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October, 2017

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Medicare options for health care dwindle in Clatsop County

4e0c3_AR-171039969 Medicare options for health care dwindle in Clatsop County

Ron Beazely

Ron Beazely and his wife, Jan, began searching for a new Medicare plan after their existing provider, CareOregon, announced it will leave Clatsop County by the end of the year.

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Ron Beazely recently learned CareOregon will no longer offer Medicare Advantage. The letter was a shock, since he relies on Social Security for income and pays only $34 a month for health care premiums. He could face a spike when he is forced to switch health plans in January.

Beazely, of Cannon Beach, is among 300 Clatsop County seniors looking for an alternative as CareOregon, following national trends, concentrates coverage in urban cores.

Jeanie Lunsford, a spokeswoman for CareOregon, said the move is about better serving the majority of customers in Clackamas, Columbia, Washington and Multnomah counties.

“It’s really that it’s a very small program, and we had a really small population in Clatsop, and it made more sense to focus in the metro area,” she said.

The move leaves someone like Beazely with two Medicare Advantage plans in Clatsop County — Moda Health and FamilyCare. CareOregon will keep its Medicare Advantage Plus program in Clatsop County for lower-income customers also supported by Medicaid, the government health insurance program for the poor and disabled.

Public and private

Medicare is a federal health insurance program for people 65 and older. The plan covers hospital care and outpatient treatment and offers other services such as prescription drug coverage through supplemental policies.

More than 7,800 seniors were on traditional Medicare in Clatsop County as of August, according to the Centers for Medicare Medicaid Services.

Another 2,343 people were using Medicare Advantage plans, with coverage provided by federally approved private insurers such as CareOregon, Moda Health and FamilyCare. Insurers negotiate with private health care providers to find the lowest-cost options.

Beazely, 71, has been covered through CareOregon’s Star Medicare Advantage plan for the past year and a half, since he and his wife, Jan, moved to Cannon Beach. The couple uses providers in the Providence Health Services network, the primary health care provider in South County.

Out of town, out of luck

Michelle Lewis, a local representative of the Senior Health Insurance Benefits Assistance program, helps seniors find health care coverage along with volunteer counselors during the open enrollment period from Oct. 15 to Dec. 7.

Lewis has seen a continuing trend of rural areas losing their plan options. Clatsop County had seven plans in 2009, compared to two as of next year, she said.

“It doesn’t surprise me,” Lewis said. “You have to have a certain number of patients to make a profit.”

A report in August by the Kaiser Family Foundation, a nonprofit focusing on health care issues, found that 147 mostly rural counties across 14 states have no Medicare Advantage plans, including Washington’s Pacific County.

“It is not entirely clear why insurers are not offering Medicare Advantage plans in these mostly rural counties, but it could be because they have less leverage to negotiate rates with hospitals and other health care providers, making these counties potentially less profitable than others,” the report said.

The lack of counties offering Medicare Advantage is about eight times that of counties that might lack insurance carriers under the federal Affordable Care Act next year. But unlike people relying on the Affordable Care Act, Medicare Advantage customers like Beazely can always fall back on traditional Medicare, although he said that option would be too expensive for him and his wife.

Beazely can also switch to Moda Health or FamilyCare, the two Medicare Advantage plans left in Clatsop County next year. But he is not a fan of Moda Health, he said, and FamilyCare’s provider network is 20 miles north in Astoria.

Beazely attended a recent town hall by U.S. Rep. Suzanne Bonamici to voice his concerns, and said he recently sat down with executives at Providence Seaside Hospital, who are trying to work out a deal with FamilyCare to expand its provider network in Clatsop County.

Beazely is waiting to hear what comes of that deal, he said. “I’m waiting on Providence Seaside Hospital to see if they can pull this rabbit out of a hat with FamilyCare.”


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Will New York’s school health centers survive Medicaid change?

  • 8597b_920x920 Will New York's school health centers survive Medicaid change?



ALBANY — The number of New York public schools with on-site health centers has nearly doubled in the past two decades, with data showing benefits to both student health and academics.

But a looming change in the way these centers are reimbursed for Medicaid patients could cause them to scale back services or close altogether, officials warned Tuesday in a news conference in the Legislative Office Building.

State legislators and health and education leaders called on the governor to sign legislation that would halt the change, by granting school-based health centers a permanent “carve-out,” or exemption, from the state’s Medicaid Managed Care program.

“Forcing school-based health centers into Medicaid managed care plans will wreck a model that works,” said Assembly Health Chair Richard Gottfried, who co-sponsored the legislation with Sen. James Seward.

The centers have received a carve-out for years on the grounds that shifting to managed care plans is too great an administrative burden. The exemption is set to expire on July 1, 2018.

Under the current system, school-based health centers receive Medicaid reimbursement directly from the state Health Department on a fee-for-service basis. Starting in July, however, they will be required to negotiate the terms and conditions for reimbursement with the students’ health plans directly. That could put 252 centers serving more than 200,000 children around the state at risk of reduced payments and increased administrative costs, including three centers in Albany, two in Schenectady, two in Middleburgh and one in Lake Luzerne, advocates say.

“If it ain’t broke, we probably don’t need to fix it,”said David Shippee, president and CEO of Whitney M. Young Jr. Health Services, which oversees centers at Giffen Memorial Elementary School, Philip Schuyler Achievement Academy and Sheridan Preparatory Academy in Albany.

The centers differ from an average school nurse’s office in that they provide a wide range of services from flu shots, annual physicals and immunizations to dentistry, mental health counseling and chronic illness management, and they are typically run by hospitals or medical practices.

They’ve become increasingly popular as a method of boosting school attendance. Students who receive their health care right in school are less likely to miss school and show up late, and more likely to seek out help for mental health issues.

A study by Johns Hopkins University found reduced hospitalization and inappropriate emergency room use among regular users of school-based health centers. A study by Emory University found the centers were responsible for a reduction in Medicaid expenditures related to inpatient, drug and emergency department use.

The legislation to grant a permanent Medicaid carve-out passed both the Senate and Assembly this June, and is awaiting a signature from the governor, whose office did not respond Tuesday to a request for comment.

It is supported by the New York School-Based Health Alliance, Greater New York Hospital Association, New York State United Teachers, the United Federation of Teachers and the New York State School Boards Association.


Opinion: The cynicism behind health-care sabotage

Open enrollment for Obamacare coverage begins Nov. 1, and already experts are warning of trouble. After years of decline, the number of uninsured has begun to rise, and as many as 1.6 million additional Americans will drop out of the program in 2018, many because they will no longer be able to afford it, according to Wall Street analyst SP Global.

The Trump administration deserves much of the blame — or in their own eyes, the credit. They have slashed the number of “navigators” hired to answer questions and help people through the enrollment process, they have slashed the number of hours that the federal website is functional, they have slashed the enrollment period itself in half, they have slashed the program’s outreach and advertising budget, and they have forced insurance companies to dramatically increase the rates they charge, with some companies abandoning the market altogether.

In short, they have used every administrative tool at their disposal to sabotage the program and to increase doubt among insurers and insured, and to some degree it appears to be working.

They have also continued to block every effort to fix the problem. Last month, for example, a group of Republican and Democratic senators hammered out a compromise that would address the rate-increase problem, and they claimed to have enough votes to pass it. However, President Trump quickly shot the plan down and House Speaker Paul Ryan said that if the Senate did pass it, he would refuse to allow his chamber to even vote on it. That ended that.

