House OKs expansion of private care at VA, budget crisis fix

WASHINGTON (AP) — The House voted Wednesday to give veterans more freedom to see doctors outside the Veterans Affairs health system, a major shift aimed at reducing wait times and improving medical care despite the concerns of some Democrats who cast it as a risky step toward dismantling the struggling agency.

The plan seeks to fulfill President Donald Trump’s promise to expand private care to veterans whenever they feel unhappy with VA health care.

The long-awaited bill would change how veterans receive their medical treatment by allowing them to go to a private physician when they felt government-run VA medical centers couldn’t provide the care they needed, with the approval of a VA health provider. Veterans could access private care when they endured lengthy wait times, or the treatment was not what they had expected.

The VA would decide in many cases when a veteran sees an outside doctor, based on conditions it sets that determine what is inadequate care.

The White House said in a statement that Trump applauded passage of the bill and urged the Senate to send it to his desk for his signature by Memorial Day. “The President encourages members of the Senate to put the needs of our nation’s veterans over partisan politics,” it said.

The House passed the bill by a 347-70 vote, with the program to be implemented later next year as the VA works to add private doctors to its network of outside referrals.

The wide-ranging plan would avert a catastrophic shutdown of the VA’s troubled Choice private-sector program, which would receive $5 billion to continue operating for another year before it is made a longer-term fixture at the VA. The program will run out of money as early as May 31, causing disruptions in care.

The $51 billion bill has the support of nearly 40 organizations, including The American Legion and Veterans of Foreign Wars. The program could be expanded based on veterans’ demand for private services and when VA care is deemed inadequate. The VA would be able to determine how quickly the program grows.

Rep. Phil Roe, the chairman of the House Veterans Affairs Committee, praised the measure as keeping “our promise to give veterans more choice in their health care.”

The program could face escalating costs due to growing demand from veterans seeking the convenience of seeing private physicians. Some House Democrats warn the VA won’t be able to handle the costs of the newly combined “community care” program that includes Choice and other VA programs of outside care, putting the VA at risk of unexpected budget shortfalls next year.

Rep. Tim Walz, the top Democrat on the Veterans Affairs Committee, cautioned that outsourcing more care to the private sector would lead to devastating cuts to VA hospitals, which many veterans see as best-suited to treat battlefield injury such as traumatic brain injury. “I am deeply concerned about the long-term health and stability of VA health care,” he said.

House Minority Leader Nancy Pelosi, D-Calif., attacked the bill as failing to do enough to keep veterans in the VA, instead opening “the doors to VA privatization.”

The bill builds on legislation passed in 2014 in response to a wait-time scandal at the Phoenix VA medical center, where some veterans died while waiting months for appointments. It comes as the VA is without a permanent leader after David Shulkin was ousted as VA secretary in March. Trump has yet to name a new secretary after his first nominee, Ronny Jackson, withdrew last month.

The legislation aims to steer more patients to the private sector to relieve pressure at VA hospitals, thus improving veterans care at VA facilities and with private providers alike. Patients could also access private walk-in clinics, such as MinuteClinics, to treat minor illnesses or injury if they used VA health care in the last two years.

The bill would create a presidentially appointed commission to review the closure of underperforming VA facilities, which House Democrats opposed when the plan was drafted in March. Democrats sought restrictions on the commission but were rebuffed by House Republicans and the White House.

It would also expand a VA caregivers program to cover families of veterans of all eras, not just the families of veterans who were seriously injured in the line of duty since Sept. 11, 2001.

Veterans would be able to access private care when VA does not offer the services they need or a veteran and his VA health provider agree it is best to receive care with a private doctor. It would loosen Choice’s restrictions that limit outside care only when a veteran must wait 30 days for an appointment or drive more than 40 miles to a VA facility.

“This is a great victory for those want to see the VA reformed and fixed,” said Dan Caldwell, executive director of the conservative Concerned Veterans for America. “This will hopefully ensure veterans aren’t trapped in failing VA hospitals.”

