KHN’s ‘What the Health?’: On Government Spending, Congress Decides Not to Decide

KHN’s ‘What the Health?’: On Government Spending, Congress Decides Not to Decide
KHN’s ‘What the Health?’: On Government Spending, Congress Decides Not to Decide

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Congress is supposed to complete its annual appropriations bills before the start of the fiscal year on Oct. 1. But it rarely does, and this year is no different, as lawmakers scramble to pass a short-term funding bill so they can put off final decisions until at least December.

Meanwhile, with an eye to the midterms, House Republicans put out a “Commitment to America,” which includes only the vaguest promises related to health care. It’s yet another demonstration that the only thing in health care that unifies Republicans is their opposition to Democrats’ health policies. It’s notable that this latest Republican plan does not suggest repealing the Affordable Care Act.

This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Victoria Knight of Axios.

Among the takeaways from this week’s episode:

  • The short-term funding bill to keep the government open includes the five-year reauthorization of the FDA’s user fees, which are charged to drugmakers and help pay the salaries of many FDA employees. Democrats had hoped to add provisions to that measure that would create regulations on dietary supplements, cosmetics, and lab tests. The current authorization runs out Oct. 1, and Republicans insisted they would support only a clean bill that did not have new government directives.
  • That government funding bill also will not include President Joe Biden’s request for $20 billion to help pay for additional covid-19 and monkeypox vaccines and testing. Democrats said they wanted to extend those programs, but Republicans balked and said the administration still has not accounted for all the previous appropriations.
  • Biden’s comment on “60 Minutes” suggesting that the covid pandemic “is over” hurt administration efforts to persuade Congress to pass the extra covid funding.
  • Biden took a victory lap this week and touted successes on administration priorities for Medicare. Among them, he said, was a reduction in next year’s Part B premium, which generally covers beneficiaries’ outpatient expenses. But that premium went down, primarily because Medicare charged too much in 2022.
  • Medicare premiums this year saw a dramatic increase because officials anticipated that the federal health program would see higher costs associated with the use of Aduhelm, an expensive medication for some Alzheimer’s patients that received tentative approval in 2021 by the FDA. Medicare officials later said they would cover the drug only for patients who also enrolled in a clinical trial, and the expectations for use of the drug plummeted.
  • Republican House members’ proposed agenda pledged to reverse the Democrats’ decision this year to allow Medicare to negotiate some drug prices. Although Democrats said the provision would help drive down costs, Republicans said they don’t like the government interfering in the private market and fear that the measure would hamper innovation.

Also this week, Rovner interviews filmmaker Cynthia Lowen, whose new documentary, “Battleground,” explores how anti-abortion forces played the long game to overturn Roe.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: KHN’s “Britain’s Hard Lessons From Handing Elder Care Over to Private Equity,” by Christine Spolar

Alice Miranda Ollstein: KHN’s “Embedded Bias: How Medical Records Sow Discrimination,” by Darius Tahir

Rachel Cohrs: The New York Times’ “Arbitration Has Come to Senior Living. You Don’t Have to Sign Up,” by Paula Span

Victoria Knight: Forbes’ “Mark Cuban Considering Leaving Shark Tank as He Bets His Legacy on Low-Cost Drugs,” by Jemima McEvoy 

Also mentioned in this week’s episode:


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Watch: Their Baby Died. The Medical Bills Haunted Them.

Watch: Their Baby Died. The Medical Bills Haunted Them.
Watch: Their Baby Died. The Medical Bills Haunted Them.

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Born with a congenital heart defect and other medical issues, Sterling Raspe lived just eight months. In that time, she needed dozens of medical procedures and often required round-the-clock care in the neonatal intensive care unit. At one point, her parents were told they owed $2.5 million for her care. “It’s an offensive amount of money,” said Sterling’s father, Kingsley Raspe, in this KHN video produced by Hannah Norman and reported by Lauren Weber.

More than 300,000 U.S. families have infants who require advanced medical attention in NICUs every year. The services are delivered and, in keeping with the U.S. health care system, billing follows. But for the smaller fraction of families whose children die, the burden can be too much to bear.

For more about the Raspe family and others in similar circumstances, read “The Cruelest Bills.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Sports Programs in States in Northern Climes Face a New Opponent: Scorching Septembers

Sports Programs in States in Northern Climes Face a New Opponent: Scorching Septembers
Sports Programs in States in Northern Climes Face a New Opponent: Scorching Septembers

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BIGFORK, Mont. — On a recent afternoon, it was a crisp 70 degrees on the football field at the high school in this northwestern Montana community less than 200 miles south of the U.S.-Canada border.

