Health and Disability

Author and migraine sufferer Joan Didion once wrote, "That no one dies of migraine seems, to someone deep into an attack, an ambiguous blessing." At that time, migraines weren't something that could be prevented. Today, that's a possibility for some people who have severe migraines, frequent migraines (more than three or four times a month), or migraines that don't respond well to treatment.

The cornerstone of migraine prevention is managing triggers like stress or certain foods or strong perfumes. Alternative and complementary therapies (like acupuncture) help some migraine sufferers keep headaches at bay.

In some cases, taking medication even when you aren't having a migraine attack can help. This usually involves taking the medication every day, with the goal of gradually tapering the dose, and, ideally, eventually discontinuing it altogether. Here are some of the medications commonly used to prevent migraine. Because they have different effects, and potential side effects, it's important to work with your doctor to find the one that's right for you.

People who received prescriptions for opioid painkillers in the months before elective abdominal operations had longer hospital stays, and a higher chance of needing follow-up care in a hospital or rehabilitation facility, than patients who weren’t taking such medications before they had the same operations, the study finds.

The extra care translated into higher costs for their post-surgery care – double or triple the amount, with higher opioid doses associated with higher costs. The results are published in the April issue of the Annals of Surgery by a team from the University of Michigan Institute for Healthcare Policy and Innovation.

The new findings, and past research on the association between opioids and outcomes for other types of surgery, are enough to prompt the researchers to suggest that pre-operation opioid use should be considered a preoperative risk factor.

Email credentials are highly valuable to cybercriminals. A compromised email account can be plundered to obtain highly sensitive data and an email account can be used to gain access to healthcare networks.

63% of data breaches in the United States occur as a result of compromised email credentials and healthcare email credentials are being sold freely on the dark web.

Evolve used its Dark Web ID analysis technology for the study and reviewed 1,000 HIPAA covered entities and business associates. Evolve discovered 68% of those organizations have employees with visibly compromised email accounts. 76% of those compromised accounts included actionable password information and that information was freely available on the dark web.

Depending on the industry segment, between 55.6% and 80.4% of organizations had compromised email accounts. Medical billing and collections organizations fared the best, with 55.6% of organizations having at least one compromised account, while regional healthcare plans the worst affected with 80.4% of organizations having compromised email accounts.

Evolve points out that in many cases the passwords associated with the email accounts were outdated, but explained that even outdated passwords are valuable to hackers.

Passwords are often recycled, so an old password could allow a hacker to gain access to other online accounts. Evolve also says “hackers can create a user profile and determine a person’s new password fairly accurately by using simple guessing or sophisticated automated algorithms.” Even when passwords are hashed, hackers can crack the hash, conduct brute force attacks and use lookup, reverse lookup, and rainbow tables to guess the passwords.

The National Disability Leadership Alliance (NDLA) today published a letter signed by over 200 disability organizations from around the country, calling on Congress to preserve Medicaid services for people with disabilities, including community-based long term services and supports. The letter identifies several programs that “underpin one of the most fundamental rights that Americans are guaranteed under the Declaration of Independence and the Constitution: Liberty.”

“The number of organizations that have signed on shows that the Disability Community is united in opposing any efforts which will reduce services that enable disabled people to live in the community and lead an independent life,” said Gary Arnold, President of Little People of America. “Disabled people have the same right to live in the community as all Americans, and the bill proposed by this Congress guts the programs that secure that right.”

The letter follows upon the release earlier this week of the American Health Care Act (AHCA), introduced by Congressional Republicans to replace the Affordable Care Act and passed by the Ways and Means Committee last night.

ProPublica has accumulated a wealth of data about how medicine is really practiced in the U.S. We’ve got millions of data points on things we believe everyone should know about his or her providers, like whether they’ve been barred from federal health care programs, their prescribing and treatment patterns, and how much money pharmaceutical companies pay them for things like consulting and speaking.