Currently, more than 30 percent of VA appointments are in the private sector.

___

Follow Hope Yen on Twitter at //twitter.com/hopeyen1

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Soccer player has pain in lower abdomen and groin – a sports hernia?

Q: I am a 25-year-old soccer player who developed pain in my right lower abdomen and groin. The more I play or run, it bothers me. I saw an orthopedic surgeon who thought I had a sports hernia. I went to a general surgeon who said I did not have a hernia and thought that physical therapy would help. I have rested and done therapy but I am no better in three months. I cannot play and wonder what to do now?
Selesnick Harlan (2).JPG

A: Sports hernias are not traditional hernias where there is a weakness in the abdominal muscles and an out pouching through the defect. Sports hernias are common injuries in soccer and hockey and can also be seen in basketball and football. The athlete will complain of groin and lower abdominal pain that worsens with play. There is no obvious defect in the abdominal muscles and subtle tears of the hip adductor and flexor muscles can be missed. Even an ultrasound or MRI scan may not be diagnostic. Many general surgeons, who do not treat athletes regularly, can miss the diagnosis. I recommend you seek another opinion from a surgeon with this experience.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net.

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How What You Eat May Affect Your Brain Size

Can your diet affect your brain? A new study published in Neurology suggests that people who eat healthy diets may have larger brain volumes.

Meike Vernooij, a professor in epidemiology and radiology at Erasmus University Medical Center in the Netherlands, and her colleagues wanted to see how diet might impact the brain. They asked more than 4,000 older people in the Netherlands (average age: 66) about what they ate and analyzed brain scans over 10 years.

People who ate healthier diets resembling the Mediterranean diet — rich in fruits, vegetables and healthy fats from sources like fish, and low in red meat — showed larger total brain volume. They also had more grey and white matter, which is a way of measuring the amount of nerve density in the brain. The area of the brain that’s responsible for processing memories, called the hippocampus, was also larger in people who ate healthier diets.

Vernooij and her team also analyzed the effect of individual foods and nutrients, and found that no single component of the diet was responsible for the apparent benefit. The combined effect of eating more fruits and vegetables, whole grains, nuts, dairy and fish seemed to contribute to larger brain volume.

The researchers also found that people who drank fewer sugar-sweetened beverages like sodas also had larger brain volumes.

While the study did not delve into whether diet could change brain volumes or affect brain function, Vernooij and Pauline Croll, a co-author on the paper and a PhD student in epidemiology and radiology at Erasmus, believe the findings could lead to new research on how diet could affect brain disorders. “I do think these results open up a lot of opportunities,” says Croll. “It’s already known that a healthy diet is associated with better brain health, and that it is protective against neurodegeneration. But to truly say that a good diet can lower the risk of dementia, we need larger studies and [longer] follow up.”

The team hopes to continue their work and look at whether changes in diet can possibly affect brain volumes and potentially increase volumes to slow or reverse cognitive decline.

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Ace Hardware employees save Michigan woman who overdosed in store parking lot

Three employees at the Great Lakes Ace Hardware store in Jackson, Michigan saved the life of a woman who allegedly overdosed on heroin.

Lisa Huff, one of three employees responsible for saving the woman, first noticed she was slumped over in her car in the store’s parking lot. Two of her fellow coworkers, Cody Brigham and Joe Bommarito, also noticed the woman, WILX-TV reported.

After they called 911, Brigham used a crowbar to pry the woman’s car window open and then dragged her out. Then, as they waited for help to arrive, Bommarito performed CPR.

“It looked like she was gone. We thought she was gone,” Bommarito later told WILX-TV.

Paramedics then treated the woman for a heroin overdose, according to the news station.

The incident occurred on Monday, a day after Mother’s Day.

“That’s somebody’s daughter,” Bommarito said. “Thank God she didn’t lose her daughter, and if she had kids, thank God they didn’t lose their mother.”