Vikings head coach Jim Benn was running his team through drills in the pristine fall weather, without much interruption. Just a couple of weeks earlier, though, players needed frequent water breaks as they sweated through temperatures in the low to mid-90s, about 15 degrees higher than average for the time of year.

Although temperatures have started to drop now that autumn is underway, Montana and many other states in the northern U.S. are getting hotter — and staying hot for longer. August is when many high school sports ramp up, and this year’s was either the hottest on record or close to it for many communities across Montana, according to the National Weather Service and other meteorologists. The heat wave stretched into September, and at least six Montana cities broke the 100-degree mark during the first half of the month.

This August was the hottest on record for the nearby states of Idaho, Washington, and Oregon. Nationwide, this summer was the third-hottest on record, according to the National Oceanic and Atmospheric Association.

Health experts and researchers say states — especially the states in the northern U.S., such as Idaho, Maine, Montana, and North Dakota — aren’t adapting fast enough to keep high school athletes safe. Students and their families have sued schools, accusing them of not doing enough to protect athletes. Many states that have taken action did so only after an athlete died.

“Between high school and college, we’re losing roughly six athletes each year to exertional heatstroke, and the majority of those are high school athletes,” said Rebecca Stearns, chief operating officer at the University of Connecticut’s Korey Stringer Institute, which is named after a Minnesota Vikings player who died from heatstroke in 2001. The institute studies and tries to prevent the condition.

The true number of heat-related deaths could be higher, she said, because death certificates aren’t always accurately filled out. Exertional heat illness is the second-leading cause of death for high school and college athletes, behind cardiac arrest, she said.

In Bigfork, Benn said he hadn’t seen one of his athletes experience an exertional heat illness — such as heat exhaustion or heatstroke, which can cause fainting, vomiting, and even death — during his nearly 30-year coaching career in Montana until last year. An athlete became overheated at an early summer football camp during the record-shattering 2021 heat wave.

“We immediately got water on him, got him cooled down,” he said.

The player recovered after he was sprayed with a hose. Benn said he didn’t have an immersion tub filled with ice water on hand, which is what Stearns said is the recommended treatment.

“It is exactly why we need standard policies that have medical best practices incorporated,” Stearns said.

The Korey Stringer Institute ranks all 50 states and Washington, D.C., based on how well they follow best practices for preventing and responding to exertional heat illness among high school athletes, as well as other health risks such as cardiac arrest. Montana is 48th on the list, followed by Minnesota, Maine, and California.

California is last, according to the institute’s report, because it’s the only state that doesn’t regulate high school athletic trainers, which are generally responsible for the health and safety of athletes. Stearns said the institute is working with California sports officials who are pushing for laws that require licensing of athletic trainers.

States in the northern U.S. dominate the bottom third of the institute’s rankings. Stearns said many states the institute has approached about improving heat safety think it isn’t an issue or resist some policies because implementing them could come with a hefty price tag.

But some of the efforts don’t cost a penny, she said. At Bigfork High School, for example, Benn has implemented a three-day acclimatization period, without football pads, when his players return to the field in early August. “That’s really low-hanging fruit, in my perspective,” Stearns said.

Stearns added that most heat-related illnesses occur during the first days of practice, which are typically the hottest and when athletes are not accustomed to exerting themselves in the heat. But she said the state’s high school sports association should mandate acclimatization periods.

Montana and many other states also don’t have a system dictating when practices need to be modified — for example, by removing pads or reducing the length and the number of workouts — or canceled altogether, said Stearns. Policies that require an emergency plan for responding to an exertional heat illness are lacking in many northern states, as well.

Stearns and other researchers, such as Bud Cooper at the University of Georgia, said states should use what’s known as the “wet bulb globe temperature” — which accounts for air temperature, humidity, and radiant heat from surfaces such as turf that absorb sunlight — to make those determinations, rather than the heat index. The heat index doesn’t account for radiant heat, which increases the risk of developing heat illness. The foundation of the National Federation of State High School Associations said in February that it was sending 5,000 of the special thermometers to high schools across the country.

Stearns said that research suggests acclimatization periods reduce the number of exertional heat illnesses by as much as 55% and that states that have used the wet bulb globe temperature to mandate changes to practice have seen an 80% reduction.

In Georgia, Cooper’s work documenting heat-related deaths among high school athletes led to sweeping policy changes in 2012. Since the policy shift, Georgia has gone from being the state with the highest number of heat-related deaths among high school football players to having no deaths.

