AMERICAN HEALTHCARE SYSTEM

 

The future of America’s healthcare is at the hands of two men—President Barack Obama and Governor Mitt Romney. It is up to the voter to decide which future they wish to inherit. Forty eight million Americans are currently on Medicare—the federal regulated health care system; fifty eight million households are dependent on the state regulated Medicaid services. According to the Census Bureau data 46 million Americans are uninsured and 10 million of those are non US-citizens.

In 2010, the majority of the House passed legislation on the healthcare bill proposed by President Obama. The key areas include an increased coverage of Medicaid for individuals, up to 133 percent of the federal poverty level, insurance exchange benefits for individuals and tax benefits for small businesses, eligibility for preventive services and coverage by insurance agents for people with pre-existing conditions. It will also reimburse Medicare part D- prescription drug services, by closing the “doughnut hole” enabling seniors to get reimbursements. Under Medicaid, children also qualify for the children’s health insurance program (CHIP). Children under 26 years will be eligible to remain on their parent’s insurance plan.

In 2010, President Obama enacted legislation for the Patient Protection and Affordable Care Act (PPACA).  This act ensures every American gets the care they need. It included the preexisting condition insurance plan (PCIP).

While voters are at crossroads, one of the issues they feel unfair is the compulsion to purchase health insurance or be fined. Another issue is the cut in Medicare expenses. According to the Congressional Budget Office, Obamacare Medicare payment cuts will decrease the Medicare expenditure by $716 billion from 2013 to 2022. Health services will suffer most with a $260 billion cut. According to Forbes health policy expert Avik Roy, the ratio of cuts to increased benefits is 15:1. These cuts will affect seniors and their accessibility to healthcare benefits and services which will be reduced.

Dr Norman Edelman is a well-seasoned professional in the medical field, a professor and policy expert who says the presidential election will determine whether the above mentioned mandates come into form or get replaced by alternatives, which are not necessarily the best.

Should Mitt Romney come into office, Obamacare will be repealed. Romney has no definitive plans that he has highlighted for healthcare. However, he has also indicated in his campaigns and presidential debates that he will encourage inter-state insurance purchasing for those who wish to buy private insurance. Purchase of Individual insurance will be eligible for tax deductions. Medicaid will be turned into block-grant programs where federal funds will be capped by the state governments. By 2030, Medicare will have moved to a voucher system, where each person will have defined premium assistance and ability to purchase insurance from private or public (Medicare). The idea a premium-support system has been largely criticized by voters and senior citizens with opinion polls showing a 2:1 ratio on it. Romney also plans to increase the eligibility age of Medicare from 65 to 67 years.

Repealing Obamacare won’t be as easy as said, because Romney will need to retain power in the House of Representatives and win the Senate by a super majority vote of 60 or more, to have filibuster power to overturn the legislation. In that case, he will be able to repeal Medicaid and financial subsidies. There is uncertainty on whether the $716 billion Medicare cut will be repealed. If that happens, there will be two consequences: advancing of the insolvency in the Medicare part A- Hospital Insurance Trust fund and an annual increase of $323 in premiums which beneficiaries will pay from 2013 to 2022.

Romney believes that purchasing of insurance should be a competitive inter-state process. He has proposed to increase health benefits for the middle class and provide fewer benefits to rich seniors. According to Kaiser Commission on Medicaid and the Uninsured, Romney’s proposed alternatives would increase the uninsured from 14 million to 17 million.

In the recent presidential debate Romney was under fire for his proposed action on Planned Parenthood and abortion.  He does not support abortion and for companies to cover health benefits including contraceptives. Obama’s contention is to have coverage so women can afford cancer screening and mammograms. Romney’s plan to repeal Obamacare will deny 30 million Americans insurance.

Additionally, the doctors’ future in Medicare and Medicaid is bleak. Reimbursements are often lower than the actual medical care. Dr Edelman says the future of doctors and private practice may get replaced by vertical integration, where hospitals own doctors. That means doctors will be employed by hospitals, thereby accelerating the number of hospitals as opposed to private practices.

Romney’s term as the governor of Massachusetts had put in place systems similar to Obamacare, however, the tried and tested model does not appear to be the model for the country.

