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Poor Health, High Expectations for Medicaid, Analysis Finds

People on Medicaid are more prone to smoke, struggle with depression and obesity, or rate their own health as fair or poor. But that’s not the whole story.

A new study suggests that low-income Medicaid recipients are also invested in their health, with 4 out of 5 saying they have a personal doctor, 3 out of 5 saying they eat healthy, and nearly half saying they exercise frequently.

Experts say the analysis for The Associated Press by the Gallup-Sharecare Well-Being Index indicates that Medicaid could gain by putting more emphasis on prevention, and stressing better coordination of care. Such strategies are already employed by many workplace health plans and by Medicare.

Call it Medicaid’s health care challenge.

Trump: Order ‘Very Big Step’ to Dismantling ‘Obamacare’

President Donald Trump talked about his intent to dismantle former President Barack Obama’s health care law “step by step,” starting with an executive order he signed Oct. 12 to offer lower premiums and an upcoming one halting payment to insurers working under “Obamacare” policies.

(Published Friday, Oct. 13, 2017)

A federal-state program originally envisioned as a safety net for poor families and severely disabled people, Medicaid has grown to cover about 1 in 5 Americans, at a total cost of about $600 billion annually. In states that expanded Medicaid under former President Barack Obama’s health law, it’s become the insurer for many low-income working adults. The Trump administration tried to unravel Obama’s expansion, but top officials have also said they want to work to better the health of Medicaid beneficiaries, not just pay medical bills.

“We now have emerging evidence in Medicare and commercial insurance of how care coordination and prevention can help patients with chronic conditions avoid costly hospitalizations and ER visits,” said Kavita Patel, a policy expert at the Brookings Institution who’s also a practicing physician. “This really should become the standard across Medicaid programs.”

In small town Stuttgart, Ark., Vickie Rose says Medicaid coverage is helping her try to quit smoking for good, which would entail shutting down a decades-long habit that once reached three packs a day.

“I’m not going to be able to stay out of hospitals if I don’t take matters into my own hands,” said Rose, who’s in her early 60s and has worked jobs from factory supervisor, to retail, to staffing an animal shelter. Sometimes she travels 20 miles to the Mid-Delta community health center in neighboring Clarendon for smoking cessation meetings.

“Instead of waiting on everyone else, this time I’m going to do it for myself,” said Rose.

Thirty-six percent of Medicaid recipients said they smoked in the Gallup-Sharecare study, compared to 13 percent of those with employer or union health insurance, and 16 percent of Medicare beneficiaries.

Trump Announces Sweeping Tax Reform Plan

President Trump traveled to Indianapolis Wednesday to pitch his new tax reform plan.

“Under our framework, the vast majority of families will be able to file their taxes on a single sheet of paper,” the president said.

(Published Wednesday, Sept. 27, 2017)

The Gallup-Sharecare survey interviews about 500 people a day on health care issues, yielding a trove of data. The new analysis for AP compared health indicators among people with different types of coverage.

In other findings:

— Twenty-five percent of Medicaid beneficiaries said they are currently suffering from depression, compared with 7 percent of those with employer coverage.

— Forty percent of people with Medicaid said they were in fair or poor health, compared with 11 percent of those in employer plans and 31 percent of those on Medicare.

— Thirty-six percent of Medicaid beneficiaries said they are obese, compared with 28 percent of people in employer plans, and 30 percent of those with Medicare.

Still, survey director Dan Witters said that’s only half the story.

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“Just because they smoke more, doesn’t mean that they don’t have an interest in their health,” Witters said of those with Medicaid. “Their interest in their health is generally just as high as it is for other groups…although I think they are swimming upstream.”

Having a low income has long been associated with poor health, but Witters said on questions such as exercise frequency, eating healthy, and eating fruits and vegetables, the answers from Medicaid recipients generally tracked those of people with workplace coverage.

In one counter-intuitive finding, 81 percent of Medicaid recipients said they had a personal doctor, about the same as 83 percent of those on employer plans. Because Medicaid pays less than private insurance or Medicare, a longstanding criticism is that beneficiaries might not be able to find a doctor who’ll see them. But most states now contract with private insurers to administer their programs, and those insurers must provide a physician network.

In theory the networks used by Medicaid insurers could also serve to promote prevention and care coordination, but Matt Salo, head of the National Association of Medicaid Directors, cautioned against a cut-and-paste approach that grafts on strategies used by employers.