“These are our neighbors around here. No matter what the situation is, we want to help them out. Joe was awesome with the chest compression, and the teamwork on the inside,” said Brigham, who added that “it’s one of those things where human nature kicks in.”

Jackson County Sheriff’s Sgt. Cullen Knoblauch said the three employees should be called heroes for helping the woman.

“They definitely went above and beyond what their job duties are. They saw a person in need and acted without even thinking about their safety,” he said, according to the news station.

The woman is expected to recover.

Knoblauch was not immediately available for comment when contacted by Fox News on Wednesday. A spokesperson for Ace Hardware has not yet returned Fox News’ request for comment.

Madeline Farber is a Reporter for Fox News. You can follow her on Twitter @MaddieFarberUDK.



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Bill aims to stop shipping of opioids through U.S. mail

The House Ways and Means Committee advanced legislation Wednesday to require shippers sending packages into the U.S. to provide more data on what’s being sent — part of an effort in Congress to close down a major pipeline delivering illegal synthetic opioids across the country.

The bipartisan bill says the U.S. Postal Service must collect and share data with customs inspectors on 70 percent of packages by the end of this year, and must cover 95 percent of packages by the end of 2022.

Private carriers, like FedEx, already submit electronic data on foreign parcels before they arrive at U.S. ports, yet only a portion of foreign posts provide that information to the U.S. mail system. Customs agents say the data is a key tool in targeting suspicious packages that may contain fentanyl, which is far more powerful than heroin and can kill in tiny amounts.

Bill sponsors hailed the effort as a major step forward in the fight against the synthetic opioids, pointing to “clear timelines” for the postal service to act.

“Clearly, I think we’ve identified an open and glaring gap in the Postal Service, which is being exploited to the substantial detriment to our citizens,” said Rep. Mike Bishop, Michigan Republican.

But senators working on their own version said the House bill moves too slowly. They want the Postal Service to have data on all foreign packages within a year.

And they disapproved of the House bill’s waiver, which would let U.S. officials delay the data requirement if, for instance, foreign shippers struggle to meet the benchmarks.

“We’re disappointed that instead of marking up our bipartisan legislation — which has 34 co-sponsors in the Senate and 271 in the House — the Ways & Means Committee instead chose to consider a weaker alternative that seems to perpetuate the status quo rather than help solve the opioid crisis,” said Sen. Rob Portman, Ohio Republican, and Sen. Amy Klobuchar, Minnesota Democrat.

They also said the House bill lacks any penalties that could push the Postal Service to comply.

Rep. Bill Pascrell, New Jersey Democrat and Mr. Bishop’s partner on the House bill, said the State Department and Postal Service raised “concerns” about the Portman-Klobuchar plan.

Government officials have told Congress it is difficult to navigate the thicket of treaties that essentially require the U.S. to deliver packages, and that some foreign nations are still building systems that generate advanced data.

Ways and Means Committee Chairman Kevin Brady appeared to acknowledge the rift with Senate sponsors, who say the Postal Service needs a strong nudge to provide more data.

Mr. Brady said he will try to reach a compromise.

“Today is just the first step, but it is a crucial first step,” Mr. Brady said.

Fentanyl is the No. 1 killer in the opioid crisis, which claimed 42,000 Americans in 2016. Officials say the death toll likely rose in 2017, meaning the crisis is killing more people than HIV/AIDS did at its height in the mid-1990s.

Congress is scrambling to get its arms around the crisis. The House Energy and Commerce Committee is scheduled to advance its second batch of dozens of opioids bills Thursday. Also Wednesday, the Ways and Means panel advanced a bill by Rep. Vern Buchanan, Florida Republican, that requires the Centers for Medicare and Medicaid Services to publish on its website the most up-to-date guidelines and research on opioid use.