Shortly thereafter, Trump’s super PAC released a new TV ad, condemning Democrats for refusing to work with the president to fix health care.

Theoretically, you could try to defend such cynical sabotage if Republicans had a plan of their own that they wanted to implement. As we all have witnessed, they do not. They can destroy, but not build, and voters are noticing. In fact, with years of GOP health-care promises now exposed as fraudulent, Americans are increasingly likely to embrace Obamacare and to want it improved rather than destroyed. In the latest Fox News poll, 54 percent now say they have a favorable opinion of Obamacare, with just 42 percent unfavorable. That’s a 16-point improvement since March of 2015.

Unfortunately, the sabotage effort has been particularly successful here in Georgia, where Republican state officials have been trying to undermine the program since its inception. According to the Kaiser Family Foundation, only two states have a higher uninsured rate than Georgia, and health-insurance rates for individuals on the benchmark “silver plans” have risen an average of 48 percent this year, well above the national average.

Then there’s the rural health-care crisis, the opioid epidemic and the question of Medicaid expansion. Mortality rates in rural communities have risen significantly, which is astonishing in a modern industrialized country, and rural hospitals are being forced to close for want of customers able to pay for treatment. Those hospitals are a major economic driver in their own rights, and without them, communities also have little chance of attracting other employers.

As other states have discovered, Medicaid expansion could help break that cycle. By increasing the number of paying customers, it has kept rural hospitals open and saved precious jobs. It has also provided treatment to men and women addicted to opioids or methamphetamine. But the odds of Georgia Republicans approving expansion in the 2018 Legislature, with many in leadership facing primary challenges, look slim.

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Report sees “momentum” against climate change and its impact on health

Global warming is hurting people’s health a bit more than previously thought, but there’s hope that the Earth — and populations — can heal if the planet kicks its coal habit, a group of doctors and other experts said.

The poor and elderly are most threatened by worsening climate change, but there remains “glimmers of progress” especially after the 2015 Paris agreement to limit heat-trapping carbon dioxide emissions, according to a new big study published Monday in the British medical journal Lancet.

“Although progress has been historically slow, the past 5 years have seen an accelerated response, and in 2017, momentum is building,” the authors wrote. Despite the Trump administration’s decision last May to withdraw from the Paris climate agreement, “the global community has demonstrated overwhelming support for enhanced action on climate change,” which the researchers believe will have “very positive short-term and long-term health benefits.”

Comparing the report to a health checkup, four researchers and several outside experts described Earth’s prognosis as “guarded.”

“There are some very severe warning signs, but there are some hopeful indicators too,” said co-author Dr. Howard Frumkin, a professor of environmental health at the University of Washington. “Given the right treatment and aggressive efforts to prevent things from getting worse, I think there’s hope.”

The report highlighted health problems stemming from more frequent heat wavesair pollution, wildfires and other woes. While severe weather-related disasters have been costly, deaths haven’t been increasing because society is doing a better but more expensive job adjusting to the changing conditions, the researchers noted.

However, they also point out that beyond the number of deaths caused by such disasters, there’s a wider toll that includes injuries, lingering mental health impacts, the risk of infectiondiseases spread by insects, and food and water insecurity. 

A team of 63 doctors, public health officials and scientists from around the world wrote what they considered the first of a regular monitoring of the health of the planet, similar to having a “finger on the pulse of the patient,” said Dr. Hugh Montgomery, an intensive care specialist and director of the University College of London’s Institute for Health and Performance.

Based on 40 indicators, the study said “the human symptoms of climate change are unequivocal and potentially irreversible.”

While other disease rates are dropping, cases of dengue fever — a mosquito-borne disease — has doubled every decade since 1990 with 58.4 million cases and 10,000 deaths in 2013. Frumkin, a former environmental health director at the U.S. Centers for Disease Control and Prevention, said climate change, which allows mosquitoes to live in more places and stay active longer with shorter freeze seasons, is part but not all of the reason.

The same goes for the increase in tick-borne Lyme disease in the United States, Frumkin said, adding “the ticks do better with warmer weather.”

Between 2000 and last year, the number of vulnerable people — those over 65 or with chronic disease — exposed to heat waves increased by about 125 million, the study said.

It also highlighted the increasing likelihood of food shortages and malnutrition as climate change worsens.

Columbia University’s Madeline Thomson, who wasn’t part of the study team, praised the work, saying “climate is a stress multiplier” so it is important to monitor this way.

Acting on climate can have side benefits, Frumkin said. Cutting coal takes smog and soot out of the air, while eating less meat and bicycling and walking more to use less electricity means fewer accidents and reduced obesity, he said.

Omega Healthcare’s Health Scare

The past couple of days now have been pretty tough for investors in Omega Healthcare Industries (OHI). Including an after-hours share price decline of 3.7%, shares of the company have dropped 6.1% in two days, shaving $380.6 million worth of market value off of the firm’s share price. This sudden and unexpected decline is worrisome at first glance, but is it reasonable or is the market merely overreacting to developments that aren’t as bad as they appear? In what follows, I will dig into some of these developments and give my thoughts on why investors should not worry too much, but should keep a close eye on the picture moving forward.

Performance was slammed

My goal in this article is not to focus too much on headline news that you can find elsewhere. That said, it is worth mentioning, at least to put matters in context, what all happened during the most recent quarter so we can better understand what investors are worried about today. Shockingly, Omega, a firm known to be a stable cash cow, ended up coming out with some pretty bad figures. Besides the fact that sales came in at $194.06 million, missing by $44.04 million, and that AFFO (adjusted funds from operations) were $0.79, down $0.06 per share compared to estimates, we need to consider actual FFO.

You see, whenever a company announces that a figure is “adjusted”, it often means that management is trying to make the picture look better than it actually is. In truth, if used and disclosed properly, this is fine, but it can also be used to obscure more significant changes to a firm’s financial position. While Omega’s AFFO came out to $163.6 million, its actual FFO was -$46.8 million (compared to $162.6 million the same time last year), for a swing of $210.4 million from one to the other. This is quite a step, and it can be chalked up mostly to the fact that the firm recognized $194.7 million in impairments during the quarter, plus it recognized a provision for uncollectible accounts totaling $11.9 million.

Some trouble is brewing

In the past, I have written articles on Omega and, truth be told, I find the company an interesting long-term prospect (though I am worried about it from a regulatory perspective). That said, not even the most interesting firms are subject to trouble from time to time. Right now, Omega’s facing its own issues that investors need to contend with. In particular, we have the fact that one of the business’s largest customers, Orianna, is responsible for the recent impairments and the writedown in uncollectible accounts.

You see, despite the fact that only 7% of the revenue generated by Omega is in the form of direct financing leases, Orianna appears to account for a large chunk of that. According to management’s most recent estimates, the customer represents 5.2% of Omega’s total rental revenue (all spread across 42 different properties as of the end of the third quarter). This makes it the company’s fifth-largest source of rental revenue and, at the end of the second quarter when Orianna (previously called New Ark Investment, Inc.) held 54 properties, it represented 6.7% of the value of Omega’s investments.