Researchers such as Cooper have begun to provide regional policy guidelines based on the local average wet bulb globe temperatures to help states understand the risks for high school athletes and give them a starting point for making policy changes.

New Jersey was among the early adopters of the wet bulb system among states in the northern U.S. when it approved a law in 2020 requiring school districts to buy the thermometers. The state also requires hundreds of schools to put cold immersion tubs on-site when temperatures reach a certain level. The state is now second in the institute’s rankings of sports safety policies, behind Florida and ahead of Georgia.

In the Pacific Northwest, Oregon and Washington have policies that mandate changes to school sports practices based on the heat index, not the wet bulb globe temperature. Heat and sports safety researchers say that’s better than nothing.

The Montana High School Association, which regulates high school athletics, has implemented heat guidance that allows referees to call for extra breaks during football or soccer games, said executive director Brian Michelotti. The association also asks other sports, such as cross-country running, to schedule meets early in the day.

While Montana health officials say the state has never documented a death related to heat illness among the state’s high school athletes, the historic heat waves over the past two summers have athletic officials considering additional precautions. “It really has triggered us to have more discussions about that and really come back and revisit with some sport science committees,” Michelotti said.

He said any policy changes would have to be approved by the association’s seven-member board and wouldn’t happen until at least next year.

Heat and sports safety experts such as Stearns at the Korey Stringer Institute said adding statewide policies and mandates saves lives by ensuring that all coaches and schools are following best practices before a death happens.

“One life is too much a price for all of the games in a season,” she said.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Pharma-Funded FDA Gets Drugs Out Faster, But Some Work Only ‘Marginally’ and Most Are Pricey

Pharma-Funded FDA Gets Drugs Out Faster, But Some Work Only ‘Marginally’ and Most Are Pricey
Pharma-Funded FDA Gets Drugs Out Faster, But Some Work Only ‘Marginally’ and Most Are Pricey

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Dr. Steven-Huy Han, a UCLA liver specialist, has prescribed Ocaliva to a handful of patients, although he’s not sure it helps.

As advertised, the drug is lowering levels of an enzyme called alkaline phosphatase in their blood, and that should be a sign of healing for their autoimmune disease, called primary biliary cholangitis. But “no one knows for sure,” Han said, whether less enzyme means they won’t get liver cancer or cirrhosis in the long run.

“I have no idea if the drug will make them better,” he said. “It could take 10, 20, or 30 years to know.”

Ocaliva came to market through an FDA review process created 30 years ago called accelerated approval, which allows pharmaceutical companies to license promising treatments without proving they are effective. It has become a common path to market — accounting for 14 of the 50 approvals of novel drugs in 2021 compared with four among 59 in 2018, for example.

The FDA’s accelerated approval is usually based on a “surrogate marker” of effectiveness — evidence of lower viral loads for HIV, for example, or shrinking tumors for cancer. Debate rages over the validity of some of these stand-ins, and some of the drugs.

“If you’ve got a game-changing drug that truly is going to make a difference, you don’t need surrogate markers to prove that. If it’s effective, patients will survive longer,” said Dr. Aaron Mitchell, an oncologist at Memorial Sloan Kettering Cancer Center. The shortened approval process, he said, is one reason “we are getting a lot of marginally effective, not clinically meaningful, more expensive drugs on the market.”

Many of the estimated 100,000 U.S. patients with primary biliary cholangitis — most are women — had few other treatment options. And their testimony, at FDA meetings and in online forums, helped boost Ocaliva to FDA approval in 2016. Its list price is about $100,000 a year.

After Deborah Sobel’s sister Sarah Jane Kiley died of liver complications in 2006 at age 47, Sobel met with members of Congress and bankers to urge support for the drug and its maker, Intercept Pharmaceuticals. Although the trial required for accelerated approval was too short to show long-term improvement, the drug lowered alkaline phosphatase levels in many patients who could tolerate taking it. For some, the side effects proved too much.

Sobel, who also has the disease, began taking Ocaliva six years ago. Her last liver scan “looked like I had rolled back some of the damage,” said Sobel, 67, of Naperville, Illinois. “I can’t attribute that to the drug, but I’m religious about taking it.”

Ocaliva’s profile is typical for the FDA’s accelerated program. In 2019 the drug ranked seventh in Medicare spending — about $54 million — among products approved through the program, which launched in 1992. That same year, Congress passed the Prescription Drug User Fee Act, or PDUFA, a law committing the drug industry to pay so-called user fees to help fund the FDA’s drug approval process.