 

 

 

 

 

 

 

 

SOURCES

http://familiesusa.org/issues/medicaid/

http://www.medicare.gov/

http://www.stopmedicarefraud.gov/

http://www.medicaremadeclear.com/about/medicare-vs-medicaid/

http://www.cbsnews.com/8301-500693_162-57523217/cutting-healthcare-costs/?tag=categoryDoorLead;catDoorHero

http://quickfacts.census.gov/qfd/states/00000.html

http://desplaines.patch.com/articles/des-plaines-woman-indicted-for-medicare-kickbacks-scheme

http://en.wikipedia.org/wiki/Poverty_line_in_the_United_States#Measures_of_poverty

http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicaid/index.html

http://www.rwjf.org/en/blogs/new-public-health/2012/10/public_health_lawco.html

http://www.kaiseredu.org/tutorials/elderly/player.html

http://www.nytimes.com/2012/07/26/us/politics/obama-and-insurers-join-to-cut-health-care-fraud.html

http://www.cwru.edu/med/epidbio/mphp439/Medicare_Medicaid.htm

http://usgovinfo.about.com/od/medicarehealthinsurance/a/insurancestats.htm

http://www.cbo.gov/topics/health-care/medicaid-and-chip/reports

http://www.opensecrets.org/

http://www.nejm.org/doi/full/10.1056/NEJMp1210265?query=featured_home

http://blog.heritage.org/2012/10/16/understanding-obamacares-716-billion-in-cuts-to-medicare/

http://www.reuters.com/article/2012/10/17/usa-campaign-healthcare-idUSL1E8LFMK120121017

http://takingnote.blogs.nytimes.com/2012/10/11/health-care-under-romney-the-status-quo-ante/?ref=healthcarereform

http://www.kaiserhealthnews.org/Daily-Reports/2012/October/17/debate-womens-health-issues.aspx

american healthcare
Advertisements

MELTING ICE CAPS, RISING PROFITS: THE FUTURE OF THE POLAR ICE CAPS

polar bear on ice

 

When we think of the polar ice caps most often the first image we bring to mind is the world map and the location of the two opposite sides of the Earth. While they can be differentiated from other land forms by their obvious frozen ice, they have been in disappearance over the last decade causing less ice and more water.

The polar ice caps were named because of the location and their distance from the sunrays which are tangential and not enough to keep the land as warm as the sub-Saharan desert. Hence, the polar ice-caps have until now, existed with little to no need for alarm.

 

Jim Quigley is a faculty director for environmental design policy and planning major at Stony Brook University. He says, while the Arctic is disappearing in astounding proportions everybody including the media are looking at the temporary profit margins from the region instead of addressing pertinent environmental hazards.

 

Quigley says that there is a positive feedback phenomena occurring. Ecologists and climate scientists have called it thus because ice has a higher reflectivity than water. This means, water being darker, absorbs more heat from the sun and as a result causes the ice to melt. This cycle has been ongoing and will eventually melt away all traces of the Arctic ice cap.

 

Presently the world is debating climate change, global warming and all its subsidiaries in great length. From documentaries on global warming to campaigns, those who believe that the ice-caps are melting due to rising temperatures are in constant battle with those who say all this is part of the natural ways of the Earth. While many parts of the world are insensitive to the melting Arctic ice, the people actually paying close attention are the money makers—oil companies, mineral investors, real estate tycoons, alternate energy moguls the list is growing every day.

 

Under the ice lies a fortune of natural earth products that will be a profitable system of revenue should any country invest in digging it up, literally. However, the polar ice cap is open for claims to its surrounding Arctic regions namely, United States (Alaska), Greenland, Denmark, Russia, Norway, Finland and Sweden.

These regions have made progress in the last year to consciously look into long term investment options in constructing oil rigs, drilling for rare earth minerals, uranium, iron-ore, lead, zinc, petroleum and gemstones that are found in Greenland. It is estimated that there is twice the amount of oil in the Arctic- 200 billion barrels more than Kuwait. Scottish firm Cairn Energy was among the initial drillers who discovered oil and gas bearing sands in Greenland. The Royal Dutch Shell Company has also invested into drilling. The Barents Sea between Russia and Norway covers an area of 67,000 square miles called the loophole. There is an estimated 7.6 billion tons of fuel in this region.

 

 

Another political and business venture has been China’s keen eye on the melting ice-cap. Currently China’s investment into rare earth minerals has been seen largely in their own regions. China’s strategic relations with Denmark have opened up talks and possibilities to give China an observer status in the Arctic. This means, China will compete to be the first to drill, or find profit. There have been indications of an understanding. Danish exports to China rose 17 percent in 2010. China’s exports to Denmark grew 25 percent according to reports by the Danish embassy in Beijing.