Due to poor performance, though, Orianna has found it difficult to make cash payments in the amounts due and on time to Omega. This instability has led the latter to require Orianna to be considered a cash-basis contributor to its sales, because otherwise accruing revenue that may or may not come through could create larger issues down the road. This change is what led to the sizable impairment, but the fact of the matter is that the problem is a bit deeper than just that.

Back in 2014, Orianna’s occupancy rates averaged 92%. Today, that number has decreased to 89%. While this does not seem to be a material change, especially over such a long period of time, the fact of the matter is that this drop has led to revenue from Orianna’s properties rising only 2%, while its costs have risen by about 6%. That’s quite a swing in a business where margins generally aren’t considered all that appealing.

In response to this change in business, Omega is now trying to replace Orianna as its facility operator, but that’s expected to take around 6 months to achieve. In addition to any financial burden that may come about as a result of this time lag, management believes that in order for a company to generate better results, current annual contractual rents will likely have to fall to between $32 million and $38 million, down from the $46 million that had been agreed upon with Orianna before. To add to the trouble, there’s another customer (one that has not been disclosed) that is not a top-ten firm but which is also being placed on a cash basis due to performance issues.

The market’s overreacting

When you look at these numbers, they all seem kinda small when you consider that Omega is a $6.26 billion firm in terms of market cap. However, the bottom line impact from an FFO perspective is anything but small. You see, previously, management had forecasted FFO to range to between $3.28 and $3.30 per share this year. Now, that number is between $2.12 and $2.13 per share, or a drop of between 35.1% and 35.8%. To put this in context, using November 30th’s closing share price, Omega has gone from a multiple of 9.4 times FFO to 14.6 times FFO. Using the AFFO results is a little better. According to my estimates, instead of trading for 9 times the metric, Omega’s trading for a more pricey 9.5 times.

All of this looks a bit disturbing, especially using the non-adjusted numbers provided by management. However, while I fully suspect that this will have an impact on the company’s financials through the rest of this year and into part of next year, the short-term impact of a major customer’s arrangement resulting in lower sales while those sales will come from another customer (or customers) will likely mean that this is a short-term affect, not a permanent one. Short-term fluctuations shouldn’t mean much in the grand scheme of things if you’re a long-term value investor.

One concern that I have

Right now, Omega is one of the few non-energy firms that I find to be an attractive prospect. That said, there is one piece of data that I am a little worried about: its occupancy rates. As you can see in the image below, the business’s occupancy, not to mention the industry’s occupany, has been on the decline for at least a few years now. Sure, except for this year, Omega has done well to continue generating strong cash flows, but when you consider that two customers now (Orianna being one of them) have been hit by lower occupancy rates while the company as a whole seems to be on a downward path in that regards, it’s a bit disconcerting.

*Taken from Omega

At best, this data may be indicating a temporary soft spot in the SNF (skilled nursing facility) market. At worst, it might represent part of a permanent decline in this space. Personally, from what I’ve seen in this space, with Omega itself projecting that SNFs will run out of spare capacity by or before 2025, I believe there’s a good chance that this shift is just a soft spot, but investors would be wise to evaluate the situation closely to see what might transpire down the road.


Based on the data provided, I must say that if I were an investor in Omega, I would be quite unhappy with this development. That said, the value investor in me would probably take this moment to buy up shares in the entity at the discount they are now trading at. Personally, I would still be wary of the falling occupancy rates affecting the business, but so long as I stayed mindful to watch over that trend and react accordingly, I wouldn’t mind buying into such a high quality firm like Omega. If, though, this occupancy issue does continue to persist, and especially if it worsens, there is a chance that this could represent a harbinger of tougher times to come.

Disclosure: I/we have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours.

I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.

To Fight The Opioid Crisis, Health Experts Recommend Safe Places To Shoot Up

There are about 100 supervised injection sites operating in 66 cities around the world, including in Australia, Canada, Denmark, France, Germany, Luxembourg, the Netherlands, Norway, Spain and Switzerland. At these sites, drug users can inject illegal drugs in a clean and legal facility under the observation of trained staff. These centers don’t provide drugs, and drug users don’t share drugs or equipment. It’s simply a space to consume them.

Allegheny Health Network reports strong quarterly operating profit – Tribune

Updated 2 hours ago

Allegheny Health Network continues to show more signs of resurgence.

The seven-hospital system reported an operating income of $10.6 million for its third quarter, according to financial documents filed Tuesday.

AHN had anticipated a $7 million loss for the period, which ended Sept. 30, according to a quarterly financial statement filed with the state Insurance Department.

The network, formed in 2013 from the former West Penn Allegheny Health System, beat expectations for the fourth quarter in a row after years of losing money, according to the filing.

Chief Financial Officer Jeff Crudele said increased doctor’s office visits, better expense management and stable hospital volumes contributed to the continued uptick in finances.

“As the health care market continues to evolve, the tremendous strides we have taken this year, and over the past four years, should be reassuring to everyone who has a stake in the availability of high-quality, patient-centric and affordable health care choices in our community,” he said in a statement.

Last month, AHN and parent company Highmark Health announced a $700 million regional expansion plan that includes construction of four neighborhood hospitals, a 160-bed hospital in Pine and renovation of its existing facilities throughout Western Pennsylvania. The expansion is expected to create 800 health care jobs. AHN employs about 17,000, while rival UPMC employs nearly 80,000.

So far through the year, AHN’s operating income is $23.2 million, while the system had anticipated about $30 million in losses for the period.

Compared to the same time period last year, inpatient discharges were up 0.7 percent and physician office visits were up 2.7 percent, Crudele said.

AHN started offering same-day doctor visits in January. Since then it has scheduled 115,422 same-day appointments, more than 25,000 were new patients, according to a news release.

“AHN’s inpatient volume continues to grow year over year, even as the health network aggressively seeks to limit hospital admissions and total impatient days by better managing chronic conditions, reducing hospital readmissions, and steering patients away from the hospital and the emergency room and into outpatient clinical settings,” Crudele said. “A factor in this positive volume trend is the expanding accessibility of AHN’s services in the region through new facilities, program expansion, enhanced customer services and growing numbers of aligned employed and independent referring physicians in the market.”

AHN said its outpatient surgeries at centers in Monroeville, Wexford, Peters and Bethel Park are up nearly 13 percent from 13,384 last year at this time to 15,087 as of Sept. 30.

AHN and Highmark Health compete with UPMC and UPMC Health Plan for customers. A state-brokered consent decree that has preserved access for some Highmark members to UPMC hospitals is expiring in 2019. A three-year plan AHN filed with the state calls for continued patient growth to stabilize the hospital system.

Over the summer, Highmark Health sought and obtained greater flexibility to invest in AHN. The Pennsylvania Insurance Department loosened requirements it imposed when Highmark formed the hospital system in 2013. Highmark Health no longer has to notify the department of any transfers to AHN over $100 million.

Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991, or via Twitter at @Bencschmitt. Staff writer Wes Venteicher contributed to this report.

Increased Cost Of Health Policies Will Be Offset By Subsidies For …

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It’s time to start shopping for health insurance if you’re one of the millions who buys it on an Affordable Care Act exchange.

Open enrollment for 2018 starts Wednesday, and new numbers released by the Trump Administration show that the average cost of a benchmark policy will be about 27 percent higher next year.