The fees have steadily swollen in importance, accounting for $2.9 billion of the agency’s $6.5 billion 2022 budget, including two-thirds of the drug regulation budget, and the work of at least 40% of the FDA’s 18,000 employees. Companies in recent years have paid between $2.5 million and $3 million to have each drug application reviewed.

In most cases, companies that win accelerated approval must submit additional data, after the drug goes to market, that proves it cures or successfully treats the disease.

It turns out that some surrogate markers are better than others. Critics lashed out at the agency in 2021 after it approved Aduhelm for Alzheimer’s disease based on the drug’s capacity to dissolve clumps of amyloid plaques in the brain. Despite that evidence, most patients, who were in the earliest stages of Alzheimer’s, didn’t get better, and over a third suffered brain swelling, a frightening and painful side effect.

When it approved Ocaliva, the FDA required Intercept to conduct another trial to produce evidence of its benefit. But the company in 2021 stopped the trial, saying it was unable to enroll enough patients. To that point, the trial had shown no clinical benefit for patients on the drug. Now, Intercept is asking the FDA to accept a combination of evidence, including studies that it says show patients taking the drug fared better than “external controls” — patients whose health records indicate they would have qualified for Ocaliva but did not receive it.

The FDA already uses such “real-world evidence” for post-market reviews of the safety of drugs, vaccines, and medical devices. But when it comes to drug approvals, records collected for routine health care are often erroneous and usually can’t replace the rigorous evidence of randomized controlled trials.

Policy Born of Impatience

Impatience — among drug companies, investors, patients, and politicians — created the user fee agreements and accelerated-approval pathway, and that impatience, for profits and cures, fuels both programs.

In the late 1980s and early 1990s, the FDA was under tremendous pressure. With AIDS cutting a deadly swath through the gay community, activists held symbolic die-ins at FDA headquarters, demanding approval of new drugs. Meanwhile, conservative groups, frustrated that approvals could take three years or more, debated changing the FDA’s charter to put drugs on the market after cursory reviews. Democrats generally were skeptical of industry user fees — and many still are. During a June debate, Sen. Bernie Sanders (I-Vt.) said drug companies might be “charging outrageous prices” because so much of FDA’s regulatory budget “comes not from taxpayers who want more access to prescription drugs but from the pharmaceutical industry itself.”

The user fees came about after then-FDA Commissioner David Kessler and industry leader Gerald Mossinghoff agreed that companies would pay sums earmarked for the agency to modernize practices, hire more staff, and set deadlines for its reviews.

The impact was immediate. AIDS drugs were the first notable success beginning in 1995, turning HIV from a death sentence into a chronic but manageable disease.

One way user fees have sped reviews is by expanding communications between industry members and the FDA. Before, “it was pretty challenging to get a meeting with FDA,” said Dr. John Jenkins, a senior agency official for 25 years and now an industry consultant. By 2019, the FDA was hosting over 3,000 drug industry meetings each year. This has dramatically changed how companies operate, he said, providing more certainty about whether they are collecting the data FDA needs for its reviews.

Although FDA-regulated products account for about a fifth of every dollar spent by U.S. consumers, Congress has never shown appetite for dramatically increasing its budget, so every five years the user fee renewals become must-pass legislation. This is their year. The user fee accords — one for each brand-name, generic, and over-the-counter drug, as well as for animal drugs, biologics, and medical devices — are packed with new programs, tweaks to old ones, regulatory deadlines, and other items negotiated by the FDA and industry, with Congress tacking its priorities onto the authorizing bill.

The fee agreements are negotiated behind closed doors — industry and FDA officials met more than 100 times to prepare the 2022 accords. At least two industry negotiators were former FDA officials, and the lead FDA negotiator, Dr. Peter Stein, was a Merck and Janssen veteran before arriving at the FDA in 2016. The FDA held six public hearings on the agreements, then announced it did not intend to incorporate a single change.

The bill stalled over the summer because of disagreements over riders affecting generic drugs, lab tests, dietary supplements — and accelerated approval. The final bill, part of a stopgap spending measure, stripped out language that would have made it harder for accelerated products to stay on the market if manufacturers failed to produce evidence of lasting value in a timely way. Stephen Ubl, president of the industry trade group Pharmaceutical Research and Manufacturers of America, or PhRMA, called the slimmed-down bill “a win for patients, biopharmaceutical innovation and regulatory predictability.”

‘I Feel Divided’

Ocaliva patients and doctors are generally grateful to have the drug, though some physicians interviewed for this article said they wouldn’t prescribe it. The drug can seriously harm patients who already have cirrhosis of the liver and produces side effects such as severe itching. But some patients can’t tolerate, or fail to benefit from, the less expensive drug ursodiol, the other main treatment for primary biliary cholangitis. And some doctors who’ve studied Ocaliva believe the drug may slow liver damage.