 

China has a fleet of ice-breakers in construction to navigate the frigid seas. The operational one is the Xuelong. Ice-breakers are ships that help break up large portions of ice for navigation, research, security and maintenance of marine borders. United States of America has invested largely into ice-breakers to maintain protection along the borders and also monitor other neighboring regions for security. Though ice-breakers serve a purpose, they are undoubtedly hastening up the melting of ice bergs and sheets of ice. Adm Thad W Allen from the coast guard commented about the presence of US ice breakers in saying that the Arctic is clearly opening to commerce — and potential conflict and hazards — like never before.

 

With melting ice the waters become viable for trade. Trade routes will decrease the amount of time spent in traversing the globe to reach northern regions. If sea routes are established directly from Greenland to China, the distance will reduce to one-fourth the total time. Currently the shipping route via the Panama Canal takes over two weeks to traverse. Shipping has a large impact on the global economy and experts predict that this change in routes will affect the economy and open up trade agreement talks between regions.

 

The largest effect will be natural resource depletion. Oil and gas are finite reserves trapped within the Earth. The melting ice poses imminent risks to drilling. One of the major issues is the lack of sufficient summer months to complete drilling projects. In the event of an oil spill, the extent of damage control is estimated to take up an entire season according to the environment audit committee. Earlier this year, Shell oil seized its exploration and initial drilling attempts after realizing potential oil spill risks. The melting ice also poses a danger of permafrost which increases the level of methane. The positive feedback phenomena also exist with melting permafrost. Methane is a greenhouse gas and highly combustible. With increased melting of permafrost, there will be more methane present in the atmosphere.

 

The Arctic ice cap is a geographical area that is made up of layers of ice that have formed over the years to create icebergs, glaciers and intermittent frigid waters. BBC wildlife photographer Doug Allen predicts that in five years all of the polar ice caps would have melted away. This region is home to the polar bears, ringed neck seals, walrus, narwhal, hooded seals, ivory gulls and the beluga whales. The ice is a source of life and sustenance for these living creatures. Their species depends on the icy cold waters that bring them food. When ice melts the temperature of the water goes up. This change in water temperature affects marine life thus having a domino effect on all Arctic animals.

With ivory gulls almost close to extinction, the worry among ecologists is the lack of resources to keep the species surviving. Author and ecologist Carl Safina writes about his experience of walking past life-sized bones of whales that had died in his book “The view from Lazy Point.”

 

One of the worse and irreversible impacts of the melting Arctic ice will be the global change in temperatures. Quigley says with the continuous retreat of ice and the confluence of warm currents from the British Isles there could be a change in the region. This area lies in the same latitude of Siberia and could become as frigid as Siberia. The resulting cold temperatures will impact populations displacing large numbers to other parts of the world. Population displacement will result in a global socio-economic-political uprising.

 

Quigley says that the Arctic ice not only affects the immediate geographical regions surrounding it, but has a global impact on all ice regions. He says the melting ice in the Himalayas will adversely affect India, causing flooding, displacement among local and indigenous people and economic expenses.

 

The Arctic ice cap is a juxtaposition of both profit and loss. While the Earth loses a critical land mass home to different types of living creatures, humans inhabit the possible future causing industrialization to re-write the future as money dictates.

 

 

SOURCES

http://www.bbc.co.uk/news/business-11381971

http://www.bbc.co.uk/news/business-11299024

http://www.nytimes.com/2012/09/19/science/earth/arctic-resources-exposed-by-warming-set-off-competition.html?pagewanted=all

http://www.dailystar.com.lb/News/International/2012/Sep-21/188747-planetary-emergency-due-to-arctic-melt-experts.ashx#axzz27anr0ynX

http://green.blogs.nytimes.com/2012/09/26/imagining-a-warmer-arctic/

 

http://news.yahoo.com/ice-free-arctic-summers-bring-100100621.html

 

http://www.nytimes.com/2012/10/14/science/earth/in-california-a-grand-experiment-to-rein-in-climate-change.html?ref=science

 

http://www.latimes.com/news/nationworld/nation/la-na-arctic-security-20121019,0,3772500.story

 

http://www.ft.com/cms/s/0/beab009e-323b-11e2-916a-00144feabdc0.html#axzz2DNHm8OE7

 

http://www.independent.co.uk/environment/unlocked-by-melting-icecaps-the-great-polar-oil-rush-has-begun-2349789.html

 

http://www.fool.com/investing/general/2012/11/27/3-key-drivers-of-energy-independence.aspx

 

http://www.independent.co.uk/environment/unlocked-by-melting-icecaps-the-great-polar-oil-rush-has-begun-2349789.html