Today we’re launching a project called Vital Signs that puts the most important information from across all of our health care projects in one easy-to-use place, and can alert you when we get new information or when something happens you should know about right away, for example if your provider is now paid more per patient than 90 percent of peers, which may be a sign of overtreatment or use of more costly services.

Approximately twenty percent of Americans, or 56.7 million people, identify has having some degree of disability. Many of them require specialized health care, from routine visits for relatively healthy people with stable impairments, to round-the-clock support for those who need help with tasks of daily living. Disabled people may have the most to lose with proposed reforms to the ACA—and, some fear, they also have a smallest voice in the conversation.

Several components of the GOP plan are particularly worrisome to the disability community, but the proposal to roll back Medicaid may be the single biggest concern. The ACA's Medicaid expansion, which extended coverage to those making up to 133 percent of the poverty level in states that opted into the program, increased health insurance enrollment in America by more than 14 million, and eliminating it will plunge people off a health-care precipice.

The proposed system of "block grants" mean that individual states may run out of Medicaid funding before they've met the needs of their residents, likely triggering crackdowns on benefits eligibility as well as dreaded lifetime per-capita limits on recipients.

Namel Norris, a paraplegic gun violence survivor who performs with hip-hop group 4 Wheel City, lives in the Bronx and is eligible for Medicaid coverage to help him manage health care needs associated with his injury. "Every month and every day," he says, "I rely on Medicaid." He needs Medicaid-covered medical supplies to leave his house, he says, so without it, he'd be trapped.

Not having to worry about lifetime limits also enables his art, Norris says: Instead of being caught in a struggle to survive, he can focus on youth outreach and education and making music. It's hard to imagine doing that, he says, with threat of Medicaid being pulled out from under him. "My life would just change," Norris says. "Drastically."

Dominick Evans, a disabled filmmaker and activist, says he is particularly worried about what "drastic" might look like for disabled people who rely on Medicaid's Home and Community-Based Services program (HCBS). Disability activists have worked for decades to keep disabled people out of institutions, earning victories in the form of the Americans with Disabilities Act in 1990 and case law like 1999's Olmstead v L.C., which ruled that community-based services should be prioritized over institutionalization.

Republicans will argue that by cutting back insurance standards, their bill would lower premiums — because people can choose to buy less coverage than the ACA currently requires. But premiums are only one expense that enrollees have to worry about. First, the level of tax credits affects how much enrollees would actually pay for those premiums, out of pocket.

Second, the degree of insurance protection affects how much enrollees would pay in deductibles, co-pays, and other forms of cost-sharing. (“Cost-sharing” refers to how the insurance company and the enrollee split the costs of health services.)

We’re presenting an analysis here of the net financial impact of the Republican bill on premiums, after tax credits, plus cost-sharing. We estimate that the bill would increase costs for the average enrollee by $1,542, for the year, if the bill were in effect today. In 2020, the bill would increase costs for the average enrollee by $2,409.

By now, it is well known that repealing the ACA could leave nearly 20 million Americans uninsured and simultaneously result in millions of job losses across the country. An associated cost that has been less discussed, but no less relevant, is what repeal could mean for the nation’s already-fragile governmental public health system. As the director of the Big Cities Health Coalition (BCHC), a membership organization of 28 governmental public health departments in the largest, most urban areas of the country, I cannot underscore the importance of these funds enough.

Without a comparable replacement, or appropriation of additional funds, at least $3 billion will be cut from state and local public health departments alone over the next five years through funds allocated by the U.S. Centers for Disease Control and Prevention (CDC). An additional $2 billion in federal resources would be lost to a number of other prevention-oriented activities across the entire public health enterprise. This $5 billion is essential to core public health programs that keep Americans healthy and safe every day and makes up 12 percent of CDC’s annual budget, supporting disease tracking, access to immunizations for those most in need, and preventing and addressing lead poisoning, among other priorities.