“I feel divided about this,” said Dr. Renumathy Dhanasekaran, an assistant professor of gastroenterology and hepatology at the Stanford University School of Medicine. “As a scientist, the accelerated approval process concerns me, but as a physician treating patients with a very challenging disease, translating some of these drugs to the clinic faster is attractive.”

While final approval of Ocaliva for primary biliary cholangitis is pending, Intercept is seeking a broader, lucrative market for the drug: as many as 13 million Americans who have non-alcoholic steatohepatitis, or NASH, a variant of fatty liver disease. The only current treatment is radical weight loss. The FDA is expected to rule on that application in 2023.

Ocaliva and Aduhelm are far from the only accelerated approval drugs whose long-term impact remains uncertain. Only a fifth of the cancer drugs approved through the platform kept people alive longer than other treatments against which they were tested, according to a 2019 study co-authored by Dr. Bishal Gyawali, an associate professor of medical oncology and public health at Queen’s University in Canada.

FDA’s cancer branch has tried to remove ineffective accelerated approval drugs from the market, and says it may begin demanding that drugmakers start confirmatory trials before receiving accelerated approval for their products. But for now, many drugs with uncertain survival benefits remain on the market. Ibrance, an oral breast cancer drug that brought Pfizer nearly $5 billion in annual revenue in recent years, falls into this category.

FDA approved Ibrance for breast cancer in 2015 after a study showed it slowed tumor progression for a full year longer than aromatase inhibitors, then the standard of care. Although Pfizer won final approval through a confirmatory trial, less tumor growth apparently did not translate into longer survival for patients on Ibrance, subsequent studies indicated.

Still, with new cancer drugs continually coming to market, it makes sense for the FDA to approve promising new medications even if their benefits are incremental, said Dr. Matthew Goetz, a breast cancer specialist at the Mayo Clinic.

“All of us were excited about Ibrance when it came out,” he said. “It was an oral drug, very well tolerated, and it pushed off the time before a patient needed chemotherapy.”

Gyawali, another breast cancer expert, said he has treated his patients with Ibrance. “Many oncologists would agree that it’s a good tool to have in their toolbox.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Listen: Grieving Families Face the Cruelest Bills

Listen: Grieving Families Face the Cruelest Bills
Listen: Grieving Families Face the Cruelest Bills

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NPR’s “Consider This” podcast tells the stories of the Markow, Shickel, and Raspe familes. All had very sick infants who died after needing highly technical, very expensive treatment in neonatal intensive care units. Medical bills lived on for each family even after their babies died. “All Things Considered” host Juana Summers spoke to KHN Midwest correspondent Lauren Weber about her reporting on The Cruelest Bills.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Journalists Dig In on the Fiscal Health of the Nation and Hospital Closures in Rural Missouri

Journalists Dig In on the Fiscal Health of the Nation and Hospital Closures in Rural Missouri
Journalists Dig In on the Fiscal Health of the Nation and Hospital Closures in Rural Missouri

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Thank you for your interest in supporting Kaiser Health News (KHN), the nation’s leading nonprofit newsroom focused on health and health policy. We distribute our journalism for free and without advertising through media partners of all sizes and in communities large and small. We appreciate all forms of engagement from our readers and listeners, and welcome your support.

KHN is an editorially independent program of KFF (Kaiser Family Foundation). You can support KHN by making a contribution to KFF, a non-profit charitable organization that is not associated with Kaiser Permanente.

Click the button below to go to KFF’s donation page which will provide more information and FAQs. Thank you!

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When to get your flu shot : Shots

When to get your flu shot : Shots
When to get your flu shot : Shots

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Gustavo Perez got his influenza vaccine from pharmacist Patricia Pernal in early September during an event hosted by the Chicago Department of Public Health at the city’s Southwest Senior Center. This year’s flu season may strike earlier and harder than usual, experts warn. A flu shot’s your best protection.

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Gustavo Perez got his influenza vaccine from pharmacist Patricia Pernal in early September during an event hosted by the Chicago Department of Public Health at the city’s Southwest Senior Center. This year’s flu season may strike earlier and harder than usual, experts warn. A flu shot’s your best protection.

Scott Olson/ Getty Images

After virtually disappearing for two years in the U.S. as the COVID-19 pandemic shut down society, there are hints the flu could reemerge this fall, potentially causing an unusually early and possibly severe flu season.