 

http://www.usgs.gov/blogs/features/usgs_top_story/polar-bears-long-distance-swimming-and-the-changing-arctic/

 

http://en.wikipedia.org/wiki/Arctic_shrinkage

 

http://blogs.wsj.com/chinarealtime/2012/01/18/china%E2%80%99s-new-strategic-target-arctic-minerals/

 

http://wwf.panda.org/what_we_do/where_we_work/arctic/what_we_do/oil_gas/

 

http://wwf.panda.org/what_we_do/where_we_work/arctic/news/?206231/Record-Arctic-ice-low-drives-urgent-global-action

 

http://www.parliament.uk/business/committees/committees-a-z/commons-select/environmental-audit-committee/news/announcement-of-report-publication1/

 

http://www.seaweb.org/resources/briefings/IvoryGull.php

 

http://www.eoearth.org/article/Polar_bear?topic=49540

 

http://www.epa.gov/climatechange/science/future.html#Temperature

 

http://www.nytimes.com/2008/08/17/world/europe/17arctic.html

 

 

 

 


HOW SAFE IS IT TO BURN THE MIDNIGHT LAMP?

cfl-bulb-uv-exposure-537x402For many students or late nighters long hours of study or work under a night lamp are commonplace. However, a recent study indicates that compact-fluorescent light bulbs that are used in lamps could cause skin damage.

The study published in June, in the Journal Photochemistry and Photobiology was led by researcher Miriam Rafailovich and her team from Stony Brook University. Their findings confirm that the energy saving CFL bulbs in our homes and offices emit harmful Ultraviolet-A and Ultraviolet-C radiation within a minute after being turned on. This happens because of cracks or bald spots in the bulbs.

“We evaluated the UV radiation coming out from the CFLs. How long does it take to reach the maximum threshold levels?  The recommended ones are over an 8 hour level. It’s also based on the distance,” she says.

Not only did the CFLs indicate radiations on the threshold level detection device 7 hours and 59 minutes earlier than expected, the distance at which the bulbs were placed also affects the extent of damage on the skin. An exposed bulb, placed within two feet is an unprotected distance resulting in maximum susceptibility to skin damage.

“These bulbs are filled with mercury, that’s why it’s so toxic.  Mercury gas when it is excited it emits two characteristic lines of mercury atoms-UVC and UVA,” she says.

Ultraviolet radiation is made up of three types: A, B and C. UVB radiations are those that cause sun burns and flecks on the skin, the high energy UVC is largely absorbed by the atmosphere and partly by the skin. UVA is the most potent.

“UVA you don’t feel, it penetrates quite deep, it doesn’t give you a sun burn but it just affects the melanocytes deep inside the skin and causes melanoma and cancer,” says the material science engineer.

The white spiral shaped bulbs are popular not only for their unique shape but also for reducing carbon footprints. Filled with amalgam, the purest form of mercury and containing a phosphor coating these features claim to prolong the life of the bulb by five times that of an incandescent. That’s the good part of a CFL. These bulbs are currently debated among health and environment agencies and now researchers like Rafailovich.

It’s the cracks or bald spots that appear because of the phosphor coating that Rafailovich says are the cause for radiation leaks. The researchers used over 20 CFLs purchased from different stores and all had cracks in them. The cracks were most likely due to the bend in the shape of the bulb and inadequate phosphor coating along the bends says Rafailovich.

“Damage does outweigh if you are 2 feet or less, there is no reason to expose yourself to cancer,” she says. The researcher does warn that although their findings indicate skin damage, medical experts need to confirm that CFL radiations are directly linked to causing cancer.

Rafailovich additionally did research to see the co-relation between CFL radiations and titanium dioxide, a colorless chemical compound frequently used in sunscreen lotions, toothpaste and even cosmetics. The findings indicated that human skin was more susceptible to damage if it had traces of titanium dioxide.

Rafailovich’s research findings have made headlines in the media. The issue she says is not the fear of using CFLs it’s the political and controversial undertones that come with it. While incandescent bulbs are currently being phased out, the concerns of using CFLs are now heightened. Manufacturing companies, distributors, retailers, consumers and even the cosmetic industry are not willing to comment on the claims put forward by the study for fear of backlash and innumerable lawsuits, should there be binding evidence.

Rafailovich however addressed the “panic” mode consumers get into with such scientific studies. She says there is no need to go ripping out light fixtures in the hope of eliminating the chances of skin damage. She also says that skin types are important to determine the effects and extent of radiation damage.