But that’s just the headline. The details suggest there’s good news for lots of people who are willing to shop around a bit for insurance.

“In theory anyone who gets a subsidy should do better next year,” says Charles Gaba, an analyst who runs the web site “I have one piece of advice: Shop around.”

An analysis released Monday by the Department of Health and Human Services shows that while the average premium is going up, the average subsidy to help defray that cost is going up even more. The average tax credit offered to people to cut the price of their insurance will rise in 2018 to $555 — up 45 percent from this year’s average credit of $382.

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That means many people can take that larger tax credit and buy better insurance for less money. The HHS report shows that about 80 percent of people who buy insurance on the federal exchange could get a policy for $75 a month or less. Last year, policies that cheap were available to only about 71 percent of enrollees, the study shows.

And many people who didn’t qualify for subsidies in past years might get one for 2018, Gaba says. That’s because the subsidies are based on two things — the federal poverty level and the insurance policy’s sticker price — and both of those are going up.

People with gross incomes between 138 percent and 400 percent of the federal poverty level qualify for subsidies to help pay their premiums. That means, for 2017 policies, an individual with a gross income below $47,520 (or a family of four whose income is less than $97,200) can get a subsidy. Because of inflation, those numbers rise to $48,240 and $98,400 for policies sold this fall for 2018.

“There are people who didn’t qualify for a subsidy last year who won’t even log on and try again,” he says. “That could mean thousands of dollars” in discounts that they forego just because they don’t expect to qualify.

The analysis by HHS shows that the number of insurance companies selling plans on the exchanges will drop from 167 for 2017 policies to 132 for 2018. That means about 30 percent of consumers, particularly in rural communities, will have only one company offering a handful of policies to choose from this fall.

But the individual experiences of shoppers will vary widely.

For example, a 35-year-old woman in Ames, Iowa who earns $35,000 a year and wants to buy insurance for herself on will qualify for $445-a-month in premium subsidies. The website shows five policies available with varying levels of benefits, and prices ranging from $155 a month to $351.

The same woman in St. Petersburg, Fla., by contrast, has no fewer than 56 different policies available on the federal exchange ranging in price from $222 a month to $716.

The headline premium increases are due in part to market factors and in part to recent actions by the Trump administration.

HHS earlier this month said it will no longer reimburse insurance companies for discounts they are required by law to offer to lowest-income policy holders. The discounts are known as cost-sharing reductions because they reduce the amount people have to spend on co-payments and deductibles.

The president has been threatening all year to cut off those payments because Congress never appropriated money for them.

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Insurance companies responded to those threats by raising rates in many states to make up for the lost revenue.

Blue Cross and Blue Shield of North Carolina boosted premiums on average by 14 percent.

“The biggest single reason for the sharp increase in rates is the lack of federal funding for cost-sharing reductions,” Briand Tajlili, the company’s director of actuarial and pricing services, said in a blog post.

Oscar Health added a surcharge of 10 percent to its benchmark plans in California at the direction of that state’s insurance commissioner, says spokesman Khan Shoieb. But in New York — which has a basic health plan for low-income residents, so very few people get the cost-sharing discounts — the company raised premiums by only one-tenth of one percent.

The co-founders of Oscar, Mario Schlosser and Josh Kushner (brother of Trump’s son-in-law and adviser Jared Kushner), said in an opinion piece published by Axios that they expect many policies to be more affordable in 2018.

As premiums rise, subsidies to pay those premiums also rise for the 85 percent of people who buy insurance through the ACA exchanges and qualify for subsidies. So many people will see little change in their own costs.

And some will see their costs decline.

“Because insurers increased premiums to compensate for the loss of CSR payments, exchange customers who are eligible for premium subsidies will actually see more affordable options than they otherwise would have,” says Dianna Welch, an actuary at the consulting firm Oliver Wyman who did an early study showing the effect.

A report by the Kaiser Family Foundation shows that many companies only raised rates on their so-called silver plans, which are the policies that the ACA subsidies are based upon. But consumers are free to use their subsidies to buy any policy sold on the exchange. So a customer could take their bigger subsidy and buy a policy whose price hasn’t done up.

The Urban Institute, a left-leaning think tank in Washington, D.C., says those deals may attract more people into the marketplace. As many as 600,000 more people might buy insurance next year, the institute estimates.

By most accounts, however, that estimate is optimistic. Throughout the year, the Trump administration and Republican leaders in Congress have talked about repealing the Affordable Care Act, and the president himself has repeatedly declared Obamacare “dead.”

Those pronouncements, combined with news that insurance premiums (before subsidies) are going up, could scare lots of people away from the marketplaces.

Amazon may indeed be getting into the pharma space — but recent state license deals are not related

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The comedian Dana Carvey once asked the question, “Don’t you love the pharmacy?” The 5-minute bit that followed highlighted all the awkward, confusing, and often frustrating elements of the pharmacy experience. The audience was with him the whole time.

Whether or not Amazon CEO Jeff Bezos watched Carvey’s show, many in the industry agree that pharmacy is primed for disruption — starting with home delivery. In fact, despite the best efforts of a group of companies called pharmacy benefits managers (PBMs), such as CVS Caremark and Express Scripts, mail order pharmacies only fill a paltry 1 out of every 10 prescriptions. Most of the 4 billion prescriptions dispensed in the U.S. every year are filled at one of 60,000 retail pharmacy locations.

That should seem surprising, as the vast majority of prescriptions are refills of ongoing medications. And that makes it ideal for home delivery.

So a recent report that Amazon had acquired pharmacy wholesaler licenses sparked a major wave of excitement in the industry. After all, Amazon had hinted at their potential ambitions last spring when they contacted several industry experts about pharmacy and PBMs, as reported by CNBC. Speculation was further fueled by the acquisition of Whole Foods. A retail base coupled with mail order could be an attractive pharmacy or foundation for a PBM. Add these new so-called pharmaceutical wholesaler licenses into the mix and all the pieces seemed to be coming together.

Except that it isn’t. At least not yet.

What do the licenses mean?

The reported pharmacy wholesale licenses that Amazon acquired in 12 states is not a clear signal that the company is entering the pharmacy or pharmaceutical distribution business. The licenses Amazon applied for happen to cover the distribution of medical-surgical equipment, devices, and other healthcare related equipment, a business they are in today. The confusion results from the fact that states lump many types of distributors together in the same databases, using the same licensing forms.

What many of the ensuing media reports failed to mention is that becoming a pharmaceutical distributor or pharmacy entails additional licensure at both the state and national level.

If Amazon was entering the pharmaceutical distribution business they would need to become a “Verified Accredited Wholesale Distributor” (VAWD) by the National Association of Boards of Pharmacy (NABP). Amazon is not one of the 607 VAWD certified facilities. The laws in Indiana require VAWD certification prior to operation.

Bottom line: Amazon doesn’t have any licenses to distribute or dispense prescription medications, in Indiana or any other state.

What’s next? Drones? 

At this point, I’m asking myself how hard would it be for Amazon to actually get VAWD-certified and/or operate a pharmacy or PBM. The answer? Not very hard at all.

Amazon could either buy or build most of the software, hardware, and teams needed to start a pharmacy operation (dispensing or wholesale). Getting state licenses could take a matter of months, and not years. A budget of a few hundred million would accomplish this job, a small portion of Amazon’s $16 billion annual RD budget.