As a result, many experts are urging people to get their flu shots right away to make sure they’re protected. But is that the best timing?

It depends on which expert you talk to and, maybe, on your age and particular situation.

“It’s time to get your flu shot right now,” advises Dr. William Schaffner, a professor of infectious disease at Vanderbilt University.

“People should get them now,” agrees Shaun Truelove, an assistant scientist at the Johns Hopkins Bloomberg School of Public Health who’s helping lead a new effort to project this year’s flu season for the Centers for Disease Control and Prevention.

The usual flu season starts in November in the U.S. and peaks in January or February. “In normal years, it makes sense to hold off on the flu shot until late fall, as protection really doesn’t last more than a few months and late fall/winter is when the flu wave usually hits here,” says Deepta Bhattacharya, an immunologist at the University of Arizona College of Medicine. “So in a normal year, I would probably try to wait until mid-October and get the flu shot then,” he says. But this year, he says, “flu cases are already starting to go up, so it makes sense to get it sooner — i.e., now.”

Why flu could come back strong this year

The reason experts are particularly concerned about the flu this year is that many people, especially very young children, may have little or no immunity against the respiratory infection because the masking, social distancing and other behaviors aimed at protecting against COVID have blunted flu’s spread, too. Also, the CDC notes, young children would do well to get a flu shot soon because they require two shots one month apart, and it takes time to build up immunity.

Because the protection that flu vaccination provides to the elderly tends to wane faster than for other adults, many experts recommend against that group getting vaccinated too early — but one now is fine.

“For the elderly, I would not recommend vaccination until September at the earliest, since immunity can wane. I tend to get my vaccination in October,” says Dr. Walter Orenstein, a vaccine specialist at Emory University who previously worked at the CDC.

Warning signs from Australia

There’s another reason for many other adults to get a flu shot sooner than later: The flu season hit early and hard in some countries in the Southern Hemisphere (such as Australia) this past winter. And what happens during the winter south of the equator often foreshadows that will happen in the Northern Hemisphere.

“So getting the vaccine earlier is definitely a good idea,” Truelove says.

Still, some experts say they’re planning to wait several weeks yet to get their own shot.

“I’ll get mine sometime in November,” says John Moore, an immunologist at Weil Cornell Medicine. “Protection by flu vaccines is usually weak and short-lived,” he notes, “so getting vaccinated too early provides too little protection when the virus is actually circulating. And that’s not now. We are not in ‘flu season’ yet.”

Others say adults might reasonably wait until it seems like cases in their region are increasing.

“I’d say it’s best to keep eyes on what flu activity is like in your area,” says Jeremy Kamil, an immunologist at Louisiana State University. “Ideally, we’d want to match our boosting to afford us optimum levels of immunity when the virus is actually on the rise.”

Just don’t wait too long. Because the flu often starts to hit hard right when people are traveling and gathering for Thanksgiving, the National Foundation for Infectious Diseases encourages people to “make sure they’re vaccinated by Halloween,” says Patsy Stinchfield, the foundation’s president. “It takes about two or three weeks for antibodies to rise high enough to be protective.”

In the end, the precise timing of when you get a flu shot over the next month or so doesn’t matter as much as that you get one, flu experts agree, especially this year. Truelove’s group estimates that, in the worst case scenario, the flu could hospitalize as many as 560,000 people in the U.S. this year — and kill as many as 63,000.

“A vaccine deferred is often a vaccine not received,” Schaffner says. “You have to have the discipline to be sure that you do get vaccinated.”

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Dignity Health Mercy Medical Group Voted “Best Medical Practice”

Dignity Health Mercy Medical Group Voted “Best Medical Practice”
Dignity Health Mercy Medical Group Voted “Best Medical Practice”

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We are proud to announce that Dignity Health Mercy Medical Group was voted “Best Medical Practice” in Style Magazine’s Readers’ Choice Awards in Folsom and El Dorado Hills. This marks the 12th year that Dignity Health Mercy Medical Group received this recognition.

Best of 2022Congratulations to our care teams who made this honor possible. See the full article here. This recognition denotes Dignity Health Mercy Medical Group’s commitment to exceptional patient care. We believe that together, we can achieve better health, wellness, and improve the quality of life for our families, neighbors, friends, and most of all, our patients.

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The 8 best foods are good for tonsillitis Tonsillitis in adults

The 8 best foods are good for tonsillitis Tonsillitis in adults
The 8 best foods are good for tonsillitis Tonsillitis in adults

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Contributed by: Rachna Arya

There is a proverbial saying that “you are what you eat”. How far this is true is a subject of debate, but what you eat can definitely make a difference when you’re experiencing the discomforting symptoms of tonsillitis.