Bulbs enclosed in glass coverings and at a distance further than two feet are considered safe.  Additionally, other options also exist like LED bulbs or even colored CFL bulbs which have no harmful radiation leaks.

“Right now people are looking into LED bulbs…They also emit x-rays at different levels. It’s a good solution, they have lower energy, are safer and they don’t break as easily,” she says reassuringly.

3D PRINTING TO THE RESCUE: RESEARCHING A MEDICAL FUTURE

Over a hundred thousand people are waiting for an organ according to reports by the American government and eighteen from this total die every day. Replacing an organ is not easy especially when the demand outweighs the supply. Medical engineers across the world are developing a 3D printer that can diminish that gap by printing organs instead of harvesting them.

In a 3D bio-printer the living cells replicate the nature of ink to form droplets. The hydrogel, a water or sugar based surface- acts as the paper onto which the cells can be printed.

Physicist Gabor Fargos from the University of Missouri is regarded by fellow researchers as a pioneer in studying the technology and applications of 3D printing. He concluded from research and experiment that living cells exhibit a similar nature to printing ink in that it can be made into droplets and sprayed onto a surface. Many biotechnology companies have put that concept to work in the lab.  Organovo, a biotechnology company in California has worked with Fargos to develop living tissues for further research.

“You can take cells that have been built into a bio-ink and load them onto a printer that can be programmed to deposit those cells in a precise architectural way that can be built layer by layer,” says Michael Renard vice president for marketing for Organovo.

Building tissues is a three step process that starts with creating cells. These are extracted or cultured in the lab from primary human cells and pluripotent stem cells which are unique because unlike other cells in the body, they can differentiate into any type.

After collecting them, the cells are then carefully injected onto a bio-paper which is a gel like surface that enable the cells to thrive momentarily until the printing is completed. The cells can be printed in any shape layer by layer which is separated by the bio-paper.

Researchers at Cornell University are currently working on a sugar medium to inject cells into, since sugar acts as a non-interfering medium. According to researchers 3D printing is only a means to organize cells which naturally fuse once the bio-paper disappears.

“Over a couple of days a bio-ink that was printed form a natural contiguous structure fused together—you have a tangible piece of material,” says Renard.

This structure which could be a blood vessels, tissue sample, skin graft or cartilage among other forms is then transferred into a bio-reactor- a chemical liquid environment that keeps the tissue alive while it continues to mature and take on its fully anatomical structure.

Using a printer to make tissue samples reduces time spent in growing cells. Researchers have also used 3D printed tissue in-vitro tissue construct which is the researching the tendencies of human tissue from effect of drugs to how diseases develop.

“Tissues that are fully human can be used in medical research, to study disease models, to study a new target or pathway that a drug can be corrected,” says Renard.

Across the country in Albany, researchers at Cornell University are working on creating spinal discs and heart valves with the same technology. Hod Lipson a robotics engineer and co-author of “Fabricated: The New World of 3D Printing” says tissue engineering has fascinating possibilities.

Evidence of those possibilities is seen in labs across the country according to researchers and their published studies. At Columbia University, a group of researchers have fabricated bone and used it in rabbits.

The future of bio-printing has many applications. Organovo among other similar companies wants to use the technology to reduce the number of patients who spend their lives waiting on donors. Among organ transplants, kidneys and hearts rank the highest in need among patients. 3D printing and tissue engineering have opened up innovations in skin grafts and creating cardio-vascular tissue for research.

Renard says transplants from pigs to humans would become obsolete when 3D printers become commercially viable. Such advancement comes at a high cost and he says that the future wont’ be cheap. Medical technology and development has seen large investments in the last couple of years but the largest investment is in restoring health according to Renard.

“There are significant opportunities in tissue engineering when you think of long term productivity. You can bring a person back to a state of stability and health,” says Renard.

From printing organs in an external environment to applying the technology directly in the body on the operating table, researchers envision a limitless future for 3D bio-printing. Currently the technology is being used to create several artificial body parts and even dental products.

“3D printing is used in the medical field to create prosthetics, hip replacements and over 50,000 invisalign braces, crowns and dental implants,” says Lipson.

The technology for printing three dimensional objects has existed for 30 years. From mechanical equipment to toys and lately- living tissues- science is pushing boundaries according to researchers.

Companies like Shapeways, Makerbot, Digilab and Pandorabot are creating 3D printers that can be sold commercially.  However, Renard says that 3D printers for tissue engineering cannot become commercial until further research and testing on animals and humans is completed. It will still take testing, regulations and success stories before medical 3D prints can be ordered.

“Putting materials in place doesn’t mean it works,” says Lipson.