Could Amazon distribute pharmaceuticals to their own Whole Foods pharmacies in conjunction with a Amazon mail order pharmacy? Absolutely. This would enable Amazon to control their own supply chain. Perhaps they would manufacture their own generic medications like many wholesalers do. Brand drug manufacturers might welcome Amazon, at least initially, as an additional channel to reach consumers. Frankly, and in my opinion, the most challenging part for Amazon would be dealing with PBMs.

Most importantly, could Amazon transform the retail pharmacy and mail experience with a combination of self-service kiosks, lockers, delivery services, and even drones?

Something tells me that something big is going to happen in pharmacy — and soon. Maybe there’s even an opportunity for a combined distribution, pharmacy, and PBM. It’s hard to believe any company is better positioned to make one or all of these happen than Amazon. And making pharmacy less of a talking-point for comedians would be very pleasant side effect indeed.

Stephen Buck is a drug supply chain expert and the co-founder of Courage Health, a start-up that provides answers to cancer patients about their life expectancy. He previously founded RxDividends, a B2B pharmacy savings company that was acquired by GoodRx.

It’s Better to Work Out With Other People Than by Yourself. Here’s Why

977da_GettyImages-583690303_1_0 It's Better to Work Out With Other People Than by Yourself. Here's Why

The benefits go way beyond working up a sweat

Exercise is great for mental health; Research has shown that it can lower stress, improve mood and even decrease symptoms of depression and anxiety. But new research finds that a group exercise class may be even better for your mental wellbeing than a solo sweat session.

A small study published in the Journal of the American Osteopathic Association found that people who took group exercise classes reported less stress and more physical, emotional and mental health benefits than those who exercised alone or did not hit the gym at all, suggesting that a social atmosphere may compound the already numerous benefits of physical activity.

At the University of New England College of Osteopathic Medicine, 69 people in their first or second year of medical school—typically a very stressful time—were recruited for the study. One group of students did at least one 30-minute core training class together each week; another exercised alone or with one or two other people at least twice a week; and a third didn’t engage in any physical activity beyond walking or biking for transportation. Students were allowed to choose their own group.

The students took surveys about their stress levels every four weeks and periodically filled out additional surveys about their physical, emotional and mental wellbeing. After 12 weeks, the researchers determined that those taking the group core training class were seeing the best results.

The study has some limitations. It’s possible that people who chose the core training group already knew they liked group exercise, and thus saw benefits. But the research suggests that the virtues of fitness classes go far beyond working up a sweat. In addition to a community vibe, the researchers note that the music and choreography used in group classes may boost mood. 

All the more reason to hit that barre exercise class after work.

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NIH establishes new research in social epigenomics to address health disparities

News Release

Tuesday, October 31, 2017

Grant program to break new ground in genomics and health disparities research.

The National Institutes of Health will award 10 grants to support social epigenomics research in health disparities. This investigator-initiated research is being funded as part of the Social Epigenomics Research Focused on Minority Health and Health Disparities research program, which seeks to support research to better understand the drivers of health disparities. The National Institute on Minority Health and Health Disparities (NIMHD), part of the National Institutes of Health, will commit $26.2 million over five years, subject to available funds, for nine awards. An additional award under this initiative will be funded by the National Cancer Institute (NCI) – also part of NIH.

Social epigenomics is the study of how social experiences affect the genes and our biology. Our experiences do not alter the genetic code itself; however, social experiences may bring about changes in the various molecules that interact with DNA, determining which genes are switched on or off. Recent studies suggest that social stressors may affect health status through epigenomic modifications of various biological pathways.

Living in disadvantaged neighborhoods with exposure to chemical stressors, violence, discrimination, residential segregation and psychosocial stress, and limited access to healthy foods, can affect a person’s ability to stay healthy – becoming barriers to health.

“We are on the cusp of unprecedented research where we are bringing together different fields of science: social science and epigenetics, to help elucidate how social factors affect biology in health disparity populations,” said NIMHD Director Eliseo J. Pérez-Stable, M.D.

Research geared toward understanding how epigenomic changes are influenced by social experiences may lead to a better understanding of mechanisms and pathways that may ultimately affect minority health and health disparities.

By identifying epigenetic modifications prior to the onset of disease, it may be possible to tailor interventions to prevent chronic conditions or diseases later in life which may result in better approaches to disease prevention, and early diagnosis, with the end goal of reducing health disparities.

The award recipients are:

University of Michigan, Ann Arbor
Epigenetic Mediation of Adverse Social Context on Stress Response, Socioemotional Development, and Health in a Population-based Study of Minority and Low SES Children and Adolescents
Colter Mitchell, Ph.D.
1R01MD011716-01 — Researchers will examine whether DNA methylation mediates the effects of adverse social experiences, such as poverty, harsh parenting, family instability and neighborhood disorganization, on biological processes related to stress response and stress-responsive behaviors in children and adolescents.

University of Illinois-Urbana Champaign
Epigenomic Predictors of PTSD and Traumatic Stress in an African American Cohort
Monica Uddin, Ph.D.
1R01MD011728-01  — Researchers will characterize genome wide patterns of leukocyte DNA methylation in African American participants in the Detroit Neighborhood Health Study, a population-based study of mental disorders among adult Detroit residents. Analyzing glucocorticoid receptor regulatory network genes, they will test the effects of social adversity on DNA methylation levels.

University of Michigan, Ann Arbor
Race/Ethnicity, DNA Methylation, and Disparities in Cardiovascular Mortality: NHANES 1999-2002
Belinda L. Needham
1R01MD011721-01 — Researchers will study whether differences in DNA methylation between African Americans, Hispanics/Latinos, and non-Hispanic Whites helps explain why mortality rates for cardiovascular disease are higher among African Americans and how socially-patterned risk factors become physically embodied.

University of Florida, Gainesville
Epigenetic Mechanisms of Emotional/Behavioral Health Among Impoverished African American Youth 
Darlene A. Kertes, Ph.D.
1R01MD011727-01 — Researchers will investigate whether environmental stressors, such as racial discrimination and exposure to violence, are associated with DNA methylation and telomere length among low-income, urban minority youth, which can help inform biological mediators of stress effects on emotional/behavioral health.

University of Southern California, Los Angeles
Influence of Prenatal Psychosocial Stressors on Maternal and Fetal Circulating miRNAs
Carrie Breton, Sc.D.
1R01MD011698-01  — Researchers will evaluate whether psychosocial stressors in the maternal environment impact the pattern of expression of maternal and fetal microRNA (miRNA) from low SES Hispanic women and whether the expression of these miRNA can impact critical newborn and early life health outcomes indicative of future health trajectory.

North Carolina State University, Raleigh
Social Adversities, Epigenetics, and the Obesity Epidemic
Cathrine Hoyo, Ph.D.
1R01MD011746-01 —  Researchers will explore mechanisms by which social adversity confers risk for obesity in youth among Blacks, Hispanics and Whites and unravel the pathways by which mothers’ prenatal stress may alter DNA methylation and influence early development, growth trajectories and childhood obesity.

University of Pittsburgh
Exposure to Violence, Epigenetic Variation, and Asthma in Puerto Rican Children
Juan Carlos Celedon M.D., Dr.PH
1R01MD011764-01  — Researchers will determine how exposure to violence leads to increased risk of asthma and asthma morbidity through altered methylation of genes regulating behavioral, autonomic, neuroendocrine and immunologic responses to stress in Puerto Rican children.