Like difficulty in swallowing, pain and irritation in the throat while talking. Your appetite might decrease and you may not feel like eating much food when your throat is on fire. However, your body still needs essential nutrients to help it heal and stay nourished. There are a variety of naturally supportive foods that can boost your immune system and fasten recovery. 

In this article, we will discuss the common foods that can help you deal with the uncomfortable symptoms of tonsillitis. 

8 Best foods good for tonsillitis

Warm beverages

Sipping on warm (not hot) liquids such as hot water, tea, ginger tea, broths, etc. helps clear the throat of dryness. And helps reduce inflammation. Various teas such as peppermint tea, ginger tea, chamomile tea, etc. have been proven remedies to soothe a sore throat. Scientific evidence shows that herbal teas/beverages form a protective film over the mucous membranes in the mouth and throat, which can help to soothe irritation.

Healing spices & herbs

Various spices and herbs have antiviral and anti-inflammatory properties. Spices like ginger, turmeric, ashwagandha, sage, cinnamon, nutmeg, and saffron are packed with antioxidants, minerals and vitamins that may help in healing. In addition to that, the healing and soothing qualities of spices will help reduce swelling and pain as well as speed up the recovery process.

Warm oats

Oats offer miraculous recovery from tonsilitis.  Its soft texture makes it easy to swallow and helps to soothe the throat. It is high in fibre, a rich source of antioxidants, magnesium, and zinc that promote fast recovery from that uncomfortable inflammation in your throat.

Pomegranate juice

Pomegranate is a superfood that is known for having high amounts of vitamin C and antioxidants that can help you quickly recover without irritating your already sore throat. Also, it is rich in many minerals and vitamins along with antioxidants that promote speedy recovery from tonsillitis in adults.

Hard-boiled or scrambled eggs

Eggs are another exceptionally viable remedy for that weird irritation and pain in the throat. This nutritional powerhouse is abundant in iron, selenium, vitamin B12, vitamin D, and zinc which helps to combat infection of tonsillitis in adults. To top it all, there are various ways to prepare them; they can be enjoyed scrambled, soft boiled and cooked without oil and seasoning, eggs may provide soothing effects and also help in dealing with inflammation.

Chicken

Consuming chicken in broths, soups, and other soothing food recipes provides soothing relief when you have tonsillitis and helps boost the immune system to fight infection. Apart from the warmth and delicious taste, it promotes the movement of nasal mucus and keeps you hydrated. 

Mashed Potatoes

The soft texture of mashed potatoes helps your immune system fight off diseases, making them a great choice when you have tonsillitis. Leave the skin on when mashing them; it’s chock full of ingredients such as magnesium, vitamin C and antioxidants which can boost recovery.  

Smoothies

Drinking fruit-based smoothies enriched with Vitamin C can also help in reduces the irritation caused in the throat. Fluids lend aromatherapeutic benefits and help in healing the sore throat faster. Just ensure that you add healing ingredients such as ginger, mint, honey, cinnamon etc. that have potent antioxidants and help support your immune system and bring down inflammation.

When it comes to how to cure tonsillitis fast, consuming foods that have soft and mushy textures is ideal. Foods such as mashed potatoes, boiled vegetables, etc. are encouraged. When suffering from tonsillitis, it is important to avoid eating spicy, dry, or fried foods that might irritate your throat. 

See a doctor as soon if your symptoms last longer than 2-3 days and are accompanied by fever. Tonsillitis can be easily treated through the right medication.

So go ahead and tweak your diet to better control or reduce the symptoms of tonsils.

Also, keep an eye on your blood pressure with regular health checks, to stay on top of your health and minimize the risk of future complications. 

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5 Healthy Drinks to Boost Your Heart Health  

5 Healthy Drinks to Boost Your Heart Health  
5 Healthy Drinks to Boost Your Heart Health  

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Contributed by: Anjali Sharma 

Introduction 

The greatest way to escape the oppressive heat and humidity is by picking up a bottle of cool water. 

Sometimes to quince the thirst we prefer to have soda and sugary drinks, which provide you with an immediate boost of freshness so you can endure the piercing weather. 

As much as we enjoy these cold beverages and prepackaged juices, we frequently ignore their negative consequences since they are filled with sugar and are aerated. The fact that these health drinks may instantly boost your blood sugar levels and actually leave you feeling lightheaded, dehydrated, and short on energy will astound you.

