meeting of Rep. Jim Himes (D-Conn.) in late May, even calling it a "potential playbook" for others who want to do the same.

Some of the tips: be organized; be prepared with detailed questions (including some that cite the legislator's voting record); try to sit in the front of the room; leave the protest signs outside the hall.

The group posted a video from the event, which you can watch below.

Continue reading "Recipe Surfaces For Guerrilla Warfare On Health Overhaul" >

By Scott Hensley

Boy, did we ever listen to Prozac.

( Getty Images )

Antidepressants have surpassed blood pressure pills as the most prescribed drugs in the land. National surveys found more than 10 percent of Americans were taking antidepressants in 2005, up from about 6 percent in 1996.

The research, published in the current issue of Archives of General Psychiatry, also finds that as drug treatment increased use of talk therapy fell--to 19 percent from 32 percent.

"There's being a greater emphasis placed on medications rather than psychotherapy in treating mental health problems," Columbia psychiatrist Marc Olfson, lead author of the paper, told Bloomberg. "I hope these numbers will draw attention to how many people are being prescribed these medications."

Continue reading "Antidepressant Use Zooms, As Talk Therapy Slips" >

By Scott Hensley

It may be back to school for swine flu this fall. The Washington Post reports that the Obama administration is rethinking guidelines for handling swine flu at schools.

See you in September ( CDC )

The Post, citing people involved in the work, said the feds may recommend that schools remain open except when there are "extenuating circumstances." Those particulars might include a school that has lots of kids with existing health problems or many ill teachers, though an official told the paper the discussions continue and no final decision has been made.

Of course, the final call at each school will be made locally. But if the feds scale back advice on when to close, schools may stay open longer even in the face of an expected resurgence of swine flu this fall.

Continue reading "Morning Rounds: Swine Flu School, BPA Warning & Cuba Exports Docs" >

By Scott Hensley

As senators prepare to head home for the dog days of August, the dog fight over remaking health care shows no sign of abating.

Sen. Kyl says it's time to hit the road. ( Terry Ketron / AP)

The latest round features a little legislative rope-a-dope from Republicans who don't like much about the proposals kicking around Washington so far.

Sen. Jon Kyl (R-Ariz.) tells NPR's Linda Wertheimer in an interview set to air on Morning Edition Tuesday that he'd rather see no health overhaul than adoption of the approaches on the table right now.

Continue reading "Kyl Would Skip Health Overhaul As Proposed So Far" >

By Scott Hensley

OK, I think I finally found the right switch for this thing. Yup. That seems to have turned it on. Cue the fluorescent lighting hum and we'll be in business.

(Duncan Moore (c) 2009)

After lending a hand at NPR when swine flu began its march across the globe this spring, I decided to take down my freelance shingle and join the NPR health team. I'll be blogging about all sort of things health right here from now on. It feels great to be on board.

Some of you might recognize me from my work at The Wall Street Journal, where I was the founding editor and a regular contributor to the paper's health blog. Before that I worked as a reporter for the Journal covering subjects ranging from the Human Genome Project to the pharmaceutical industry's marketing of drugs.

Continue reading "Hensley Signs On At NPR Health" >

By Allison Aubrey

Have you ever heard that cigarettes are good for asthma? I know. It's a ridiculous notion -- particularly to people like me who grew up wheezing -- but that's what the Victorians believed. When I was kid, even campfire smoke could be a terrible trigger, and in those days before asthmatics carried inhalers around, my parents and I had to make lots of visits to the ER. My mom still reminds me about those late night ordeals.

How times change. Today I can control my son's asthma attacks with medicines that I give at home -- such as Xopenex and Pulmicort, an inhaled corticosteroid.

In this week's Your Health podcast, check out my interview with Dr. Adriane Fugh-Berman. She gives us a tour of the botanical garden at Georgetown University, and explains to us how, a century ago, a common plant that grows there -- Jimson Weed -- was rolled into cigarettes and used to treat asthma.

(Read past the jump to hear why smoking this weed is a particularly bad idea)

Continue reading "Jimson Weed for Asthma? Don't Do it" >