Beckman Research Institute, City of Hope, Duarte, California (NCI-funded)
Epigenetic Damage in Women Living in LA Food Desert Zip Codes Victoria Seewaldt, M.D.
1R01CA220693-01 —Researchers will explore in young Women-of-Color (African-American and Latina/Hispanic-American) living in food-desert zip codes in Los Angeles, whether insulin-resistance promotes epigenetic damage and triple-negative breast cancer (TNBC) risk.

North Carolina Central University, Kannapolis
Molecular Determinants of Social Factors in Prostate Cance
1R01MD012767-01 — Deepak Kumar, Ph.D.
Researchers will analyze circulating microRNAs and stress hormone levels in African American prostate cancer patients living in the Washington D.C., metropolitan area, at different levels of socioeconomic status (SES) and social stress to understand the epigenetic mechanisms modified by social stress that may cause prostate cancer health disparities.

Northwestern University
Understanding Socioeconomic Disparities in Perinatal Risk: The Role of Epigenetic and Transcriptional Regulation in the Placent
1R01MD011749-01 — Gregory Evan Miller, Ph.D.
Researchers will determine the extent to which socioeconomic/psychosocial conditions affect prenatal DNA methylation, miRNA expression, mRNA expression and inflammation, and influence preterm birth and small for gestational age among low SES women.

NIMHD is one of NIH’s 27 Institutes and Centers. It leads scientific research to improve minority health and eliminate health disparities by conducting and supporting research; planning, reviewing, coordinating, and evaluating all minority health and health disparities research at NIH; promoting and supporting the training of a diverse research workforce; translating and disseminating research information; and fostering collaborations and partnerships. For more information about NIMHD, visit

About the National Cancer Institute (NCI): NCI leads the National Cancer Program and the NIH’s efforts to dramatically reduce the prevalence of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI website at or call NCI’s Cancer Information Service at 1-800-4-CANCER.

About the National Institutes of Health (NIH):
NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

NIH…Turning Discovery Into Health®


Pfizer expects broad interest for consumer health business

NEW YORK (Reuters) – Pfizer Inc, the largest U.S. drugmaker, expects no shortage of suitors for its consumer health business and said it would decide whether to sell, spin off or retain the unit next year.

The business, with brands such as pain drug Advil, Centrum multivitamins and Chapstick lip balm, had sales of about $3.4 billion in 2016.

“We expect broad interest from potential acquirers,” Chief Executive Ian Read said on Tuesday after the company reported its third quarter results.

Supply problems related to sterile injectable products acquired in Pfizer’s purchase of Hospira, along with steep declines in sales of off-patent products, contributed to an 11 percent drop in third quarter revenue from the Essential Health unit to $5.05 billion.

Pfizer said the supply challenges would have a negative impact of “several hundred million dollars” this year, moderating in 2018.

Pfizer shares were off 0.7 percent at $34.90 shortly after midday.

SunTrust Robinson Humphrey analyst John Boris said Essential Health was “under pressure” and that investors were concerned about new competitors grabbing sterile injectables market share before Pfizer’s manufacturing challenges are fully addressed.

Pfizer said all of its 2,000 Puerto Rico-based employees were safe and that it had made significant progress in dealing with damage to its three manufacturing plants on the island devastated by hurricane Maria last month.

Chief Financial Officer Frank D‘Amelio said the revenue impact from the storm was “expected to be insignificant.”

Innovative Health sales rose 11 percent in the quarter to $8.12 billion with strong contributions from its blockbuster pneumonia vaccine Prevnar and breast cancer drug Ibrance.

Prevnar sales declined 1 percent to $1.52 billion, but topped analysts’ estimates of about $1.46 billion.

Ibrance sales surged nearly 60 percent to $878 million but fell short of lofty Wall Street expectations for $914 million.

Sales of rheumatoid arthritis drug Xeljanz rose 48 percent to $348 million but were held back in Europe, where the company is still negotiating reimbursement with several countries.

Pfizer sees additional sales growth with an expected approval in psoriatic arthritis and said it still expected new eczema cream Eucrisa to eventually reach annual sales exceeding $2 billion.

It also said it hoped a potential approval for Xtandi in non-metatstatic prostate cancer based on recent data would provide a new growth ramp for that key medicine from its 2016 acquisition of Medivation.

The company raised the midpoint of its full-year adjusted earnings forecast by 3 cents to a range of $2.58 to $2.62 per share. It tightened its 2017 revenue forecast to $52.4 billion to $53.1 billion, from $52 billion to $54 billion.

Excluding items, Pfizer earned 67 cents per share for the quarter, beating analysts’ average estimates by 3 cents, according to Thomson Reuters I/B/E/S.

“We view these results as refreshingly boring. We think boring is a good thing right now,” Credit Suisse analyst Vamil Divan said in a client note.

The lack of drama was welcomed after several drugmakers this quarter spooked investors with new concerns over critical growth products, including Merck Co, Celgene Corp and Gilead Sciences Inc.

Reporting by Bill Berkrot in New York and Akankshita Mukhopadhyay and Ankur Banerjee in Bengaluru; Editing by Savio D’Souza and Richard Chang

Flint Residents Confront Long-Term Health Issues After Lead Exposure

045de_ap_160986322233_wide-84ba3219d41a769634815d11562fb6fcace56d1e-s1100-c15 Flint Residents Confront Long-Term Health Issues After Lead Exposure

Dr. Mona Hanna-Attisha, who helped expose the Flint water crisis, speaks during a House Democratic Steering and Policy Committee hearing on Capitol Hill in Washington, D.C., on Feb. 10, 2016.

Andrew Harnik/AP

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Andrew Harnik/AP

Dr. Mona Hanna-Attisha, who helped expose the Flint water crisis, speaks during a House Democratic Steering and Policy Committee hearing on Capitol Hill in Washington, D.C., on Feb. 10, 2016.

Andrew Harnik/AP

Three years into the water crisis in Flint, Mich., many residents still rely on bottled water, and experts say the ramifications are likely to continue for years to come.

The water crisis began in 2012, when Flint decided to switch the city’s water source and failed to treat the water with an anti-corrosive. Water corroded the pipes, allowing lead to dissolve into the water. Even as the city replaces the tainted lines, the water remains unsafe to drink.

045de_ap_160986322233_wide-84ba3219d41a769634815d11562fb6fcace56d1e-s1100-c15 Flint Residents Confront Long-Term Health Issues After Lead Exposure

A federal judge last week ordered the city to decide on a long-term water source, Michigan Radio’s Steve Carmody reports. Court hearings for state officials facing criminal charges for their role in the crisis and cover-up are scheduled to resume in November.

Exposure to lead-tainted water can also cause long-term health impacts. Flint pediatrician Dr. Mona Hanna-Attisha, who helped expose the water crisis, tells Here Now’s Jeremy Hobson that the health effects of lead exposure are not immediately seen.

“It’s known as a silent pediatric epidemic,” she says. “It’s something that we see years if not decades after exposure to lead.”

Hanna-Attisha explains that lead exposure lowers IQ levels, creating cognitive and behavioral issues for children in the future. Lead exposure is difficult to treat because it is an irreversible neurotoxin, Hanna-Attisha says.