However, repeated drinking of these beverages tends to alter your sugar levels and heart health to the point where it can raise your risk of heart attacks, strokes, and other metabolic problems. 

Here are a few simple health drinks to help maintain the health of your heart.

Healthy drinks for a good heart health

Our heart health is directly related to the lifestyle choices we make.

Consequently, including healthy drinks and edibles in your diet may maintain your overall health. Vegetable juices that are freshly produced might help your heart. In fact, choosing a variety of vegetables and leafy greens including spinach, carrots, beets, bottle gourds, and kale can assist to boost your metabolism and heart health.

In fact, freshly prepared juices have a far higher concentration of minerals and antioxidants than any other beverage. Therefore, including a glass of nutrient-rich juices can aid in both improving and reducing the risk to your heart health.

Our morning routine would benefit greatly from the inclusion of fresh juice made from heart-healthy fruits and vegetables including raspberries, blueberries, kale, carrots, and blackberries. 

Additionally, there is evidence that compounds like flavonoids or polyphenols lower inflammation, stroke risk, and cardiovascular disease risk, thus juice from antioxidant-rich berries, grapes, cranberries, cherries, carrots, celery, and oranges can help your cardiovascular system.

Going for smoothies and shakes with low-fat milk substitutes like almond milk, oats, milk, or homemade yoghurt is another intriguing approach to boost your morning or summer diet with heart-healthy nutrients. Almond milk contains omega-3 fatty acids and vitamin E, both of which can assist to improve heart health.

Similar to this, oats are high in beta-glucans, which lower LDL levels, aid in clearing blockages in the arteries, and minimise the risk of cardiovascular illnesses. By including leafy greens like kale, broccoli, and spinach to mention a few, as well as berries high in antioxidants and avocados high in omega 3s, you may give a nutritious twist to your smoothies.

Why go for sugary beverages when you can prepare your own healthy detox drinks using a combination of fruits, vegetables, herbs, and spices? 

The appropriate combination of nutrients can increase your metabolic rate and enhance your heart health. In fact, several detox mixtures have been shown to help your body cleanse its organs, lose weight, and lower triglyceride levels. By blending your preferred components into a drink and refrigerating it, you can create these simple detox mixes and enjoy them all day long!

To prepare a heart-healthy beverage at home, combine 1 litre of water with 1/2 apple chunks, 1/2 lemon (chop into slices), 4 to 5 mint leaves, and small pieces of two-inch cinnamon.

Stir it thoroughly, then place the lid on and chill. If you enjoy the acidic flavour of lemon, add 1/2 teaspoon of lemon juice and then stir in some raw honey. You may enjoy this flavorful beverage all day long.

You can prepare additional detox beverages quite similar to this one using ingredients like strawberries, ginger, cinnamon, apple cider vinegar, carrots, and beets, to name a few.

  • Turmeric latte or Golden milk

Turmeric’s anti-inflammatory benefits are widely known. Similar to ginger, turmeric eases gastrointestinal problems and anxiety. Many health experts assert that curcumin transforms turmeric into a cardiovascular superfood. 

There is proof that the substance shields the body from cardiovascular illnesses over time. So you may use your preferred type of milk, turmeric, ginger for taste, and a spray of black pepper to reap the benefits of turmeric in the morning. Black pepper is crucial since it includes piperine, which makes it up to 2000% simpler for your body to absorb the health advantages of turmeric.

If you are looking for a caffeine fix, green tea is a great choice for your brain and heart. 

According to Nutrition Review Research, green tea consumption is associated with comparatively lesser cardiovascular health issues than regular tea. In South East Asia, it has been seen to lower levels of LDL cholesterol.

Final thoughts 

After reading this blog you must be enticed to have a glass of any of the above heart-friendly drinks. Right? Juices, smoothies, detox water, and turmeric milk can be excellent sources of nutrients, especially antioxidants.

This heart day we are spreading awareness about some of the most healthy drinks that boost heart health. These healthy drinks are the best replacements for processed juices, soft drinks and other beverages, as these healthy drinks are filled with a pack of nutrition that helps reduce the risk of cardiovascular diseases. 

In the long term, however, processed drinks can harm your health. Because it offers your limited body nutrition and a large amount of sugar and other undesirable components, it is always a good idea to satisfy your thirst with something nutritious, light, and unprocessed. 

For your herbal natural supplements for the heart, check out HerbVed Heart-up with just a click.  

Furthermore, you should also undergo preventive health checkups. These health checks give a complete report about your health, allowing you to take necessary precautionary measures to improve your well-being and keep a host of ailments at bay.

Book The Full Body Good Health Test Today!

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