“The Medicaid population is not just an employer population with less income,” said Salo. “It is people who have health conditions.”

Salo said he was struck by the high rates of depression in the survey. “Depression is inextricably linked to physical health and the ability to engage effectively in the work force,” he said.

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Some states are trying to get ahead of the health challenges of their Medicaid beneficiaries. In Michigan, for example, people covered by expanded Medicaid complete an annual health assessment, somewhat similar to workplace wellness programs.

“We’ve got some figuring out to do,” Salo said.

The Gallup-Sharecare results are based on telephone interviews conducted Jan. 2-Nov. 5, with a random sample of 147,465 adults, aged 18 and older, living in all 50 U.S. states and Washington. D.C.

For the total sample of national adults, the margin of sampling error is plus or minus 1 percentage point. For Medicaid recipients, the margin of sampling error is plus or minus 1.6 percentage points.

AP Exclusive: Poor health and high expectations for Medicaid

People on Medicaid are more prone to smoke, struggle with depression and obesity, or rate their own health as fair or poor. But that’s not the whole story.

A new study suggests that low-income Medicaid recipients are also invested in their health, with 4 out of 5 saying they have a personal doctor, 3 out of 5 saying they eat healthy, and nearly half saying they exercise frequently.

Experts say the analysis for The Associated Press by the Gallup-Sharecare Well-Being Index indicates that Medicaid could gain by putting more emphasis on prevention, and stressing better coordination of care. Such strategies are already employed by many workplace health plans and by Medicare.

Call it Medicaid’s health care challenge.

A federal-state program originally envisioned as a safety net for poor families and severely disabled people, Medicaid has grown to cover about 1 in 5 Americans, at a total cost of about $600 billion annually. In states that expanded Medicaid under former President Barack Obama’s health law, it’s become the insurer for many low-income working adults. The Trump administration tried to unravel Obama’s expansion, but top officials have also said they want to work to better the health of Medicaid beneficiaries, not just pay medical bills.

“We now have emerging evidence in Medicare and commercial insurance of how care coordination and prevention can help patients with chronic conditions avoid costly hospitalizations and ER visits,” said Kavita Patel, a policy expert at the Brookings Institution who’s also a practicing physician. “This really should become the standard across Medicaid programs.”

In small town Stuttgart, Ark., Vickie Rose says Medicaid coverage is helping her try to quit smoking for good, which would entail shutting down a decades-long habit that once reached three packs a day.

“I’m not going to be able to stay out of hospitals if I don’t take matters into my own hands,” said Rose, who’s in her early 60s and has worked jobs from factory supervisor, to retail, to staffing an animal shelter. Sometimes she travels 20 miles to the Mid-Delta community health center in neighboring Clarendon for smoking cessation meetings.

“Instead of waiting on everyone else, this time I’m going to do it for myself,” said Rose.

Thirty-six percent of Medicaid recipients said they smoked in the Gallup-Sharecare study, compared to 13 percent of those with employer or union health insurance, and 16 percent of Medicare beneficiaries.

The Gallup-Sharecare survey interviews about 500 people a day on health care issues, yielding a trove of data. The new analysis for AP compared health indicators among people with different types of coverage.

In other findings:

— Twenty-five percent of Medicaid beneficiaries said they are currently suffering from depression, compared with 7 percent of those with employer coverage.

— Forty percent of people with Medicaid said they were in fair or poor health, compared with 11 percent of those in employer plans and 31 percent of those on Medicare.

— Thirty-six percent of Medicaid beneficiaries said they are obese, compared with 28 percent of people in employer plans, and 30 percent of those with Medicare.

Still, survey director Dan Witters said that’s only half the story.

“Just because they smoke more, doesn’t mean that they don’t have an interest in their health,” Witters said of those with Medicaid. “Their interest in their health is generally just as high as it is for other groups…although I think they are swimming upstream.”

Having a low income has long been associated with poor health, but Witters said on questions such as exercise frequency, eating healthy, and eating fruits and vegetables, the answers from Medicaid recipients generally tracked those of people with workplace coverage.