“There is no cure. There is no antidote,” she says. “However, there is so much that we can do and that we are doing to minimize, to mitigate, to buffer the impact of the exposure. We cannot take it away, but we can do so much to lessen it.”

045de_ap_160986322233_wide-84ba3219d41a769634815d11562fb6fcace56d1e-s1100-c15 Flint Residents Confront Long-Term Health Issues After Lead Exposure

Hanna-Attisha says the city is building programs to help support children, so they can overcome future challenges caused by lead exposure. She says interventions like universal preschool and access to nutrition are key to reducing the impact.

We have a robust investment in early education,” she says. “We have Medicaid expansion. We have mobile grocery stores, breastfeeding services, 24-hour mental health care. These are things that all children need everywhere, but these are things that we are putting in place for the kids in Flint.”

When they discovered the water was tainted, Hanna-Attisha and her fellow researchers struggled to convince state officials, who long-denied the water was contaminated. They revealed their findings at a press conference in September 2015.

“We were hearing reports of lead in the water by the Virginia Tech group and when we, as pediatricians, hear about lead anywhere we need to act,” Hanna-Attisha told Here Now’s Robin Young last year. “You don’t release research at press conferences, but we had an ethical, moral obligation to inform the community that the water has lead and it looks like it’s getting into the bodies of children.”

Flint Mayor Karen Weaver says the city is stuck in “limbo” without a long-term water contract. According to Michigan Radio, her efforts to sign a 30-year contract with the Great Lakes Water Authority have been blocked by the city council over cost concerns. GLWA has been providing water to Flint on a month-to-month basis, but the lack of a long-term agreement is draining the city financially.

045de_ap_160986322233_wide-84ba3219d41a769634815d11562fb6fcace56d1e-s1100-c15 Flint Residents Confront Long-Term Health Issues After Lead Exposure

According to the American Society of Civil Engineers, water infrastructure in the nation as a whole is in horrible shape, water quality engineer Marc Edwards told Hobson last year.

“I think the best grade the drinking water pipes system has gotten in the last six years is a D-minus,” Edwards says. “So because it’s out of sight, out of mind, no one pays attention to it until a pipe breaks or it hurts us somehow and that’s certainly what’s happened in Flint.”

Flint’s refusal to treat the water with an anti-corrosive reflects how the U.S. has been slow to protect drinking water, Hanna-Attisha says. Congress did not prohibit the use of lead pipes that provided water for human consumption until 1986. And it wasn’t until 2014 that the government restricted lead from brass plumbing fixtures.

“We were stubbornly, stubbornly slow as a nation to restrict lead from our plumbing, even though we’ve known about the evil of lead for really centuries,” Hanna-Attisha says. “The EPA had an opportunity to strengthen that rule, and they said, ‘Hey, we’re going to pass on this. We’re not going to strengthen this, we’re not going to learn from Flint, and we’re going to let countless other children be exposed to a neurotoxin.’ “

How Climate Change Is Already Affecting Health, Spreading Disease

c7271_climatetriptych_custom-263458d0e29bff7088dcba3d23f918710dab8182-s1100-c15 How Climate Change Is Already Affecting Health, Spreading Disease

Monsoon rains flooded Mumbai in August 2017. Aedes aegypti mosquitoes can spread diseases like dengue fever. Drought has affected the health of Somalians.

(From left) Punit Paranjpe/AFP/Getty Images; Christophe Simon/AFP/Getty Images; Arif Hudaverdi Yaman/Anadolu Agency/Getty Images

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(From left) Punit Paranjpe/AFP/Getty Images; Christophe Simon/AFP/Getty Images; Arif Hudaverdi Yaman/Anadolu Agency/Getty Images

Monsoon rains flooded Mumbai in August 2017. Aedes aegypti mosquitoes can spread diseases like dengue fever. Drought has affected the health of Somalians.

(From left) Punit Paranjpe/AFP/Getty Images; Christophe Simon/AFP/Getty Images; Arif Hudaverdi Yaman/Anadolu Agency/Getty Images

For decades, scientists have been making predictions about how climate change will hurt health around the world.

But actually showing a link? That’s been pretty tough.

Take for example, mosquito-borne diseases. It’s easy to blame rising temperatures for the global spread of Zika or the explosion of dengue fever. Mosquitoes thrive in higher temperatures, right?

Yes and no. As we reported earlier this year, warmer weather doesn’t necessarily mean mosquitoes are more likely to spread viruses like dengue, yellow fever and Zika. Higher temperatures can actually reduce transmission of viruses because the insect’s lifespan can decrease in warmer weather. So the mosquito may die before the virus has time to mature and become infectious inside of it.

In other words, climate’s connection to health is extraordinarily complicated.

Now international team of scientists has taken a step toward untangling this problem on a global scale.

“All of the work we present is pretty tricky,” says Dr. Nick Watts, at University College London, who led the study. “I don’t think any of us would ever say that this has been easy.”

Around the world, people have experienced an average increase in temperature about 1.5 degrees Fahrenheit, and the study — published Monday in The Lancet journal — finds several signs that even this small amount of warming threatens the health of hundreds of millions of people each year.

First, the number of vulnerable people exposed to heat waves has surged worldwide, the study finds. In the past few years, more about 125 million people over age 65 experienced heat waves each year, compared to about 19 million people each year in the 1990s.

“That’s a pretty stunning number,” says Kim Knowlton, an environmental researcher at Columbia University, who studies climate change and health at but wasn’t involved in this study. “Heat waves aren’t just an inconvenience. Heat kills.” And it also exacerbates existing problems, such heart disease and kidney problems.

This recent surge in heat waves is consistent with previous studies looking at health and climate change, including meta-analyses published by the Intergovernmental Panel on Climate Change in 2014. “Rising temperatures have [likely] increased the risk of heat-related death and illness,” the IPCC wrote.

The second major consequence of warming temperatures is an increase in weather-related disasters. The frequency of floods, droughts and wildfires, collectively, has increased by 46 percent since the 1980s, rising from about 200 events each year to 300 events per year. And some of that increase is due to climate change, the Lancet study finds.

Families around the world — including those in the U.S. — are already experiencing these events firsthand, Knowlton says.

“Communities are hurting. People are reeling globally,” she says. “And I think this experience might mark a turning point in the public’s perception of climate change because people are connecting the dots to their health, here and now.”

Surprisingly, the study finds that deaths from weather-related disasters has not increased during the same time period.

There’s no discernible upward or downward trend in the lethality of these extreme weather events,” Watts says. “That may simply be because the data is not over a long enough period of time to isolate that trend.”

And then there’s the question of mosquito-borne diseases. Since 1990, annual cases of dengue worldwide have doubled each decade. Much of this rise is likely due to rapid urbanization and global travel, the World Health Organization says.

But Watt and his collaborators do find that climate change has contributed to dengue’s explosion — at least a little bit.

“We’re not trying to say that all cases of dengue fever are the result of climate change,” Watts says. “But we’ve identified a very strong signal in the climate trends that are increasing the capacity of the Aedes mosquitoes to spread dengue.” Although they don’t yet know why.

Specifically, the team estimates that climate change has increased dengue transmission by Aedes aegypti and Aedes albopictus by 3 percent and 6 percent, respectively, since 1990.