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Merck KGaA’s lung cancer drugs show promise in early-stage trials

FRANKFURT (Reuters) – Germany’s Merck KGaA said two of its experimental oncology drugs showed early signs of promise in certain lung cancer patients, potentially helping efforts to find drug-industry partners to share further development costs.

FILE PHOTO: A logo of drugs and chemicals group Merck KGaA is pictured in Darmstadt, Germany January 28, 2016. REUTERS/Ralph Orlowski

Merck, which has a promising drug pipeline for the first time in several years, is looking for partners for experimental treatments as an expected decline in operating profit this year forces it to find new ways to fund pharmaceutical development.

The family-controlled company late on Wednesday released some initial data from early- and mid-stage trials, giving a 3.5 percent boost to the share price after the open on Thursday.

A bifunctional fusion protein known as M7824, which combines two immunotherapy mechanisms, led to tumor shrinkage in 40.7 percent of patients in a small study group suffering from non-small cell lung cancer (NSCLC).

Those patients, being tested in the first of what are typically three trial stages, had tumors with at least some level of PD-L1, a protein that helps the cancer evade an immune system response.

In lung cancer patients where PD-L1 was at a level of at least 80 percent, the rate of tumor shrinkage was 71.4 percent.

“Merck will not have a problem finding a partner with this data set,” said Bernstein analyst Wimal Kapadia, adding that competing immunotherapies have shown a percentage of patients that respond to treatment of 15-20 percent.

The stock was the second-biggest gainer on the STOXX Europe 600 Health Care index <0#.SXDP>.

In another study, cancer drug tepotinib was associated with partial tumor shrinkage in 9 out of 15 trial participants, according to an interim analysis of an ongoing trial in the second of typically three stages of testing on humans.

Patients in that trial are suffering from NSCLC that is driven by a certain type of genetic mutation.

“It is early data but investors will struggle to ignore the potential, particularly given the lack of expectations on both assets,” said Bernstein’s Kapadia.

Globally, lung cancer is the biggest killer of all cancer types but drugmakers have resorted to targeting small subcategories defined by genetic vulnerabilities that new drugs can attack.

More details will be presented at the annual conference of the American Society of Clinical Oncology (ASCO) in Chicago in early June.

Reporting by Ludwig Burger; Editing by Mark Potter/Keith Weir

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Adidas SolarBoost Running Shoe First Impressions

Just as you don’t know what you’ve got till it’s gone, sometimes you only realise what’s been missing when it arrives. Adidas’s line-up of Boost shoes is phenomenally successful, but it’s been missing a shoe like the SolarBoost – a performance running shoe that’s not as lightweight as the Adios or the Boston, but more stable and lighter than the UltraBoost. I’ve taken the SolarBoost out for a couple of runs, so while this is just my initial impressions of the shoe with a full review in the works, it lives up to the hype so far.

The Boost foam provides as enjoyable a ride as ever, but the upper on the SolarBoost is very different to the UltraBoost. The toe box is snug and keeps the foot locked in place better than a knit upper. I feared it would be too tight and annoy me when running, but that didn’t prove to be the case. It’s best described as secure rather than tight, and it’s consistently stable, even when you pick up the pace. The guide rail on the shoe also helps with this. The SolarBoost is not a stability shoe designed to counter pronation problems, but it is more supportive than the UltraBoost, the knit upper on which can feel slightly sloppy when running at speed.

I took the SolarBoost out for a steady five miles on some light trails and a speed session involving eight 1km intervals at 10K pace. From the limited experience I’ve had with the shoe I’d say it’s slightly too heavy to excel in 10K races and in sprint sessions, when I’d prefer a shoe like the Adios instead, but it feels like a great shoe for holding a brisk pace over longer distances and bouncing through your general training in comfort.

If you’re a very keen runner who has truly embraced Boost shoes, the SolarBoost will fit into your line-up for long training runs and easy days, with the lighter Boost shoes saved for track and races. And if you’re a casual runner looking for a cushioned neutral shoe to tackle everything, the SolarBoost fits the bill as an all-purpose trainer/racer.