In one counter-intuitive finding, 81 percent of Medicaid recipients said they had a personal doctor, about the same as 83 percent of those on employer plans. Because Medicaid pays less than private insurance or Medicare, a longstanding criticism is that beneficiaries might not be able to find a doctor who’ll see them. But most states now contract with private insurers to administer their programs, and those insurers must provide a physician network.

In theory the networks used by Medicaid insurers could also serve to promote prevention and care coordination, but Matt Salo, head of the National Association of Medicaid Directors, cautioned against a cut-and-paste approach that grafts on strategies used by employers.

“The Medicaid population is not just an employer population with less income,” said Salo. “It is people who have health conditions.”

Salo said he was struck by the high rates of depression in the survey. “Depression is inextricably linked to physical health and the ability to engage effectively in the work force,” he said.

Some states are trying to get ahead of the health challenges of their Medicaid beneficiaries. In Michigan, for example, people covered by expanded Medicaid complete an annual health assessment, somewhat similar to workplace wellness programs.

“We’ve got some figuring out to do,” Salo said.

The Gallup-Sharecare results are based on telephone interviews conducted Jan. 2-Nov. 5, with a random sample of 147,465 adults, aged 18 and older, living in all 50 U.S. states and Washington. D.C.

For the total sample of national adults, the margin of sampling error is plus or minus 1 percentage point. For Medicaid recipients, the margin of sampling error is plus or minus 1.6 percentage points.

One month later: iPhone X has far exceeded my expectations [Video]

The iPhone X was a big risk for Apple, because of the removal of the Home button and its heavy reliance on gestures, but it’s clear to me that Apple succeeded in making it work. After using the iPhone X day-to-day for almost four weeks, I’ve become well-accustomed to it as my daily driver.

At its core, the iPhone X is basically an enhanced iPhone 8, but its reliance on gestures, significantly reduced bezels, TrueDepth Camera, and OLED display make it look, feel, and at times, perform like an entirely new device. There are other things to consider as well: the glass and metal design, and upgraded telephoto camera hardware, to name a few.

For as much flack as Apple has received for the iPhone X’s so-called notch, and some of the nagging issues that continue to persist throughout iOS, the release is nonetheless a remarkable achievement.

9ed62_matias-wireless-aluminum-keyboard-hands-on One month later: iPhone X has far exceeded my expectations [Video]

The best wireless keyboard for the Mac?

Glass meets metal

I was never a fan of the iPhone 6-era design. To me it started to look dated right after the iPhone 6s launched, and by the iPhone 7’s release I was tired of the design. I still consider both the original iPhone and the iPhone 4 to be the best designs in the product’s storied history. The iPhone X is like an amalgamation of the original iPhone and the iPhone 4, making it my favorite design yet.

More importantly, the iPhone X feels great in the hand. Its polished metal band and glass back make it less slippery than previous iPhones, and it’s narrow enough to easily hold in the hand.

Video walkthrough

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Tiny bezels

I’ve heard some people say that the iPhone X’s reduced bezels aren’t a big deal, but I disagree. For one, the reduced bezels allow for a smaller iPhone with a large screen. As I just explained, that makes for a device that’s easier to manage in the hand without sacrificing too much on screen real estate.

For apps that have been updated for the iPhone X, the smaller bezels make on-screen content more of the centerpiece of the experience. It also looks stunning; I’m still taken aback by the screen even after having used the iPhone X for nearly a month.

The so-called notch is there, and let’s be honest, it does tend stand out like a sore thumb when looking at the iPhone in press materials and such. Yet, when you actually use the device on a day-to-day basis, as Ben noted in his iPhone X Diary piece, the notch fades into the background. Nearly four weeks in, and it’s something that I rarely think about.

The sensor housing, as the notch is officially called, is a necessary evil until technology reaches the point where cameras and other sensors can be practically embedded behind the display.

Apple is looking to make the best out of the notch situation by embracing it, and using the unique design to set its flagship device apart from the competition. In a world filled with black slabs of metal and glass, having a design that’s set apart from others isn’t necessarily a bad thing.

Gestures

Omitting the Home button, a hardware feature that’s been a staple of the iPhone since its inception, was a huge risk for Apple — easily the biggest such risk for the iPhone X. The beauty of the iPhone has long been its relative ease of use – highlighted by the ability to quickly navigate back to the Home screen via a simple press of the Home button. The Home button was like a “get out of jail free card” for users who weren’t as familiar with iOS, and like a familiar old friend to longtime iPhone users.