Finally, the Lancet study also analyzes what countries are doing to slow down climate change. “That’s probably the part of this report that really surprised me,” Watts says. “There are glimmers of hope in that data.”

For the past 25 year, he says, countries have been basically doing very little to reduce carbon emissions. “Progress has been woefully inadequate.”

But now there are signs the tide may be turning by a small degree.

“In the past five years, we have started to see an acceleration in the response to climate change,” Watts says.

In particular, the use of coal around the world has slowed down, the study finds and even possibly even peaked in 2013. Some countries are relying more on natural gas and some are starting to swap in renewable energy sources — like geothermal, hydropower, ocean energy, solar energy and wind energy — which not only reduce carbon emissions but also make the air healthier for people to breath.

“That’s really exciting,” Watt says. “Because we could all use a little bit of hope at the moment.”

c7271_climatetriptych_custom-263458d0e29bff7088dcba3d23f918710dab8182-s1100-c15 How Climate Change Is Already Affecting Health, Spreading Disease

Essential Phone update adds fingerprint gestures, touch scrolling improvements, and more

6dd5d_essential-ph-1-phone-review-aa-21-of-28-840x473 Essential Phone update adds fingerprint gestures, touch scrolling improvements, and more

During a Reddit AMA earlier this month, the Essential team discussed some of the current problems facing the Essential Phone, and the improvements that were coming up. Among them was a fix for a touch issue that causes a stutter when scrolling, as well as finger gestures for use with its fingerprint scanner.

With a nimble 75 MB update currently rolling out, Essential seems to be making good on its promises. The update, which features build number NMJ20D, delivers the aforementioned optimizations and is said to be hitting devices right now (according to Droid Life). In addition to the expected upgrades, Essential has also rolled out the October Android security updates — including a patch for the recently discovered KRACK exploit — plus general performance improvements and bug fixes.

Essential Phone now priced at $499, previous buyers get a $200 ‘friends and family’ code

As for when the device will see Android Oreo, Essential has confirmed that it’s in progress, but we’re still waiting on the beta to arrive. In the aforementioned AMA, the Essential Team said that a public Oreo beta was “several weeks” away. That was three weeks ago, so it could arrive any time now; judging by the delays we’ve already seen at Essential, I wouldn’t be surprised if this was still some ways away, though.

Look out for the NMJ20D update arriving to your Essential Phone soon.

Moto X4 now on sale for $399 in the US


Order the Google Pixel 2:
Verizon |
Best Buy

The 10 best antivirus tools for Android | CSO Online

Android viruses (and other malware) are on the rise, but how much of a threat are they to enterprises? And what are the best tools for combating them?

AV-TEST’s Research from the AV-TEST Institute, a Germany-based independent service provider of IT security and antivirus research, shows that Android malware samples collected have increased sizably every year. In 2014, the total was more than 326 million. The next year, the malware tally reached more than 470 million. In 2016, AV-TEST recorded nearly 597.5 million samples—nearly double the amount from two years earlier.

e0d8e_avtest_malicious_android_apps-100740146-large The 10 best antivirus tools for Android | CSO Online AV-TEST Institute

AV-TEST data shows steep growth of Android malware

By 2019, mobile malware will comprise about 33 percent of all malware reported in standard tests, up from 7.5 percent today, according to Gartner’s August 2017 “Market Guide for Mobile Threat Defense Solutions.” Though iOS devices aren’t immune from malware, “The mobile malware threat is primarily coming from Android,” said Dionisio Zumerle, research director at Gartner. The threat should be a concern for all companies with Android users, he said—especially those with large fleets of Android devices or that are in high-security verticals such as finance, healthcare, and government.

Android malware is getting more sophisticated, too. Consider DoubleLocker—Android ransomware that IT security firm ESET recently detected. DoubleLocker is capable of changing a device’s PIN, preventing users from accessing their devices. It can encrypt the data on the device. That’s a double whammy, the likes of which haven’t been seen before in the Android ecosystem, according to ESET.

Android 8.1 feature spotlight: Covering the proximity sensor no longer turns off Ambient Display

The latest Android developer preview is filled with lots of incremental changes, many of which are thoughtful and useful. It wouldn’t be possible for Google to get everything right in a beta release, though, and this alteration seems to be more of a backward step.

Previously in Oreo, if you’d set Ambient Display to wake with a notification or with a double tap, it would shut off if the proximity sensor was covered. This was useful for conserving battery as it would turn the screen off as soon as you put it in a pocket or a bag. It was also good if you’d already seen whatever it was notifying you about, as you could simply wave your hand over the sensor to sleep the screen. Now that’s no longer possible.

In the 8.1 dev preview on any device, just as in 8.0 on the Pixel 2 and 2 XL, the proximity sensor has no bearing on the functioning of Ambient Display, or at least it doesn’t shut off when you cover the sensor. From my testing, if the sensor is already covered, AD won’t trigger and the screen won’t wake. So it won’t constantly fire while it’s in your pocket, which is a relief.

Edit: It’s important to note that the behavior I’m describing occurs when ‘Always on’ is in the off position (Pixel 2 and Pixel 2 XL only). Specifically I’m talking about when Ambient Display is triggered by double tap, lifting the phone, or a new notification, depending on how you’ve got AD set up. This applies to any situation on OG Pixels, since they don’t have an ‘Always on’ setting like the new Pixels.

Ultimately, Ambient Display shouldn’t use up too much battery anyway, not with an OLED display that’s capable of waking only specific pixels, such as the ones used on all Pixel phones. It does present a greater risk of screen burn-in if it’s overused, though, so it’s certainly something to keep an eye on. The Pixel 2 XL, in particular, could do without further screen related woes.

Unroll.Me brings its email management app to Android | TechCrunch

0241d_mailbox Unroll.Me brings its email management app to Android | TechCrunch

Android users will now be able to battle junk mail and manage their email subscriptions using the new Android app from Unroll.Me.

To be clear, anyone with a smartphone could get the benefits of the service already. You just had to connect you email account, then use Unroll.Me’s features to unsubscribe to the emails you didn’t want and roll-up the rest into a single daily digest.

However, CEO Jojo Hedaya sounds particularly proud of his team’s app interface — first released on iOS and now on Android. The idea is to turn managing your subscriptions into a fun, Tinder-style interaction, where you swipe left to unsubscribe, swipe up to add a newsletter to your daily Rollup and swipe right to just keep it in your inbox.

“I’m very confident this is the best way to remove clutter from your inbox,” Hedaya said.

Do most people really have enough subscriptions for to do much swiping? Well, Unroll.Me says the average user has more than 62 subscriptions on signup. And aside from the swiping, the app also allows you to manage a list of all your subscriptions and read your Rollup.

0241d_mailbox Unroll.Me brings its email management app to Android | TechCrunch

While you can get a lot done in the app, Hedaya emphasized that he’s not trying to replace a traditional email client.

“In my opinion, past [attempts] to solve the email client game went 75 percent of the way there,” he said. “I wanted to make sure that we had a separate solution that just helps you with email clutter.”

Like Unroll.Me’s other services, the Android app is available for free — the company is owned by Rakuten/Slice and makes its money from user data. (That got Unroll.Me into hot water earlier this year, and as a response, Hedaya has vowed to be more transparent.)

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