£139.95, buy on adidas.co.uk

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Refuel With These Apricot And Almond Butter Squares

Protein balls and bars have become the common shapes for when you’re consuming your post-workout muscle fuel in solid form, but why limit yourself? There’s a big wide world of geometric shapes out there, one that includes squares. Squares like these, which contain vanilla protein powder, almond butter and seeds to ensure they deliver a protein hit that satisfies your aching muscles after you’ve put them through a savage workout.

As well as packing in the protein, almond butter is high in monounsaturated fats, vitamin E and manganese, while seeds are rich in essential minerals such as zinc and copper, which play critical roles in energy metabolism. The recipe also contains cinnamon, just because it tastes fantastic, a quality that is just as important as all the minerals and such.

The squares are also simple to make. Sure, there are a lot of ingredients, but they all get chucked in together pretty quickly, there’s no faffing about with separate parts. Once you’ve made a batch they will keep in the fridge for a few days, so you’ll have a ready supply of snacks to support your training.

We should say that if you’re not training, it’s probably best not to scoff too many because the squares are high in energy at 308 calories apiece. That makes them ideal for someone bashing out workouts regularly, but not so good for someone who hasn’t had a chance to leave their desk all week.

Ingredients (Makes Eight Squares)

  • 170g almond butter
  • 75g butter
  • 100g honey
  • 100g dried apricots, chopped
  • 25g mixed seeds
  • 1tsp cinnamon
  • ½tsp bicarbonate of soda
  • 1 scoop of vanilla protein powder
  • 100g wholemeal self-raising flour
  • 150g porridge oats

Method

  1. Melt the butter, almond butter and honey in a large saucepan.
  2. Add the protein powder, apricots, seeds, cinnamon, bicarbonate of soda, flour and oats and mix.
  3. Press the mixture into a greased or lined baking tray. Bake at 180˚C/gas mark 4 for 20 minutes until the edges are crisp but it is still soft in the middle.
  4. Leave in the tray until completely cool, then cut into eight squares and refrigerate.

Nutritional Info (Per Square)

Calories 308
Protein 8g
Fat 16g
Carbohydrate 35g

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Some calories are more harmful than others, study finds

Some calories are more harmful than others: study


Even when eaten as part of an otherwise healthy diet. 

Researchers have concluded that sugar-sweetened beverages have a unique propensity to cause chronic health problems.

Although all calories have an impact on the body, these harmful sugars impact on the effects of cardiometabolic disease and obesity, even when consumed within an otherwise healthy diet.

The paper, published in Obesity Reviewsin was compiled by 22 leading nutrition researchers. It examined whether the effects of all calories were equal, finding that calories present in sugar-based drinks were particularly harmful to the body.

The fad-free guide to weight loss

“What’s new is that this is an impressive group of scientists with vast experience in nutrition and metabolism agreeing with the conclusion that sugar-sweetened beverages increase cardio-metabolic risk factors,” said lead author Kimber Stanhope, a research nutritional biologist with the School of Veterinary Medicine at the University of California, Davis.

Surprisingly researchers concluded that sugar substitutes, such as aspartame (found in NutraSweet and Equal) did not have the same effect

“If you go on the internet and look up aspartame, the layperson would be convinced that aspartame is going to make them fat, but it’s not,” said Stanhope. “The long and short of it is that no human studies on noncaloric sweeteners show weight gain.”

The researchers also found that the consumption of polyunsaturated fats (found in vegetable oil, seeds and nuts) lowered disease risk when compared to the same amount of saturated fat. The nutrition experts encourage the addition of these healthy fats to your diet while limiting the consumption of other fat, especially in dairy products.

Overall Stanhope and her fellow researchers conclude that the best way to go is “a healthy diet pattern consisting of minimally processed whole grains, fruit, vegetables, and healthy fats.”

While we’re on the topic, here’s how to quit sugar and a 3-day total reset meal plan. 

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