As a former jailbreaker, having an iPhone dominated by gestures is nothing new to me. Jailbreak tweaks like Zephyr long-ago illustrated how well gesture-based navigation could work on the iPhone. But to see an official implementation, Apple’s own take on gesture-based navigation, is a sight to behold.

I broke down many of the new gestures in our hands-on video below. If you’re looking to catch up on all of the available gestures to navigate your iPhone X like an expert, then be sure to have a look:

TrueDepth Camera

If the design was potentially the most polarizing aspect, and the removal of the Home button was the biggest risk, then the TrueDepth Camera is the iPhone X’s biggest technical feat. I’m not going to rehash how it all works, but I can say that it works remarkably well.

The most notable feature that takes advantage of the TrueDepth Camera is Face ID, a technology that replaces the beloved Touch ID biometric authentication that’s been around since the iPhone 5s.

Like most, I was highly skeptical of Face ID at first, because Touch ID generally worked so well. Now that I’ve used Face ID, I can honestly say that I don’t miss Touch ID much, if at all. Face ID is so much better for unlocking your iPhone in certain circumstances, like when your hands are wet, sweaty, or soiled.

It’s been said before, but it’s worth reiterating: having Face ID is almost like not having a passcode at all, and it works for me 98% of the time. Your iPhone just unlocks when you look at it, and any app that uses Touch ID works with Face ID. It’s a truly remarkable piece of tech, and I can’t wait to see it implemented in more Apple devices.

Other front-facing camera features, like Animoji, have proved to be a small phenomenon, but the jury is still out as to whether Animoji has legs, or if it’s just a flash in the pan. Other features, like Portrait Lighting — a feature that allows you to add dynamic lightning to a selfie in realtime — are still in beta. It’s hit and miss, and from my hands-on experience it’s more of the latter, but it’s hard to pass real judgement on a feature that’s still in beta.

Super Retina (OLED) Display

The iPhone X marks the first time that Apple has used an OLED display on its flagship product. OLED has some distinct advantages, such as less power consumption, significantly increased contrast ratio, and true blacks.

The screen is on, but totally black

OLED displays have downsides as well, such as off-axis blue shift, increased chance of burn-in, and over-saturated colors, but each downside seems to have been addressed better on the iPhone X than I’ve seen from competing smartphones. For example, the colors on the iPhone X are way more natural looking than the unrealistic colors that you’d find on a typical Samsung flagship device. Blue shift rears it’s ugly head here as well, but it isn’t as bad as what I’ve seen firsthand from competing devices.

I’ve been waiting on the iPhone to adopt OLED for display technology for several years now, and I’m very happy to finally have it. The upsides to OLED far outweighs any potential negatives in my opinion, and I would not be willing to go back to a device sporting an LED display, like the iPhone 8.

Improved telephoto lens

Most of the technical aspects between the iPhone 8 Plus and the iPhone X are the same. They sport the same processor, same amount of RAM, same GPU, and same wide angle camera. Internally, both devices share many of the same specs.

One thing that is different, however, is the telephoto lens. The telephoto lens on the iPhone X is better than the telephoto lens on the iPhone 8 Plus. With the iPhone X, you get a stabilized lens on both the wide angle and telephoto offerings. You also get a faster f/2.4 aperture on the iPhone X, versus f/2.8 on the iPhone 8 Plus. Not only does this result in more stabilized videos, and enhanced bokeh, but it results in the iPhone X’s telephoto lens being a more capable low light shooter.

Not perfect

I don’t want to give the impression that I think the iPhone X is perfect, because no device is. Some changes have proved to reduce usability, such as the awkward locations of Control Center and Notification Center, the fact that you can’t view your battery percentage as easily, along with how the status bar hides Do Not Disturb status.

Other features, like Portrait Lighting, are pretty hit and miss. To be fair, though, it’s still in beta and will no doubt improve over time just like the regular Portrait mode did for the iPhone 7 Plus.

One additional point of complaint is with iOS 11 in general. This is less of an issue with the iPhone X hardware, and more of an issue with iOS performance across any modern iOS device. Framerate dips occur regularly when doing mundane things like opening the Mail app, for instance. For a device this powerful, iOS should run like an absolute champ. It’s not the hardware that’s the issue, it’s an issue with iOS performance as a whole, and I’m hoping that Apple will clean it up in the next major version.

Conclusion

All things considered, the iPhone X is as good of a device as one could hope to have considering that it makes a hard pivot away from many of the the staples that have long been characteristics of the iPhone. A lot of the internal tech is shared between the iPhone X and the iPhone 8, but make no mistake, this is a massively different device.

The fact that Apple was able to pull off the iPhone X, not just in a satisfactory way, but in an outstanding way, is extremely impressive to me. What do you think? Sound off in the comments below with your opinions.


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New iPhones’ ‘strongest glass ever’ does not live up to expectations

Apple’s claim that new iPhones will have their strongest glass ever is being tested by consumers as the new phones hit the market.

It has being found that while the phone makers say the iPhone glass is the strongest ever, consumers are having different results.

YouTube user Zack Nelson put the new glass to the test, dropping a new iPhone 8 from several different heights to see if it was damaged.

Dropping the phone from three feet produced a small crack, but dropping from the waist height, shoulder height and above his head Mr Nelson was able to severely damage the phone and crack the screen.

“I think it’s pretty safe to say that whatever Apple says about their most durable glass ever, glass is glass and it’s going to break if it’s dropped,” he says.

Considering the glass does still break, consumers would hope repair costs are cheap, but Apple is charging up to $790 to repair glass on the new phones.

To get an iPhone 8 repaired the screen will cost US$149 (NZ$215), while the back will cost US$ 349 (NZ$505). It gets more expensive for the iPhone 8 Plus, however, with the front glass costing US$169 (NZ$244) to replace and rear US$399 (NZ$577).

The price to replace the screen on the iPhone X model is raising the most eyebrows, with the cost of US$279 (NZ$403) to replace the front screen and US$549 (NZ$795) to replace the back glass.

Even with the addition of AppleCare insurance the screen replacement will cost US$99 (NZ$143).

iPhone fans in China have also found the screens are easy to crack, with pictures on social media showing shattered screens on the brand new iPhone X.

Newshub.

Analyst predicts Apple shares will drop as iPhone sales expectations are not ‘realistic’

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16a74_104726617-RTX3H4UD-tim-cook.530x298 Analyst predicts Apple shares will drop as iPhone sales expectations are not 'realistic'

The market’s anticipation of big sales of new iPhones drove Apple shares higher this year, but now one Wall Street firm says the smartphone maker’s stock has risen too far.

Deutsche Bank reiterated its hold rating for Apple shares, saying Wall Street’s consensus estimate for future iPhone sales are too high.

“We remain wary that investor expectations for the iPhone 8/X cycle are more optimistic than realistic,” analyst Sherri Scribner wrote in a note to clients Wednesday entitled “Expectations are pricing in more than Apple can chew.”

“Given the substantial additional upside needed to drive further share gains from here, and our view that FY-19 estimates need to come down to realistically reflect a year after a strong cycle, we see modest downside risk to shares near-term,” she added.

Apple shares fell 0.7 percent in early trading Thursday after the report.

The shares have lost about $50 billion in market value so far this month, falling 6 percent. Despite recent weakness, Apple is still one of the market’s best-performing large-cap stocks, rallying 33 percent this year through Wednesday versus the SP 500’s 12 percent gain.

The analyst reaffirmed her $140 price target for Apple shares, which is 9 percent lower than Wednesday’s closing price.

Scribner said investors are expecting fiscal 2018 to be a repeat of the big iPhone 6 upgrade cycle in fiscal 2015, when the company generated sales $31 billion above expectations.

“To beat expectations by a similar magnitude ($30B) this cycle would require that AAPL ship 45M more iPhone units in FY-18 than current expectations, or nearly 290M iPhones in total. We view this as highly unlikely,” she wrote.

She is more pessimistic for the following year and predicts Apple’s fiscal 2019 sales will drop.

“We believe it is more likely that unit forecasts decline, similar to the iPhone 6s cycle, and Street estimates for FY-19 need to come down to reflect a more realistic down year following the iPhone 8/X cycle,” the analyst wrote.

Apple did not immediately respond to a request for comment.

16a74_104726617-RTX3H4UD-tim-cook.530x298 Analyst predicts Apple shares will drop as iPhone sales expectations are not 'realistic'



Taiwan tech stocks hit by faltering iPhone expectations

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